Objective To explore the role and significance of standardized scheme for diagnosis and treatment of pulmonary thromboembolism(PTE).Methods The clinical data of 163 consecutive PTE patients who were treated in our hospital from Jan.1972 to Dec.2006 were retrospectively reviewed.The patients were divided into group A and group B based on the time of application of standardized treatment and diagnosis for PTE.The clinical data of the two groups were analyzed and compared.Results The main risk factors included deep vein thrombus,operation,injury,fracture and tumors,etc.Dyspnea was the most important clinical symptoms.The incidences of dyspnea in group A and B were 92.5% and 84.6%,respectively.The diagnostic case and the ratio of final diagnosis in group B was increased compared to those in group A on an annual basis.The median time for diagnosis was shortened(P

Cognitive dysfunction is one of the complications of chronic obstructive pulmonary disease(COPD),often affecting the patient's daily life ability and reducing the quality of life.COPD associated cognitive dysfunction includes five areas of primary cognitive domain of awareness,attention,learning and memory ability,execution ability and language skills.The decreased cognitive dysfunction may be correlated with the age,education background,smoking,malnutrition,as well as hypoxemia,hypercapnemia,COPD duration and length of hospitalization stay,inflammatory and other factors.Early screening and assessment of COPD cognitive dysfunction,long-term oxygen therapy and other measures for interfering risk factors and improving the quality of life of patients have a positive significance.

OBJECTIVE:To study the percutaneous permeability of methoxypsoralen liposomal gel METHODS:The preparations were applied on the rat skin in vitro and in vivo with common gel and Mingbailing tincture as control,and the drug concentrations in the receiver,skin,blood and other organs were determined by RP-HPLC RESULTS:In vitro experiment,liposomal gel showed the lowest percutaneous permeation rate and the highest retention in skin In vivo studies illuminated that the skin depositions of drug encapsulated in liposome was(4 37?0 91) and (3 36?0 58) times those of the common gel and tincture respectively CONCLUSION:Methoxypsoralen liposomal gel showed an evident targeting effect on skin

Objective To evaluate the vulnerability of carotid arteriosclerosis plaque by ultrasound real-time tissue elastography in patients with SSS-TOAST1 style cerebral infarction, and discussing the value of the technique in assessment of the clinical course after cerebral infarction. Methods There were 113 patients of SSS-TOAST1 style cerebral infarction who had carotid arteriosclerosis plaque and 48 patients of contrast group who had carotid arteriosclerosis plaque selected by ultrasound in Department of Ultrasound, Beijing Tiantan Hospital, Capital University of Medical Sciences. The results between two groups were compared. The cerebral infarction group was divided into two sub-groups according to the clinical course of patients after cerebral infarction, and the difference between them was compared. Results The size had no significant difference between cerebral infarction group and contrast group as well as between aggravated group and non-aggravated group (t=15.61, 10.77, 4.52, P<0.05). The real-time tissue elastography of carotid arteriosclerosis plaques were red-green in most patients of cerebral infarction group. The real-time tissue elastography of carotid arteriosclerosis plaques were green-blue in most patients of in control group. The value of elasticity of plaque, vessel wall and stiffness of carotid arteriosclerosis plaque between cerebral infarction group and control group had significant differences (t=15.61, 10.77, 4.52, P<0.05). The value of real-time tissue elastography between aggravated group and non-aggravated group had significant difference (t=6.39, 2.30, 3.80, P<0.05). Conclusion Real-time tissue elastography could evaluate the stiffness of carotid arteriosclerosis plaque, which was related with the vulnerability of carotid arteriosclerosis plaque. The values of elasticity of plaque, vessel wall and stiffness of carotid arteriosclerosis plaque in patients with SSS-TOAST1 style cerebral infarction were lower, and the vulnerability of carotid arteriosclerosis plaque was higher. Real-time tissue elastography had some worth in evaluating the clinical course of patients after cerebral infarction.

OBJECTIVE:To study the effect of Erdong granules on glucose metabolism and lipid metabolism in type 2 diabetes mellitus rats.METHODS:Type 2 diabetes mellitus model was induced by giving high-fat and high-calorie diet with intraperitoneal administration of streptozotcin for eight weeks.Model rats were divided into normal group,model group,streptozotcin group and erdong granules high-dose,middle-dose and low-dose groups.The levels of FBG,LDL-C,FFA,SOD and MDA were detected and immunohistochemistry method was used to determine the morphology change of islet cell.RESULTS:The serum levels of FBS,MDA,FFA and LDL-C in Erdong granules high-dose and low-dose group were significantly decreased while the activity of SOD was increased.Erdong granules could protect islet cell.CONCLUSION:Erdong granules can notably improve glucose metabolism and lipid metabolism,antioxidant enzyme activity and inhibit oxidative stress so as to protect islet cells of type 2 diabetic mellitus rats.

