Objective To investigate the effect of intravenous thrombolytic therapy with urokinase on the neurological function and the concentration of serum matrix metalloproteinase 9 (MMP-9) in the patients with acute cerebral infarction.Methods The patients with acute cerebral infarction were divided into the experimental and control groups.The experimental group included 27 patients who were complied with thrombolytic criterion within 4.5 hours after stroke and were firstly treated by intravenous thrombolytic therapy with urokinase by 100 million units after 24 h and 300 mg aspirin by oral.The control group included 27 cases that were directly administrated by 300 mg aspirin 4.5 hours later after stroke.After 24 h,the two groups were administrated with other same conventional treatments such as neurotrophy,improvement of microcirculation,and control of blood-fat.The neurological function and dynamic concentration of serum MMP-9 were observed before treatment and after treatment.Results After treatment,the neurological deficit evaluation score in both groups was gradually reduced with the treatment time,and the neurological deficit evaluation score in the experimental group was significantly lower than that in the control group at the 1 st,3rd,and 14th day,respectively[(10.97 ± 1.53) Score vs (15.67 ±1.78)Score,t =8.35,P =0.03;(8.15 ± 1.40) Score vs(12.72 ± 3.31) Score,t =6.62,P =0.03; (5.87 ± 1.03) Score vs (11.92 ±2.05) Score,t =13.70,P =0.01].After treatment,the concentration of serum MMP-9 in both groups was reduced with the treatment time,and serum MMP-9 in the experimental group was significantly lower than that in the control group at the 1st,3rd,and 14th day,respectively[(282.84 ±37.51) ng/ml vs (316.90±36.75)ng/ml,t =3.37,P =0.00;(309.11±37.71)ng/mlvs (348.39 ±15.26) ng/ml,t =5.02,P=0.04;(264.68±31.91)ng/ml vs (302.81 ±36.30)ng/ml,t =4.10,P =0.03].Conclusions Intravenous thrombolytic therapy with urokinase can effectively reduce the neurological deficit and the produce of MMP-9 in patients with acute cerebral infarction.

BACKGROUND:Traumatic auricle defectsin upper 1/2 or lower 1/2,seriously involve theauricular cartilage and skin blood vessels. The autogenic rib cartilage graft and acelular dermal matrix have good histocompatibility, and expanded flapis a kind of thin and achromatic tissue for skin defect repair. OBJECTIVE:To explore theapplication ofacelular dermal matrix and expanded flap in half auricular reconstruction,and to find out the fine carving and anastomosis of autogenic rib cartilage graftas wel as its similarities with the ear and clinical significance. METHODS:Eight cases of half auricular defects were treated with expanded flap, autogenic rib cartilage graft, fine anastomosisofautogenic rib cartilage graft and residual earfor half auricular reconstruction,during which theacelular dermal matrixwas usedto promote residual ear docking and skul auricle angle formation. The reconstructionwasperformed in three stages:first,anexpander(volume, 80mL)wassubcutaneously implanted attheretro-auricular area;second, the auricular defects were reconstructed with fine rib cartilage graft, acelular dermal matrix and auriculoplasty;finaly, acelular dermal matrixwas usedto promote residual ear docking. Thenthehalf auricular reconstructionwas evaluatedby objective measurement and subjective rating. RESULTS AND CONCLUSION:Half auricular reconstruction was successful in al the eight caseswithout obvious complications, and the cartilage grafts were in good condition.During thefolow-up,thereconstructed auriclewasshapedwel andformed a good involution withtheresidualauricle. In addition, the flange was smooth withoutobviouscolor difference and edema, and its position, size and shape were consistent with those of thecontralateralone. Afterthefolow-up of 6 months, objective indicators showed that the affected side had no significant differencefromthe contralateralone(P> 0.05). In conclusion,theacelular dermal matrixcanobviously decrease the complications of the cartilage grafts andcontributeto agood shaped auricle;and half auricular reconstructionby expanded flap, autogenic rib cartilage graft,andfine anastomosis of autogenic rib cartilage graftcanachieve significant clinical effects.

