Objective To explore the measures in early diagnosis and treatment for venous thromboembolism(VTE)in patients with fracture.Methods All the patients with fracture visiting Beijing Jishuitan Hospital in emergency during October 2004 to October 2007 were screened by Well's prediction rules,and anticoagulation and thrombolysis were instituted for those with established diagnosis of VTE by color Doppler ultrasonography and venography.Results Totally,1 508 patients at higg-risk of VTE were identified by D-dimer test.1 455 by color ultrasonography and 53 by venography.Diagnosis of VTE was established in 652 of them(43.2%),619(94.9%)received anticoagulant treatment,162(24.8%)received anticoagulant plus thrombolytie treatment and 25 (3.8%) received anticoagulation plus thrombectomy.In order to prevent fatal pulmonary embolism,vena cava filters(VCFs)were implanted in 146(22.4%)patients,and 33(5.1%)of them were contraindicated to anticoagulation.After treatment,412 cases were cured and 240 were improved,with no one failed.Conclusions Patients with fracture are at high-risk of VTE and should be screened by D-dimer test and color Doppler ultrasonography based on Well's evaluation,as well as by venography for confirming the diagnosis of VTF as appropriate.Anticoagulation and thrombolysis are still the treatment of choice,with thrombectomy and VCF implantation performed only if necessary.

Platelets is the important hemostatic component in the blood and the critical participants in inflammation. It is an important promoting factor during inflammation and can recruit leukocytes and aggregate in sepsis. Decreasing plate?let count was correlated with reverse clinical outcome. Therefore, the value of the platelets examination in clinical monitor was studied by many researchers. Under circumstance of fungal infections, platelets mediate antimicrobial activity and assist dissemination of the fungi synchronously. Regulating interaction between platelets and fungi is difficult. In allergic inflamma?tion patients, the excessive activating of platelets aggravates airway obstruction and worsen pulmonary function. We reviewed current research in activating platelets during inflammation.

Venous thromboembolism ( VTE ) is a common vascular disease.It has become an important public health problem because of its high incidence, recurrence and mortality rate.Because the clinical symptom of VTE is relatively hidden, it is difficult to diagnose and treat it.This article focuses on the clinical diagnosis,treatment and laboratory examination of VTE.

Objective:To investigate the clinical value of changes of platelet and anticoagulation function in patients with acute pancreatitis. Methods:β-TG, PF4 ,TXB2 ,GMP-140,antithrombin-Ⅲ,and protein C were measured in all patients. Results:There was no significant difference in all parameters between acute edema pancreatitis group and normal group(P＞0.05).Compared with the control group, parameters of platelet significantly increased in acute necrosis pancreatitis group(P＜0.01),and parameters of anticoagulation significantly decreased(P＜0.01). Conclusion: The platelet system was activated and the level of anticoagulation system decreased in acute necrosis pancreatitis. Parameters are important in understanding and preventing this disease.

Objective To observe and compare the effect of different concentration of ropivacaine on elderly patient with bra-chial plexus block under ultrasound-guided ,to assess its effectiveness and security ,so as to determine the optimum dosage of anes-thetic for elderly patients with brachial plexus block .Methods 120 patients undergoing elective surgery of forearm or hand in this hospital from February 2013 to December 2014 were selected as the observation group in this study .These patients were randomly divided into four groups on average ,narcosis was conducted in each group with ultrasound-guided :group A with 30 mL of 0 .250%ropivacaine ,group B with 30 mL of 0 .375% ropivacaine ,group C with 30 mL of 0 .500% ropivacaine ,group D with 30 mL of 0 .750% ropivacaine .The onset time of sensory block ,motor block level ,duration of analgesia and adverse reactions were observed and recorded .Results With the increase of concentration of ropivacaine ,the onset time of narcotize became shorter(P< 0 .05) and duration of analgesia became longer(P < 0 .05) .There were no significant difference in the effects of brachial plexus block (P>0 .05) .There was no complications occurred in four groups after narcosis .Conclusion Concentration of ropivacaine more than 0 .375% can achieve perfect clinical effect on elderly patients with brachial plexus block under guidance of ultrasound .

Objective To explore the clinical value of Glucosamine hydrochloride tablets(GH)alone and combination with Xianlinggubao capsules(XLGB)for treatment patients with knee osteoarthritis(KOA).Methods 96 patients with KOA were selected,and were divided into two groups according to the random number method, 48 cases in each group.The control group was treated with GH alone,while the observation group was treated with XL-GB on the basis of the control group.US Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were used to evaluate the symptoms change,including pain,stiffness,physical function scores and total scores before and after treatment.The onset time,knee function (HSS)score at 3 months and 6 months after treatment were recor-ded.CRP and ESR were measured,and the total efficacy was evaluated at the end of treatment.Results The differ-ence of WOMAC score between the two groups was not statistically significant before treatment (P >0.05 ).After treatment,pain,stiffness,physical function scores and total scores were (10.2 ±1.4)points,(3.5 ±1.6)points, (40.5 ±5.0)points and (56.4 ±6.7)points in the observation group,those were (14.8 ±2.6)points,(6.2 ±2.3)points, (52.2 ±6.8)points and (73.3 ±4.5)points in the control group,the differences were statistically significant (t =7.631,4.721,6.791,10.26,all P <0.01).The onset time,HSS score at 3 months and 6 months after treatment in the observation group were (6.0 ±2.2)d,(68.2 ±6.4)points and (84.3 ±6.2)points,while those were (9.8 ± 2.8)d,(58.5 ±3.9)points and (72.8 ±5.4)points in the control group,the differences were statistically significant (t =5.228,6.341,6.852,all P <0.01 ).The improvements of CRP level and ESR in the observation group were more pronounced than those in the control group (t =3.880,2.668,all P <0.05).After treatment,the total effective rate of the observation group was 93.8%(45 /48),while that was 77.1%(37 /48)in the control group,the difference was statistically significant (χ2 =5.352,P <0.05).Conclusion GH combines with XLGB can significantly improve symptoms in patients with KOA,with more rapid recovery of knee function,thus it is a safe and effective therapy.

