Abstract:Objective To screen for a fetal liver specific oncofetal RNA and to study its effect on the proliferation and mobility of hepatocellular carcinoma (HCC) cells. Methods By overlapping the microarray results of mouse fetal liver and regenerated liver following partial hepatectomy (PH), we obtained several candidate lncRNAs which were highly expressed in both fetal liver and regenerated liver tissues, and then the expression of these candidate lncRNAs in HCC tissue were also detected. The most differentially expressed lncRNA in the mouse HCC tissues as detected by real-time PCR were chosen for further research. By real-time PCR,the expression of those lncRNA in fetal liver and regenerated liver tissue was verified. For the function study, EdU labeling system and Transwell experiment were carried out to determine the proliferation ability and mobility after knocking down the lncRNA by siRNA transfection in HCC cell line Hepa1-6. Results Seven candidate lncRNAs which were highly expressed in both fetal liver and regenerated liver tissues were obtained; 3 of them were overexpressed in HCC tissues compared with normal liver tissues, 3 had no differential expression, and 1 was undetectable. Among the 3 overexpressed lncRNAs, lncRNA-AK003710 was the most differentially expressed lncRNA according to microarray and real-time PCR results. And then we detected that lncRNA-AK003710 was overexpressed in the fetal liver and 3 kinds of injured liver tissues. Furthermore, the proliferation ability and mobility of Hepa1-6 were impaired after knocking down lncRNA-AK003710 in HCC cell line Hepa1-6. Conclusion lncRNA-AK003710 is overexpressed in the fetal liver, regenerated liver tissues, and HCC tissues; therefore it is an oncofetal RNA that can regulate the proliferation and invasion of HCC cells and may be a potential therapeutic target for HCC.

Abstract:Objective To verify the presence and location of the NLS-RARα protein in the peripheral blood tumor cells of patients with acute promyeolic leukemia (APL). Methods Western blotting analysis was used to identify the NE enzyme in the peripheral blood tumor cells of APL patients. The nucleoprotein in tumor cells was prepared and NLS-RARα protein was detected by Western blotting analysis. The expression and location of NLS-RARα protein in peripheral blood tumor cells of APL patients were examined by FITC/DAPI double immunofluorescence staining and FITC/PI double staining laser confocal microscopy. The expression and location of NLS-RARα protein in NB4 cells infected with recombinant adenovirus Ad-NE was used as positive control and those of wildtype RARα in the neutrophils of healthy controls were taken as negative control. Results Positive control was successfully established. NE enzyme and NLS-RARα protein were expressed in peripheral blood tumor cells of APL patients. Immunofluorescence and laser confocal findings indicated that NLS-RARα protein was mainly located at the nuclei of peripheral blood tumors cells in APL patients. Conclusion NLS-RARα protein has been successfully detected by 3 different methods in the peripheral blood tumor cells of APL patients and its intracellular location has also been proposed, which can contribute to the early diagnosis and recurrence monitoring of APL.

Abstract:Objective To study the effect of basic fibroblast growth factor (bFGF) of different concentrations on phenotypes and dedifferentiation of rabbit chondrocytes in porous tantalum-chondrocyte composites in vitro, so as to provide theoretic basis for cartilage defect repair. Methods The articular chondrocytes from 3-week-old rabbit were cultured and identified by type Ⅱ collagen immunocytochemistry and Safranin O staining. The 3^rd generation chondrocytes were implanted in the porous tantalum and was treated with bFGF of various concentrations. The bFGF-chondrocyte-porous tantalum composites (bFGF compostes) were then divided into 5 groups: group A (1 ng/mL bFGF composites), group B (10 ng/mL bFGF composites), group C (50 ng/mL bFGF composites), group D (chondrocyte-porous tantalum), and group E (pure chondrocyte). The proliferation of chondrocytes was measured by MTT and the cell morphology and growth were observed by scanning electron microscopy (SEM). Phenotypes and dedifferentiation (type Ⅰ, Ⅱ, Ⅸ, and Ⅹ collagen) of the chondrocytes were detected by immunocytochemical method. Type Ⅱ and Ⅹ collagen mRNA was tested by real-time PCR. Results Type Ⅱ collagen immunocytochemistry and Safranin O staining were positive, confirming that the cultured cells were chondrocytes. MTT results showed that chondrocyte proliferation in groups A, B, C, and D were significantly greater than that in group E (P<0.05), with the most significant proliferation promoting effect seen at 10 ng/mL; significant difference was also found between different groups (P<0.05). SEM observation: the chondrocytes grew adherently on the surface of the scaffolds and within scaffold pores, in the early stage the chondrocytes were spherical, after 24 h the chondrocytes stretched, lengthened, and extended pseudopodia gradually over time, and the chondrocytes connected with each other across the pores and covering the scaffold. Immunocytochemical staining showed that collagen Ⅱ and Ⅸ expressions were significantly stronger in 10 ng/mL bFGF-tantalum-chondrocytes group (group B) compared with the control group (group E, P<0.05), and there were significant differences between different groups (P<0.05); while collagen Ⅰ and Ⅹ expressions were significantly weaker compared with the control group (P<0.05). Expression of collagen type Ⅱ mRNA in the chondrocytes was significantly up-regulated in group A, B, C, and D compared with group E (P<0.05), and collagen type Ⅹ gene was significantly down-regulated (P<0.05). Conclusion bFGF can maintain chondrocyte phenotype in tantalum-chondrocyte composites, inhibit dedifferentiation and promote the secretion function of chondrocytes.

