Objective:To observe the therapeutic effect and timing of reteplase in patients with ST-segment elevation myocardial infarction (STEMI) .Methods:A total of 106 STEMI patients were selected from Central Hospital of Wafangdian City of Liaoning Province , from Jan 2013 to Apr 2014 ,and all patients received thrombolytic treat-ment .According to the duration from onset to thrombolysis ,patients were divided into :group 1 with duration <3h (<3h group ,n=28) ,group 2 with duration 3~6h (3~6h group ,n=47) ,group 3 with duration 6~12h (6~12h group ,n=22) and group 4 with duration 12~24h combined sustained chest pain (12~24h group ,n=9) .Thrombo-lytic recanalization rate ,30d all-cause mortality and incidence rate of adverse reactions were observed in all groups . Results:Compared with group 1 , 2 , the thrombolytic recanalization rate significantly reduced (82.14% vs . 76.60% vs .50.00% vs .44.44% ) in group 3 ,4 (P<0.05 all) ,but there was no significant difference between group 3 and group 4 ;Compared with group 1 , the 30d all-cause mortality (3.57% vs .6.38% vs .9.09% vs . 11.11% ) and incidence rate of adverse reactions (3.57% vs .10.64% vs .13.64% vs .22.22% ) in group 2~4 (P<0.05 all) ,but there were no significant difference among group 2~4 (P>0.05 all) .Conclusion:The thrombolytic recanalization rate is highest ,and the 30d all-cause mortality and incidence rate of adverse reactions are lowest for thrombolysis within 3 h from onset .

Objective To construct an oral recombinant DNA vaccine of Helicobacter pylori(H. pylori) neutrophil activating protein (Hp-NAP), and to evaluate its immunotherapeutic effects. Methods The napA gene (encoding Hp-NAP) was amplified by poly mera se chain reaction(PCR) and cloned into TA cloning vector pBT. After nucleotide s equencing and sequence analysis, the target sequence was subcloned into an eukar yot ic expression vector pIRES. Then the identified recombinant plasmid, pIRES-napA , was transformed into a live attenuated Salmonella typhimurium(S. typhimurium ) strain SL7207, and lavaged into a long-term(30 weeks) model of BALB/c mice infected by Sydney strain(SS1) of H. pylori. Results A 435 bp target gene of napA was amplified by PCR. Seq uenci ng and BLAST analysis showed that most of the cloned napA sequence was homologou s with that of SS1 strain of H. pylori. provided by GenBank, and the homolog y of neucleotide and protein was over 98%, respectively. PCR and restriction enzyme digestion id entification indicated that a recombinant live attenuated S. typhimurium DNA vaccine strain carrying Hp-napA gene was successfully constructed. After 4 wee ks of oral immunization, 75% of mice treated with DNA vaccine were rapid urease test negative, while those with vacant plasmid or normal saline alone were all p ositive (P= 0.0476). The titer of serum Hp-NAP antibody was signific antly elevated in treatment group. Conclusions The successful construction of an effective oral recom binant DNA vaccine of Hp-NAP may be helpful for the further development of polyvalent DNA vaccine against H. pylori infection.

Fanconi Syndrome ; complications ; diagnosis ; therapy ; Female ; Humans ; Infant, Newborn ; Potassium ; therapeutic use ; Prognosis ; Proteinuria ; etiology ; Treatment Outcome ; Vitamin D ; therapeutic use

Objective To investigate the value of intraoperative neuromonitoring(IONM) for preventing recurrent laryngeal nerve(RLN) injury in thyroid surgery.Methods 1087 consecutive patients undergoing thyroid surgery at Wuhan Central Hospital from Oct 2010 to Dec 2012 were evaluated.277 cases(the study group) underwent thyroidectomy with RLN identification by naked eye plus IONM.810 cases(the control group)underwent thyroidectomy with RLN identification by naked eye only.Results In the control group,733 RLNs (90.49％,733/810)were successfully identified and 77 RLNs were failed to be identified.In the study group,all the 277 RLNs(100％,277/277)were successfully identified.28 cases had postoperative temporal RLN injury,among whom 26 cases were in the control group and 2 cases were in the study group.18 cases in the control group and 2 cases in the study group recovered in 2 weeks after surgery.The rest recovered in 2 months after surgery.RLN injury rate was significantly lower in the study group than in the control group.There was no significant difference in RLN injury for low-risk surgical patients between the 2 groups; however,the study group had advantages in RLN injury than the control group for high-risk patients.Conclusions IONM in thyroid surgery can improve the recognition rate of RLN during thyroidectomy.IONM can significantly reduce the incidence of RLN injury,especially in high-risk surgery.

