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.

Objective To compare the safety and efficacy of varied treatments for cardioversion of paroxysmal atria] fibrillation (AF) in the aged patients and to explore choice of electrical cardioversion with direct current. Methods Clinical data of cardioversion with lanatoside (cedilandid) or propafenone, a sodium channel blocker prolongs refractoriness, for 57 aged patients with paroxysmal AF were summarized to observe their cardioversion and control of heart rate. And, synchronous electrical cardioversion will be offered to those with severe complications and ineffective with drug treatment within 24 h after the onset of AF. Results An emergency cardioversion ratio was 28.1 % with lanatoside within 24 h with a satisfactory control of ventricular rate, as compared with that of 62.2% with propafenone (P

Objective To investigate the effects of propofol on nitric oxide (NO), superoxide dismutase (SOD) and malondialdehyde (MDA) levels in blood and lung during endotoxic shock in rats.Methods Seventy-two male Wistar rats weighing 180-220 g were randomly divided into thiee groups :group Ⅰ control (C) ( n = 8) ; group Ⅱ endotoxic shock (L) ( n = 32) and group Ⅲ propofol + endotoxic shock (P) ( n = 32) . The animals were anesthetized with 3% pentobarbital 25 mg?kg-1 , tracheostomized and mechanically ventilated . Carotid and pulmonary artery were cannulated for MAP and MPAP monitoring. In group Ⅱ (L) and Ⅲ (P) endotoxin 10 mg?kg-1 was injected intraperitoneally. In group P 10 min before endotoxin administration subcutaneous propofol infusion was started at a rate of 20 mg?kg-1?h-1 . In control group normal saline(NS) was given ip instead of endotoxin. Venous blood samples were taken at 30, 90, 180 and 360 min after intraperitoneal endotoxin or NS injection. In group L and P 8 animals were killed at each time point respectively and in control group the 8 animals were killed at 360 min after ip NS injection. The lungs were immediately removed. Blood and lung NO and MDA levels and RBC SOD content were measured.Results The serum and lung NO concentration measured at all 4 time points were significantly lower in group Ⅲ than those in group n (P

Objective To determine whether tissue factor(TF) is present in the amniotic fluid of normal term pregnancy. Methods Tissue factor antigen levels in amniotic fluid, blood plasma, centrifugal supernatant and sediment of 16 normal term pregnancies were detected with immunoenzymatic method(ELISA). Results Tissue factor antigen levels in the blood plasma, the whole amniotic fluid, the centrifugal supernatant and the sediment were [(31?9) ng/L0, [(404?186) ng/L], [(348?177) ng/L] and [(1360?639) ng/L], respectively. Tissue factor antigen concentrations in three states of the amniotic sediment(P

Objective To evaluate the results of orthodontic micro- implant anchorage implantation by application of Spiral CT and three-dimensional reconstruction techniques,so as to explore its application value in assisting clinical diagnosis and treatment. Methods 20 orthodontic patients were implanted with 48 micro-planting screws. SOMATOM Sensation40/64 helical CT scan was performed . The axial unenhanced helical CT data were given multi-planar reconstruction (MPR),maximum intensity projection (MIP),volume rendering (VR) and surface multidimensional reconstruction (CPR) by using the Siemens 3D post-processing software. The axial scanning images and reconstructed images were compared, observed and analyzed . Results The planting results of 37 micro screws were satisfactory without injuring the vital tissues surrounding the root. The planting results of 11 micro-screw were not ideal, and these micro-screws were observed or reimplanted and got success. Spiral CT axial scan showed better the tooth root interval and the relationship between tooth root and the planting screws. VR can directly showed the overall relationship between the planting screws and teeth , jaw contour appearance. The relationship between the screw and tooth was showed satisfactorily by MIP which could rotate freely and observe from different angles. MPR could clearly show the structural relationships between micro-root planting screws and tooth root and surrounding tissues from the cross section, and could make up for the shortcomings of axial limitations, and was easy to measure the distance and tilt angle of the long axis . Conclusion Spiral CT and three-dimensional reconstruction can accurately show the jaw micro planting screw shape,location and spatial relationships with adjacent teeth , the image is clear,intuitive and definite,and spiral CT and three-dimensional reconstruction has high application value in orthodontics micro-implant anchorage clinic as a powerful auxiliary examination means.

Treating from liver is an important thought to treat esophageal cancer.Regulating the liver has very important significance in the process of treating esophageal carcinoma,which embodies at regulating liver is the key of soothing emotional injuries of esophageal carcinoma,removing esophageal pathology product and coordinating rising-descending function of spleen and stomach,and improving accompainedg symptoms of esophageal cancer.The thought of treating from liver should be used throughout the whole process of the treatment.So we must pay morn attention to regulate the liver and prevent liver injury during the differentiation and treatment of esophageal carcinoma.

