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Objective To study the effect of clopidogrel on different CYP2C19 genotypes and platelet reactivity in acute cerebral infarction patients with antiplatelet aggregation.Methods Four hundred and seventy-four cases of cerebral infarction patients in Beijing Tiantan Hospital Affiliated to Capital Medical University from April 2015 to April 2016 were collected.CYP2C19 genotype was determined,and the genotype was divided into the wild type group,the heterozygous type group and the mutant homozygous group.Platelet aggregation inhibition rate(ADP%) and platelet reactivity index induced by ADP were detected.Patients were divided into clopidogrel resistance group(group CR) and non resistant group according to whether ADP% was less than 30.SPSS 16.0 statistical software was used for statistical analysis,the comparison between groups using independent samples t test,chi square test and multivariate analysis using Logistic regression analysis,when P<0.05 difference was statistically significant.Results Among the 474 patients,204 cases(43.04%) were divided into wild-type group,and 204(43.04%) and 66(13.92%) were divided into the mutant heterozygous group and mutant homozygous group.In Chi square test analysis,clopidogrel resistance group and non resistance group CYP2C19 genotype distribution was significantly different(χ2=6.658,P=0.036).CR group angle(α) values((68.87±5.47)°) and MA((66.77±6.25) mm) were higher than that of CS group ((66.55±6.05)° and (63.30±5.66) mm,t=2.199,3.387,P=0.029,0.001).The multivariate logistic regression analysis showed that OR of angle level was 1.028,95%CI was 0.929-1.137 (P=0.595);OR of Ma level was 1.561,95%CI was 0.785-0.970 (P=0.012).Conclusion The effect of clopidogrel on platelet aggregation in patients with acute cerebral infarction is decreased by CYP2C19 gene mutation.CYP2C19 mutant allele is a risk factor for clopidogrel resistance.Angle (α) value and MA value are the risk factors for the diagnosis of CR in the patients with acute cerebral infarction,and the risk of clopidogrel resistance increased when the patients′ Angle (α) value and the value of MA increased.MA value as a predictor of CR and the screening tool has a certain value.
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Objective To discuss the X-ray characteristics of triple negative breast cancer(TNBC)for improving the diagnostic level.Methods 105 cases of TNBC which confirmed by pathology and immunohistochemistry were analyzed their X-ray performance and clinical pathology.Results (1)The main pathologic types of TNBC was infiltrating ductal carcinoma(64 cases,61.0%),secondly was medullary carcinoma(24 cases,22.9%).(2)The X-ray manifestations of this group were mainly the mass shape(78.1 %).Nearly half of them had clear edge(46.3%).And 24.4% were tumor with calcification.(3)The calcification in TNBC was rare and the distribu-tion mainly for regional or cluster,while the morphology was mainly for malignant and suspicious for malignancy.(4)The X-ray per-formance characteristics of infiltrating ductal carcinoma and medullary carcinoma in TNBC had differences in tumor morphology and edge(P <0.05).Conclusion (1)The X-ray manifestations were always the circular similarity of tumor with clear edge in TNBC.(2) The proportion of medullary carcinoma is larger in TNBC,and the X-ray manifestations is more likely show as benign lesions.(3) The calcification probability is lower in TNBC,and the calcification form is mainly as suspicious for malignancy and malignant.
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Objective To investigate the immune cell population change during the anesthesia process in patients undergoing craniotomy surgery. Methods A total of 18 patients undergoing craniotomy who had an inhalational general anesthetic were selected as our subjects. Blood samples were collected before anesthesia (T0)and 30 min(T1),45 min(T2),60 min(craniotomy operated,T3),120 min(tumor resected,T4)and 240 min(T5)after anesthesia. Blood cell counts including neutrophils,monocytes and lymphocytes were determined along with lymphocyte subpopulations( T cells,inducer and helper T cells,suppressor and cytotoxic T cells,NK cells,B cells ). Data were analyzed by SPSS 13. 0 software. Results In terms of the immune cell during neuroanesthesia,induction neutrophils,monocytes and lymphocytes decreased significantly from( 4. 50 ± 2. 00 ) × 109/L(,0. 51 ± 0. 22)× 109/L,(1. 90 ± 0. 70)× 109/L to(3. 10 ± 1. 50)× 109/L,(0. 32 ± 0. 17)× 109/L, (1. 10 ± 0. 50)× 109/L at the 30 min after anesthesia,and the differences were significant( P﹤0. 05). It also showed that Ts and NK cells decreased significantly from( 0. 55 ± 0. 29 )× 109/L,( 0. 32 ± 0. 14 )× 109/L to (0. 33 ± 0. 22 )× 109/L,( 0. 10 ± 0. 08 )× 109/L at the 30 min after anesthesia,and the differences were significant( P﹤0. 05 ). Conclusion Special and non special immune system are inhibited during craniotomy, especially at the early anesthesia. Among the inhibited immune cells,neutrophils recover early and followed Ts and NK cells.
