Current setup and insights of the practicing scope of physicians in China / 中华医院管理杂志

Objective:To analyze the setup basis and registration rules of the practice scope of physicians in China, and take into account the current situation of individual provinces, for suggestions on further revision of the practice scope of these physicians.Methods:Relevant documents on practice scope setup were retrieved from such databases as CNKI, Wanfang and Weipu databases, while relevant national policies, laws and regulations were reviewed. On-site visits were conducted to health committees and medical institutions in 7 provinces from June 2020 through December 2020. Seminars and special interviews were held with relevant management personnel and doctors of different positions, for the purpose of learning the current physician practice scope setup and their suggestions for reform. Data gained from the above methods were summarized to arrive at reform suggestions for optimizing China′s practice scope setup, with further improvement made based on expert consultation method.Results:Several setbacks were found in the setup of their practice scope in China, namely as unclear setup principles, generalized setup of the national standards, inconsistent setup standards among the provinces, prohibition of cross-category registration, and roadblocks against in changing scope of practice. As the setup of the practice scope should set free manpower, unleash vitality, and delegate power, the practice scope should be changed to three categories of " discipline" , " discipline+ technology" and " comprehensive" . Physicians should be entitled to register separately as " discipline" and " discipline+ technology" as their practice scope, with " comprehensive" practice scope approved by a simple procedure of a notice.Conclusions:The setup and modification of the practice scope should be in a general rather than detailed manner, and conducive to the development of related disciplines. Such measures should also fully unleash the vitality of Chinese physicians, and take into account of both peacetime and emergencies, and both medical service and prevention.

Current setup and insights of the diagnosis and treatment subjects in medical institutions in China / 中华医院管理杂志

Objective:To study the current setup of diagnosis and treatment subjects in China and make reform suggestions in light of existing problems.Methods:Relevant documents on medical institutions′ diagnosis and treatment subjects setup were retrieved from such databases as CNKI, Wanfang and Weipu database, while relevant national policies, laws and regulations were reviewed. On-site visits were conducted to health committees and medical institutions in 7 provinces from June 2020 through December 2020. Seminars and special interviews were held with relevant management personnel and doctors of different positions, for the purpose of learning the current medical institutions′ diagnosis and treatment subjects and their suggestions for reform. Data gained from the above methods were summarized to arrive at reform suggestions for optimizing China′s medical institutions′ diagnosis and treatment subjects, with further improvement made based on expert consultation method.Results:Problems found focus on such areas as inconsistent setup standards for medical treatment subjects, multiple overlapping services, and unclear numbering rules. Based on the disease list and skill list of the DRG system, a novel diagnosis and treatment subject setup method guided by service items could be established. Otherwise, the numbering and categories could changed on the current basis to correct existing problems. The subjects could be divided into such five categories as clinical, oral, traditional Chinese medicine, medical technology, and comprehensive, with level-1 and level-2 subjects set up respectively.Conclusions:In terms of subject functions, the setup of diagnosis and treatment subjects should be regularly adjusted or filed, instead of complete equivalence with administratively licensed subjects. As the current setup of diagnosis and treatment subjects had been in place for years, and had become key references for the department setup and performance appraisal of medical institutions, it was proposed to make adjustment on the current basis for the purpose of correcting existing problems.

Selenoprotein thioredoxin reductase mediated menadione reduction: catalytic properties & inhibition effects / 生物工程学报