Objective To explore the effect of dexmedetomidine on hemodynamics in hypertensive patients undergoing thyroid surgery with local anesthesia.Methods Sixty patients with preoperatively diagnosed class Ⅰ to Ⅱ hypertension undergoing selective thyroidectomy were randomly divided into D (dexmedetomidine) and M (midazolam) groups (30 patients in each group).Doses of dexmedetomidine 0.5 μg/kg were finished in 20 minutes injection in patients of D group before the start of the surgery,then sequentially maintained at the rate of 0.1 ～ 0.5 μg/ (kg · h) with decreasing speed of 0.1 μg/(kg · h) when systolic pressure kept down to 110 mmHg or heart rare down to 60 bpm or Ramsay score of 3 points.The patients in M group were injected with midazolam 0.04 mg/kg 20 minutes before the start of surgery,then maintained at the rate of 0.02 ～ 0.05 mg/(kg · h),decreasing speed of 0.1 mg/(kg · h) to keep Ramsay score of 3 points if necessary.Two groups of patients with Ramsay score of 3 points but a high blood pressure (higher than 30％ of basic level) or heart rate (more than 100 bpm) were treated with drugs during operation.Record the systolic pressure,diastolic pressure,heart rate and Ramsay score at the time of before medication (T0),the injection of local anesthetics (T1),the start of surgery (T2),pain compliments required additional local anesthetics (T3),dealing with gland (T4) and the end of surgery,VAS in 8 h after operation and adverse reaction were recorded.Results In D group,the dosages of urapidil and esmolol [(10 ±5)mg and (0 ±0)mg] were significantly less than those in patients of M group [(60 ± 10) mg and (80 ±5) mg,t =14.82,t =19.78,P ＜ 0.05].Blood pressure and heart rate were all significantly decreased at the time of T1,T2 and T5 when comparing with T0(P ＜0.05 orP ＜0.01),and only heart rate was significantly decreased at the time of T3 and T4 (P ＜ 0.05).While in M group,blood pressure and heart rate were higher than basic levels at the time of T3 and T4 (P ＜ 0.05).Besides,lower blood pressure and heart rate were less than those in M group at all observed time expect T0 (P ＜ 0.05).Conclusions Good sedation effects can be produced by both dexmedetomidine and midazolam in hypertensive patients undergoing thyroid surgery with local anesthesia,but dexmedetomidine was determined more suitable in sedation and anti-hypertension in patients with light to moderate hypertension for better hemodynamic stability effect with local anesthesia.

Objective:To investigate the association between LPHN3 andattention-deficit/hyperactivity disor-der(ADHD)in Chinese Han children.Methods:Based on the Diagnostic and Statistical Manual of Mental Disor-ders,Fourth Edition (DSM-IV)diagnosis criteria,921 normal controls and 1052 ADHD children were included in the study.The Clinical Diagnostic Interview Scale (CDIS )was used to assess symptoms and ADHD sub-types.ADHD was divided into three subtypes,namely ADHD inattentive type (ADHD-I),ADHD hyperactive-im-pulsive type (ADHD-HI),and ADHD combined type (ADHD-C).The ADHD rating-scale was used to assess ADHD symptoms.Including inattentive symptoms,hyperactive symptoms,impulsive symptoms and ADHD total symptoms.Three single nucleotide polymorphisms (SNPs)of LPHN3 were genotyped.Case-control studies were conducted to investigate the association of each SNP with the ADHD and the subgroups using chi-square test.Results:rs11131347 was associated with ADHD P <0.05,OR =0.86(0.76 -0.98)],but the difference didn't survive significance after corrections,The frequency of minor allele C in cases and control was0.409 vs.0.445.For different genders,rs11131347 was significantly associated with ADHD boys [P <0.05,OR =0.82(0.71 -0.96)], The frequency of minor allele C in cases and control was0.402 vs.0.449.For different subtypes,rs11131347 was associated with ADHD-C [P <0.05,OR =0.85(0.74 -0.98)]and ADHD-C boys[P <0.05,OR =0.82(0.70 -0.97)],but none of the difference survived significance after corrections,The frequencies of minor allele C in cases and control were respectively 0.407 vs.0.445 and 0.401 vs.0.449.Genotypes distribution analysis indicated that rs11131347 was associated with ADHD in general (recessive model,P <0.05),ADHD boys (additive model,P <0.05;dominant model,P <0.05;recessive model,P <0.05),ADHD-C(recessive model,P <0.05)and ADHD-C boys (dominant model,P <0.05 ),however,none of the difference survived significance after correc-tions.rs11131347 was nominal associated with impulsive scores(P <0.05).Conclusion:These findings suggest that the polymorphism of LPHN3 is probably involved in the pathological mechanisms of ADHD and its core symptoms of impulsivity.

Objective To evaluate the clinical effect of Tanreqing in the treatment of radiation pneumonia. Methods 75 patients with radiation pneumonia were randomly divided into treatment group and control group according to the registration of this study.38 cases in the treatment group treated by Tanreqing,antibiotics and glucocorticoid,while 37 cases in the control group was given antibiotics and glucocorticoid.Then,the therapeutic efficacy was compared.Results From the chest routine scan result and the clinical symptom release,the excellence rate of the treatment group was 68.4%,which of the control group was 43.2%,there was statistically significant difference between the two groups (χ2 =4.823,P =0.028 ).Conclusion Treating radiation pneumonia with Tanreqing has good effect,and it is worthy of clinical application.

AIM:To investigate the effect of caveolin-1 and phosphorylation of ERK1/2 on 17?-estradiol (E2) induced inhibition of vascular smooth muscle cells (VSMCs). METHODS:The proliferation in cultured VSMCs was determined by using [3H]-thymidine incorporation. The expressions of caveolin-1,MKP-1 and ERK1/2 phosphorylation were measured by Western blotting. The expression of caveolin-1 mRNA was measured by RT-PCR. RESULTS:Exposed to fetal calf serum (FCS) for 24 h,the increase in proliferation of VSMCs was detected by [3H]-thymidine incorporation. Pretreatment with various concentrations of E2 for 24 h inhibited VSMC proliferation induced by FCS. The results of Western blotting and RT-PCR showed that pretreated with 17?-estradiol for 24 h reserved the decrease in caveolin-1 induced by FCS. Western blotting results further proved that the expression of MKP-1 was significantly increased and the expression of ERK1/2 phosphorylation was decreased after incubated with 17?-estradiol. CONCLUSION:17?-estradiol increases caveolin-1 and MKP-1 expressions,and decreases ERK1/2 phosphorylation,leading to the inhibition of VSMC proliferation.