Objective To compare the therapeutic efficacy of reteplase(r-PA) and alteplase(t-PA) in the high risk patients with pulmonary embolism during a pulmonary artery catheter broken bolt in the interventional treatment,and to evaluate the clinical safety.Methods 54 high risk patients were selected as the research subjects,and they were randomly divided into treatment group(24 patients) and control group(30 patients).Patients in both two groups were given general treatment,low molecular heparin sodium anticoagulation therapy.Besides,the control group was given local perfusion thrombolysis enzyme treatment.While the treatment group was given local perfusion at enzyme thrombolysis treatment.Results Two-way Chi-square test results showed that before treatment,there were no significant differences in HR,RF,PaO2,PaCO2 and SaO2 between the two groups(all P>0.05).After 3-day treatment,in the treatment group,HR[(83.39±14.25)times/min],RF[(17.80±1.65)times/min],PaO2[(87.59±7.34)mmHg],PaCO2[(37.60±7.62)mmHg],SaO2[(97.29±6.72)%] in the treatment group group,which in the control group were (97.7±15.51)times/min,(20.49±1.68)times/min,(81.53±6.42)mmHg,(35.69±4.57)mmHg,(93.91±3.27)%,the differences between the two groups were statistically significant(t=8.01,7.33,6.32,all P<0.05).After three days therapy,the total effective rate was 86.67% in the treatment group,which was significantly higher than 75.00% in the control group (x2=1.21,P=0.55).After thrombolysis treatment,there was no significant difference between the treatment group and control group in hemorrhage rate(x2=2.24,P=0.53),which were 13.33% and 12.50%,respectively.Besides,the hemorrhage patients were all got effectively treated and their condition was significantly improved,and none of them occurred severe bleeding during the observation periods in the two groups.Conclusion Local perfusion reteplase therapy in high-risk patients with PE through the pulmonary artery catheter broken bolt in the interventional treatment is safe and is worthy of clinical promotion.

Objective To observe the treatment effect of Buyang Huanwu Decoction combined with low molecular weight heparin calcium injection in treating deep venous thrombosis (DVT) in lower limb after cesarean section. Methods Seventy-six cases of DVT after cesarean were randomly divided into 2 groups. Thirty-six cases of control group were injected low molecular weight heparin calcium subcutaneously 100 AXaIU/kg twice daily, and forty cases of treatment group were treated with Buyang Huanwu Decoction additionally. After analysing the clinical symptoms and sign before and after treatment, HBV, LBV, PV, FIB, PLT, APTT, TT, PT and indexes of impedance plethysmography, CDFI were observed to evaluate the efficacy. Results After treatment, the total effective rate of treatment group was 97.5%(39/40), and the control group was 77.8%(28/36), the difference was statistically significant (P<0.05). The differences of hemorheological indexes (HBV, LBV, PV, FIB) and impedance plethysmography indexes between before and after treatment in treatment group were statistically significant (P<0.05), while the differences of blood coagulation indexes (APTT, TT, PT) were not significant (P>0.05). No adverse reaction was found during treatment. Conclusion The treatment of DVT after cesarean section with Buyang Huanwu Decoction combined with low molecular weight heparin calcium injection is safe and effective.

Conditionally replication adenovirus M4, which was constructed in our lab, was proved to have good clinical application prospect for its good anti-tumor and anti-metastasis effect. However, clinically applying M4 faces many problems. One of the most important is the safety of M4. In this study, we investigated the safety of M4 by comparing with Adv-TK, which was proved to be safe in I-III phase clinical trials. M4 and Adv-TK were injected into mice via the tail vein separately, and the mice were sacrificed at the indicated time. Blood was collected for biochemical tests, the liver was harvested for hematoxylin and eosin (H&E) staining and viral quantification, and splenic lymphocytes were separated for adenovirus specific cellular immune response. Our results showed that M4 had no obvious effect on mouse general symptoms. A transient reversible infiltration of inflammatory cells in collect abbacy was only observed in M4 group, and a transient slight increase in Cr level was detected both after M4 and Adv-TK injection. The adenovirus specific cellular immune response induced by M4 was similar to that by Adv-TK, and the distribution and metabolism of M4 in the mouse liver were also similar to those of Adv-TK. It was concluded that conditionally replication adenovirus M4 had the same safety as Adv-TK. The study provides safety basis for the coming clinical trials of M4.

