Objective To investigate the effect and safety of the recombinant tissue plasminogen activator ( rt-PA) combined with reduced glutathione ( RGSH ) in the treatment of acute ST-elevation myocardial infarction ( ASTEMI) .Methods 110 cases of ASTEMI were randomly divided into the control group and the observation group,55 cases in each group.The control group was intravenously injected 50mg rt-PA once a day,while the observa-tion group was injected 1200 mg RGSH freeze-dried powder once a day based on the control group .The vascular reca-nalization rate,the changes of myocardial enzymes ,cardiac structure and function parameters before and after treat-ment and adverse reactions in two groups were compared .Results The recanalization rate of the observation group and the control group reached 92.73%and 89.09% respectively,the difference between two groups was not signifi-cant (P>0.05).After treatment,the levels of CK,AST,cTnT,cTnI and CK-MB in the observation group were signifi-cantly lower than those of the control group (P<0.05),while the level of SOD was significantly higher than the con-trol group(P<0.05).The LVEDd and LVESd in the observation group were (52.24 ±5.83)mm and (39.95 ± 7.06)mm respectively,which were significantly lower than those in the control group (P <0.05),while the EF [(63.25 ±9.38)%] was significantly higher than that of the control group (P<0.05).The total adverse reaction rate in the observation group was 10.91%,which was significantly lower than 21.82% in the control group ( P<0.05).The reinfarction rate in the observation group was 3.63%,which was significantly lower than 12.73% in the control group(P<0.05).Conclusion The rt-PA routine thrombolysis therapy combined with RGSH could improve the recanalization rate and left ventricular structure and function of the ASTEMI patients and has less adverse reac -tion.The curative effect is better than single rt-PA.

Aim To investigate the in vivo effects of cilostazol,a novel phosphodiesterase III inhibitor,on signaling regulation,that is PPARs and NF-?B on vascular cell adhesion molecule-1(VCAM-1) in aorta of diabetic rats.Methods Diabetes was induced by intraperitoneally injecting fasted SD rats with streptozocin(STZ) at the dose of 65 mg? kg~(-1).32 diabetic rats were randomly divided into three groups,diabetes mellitus group(DM,n=12),high dosage of cilostazol group(GX,27 mg?kg~(-1)?d~(-1),n=10) and low dosage of cilostazol(DX,9 mg?kg~(-1)?d~(-1),n=10),plus normal control group(NC,n=8).After treatment for 8 weeks,using immunohistochemitry(IHC),in situ hybridyzation(ISH) and electrophoresis mobility shift assay(EMSA),we determined expression of VCAM-1,translocation of P65 subunit and activity of NF-?B in aorta tissues.PPAR? and PPAR? were examined by RT-PCR or Real-Time PCR.Results ①Compared with NC group,diabetic groups had elevated VCAM-1 expression of protein and mRNA(P

Objective To understand patients with gestational diabetes mellitus (GDM)in postpartum dia-betes incidence,and analyze risk factors of postpartum diabetes.Methods 144 cases with GDMwere selected as the research objects,according to the 5 year follow -up results,they were divided into the abnormal glucose tolerance group,diabetes group and normal blood glucose group,blood glucose during pregnancy,HbA1c,before the number of pregnancy,the changes of BMI and age were compared,the risk factors of postpartum diabetes was observed.Results Gestational diabetes mellitus patients 5 years postpartum diabetes morbidity rate was 25%,Postpartum diabetes gesta-tional fasting blood glucose(5.6 ±1.2)mmol/L and HbA1c(4.3 ±1.6)% were higher than those of the abnormal glucose tolerance group(6.6 ±1.3)mmol/L,(6.7 ±2.4)% and normal blood glucose group (7.3 ±1.2)mmol/L, (8.2 ±2.9)%.The difference among the three groups had statistical significance(P <0.001);HOMA -beta index (82.4 ±39.5)were lower than the other two groups(P =0.001),Pregnancy HbA1c(OR =6.37,P =0.001)and fasting blood glucose(OR =4.32,P =0.003)as well as previous pregnancies (OR =5.51,P =0.006)were inde-pendent predictors of postpartum diabetesindications.Conclusion Pregnancy HbA1c and fasting blood glucose level can determine the risk of gestational diabetes mellitus patients with postpartum diabetes;Have a family history of dia-betes and previous history of pregnancy patients.The risk of postpartum diabetes mellitus increase.

Objective:To investigate the effect of Operation Maps application on relieving anxiety of patients of the nurses of operation room preoperative visits. Methods:39 cases of operation were randomly divided into the application of operation maps 19 cases and routine visit group 20 cases, regular visiting group received routine preoperative interview content, and on the basis of content, the original application mapping group are visited by nurses carrying atlas album, and according to the related content the nurses explain to patients in the album when they introduce the patients the operating room environment surgery, surgical notes, position, etc. At the same time, the self rating anxiety scale measurement measures the anxiety of patients when they are admitted and after into operation room, and blood pressure, heart rate, pain intensity, the first time getting out of bed, exhaust time, clearing time, and they compare the difference. Results:The anxiety values of the original application mapping group mapping group, systolic blood pressure, heart rate are lower than regular visits group(t=2.28, t=4.756, t=10.28;P<0.05). Intensity of pain after operation in the two groups , get out of bed the first time, exhaust time showed no significant differences(t=3.04, t=3.06, t=2.56;P<0.01). Conclusion:Application of operation atlas of systematic, standardized preoperative visit is an important psychological guidance, and it can reduce the anxiety level of patients and effectively improve the quality of medical operation period.

