Objective To explore the effect of intratympanic gentamycin on intractable Meniere's disease.Methods 10 patients diagnosed of intractable Meniere disease were analyzed respectively.Results 9 patients got A and 2 patients got B in controlling vertigo.1 patient gots B and 9 patients got C in hearing result.Conclusion Intratympanic gentamycin for intractable Meniere disease is an effective method.It should be studied further.

This paper is to report the polymorphism of raw materials of clopidogrel bisulfate at home and abroad. By the analysis of Fourier transform infrared spectroscopy (FTIR) and powder X-ray diffraction (p-XRD), samples are roughly classified into two groups, except one patent material. And the differential scanning calorimeter (DSC) examination showed more detailed information for these materials. The results of the study could provide comprehensive basis for the quality evaluation of clopidogrel bisulfate.

Objective To study the effects of exogenous hormones,gibberellin(GA3)and indole-3-acetic acid(IAA),on growth and tanshinones accumulation in the radix of Salvia miltiorrhiza.MethodsThe herb characters and contents of tanshinones(cryptotanshinone,tanshinone Ⅰ,and tanshinone ⅡA)in the radix of S.miltiorrhiza with different hormone treatments were investigated and compared in the combination of trail pot and indoor analysis.Results It promoted aboveground biomass in the radix of S.miltiorrhiza increasing with single GA3.But it inhibited underground biomass increasing.The exogenous addition of low-level and high-level GA3 was benefit for tanshinones accumulation,whereas the middle-level GA3 wasn't.The aboveground and underground biomass in the radix of S.miltiorrhiza increased indistinctively with the increasing of IAA concentration and then decreased.And the IAA solutions also increased plant height and root length indistinctively.in a whole,it was benefit for tanshinones accumulation when applying low-level IAA(0.5 mg/L)singly.With the increasing of IAA concentration,the content of cryptotanshinone increased,but the contents of tanshinone Ⅰ and tanshinone ⅡA decreased.It promoted S.miltiorrhiza radix growth and three tanshinones contents increasing obviously with the combined application of two low-level hormones.Conclusion The applying of GA3 and IAA is benefit for the growth and three tanshinones accumulation in the radix of S.miltiorrhiza.

Objective:To explore the association between the changes in ideal cardiovascular health (CVH) indices and the renal function.Methods:The retrospective cohort study consisted of 837 Chinese individuals from Department of Health Management in the Third Xiangya Hospital.The general information,anthropometry and blood biochemistry were obtained for all subjects from 2008 to 2014,respectively.The 6-year changes of 7 ideal CVH metrics defined by American Heart Association and the estimated glomerular filtration rate (eGFR) were calculated.Linear regression analysis was used to study the association between the changes in the ideal CVH metrics and eGFR.Covariance analysis was used to compare the levels of changes in eGFR stratified by variations of the ideal CVH metrics.Results:After 6 years' follow-up,we did not find significant difference in ideal cardiovascular health indexes between 2014 and 2008 [(3.3±1.4) items vs.(3.2±1.3) items,respectively] (P＜0.05).However,the eGFR in 2014 was significantly lower than that in 2008 [(99.8±22.7) mL/(min.1.73 m2)vs (104.3±24.9) mL/(min.1.73 m2),respectively] (P＜0.01).After adjusting for age,sex,history of hypertension and diabetes,and history of drug usage (antihypertensive,cholesterol-lowering and blood glucose-lowering medication),the changes in ideal CVH metrics were positively associated with the changes in eGFR (β=0.701,P＜0.01).With the improved change in ideal CVH metrics from ≤-2 points,-1 point,0 point,1 point to ≥ 2 points,the magnitude of decline in eGFR was gradually decreased,with significant difference (F=21.71,P＜0.01).Conclusion:The changes in ideal CVH metrics are an independent risk factor for changes of eGFR.Positive changes in ideal CVH metrics exert a favorable effect on renal function evolution.

Objective: To explore the value of CYP2C19 genotype polymorphisms for guiding the strategy of anti-platelet therapy in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) with clinical prognosis.
Methods: A total of 326 CAD patients with PCI treatment received CYP2C19 genotype examination. According to CYP2C19 polymorphisms, the patients were divided into 3 groups. The patients with CYP2C19*1/*1, fast metabolism were defined as Routine group, who received clopidogrel 75 mg/day,n=128. The patients with CYP2C19*1/*2, CYP2C19*1/*3, CYP2C19*2/*3, CYP2C19*2/*2, CYP2C19*3/*3, medium and slow metabolism were further divided into 2 groups as High clopidogrel group, who received clopidogrel 150 mg/day,n=99 and Ticagrelor group, who received ticagrelor 90 mg/bid,n=99. The changes of platelet aggregation rate (PAgT) at before and 1, 3, 6 months after PCI were observed, the major adverse cardiac events (MACE) and bleeding condition were compared among different groups at 6 months after PCI.
Results: The PAgT was similar between High clopidogrel group and Routine group at 1, 3, 6 months after PCI, P>0.05;while compared with High clopidogrel group and Routine group, the PAgT decreased in Ticagrelor group at 1, 3, 6 months after PCI,P<0.05. The occurrence of MACE was similar between High clopidogrel group and Routine group at 6 months after PCI,P>0.05; while compared with High clopidogrel group and Routine group, Ticagrelor group had much less MACE occurrence,P<0.05. Ticagrelor group had no more major bleeding events than the other 2 groups,P>0.05.
Conclusion: High dose clopidogrel does not increase MACE occurrence in CAD patients with CYP2C19 medium and slow metabolism after PCI. Ticagrelor may decrease PAgT and MACE occurrence without elevating the major bleeding events.