Objective To investigate the clinicopathological characteristics, differential diagnosis and biological features of natural killer (NK)/T cell lymphoma in nasal cavity. Methods The data of 17 cases of nasal NK/T-cell lymphoma from Department of Pathology in the Affiliated Hospital of Yangzhou University between September 2007 and July 2017 were collected. Pathologic analysis including clinical symptoms, pathomorphism and immunophenotyping was performed, and the literatures were also analyzed. Results The clinical symptoms of the patients with nasal NK/T cell lymphoma were not obvious, which were accompanied by nasal congestion,runny nose,and blood in the runny nose.Pathologic examination showed obvious necrosis and inflammatory background of different levels. There were allotypic lymphocytes in the inflammatory background, nuclear irregular distortion or folding, unapparent nucleoli and visible nuclear fission, tumor cell growth for the center with blood vessels resulting in invasion and damage to blood vessels, in which normal lymphocytes,plasma cells and tissue cells could be seen.CD3,CD43,CD56,TIA-1,granzyme B,perforin and other markers were expressed in the tumor cells, and EB virus in situ hybridization was positive. Conclusions Nasal NK/T cell lymphoma is rare,with high incidence of invasive tumor, high recurrence rate, poor prognosis and easy misdiagnosis, which needs immunohistochemistry for differential diagnosis. Treatment is mainly based on radiotherapy and chemotherapy.

Objective To explore the therapeutic effect of drinking water test combined with swallowing training on cerebral infarction patients with dysphagia.Methods A total of 68 cerebral infarction patients with dysphagia in our department were randomly divided into observation group and control group.The control group was given routine nursing,while the observation group was given drinking water test to guide diet,and systemic swallowing function training on the basis of the control group.The therapeutic effects,feeding conditions and VSD scale scores were compared after 1 month of intervention between the two groups.Results The drinking water test score in the observation group was lower than that in the control group,and the total effective rate of the swallowing function improvement was higher than that in the control group,the differences were statistically significant (P ＜ 0.05).The FOIS score in the observation group was higher,and the score of VSD scale was lower than that in the control group,the differences were statistically significant (P ＜ 0.05).Conclusion Drinking water test combined with swallowing training can effectively improve the swallowing function of patients with dysphagia after cerebral infarction,and is beneficial to the normal diet of the patients.

Objective To study the effect of comprehensive nursing intervention on improving postoperative pain in middle-aged and elderly patients with proximal humerus fractures.Methods A total of 94 elderly patients underwent surgical treatment of proximal humerus fractures were divided into control group and experimental group according to the random number table method,with 47 cases per group.The control group was given routine fracture nursing intervention during perioperation,and the experimental group was given comprehensive nursing intervention on the basis of conventional nursing,all the patients were followed up for 6 months.The complications,the degree of pain and the recovery of shoulder function were observed and compared between the two groups.Results The total incidences of complication in postoperative bedsores,respiratory infections,fluctuations in blood pressure,inflamed fractures were lower than that in the control group (P ＜ 0.05);The VAS score of the experimental group was lower than that of the control group at 1 d,1 week and 1 month after nursing intervention (P ＜ 0.05).The Constant-Murley score of the experimental group was significantly higher than that of the control group at 3 months and 6 months after the intervention (P ＜ 0.05).Conclusion Comprehensive care intervention is effective for elderly patients with proximal humerus fractures in the perioperative period,and it can effectively reduce postoperative complications and degree of postoperative pain,promote patients'shoulder function recovery,so it is worthy of application and promotion.

Objective To explore the therapeutic effect of drinking water test combined with swallowing training on cerebral infarction patients with dysphagia.Methods A total of 68 cerebral infarction patients with dysphagia in our department were randomly divided into observation group and control group.The control group was given routine nursing,while the observation group was given drinking water test to guide diet,and systemic swallowing function training on the basis of the control group.The therapeutic effects,feeding conditions and VSD scale scores were compared after 1 month of intervention between the two groups.Results The drinking water test score in the observation group was lower than that in the control group,and the total effective rate of the swallowing function improvement was higher than that in the control group,the differences were statistically significant (P ＜ 0.05).The FOIS score in the observation group was higher,and the score of VSD scale was lower than that in the control group,the differences were statistically significant (P ＜ 0.05).Conclusion Drinking water test combined with swallowing training can effectively improve the swallowing function of patients with dysphagia after cerebral infarction,and is beneficial to the normal diet of the patients.

