Objective To understand the use of antiplatelet drugs in patients with coronary heart disease( CHD) ,and to compare the effect of different anti platelet drugs on cardiovascular events in patients with CHD,and to provide clinical evidence for the optimization of anti platelet therapy?Methods One thousand and twenty?three cases patients with CHD who were treated in the First Hospital Affiliated to Chongqing Medical University from April 2010 to June 2014 were chosen?On the basis of conventional treatment,according to the different anti platelet program,the patents were divided into A group(703 cases),B group(211 cases) and C group(109 cases)?Group A was treated with aspirin and clopidogrel,B group was treated with clopidogrel,and C group was given aspirin therapy?Cardiovascular events( MACE) and bleeding events were observed at 1 month,6 months and 1 year after treatment in the 3 groups?Results After treatment for 1 month,6 months and 1 year,the incidence rates of MACE in group A were 9?1%( 64/703) ,16?6%( 117/703) and 28?4%( 200/703) ,in group B were 14?6%(31/211),25?5%(54/211) and 37?9%(80/211),in group C were 16?5%(18/109),29?4%( 32/109) and 34?0%( 37/109)?After treatment for 1 month,6 months and 1 year,the incidence rates of MACE in group A was significantly lower than group B and C(P<0?05);after treatment for 1 month,6 months,the incidence rates of MACE in group B were lower than group C,while higher than group C after 1 year,but the differences were not signifiacnt( P>0?05)?There were no significant differences in total incidence of deaths,the recurrence rate of myocardial infarction and stent restenosis rate among the three groups ( P>0?05 )?After treatment for 1 month,6 months,the incidence of angina in group A was lower significantly than that in group B and C( P<0?05) ,but When the treatment time was extended to 1 year,there was no significant difference in the three groups(P>0?05)?At 1 year follow?up,the incidence of gastrointestinal bleeding in group A was slightly higher than that in group B and group C ( 4?3% vs? 2?4% vs?3?7%) , but the difference was not statistically significant ( P>0?05 )?Conclusion In the CHD patients receiving aspirin and clopidogrel dual antiplatelet therapy,the incidence of MACE was lower than that in patients with aspirin or clopidogrel treatment alone, especially a reduction in the incidence of angina,and without increase of the risks in the gastrointestinal bleeding events,but the advantages above waning with treatment time extended to 1 year.

Humans ; Hyperphosphatemia ; diagnosis ; drug therapy ; Kidney Failure, Chronic ; diagnosis ; therapy ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; methods

Objective In order to find the polymorphism site applicable to efficient genetic diagnosis on Haemophilia A in Han Chinese Population in Wenzhou.Methods With the method of polymerase chain reaction(PCR) and polyacrylamide gel electrophoresis(PAGE),288 of X chromosomes from 96 men and 96 women were detected on the polymorphism of BCL I in the intron 18 of FV Ⅲ gene.Results The gene frequency of the polymorphic site BCL I was 34.38% in Han Chinese population in Wenzhou.43.75% women were heterozygous and the polymorphism information content(PIC) was 0.4512.Conclusion For Han Chinese population in Wenzhou,the BCL I genetic site has enough information,being one of the genetic markers with high polymorphism,applicable to the screening for carrier and prenatal diagnosis of Haemophilia A in Wenzhou.

Objective To investigate the acute phase adverse effects and influencing factors of adverse effects of diphosphonate treatment in the elderly patients with primary osteoporosis.Methods A total of 208 patients [male 25 patients,female 183 patients,age 60 ～ 93 with a average of (75.51 ± 7.73) years] with primary osteoporosis were selected from 1 Jan 2012 to 30 Nov 2015,admitted to Department of Geriatrics.According to the serious condition of osteoporosis and willingness of patients,208 patients were divided into zoledronic acid treatment group,alendronate treatment group,and pamidronic acid group,and received corresponding diphosphonate treatment.All kinds of adverse reactions of diphosphonate in each treatment group were closely to be observed after administration of diphosphonate in 3 days and 7 days.Results The incidence rate of adverse reactions in the zoledronic acid treatment group (59/134,44.03％;60/134,44.78％) was obviously higher than that in the alendronate treatment group (1/57,1.75％;1/57,1.75％),and the pamidronic acid group (3/17,17.65％;3/17,17.65％) after treatment of diphosphonate in three and seven days (P ＜ 0.05).In different generations,the incidence rate of adverse reactions in the zoledronic acid group and the pamidronic acid group after treatment of diphosphonate in three and seven days was not statistically significant (P ＞ 0.05).There were three patients suffering from severe acute kidney injure (AKI) and three patients suffering from hypokalemia in the 134 patients treatment with zoledronic acid.Conclusions There are obvious differences in the incidence rate of acute phase adverse reactions in the osteoporosis patients who received different treatment policy (P ＜ 0.05).The safety issues in the kidney function and electrolyte abnormality (such as hypokalemia) should be paid much enough attention in the primary osteoporosis patients who receive zoledronic acid treatment.

ObjectiveTo investigate the clinical feature peripheral neuropathy and vasculopathy after acrylamide toxication. Methods2 young male patients with peripheral neuropathy who had exposed to acrylamide for job more than one year were reported.ResultsNeuroelectrophysiological examination showed marked abnormalities in both peripheral and central nerve conduction in both patients. Sural nerve biopsies revealed axonal degeneration, Wallerian degeneration and giant axon with accumulated neurofilaments. Additonally, vasculopathies including prominant thickness of arterial intesma and basal membrane of capillary as well as apoptosis of vascular pericyte, were evident. ConclusionAxonal degeneration and vascular involvement has been found in acrylamide toxication. Vascular impairment maybe plays an important role in the pathogenesis of neuropathy.

