Objective To investigate the coagulation and fibrinolytie system changes in liver cirrhosis (LC) patients with and without portal vein thrombosis (PVT). Method Twenty-six cases of LC with PVT (PVT group) and 61 eases of LC without PVT (control group) were chosen. Platelet(Pt), prothrpmbin time (PT), activated partial thromboplastin time (APTT), fibrin (Fib), D-dimer, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-l) were determined. SPSS 11.5software was used for statistic analysis. Results In PVT group, the average level of D-dimer was (0.97±0.53 ) mg/L,signifieantly higher than that in control group (0.61±0.40) mg/L. No significant difference was found between the two groups in Pt PT, APTT, Fib, t-PA and PAI-1. PT and APTT were progressively prolonged from Child-Pugh grade A to B and then to C. Fib was progressively decreased from Child-Pugh grade A to B and then to C. Decreased Pt and increased t-PA, PAI-1 were found in LC patients, but had no sighifieant difference. Conclusions The changes determined of coagulation and fibrinolytie system in patients with LC are abnormal. The average level of D-dimer is higher in LC patients with PVT than that in LC patients without PVT. D-dimer may be a helpful tool to rule out the presence of an underlying PVT in LC patients.

Objective To evaluate the application of fast track surgery (FTS) in the rib internal fixation of multiple rib fractures. Methods Forty-eight chest trauma with multiple rib fractures patients from March 2008 to March 2010 were divided into FTS group and traditional care group randomly. Meanwhile two groups accepted FTS and conventional management of perioperative period respectively. The degree and duration of the chest pain, early exercise tolerance, intravenous infusion time, the length of postoperative hospital stay,chest scar and postoperative complications were observed and compared between the two groups. Results The duration of chest pain was significantly shorter in FTS group than in the traditional care group([ 112. 46 ±23. 24 ] mins vs [ 180. 23 ± 51.56 ] mins, t = 4. 23 ,P ＜ 0. 05); the early exercise tolerance was longer([ 68. 35 ±9. 30 ] mins vs [ 33.48± 5. 18 ] mins,t = 2. 87, P ＜ 0. 05) ;the intravenous infusion time was shorter ([ 10. 83 ±1.87 ] d vs [ 13. 30 ± 2. 12 ] d, t = 2. 38, P ＜ 0. 05); the length of postoperative hospital stay was shorter([ 12. 35 ± 2.03 ] d vs [ 16. 48 ± 3. 18 ] d, t = 3.04, P ＜ 0. 05); the less postoperative complications(8.3% vs 37. 5 %, x2 = 5. 005,P ＜ 0. 05); chest pain was relieved([ 3.43 ± 0. 45 ] cm vs. [ 6. 62 ± 0. 62 ] cm, P ＜ 0. 05);the scar healed well. All patients were successfully discharged. Conclusion The perioperative idea of fast track surgery was feasible and effective in the chest trauma with multiple rib fractures patients. FTS can improve the patients long term living quality.

feature of GD that has not previously been described.

Objective To investigate the changes of anticardiolipin antibody(ACA) and protein C(PC) in cirrhotic patients with or without portal vein thrombosis(PVT). Methods During Jan. 2006 to Dec. 2007, 60 cirrhotic patients with (n=20) or without (n=40) PVT were analyzed. The concentrations of prothrombin time (PT), activited patial thromboplastin time (APTT), fibrogen, ACA and protein C (PC) were determined. Results The positive rate of ACA was 35% (7/20) in PVT group and 10% (4/40) in control group (P=0.045). The average level of ACA-IgG was significantly higher in PVT group [(10.15±5.31)U/ml] than that in control group [(6.70±3.75) U/ml]. The concentration of PC was significantly lower in PVT group [(2.47±0.62) mg/L] than that in control group [(2.93±0.88)mg/L]. No difference was found in APTT, levels of fibrogen and ACA-IgM between two groups. PT and APTT were progressively prolonged and fibrogen and PC were decreasing with the severity of Child-Pugh, respectively. The levels of ACA-IgG and ACA-IgM were increasing with the severity of Child-Pugh. Conclusions The coagulation and anticoagulation system is abnormal in patients with PVT who has higer ACA-IgG level and lower PC level. It is indicated that the ACA and PC may play an important role in formation of PVT.

