OBJECTIVE:To compare clinical efficacy,safety and economy of urokinase and alteplase each combined with Enoxaparin sodium in the treatment of acute ST segment elevation myocardial infarction (STEMI). METHODS:80 STEMI pa-tients were randomly divided into control group and observation group,with 40 cases in each group. Both groups received Aspirin enteric-coated tablet for antiplatelet aggregation,and Clopidogrel hydrogen sulfate tablet for anticoagulation before thrombolysis. Control group were given urokinase 1 500 000 U added into 0.9% Sodium chloride injection 100 ml,ivgtt,within 30 min;given Enoxaparin sodium injection 7 500 U intramuscularly 12 h after thrombolysis,for 3-5 d. Observation group was given Enoxaparin sodium 60 U/kg,ivgtt,1 mg/ml Alteplase for injection 8 ml with intravenous push,other 42 ml ivgtt within 90 min;continued to receive Enoxaparin sodium with 12 U/(kg·h)micro-pump for 48 h,followed by Low molecular weight heparin calcium injection 5 000 U intramuscularly,bid,for consecutive 5 d. Clinical efficacy of 2 groups were observed,and thrombolytic recanalization situa-tion were observed 30,60,90 and 120 min after thrombolysis. ECG,cost-effectiveness and ADR were also observed. RESULTS:The effective rate of observation group(92.50%)was significantly higher than that of control group(85.00%). The rates of throm-bolytic recanalization in observation group 60,90 and 120 min after thrombolysis were significantly higher than in control group, with statistical significance(P<0.05). Q wave time,Qwave/Rwave and ST segment deviation of observation group after treatment were significantly lower than those of control group,with statistical significance(P<0.05). The total hospitalization cost of obser-vation group was significantly higher than that of control group,with statistical significance(P<0.05);there was no statistical sig-nificance in effective rate and the per unit cost of thrombolytic recanalization rate (P>0.05). The incidence of ventricular aneu-rysm,pericardial effusion,heart failure or cardiac shock,angina pectoris after infarction,severe arrhythmia,death and other as-pects in observation group were significantly lower than in control group,with statistical significance(P<0.05). CONCLUSIONS:Alteplase and enoxaparin thrombolysis therapy is better than urokinase and enoxaparin for STMEI in respects of clinical efficacy, and thrombolytic recanalization with less ADR and better safety;urokinase is cheaper and better than alteplase in cost-effectiveness ratio. Both of them can be used after careful consideration.

The chiral resolution of the optical isomers of aryloxypropionic acid herbicide intermediate α-chloro-N-phenyl propanamide was studied by reversed phase high performance liquid chromatography on chiral column. The experimental results showed that the optical isomers of α-chloro-N-phenyl propanamide could be resolved much better on the tribenzoylcellulose (CTB) chiral column with ethanol as mobile phase. The separation factor and separation degree were 1.52 and 0.60 respectively

Objective To investigate the effects of lower limb training combined with hyperbaric oxygen on motor function in a paretic lower limb and on the ability in the activities of daily living (ADL) of hemiplegic stroke survivors. Methods A total of 297 hemiplegic stroke patients received routine interventions and then were randomly divided into 3 groups. The hyperbaric oxygen group accepted hyperbaric oxygen, the training group accepted lower limb training, and the treatment group accepted both hyperbaric oxygen and lower limb training. Evalnations were carried out pretreatment and 30 d post treatment to assess the function of the paretic lower limb and ADL ability with the Fugl-Meyer assessment ( FMA), a modified Barthel index (MBI) , Berg's balance scale (BBS) and the timed up and go test (TUGT). Results FMA, MBI, BBS and TUGT scores in all 3 groups improved significantly compared with pretreatment. On the 30th day post treatment, the scores in the treatment group were significantly better than in the other two groups. Conclusions Lower limb training combined with hyperbaric oxygen can significantly improve motor function in the paretic lower limbs of stroke patients and their ADL performance.

This paper dealt with the influences of different media, temperature, light and pH to the amount of oospore formation. The results showed that millet agar, bai yun beau agar and soybean agar provided the favorable condition for oospore formation, the number of oospores was 131.6~149.6 /cm2, but a few oospores was formation on frozen pea agar. The results also suggested that the optimal conditions for oospore formation were 18℃, pH7 and darkness. The oospores failed to be formed tinder fluorescent or black light.

