ObjectiveTo observe the effects of clopidogrel on inflammatory cytokines in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods68 cases diagnosed of CHD were randomly divided into clopidogrel 1 month group( group A), clopidogrel 6 months (roup B), every group had 34 cases. Before and after treatment adopt fasting blood respectively and in determination of serum interleukin-18 (IL-18)and C-reactive protein(hs-CRP). ResultsIL-18 and CRP were reduced more apparently in group B. Compared with group A,there were significant differences (P ＜ 0.05 ). ConclusionClopidogrel could significandy reduce coronary heart disease patients in which based on conventional treatment postoperative PCI inflammatory reaction, reduce the patients with coronary artery disease postoperative PCI vascular inflammatory reaction.

Objective To investigate the myocardial protection effect of dexmedetomidine hydrochloride during off-pump coronary artery bypass graft surgery. Methods Forty patients undergoing off-pump coronary artery bypass grafting were randomly divided into two groups:control group (group C) and dexmedetomidine group (group D).Dexmedetomidine hydrochlo-ride was given at a loading dose of 0. 5 μg?kg-1 to patients in group D, and then infused continuously at a rate of 0.5 μg?kg-1?h-1.The same amount of saline was given to patients in group C. After loading dosing,general anesthesia was per-formed with TCI technique.Trans-esophagus Doppler monitoring was conducted to monitor the blood volume and heart function, and close monitoring of fluid infusion to maintain stable circulation.Invasive blood pressure and heart rate were recorded every 5 min. Blood samples were taken for detection of cTnI,CK-MB,TNF-αand IL-6 contents at the following time points:after induction ( t0 ) ,before operation ( t1 ) ,after operation ( t2 ) ,12 h postoperation ( t3 ) and 24 h postoperation ( t4 ) . Results The blood pressure and heart rate decreased significantly at t0 and t1 in group D compared with group C,and there were no significant differ-ences in the two indexes at other time points between the two groups.Blood CK-MB,cTnI and inflammation factors TNF-α,IL-6 were much higher at t2,t3,t4 than at t0 and t1 in both groups(P<0.05).They were significantly decreased at t2,t3,t4 in group D relative to group C (P<0.05).Vessel active medicines were less given after the operation in group D (P<0.05). Conclusion Dexmedetomidine hydrochloride can mitigate the inflammation responses caused by off-pump coronary artery bypass grafting,re-duce the myocardial injury and improve the cardiac function of the patients.

OBJECTIVE:To observe the influence of capecitabine combined with radiotherapy on postoperative survival rate, relapse rate and survival quality of elderly patients with rectal cancer at Ⅱ-Ⅲ stage. METHODS:110 patients with rectal cancer atⅡ-Ⅲ stage were selected and randomly divided into control group and observation group with 55 cases in each group. Both group received radical resection of rectal carcinoma. Control group was given three dimensional conformal radiation therapy(3DCRT)af-ter operation;observation group was additionally given capecitabine 1 500 mg/m2,d1-14,qd,on the basis of control group. A treatment course lasted for 21 d,and both groups received 2 courses of treatment and followed up for 3 years. The survival rate and metastasis and recurrence rate of 2 groups were compared as well as KPS score before and after treatment. Toxic reaction of 2 groups was also observed. RESULTS:The follow-up total survival rate and disease-free survival rate of observation group were 89.09%and 76.36%,which were significantly higher than 74.55%and 54.55%of control group;the distant metastasis rate and lo-cal recurrence rate were 12.73% and 5.45%,which were significantly lower than 30.91% and 21.82%,with statistical significance (P<0.05). KPS score of 2 groups were increased significantly,between 2 groups before and after treatment ,with statistical signifi-cance(P<0.05);Comparison between groups(P>0.05). There was no statistical significance in the incidence of nausea and vom-iting,diarrhea and urinary tract reaction between 2 groups (P>0.05);but the incidence of bone marrow arrest in observation group was significantly higher than control group(P<0.05). CONCLUSIONS:Capecitabine combined with 3DCRT can effectively improve postoperative distant survival rate of patients with rectal cancer at Ⅱ-Ⅲ stage,and reduce the metastasis and recurrence risk;do not lower life quality and induce serious adverse reactions.

Objective To investigate the short and long term effect of mifepristone on hysteromyoma.Methods The treatment group ( n=60 ) was given mifepristone and the control group ( n=60 ) vitamin C.The volume of hysteromyoma was measured using B-mode ultrasound prior to and at the end of treatment.L H,FSH,E2 progesterone ( P) ,liver function and blood creatinine were monitored each month.At the second year,3 0 cases from treatmentgroup were given mifepristone again for 3 months in the same way as the first course and with the same indexes monitored. Results Mifepristone had1 0 0 % effective rate with one-course curative rate of6.67% ,the hysteromyoma volume decreased by an average of at least 3 5.1 0 % ,while the volume gradually increased over 6months after discontinuing mifepristone with the recurrence rate of3 0 .0 0 % .At the second course of treatment hysteromyoma was further reduced by50 .2 0 % ,with the scope of reduction larger than thatatthe firstcourse( P

