Objective To investigate the clinical significance of serum D-dimer in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods 98 patients with COPD were selected as the research objects,including 38 patients with stable COPD and 60 patients with AECOPD.At the same time,fifty healthy subjects were enrolled in this study as healthy control group.The arterial blood gas(pH,PaCO2,PaO2,PaO2/FiO2),pulmonary function(FVC％,FEV1％,FEV1/FVC) were detected,plasma D-D were measured by immunoturbidimetry with fully automated biochemical analyzer.Results The PaCO2 of the stable COPD group and the AECOPD group were (45.30 ± 3.18) mmHg and (51.44 ± 5.12) mmHg,which were significantly higher than that of the healthy control group[(39.45 ± 4.05) mmHg] (t =4.414,7.556,all P ＜ 0.01).Tthe PaO2,PaO2/FiO2,FVC％ and FEV1/FVC were significantly lower than those of the healthy control group (t =3.618,7.702,21.433,26.316,4.323,8.302,5.112,10.384,4.191,9.511,all P ＜ 0.01).The PaCO2 of AECOPD group was significantly higher than that of the stable COPD group(t =4.331,P ＜ 0.05),while the PaO2,PaO2/FiO2,FVC％,FEV1 ％ and FEV1/FVC were significantl) lower than those of the stable COPD group(t =5.702,4.652,3.773,6.241,5.806,all P ＜ 0.05).The serum DD of the healthy control group was (0.33 ± 0.05) mg/L,which of the stable COPD group was (0.77 ± 0.08) mg/L,which of the AECOPD group was (1.58 ±0.10)mg/L,and the difference of the these groups was statistically significant(F =14.667,P ＜ 0.01).The plasma D-D of the stable COPD group and the AECOPD group were significantly higher than that of the healthy control group (t =4.667,13.224,all P ＜ 0.05).The plasma DD of the AECOPD group was significantly higher than that of the stable COPD group (t =9.471,P ＜ 0.05).There were positively correlation betweem D-D and PaCO2 (r =0.661,P ＜ 0.05),and there were negatively correlation betweem D-D and PaO2/FiO2 and FEV1/FVC(r =-0.964,-0.589,all P＜0.05).Conclusion D-dimer is correlated with arterial blood gas and lung function.D-dimer test can help to evaluate the stage and severity of COPD accurately,which is helpful for effective treatment.

Effect of lithium salt(Li)administnation to caudate-putamen nucleus (CPN) on pain response in the rat was studied by chronic cannula implantation and direct injection of drugs into the brain structurementioned above. The results were as follows:( 1 ) The injection of Li into anterior part of the head of CPN of rats produced significantly the analgesic effect that could be antagonized by naloxone, atropine,phento-lamine.propranolol, lysergic acid diethylamide and bicuculline, but not by haloperidol.(2) The injection of Li into central part of the head of CPN of rats did not produce analgesic effect.The results above showed that microinjection of Li into different parts of the head of CPN could give rise to different effects on pain response and the analgesic effect of Li could be related to metabolic changes of endogenous opioid peptides, acetylcholine, noradrenaline, gama aminobutyric acid and 5-hydroXytryptamin aad mediated by their receptors respectively

Objective: To observe the curative effects of high tibial osteotomy with slotting plate for the treatment of osteoarthritis of the knee with genu varum.Methods:The general status of all patients were comprehensively evaluated.Their weight bearing lines of lower limbs were measured at standing positions in order to determine the angles of corrective osteotomy with high tibial osteotomy.Results:Evaluation was done according to the criterions made by Dou Baoxin 85.8% of curative effects were excellent and good,The ideal tibiofemoral angles were 170°～172° degree.Conclusion:With slotting plate fixation to correct the weight bearing line of lower limbs,with advantages of reasonable operative method,easy mastering of the angles of correction,and firm fixation and high union rate,is the best method to treat the osteoarthritis of the knee with genu varum.

The morphological changes of the humerus and femur were examined in 52 sports- men (30 weight-lifters-static type of movement and 22 runners—dynamic type of move- ment).The results were as follows: 1.In the humerus of the weight-lifters the thickness of the wall of bone was very much increased as compared with that of the runners and,as a result,the transverse diameter of the shaft enlarged and the cavity diminished. 2.In the femur,however,no such changes were observed in both types of exercise. On the contrary,there is some indication that the femur of the runners increased in longitudinal direction. 3.In the weight-lifters,the thickness of the wall of the bone was not only shown in the shaft,but also in the metaphyses where it ended as a sickle in the longitudinal section.On the other hand,that of the runners gradually pointed out. 4.The bony prominences of the humerus of the weight-lifters were very much marked and its internal bony lamellae were clearly visible.

