Objective To investigate clinical efficacy and safety of half quantity of tirofiban on elderly patients with ST segment elevation myocardial infarction ( STEMI ) .Methods 120 elderly patients with STEMI underwent emergency PCI patients,120 cases of digital method were randomly divided into the control group and observation group,60 cases in the control group with conventional surgery and drug treatment,the observation group of 60 cases on the basis of conventional therapy was given to half the amount for tirofiban,the two groups were observed in the risk of bleeding, the occurrence of adverse cardiovascular events after operation.Results The postoperative bleeding risk of the observation group compared with the control group had no significant difference(χ2 =1.51,1.35, 0.94,P=0.643,0.768,0.578);for the observation group in 30 days after operation,90 days of re infarction,death and target vessel revascularization rate compared with the control group decreased,the difference was statisticallysig-nificant(30 days after operation,χ2 =9.54,18.33,16.75,P=0.043,0.029,0.031;90 days after operation,χ2 =17.48,21.78,19.54,P=0.034,0.011,0.021).Conclusion Semi quantity for tirofiban can reduce the risk of elderly patients with STEMI after PCI,improve clinical outcome,which will not increase the risk of hemorrhage.

OBJECTIVE:To compare the efficacy and safety of levonorgestrel intrauterine system and mifepristone in the treat-ment of perimenopausal dysfunctional uterine bleeding. METHODS:200 patients with perimenopausal dysfunctional uterine bleed-ing were randomly divided into observation group (100 cases) and control group (100 cases). Patients in the observation group placed levonorgestrel intrauterine system (containing levonorgestrel 52 mg),patients in control group received Mifepristone cap-sule 10 mg/d,oral,the treatment course for 2 groups were 3 months. Clinical efficacy,endometrial thickness,menstruation(PBAC score),hemoglobin level before and after treatment and incidence of adverse reaction in 2 groups were observed. RESULTS:After treatment,the total effective rate in observation group was significantly higher than control group,incidence of adverse reactions was significantly lower than control group,the differences were statistically significant(P<0.01). Before treatment,there were no significant differences in the endometrial thickness,PBAC score and hemoglobin level between 2 groups;after treatment,endome-trial thickness and PBAC score were significantly lower than before,and observation group was lower than control group;hemoglo-bin level was significantly higher than before,and observation group was higher than control group,the differences were statistical-ly significant(P<0.01 or P<0.05). CONCLUSIONS:The efficacy and safety of levonorgestrel intrauterine system are significant-ly superior to mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding.

Objective To observe and analyze the four changes of plasma D- dimer and coagulation in pregnant women at different stages of pregnancy, and to explore the value of the test. Methods The subjects of this study were 120 pregnant women who underwent routine physical examination in our hospital, according to different stages of pregnancy (early pregnancy, middle pregnancy, late pregnancy, and before delivery) Four D- dimer and four blood coagulation tests were performed in pregnant women, and the results were observed and compared. Results During the pregnancy, D- dimer has increase trend (P<0.05); early in pregnancy, pregnancy and late pregnancy, PT has shortened(P<0.05); pregnancy, APTT has shortened (P<0.05), at the end of pregnancy and parturient period, showing a significant shortening (P<0.05); phenomenon in early pregnancy to mid pregnancy stage, FIB increased significantly (P<0.05), and at the end of pregnancy to perinatal period, with a sharp increase (P<0.05). Conclusion It is of great significance to perform dynamic monitoring of of plasma D- dimer and coagulation four indices in pregnant women during pregnancy.

The established immunodeficient animal models could be used as valuable resource for mechanism re-search of related disease in humans, drug discovery and development, translational research and stem cell research.How-ever, it is difficult and low-efficient to establish the genetic modified animal models using traditional technologies.The re-ports for immunodeficient animal models are few in middle-size and large animals.Recently, several effective gene-targeting tools, including ZFNs, TALENs, CRISPR/Cas9, develop quickly and provide technology basis for the establishment of im-munodeficient animal models.In this paper, the technology principles and research progresses of ZFNs, TALENs, CRISPR/Cas9 are introduced.The significant progresses of these emerging technologies achieved in immunodeficient ani-mal models are also elaborated, including KO Rag1/Rag2 rabbit, KO Rag1/Rag2 pig, KO IL2rg pig, KO Ppar-g/Rag1 monkey, and so on.In addition to being models for researching SCID-related diseases in humans, and evaluating the effica-cy and safety of stem-cell engraftment, these models may be also useful to develop surgical procedures for placement of grafts before clinical trials in humans, to produce humanized animals and bridge the gap between laboratory animal and medicical research.The immunodeficient animal models described here represent a step toward the comprehensive evalua-tion of preclinical cellular regenerative strategies.

Ascites is an important indicator of poor prognosis of liver cirrhosis.Although several guidelines and consensus statements on the management of ascites have been published in the past years,there are still a lot of controversial problems in this regard.The current contro-versial problems and difficulties in the management of ascites,such as the timing of sodium supplementation or sodium restriction,the selec-tion of diuretics,the application value of aquaretics,the strategy of albumin administration after large-volume paracentesis,and the indica-tions and efficacy of transjugular intrahepatic portosystemic shunt,are reviewed.It is pointed out that further studies on these problems with evidence-based medicine means will enhance the diagnosis and treatment of cirrhotic ascites and improve patients'prognosis.