Thioredoxin reductase (TrxR) is one class of the most important antioxidant selenoproteins and is involved in regulating tumor genesis and progression. It has been reported that naphthoquinones can target and inhibit TrxR1 activity therefore produce reactive oxygen species (ROS) mediated by TrxR1, resulting into cellular redox imbalance and making the naphthoquinone compounds to become potential antitumor chemotherapy drugs. The purpose of this work is to explore the interaction between TrxR1 and menadione using biochemical and mass-spectrometric (MS) analyses, to further reveal the detailed mechanisms of TrxR1-mediated naphthoquinone reduction and inhibition of TrxR1 by naphthoquinone compounds. Using the site-directed mutagenesis and recombinantly expressed TrxR1 variants, we measured the steady-state kinetic parameters of menadione reduction mediated by TrxR1 and its variants, performed the inhibition analysis of menadione on TrxR1 activity, and eventually identified the interaction between menadione and TrxR1 through MS analysis. We found that Sec-to-Cys mutation at residue of 498 significantly enhanced the efficiency of TrxR1-mediated menadione reduction, though the Sec⁴⁹⁸ is capable to catalyze the menadione reduction, indicating that TrxR1-mediated menadione reduction is dominantly in a Se-independent manner. Mutation experiments showed that Cys⁴⁹⁸ is mainly responsible for menadione catalysis in comparison to Cys⁴⁹⁷, while the N-terminal Cys⁶⁴ is slightly stronger than Cys⁵⁹ regarding the menadione reduction. LC-MS results detected that TrxR1 was arylated with one molecule of menadione, suggesting that menadione irreversibly modified the hyper-reactive Sec residue at the C-terminus of selenoprotein TrxR1. This study revealed that TrxR1 catalyzes the reduction of menadione in a Se-independent manner meanwhile its activity is irreversibly inhibited by menadione. Hereby it will be useful for the research and development of naphthoquinone anticancer drugs targeting TrxR1.

Effectiveness of home service in rehabilitation of post-stroke patients on recovering period / 中华全科医师杂志

One hundred and fifty eight post-stroke patients in the recovering period were divided into intervention group (78 cases) and control group (80 cases).Patients in intervention group received home rehabilitation service provided by general practitioners (GP) for 6 months,while patients in control group received routine rehabilitation.After 6-months,the scores of self-rated health measurement scale (SRHMS) in intervention group were significantly higher than those of control group (P ＜0.01);the visiting time and frequency,medical costs and time of caregiving were decreased (P ＜ 0.01);and the satisfaction score of the patients in intervention group was 97％.The results show that home rehabilitation service can improve effectiveness of rehabilitation for post-stroke patient in recovering period.

Comparative study of superb microvascular imaging and contrast-enhanced ultrasound in differentiating thyroid micronodules / 中华超声影像学杂志

Objective To explore the value of superb microvacular imaging ( SMI) technology in differentiating thyroid microcarcinomas from benign micronodules comparing with contrast‐enhanced ultrasound (CEUS) . Methods A total of 195 thyroid micronodules ( ≤1 .0 cm) from 172 patients were examined using CEUS and SMI ,and the findings were reviewed and evaluated in comparison to the pathological results . Results Of all the 195 thyroid nodules ,pathologic findings revealed that 140 (71 .8% ) were malignant and 55 (28 .2% ) were benign ,CEUS diagnosed that 127 (65 .1% ) were malignant and 68 (34 .9% ) were benign ,and SMI diagnosed that 129 (66 .2% ) were malignant and 66 (33 .8% ) were benign . There were no differences between the SMI and CEUS in terms of sensitivity ( 90 .0% vs 87 .9% ) , specificity ( 94 .5% vs 92 .7% ) ,accuracy ( 91 .3% vs 89 .2% ) ,positive predictive value ( 97 .7% vs 96 .9% ) and negative predictive value ( 92 .9% vs 87 .9% ) ( P > 0 .05 for all) . Conclusions SMI can effectively observe the perforating blood vessels of thyroid micronodules , which plays an important role in differentiating of benign and malignant thyroid micronodules .

Application of two-dimensional ultrasound combined with three-dimensional imaging technology in the diagnosis of anal fistula / 中华超声影像学杂志