Objective To observe the morphological changes of rats' pancreas and nitric oxide (NO) and endothelin(ET) in the blood serum in rats after exposure to different pulses of high power pulse microwave (HPPMW).Methods SD-rats were irradiated with 104,105 and 4 × 105 pulses of HPPMW,respectively.After gloss observation,the histopathological changes of pancreas were observed through biological microscope and electroscope.The changes of amylase,nitric oxide and endothelin in blood serum were detected by biochemical and radio-immunological methods. Results Compared with the blank control,no apparent abnormality could be observed in the pancreas of all groups.The dilatation of capillary could be observed in each experimental group by microscope.The ultrastructure changes of pancreas were most serious in 4 × 105 pulse group,especially at 24 and 48 h after irradiation.Compared with the control group,the levels of serum amylase were decreased (F =12.58,11.73,P ＜ 0.05),while ET were increased (F =4.50,4.49,P ＜0.05) at 24 and 48 h after irradiation.The levels of NO in serum were increased ( F =17.51,41.72,19.98,32.64,P ＜ 0.05 ) at each time-point.The level of NO went up with the increase of pulses.Conclusions HPPMW has damage effects on the pancreas in rats.The pulses with the pancreas can lead to severity of the damage. The mechanism of HPPMW may be involved in the enhancement of ET and NO in serum.

Objective To assess the effectiveness of the combined treatment model for Wilms'tumor and to improve treatment results.Methods Fifty-five patients diagnosed with Wilms' tumor between July 1981 to June 2010 were analyzed retrospectively.Eighteen patients were diagnosed by preoperative ultrasound-guided fine needle biopsy,and 53 patients were confirmed by postoperative pathology results.Seven cases were in clinical stage Ⅰ,19 cases in clinical stage Ⅱ,21 cases in stage Ⅲ,six cases in stage Ⅳ and two cases in stage Ⅴ.Thirty-five cases had histopathological subtype,30 cases had the favorable type,and five cases had the unfavorable type.Among the 55 patients,kidney tumor resection was performed on 48 cases,wide edge partial nephrectomy was performed on two cases,tumor enucleation was performed on one bilateral renal tumor case,kidney tumor resection with pulmonary metastasectomy was performed on two cases,and two cases had no surgical procedures.Eighteen cases received preoperative chemotherapy,40 cases received postoperative chemotherapy,and 12 cases received postoperative radiotherapy.Patients were grouped according to age,stage,histological type,treatment model,treatment course and whether or not they had radiotherapy.The Kaplan-Meier method was used in the evaluation and comparison of over survival (OS),disease free survival (DFS) and relapse free survival (RFS) of the different groups to reveal the relationship between different grouping factors with the prognosis of Wilms' tumor. ResultsThe median of follow-up was 34 mon ( ranging from 3 to 355 mon).The 3-year OS,5-year OS and 2-year DFS were 77.6％,69.0％ and 52.4％,respectively.The differences of OS in different stages ( P =0.006 ),DFS between pure operation group and combined therapy group ( P =0.004 ) and RFS between radiotherapy group and no radiotherapy group ( P =0.03 ) were significant,P ＜ 0.05.ConclusionsThe normative multi-disciplinary treatment model for patients with Wilms' tumor can achieve good results and is well tolerated.

