Objective To investigate the clinical and epidemiological characteristics of pulmonary thromboembolism (PTE) and deep venous thrombosis (DVT). Methods The clinical data of 114 200 inpatients from June 2002 to June 2008, including gender, age, smoking history, primary disease and risk factors, were reviewed. Results There were 1445(1.27%) cases with venous thromboembolism (VTE), while 1433(1. 25%) patients suffered from DVT and 153(0. 13%) patients suffered from PTE, 16(11. 11 %) patients were dead of PTE. Of all the DVT patients, there were 1348(94. 1%) cases with DVT of lower limbs with no significant difference between left or right lower limb (P>0. 05). There were 49(3.4%) cases with inferior vena cava, 23(1.6%) cases with cavitas pelvis veins and 13(0. 9%) cases with upper extremity veins. The peak ages of morbidity were between 51 to 60 years. Conclusions The incidence of VTE is increasing with ageing and there is no significant difference between males and females. The most common risk factors for thromboembolism include trauma, surgery, cardiac and pulmonary disease, age over 50 years, deep phlebitis, long-term smoking, cancer, pregnancy, childbirth, braking, history of VTE, etc. We may lower the incidence and mortality of VTE by strengthening prevention work according to the high risk factors.

Objective To evaluate the relationship between the mechanism underlying propofol-induced inhibition of migration of human breast cancer cells and glyc olysis.Methods Human breast cancer cell line MDA-MB-231 cells were inoculated in 12-well culture plates at a density of 3× 105 cells/well.After being cultured for 24 h,the cells were divided into 2 groups (n=12 each) by using a random number table:control group (group C) and propofol group (group P).Propofol at the final concentration of 5 μg/ml was added to the culture medium in group P,and the equal volume of phosphate buffer solution was added to the culture medium in group C.At 6 h of incubation,the culture media were changed to the common culture media containing no drugs,and the cells were then incubated for another 24 h.The culture media were collected for determination of glucose concentrations (by oxidase mnethod) and lactate concentrations (by chemical colorimetry).Glucose consumption and lactate production were calculated according to glucose and lactate concentrations.Cells were collected,the expression of lactate dehydrogenase A was detected by Western blot,and the migration of cells was determined by cell scratch test.Results Compared with group C,the consumption of glucose and production of lactate were significantly decreased,the expression of lactate dehydrogenase A was down-regulated,and the migration rate was decreased in group P (P＜0.05).Conclusion The mechanism by which propofol inhibits migration of human breast cancer cells may be associated with inhibition of glycolysis.

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.

Objective To investigate the effects and mechanisms of propofol and dexmedetomidine on neurites and synapses of hippocampal neurons neonatal rats, in vitro. Methods Hippocampal neurons of neonatal Sprague-Dawley rats were cultured 6 days, in vitro and were divided into control group (Group C), solvent of propofol group (Group S), propofol group (Group P), dexmedetomidine group (Group D),propofol and dexmedetomidine group (Group PD), and yohimbine group (Group Y). All groups were cultured for 24 h further. Neuron morphology and the expression of protein were measured. Results After exposing to propofol, we found that the mean total length of neurites of primary cultured hippocampal neurons and synapses and the expression of BDNF, TrkB and CRMP-2 protein were reduced; dexmedetomidine played a protective role. Moreover, yohimbine, partly inhibited neuroprotection of dexmedetomidine. Conclusions Propofol decreases the development of neurites and synapses of hippocampal neurons neonatal rats, in vitro, and dexmedetomidine provides a protective effect on propofol by up-regulating the expression of BDNF, TrkB and CRMP-2. The effect, partly has a concern aboutα2-adrenergic agonist.

Objective To investigate psychosocial factors for post-stroke depression (PSD). Methods 405 in-pa-tients with stroke were first screened for depression using Comprehensive International Diagnostic Interview-3.0. 22 pa-tients with depression were recruited as the depression group. From 383 patients without depression, 44 patients were se-lected and served as the non depression controlled group according to the sex and age paired with 1:2. Both groups were measured by using questionnaires including Life Event Scale, Simplified Coping Style Questionnaire, Social Support Rat-ing Scale, Activities of Daily Living Scale and Quality of Life Enjoyment and Satisfaction Questionnaire, Short Form. Re-sults The score of passive coping was significantly higher in depression group than in non depression group [(1.2 ± 0.5) vs. (0.8±0.7), P<0.05]. The score of subjective support was significantly lower in depression group than in non depression group [(17.5±4.0) vs. (20.7±4.6), P<0.05]. Logistic regression analysis showed, minority nationality (OR=2.564, 95%CI:1.039~6.327) and passive coping style (OR=2.223, 95%CI:1.052~5.192) were risk factors for PSD, while subjective sup-port was protective factor for PSD (OR=0.884, 95%CI:0.793~0.986). Conclusions Passive coping style and low subjec-tive support may be the important psychosocial factors of PSD.

