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 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 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 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.

Twenty-seven patients with subclinical hyperthyroidism(SH)complicated by paroxysmal atrial fibrillation(PAF)were treated with methimazole plus bisoprolol.All patients were examined by Doppler echocardiogram and 24 h ambulatory electrocardiograms before and 3 months after treatment.Serum FT3,FT4,and TSH levels were measured with RIA.The results showed that low-dose methimazole therapy could improve the left ventricular diastolic function(P < 0.01)and help maintain sinus rhythm.The incidence of subclinical hypothyroidism was low.Low-dose methimazole was effective and safe in patients with SH complicated by PAF.

Objective To investigate the effect of edaravone plus beating-heart-preservation as well as beating-heart-transplantation technique on myocardial protection in donation after cardiac death (DCD) heart transplantation.Methods Twenty-four swine (body weight 28 ± 3 kg) were divided into two groups (n =12 each),and another twelve swine were used for blood donor.( 1 ) Experimental group:cardiac arrest was induced by asphyxiation (turning off the ventilation),and then the swine were subjected to 25-min warm ischemia,and cold oxygenated blood was perfused before the harvest of donor heart.Cardiac resuscitation was initiated by the ex vivo perfusion equipment and warm oxygenated blood was reperfused.Edaravone was given before harvesting of donor heart and in the early period of reperfusion.Donor hearts were kept beating throughout preservation and transplantation period.(2) Control group:all animals were treated in the same way except for without the application of edaravone.Hemodynamic,myocardial enzymes,and water content of myocardium were observed,and uhrastructural damage of cardiomyocytes was examined.Results All recipient animals could wean from cardiopulmonary bypass successfully.Left ventricular compliance and left ventricular contractility were significantly better preserved in experiment group than in control group.Though there was no significant difference in myocardial creatase level,the myocardial edema in experimental group was milder than in control group,and myocardial ultrastructure was better preserved in experimental group.Conclusion Heart from DCD,even though experienced 25-min warm ischemia after cardiac arrest by asphyxiation,still could be resuscitated via isolated heart perfusion equipment ( i.e.,beating-heart-preservation ) successfully.Furthermore,beating-hearttransplantation is feasible technically.Edaravone,a free-radical scavenger,could alleviate asphyxiation-induced myocardial injury,and further improve post-transplantation heart function.

Objective To investigate the method and efficacy in treating acetabular bone defects by the use of titanium wire mesh and impact bone allograft in revision total hip arthroplasty.Methods Twenty-two patients (22 hips) with acetabular bone defects in revision total hip arthroplasty were treated with wire mesh and impact bone allograft from January 2008 to December 2013.There were 7 males and 15 females in the present study.The average age of the patients at the surgery was 64.8 (37-78) years.According to Paprosky classification,there were 9 cases of type ⅡA,4 cases of ⅡB,7 cases of ⅡC and 2 cases of ⅢB.Twenty cases with aseptic loosen and 2 with periprosthetic infection were underwent revision surgery.Deep frozen cancellous bone allograft was sterilized and morselized to particles with the size of 7 to 10 mm.After removal of loosed acetabular component,the bone grafts were impacted into the acetabular defects area to restore the bone quantity.Titanium wire mesh with appropriate diameter was chosen to fix on impacted bone graft and fixed acetabulum with screws.Polyethylene cup was cemented in the mesh wire with proper position.Harris hip score system was used to evaluate the hip joint function.The AP pelvis X-ray was taken at 1 week,3 months,12 months and annually thereafter postoperatively to evaluate the rotation center,fusion of the bone graft and loosening of cup.Results All patients were followed up with the average period 5.1 years (3-7 years).The average Harris hip score before revision was 43.75±13.45,while the score was 85.33±7.84 at last follow-up (t=7.930,P=0.000).The average height of hip rotation center of surgical side was 3.49±0.77 cm before surgery,while its height at last follow-up was 2.22±0.22 cm (t=4.390,P=0.005).The distance between hip rotation center and the base of acetabulum was 3.54±0.45 cm before surgery,while its value was 3.52± 0.76 cm at last follow-up.All the bone grafts came to infusion with the average time 12 months (9-15 months).There was no case with cup migration more than 4 mm or rotation greater than 5° at last follow-up.One patient had the symptom of sciatic nerve injury.No case was with infection or dislocation.Conclusion In the treatment of acetabular bone defects,wire mesh and impact bone allograft with cemented cup in revision total hip arthroplasty can reconstruct hip rotation center and the acetabular bone quantity effectively.Satisfied early-midterm curative effects could be acquired by using this method.

Objective To compare the serum metal ion levels and host immunologic response of patients received non-modular,large-head metal-on-metal total hip arthroplasty (THA,Durom) with those received modular titanium acetabular component (Trilogy) using conventional head sizes and metal-on-highly cross-linked polyethylene articulations at mean 2-year follow-up interval.Methods A continuous series of 32 consecutive patients (32 hips) accepted THA with a Durom large head metal-on-metal articulation between January 2008 and December 2010 was as study group (Durom Group).From all the patients who received THA with Trilogy prosthesis at the same period,32 patients matched the Durom group in age,gender and body mass index (BMI) were chosen to form the Trilogy group.Another 32 healthy volunteers also matched the Durom group were chosen to form the control group.At the final follow-up,the serum metal ion levels,host immunologic response were evaluated.Results The mean follow-up time for Durom group was 24.9 months (range,15-34 months) compared to 25.53 months (range,15-48 months) for Trilogy group.Co and Cr levels in Durom group were 4.33 and 1.95 times as high as those in Trilogy group.There was no statistically significant difference in serum C3,C4,IgA,IgG,IgM value in three groups.CD3+,CD4+ and CD8+cells in Durom group decreased significantly compared with Trilogy and control groups.The interferon-γ(IFN-γ) level in Durom group was significantly higher than that in Trilogy and control groups.Conclusion The serum cobalt and chromium levels in patients received Durom metal-on-metal THA elevated significantly in early period.Meanwhile,some amount of impact on host cell mediated immunity occurred.