Objective A meta-analysis of clinical trials of prehospital thrombolysis versus in-hospital thrombolysis or PCI for acute myocardia infarction (AMI). Method We collected the literature on prehospital thrombolysis for AMI published at home and abroad from January 1989 to April 2009. Recanalization rate of infarct-related arter, complication incidence and mortality ( ＜ 30 d) were regarded as result indicators. Software RevMan 4.2.8 was used to process meta-analysis. Results There were only 27 literatures selected. Prehospital thrombolysis was associated with higher recanalization rate of infarct-related arter[OR 2.67,95%CI(1.86 ～ 3.85);P ＜0.01] and lower mortality ( ＜ 30 d ) [OR 0.71,95%CI(0.64 ～ 0.78); P ＜ 0.01] than in-hospital thrombolysis. There was no significant difference in complications between them. Compared with PCI, prehospital thrombolysis was associated with higher complication incidence [OR 2.91,95% CI ( 1.26 ～ 3.80); P = O.005]. There was no significant statistical difference of mortality ( ＜30 d ),but the sensitivity analysis was not good. Conchusions The effect and prognosis of prehospital thrombolytic are superior to that of in-hospital thrombolysis,and the same with PCI,but prehospital thrombolytic has higher incidences of complications,and the sensitivity is not good.

To investigate the protective effects and possible mechanism of Mycelium of Hirsutella hepiali Chen et Shen (MHCS) on metabolic syndromes, free fatty acid and MHCS-treated hepatocytes were used for detecting autophagy-related LC3, p62 and lipid accumulation. Moreover, high fat diet fed mice were used to establish metabolic syndromes model. 50-weeks age mice were randomly divided into: control group, model group and MHCS group. At 80-weeks age, 15 mice were randomly chosen from each group separately for examining oral glucose tolerance, serum insulin, insulin-like growth factor 1 (IGF-1), hepatic LC3, p62, p-NF-kappaB p65, NF-kappaB p65, IL-6 and CXCL-8. Moreover, insulin resistance index (IRI) was calculated. Hepatic pathological changes, including vacuoles, lipids accumulation and fibrosis were observed. Remaining mice were fed with diet separately to 110 weeks-age for statistics of mortality. MHCS promoted autophagy of free fatty acid treated hepatocytes. Mice fed with high fat plus MHCS diet exhibited improved oral glucose tolerance, insulin resistance, hepatic pathology, inflammation, mortality and activated autophagy. The protective effects of MHCS against metabolic syndroms might be through the activation of hepatic autophagy.

Objective To explore the effect of drug injection in muscle motor points on children with spastic cerebral palsy. Methods 230 children with spastic cerebral palsy were divided into control group and observation group, with 115 cases in each group. The control group received comprehensive rehabilitation including functional training, physical therapy and medicine, while the observation group received injection of vitamin B1 and vitamin B12 in muscle motor points in addition. They were assessed with Gross Motor Function Measure (GMFM), modified Ashworth Scale (MAS), mental development index (MDI) and psychomoter developmental index (PDI) of CDCC Infant Me Ntal Development Scale. Results The gross motor function improved, MAS score decreased, the scores of MDI and PDI increased after treatment (P<0.01) in both groups, which were better in the observation group than in the control group (P<0.05). Conclusion Drug injection in muscle motor points can improve the gross motor function, relieve spasm, and improve intelligence development of children with spastic cerebral palsy.

Objective To investigate the application of the three-dimensional reconstruction for the random flap.Methods The bones,muscles,fascia,skin and vessels in eleven patents were reconstructed by the MIMICS 10.01 CT angiography (CTA) scanning,and the single artery and its branches were gained by the subdivision of the vessels.3D-images were shown respectively and jointly.Results Arterial reconstruction images were clearly displayed by 3D workstation CTA and if they were combined with the original cross-sectional images and vessel analysis software,they were able to accurately evaluate the location,range,degree of artery,the distal outflow tract.The vessels and soft tissue displayed in the software could show detailed distribution of the vessels in one region and this could provide the accurate anatomical basis for the random flap and the design of the operation.This method could easily meet the preoperative design demands and also had the guiding significance for postoperative evaluation.Conclusions The method of 3D-reconstruction is very good for studying the random flap and the design of the operation.

