Objective To compare the risk effects of different antiplatelet therapies on gastrointestinal injury and summarize the endoscopic characteristics of gastrointestinal mucosal injury in the elderly. Methods The dyspepsia symptoms, gastrointestinal bleeding and endoscopic findings were retrospectively evaluated among 577 patients who received the antiplatelet therapy with aspirin and/or clopidogrel. Results The risk of dyspepsia symptoms and gastrointestinal bleeding was slightly higher in clopidogrel group than in aspirin group (both P＞0.05, x2=0.48, 0.72), and OR (95% CI): 1.10 (0.59-2.07) and 1.74 (0.48-6.33), for the risk of dyspepsia symptoms and gastrointestinal bleeding, respectively. In aspirin plus clopidogrel group, the risk of dyspepsia symptoms had no significant increase as compared with aspirin or clopidogrel group (x2=0.37, 0.03, for aspirin or clopidogrel group, respectively, both P＞0.05), but the risk of gastrointestinal bleeding was significantly higher than in aspirin group (x2=5.43, P＜0.05), OR (95% CI): 4.77 (1.15-19.79) and slightly higher than in clopidogrel group (P＞0.05). In this study, 57 patients received endoscopy and the detection rate of erosion or ulcer was 78.9%. Erosion (61.4%) was most in the gastric antrum; gastric ulcer (10.6%) located in gastric antrum and angle; duodenal ulcer (18.0%) located in bulb. In patients with dyspepsia symptoms erosion (70.5%), were most likely found but patients with gastrointestinal bleeding showed mainly ulcer (69.2%). Conclusions In the elderly the use of clopidogrel alone is not safer than low-dose aspirin and the combination would increase the risk of gastrointestinal bleeding. The detection rate of erosion or ulcer is high in patients with symptoms. Patients with dyspepsia symptoms most likely show erosion, but patients with gastrointestinal bleeding have mainly ulcer and complex ulcers more common.

Caspase 3 ; metabolism ; Child ; Female ; Glomerulonephritis, Membranous ; enzymology ; etiology ; pathology ; virology ; Hepatitis B ; complications ; pathology ; Hepatitis B virus ; Humans ; Male

Humans ; Lichen Planus, Oral ; psychology

Objective:To observe the difference of results of treadmill exercise test (TET) between male smokers and non-smokers .Methods:A total of 200 men with long-term smoking ≥20 cigarette per day were screened from outpatients and treated as smoking group .Another 200 men with similar age ,who didn’ t smoke at all ,were regarded as non-smoking control group (control group) .There were no medical history for hypertension ,hyperlipidemia ,diabetes ,and were nega-tive for electrocardiography and color echocardiography (exclude left ventricular hypertrophy etc .organic heart disease) in two groups .TET results and incidence rate of acute myocardial infarction (AMI) within two years were compared between two groups .Results:Compared with control group ,there were significant rise in TET positive rate (37. 5% vs .57. 5% , P<0.001) and incidence rate of AMI (8.5% vs .17.5% ,P=0.007) within two years in smoking group .Conclusion:Risk of suffering from coronary artery disease is more high in smokers among men .

[Objective]To explore the clinic results of the locking compression plate fixation for the acetabular fractures.[Method]Twenty-three patients were treated in the author's department, 16 of them were male and 7 were female patients.The ages ranged from 21 to 61 years, and mean age was 43.3 years.Ninteen patients had been injured in an automobile accident,3 were fell from height and 1 was crushed by a heavy object. The patients were classified according to Letournel classification.There were 7 anterior column fractures,3 posterior wall fractures,5 anterior wall fractures,2 transverse fractures,1 anterior column and posterior column fracture,1 T shape fracture, 3 posterior wall and posterior column fractures,1 transverse and posterior wall fracture.[Result]All the incisions healed during the primary procedure and all the patients were available at follow-up ranging from 3 to 24 months(average 20.1 months).The average intraoperation time was 123 minutes(50～235 minutes),and the intraoperative blood loss was 100 to 1500 ml.The patinents underwent blood transfusion from 0 ml to 1 200 ml.According to Matt's criteria, the rate of excellent and good was 73.9%(17/23).[Conclusion]The locking compression plate fixation is one of the effective methods for treatment of acetabular fractures, with the advantages of being simple and minimally traumatic.

Objective To investigate the anatomical character and clinical application value of external malleolus periosteum bone flap pedicled with facia and external malleolus anterior artery. Methods Applied anatomy was studied with 10 adult corpse specimen after artery perfusion,observed the origin.trackway,and measured the external diameter and major vessel's length of external malleolus anterior artery,observed the composition of external malleolus artery net,and completed the performance in clinic in 10 patients and followed up for 6 months～6 years. Resultes The bone flap had abundant blood-supply,its pedicle was long enough for transfer,little injury to donor,the surgical procedure was easy to manipulate,and was used in clinic to treat talus fracture in 9 cases (fresh 5 and old 4) and old tibia fracture in 1 case,10 cases were involved with satisfactory outcome. Conclusion External malleolus periosteum bone flap pedicled with fascia and external malleolus anterior artery is a good new donor for the patients with fracture of talus or lower tibia,especially ununited case or osteonecrosis.

Objective To explore the value of dynamic contrast-enhanced CT for differentially diagnosing benign and malignant the solitary pulmonary nodules. Methods 117 solitary pulmonary nodules proved by histopathological examination were enrolled in this study. Thin-section CT scanning was performed before and 1,2,3,4 and 5 minutes after contrast enhancement. Results The enhanced value of malignant nodules (39.6?15.8)Hu was significantly higher than that of benign nodules (19.18?17.23)Hu (P

Objective To explore the value of endoscopic duodenal feeding tube placement in severe coma patients with endotracheal tube by tracheostomy. Methods 28 patients, who suffered from severe coma with endotracheal tube by tracheostomy, received endoscopic duodenal feeding tube placement. Results Endoscopic duodenal feeding tube placement in all 28 patients was successful, and complications such as tube blocking or dropping occurred only in one patient. The average time of placing duodenal feeding tube was 16 min. Conclusion Endoscopic duodenal feeding tube placement was an effective, simple,convenient and safe way to set up enteral nutrition for severe coma patients with endotracheal tube by tracheostomy.

Objective To evaluate the efficacy and safety of contact endoscopic argon plasma coagulation(APC) for treating protuberant erosive gastritis. Methods 63 patients with protuberant erosive gastritis were randomly divided into groups A and group B, which were treated with non-contact and contact APC, respectively. The efficacy and safety were compared between the two groups. Results There was no significant difference between group A and group B in the efficacy and complication frequency. The curative rates in group A and B were 96.8% and 96.9%, respectively, and only 3 patients had abdominal pain or distension 1 to 3 days after operation, and disappeared within 3 to 7 days after treatment in each group. The numbers of ineffective operation in groups A and B were 284 and 96, respectively. The duration of operation in groups A and B was 11 min and 38 sec,7 min and 22 sec, respectivley. The numbers of accidental injury in group A and B were 137 and 58 times, respectively (all P