Objective To study the risk factors of pulmonary embolism and comparison of the effect of different therapy.Methods Risk factors of 182 patients with pulmonary embolism were analyzed retrospectively.The patients were randomly divided into simple drug group and drug joint intervention group.Simple drug group was given heparin and warfarin,or jiont urokinase fibrinolytic therapy.The drug joint intervention group was given the same drug therapy joint vena cava filter implantation and/or catheter broken bolt therapy.After different treatment,the clinical prognosis was compared between the two groups.Results Of 182 patients with pulmonary embolism,the elderly and smoking prevalence rate increased significantly,deep vein thrombosis,cardiovascular disease,cancer,blood system diseases,trauma and surgery,chronic lung disease,fracture and orthopaedic surgery were the main risk factors.The effective rate and mortality between the pure drug therapy group and drug joint intervention group had no significant differences(x2 =0.145,P ＞ 0.05).Conclusion The incidence of pulmonary embolism is closely related to the risk factors.Cancer is one of the important diseases caused by pulmonary embolism.In a timely manner to give the antithrombotic drug treatment has great significance to the prognosis of pulmonary thromboembolism,there was no significant difference compared with the antithrombotic joint intervention.

Objective To investigate the effects of ageing on the expression of peroxisome proliferat or-activated receptor (PPAR)? and explore the relation with insulin resistance (IR).Methods Minimal model technique of Bergman was used to estimate the insulin sensitivity of young (10-12 weeks) and aged (24 months) SD rat. The PPAR?mRNA levels of omental fat were measured by reverse transcription-polymerase chain reaction(RT -PCR) and PPAR? protein level were determined by western blotting respectively . Results The level of IR in the aged group was significantly increased compared with tha t of the young group(IR: 11 49?6 92 vs 5 28?1 94,P

Background Patients' experience during phacoemulsification cataract surgery is an important determinant of patient's satisfaction with surgery effectiveness.Local anaesthesia could be associated with different intraoperative visual awareness because of retention of optic nerve function.Relieving the anxiety of patients arose from intraoperative visual awareness is of important clinical significance.Objective This study was to discuss the necessity of preoperative conversation and psychological counseling and to improve the quality of surgery and the satisfaction of patients.Methods One hundred and fifty-three patients who had undergone sequential phacoemulsification and intraocular lens (IOL) implantation in the same operation under local anaesthesia from October,2010 to December,2010 in Tangdu Hospital and Xi'an First People's Hospital,received a standardized questionnaire designed based on similar questionnaires from abroad and surveyed regarding their intraoperative visual experience,including light perception,their detection of color,photopsia,and their detection of the movement of the surgeon,instrument,and changes in light intensity during cataract surgery.In another survey,seventy ophthalmologists in the Xi'an area with ≥ 10 years (33) and ＜ 10 years of experience (37) participated in a questionnaire about their recognition and response to these visual experiences,designed based on the 2010 Chinese Doctors General Questionnaire.Results During the phacoemulsification and IOL implantation,27 patients (17.6％) lost light perception,98 patients (64.1％) had light perception,28 patients (18.3％) detected more than one color,25 patients (16.3％) had photopsia,49 patients (45.1％) sensed the movement of the surgeon,26 patients (17.0％) was able to see surgical instruments,11 patients (7.2％) saw the surgeon's fingers,4 patients (2.6％) saw the surgeons,65 patients (42.5％) detected changes in light intensity and 12 patients (7.8％) saw the IOL loop and others.21.4％ of the 70ophthalmologists believed these patients might have lost light perception;while 78.3％ thought these patients retained light perception.Under local anaesthesia,93.9％ of the more experienced surgeons and 75.6％ of the junior surgeons deemed that good preoperative counseling was helpful for the patients,but only 45.5％ of the more experienced surgeons and 24.3％ of the junior surgeons counseled patients regarding intraoperative visual experience.Conclusions Most patients will experience a variety of visual sensations during phacoemulsification and IOL implantation under local anaesthesia.Many ophthalmologists are aware of these conditions.Most of the ophthalmologists believe that patients suffer from fear from these intraoperative visual experiences and claim that preoperative counseling to patients can relieve that fear,but less of them communicate these possible experiences to patients.This study offers some discussions about preoperative counseling.

