Objective To compare the efficacy and safety of thrombolysis and anticoagulant therapy for post-traumatic acute submassive pulmonary embolism (PE) in middle-aged and elderly patients.Methods Totally 45 patients with post-traumatic acute submassive pulmonary embolism in our hospital were selected.Patients were divided into thrombolysis group (n =22) and anticoagulation group (n=23) according to their conditions.Symptoms and signs,blood gas analysis,D-dimer,echocardiography,CT pulmonary angiography (CTPA) were performed before and after thrombolysis or anticoagulant therapy.Results There were no significant differences in clinical curative rate between thrombolysis group and anticoagulation group [95.5％ (21/22) vs.91.3％ (21/23),x2 =0.32,P＞0.05],and no case was found dead in both two groups.There was a significant difference in hemorrhage rate between thrombolysis group and anticoagulation group [27.3％ vs.4.3％,x2 =4.53,P ＜ 0.05].At 24 hours after thrombolysis or anticoagulant therapy,the improvement rate of dyspnea,PaO2 level was significantly higher and the pulmonary arterial pressure was significantly lower in thrombolysis group than in anticoagulation group [45.5％ (10/22) vs.17.4％ (4/23),(80.4±8.1) mm Hg vs.(73.6±9.3) mm Hg,(51.2±6.2) mm Hgvs.(60.3±5.7) mm Hg,respectively,all P＜0.05],and there were no statistical significances at other time points between the two groups.Conclusions The clinical curative rate and fatality rate are similar in thrombolysis group versus anticoagulation group.Hemorrhage rate is higher in thrombolysis group than in anticoagulation group.Thrombolysis can relieve dyspnea rapidly,reduce pulmonary artery pressure and make the embolized blood vessels recanalized.Patients with low bleeding risk in a critical condition are suggested to take thrombolysis therapy,while patients with high bleeding risk in a light condition are suggested to take anticoagulant therapy.

Idiosyncratic adverse drug reactions (IDR) induce severe medical complications or even death in patients. Alert structure in drugs can be metabolized as reactive metabolite (RM) in the bodies, which is one of the major factors to induce IDR. Structure modification and avoidance of alert structure in the drug candidates is an efficient method for reducing toxicity risks in drug design. This review briefly summarized the recent development of the methodologies for structure optimization strategy to reduce the toxicity risks of drug candidates. These methods include blocking metabolic site, altering metabolic pathway, reducing activity, bioisosterism, and prodrug.
Binding Sites ; Cytochrome P-450 Enzyme System ; metabolism ; Drug Design ; Drug Discovery ; methods ; Drug Recalls ; Drug-Related Side Effects and Adverse Reactions ; prevention & control ; Humans ; Structure-Activity Relationship

Objective To investigate the changes of stress response on inhalation-intravenous general anesthesia during pericystectomy for Liver hydatid cyst. Methods Thirty ASA I-II patients with liver hydatidosis for pericystectomy were studied. The blood from right jugular vein were collected for measurement of serum cortisol (Cor) concentrations and glucose (BG) levels, and MAP, HR and BIS were observed and recorded at different point-times: pre-intubation for 1 min, post-intubation for 3 min, pre-incision for 1 min, post-incision for 3 min, post-incision for 10 min, post-surgical exploration 10 min. The data of pre-intubation and pre-incision served as controls. Results The levels of Cor concentration of post-incision for 10 min were decreased than those of pre-intubation and pre-incision (P<0.05); MAP of post-incision for 10 min and post-surgical exploration for 10 min were increased than those of pre-intubation and pre-incision (P < 0.01); For HR, the data of post-surgical exploration 10 min was much quicker compared with pre-incision (P < 0.01), which is slower than that of pre-intubation(P<0.01). Conclusion Inhalation-intravenous general anesthesia may inhibit the stress response during intubation,incision and surgical exploration for liver hydatidosis pericystectomy. Hemodynamic changes during incision may reflect the trend of stress response in advance.

