Objective To explore the clinical characteristics and effects of thrombolytic and anti coagulation treatment in over 70 year old patients with pulmonary thromb embolism(PTE). Methods The clinical findings, diagnostic techniques, effects of thrombolytic therapy and anti coagulation in 58 over 70 year old patients with PTE were analyzed retrospectively. Results Deep venous thrombosis (DVT) in lower limbs (74 1%) was the most common thrombolism prone factors in our study. Limitation of movement and long term stay in bed due to a variety of causes were in the next place. The clinical findings were atypical, associated with a false diagnostic ratio of 46 5% in elderly patients with PTE. Undefined causal and different degree of dyspnea along with sudden and persistent hypoxemia were the main characteristics. Spiral CT and radioactive nuclear ventilation perfusion scan were important methods for diagnosis of PTE with positive finding of 95 7% and 62 5%, respectively. The effective and cure rate of thrombolytic therapy combined with anti coagulation, anti coagulation and anti platelet therapy was 91 3%, 75 8%, 0 and 47 8%, 17 2%, 0, respectively. Conclusions The most common risk factors of PTE in the elderly was DVT and the long term stay in bed or stay without active moving. The clinical symptoms were not only atypical but also variable. Thrombolytic with anti coagulation therapy is safe and effective, but anti platelet coagulation alone is not benefit.

BACKGROUND:It is wel known that long-term aerobic exercise aleviates renal dysfunction in spontaneously hypertensive rats. However, the underlying molecular mechanism remains unclear.
OBJECTIVE:To investigate the effect of long-term aerobic exercise on endogenous formation of hydrogensulfide in the kidney of spontaneously hypertensive rats.
METHODS:Rat models of long-term aerobic exercise were established and randomly assigned to four groups: Wistar-Kyoto (WKY) rat static group, WKY rat exercise group, spontaneously hypertensive rat static group and spontaneously hypertensive rat exercise group. Moderate-intensity exercise on treadmil was given for 12 weeks. At 24 hours after model establishment, weight was weighted. Blood pressure was detected in the caudal artery. Blood and urine were colected for measuring biochemical indicators related to kidney functions. The degree of glomerular sclerosis was observed. Hydrogen sulfide production activity was detected in the kidney. RT-PCR was used to detect mRNA expression levels of hydrogen sulfide production-related enzymes. Simultaneously, oxidative stress of the kidney was observed.
RESULTS AND CONCLUSION:(1) Long-term aerobic exercise obviously reduced body mass, systolic blood pressure and diastolic blood pressure, increased glomerular filtration rate and renal blood flow, decreased serum creatinine and urea nitrogen levels, urinary albumin levels, significantly reduced glomerular sclerosis score, increased hydrogen sulfide content in plasma and the rate of hydrogen sulfide formation in renal tissue, up-regulated cystathionine γ-lyase expression, obviously diminished malondialdehyde content in serum and kidney, and remarkably increasedthereduced glutathione and oxidized glutathione ratio in spontaneously hypertensive rats. (2) Results indicated that long-term aerobic exercise could increase the generation of endogenous hydrogen sulfide in kidney, lessen oxidative stress in the kidney, and amelioraterenal dysfunction in spontaneously hypertensive rats.

To analysis the reason of the arguments of “Sexual hallucinations” or “Sexual harassment”between clinicians and patients,and find out how to prevent its happening.Methods:Base on clinical case about patients complaints that clinicians sexually assault,review and analysis the prtinent literatures.Results:Sexual hallucinations is a complication following anesthesia with psychotropic drugs,it 's easy to be misunderstand as Sexual harassment and result in allegations of sexual misconduct between patient and clinician.Conclusion:Clinicians need to be aware that sexual hallucinations to occur during sedation or after anesthesia,to protect themselves against the accusations of sexual harassment,the practitioner should never be unchaperoned with a patient of the opposite sex during sedation or anesthesia.

Objective To investigate the clinical and skeletal muscular pathological features of chronic progressive external ophthalmoplegia(CPEO).Methods The clinical and skeletal muscular pathological data of 6 patients with CPEO were analyzed retrospectively.Results All of the 6 patients onset were 4 to 18 years old.The first symptom was blepharoptosis.The clinical mainly manifestations were limited activity of eyeball,accompanied with limbs muscle fatigue,weakness and level elevatation of serum creatine kinase(CK).5 cases had myogenic changes in electromyography(EMG).The skeletal muscular pathological examination showed that the ragged red fibers(RRF)were scattered among the muscle fibers,and the deficient or absent of COX activity in many fibers.A few degenerating and necrotic fibers were observed in 4 cases.Lipid-drops were increased by oil red "O" stain in 3 cases.Electromicroscope showed that abnormal mitochondria increased in number and aggregated under sarcolemma or in cytoplasm.Crystalloid inclusion body could be observed.Conclusions The clinical mainly features of CPEO are external ophthalmoplegia and accompanied with limbs weakness.RRF and COX activity deficiency or absence according to skeletal muscle pathology can be suggest and support the diagnosis of CPEO.Gene sequencing based on skeletal muscle biopsy is necessary to make the final diagnosis of CPEO.

Objective To establish a suitable formulation for the dispersible tablets of breviscapinum. Methods The preparative process was scanned out by single factor test and orthogonal design. A comprehensive scoring analysis was performed with disintegrating time and rigidity as the indexes. Results The demonstration for the dispersible tablets from the optimized formulation,being totally disintegrated within three minutes and sifted through the sieve in size of the 2nd,show better dissolubility in-vitro in comparison with the common tablets and their quality meets with the requirement for the dispersible in Phamarcopoeia of the People's Republic of China. Conclusion The formulation screened out for the dispersible tablets of breviscapinum is suitable for the production on a large scale.