Objective To evaluate the clinical value of the real-time three-dimensional ultrasound in the diagnosis of the fistula-in-ano.Methods One hundred and eighteen fistula-in-ano patients were examined using conventional and three-dimensional ultrasound,the stereotaxis of interal opening and the shape of the fistula-in-ano were analyzed.Then the diagnosis results of ultrasound were compared with the surgery and pathology.Results In 1 1 8 patients,the accuracy of preoperative identifying internal opening by two-dimensional ultrasound was 85%,and 95% for three-dimensional ultrasound with statistically significant difference (χ2 =6.679,P <0.05).For complex anal fistula,the diagnostic accuracy rates of main fistula tract by three-dimensional ultrasound (100%,82/82 )was higher than that by two-dimensional ultrasound(95%,78/82),the difference was statistically significant (χ2 =4.100,P <0.05 ).In 82 cases of complex anal fistula,the diagnostic accuracy of branch fistula tract by two-dimensional ultrasound was 70%(57/82 ),the accuracy using three-dimensional ultrasound was 89% (73/82 ),there was statistically significance (χ2 =9.499,P < 0.05 ).Conclusions Three-dimensional ultrasound can accurately locate the interal opening of fistula-in-ano and determine the shape of fistula-in-ano,which provided the most intuitive information for clinical treatment and had high practical value.

MicroRNA-182 modulates high glucose-induced cardiomyocyte hypertrophy via targeting Rac1 / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the role and signalling of microRNA(miR)-182 on regulating high glucose-induced cardiomyocyte hypertrophy.</p><p><b>METHODS</b>The candidates of miR which might potentially be involved on targeting Rac1 were predicted by applying bioinformatics analysis. The expression of all related candidates miRs was verified by real-time reverse transcription-PCR (RT-PCR) in cardiac tissues of db/db mice and db/m mice. Then the relationship between candidates miR and Rac1 was investigated with Pearson relevant analysis. Neonatal mice cardiomyocytes were cultured and divided into 2 groups: normal glucose group and high glucose group. The level of selected miR and Rac1 in two groups was detected by RT-PCR. Neonatal mice cardiomyocytes were then randomly divided into 4 groups: normal glucose group, selected microRNA mimics control group, high glucose group, high glucose plus selected miR mimics control group. The morphology of cardiomyocyte in each group was detected under light microscope. Furthermore, Rac1, β-MHC and α-SMA expressions were detected in cultured cardiomyocyte treated by high glucose for 48 h after transfecting selected miR mimics by RT-PCR and Western blot.</p><p><b>RESULTS</b>A total of 6 miR candidates potentially targeting Rac1 were screened by bioinformatics, which were miR-182, miR-142-3p, miR-140, miR-101a, miR-429 and miR-200b. Among these candidates, miR-182 and miR-142-3p expression was significantly downregulated in cardiac tissues of db/db mice compared with db/m controls (P < 0.05). MiR-182 was negatively correlated with Rac1 by person analysis (r = -0.891 02). Downregulation of miR-182 and upregulation of Rac1, β-MHC, α-SMA were found in high glucose-induced cardiomyocyte. After transfection of miR-182 mimics, hypertrophic changes were significantly reduced and Rac1 as well β-MHC expression was significantly downregulated in cardiomyocyte incubated with high glucose.</p><p><b>CONCLUSION</b>MiR-182 might be involved in the regulation of high glucose-induced myocardial hypertrophy process via targeting Rac1.</p>

The usefulness of rapid diagnostic tests in the new context of low malaria transmission in Zanzibar.