Abstract:Objective To establish miRNA knockout mouse model using CRISPR/Cas9 gene targeting technology. Methods According to the gene sequence of miRNA, we designed the primers of the gRNA targeting miR-301a (two targets) and obtained DNA template for in vitro transcription using PCR amplification; then we constructed Cas9 template for in vitro transcription, followed by in vitro transcription for gRNA of Cas9. In vitro transcribed gRNA/Cas9 mRNA was microinjected into the mouse zygote. T7E1 digestion and gene sequencing were used to detect and characterize the mutation of miRNA. Results PCR amplification, gel electrophoresis and gene sequencing proved that we had obtained the correct DNA template targeting miR-301a for in vitro transcription. By in vitro transcription we obtained gRNA/Cas9 mRNA, which was successfully microinjected into mouse zygote. The miR-301a mutants were detected by digestion with T7E1, and it was found that 7 of the 8 (87.5%) neonatal mice were found carrying mutations in miR-301a sites. Gene sequencing results showed that all mice had different levels of nucleotide insertion or deletion mutation, with the maximum number of 31 bases deletion found in No.4 mouse. Conclusion We have successfully established a mouse model with miR-301a gene knocked out, which lays a solid foundation for related future research.

Abstract:Objective To investigate the alterations of the amplitude of low frequency fluctuation (ALFF) by the resting-state fMRI in first-episode major depressive disorder (MDD) patients, and to analyze the relationship between brain area of different ALFF alterations with their aggressive behaviors. Methods Thirty first-episode MDD patients receiving no treatment or stopping treatment for 2 weeks and 30 sex-, age-, and education-matched healthy controls were included in this study. All the participants were scanned with 3.0 T resting-state fMRI scanner and the blood oxygenation level dependent (BOLD) signals were acquired to calculate the amplitude of low frequency fluctuation (ALFF). Then we examined the differences in ALFF findings between the two groups and the correlations between the scores of aggressive behavior and ALFF in the brain areas showing significant group differences. Results Our results showed that MDD patients had significantly increased ALFF in the left insula, parietal lobe sub-gyral, precentral gyrus, and the right superior temporal gyrus, precentral gyrus, and inferior frontal gyrus compared with the health controls (P<0.001, corrected by Alphasim); while they had decreased ALFF in the left thalamus, precuneus and right lingual gyrus, and fusiform gyrus (P<0.001, corrected by Alphasim). The correlation analysis indicated that the increased ALFF in the left precentral gyrus was positively correlated with the scores of physical aggression, self-aggression, and total score of aggressive behaviors (r=0.41, 0.49, 0.39, P<0.05 or 0.01). The increased ALFF in the right inferior frontal gyrus was negatively correlated with anger (r=-0.44, P<0.05). Conclusion Spontaneous abnormal neural activities exist in some brain regions of MDD patients in the resting-state fMRI, and the increase of ALFF in regions of frontal is closely related to the aggressive behaviors of patients.