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Objective To analyze the prevalence of human papilloma virus(HPV) and the relationship between HPV and vaginal environment in puerperium women.Methods One thousand and twenty-nine cases puerperium women were detected for HPV subtype by using nucleic acid flow-through hybridization.Patients with HPV positive had been considered as observe group and the rest as control.The prenatal infection of HPV of HPV-DNA positive and negative postpartum puerperium women, and the vaginal cleanliness of prenatal and postpartum were analyzed.Results In 1 029 cases puerperium women, the total HPV-DNA positive rate was 10.30％(106/1029) ,and high risk infection rate was 95.65％ (110/115).The rate of HPV positive before pregnant in HPV positive group (46.51％, 40/86) was higher than that in HPV negative group (9.09％, 10/110).There was significant difference of vaginal environment in the two groups (x2 =36.567, P＜0.05).In HPV-DNA positive and negative women during the puerperium vaginal cleaning degree of Ⅰ , Ⅱ ratio prenatal respectively were 56.98％ (49/86) and 76.36％ (84/110), and the difference was significant (x2 =8.317, P ＜0.05).Postpartum to 45.35％ (39/86) and 60.00 (66/110), and the difference was significant (x2 =3.941, P＜0.05).Conclusion The HPV infection of pregnant women are easy to getagain.There is relevance between HPV infection and vaginal environment.
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Objective To evaluate the correlation of Omentin-1, the high sensitivity C-reactive protein (hsCRP) and coronary heart disease (CHD). Methods Sixty-eight patients with CHD were divided into the unstable angina pectoris (UAP) group (n=36), stable angina pectoris (SAP) group (n=32). And 30 normal subjects without CHD diagnosed by coronary arteriography (CAG) were served as the control group. The serum level of Omentin-1 was measured by enzyme linked immu-nosorbent assay (ELISA) and the serum level of hsCRP was measured by turbidmetric immunoassay. Results The serum level of Omentin-1 was significantly lower, but the serum level of hsCRP was significantly higher in CHD group than that of control group (P0.05). The serum level of Omentin-1 was significantly lower in patients with single, double and three-vessel lesion group than that of control group, but the serum level of hsCRP was significantly higher in CHD group than that of control group (P0.05). The se-rum level of Omentin-1 was negatively correlated with serum level of hsCRP (P<0.01). Conclusion The serum level of Omentin-1 and hsCRP may correlate with CHD, but which may not reflect the severity of artery stenosis.
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Objective To investigate the relationship between the differential expressing characters of metastasis-relating genes in the nasopharyngeal primary cancerous tissues of untreated nasopharyngeal carcinoma (NPC) cases and the patterns in the terms of Traditional Chinese Medicine (TCM) manifested by these patients. Methods Forty one untreated NPC cases included were differentiated for their own patterns respectively at first and biopsys were made to take tissue samples from the nasopharyngeal mass of them for histopathological diagnosis. Furthermore, expressing level determination of metastasis-relating genes nm23-H1 and VEGF165 was carried out among these samples to analyze the correlation of expressing activity of these genes with their firstly differentiated patterns respectively. Results The expressing level of nm23-H1 was significantly lower in the biopsied tissue samples of nasopharyngeal primary focus among the untreated NPC cases with a pattern of dual deficiency of Qi and Yin than those with the other two kinds of pattern, while the expressing level of VEGF165 was in a reverse way to that of nm23-H1 in its activity expression among these cases with the same kind of pattern (P