Objective To observe the therapeutic efficacy and safety of recombinant tissue plasminogen activator (rt-PA) for treatment of patients with acute cerebral infarction and investigate the prognostic factors of thrombolysis. Methods The clinical data of 60 patients with acute cerebral infarction from January 2009 to November 2013 in Department of Emergency, Hangzhou Traditional Chinese Medicine Hospital were retrospectively analyzed;of them, 30 cases received intravenous rt-PA thrombolytic treatment, being in the thrombolytic group, 0.9 mg/kg rt-PA was given to the patient within 4.5 hours after the disease onset, the total dosage could not exceed 90 mg, in which 10%was intravenously injected and the rest 90%was intravenously dripped slowly within 60 minutes. That another 30 cases did not undergo thrombolytic therapy was assigned as the control group, and they took aspirin, etc anti-platelet aggregation routine treatment. Before and after thrombolytic treatment for 1 hour, 24 hours and 14 days, the National Institutes of Health Stroke Scale (NIHSS) score was evaluated in the two groups;before and after thrombolytic therapy for 0.5, 1.0, and 1.5 hours, the patient's scores of Barthel index (BI) were observed in the two groups. In thrombolytic group, the situations of hemorrhage transformation, symptomatic hemorrhage and modified Rankin scale (mRS) score in 3 months of the patients with different ages, complications and NIHSS scores were observed. Results Before treatment, no statistically significant differences were found in the NIHSS score (15.2±3.6 vs. 15.5±3.3) and BI score (45.0±8.8 vs. 44.1±7.6) between the control group and thrombolytic group (both P>0.05);after treatment with the extension of time, the NIHSS score was gradually reduced, reaching the lowest level on the 14th day after thrombolytic treatment, while the BI score was gradually increased, reaching its peak at 1.5 hours after thrombolytic treatment, the changes being more prominent in thrombolytic group (NIHSS score:9.7±2.6 vs. 12.8±4.2, BI score:82.6±7.8 vs. 69.6±9.8, both P<0.05). In thrombolytic group, there were cerebral hemorrhage transformation 2 cases, gum bleeding 3 cases, skin bleeding 1 case, urethral bleeding 1 case, gastrointestinal bleeding and black stool 1 case. In control group, cerebral hemorrhage transformation was seen in 1 case. There was no obvious systemic hemorrhage in the two groups. In the 30 cases in thrombolytic group, the baseline NIHSS score of patients>80 years old was higher than that in cases≤80 years old (15 vs. 12); the age (years: 71.0±4.1 vs. 61.5±2.6), baseline NIHSS score (14 vs. 11) and bleeding conversion rate [37.50% (3/8) vs. 18.18% (4/22)] of cases with atrial fibrillation were higher than those not complicated with atrial fibrillation; the NIHSS score of cases with elevated international normalized ratio (INR) was lower than those without elevated INR (11 vs. 14);The bleeding conversion rate [16.67%(1/6) vs. 29.17%(7/24)] with NIHSS score≤4 were lower than those with NIHSS score>4;the mRS score in 3 months (4 vs. 2), and percentage of 3-month mRS score≤2 [11.1%(1/9) vs. 52.38%(11/21)] in cases with NIHSS score≥20 was higher than that in cases with NIHSS score<20 (all P<0.05). The fatality rate of two groups was 3.33%. Conclusions The intravenous rt-PA thrombolytic treatment can significantly promote the early recovery of neurologic impairment for patients with acute cerebral infarction. The therapy can improve the prognosis and its safety is relatively good. Meanwhile it is similarly effective for cases over 80, with complications such as atrial fibrillation, raised INR, and with different degrees of severity.

Objective To compare the analgesic efficacy and side effects of patient-controlled intravenous analgesia (PCIA) with Lornoxicam and patient-controlled epidural analgesia(PCEA) with morphine in patients undergoing Orthopaedics surgery. Methods 100 ASA Ⅰ-Ⅱ Patients scheduled for Orthopaedic surgery were divided randomly into two groups: Lornoxicam PCIA group( n =50) , Lornoxicam 48mg was diluted to 100ml with normal saline (0.9%NS). Morphine PCEA group( n =50), Morphine 9mg + bupivacaine 150mg were diluted to 100ml with normal saline (0.9%NS) .In both groups the patients were received PCA at a rate of 2ml/h with the bolus dose of 0.5ml and lockout interval of 15min. The loading dose was Lornoxicam 8mg plus Ondansetron 4mg in group PCIA and morphine 1mg and Ondansetron 4mg diluted to 10ml with normal saline (0.9%NS) in group PCEA 30 minutes before the end of operation. BP, RR, ECG, SpO_2 were monitored continuously after operation. Efficacy of analgesia was assessed by VAS scores. Side effects such as drowsiness, sweat, nausea, vomiting and skin pruritus were also observed. Results There was no significant difference in the mean VAS score between group PCIA and group PCEA at 4h, 8h, 16h ,20h, 24h, 32h and 48h. after operation. There was no significant difference in side effects between the two groups except the occurrence of sweat, nausea, vomiting and skin pruritus which was lower in group PCIA than in group PCEA ( P

