Objective To observe the influence of clopidogrel combined with proton pump inhibitor (PPI) on the postoperative complication of percutaneous coronary intervention.Methods The clinical data of 600 patients who were taking clopidogrel antiplatelet therapy were retrospectively analyzed.All patients were divided into observation group (with PPI,n =300) and control group (without PPI,n=300).In-stent restenosis (ISR) and the adverse event rates were compared between the two groups during the period of follow up.Results The incidence of gastrointestinal bleeding was less in observation group than in control group (6.7％ vs.13.7％,x2 =8.048,P＜0.01),but the incidences of ISR,target vessel revascularization (TVR) and non-fatal myocardial infarction were higher in observation group than in control group(x2 =6.426、5.511、4.718,all P＜0.05).Conclusions Clopidogrel combined with PPI treatment can significantly reduce the risk of gastrointestinal bleeding,but increase the incidences of major adverse cardiovascular events.We suggest that PPI should be used with caution for the patients who need longer-term PPI use.

0.05) and systolic velocity of regional myocardium, the difference between Ven and Vep, and mitral valve annulus have improved during the follow up study( P

Objective To evaluate the clinical efficacy of endoscopic esophageal variceal ligation (EVL) for esophageal variceal bleeding (EVB) in elderly patients with hepatic cirrhosis.Methods From July 2007 to July 2013,clinical data of 198 patients who had been diagnosed with liver cirrhosis presenting with EVB were retrospectively analyzed.Among them,167 patients who had received EVL were divided into the elderly EVL group (n=97,age≥60 years) and the non-elderly EVL group (n=70,aged ＜ 60 years).The other 31 cases (aged ≥ 60 years) had received propranolol therapy.Treatment effectiveness,adverse effects,complications and the one-year survival rate of each group were analyzed.Results The efficacy rates and variceal recurrences were 77.3％ (75/97) and 78.6％ (55/70) in the elderly EVL group and 19.6％ (19/97) and 18.6％ (13/70) in the non-elderly EVL group,respectively,with no significant difference between the two groups (each P＞0.05).The re-bleeding rate was higher in the propranolol treatment group than in the elderly and non-elderly EVL groups [58.1％ (18/31) vs.24.7％ (24/97) vs,22.9％ (16/70),x2 =14.76,P =0.00].One-year survival rates in the elderly group,the non-elderly EVL group and the propranolol treatment group were 86.6 (84/97),88.6％ (62/70),64.5％ (20/31),respectively,with statistically significant differences between the three groups (x2 =10.24,P=0.01).Conclusions EVL is effective for the treatment of hepatic cirrhosis with EVB and can be used as a secondary prophylaxis measure for EVB in elderly patients with hepatic cirrhosis.

Objective:To investigate the thoughts and the methods of clinical pharmacists in the individual continuous renal re-placement therapy ( CRRT) anticoagulation treatment for severe patients. Methods:Clinical pharmacists participated in the CRRT anti-coagulation treatment for one patient with severe thrombocytopenia after aortic dissection surgery. Clinical pharmacists analyzed the cau-ses of thrombocytopenia and the coagulation function of the patient to exclude heparin-induced thrombocytopenia, and developed the treatment of supplementing platelets and regional citrate anticoagulation as the way of CRRT. Results:Three days after the treatment, the patient was changed to the general ward with normal renal function. Conclusion:Clinical pharmacists should participate in clinical treatment comprehensively and perform individual treatment for patients in order to ensure the effect and safety of medication.

Compressive cervical myelopathy (CCM) is a common disease of spinal surgery. Various kinds of reasons such as herniation of cervical disc and ossification of the posterior longitudinal ligament (OPLL) lead to spinal canal stenosis, thereby compressing the spinal cord, and a series of neurological symptoms are caused. Currently, posterior cervical expansive open-door laminoplasty (PCEOLP) is widely used for cervical decompression in patients with CCM involving three or more levels. This operation can expand the spinal canal while preserving the posterior structures of the cervical spine, and non-neurological complications are relatively rare. However, there are characteristic complications to this procedure such as nerve root palsy, axial neck pain, and loss of range of motion (ROM). Various modified techniques of PCEOLP have been developed to reduce postoperative complications. In this review, clinical research progress of PCEOLP in recent years is summarized, mainly focusing on internal fixation of materials and methods, operative approach, cervical decompression level, combined application of different surgical procedures, opening size and application of new technologies.