BACKGROUND:At present, the common filing materials used to correct secondary unilateral cleft lip nasal deformity include conchae cartilage, costal cartilage, Medpor implants, expanded polytetrafluoroethylene (ePTFE), alogenic acelular dermal matrix. OBJECTIVE:To analyze the therapeutic effects of comprehensive procedures with alogenic acelular dermal matrix or ePTFE for secondary unilateral cleft lip nasal deformity. METHODS: Thirty-six patients with secondary unilateral cleft lip nasal deformity were enroled, including 19 males and 17 females, aged 15-32 years. Alogenic acelular dermal matrix (n=22) or ePTFE (n=14) was used to correct nasal base colapse deformities. Anthropometry method was employed to make measurements. Fixed-point measurement was performed based on patient's pictures before and after correction. Long-term effects of these two kinds of filing materials were analyzed and assessed objectively and quantitatively. RESULTS AND CONCLUSION: After the folow-up of 6 months, al the patients were satisfied with their results, and no infection and no exposure occurred. The treatment effect of the alogenic acelular dermal matrix group was excelent in 16 cases and good in 6 cases; there were 10 cases of excelent and 4 cases of good in the ePTFE group. The objective indicators in the two groups were al improved at 6 months after correction (P < 0.05), but there was no difference between the two groups (P > 0.05). These findings indicate that alogenic acelular dermal matrix or ePTFE is useful to correct secondary unilateral cleft lip nasal deformity.

Bacillus amyloliquefaciensin can cause infections and the building related ill-health syndrome among newborns, infants and other immunocompromised populations by polluting hospital disinfectants, such as alcohol 75%, moisture housing and food. In this article, we reviewed the prevalence of Bacillus amyloliquefaciens in environment, food and intrahospital infection, the toxicology by describing its toxicity in mammalian cells, the physicoehemical characteristics by analyzing its special structure of bacterial spores. Its pathogenicity through animal model of disease was discussed as well.(J Glin Pediatr,2010,28(2) :190-192)

Objective To evaluate the safety and efficacy of carbon dioxide (CO2) used as an alternative to air in the gastric endoscopic submucosal dissection (ESD). Methods 80 cases underwent ESD treatment were randomly as-signed to two groups, 40 cases in CO2 group and 40 in air group. Arterial blood CO2 partial pressure was measured preoperative, intraoperative and postoperative respectively. Visual analog scale (VAS) was used to record patients the degree of abdominal pain and distention at 1 h, 6 h and 24 h after operation in each group. The incidence of com-plications were evaluated. Regular follow up were scheduled in all the patients. Results There was no significant dif-ference in degree of abdominal pain score and the CO2 partial pressure between the two groups. The abdominal dis-tension scores of CO2 group were significant lower than air group at 1 h, 6 h after the ESD procedure. There were no statistically significant difference in the incidence rate of complications. Conclusion The utilization of CO2 in gas in-sufflation during gastric ESD is safe. CO2 insufflation can significant reduce the postoperative abdominal distension and improve the quality of postoperative recovery.

Objective To assess the peripheral arterial structural and elastic remodeling in patients with lower extremity atherosclerotic disease (LEAD).Methods Thirty-one patients with LEAD and 34 age-,sex-matched healthy subjects (control group) were enrolled in this study.The intima-media thickness (IMT),diameter (D) and parameters of arterial stiffness (β,pulse wave velocity (PWVβ)) were measured by acquiring the longitudinal view of left and right common femoral artery (LCFA,RCFA) and common carotid artery (LCCA,RCCA) by quality intima-media thickness (QIMT) and quality arterial stiffness (QAS) techniques.The factors correlated with arterial stiffness in LEAD patients were analyzed.Results ① The systolic blood pressure(SBP),pulse pressure(PP),smoking pack-year and smoking extent (nonsmoker,smoker with ＜40 pack-year,or smoker with ≥40 pack-year) were significantly higher in LEAD group than those in the control group (P ＜0.05).②IMT of the LCCA and the diameters (D) of LCCA and RCCA were significantly increased in the LEAD group (P ＜0.05-0.01).As to the both sides CFA,IMT and IMT/D values were significantly increased (P ＜ 0.01).The mean IMT (mIMT) of both sides of CCA and CFA were increased (P ＜0.05).The values of β,PWVβ of LCCA and PWVβ of RCCA were significantly increased,and β and PWVβ values of both sides of CFA were significantly increased in the LEAD group (P ＜ 0.05).There was a positive correlation between the stiffness indexes of the carotid artery and that of the femoral artery (P ＜0.01).③The femoral mβ was correlated with femoral mIMT,SBP,PP,smoking amount and smoking extent,and the femoral mPWVβ was also correlated with mIMT,age,SBP,PP,smoking pack-year and smoking extent (P ＜0.05-0.01).In multivariable stepwise regression analysis,mIMT and PP were factors independently correlated with femoral mβ.And SBP,smoking extent,and mIMT were independently correlated with femoral mPWVβ.Conclusions Peripheral arteries in patients with LEAD experience vascular remodeling,as well as increased carotid and femoral stiffness.Femoral stiffness is correlated with IMT,arterial blood pressure and smoking extent.