Objective To explore the relationship between the prothrombotic state and blood coagulation-fibrinolysis system changes with deep venous thrombosis(DVT)in aged patients after total joint arthroplasty,and to propose preventive measures.Methods 400 patients who underwent total hip or knee replacement from January 2003 to June 2011 were classified into suspected DVT(n=200 cases)and non-suspected DVT(n=200 cases)according to Well's clinical scoring system.The patients were divided into 4 subgroups based on the measures to prevent DVT:low molecular weigh heparin group,intermittent pneumatic bag compression group,combined above measures group,control group who refused any preventive measures.Plasma thrombin-antithrombin complex(TAT),plasmin-α2 antiplasmin complex(PAP)were determined preoperatively.Venous Doppler ultrasound was performed before surgery,4 d and 10 d after surgery to detect the presence of DVT.Results Totally 71 cases(17.8％)were diagnosed as DVT and 5 cases(1.3％)as pulmonary thromboembolism(PTE).The incidence of DVT in suspected DVT group(28.5％,57 cases)was lower than in non-suspected DVT group(7.0 ％,14 cases)(x2 =31.66,P＜ 0.01).Among patients with suspected DVT,the DVT prevalence in combined measures group(2.0 ％,1 cases)was decreased than in low molecular weigh heparin group(14.0％,7 cases),intermittent pneumatic bag compression (34.0％,17 cases)and control groups(64.0％,32 cases)(x2=4.89,17.34,18.01,all P＜0.05).In the patients with non-suspected DVT,the DVT prevalence in combined measures group(0.0％)was lower than in control group(24.0 ％,12 cases)(x2 =13.64,P＜0.01).The average preoperative level of TAT[(9.63±3.06)μg/L]in patients with DVT was higher than without DVT[(2.59±0.87)μg/L](t=35.70,P＜0.01),while PAP level in patients with DVT[(38.52± 21.13)μg/L]was reduced than without DVT[69.75±30.26)μg/L](t=8.27,P＜0.01).Conclusions The levels of TAT and PAP before total hip or knee replacement are predictive for lower extremity DVT.The clinical effectiveness of Well's scoring on DVT prevention is dependent on the different TAT and PAP state.

Objective To establish a rapid method to detect mutations in rpoB genes of rifampin-resistant Mycobacterium tubereulosis in dinical specimens using Real-time fluorescence PCR molecular beacon assay.Methods 174 strains of Mvcobacterium tuberculosis clinical isolates were analyzed using real-time fluorescence PCR molecular beacon assay foilowed with DNA sequencing while 12 strains of NTM and 4 strains of bacteria other than Mycobacterium tuberculosis were used as the contrast.Results Eighty-two 89.1 of 92 rifampin (RIF)-resistant strains and 3 of 82 RIF-sensitive strains were found to harbor mutation in the rpoB gene using real-time fluorescence PCR-molecular beacon assay.The specificity, sensitivity,and accuracy of this assay were 96.3%,89.1%,and 92.5%,respectively-Eithty-three of 92 RIF-resistant strains and 1 of 82 RIF-sensitive strains were found to harbor mutation in the rpoB gene using the direct DNA sequencing.The specificity,sensitivity,and accuracy of the direct DNA sequencing were 98.8,90.2%,and 94.2%,respectively.As compared with real-time PCR molecular beacon assay,171 of 174(98.3%)strains of myeobactefium tuberculosis clinical isolates had the salne results.Conclusion Real-time fluorescence PCR-molecular beacon assay can be used as a rapid screen method to detect RIF-resistant isolates.