Cyclic AMP Response Element-Binding Protein ; DNA ; analysis ; genetics ; Female ; Humans ; Infant ; Male ; Muscular Atrophy, Spinal ; genetics ; Nerve Tissue Proteins ; genetics ; Polymerase Chain Reaction ; RNA-Binding Proteins ; SMN Complex Proteins

Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Needles ; Periarthritis ; therapy ; Punctures ; Treatment Outcome

Objective To observe the clinical effect of budesonide combined with ambroxol hydrochloride on the treatment of infant bronchopneumonia through oxygen atomizing inhalation .Methods One hundred and twenty -two cases of infant patients suf-fered with bronchopneumonia were randomly divided into two groups , control group (60 cases), the patients accept conventional treat-ment such as antibiotics, oxygen inhalation and anti-cough;treatment group (62 cases), patients were given budesonide combined with ambroxol hydrochloride through oxygen atomizing inhalation , beside conventional treatment .Main clinical signs and pulmonary symp-toms disappear time and treatment efficacy in two groups were observed and analyzed .Results The total effectiveness was obviously higher in treatment group(91.9%) than that of control group(81.7%) ( P <0.01).Wheezing disappearance time, wheezing sounds disappear time , crackles disappear time and cough disappear time in treatment group were significantly shorter than that in the control group ( P <0.01 ) .There were no adverse reactions on infant patients in both groups .Conclusions The effect of budesonide com-bined with ambroxol hydrochloride on the treatment of infant bronchopneumonia through oxygen atomizing inhalation was significant , and it is worthy of promotion in the clinic .

Objective:To investigate the efficacy of tramadol hydrochloride tablets in the control of periodontal pain following ortho-dontic treatment.Methods:76 orthodontic patients were randomly assigned to I,II,III and IV groups according to the different doses of tramadol hydrochloride tablets or placebo(control).Periodontal pain was recorded and analysed by VAS,adverse reaction was ob-served.Results:The pain scores were all lower when teeth were not touching than when teeth were touching.Pain scores of experi-mental group were less than that of the control group,muff-doses are more effective than single-dose.No obvious adverse reaction was found in all group.Conclusion:Tramadol hydrochloride tablet is effective in the control of the pain following orthodontic treatment.

Objective To explore the role of nucleotide-binding oligomerization domain receptor protein 3 (NLRP3) inflammasome in the pathogenesis of dementia. Methods 16 patients with with Alzheimer's disease (AD), 22 patients with vascular dementia (VD) and 20 healthy persons with similar age were detected the level of NLRP3 mRNA with RT-PCR in peripheral blood mononuclear cells January, 2014 to October, 2015. The serum level of interleukin (IL)-1βand IL-18 were detected with ELISA. The total number of white blood cells (WBC) and serum total calcium were collected. Single factor correlation analysis was performed between NLRP3mRNA and IL-1β, or IL-18, or WBC, or calcium concentration. Results The levels of NLRP3 mRNA ranged from high to low were as in AD group>VD group>the healthy group (q>11.48, P<0.05). The serum level of IL-1βwas higher in AD group than in the the healthy group (q=16.74, P<0.05), but not significantly different between VD group and the healthy group, nor between VD group and AD group (P<0.05). There was no signifi-cant difference about IL-18 among AD group, VD group and the healthy group (P<0.05). NLRP3 mRNA was positively correlated with the serum levels of IL-1β(r=0.64) and calcium (r=0.58) in AD group. There was no correlation between NLRP3 mRNA and IL-18 or WBC (P<0.05). Conclusion The expression of NLRP3 inflammasome may be related with the pathogenesis of AD, but little impact on the pathogene-sis of VD.

Objective:To investigate the serum level of miR-224 in hepatocellular carcinoma (HCC) patients and its clinical diag-nostic significance. Methods:The serum level of miR-224 was detected by real-time quantitative PCR. This study included 42 cases of patients with HCC, 36 patients with liver cirrhosis (LC), 55 patients with chronic hepatitis B (CHB), and 40 healthy persons (NC). The relative expressions of miR-224 were calculated. The receiver operating characteristic (ROC) curves were analyzed to determine the sensitivity and specificity of miR-224 expression levels in HCC diagnosis. Results:Result shows that the relative miR-224 expression was higher in the serum of HCC patients than that in the CHB, LC, and NC groups. The difference was statistically significant (P<0.05 or P<0.01). The relative miR-224 expression in the serum of HCC patients and alpha fetoprotein (AFP) were positively correlated (P<0.05). By comparison, the tumor size, TNM stage, tumor differentiation, and lymph node metastasis were not correlated with mirR-224 expression (P>0.05). ROC analysis shows that the best critical value of the relative expression levels of miR-224 was 3.47, with sensi-tivity of 82.2%, specificity of 92.8%, and area under the curve of 0.935. Conclusion:The serum level of miR-224 in HCC patients has high specificity, and miR-224 has great potential to become a new serological marker for the diagnosis of HCC.