Objective A meta-analysis of clinical trials of prehospital thrombolysis versus in-hospital thrombolysis or PCI for acute myocardia infarction (AMI). Method We collected the literature on prehospital thrombolysis for AMI published at home and abroad from January 1989 to April 2009. Recanalization rate of infarct-related arter, complication incidence and mortality ( ＜ 30 d) were regarded as result indicators. Software RevMan 4.2.8 was used to process meta-analysis. Results There were only 27 literatures selected. Prehospital thrombolysis was associated with higher recanalization rate of infarct-related arter[OR 2.67,95%CI(1.86 ～ 3.85);P ＜0.01] and lower mortality ( ＜ 30 d ) [OR 0.71,95%CI(0.64 ～ 0.78); P ＜ 0.01] than in-hospital thrombolysis. There was no significant difference in complications between them. Compared with PCI, prehospital thrombolysis was associated with higher complication incidence [OR 2.91,95% CI ( 1.26 ～ 3.80); P = O.005]. There was no significant statistical difference of mortality ( ＜30 d ),but the sensitivity analysis was not good. Conchusions The effect and prognosis of prehospital thrombolytic are superior to that of in-hospital thrombolysis,and the same with PCI,but prehospital thrombolytic has higher incidences of complications,and the sensitivity is not good.

To investigate the protective effects and possible mechanism of Mycelium of Hirsutella hepiali Chen et Shen (MHCS) on metabolic syndromes, free fatty acid and MHCS-treated hepatocytes were used for detecting autophagy-related LC3, p62 and lipid accumulation. Moreover, high fat diet fed mice were used to establish metabolic syndromes model. 50-weeks age mice were randomly divided into: control group, model group and MHCS group. At 80-weeks age, 15 mice were randomly chosen from each group separately for examining oral glucose tolerance, serum insulin, insulin-like growth factor 1 (IGF-1), hepatic LC3, p62, p-NF-kappaB p65, NF-kappaB p65, IL-6 and CXCL-8. Moreover, insulin resistance index (IRI) was calculated. Hepatic pathological changes, including vacuoles, lipids accumulation and fibrosis were observed. Remaining mice were fed with diet separately to 110 weeks-age for statistics of mortality. MHCS promoted autophagy of free fatty acid treated hepatocytes. Mice fed with high fat plus MHCS diet exhibited improved oral glucose tolerance, insulin resistance, hepatic pathology, inflammation, mortality and activated autophagy. The protective effects of MHCS against metabolic syndroms might be through the activation of hepatic autophagy.

Objective To explore the effect of drug injection in muscle motor points on children with spastic cerebral palsy. Methods 230 children with spastic cerebral palsy were divided into control group and observation group, with 115 cases in each group. The control group received comprehensive rehabilitation including functional training, physical therapy and medicine, while the observation group received injection of vitamin B1 and vitamin B12 in muscle motor points in addition. They were assessed with Gross Motor Function Measure (GMFM), modified Ashworth Scale (MAS), mental development index (MDI) and psychomoter developmental index (PDI) of CDCC Infant Me Ntal Development Scale. Results The gross motor function improved, MAS score decreased, the scores of MDI and PDI increased after treatment (P<0.01) in both groups, which were better in the observation group than in the control group (P<0.05). Conclusion Drug injection in muscle motor points can improve the gross motor function, relieve spasm, and improve intelligence development of children with spastic cerebral palsy.

Objective To investigate the expression and clinical significance of lactate dehydrogenase A (LDHA) in breast cancer.Methods Tissue samples of 76 breast cancers and corresponding paired adjacent normal tissues were collected and made into tissue micrcarrays (TMAs).Immunohistochemistry (IHC) analysis was performed to detect the expression of LDHA and further analyzed the correlation of LDHA expression and clinicopathological variables and prognosis of breast cancers.Results LDHA was frequently upregulated in breast cancer tissues compared to the normal breast tissues (P ＜ 0.05).High LDHA expression was associated with distant metastasis (P ＜ 0.05) and worse patient prognosis (P ＜ 0.05).Conclusions LDHA is closely related to the occurrence and clinical progress of breast cancers.LDHA might be a potential novel molecular marker for diagnosis,prognosis and therapy in breast cancers.

Integrity education is not only one of an important aspect of moral education topics for Medical postgraduates,but also an objective requirement in the socialist market economy.Aiming at the modern medical postgraduates'lack of credibility,this paper mainly analyzes its causes such as the limitation of postgraduates'quality and the pressure of employment and dis-cusses how to strengthen integrity education for postgraduate in medical university by bringing supervisors'leading role,enhance the standardized management of employment and upbuilding credibility file etc.