Objective To establish a model of cervical spondylosis in rats. Methods Sixty SD rats (four months old) were ran-domly divided into control, muscle imbalance and posterior column instability group, ten rats in each group. Then the degeneration of X-ray film and motion function were evaluated by oblique board test. Results After analyzed the cervical films of control groups, the nature curve still existed, vertebral clearance had no abnormal. No ostensis spurs or ossifies in Luschka joint and joint processes were found. But in mus-cle imbalance and posterior column instability groups, the nature curve was disappeared or stiff, vertebral clearance were stenosis, osteosis spur formed, ossify or sclerosis emerged in Lnschka joint and joint process. Compared with control group in oblique board test, the muscle force decreased in muscle imbalance and posterior column instability group. There were no statistic significant difference between 2 and 4 months of control group, and also no difference in muscle imbalance and posterior column instability group, but there were significant differ-ence in 2 and 4 months of muscle imbalance and posterior column group. Conclusion Not only cervical posterior column instability but also muscle imbalance could result in cervical spendylosis, both muscle force balance and posterior column were important factors in maintaining spine stability.

Objective To evaluate the role of Ras homolog family member A (RhoA)/Rho-associated coiled-coil containing protein kinase 2 (ROCK2) signaling pathway in propofol-induced neuroapoptosis in the hippocampus of newborn rats.Methods Experiment Ⅰ Primarily cultured hippocampal neurons were seeded in 6-well culture plates at a density of 1×106 cells/ml and divided into 2 groups (n=6 each) using a random number table:solvent control group (C group) and propofol group (P group).Propofol was added with the final concentration of 60 μg/ml in group P.Dimethyl sulfoxide was added with the final concentration of 0.04％ in group C.The expression of RhoA and ROCK2 in hippocampal neurons was measured by Western blot at 24 h of incubation.Experiment Ⅱ Primarily cultured hippocampal neurons were seeded in 6-well culture plates at a density of 1 × 106 cells/ml and divided into 3 groups (n =6 each) using a random number table:solvent control group (C group),propofol group (P group) and propofol plus specific RhoA/ROCK2 signaling pathway blocker Y27632 group (P+Y group).Propofol was added with the final concentration of 60 μg/ml in group P.Propofol at the final concentration of 60 μg/ml and Y27632 at the final concentration of 10 μmol/L were added in group P+Y.Dimethyl sulfoxide was added with the final concentrauon of 0.04％ in group C.At 24 h of incubation,the neuroapoptosis in hippocampi was detected by flow cytometry,and the expression of activated caspase-3 in hippocampal neurons was measured by Western blot.The apoptotic rate was calculated.Results Experiment Ⅰ Compared with group C,the expression of RhoA and ROCK2 in hippocampal neurons was significantly up-regulated in group P (P＜0.05).Experiment Ⅱ Compared with group C,the apoptotic rate of hippocampal neurons was significantly increased,and the expression of activated caspase-3 was up-regulated in P and P+Y groups (P＜0.05 or 0.01).Compared with group P,the apoptotic rate of hippocampal neurons was significantly decreased,and the expression of activated caspase-3 was down-rcgulatcd in group P + Y (P＜ 0.05).Conclusion Activation of RhoA/ROCK2 signaling pathway is involved in propofol-induced neuroapoptosis in hippocampi of newborn rats.

Objective To evaluate the role of conventional protein kinase Cγ (cPKCγ)/growthassociated protein-43 (GAP-43) signaling pathway in ketamine-induced apoptosis in hippocampal neurons of developing rats in an in vitro experiment.Methods Primarily cultured hippocampal neurons were seeded in culture plates at a density of 1×10.6 cells/ml and divided into 2 groups (n=10 each) using a random number table:control group (C group) and ketamine group (K group).Group C received no treatment.Ketamine was added with the final concentration of 300 μmol/L in group K.At 12 h of culture or incubation,the apoptosis in hippocampal neurons was detected by flow cytometry.The apoptotic rate was calculated.The expression of cPKCγ,GAP-43 and phosphorylated GAP-43 in hippocampal neurons was measured by Western blot.Results Compared with group C,the apoptotic rates of hippocampal neurons were significantly increased,and the expression of cPKCγ,GAP-43 and phosphorylated GAP-43 was down-regulated in group K (P<0.01).Conclusion The mechanism by which ketamine induces apoptosis in hippocampal neurons of developing rats may be related to inhibition of cPKCγ/GAP-43 signaling pathway activation in an in vitro experiment.