Objective To analyze the epidemiological characteristics of Mycoplasma pneumoniae(MP)infection in children with acute respiratory tract infection in Haikou area and surrounding area to provide a scientific evidence for the prevention and treatment of MP infection in children.Methods A total of 1 699 children inpatients with acute respiratory tract infection in our hospital from 1 January to 1 December,2014 were collected.The serum MP antibody was detected.The MP infection status of different sites,genders,ages and months was retrospectively analyzed.Results Among 1 699 children patients with acute respiratory tract infection,the total positive rate of MP infection was 17.60％,in which male was 15.73％ and female was 21.59％,the positive rate of female was higher than that of male with statistical difference(P＜0.01).The lower respiratory infection rate was 18.75％ and upper respiratory tract infection was 13.70％,the difference was statistically significant(P＜0.05).The MP infection rates was common in children aged >1-4 years old,in which children aged >3-4 years old had the highest infection rate.MP infection was sporadic in the whole year and was highly epidemic in March and April.Conclusion MP was an important pathogen of acute respiratory tract infection for children in Haikou during 2014,and its epidemic characteristics were manifested by higher incidence in female than that in male.Children aged within 4 years old are a high onset group and MP infection occurs all year round,March and April are the relatively high onset period of MP infecting.

Objective To evaluate the role of serine-threonine kinase (Akt)/glycogen synthase kinase-3 beta (GSK-3β) signaling pathway in isoflurane preconditioning-induced inhibition of mitochondrial permeability transition pore protein (mPTP) opening during myocardial ischemia-reperfusion (I/R) in rats.Methods Ninety-six male Sprague-Dawley rats,aged 3-4 months,weighing 200-250 g,were randomly divided into 4 groups (n =24 each) using a random number table:control group (group C);I/R group;isoflurane preconditioning group (group IPC);Akt inhibitor MK-2206 group (group MK).Myocardial I/R was induced by occlusion of the anterior descending branch of the left coronary artery for 30 min followed by 2 h of reperfusion.In group IPC,1.5％ isoflurane was inhaled for 30 min followed by 45 min washout,and then the model of myocardial I/R injury was established.In group MK,MK-2206 300 μg/kg (in dimethyl sulfoxide) was injected intraperitoneally at 30 min before isoflurane inhalation.At 2 h of reperfusion,8 rats were selected and sacrificed,and the hearts were removed for determination of myocardial infarct size.At 2 h of reperfusion,8 rats were selected,and blood samples were collected from the right internal jugular vein for determination of serum cardiac troponin Ⅰ (cTnI) concentrations.The rats were then sacrificed,and myocardial specimens were obtained for determination of the expression of phosphorylated GSK-3β (p-GSK-3β) in cytoplasm and mitochondria (by Western blot) and co-expression of p-GSK-3β with adenine nucleotide translocator (ANT),voltage-dependent anion channel or cyclophilin D in myocardial tissues (using co-immunoprecipitation).At 2 h of reperfusion,8 rats were selected and sacrificed,myocardial cells were obtained,and the opening time of mPTP was determined with a laser scanning confocal microscope.Results Compared with group C,the myocardial infarct size and serum cTnI concentrations were significantly increased,and the expression of p-GSK-3β in cytoplasm and mitochondria was up-regulated in I/R and IPC groups,the co-expression of p-GSK-3β with ANT was significantly down-regulated,and the opening time of mPTP was shortened in group I/R,and the co-expression of p-GSK-3β with ANT was significantly up-regulated,and the opening time of mPTP was prolonged in group IPC (P＜0.05).Compared with group I/R,the myocardial infarct size and serum cTnI concentrations were significantly decreased,the expression of p-GSK-3β in cytoplasm and mitochondria was up-regulated,the co-expression of p-GSK-3β with ANT was significantly up-regulated,and the opening time of mPTP was prolonged in group IPC,and the opening time of mPTP was significantly prolonged (P＜0.05),and no significant change was found in the other parameters in group MK (P＞0.05).Compared with group IPC,the myocardial infarct size and serum cTnI concentrations were significantly increased,the expression of p-GSK-3β in cytoplasm and mitochondria was up-regulated,the co-expression of p-GSK-3β with ANT was significantly down-regulated,and the opening time of mPTP was shortened in group MK (P＜0.05).No co-expression of p-GSK-3β with voltage-dependent anion channel or cyclophilin D was found in myocardial tissues.Conclusion The mechanism by which isoflurane preconditioning inhibits mPTP opening during myocardial ischemia-reperfusion is partially related to activation of Akt/GSK-3β signaling pathway in rats.

