Objective To observe the effect of small dose reteplase thrombolytic therapy on old patients with acute myocardial infarction(AMI).Methods Eighty-two old patients with AMI were divided into two groups by random digits table,each group had 41 cases.Control group was treated with recombinant streptokinase,and observation group was treated with small dose reteplase.The clinical effect,1 h and 2 h coronary artery recanalization rates between two groups were compared.Results After treatment 24 h,there was no significant difference in total effective rate and death rate between two groups(P＞ 0.05).The 1 h and 2 h coronary artery recanalization rates in observation group were significantly higher than those in control group[56.1％(23/41)vs.26.8％(11/41),63.4％(26/41)vs.39.0％(16/41)](P＜ 0.05).The mild bleeding incidence in observation group was significantly higher than that in control group(P ＜ 0.05),while there was no significant difference between two groups in severe bleeding incidence(P ＞ 0.05).Conclusion Small dose reteplase thrombolytic therapy on old patients with AMI is effective,which provide a safe and effective method for elderly patients unwilling or unable to accept the coronary angioplasty.

Secreted rotein acidicand rich in cysteine (SPARC), belonging to a family of matricellular proteins, is a multifunctional calcium-binding glycoprotein. In tumors, it functions as de-adhesion, antiproliferation, and regulation of extracellular matrix (ECM) interactions. But in different tumors,SPARC performances different biological effects, as in melanoma, breast cancer, esophageal cancer, etc, SPARC is associated with a highly aggressive tumor phenotype, while in ovarian cancer, cervical cancer, non-small cell lung cancer,SPARC may function as a tumor suppressor.

AIM: To investigate the effect and mechanism of Mingjing decoction combining with argon laser on the levels of plasma vascular endothelial growth factor (VEGF) in patients with diabetic retinopathy(DR).
METHODS:The 66 patients(118 eyes)with DR at Ⅲ ~ Ⅴstage were randomly divided into two groups (treatment group and control group). The control group (33 patients with 56 eyes ) was treated with argon laser, and the treatment group (33 patients with 62 eyes) was treated with mingjing decoction combining with argon laser, and a blank group(30 eyes) was set up. The levels of plasma VEGF were detected by enzyme linked immunosorbent assay (ELISA). The results of best corrected visual acuity and fundus fluorescein angiography(FFA) were analyzed, as well as detected glycosylated hemoglobin ( HbA1c), blood coagulation function and the function of liver and kidney.
RESULTS: Patients with DR had significantly risen plasma VEGF before treatment when compared with blank control group ( P < 0. 05 ). After 3mo of combined treatment, the levels of plasma VEGF significantly reduced and HbA1c decreased in patients treated with mingjing decoction and argon laser, there were statistically significant difference compared to control group ( P < 0. 05 ). In the treatment group, the best corrected visual acuity and FFA were significantly improved in patients treated with mingjing decoction combining with argon laser compared to patients treated with argon laser alone after 3mo of combined treatment. CONCLUSION: Mingjing decoction combining with argon laser for DR can effectively reduce the level of plasma VEGF, stabilize blood sugar levels, improve the function of retina, and delay DR progresses.

Objective To investigate the clinical effect of psychological intervention combined with insulin and glimepiride on the the treatment of elderly patients with diabetes. Methods 150 cases of elderly patients with diabetes in our hospital from July 2012 to March 2017 were treated as the research object, the single and double number (hospital admission order) 150 cases of elderly patients with diabetes were randomly divided into study group (n=75) and control group (n=75). The control group of elderly diabetic patients receiving insulin combined with glimepiride treatment in the study group received the basic treatment combined with psychological intervention. Results After treatement, 2 hPG, FBG and HbAlc were better than those in the control group (P<0.05). HAMD score in the study group after treatment decreased significantly than that before treatment(P<0.05). The difference of HAMD score in the control group had no statistically significant. Conclusion Psychological intervention combined with insulin and glimepiride on the treatment of elderly patients with diabetes can improve the depression, has a positive significance to improve the effect of blood glucose.

