Objective The study evaluated the efficiency and safety of a short-acting full-dose fibfinolytic regimen to promote early infarct-related artery (IRA) patency during the inherent delay experienced by infarction patients referred for angioplasty as the principal recanalization modality. Method Accepted aspirin and heparin, 75 patients were treated by an intravenous bolus of 20 mg recombined tissue-type plasminogen activator (rt-PA), then followed by 80 mg over 30 minutes. Patients were to undergo angiography as soon as possible following study drug. If the IRA was occlude (TIMI flow grade 0 or 1),or was open but with ≥50% stenosis, immediate early PTCA at the same time. The end point included patency rates on catheterzation laboratory (cath Lab) arrival, technical results when PTCA was performed, complication rates, clinical adverse events rates and left ventricular (LV) function by treatment assignment in two weeks. Results Patency on Cath lab arrival was 88% with combination treatment group (26% Thrombolysis in myocardia infarction trial TIMI-2, 66%TIMI-3), and 36%with primary PTCA group (20%TIMI-2, 16%TIMI-3), (P

Objective To evaluate the value of double stapling technique with curved cutter stapler in colorectal anastomosis,especially in low colorectal anastomosis. Methods The clinical data of 168 cases of rectal carcinomas treated with double stapling technique with curved cutter stapler were retrospectively reviewed.The intraoperative condition,postoperative complications and findings during follow up were analysed. Results During the operations,the processes of closure and anastomosis of all the patients were satisfactory,and no operative death occurred.After the operations,4 cases(2.4%) had anastomotic leakage,3 cases(1.8%) had anastomotic bleeding,and 2 cases(1.2%) had rectovaginal fistula.All the complications were cured.There was no anastomotic stricture. Conclusion Double stapling technique with curved cutter stapler may help to accomplish low colorectal anastomosis which is a difficult task for handed suture.

Objective There is still a concern that epidural labor analgesia could affect uterinecontraction.The purpose of this study was to investigate the effect of epidural labor analgesia on uterinecontraction.Methods Forty ASA Ⅰ-Ⅱ primiparous women aged 20-30 yr at full term in normal uncomplicateddelivery were enrolled in this study.They were taller than 1.5 m and weighed less than 100 kg.The amnioticmembrane was artificially ruptured at 3 cm cervical dilation and a catheter was inserted into uterine cavity beyondthe head of the fetus and connected to a maternal-fetal monitor.The patients were randomly divided into 2 groupswith 20 patients in each group:Ⅰ control group received no analgesia and Ⅱ epidural group received continuousepidural analgesia(PCEA).An epidural catheter was placed at L_2-3.After a loading dose of 8-10 ml of the PCEAsolution(0.1% ropivacaine+1 ?g?ml~(-1) fentanyl)PCEA was started(bolus 3 ml,lockout interval 15 min andback ground infusion 6-8 ml?h~(-1)).The height of block was controlled below T_10.Blood samples were taken frommaternal vein at 3 cm cervical dilation(T_1),1h later(T_2)and at delivery(T_3)and from umbilical vein andamniotic fluid was aiso collected for determination of cortisol,PGE_2 and pitocin levels.VAS scores,intrauterinepressure,the frequency and duration of uterine contraction,the use of pitocin(%),incidence of cesareansection,the length of labor and neonatal Apgar scores were recorded.Results The maternal blood eortisolconcentration was significantly lower during PCEA(T_2,T_3)in group Ⅱ than in control group(P

Objective To investigate the mechanisms of the inhibitory effects of peripheral electrical stimu- lation(PES)on chronic central pain(CCP)after spinal cord injury(SCI).Methods Twenty-four male Sprague- Dawley rats with CCP following SCI were randomly divided into three groups:a group without stainless steel needles implanted (NSSN group,n=8),a group with a stainless steel needle implanted but no peripheral electrical stimula- tion applied(NPES group,n=8)and a PES group(PES group,n=8).The rats' CCP was evaluated through ob- serving their response to nociceptive stimulation by means of the paw withdrawal pressure threshold(PWPT)and the paw withdrawal latency(PWL).Spontaneous pain behaviors including autophagia and scratching were observed at the same time.PES was applied via stainless steel needles inserted into standard acupoints on the hind limps and the back.The expression of the NMDA receptor 1(NR-1)subunit in the spinal cord horn was measured using immuno- chemical methods.Results Compared with the NSSN and NPES groups,CCP in the PES group was alleviated, PWPT and PWL were dramatically increased(P＜0.01)and the expression of NR-1 was obviously decreased (P＜0.01).Conclusion Peripheral electrical stimulation may alleviate chronic central pain after spinal cord injury in rats.

