Antiplatelet therapy is a major strategy with a growing body of evidence in management of ischemic cerebrovascular diseases.This article introduces the mechanism of currently available antiplatelet drugs as well as their practice guidelines and evidence from clinical trials.There is currently no robust evidence to support the use of venous antiplatelet agents.Aspirin is the sole evidence-based antiplatelet drug for treatment of acute ischemic stroke.Aspirin,dipyridamole and clopidogrel are effective in secondary stroke prevention.Combination therapy using aspirin plus extended-release dipyridamole is the only combination approach to demonstrate additive benefit.

AIM:To disscus the clinical effect of the silicone tube implantation under the guidance of memory wire in the treatment of lacrimal canaliculus.
METHODS:One hundred and fifteen cases (115 eyes ) of traumatic canalicular laceration were treated by canaliculoplasty from September 2012 to June 2014. Finding the end of lacrimal canaliculus under microscope, guided by memory wire which was probed in lacrimal passage to the nasal cavity, intubating double-passage silicone tube as a support and end-to-end anastomosis. The condition of epiphora and irrigation of lacrimal passage were observed after extubation.
RESULTS: All 115 cases were experienced successful operation. All patients were followed up for 6mo ~ 1a (mean 9. 3mo) after extubation. Lacrimal passage was unobstructed in 96 cases 96 eyes(83. 5%), stricture in 13 cases 13 eyes (11. 3%), and blocked in 6 cases 6 eyes (5. 2%).
CONCLUSION:Double-passage silicone tube guided by memory wire may be an optional technique in the treatment of traumatic lacrimal duct laceration, which is a feasible, minimally - invasive, safe and effective method.

Objective To investigate effect of Xuebijing injection on Th1/2, endotoxin and immune factors in patients with acute sepsis.Methods 110 cases of sepsis patients were selected and divided into two groups from September 2014 to January 2015.The control group of 55 cases were treated by clinical routine therapy, the experiment group of 55 cases were treated with Xuebijing injection on the basis of control group.Hemodynamics, serum Th1/2, endotoxin and specific immunological function of spleen were compared.Results After treatment, the heart rate of experiment group was significantly lower than control group (P<0.05), the mean arterial pressure and central venous pressure were higher than control group (P<0.05), vasoconstrictive drugs application amount was less than control group ( P<0.05 ) , the ratio of Th1/Th2 was higher than control group ( P<0.05 ) , serum endotoxin levels was lower than control group (P<0.05), and the ratio of HLA-DR, lymphocyte proliferation and positive index of caspase-3 cells were lower than control group(P<0.05).Conclusion Xuebijing injection can effectively improve haemodynamics in patients with sepsis, regulate serum Th1/Th2 levels, reduce serum endotoxin level and enhance specific immune function of spleen, which has important significance for clinical treatment of sepsis.

In recent 30 years, it was approved that extracorporeal shock wave (ESW) is effective on musculoskeletal disorders. Hypertonia is a common complication in patients suffered from central nervous system lesion. Recently, there were several literatures report hypertonia can be treated with ESW. This paper reviewed the research in basic principle of ESW and its use on hypertonia.

Aim To study the effect of PLC on rabbit and human platelet actin polymerization, and then to explore the mechanism of PLC anti-aggregation to platelet. Methods Platelets of rabbit and human were treated with PSS, ASA and different doses of PLC respectively and then were extracted by Triton abstraction. The relative concentration of actin of differently treated platelets induced by ADP was determined by SDS-PAGE and spectrophotometre. Results For rabbit platelets were treated with PSS, the relative concentration of actin determined at static state was 1.682?0.319; when the platelets were treated with ASA 668 ?mol?L -1,PLC 5,10,15,20 and 25 U?ml -1, the relative concentration of actin determined at activated state induced by ADP was 2.450?0.562,1.089?0.322,1.727?0.442,1.450?0.324,1.161?0.306, 0.857?0.242 and 0.692?0.187 respectively. Compared with PSS, inhibition rates (%) of ASA 668 ?mol?L -1, PLC 5, 10, 15, 20, 25 U?ml -1 to the relative concentration of actin were 55.55,29.51, 40.82,52.61, 65.02,71.76 respectively.For human platelets were treated with PSS, the relative concentration of actin determined at static state was 1.358?0.376; when the platelets were treated with ASA 668 ?mol?L -1,PLC 5,10,15,20 and 25 U?ml -1, the relative concentration of actin determined at activated state induced by ADP was 2.445?0.750, 1.096?0.344, 1.705?0.507,1.437?0.416, 1.165?0.355, 0.845?0.257 and 0.679?0.198 respectively. Compared with PSS, inhibition rates (%) of ASA 668 ?mol?L -1, PLC 5, 10, 15, 20, 25 U?ml -1 to the relative concentration of actin were 55.17,30.27, 41.23,52.35, 65.44, 72.23 respectively. Conclusion PLC has significant effects on actin polymerization of rabbit and healthy human platelets (P

