Objective To investigate the significance of detection of blood coagulation and fibrinolytic indexes before and after delivery.Methods 212 cases in the postpartum hemorrhage group(bleeding amount ≥500 mL)and 235 cases in the normal deliver-y group were retrospectively analyzed.The prothrombin time(PT),international normalized ratio(PT-INR),activated partial throm-boplastin time(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer(DD),blood platelets(PLT)and hemoglobin(HB)were de-tected before delivery and at 72 h after delivery.85 women with the physical examination were selected as the healthy group.Results Before delivery,PT/PT-INR,APTT,TT,PLT and HB in the normal delivery group were lower than those in the healthy group, while FIB and DD were higher than those in the healthy group;PT/PT-INR,APTT,TT and DD in the postpartum hemorrhage group were higher than those in the normal delivery group,while FIB and PLT were lower than those in the normal delivery group. At 72 h after delivery,there was no statistically significant differences in PT/PT-INR,APTT,TT and DD between the normal de-livery group and the healthy group(P >0.05),but FIB was higher than that in the healthy group;PT/PT-INR,APTT,TT and DD in the postpartum hemorrhage group were higher than those in the normal delivery group,while FIB,PLT and HB were lower than those in the normal delivery group.Conclusion Dynamically monitoring the change of the blood coagulation and fibrinolysis indexes before and after delivery has important significance in preventing postpartum hemorrhage and thrombosis.

Objective To build a simulation model for outpatients queuing,using data from a general outpatient cardiovascular clinic of a general hospital in Shanghai and different rules in the process.The study employs time-interval controlled mode for appointment registration,for the purpose of analyzing characteristics of different queues.Methods Extraction of data of the clinic in a given month by means of HIS system to determine the parameters of the queuing models.Building the simulation model with Matlab to develop the plan of mixed queues and that of discrete queues,for analyzing the waiting time variations,with different number of doctors on duty and different number of appointments in one time interval.Resnlts In the Monday mornings for example,the mean waiting time of appointments or no-appointments are calculated by simulation with different queuing rules,different number of doctors on duty and different appointment quantities of one time interval.Conclusion The mean waiting times of appointments and no-appointments can be both sizably cut short by means of time-interval controlled appointment; different queuing plans are recommended for different departments; the simulation model should be further verified and optimized in practice.

Objective To explore the relationship between left atrial diameters (LAD) and prothrombotic state in senile patients with hypertension (HT) and atrial fibrillation (AF). Mcthods Totally 105 patients with cssential hypertension were divided into 65 patients with atrial fibrillation and 40 cases without atrial fibrillation,and then patients with atrial fibrillation were subgrouped into paroxysmal and persistent atrial fibrillation groups.30 healthy people without hypertension and atrial fibrillation were used as control group.LAD was determined by M type ultrasound cardiogram.Fibrinogen (Fg),D-Dimer(D-Dimer),von willebrand (vwF) and haematocrit (HCT) were also measured as prothrombotic state and compared among the groups. Results In groups of HT with AF versus HT without AF versus control,LAD[(43.56 ± 6.72) mm vs.(36.28 ± 5.83) mm vs.(31.63±4.32)mm],Fg[(4.24±0.59)g/L vs.(3.09 ±0.49)g/L vs.(2.80± 0.46)g/L],D-Dimer [(0.43±0.13)mg/L vs.(0.28±0.]0)mg/L vs.(0.18±0.08)mg/L],vwF[(290.44±29.02)％ vs.(101.32±21.36)％ vs.(84.15±20.26) ％],HCT[(0.46±±0.07)vs.(0.37±0.05)vs.(0.34±0.03)]were significantly higher in HT patients with atrial fibrillation than those without atrial fibrillation and control ( all P＜ 0.05),and there were differences in LAD and D-Dimet (P＜＜0.05),but not in Fg,vwF and HCT (all P＞0.05) between patients without atrial fibrillation and control.LAD[(46.75±7.32)mm vs.(40.82±6.21)mm],Fg [(4.68±0.65)g/L vs.(3.85±0.53)g/L],D-Dimer [(0.48±0.16)mg/L vs.(0.40±0.12)mg/L],vwF [(384.96±29.75)％ vs.(209.43±28.63)％] and HCT [(0.49±0.08)vs.(0.43±0.06)] in persistent atrial fibrillation group were increased than those in paroxysmal atrial fibrillation group ( P ＜ 0.05 ).Fg ( r =0.683 ),D-Dimer ( r =0.735 ),vwF ( r=0.763) and HCT(r=0.759)were corrclated with LAD (all P＜0.01). Conclusions Increased LADmight he one of the elevated risks of atrial fibrillation and a higher prothrombotic state is increasing with larger LAD in senile hypertension.

Objective To analyze the correlation between non-motor symptoms (NMS) and the quality of life in the mild Parkinson's disease (PD) patients of different genders.Methods 85 mild PD patients (H-Y stage 1～2) were investigated.The PD NMS Quest was used to assess NMS.The quality of life was assessed with SF-36 questionnaire.Results Stepwise linear regression analysis showed that nocturia,restless legs,depression,daytime sleepiness,decreased interest,smell taste problems were positively correlated with the score of life quality of male and pain,increased sweating,taste smell problems,sleep problems,changes in libido,decreased memory,diplopia influenced life quality score of female.The scores of SF-36 questionnaire of the male with PD were lower than that of female patients.Conclusions The nonmotor symptom (NMS) There was a gender difference about the influence that NMS has made on PD patients.The male's life quality were lower than that of female patients about mild PD patients.

