Objective To investigate the clinical efficacy and safety of reteplase(rPA)adminis-tration in treating acute deep venous thrombosis(ADVT)of lower extremity.Methods A total of 1 87 pa-tients with ADVT were randomly divided into two groups,with 85 patients in rapid intravenous dripping group and 1 02 patients in 24-hour venouspumping group.Their effects on limb swelling,thrombolysis,and complicationswere compared for analysis.Results The differences in the curative effectsof reducingswell-ingand thrombolysis effect between the two groups werenot significant(P >0.05).Thethrombolysis time in the 24-hour venouspumping group was shorter than that of the rapid intravenous dripping group [(4.76 ± 1 .56)days vs(6.56 ±0.83)days,P <0.05],indicating 24-hour venouspumping was more effective than rapid intravenous dripping.Complication incidence in the 24-hour venouspumping group was less than that of the rapid intravenous dripping group(3.90% vs 1 7.6%,P <0.05).Conclusion rPA is a goodvenous thrombolytic agentwith rapid effect in treating ADVT.The 24-hour venouspumping was more effective and safe than the rapid intravenous dripping.

Objective To explore the expression of RET in cervical squamous carcinoma tissues and evaluate its relationship with cervical squamous carcinoma clinical pathological indexes and its prognostic value. Methods The expression and distribution of RET in normal cervical tissues ,CINⅠ,CINⅡ& CINⅢ and cervical squamous carcinomas tissues were detected by immunohistochemistry in wax blocks. Clinical data and follow-up data are integrated to analyze its relationship with clinical pathological factors and prognosis value. Results The positive rate of RET protein in cervical squamous carcinomas tissues is higher than in other tissues.The positive rate was related to FIGO stage and lymph node metastasis(P<0.05),and not related with the age of patients or the degree of tumor differentiation(P>0.05). The result of survival analysis with Kaplan-Meier method showed poorer disease-free survival time in the patients with high expression of RET (P < 0.05). Prognostic analysis of patients with cervical cancer through COX proportional hazard regression model suggested that RET expression was an independent prognostic factor. Conclusions RET has been involved in the progression ,FIGO stage and metastasis of cervical squamous cell carcinomas.

Objective To compare the difference of dosimetric results between 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) with 5-field for thoracic middle esophageal carcinoma.Methods Ten patients with thoracic middle esophageal carcinoma were involved in this study.Four treatment plans were designed for each patient,including one 3D-CRT plan and three IMRT plans with 5-field and all evaluation contents were compared.Results There were no significant differences of cord Dmax,total-lung mean dose (Dmean),L-lung Dmean and R-lung V25,V30.Significant differences of heart V30,V40 and Dmean were obtained among the plans,with the lowest of 5IMRT2 (V30:28.67±15.97,V40:13.04±7.28,Dmean:2097.76±718.26) and 5IM RT3(27.39±14.96,13.00±7.32,2096.16±718.85),the highest of 5CRT (43.27±18.69,26.83±19.18,2393.48±896.12) and 5IMRT1 (41.81±17.16,23.08±11.17,2403.77±834.73).There were significant differences of L-lung V5,V10,V15,V20 V25 and V30.All IMRT plans reduce V20,V25 and V30.5IMRT1 did not increase V5 (54.39±7.58) and V10 (44.76±6.30),but reducesd V15 (20.86±5.16),5IMRT2 (V5:70.89±7.95,V10:50.94±8.71,V15:34.20±6.62) and 5IMRT3 (V5:70.26±7.94,V10:49.80±7.62,V15:34.60±5.40)increased V5,V10 and V15.There were also significant differences of R-lung V5.V10,V10,V20 and Dmean.All IMRT plans reduced V20,but increased Vs and V10.5IMRT1 did not increase V15 (23.67±5.73) and Dmean (923.49±182.34); 5IMRT2 did not increases V15 (26.72±±6.79) but increases Dmean (1060.34±205.02); 5IMRT3 increased both V15 (32.40±6.59) and Dmean (1100.54±197.84).Significant differences were found in Dmean,homogeneity index (HI) and conformity index (CI) of PTV,with the best Dmean of 5IMRT1 (6219.80±37.90),the second of 5IMRT3 (6268.91±56.26); the best HI of 5IMRT1 (0.0870±0.0219) and 5IMRT3 (0.0990±0.0219);the best CI of 5IRT2 (0.8682±0.0172) and 5IMRT3 (0.8667±0.0183).Conclusion 5-field IMRT plans have the advantages in the treatment of thoracic middle esophageal carcinoma with better HI,CI of target volume and sparing of lung (V20,V25 and V30) compared to 3D-CRT.5IMRT1 plan has the advantages in reducing low-dose volume (V5,V10,V15 and Dmean) of lung.

