Objective: To assess the safety and efficacy of simultaneous intravenous plus intracoronary administration of tirofiban bolus for patients with acute ST-elevation myocardial infarction(STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods: Forty-three patients with acute STEMI ready to receive primary PCI were randomly divided into tirofiban IV group (intravenous tirofiban bolus only before stent deployment, n = 22) or tirofiban IV&IC group (intravenous plus intracoronary administration of tirofiban bolos simultaneously, n = 21). The thrombolysis in myocardial infarction trial and perfusion of the myocardium were observed before and after PCI. Major adverse cardiovascular event (MACE), hemorrhage event,and thrombocytopenia were observed during hospital stay; MACE was also observed 30 days after PCI. Results: The clinical characteristics and baseline angiographic findings were similar in the two groups. After PCI, no difference was observed in the final TIMI flow grade 3,CTFC≤27, sumSTR≥70% between the two groups (P=0.951,0.933,0.666, respectively). There was no significant difference in the frequencies of MACE (P=0.101) and the left ventricular ejection fraction between the two groups (P=0.694). No major hemorrhage or severe thrombocytopenia were found in the two groups during hospital stay. The total rate of bleeding was also similar in the two groups (P = 0.558). The frequencies of MACE were similar in the two groups 30 days after operation. Conclusion: Simultaneous intravenous and intracoronary administration of tirofiban bolus is safe for STEMI patients undergoing primary PCI; the short-term efficacy is similar to that of intravenous administration only.

Atropine ; therapeutic use ; Humans ; Organophosphate Poisoning ; Poisoning ; drug therapy ; Quinuclidines ; therapeutic use

Accidents, Occupational ; Bromine ; poisoning ; Humans ; Hydrobromic Acid ; poisoning

OBJECTIVETo evaluate the clinical results of the medial patellofemoral ligament (MPFL) reconstruction combined with the lateral retinacular release for the treatment of recurrent patellar dislocation.

METHODSFrom March 2011 to June 2013, 15 patients with recurrent patellar dislocation underwent arthroscopic MPFL reconstruction combined with the lateral retinacular release. The graft was autogenous semitendinosus and semimembranosus tendon. There were 5 males and 10 females with an average age of 19.4 years old (ranged,14 to 32 years old). The patients suffered recurrent patellar dislocation at least twice preoperatively. Preoperative conventional X-ray, CT, and MR examination were used to analyze the causes of the patellofemoral joint and MPFL injury. Preoperative Lysholm score was 69.85 ± 11.52. During operation, the arthroscopic examination was performed to evaluate the patellofemoral alignment and patellar tracking.

RESULTSAll the patients were followed up for an average of 27.6 months (ranged,12 to 36 months) with no recurrent dislocation and sub-dislocation. All the patients showed negative apprehension test at straight and 30 ° flexions of knee. The range of motion of knee returned to normal level at 12 months after operation. There were no patients with subjective discomfort of knee. Postoperative Lysholm score was improved to 92.60 ± 5.75.

CONCLUSIONThe technique of arthroscopic MPFL reconstruction combined with the lateral retinacular release is an effective surgical procedure for the treatment of recurrent patellar dislocation, which can relieve the symptom of knee and improve the patella stability and knee function.

Adolescent ; Adult ; Arthroscopy ; Female ; Humans ; Knee Joint ; surgery ; Male ; Patellar Dislocation ; physiopathology ; surgery ; Patellar Ligament ; physiopathology ; surgery ; Patellofemoral Joint ; physiopathology ; surgery ; Range of Motion, Articular ; Treatment Outcome ; Young Adult

Air ; Humans ; Workplace

BackgroundSmad4,a key intracellular mediator in transforming growth factor-β (TGF-β)signaling,plays a critical role in the normal development of many tissues/organs.However,its functional role in the development of lacrimal gland has rarely been reported.ObjectiveThe aim of this study was to investigate the role that Smad4 may play in the development of lacrimal glands using Smad4 conditional knockout (CKO) mice( C57BL/6 mouse line),MethodsSmad4 in lacrimal glands,as well as in the lens,cornea and ectoderm of the eyelids,was conditionally inactivated by the Pax6 promoter-driven Cre transgenic mice and Smad4 conditional gene mice,LacZ reporter was used to visualize the developing lacrimal gland by X-gal staining,and standard histological approaches were used to reveal morphological changes.Six or more mice or embryos in each group were used for comparisons at the same stage.ResultsLacZ staining showed that E15.0,Smad4 CKO mice could still develop primary lacrimal bud,but much shorter than the wild-type ones.At E16.5,the primary lacrimal bud in wild-type mice began branching,but no branching was found in Smad4 CKO mice except that the primary lacimal bud became blunt at the tip.At E18.0,although Smad4 CKO mice develop some acini,the branching and size and number of acini were obviously less than ones in Smad4 wild-type mice.Based on histological findings,lacrimal glands in Smad4 CKO mice developed slowly,and the size was considerably smaller,and the numbers of lobes as well as the numbers of acini were much fewer than those of Smad4 wild-type mice lacrimal glands at various stages.Pigment and adipose tissue were also observed within the lacrimal glands starting from P7 in Smad4 CKO mice and increased with age growing.Lacrimal glands in mutant adult mice were eventually replaced by adipose tissue and accumulation of pigments.Conclusions These results support the notion that Smad4 is essential for the normal development and maintenance of the mouse LG and may be involved in the metabolism of pigment and adipose tissue in LG.