Objective To study the effect of lipoteichoic acid(LTA) of Bifidobacterium on the expression of vascular endothelial growth factor(VEGF) and invasion and metastasis of colon carcinoma cell lines.Methods The effects of LTA on adhesion,invasion and metastasis of human colon carcinoma lines LoVo and HT-29 in vitro were examined by MTT colorimetric and transwell chamber.The mRNA and protein expressions of VEGF in the two colon carcinoma cells treated with LTA were detected by RT-PCR and Western blot.Results The adhesion ability decreased in LoVo cells and HT-29 cells after the treatment of LTA(20,50,80 ?g/ml) for 30,60,90,120 min(P

Objective To investigate the effects of continuous vennvenous haemodiafihration(CVVHDF)on major organ fimction and plasma cytokine levels in MODS dogs.Methods Fifteen Beagle dogs were subjected to hemorrhagic shock plus resuscitation and endotoxemia to establish MODS model,then dogs were randomly divided into 2 groups:CVVHDF group(n=8)and MODS group without CVVHDF (n=7).CVVHDF was performed for 12 hours after endotoxin injection in CVVHDF group dogs.Serum ALT,AST,Scr,BUN and blood gas were routinely measured,and plasma TNF-α,IL-6 and IL-10 coneentrations were measured by ELISA at different time points. Results Plasma levels of IL-6 and IL-10 were significantly decreased in the CVVHDF group at 3 h,6 h,9 h and 12 h after endotoxin injection as compared with MODS group (P＜0.01).TNF-α levels were similar in both groups(P＞0.05).IL-6 and TNF-α were detected in the ultrafihrate.The sieving coefficients (SC) for IL-6 and TNF-α were 0.27±0.13 and 0.1±0.1 respectively.IL-10 could not be detected in the ultrafiltrate.In CVVHDF group,function of major organs was improved.The beneficial effect of CVVHDF on the hypotension of MODS dogs was particularly striking at 6 h,9 h,and 12 h alter endotoxin injection(P＜0.01).Mean PaO2 in CVVHDF groups at 3 h,6 h,9 h,and 12 h after endotoxin injection was significantly higher than that in MODS group(P＜0.01). Conclusion CVVHDF effectively removes IL-6 and IL-10from the cireulation,attennates endotoxin-induced hypotension and improves arterial oxygenation in MODS dogs.

Objective To probe imaging manifestations of bronchogenic cysts,as that to improve the knowledge of this disease.Methods Imaging features of congenital bronchial cyst in 32 cases confirmed by operation and pathology were analyzed.Results 4 cases of cyst localized in mediastinum ,all were liquid cyst.28 cases of cyst localized in lungs,aqmong them,22 cases were air-liquid cyst and 6 cases were air cyst,the diameter of lesions was 1~10 cm,there were 2 cases with pyothorax,4 cases with pulmonary maldevelopment,one case with brochio-pleural fistula.The cysts appeared as round or similar round,the walls of cyst was thin.The wall of cyst was obscure and there was infiltrating shadow around cysts when in company with infection.Conclusion X-ray and CT are very important in diagnosing congenital bronchial cysts,CT scan is of very help in diagnosing the compley cysts.

Objective To investigate the operation timing of laparoscopic cholecystectomy (LC)after endoscopic sphincterotomy (EST).Methods A total of 240 patients with cholecystolithiasis and choledocholithiasis received EST combined with LC.They were divided into 3 groups by random digits table method with 80 cases each:3 days after EST(group A),7 days after EST(group B),and 30 days after EST (group C).Intraoperative and postoperative clinical data were compared among three groups.Results The operation time of LC in group B [(52.5 ± 6.4) min] was longer than that in group A and group C [(35.8 ± 5.7),(34.6 ± 2.6) min],and there was significant difference (P ＜ 0.01).The intraoperative conversion rate in group B [10.0 ％ (8/80)] was higher than that in group A and group C [1.3 ％ (1/80),1.3 ％ (1/80)],and there was significant difference (P ＜ 0.05).The amount of bleeding in group B [(51.7 ± 4.8) ml] was larger than that in group A and group C [(27.9 ± 6.4),(28.2 ± 3.6) ml],and there was significant difference (P ＜ 0.01).The cost of hospitalization in group C [(15 361.2 ± 1 007.8) yuan] was more than that in group A and group B [(10 085.1 ± 695.4),(10 632.4 ± 855.9) yuan],and there was significant difference (P＜ 0.01).Conclusion LC performed 3 days after EST can reduce the operation difficulty and conversion rate,and shorten the operation time,and this modality is safe and effective.