ObjectiveTo seek the approach to the initial diagnosis of pulmonary embolism through analysis and conclusion of the clinical features of pulmonary embolism.MethodsThe high risk factors,clinical manifestation and results of common auxiliary examinations of 23 patients with pulmonary embolism were analyzed retrospectively.ResultsThere were 91.30％(21/23)patients with high risk factors.The common symptoms were dyspnea (91.30％,21/23) and chest tightness (69.57％,16/23 ),while the triad of pulmonary embolism merely accounted for 13.04％ (3/23).And other symptoms included palpitation,chest pain,hemoptysis and syncope,etc.Blood gas analysis indicated that there were hypoxemia and hypocarbia.The positive rate of D-dimer was 91.30％ (21/23).The abnormal rate of electrocardiogram was 91.30％( 21/23 ) and the abnormal rate of echocardiography was 86.96％(20/23).ConclusionAppropriate approach to the initial prognosis can help to establish the diagnosis of patients with suspected pulmonary embolism as early as possible,as well as differentiate other cardiopulmonary diseases.

Objective:To explore the necessity of monitoring polysomnography (PSG ) in snoring children.Method:The PSG were monitored in 162 children with snoring or apnea.Acording to results of PSG,162 cases were separated into two groups:group obstructive sleep apnea hypopnea syndrome(OSAHS) and group primary snoring(PS),monitoring data including:apnea hypopnea index(AHI),snoring index(SI),lowest oxygen saturation(LSaO_2) and time of SaO_2<0.9,all data were undertaked statistical analysis. Result:In all 162 snoring cases,150 cases(92.6%) belong to group OSAHS,12 cases(7.4%) belong to group PS;Differences of data of age,sex and body mass index(BMI) are not significant but that of AHI,SI,LSaO_2 and time of SaO_2<0.9 are significant(P<0.05).Conclusion:It's necessary to monitor PSG in snoring children for early diagnosis and correct treatment to avoid disadvantage of OSAHS.

Colorectal carcinogenesis is the result of accumulation of genetic and epigenetic alters.Gene mutations and changes in DNA methylation patterns,resulted from genomic instability,are the main molecular events in colorectal cancer.Identification of key mutations and methylation phenotypes in genes leading to colorectal cancer progression,and molecular pathology classification and diagnosis are likely to be the prerequisites for individualized and targeted treatment.

OBJECTIVE:To establish the method for simultaneous determination of heavy metals in Platycodon grandiflorus, and to explore the effects of altitude on the contents of heavy metals. METHODS:The contents of As,Hg,Pb,Cu and Cd were determined by hydride generation,hydride generation method,graphite furnace method,flame spectrometry,graphite furnace meth-od. SPSS 19.0 software was adopted for clustering analysis and correlation analysis. RESULTS:The linear ranges of As,Hg,Pb, Cu and Cd were 0-16 μg/L(r=0.9960),0-18 μg/L(r=0.9996),0-50 μg/L(r=0.9997),0-0.8 μg/L(r=0.9990)and 0-4 μg/L (r=0.9980). Detection limit were 1.3×10-3,2.4×10-4,1.9×10-3,0.33,1.8×10-4 mg/kg. Quantitation limit were 4.4×10-3,8.0×10-4, 6.2 × 10-3,1.1,6.0 × 10-3 mg/kg. RSDs of precision,stability and repeatability tests were all lower than 3.0%. Recoveries were 99.1%-107.1%(RSD=3.13%,n=6),94.1%-100.5%(RSD=2.36%,n=6),98.9%-104.8%(RSD=1.81%,n=6),92.7%-100.3%(RSD=2.92%,n=6),96.6%-99.9%(RSD=1.26%,n=6). Samples with similar altitudes were clustered into a class;the con-tents of heavy metals decreased as the increase of altitude;there was significant correlation among 5 heavy metals. CONCLU-SIONS:The method is simple,precise,stable and repeatable,and can be used for simultaneous determination of heavy metals' contents in P. grandiflorus. The altitude has a certain effect on the quality of P. grandiflorus.

