A large number of studies have confirmed that antiplatelet agents reduce the relative risk of stroke,myocardial infarction,or death by an average of 22％.However,many patients still have thrombotic events during the period of taking anti-platelet agents,and this is called anti-platelet agent resistance.Its incidences reported are very different.The incidence of aspirin is 3％ to 85％,and that of clopidogrel is 28％ to 44％.The exact cause of antiplatelet agent resistance remains unclear.It may be associated with several factors,including decreased drug bioavailability,genetic polymorphisms,activation of other platelet activation pathways,and increased circulating platelets.Currently,a variety of laboratory methods have been used to detect antiplatelet agent resistance,its criteria are different.In addition,the response measures of antiplatelet agent resistance also have no conclusion,and this has brought greater difficulties for the prevention and treatment of stroke.

Functional near-infrared spectroscopy is a non-invasive optical brain function detection technology,which can do multi-point measurement of changes on cerebral cortical area corresponding to the oxygenation of the blood hemoglobin and deoxygenated hemoglobin concentration,and then reflect the state of brain cortex function.Its greatest advantage is to allow the subjects head moving in a certain range,especially suitable for children.At present this technology could be applied to clinical pediatric,such as epilepsy,autism,attention deficit/hyperactivity disorder,neonatal disease,neurosurgery and cardiovascular surgery,etc.Functional near-infrared spectroscopy technology will have more applications in the field of research on brain function.

Background phacoemulsification combined with limbal relaxing incision (LRI) is reported to be effective for the management of coexisting cataract astigmatism,but the influence of after phacoemulsification with LRI on corneal high-order aberration is still rarely reported.Objective This study was to evaluate the effect of cataract surgery with LRI for preoperative astigmatism or on corneal high-order aberration.Methods A selfcontrolled serial cases observational study was designed.A total of 35 cataractous eyes of 35 patients with astigmatism ≥ 1.0 D before cataract surgery were enrolled in Tianjin Medical University Eye Hospital from August 2014 to April 2015 under the informed consent of patients.LRIs were performed on the eyes during the phacoemulsification and IOL implantation.The uncorrected visual acuity (UCVA),BCVA and optometry were recorded before operation and 1 day,1 week,1 month,3 months after operation.Pentacam was employed to measure the maximal and minimal diopters,astigmatism and high-order aberrations within 3 mm of the anterior corneal surface at above-mentioned time points.All the results were compared among different time points.The optometry outcomes and the anterior corneal surface astigmatism change were analyzed using vector analysis method.Results The UCVA was 0.34 ±0.22,0.38 ± 0.25,0.43±0.27,0.42±0.28 in 1 day,1 week,1 month and 3 months after operation,which was significantly higher than 0.08 ±0.09 before operation;and the BCVA was 0.54 ± 0.27,0.64 ± 0.29,0.67 ± 0.29,0.71 ± 0.32 in 1 day,1 week,1 month and 3 months after operation,showing a significant increase in comparison with 0.22±0.51 before operation(F=54.457,P=0.000;F =62.653,P =0.000).The refractive cylindrical error and corneal astigmatism were significantly decreased after operation in comparison with before operation (F =31.061,P =0.000;F =113.043,P=0.000).High order aberrations (HOA) at postoperative 1 day,1 week,1 month,3 months were all higher than those in preoperation (F =11.189,P =0.000) under the 4 mm pupil diameter.Compared with preoperation,the vertical coma,secondary vertical coma and three leaf clover were significantly increased(all at P＜0.05),but the horizontal coma and primary spherical aberration were not significantly changed (all at P＞0.05) under the 6 mm pupil diameter.Conclusions Phacoemulsification combined with LRI can reduce the corneal astigmatism effectively and steadily,and the increase of corneal aberrations does not affect visual acuity.

