With the wide development of intra-arterial thrombolysis,the risk factors and the occurrence mechanism of hemorrhagic transformation have drawn great attention.Hemorrhagic tramformation is the most dangerous complication of intra-arterial thrombolysis.The understanding of the occurrence mechanism of hemorrhagic transformation from macroscopic tO microscopic,it is attributed ultimately to the destruction of vascular wall structure or function.The related mechanisms include oxidative stress reaction,leukocyte infiltration and inflammatory reaction,vascular reaction,and extracellular proteolysis.

Objective: To optimize the hospital medical examination process, reduce the patient waiting time. Methods: Established a centralized examination appointment center at outpatient department. Development and implementation of medical examination appointment platform, integrated with the hospital HIS system, PACS systems and queue system. Results:Achieved the function of“one-stop booking, network distribution, multi-point examination”for all patients, a better solution to the disorder problem of medication examination. Conclusion:The implementation of the medication examination platform has played a positive role. Facilitate patient visits, rational use of equipment, improve work efficiency and improve the treatment environment.

Objective To investigate the efficacy and safety of carvedilol in patients with chronic heart failure (CHF).Methods Forty-six patients with CHF were randomly divided into carvedilol group (n=26) and control group (n=20) on the basis of standard therapy including digitalis, diuretics and ACEI. Before and after treatment, NYHA class, echocardiography and adverse reaction were observed. Results The mean dose of carvedilol was titrated to 25.14?3.05mg/day. After treatment, NYHA class was improved in both groups. Left ventricular end-diastolic diameter (LVEDD) measured by echocardiography reduced [(58.79?8.99)mm vs (64.68?10.12) mm,P

Objective To explore the diagnostic value of HR -HPV combined with TCT in the diagnosis of cervical cancer and precancerous lesion.Methods 1 198 cervical specimens were selected for the study.The results of HR -HPV detection and TCT detection were analyzed,with the pathological results as the gold standard,the diag-nostic value of HR -HPV and TCT in the diagnosis of cervical cancer and precancerous lesion were discussed. Results With increasing pathological grade,TCT positive rate increased gradually,there was a correlation between them(r =0.629,P <0.05).With increasing pathological grade,HR -HPV positive rate increased gradually,there was a correlation between them(r =0.684,P <0.05).The sensitivity of HR -HPV combined with TCT in the differ-ential diagnosis of cervical cancer,precancerous lesions was 100.00%,specificity was 79.64%,missed diagnosis rate was 0.00%,the misdiagnosis rate was 20.36%.Conclusion HR -HPV combined with TCT examination has high clinical value in the diagnosis of cervical cancer and precancerous lesions.

Objective To evaluate the effect of propofol infusion on hepatic blood flow (HBF) and oxygen delivery and consumption in rabbit. Methods Thirty adult male rabbits weighing 1.6-2.4 kg were randomly allocated into 3 groups: group I high dose propofol (HP) ( n = 11); group II low dose propofol (LP) (n = 10) and group III control group (C) ( n = 9). The rabbits were anesthetized with intravenous 3 % pentobarbital 45 mg ?kg-1 and mechanically ventilated (VT = 10 ml?kg-1 RR = 40 bpm, I:E= 1:2) after tracheal intubation. ECG, urinary output and rectal temperature were continuously monitored. Portal vein and hepatic artery were dissected and exposed for measurement of blood flow using electromagnetic flowmeter. Catheters were inserted into carotid artery, portal vein and hepatic vein via the mesenteric vein and right femoral vein for collection of blood samples. After the circulation was stabilized for 30 min, propofol infusion was started at a rate of 1.2 mg ? kg-1 ? min-1 ( HP) or 0.4 mg?kg-1 ?min-1(LP). In control group normal saline was infused instead of propofol. Portal venous and hepatic arterial blood flow were continuously measured. Blood samples were obtained from carotid artery, portal vein and hepatic vein before ( baseline) and at 30, 50, 70 and 90 min of propofol infusion for determination of Hb, SO2, PO2 and PCO2. The hepatic O2 delivery (DO2 ) and consumption (VO2 ) were calculated. Results The three groups were comparable with respect to body weight, duration of operation, the volume of fluid infused and blood loss and urinary output. HBF was significantly higher at 30-90 min of propofol infusion in HP group than in C group, meanwhile DO2 and VO2 in HP group were significantly higher during propofol infusion than the baseline value before infusion and those in C group. However, there was no significant difference in DO2/VO2 ratio between HP and C group. Conclusion High dose propofol infusion improves liver blood flow and O2 delivery but it also increases hepatic O2 consumption. However the balance between hepatic O2 supply/demand remains unchanged.