Objective To evaluate the effectiveness and safety of long-pulsed laser for hair removal in different colour of skin. Methods Hair removal was performed in 607 hirsute patients with two long-pulsed lasers. Results Although the effectiveness rates of hair removal in upper lip and full bread were not different, their complications were different by using two long-pulsed lasers. Also there were signifi-cant decreases of effectiveness and complication in the lighter skin and thc darker skin (P<0.01). Con-clusion The 755 nm wavelength has more effectiveness and lower complication in the lighter skin. How-ever, the 1 064 nm wavelength has more effectiveness and lower complication in the darker skin.

Objective To explore the anatomical basis for clinical application of the compound flap pedicled with arterial arch of palpebral margin by observing eyelid blood supply and anatomical structure and to prove that it is an ideal method of repairing the eyelid defect for clinical application. Methods 15 adult cadavers (30 eyelids) were dissected. The origin, course, branches, diameters and vessel networks of palpebral margin arterial arch were observed particularly. 30 cases of eyelid marginal defect were reviewed and the therapeutic effect of this method evaluated. Results Eyelid was constituted by 5 layers: skin, subcutaneous tissue, muscle, tarsal plate and conjunctival layers. Most eyelid vessels were mutually anastomosed to form a constant vessel network. Palpebral margin arterial arch and peripheral arterial arch were formed by dorsal nasal artery branches and lacrimal artery branches, both of which nourished the eyelid tissue. All the compound flaps of 30 cases survived completely without any complications. All cases obtained satisfactory results functionally and esthetically. Conclusions The arterial arch of palpebral margin is constant and the blood supply of the compound flap is reliable. It can repair full eyelid defect with the same kind of tissue, and obtain satisfactory appearance. It is an ideal method of repairing the eyelid defect.

Aim To investigate the effects of cell pro-liferation and activation in HSC-T6 cells by inhibiting the expression of EZH2 , and its partial relevant mech-anism. Methods By introducing the inhibitor DZNep in activated HSC-T6 cells stimulated by TGF-β1 , the protein expression levels of EZH2, p-ERK, p-AKT andα-SMA were detected by Western blot. The siRNA targeting EZH2 was designed and synthesized according to its nucleotide sequence, and their corresponding ex-pression vectors were constructed and transfected into HSC-T6 cells with LipofectamineTM 2000. The prolifer-ation of HSC-T6 cells was determined by MTT. And the protein expression levels of EZH2, p-ERK, p-AKT and α-SMA were measured by Western blot. Results By introducing the inhibitor DZNep in activated HSC-T6 cells stimulated by TGF-β1 , it effectively de-creased the protein levels of EZH2 and also the protein levels of p-ERK, p-AKT and α-SMA. By introducing EZH2-siRNA in activated HSC-T6 cells, it effectively inhibited the cell proliferation, and also the protein levels of EZH2, p-ERK, p-AKT andα-SMA. Conclu-sion Silencing EZH2 expression inhibits HSC-T6 cell proliferation and activation, and EZH2 may be a poten-tial therapeutic target gene for hepatic fibrosis.

Objective To investigate the application of the three-dimensional reconstruction for the random flap.Methods The bones,muscles,fascia,skin and vessels in eleven patents were reconstructed by the MIMICS 10.01 CT angiography (CTA) scanning,and the single artery and its branches were gained by the subdivision of the vessels.3D-images were shown respectively and jointly.Results Arterial reconstruction images were clearly displayed by 3D workstation CTA and if they were combined with the original cross-sectional images and vessel analysis software,they were able to accurately evaluate the location,range,degree of artery,the distal outflow tract.The vessels and soft tissue displayed in the software could show detailed distribution of the vessels in one region and this could provide the accurate anatomical basis for the random flap and the design of the operation.This method could easily meet the preoperative design demands and also had the guiding significance for postoperative evaluation.Conclusions The method of 3D-reconstruction is very good for studying the random flap and the design of the operation.

Objective To study the function of hypoxia mimics of different exposure time of deferasirox in improving the growth of micrangium in a narrow pedicle flap.Methods Fourty male SD rats were divided into 2 groups:experimental group was fed with deferasirox 100 mg/kg per day from 1d,3d,5d and 7d,respectively,before the surgery of transferring the narrow pedicle flap,while control group just fed with saline.After 7 days,the immunohistochemistry,Western blot and quantitative reverse transcription-PCR (qPCR) were performed to examine the expression of CD34.qPCR was used to examine the expression of HIF-1α,VEGF in order to investigate the regulatory effect of deferasirox in improving the growth of micrangium and the distinction among the different exposed time of deferasirox in the narrow pedicle flap.Results The deferasirox group exhibited a marked improvement in flap healing time,and with the increasing administration time of deferasirox,the expression of MVD,HIF-1α and VEGF was improved in each treated group (P＜0.05).Conclusions Deferasirox can induce HIF-1α secretion and increase CD34 expression,and so deferasirox can protect endothelial cells from hypoxic and ischaemic injury.