Objective To explore the elinical characteristics and the effects of thrombolytic and anti-coagulation therapy on pulmonary embolism(PE)in over 60-year-old patients. Methods The clinical findings,diagnostic techniques,effects of thrombolytic and anti coagulation therapy in 72 patients with PE aged over 60-year were analyzed retrospectively. Results Each one of 72 patients in this study suffered from two or more chronic diseases.Hypertension(56.9%)and deep venous thrombosis(DVT)in lower limbs(53.6%)were the most common thrombosis risk factors in the study.The clinical findings were atypical in elderly patients with PE.Different degree of dyspnea was the main characteristics(91.7%).Other findings were cough(30.6%),chest pain(27.8%),cyanosis (18.1%),faint(13.9%)and emptysis(12.5%).The objective signs showed edema of lower extremity (44.4%),moist rales(31.9%),P2 accentuation(18.1%),vascular murmur(5.6%).Blood gas analysis in 61 cases showed that 53 patients suffered from hypoxemia(86.9%)along with 37 cases of hypocapnia(60.7%).The alveolar-arterial oxygen gradient was increased in 27/31 cases(87.1%)and blood D-dipolymer was positive in 50/61 cases(82.0%).Spiral CT pulmonary angiogram(CTPA)in 62 cases and radioactive nuclear ventilation perfusion scan in 16 cases demonstrated PE in 58(93.5%) and 16(100%)patients respectively.The cure rate of thrombolytic therapy combined with anti-coagulation versus anti-coagulation therapy alone was 86.2%versus 30.2%(P=0.000).There was no haemorrhagia phenomenon during thrombolytic and anti-coagulation therapy. Conclusions The most common risk factors of PE in the elderly are hypertension and DVT in Iower limbs.The clinical symptoms are atypical and variable.Dyspnea is the main characteristics.Thrombolytic with anti-coagulation therapy is safe and effective,but anti-coagulation therapy alone has no benefit.

Objective To investigate the status of patient safety culture cognition and safety nursing behavior among nurses and examine the influence of patient safety culture cognition on safety nursing behavior of nurses using structural equation model. Methods A total of 350 clinical nurses were recruited in a hospital in Dalian with multi-stage sampling method. Patient Safety Culture Assessing Scale, Safety Behavior Scale were delivered to the investigation object. Results The mean score of the patients safety culture was 4.09±0.47, which was above average;the total score of nurses′safety nursing behavior was 4.74 ± 0.31, which was at high level; the causality model of patient safety culture cognition and the safety nursing behavior was accepted (path coefficient=0.35,P<0.01). Conclusions Nurses′ patient safety culture cognition has a significant impact on safety nursing behavior. Hospital should cultivate the awareness of the patient safety culture, so as to promote the safety nursing behavior.

Objective To explore the effect of tumor necrosis factor (TNF)-α inhibitors therapy on bone mineral density (BMD) in active rheumatoid arthritis (RA) patients with low bone mass.Methods Sixtytwo active RA patients with low bone mass were treated with a standard treatment of calcium carbonate 0.5 g/d and alfacalcidol 0.25 μg/d,and were divided into two groups.Patients of the control group were treated with methotrexate 10 mg per week,while patients of the experimental group were treated with combined recombinant human type Ⅱ tumor necrosis factor receptor-antibody fusion protein 50 mg per week or adalimumab 40 mg/2 week subcutaneously for 12 months with methotrexate.BMD of lumbar spine (L2-4),femoral neck,trochanter and Ward's triangle region by dual energy X-ray absorptiometry (DEXA),as well as the bone turnover markers serum C telopeptide of type-Ⅰ collagen (CTX-Ⅰ) and serum procollagen type-Ⅰ N propeptide (PINP) were measured by enzyme-linkedimmunosorbent assay (ELISA) in both groups at the baseline,treatment for six-month and twelve-month.T test and Chi-square test was used to process the data.Results ① After 6 months of treatment,the BMD of lumbar spine,femoral neck and trochanter in the group with TNF-α inhibitors were higher than the control group [(0.68±0.08) g/cm2 vs (0.65±0.06) g/cm2,t=2.269,P=0.027; (0.63±0.08) g/cm2 vs (0.58±0.09) g/cm2,t=2.111,P=0.040; (0.61±0.10) g/cm2 vs (0.56±0.07) g/cm2,t=2.203,P=0.032; respectively].And after 12 months,the BMD of all regions were significantly higher thanthe control group [spine,(0.68±0.07) g/cm2 vs (0.62±0.08) g/cm2,t=5.115,P=0.000; femoral neck,(0.63±0.08)g/cm2 vs (0.56±0.08) g/cm2,t=3.475,P=0.001; Ward's triangle region (0.60±0.08) g/cm2 vs (0.56±0.08) g/cm2,t=2.309,P=0.025; trochanter,(0.61±0.10) g/cm2 vs (0.53±0.08) g/cm2,t=3.254,P=0.002; respectively].② Compared to the baseline,BMD of lumbar spine was significantly decreased in the control group after 12 months.While in the group of TNF-α inhibitors,BMD of lumbar spine was increased[(0.66±0.08) g/cm2 vs (0.68±0.07)g/cm2,t=3.411,P=0.001].③ Compared to the baseline,CTX-Ⅰ,a marker of bone resorption was significantly decreased at 6 months and 12 months in the group with TNF-αinhibitors [6 months,(0.33±0.2) ng/ml vs (0.46±0.22) ng/ml,t=5.548,P＜0.01; 12 months,(0.31±0.21) ng/ml vs (0.46±0.22) ng/ml,t=5.974,P＜0.01],while this decline was not found in the control group.PINP,a marker of bone formation was stable in both 2 groups during the study.Conclusion In active RA patients with low bone mass,loss of BMD in the spine and hip can be arrested by the treatmentof TNF-α inhibitors.