Objective To study the effect of comprehensive nursing intervention on improving postoperative pain in middle-aged and elderly patients with proximal humerus fractures.Methods A total of 94 elderly patients underwent surgical treatment of proximal humerus fractures were divided into control group and experimental group according to the random number table method,with 47 cases per group.The control group was given routine fracture nursing intervention during perioperation,and the experimental group was given comprehensive nursing intervention on the basis of conventional nursing,all the patients were followed up for 6 months.The complications,the degree of pain and the recovery of shoulder function were observed and compared between the two groups.Results The total incidences of complication in postoperative bedsores,respiratory infections,fluctuations in blood pressure,inflamed fractures were lower than that in the control group (P ＜ 0.05);The VAS score of the experimental group was lower than that of the control group at 1 d,1 week and 1 month after nursing intervention (P ＜ 0.05).The Constant-Murley score of the experimental group was significantly higher than that of the control group at 3 months and 6 months after the intervention (P ＜ 0.05).Conclusion Comprehensive care intervention is effective for elderly patients with proximal humerus fractures in the perioperative period,and it can effectively reduce postoperative complications and degree of postoperative pain,promote patients'shoulder function recovery,so it is worthy of application and promotion.

Objective:To analyze the clinical phenotypic characteristics and therapeutic effect of cutaneous anthrax patients in Ningxia Hui Autonomous Region (referred to as Ningxia).Methods:A retrospective analysis was conducted on the medical records of 76 confirmed patients with cutaneous anthrax in three prefecture level hospitals in Ningxia from 2017 to 2022. According to the length of hospital treatment, the patients were divided into a disease course ≥7 d group ( n = 54) and a disease course < 7 d group ( n = 22), and the clinical phenotypic characteristics (including patients' general condition, clinical symptoms, and laboratory tests) and therapeutic effects (the effect of hormone use and the choice of antibiotics) of the two groups were analyzed by methods such as χ 2 test. Results:Among 76 patients with cutaneous anthrax, males accounted for 81.6% (62/76) and females accounted for 18.4% (14/76), with a statistically significant difference in gender composition ratio (χ 2 = 5.71, P = 0.017). Among the 76 patients, 73 caces (96.1%) achieved clinical cure. There was no statistically significant differences between the groups in clinical characteristics such as temperature, pain, pruritus, edema, and site of onset ( P > 0.05). There were no statistically significant differences between groups in laboratory tests such as blood routine, liver function, hypersensitive C-reactive protein, secretion culture, PCR, etc. ( P > 0.05). There was a statistically significant difference in the distribution of edema resolution time between patients using hormone or not (χ 2 = 17.01, P = 0.002). There was no statistically significant difference in the distribution of disease course between different antibiotic treatment regimens when using hormone (χ 2 = 5.43, P = 0.143). There was a statistically significant difference in the distribution of disease course between different antibiotic treatment regimens when no using hormone (χ 2 = 108.46, P < 0.001). Conclusions:The majority of cutaneous anthrax patients in Ningxia from 2017 to 2022 are males. Early use of hormones can affect the duration of edema in patients. For patients who have not received hormone therapy, different treatment plans can affect the patient's course of disease.

Objective To explore the characteristics of contrast-enhanced ultrasonagraphy(CEUS) of sarcomatoid hepatocellular carcinoma ( SHC ) . Methods Fifteen lesions identified pathologically from 15 patients were included in this study . Among them ,9 lesions had completely sarcomatoid change and 6 lesions had partially sarcomatoid change . Totally 8 lesions were in the small size group with maximum diameter＜ 50 mm and 7 lesions in the big size group with maximum diameter ≥ 50 mm . The CEUS performance was observed and analyzed . Results In the arterial phase of CEUS ,9 lesions in the group with completely sarcomatoid change showed rim hyperenhancement and 6 lesions in the group with partially sarcomatoid change showed whole hyperenhancement , the difference between the two groups was statistically significant ( P ＜ 0 .001 ) . However ,the difference of CEUS performance between small size group and big size group was not statistically significant ( P ＝ 0 .608 ) , all the lesions showed hypoechogenecity in portal and(or) late phase of CEUS . Conclusions The difference of performance on CEUS is not related to the size of SHC ,but to the degree of sarcomatoid change within the tumor . SHC with completely sarcomatoid change shows rim hyperenhancement and SHC with partially sarcomatoid change shows entire hyperenhancement in arterial phase on CEUS .