BACKGROUND: We assessed if histidine-rich-protein-2 (HRP2) based rapid diagnostic test (RDT) remains an efficient tool for Plasmodium falciparum case detection among fever patients in Zanzibar and if primary health care workers continue to adhere to RDT results in the new epidemiological context of low malaria transmission. Further, we evaluated the performance of RDT within the newly adopted integrated management of childhood illness (IMCI) algorithm in Zanzibar. METHODS AND FINDINGS: We enrolled 3890 patients aged ≥ 2 months with uncomplicated febrile illness in this health facility based observational study conducted in 12 primary health care facilities in Zanzibar, between May-July 2010. One patient had an inconclusive RDT result. Overall 121/3889 (3.1%) patients were RDT positive. The highest RDT positivity rate, 32/528 (6.1%), was found in children aged 5-14 years. RDT sensitivity and specificity against PCR was 76.5% (95% CI 69.0-83.9%) and 99.9% (95% CI 99.7-100%), and against blood smear microscopy 78.6% (95% CI 70.8-85.1%) and 99.7% (95% CI 99.6-99.9%), respectively. All RDT positive, but only 3/3768 RDT negative patients received anti-malarial treatment. Adherence to RDT results was thus 3887/3889 (99.9%). RDT performed well in the IMCI algorithm with equally high adherence among children <5 years as compared with other age groups. CONCLUSIONS: The sensitivity of HRP-2 based RDT in the hands of health care workers compared with both PCR and microscopy for P. falciparum case detection was relatively low, whereas adherence to test results with anti-malarial treatment was excellent. Moreover, the results provide evidence that RDT can be reliably integrated in IMCI as a tool for improved childhood fever management. However, the relatively low RDT sensitivity highlights the need for improved quality control of RDT use in primary health care facilities, but also for more sensitive point-of-care malaria diagnostic tools in the new epidemiological context of low malaria transmission in Zanzibar. TRIAL REGISTRATION: ClinicalTrials.gov NCT01002066.

Establishment and evaluation of mild cognitive dysfunction models in elderly rats and roles of G proteincoupled receptor kinase 2 / 中华老年医学杂志

Objective To establish mild cognitive dysfunction (MCI) models in elderly rats,and to investigate the pathophysiological features.Methods Totally 40 SD rats (14 to 18-month-old) were randomly divided into 2 groups:the model group (n=20) and the sham operation group (n=20).Bilateral carotid artery stenosis was prepared in the model group while bilateral carotid artery was seperated with no bilateral narrowing in the sham operation group.30 days after the operation,Morris water maze test was performed,pathomorphological and electron microscopic observations of the cerebral tissue were examined and the expression of G protein-coupled receptor kinase 2(GRK2) in hippocampus tissue w detected by reverse transcription polymerase chain reaction (RT-PCR) and Western blottin.Results The mortality in model group was only 10％.Pathological morphology and ultrastructure showed that hippocampal tissue structure was almost normal in sham operated group,but in model group group,hippocampal CA1 pyramidal cells were in ischemic demyelination,arranged loose,and part of the cells showed nucleus pyknosis,deeply stained; there was no obvious infarct in white matter,part of the white matter fiher hecame thinner and disorder,nucleolus became smaller and steped aside,cytoplasmic electron density increased,lipofuscin appeared occasionally.Rough endoplasmic reticulum and Golgi were expanded,cytosolic free ribosomes increased,part of mitochondria became swelled,vacuolated.Morris water maze test results showed that the average escape latency in model group was longer than in sham group (P＜0.05).In spatial probe test,the average time of crossing the first original platform in model rats was significantly longer than the sham operated group [(36.80±7.68) s vs.(20.87±6.16)s,P＜0.05].The average number of crossing the original platform in 60 seconds in model group was significantly less than in sham group(1.43±0.51 vs.3.10±1.45,P＜0.05).The expressiones of GRK2 mRNA and protein in the hippocampus were significantly increased in model group rats than in sham group (P＜0.05).Conclusions The model of severe CCA stenosis in elderly rats can be applied for MCI animal models with good stability and repeatability.Compared with sham group,the cells morphology and ultrastructure in model group appeare more obvious pathological changes and mild impairments in cognitive function.GRK2 may play an important role in the development of MCI.

Differentiation of benign from malignant lesions of heart and pericardium: the feasibility of Fluorine-18 fluorodeoxyglucose positron emission tomography CT / 中华放射学杂志

