Objective To identify right-sided chest lead electrocardiograph (ECG) abnormalities in acute pulmonary embolismMethods Changes of routinely recorded 12-lead and right-sided chest leads V 3R, V 4R and V 5R ECGs in 98 patients with suspected pulmonary embolism hospitalized at Ninghe County Hospital during March 1999 to October 2003 were analyzed retrospectively Parameters of both right and left-sided ECGs available were measured and comparedResults Diagnosis of acute pulmonary embolism was established in only 23 (234%) of 98 suspected patients, 18 men (78%) and 5 women (22%), with mean age of (48 ? 10) ECG changes suggestive of acute right ventricular strain were found in both right and left-sided leads in 18 (78%) of 23 patients with pulmonary embolism, and their ECG changes disappeared within 24 hours after admission or onset of symptoms with pulmonary embolism in 13 (72%) of them ST segment elevation in leads V 3R, V 4R, V 5R ,and abnormalities in standard 12-lead ECGs were found in nine (39%), and five (22%) of them with a diagnosis of pulmonary embolism had normal left-sided ECGs, but elevated ST segment and qr or QS pattern (prominent q waves) in leads V 3R, V 4R and V 5R in their right-sided ECGs Thirteen (565%) of them showed ST-segment elevated in leads V 3R, V 4R and V 5R,and 20 (87%) showed qr configuration in lead V 3RConclusions Patients with acute pulmonary embolism often show characteristic ECG changes in right-sided chest leads When pulmonary embolism is suspected, especially no typical changes in routinely-recorded standard 12-lead ECGs can be found, right-sided chest lead ECG should be performed

Ninety specimens of pathologically confirmed transitional cell carcinoma of the urinary bladder were studied. The patients consisted of 71 male and 19 female with a male/femai ratio of 3.5:1. Their age was ranged from 32 to 79. 12 specimens were studied with electron microscope. The histopathological and ultrastructural features of transitional cell carcinoma were described. Our fol-lowup data of the cases revealed that the larger a tumor,the lower its differentiation, the deeper its invasion, and the more extensive the involvement of lymphatic and blood vessels, the poorer the prognosis of the tumor. In addition the ultrastructural characteristics of transitional oell carcinoma were briefly discussed.

Objective:To isolate mesenchymal stem cells (MSCs) from mouse fetal liver and induce them differentiate into islet B-like cells. Methods:MSCs were isolated from C57BL/6J mouse fetal liver and were induced with high concentration of glucose, basic fibroblast growth factor(bFGF) ,and nicotamine medium. The gene expressions related to islet B cells such as pancreatic duodenal homeobox-1 (PDX-1), proinsulin-1 (INS-1) ,and glucose transporter-2 (GLUT-2) were detected by RT-PCR. Insulin in the treated cells was examined by immunocytochemistry. The insulin clusters were stained with dithizone (DTZ), a zinc-chelating agent known to selectively stain pancreatic B cells. Results: RT-PCR showed that the treated cells expressed PDX-1, INS-1 and GLUT-2, while the undifferentiated cells did not. After approximately 10 d of treatment, the fetal liver cells formed DTZ-stained cell clusters in flasks (80-120 clusters in a flask 25 cm2 in area). Immunocytochemistry also confirmed that these aggregates were strongly positive for insulin. Conclusion: MSCs derived from fetal liver can be induced into islet B-like cells in vitro.

0.05).Maxillary incisors were easily to be affected,especially the maxillary central incisor.Crown fracture was the most common traumatic type.The combination of dental trauma and oral and maxillofacial soft tissue injury was experienced by 692 patients(71.0%).Conclusion: Dental trauma was one of the common diseases in oral emergencies.Knowledge of the etiological and clinical characteristics of emergency dental trauma could help us to treat them and make specific preventive measures.Clinical examination should be comprehensive and meticulous to avoid misdiagnosis,for emergency dental trauma often involving multiple teeth,and associated with different degrees of maxillofacial soft tissue injury.