Objective To explore the clinical effect of laparoscopic splenectomy caused by liver cirrhosis portal hypertension .Methods 38 patients treated with splenectomy as a result of hypersplenism induced by liver cir-rhosis portal hypertensions were selected .Laparotomy splenectomy was used in 18 cases ( OS group ) , laparoscopic splenectomy was used in 20 cases(LS group).Operation time , amount of bleeding during operation ,duration of hos-pital stays,liver and kidney function,blood routine,AYM were retrospectively analyzed.Results Compared with the preoperative group,LS ALT 2D after operation,postoperative 3~6d were significantly decreased(t=6.75,9.32,all P<0.05);3~6d AST levels after operation in LS group significantly decreased (t=8.87,P<0.05);LS group 2D after operation,postoperative 3~6d GGT levels were significantly lower than that of the preoperative (t=6.54,10.76, all P<0.05);group LS patients urea nitrogen levels falling postoperation ,there was statistically significant difference (t=3.43,P<0.05),leukocyte levels,PLT and HBG in the two groups increased postoperation ,these were statistical-ly significant difference(t=19.32,10.21,8.42,6.76,9.32,13.32,all P<0.05),OS group increased more obvious-ly.Conclusion LS has a better treatment effect on hypersplenism caused by liver cirrhosis ,which is worthy of popu-larization and application .

Short stature refers to the individual of the same race,gender and age,whose height is lower than the average height for about 2 standard deviations or under the 3rd percentile in the similar living environment.Its etiology mainly includes growth hormone deficiency,hypothyroidism,idiopathic short stature,Turner syndrome and so on.Short stature can be treated in childhood with recombinant human growth hormone (rhGH).Clinical evidence suggests that doctors should pay attention to thyroid hormone levels before and after rhGH therapy,so that they can offer thyroxine timely and maintain normal thyroid function for the children with hypothyroidism,which can improve the efficacy of rhGH in children with short stature.

Objective To study the maturation of the postural equilibrium in young children and the effects of eye-closure.Methods Altogether 214 healthy children age 4~15 were examined for upright postural equilibrium using a computerized equilibrium instrument(ST-939).With 20 healthy adults as control group,the velocity of postural sway was measured.Results ①Within the age-range of the children tested,postural sway decreased linearly with age.②Eye-closure had a remarkably effect on children's sway velocity in comparison with adult values before age eight.Conclusion Children's postural stability gradually maturates with the age.Young children may use visual information to control balance in a manner different from that of adults.It is not until after eight-year old that adults-like balance-control strategies begin to appear.

Objective To investigate the effect of lipoteichoic acid of bifidobacterium (BLTA) on the expressions of Fas/FasL in bearing melanoma B16 cancer mice. Methods Forty C57BL/6 mice were randomly divided into 4 groups (n=10),normal saline group (NS group),low-dose BLTA group (50 mg/L),middle-dose BLTA group (100 mg/L),and high-dose BLTA group (150 mg/L). Melanoma B16 cells (0.2 ml 5?109/L) were subcutaneously injected into the mice of the later 3 groups,and then,0.2 ml BLTA at corresponding doses was injected subcutaneously at the sites around the mass once a day for 10 d when the tumor (at least 2 mm?2 mm) was palpable. The NS group was given normal saline at same volume as in BLTA group. The changes of the killing activity of CTL was examined by MTT assay. The expression of the tumor-infiltrating CD4+ and CD8+ lymphocytes in tumor tissue were detected by immunohistochemistry. RT-PCR was used to detect the mRNA expression variance of the Fas and FasL in tumor and spleen tissue. The protein expression of Fas,FasL in tumor tissue and lymphocytes of spleen were detected by immunohistochemistry and Western blotting. Results Compared with the control group,BLTA significantly improved the CTL killing activity (P0.05). Conclusion BLTA enhances the killing activity of CTL by regulating Fas/FasL system,and thus,promotes apoptosis of tumor cells to suppress tumor immune escape in tumor-bearing mice,thereby it exerts anti-tumor effect further.

Afatinib is an irreversible inhibitor for the ErbB family of tyrosine kinases with oral administration. In two randomized, open-label and multinational phase III trials, the progression-free survival was significantly prolonged by afatinib compared with peme-trexed plus cisplatin (LUX-Lung 3) or gemcitabine plus cisplatin (LUX-Lung 6) in the treatment-naive patients with advanced non-small cell lung cancer ( NSCLC) with activating EGFR mutations. The patient-reported symptoms such as cough and dyspnoea, and certain health-related quality of life after the treatment by afatinib were also better than those treated by control dugs. Afatinib was ap-proved by FDA in July 2013 as the first-line treatment drug for the patients with metastatic NSCLC with EGFR exon 19 deletions or exon 21 (L858R) mutations. The action mechanisms, pharmacokinetics, clinical trials and adverse events were reviewed in this paper.

Objectives: To study the clinical meaning of condyle-form asymmetry and its osseous changes shown on TMJ images of lateral oblique transcranial projection and lateral tomography. Methods: 113 patients with partial posterior teeth lose were enroled in the study.Among them 25 were with temporomandibular disorder (TMD group),39 with slight TMD sings (sub-TMD group) and 45 without TMD(TMD-free group). Radiographs were taken and studied for each patient. Results: It was found that the condyle form asymmetry and osseous changes were not significantly different among the three groups. Osseous change was related to the number of teeth-lose (P0.05). The symptoms and signs of TMD had close relationship with occlusal interferences. Conclusions: The changes shown on TMJ images do not show close relationship with TMD symptoms and signs. Occlusal interferences resulted from teeth-lose are related to the clinical symptoms and signs of TMD.