Objective To observe the therapeutic effects of muscle energy technique combined with joint mobilization on frozen shoulder.Methods Thirty-six patients with frozen shoulder were randomly assigned to:group A (treated with muscle energy technique plus joint mobilization),group B (treated with passive stretching with joint mobilization),and group C (treated with joint mobilization merely),and each had 12 patients.All the patients were treated accordingly for 3 times a week,totally for 4 weeks.The American Shoulder and Elbow Surgeons evaluation system (ASES) was adopted to evaluate clinical effects before and at the end of treatment.Results After 4 weeks of treatment,all patients' ASES scores were improved significantly (P ＜ 0.05).The improvement in the shoulder score index and shoulder range of motion were to a significantly better extent in group A than in the other two groups.Conclusion Muscle energy technique plus joint mobilization could effectively relieve pain increase the shoulder ROM and improve performance in activities of daily living in patients suffering from frozen shoulder.

Objective To compare clinical outcomes in cardiac transplant recipients treated with individualized dosing (ID) and fixed dosing (FD) of mycophenolate mofetil (MMF).Methods Fortyeight de novo cardiac transplant patients in ID group received MMF (2.0 g/day) in combination with calcineurin inhibitors and prednisone.The MMF dosages were adjusted individually based on clinical events and MPA trough levels (MPA-C0).The target range of C0 was maintained within 2.0-4.0rng/L.The FD group included 55 recipients retrospectively from the transplant database who were also treated with MMF (2.0 g/day).In this group,the MMF dose adjustment was performed empirically according to clinical events only.All of the follow-up data were collected up to 12 months post-transplantation.Results The follow-up rate was 95.8％ and the mean MPA-AUC0-12 was (54.37± 17.03) rng h-1 L-1 in the ID group.The mean MPA-C0 on the day 7 post-transplantation was significantly higher in the ID group than that at 12th month [(3.44 ± 0.58) mg/L vs.(2.79 ± 0.54)mg/L] (P＜0.05).The dose of MMF was significantly lower in the ID group at 4th week posttransplantation than in control group [(1.49± 0.48) g/day vs.(1.96 ± 0.39) g/d] (P＜0.05),while there was no significant difference at 12 th month post-transplantation [(1.61 ± 0.77) g/day vs.(1.68 ± 0.84) g/day] (P＞ 0.05).No significant difference was found in the incidence of acute rejection episode between two groups (8.7％ vs.9.1％,P＞0.05).57.6％ of overall side effects were observed within one month postoperatively,and the incidence of MPA-related side effects was significantly lower in the ID group than in the control group (47.8％ vs.67.3％,P＜0.05).Conclusion It was demonstrated that individualized use of MMF based on therapeutic drug monitoring may prevent MMF-related side effect and appears to be valuable to optimize the treatment of cardiac transplantation.

Objective:To investigate the reliability of a tool based on the International Classification of Functioning, Disability and Health (ICF) in the assessment of functioning despite disability.Methods:A total of 371 patients were assessed using a tool based on the ICF rehabilitation set combined with a numerical rating scale ranging from 0 to 10. The internal consistency, inter-rater reliability and intra-rater reliability were analyzed.Results:The scale′s Cronbach′s alpha coefficient was 0.89. The inter-rater correlation coefficient was 0.85, and the correlations among the items ranged from 0.78 to 0.94. The intra-rater correlation coefficient with the scale was 0.95, with the item correlations ranging from 0.72 to 0.97. Only item b230 Hearing function did not correlate well.Conclusions:The functioning assessment tool based on the ICF rehabilitation set when combined with a numerical rating scale has internal consistency, inter-rater reliability and intra-rater reliability sufficient for use in clinical practice.

