Objective　To analyze the efficacy,safety and pharmacological mechanism of butylphthalide in patients with rt-PA intravenous thrombolytic stroke.Methods　Patients were divided into rt-PA+butylphthalide injection treatment group (n=124) and rt-PA+0.9% normal saline control group (n=75).We compared the baseline and clinical parameters such as the National Institute of Health stroke scale (NIHSS) score,Transcranial Dopple monitor mean flow velocity (Vm) and Pulse Index (PI) of the middle cerebral artery and serum levels of Matrix metalloprotein-9 (MMP-9) at 24 hours,7 days,and 14 days after treatment between the two groups.Modified Rankin Scale (mRS) scores were compared between the two groups after ninety-days of treatment.Results　The NIHSS score and MMP-9 in the treatment group were significantly lower than those in the control group (P<0.05);the Vm and PI of the middle cerebral artery in the treatment group were significantly higher than those in the control group (P<0.05).The mRS score in the treatment group was 93.0%,and the difference was statistically significant (P<0.05).Conclusion　Butyphthalide combined with alteplase helps to improve the clinical efficacy and prognosis of patients without increasing the incidence and mortality of adverse reactions and its mechanism may be related to the reduction of MMP-9 level in serum.

Objective:To describe a systematic approach on identification of poisonous mushroom by investigating two cases of Omphalotus guepiniformis poisoning in Jianyang district, Nanping, Fujian province. Methods:Two incidents of food poisoning on 10 migrant workers were investigated. The remaining suspected mushroom samples were collected and the same fresh mushroom specimens were also collected in the following field investigations from the same dead tree and fallen trunk. These mushroom specimens were identified based on morphological and phylogenetic analyses.Results:On November 24 and 26, 2018, 8 and 2 migrant workers from Jianyang District, Nanping ate wild mushrooms and developed acute nausea, vomiting, abdominal pain and other symptoms within 10 to 90 min after consumption. They were diagnosed as mushroom poisoning, with gastroenteritis as the main manifestation. Further analysis showed that the more poisonous mushroom were consumed, the shorter latency and longer duration of nausea and vomiting were resulted. After admission, gastric lavage, catharsis, acid preparation, gastric protection, fluid replenishment and other symptomatic support treatments were given in time, all patients were discharged in 1-3 d. Based on morphological and phylogenetic analyses, the samples were identified as O. guepiniformis. Conclusions:The two incidents were caused by accidental consumption of O. guepiniformis. Awareness education about poisonous mushroom should be provided to migrant workers to prevent more such poisoning incidents in the future.