Objective To observe the clinical curative effect of early intravenous thrombolysis combined with atorvastatin in the treatment of acute myocardial infarction.Methods Seventy-two patients with acute myocardial infarction from March 2011 to March 2012 were divided into experimental group and control group by random number table method,with 36 cases in each.Experimental group was given early intravenous thrombolysis combined with atorvastatin treatment,and control group was given atorvastatin treatment.The effects in 2 groups was observed.Results The recanalization rate in experimental group was significantly higher than that in control group [80.6％ (29/36) vs.52.8％ (19/36)],and the incidence of post infarction angina,heart failure and reperfusion arrhythmia were significantly lower than those in control group [11.1％(4/36) vs.27.8％(10/36),8.3％(3/36) vs.25.0％(9/36),44.4％(16/36) vs.72.2％(26/36)],there were significant differences(P＜ 0.05).The leukocyte differentiation antigen,matrix metalloproteinases and C reactive protein between 2 groups before treatment had no significant difference (P ＞ 0.05),but those indexes after treatment were obviously improved,the improvement in experimental group was better than that in control group,there was significant difference (P ＜0.05).The United States National Institutes of Health Stroke Scale (NIHSS) score between 2 groups before treatment had no significant difference (P ＞ 0.05),the NIHSS score after treatment in experimental group was better than that in control group [(4.2 ± 3.7) scores vs.(7.9 ± 4.1) scores] (P ＜ 0.05).The proportion of mRS score 0-1 after 3 months of treatment in experimental group was higher than that in control group [52.8％(19/36) vs.33.3％(12/36)],the proportion of 2-6 scores was lower than that in control group [47.2％ (17/36) vs.66.7％ (24/36)] (P ＜0.05).Conclusion Early intravenous thrombolysis combined with atorvastatin has obviously curative effect in the treatment of acute myocardial infarction and has some clinical value.

Objective To observe the clinical efficacy of ventilator-assisted breathing for the treatment of respiratory failure brainstem hemorrhage.Methods Clinical data of 29 cases of brainstem hemorrhage complicated with respiratory failure were retrospectively analyzed.Patients were treated with conventional symptomatic treatment based on ventilator-assisted breathing therapy and before and after treatment of ventilator-assisted breathing index changes were analyzed.Results After treatment,29 patients improved and discharged 11 patients(37.9％),and automatically discharged 10 patients(34.5 ％),8 patients died(27.5％);R,PaO2,PaCO2,SaO2 significantly improved than before treatment(t=4.932,4.393,3.784,3.297,all P＜0.05);compared with pre-treatment plasma albumin level,Glasgow score improved significantly(t=2.675,4.947,all P＜0.05),blood glucose level before and after treatment,peripheral blood leukocytes count had no statistically significant differences(t=1.037,0.852,all P＞0.05).Conclusion Ventilator-assisted respiratory therapy brainstem hemorrhage complicated with respiratory failure can significantly improve various respiratory indicators,improve the survival rate.

Objective To investigate the diagnosis judgment values of trimester ultrasound screening for simple single umbilical artery fetal malformation.Methods From January 2011 to January 2015,selected the 15-28 weeks pregnant singleton pregnancies in Shunyi Hospital of Beijing Chinese Medicine Hospital for system fetal ultrasound,in which the single umbilical artery group of 50 patients,50 cases of healthy pregnant women (control group),the two groups were carried ultrasound screening with single umbilical artery flow spectrum analysis,and observed the prognosis.Results The single umbilical artery fetal bladder after abdominal oblique horizontal cross-section of the umbilical artery bypass saw one side of the bladder,and there were 24 patients the malformations with the incidence rate was 48.0％.In the two groups can be clearly demonstrated umbilical artery condition,but the umbilical artery pulsation index(PI),arterial resistance index (RI) and peak valley ratio of umbilical artery blood flow velocity (S/D) value in the single umbilical artery group were 1.02±0.17,0.66±0.06 and 3.08 ±0.57,significantly higher than those of the control group (0.75 ± 0.21,0.53 ± 0.08,2.11±0.27;t=7.298,11.874,15.983,P＜ 0.05).In the single umbilical artery group,there were 32 patients of abortion,10 patients of birth were,8 patients ogpregnancy.Perinatal death in 8 cases,the mortality rate was 16.0％,the single umbilical artery fetal malformations of perinatal mortality was significantly higher than that of children with simple single fetal umbilical artery (x2 =9.333,P ＜ 0.05).Conclusion Trimester ultrasound screening for single umbilical artery combined with simple two-dimensional ultrasound and umbilical arteryblood flow velocity conditions can improve fetal malformations value judgment,provide a reliable detection method to reduce oerinatal mortality.