Abstract:Objective To explore the value of the apparent diffusion coefficient (ADC) ratio and fractional anisotropy (FA) ratio of magnetic resonance (MR) diffusion tensor imaging (DTI) in evaluating the clinical symptoms, prognosis of cervical spondylotic myelopathy (CSM). Methods Thirty-six healthy subjects and fifty CSM patients were involved and received MRI examination. Regions of interest (ROIs) were selected in the ventral funiculus (VF), lateral funiculi (LF), dorsal funiculus (DF), and central gray matter (GM) for ADC and FA measurements. In the control group, ADC and FA ratios were calculated using the original values at the C_3/4, C_4/5, C_5/6, and C_6/7 levels to divide the corresponding values at their C_1/2 levels. In the CSM group, ADC and FA ratios were calculated using the ADC and FA values at the most compressed levels to divide the corresponding values at their C_1/2 levels. In the control group, the variances of the two ratios were compared between different cervical levels and ages. CSM patients were divided into mild, moderate, and severe group according to the preoperative Japanese Orthopaedic Association (JOA) scoring system, and were divided into well, moderate, and poor group according to the postoperative JOA recovery rates. Correlations between DTI parameters, DTI ratios of the VF, LF, DF, and GM of the CSM patients and the JOA scores, JOA recovery rates were assessed among different clinical symptom subgroups and prognosis subgroups. Results In control group, DTI ratios (ADC ratios and FA ratios) in VF, LF, DF, and GM were significantly different between C_3/4, C_4/5, C_5/6, and C_6/7 levels(P<0.05), but not found between different age subgroups. Correlations between DTI ratios of the VF, LF, DF, and GM and JOA scores, JOA recovery rates were significantly superior than the correlations between DTI parameters and JOA scores, JOA recovery rates (P<0.05 or P<0.01), with the FA ratio being superior to the ADC ratio. Compared with normal control group, the ADC ratios increased gradually in order and FA ratios decreased gradually in the mild, moderate, and severe injury subgroups (P<0.05). Compared with normal control group, the ADC ratios increased gradually in order and FA ratios decreased gradually in the well, moderate, and poor recovery subgroups(P<0.05). Conclusion DTI ratios might eliminate the influence of age in evaluating the clinical symptoms and prognosis of CSM. Therefore DTI ratios, compared with DTI parameters, may better evaluate the clinical symptoms, prognosis of CSM.

Abstract:Objective To investigate the association of proximal and distal resection margin (PRM/DRM) distances in R0 gastrectomy with the prognosis of gastric cancer patients with no distant metastases. Methods From Jan. 2008 to Nov. 2009, a total of 288 patients with gastric cancer were selected; they received radical and R0 gastrectomy, with pathological diagnosis after surgery and with complete pathological and follow-up data. The relationship of the pathological parameters with the PRM, DRM distance was analyzed. Univariate and multivariate analyses were performed to indentify the independent risk factors of prognosis and to evaluate the association between PRM, DRM distance and overall survival (OS). Results Increased PRM distance was significantly correlated with tumor location at the lower third of the stomach (P<0.001). Increased DRM distance was significantly correlated with an early T-stage (P=0.044 2), tumor location at the middle third of stomch (P=0.008 4), smaller tumor size (P=0.024 1), normal preoperative serum markers (P=0.013 2) and total gastrectomy (P=0.001 7). Univariate analysis showed that PRM distance (P=0.650) and DRM distance (P=0.095) were not significantly correlated with gastric cancer survival, and they did not significantly influence locoregional recurrence or distant recurrence. Multivariate analysis showed that the independent prognostic factor for gastric cancer included N-stage, tumor location, tumor size, and presence of lymphatic invasion; also PRM distance (P=0.650) and DRM distance (P=0.095) had no significant influence on the survival of gastric cancer patients. Subgroup analysis showed that PRM distance had no significant influence on the overall survival (P=0.312) in N-stage N₀+N₁ group, but DRM distance had significant difference on the overall survival (P=0.011) in N₀+N₁ group. Conclusion PRM and DRM distance are not the independent risk factors for the overall survival of gastric cancer patients undergoing R0 gastrectomy. DRM distance of more than 2 cm can markedly improve the prognosis of the patients with less than 3 metastatic lymph nodes.