Objective To describe clinical and functional features of patients with left main coronary artery (LM) stenosis. Methods Significant stenosis was defined as ≥ 50%.One hundred and eighty-eight patients with LM stenosis and 200 patients with clinically suspected coronary heart disease (CHD) without LM stenosis were enrolled. Results (1) The incidence rate of LM stenosis was 5.59%.(2) Patients with LM stenosis all had risk factors.Furthermore,featured older age,higher incidence of angina pectoris,and the same incidence of myocardial infarction history when compared with the patients without LM stenosis.(3) The left ventricular ejection fraction was lower in patients with LM stenosis than that in patients without LM stenosis,and it was lower too in patients with isolated LM stenosis than in patients with LM stenosis accompanied by triple vessel stenosis.The left ventricular end diastolic pressure showed no significant difference among various groups. Conclusion Patients with LM stenosis feature older age,severe angina pectoris.Furthermore, most of them are accompanied by other vessel lesions.Most LM stenosis are located at the ostium and the crotch of LM is presented as stenosis

Objective:To research the quality standard for Xilei San. Methods:Imdigo naturalis and calculus bovis were identi-fied by TLC and their contents were determined by HPLC, and Borneolum syntheticum was determined by GC. Results: Indirubin showed good linearity over the concentration range of 0. 043-4. 255 0 μg(r=0. 999 2) with the average recovery of 97. 9%(RSD=1.5%,n=6). Bilirubin showed good linearity over the concentration range of 9.968 ×10 -4-9.968 ×10 -2 μg(r=0.999 9) with the average recovery of 95.3%(RSD =0.55%, n =6). Borneolum syntheticum showed good linearity over the concentration range of 0. 010 3-0. 826 6 mg(r=0. 999 8) with the average recovery of 94. 9%(RSD=3. 2%,n=6). Conclusion: The method is accurate with good reproducibility,which can be used as the quality control for Xilei San.

Objective To observe the effects of hyperbaric oxygen (HBO) on the expression of NF-?B and ICAM-1 after cerebral ischemia-reperfusion in rats. Methods The middle cerebral artery occlusion-reperfusion (MCAOR) model was established by using Zea-Longas method in rats. Seventy-two rats were recruited in this study and randomly divided into 3 groups: a cerebral ischemia-reperfusion group (CIR group),a CIR+HBO group(HBO group),and a sham-operation group(SO group). The infarct volume of each group was measured by TTC staining technique, and the expression of NF-?B and ICAM-1 was measured at 24 h, 48 h, 72 h and 120 h, respectively, after reperfusion by using immunohistochemistry staining. Results The infarct volume in HBO group was significantly smaller than that in CIR group (P

Imatinib mesylate,as the first generation Bcr-Abl tyrosine kinase inhibitor,has brought revolutionary treatment for Philadelphia chromosome (Ph)-positive chronic myelogenous leukemia (CML);it has been recommended as the first-line treatment for CML by NCCN Practice Guidelines in Oncology in 2008 and European LeukemiaNet(ELN) criteria.However,imatinib has three limitations:first,it is expensive and can not be stopped if efficancy to be maintained;Second,some 20%~30% of patients develope resistance to imatinib;and third,the CML patients can not be cured with imatinib.Taking into consideration of the situation in China,we recommend individual therapy using TKI,HSCT,interferon and cytotoxic drugs for CML patients in China.

Uncoupling protein 2 (UCP2), a member of the mitochondrial inner membrane carrier family, partly dissipate the proton electrochemical gradient, decrease ATP production. UCP2 limits production of reactive oxygen species (ROS) and inhibits insulin secretion and regulates fatty acid oxidation. FFA, PPAR?,leptin, thyroid hormones and so on could regulate the UCP2 expression. The function of UCP2 in myocardial energy metabolism remains unknown.