Non-motor symptoms are important components of the manifestations of Parkinson's disease, usually including neuropsychotic symptoms, sleep disorder, autonomic dysfunction, feels obstacle, and so on. This paper reviewed the manifestation, relevant factors,pathogenesis and treatment of non-motor symptoms of Parkinson's disease.

The use of immune checkpoint inhibitors (ICIs) has changed the clinical outcome of non-small cell lung cancer (NSCLC), with the widespread application of ICIs, immune-related adverse events (irAEs) have also appeared. Immune checkpoint inhibitor pneumonitis (CIP) is a serious adverse event of ICIs treatment that needs attention. Therefore, early identification of high-risk groups of CIPs and early intervention can reduce the occurrence of permanent drug withdrawal and severe CIPs, thereby improving patients′ prognosis.

Objective To investigate the status about non-motor symptoms (NMS) in Parkinson's disease (PD) patients and the effect on quality of life. Methods 50 PD patients and 50 normal controls were investigated with the NMS questionnaire and the Healthy Survey short form (SF-36), and analysed with Spearman correlation. Results 98% of PD patients presented NMS, and recent memory loss, restless legs,constipation were the most frequent. All the NMS were more frequent than in the controls (P<0.05) except sexual desire, sexual difficulties and nausea or vomiting. All the dimensions of SF-36 were significantly different between the groups (P<0.05). The symptoms of constipation,decline in recent memory, decreased attention, restless legs and sleep disorders correlated with the scores of SF-36 (P<0.05). Conclusion NMS is common in PD patients, and impacts their quality of life.

Objective To evaluate the feasibility,efficacy,and short to mid-term results of endovascular management of acute type B aortic dissection complicating visceral or lower limb malperfusion.Methods A retrospective study was conducted in 23 consecutive patients with acute type B dissection complicating visceral or lower limb malperfusion treated endovascularly at a single center between July 2001 to December 2012.Of the 23 patients identified [20 men,3 women; mean age (52 ±9) ranging 42-75]presented with clinical and imaging evidence of end-organ malperfusion:renal artary in 5 (21.7％),superior mesenteric artery in 9 (39.1％),celiac trunk in 3 (13％) and lower limb in 6 (20.1％),artary renal and lower limb in 2.Results All patients had stent-graft coverage of the proximal entry tear.11 (47.8％) patients needed additional branch vessel stenting.Successful correction of malperfusion was achieved in all the patients and the successful rate of operation and technology was 100％.In 1 patient,ischemia in the lower limb was resolved after a stent was implanted to the right iliac artery.In another patient,complicated with lower limb ischemic necrosis,amputation was performed after one stage stent-graft placement.The duration of follow-up was 6 months to 72 months,mean (21 ± 11)months.There was no migration of stent-graft and end-organ ischemia.No patients suffered from paraplegia in this group.Conclusions Endovascular coverage of the proximal entry tear in acute type B aortic dissections complicating end-organ malperfusion is a reasonable first line treatment.But some cases may need a combination branch vessel stenting.

Objective To evaluate femoral artery ligation for femoral artery pseudoaneurysm secondary to drug injection. Methods Clinical data of 32 drug addicts of femoral artery pseudoaneursysm caused by drug injection undergoing femoral artery ligation and local debridement were reviewed retrospectively.The blood supply of affected limb was evaluated by oxygen saturation of distal limb and its function.All the cases were followed up at 3,6,9,and 12months after the operation. Results Surgery was successful in all cases. There were no significantly difference of the limb oxygen saturation between postoperative and preoperative period (95.1％ ± 2.8％ vs.96.9％ ± 1.9％ ; t =1.26,P =0.25 ).White blood cells and neutrophils percentage significantly decreased after surgery.All patients were followed up for 1 year.Lower extremity ischemia after 6 hours of operation in one case treated by autologous saphenous vein bypass recovered. On 3 months mild claudication was observed in 5 cases. On 6 months claudication remained in only 2 cases,which disappeared on 9 months.All patients were able to maintain normal life.Conclusions Femoral artery ligation is a safe, effective and simple treatment modality for femoral pseudoaneurysms secondary to drug injection.

BACKGROUND:Bone marrow mesenchymal stem cells have the potential of self-proliferation and multi-directional differentiation, while mesenchymal stem cells are few in adult bone marrow. In vitro purification, amplification and osteoinduction are very important for the research of bone tissue engineering. OBJECTIVE:To establish a simple and reliable in vitro cultivation and identification system of adult bone marrow mesenchymal stem cells, and to induce the mesenchymal stem cells to differentiate into osteoblasts. METHODS:Bone marrow were extracted from adult anterior superior iliac, the density gradient centrifugation and adhesion method were used to isolate, purify, culture and amplify the bone marrow mesenchymal stem cells. Osteogenic medium was prepared by mixing appropriate amount of dexamethasone,β-glycerophosphate and ascorbic acid C. The cells were divided into osteoinduction group and blank control group for observation.
RESULTS AND CONCLUSION:Adult bone marrow mesenchymal stem cells were in typical long spindle-shape. The cells grew into rapid proliferation phase at 8-11 days and the growth curve was S-shape. CD44 and CD90 were in positive expression, while CD34 and CD45 were negative. The alkaline phosphatase activity was increased with culturing time prolonging, and reached the summit at the 12th day. The alkaline phosphatase activities of osteoinduction group were higher than those in the blank control group at different time points. These results suggested that in vitro cultivation, identification and osteoinduction system could obtain mesenchymal stem cells with high purity and good osteogenic differentiation capacity.