Objective To observe the influence of clopidogrel combined with proton pump inhibitor (PPI) on the postoperative complication of percutaneous coronary intervention.Methods The clinical data of 600 patients who were taking clopidogrel antiplatelet therapy were retrospectively analyzed.All patients were divided into observation group (with PPI,n =300) and control group (without PPI,n=300).In-stent restenosis (ISR) and the adverse event rates were compared between the two groups during the period of follow up.Results The incidence of gastrointestinal bleeding was less in observation group than in control group (6.7％ vs.13.7％,x2 =8.048,P＜0.01),but the incidences of ISR,target vessel revascularization (TVR) and non-fatal myocardial infarction were higher in observation group than in control group(x2 =6.426、5.511、4.718,all P＜0.05).Conclusions Clopidogrel combined with PPI treatment can significantly reduce the risk of gastrointestinal bleeding,but increase the incidences of major adverse cardiovascular events.We suggest that PPI should be used with caution for the patients who need longer-term PPI use.

This article reviewed the internationalization history of the Traditional Korean Medicine (TKM).It expounded the current situation of TKM's international standard application for WHO and International Standard Organization (international organization for standardization,ISO),and the competition between Traditional Chinese Medicine (TCM) and Traditional Korean Medicine.The authors presumed the essence content of TCM should be included in multiple international standards as early as possible to promote the intemationalization of TCM.

Objective To analyze the distribution features of injury regions and severty of patients with traumatic brain injury ( TBI ) associated with muhiple injuries and discuss the influence of different injury regions and severity on their outcome.Methods Retrospective analysis was performed for clinical data of 1026 patients treated from August,2007 to August,2010. Results The majority of TBI patients associated with multiple injuries were young people( accounting for 78.07％ of the total injuries),among whom the males outnumbered females in proportion of 3.62:1,and the multiple injuries were mainly characterized by chest injuries (accounting for 46.69％ of multiple injuries).Spearman analysis indicated that Glasgow Outcome Scale (GOS) was correlated with Glasgow Coma Scale (GCS)score,age,maxillofacial region injuries,chest and abdomen injuries (P ＜ 0.05 ).Logistic regression analysis manifested that age,GCS score,and lung injury were the independent risk factors of high mortality in TBI patients associated with multiple injuries. Conclusion Low GCS scores,old age and severe lung injuries indicate a high mortality and morbidity,while injuries in extremities and pelvis have no significant influence on the outcome.

ObjectiveTo improve imaging teaching of the central nervous system ( CNS ) by applying picture archiving and communication system ( PACS ).MethodsFifty medical imaging undergraduate students were arranged to study the content of CNS by introduction training about PACS,postprocess viewing cerebral stenosis and aneurysm by practicing,studying by searching the disease and browsing teaching picture archiving.ResultsStudents could master the content efficiently and enhance their initiative and creativity.ConclusionPACS has an important value in the imaging teaching of CNS.

BACKGROUND: As a new-type and effective restoration means of dentition defect and edentulous,implant denture is a restoration method most closely related to natural teeth,and is accepted by more and more patients.OBJECTIVE: To investigate the clinical effects of non-submerged dental implants with sandblasted and acid-etched surface preparation(Straumann implants system).METHODS: Patients who visited Oral Implantology Center of the Affiliated Hospital of Qingdao University Medical College from June 2007 to June 2009 were selected as study subjects.Systemic and local contraindications were excluded.A total of 124patients who had 218 Straumann implants implanted were followed up for 3 to 24 months.According to various patients' conditions,conventional approach,immediately implanted,GBR technique and flapless operation were adopted respectively.Clinical effects were evaluated with the Albrektsson's criteria.RESULTS AND CONCLUSION: There was no implant loosen,shedding or X-ray transmission in 218 implants.Both the survival rate and successful rate of implants were 100%.High degree of satisfaction from patients was achieved.Straumann implants system could be considered as a manageable and satisfactory non-submerged implant system.

Objective To observe the effects of Donepezil on cognitive function of delyed ephalophthy after acute carbon monoxide poisoning ( DEACMP) .Methods Eighty patients with DEACMP were randomly divided into control group ( 40 cases ) and treatment group ( 40 cases ) .The control group was given treatment of regular medicine, placebo and hyperbaric oxygenation.The treatment group was given treatment of regular medicine, Donepezil and hyperbaric oxygenation.The dose of Donepezil was 5.0 mg per night, and 90 d was a period of treatment.The cognitive function of patients was evaluated respectively by MMSE and Barthel Index rating scale ( BI) .And the results were compared between the two groups.Results Compared with before treatment, the MMSE and BI scores of the two groups after treatment were significantly increased (P<0.05 -0.01).And after the treatment, the MMSE and BI scores of the treatment group were significantly higher than those in the control group (P<0.05-0.01).Conclusion Donepezil can greatly improve the cognitive function of DEACMP patients, it is worthy to be clinical promoted.