Abstract:Objective To explore the clinical significance of urine microalbuminuria (U-ALB) and blood fibrinogen (Fb) and hemoglobin (Hb) levels in retinopathy of patients with type 2 diabetes mellitus (T2DM). Methods From Jan. 2010 to Sep. 2014, a total of 101 T2DM patients who were treated in our hospital were enrolled in this study. According to whether combined with retinopathy the patients were divided into 2 groups: non-complication group (49 cases) and diabetic combined with retinopathy group (DR-complication group 52 cases, 38 patients with non-proliferative DR and 12 cases with proliferative DR). In addition, 50 healthy subjects were enrolled as controls. All the participants were examined for BMI, fasting blood glucose, and blood pressure. The urinary U-ALB level and blood Fb/Hb were also determined. Results The urine U-ALB level of T2DM patients was significantly higher than that in healthy subjects, and that in DR-complication group was significantly higher than that in the non-complication group (all P<0.01). Plasma Fb level in T2DM patients was significantly higher than that in healthy subjects, and that in the DR-complication group was significantly higher than that in the non-complication group (all P<0.01). Hb level in healthy subjects was significantly higher than that in patients with type 2 diabetes, and that in the DR-complication group was significantly lower than that in the non-complication group (all P<0.01). Compared with the non-proliferative DR patients, the changes of urine U-ALB and blood Fb/Hb in the proliferative DR patients were significantly greater(P<0.01). Conclusion Urine U-ALB level and blood Fb and Hb levels are changed in patients with type 2 diabetes mellitus, and the changes are even greater in those complicated with diabetic retinopathy.

Abstract:Objective To systematically review the clinical trials examining the effects of inulin-type fructans on 3 major atherosclerosis associated blood lipid profiles, so as to provide references on dietary strategy for atherosclerosis prevention. Methods Relevant literatures were comprehensively searched in PubMed, Embase, CNKI, CBM, VIP, and Wanfang Databases. Eligible studies were selected according to the inclusion and exclusion criteria. Then the quality evaluation (JADAD scale) and data extraction were conducted. Meta-analysis and publication bias were performed using software Stata 11.0. Results Twenty-two studies were finally included in this study, involving a total of 822 cases, with 413 in the treatment group and 409 in the control group. The results of the meta-analysis showed that the pooled WMD (95% confidence interval) of inulin-type frutans' effect on HDL-C, TG, and LDL-C were 0.05 (0.01,0.08) mmol/L, -0.08 (－0.14,－0.01) mmol/L and -0.16 (－0.25,－0.06) mmol/L, respectively. Subgroup analysis results revealed that TG level decreased dramatically by 0.17 mmol/L in the dyslipidemia group (P<0.05). In the diabetes group, a noticeable increment of 0.15 mmol/L was found for HDL-C and a reduction of 0.30 mmol/L was found for TG (P<0.05). In addition, no significant changes were found for other parameters of the blood lipids. Conclusion Daily intake of proper amount of inulin-type fructans can increase serum HDL-C level and decrease TG and LDL-C levels, which is especially beneficial for dyslipidemia and diabetic patients.

Abstract:Coagulopathy is common in patients with traumatic brain injury (TBI). It is associated with the dysfunction of the normal clotting-anticoagulant-fibrinolytic system, with unknown pathogenesis. Recently a large number of studies have confirmed that the prognosis of TBI patients is closely related to coagulopathy of these patients at admission. Most prospective studies have also found that several coagulation abnormalities indicate poor prognosis. However, whether there is a cause and effect relationship between coagulopathy and prognosis of TBI patients, whether correcting abnormal coagulation parameters can improve the prognosis, all remain to be illuminated. Here we reviewed the related issue and hope to lay a foundation for future researches.

Abstract:Chronic kidney disease (CKD) is a common disease with an estimated prevalence of 10%-16% in the general population. With high mortality and high risk of cardiovascular disease, CKD imposes substantial cost burden. Recent studies have shown that neutrophil gelatinase-associated lipocalin (NGAL) is tightly associated with CKD, suggesting that it has an important role in the diagnosis, treatment and monitoring of CKD. This paper reviewed the progress in the biological function, originality, structure, and role in CKD of NGAL.

Abstract:The incidence of calcific aortic valve disease (CAVD) has increased dramatically as a result of the decline in rheumatic fever and the increase of the aging population, and by now CAVD has become the most common cardiac valve disease in the elderly in China. CAVD used to be thought as an irreversible passive process relating to valve degeneration and calcium accumulation. However, latest research has shown that CAVD is a complex active process, which involving vascular endothelial injury, lipid infiltration, chronic inflammation, matrix remodeling, cell differentiation, progressive bone formation, and neovascularization. Besides, genetic mutation also play a significant role in the process. Novel therapeutic target and technology such as transcatheter aortic valve implantation have been developed, which casts new lights on CAVD prevention and treatment. This review focused on the current understanding of the pathogenesis and future diagnosis/therapies of CAVD.

Abstract:Hepatoblastoma is the most commonly-seen liver tumor in children. The past 30 years has witnessed graduall changes in the diagnosis and treatment of HB: from single operative excision to multimodality therapies. Recently many research groups have focused on the risk groups and stratified treatment, looked for novel potential prognostic risk factors. This paper reviewed the etiology, clinical diagnosis, criterion of risk groups, treatment principle, and prognosis factors of hepatoblastoma in children.