Objective To investigate therapeutic autcomes of using telomerase inhibitors to treat cancer at the presumably most and least opportune circadian stages basing on our earlier study. Methods Twenty-four BALB/C nude mice were synchronized to a regimen of LD12:12 for 4 wk. Hepatic cancer cells (SMMC-7721) were implanted into both flanks of each mouse.Two weeks after transplantation,the hTERT-5'RZ was used to treat the hepatic cancer transplanted into the nude mice daily for two weeks,the injection times being either 9 or 21 HALO.Results The tumorinhibition ratio of mice treated at 21 HALO (65%) was statistically significantly higher than that of mice treated at 9 HALO (48%). Telomerase activity was also reduced to a greater extent in mice treated withhTERT-5'RZ at 21 than at 9 HALO, that was at the time of maximal circadian telomerase activity. Conclusion Injection of ribozyme targeted to telomerase during the tumor's DNA synthesis is associated with a betterinhibition of tumor growth and a better therapeutic outcome in hepaticcancer.

Objective We tried to explore the puerperal women's nature demand for management of health quotient,so as to provide theoretical basis for the health quotient management mode of puerperal women.Methods The phenomenological methodology was used in the research.Data of fifteen puerperal women were collected by semi-structured interview and analyzed by Colaizzi method.Results Four themes were summarized:health consciousness,health needs,in-hospital education status,social support needs.Conclusions The health quotient management of puerperal women is feasible.Therefore,the health quotient management model of maternal dominance and medical staff,family,peer support will be one of the maternal and infant health care research.

Objective To analyze the treatment and prognosis of patients with gestational trophoblastic neoplasia with urinary system and adrenal glands metastasis.Methods The treatment and prognoses of 32 patients with gestational trophoblastic neoplasia with urinary system and adrenal glands metastasis from Dec.1990 to Dec.2010 at Peking Union Medical College Hospital,Chinese Academy of Medical Sciences were respectively reviewed.Results Treatment methods:all 32 patients received 9 courses(in average) of a multi-drug chemotherapy in our hospital (range 1-24 coures).Among them,3 patients with bladder metastasis received intravesical chemotherapy of fluorouracil.9 patients received surgical treatments in other hospital and 15 patients received surgical treatments while undergoing chemotherapy in our hospital.Treatment results:after the treatments,of the 32 patients,21 (66％) patients achieved complete remission,3(9％) exhibited partial remission and 8 (25％) progressed.Seven patients with renal metastasis achieved complete remission.Two patients with adrenal glands metastasis achieved complete remission.Nine patients with urinary bladder metastasis achieved complete remission.Seven patients with ureters metastasis achieved complete remission.Two (10％) of 21 patients with complete remission relapsed.Conclusions Multidrug and muhiroute chemotherapy is the main strategy for patients with gestational trophoblastic neoplasia with urinary system and adrenal glands metastasis.The prognoses of patients with renal or adrenal glands metastasis are much worse than those in patients with bladder and ureters metastasis because of concomitant multiogran metastasis.Adequate attention should be given to patients with renal or adrenal glands metastasis.Individual treatment,assisted by surgery when necessary,may be carried out for these patients to achieve a better outcome.

0.05). After dividing the patients into early-onset and late-onset subgroups, there were significant differences of DRD4 genotype and allele frequency between early-onset patients and controls (P0.05). Conclusion The results suggested that the polymorphism of DRD4 receptor gene may be associated with early-onset OCD. The 3/4 genetype may be the risk factor of early-onset OCD. Early-onset and late-onset OCD may have different etiology.