To investigate the effect of compound Chinese traditional medicine PC-SPES II I in inhibiting proliferation of human prostate cancer cell LNCaP based on the androgen receptor (AR) signaling pathway. The effect of PC-SPES II on LNCaP cell proliferation was detected by MTT assay. According to the findings, at the mass concentration of 180-1 440 mg x L(-1), PC-SPES II significantly inhibited the proliferation of LNCaP cells; the IC50 of PC-SPES II at 24 h and 48 h were 311.48, 199.01 mg x L(-1), respectively. The flow Cytometry detection showed 240 mg x L(-1) PC-SPES II arrested cells in G2/M phase, and an obvious apoptotic peak appeared before G0/G1 peak and rose over time. Meanwhile, Hoechst 33258 staining revealed apoptotic cellular morphology. Annexin V-FITC/PI staining manifested an increase in apoptotic cell ratio at the PC-SPES II concentration of 480 mg x L(-1) in a dose dependent manner. The prostate specific antigen (PSA) secretion of LNCaP cells was tested by PSA ELISA kit. Besides, compared with 25 mg x L(-1) Bic, 480 mg x L(-1) PC-SPES II significantly reduced the cell secretion of PSA. The AR and PSA mRNA and protein expressions were detected by qRT-PCR and Western blot. According to the results, after the induction of LNCaP cells with synthetic androgen 25 μg x L(-1) R1881, 240-480 mg x L(-1) PC-SPES II notably down-regulated the AR and PSA mRNA and protein expressions and inhibited the translocation of AR from cytoplasm to nucleus. In summary, PC-SPES II significantly can inhibit the in vitro proliferation of LNCaP cells and arrest cell cycle arrest in G2/M phase. Its mechanism may be associated with the down-regulation of the AR and PSA expressions and the inhibition of AR nuclear translocation.
Antineoplastic Agents, Phytogenic ; pharmacology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Male ; Prostate-Specific Antigen ; genetics ; metabolism ; Prostatic Neoplasms ; drug therapy ; genetics ; metabolism ; physiopathology ; Receptors, Androgen ; genetics ; metabolism ; Signal Transduction ; drug effects

Objective To investigate the clinical and pathological characteristics of normotensive pheochromocytomas ( NP) . Methods This retrospective study included 97 patients with a pathological diagnosis of pheochromocytoma at the Drum Tower Hospital Affiliated to Nanjing University Medical School during January 2004 to December 2013. All available clinical, biochemical, and radiological records were reviewed in these patients who were then categorized into hypertensive pheochromocytomas (HP) (n=64) and NP (n=33) groups. 97 cases of Adrenal Gland Scale Score of pheochromocytoma were examined, including tissue microscopic pathology assessment, ki67 and phenylethanolamine-N-methyltransferase ( PNMT ) immunohistochemistry and catecholamine type. Biochemical examinations of 95 subjects with primary hypertension ( PH) were recorded for comparative study. Results The patients with NP showed lower proportion of clinical triad than HP, inapparent metabolic disorders, and lower urinary catecholamine levels than HP, but showed higher results than primary hypertension. The weight of tumor was positively correlated with 24 hour urinary norepinephrine level in patients with HP(Y=1. 376+0. 653X,R2=0. 118, P=0. 028), but not in patients with NP;and the size or diameter of the tumor was negatively correlated with PNMT immunohistochemistry in patients with NP(Y=0. 940-0. 356X, R2=0. 494, P=0. 005), but not in patients with HP, indicating that NP may be misdiagnosed clinically. Conclusion Patients with NP have distinct clinical, biochemical, and pathological phenotypes; the phenotypic changes are closely related with the expression levels of catecholamine pathway products during the occurrence and development of the tumors.

Objective To evaluate the relationship between carotid atherosclerotic plaques stability and the clinical symptoms of carotid atherosclerosis by contrast-enhanced ultrasonography. Methods Fifty patients with carotid atherosclerotic plaques were examed with contrast-enhanced ultrasonography,the contrast agent visualization of the carotid atherosclerotic plques were analyzed and compared with their clinical symptoms. Results Twenty-three patients who suffered from obvious clinical symptom were entirely visualized. Twenty-weven patients had not apparent clinical symptom,of these patients,15 were sparse visualized,there was no visualization in other 12 patients. Conclusions Conlrast enhanced ultrasonography can real-time observe microcirculation in carotid atherosclerotic piques,and assess the stability of carotid atherosclerotic plaques.

Objective To report the clinical and myopathological features in a patient with common variable immunodeficiency (CVID) with myositis.Methods A 33 years old man suffered from recurrent respiratory infection with fever over 10 years.The symptoms improved after anti-infection therapy.At the same time he presented with fatigue.Two years ago he developed general muscle weakness,hypertrophy and myotonia,especially in the hands,neck and thighs.Genetic test for myotonic dystrophy protein kinase (DMPK) and zinc finger protein 9 (ZNF9) was performed.Laboratory tests,electromyography,muscle ultrasound and muscle biopsy were performed.In addition to standard histological and enzyme histochemical stainings,immunohistochemical method was used with primary antibodies of mouse anti human monoclonal antibodies including CD8 for T-lymphocytes,CD20 for B-lymphocytes,CD68 for macrophages and MHC-Ⅰ for muscle membrane.Results Electromyography revealed myogenic changes and abound with myotonic potentials.There was muscle hypertrophy in muscle ultrasound.Lung biopsy showed chronic inflammatory changes.Serum hypoimmunoglobulin and anemia were found.Muscle biopsy showed muscle fiber necrosis and regeneration with lymphocyte and macrophage infiltration.There were no gene mutations in DMPK and ZNF9 gene.Conclusion Muscle hypertrophy and myotonia appeared in CVID with myositis.