Objectives To analyse the predisposing cause and clinical manifestasion of diabetic ketoacidosis (DKA) complicated with multiple organic failure (MOF),in order to diagnose early and management timely.Methods 537 diabetic patients admitted in our hospital from 1997 to 2000 were included in this cases retrospective study. 182 cases of them complicated with DKA or DKA complicated with MOF (58) were further analyzed by cause, clinical manifestation, number of organs in MOF and the prognosis. Results Analysis showed that the main cause of MOF in DKA patients was infection (84 5%). The higher incidence of MOF in older DKA patients than those of younger. The possible involved organs in MOF were kidney, heart and brain etc. Involving organs of MOF were much, the mortality was closely correlated with the number of involved organs. Conclusions The possible way to reduce the incidence of MOF in DKA patients is intensive preventing and treating infection. To avoid MOF occurring in DKA patients, complications of kidney, heart and brain should be timely diagnosed and managed.

Objective To investigate the effects of sensorimotor therapy on patients with knee osteoarthritis.Methods Ninety-two patients with knee osteoarthritis were divided into a treatment group and a control group by using random digits table. Both groups received conventional rehabilitation therapy, including knee isometric and isotonic contraction training, ultrashort wave diathermy as well as aerobic exercise. The treatment group was also administered with sensorimotor training, in addition to the conventional training,including the muscle strengthening and control training of quadriceps and hamstring muscle using sling exercise therapy system and on the Thera-band mattress. The visual analogue scale (VAS) for pain, manual muscle testing and knee range of motion as well as the Japanese Orthopedic Association knee function evaluation form were used to evaluate the patients. Results There was no statistic difference between the 2 groups before treatment, with regard to the evaluation parameters used in this study. After 2 months of treatment, both groups improved significantly (P ＜0.05),with the treatment group improved to a significantly greater extent (P ＜0.05). Conclusions Sensorimotor training in addition to the conventional rehabilitation treatment can further relieve the pain of patients with knee osteoarthritis joints arthritis and improve the function of patients with knee osteoarthritis.

Objective To explore the clinical effect of psychological rehabilitation on dysphagia with cognitive and psychological disorders post stroke. Methods 120 stroke patients with dysphagia complicated with cognitive and psychological disorders were divided into experimental group (n=60) and control group (n=60). Both groups received neurological routine medical treatment, swallowing function rehabilitation training, feeding training and low-frequency electrical stimulation. Cognitive and psychological therapy was additionally used in the experimental group. Both groups were assessed by Kubota DrinkingWater Test, Mini-Mental State Examination (MMSE), Hamilton Rating Scale for Depression (HAMD) and Hamilton Rating Scale for Anxiety (HAMA). Results 1 month after intervention, the score of Kubota Drinking Water Test improved significantly in both groups, and was higher in the experimental group than in the control group (P<0.001).The rate of clinical improvement was higher in the experimental group than in the control group (P<0.01). The scores of MMSE increased significantly in the experimental group (P<0.001). The scores of HAMD and HAMA decreased significantly in the experimental group (P<0.01). Only the scores of HAMA decreased in the control group (P<0.05). Conclusion Swallowing function rehabilitation training combined with cognitive and psychological therapy may facilitate to improve the cognitive function and psychological state and swallowing function for dysphagia with cognitive and psychological disorders post stroke.