Objective To evaluate the diagnosis and efficiency of nasal endoscopic surgery treatment for rhinogenous optic function damage (ROFD).Methods The clinical data of 36 patients (36eyes) with ROFD were retrospectively reviewed.All patients were operated on nasal sinus probing and open sinus surgery through transnasal endoscopic approach,and 10 patients underwent endoscopic optic nerve decompression.Results Seven patients had bilateral pansinusitis,9 patients had unilateral posterior ethmoidal sinusitis and sphenoiditis,8 patients had isolated sphenoiditis,8 patients had fungal sinusitis occured in the sphenoid sinus and unilateral posterior ethmoid sinus,3 patients had unilateral pyocyst and cyst of the sphenoid and ethmoid sinus,1 patient had frontal and ethmoidal sinusitis.All patients were confiemed by pathology after surgery.The visual acuity preoperative were as follows:3 eyes no light perception,10 eyes hand movement,11 eyes fingers counting less than 20 cm and 12 eyes were vision impaired in different degree.The visual acuity postoperative were as follows:3 eyes failed,13 eyes cured,20eyes improved from hand movement or fingers counting to fingers counting (30-60 cm).The efficiency rate was 91.7％(33/36).The other eye symptom was disappeared.Sinus epithelization was happened after surgery in all patients.Conclusions If the medicine expectant treatment is invalid,nasal sinus probing and open sinus surgery through transnasal endoscopic approach should be performed early in treatment of ROFD.Patients who suffered frnm severe visual damage and either unresponsive or intolerant to medical treatment should be administrated endoscopic sinus surgery including endoscopic optic nerve decompression.

In order to evaluate the anti-influenza virus activity of the effective monomer from Folium Isatidis (FI) in vivo, we established mice model with viral pneumonia and divided them into 3 different dose groups, then observed their lung indexes, pulmonary pathological changes, pulmonary virus hemagglitination titers, living time and death rates. The results showed that the monomer could reduce the pulmonary index from 2.64 to 1.93, 1.63 and 1.40 (P<0.01) and decrease the hemagglitination titer from 1.15 to 0.84, 0.70 and 0.59 (P<0.01). In addition,the living time from 5.1d to 6.5d, 8.4d and 8.9d respectively(P<0.01). The high dose (75 mg/kg/d) has the similar effect with 100 mg/kg/d dose of virazole(P>0.05), and more effective than 200 mg/kg/d dose of antiviral liquor (P<0.05).

BACKGROUND:Breviscapine treatment of cerebral infarction has curative effects, few side effects, stable long-term efficacy and few side effects, which can improve the micro-environment of damaged central nervous system after cerebral infarction.
OBJECTIVE:To investigate the effects of breviscapine injection combined with bone marrow mesenchymal stem cel transplantation on neurological recovery and growth-associated protein 43 expression in rats after cerebral infarction.
METHODS:Sixty Sprague-Dawley rats undergoing middle cerebral artery occlusion were randomized into cerebral infarction group, cel transplantation group and combined group. At 6 hours after modeling, 1 mL PBS, 1 mL bone marrow mesenchymal stem cel suspension (2.5×106), and 1 mL bone marrow mesenchymal stem cel suspension (2.5×106)+75 mg/kg breviscapine injection were respectively injected via the tail vein in the three groups, once a day, continuously for 5 days.
RESULTS AND CONCLUSION:At 2 weeks after transplantation, BrdU-positive bone marrow mesenchymal stem cels were mainly gathered in the peri-infarction region, and the number of positive cels was higher in the combined group than the other two groups (P < 0.01). At 1, 2, 3 weeks after transplantation, the neurological deficit scores were significantly lower in the combined group than the other two groups (P < 0.05). At 2 weeks after transplantation, the combined group had smaler infarct size, milder edema, and higher expression of growth-associated protein 43 as compared with the other two groups (P < 0.05). Under light microscope, glial cels proliferated dramaticaly and brain edema significantly reduced in the combined group. These findings indicate that breviscapine injection combined with bone marrow mesenchymal stem cel transplantation can significantly reduce infarct size and brain edema, promote neurological recovery and increase the expression of growth-associated protein 43 in rats with cerebral infarction.