Abstract:Objective To observe the changes of the neuropeptide S (NPS) expression in dorsomedial nucleus of rat hypothalamus after rapid eye movement (REM) sleep deprivation. Methods Totally 24 adult male rats were evenly randomized into 3 groups: normal control group (CC), tank control group (TC) and REM sleep deprivation group (SD). Modified multiple platform method (MMPM) was used to establish REM sleep deprivation model in rats. Immunohistochemistry and hybridization in situ were applied to examine the expression of NPS protein and mRNA in the rat hypothalamus. Results There was no significant differences in the expression of NPS protein or mRNA in rats hypothalamus between CC group and TC group. After REM sleep deprivation, NPS protein and mRNA positive cells in rats hypothalamus in SD group were (27.86±2.47) and (25.75±2.12), respectively, which were significantly more than those in CC group and TC group (16.75±2.12 and 19.63±1.85 in CC group, 18.60±1.60 and 18.50±1.69 in TC group; P<0.05). Conclusion The expression of NPS is increased in the awakening region of rat hypothalamus after REM sleep deviation, suggesting that NPS might be related to the sleep awakening mechanism.

Abstract:Objective To observe the biocompatibility of bacterial cellulose and Schwann cells during in vitro co-culture, so as to lay a foundation for preparing tissue-engineered nerve with bacterial cellulose. Methods The bacterial cellulose was co-cultured with the dorsal root ganglion. The morphology, proliferation, and migration of the Schwann cells were examined by scanning electron microscope and optical microscope at day 1, 2, and 5, and the protein expression of S-100 was detected by immunocytochemical method. Schwann cells were also cultivated in the leach liquor of bacterial cellulose, and then optical microscope and immunocytochemical were used to observe the morphology and S-100 protein expression after 24, 48 and 72 hours; MTT and flow cytometry were used to evaluate the biocompatibility of the bacterial cellulose and Schwann cells. Results Schwann cells could grow and migrate on the surface of bacterial cellulose's membrane. The Schwann cell growth, proliferation and S-100 expression were not significantly affected by the leach liquor of bacterial cellulose as compared with the control group. Conclusion Schwann cells can grow well on the surface of the bacterial cellulose membrane and in its leach liquor, suggesting good biocompatibility with bacterial cellulose in vitro.

Abstract:Objective To assess the safety and efficacy of endovascular treatment for basilar tip aneurysms associated with moyamoya disease. Methods Seven patients with basilar tip aneurysms associated with moyamoya disease were treated by endovascular embolization in our department between Oct. 2006 and Jul. 2013. Two patients were treated by pure coiling and the others were treated by stent-assisted coiling. The immediate angiographic result was evaluated by Raymond scale. Postoperative angiographic and clinical follow-ups were obtained in all the 7 cases, and the clinical outcomes were evaluated by the modified Rankin score (mRS). Results All the 7 patients successfully received endovascular embolization without procedure-related complications. Immediate angiographic results showed complete occlusion in 3 cases, neck residual in 2, and partial occlusion in 2. Postoperative angiographic follow-ups were obtained for a mean of (10.4±3.5) months, with complete occlusion found in 6 patients and stable in 1 patient. No progressive thrombosis or in-stent occlusion were detected by follow-up angiograms in the stent group. Clinical follow-ups were obtained for a mean of (21.1±15.8) months and all the patients reported good outcomes (mRS 0-2). Conclusion Our data suggest that endovascular embolization is a safe and efficient treatment for basilar tip aneurysms associated with moyamoya disease. Stent-assistance might be a safe and effective option for the large or wide-necked aneurysms, though the long-term safety still remains to be confirmed.

Abstract:Objective To observe the clinical effects of frontal muscular flap suspension surgery in the treatment of unilateral severe blepharoptosis. Methods Totally 23 patients with unilateral severe blepharoptosis received frontal muscular flap suspension surgery, including 9 males and 14 females, with 12 in the left side and 11 in the right side. Results Nineteen patients (82.61%) were corrected satisfactorily and 4 (17.39%) were corrected basically, with no failure cases. During a follow-up of 6 months, the eyelids restored to the normal positions in all the 23 cases, with good facial function, flexible movement, and appropriate, symmetrical palpebral fissure, and with no complications. Conclusion Frontal muscular flap suspension surgery is a safe, effective operation for unilateral severe blepharoptosis; it can correct the deformity, restore the eyelid function, improve the cosmetic appearance and has less complications.

