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 explore the clinical efficacy and safety of closed negative pressure drainage(VSD) in the treatment of elderly patients with abdominal trauma and infection.Methods 82 elderly patients with abdominal trauma and infection were selected into clinical research,they were divided into two groups according to the treatment time number.41 cases of odd numbers were in the control group,they were given conventional dressing change and antibiotic therapy.41 cases of double numbers were in the observation group,they were given VSD therapy and antibiotic therapy.The clinical efficacy and safety after treatment was evaluated.Results The daily volume of the observation group [(48.67 ± 3.87) mL] was significantly increased compared with the control group,the dressing times [(8.59 ±1.04) times],hospitalization time [(18.33 ± 1.50) d] were significantly reduced compared with the control group,the differences were statistically significant(t =8.56,7.88,6.74,all P ＜ 0.05).The VAS score after treatment of the observation group was (3.38 ± 0.51)points,which was significantly lower than those before treatment and of the control group,the difference was statistically significant (t =8.06,7.56,all P ＜ 0.05).The infection control rate of the observation group was 92.68％,which was higher than that of control group,and the incidence of adverse reactions of the observation group was 4.88％,which was lower than that of the control group,the differences were statistically significant(x2 =6.87,7.69,all P ＜ 0.05).Conclusion The effect of vacuum sealing drainage technique in the treatment of elderly abdominal trauma and wound infection is significantly,it can effectively control the infection,reduce the number of dressing,relieve the pain of patients,and has the advantages of simple operation,high safety,which is suitable for promotion and application.

0 05). Conclusions Serum ? hCG could reflect the degree of functional imbalance of the placental trophoblasts on PIH and it may be used as a clinical detecting index of PIH. On the other hand, HPL is not such a useful factor.

Objective To investigate the effect of transabdominal gastroesophageal stapling in management of variceal bleeding in portal hypertension with Hassabi operation and sum up our clinical experience.Methods Retrospective analysis of 48 cases with portal hypertension operated by transabdominal gastroesophageal stapling between May,1998 and Oct.2005.The elimination of oesophagus venous、the rebleeding rate、the operation mortality、the stricture and the fistula rate and the index that influences the liver function were maily observed.Results No case suffered rebleeding and hepatal encephalopathy during the hospitaligation of the patients.Esophageal varices disappeared or reduced in all cases.One case resulted from stricture and one case died of multiple organ failure.Conclusions Transabdominal extensive oesophagogastric devascularization combined with gastrooesophageal stapling is an effective and safe procedure for control of acute variceal haemorrhage with satisfactory short-term control,but the long-term effect needs to be long follow-up for the patients.

OBJECTIVE:To understand the drug use of sample hospitals,and to provide reference for drug production,man-agement and service department. METHODS:Statistical analysis was conducted in the data of drug use in national 1 248 sample hos-pitals during 4th quarter of 2012-3rd quarter of 2013. RESULTS&CONCLUSIONS:Anti-infection medicine,Chinese patent medi-cine,nervous system drugs has being ranked the top 3 in the list of consumption sum,and that of various drugs is in an upward trend. Top 20 drugs in the list of consumption sum mainly are biological products,drugs for the nervous system,digestive system drugs;that of human albumin and deproteinized calf serum have increased greatly. Top 10 imported pharmaceutical enterprises or joint ventures in the list of consumption sum mainly are multinational enterprises,and they are stable in ranking. The development of pharmaceutical enterprises should focus on brand,quality,price and service,etc.,so that their competitiveness can be improved.

Objective To investigate the mRNA expression of secondary lymphoid tissue chemokine (SLC) in human gastric carcinoma. Method The study was designed to investigate semi-quantitatively the expression of SLC mRNA in gastric carcinoma and metastatic lymph nodes by reverse transcription-polymerase chain reaction.Result The expression of SLC mRNA in the gastric cancer tissues was markedly reduced compared with that in adjacent noncancer tissues. The average tumor/normal (T/N) ratio determined by RT-PCR was 0.43?0.08 in 29 patients.Metastatic lymph node/normal ratio was 0.63?0.07.Negative lymph node/normal ratio was 1.19?0.11. As a control,the mean G3PDH T/N ratio was 1.16?0.06,there was no correlation between SLC mRNA expression and clinicopathological characteristics in gastric cancer.ConclusionSLC mRNA expression is suppressed in the gastric tumours. SLC may play an important role in the early stage of carcinogenesis.