Recombinant antibodies have become the major growth trends in biotech industry following their success on therapeutic application and good revenue. But the low level of mammalian expression and laggard fermentation process constrained the development of antibody industry in China. The global advances of antibody industry were reviewed, compared the respective advantage between dihydrofolate reductase and glutamine synthetase expression system, continuous perfusion and fed-batch processes were compared. Finally, based on the knowledge and experience of antibody expression and fermentation, the suitable strategy of antibody industrialization, e.g. the fermentation model and scale, should depend on the comprehensive consideration of entrepreneur for the productivity, manufacturing capacity and market revenue. It may be a wise choice to use glutamine synthetase expression system and continuous perfusion process for the need of Chinese antibody industrialization.

AIM: To investigate the role of nitric oxide (NO) in vascular hyporeactivity during prolonged hemorrhagic shock (HS). METHODS: Anesthetized Sprague-Dawley rats (180-220 g) were subjected to HS insult in which they were bled to a mean arterial pressure (MAP) of 40 mmHg (5.33 kPa) and arteriolar reactivity to norepinephrine in spinotrapezius was detected. The constant MAP of 40 mmHg was maintained until vascular hyporeactivity had occurred and then were resuscitated or sacrificed for further analysis. NO synthase (NOS) activity was measured ex vivo by the conversion of [3H]-arginine to [3H]-citrulline in homogenates from heart, lung, liver, spleen, duodunum, skeletal muscle. 24 h survival rates of resuscitated rats were observed with and without administration of aminoguanidine (AG), a selective inducible NOS (iNOS) inhibitor. Mesenteric arteriolar smooth muscle cells (ASMC) were isolated, and the effects of L-arginine (L-Arg) on membrane potential (MP) of ASMC were determined by fluorescent probe and confocal microscopy in the absence and presence of AG. RESULTS: When vascular hyporeactivity occurred, an increase of NOS activity was observed in liver and heart. Resuscitated rats with AG had a higher survival rate compared with that of control. The MP of ASMC was decreased (more negative) immediately following the addition of L-Arg, and the hyperpolarization effects of L-Arg were partially blocked in the presence of AG. CONCLUSION: These results suggest that excessive NO produced in HS is responsible for the occurrence of vascular hyporeactivity in prolonged hemorrhagic shock, and one of the mechanisms of which may be hyperpolarization of ASMC caused by NO.

OBJECTIVE:To provide reference for the development of clinical pharmacists’career and the establishment of le-gal system in China. METHODS:The background,progress and situation of applying for“pharmacists’health care provider sta-tus”in the United States were introduced. The reasons for achieving provider status in California,Washington,and Oregon were summed up in aspects of politics,economics and education. The chance and challenge for achieving provider status at federal level were also discussed. Based on the development of clinical pharmacists in China,the suggestions were put forward for the improve-ment of legal system of clinical pharmacists in China. RESULTS & CONCLUSIONS:“Health care provider status”in the United Stated were recognised by 3 states with local developed economics,high-level education,and collective efforts of pharmacy organi-zations. Multiple national pharmacy organizations as American Pharmacists Association,American Society of Health-System Phar-macists and American Pharmacy College Society are working together toward provider status at the federal level. Our country should pay attention to related legal system construction,establish perfect and definite clinical pharmacists legal system as soon as possible to provide legal guarantee for career development of clinical pharmacists in China.

Objective To build high availability cluster using VMware to improve availability of hospital information system.Methods Virtual machines were installed in VMware server to act as backup servers.High availability software continuously detected status of physical servers using heartbeat signals.Results When physical servers failed,high availability cluster switched services automatically.The business switched to virtual machine quickly and smoothly.Conclusion High availability cluster based on VMware can improve HIS availability and lower implementation costs effectively.