Objective To explore the use of mosapride citrate in treating reflux esophagitis and nursing intervention spitley effect. Methods In 40 cases of reflux esophagitis in patients with routine therapy, and classified as the control group, the other 40 patients in the control group based on the use of mosapride citrate. And classified as the observation group, two groups of patients were in our hospital from June 2015 to January 2017. Results The study in the treatment of the two groups of patients with effective rate of 95.0%, the observation group was significantly higher than the control group 80.0%, between the two groups showed significant differences (P<0.05). The adverse effects of more than two groups found, two groups of patients with adverse reaction incidence was no significant difference, that shows no significant difference. Conclusion Mosapride citrate in reflux esophagitis treatment and intervention effect analysis found that the compared with conventional therapy, can be in At the same time, it can improve the curative effect of the patients, and will not increase the possibility of adverse reactions, so it is worthy of clinical reference.

It is urgent to construct the integrity of medical students on campus.Students of the first and fifth grade which are also the two special stages are investigated in the survey,According to the comparison of the honor credibility knowledge and behavior,the article summarized the effectiveness of contemporary medical education,and discussed the dialectical relationship between the integrity education of the medical students and medical integrity,to give full play to the clinical practice teaching as a significant role of the integrity education of medical students.

The technology of artificial intelligence and the diagnosis of medical laboratory are combined to design a prototype of medical laboratory expert system.Adopting the present successful production rule to express the method as knowledge and using inaccurate inference engine,this prototype designs and realizes six major function module,such as "laboratory project meaning analysis",etc.It can be used as a clinical tool.

Background and purpose:High frequency loop electrosurgical excision procedure(LEEP)has been widely used in the treatment of cervical intraepithelial neoplasia. The purpose of this study was to explore the value of loop electrosurgical excision procedure in the diagnosis and management of CINⅢ and stage ⅠAl cervical carcinoma.Methods:A retrospective analysis was carried out in 396 cases of CINⅢ and cervical carcinoma with stage ⅠAl undergoing operation and loop electrosurgical excision procedure between January 2003 and October 2006 at Obstetrics and Gynecology Hospital of Fudan University.Results:The coincidence rate of the multiple biopsies before the procedures compared with the conization ones was 88.6 % (351/395). The incidence of residual disease was 10.2%(6/59) and 7.7 % (6/78), respectively in patients with positive margins and negative margins.Conclusions:Loop electrosurgical excision procedure can improve both the diagnosis and treatment of CINⅢ and cervical carcinoma stage ⅠAl. We should offer further treatment properly to the cases with positive margin because of the persistent lesions.

Anti-inflammatory and analgesic and antipyretic and gastrointestinal ulcerogenic activities of ketoprofen 2-(3-benzoylphenyl -propionic acid) were investigated in experimental animals.Anti-inflammatory potency of ketoprofen was almost equal to that of indomethacin in carrageenin, yeast or nystatin-incluced hind paw edema and in acetic acid-induced increase of vascular permeability.Oral analgesic ED50-value of ketoprofen was on the whole campa-rable to that of indomethacin.Ketoprofen exerted a strong antipyretic action at oral doses in rats and its potency (ED50-1.22 mg/kg) was 2.3 times of that of indomethacin. However, ulcerogenicity of ketoprofen was weeker than that of indomethacin safety index and therapeutic index (SUD60/ED50 and LD60/ED40) of ketoprofen were greater than that of indomethacin and extremely great (the index ratio=114.7/4.5 ) in the antipyretic activity. It was suggested from these findings that ketoprofen is a potent anti-inflammatory drug with analgesic and antipyretic actions superior to indomethacin and a wide safety margin.

Objective To compare the consumption of the drugs for patient-controlled intravenous analgesia (PCIA) in patients with different blood groups. Methods One hundred female ASA Ⅰ or Ⅱ patients, aged 30-50 yr, body mass index ＜ 30 kg/m2 , scheduled for elective total hysterectomy or myomectomy, were enrolled in this study. The patients were divided into 4 groups according to the blood group: group A ( n= 25), group B ( n = 30), group AB ( n = 11 ) and group O ( n = 34). Patients received iv injection of flurbiprofen 30 min before the end of surgery and sufentanil at the end of surgery. PCIA with sufentanil 1.2 μg/ml ( bolus dose 2.0 ml, background infusion 0.5 ml/h, lockout interval 5 min) was performed when the VAS score ≤4. The loading dose and consumption on 1 st and 2nd day after operation for sufentanil were recorded. The adverse reactions were observed.Results The loading dose and consumption on 1st day after operation for sufentanil were the highest in group A and B, the second in group AB, and the lowest in group O among the 4 groups. Conclusion The consumption of the drugs for PCIA is different in patients with different blood groups.