Aim: To observe the effect of ursolic acid(UA)on the proliferation of rat vascular smooth muscle cell(VSMC)induced by high-level glucose and explore its relationship with p38MAPK signal transduction pathway.Methods: The proliferation of VSMC induced by high-level glucose(25 mmol/L glucose)was adopted as model,the inhibition of UA on the proliferation of VSMC was measured by MTT assay,and the expression lev-els of phospho-p38MAPK was detected by cell-based ELISA as well as the expression of c-fos protein was exam-ined by SABC method.Results: UA(20 μmol/L and 40 μmoL/L)inhibited glucose-induced proliferation of VSMC(P <0.05).Compared with the group subjected to glucose induction,UA decreased the expression levels of phosphorylated p38MAPK(P < 0.05),and also inhibited c-fos expression.Conclusion: UA suppressed glucose induced proliferation of VSMC,which might be related to the suppression of the activation of p38MAPK signal transduction pathway,and thereby down-regulated c-fos expression.

Objective To investigate the effects of the intellegent CO2 laser assisted Fisch stapedotomy with artificial stape prostheses in the treatment of otosclerosis.Methods A total of 28 patients with otosclerosis who had undergone the intellegent CO2 laser assisted Fisch stapedotomy with artificial stape prostheses were retrospectively e-valuated.The intellegent CO2 lasersare was used to vaporize stapedius tendon,posterior crus of stapes,and most importantly perforate stapes footplate.Bone and air conduction thresholds were determined at 0 .5 ,1 ,2 ,and 4 kHz preoperatively and 6 months postoperatively in all patients.Results No sustained vertigo or sensorineural hearing loss occurred postoperatively.There were no statistically significant differences between preoperative and postopera-tive average bone conduction thresholds.Preoperative and postoperative air bone gap were 30.38(23.13,39.38)dB HL,9.75(8.25,10)dB respectively and the postoperative results were significantly different from the preopera-tive.Conclusion The intellegent CO2 laser can be used safely in stapes footplate surgery and is well suited for trea-ting otosclerosis.

Objective: To establish a method to determine the serum concentration of FA. Methods: The serum concentration of FA in rat was determined by fluorospectrophotometry and pharmacokinetic parameters were calculated by computer. Results: The calibration curve was linear in the range of 1.6～40?g?mL -1 with r =0.9987. The limit of identification was 0.2 ?g?mL -1 . The RSD (%) in within day and between days were no more than 2.5%. The recovery of FA was 100.49% . The pharmacokinetic behavior of FA showed zero order absorption. Conclusion: Flavohumic acid ointment was a ideal preparation with stable and lasting potency.

Objective To evaluate the characteristics and treatment of ovary torsion after controlled ovarian hyperstimulation.Methods Between Jan.2008 and Dec.2011,5 cases with ovary torsion who underwent ovarian hyperstimulation were retrospectively studied.Results Five cases presented intermittent lower abdominal from I to 38 days after oocyte retrieval.Enlargement of ovary and decreased or absent venous and/or arterial flow were demonstrated by Doppler sonography.Two torsions at left side,two torsions at right side,and one on bilateral side were observed.Three cases give up embryo transplantation,2 cases were pregnant after surgical treatment.One case with partial torsion was successfully treated with simple conservative treatment.Two cases with complete torsion were performed adnexectomy by laparotomy.One case with complete torsion with early pregnancy was managed by laparoscopic adnexectomy.One case with chemical pregnancy was managed by laparoscopic detorsion for left side and excision for right side.Postoperative pathology of ovary tissue all confirmed haemorrhage and necrosis.Conclusions Ovary torsion might occur after controlled ovarian hyperstimulation.The early management on ovary torsion will be benefit for preserving ovarian function.

Objective:In the teaching practice based on "Internet+", there are relatively few studies on the transformation of learners' learning styles. This paper focuses on the practical factors that may affect the change of students' learning style in the teaching process of blended learning.Methods:Taking students from Batch 2017 of Inner Mongolia Medical University as the teaching objects who taught by blended learning, by means of questionnaire survey, interview, course performance analysis and other methods, this paper discusses the influence of students' learning style on learning effect and possible influencing factors in the process of blended learning.Results:In the process of teaching, students' learning styles have a profound impact on the learning effect to some extent. Therefore, the subjective and objective factors that affect students' learning style should be paid attention to.Conclusion:With the popularization of "Internet + education", the ways and environment of traditional education have undergone great changes. In the process of blended learning reform, teachers should pay more attention to learning styles of students, so as to better improve the teaching effect.