Objective To assess the feasibility of integrated 18F-FDG PET-CT for the differentiation of malignancy from benign lesions of heart and pericardium. Methods A total of 23 cases (malignancy∶benign= 13∶10) with cardiac and pericardial lesions confirmed by pathology or clinic were analyzed in the present study. All lesions were evaluated semi-quantitatively using maximum standard uptake values (SUVmax) and SUVmax lesion/blood, and the density of the heart and pericardium lesions and the relationship with surrounding tissues were evaluated. The differences of SUVmax and SUVmax lesion/blood between benign and malignant lesions were analyzed using Mann-Whitney test. Subsequently, the diagnostic sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated for CT and PET-CT respectively. Results The maximum SUV showed significant difference between malignancy(6. 5 ) and benign ( 1.5 ) ( Z = - 3. 601, P ＜ 0. 01 ), the SUVmax Lesion/Blood of malignancy and benign were 3.4 and 0. 9 respectively, also with significant difference(Z = -3. 600, P ＜0. 01 ). The optimal cut-off value of SUVmax is 3.5-4. 0 and SUVmax Lesion/Blood is 1.3-2. 0. The sensitivity, specificity, accuracy, PPV and NPV of CT and PET-CT were 76. 9％ ( 10/13 ), 100. 0％ ( 10/10) ,87.0％ (20/23), 100. 0％ ( 10/10 ), 76. 9％ ( 10/13 ) and 100. 0％ ( 13/13 ), 90. 0％ (9/10), 95.7％(22/23),92.9％ (13/14),100.0％ (9/9) respectively. Conclusion 18F-FDG PET-CT can correctly differentiate benignity and malignancy of cardiac and pericardial lesions.

Prognostic value of heart rate turbulence in patients with chronic heart failure / 中华老年医学杂志

Objective To investigate the prognostic value of heart rate turbulence (HRT) in patients with chronic heart failure (CHF). Methods From October 2006 to May 2009, a total of 96 elderly CHF inpatients were selected, and the clinic data were recorded. Based on the echocardiogram and dynamic electrocardiogram, the differences of sinus HRT index of patients with different cardiac function classification were analyzed. During 9-28 months medical follow-up, the treatment endpoint was death from heart disease. Based on Logisitc regression, the prognostic values of HRT, age, hypertension, diabetes, myocardial infarction (MI), left ventricular ejection fraction, ACEI and β- adrenergic blocker for death of CHF patients were analyzed.Results There was no significant difference in HRT between grade Ⅱ and grade Ⅲ cardiac function (χ~2 = 1.60, P>0. 05), and between grade Ⅲ and grade Ⅳ cardiac function (χ~2 = 1.43, P>0. 05). But there was significant difference in HRT between grade Ⅱ and grade Ⅳ cardiac function patients χ~2 =9.84, P<0. 05), and HRT was weaken in grade Ⅳ group. The average follow-up time was (18. 0±9.6) months. Of all 96 patients, there were 34 dead of heart disease. There were correlations of death of CHF with HRT, low LVEF (≤ 45%), age (≥65 years), diabetes, MI and classification of heart function. Conclusions The sinus HRT in CHF patients has a favorable prognostic value.

Clinical study on dual antiplatelet therapy with ciopidogrel and aspirin in patients with ST-segment elevation acute myocardial infarction: a systematic review / 中华老年医学杂志

Objective To evaluate the effectivity and safety of dual antiplatelet therapy with clopidogrel and aspirin in patients with ST-segment elevation acute yocardial infarction(AMI).Methods We searched for randomized controlled trials(RCTs)and quasi-RCTs in the following electronic databases:PubMed,EMBASE,The Cochrane Library(Issue 3,2007),CBM,CNKI,VIP and Wanfang.Quality assessment and data extraction were conducted by two reviewers independently.Disagreement were resolved through discussion.All data were analyzed by using Review Manager 4.2. Results Ten studies involving a total of 52 433 participants met the inclusion criteria.Metaanalysis results showed that:(1)Compared with aspirin alone,the incidence rates of death caused by any reason(RR=0.91,95% CI:0.85～0.97),recurrent myocardial infarction(RR=0.80,95% CI:0.72～0.89),stroke(RR=0.81,95% CI:0.68～0.96),post-infarction angina(RR=0.35,95% CI:0.19～0.66),incoronary thrombus(RR=0.73,95% CI:0.64～0.83)and the combined endpoint events of death,reinfarction or stroke(RR=0.89,95% CI:0.84～0.95)could be reduced by clopidogrel and aspirin.(2)There were no significant differences in ameliorating the cardiac function and increasing TIMI blood flow of infarct-related artery between the two groups RR=0.97,95% CI:0.92～1.03;RR=1.14,95% CI:1.00～1.30;both P＞0.05.(3)There was no significant difference in bleeding between the tWO groups(RR=1.11,95% CI:0.92～1.34). Conclusions Compared with aspirin alone,clopidogrel plus aspirin has good effects on reducing the incidence rates of death caused by any reason,recurrent myocardial infarction,stroke,post-infarction angina,incoronary thrombus and the combined endpoint events of death,reinfarction or stroke in patients with ST-segment elevation AMI,and it has the same efficacy in ameliorating the cardiac function,increasing TIMI blood flow of infarct-related artery and bleeding.

