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.

It has widely spread thta critical li lness is characterizedas a sat te of immunosuppression and inflammation,and patients are unable to provide their own nourishment.So it has lead to the ed velopment of un tritional support por ducts or interventions designed to enhance the host immune response and/or suppress the inflammation.But there′s still a lot of controversy about immunonutrition in critically ill patients.This pa-per reviewed the research status of immunonutrition and nutritional support products.

To observe whether human aortic smooth muscle cells (SMC) may expressHLA-DR and DP antigens, we used ?-IFN and lymphocytes conditioned media (LCM) to induce SMC in vitro. The results showed that ?-IFN increased HLA-DR and HLA-DP expression on SMC by 80% and 73%, and LCM did so by 74% and 70% respec-tively. HLA-DR and DP (11% and 7%) in both groups were significantly higher thanthat of the control group. These results suggested that activated T lymphocytes may in-crease HLA-DR and HLA-DP antigens expression on human SMC by secreating ?-IFN (orwith other cytokines), which may play certain important roles in atherogenesis.

[Summary] Obesity is the most important risk factor of essential hypertension.Obesity-related hypertention has become a worldwide problem.Many clinical studies show that bariatric surgery has significant therapeutic effect on essential hypertension, but the specific mechanism of the condition remains to be fully understood.This paper tried to explain the mechanism of the treatment of bariatric surgery for essential hypertension from the following two aspects: the reversal of the sympathetic disorder and the decline of plasma leptin.

Zika virus disease is a mosquito-borne disease with aedes as a potential viral vector. Besides Zika virus, aedes can also serve as a vector for other viruses such as yellow fever virus and dengue virus.With the impact of globalization and climate changes, many regions in the world are experiencing outbreaks of mosquito-borne diseases in recently years.This paper focuses on the epidemic, prevention and control measures of mosquito-borne infectious diseases such as Zika virus disease and yellow fever which are firstly imported to China.

Objective To evaluate the value and significance of testing megakaryocyte micronuclei in bone marrow smears for hematopathy diagnosis.Methods Bone marrow smears from a total of 863 cases of patients with hemopathy were collected from 2002 to 2009 at the second affiliated hospital of zhejiang university school of medicine.Smears from 25 healthy individuals were used as control.The bone marrow smears were subjected to Wright-Giemsa staining.The number of megakaryocytes, morphous and positive rate of megakaryocyte micronucleis were recorded by using low power lens and immersion objective.Statistical differences of positive rate in the different diseases, pathologic subtypes, total number and type of megakaryocyte were analyzed.Results The megakaryocyte micronucleis were round or oval with varying size, distributed in paranuclear or away from nuclear and even free in extracellular, which could be observed in large and medium megakaryocytes.The positive rate of megakaryocyte micronucleis was highest in myeloid leukemia, particularly in the subtype of M6, M2, M4 and M5b with dyshaematopoiesis.Megakaryocyte micronucleis could also be found in MA, infection and benzolism, but rarely observed in the lymphocytic leukemia.Conclution The detection of megakaryocyte micronuclei was related with its amount, size and type.There is significant difference of the postive rates of megakaryocyte micronuclei testing among the different hematopathies and pathologic subtypes.Megakaryocyte micronuclei testing should be valuable in the the diagnoses of hematopathy.

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.

According to the records in Neijing (Internal Classic), this article discusses the relationship during the connotative evolution of mai (vessel) and jing (meridian) in the three aspects, named mai (vessels), the evolution from mai (vessel) to jing (meridian), and the connotation replacement of jing (meridian) with mai (vessel). The study results show that the connotation of Jingmai is originated from mai (vessel), but more enriched, which cannot be confused with each other. The recognition on the connotation of jingmai from mai (vessel) to jing (meridian) is the process of TCM understanding from concretization to abstraction, and from the entity to the concept. Jing (meridian) represents the law on the longitudinal and invariable running course of meridian, differenti from the perspective in western medicine in human body. This law results from the naive observation and is based on the rational summary and thinking, and it stands up the approval from practice. The description of jing (meridian) as mai (vessel) is just the superficial description of this term. In fact, its concept infers to the connotation of meridian.
China ; History, Ancient ; Humans ; Medicine in Literature ; Meridians ; Qi ; history

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.