Objective To investigate the clinical efficacy and safety analysis on the different doses of rivaroxaban in treatment of left ventricular apical thrombus.Methods 87 patients with left ventricular apical thrombus were randomly divided into warfarin group (n =21 ),rivaroxaban 1 group (n =22),rivaroxaban 2 group (n =21 )and rivaroxaban 3 group(n =23).Patients in the warfarin group were given the doses of warfarin 2.5mg once daily,and the doses were adjusted according to INR.Patients in the rivaroxaban 1 group were given the doses of rivaroxaban 10mg once daily.Patients in the rivaroxaban 2 group were given the doses of rivaroxaban 20mg once daily.Patients in the rivaroxaban 3 group were given the doses of rivaroxaban 15mg twice daily for 21d,then followed by 20mg once daily. Patients in the four groups were followed up for 3 months.The percent reduction of D -dimmer at taking drug 3d,D -dimmer normal time,left ventricular apical thrombus disappearing time,the number of disappearance and INR compliance rate were recorded.The occurrences of thromboembolic events and bleeding events in the four groups were recorded. Results The percent reduction of D -dimmer at taking drug 3d in the rivaroxaban 1 group,rivaroxaban 2 group and rivaroxaban 3 group were higher than the warfarin group,and the rivaroxaban 3 group were higher than the rivaroxaban 1 group and rivaroxaban 2 group,the D -dimmer normal time and thrombus disappearing time in the rivaroxaban 1 group,rivaroxaban 2 group and rivaroxaban 3 group were lower than the warfarin group,and the rivaroxaban 3 group were lower than the rivaroxaban 1 group and rivaroxaban 2 group,the differences were statistically significant(F =8.443,19.319,35.475,all P <0.05).The numbers of INR compliance in the rivaroxaban 3 group were higher than those in the warfarin group,the differences were statistically significant[18cases(78.3%)vs.9cases(42.9%),χ2 =5.803,P <0.05].There was 1 case of patient appeared minor bleeding in each rivaroxaban 1 group and rivaroxaban 3 group.The occurrence rates of thromboembolic events and bleeding events in the rivaroxaban 1 group,rivaroxaban 2 group and rivaroxaban 3 group were lower than those in the warfarin group,but the differences were not statistically significant(χ2 =0.732,2.357,all P >0.05).Conclusion Rivaroxaban applied to treatment of left ventricular apical thrombus was safe and effective,and without increasing embolism and bleeding events.And treatment plan of the doses of rivaroxaban 15mg twice daily for 21d,then followed by 20mg once daily was superior.

Subclavian artery pseudoaneurysm that induced from central venous catheterization through the internal jugular vein is relatively uncommon. However, the management of subclavian artery pseudoaneurysm remains a challenge because of their non-compressibility of deep locality and relationship to important surrounding anatomy, such as the origin of vertebral artery. In this paper, the authors report a patient with larger iatrogenic subclavian arterial pseudoaneurysm near the origin of vertebral artery, that was treated successfully by endovascular covered stent and coils.

Anticoagulation, which has been used in clinical practice since 1940's, is one of the important measures in the prevention and treatment of cerebrovascular diseases. This article reviews the progress in anticoagulation for ischemic cerebrovascular diseases by introducing a series of large, important, international, randomized controlled clinical trials in the past 20 years (particularly in the recent 10 years).

The changes of skeletal muscle mitochondral monoamine oxidase (MAO) activity in rats fed with low Se grains from a Keshan-disease area were observed. The rats were killed at the time for feeding 30, 60 and 90 days respectiely. The mitochondrium of skeletal muscle was isolated MAO activity was determined with fluorescent methed. The results showed that in low-Se group the mitochondrial MAO activity was significantly decreased only at the time for 90 days feeding however GSH-px activity in red blood cells and Se content in plasma were significantly decreased at all experimental period as compared to Se-supplemented or stock died group.