Fiberoptic ductoscopy-guided intraductal biopsy for the diagnosis of intraductal lesions concomitant with pathologic nipple discharge / 中华普通外科杂志

Objective To investigate the clinical significance of fiberoptic ductoscopy-guided intraductal biopsy in diagnosing nipple discharge.Methods From May 2006 to April 2007,screening fiberoptic ductoscopy was performed for intraductal papillary lesions in 53 ducts among 51 patients.Fiberoptic ductoscopy-guided intraductal biopsy was carried out followed by open microdochectomy. Results Except for a failure in 5 ducts,biopsy found papilloma in 29 cases,ductal hyperplasia in 15 cases,severe ductal hyperplasia in 2 and carcinoma in 2.Microdochectomy revealed 43 benign diseases (12 solitary intraductal papillomas,12 multiple intraductal papillomas,and 25 ductal hyperplasia)and 4 malignancies (3 ductal carcinoma in situ,1 invasive ductal carcinoma).Surgeries performed for the 5 ducts failing a biopsy attempt revealed papilloma in one and adenosis in 4.Compared with conventional microdochectomy,fiberoptic ductoscopy-guided intraductal biopsy can significantly increase the detection rate of solitary papilloma(40.7% vs. 92.6%,P＜0.05).It might also underestimate multiple intraductal papilloma and breast cancer. Conclusion Fiberoptic ductoscopy-guided intraductal biopsy is microinvasive,safe,convenient with a high success rate,and could be as a routine procedure after intraductal lesion found by screening fiberoptic ductoscopy.

Effect of chemotherapy combined with amino acid on quality of life in elderly patients with non-small cell lung cancer / 中华老年医学杂志

Objective To investigate the effect of chemotherapy combined with amino acid on quality of life(QOL)in elderly patients with non-small cell lung cancer(NSCLC). Methods Seventy-four elderly patients with NSCLC were divided randomly into experimental group and control group.The same NP(cisplatin+vinorelbine)chemotherapy was carried out in all the 2 groups for 3 cycles.Except of chemotherapy,experimental group were treated with amino acid 500 ml/d in the same time,while control group recieved chemotherapy only.After 3 monthes,the QOL was analyzed using Chinese Version of European Organization for Researeh and Treatment of Cancer(EORTC)core questionnaire(QLQ-C30)and specific lung cancer module QLQ-LC13,and therapeutic effectiveness was evaluated according to WHO standard as well. Results After chemotherapy,the body function,mood function,social function were better in experimental group than in control group(all P＜0.05),the effective rate was 87.8%,83.8%and 77.0%in experimental group;77.0%,45.9%and 45.9%in control group.Insomnia(8.1%),suppressed appetite(5.4%),weary(47.3%)were less serious in experimental group than in control group(17.6%,17.6%and 59.5%)(all P＜0.05).The primary symptoms were cough,emptysis,thoracalgia and dyspnoea in both 2 groups before chemotherapy.All the symptoms were alleviated after chemotherapy.Some patients have side effects such as tongue pain,alopecie,hand and foot tingle.But the number of patients with tongue pain was less in experimental group(8.3%)than in control group(18.4%).The chemotherapy effect had no difference by the WHO standard. Conclusions The QOL of elderly patients with NSCLC can be improved by chemotherapy combined with amino acid treatment,and the treatment with amino acid 500 ml/d is safety.

