Objective To study the different curative effect between r-tPA application and urokinase in the interventional therapy for acute and severe pulmonary embolism.Methods Analyzed the clinical date of 22 cases acute and severe pulmonary embolism patients,and classified them into two groups according to the application of r-tPA and urokinase to compare the changes of their blood pressure,heart rate,arterial partial pressure of oxygen,hemachrome and pulmonary arterial pressure before and after therapy,meanwhile,record the thrombolysis time that the two groups took.Results The thrombolysis effect time adopting urokinase was remarkably longer than that thrombolysis adopting r-tPA(P<0.05); The blood pressure,heart rate,arterial partial pressure of oxygen of the two groups gained remarkable improvement after therapy(P<0.05).The pulmonary arterial pressure of the urokinase group dropped obviously after operation(P<0.05),while the r-tPA group dropped not so significantly after operation.The hemachrome of the two groups did not dropped significantly after operation.Conclusion The r-tPA and urokinase are both effective to interventional therapy for acute and severe pulmonary embolism,while r-tPA can clearly shorten the time in thrombolysis and could reduce any bleeding risk.

Objective To study the correlation between the obstructive sleep apnea-hypopnea syndrome (OSAHS) and hypertension by monitoring nocturnal blood pressure fluctuation in patients.Methods 95 patients with OSAHS and hypertension (group A) and 95 patients with OSAHS only (group B) were selected and their body mass index, the ratio of neck circumference and height , the blood pressure at time of visit were recorded.At least 7 hours, polysomnography(PSG) was performed for every patient , meanwhile, the blood pressure before sleep, at night and right after wake-up were also collected.The two groups' data was compared and analyzed.Re-sults There was no statistical difference in the body mass index and neck circumference/height between the two groups.No significant difference was found in the highest blood pressure in patients with different severity of OS-AHS.There was no statistical correlation between AHI and systolic blood pressure(SBP) difference of sleep and right after wake, so was AHI and diastolic blood pressure (DBP) difference of before sleep and sleep and bedtime (P > 0.05).But there was correlation between AHI and the different value of SBP before sleep and sleep, so is AHI and DBP diferenee of right after wake and sleep (P > 0.05).Conclusions There is correlation between AHI and the different value of SBP before sleep and sleep, so was AHI and DBP diferenee of right after wake and sleep.Measure of different time-points blood pressure at night can avoid interrupting the sleep state of patients, will help better evaluate cardiovascular complications and prognosis of patients with OSAHS .

Objective To understand the adherence to current treatment guidelines after training in man-agement of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in emergency department (ED),and to assess the patients' prognosis. Methods Were ED doctors trained with a standard management flow-sheet for AECOPD. The treatment of 152 AECOPD patients recruited from November 1,2008 to April 30,2009 in our hospital and their prognosis were compared to those of 133 AECOPD patients who were treated between Novem-ber 1,0007 to April 30,2008. Results After training, the ED doctors' management of AECOPD is more standard. The rate of the combination of inhaled anticholinergics and short-acting β_2-agonists was increased from 12.0% (16/133) to 27.6% (42/152), the use of inhaled glucocorticosteroids was increased from 52.6% (70/133) to 88.8% (135/152), and the early use of noninvasive imermittent positive pressure ventilation(NIPPV) for the mod-erate to severe was increased from 10.5% (14/133) to 16.4% (25/152). The use of theophylline was decreased from 69.2% (92/133) to 49.3% (75/152). The in-ED mortality rate was decreased from 15.8% (21/133) to 12.5% (19/152). All the difference were significant (P< 0.05). The rate of inhaled β_2-agonists was increased from 78.2% (104/133) to 82.9% (126/152), the use of systemic glucocorticosteroids was decreased from 63.2% (84/133) to 56.6% (86/152),the use of antibiotics was increased from 88.0% (117/133) to 92.8% (141/152), and the use of invasive mechanical ventilation was increased from 14.3% (19/133) to 15.1% (23/152) ,the in-hos-pital mortality rate was decreased from 6.0% (8/133) to 5.3% (8/152), the average days in hospital was decreased from 13.3 to 12.4 days, but the difference was not significant (P > 0.05). Conclusions There are still some differences exist between guideline recommendations and actual ED management of AECOPD. After training ED doctora with a standard flow-sheet, their management of AECOPD is improved. The rate of the combination of inhaled anticholinergics and short-acting β_2-agonists, use of inhaled glucocorticosteroids, and early use of NIPPV is increased. The use of theophylline and the in-ED mortality rate is decreased.

Objective To study the relationships among health-related quality of life(HRQL), social support, excessive daytime sleepiness (EDS) and PSG parameters in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods Eighty-five patients were recruited who were diagnosed as OSAHS by overnight po]ysomnography from August 2007 through November 2007 in West China Hospital.The Calgary sleep apnea quality of life index (SAQLI) was used for HRQL, social support rating scale (SSRS) was used for social support,and Epworth sleepiness scale(ESS) was used for EDS.The Pearson linear correlation and stepwise multiple regression analysis were used to analyze the correlation among SAQLI, SSRS, ESS, and PSG.Results The SAQLI was correlated with SSRS score (r = 0.402, P < 0.01) ; ESS score (r =-0.505 ,P <0.01) ; apnea-hypopnea index (AHI) (r =-0.269,P <0.05) and lowest artery oxygen saturation (ISaO2) (r = 0.226, P < 0.05).Stepwise muhiple regression analysis determined two variables,the SSRS and ESS score,as independent factors for predicting the total score of SAQLI which accounted for 37.3% of the total variance in the total score on SAQLI (R2 = 0.373, P < 0.001).Conclusions The HRQL of patients with OSAHS was correlated with the SSRS score, ESS score and PSG parameters.The former two were the more important factors to affect the HRQL of patients with OSAHS.

Objectives: To express HBeAg in prokaryotic and eukaryotic cells and compare the two types of HBeAg in the anti-HBeAg testing. Methods: HBeAg was expressed both in E.coli cells and in silk worm cells, purified by Sephacryl S-200.HBeAg protein concentration and antigenic titer were determined respectively by ultraviolet-spectroscopy and EIA. Results: HBeAg produced by E.coli cells: Activation ratio was 10 000/mg, HBeAg/HBcAg = 50; The specificity in testing anti-HbeAg was 96%;HBeAg produced by silk worm cells: Activation ratio was 160 000/mg, HBeAg/HBcAg = 5 000, The specificity in testing anti-HbeAg was 100%. Conclusions: HBeAg produced by eukaryotic cells contained much lower proportion of HbcAg and higher activation ratio, which therefore bring about a possibility to improve the quality of the kit for testing Anti-HBe.

At present, there has been no report in China that novel coronavirus specific immune globulin has been used to treat coronavirus disease 2019 (COVID-19). Recently, we had successfully treated one COVID-19 patient with intravenous injection of human immunoglobulin (COVID-19-IVIG). The female patient, aged 57 years, had clinical diagnosis: (1) COVID-19, common type; (2) postoperative colon cancer; (3) leukopenia; (4) low cellular immunity. 75 mL COVID-19 human immunoglobulin (Sinoptic Wuhan Blood Products Co., Ltd.) was intravenously injected twice. The patient was hospitalized for 49 days and had a good prognosis.