Objective:To explore diagnostic value of soluble tumor necrosis factor - like weak inducer of apoptosis (sTWEAK) and interleukin (IL) -6 concentrations in patients with acute coronary syndrome (ACS) .Methods:A total of 170 ACS patients hospitalized in our hospital from Jan 1st ,2014 to Jun 31st ,2014 were selected as ACS group ,mean‐while ,80 inpatients with stable angina pectoris (SAP) confirmed by coronary angiography (CAG) or coronary CT were se‐lected as SAP group ,and another 80 patients excluded for coronary heart disease (CHD) by CAG were regarded as normal control group .ACS group was further divided into ST elevation myocardial infarction (STEMI) group (n=45) ,non -STEMI (NSTEMI) group (n=52) and unstable angina pectoris (UAP) group (n=73) .Plasma sTWEAK and serum IL‐6 concentrations were compared among all groups .Results:Compared with normal control group and SAP group ,there were significant rise in concentrations of plasma sTWEAK [ (120.32 ± 10.15) ng/L vs .(123.86 ± 15.23) ng/L vs .(140.05 ± 17.51) ng/L] and serum IL‐6 [ (110.34 ± 26.01) pg/ml vs .(112.38 ± 25.74) pg/ml vs .(245.23 ± 68.58) pg/ml] (P<0.01 all) ,but there were no significant difference between normal control group and SAP group , P>0.05. There were no significant difference in plasma sTWEAK and serum IL‐6 concentrations among UAP group ,NSTEMI group and STEMI group , P>0.05 all .Conclusion:Plasma sTWEAK and serum IL‐6 concentrations significantly rise in ACS patients ,which possesses certain diagnostic value for ACS .

OBJECTIVE To prevent occurrence of infection in clinical laboratory. METHODS The biosafety system was continuously improved and complet step by step and amplifed rules and regulation,done well protection of person,making the operating process of laboratory more norma,enforcing the air and environment,sterilizeing the equipment,detecting implement,disinfecting the used material and medical garbage and inspecting. RESULTS The hospital infection in laboratory was effectly controlled,the staff′s safety and health were addressd when they worked in an infected area of laboratory. CONCLUSIONS Amplifying the rules and regulation,and insisting the principle of work without slacking could effecttively prevent the occurring of hospital infection in clinical laboratory.

BACKGROUND:Studies have confirmed that the active ingredients ofPaeonia lactiflora Pal. have better inhibitory effects onCandida albicans, but its monomer paeoniflorin has not been reported whether it can inhibit Candida albicans biofilm. OBJECTIVE:To observe the effect of paeoniflorin onCandida albicans biofilm in vitro. METHODS:Paeoniflorin solution at different concentrations of 4, 2, 1, 0.5, 0.25 g/L was prepared using RPMI-1640 according to 2-fold dilution method. Chlorhexidine was diluted with RPMI-1640 to different concentrations, including 2%, 1%, 0.5%, 0.25%, 0.125%. We compared the effects of different concentrations of chlorhexidine and paeoniflorin on diameter ofCandida albicans by agar diffusion method. MTT assay was used to detect the effect of different concentrations of chlorhexidine or paeoniflorin on the celladhesion of Candida albicans as wel as their inhibitory effects onCandida albicans biofilms. Confocal laser scanning microscope and LIVE/DEAD BacLight Bacterial Viability Kits were combined to observe the changes ofCandida albicans biofilms under normal or intervention conditions. RESULTS AND CONCLUSION:Both chlorhexidine and paeoniflorin possessed bacteriostatic ability, and their bacteriostatic ring diameters were positively correlated with drug concentrations. Significant differences in the bacteriostatic ring diameter were observed between chlorhexidine and paeoniflorin, except between 2 g/L paeoniflorin and 1%, 2% chlorhexidine. Paeoniflorin at different concentration could inhibit celladhesion of Candida albicans as wel as inhibitCandida albicans biofilm. The inhibition rate was also positively correlated with drug concentrations. Under normal conditions, most of bacteria in the biofilms were alive, and there was a smal amount of dead bacteria after 48 hours. After intervention with paeoniflorin, the proportion of dead bacteria in the biofilms was increasing along with the concentrations of paeoniflorin. Compared with the chlorhexidine, paeoniflorin showed a lower bacteriostatic activity. These findings indicate that paeoniflorin has an obvious inhibitory action in Candida albicans biofilms in vitro.

