Objective To assess the efficacy and safety of co-administration of aspirin and low-dose clopidogrel in patients undergoing percutaneous coronary intervention (PCI) after 1 year.Methods From March 2004 to September 2010,a total of 3366 patients with successful drug-eluting stents implantation after 1 year were divided into group A (aspirin combined with low-dose clopidogrel,n=1682) and group B (aspirin alone,n=1684).The average follow-up period was (29.5±16.3) months (19 months-76 months).The major adverse cardiovascular and cerebrovascular events and clinical complications were evaluated.Results Rates of cardiovascular death were 0.1 ％(2 cases) in combination group and 0.9％ (15 cases) in aspirin group,the risk ratio (HR) was 0.154 [(95％ CI:0.035 0.675),P＜0.05].Myocardial infarction occurred in 9 patients (0.5％) in group A and 27 patients (1.6％) in group B,the risk ratio (HR) was 0.036 [(95％ CI:0.153-0.741),P＜0.01].Rates of stroke were 0.4％ (7 cases) in group A and 1.6％ (27 cases) in group B,the risk ratio (HR) was 0.301 [(95％ CI:0.131 0.693),P ＜ 0.01].Recurrent ischemia with rehospitalization occurred in 152 patients (9.0％) in group A and 274 patients (16.3％) in group B,the risk ratio (HR) was0.601 [(95％ CI:0.491-0.735),P＜0.01].The cumulative survival rate in patients died of cardiac causes was significantly better in group A than in group B (P＜0.01).The cumulative incidence of major adverse cardiovascular and cerebrovascular events was significantly lower in group A than in group B (P＜0.01).There were no significant differences in total number of deaths,target vessel revascularization,stent thrombosis,incidences of severe bleeding,mild bleeding,leukopenia and thrombocytopenia between the two groups (all P＞0.05).Conclusions In patients with PCI after 1 year,the co-administration of aspirin and low-dose clopidogrel reduces the risks of major adverse cardiovascular and cerebrovascular events,and does not increase the risks of bleeding and cytopenia.

The patient was treated as pharyngeal foreign body sensation for six months. Laryngeal endoscopy: one about 1 cm x 2 cm x 2 cm, hard, smooth bulge in hypopharyngeal wall at the plane of epiglottis valley. The cervical MRI showed that the C3-C4 disc herniation and degeneration of the C3-C4 vertebrae. Cervical CT showed the C3-C4 disc osteophyte formation and forward bulge. After orthopedic consultation, the patient was diagnosed as esophageal cervical spondylosis. C3-C4 diskectomy and vertebral interbody bone grafted with plate fixation were undertaken. At postoperational day 2, the pharyngeal foreign body sensation disappeared.
Adult ; Cervical Vertebrae ; Foreign Bodies ; diagnosis ; etiology ; Humans ; Male ; Pharyngitis ; diagnosis ; etiology ; Spondylosis ; complications ; diagnosis

Pyogenic granuloma also known as granulomatous type capillary hemangioma, telangiectatic granuloma, lobular capillary hemangioma, is not really a tumor, its nature is still controversial. A rare clinical entity. I Division in treating facial pyogenic granuloma in 1 cases, the report is as follows.
Aged ; Facial Dermatoses ; surgery ; Granuloma, Pyogenic ; surgery ; Humans ; Male

Electrocoagulation ; instrumentation ; Humans ; Larynx ; surgery ; Microsurgery ; instrumentation ; Needles

Cervical esophageal carcinoma is rare, the lack of early clinical manifestations, early diagnosis is difficult, easily missed or misdiagnosed, especially at present for the method of repairing defect of cervical esophagus cancer after operation. In many mainstream, the repair methods with free jejunum, gastric pull up, and anterolateral thigh flap freeforearm flap. We used the platysma skin flap to repair of cervical esophagus defect which is worthy of reference,report as follows now.
Carcinoma ; surgery ; Esophageal Neoplasms ; surgery ; Esophagoplasty ; Humans ; Myocutaneous Flap ; Neck ; Skin

Objective To investigate the efficacy of autologous peripheral hematopoietic stem cell transplantation in the treatment of adult dermatomyositis. Methods A 21-year-old patient with dermatomyositis received autologous peripheral hematopoietic stem cell transplantation and was followed up for 6 years. Autologous peripheral hematopoietic stem cells were mobilized by recombinant human granulocyte colony stimulating factor (rhG-CSF) before the transplantation, and the conditioning regimens consisted of cyclophosphamide,methylprednisolone and cyclosporin. Rabbit anti-human T lymphocyte immunoglobulin began to be applied on day 3 after retransfer of stem cells. The improvement in symptoms, physical signs and biochemical indicators was observed, and hematopoietic restructuration and immunity resurrection were evaluated after the transplantation. Results After the transplantation, skin eruption greatly improved and gradually subsided. The muscle force of extremities restored from level Ⅳ before transplantation to level Ⅴ. The level of creatine kinase declined sharply after transplantation, but gradually returned to previous level. Leucocyte count began to decrease on the day of retransfer, and returned to the normal level on day 8. Immune function remained normal before and after the transplantation. Conclusion Autologous peripheral hematopoietic stem cell transplantation is an alternative treatment for severe and refractory dermatomyositis.