For a period of 3 months,an experimental exercise under the influence of dynamic and static factors was given to 3 groups (15 each) of mice.The histological changes of the extensor muscle of the post extremities of these mice were examined by the Bielschowsky-Gros and H.E.methods.The result,as compared with that of the control group,was summarized as follows: 1.The structural changes of the muscle fibers differ in different groups under the influence of different mechanical factors,for instance,under the influence of static factors either the muscle fibers as a whole or their nuclei were enlarged mainly along the trans- verse diameter. 2.The increase in number of nuclei of the muscle was observed in the experi- mental animals among which the dynamic type was most conspicuous.This increase was not only related to the character of mechanical factors,but also the intensity of the muscular activity. 3.Under mechanical factors,the nuclei of the muscles were increased both in number and in size.Under the influence of dynamic factors,the nuclei increased pre- dominantly in length (long type nuclei) while under the influence of static factor,its in- crease was mainly along the transverse direction.In the latter the transverse diameter of the long type nuclei was also wider and tends to become oval in shape.It is,therefore, assumed that the type and number of the nuclei of the muscle cells depend upon the func- tional activity of the organ and the character of the force acting upon it. 4.After a long period of exercise,either by means of dynamic or static factor, a large number of annular nuclei was found in the muscles.This phenomenum has not been reported in the literature.

Fifteen mice, were divided into 3 groups, each was trained to adopt a particularfunctional state of muscular activity for a long term. The histological changes of theirmotor end-plates were examined by means of the Bielschowsky-Gros and the Ranvier'sgold chloride techniques. The results were summarized as follows: 1. It was found that, by increasing the dynamic or static functional activity of mus-cles of the mice, the motor end-plates were enlarged in size and their nuclei were in-creased in number, as compared with those of the control group. 2. The size of the nuclei of the end-plates of both experimental groups was notequally affected, e.g., the nuclei in the static group were larger, while those in the dyna-mic group were comparatively smaller. 3. Under the influence of the dynamic or static muscular exercise, the end-platesincreased in their sizes, more so in the static than in the dynamic group, while the controlgroup remained to be the smallest. The diameter had a tendency to increase along thelong axis in the dynamic group, and along the transverse axis in the static group; hencethe end plate appeared to be oblong in the former and oval in the latter group. 4. After a long term of muscular exercise, whether dynamic or static in nature, thenerve fibers supplying the end-plates increased in thickness and degree of complexity oframification. There were some unidentified cells with annular nucleus in the vicinity ofthe end-plate. 5. Mechanism of the changes of the motor end-plates was discussed in the light offunctional morphology.

Objective To explore the current situation of knowledge,attitude and behavior of smoking among the college student.Methods 1855 subjects,who were randomly chosen from colleges,were investigated with the questionnaire and analyzed the recognition and behavior of smoking.Results 1700 valid questionnaire were reclaimed.(effective rate 91.6%).The awareness of harmful components in the cigarette,such as nicotine,Tar cigarettes,had no difference among different grades (P＞0.05),but the recognition about the nitrogen oxides,carbon monoxide and radioactivity in higher grades was higher than that of lowers(P＜0.01,).The rate of smoking was 21.1% in total,there was no significant difference among different grades (P＞0.05).Conclusion Although the level of awareness about the harmful components in the cigarette and its harmness to health was different among different grades.Health education should be enforced in college students.

Hepatocellular carcinoma (HCC) with a diameter > 5 cm is defined as large HCC. Hepatic resection is the first choice for solitary large HCC with intact capsule and without satellite nodules. The key to successful large HCC resection is to judge the resectability and estimate the remnant liver function preoperatively. Moreover, the liver must be exposed and dissociated adequately, and familiarity with the anatomy of the liver is crucial. Choosing the right technique of hepatic blood flow occlusion and avoiding excessive resection of the liver are important elements. Special attention should be paid to the efficacy of liver transplantation for patients with large HCC exceeding Milan criteria, h is advisable to resect large HCC actively.The hepatic resection is safe and feasible in selected patients with large HCC.

Objective To study the effects of preoperative psychological state on calm time、recovery time and the level of pain about female tumer patients with general anesthesia.Methods We selected 105 female tumer patients whose ages were from 39 years to 66 years.They were divided into two groups according to SAS grade.We observed the calm time,recovery time and the VAS about the two groups.Results The calm time and reeovery time in disquieting group was significant longer than that of the normal group.There was a significant difference between group A and group B(P＜0.01).Otherwise the grade of VAS after operation was significant greater than that of the normal group.Conclusion The disquieting preoperative psychological state would effect the results of general anesthesia.The anesthetist should pay attention to the visiting patients before operation.

That thranscatheter therapy of congenital heart disease (CHD) can cause myocardial injury is one of the focal points of attention in disciplines. Cardiac troponin (cTn) with its high specificity and sensitivity becomes special myocardial injury measure indicators. The types of CHD, the sizes of defect and occluder, the degree of stenosis, and the patients age and body weight, with their influence due to the concentrations of cTn,can be tested as associated risk factors of the myocardial injury.