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.

Sauropunol A-D potentially with anti-inflammatory,anti-bacterial activities were recently isolated from traditional Chinese medicinal plant Sauropus rostratus.Herein,we report the total synthesis of sauropunol (A-D) starting from a commercially available 2-deoxy-D-arabino-hexopyranose.The trifluoromethane sulfonation of intermediates could simultaneously trigger intramolecular cyclization to afford 3,6-anhydro hexofuranoside scaffold.The following deprotection reaction could produce sauropunol A,B and C/D with total yields of 21％,5％,and 17％ (isomer sauropunol C/D),respectively.Structures of the target compounds were confirmed by comparison with NMR spectroscopic properties of those previously reported.

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.

Based on the released statistics from 1980 to 2009,this article summarized the scientific research awards gained by Xi' An health-related organizations. The analysis was mainly focused on the achievements of subordinate organizations of the city Health Bureau.In the end,the author discussed about the awards in aspects of quantity,level,institution,descipline,specialty and talents.

ObjectiveTo evaluate the correlation between serum anti-Jo-1 antibody level and myositis disease activity in polymyositis/dermatomyositis.MethodsAnti-Jo-1 antibody levels in serum from 148 polymyositis/dermatomyositis patients and 130 healthy controls were measured by both ELISA and immunoblot assay.Disease activity of the anti-Jo-1 antibody positive patients was assessed by the global myositis disease activity score (visual analogue score,VAS) established by the International Myositis Assessment and Clinical Studies(IMACS) Group.The correlation between disease activity and level of serum antiJo-1 antibody was assessed.Comparisons between groups were performed by x2 test or t test.ResultsThe positive rate of ELISA and EUROLINE was 24.3％(36/148) and 27.0％(40/148) respectively.Fever,ILD,arthritis/arthralgia were found to be more predominant in anti-Jo-1 antibody positive patients than those who were anti-Jo-1 antibody negative patients.There was significant positive correlation between the global myositis disease activity score (VAS) and serum level of anti-Jo-1 antibody (r=0.874,P=9.000).Serum antiJo-1 antibody levels,together with global disease activity,were significantly decreased in the 7 patients after treatment.ConclusionAnti-Jo-1 antibody level measured by ELISA is associated with disease activity of PM/DM,and could be a marker of disease activity.

ObjectiveTo study the effect of bone mesenchymal stem cells (BMSC) transplantation into traumatic brain injury(TBI) rats by the external carotid artery on neurological function and learning and memory.MethodsTen adult SD rats were randomly divided into TBI group ( n =5 ) and BMSC transplantation group ( n=5).Feeney free falling method was used to establish TBI models.The experimental rats were administrated with BMSC via external carotid artery (ECA),while TBI rats were injected with sterile liquid medium of equal volume via right ECA.Neurological function were evaluated according to the modified neurological severity score (NSS) at 1,3,7,15 days.Morris water maze test was used to observe the animal capabilities of place navigation and space exploration at 15 days,then animals were sacrificed.Survival and migration of implanted BMSC in brains under fluorescence microscope. ResultAfter traumatic brain,varying degrees convulsions,paralysis,loss of balance function in rats were found.Compared with TBI group,BMSC transplantation decreased significantly NSS (P ＜0.01 ).BMSC transplantation significantly decreased on escape latency ( ( 20.48 ± 2.29 ) s ) than the TBI group ( ( 85.93 ± 47.48 ) s) (P ＜ 0.01 ).Moreover,BMSC group in the target quadrant dwell time ( ( 28.62 ± 1.72) ％ )and distance ( (29.05 ± 3.08 )％ ) as well as the number of passing the platform (8.00 ± 2.45 ) were significantly higher than the TBI group ( ( 19.37 ± 2.81 ) ％,(21.78 ± 3.06) ％,(2.00 ± 1.87) respectively,P ＜ 0.01 ).Transplanted BMSC could survive and migrate around injury brain through Hochest mark immunofluorescence.ConclusionBMSC can survive and migrate around injury brain by transplantation of external carotid artery,which results in a significant neurological function improvement and learning and memory increase in rats with traumatic brain injury.