Objective To investigate clinical efficacy and safety of half quantity of tirofiban on elderly patients with ST segment elevation myocardial infarction ( STEMI ) .Methods 120 elderly patients with STEMI underwent emergency PCI patients,120 cases of digital method were randomly divided into the control group and observation group,60 cases in the control group with conventional surgery and drug treatment,the observation group of 60 cases on the basis of conventional therapy was given to half the amount for tirofiban,the two groups were observed in the risk of bleeding, the occurrence of adverse cardiovascular events after operation.Results The postoperative bleeding risk of the observation group compared with the control group had no significant difference(χ2 =1.51,1.35, 0.94,P=0.643,0.768,0.578);for the observation group in 30 days after operation,90 days of re infarction,death and target vessel revascularization rate compared with the control group decreased,the difference was statisticallysig-nificant(30 days after operation,χ2 =9.54,18.33,16.75,P=0.043,0.029,0.031;90 days after operation,χ2 =17.48,21.78,19.54,P=0.034,0.011,0.021).Conclusion Semi quantity for tirofiban can reduce the risk of elderly patients with STEMI after PCI,improve clinical outcome,which will not increase the risk of hemorrhage.

Ascites is an important indicator of poor prognosis of liver cirrhosis.Although several guidelines and consensus statements on the management of ascites have been published in the past years,there are still a lot of controversial problems in this regard.The current contro-versial problems and difficulties in the management of ascites,such as the timing of sodium supplementation or sodium restriction,the selec-tion of diuretics,the application value of aquaretics,the strategy of albumin administration after large-volume paracentesis,and the indica-tions and efficacy of transjugular intrahepatic portosystemic shunt,are reviewed.It is pointed out that further studies on these problems with evidence-based medicine means will enhance the diagnosis and treatment of cirrhotic ascites and improve patients'prognosis.

The established immunodeficient animal models could be used as valuable resource for mechanism re-search of related disease in humans, drug discovery and development, translational research and stem cell research.How-ever, it is difficult and low-efficient to establish the genetic modified animal models using traditional technologies.The re-ports for immunodeficient animal models are few in middle-size and large animals.Recently, several effective gene-targeting tools, including ZFNs, TALENs, CRISPR/Cas9, develop quickly and provide technology basis for the establishment of im-munodeficient animal models.In this paper, the technology principles and research progresses of ZFNs, TALENs, CRISPR/Cas9 are introduced.The significant progresses of these emerging technologies achieved in immunodeficient ani-mal models are also elaborated, including KO Rag1/Rag2 rabbit, KO Rag1/Rag2 pig, KO IL2rg pig, KO Ppar-g/Rag1 monkey, and so on.In addition to being models for researching SCID-related diseases in humans, and evaluating the effica-cy and safety of stem-cell engraftment, these models may be also useful to develop surgical procedures for placement of grafts before clinical trials in humans, to produce humanized animals and bridge the gap between laboratory animal and medicical research.The immunodeficient animal models described here represent a step toward the comprehensive evalua-tion of preclinical cellular regenerative strategies.

Objective To observe and analyze the four changes of plasma D- dimer and coagulation in pregnant women at different stages of pregnancy, and to explore the value of the test. Methods The subjects of this study were 120 pregnant women who underwent routine physical examination in our hospital, according to different stages of pregnancy (early pregnancy, middle pregnancy, late pregnancy, and before delivery) Four D- dimer and four blood coagulation tests were performed in pregnant women, and the results were observed and compared. Results During the pregnancy, D- dimer has increase trend (P<0.05); early in pregnancy, pregnancy and late pregnancy, PT has shortened(P<0.05); pregnancy, APTT has shortened (P<0.05), at the end of pregnancy and parturient period, showing a significant shortening (P<0.05); phenomenon in early pregnancy to mid pregnancy stage, FIB increased significantly (P<0.05), and at the end of pregnancy to perinatal period, with a sharp increase (P<0.05). Conclusion It is of great significance to perform dynamic monitoring of of plasma D- dimer and coagulation four indices in pregnant women during pregnancy.

OBJECTIVE:To compare the efficacy and safety of levonorgestrel intrauterine system and mifepristone in the treat-ment of perimenopausal dysfunctional uterine bleeding. METHODS:200 patients with perimenopausal dysfunctional uterine bleed-ing were randomly divided into observation group (100 cases) and control group (100 cases). Patients in the observation group placed levonorgestrel intrauterine system (containing levonorgestrel 52 mg),patients in control group received Mifepristone cap-sule 10 mg/d,oral,the treatment course for 2 groups were 3 months. Clinical efficacy,endometrial thickness,menstruation(PBAC score),hemoglobin level before and after treatment and incidence of adverse reaction in 2 groups were observed. RESULTS:After treatment,the total effective rate in observation group was significantly higher than control group,incidence of adverse reactions was significantly lower than control group,the differences were statistically significant(P<0.01). Before treatment,there were no significant differences in the endometrial thickness,PBAC score and hemoglobin level between 2 groups;after treatment,endome-trial thickness and PBAC score were significantly lower than before,and observation group was lower than control group;hemoglo-bin level was significantly higher than before,and observation group was higher than control group,the differences were statistical-ly significant(P<0.01 or P<0.05). CONCLUSIONS:The efficacy and safety of levonorgestrel intrauterine system are significant-ly superior to mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding.

