Objective To investigate the efficacy and safety of intraarterial or intravenous recombinant tissue plasminogen activator(rtPA) for patients with acute cerebral infarction.Methods 60 patients consistent with the inclusion criteria were divided into intra-arterial thrombolysis group, intravenous thrombolysis group and control group. rtPA of 10～20 mg was infused over the course of 30 minutes in intra-arterial thrombolysis group. rtPA was administered in a dose of 0.7～0.8 mg/kg(maximum dose 50 mg),with 100% as a constant infusion over a period of 90 minutes in intravenous thrombolysis group.24 hours late, both groups were followed by subcutaneous injection of low molecular weight heparin(0.4 ml,twice daily) for 7 days. The control group received only routine treatment. European Stroke Scale(ESS) and Barthel Index(BI) were used to evaluate the recovery of neurological functions.Results The efficacy in both thrombolysis groups was significantly higher than that in the control group(all P 0.05).But in intraarterial group, the stenosis of intracranial arteries or extracranial arteries could be found, and new thrombosis could be prevented by transluminal stent-assistant angioplasty. One case of intracerebral hemorrhage and one case of asymptomatic hemorrhage occurred in intraarterial thrombolysis group. One case of asymptomatic hemorrhage was found in intravenous thrombolysis group and control group respectively. No dead case was found in the three groups.Conclusion Thrombolytic therapy of intra-arterial and intravenous rtPA can be performed safely and efficaciously in patients with acute cerebral infarction within 6 hours from the onset.

Objective To discuss the value of percutaneous dilatational tracheotomy(PDT) for cardiosurgery in intensive care unit by comparing its outcomes with that of open tracheotomy(OT).MethodsA prospective study was conducted on 40 severe patients undergoing cardiosurgery.The patients were divided into PDT(treated from January 2002 to July 2003) and OT groups(treated from August 2003 to February 2008) with 20 cases in each.The operation time,length and heal time of the incision,blood loss,vital signs,and postoperative complications were compared between the two groups.ResultsThe operation time,length and heal time of the incision in the PDT group were significantly different from that in the OT group [(8.8?2.2) min vs(21.5?5.3) min,t=-9.897;(1.3?0.2) cm vs(3.4?0.5) cm,t=-17.440;and(3.9?0.9) d vs(5.9?1.2) d,t=-5.963;P=0.000].One patient in the PDT group(5%) had Ⅱ degree blood loss during the operation that was significantly less than those in the OT group(13 patients,65%,?2=15.824,P=0.000).The level of the vital signs change in the PDT group was significantly milder than those in the OT group [MAP: 1-5 mm Hg(median 2) vs 1-20 mm Hg(median 3.5),Z=-2.959,P=0.003;heart rate: 3-12 beats/min(median 5.5) vs 7-70 beats/min(median 10),Z=-3.956,P=0.000;SpO2: 0-4%(median 2%) vs 0-31%(median 3.5%),Z=-3.548,P=0.000].Furthermore,the rate of incisional leakage of sputum and overall rate of complications in the PDT group were significantly lower than those in the OT group.[1(5%) vs 8(40%),?2=5.161,P=0.023;and 1(5%) vs 12(60%),?2=13.789,P=0.000].ConclusionsPDT is a safe and minimally invasive technique with a high rate of success and low rate of complications.The method is easy to operate,and thus could be a good choice for severe patients after cardiovascular surgeries.

Objective To explore the relationship of autoantibodies against G protein coupled angiotensin Ⅱ-1 receptor (AT1 R),α1-adrenergic and β1-adrenergic receptors (α1 R and β1 R) with thyrotoxicosis heart disease (THD).Methods The epitopes of the second extracellular loop ofAT1 R (165-191),α1 R (192-218),and β1 R(197-222) were synthesized for screening autoantibodies from 277 participants by ELISA.237 patients with thyrotoxicosis were subdivided into thyrotoxicosis treatment group (n =148) and thyrotoxicosis recovery group (n =89),or into THD group (n =46) and simple hyperthyroidism group (n =191).40 healthy subjects were served as control group.Results (1) The positive rates of autoantibodies against AT1 R,α1 R and β1 R in thyrotoxicosis patients were higher than those in the control subjects (31.6％ vs 12.5％,27.8％ vs 10.0％,and 23.6％ vs 7.5％,all P＜0.05).The positive rates of the three autoantibodies in the patients with Graves' disease were higher compared with thyrotoxicosis caused by other reasons (36.3％ vs 19.7％,32.2％ vs 16.7％,and 28.1％ vs 12.1％,all P＜0.05).(2) In thyrotoxicosis treatment group,the positive rates of autoantibodies against AT1 R and α1 R were higher than those in the hyperthyroidism recovery group (40.5％ vs 16.9％ and 33.1％ vs 19.1％,both P＜0.05).(3) The incidence of autoantibodies against AT1 R and α1 R in THD were significantly higher compared with simple hyperthyroidism (52.2％ vs 26.7％ and 43.5％ vs 24.1％,both P＜0.05).Conclusions Autoantibodies against AT1 R,α1 R,and β1 R may play important roles in the pathogenesis of hyperthyroidism,which may be involved in the progression of THD.

