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.

Objectives:To investigate the effects of nutritional support by the way of peripheral vein(PV) in the patients of severe acute pancreatitis(SAP). Methods:The treatment results of nutritional support by the way of PV was observed retrospectively within the latest eight years in the patients of SAP. Results:31 cases were cared,and no complications relating to the use of PV in TPN happened. Conclusions:Nutritional support is an important and effective treatment in SAP patients,and the use of PV is an effective and safety route.

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 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.

Objective To study the relationship of angiotensin Ⅱ type 1 receptor (AT1R) autoantibody (AT1-AA) and renal cell apoptosis induced by caspase-12 in diabetic nephropathy (DN)rats.Methods High-sucrose and high-fat diet and intraperitoneal injection of streptozotocin (35 mg/kg) were utilized to establish DN rat model.Serum AT1-AA was detected by enzyme-linked immunosorbent assay (ELISA) and renal cell apoptosis was detected by TUNEL staining.Furthermore,the mRNA levels of the endoplasmic reticulum stress (ERS) chaperone protein glucose regulated protein 78 (GRP78) and ERS-associated apoptosis protein caspase-12 were measured by real-time quantitative PCR.Additionally,the levels of GRP78 and caspase-12 protein were measured by Western blotting.Results The renal cell apoptosis rate in DN group was increased significantly (P ＜ 0.01),and the renal cells apoptosis rate in AT1-AA positive DN group was higher than that in AT1-AA negative DN group [(20.05±1.71)％ vs (13.24±4.93)％,P ＜ 0.01].The mRNA expressions of GRP78 and caspase-12 in DN group,in comparison to NC group,were increased significantly (P ＜ 0.01),as well as the proteins (P ＜ 0.01).And the expression of these mRNA and proteins had significant increment in AT1-AA positive DN rats when compared with AT1-AA negative DN rats (P ＜ 0.05).Conclusions AT1-AA can induce ERS in the renal tissue of DN rats,and promote renal cell apoptosis likely via the modulation of caspase-12 signaling pathway.

Objective To evaluate the efficacy of endoscopic variceal ligation(EVL)in esophageal variceal bleeding (EVB)in elderly patients with hepatic cirrhosis,and the safety of endoscopic operation under anesthesia.Methods From July 2007 to July 2013,170 patients diagnosed as liver cirrhosis complicated with EVB were retrospectively analyzed.Among them,139 patients who received EVL were divided into elderly anesthesia group (n=52,age≥60 years),elderly non-anesthesia group (n=45 ,age≥60 years)and non-elderly anesthesia group (n=42,age<60 years);the other 31 cases (age≥60 years) received propranolol therapy.The degree of satisfaction of visual fields and esophageal peristalsis under the gastroscope,the effect,adverse effects and complications of EVL,the recurrence of EVB and mortality of each group were analyzed.Two-way analysis of variance and crosstabs chi square test were performed for statistical analysis.Results The satisfaction rate of visual fields and esophageal peristalsis under the gastroscope were 82.5 % (104/126)and 89.7% (113/126)in elderly anesthesia group;82.6% (71/86) and 89.5 % (77/86)in non-elderly anesthesia group;40.3% (29/72)and 44.4% (32/72)in elderly non-anesthesia group.The satisfaction rate of visual fields and esophageal peristalsis under the gastroscope in anesthesia group were better than those in non-anesthesia group (χ2 =47.46,64.28;both P <0.01 ). The efficacy rates of EVL in elderly anesthesia group,elderly non-anesthesia group and non-elderly anesthesia group were 84.6%(44/52 ),68.9%(31/45 )and 81 .0%(34/42 ),respectively.The variceal recurrence rates were 19.2% (10/52 ),20.0% (9/45 )and 19.0% (8/42 ),respectively.There was no significant difference among them (all P > 0.05). Rebleeding rate of medication treatment group was 58.1%(18/31),which was obviously higher than that of elderly anesthesia group (19.2%,10/52 ), elderly non-anesthesia group (31 .1 %,14/45 )and non-elderly anesthesia group (23.8%,10/42 ),and the difference was statistically significant (χ2 =15 .10,P <0.01 ).No case of hepatic encephalopathy was found in elderly anesthesia group or non-elderly anesthesia group after EVL.The incidence of pneumonia in elderly non-anesthesia group was 4.2%(3/72),which was higher than that of elderly anesthesia group and non-elderly anesthesia group,and the difference was statistically significant (χ2 =8.93,P =0.01). The mortality within a month after EVL in elderly anesthesia group,elderly non-anesthesia group and non-elderly anesthesia group was 0,8.9% (4/45 )and 0,and the difference was statistically significant (χ2 =9.27,P =0.01).Conclusion The efficacy of EVL under anesthesia in EVB in elderly patients with liver cirrhosis was good,with no induction or aggravation of hepatic encephalopathy or irreversible complications were found.

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.

This paper presents an analysis of Professor LuoYuankai from diagnosis and treatment of anovulatory infertility from kidney, and have preliminarily summarized the various clinical experience of kidney diseases therapeutic methods. Through the discussion of the famous prescription, thoughts of comorbidity by different treatments and characteristics of medicine uses, in order to provide reference for the clinical treatment thus improve clinical curative effect.

The life cycle, evolution and trend of EEG technology were studied by plotting its S curve model ac-cording to its maturity theory with Derwent Innovation Index Database-covered EEG technology patent data as a sample. Cluster analysis and strategic coordinate analysis according to the co-classification network of Derwent pa-tent classification code showed the linkage relationship and evolution trend in different fields of EEG technology. The frequency and centrality of EEG technology were analyzed according to the co-word network of Derwent manual code in order to identify the distribution and hotspots of research on EEG technology.

Moyamoya disease is a progressive cerebrovascular occlusive disease, which is characterized by the formation of abnormal vascular network at the brain base. It is an important cause of stroke in children and adults. Now, the etiology of moyamoya disease is not clear. This article reviews its pathogenesis from 3 aspects, including genetic factors, angiogenesis, and immune inflammation.