Objective To investigate the effect of CD34+ stem cells seeded stent graft in venous system. Method Twelve mongrel dogs were randomized into 2 groups. Stent grafts covered with PTFE or Dacron were implanted into infrarenal vena cava through a delivery system. In each group, 4 stent grafts were seeded by autogenous bone marrow CD34+ cells, and 2 treated by autogenous blood only as control. The grafts were explanted at 2 weeks. Light and electron microscopy were used to examine endothelialization of neointima. CD34 and Ⅷ factor stain were applied to identify endothelial cells. Results All stent grafts were patent except for one Dacron stent without seeding. Light, electron microscopy, CD34 and Ⅷ factor stain demonstrated that confluent endothelial cells appeared on the neointima of seeded grafts. No endothelial cells were detected in the non-seeding grafts. Conclusions Rapid endothelialization of stent grafts can be achieved through bone marrow CD34+ cells seeding in venous systems.

Objective To evaluate the effectiveness and safety of long-pulsed laser for hair removal in different colour of skin. Methods Hair removal was performed in 607 hirsute patients with two long-pulsed lasers. Results Although the effectiveness rates of hair removal in upper lip and full bread were not different, their complications were different by using two long-pulsed lasers. Also there were signifi-cant decreases of effectiveness and complication in the lighter skin and thc darker skin (P<0.01). Con-clusion The 755 nm wavelength has more effectiveness and lower complication in the lighter skin. How-ever, the 1 064 nm wavelength has more effectiveness and lower complication in the darker skin.

Objective To explore the anatomical basis for clinical application of the compound flap pedicled with arterial arch of palpebral margin by observing eyelid blood supply and anatomical structure and to prove that it is an ideal method of repairing the eyelid defect for clinical application. Methods 15 adult cadavers (30 eyelids) were dissected. The origin, course, branches, diameters and vessel networks of palpebral margin arterial arch were observed particularly. 30 cases of eyelid marginal defect were reviewed and the therapeutic effect of this method evaluated. Results Eyelid was constituted by 5 layers: skin, subcutaneous tissue, muscle, tarsal plate and conjunctival layers. Most eyelid vessels were mutually anastomosed to form a constant vessel network. Palpebral margin arterial arch and peripheral arterial arch were formed by dorsal nasal artery branches and lacrimal artery branches, both of which nourished the eyelid tissue. All the compound flaps of 30 cases survived completely without any complications. All cases obtained satisfactory results functionally and esthetically. Conclusions The arterial arch of palpebral margin is constant and the blood supply of the compound flap is reliable. It can repair full eyelid defect with the same kind of tissue, and obtain satisfactory appearance. It is an ideal method of repairing the eyelid defect.

ObjectiveTo evaluate the correlation between serum anti-Jo-1 antibody level and myositis disease activity in polymyositis/dermatomyositis.MethodsAnti-Jo-1 antibody levels in serum from 148 polymyositis/dermatomyositis patients and 130 healthy controls were measured by both ELISA and immunoblot assay.Disease activity of the anti-Jo-1 antibody positive patients was assessed by the global myositis disease activity score (visual analogue score,VAS) established by the International Myositis Assessment and Clinical Studies(IMACS) Group.The correlation between disease activity and level of serum antiJo-1 antibody was assessed.Comparisons between groups were performed by x2 test or t test.ResultsThe positive rate of ELISA and EUROLINE was 24.3％(36/148) and 27.0％(40/148) respectively.Fever,ILD,arthritis/arthralgia were found to be more predominant in anti-Jo-1 antibody positive patients than those who were anti-Jo-1 antibody negative patients.There was significant positive correlation between the global myositis disease activity score (VAS) and serum level of anti-Jo-1 antibody (r=0.874,P=9.000).Serum antiJo-1 antibody levels,together with global disease activity,were significantly decreased in the 7 patients after treatment.ConclusionAnti-Jo-1 antibody level measured by ELISA is associated with disease activity of PM/DM,and could be a marker of disease activity.