Antigen Presentation ; Apoptosis ; Hepatitis C ; Humans ; Lichen Planus, Oral ; etiology ; genetics ; pathology ; virology ; Polymorphism, Single Nucleotide ; T-Lymphocytes, Cytotoxic ; pathology ; T-Lymphocytes, Helper-Inducer ; pathology ; Tumor Necrosis Factor-alpha ; genetics ; metabolism

Hepacivirus ; Hepatitis C ; complications ; epidemiology ; Humans ; Lichen Planus, Oral ; complications ; epidemiology ; virology

[Objective]To investigate the curative effect and methods of distal tibial fracture by operation.[Method]From May 2004 to Feb.2005,30 cases of distal tibial fracture were treated in the department.All cases were treated with open reduction,internal fixation with medial anatomic plates,and with bone-grafting prophylacticly in all cases.The operation would be done on 10~14 days after fracture.They were followed up and analyzed retrospectively.[Result]All cases were followed up for 8～17 months(average 13.9 months).All wounds were primary healing and all fractures obtained bone-union.Twenty-two cases were the excellent,6 cases were the good according to Mazur's criteria.The excellent and good rate was 93.3%.All cases had no severe complication,such as wound infection,cutaneous necrosis and bone non-union.[Conclusion]Anatomic plate of distal tibia is a perfect choice for treatment of distal tibial fracture.Operative juncture and prophylactic bone grafting were very important to obtain satisfactory effect.

Objective To study the effects of tri-ortho-cresyl phosphate(TOCP) on mitochondrial membrane permeability in hen's nerve tissues and investigate the mechanism of the organophosphorus ester-induced delayed neurotoxicity(OPIDN).Methods Adult Roman hens were randomly divided into four groups,including three treated groups and one control group(24 in each group).The hens in the experimental groups were treated with TOCP by gavage at the single dosages of 185,375 and 750 mg/kg respectively.TOCP was dissolved in corn oil and administered at 0.65 ml/kg.The control hens received an equivalent volume of corn oil by gavage.The hens were sacrificed on the 1st,5th,15th and 21st day after treatment and the cerebrum,cerebellum,spinal cord were dissected and homogenized in ice bath.The mitochondria in these nerve tissues were extracted to determine the changes of the membrane permeability and membrane potential.Results Compared with the control group,no significant increase of the mitochondrial membrane permeability in the cerebrum was observed in treated groups.In the cerebellum,the membrane permeability in the 185 mg/kg group had no significant changes,while in the 375 and 750 mg/kg groups it increased significantly on the 1st and 5th day after TOCP treatment(P

Objective To investigate the values of computed tomography(CT) and endoscopic retrograde cholangiopanc reatography(ERCP) in acute biliary tract obstruction associated with Clonorchiasis. Methods The image features of 47 patients with acute biliary tract obstruction associated with Clonorchiasis proved by operation (27 cases) and ERCP (20 cases) were reviewed retrospectively. Results Fourty-three cases showed equal intrahepatic bile duct diffuse dilatation from porta hepatis to capusle with different levels in CT, and 39 cases showed extrahepatic bile duct dilatation. There was no significant relationship for the extent of intra and extrahepatic bile duct dilatation. It showed the end of intrahepatic bile duct shaped like a bag in 41 cases, a enlarged gallbladder in 38 cases, and 9 cases with a soft intralumenal masses. There were 13 patients with pancreas swelling and 8 with pancreatic duct dilatation. Of the 20 patients underwent ERCP, eighteen cases showed intrahepatic bile duct diffuse dilatation with the end shaped like a bag, and 16 showed extrahepatic bile duct dilatation. Irregular filling-defect was seen in the common bile duct in 9 cases. The obstruction were relieved after Oddi's muscle endoscopic sphincrectomy(EST). Conclusion The patients with acute obstructive jaundice can be diagnosed as Clonorchiasis, if CT or ERCP showed equal intrahepatic bile duct diffuse dilatation with the end shaped like a bag and with extrahepatic bile duct dilatation, which can be confirmed by the worms and eggs found in the drawing-out bile, and the obstruction can be relived by EST.