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.

Compressive cervical myelopathy (CCM) is a common disease of spinal surgery. Various kinds of reasons such as herniation of cervical disc and ossification of the posterior longitudinal ligament (OPLL) lead to spinal canal stenosis, thereby compressing the spinal cord, and a series of neurological symptoms are caused. Currently, posterior cervical expansive open-door laminoplasty (PCEOLP) is widely used for cervical decompression in patients with CCM involving three or more levels. This operation can expand the spinal canal while preserving the posterior structures of the cervical spine, and non-neurological complications are relatively rare. However, there are characteristic complications to this procedure such as nerve root palsy, axial neck pain, and loss of range of motion (ROM). Various modified techniques of PCEOLP have been developed to reduce postoperative complications. In this review, clinical research progress of PCEOLP in recent years is summarized, mainly focusing on internal fixation of materials and methods, operative approach, cervical decompression level, combined application of different surgical procedures, opening size and application of new technologies.

OBJECTIVE:To provide reference for improving the pharmacy self-taught undergraduate course system in general universities in China. METHODS:According to comparative study and researching related literatures,the situation of pharmacy self-taught undergraduate course system in general universities in China was analyzed,and reform ideas and programs were present-ed. RESULTS & CONCLUSIONS:Based onchemistry-biology-psychology-society-medicine-pharmacyin the overall framework of pharmacy undergraduate self-examination course system,it was designed with target of cultivating applied talents;related con-tents in public basic courses,humanities basic course and professional ethics course should throughout the whole teaching process;professional main course should be pharmaceutical knowledge-based,supplemented by medical related courses;the school should set vocational elective course to reform based on combining with the own teaching research direction,characteristics and career ori-entation of different self-taught students. The reform can develop applied talents with ability and political integrity,which meets the needs of social development.

Objective To evaluate the clinical efficacy of endoscopic esophageal variceal ligation (EVL) for esophageal variceal bleeding (EVB) in elderly patients with hepatic cirrhosis.Methods From July 2007 to July 2013,clinical data of 198 patients who had been diagnosed with liver cirrhosis presenting with EVB were retrospectively analyzed.Among them,167 patients who had received EVL were divided into the elderly EVL group (n=97,age≥60 years) and the non-elderly EVL group (n=70,aged ＜ 60 years).The other 31 cases (aged ≥ 60 years) had received propranolol therapy.Treatment effectiveness,adverse effects,complications and the one-year survival rate of each group were analyzed.Results The efficacy rates and variceal recurrences were 77.3％ (75/97) and 78.6％ (55/70) in the elderly EVL group and 19.6％ (19/97) and 18.6％ (13/70) in the non-elderly EVL group,respectively,with no significant difference between the two groups (each P＞0.05).The re-bleeding rate was higher in the propranolol treatment group than in the elderly and non-elderly EVL groups [58.1％ (18/31) vs.24.7％ (24/97) vs,22.9％ (16/70),x2 =14.76,P =0.00].One-year survival rates in the elderly group,the non-elderly EVL group and the propranolol treatment group were 86.6 (84/97),88.6％ (62/70),64.5％ (20/31),respectively,with statistically significant differences between the three groups (x2 =10.24,P=0.01).Conclusions EVL is effective for the treatment of hepatic cirrhosis with EVB and can be used as a secondary prophylaxis measure for EVB in elderly patients with hepatic cirrhosis.

Nephrotic syndrome,a common glomerular disease in pediatric department,is characterized by its long course of disease and facility to repeat or relapse,thus severely influences the physical and mental health of pediatric patients.Besides physical pains,most family members and patients show different degrees of mental stress towards this specific disease.Based on investigating clinical cases,we explored the features of mental stress among children with nephritic syndrome and their family members,and came up with corresponding psychological interference by effective communication skills between doctors and children with nephritic syndrome,offering humane concern,and proper instruction in clinical treatment in order to increase the compliance of children patients and their family members to medical treatment.Therefore,children patients and their family members manifest favorable attitude and cooperate with medical staff in the treating process,thus a satisfactory treating outcome will be achieved.