Objective To establilsh the quality standard for Qingfei Yihuo tablet. Methods TLC was performed to identify Sophora flavescens Ait, Peucedani and Cortex Phellodendri. HPLC was used to determine Baicalin. ODS column was used. The mobile phase consisted of methanol-water-phosphoric acid (47∶53∶0.2). The flow rate was 1.0 mL/min and column temperature was at 25 ℃. The detecting wave length was at 280 nm. Results The characteristic for identification by TLC was distinct and hightly specific. Baicalin could be determined by HPLC. The linearity of Baicalin was good in the range of 0.163～0.975 ?g (r=0.999 9). The average recovery of Baicalin was 97.43% and RSD was 1.97% (n=6). Conclusion The methods of identification and quantification is simple and reproducible. It can be used effectively for the quality control of Qingfei Yihuo table.

Objective:To observe the effect of Livostin spray on children＇s allergic rhinitis and to search the mechanism of treating allergic rhinitis. Method: 113 patients were treated with Livostin spray (Livostin group) or normal saline spray (control group). Result:The total efficiency of Livostin group in treating allergic rhinitis is above 95.1％ and that of the control group is 25.0％. Initial time of starting effect of Livostin (72.1％) is in 1 minute, and that of the control group (mostly 23.1％) is in 3 minutes. The keeping curativeeffect time of Livostin spray is mostly (72.1％) above 5 hours and that of the control group is mostly (30.8％) in 3 hours. After 2 weeks,the eosinophilic granulocyte number in nose＇s secretion of Livostin group is obviously reduced (P＜0.05). Conclusion: Livostin is better than control group in relieving symptoms, keeping curative effect and safety,so Livostin is one kind of effective drug in treating children＇s allergic rhinitis.

OBJECTIVE:To conduct pharmacognostical study of Caulopyhllum robustum Diels so as to offer evidences for exploiting and utilization of this herbal plant. METHODS:A pharmacognostical study of C.robustum was performed by carrying out identification of characteristics,microscopic identification and physicochemical identification. RESULTS:The pharmacognostical features of C.robustum have been established in our study. CONCLUSIONS:This study is suitable for the identification of the origin of C.robustum and it provides approach and evidence for the establishment of the quality standard and sustainable development of resources of C.robustum.

Objective To study the effect of three fungi of Helminthosporium on the seven kinds of bioactive constituents in root of seedling Rumex gmelini. Methods Let the R. gmelini infect the fungi of Helminthosporium by dealing the leave surface of R. gmelini with fungal spore suspension. The content of seven kinds of bioactive constituents was determined by HPLC and the results were analyzed by variance analysis. Results During the treatment time, little effect of three fungi of Helminthosporium on content of polydatin, chrysophanol 1-glucoside, and physcion, but the obvious effect on resveratrol, musizin, emodin, and chrysophanol was found. Conclusion The effects of H. turcicum 001 on yield and content of resveratrol are significant in early-middle stage (0—40 d), but treatment time over 40 d is not suitable. The results of this study could provide the new idea and theoretical basis for the exploiting of natural medicines and the planting of Chinese herbal medicine.

Objective To develop a flow cytometrie assay to for diagnosis of X-Linked Hyper.1gM Syndrome(XHIM).Methods Heparinized peripheral blood obtained from patient,mother and a healthy control was diluted with RPMI- 1640(unstimulated control)or with RPMI-1640 containing 15μl PMA(1 rig/μl)and 6 trl ionomycin(50 ng/μl)(stimulated cell).Using directly labeled antibodies,we have examined CD40 ligand levels on CD3+ CD8- lymphocyte surface,and CD69 levels on CD;lymphocyte Surface to determine whether the cells were activated.Results CD69 levels on CD3+ lymphocyte surface from stimulated group and from unstimulated group were above 96% and below 3%,respectively.CD40L levels Oil CD3 CDs-T lymphocyte surface from stimulated group were 0.8% (patient),60.04%(mother) and 62.87%(healthy contr01).CD40L levels on CD3+ CD8-T lymphocyte surface from unstimulated group were 0.88% (patient),4.15%(mother)and 5.51%(healthy contr01).Conclusion This flow cytometric assayis accurate and convenient,which Can be used in neonatal screening.