Objective:To study the effects of nitrous oxide(N2 O)sedation in the management of dental fear(DF)for dental treat-ments of children.Methods:66 cases of pediatric patients(aged 6 to 14 years)were given N2 O sedation for dental treatments.The heart rate(HR)and oxygen saturation(SpO2 )were measured before and after N2 O inhalation.N2 O effective concentration was eval-uated by Ramsay sedation score and Houpt behavior score.Results:The effective concentration of N2 O sedation was 25% -70%(49.6% ±12.1%),the maximum endurance concentration 35%-70% (56.4% ±10.1%).The Ramsy scores of N2 O sedation was (2.3 ±0.6).After N2 O inhalation,all patients could receive verbal demand during the treatments.The HR decreased(P <0. 05)and the Houpt behavior score increased(P <0.01).Before and after N2 O inhalation SpO2 had no significant difference(P >0.05).Conclusion:N2 O inhalation at 25% -70% is safe and effective in the management of DF for dental treatments of children.

Objective To investigate the preoperative management and the clinical effeciency of Lichtenstein tension-free hernioplasty in adult patients with inguinal incarcerated hernia.Methods Clinical data of 86 patients with inguinal incarcerated hernia were analyzed retrospectively.Hernia was repaired with Lichtenstein tension free after reposition.Results There were 59 male patients and 27 female patients with median age of (63 ± 18) years.There were 8 patients with liver cirrhosis.The operation was performed successfully in all patients.Segmental bowel resection with end-to-end anastomosis was performed in 38 emergency cases.Operative time was 20-120 min,with an average time of 54 min.The postoperative hospitalization was 5-17 d,with an average of 8 d.There were 7 cases of skin ecchymosis at the scrotum,there were no intestinal perforation,hepatic encephalopathy and upper gastrointestinal hemorrhage after operation.In early series of 24 cases without drainage tube left in place,there were 10 cases of fat liquefaction,10 cases of hydrops of hernial sac,6 cases of seroma and 3 cases of wound infection after operation.After 12 to 48 months of follow-up,there was no mortality after 2 years,no hernia recurrence.Conclusions Tension free repair in the treatment of incarcerated inguinal hernia is safe and feasible.

Objective To study the clinic features and the mechanism of skin damage induced by high-dose methotrexate(HD-MTX).Method Children treated with HD-MTX were enrolled in a retrospective study in which the incidence and presentations of skin damage were concluded.Mechanism of the damage was studied base on skin pathology of an animal model.Result Skin damage presented in 3～9(median 5) days after HD-MTX and usually followed by bullation and exfoliation.Twelve cases,more severe than the others,accompanied with fever and symptoms of other organs especially the respiratory tract and the intestine.Skin damage was reduced when large dose rehydration used before,during and after HD-MTX.Conclusion HD-MTX may cause scald-like skin damage directly by its prolonged toxic effect on epidermal cells.Besides extended tetrahydrofolic acid rescue and supportive treatments,anti infection is the most important in dealing this condition.

Objective To develop a equipment of vehicular multifunctional water,and the problem of water in disaster medical rescue was solved. Methods According to the features of the field water in earthquakes,floods and other disasters,a kind of disaster relief in the wild integrated production,supplying softening water and water purification technology was created,and a system by the pretreatment system, ion exchange,reverse osmosis systems,and storage and transportation system and other parts of the small truck-mounted multifunctional water treatment equipment was developed. Results The vehicular prototypes of multifunctional water treatment machine was developed,the pond water and river water were tested to prove that the throughput of the equipment in production and supply in the land of disaster relief,the puri-fied water and softening water reached 2 080 L/day and 12 100 L/day,which could meet the conducted large-scale medical treatment de-mand. Conclusion The successful design of the vehicular multifunctional water processor carried out the medical rescue with water prob-lem,and provided a new method and new equipment,which was worthy of popularization and application.

Objective To identify the correlativity between SCN4A V781I mutation and hypokalemic periodic paralysis(HOKPP).Methods The SCN4A V781I mutation was screened on the members of a hypokalemic periodic paralysis family(including 3 patients and 14 healthy relatives), 71 sporadical hypokalemic periodic paralysis patients and 100 healthy adults with the PCR sequencing and the incision enzyme techniques.Results The mutation existed not only in all the patients but also in 4 healthy relatives, including 1 male and 3 females, in the hypokalemic periodic paralysis family.Seven of 71 sporadieal hypokalemic periodic paralysis patients and 7 of 100 health adults indicated the SCN4A V781I mutation.There was no significant difference in the SCN4A V781I mutation rate between the hypokalemic periodic paralysis patients and the healthy adults(X~2=0.452, P=0.502).Conclusions SCN4A V781I mutation maybe is an innocent polymorphism.There is little correlativity between SCN4A V781I and hypokalemic periodic paralysis.