Objective A distintegrin and metalloproteinase 33 (ADAM33) is one of the asthma susceptibility gene, which is closely related to the pathogenesis of asthma and airway hyperreactivity.The aim of this study was to evaluate the expression of serum ADAM33 in patients with different severity of asthma and the relation to airway chronic inflammation through clinical trials.MethodsPatients diagnosed as mild-to-moderate asthma (n=54), severe asthma (n=35) and healthy controls (n=30) were recruited from May 2015 to May 2016.The serum IgE, ADAM33, IL-4 and IL-13 1evels and Eosinophil (EOS) in peripheral blood were detected, and the correlation analysis was performed Results The serum levels of ADAM33 in mild-to-moderate asthma group, severe asthma group and healthy control group were 23.8±6.21pg/mL,64.8±12.8pg/mL and 18.3±4.49pg/mL, respectively.The ADAM33 levels in mild-to-moderate asthma group and severe asthma group were higher than those in control group (P<0.05).The ADAM33 levels in severe asthma group were higher than those in mild to moderate asthma group.(P<0.05).The correlation analysis showed that ADAM33 had positive correlation with IL-4 and IL-13(r=0.79 and r=0.81), but no correlation with EOS and IgE(r=0.54 and r=0.46).Conclusion The expression of serum ADAM33 was up-regulated in asthmatic patients along with the severity of asthma.ADAM33 was positively correlated with serum IL-4 and IL-13, implying that the expression of ADAM33 may be regulated by Th2 type cytokines.

Objective To investigate the effects of Berberine on growth of Immorto-Min colonic epithelial cell line (IMCE) and explore its possible mechanisms. Methods IMCE cells were treated with Berberine in the absence or presence of epidermal growth factor (EGF) and TNFα. Ki-67 staining and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay were used to identify the cell proliferation and apoptosis respectively. Furthermore, Western blot analysis was performed to detect the epidermal growth factor receptor ( EGFR), protein kinase B (Akt) and their phosphorylation.Results ( 1 ) Proliferating activity of IMCE cells was increased after adding EGF and the proportion of cell proliferation was ( 10. 64 ± 1.41 ) %. The proportion was significantly lowed in EGF plus Berberine group [(1.81 ±0. 85)%] compared to the EGF group(P ＜0. 01 ), while the lowest was the Berberine group [(0.49 ± 0.42) %]. (2) The proportions of cell apoptosis were ( 8.47 ± 2. 52 ) % and (9. 39 ± 2. 13 ) %in the Berberine group and TNFt group respectively which were significantly higher compared to the normal control [(0. 27 ± 0. 30)%], both P ＜ 0. 01. (3) The phosphorylation of EGFR was significantly increased after adding EGF and p-EGFR was decreased in EGF plus Berberine group at a concentration-dependent manner. (4) Moreover, the phosphorylation of Akt was enhanced after addition of TNFα , while the phosphorylation in the TNFα and Berberine group was inhibited compared to the TNFα group. Conclusions Berberine may suppress the proliferation and promote the apoptosis of IMCE cells. The mechanisms may relate to the inhibition of the phosphorylation of EGFR and Akt.