Urothelial carcinoma associated antigen 1(UCA1)is a highly bladder cancer-specific long non-coding RNA(lncRNA),and it does not have the function of encoding protein. UCA1 differentially expre-sses in various fetal tissues,but its expression is turned off in most adult tissues. It reactivates during tumori-genesis. Researches indicate that UCA1 may regulate cell proliferation,apoptosis,metastasis and chemoresis-tance of tumors,such as bladder cancer,breast cancer and hepatocellular cancer.

Long non-coding RNA (lncRNA)is a kind of RNA molecule which is longer than 200 nucleotides and has no capacity of coding proteins.Accumulating evidences have indicated that several lncRNAs,such as HOTAIR,MALAT-1 ,H1 9 and BANCR may promote tumor metastasis by inducing epitheli-al-mesenchymal transition.

To investigate the methods of learning coaxial microincision phacoemulsification and assess the related complications.METHODS:The clinical data of 1 080 eyes of coaxial microincision phacoemulsification performed by beginners from October 2011 to December 2013 was retrospectively analyzed. ln order of surgery dates, the patients were equally divided into groups A, B, C and D, 270 eyes in each group. Comparisons were made among the four groups in operation time, cumulative dissipated energy (CDE), rate of intraoperative, and postoperative complications at 1d; and best corrected distance visual acuity (BCDVA) at 1mo postoperatively.RESULTS:No significant differences were found in age, sex, lens grading, BCDVA at 1mo postoperatively among the four groups ( P> 0. 05 ). The operation time was significantly longer in group A than in groups B, C and D (25. 15 ± 3. 11min vs 15. 20 ± 3. 40min, 14. 71 ± 3. 02min and 14. 41±2. 91min, P<0. 05). No significant differences were found in the operation time among the other three groups (P>0. 05). The CDE of grade ‖ and Ⅲ was significantly higher in group A than that in groups B, C and D (95. 9%, 97. 8% and 98. 5%) (P<0. 01). The number of continuous curvilinear capsulorhexis ( CCC ) were performed successfully was significantly less in group A ( 80. 7%) than the other three groups (95. 9%, 97. 8% and 98. 5%) (P<0. 01). The incidence of posterior capasular rupture of group A (7. 8%) was higher than that of group B (3. 7%), group C (1. 1%) and group D (0. 4%) (P<0. 05), but there was no significant difference between group C and group D (P>0. 05). There were no significant differences both in the number of corneal edema and BCDVA at 1d between group A and group B. (P=0. 66, P=0. 53).CONCLUSlON: With learning step by step, appropriate training program, careful case selection, and accurate managing complications, coxial microincision phacoemusification can be safe for a beginner.

Objective To compare the effects of neutral posture training (NPT) and gas resistance training on balance and motor func-tion in stroke patients. Methods From June, 2014 to February, 2016, 44 hemiplegic patients were randomly divided into control group (n=22) and experimental group (n=22). The control group received conventional decubitus trunk muscle training and sitting gas resistance train-ing. The experimental group received NPT. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Fugl-Meyer Assessment-Lower Extremities (FMA-LE), and Berg Balance Scale (BBS) before and after training. Results There was no significant differ-ence in the scores of FMA-UE, FMA-LE and BBS between two groups (t<0.962, P>0.05). The scores significantly increased after training in both groups (t>12.248, P<0.001), and were higher in the experimental group than in the control group (t>1.972, P<0.05). Conclusion The NPT could improve the motor and balance function of stroke patients, rather than gas resistance training.

