To inquire into the influence on effect, safety and receiving rate of thrombolysis in acute myocardial infarction (AMI) after extending its selective indications. We observed the main indication changes and effect of 201 cases of AMI receiving thrombolytic therapy who from 108 patients with AMI. Results: (1)On basis of the thrombolytic scheme recommended by the committee of Chinese Journal of Cardiology in 1991,further extend the time of onset to medication from ≤6 hr. to ≤12 hour,age from ≤65 yr,to all yr, unlimited. The ratio of cases receiving thrombolysis/all AMI is 49. 3%, more than before extending indications (28. 1% ,P0. 05) between group 6- 12 hr,medication (n- 32) and ≤6 hr's (n= 169) ,but its mortality in both groups above is significantly lower than group non-thrombolysis (18. 4%,both P

ObjectiveTo observe the relationship between HPA-1—5,6,15 alleles and idiopathic thrombocytopenic purpura.MethodsPolymerase chain reaction-specific sequence primers(PCR-SSP) was used to genotype HPA-1-5,6,and 15 in the ITP group(n=25) and the health control group(n=25).The platelet adsorbed and free antibodies in the two groups were detected by ELISA and microcolumn gel immunoassay.ResultsThe allele frequencies of HPA-3 was significantly different between the ITP group and control group(P0.05).The platelet free antibodies were detected in 17 ITP samples(68%) and the adsorbed antibodies were detected in 21 ITP samples(84%).No platelet antibodies were detected in the control group.ConclusionThere was a possible association between the HPA-3 allele and ITP.The detection rate of platelet adsorbed antibodies is significant higher than that of platelet free antibodies.

Objective To study the level of the Toll like-receptor mRNA expression on PBMCs from patients with the idiopathic thrombocytopenic purpura.Methods We performed quantitative real-time reverse transcription-polymerase chain reaction(SYBR Green Ⅰ fluorescent dye combination technique)analyses of PBMCs from 30 idiopathic thrombocytopenic purpura(ITP) patients and 30 healthy subjects,to estimate the relative levels of TLR2,TLR4,TLR6,TLR7 and TLR9 mRNA expression.Results Relative expression levels of TLR2 and TLR7 mRNAs in ITP group(n=30)were significantly higher than those in health control group(n=30)(P0.05).Conclusion Expressions of TLR2 and TLR7 mRNA are up-regulated in patients with ITP,which may play an important role in the pathogenesis of ITP.

Objective To induce CD4+CD25+ regulatory T lymphocytes from mononuclear cells of rhG-CSF mobilized peripheral blood,and to analyze the phenotype and function of them.Methods Blood samples of ten donors of peripheral blood stem cell were collected,CD4+CD25–T lymphocytes from rhG-CSF mobilized peripheral blood(G-PB group) and unmobilezed peripheral blood(PB group) were isolated with a CD4+CD25+T lymphocytes selection kit,and then were induced by TGF-?1.FCM,RT-PCR,cell proliferration and suppression assay were used to test the expression of CD25+,Foxp3 and suppressive function,and the difference of the rate and the suppressive activity of CD4+CD25+T cells were compared.Results 1) After treated with anti-CD3mAb and TGF-?1,there was a difference between CD4+CD25–T lymphocytes isolated from G-PB group and PB group,the expression of CD25+ were(77.9?2.3)% and(65.7?4.2)%,respectively(P

BACKGROUND: Interlocking nail implantation exhibits great stability and preventory effect on fracture shortening or rotation.OBJECTIVE: To evaluate the reasons and countermeasures for the complication after interlocking nail implantation in treating femoral fracture.DESIGN, TIME AND SETTING: The case analysis was performed at Department of Orthopedics, Changhai Hospital of Second Military Medical University of Chinese PLA from April 1987 to April 2008.PARTICIPANTS: 352 patients underwent femoral interlocking nail implantation, including 289 male and 63 female with an average age of 35.9 years (range 18-84 years).METHODS: 127 patients were treated with close interlocking nail implantation, of which 30 cases were subjected to minimal incision to assist nail insertion; 24 were treated with dynamic interlocking nail implantation; 321 with static interlocking nail implantation, and 38 with interlocking nail implantation for femoral reconstruction.MIAN OUTCOME MEASURES: Complications post-implantation; limb joint function recovery during long-term follow-up.RESULTS: 331 cases were followed-up for over 60 months, and the longest follow-up lasted for 252 months. Complications were found in 16 cases, including deformity union in 2, femoral neck fracture in 1, exit of the nail in 2, infection in 2, breakage in 8 (nonunion in 3), and perineal nerve injury in 1. Except 2 with deformity union and recovered by secondary surgery, all patients developed bone union. During the followed-up, no pain or knocked pain was found with normal pseudoarthrosis activities and functional activities. The excellent function recovery in joints and limbs was 91.2%.CONCLUSION: Nail breakage is the main complication after interlocking nail implantation. Therefore, we should select longer and thicker interlocking nail as the first choice. In addition, the interlocked screws should be distal to fracture site. For the patients with severe trauma, the interlocking nail implantation in early stage of fracture would not increase complications.