Objective To explore the clinical effect of hysteroscopic scar defect correction in the treatment of cesarean scar.Methods Eighty-four cases patients with cesarean section uterine incision scars who were treated in Affiliated Hospital of Hubei Polytechnic University from August 2015 to July 2016 were selected and randomly divided into observation group with hysteroscopic surgery and control group with vaginal surgery,42 cases in each group.The operation condition,clinical efficacy and the incidence of complications of the two groups were observed and compared.Results The amomt of blood loss,hospitalization expenses,hospitalization time and operation time in the observation group were (22.45±3.78) ml,(3028.89±218.79) yuan,(3.89 ±0.80) d,(20.13±2.90) min respectively,in the control group were (40.56±5.48) ml,(4189.58±269.78)yuan,(5.46 ± 1.02) d,(30.78 ± 6.99) min respectively,the differences were significant (P ＞ 0.05).The incidence of infection,relapse and incisional wound healing in the observation group were significantly lower than in the control group,the differences were significant (P＜0.05).The total effective rate was 90.48％ in the observation group and 85.71％ in the control group after treatment,the difference was not significant(P ＞0.05).Conclusion Hysteroscopic scar repair has the same effect as that of vaginal surgery,but the rate of blood loss and complication is lower than that of vaginal operation,which is safer and more effective.

Objective To investigate the effects of four interior-warming drugs( galangal,cinnamon,evodia rutaecarpa,and dried ginger)on the tension of ileum smooth muscle and Ca2+-ATPase on the cell membrane in rabbits. Methods The effects of galangal,cinnamon,evodia rutaecarpa,and dried ginger were examined on normal ileum smooth muscle,in vitro intestinal muscle contraction caused by acetylcholine(ACh),barium chloride(BaCl2 )and histamine(His), and ACh-induced calcium release by using BL-420E+ biological signal collection and processing system.The average tension was measured within 1 min before delivery and within 3 minutes after the treatment,and the inhibition rate was calculated according to the average tension value.The effects of sera containing galangal,cinnamon,evodia rutaecarpa,and dried ginger on Ca2+-ATPase activity on the cell membrane of the intestinal smooth muscle were examined by phosphorus method. Results Galangal,cinnamon,evodia rutaecarpa,and dried ginger at high concentrations could restrain in vitro intestinal contraction in normal circumstances(P<0.05 or P<0.01).Significant inhibitory effects on intestinal contraction caused by ACh,His and BaCl2 were found in low,medium and high concentration groups(P<0.01).There was a dose-effectiveness relationship between the inhibition rate and final drug concentrations.The ACh-induced intracellular and extracellular calcium dependent contraction were significantly inhibited by the four interior-warming drugs( P < 0. 05 or P < 0. 01). The Ca2+-ATPase activities were( 0. 384 ± 0.070),(0.302±0.016),(0.307±0.016),(0.296±0.016),(0.313±0.003)U·mg-1 ,respectively,in intestinal smooth muscle in normal control group and high concentration groups of galangal,cinnamon,evodia rutaecarpa,and dried ginger(P<0.01). Conclusion Interior-warming drugs may relax intestinal smooth muscle by reducing the intracellular calcium release and the extracellular calcium inflow via receptor-controlled calcium channels,and inhibiting the Ca2+-ATPase activity in smooth muscle.

Objective To investigate the effects of recombinant human thioredox ( rhTrx) on primary cultured hepatocytes. Methods The cDNA coding hTrx was amplified by using RT-PCR. The objective protein was expressed in E. Coli. The activity of purified rhTrx protein was determined by IgM and insulin disulfide reduction assay. DNA synthesis was determined by 3H-TdR mixing assay to realize the proliferating roles of rhTrx in murine primary cultured hepatocytes. Cell viability was assessed by lactate dehydrogenase ( LDH) releasing assay. Results The cloning hTrx open reading frames cDNA was confirmed by sequence analysis. The soluble recombinant hTrx are expressed efficiently in the prokaryotic expression system. The recovery ratio was 23. 20% of total bacteria protein with a purity of the expressive protein of 96. 30%. The rhTrx had stronger IgM and insulin reduced activity compared with the controls (P

ObjectiveTo investigate the etiology of epileptic seizures after orthotopic liver transplantation and preventive measures.MethodClinical data of 83 patients receiving orthotopic liver transplantation from May 1998 to December 2001 were retrospectively studied.ResultsSix cases suffered seizures with an incidence of 7.23%.The interval between transplantation and clinical diagnosis of seizures ranged from 4 to 15 days with a meadian time of 9.3?1.2 days. Tonic-clonic seizure was the most common type of seizures. Three patients had a previous history of seizure. Computed tomographic(CT) scan revealed strokes in 2 patients. Seizure related mortality was 3.61% in this group of 83 cases.ConclusionSeizures are not infrequent neurological complication after liver transplantation and it may indicate an underlying CNS lesions. Cyclosporine and tacrolimus neurotoxicity, metabolic abnormalities and pneumonia are factors contributing to the onset of seizures. Proper mangement and comprehensive therapy may improve the prognosis.