Objective To investigate the relationship between thrombomodulin(TM), fibrinolytic system changes and the score of the model for end-stage liver disease(MELD)in liver cirrhosis patients.Methods Eighty-five liver cirrhosis patients admitted from January 2008 to December 2009 were included in this study. TM, D-dimer, tissue plasminogen activator(t-PA), plasminogen activator inhibitor -1(PAI-1),serum creatinine, serum total bilirubin and international normalized ratio(INR)on all patients were measured and then the score of the MELD was calculated. Results The score of the MELD was 1-29(11.35 ± 6.02)scores. The score of the MELD ≤ 9 scores was 40 cases(47.1%), 10- 19 scores was 32 cases (37.6%),20-29 scores was 13 cases(15.3%).TM and D-dimer were progressively increased with MELD score. There was significant difference among the three groups(P＜0.01). The levels of TM and D-dimer had positive correlation with the score of the MELD(r = 0.706,0.425,P ＜ 0.01). Conclusions The levels of TM and D-dimer have positive correlation with the score of the MELD in liver cirrhosis patients. These indices can help predicting the degree of liver function disorder and prognosis.

Objective To observe the effect of core stability training on the associated reaction of upper limbs in stroke patients with hemiplegia. Methods From November, 2014 to May, 2016, sixty stroke patients with hemiplegia were randomly divided into control group (n=30) and treatment group (n=30). Both groups accepted routine rehabilitation, while the treatment group received core stability training for 20 minutes during exercise. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Fugl-Meyer Assess-ment-Lower Extremities (FMA-LE), Berg Balance Scale (BBS) and Associated Reaction Rating Scale (ARRS) before and 6 weeks after treatment. Results The scores of FMA-UE, FMA-LE, BBS and ARRS improved significantly in both groups after treatment (t>12.158, P<0.001), and improved more in the treatment group than in the control group (t>2.317, P<0.05). Conclusion Core stability training can re-lieve the associated reaction of upper limb in stroke patients with hemiplegia.

Objective To investigate the changes of C-reactive protein(CRP)and D-dimer in the patients with hyperlipidemic acute pancreatitis(HLAP)and biliogenic acute pancreatitis(BAP).Methods One hundred fifty-five inpatients with acute pancreati-tis in our hospital from Jan.2012 to Dec.2014 were divided into the HLAP group and BAP group by etiology.Also the patients were divided into mild acute pancreatitis(MAP)subgroup and moderately severe acute pancreatitis(MSAP)subgroup by disease se-verity.Blood routine,liver and kidney function,glucose(Glu),calcium,blood lipids,CRP and D-dimer were measured.Results Platelet,Glu and blood lipid indicators in the HLAP group were significantly higher than those in the BAP group.But alanine amin-otransferase(ALT),r-glutamyl transferase(GGT),alkaline phosphatase(ALP),total bilirubin(TBIL),direct bilirubin(DBIL),calci-um(Ca)and creatinine(Cr)in the HLAP group were significantly lower than those in the BAP group(P <0.05).CRP in the HLAP group was significantly higher than that in the BAP group with statistical difference(P <0.01).CRP had statistical difference be-tween the HLAP group and BAP group in the MAP and MSAP subgroups (P <0.01).CRP and D-dimer had statistical difference between in the MAP and MSAP subgroups of the HLAP group(P <0.05).Increased CRP and D-dimer in the HLAP group were the risk factors for MSAP occurrence(OR =1.121,3.716,P =0.025,0.001 ).In the BAP group,only increased D-dimer was the risk factor for MSAP occurrence(OR=2.717,P =0.002).Conclusion CRP and D-dimer in HLAP and BAP are increased with dis-ease severity aggravation,moreover CRP increase is more obvious in HLAP patients.

Objective To investigate the relationship of thyroid hormone (TH), thyroid stimulating hormone (TSH) and blood calcium in hyperlipidemic acute pancreatitis (HLAP) patients. Methods Fifty patients with HLAP were selected, among whom 37 patients with mild acute pancreatitis (MAP) were enrolled into MAP group, and 13 patients with moderately severe acute pancreatitis (MSAP) were enrolled into MSAP group. The albumin, blood glucose, creatinine, blood lipids, blood calcium, free tri-iodothyronine (FT3), free thyroxine (FT4) and TSH levels were measured and analyzed. Results The blood calcium, FT3 and TSH levels in MAP group were significantly higher than those in MSAP group:(2.02 ± 0.26) mmol/L vs. (1.75 ± 0.27) mmol/L, (1.88 ± 0.46) ng/L vs. (1.52 ± 0.35) ng/L and (0.28 ± 0.20) mU/L vs. (0.17 ± 0.12) mU/L, but the blood glucose and triglycerides (TG) levels were significantly lower than those in MSAP group: (13.36 ± 5.83) mmol/L vs. (19.99 ± 7.97) mmol/L and (24.01±12.46) mmol/L vs. (34.76 ± 20.39) mmol/L, and there were statistical differences (P<0.01 or<0.05). There were no statistical differences in albumin, creatinine, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol (LDL-C) and FT4 levels between 2 groups (P>0.05). The correlation analysis result showed: in patients with HLAP, TSH and albumin had a positive correlation with blood calcium (r=0.344 and 0.372, P=0.014 and 0.008), LDL-C and TG had negative correlation with blood calcium (r=-0.315 and-0.444, P=0.026 and 0.001), and other indexes had no correlation with blood calcium (P>0.05). Conclusions Blood calcium, FT3 and TSH levels are decreased with severity of HLAP. Decreased blood calcium may be one of reasons for decreased TSH in HLAP patients.