Objective To analyze factors contributing to the quality of life of earthquake victims with nonunion fracture in limbs after medical rehabilitation and to provide a clinical reference for future disasters.Methods Thirty-one wounded who sustained their injuries in the Sichuan earthquake completed the short form-36(SF-36)questionnaire 2 weeks before their amputation,and after 3,6 and 12 months of medical rehabilitation.The SF-36scores were compared with Sichuan population norms.Stepwise multiple linear regression was used to highlight variables which influenced their functional recovery and their physical and mental health.Results The physical and mental health composite scores of the 31 victims were significantly lower than Sichuan population norms before medical rehabilitation,but they had a significant increasing trend after 3,6 and 12 months of treatment.Their scores on all the domains remained significantly lower than Sichuan population norms at a later follow-up.Smoking,external fixations and chronic diseases were related to their recovery of physical function.Age,permanent housing,family income and casualties among family members were related to their mental health recovery.Conclusion The quality of life of patients with nonunion fracture caused by earthquake can be improved significantly through medical rehabilitation.But social factors should be considered in addition to medical rehabilitation after an earthquake.

Objective To determine the effectiveness and medical cost-effectiveness of clinical rehabilitation for promoting the functional recovery of sub-acute cerebral infarction patients.Methods Totally 247 sub-acute patients with cerebral infarction were randomly divided into a clinical rehabilitation group of 129 and a routine rehabilitation group of 118.The clinical group received a standardized rehabilitation intervention and drug treatment,while the routine rehabilitation group received routine rehabilitation therapy and drug treatment.The Fugl-Meyer assessment (FMA) and the modified Barthel index (MBI) were used to compare the two groups after the treatment and 3 and 6 weeks later.The hospital cost for six weeks was also compared between the 2 groups.Results At 3 and 6 weeks,improvement in the average FMA and MBI scores was observed in both groups but the inter-group differences were not significant.The total hospital cost of the clinical group was,however,significantly less than that of the others.Conclusion Clinical rehabilitation can improve the motor function and ability in the activities of daily living of stroke patients.It also has economic benefits.

OBJECTIVE To investigate the distribution of integron in Gram-negative isolates which are causing nosocomial infection the association with drug resistance,and it′s contribution in horizontal transfer of drug resistance.METHODS Drug resistance test was performed by K-B method.ESBL-positive strains were detected by double-disk synergy test.Integron was determined by PCR assay with integron-specific-primer.Conjugative transfer test,plasmid profile analysis,nested-PCR,and DNA sequence analysis were used to investigate the transferable mechanism of integron mediated.RESULTS 66.4% of Strains were shown to be positive for classes Ⅰ integron,no class Ⅱ and Ⅲ integrons were detected.Profiles of class Ⅰ integron were 11 types,which sized from 700bp to 2300bp,gene cassettes included genes encoding resistance to aminoglycosides(aadA1,aadA2,aadA5 and aacA4),sulfamethoxazole/trimethoprim(dfrA12,dfrA5 and dfrA17) and chloramphenicol(catB8).Strains positive for class Ⅰ integron were highly related to multidrug resistance and ESBLs.Class Ⅰ integron could horizontal transfer along with plasmid among bacteria.CONCLUSIONS Class 1 integron is widespread in Gram-negative isolates which are causing nosocomial infection.Drug resistance is more liable to horizontal transfer via class Ⅰ integron along with plasmid.It implies the necessary for surveillance of horizontal transfer of antibiotic resistance gene among bacteria genus.

Objective:To explore the validity of a function assessing tool based on the International Classification of Functioning, Disability and Health′s (ICF′s) rehabilitation set in assessing aging-related disability.Methods:A total of 1610 elderly people from 15 nursing homes across China were assessed using the tool based on the ICF′s rehabilitation set and with the 12-item short form health survey (SF-12). The structural validity of the responses was analyzed using factor analysis, and criterion-related validity was also evaluated.Results:The factor analysis yielded three factors with eigenvalues greater than 1. Their cumulative explanatory power was 74.4%. Item d550 eating had double loading in the factor analysis. The item scores and the total scores of the disability assessment tool were significantly negatively correlated with the physiological function domain scores and the psychological function domain scores.Conclusion:The function assessment tool based on the ICF′s rehabilitation set when combined with a numerical rating scale has good structural and criterion-related validity in the assessment of disability due to aging.