Objective To analyze the changes of myeloid-derived suppressor cells (MDSCs) in peripheral blood and serum nitric oxide in tumor-bearing mice, and to explore their correlation and functions in tumor progression. Methods Orthotopic transplantation tumor model of hepatocarcinoma in mice was established. At the 7th, 14th, 21st day after tumor implantation, the proportion of peripheral blood MDSCs was tested by flow cytometry, and serum nitric oxide was detected using the method of nitric acid reductase. Results The proportion of peripheral blood MDSCs at the 7th, 14th, 21st day after tumor implantation in tumor-bearing mice was significantly higher than that in normal mice [(8.65±1.01)%, (14.20±2.52)%, (27.51± 2.98) % vs. (2.51 ±0.44) %, P<0.05]. The level of nitric oxide at the 7th, 14th, 21st day after tumor implantation in tumor-bearing mice was significantly lower than that in normal mice [(72.02 ±5.05) μmol/L, (94.70 ±3.34) μmol/L, (78.90 ± 8.19) μmol/L vs. (57.03 ±16.94) μmol/L, P<0.05]. The level of serum nitric oxide was positively associated with the proportion of MDSCs (r=0.689, P<0.01). Conclusion The proportion of peripheral blood MDSCs and the level of serum nitric oxide in mice are increased with the tumor progression, and there is a positive correlation between them.

Objective To study the reverse roles of reverse effect of tetramethylpyrazine on the resistance to adriamycin in human ovarian carcinoma cell line A2780/ADM.Methods The drug sensitivity of A2780/ADM cells was measured by MTT assay.The intracellular concentration of ADM was determined by fluorescent spectrophotometry.The changes of cell apoptosis percentage of A2780/ADM was demonstrated by flow cytometry.Results The IC50 value of TMP in A2780/ADM cell line was significantly decreased by the non-cytotoxic dose or low-cytotoxic dose of TMP.The resistance reversing effect comparing with the IC50 value of ADM cells was respectively 2.07 folds.The intracellular ADM concentration in A2780/ADM cells was significantly elevated by TMP at the same dose and the cell apoptosis percentage was significantly increased by TMP.The expression of P-gp was reduced significantly by TMP.Conclusion TMP could reverse the resistance of human ovarian carcinoma of A2780/ADM cell line to ADM,which may be related to the increased intracellular.

Objective To observe the effects of Donepezil on cognitive function of delyed ephalophthy after acute carbon monoxide poisoning ( DEACMP) .Methods Eighty patients with DEACMP were randomly divided into control group ( 40 cases ) and treatment group ( 40 cases ) .The control group was given treatment of regular medicine, placebo and hyperbaric oxygenation.The treatment group was given treatment of regular medicine, Donepezil and hyperbaric oxygenation.The dose of Donepezil was 5.0 mg per night, and 90 d was a period of treatment.The cognitive function of patients was evaluated respectively by MMSE and Barthel Index rating scale ( BI) .And the results were compared between the two groups.Results Compared with before treatment, the MMSE and BI scores of the two groups after treatment were significantly increased (P<0.05 -0.01).And after the treatment, the MMSE and BI scores of the treatment group were significantly higher than those in the control group (P<0.05-0.01).Conclusion Donepezil can greatly improve the cognitive function of DEACMP patients, it is worthy to be clinical promoted.

This article reviewed the internationalization history of the Traditional Korean Medicine (TKM).It expounded the current situation of TKM's international standard application for WHO and International Standard Organization (international organization for standardization,ISO),and the competition between Traditional Chinese Medicine (TCM) and Traditional Korean Medicine.The authors presumed the essence content of TCM should be included in multiple international standards as early as possible to promote the intemationalization of TCM.

"Yongling"oral liquid composed of Cordyceps miliaris and Ganoderma lucidum was prepared by biochemical means. By comparing three different formulations,it was found that the optimum ratio between C. miliaris and G. lucidum was 7:3,which presented the entire active principles in proper proportion while retaining the original natural color and flavor.The preparation is a high protein,low fat,nontoxic oral liquid with diversified therapeutic actions and devoid of side effects