Objective To study the relationship between fibrinolysis,anticoagulation system indexes and serum albumin (ALB) in patients with liver cirrhosis.Methods One hundred and thirty-seven patients with liver cirrhosis were enrolled.Serum ALB,D-dimer (D-D),tissue plasminogen activator (t-PA),plasminogen activator inhibitor-1 (PAI-1),protein C (PC),protein S (PS) and antithrombin-Ⅲ (AT-Ⅲ) levels were measured.Results D-D level was increased with deterioration of liver function.D-D levels were (0.38 ± 0.24),(0.58 ± 0.43) and (0.90 ± 0.55) mg/L in Child-Pugh class A,B and C,respectively.PC,PS and AT-Ⅲ levels were decreased with deterioration of liver function.PC levels were (3.29 ± 1.04),(2.50 ± 1.27) and (2.29 ± 1.05)mg/L in Child-Pugh class A,B and C,respectively.PS levels were (20.74 ± 5.91),(17.97 ± 5.26) and (17.79 ± 5.12) mg/L,respectively.AT-Ⅲ levels were (104.62 ± 8.59)％,(101.76 ± 10.08)％ and (92.91 ± 10.48)％,respectively.D-D showed negative correlation with ALB (r =-0.402,P ＜ 0.01).On the contrary,PC,PS and AT-Ⅲ levels showed positive correlation with ALB (r =0.266,0.286 and 0.405,P ＜0.01).Conclusions Fibrinolysis and anticoagulation system indexes are changed with deterioration of liver function and are related with ALB directly.The indexes may be a helpful tool to evaluate the liver function in patients with liver cirrhosis.

Objective To investigate the correlation and differences of serum calcium ( Ca) and intact parathyroid hormone ( i-PTH) in patients with hyperlipidemic or biliogenic acute pancreatitis ( AP) .Methods From Jan 2012 to Jan 2014 , total 80 AP patients admitted to Bejing Chaoyang Hospital were enrolled . According to the etiology , AP patients were divided into 2 groups, hyperlipidemic acute pancreatitis ( HLAP) group and biliogenic acute pancreatitis (BAP) group.Blood routine, function of liver and kidney , blood lipids, Ca, and i-PTH were measured .Differences between Ca and i-PTH in HLAP group and BAP group were analyzed, and found the correlation with disease severity of AP .Results 80 AP patients included 43 HLAP and 37 BAP patients, 55 mild acute pancreatitis(MAP) and 25 moderately severe acute pancreatitis (MSAP) patients.HLAP group had 34 male and 9 female patients, average age was 37 years, 31 MAP and 12 MSAP patients.BAP group had 17 male and 20 female patients, average age was 58 years, 24 MAP and 13 MSAP patients.proportion of males was significantly higher in HLAP group than BAP group .on the contrary, average age was significantly lower (P<0.01 and <0.01, respectively).No significantly difference was found in MAP/MSAP ration.Level of serum Ca in HLAP group was significantly decreased than BAP group (1.92 ± 0.24 mmol/L vs 2.14 ±1.99 mmol/L, P<0.05).No significantly difference was found in i-PTH between two groups.Level of serum Ca in MAP and MSAP subgroup in HLAP group were 1.98 ±0.20 mmol/L and 1.76 ± 0.27 mmol/L.Accordingly, Level of serum Ca were 2.23 ±0.15 mmol/L and 1.98 ±0.19 mmol/L in BAP group. i-PTH in MAP and MSAP subgroup in HLAP group were 43.41 ±18.40 ng/L and 56.07 ±33.61 ng/L.Accordingly, i-PTH was 39.22 ±17.19 mmol/L and 52.73 ±29.42 mmol/L in BAP group.Compared to MAP, Ca in MSAP group was significantly decreased in HLAP and BAP group ( P<0.01 and <00.5, respectively).In HLAP group, Ca was a negative correlation with low density lipoprotein cholesterol (LDLC-) and triglycerides(TG) (P<0.05 and <0.01, respectively).In BAP group, Ca was a negative correlation with i-PTH(P<0.05).Conclusions Serum Ca is decreased with severity of HLAP and BAP .Decreased Ca has correlation with increased LDL-C, TG in HLAP and increased i-PTH in BAP.