Anticoagulants is the drugs which prevent blood clotting process by affecting coagulation factor.They can be used for prevention of thromboembolic disease and stroke.As we stand on the threshold of a new era of anticoagulants,it is time to take an overview of the different types of anticoagulants and how to use them in the management of some specific conditions,including pregnancy,renal impairment,heparininduced thrombocytopenia and cancer.

Objective To explore which method is more advantaged by comparing two kinds of tubular stomach in esophageal cancer operation and the occurrence of postoperative complications.Methods There were 47 esophageal cancer patients and they were randomly divided into two groups:A group including 24 patients and making mechanical clipping lesser curvature,B group including 23 patients and hand-sewn shrink lesser,and the major complications were analyzed and compared.Results All patients underwent radical tumor resection without the operative mortality.There was 1 patient of acute hemorrhagic of gastric resection margin in A group,and there was 1 patient of thoracic gastric leakage and 1 patient of anastomotic fistula in B group.In 12-month follow-up,there was 1 patient of anastomotic narrow in A group and 4 cases in B group (P ＞ 0.05).After 3,6 and 12 months,emptying dysfunction was not found by upper gastrointestinal imaging and CT,but the thoracic stomach expansion was found in two groups,and the degree of thoracic stomach expansion in B group was more serious than that in A group,the part of the thoracic stomach of 3 patients in B group protruding into the opposite chest.There was 1 patient with thoracic-gastro syndrome after eating in A group and 3 patients in B group (P ＞ 0.05).There were 3 patients with mild reflux esophagitis in A group and 10 patients with serious reflux esophagitis in B group (P＜0.05).Conclusion Comparing two operative methods,the mechanical clipping lesser curvature is more advantaged than hand-sewn shrink lesser.

Heparanase (Hpa) is the only β-D-glucuronidase of degading heparan sulfate proteoglycans in the body of mammalian.Studies have confirmed that Hpa accelerates angiogenesis in multiple physiopathological processes; however there are still a few studies about the expression and role of Hpa after cerebral ischemia.This article mainly introduces the relation between Hpa and angiogenesis after cerebral ischemia.

Objective To study the effects of diet and exercise intervention on prognosis of nonalcoholic fatty liver disease (NAFLD).Methods Fifty two patients with NAFLD received diet and exercise intervention.The treatment effects before and after intervention were analyzed.Result The body mass index(BMI),triglyceride(TG),cholesterol(TC)were significantly lower than those in control group after three-month intervention(all P<0.05).Conclusions Diet and exercise intervention can effectively improve liver function and promote the prognosis of nonalcoholic fatty liver,thus promote their quality of life.

OBJECTIVE:To explore the clinical efficacy and safety of nedaplatin combined with docetaxel in the treatment of advanced cervical cancer. METHODS:A total of 53 patients with advanced cervical cancer selected from our hospital during Apr. 2014-Apr. 2016 were divided into observation group(31 cases)and control group(22 cases)according to chemotherapy plan. Con-trol group was given Docetaxel injection 60 mg/m2,ivgtt,qw. Observation group was additionally given Nedaplatin for injection 35 mg/m2+0.9% Sodium chloride injection diluted into 500 mL,ivgtt (≥60 min),qw. A chemotherapy cycle lased for 21 d,and both groups received 2 cycles of chemotherapy. Clinical efficacies of 2 groups were evaluated 2 weeks after treatment,and the level of PCNA integal was detected before and 2 weeks after treatment. The occurrence of ADR was recorded. RESULTS:The total re-sponse rate of observation group (77.42%) was significantly higher than that of control group (63.64%),with statistical signifi-cance(P<0.05). Before treatment,there was no statistical significance in PCNA integval between 2 groups(P>0.05). After treat-ment,PCNA integval of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). ADR were concentrated in grade I,and there was no statistical significance in the in-cidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Docetaxel combined with nedaplatin can significantly improve the clinical efficacy of patients with advanced cervical cancer,and does not increase the adverse reactions compared to docetaxel alone.