Objective To evaluate the diffuse characteristics of two types of botulinum toxin type A (BOTOX and CBTX A) in the forehead and the effect of intradermal (ID) and subcutanous (SC) infections on their diffusion.Methods Healthy volunteers (n =20) were recruited to receive a 0.05 ml (2 U) injection of botulinum toxin type A at four forehead sites [both sides of medial forehead (SC) and temporal forehead (ID)],one side for BOTOX and another for CBTX-A.On day 14,the Minors' iodine starch test was performed and photographs were taken for calculating the area and dimensions of anhydrotic area.Results The areas of anhidrosis ID were significantly greater with CBTX-A (180±15) mm2 than that of BOTOX (144±14) mm2.The same conditions occurred in vertical dimensions (14.4±1.1) mm vs.(15.8±1.0) mm and horizontal dimensions (10.8±0.6) mm vs.(12.5±0.7) mm.There was significant variation between the both for diffuseness in the two anhidrotic halos observed after ID injection (P＜0.05).The areas of anhidrosis by SC were significantly greater with CBTX-A (207±17) mm2 than that in BOTOX (183±18) mm2.The mean horizontal dimension was greater with CBTX-A by SC (13.2±0.6) mm than that of BOTOX by SC (12.2±0.7) mm,but not statistically significant (P =0.06).The mean horizontal dimension in BOTOX was significantly greater with SC than that with ID (P＜0.05).There was no statistically significant difference between SC and ID administration of CBTX-A.Conclusions BOTOX diffuses less than CBTX-A.ID injection technique may result in less diffusion than SC.

Objective To assess the clinical efficacy and safety of uniport video-assisted thoracoscopic surgery in treatment of pulmonary bulla.Methods Clinical data of 38 patients with pulmonary bulla treated with uniport video-assisted thoracoscopic surgery were analyzed.Results 30 patients under general anesthesia and double-chamber tracheal intubation anesthesia and 8 patients under general anesthesia and single-chamber tracheal intubation and tracheal plugger anesthesia underwent the resection of their pulmonary bulla through the surgery with uniport video-assisted thoracoscope, and 2 patients therein were simultaneously treated with bilateral resection of pulmonary bulla.36 patients were treated successfully;1 patient was given another exploratory thoracotomy after his unilateral surgery because of progressive hemothorax and substantial pneumothorax;and 1 patient underwent respiratory failure after his unilateral surgery and was improved in respiration 2 days after the help of a respirator.The average time of operations were 52 minutes.It averagely took 3.2 days to remove closed thoracic drainage pipes.The post-operation hospital stays took 6 days.The post-operation follow-up took 7-39 months,without relapse and other compli-cations.No death occurred in this group.Conclusion It is safe and reliable to treat pulmonary bulla by the surgery with uniport video-assisted thoracoscope,which is in line with the concept of minimally invasive surgery and therefore deserves promotion.

Three hybridomas producing monoclonal antibodies (Mab) to zona pellucida of porcine ovarian egg(ZP-OVA) were established(LPDg, LPC4, LPD,).Two Mab(LPD_8 LPC_4) were examined against human ovarian tissue by immunohistochemical technique in vitro. We found that the two Mab had cross-reaction with zona pellucida and ovum cytoplasm and no cross-reaction with membrana granulosa and theca folliculi. It showed that there were affinities of LPD_8 and LPC_4 to antigenic determinamts in the ovum cytoplasm and common antigenic components in zona pellucida and ovum cytoplasm. It suggested that the zona pellucida was derived from oocyte.