0.05), although there were more patients with large area anterior infarction and enlarged left ventricle in the DEF group (P

0.05),but incidence of recurrent angina was higher in NHT group(P

0.05).Conclusion Certain changes have been found in mental health of Chinese standby peacekeepers,such as expectancy anxiety,depression,neurasthenia,interpersonal sensitivity etc.

Objective To investigate the application efficacy objective structured clinical exam-ination (OSCE) in assessment of interns of traditional Chinese medicine in anesthesiology department. Methods Totally 62 interns were examed by OSCE formulated by anesthesiology department before de-partmental rotation. Contents of the exam included preoperative evaluation,endotracheal intubation tech-nique,deep venipuncture,lumbar puncture,case analysis,medical documents writing,etc. Assessment was made by exam results and questionnaire survey. Quantitative data were analyzed by ANOVA and results of questionnaire were analyzed by calculating percentage of each option and describing directly. Results Test results showed that the score of medical document writing was the highest(18.25 ± 1.53),while that of case analysis was the lowest(13.49±1.46)and there was no significant difference in scores of three clinical skills. Questionnaire survey showed the OSCE method is superior to traditional method since it is more scientific,objective and fair. Conclusions OSCE method can scientifically as-sess the clinical practice effect of interns of traditional Chinese medicine in anesthesiology department. Meanwhile, it can find the shortcomings in the teaching, which is helpful in promoting the assessment and improvement of clinical teaching.

Objective To investigate the sedative effect of propofol combined with different doses of midazolam in patients undergoing long-time microsurgeries.Methods Forty ASA(American Society of Anesthesiologists)Ⅰ～Ⅱ patients were randomly divided into 4 groups.Normal saline(NS) 2 mL was administered in groupⅠ,while midazolam 0.01,0.02 and 0.04 mg/kg was administered in groupⅡ,Ⅲ,Ⅳ respectively.one min later,propofol was infused at a rate of 5～10 mg/kg?h combined with midazolam based on the abovementioned dosage per hour for groupⅡ,Ⅲ,Ⅳ respectively.Taking auditory evoked potential index(AAI) as a parameter,after it decreased to 40,the infusion rate of propofol was adjusted to keep AAI at the level of 30～45,and maintained the level by infusing propofol and midazolam for 5 hours.The dosage of propofol required for induction and maintenance was recorded.The emergence time and whether patients had awareness during the operation were recorded after the infusion stopped.Results At the target sedative level of AAI 30～45,the Observer's Assessment of alertness/sedation(OAA/S) score of all patients in the four groups reached 0～1.The induction period was obviously shortened and the propofol dosage was dramatically reduced in group Ⅱ～Ⅳ as compared with groupⅠ.At the stage of maintenance of sedation,the dosages of propofol in both groupⅠandⅡ were larger than those in group Ⅲ and Ⅳ.The emergence time in group Ⅳ was dramatically longer than the other groups(P

Objective To determine the preventive effect of Celecoxib on postoperative adhesion formation and its mechanism. Methods We divided 80 SD rats into 5 groups: Groups A, B, C, H and S. Rats in Groups A, B, C and H received the operation of peritoneum rubbing to promote adhesion formation. Group S underwent sham operation. Rats in Group B were given Celecoxib of 40 mg/(kg·d), those in Group C were also given Celecoxib of 20mg/(kg·d), and those in Group H were given sodium hyaluronate (HA) during the operation. On the 8th and 15th postoperative day, half of the rats were sacrificed, the extent of adhesion formation was assessed and the adhesive peritoneum was subjected to immunohistochemistry with VEGF and CD_(34). Results The extent of postoperative adhesion differed significantly among the five groups (P<0.01). Groups B and C had significantly fewer adhesions than Groups H and A. VEGF was expressed most highly in Group A, followed by Groups H, C and B, and most weakly in Group S. CD34 was expressed most highly in Group A, followed by Groups H, C and B, and most weakly in Group S. Conclusion Celecoxib provides durable inhibition of intra-abdominal adhesions in a murine model compared with HA. The mechanism of preventing intra-abdominal adhesion via inhibiting COX-2 is possibly through down-regulated expression of VEGF and reduced microvascular density.