ObjectiveTo investigate the effect of urinary kallidinogenase on the expression of Bcl-2 and Bax in cerebral ischemia-reperfusion injury of rats.Methods Forty eight male adult Sprague-Dawley rats were randomly assigned into four groups: sham operation group, model group,normal saline group andurinary kallidinogenase group.The middle cerebral artery occlusion reperfusion model was made by the suture method. After focal cerebral ischemia-reperfusion, the animals were neurologically assessed on a 5 point scale. The levels of Bcl-2 and Bax expression were measured by immunohistochemical and RT-PCR.Results In model and normal saline group, the expressions of positive Bcl-2 neurocytes and mRNA [(14.28±2.54)/HP, 0.551±0.068 and (16.54± 1.84)/HP, 0.585 ± 0.084] were significantly increased compared with the sham operation group [ (7.58 ± 0.97 )/HP、 0.324 ± 0.042] ( P ＜ 0.05 ) ; The expressions of Bax positive neurocytes and mRNA[( 24.38 ± 3.58 )/HP, 0.540±0.076 and (26.74 ±4.04) /HP, 0.527 ± 0.065] were significantly increased than the sham operation group [ (8.24±1.95 )个/HP, 0.309 ± 0.037] (P ＜0.05). After treatment with urinary kallidinogenase, the expressions of Bcl-2 positive neurocytes and mRNA [(25.61±3.41)/HP, 0.791 ±0.096] were upregulated ( P＜0.05), and the expressions of Bax positive neurocytes and mRNA [( 18.54 ± 2.38)/HP, 0.359±0.053] were down regulated (P＜0.05), compared with model group and normal saline group.ConclusionsUrinary kallidinogenase is significantly related to the upregulation of Bcl-2 expression and the downregulation of Bax expression, which suggest that urinary kallidinogenase could be related with the inhibitory effects on ischemic neurocyte apoptosis.

Objective By using 18F-deoxyglucose (18F-FDG) positron emission computed tomography (PET-CT) to measure the brain glucose metabolism of patients with severe traumatic brain injury before and after hyperbaric oxygen (HBO) therapy,and to investigate the mechanisms of H BO treating patients with traumatic brain injury.Methods Twenty-six patients suffered form severe traumatic brain injury with stable vital signs within 2 weeks were randomly divided into the HBO group and the control group.The patients of both groups received routine clinical interventions (including neuroprotection,dehydration,reducing intracranial pressure,anti-infection and other symptomatic treatments).Patients of the HBO group received the basic treatment combined with HBO therapy one tine per day for 7 days per week.In early stage and 4 weeks after treatment,all patients were examined with PET-CT scanning and Glasgow coma scale (GCS),disability rating scale (DRS) at the same time.Results There was standard uptake value (SUV) of significant difference between affected and unaffected brain areas in two groups before treatment(P＜0.01),but no significant difference between two groups (P＞0.05).After 4-week of treatment,SUV of affected and unaffected brain areas of two groups improved,the damaged area of HBO group improved obviously and the SUV was much better than before treatment and the control group (P＜0.0l).The GCS and DRS scores of HBO group were also significantly better than that of control group (P＜0.05).Conclusion The 18F-FDG PET-CT examination showed that HBO therapy can significantly improve glucose metabolism function of the brain damaged area,promote the brain functional recovery and awakening,and improve the prognosis in patients with severe traumatic brain injury.

Objective To observe the effects of hyperbaric oxygen (HBO) on cerebral small vessel disease (CSVD) and on learning,memory and the expression of brain-derived neurotrophic factor (BDNF) and acetylcholine (Ach) in the cerebral cortex and hippocampus.Methods Sixty healthy,male Wistar rats were studied.Allograft thrombosis particles 48 to 74 μm in diameter were injected into the rats' external carotid arteries to create a CSVD model.The rats were then divided randomly into a hyperbaric oxygen group,a nimotop group and a control group.The hyperbaric oxygen group rats were given hyperbaric oxygen therapy 12 hours after the modeling.The nimotop group rats were given nimodipine by intragastric perfusion 12h after the modeling.The rats in the control group had no special intervention.At 7,14 and 28 days after the modeling,any changes in learning and memory were assessed with a Morris water maze test.Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of BDNF in the cerebral cortex and of Ach in the hippocampus at 28 days.Results At both 14 and 28 days the average escape latency of the rats in the hyperbaric oxygen group was significantly shorter than those of the nimotop and control groups.The average platform crossing time had increased significantly more than in the nimotop and control groups.At both 14 and 28 days the escape latency and platform crossing times of the nimotop group were significantly better than in the control group.Ach content and BDNF content were significantly higher in the HBO group than in the nimotop and control groups.Conclusions Hyperbaric oxygen treatment can promote BDNF release in CSVD,which is helpful to protect and repair neural mitochondria,to maintain the cortex and hippocampal neurotransmitters on a stable level,and to improve learning and memory.Its effect is better than that of nimotop.