Objective To study the clinical characteristics of Gitelman′s syndrome, and the differentiation of Gitelman′s syndrome from Bartter′s syndrome. Methods Clinical data of 2 patients diagnosed as Gitelman′s syndrome were retrospectively analysed. Results The symptoms of both patients appeared at adult age, their main manifestation included hypokalaemic alkalosis, hyperreninemia and juxtaglomerular apparatus hyperplasia with normal blood pressure, hypocalciuria and hypomagnesemia, then the diagnosis of Gitelman′s syndrome was established. Potassium and magnesium supplementation ameliorated one patient′s symptom. Another patient treated with indomethacin, serum potassium was recovered to normal level. Conclusion Gitelman′s syndrome and Bartter′s syndrome appear to be similar in the pathogenesis, clinical manifestation and prognosis, but still show some differences, Gitelman′s syndrome should be carefully differentiated from Bartter′s syndrome.

ObjectiveTo investigate the situation of the rehabilitation service for the stroke residents of communities in Beijing, and explore the related factors of rehabilitation training for stroke patients in community. Methods216 stroke residents and their 197 families at Chongwen district in Beijing were surveyed with questionnaires. Results and ConclusionThe awareness of rehabilitation in stroke patients obviously correlated with rehabilitation training accepted in hospital, while their rehabilitation in community correlated with the development of community-based rehabilitation and the rehabilitation accepted in hospital.

Objective To investigate the effect of simple rehabilitation technique for community on activities of daily living (ADL) and balance function in stroke patients with hemiplegia. Methods 48 patients were subdivided into two groups: treatment group (n=26) and control group (n=22), who received simple rehabilitation combining with routine or routine only. All patients were assessed with the Barthel index (BI) and Fugl-Meyer balance assessment (FMA-B) at the enrollment time, and 1 month, 3 months after treatment. Results 3 months after treatment, the scores of BI and FMA-B improved more significantly in the treatment group than those in the control group (P<0.05).Conclusion Simple rehabilitation technique for community is effective to improve activities of daily living and balance function of stroke patients with hemiplegia.

ObjectiveTo explore the effect of the appropriate rehabilitation technique on social function for stroke residents in community.Methods38 residents suffering from stroke were treated mainly using the appropriate rehabilitation technology mainly derived from conductive education. The patients were assessed by Functional Activities Questionnaire (FAQ) before and 3 months after intervention.ResultsThe social function of post-treatment improved significantly comparing to pre-treatment.ConclusionThe appropriate rehabilitation technology is effect for stroke residents in community.

Objective To understand the prevalence of allergic rhinitis and the related risk factors in Kashgar region of Xinjiang.Methods Cross-sectional epidemiological study was carried out from August to September 2007,and the questionnaires,nasal examination and nasal mucous membrane pathological examination were used to diagnose the prevalence of allergic rhinitis in Kashgar region.The relevant factors were analyzed by using the multivariate Logistic regression analysis.Results Among the investigated 1 749 people,242 cases of allergic rhinitis were diagnosed,the total prevalence rate was 13.84%,and the prevalence rate in Uighur nationality was 12.76%,which was less than that in Han (27.05%),P0.05).Conclusion The prevalence rate of allergic rhinitis is higher and there is a significant ethnic distribution difference in Xinjiang,China.

Objective To study the short and long-term effects of vocational rehabilitation on the disabled with low job satisfaction.Methods 66 disabled workers were divided into control group (n=32) and treatment group (n=34). The treatment group accepted physical,occupational and psychosocial therapy for 4 weeks. All the workers were assessed with Minnesota satisfaction questionnaire before treatment,3 and 12 months later. Results The total, internal and external satisfaction significantly improved in treatment group after treatment (P<0.01), except the internal satisfaction 1 year later (P>0.05). Conclusion Specific vocational rehabilitation programme may promote the inclusion of disabled workers into the workplace.

Objective To investigate the preventive effects of 103 Pd radioactive stent on stenosis after bile duct injury in dogs.Methods Twelve healthy dogs (15～20kg) were randomly divided into 103 Pd radioactive stent group (n=6) and control group (n=6). Immediately after balloon dilatation injury to the bile duct, the 103 Pd radioactive stent(experiment group) or the ordinary stent(control group) was positioned into the target segment. The dogs were killed one month later. The injured bile duct segments were dissected free from the dogs, and were examined radionucleonically, immunohistochemically and pathologically. Muscular proliferation area and lumen area were determined by computer assisted picture analysis system. Results In the control group, 30 days after ductal injury, the mucosa of the bile duct was fractured, the mucosa was proliferated and the lumen stenosed.Compared with the control group, 103 Pd radioactive stent significantly reduced muscular proliferation area (P