Objective: To examine the correlation between atmospheric PM2.5 and emergency call for respiratory diseases. Methods: The daily emergency call for respiratory and cardio-cerebrovascular diseases was collected from Hangzhou Emergency Medical Center from 2018 to 2020, and meteorological and atmospheric pollutant data were collected from Hangzhou Municipal Center for Ecological and Environmental Monitoring during the same period, including daily mean air temperature, daily mean relative humidity, PM2.5, PM10 and SO2 levels. The correlation between atmospheric PM2.5 and emergency call for respiratory and cardio-cerebrovascular diseases was examined using a generalized additive model, and the risk of emergency call was predicted using excessive risk (ER) and its 95%CI. Results: The daily mean emergency call was 14 (interquartile range, 12) cases for respiratory diseases and 20 (interquartile range, 7) cases for cardio-cerebrovascular diseases in Hangzhou City from 2018 to 2020, and the daily mean PM2.5 mass concentration was 29.77 (interquartile range, 21.32) μg/m3. Cumulative exposure to PM2.5 for 5 or 6 d caused the largest effect on the emergency call for respiratory diseases, and an increase in PM2.5 by 10 μg/m3 led to a 1.93% (95%CI: 0.76%-3.11%) rise in the emergency call for respiratory diseases. Cumulative exposure to PM2.5 for 4 d caused the largest effect on the emergency call for cardio-cerebrovascular diseases, and an increase in PM2.5 by 10 μg/m3 led to a 1.88% (95%CI: 0.80%-2.97%) rise in the emergency call for cardio-cerebrovascular diseases. Cumulative exposure to PM2.5 for 7 d caused the largest effect on the emergency call for respiratory diseases among residents aged 60 years and older, and an increase in PM2.5 by 10 μg/m3 led to a 4.37% (95%CI: 2.70%-6.06%) rise in the emergency call for respiratory diseases. Cumulative exposure to PM2.5 for 4 d caused the largest effect on the emergency call for cardio-cerebrovascular diseases among residents aged 60 years and older, and an increase in PM2.5 by 10 μg/m3 led to a 2.44% (95%CI: 0.97%-3.52%) rise in the emergency call for cardio-cerebrovascular diseases. However, exposure to PM2.5 had no marked effects on emergency call for respiratory or cardio-cerebrovascular diseases among residents aged <60 years. Conclusions Elevated atmospheric PM2.5 mass concentration may lead to an increase in the daily emergency calls for respiratory and cardio-cerebrovascular diseases, notably among residents aged 60 years and older.

Skillful in the treatment of gouty arthritis (GA) by integrated therapies of Chinese and Western medicine,chief physician Zhang Tang-fa proposes to ‘deal with the exterior with the needles,and attack the interior with the drugs,by integrated application of acupuncture and herbal medicine',in combination with comprehensive intervention of dietetic therapy and health education.In the treatment of GA,he adopts the syndrome differentiation based upon the pathogenic factors,in combination of syndrome differentiation based upon the six meridians,to reinforce and benefit the spleen and kidney,clear away heat and remove dampness as the therapeutic principle.By acupuncture mainly at the acupoints of the Spleen and Liver Meridians,he also proposes to select the acupoints by the theory of Na Zi Fa (earthly branch method) of Zi Wu Liu Zhu (midnight-noon ebb-flow),and to puncture the surrounding area of the involved joints shallowly by multiple needles as the major needling method,simultaneously with the reinforcing and reducing manipulations based upon the respiration.In the treatment,acupuncture and acupoint-injection are often used.In diet,low purine diet is often suggested.In health education,the patients are often instructed to understand the disease correctly,eliminate fears and cooperate with doctor's treatment positively.

NAD +-dependent cytosolic glycerol-3-phosphate dehydrogenase in Sacch aromyces cerevisiae is one of the key enzymes in metabolic pathway of glycerol . catalysing the reduction of dihydroxyacetone phosphate to glycerol-3-phosph ate.It has two isoenzymes.To study the differences between their structures, their expression of encoding genes and their functions may help increase the understan ding of the cell response mechanism to the hyperosmotic and anoxic conditions. In this paper the research on the two isoenzymes was reviewed.

Using the tissue culture technology to achieve the fast propagation of P.ternata and through the photosynthetic characters and yield comparison,two high-yield indivaduals were obtained. The result showed that the coefficent of propagation can get to 1∶6.23 per generation, through 3 month culture the average diameter of the in vitro tuber can get 0.88 cm. P.ternata was a typical shade-plant, of which LCP was only 700?mol?photons/s?m2. Photo-inhibition was observed among all the three leaf-types of P.ternata, and the willow leaf type showed the most obvious photo-inhibition. Both of the light response Pn curve and single tuber weight were significant different among leaf styles. Result for studying the chlorophyll fluorescence parameters showed that all the difference of NPQ, qP and qN among three leaf-types of P.ternata were significant and the difference of potential-photosynthetic productivity among them was significant. The willow leaf style had the strongest light-tolerance capacity.The individuals of T2(peach-leaf type) had the highest Pn and single tuber weight among 11 superior individuals and the individuals of L2(willow-leaf type) showed the strongest light-tolerance capacity. Through 6 month propagation ten thousands in virto tuber of T2 and L2 each were gotten. And after growing in Wenzhou experimental base for one year, the total gross weight of the high-yield individual tuber get to 100kg each.