Objective To analyze the changes of myeloid-derived suppressor cells (MDSCs) in peripheral blood and serum nitric oxide in tumor-bearing mice, and to explore their correlation and functions in tumor progression. Methods Orthotopic transplantation tumor model of hepatocarcinoma in mice was established. At the 7th, 14th, 21st day after tumor implantation, the proportion of peripheral blood MDSCs was tested by flow cytometry, and serum nitric oxide was detected using the method of nitric acid reductase. Results The proportion of peripheral blood MDSCs at the 7th, 14th, 21st day after tumor implantation in tumor-bearing mice was significantly higher than that in normal mice [(8.65±1.01)%, (14.20±2.52)%, (27.51± 2.98) % vs. (2.51 ±0.44) %, P<0.05]. The level of nitric oxide at the 7th, 14th, 21st day after tumor implantation in tumor-bearing mice was significantly lower than that in normal mice [(72.02 ±5.05) μmol/L, (94.70 ±3.34) μmol/L, (78.90 ± 8.19) μmol/L vs. (57.03 ±16.94) μmol/L, P<0.05]. The level of serum nitric oxide was positively associated with the proportion of MDSCs (r=0.689, P<0.01). Conclusion The proportion of peripheral blood MDSCs and the level of serum nitric oxide in mice are increased with the tumor progression, and there is a positive correlation between them.

Objective To analyze the characteristics of magnetic resonance imaging(MRI)and DWI in newly diagnosed patients with cervical cancer,and to investigate the correlation between the clinical pathological features and the clinical pathological characteristics.Methods 100 cases of newly diagnosed cervical cancer were selected as the research subjects.All patients received magnetic resonance plain scan,DWI examination,MRI features of cervical carcinoma were observed,its ADC value and MVD were measured,ADC and MVD in different stages of cervical cancer were compared,its correlation was analyzed.Results The signal features of the lesions were as long as T2 , slightly longer T1 signal.The pressure sequence was obviously high signal.Compared with the surrounding tissue,DWI sequence was high signal.In the diagnosis and staging of Ⅲ and Ⅳstage lesion,the MRI diagnosis was right,MRI of the 9 cases of Ⅱstage lesion was misdiagnosed as Ⅰstage lesion,7 cases of Ⅰstage lesion were misdiagnosed as Ⅱstage lesion,compared with the postoperative pathologic staging,the diagnostic accuracy was 84%.There were signifi-cant differences in ADC value[(0.917 ±0.055)s/mm2 vs.(0.911 ±0.044)s/mm2 vs.(0.887 ±0.047)s/mm2 vs. (0.815 ±0.043)s/mm2 ]and MVD[(27.38 ±5.66)vs.(29.54 ±7.32)vs.(34.46 ±8.92)vs.(35.26 ±8.84)] between different stages of cervical cancer(F =3.024,2.941,all P <0.05),The ADC value of cervical carcinoma inⅢ and Ⅳstage lesion was significantly lower than that of the Ⅰ and Ⅱstage lesion of cervical cancer,MVD was significantly higher than that of the Ⅰ and Ⅱstage lesion of cervical cancer,the differences were statistically signifi-cant(t =2.992,2.976,3.954,3.689,all P <0.05).By Pearson correlation analysis,significantly negative correlation was found between ADC value and MVD value of cervical cancer(r =-0.678,P =0.021).Conclusion The MRI and DWI images of cervical carcinoma are characteristic,there was a significant correlation between clinical stage and MVD.

With the constant development of economic globalization and the growth of knowledge economy, hospitals are confronted with severe challenges and are development opportunities. As leaders of their institutions, hospital directors ought to correctly appraise the situation and attach importance to the following five issues: ①scientific and technological innovations; ②development of unique key specialties; ③cultivation of top notch personnel; ④amplification and perfection of market oriented operational mechanisms; and ⑤team building for joint tackling of key problems. Only in this way can the intensional building of hospitals be enhanced and the competitiveness of them strengthened.

OBJECTIVE:To investigate the methods of calculating pediatric dose of medication.METHODS:The validity of several methods of calculating pediatric dose of medication was evaluated by statistical methods and demonstration analysis,and the expression of the pediatric dosage of administration in drug instruction was discussed.RESULTS&CONCLUSION:There exist improper medical manipulation in the rational use of medicines in pediatrics,uniform criterion and calculation are lack for measuring age groups in pediatrics,aseries of integrated and uniform criteria to determine the safe dosage for child are needed.

As a newly identified T helper cell subset, Th9 plays an important role in anti-tumor immunity. Th9 can be differentiated from CD4+T cells that have been induced by TGF-beta and IL-4. In addition, other CD4+T helper cell subsets can be developed to Th9 cell in particular situations, thereby showing its plasticity. Results of animal experiments have indicated that Th9 inhibits tumor growth and plays a significant role in anti-tumor immunity by secreting related cytokines such as IL-9. A few cytokines and molecules can regu-late the differentiation and development of Th9 cells in different signaling pathways. This review will focus on the production, anti-tu-mor immunity, related mechanism, and signaling pathways of Th9 cells, thereby providing a new field of vision and idea for anti-tumor therapy in the future.