Purpose:To clone and construct an eukaryotic expressive vector of ribonuclease inhibitor (RI) gene ,as well as to observe the effects of the transfected pLNCX-ri on the growth of C6 glioma cells.Methods:A segment of RI gene of 1.4 kb was obtained by Nde I/Xho digestion and cloned into pLNCX. Transfective agent and selective antibiotic were lipofect AMINE and G418 respectively. The expression of pLNCX-ri in C6 glioma cells was detected by Western blotting. And SD rats were inoculated by the transfected C6 glioma cells.Results:An eukaryotic expressive vector of RI gene was constructed successfully. RI content was remarkably higher in the transfected cells than that of in the untransfected cells. After SD rats were inoculated by the transfected C6 glioma cells,the tumorigenic time was prolonged, the tumor weight was reduced and the density of tumor vessels was notably decreased. Conclusions:These results indicated that RI gene powerfully inhibited the growth of C6 glioma cells via decreasing tumor vessels formation.

Objective To investigate the protective effect of ulinastatin on myocardium against ischemia-reperfusion injury in open heart surgery with cardiopulmonary bypass (CPB) .Methods Twenty ASA Ⅰ - Ⅱ patients undergoing atrioseptopexy or surgical repair of VSD under CPB were randomly divided into two groups: in ulinastatin group (U n = 10) patients received ulinastatin 12000 unit?kg-1, half of the dose was given iv, 10 min before aorta cannulation and another half was added into the priming fluid; in control group (C n = 10) the patients received same volume of saline instead of ulinastatin. Premedication consisted of intramuscular pethidine 1 mg?kg-1 and scopolamine 0.01 mg?kg-1 .Anesthesia was induced with midazolam 0.1 mg?kg-1, fentanyl 10 ?g?kg-1 and pancuronium 0.1 mg**kg-1 and maintained with fentanyl, enflurane or isoflurane, diazepam and pancuronium. Arterial blood samples were taken before CPB (T1), at release of the aortic cross-clamp (T2), 30 min after aortic release (T3), 4h and 24h after discontinuation of CPB (T4, T5 ) for determination of plasma levels of cardiac troponin I (cTnI), creatine phosphokinase (CK) and creative phosphokinase isoenzyme (CK-MB) .Results The demographic data were comparable between the two groups. The CPB time, aortic cross-clamping time and duration of operation were also comparable. The plasma cTnI level and CK, CK-MB activity were all within normal range before CPB in both groups. In group C the plasma level of cTnI started increasing at T2, peaked at T4 and started decreasing at T5. In group U the plasma level of cTnI at T3 and T4 was significantly higher than the baseline (P

Objective To survey the influence of nursing intervention on cognition level for pressure sores and psychological state among accompany family members of patients with cerebral injury. Methods 123 accompany family members of patients with cerebral injury were selected and took part in the investigation about cognition level for pressure sores, besides, SDS and SAS were also adopted to evaluate their psychological state. Later nursing intervention was given to increase their cognition level for pressure sores, then another evaluation was carried out. Results before and after the intervention were compared. Results The accompany family members lacked knowledge of pressure sore, showed serious anxiety and depression for nursing pressure sore before intervention. But their cognition level for pressure sore improved and anxiety and depression lightened after intervention. Conclusions Nursing intervention is effective to alleviate cognition level for pressure sore and psychological state among accompany family members of patients with cerebral injury, which is worthy of clinical application.

OBJECTIVE:To optimize the extraction technology of polyphenols from Juglans regia branch and evaluate its anti-oxidant activity in vitro. METHODS:Using extraction amount of polyphenols from J. regia branch as response value,solvent-solid ratio,extraction temperature and ethanol volume fraction as response factors,based on single factor test,response surface method was used to optimize the extraction technology of polyphenols from J. regia branch. Using vitamin C as positive control,scaveng-ing on hydroxyl radicals and 1,1-diphenyl-2-picrylhydrazyl(DPPH)radicals and total reducing activities of polyphenols from J. re-gia branch were investigated. And its antioxidant activity in vitro was evaluated. RESULTS:Optimized extraction conditions for polyphenols from J. regia branch was as follow as solid-liquid ratio of 1:25(g/mL),extraction temperature of 50 ℃,ethanol vol-ume fraction of 70%. The extraction amount of polyphenols from J. regia branch was 9.30 mg/g(RSD=0.57%,n=3)in the veri-fication test. Clearance rate on hydroxyl radicals and DPPH radicals and total reducing activity of polyphenols from J. regia branch were respectively 50.24%,95.42%,1.118 when it was under the mass concentration of 12.0,3.0,3.0μg/mL;and the related data of vitamin C was 93.71%,46.17%,0.628 under the same mass concentration(P<0.05). CONCLUSIONS:Extraction technology of polyphenols from J. regia branch optimized by response surface method is stable and feasible;polyphenols from J. regia branch shows certain antioxidant activity in vitro.