Objective To evaluate the efficacy of endoscopic variceal ligation(EVL)in esophageal variceal bleeding (EVB)in elderly patients with hepatic cirrhosis,and the safety of endoscopic operation under anesthesia.Methods From July 2007 to July 2013,170 patients diagnosed as liver cirrhosis complicated with EVB were retrospectively analyzed.Among them,139 patients who received EVL were divided into elderly anesthesia group (n=52,age≥60 years),elderly non-anesthesia group (n=45 ,age≥60 years)and non-elderly anesthesia group (n=42,age<60 years);the other 31 cases (age≥60 years) received propranolol therapy.The degree of satisfaction of visual fields and esophageal peristalsis under the gastroscope,the effect,adverse effects and complications of EVL,the recurrence of EVB and mortality of each group were analyzed.Two-way analysis of variance and crosstabs chi square test were performed for statistical analysis.Results The satisfaction rate of visual fields and esophageal peristalsis under the gastroscope were 82.5 % (104/126)and 89.7% (113/126)in elderly anesthesia group;82.6% (71/86) and 89.5 % (77/86)in non-elderly anesthesia group;40.3% (29/72)and 44.4% (32/72)in elderly non-anesthesia group.The satisfaction rate of visual fields and esophageal peristalsis under the gastroscope in anesthesia group were better than those in non-anesthesia group (χ2 =47.46,64.28;both P <0.01 ). The efficacy rates of EVL in elderly anesthesia group,elderly non-anesthesia group and non-elderly anesthesia group were 84.6%(44/52 ),68.9%(31/45 )and 81 .0%(34/42 ),respectively.The variceal recurrence rates were 19.2% (10/52 ),20.0% (9/45 )and 19.0% (8/42 ),respectively.There was no significant difference among them (all P > 0.05). Rebleeding rate of medication treatment group was 58.1%(18/31),which was obviously higher than that of elderly anesthesia group (19.2%,10/52 ), elderly non-anesthesia group (31 .1 %,14/45 )and non-elderly anesthesia group (23.8%,10/42 ),and the difference was statistically significant (χ2 =15 .10,P <0.01 ).No case of hepatic encephalopathy was found in elderly anesthesia group or non-elderly anesthesia group after EVL.The incidence of pneumonia in elderly non-anesthesia group was 4.2%(3/72),which was higher than that of elderly anesthesia group and non-elderly anesthesia group,and the difference was statistically significant (χ2 =8.93,P =0.01). The mortality within a month after EVL in elderly anesthesia group,elderly non-anesthesia group and non-elderly anesthesia group was 0,8.9% (4/45 )and 0,and the difference was statistically significant (χ2 =9.27,P =0.01).Conclusion The efficacy of EVL under anesthesia in EVB in elderly patients with liver cirrhosis was good,with no induction or aggravation of hepatic encephalopathy or irreversible complications were found.

〔Abstract〕 The paper introduces the definition of mobile health care app , sorts out the research status of mobile health care App from aspects such as classification , contents and quality , supervision , standards and requirements and problems such as low quality , lack of supervision, unsafe data and indefinite definitions , and proposes suggestions from the angle of developers , users, markets, etc.

Objective To study the value of magnetic resonance diffusion weighted imaging (DWI)and dynamic enhanced imaging (DCE)in endometrial carcinoma staging.Methods 200 cases with endometrial carcinoma were selected,DWI and DCE were given before operation.The diagnostic value of two kinds of examination methods for the diagnosis of endometrial carcinoma in general and basic level was compared.Results The overall accuracy of muscle invasion of magnetic resonance DWI was 91.5%(183 /200),which was significantly higher than 77.5%(155 /200)of magnetic resonance DCE,the difference was statistically significant (χ2 =11.231,P <0.05 ).The accuracy,sensitivity and positive predictive value of the magnetic resonance DWI superficial and deep muscular layer were significantly higher than those of the magnetic resonance DCE (χ2 =9.283,8.231,9.021,8.927,8.142, 9.405,all P <0.05).Compared with pathological results,Kappa value of magnetic resonance DWI was 0.807,Kappa value of magnetic resonance DCE was 0.587.Conclusion Magnetic resonance DWI compared with magnetic reso-nance DCE,the accuracy and sensitivity of the infiltration of endometrial carcinoma was higher.

Objective To investigate the expressions of interluekin-3 in BALB/c mice infected by mycoplasma pneumonia (MP)and to clarify the relationship between IL-3 and MP infection.Methods Total 36 BALB/c mice were randomly divid-ed into control group,MP infection group and clarithromycin treatment group.MP infection models were established with the method of dripping cultured MP into nasal cavity of mice.ELISA method was used to assay the levels of IL-3 in the the serum of the mice and bronchoalveolar lavage fluid in various groups.The lung tissue was fixed in formalin for sections,HE staining was performed for the observation of histological changes.Results The MP-infected mouse models were established successfully and MP strains were dripped into the respiratory system of mice.As showed in histopathological observasion re-sults,significantly increased after MP infection and then gradually decreased after clarithromycin treatment.The ELISA re-sults showed that the level of serum and bronchoalveolar lavage fluid of IL-3 of the mice in MP infection group were 96.4± 8.3 ng/L and 60.9 ±6.5 ng/L.Compared with the control group(203.1±14.5 ng/L,96.3±12.6ng/L),serum and bron-choalveolar lavage fluid of mice infected with MP in IL-3 levels were significantly lower (t serum = 19.50,t balf = 17.20,P <0.01),and after treatment with clarithromycin,serum and bronchoalveolar lavage fluid of IL-3 significantly increased,re-spectively(175.6±12.5 ng/L and 85.6± 10.2 ng/L,tserum = 17.41,tbalf = 14.62,P <0.01),the difference was statistically significant.Conclusion IL-3 levels were decreased in mycoplasma pneumonia mice.Clarithromycin treatment had effect on mycoplasma pneumonia infecttion.The expression level IL-3 may be related to the severity degree of MP infection.