Objective To investigate the effects of estrogen on extracellular signal-regulated kinase-1/2(ERK1/2) phosphorylation levels in hippocampal CA4 region of ovariectomized rats. Methods Experimental female Wistar rats were randomly divided into three groups: intact (INT) group, ovariectomized (OVX) group, and OVX+estrogen (1 mg/kg, weekly) group. Radioimmunoassay (RIA) was used to measure the estrogen content in plasma, and the levels of ERK1/2 phosphorylation were measured with immunohistochemistry. Results Compared with the control animals, the plasma estrogen level was significantly lower in OVX group (P＜0.001). However, the plasma estrogen level was higher in the OVX+estrogen group than that of the OVX group (P＜0.001). Immunohistochemical staining showed that the phospho-ERK1/2 (p-ERK1/2) substances were present in the nucleus and cytosol of neurons. Compared with the control group, immunostaining positive cells markedly decreased in OVX group, with light nucleus and cytosol staining in the hippocampal CA4 region (P＜0.001). The phospho-ERK1/2 positive neurons increased more obviously in OVX+estrogen group than in the OVX group (P＜0.001). Conclusion Estrogen can increase ERK1/2 phosphorylation levels in hippocampi of aging female rats, which suggests that the ERK signal transduction pathway may be regulated by estrogen during the process of aging.

Objective To determine the regulation of electroacupuncture(EA)at Zusanli acupoint for the expression of estrogen receptors mRNA in the brain of ovariectomized rats.MethodsFemale Wistar rats were randomly divided into 3 groups:intact group(INT),ovariectomized group(OVX),and ovariectomy and acupuncture group(OVX+EA).Radioimmunoassay(RIA)was used to measure the estradiol(E2)and testosterone(T)levels in plasma.The mRNA levels of estrogen receptor(ER)α and ERβ in the brain of rats were measured with RT-PCR.ResultsThe levels of endogenous estrogen increased significantly in OVX+EA rats compared with OVX rats(P<0.01),while the plasma T levels were lower in the OVX+EA group than those of the OVX group(P<0.01).Eelectroacupuncture can up-regulate ERα expression in the brain of ovariectomized rats(P<0.01).However,it was shown to have a down-regulatory effect on the levels of ERβ expression(P<0.01).ConclusionThere is an intimate relationship between the expressions of estrogen receptors mRNA and the endogenous hormone levels,such as E2 and T.Electroacupuncture can regulate the expression of estrogen receptors mRNA in the brain and the E2 and T levels in plasma of ovariectomized rats,which might,at least in part,explain the mechanisms of acupuncture adjusting the neuroendocrine system.

According to the advantages and disadvantages of the clinical medical educa-tion of the ordinary specialized subject-to-undergraduate,the traditional teaching method has been improved in two aspects:choosing case and teaching process.It can be conformed that teaching method of case-based learning is very suitable for physiological teaching.It can improve the effective interaction of teachers and students,and enchance the students' abilities of self-study and theory with practice.

Objective To investigate the effects of estrogen on brain derived neurotrophic factor (BDNF) and neuropeptide Y (NPY) levels in cerebellar cortex of ovariectomized rats. Methods 24 female Wistar rats were randomly divided into three groups: intact (INT) group, ovariectomized (OVX) group, and OVX+estrogen 0.5 mg/kg every day group (E group). Radioimmunoassay (RIA) was used to measure the estrogen content in plasma, and the levels of BDNF and NPY were measured with Immunohistochemistry. Results Compared with the INT group, the plasma estrogen level significantly reduced in OVX group (P<0.001). However, the plasma estrogen level was higher in the E group than that in the OVX group (P<0.001). The BDNF and NPY presented in the Purkinje cell layer,and BDNF also distributed in the molecular layer and granular layer. Compared with that in the INT group, BDNF and NPY positive cells markedly decreased in OVX group, with slight cytosol staining in the cerebellar cortex (P<0.001). The BDNF and NPY positive neurons increased in E group compared with that in the OVX group (P<0.001). Conclusion Estrogen can increase the BDNF and NPY levels in cerebellar cortex of female rats, which may protect the structure and function of cerebellar neurons.