Objective To further elaborate the clinical characteristics,diagnosis,treatment and prognosis of primary cutaneous invasive epidermo-tropic CD8 positive cytotoxicity T-cell lymphoma.Methods The clinical characteristics,diagnosis and treatment of a patient with primary cutaneous invasive epidermotropic CD8 positive cytotoxicity T-cell lymphoma were summarized,and diagnosis and treatment of the disease from published literature were reviewed.Results After one year long,recurrence of exudative maculopapule on his body and limbs,a middle-aged male patient visited our hospital.Then,the patient was diagnosed as T2N0M0 Ⅰ phase of primary cutaneous invasive epidermo-tropic CD8 positive cytotoxicity T-cell lymphoma based on results of skin biopsy,immunohistochemistry,T-cell gene rearrangement and PET-CT.Through integrative medicine treatment (combination of bruceolic oil emulsion and chemotherapy with GDP regimen),the patient achieved complete remission (CR).The treatment and follow-up continues till now and his condition was stable.Conclusions Clinical occurrence of primary cutaneous invasive epidermo-tropic CD8 positive cytotoxicity T-cell lymphoma is rare and early diagnosis is difficult.It could be diagnosed with histopathology combined with T-cell gene rearrangement.In order to avoid misdiagnosis,great caution should be taken during disease history inquiry and physical examination,should be early lesion for delayed healing of recurrent lesions,biopsy should be conducted as soon as possible and immunohistochemistry should be performed simultaneously,which will provide a good basis for further treatment.

Objective To evaluate the differences, including clinical symptoms, endoscopic and histopathologic findings, status of Helicobacter pylori (Hp) infection and cytokeratin (CK) expressions, be-tween Barrett esophagus (BE) and heterotopic gastric mucosa (HGM) in upper esophagus. Methods Clinical data of 152 patients with BE and 52 patients with HGM in upper esophagus diagnosed from February 2004 to September 2005 were retrospectively studied. The parameters being compared include-ed clinical manifestations, conventional and magnifying endoscopic findings, histopathological findings, Hp infection determined by rapid urease test and Warthin-Starry staining and expression of CK phenotypes detec-ted by immunohistochemistry. Results Gastro-esophngeal reflux was observed in 64. 5% of patients with BE (98/152), higher than that in patients with HGM ( 13.5%, 7/52, χ2 = 40. 36, P < 0. 01 ). Endoscopic faveolus of BE mucosa included 46 cases of spot pattern, 65 striations and 41 villiform patterns, while those of HGM were all striation patterns. The histologic classification in BE included 56 cases of fundic type, 39 junction type and 57 specialized intestinal metaplasia, while in HGM mucesa, 31 cases of fundic type, 16 junction type and 5 antrum type were diagnosed, and no goblet cells were found. Moderate and severe infil-tration of inflammatory cells in BE mucosa was 63.2% (96/152), which was significantly higher than that in HGM mucosa (15/52, 28. 8%, P<0. 01). However, no difference was found in gastric antrum inflam-mation between the two groups (44.7%, 68/152, vs. 51.9%, 27/52, P>0.05). No difference was ob-served in prevalence of Hp infection between BE and HGM groups (P >0. 05 ), either in involved mucosa or in antrum. CK7 was not expressed in HGM or normal squamons mucosa, but was expressed in BE. CK20 and CK19 were expressed in both HGM and BE, and CK13 expression was found in some BE nmcosa including gas-tric metaplesia (55/95) and intestinal metaplasia (29/57) but not in HGM mucosa. Conclusion There are differences between HGM and BE, in regarding of reflux symptoms, magnifying endoscopic findings, histo-logical types and CKs expressions, which may be indicators to make differential diagnosis.

Objective To study the effect of different doses of Zhengan xifeng decoction on Raf-1 mRNA and protein expression in the cardiovascular tissue of spontaneously hypertensive rats( SHR). Methods A total of 50 male SHR,24 weeks old,were randomly divided into the model,low dose,medium dose,high dose of Zhengan xifeng decoction and the compound apocynum groups,10 in each group. Ten homologous male rats( WKY)served as the normal control group. After gavaged for 5 weeks,western blotting and RT-PCR were used to detect the Raf-1 protein and mRNA expression in the cardiovascular tissue,respectively. Results Compared with the model control group,both Raf-1 protein and mRNA expressions significantly increased in all treatment groups( P〈0. 01 ). Conclusion The Zhengan xifeng decoction can stimulate cell proliferation and inhibit cell apoptosis by up-regulating the expression of Raf-1.