Objective To explore the change of function of adrenal cortex in patients with hyperthyroidism to provide theoretical evidence for clinical practice. Methods The reaction of adrenal cortex to small dosage of ACTH was detected and compared with each other in normal controls,in patients with mild hyperthyroidism,and patients with severe hyperthyroidism. Results The reaction to small dosage of ACTH was statistically different among the three groups \[F=278.3(15 min), 274.2(30 min), 469.8 (60 min), 273.3(min),866.2(AUC),P

0.05).In groups A and B,the intraoperative blood loss was(94.4?51.6)ml and(155.8?84.3)ml;the 4% mannitol solution used for intraoperative irrigation was(18.4?6.2)L and(25.4?8.8)L;the operative time was(65.0?16.4)min and((86.8?)25.0)min;the time for postoperative bladder infusion was(46.5?9.1)h and(57.8?17.4)h;the infused saline volume was(19.2?4.2)L and(26.7?10.2)L;the degree of satisfaction of the surgeons with the TURP field was 75.0%(36/48) and 41.9%(26/62);the cases who needed to increase the perfusion pressure during TURP accounted for 22.9%(11/48) and 45.2%(28/62);the blood transfusion rates were 6.2%(3/48) and 22.6%(14/62);and the incidence rates of secondary prostatic bleeding were(10.4)%(5/48) and 25.8%(16/62),respectively.The differences in all these parameters were statistically significant between the 2 groups(P

Overweight and obesity are main risk factors for chronic metabolic diseases, and are strongly associated with the increased risk of premature death. Low carbohydrate diet (LCD) has been proven to effectively control body weight and fat mass in overweight and obese patients by short-term (≤6 months) dietary intervention studies. The mechanisms include regulation of energy metabolism, anti-inflammatory, antioxidant, alteration in expression of lipid metabolic-related genes and modulation of intestinal flora. However, the conclusions are inconsistent on whether LCD can cause durable weight loss and reduce the risk of overweight and obesity. This review summarizes the current research progress on the mechanisms, epidemiological studies, intervention studies and potential risks of LCD in controlling overweight and obesity, providing a reference for the future research and clinical application.

Objective To assess the correlation between magnetic resonance imaging (MRI)and clinical staging of pelvic organ prolapse (POP)by using pubococcygeal line (PCL)and midpubic line (MPL)respectively.And to determine which(MRI)reference line for staging pelvic organ prolapse had the highest agreement with clinical staging.Methods A retrospective study of 32 women with pelvic organ prolapse who underwent dynamic pelvic MRI from Jan 2013 to May 2013 was conducted.One radiologist staged descent on MRI for each pelvic compartment (anterior,middle,posterior),using PCL and MPL lines.Agreement between MRI and clinical staging was estimated respectively.Results Thirty-two women were included.Agreement between clinical and MPL staging was morderate in the anterior (κ=0.44,SE=0.13)and middle compartment (κ=0.46,SE=0.12),but fair in the posterior com-partment (κ=0.23,SE=0.10).Agreement between clinical and PCL staging was poor in all compartments of pelvic.Conclusion MPL appeared more reliable and simple than the PCL for the evaluation of pelvic prolapse on MRI.

Objective To investigate the prediction value of ultrasound endometrial pattern at the day of hCG administration on clinical outcome in patients undergoing in vitro fertilization-embryo transfer (IVF-ET).Methods 679 cycles of IVF-ET conducted between January 2011 and December 2012 in Beijing Obstetrics and Gynecology Hospital were reviewed retrospectively.All cycles were divided into three groups based on the endometrial pattern measured on the hCG day:group A (n =411) with triple line endometrium,group B (n =228) with no obvious triple line endometrium,group C (n =40) with homogeneous hyperechoic endometrium.Clinical outcomes such as implantation rate,pregnancy rate and miscarriage rate were analyzed.Results Among three groups,the implantation rates were 27.05％,20.33％,19.57％,respectively (x2 =9.04,P =0.01); the pregnancy rates were 34.31％,25.00％,12.50％,respectively (x2 =12.20,P =0.00).The implantation rate and pregnancy rate in group A were higher than the other two groups (P ＜0.05).The miscarriage rates were 16.31％,19.30％,40.00％,respectively(P ＞ 0.05),there were no significant difference among them.Conclusions The ultrasound endometrium pattern on the day of hCG administration has predictive value on clinical outcome in patients undergoing in vitro fertilization-embryo transfer.