Objective To explore the characteristic of transcranial color-coded sonography(TCCS)and contrast-enhanced transcranial color-coded sonography (CE-TCCS) in patients with intracerebral hemorrhage and thiers clinical value.Methods 66 patients were randomly selected,whose preliminary clinical diagnosis were intracerebral hemorrhage (ICH).The patients were followed up by TCCS in acute phase,subacute phase and chronic phase.The changes of the echo,boundary and the hematoma volume were recorded in different stages.In acute phase,patients' complications of intracerebral structure were observed.32 patients were selected randomly to underwent CE-TCCS examination in the subacute phase.The size,shape and the perfusion situation of hematoma were observed.The results of CE-TCCS were compared with the results of TCCS.Correlation analysis was made between the results of ultrasound and CT scan.Results (1) CT results:61 patients (61/66) were confirmed ICH through CT scan.(2) TCCS results:50 patients (50/61) with ICH could show the bleeding site.TCCS showed that 33 patients with ICH accompanied by intraventricular pressure,haematoma defeats ventricle and midline shift in acute phase.The echo became lower and the boundary became more clear with time.The long diameter,wide diameter,thickness diameter and volume of hematoma in different stages on TCCS had a good correlation with that on CT scan.(3)CE-TCCS results:30 cases of intracerebral hematoma could be clearly displayed the situation of hematoma through the ipsilateral temporal window.Compared with TCCS,CE TCCS had a better correlation with CT scan on the measurement of the hematoma length,width.The images of 2 cases observed through contralateral temporal window failded to be clearly shown.In 7 cases of ICH,visible low-enhanced edema area could be seen around the hematoma.The width of the edema area had a good correlation with the CTP result.Conclusions TCCS could clearly show the bleeding sites,hematoma volume and complications and the features of ICH in different stages of disease.TCCS could be used to monitor the condition of patients with ICH and recognized the disease progression initially.CE-TCCS had a much more clear display of intracerebral hematoma location,shape,boundary.At the same time,CE-TCCS could provide blood perfusion information of surrounding tissue in hematoma so that it could observe the change of peripheral edema more convenient.

Objective To explore the ultrasonographic characteristics of internal jugular vein(IJV) valve insufficiency and reflux.Methods 40 healthy volunteers' bilateral IJVs were study subjects.The inner diameter,valve morphological feature,reflux distance and hemodynamic parameters in IJV were detected by color Doppler ultrasound (CDU),the contrast agents transvalvular regurgitation in IJV was monitored by contrast-enhanced ultrasound (CEUS) (with low mechanical index,MI 0.10),then analyse the results of two methods.Results Of 80 investigated IJVs,1 vein was excluded due to absence of its left valve,so 79 veins were evaluated in the study.The IJV's inner diameter on the right side was larger than on the left side,but there was no significant difference (P ＞0.05).The detection rate of IJV valve insufficiency was 31.6％ (25/79),which was higher on the right than that on the left,but without significant difference (P ＞ 0.05).The detection rate of IJV valve insufficiency was significantly higher in the group of greater than or equal to 50 years old than that in less than 50 years old(P ＜0.05).The reflux distance in IJV displayed by CDU was associated with IJV valve's function.Compaired with sufficient valves,the reflux duration time in insufficient valves during quiet respiration showed no significant difference (P ＞0.05).During Valsalvalike manoeuvres and quiet respiration,the reflux duration time in sufficient valves showed no significant difference (P ＞ 0.05).The reflux duration time in insufficient valves during Valsalva-like manoeuvres showed significantly higher than that during quiet respiration (P ＜0.01).Compaired with sufficient valves,the peak flow velocity of reflux flow in insufficient valves was significantly prolonged during quiet respiration and Valsalva-like manoeuvres (P ＜0.05,P ＜0.01,respectively).Conclusions The incidence rate of IJV valve insufficiency and reflux is high in healthy individuals.During quiet respiration and/or Valsalva-like manoeuvres,detecting the reflux distance,reflux duration time and peak flow velocity of reflux flow by CDU are valuable in evaluating IJV valve insufficiency and the degree of IJV reflux.

Objective To evaluate the effect of azithromycin on Pseudomonas aeruginosa PAO1 biofilm formation and virulence factors production. Methods Detect the minimum inhibitory concentration of azithromycin against PAO1 by 2-fold dilution method. Crystal violet staining assay was used for initial adhesion assays. The PAO1 biofilm was established in vitro and observed by scanning electron microscope. Viable bacterial counts were determined by serial dilution. LasB elastolytic activity was determined by using Elastin-Congo Red. Protease activity was determined by Azo-casein. Chloroform extraction method was used for pyoverdine assay . The orcinol assay was used to directly assess the amount of rhamnolipids . Results Scanning electron microscope biofilm and viable bacterial counts of PAO1 adhered to the surface of catheter in PAO1 azithromycin group were less than the PAO1 control group after incubated for 3 d and 7 d ( P ＜0.05), and the initial adhesion was weaker ( P ＜ 0. 05 ). The virulence factors production were obviously decreased (P ＜0.01 ). LasB elastolytic activity and pyoverdine were even reduced to the same as with the PA-JP3 group ( P ＞ 0.05 ), but the protease activity and the rhamnolipids concentration were higher than the PA-JP3 group ( P ＜ 0.05 ). Conclusion Azithromycin can inhibit PAO1 bioflim formation in vitro and virulence factors production.