Antigen Presentation ; Apoptosis ; Hepatitis C ; Humans ; Lichen Planus, Oral ; etiology ; genetics ; pathology ; virology ; Polymorphism, Single Nucleotide ; T-Lymphocytes, Cytotoxic ; pathology ; T-Lymphocytes, Helper-Inducer ; pathology ; Tumor Necrosis Factor-alpha ; genetics ; metabolism

Portal hypertension is a common complication of chronic liver diseases and is responsible for most of the clinical consequences of cirrhosis.Accurate assessment of portal venous pressure is essential for the designing of treatment strategy and judging of prognosis.Measurement of hepatic venous pressure gradient (HVPG) is the gold standard for evaluating portal venous pressure, however, it is an invasive procedure and is hard to be performed routinely in clinical practice.Therefore, it is urgent to explore a noninvasive method for assessing portal venous pressure.Recent evidence highlights that biochemical parameters, transient elastography, CT, MRI and the conjoint analysis model of multiple parameters have the potential diagnostic value.This article reviewed the advances in study on noninvasive assessment of portal venous pressure.

Objective To discuss the value of video-assisted thoracoscopic repair in the treatment of pectus excavatum in children.Methods Thoracoscopic sternum elevation with an internal steel bar(Nuss procedure) was performed in 45 children with pectus excavatum.Preoperatively,a curved steel bar was prepared and the site of incision and the lowest part of the depression were labeled with methylene blue.Under right-sided thoracoscopic vision,the bar was inserted into the retrosternal tunnel thereby correcting deformity. Results The steel bar was placed safely in all the 45 patients.The operation time was 35~80 min(mean,60 min).The intraoperative blood loss was less than 5 ml.The length of postoperative hospital stay was 4~10 days(mean,7 days).Forty children were followed for 3~30 months(mean,16.5 months).Short-term complications included pneumothorax in 1 patient and pneumonia in 1 patient.Long-term complications included bar shift after 1 year in 1 patient and persistent sternal pain in 2 patients(which had been cured by oral and local analgetic administration).The bar had been removed in 10 children,all of whom had good cosmetic results.Conclusions Video-assisted thoracoscopic Nuss procedure is safe and effective in the management of pectus excavatum in children,with advantages of short operation time,simple performance,satisfactory cosmetic results,and fewer complications.

BACKGROUND:Ideal dural substitute materials requires its good biomechanics properties,tenacity and elasticity.OBJECTIVE:To determine freeze-dried and irradiated porker dura's resistant ability,including type Ⅰ collagenase digestion,the biggest load and tensile strength,to assess the porker's dura irradiated and freeze-dried whether or not can satisfy the biomechanics requirment in dura draft.DESIGN,TIME AND SETTING:This controlled analysis experiment was performed at the Burn Institute,Nanchang University,Association Mechanics Laboratory,Nanchang University-New Sans Company,Chinese Crude Drug Solid Preparation Nation Project Research Center of Jiangxi Traditional Chinese Medical College and Jiangxi Tianzhao Technology Development Company from July 2007 to June 2008.MATERIALS:Six healthy living pigs was used to sterilely obtain fresh dura mater.METHODS:After washing,pre-frozen,freeze-dried and radiation by Co ?-ray,we prepared fresh,freeze-dried,irradiated and 60 freeze-dried plus irradiated pig dura.MAIN OUTCOME MEASURES:5-mm wafer of four group dura were dealt with typeⅠcollagenase meanwhile,digested time was recorded.EMT color screen electronic testing machine was used to measure the biggest load and tensile strength of the porker dura in each group.RESULTS:Time of the dura resistance to collagenase digestion were respectively(8.3 ? 2.5),(7.6 ? 1.8),(23.6 ? 5.7)and(21.1 ? 5.3)minutes,and the largest load and tensile strength were(79.93 ? 4.36),(70.50 ? 5.97),(96.97 ? 4.84)N and(93.59 ? 4.61),(7.98?0.44),(7.05?0.60),(9.70?0.48)and(9.40?0.46)N/mm in the fresh,freeze-dried,irradiated,and freeze-dried plus irradiated pig dura groups.Compared with the fresh and freeze-dried pig dura groups,the time was longer in the irradiated and freeze-dried plus irradiated pig dura groups(P 0.05).CONCLUSION:Dural substitute materials irradiated by Co ?-ray enhanced the ability against enzymatic hydrolysis and 60 biomechanics.Irradiated and freeze-dried plus irradiated dural substitution can meet the requirements of the biomechanics in dura mater transplantation.

Objective: To investigate the source of Candida alb ic ans in the mouth of neonates. Methods: 208 mother in fant pairs were recruited. Specimens from mothers for fungal culture were obtain de from the mouths by oral rinse and from vagina by swab within 48 h before de livery, and specimens from full term neonates were obtained from mouth by swab on the 1st, 3rd and 5th day while still in hospital and when the neonates were 1 month old. Candida species were identified by the routine microbiologica l methods, then Candida albicans isolated from mother infant pairs were com pared genetically by random amplified polymorphic DNA analysis (RAPD). Results: Candida albicans was isolated in the mouth of only 2 neonates (0.96%) and in the vagina and mouth of the corresponding 2 mothers in hospital.That was isola ted in the mouth of 43 neonates (21.39%) when they were 1 month old and in both vagina and mouth of 3 corresponding mothers and in the mouth of another 2 corr esponding mothers. RAPD revealed different genotypes of Candida albicans in each mother infant pair. Conclusions: The vertical tran smission of Candida albicans from mother to baby seems not to be the main so urce of Candida albicans in neonate mouth.