Objective To detect the metabolites of non-motor functional area in patients with Parkinson disease (PD) by proton magnetic resonance spectroscopy (1H-MRS).Methods Forty-two PD patients (PD group) tested with unified PD rating scale (UPDRS) and 20 healthy controls(normal control group) were enrolled in this study.MRI and 1H-MRS using a GE signa excite1.5T MR was obtained,and the ratios of metabolites such as N-acetylaspartate(NAA)/creatin(Cr),NAA/cholinecompounds(Cho) in the prefrontal lobe,hippocampus,cuneus gyrus and dorsal thalamus were compared.Correlations between brain metabolites and UPDRS were analyzed.Results The levels of NAA/Cr,and NAA/Cho in bilateral dorsal thalamus,cuneus gyrus,hippocampus,prefrontal lobe in PD group were significantly lower than those in normal control group (P ＜ 0.01).The level of Cho/Cr in right hippocampus,right cuneus gyms,and right dorsal thalamus in PD group was significantly higher than that in normal control group (P ＜ 0.05).The NAA/Cho in the left hippocampus (r =-0.388,P =0.011) and left cuneus gyrus (r =-0.325,P =0.036) was negatively correlated with UPDRS scores (P ＜ 0.05).Conclusions There is extensive neuronal damage and some glial proliferation in the non-motor functional areas including prefrontal lobe,hippocampus,cuneus gyrus,anddorsal thalamus in the PD patients.The degree of damage in left hippocampus and left cuneus gyms is positively correlated with the severity of the disease clinically.

ObjectiveTo explore the changes of the levels of cytokines in patients with first-episode depression and the effect on the levels of cytokines after the treatment with duloxetine.MethodsThe serum levels of interleukin 1 ( IL-1 ),interleukin 6 ( IL-6 ),tumor necrosis factor-alpha ( TNF-αt ),interleukin4 ( IL-4 ),interleukin10(IL-10) were measured in 38 patients with depression before and after duloxetine treatment by enzyme linked immunosorbent assay(ELISA).HAMD score were assessed at pre- treatment and post-treatment to assess curative effect.The control group was 30 healthy individuals.All data were statisticaly analyzed by SPSS.ResultsBefore treatment,the HAMD score and the levels of serum IL-6,TNF-α,IL-1 in first-episode depressant patients were remarkablely higher than those in the control group( IL-6:( 10.66 ± 3.12 ) pg/ml vs (2.72 ± 0.91 ) pg/ml ;TNF-α:(77.49 ±3.12) pg/ml vs (37.48 ±5.87) pg/ml; IL-1:(39.09 ± 3.77 ) pg/ml vs ( 10.31 ± 1.05 ) pg/ml ),the levels of serum IL-4 and IL-10 in first-episode depressant patients were remarkablely lower than those in the control group(P＜0.05,P＜0.01 ).The HAMD score and the levels of serum IL-6,TNF-α,IL-1 in post-treatment were remarkablely lower than pre-treatment (P ＜ 0.05 ),but which were still higher than the control group(P＜ 0.05 ).The levels of serum IL-4 and IL-10 in post-treatment were remarkablely increased than pre-treatment(P＜0.05).The levels of serum IL-6,TNF-α,IL-1 were positively correlated with the HAMD score( r =0.667,0.486,0.727,P ＜0.01 ),but the levels of serum IL-4 and IL-10 were negatively correlated with the HAMD scorae ( r=-0.433,-0.269,P＜0.05,P＜ 0.01 ).ConclusionsThe first-episode depressant patients show immune disorder induced by cytokines.Anti-depressant activity of duloxetine may participate in the regulation of cytokines and Th1/Th2 unbalance.

Objective To study the influence of center of gravity excursion in standing on function outcome of stroke patients.Methods46 stroke patients were assessed with static posturography in standing,Fugl-Meyer Balance Scale,Barthel Index and the time in hospital.The patients were divided into 2 groups according to posturography results:center of gravity was inclined to the normal side (normal group),center of gravity was inclined to the hemiplegia side (hemiplegia group).ResultsThe ability of balance,walking and activity of daily living(ADL)of the normal group patients were better than that of the hemiplegia group patients,and the in-hospital time was shorter (P<0.001).ConclusionThe center of gravity excursion in standing is highly correlated with functional outcome of stroke patients.