Objective To explore the effect of Sunset Abelmoschus on podocyte injury in adriamycin-induced nephropathy rats.Methods Fifty male SD rats were randomly divided into five groups:sham operation group (n=10),model group (n=10),Sunset Abelmoschus low dose group (0.5 g·kg-1· d-1 n=10),middle dose group (1.0 g· kg-1· d-1,n=10) and high dose group (2.0 g· kg-1· d-1,n=10).Unilateral nephrectomy combined repeated adriamycin injection were performed to establish adriamycininduced nephropathy models.The rats were administered with the corresponding dose of Sunset Abelmoschus during the experiment period.Urinary protein,urinary N-acetyl glucose aminotransferase (NAG),serum albumin,serum creatinine and blood lipid were measured before operation and 2,4,6,8 weeks after operation.The rats were sacrificed on week 8 for the renal histological examination,including light microscope and electron microscope.Expression of nephrin was examined by immunofluorescence assays.Results As compared to model group,urinary protein and NAG significantly decreases in Sunset Abelmoschus groups in each time point,especially in high dose group (P＜0.01),meanwhile the serum albumin increased and the disturbance of lipid metabolism was improved in Sunset Abelmoschus groups (P＜0.05).Compared with sham group,Scr increased significantly in model group and Sunset Abelmoschus groups at the 4th week.At the 8th week,Scr in high dose group was lower than that in model group (P＜0.05),and the ratio of glomerular globe sclerosis and segmental sclerosis,tubulointerstitial damage reduced in Sunset Abelmoschus groups,especially in high dose group.The podocyte damage and the extent of foot process fusion were improved in Sunset Abelmoschus groups compared with model group.Expression of nephrin increased in Sunset Abelmoschus groups than that in model group.Conclusion Sunset Abelmoschus can ameliorate proteinuria and renal tissue damage of adriamycin-induced nephropathy rats,whose mechanism may be associated with the improvement of podocyte injury.

BACKGROUND: Poly(lactic-co-glycolic acid) (PLGA) has been widely used as medical implants and drug vehicle. Due to various factors involved in the degradation process, it is rather difficult to simulate the mass loss properties of PLGA.OBJECTIVE: To investigate the mass loss properties of PLGA films, and observe the correlation between the stimulation and the factual measurement.DESIGN: Repeated measuring experiment. SETTING: School of Materials Science and Engineering, Dalian University of Technology.MATERIALS: PLGA 50:50, 70:30 and 75:25 with weight average molecular weight (Mw) of 63 000, 115 000 and 400 000 were purchased from Shandong Key Laboratory of Medical Polymer Materials, and 1,4-dioxane (analytically pure) was purchased from Tianjin No.1 Chemical Reagent Factory and used as solvent.METHODS: The experiments were carried out in the School of Materials Science and Engineering of Dalian University of Technology from April to July in 2006.①PLGA were dissolved in 1, 4-dioxane according to the mass ratio of 50:50, 70:30 and 75:25, and the solution were cast into 10 mm×10 mm×1 mm polymer films.②PLGA films were immersed in Hank's simulated body fluid (Ph 7.4) at 37 ℃, and then taken out every week (every 5 days for PLGA 50:50). The samples were washed and dried to measure the changes of number and Mw using gel permeation chromatography. Degradation velocity was also worked out. Meanwhile the mass loss properties of PLGA films were measured using electronic balance. Furthermore, an improved Monte Carlo method was applied to carry out the correlation analysis with experiment data. MAIN OUTCOME MEASURES: ①degradation rates of PLGA with different ratios of lactic acid and glycolic acid.②the correlation coefficient between simulation results and experiment data.RESULTS: ①The degradation rates for PLGA at 50:50, 70:30 and 75:25 were 0.058 5, 0.016 6 and 0.010 1 /d (based on Mn), or 0.061 0, 0.017 5 and 0.008 5 /d (based on Mw), respectively.②Correlation coefficients between simulation results and experiment data for PLGA 50:50, 70:30 and 75:25 were 0.973 6, 0.987 4 and 0.990 3 correspondingly. CONCLUSION:The numerical simulation results for the mass loss properties of PLGA fit the experiment data well.

Bulk erosion type biodegradable materials play an important role in pharmaceutics.However,the instability of carriers affects drug delivery systems critically,and complicates their drug release kinetics.Among these problems,how degradation and erosion affect drug release patterns becomes a focus.Mathematical models facilitate to understand complex pharmaceutical drug release patterns,and are easily applied in structure design of drug delivery systems and to predict their drug release kinetics.This paper reviews the degradation and erosion patterns,drug release mechanisms,and the recent research of mathematical models.

Objective To summarize the clinical presentation, pathology features, and treat-ment principle for primary testicular non-Hodgkin's lymphoma. Methods Twelve patients were di-agnosed with primary testicular lymphoma. The mean age was 62 years (36-78). Of the patients, unilateral primary testicular tumors were found in 11 cases and bilateral tumors were found in 1 case. All cases had swollen testes, 3 cases had mild pain and 1 had low-grade fever. Ultrasonic examination detected solid mass in all 12 cases. CT scan revealed retroperitoneal enlarged lymph nodes in 3 cases. Nine patients were diagnosed with disease of stage Ⅰ E, 2 of stage Ⅱ E, and 1 of stage Ⅲ E. All of the patients underwent radical orchiectomies. Postoperative treatment included: CHOP chemotherapy for 10 cases, radiotherapy after chemotherapy for 5 cases, and surgery alone for 2 cases. Results Post-operative pathology results were non-Hodgkin's lymphoma in all cases. One patient lost in follow up, one died within 2 years because of other disease. The 1, 3 and 5 year actual survival rates were 82% (9/11) ,40%(4/10),20% (2/10), respectively. The relapsed organs included contralateral testis(3/ 11), central nervous system(3/11), liver(1/11)and retroperitoneal lymph node(1/11). Conclusions The prognosis of the primary testicular non-Hodgkin's lymphoma is very poor. Chemotherapy must be used after surgery for any stage. Stage Ⅰ E and Ⅱ E patient should be treated by surgery combined with radiotherapy and chemotherapy. Contralateral testis should be irradiated prophylactically. Pa-tients beyond stage Ⅱ E should accept chemotherapy after surgery and radiotherapy according to the patient's status.