Objective To assess the value of chest computer tomography (CT) and serum tumor marker in lung cancer screening among health check-up populations.Methods A total of 88 596 adults who had a medical check-up (including chest CT,chest DR,and tumor biomarkers test) in our center were enrolled in this investigation.Clinical diagnosis of lung cancer was confirmed by three professional doctors.Receiver operating characteristic (ROC) curve was used to assess the relationship between serum level of tumor biomarkers and lung cancer.Results The average detection rate of lung cancer was 59.8/100 000 in our center during 2007 and 2011 (men 42.9/100 000,women 92.2/100 000).Rate of positive results of chest CT was 94.3％,which was approximately 2 times of chest DR.Moreover,carcinoembryonic antigen (CEA) testing was effective in early diagnosis of lung cancer with higher sensitivity (73.6％) and specificity (57.1％).Conclusion This study suggests that health checkup centers should pay more attention to lung cancer screening in high risk populations,and new technologies might be used to facilitate the early diagnosis of lung cancer.

OBJECTIVE:To promote rational drug use and improve medical quality.METHODS:A comprehensive analysis was performed on the contents of drug counseling problems presented by 483 patients and medical staff.RESULTS:The use of cardio-cerebral-vascular drugs,anti-bacterial drugs and digestive system drugs were the most common drugs inquired by patients,and their questions focused on the action and clinical use,adverse reactions,administration and dosage etc of drugs.However,anti-bacterial drugs were the leading drugs inquired by medical staff,and their questions focused on drugs available for choice and combined use of drugs etc.CONCLUSIONS:Drug counseling can help promote rational drug use,improve medical quality and patients' awareness toward medical care,besides,it is conducive to the publicity for hospital pharmacists.

AIM: To establish a quantitative method of determining thymol and carvacrol in Shushi Ganmao Ling(dripping pill)(Herba Moslae,Herba Artemisiae Annuae,Radix Scutellariae,etc.). METHODS: The GC method was used with HP-17 quartz capillary column(HP 50% PhMe Silicone,10 m?0.25 mm?0.25 ?m).The initial temperature of chromatographic column was at 130 ℃ for 14 min,then elevated to 220 ℃ with the rate of 20 ℃/min,and retention for 36 min. RESULTS: The linearities of thymol and carvacrol were respective in the range of 12.51 ?g/mL-125.1 ?g/mL(r=0.999 8) and 21.52 ?g/mL~215.2 ?g/mL(r=0.999 7).The average recoveries were 97.9%(RSD was 1.69%) and 100.6%(RSD was 2.27%).RSD of repeatability were 1.88% and 1.60%,respectively. CONCLUSION: The method is reliable,accurate and specific.It can be used for quality control of Shushi Ganmao Ling(dripping Pill).

Objective To study the synthesis and degradation of collagen at the transcription level during liver fibrosis in rabbits with schistosomiasis japonica. Methods New Zealand rabbits infected with Schistosoma japonicum cercariae were served as animal models of liver fibrosis. The liver specimens were collected through operations at 4, 6, 8, 10, 12, 16, 20, 24 and 28 weeks after infection. TypeⅠcollagen, type Ⅲ collagen, type Ⅳ collagen, MMP\|1 and MMP\|9 mRNA levels of liver tissue were detected by RT\|PCR plus dot blotting, and the size of egg granulomas and the degree of liver fibrosis were measured by histopathological examinations. Results TypeⅠcollagen, type Ⅲ collagen, type Ⅳ collagen, MMP\|1 and MMP\|9 mRNA levels increased simultaneously in the early stage after the infection, mostly reaching their peaks at 10 weeks after infection. Compared with normal controls, type Ⅰ collagen, type Ⅲ collagen, type Ⅳ collagen, MMP\|1 and MMP\|9 mRNA levels increased by 12\^0 , 11\^0 , 6\^6 , 10\^0 and 11\^0\|fold, respectively, coinciding with the changes of egg granulomas. Thereafter, both collagen and collagenase mRNA levels decreased. TypesⅠ, Ⅲ and Ⅳ collagen mRNA levels declined to 2\|fold to 3\|fold compared with normal controls ( P 0\^05) at 28 weeks. This study showed that the synthesis and degradation of collagen remained dynamic balance in the early stage of schistosomiasis, while in the later stage the metabolism of collagen synthesis was higher than that of collagen degradation. Conclusion It was confirmed at the transcription level that when the metabolism of collagen synthesis was higher than that of collagen degradation in rabbits with schistosomiasis japonica, liver fibrosis might be produced.