BACKGROUND:Osteoporosis caused by diabetes melitus as common secondary osteoporosis has been paid more and more attention recently. Zoledronic acid serves as a novel drug for osteoporosis, and its effect on osteoblasts in vivo remains unclear. OBJECTIVE:To investigate the changes of the expression of bone morphogenetic protein 2 andNoggin in the femur of type 1 diabetes melitus rats and the effect of zoledronic acid on them. METHODS:Models of type 1 diabetes melitus were established by intraperitoneal injection of streptozotocin in 130 Wistar rats. 3 days later, rats with blood sugar > 16.7 mmol/L for three consecutive times were considered as successful models, 120 in total. These models were randomly divided into model, prevention and treatment groups. Rats in the prevention and treatment groups were intravenously administered zoledronic acid (0.1 mg/kg) on the day of modeling and 2 weeks after model establishment. An additional 40 rats were injected with citrate buffer solution as control group. RESULTS AND CONCLUSION: Compared with the control group, femur bone mineral density, serum alkaline phosphatase levels, and femur bone morphogenetic protein 2 mRNA expression levels were significantly lower in the model group (P < 0.05), butNoggin mRNA expression significantly increased (P < 0.05). Compared with the model group, bone mineral density and bone morphogenetic protein 2 mRNA expression levels were significantly higher in the prevention and treatment groups (P < 0.05), butNoggin mRNA expression significantly lower (P < 0.05), and serum alkaline phosphatase levels gradualy restored. These results indicated that the bone metabolic disturbance occurs in early stage in rats with type 1 diabetes melitus. Zoledronic acid can promote bone formation, increase bone density, and improve bone metabolism.

Objective: To find out the attitudes of university students and postgraduates to donating corneas after their death in Chongqing. Method: In order to find out the attitudes to the donation of corneas and remains after their death, the understanding degree of the knowledge on donation and the actual participation, cue formulated 10 questions including 3-4 selective answers each one to have a questionnaire investigation among university students and postgraduates of three universities in Chongqing. Result: In 311 questionnaires, 288 of them are valid. 53.82 % of students investigated are willing to donate their corneas and 77.08% of them support the donation, but the majority don't want to go through the formalities of donation and don't know how to deal with this; nearly 2/3 of them don't know an eye bank has been set up in Chongqing; 77% of them agrees to legislate or make the local regulations as soon as possible. Conclusion: There are quite a number of volunteers in the university students, but the number of the actual participants is small. Therefore we need to strengthen the propaganda of the eye bank to impel more students to comprehend the knowledge of donation and join the volunteers.

Objective To observe the effects of Yougui Pills (YP) intervention on SREBP pathway related factors of sterol regulatory element binding protein-1c ( SREBP-1c) , cholesteryl ester transfer protein ( CETP) and fatty acid synthase ( FAS) protein and gene expression in kidney yang deficiency hyperlipidemia rat model. Methods Sixty SD rats were divided into normal control group, model group (in the dosage of 2.43 g/kg), and YP group. Rat model of kidney yang deficiency hyperlipidemia was induced with intramuscular injection of hydrocortisone. Normal control group and model group were given normal saline, and YP group was given YP suspension intragastrically. After treatment, the hepatic pathomorphology of rats in the three groups was examined, and the contents of serum lipids were examined. Hepatic SREBP-1c, CETP and FAS protein expression was detected by Western-blotting method, and their mRNA expression was detected by real-time polymerase chain reaction ( RT-PCR) . Results Compared with the normal control group, serum triglyceride ( TG ) , total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) contents were significantly increased (P<0.01), high-density lipoprotein cholesterol (HDL-C) was significantly decreased (P<0.01), and hepatic pathomorphological changes of hyperlipoidemia were obvious in the model group. Compared with the model group, TG, TC, LDL-C contents were significantly decreased ( P<0.01) , and HDL-C was significantly increased (P<0.01) in YP group. Model group had higher SREBP-1c, CETP and FAS mRNA and protein expression than the normal control group ( P<0.05) , while YP group had lower SREBP-1c, CETP and FAS mRNA and protein expression than the model group ( P<0.05) . Conclusion YP can decrease the blood lipid levels probably by down-regulating the expression levels of SREBP-1c, CETP and FAS gene and protein related to the the SREBP pathway in rats of kidney yang deficiency hyperlipidemia induced by intramuscular injection of hydrocortisone.