Comorbidity ; Humans

ObjectiveTo study the effct of the early rehabilitation of acute stroke with acupunction added to rehabilitational training.Methods120 patients with acute stroke were divided into 2 growps with 60 cases each:the acupunction growp,in which the patients were acepted acupuncture added to rehabilitational training,and the control growp,in which the patients were acepted the rehabilitational training only.All the patients were evaluated with Clinical Nervous Functional Deficiency(CNFD),Fugl-Meyer Assessment(FMA) and Modified Barthel Index(MBI).Results The scales of CNFD,FMAanal Deficiency (CNFD),Fugl-Meyer Assess me that of the control growp.The rate of cure and significantly in the acupunction growp was 75%,while that of the control growp was 41.7%(P<0.01).Conclusions Acupunction compared with the rehabilitational training is effective on the with stroke.

Objective To investigate the diagnosis and treatment of pulmonary tuberculosis in renal transplantation recipients.Method The clinical data of 8 renal transplantation recipients suffering from pulmonary tuberculosis infection were retrospectively analyzed.Result Fever,cough and expectoration were the most common symptoms,however,lacking typicality.Images of chest Xray and CT scan were various and couldn't verify TB infection from pneumonia.Seven of 8 cases were diagnosed through invasive methods,either bronchofibroscope or fiberthoracoscopy.Immunosuppressants were decreased in all cases.Three-drug regimens,including isoniazide,rifampicin and ethambutol or pyrazinarnide,were administrated as anti-tuberculosis chemotherapy.All the cases were cured,without episodes like acute rejection and liver function impairment.Conclusion Routine examinations are not sufficient to diagnose pulmonary tuberculosis in kidney transplantation recipients.While,invasive methods like bronchofibroscope and fiberthoracoscope are helpful.When diagnosed,patients should receive normative anti-tuberculosis treatment and immunosuppressive agents adjustment,which can benefit the prognosis of pulmonary tuberculosis in renal transplantation recipients.

Objective:Osteoprotegerin (OPG) is a key molecule negatively regulating osteoclast differentiation and activation; and the conserved mycobacterial heat shock 70 (HSP70) peptide p111-125 has also been found to inhibit inflammation reactions in chronic arthritis. BaculoDirectTM baculovirus expression system was selected to express recombinant OPG-HSP70 in insect cells.Methods:The human functional fragment (p22-194) of OPG and functional fragment (p111-125) of mycobacterial HSP70 gene were cloned into the transfer vector pENTRTM/SD/D-TOPO. The recombinant plasmid was performed an LR reaction with the BaculoDirectTM Linear DNA to generate recombinant baculovirus DNA. The cultured Sf9 insect cells were directly transferred with the recombinant baculovirus DNA,and the pure recombinant baculovirus was obtained. Then recombinant baculovirus was infected Sf9 insect cells again to express the OPG-HSP70 gene.Results:The target protein was detected at the time of 48h post infection,reached at highest yield at the time of 72h post-infection. A 28kDa protein immunostaining band was detected by Western blotting from lysate of those cells.And the purified protein was obtained by using Ni-NTA system. Functional stuies on the fusion protein showed it significantly reduce osteoclast cell number[(3.10?0.640) cells under each microscope field in treatment group by comparing to (10.70?0.817)cells in the control group] in the osteoclast inhibition test,and reduce the inflammation reaction in a delayed type hypersensitivity (DTH) mice model (P

China ; epidemiology ; Communicable Diseases ; epidemiology ; mortality ; Female ; Hepatitis, Viral, Human ; epidemiology ; mortality ; Humans ; Incidence ; Male ; Rabies ; epidemiology ; mortality ; Tuberculosis, Pulmonary ; epidemiology ; mortality

Objective To investigate the clinical value and prenatal diagnosis feasibility of fetal aberrant right subclavian artery(ARSA) with fetal echocardiography.Methods The data of 39 fetuses with ARSA were retrospectively reviewed.The prenatal and postnatal medical records,including the presence of fetal abnormalities,cardiac defect,karyotype and the outcomes of each pregnancy were collected.Results The echocardiographic feature of ARSA was that an ARSA arises as a fourth branch of the arch,from the descending aorta behind the trachea,crosses the thorax between the trachea and the spine,to reach the right arm.The overall incidence of ARSA was 2.3 ％ (39/17 280),23 cases (59.0 ％) as an isolated malformation,16 cases (41.0％) combined with cardiac defect and extracardiac abnormalities,9 cases (23.1％) with chromosomal abnormalities.23 cases underwent termination of pregnancy,2 cases died in uterus and 14 cases were born live.Isolated ARSA group had lower incidence of chromosomal abnormalities (8.7％ vs 43.8 ％,P ＜ 0.05) and higher fetal survival rate (56.5％ vs 6.2％,P ＜0.05) than the combined detects group.Conclusions The fetus with ARSA complicated with aneuploid karyotype,cardiac defects and extracardiac anomalies are at hight risk of poor prognosis.