BACKGROUND: With the advanced progress of prostheses manufacture and surgical technique, early loosening of hip articulation prostheses and femoral neck fracture tend to reduce after hip surface arthroplasty. Meanwhile hip articulation activity has been improved.OBJECTIVE: To discuss the biocompatibility between the implants and the hosts in patients underwent hip surface arthroplasty and observe the functional recovery of hip articulations.DESIGN, TIME AND SETTING: Retrospective case analysis was carded out in the Department of Orthopaedics, Changhai Hospital Affiliated to the Second Military Medical University of Chinese PLA (Shanghai, China) from January 2006 to August 2007.PARTICIPANTS: Fifty-two patients with hip articulation diseases, including 25 females and 27 males, underwent sixty-three hip surface arthroplasties, and eleven cases of them were subjected to bilateral arthroplasty. Their average age was 47.6 years.METHODS: Hip resurfacing prostheses were offered by Zimmerm Company (Huntington, Indiana, USA). Hip resurfacing was performed using 4-mm-thick cement-less acetabular bone (metal acetabular cup of 3.7-ram thickness was coated with 0.3-mm plasma titanium). Acetabular cup exhibits large diameter and arch shape (165°), is coated with 0.3-ram plasma titanium and fixed with cement less. By means of posterolateral approach, acetabular prostheses were implanted to the central position of hip articulation with regards to anatomy. Acetabular prostheses were covered more than 90% area.MAIN OUTCOME MEASURES: Subsequent to the arthroplasty, biocompatibility between the implant materials and the hosts was recorded, such as dislocation and infection. Functional recovery of the patients was assessed with Harris hip score at 1, 3, 6 and 12 months after operation and annually thereafter. Radiological evaluation was conducted to record radioactive permeability in the areas of 1 ram around acetabular cup in the DeLee and Charnley zone.RESULTS: All patients were involved in the follow-up. There were no cases of dislocation, deep venous embolism, deep infection or neurovascular complications that required further treatment. The mean Harris score was 38 points before operation and significantly increased to 90 points after operation. Two patients appeared a 2-mm crevice below acetabular prostheses, which disappeared 6 months after arthroplasty. Acetabular or femoral prostheses removal, or local osteolysis was detectable.CONCLUSION: Metal-on-metal hip surface arthroplasty has excellent early effects on young and active patients. The arthroplasty potentially offers the ultimate bone preservation and better restoration of hip articulation function in patients, without specific biocompatibility.

BACKGROUND:Closed reduction and interlocking intramedullary nailing can protect blood supply of fractured bone,decrease infection and promote bone healing.which is becoming the first choice for treating femoral shaft fracture However,it is difficult to conduct in closed reduction and keep stabilization of fractured bone.OBJECTIVE:To explore the curative effect of closed reduction and interlocking intramedullary nailing in treating femoral shaft fracture with assist of rubber tourniquet 360°elastic fixation METHODS:From May 2008 to November 2009,18 patients(14 males,4 females;aged 18-65 years)with closed femoral shaft fracture were treated at the Dongguan Hospital of Traditional Chinese Medicine.Body skin was protected by cloth,elastic rubber tourniquet was doubled and 360°wrapped around the fractured bone with the length of 10 cm from up and down.Supracondylar femur was reamed by Kernig-needle;fractured bone was dealt with countertraction and horizontal rotation.Another assistant compressed the fractured bone according to the displacement of fracture,which contributes to bone fracture reduetion and interlocking intramedullary nailing.RESULTS AND CONCLUSION:All 18 patients were followed up postoperatively,no case was found with skim necrosis and damage of nerve and blood vessel.16 cases were bone union with excellent 15 cases,fine 1 case;2 cases were still being followed up.Callus was firstly found 1 month after operation and was obviously found in 3e months postoperatively The result suggested that the treatment of closed reduction and interlocking intramedullary nailing with assist of rubber tourniquet360°elastic fixation is a simple and applicable approach.which reduces the interruption of blood supply for fractured bone and closed reduction gets good result,which reduces the chance of open reduction.

Objective To observe the efficacy of WS-frequency spectrum in treating second degree burn wounds. Methods 350 cases of second degree burn were treated in the whole couse with WS-frequency spectrum in association with systemic treatment including anti-shock,anti-infection and expecant treatment. Results All the patiens healed,only 23 cases with deep burn area over 20% TBSA resulted in superficial pigmentation and scar formation without dysfuntion. Conclusion WS-frequency spectrum is a good remedy for treating second degree burn. This method is easy and simple to apply and has very good efficacy.

Objective To design the family support scale for adolescent patients with nephritic syndrome. Methods 192 adolescent patients with nephritic syndrome were selected in the pilot investigation, and then formed the first questionnaire. The reliability and the validity of the questionnaire were evaluated by the experts. Results The questionnaire involved 15 items and its reliability and the validity were satisfied. There was a positive correlation between the family support and the self-nursing degree. Conclusion The reliability and the validity of this questionnaire are both up to the demands, it can used to study the condition of family support for adolescent patients with nephrotic syndrome.

Student as standard patient(SSP) was defined as student receiving relative medical training,who was willing to act as a human analogue as a patient and could be used as not only a patient but also a teacher in clinic practice.The results indicates that the using of SSP in the clinical teaching of endocrinology could promote the students'level in practice and in the meanwhile,it could be useful to testing the learning result.