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.

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.

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.

BACKGROUND:Presently used pulmonary vein antrum location methods mainly performed by three-dimensional electroanatomy combined with X-ray image or CT image fusion.These methods conducted vein antrum location and ablation by anatomy instructions.It is still poorly understood whether the ablation hit the key part of atrial fibrillation.OBJECTIVE:To explore the feasibility of catheter ablation guided by three-dimensional electroanatomic mapping system in conjunct with pulmonary vein antrum potential in patients with atrial fibrillation.DESIGN,TIME AND SETTING:The verification clinical study was performed at the Department of Cardiology of Jinan Fourth People's Hospital and Hebei People's Hospital from March 2007 to June 2009.PARTICIPANTS:Fifty-one patients with drugs refractory,paroxysmal atrial fibrillation were included.METHODS:All patients underwent circumferential pulmonary vein antrum ablation guided by three-dimensional electroanatomic mapping system (CARTO) in conjunct with pulmonary vein antrum potential with the endpoint of electrical isolation.Relevant parameters and ablation success rate were observed.MAIN OUTCOME MEASURES:Procedure-related parameters,such as procedure duration,fluoroscopy duration,cumulative success rate and complication were observed.RESULTS:Pulmonary veins were isolated in all 51 patients.The mean procedure duration,fluoroscopy time and radiofrequency ablation duration are respectively (207±36.7) minutes,(38.2±14.3) minutes,(56.4±15.7) minutes.After (17.5±3.8)-months follow-up,forty (78.4%) patients did not have recurrence of atrial fibrillation,atrial flutter or atrial tachycardia.No severe procedure-related complication had happened.CONCLUSION:Pulmonary vein antrum potential can be used as a landmark to define pulmonary vein antrum,that combined with CARTO system to guide pulmonary vein antrum ablation is effective,safety and feasible for catheter ablation of atrial fibrillation.

BACKGROUND: Embryonic stem cells (ESCs), the seed cells of all mature cells in vivo, are useful tools for nerve transplantation and developmental gene function research. Notch1 signaling pathway is the key pathway to control the ordered neural development and differentiation of many kinds of neural cells, however, there is no report on the dynamic expression of Notch1 signal during the ESC differentiation to date. OBJECTIVE: To investigate the expression of Notch1 protein, transmembrane signal transduction molecule, during directional differentiation of embryonic stem cells into neural cells. DESIGN, TIME AND SETTING: Cell research was carried out between October 2003 and October 2004 at Zhongshan Ophthalmic Center, SUN Yat-sen University, Guangzhou, Guangdong Province, China. MATERIALS: BALB/C mouse embryonic stem cell line Ⅵ (passage 11)was obtained from experimental animal center of SUN Yat-sen University, provided by professor Huang Bing. ESC culture medium was high-glucose DMEM medium with 20% bovine serum and 106 IU/L mouse leukemia inhibitory factor. Induced differentiation medium was high-glucose DMEM medium with 20% fetal bovine.serum and 5×107 mol/L retinoid acid(RA). METHODS: Passage 11 ESCs were resuscitated and incubated by ESC culture medium in incubator at 37℃ with 5% CO2. Passage 11 ESCs were subcultured after 2 or 3 days and RA was added into medium to induce differentiation. Three time points for observation were established: induced for 1, 5 and 9 days. MAIN OUTCOME MEASURES: Morphological changes were observed under inverted phase contrast microscope, MAP-2 antigen expressed in differentiated cells was detected by immunofluorescence method. Immunocytochemistry, Western Blot, flow cytometry assay were used to investigate the Notch1 protein expression. RESULTS: ESCs presented clone-like growth. After induced by RA for 9 days, single neural network was achieved around most of the cell clusters. With the prolongation of induction, MAP-2 positive neural cells increased gradually. Almost all ESC clones expressed Notch1 protein strongly or positively, but Notehl protein expression decreased gradually after induced differentiation (P < 0.01). CONCLUSION: Notch1 signal shuts off progressively during induction of ESCs into neural cells, which suggests Notch1 may play an important role in the differentiation of ESCs into neural cells.

Objective To compare the therapeutic effect of anatomic plate (AP)and locking compression plate(LCP) in treatment of fermoral intertrochanteric fracture in elderly patients. Methods Nineteen and three patients with fermoral intertrochanteric fracture were treated with anatomic plate (AP) and locking compression plate (LCP). The therapeutic effects were compared in the study. Results All operations were done successfully. Of all cases,72 patients were followed up for 5-24 months. Excellence rate: AP was 66. 7% and LCP was 88. 2%.Conclusions AP had significantly low excellence rate with more complications when compared with LCP. LCP could be the first choice in treatment of fermoral intertrochanteric fractures with high excellence rates and few complications.

Objective To learn about the state of anxiety, related factors and demand of the family members of youngster patients with eye traumas during the operations, to improve the quality of nursing care by effectively relieve the anxiety of family memebers through appropriate intervention. Methods The anxiety and needs of family members of 148 children patients with eye traumas were investigated during the perioperative period with self-rating anxiety scale and self-designed questionnaires, and appropriate nursing was given according to the survey results. Results The anxiety score of family members was (56.93 ± 14.72), which was at higher level when the patients were just admitted. The scores statistically de creased after nursing care. The anxiety was related to factors such as the security and the effect of the operation, the technical level of the surgeon, the anesthesia method (general anesthesia),the age of the children patients and the emergency operation. Conclusions Nursing staff can effectively relieve the anxiety of the family members of children patients during perioperative period by supplying special care according to their different demands.