[Objective] To study the bacteriological feature of the wound infection of open fracture and supply the reasonable advise to the use of antibacterials. [Methods]One hundred and thirty-six samples were collected from the wound patients with open fracture between January in 2004 and December in 2008. The identification of bacteria and drug sensitive test were carded out by ATP-expression.[Results]One hundred and fifty one isolates were collected from 136 samples. The prevalence of staphylococcus aureus, pseudomonas aeruginosa, staphylococcus haemolyticus,staphylococcus epidermidis, eolon bacillus were most ,accounting for 17.22%, 13.24%, 11.92%, 9.93%and 9.27% respectively. The prevalence of MRSA was higher than 57.7%.Gram positive coccus , gram negative bacilli and candida accounted for 48.34%, 43.05% and 8.61% respectively. The prevalence of ESBLs was 28.6%. None of gram negative bacilli was found resistant to sulbactam and cefopcrazone. The resistance rate of gram negative bacilli to ampicillin , ampicillin -sulbactam and cephazolme were 71.4%. The rate of resistance of staphylococcus to methicillin was higher than 57.7%.Except vancomycin was not drug-fast, some sensitive antibacterials include cotrimoxazole, nitrofurantion, rifampicm tetracycline.[Conclusion]Endogenic normal flora and conditioned pathogen from the surroundings have become the main pathogens of the wound infection of open fracture. So the early debride and reasonable use of antibacterials would play a positive role in preventing postoperative fracture infection.

Objective To evaluate the effect of penehyclidine hydrochloride (PHC) on the level of angiopoietin-1 (Ang-1) and tyrosine kinase receptor-2 (Tie-2) during endotoxin-induced acute lung injury (ALI) in rats.Methods Forty adult male Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 4 groups using a random number table (n =10 each):control group (group C),ALI group,low-dose PHC group (group L-PHC) and high-dose PHC group (group H-PHC).ALI was induced with iv injection of lipopolysaccharide 5.0 mg/kg via the tail vein.In L-PHC and H-PHC groups,PHC 0.6 and 2 mg/kg were injected,respectively,via the tail vein at 1 and 24 h after lipopolysaccharide injection.The rats were sacrificed at 48 h after the initial injection of PHC to measure the lung water content,protein concentration in bronchoalveolar lavage fluid (BALF),and the expression of Ang-1,Tie-2 and phosphorylated Tie-2 in lung tissues.The morphological changes of lung tissues were observed under light microscope and the ultrastructural changes of alveolar epithelial barrier under transmission electron microscope.Results Compared with group C,the lung water content and protein concentrations in BALF were significantly increased,and the expression of Ang-1 and phosphorylated Tie-2 was down-regulated in the other three groups (P ＜ 0.05).Compared with group ALI,the lung water content and protein concentrations in BALF were significantly decreased,and the expression of Ang-1 and phosphorylated Tie-2 was up-regulated in H-PHC group (P ＜ 0.05),and no significant changes were found in the parameters mentioned above in group L-PHC (P ＞0.05).The damage to lung tissues was significantly reduced in group H-PHC as compared with group ALI.Conclusion PHC can improve the permeability of pulmonary microvascular and reduce injury to alveolar epithelial barrier,thus ameliorating endotoxin-induced ALI in rats,and the effect is dose-related and up-regulation of Ang-1 expression and inhancement of Tie-2 activity are involved in the mechanism.