Objective To investigate the application of the ultrasonic guidance-assisted neonatal internal jugular vein catheterization.Methods Sixty two newborns (including low birth weight infants) receving thoracic/abdominal operation or resection of malignant tumor on the body-surface were randomly assigned to ultrasound guidance (UG) group or surface mark landmark(S) group.Newborns in both groups were all punctured with 22G venous indwelling needles to place the external casing,followed by the steel wire guidance-assisted implantation of ARROW 4F dual chamber central venous catheter.Then we compared the rate of successful insertion attempt,rate of malpositioning,complications and average operation time between the two groups.Results The rate of successful insertion attempt was 96.8%(30/31) in the UG group,significantly higher than that in the S group (32.3%,10/31),there was significant difference between the two groups(χ2=28.182,P=0.000).Malpositioning happened in 2 cases in the UG group,but 25 cases in the S group.Rate of complications was higher in the S group compared to the UG group (64.5% vs 3.2%,χ2=25.99,P=0.000).Most importantly,the average operation time was (4.366±1.137)min in the UG group,significantly shorter than that of the S group [(13.70±5.34)min,t=5.463,P=0.028)].ConclusionUltrasound guidance-assisted catheterization for neonatal internal jugular vein is safe and feasible and can dramatically improve the success rate and prevent complications.

The carotene content of 63 kinds of plant materials including vegetables, grasses, wild plants and tree leaves were determined by the column chromatography method. Alfalfa, shepherd purse and carrot had the highest carotene content among the tested plants.Four methods were tried for the preparation of carotene concentrates. It was found that percolation with ethyl ether after grinding in ethanol showed the highest yield at low cost.The carotene content of the above mentioned concentrates was almost completely destroyed after 4 months when stored at room temperature and exposed to light. There was appreciable loss of the vitamin after 5 months' storage in the dark at low temperature (below 6℃), however, the loss was much smaller than that stored at room temperature. The loss of carotene was greatly reduced when the carotene concentrates were stored under nitrogen either at low temperature or at room temperature compared with those stored in the air. The addition of heated soy-bean meal to the carotene concentrate also considerably reduced the carotene loss during storage at room temperature.

Objective To compare the clinical value of 2 oral contrast agents for magnetic resonance cholangiopancreatography(MRCP)and to investigate the safety,potency ratio of negative gastrointestinal contrast agents and to improve MRCP image quality.Methods Before MRCP,30 patients took oral ferric ammonium citrate(FAC)solution as group A and another 30 patients took Gd-DTPA dilution as group B.Then all patients underwent MRCP with T2-haste-fs-thick-slab sequence.Image assessment was done before and after oral taking of negative gastrointestinal contrast agents.Results After oral taking of negative gastrointestinal contrast agents,the interference of liquid in stomach and duodenum was suppressed and even effectively eliminated on MRCP.MRCP image quality was improved.Though the display of bile duct and pancreatic duct was of less image artifact,it reached the quality for diagnosis.No significant difference of MRCP image quality was found between those took FAC solution or Gd-DTPA solution.Conclusion FAC and Gd-DTPA both are effective negative gastrointestinal contrast agents.Gd-DTPA solution is of better function and higher quality-price ratio.

Objective To explore the diagnostic and prognostic significances of platelet parameters changes in Kawasaki disease(KD).Methods The platelet total(PLT),mean platelet volume(MPV),platelet distribution width(PDW)and plateletcrit(PCT)were measured in 23 cases of KD on acute febrile phase and early recovery phase.It was compared with 33 cases suffered from other febrile diseases during the same period and in similar ages.Each KD child should accept the cardiology ultrasonic examination.Results The level of PLT,PCT increased in KD patients.It was more significant in early recover period than in acute febrile period(P0.05).PLT negatively correlated with MPV,PDW(r=0.358,0.268 Pa0.05).Conclusions The changes of platelet parameter play a very important role in diagnosis of KD.But it still can not be certain that whether the changes can help us estimate the variety of the patients condition and prognosis of KD children.It requires further study.