Objective To explore the early characteristics,risk factors and correct diagnosis procedure of acute pulmonary embolism.Methods The onset,axillary examination and susceptibility of 52 cases of acute pulmonary embolism between Jan 2004 and Dec 2005 were analyzed.Results The early manifestation of acute pulmonary embolism was difficulty in breathing,chest pain,hemota and fatigue.Only 11.5%patients presented all the obove symptomes at the same time.D-dimer＞500μg/L was 100%.Blood gas analysis showed hypoximia in 94.2%,typical SⅠQⅢTⅢin 13.6% on electrocardiograph,pulmonary artery hypertension in 82.5%on ultrasonography,dilated right in 38.5%of all the subjects.The diagnosis rate was 82.7%at the first diagnosis.Lower limb deep vein embolism,chronic cardiac,kidney disease,malignant tumor and periooperation patients were the risk factors.Conclusion Acute pulmonary embolism is specific-free of clincial manifestation,patients with history of vertigo but excluding difficulty in breathing,chest pain,hemato should go proper examination.

Objective To investigate the circadian blood pressure(BP)rhythm in hypertensive patients with chronic renal insufficiency.Methods Circadian blood pressure(BP)rhythm was studied by ambulatory 24-h monitoring among hypertensive(n=25,group B)patients with stable progression of chronic renal insufficiency,and among patients with essential hypertension(n=28,group A)without renal disease.Results ①The 24-h diastolic BP and nocturnal systolic and diastolic BP of group B were significantly higher than those of group A[(80.9±13.4)mmHg vs[70.3±15.6)mm Hg,(160.2±17.8)mm Hg vs(140.3+25.9)mm Hg,(82.6±16.1)mm Hg vs(68.8±20.2)mm Hg,P＜0.05)].②Blooa pressure variability(BPV)of 24 hour systolic and diastolic BP of group B was higher than group A[(13.5±3.9)mm Hg vs(11.3±2.1)mm Hg and(9.2±1.2)mm Hg vs(8.3±1.8)mm Hg,P＜0.05).BPV of nocturnal systolic and diastolic BP in group B was signitleantly higher than group A [(14.9±3.3)mm Hg vs(9.3±2.1)mm Hg and (9.7±2.4)mm Hg vs(8.0±2.2)mm Hg,P＜0.01)].③The 24-h profile of BP of group A showed more non-dipper according for 64.3%(18/28),reverse-dipper according for 10.7%(3/28),but which was 40.O%(10/25)and 48.0%(12/25).Conclusion The renal patients show a disturbance in the 24-h profile of BP,higher indexes of noetttrnal BP and a greater nocturnal variability,which may be important factor for event of cardiovascular disease and renal insufficiency.

With the popularization of rehabilitation and the development of the physiotherapy, some chronic diseases do not only mean the history of the patients, but also the objects of physiotherapy. The exercises will affect the cardiopulmonary function of the patient, and result in a high risk of accident. This article would review the risk factors and risk management in physiotherapy for chronic diseases.

Objective To investigate the correlation between left ventricular remodeling and systolic function by mid-wall fractional shortening(mFS).Methods 51 cases of hypertension and 47 cases of healthy volunteers were enrolled and systolic parameters were measured as ejection fraction(EF), fractional shortening(FS) and mFS. Acorrding to left ventricular remodeling parameteres inclulding LVMI and RWT, hypertension group was divided into four subgroups. The correlation among these parameters were analyzed.Results Thicker left ventricular wall and lower mFS in patient with hypertension compaired with those in controll (P<0.05). There were negative correlation between mFS and RWTr=-0.42, P<0.05) and positive correlation between mFS and LVMI r=-0.67, P<0.01).Conclusion mFS is a valuable parameter compared with traditional parameteres such as EF and FS. There is a linear association between parameteres of ventricular remodeling and systolic function assessed by mFS in early stage of hypertension.

Objective To validate the biology reference interval of the Dartial biochemistry test items and provide accurate diagnosis basis for the clinic.Methods According to NCCLS C28-A2 recommendation method,two biochemistry analyzers'performance was validated.20 healthy persons for the asexual biological difference project and female group as well as male group (each group consist of 20 persons)for the sex biology difference project were recruited according to the laboratory SOP.If the validation had doubt,other two groups were need.The sera from these individuals were examined by the full-automatic ADVIA 1650 biochemistry analysis system.Results Two full-automatic ADVIA 1650 biochemistry analyzes conformed to the requirements.In 16 test items participating in this investigation.the analysis showed more than 5%results fell outside the biology reference interval for GGT and HDL-C,whereas 95% results fell in the biology reference interval for TP.All other results fell in the biology reference interval.Conclusions This validation indicats that except GGT and HDL-C,the biology reference intervals which are currently being used are suitable for our laboratory.This verification is persuasive and calpable of finding the deviation of biology reference interval.Setting up verification system warrants further generalization.