Surgical treatment for gastric cancer in 1072 cases / 肿瘤研究与临床

Objective To analyze, the surgical treatment for gastric cancer. Methods Clinical data of 1072 patients with gastric cancer were analyzed retrospectively. Results The main clinical manifestations included upper abdominal pain(671 cases), difficulty in swallow(311 cases), appetite loss(187 cases),wasting or weight loss(158 cases), nausea and vomiting(97 cases), distention or upset(178 cases) and hematochezia (116 cases). 922 of 1072 patients (86 %) underwent resection, including 783 radical operation and 139 pauiative operation, including 239 proximal gastrectomy,361 distal gastrectomy and 322 total gastrectomy (jejunal interposition in 132 cases and "P"-Roux-en-y reconstruction in 200 cases). 92 cases received combined organs resection while 150 cases received exploratory laparotomy among them. D1 lymphadenectomy was performed for 86 cases and D2 lymphadenectomy 592 cases, D3 99 cases, and D4 6 cases. Stage Ⅰ accounted for 102 cases and stage Ⅱ269 cases, ⅢA 378 cases, ⅢB 172 cases, and stage Ⅳ 151 cases. The 1, 3,5 year overall survival rate were 74.6 %, 61.7 % and 41.1% in all cases but 83.1%, 65.2 % and 45.8 % in the group under radical treatment of gastric carcinoma. Conclusion To increase the survival rate and improve the quality of life,we shall pay attention to surgical procedure,digestive tract reconstruction,prevention of positive stump and postoperative complications in gastric cancer.

Effect of clopidogrel on intimal hyperplasia of rabit aorta injured by balloon / 中国介入心脏病学杂志

Objective To study the effect of clopidogrel on intimal hyperplasia of rabit arta injured by balloon and its mechanism.Methods Twelve New Zealand rabbits were established as atherosclerosis plaques rupture models and were evenly divided in to the high-cholesterol group and the clopidogrel group.Another 6 rabbits were set as the control.Serum cholesterol and triglyceride levels were taken in the beginning,before and after surgery.Meansurement alsincluded the changes in macrophage count and collagen levels in the plaques,changes of plasma fibrinogen and P-selectin levels as well as changes in activity of t-PA and PAI-1.The changes of intima thickness and the degree of stenosis were recorded.Results Compared to the control group,the high-cholesterol group and the clopidogrel group had higher average macrophages count and collagen levels in the plaques.The clopidogrel group had less macrophages count in the plaques than the high-cholesterol group;however,the clopidogrel group had higher levels of collagen in the plaques than the high-cholesterol group.The plasma level of P-selectin reduced in the clopidogrel group after plaques rupture.The activity of t-PA remained uncharged in the clopidogrel group but increased in the high cholesterol group.Compared to pre-treatment level,the activity of PAI-1 increased in the high-cholesterol group but reduced in the clopidogrel groups after atherosclerosis plaques rupture.The thickness of vessel intima increased in both the high-cholesterol group and the clopidogrel group,however,the degree of intima thickening and vessel stenosis is less in the clopidogrel group compared to the high-cholesterol group.Conclusion Clopidogrel relieves inflammation reaction by inhibitting thrombogenesis and the movement of macrophages in atherosclerosis plaques,thus minimizes the degree atherosclerosis and vessel intima hyperplasia.

Effect of simulated high way transportation on the quality of red blood cells / 中国输血杂志

Objectives To study the effect of highway transportation on the quality of red blood cells. Methods Highway transportation environment was simulated by random vibration test. Red blood cell suspensions and whole blood were vibrated for 120 minutes based upon GB/T 4857.23-2003 with the RMSVA of 0.38 and 0.52grms, as well as GJB 2711-1996 with the RMSVA of 1.04grms and weight loading of 60kg. Five ml of specimen were taken before the testing (as Control Group), and after the testing at 30mins' intervals (as Testing Group). K+, FHb and red blood cell osmotic fragility were tested. Results The red blood cell osmotic fragility of whole blood increased in 0.38grms, 90min and 0.52grms, 60min specimens (P