Abstract:Objective To investigate the effect and safety of flurbiprofen axetil preemptive analgesia for patients undergoing laparoscopic cholecystotomy. Methods Sixty patients of ASAⅠ-Ⅱ undergoing selective laparoscopic cholecystotomy were randomly assigned to two groups: either to receive flurbiprofen axetil 100 mg (flurbiprofen axetil group, n=30)or normal saline 10 mL (control group, n=30) before operation. Postoperative pain was treated by patient-controlled intravenous fentanyl analgesia. The extubation time, recovery time, and sedation-agitation scale (SAS) scores were estimated immediately after anesthesia. Postoperative fentanyl doses, side effects and the visual analgesia scale scores were recorded at 0,2,4,6,12, and 24 h after operation. Results The SAS score, VAS scores immediately after extubation and at different time points after operation in flurbiprofen axetil group were significantly lower than those in control group (P<0.05). The flurbiprofen axetil group had significantly lower total dose of fentanyl (0-24 h after surgery) and significantly less nausea and vomiting than the control group (P<0.05). There were no significant differences in the extubation time and recovery time between the two groups. Conclusion Flurbiprofen axetil preemptive analgesia can alleviate acute postoperative pain of laparoscopic cholecystotomy, with no obvious adverse effect and without increasing the recovery time, making it worth popularizing in clinical practice.

Abstract:Objective To analyze the risk factors of venous thromboembolism (VTE) in elderly patients with diffuse large B-cell lymphoma (DLBCL). Methods A total of 142 elderly DLBCL patients who were treated in our hospital from Jun. 2003 to Oct. 2013 were included in the present study. The relationship of VTE with gender, body mass index (BMI), physical score (ECOG-PS), tumor stage, lactate dehydrogenase level, hypertension, diabetes, hemoglobin level, white blood cell count, and platelet count were analyzed. The efficacy of current treatment of thrombosis was also analyzed. Results Univariate analysis showed that PS score≥2 (P=0.027), IPI points=3-4 (P=0.051), and non-CR after 3-4 cycles of chemotherapy (P=0.016) were risk factors for thrombosis in elderly DLBCL patients; multivariate analysis displayed that PS score≥2 and non-CR after 3-4 cycles of chemotherapy were independent risk factors for thrombosis (P<0.05). Conclusion PS score ≥2 and non-CR after 3-4 cycles of chemotherapy are the independent risk factors for thrombosis in elderly DLBCL patients.

Abstract:Objective To investigate the eurative effect and safety of oxaliplatin plus capecitabine with subsequent capecitabine maintenance chemotherapy for patients with advanced gastric cancer. Methods A total of 32 patients were enrolled into this study, they received first line oxaliplatin plus capecitabine (XELOX) chemotherapy. Patients without tumor progression were assigned to the group with capecitabine maintenance chemotherapy. Results: The response rate (RR) of first-line chemotherapy was 46.9% (15/32); 26 patients entered the capecitabine maintenance chemotherapy group, RR was 26.9% (7/26). The median PFS of whole group was 8.9 months, 1 and 2 year survival rate were 56.2% (18/32) and 31.2% (10/32), respectively. The main adverse reactions were nausea, vomiting, diarrhea, bone marrow suppression, neurotoxicity and hand foot syndrome, which can be tolerated. Conclusion XELOX regimen chemotherapy followed by capecitabine maintenance therapy for advanced gastric cancer patients is effective and safe, while bring a certain degree of survival benefit.

Abstract:Antiplatelet therapy is the cornerstone of treatment in patients with coronary heart disease . Currently its medical routine for patients who received PCI take dual antiplatelet therapy of aspirin and clopidogrel. Due to genetic polymorphism and other reasons, some patients appeared clopidogrel resistance leading to poor antiplatelet effect. Ticagrelor is a new antiplatelet drug different from past P2Y12 receptor antagonis, its better oral absorption rate and bioavailability, without metabolic activation by liver enzymes showed good characteristics to inhibit platelet aggregation. Large-scale clinical studies have shown tha ticagrelor was superior to clopidogrel in patients with acute coronary syndrome. Because of its short time usage in China, the mechanism for the occurrence of dyspnea was not widely known. And the dealing experience to dyspnea is still lacking. Therefore, this paper reported 10 cases of patients with dyspnea after treatment of ticagrelor, retrieved literature finding the odds ratio for ticagrelor was 1.93 times compared with clopidogrel, and discussed the mechanism of dyspnea.