Objective To evaluate the effect of duloxetine on the expression of Toll?like receptor 4 (TLR4) in the spinal dorsal horn in a rat model of diabetic neuropathic pain (DNP). Methods Type 2 di?abetes mellitus was induced by high?fat and high?sucrose diet and intraperitoneal streptozotocin ( STZ) 35 mg∕kg in male Sprague?Dawley rats, aged 2 months, weighing 180-220 g. Seventy?five rats with type 2 di?abetes mellitus were randomly divided into 5 groups ( n=15 each ) using a random number table: group DNP, DNP + normal saline group (group DNP+NS), and DNP + duloxetine 5, 10 and 20 mg∕kg groups (DNP+D5, DNP+D10, DNP+D20 groups). Another normal 15 rats were selected and served as control group ( group C) . Duloxetine 5, 10 and 20 mg∕kg were injected intraperitoneally once a day for 14 consecu?tive days starting from 15 days after administration of STZ in DNP+D5 , DNP+D10 and DNP+D20 groups, respectively. The equal volume of normal saline was given instead in group DNP+NS. The mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal latency ( TWL) were measured on the day before STZ administration and 14, 17, 21 and 28 days after STZ administration. After the last measurement of pain threshold, the L4?6 segments of the spinal cord were removed for determination of the expression of
TLR4 by immuno?histochemistry and Western blot. Results Compared with group C, the MWT was signif?icantly decreased, TWL was shortened, and the expression of TLR4 was up?regulated in DNP, DNP+D5, DNP+D10 and DNP+D20 groups (P<0?05). Compared with group DNP, the MWT was significantly in?creased, TWL was prolonged, and the expression of TLR4 was down?regulated in DNP+D5 , DNP+D10 and DNP+D2 0 groups ( P<0?05) , and no significant changes were found in the parameters mentioned above in group DNP+NS ( P>0?05) . Conclusion The mechanism by which duloxetine attenuates DNP is related to down?regulated expression of TLR4 in the spinal dorsal horn of rats.

Objective To study the relationship between arterial compliance and diastolic dysfunction in essential hypertensive patients.Methods Fifty-one treated hypertensive patients and 47 normotensive controls were enrolled.Arterial stiffness was assessed by vascular e-TRACKING technology of ultrosonic.Tissue Doppler echocardiography combined with conventional Doppler echocardiography was used for assessment of left ventricular diastolic function and peak late diastolic velocity of mitral flow.The ratio of E/A,Em/Am and E/Em were measured.Results Compared with normotensive controls,hypertensive patients have increased arterial sclerosis index(?) [(10.5?3.8) vs control(8.1?3.4),P

Physiotherapy involves wide range elements. Many factors, such as the complications of the patients, may complicate the treatment. It is important for the physiotherapists to control the potential risk factors as much as to improve their efficacy.

Objective To investigate the attention and awareness of risk management in physical therapists during their treatments. Methods The staffs visited China Rehabilitation Research Center for studying physical therapy from other hospitals were investigated with a questionnaire. Results and Conclusion 41 out of 52 questionnaires came back. The consciousnesses of risk management were variable with the profession they engaged before, that the physicians were the best.

Objective To explore the value of high frequency echocardiography to evaluate cardiac structure and function of rat with acute myocardial infarction (AMI).Methods The rat AMI model was established by ligating the proximal left anterior descending coronary artery. The cardiac structure and function of model rats were examined with high frequency echocardiography in the 2nd and 8th week after ligation successfully. Another 20 healthy rat were selected as the sham operative group.Results The survival rat is 82.0% beyond 24 hours. At 2nd week, the model animals had an increased end-diastolic diameter (EDD), end-systolic diameter (ESD), end-diastolic volume (EDV), and further end-systolic volume (ESD), compared with the sham operative group. Ejection fraction (EF) and fraction shortening (FS) of model rats decreased. The ratio of E/A was higher. At 8th week, these parameters deteriorated left atrial diameter (LA) increased ( P<0.05). EF and FS were relevant to dp/dtmax.Conclusion High frequency echocardiography can evaluate left ventricle remodeling of rat dynamically.