Objective To analyze the impact of allograft category on the result of living related donor kidney transplantation (LRKT)and to evaluate the predominant donors. Methods A retrospective analysis of 104 recipients receiving LRKT from Apr. 2004 to Mar. 2008 was performed. Based on donor resource, all the recipient-donor pairs were divided into four groups: spousal donation group,parental donation group, sibling donation group and cousinly donation group. The observational parameters were selected for analysis, such as average post-transplant hospitalization dates, time for serum creatinine (Scr) back to normal level, Scr levels of every observational time point, incidence of major complications (infection, rejection, DGF) and recipient/graft survival rate. Results Recipient/graft survival rate of sibling donation group seemed higher. Recipients of sibling donation group seemed to have fewer post-transplant hospitalization dates, but higher rates of infection, while those of parental donation group seemed to have higher rates of rejection. Rates of rejection and infection of spousal donation group were lower than supposed. There was no statistically significant difference in time for Scr back to normal level and Set levels of every observational time point among these four groups. Conclusions The result of sibling donor renal transplantation is better, while short-term outcome of spouse donor renal transplantation is ideal, which is similar with parent or cousin donor renal transplantation. Except for human leukocyte antigen, aspects such as quality of donor kidney, predominance during operation and self-administration post-transplant are also the guarantee for the success.

Objective To explore treatment of bile duct variation in Laparoscopic Cholecystectom.Methods The author retrospectively analyzed the clinical data of 7 cases with bile duct variation in 2 000 patients performing Laparoscopic Cholecystectomy.Among the 7 cases,2 cases had small hepatic duct openings in the gallbladder bed;2 cases had cystic duct openings in the right hepatic duct;2 cases had accessory right hepatic duct;and one case had rare variation whose right hepatic bile duct and the jejunum connect together.2 cases of the first variation had no bile leakage,adopting the suture method in LC.Among 2 cases of the second variation(all found in LC),one case had bile spillage in the junction of the cystic duct and the right hepatic duct,so the operator converses to laparotomy,cuts the gallbladder,sutures the break,and the patient had no bile leakage at last;The other one case was anatomized clearly under the cavity mirror.Among 2 cases of the third variation,one had no bile leakage,whose accessory hepatic duct was ligated in LC.The other one case had bile leakage after LC,so the operator converses to laparotomy,clips the accessory hepatic duct,and extract the drainage tube until there was no bile drainage.The last case was mistaken and cut it,the next day biliary peritonitis appeared,so the bile leakage was sewed up under the laparoscope.Results The seven cases were followed 1 ~3 years,they had no jaundice and their liver function was normal.Conclusion Careful-ly dissect Calot's triangle in LC,observe bile leakage after LC;improve the level of understanding and dealing bile duct variation in LC,don't cut the duct which is known to us.We should treat differently according to particular case.

Objective To evaluate the pulmonary protection of dexmedetomidine in combination with parecoxib in pa?tients undergoing thoracotomy with one-lung ventilation. Methods Eighty patients undergoing elective resection of esopha?geal or lung cancer, including both sex, aged 40-70 yr, ASAⅠ-Ⅲ, were randomly divided into four groups (n=20), dexme?detomidine group (D group), parecoxib group (P group), dexmedetomidine in combination with parecoxib group (DP group) and control group (C group). Dexmedetomidine 1μg/kg was infused in ten minutes and then continued infusion at the rate 0.6μg·kg-1·h-1 until the chest was closed in group D. Parecoxib 40 mg was infused 10 min before the induction of anesthesia in group P. DP group was given parecoxib 40 mg and parecoxib 40 mg 10 min before the induction of anesthesia. The equal volume of normal saline was given in group C. Blood samples were collected for determination of blood gas analysis and the serum concentration of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-8 immediately after the induction of anes?thesia (T1), 30 min (T2) and 60 min(T3) after one-lung ventilation, and at the end of the operation (T4). Oxygenation index (OI) was calculated. The serum levels of TNF-α, IL-6 and IL-8 were detected by ELISA. Results Compared with time T0, the serum concentrations of TNF-α, IL-6 and IL-8 (except IL-8 at the time T2 in DP group) were significantly increased, and OI was decreased in all groups at the time T2-4 (P<0.05). Compared with group C, concentrations of TNF-α, IL-6 and IL-8 decreased and OI increased significantly at the time T2-4 in D group, P group and DP group (P<0.05). There were no obvious differences in concentrations of TNF-α, IL-6, IL-8 and OI value between D group and P group (P > 0.05). Conclusion Combination of dexmedetomidine and parecoxib can further mitigate inflammatory response, improve lung oxygenation dur?ing one-lung ventilation, and provide pulmonary protection in patients undergoing thoracotomy.