BACKGROUND: Learning memory disorder is one of the major manifestations of aging. The model of aging induced by D-galactose is a commonly used animal model in recent years, and long-term D-galactose exposure may cause nerve cell morphological changes in animals.OBJETCIVE: To observe spatial learning memory behavior during Dgalactose-induced aging process in order to further explore in vivo evoked long-term potentiation in hippocampus dentate gyrus and synaptic morphological changes in hippocampal CA3 region.DESIGN: Randomized controlled observation.SETTING: Anatomical Teaching and Research Secti , Shanghai Second Medical University; Department of Physiology, Shanghai Traditional Chinese Medicine University.MATERIALS: The experiment was carried out at the Physiological Laboratory of Shanghai Traditional Chinese Medicine University between August 2000 and April 2001. Totally 22 male Wistar rats of 3-month birth age were included and randomized into normal group and D-galactose group with 11 rats in each group. D-galactose was produced by Shanghai No. 2 Chemical Reagent Factory, Morris water maze was home-made by the Institute of Geriatrics, Shanghai Traditional Chinese Medicine university.METHODS: Rats were subjected to hypodermic injection of 1 mL normal saline every day in normal group, or D-galactose of 800 mg/kg daily for 6consecutive weeks in D-galactose group. Rat spatial learning memory behavior was assessed by the latency of Morris water maze; hippocampal dentate gyrus community potentials evoked by monopulse stimulation on perforating fibers were recordedin vivo; meanwhile, the amplitude of monopulse evoked potentials was determined before and after high frequency stimulation, with the amplitude before high frequency stimulation taken as baseline. Transmission electromicroscope was applied in combination with imaging analysis to observe synaptic morphology and structure in rat hippocampal CA3 region. Water labyrinth latency was compared using the variance analysis of repetitive survey design, t-test was used to compare the differences of peak potential latency of community potentials at various time points after long-term potentiation. Moreover, inducing rate of longterm potentiation was compared by χ2-test, XY-540 type biological imaging processing system was used to analyze electromicroscopic pictures, and all available data were analyzed with t-test.MAN OUTCOME MEASURES: [1] Main outcomes: Changes of Morris water maze latency, as well as inducing rate of long-term potentiation and community potentials. [2] Secondary outcomes: Synaptic morphological and structural changes in hippocampal CA3 region.RESULTS: Totally 22 rats were enrolled in this study, with no one lost during water labyrinth test, but one rat in both normal group and D-galactose group died during electrophysiological experiment. Finally 3 rats were randomly selected from each group for electromicroscopic observation. [1]Comparison of the latency for Morris water maze: In contrast with that of normal group, latency for seeking submarine platform was obviously prolonged in D-galactose group [(14.77±10.10), (51.36±12.45) s, P ＜ 0.05].[2] Comparison of evoked potential in hippocampus dentate before high frequency stimulation: The two groups did not obviously differ in community potential amplitude and community potential latency [(1.05±0.47),(0.91±0.41) mV; (5.46±2.09), (5.38±2.26) ms; P ＞ 0.05]. [3] Inducing rate of long-term potentiation in hippocampal dentate gyrus: Compared to that of normal group, inducing rate in D-galactose group obviously reduced after high frequency stimulation (80%, 20%, χ2=7.20, P ＜ 0.01). [4] Comparison of community potential ratio at different time points after high frequency stimulation: Compared to that of normal group, it was notably reduced in D-galactose group at post-stimulation 20, 30, 60 minutes, respectively (1.104±0.196, 0.919±0.162; 1.354±0.212, 0.999±0.219; 1.236±0.174,0.875±0.311; P ＜ 0.05). [5] Comparison of synaptic struc tural parameters in hippocampal CA3 region: Compared to that of normal group, postsynaptic dense bodies became thickened in hippocampal CA3 region of D-galactose group [(40.60±18.26), (26.35±8.15) nm, P ＜ 0.05], the synapse gap increased [(17.69±6.28), (26.95±5.67) nm, P ＜ 0.05] while synaptic active zone was shortened [(265.13±76.50), (229.13±90.68) nm, P ＜ 0.05].CONCLUSION: Hypodermic injection of D-galactose does harm to rat spatial learning memory by reducing the long-term potentiation, inducing rate in rat hippocampal dentate gyrus, attenuating the increase of long-term potentiation-evoked potential amplitude, and even remarkably changing the synaptic ultrastructure in rat hippocampal CA3 region. It suggests that Dgalactose inhibits the long-term potentiation at hippocampal dentate gyrus and affects synaptic structure in hippocampal CA3 region, which is considered as the basis of spatial learning memory behavioral disorder.

Papillary thyroid carcinoma is the most common pathology type of thyroid carcinoma with the following biological characteristics:low malignancy,slow progress,longer duration,good prognosis,but it is prone to lymph node metastasis.Lateral lymph node metastasis relates with patients' age,sex,tumor size,tumor location,capsular invasion/extra-thyroidal extension,muli-focality and the number of positive central lymph nodes.Understanding the influencing factors of the lateral lymph node metastasis has important clinical significance for determining the lymph node dissection scope and the indications for the patients with thyroid carcinoma.

Objective To establish a quality standard forZishen Tongguan Capsules.Methods Anemarrhneae Rhizoma and Phellodendri Chinensis Cortex were qualitatively identified by TLC method. The contents of neomangferin, phellodendrine hydrochloride, mangiferin and berberine hydrochloride inZishen Tongguan Capsules were quantitatively determined by HPLC method.Results The spots of qualitative identification method were clear without interference. Neomangferin in Anemarrhneae Rhizoma and phellodendrinehy drochloride in Phellodendri Chinensis Cortex were identified. Neomangferin, phellodendrinehy drochloride, mangiferin and berberine hydrochloride showed good linearity in the range of 0.025 25–2.02 μg (r=0.999 7), 0.025 5–2.04 μg (r=0.999 7), 0.026–2.08 μg (r=0.999 7), and 0.025 5–2.04 μg (r=0.999 6) respectively. The average recoveries of neomangferin, phellodendrinehy drochloride, mangiferin and berberine hydrochloride were 99.99%, 101.06%, 103.05%, and 100.55%, respectively. The RSD were 2.69%, 5.62%, 2.49%, and 2.06%, respectively.Conclusion The method is accurate and rapid, with good stability, reliability and reproducibility, which can be used for the quality control and evaluation of the preparation of Zishen Tongguan Capsules.