Objective To explore the short-term and long-term effects ofapplication of Percutaneous Transhepatic Cholangioscopic Lithotripsy on the treatment of hepatolithiasis. Methods Eighty-threecases of hepatolithiasis were treated with the PTCSL and the other 87cases were treated with the Laparoscopic exploration lithotomy.The general clinical parameters , curative effect in the near future and long-term curative effect were anlyzed. Results No significant differences were found between the two groups in the general clinical parameters (P>0.05). The operation time,intraoperative blood transfusion volume and intraoperatve blood soss in group A were significantly shorter than those in group B(P<0.05, respectively). The original calculi residual rate was 2.4%, the eventually calculi residual rate was 4.8%and the recurrent cholangitis was4.8%in the model of PTCSL (Group A). The original calculi residual rate was 18.4%, the eventually calculi residual rate was 23.0% and the recurrent cholangitis was 23.0%in the model of Laparoscopic exploration lithotomy (Group B), with significant difference between these two groups (P<0.05). The calculi recurrence rate of group A was 12.0%,the calculi recurrence rate of group B was 22.9%,withno significant difference between these two group (P>0.05). No patients died in each group. The results of complications showed thatthe incidence of residual calculi of group A was significantly lower than that of group B (P<0.01). Conclusions Compared with the model of Laparoscopic exploration lithotomy, the PTCSL was more safe, minimally invasive and effective. The short-term efficacy of the model of PTCSL was better than that of the model of Laparoscopic exploration lithotomy.

Objective To establish the phenobarbital addiction rat model by the modified drug‐admixed‐food(DAF) method . Methods Rats were selected as the experimental animal .The modified DAF method was adopted to construct the model .The initial dose of phenobarbital 75 mg/kg was given mixed and the dase was gradually increased day by day ,which continued for 45 d .The es‐tablished model was verified by the precipitated withdrawal method and the natural withdrawal method for judging whether the model construction succeeding .Results The convulsion rate in the DAF precipitated withdrawal group was higher than that in the control group(P< 0 .01) ;the withdrawal symptoms scores in the DAF natural withdrawal group were higher than those in the con‐trol group(P< 0 .05) ;the relieving degree of body mass in the two withdrawal groups was greater than that in the control group (P< 0 .05) .The brain section in the mode group revealed obvious cellular apoptotic change .Conclusion DAF is simple and feasible for establishing the phenobarbital addiction rat model .

Objective To perform the image edge extraction by image segmentation in computer view. Methods The T- lymphocytes images were divided, distinguished and extracted automatically by gray histogram and gray changing distribution map overlap method. Results In the development of the peripheral blood T-lymphocytes rDNA transcriptional activity detection system, the processing method of stained T-lymphocytes images was researched to solve the problem of edge extraction. Conclusion The system is reliable, simple and convenient. The veracity and accuracy can meet requirements of clinical diagnosis.

Objective To investigate the correlation between microalbuminuria (MAU) and obesity and its indexes, including BMI, waist circumference(WC), and waist-to-hip ratio(WHR) , among partial community population in Beijing. Methods A total of 2080 subjects who took physical examination in Beijing, including 810 men and 1270 women with a mean age of(50. 9 ± 13. 1 )years, were enrolled. The informed consent has been achieved from each patients. BMI and WHR were calculated based on collected data of height, weight, WC, and hipline. Urine albumin-creatinine ratio(ACR) within the range of 30-300mg/g was classified as MAU. The subjects were divided into normal albuminuria ( NAU ) group and MAU group. The correlations between MAU and different obesity indexes including BMI, WC and WHR, were analyzed. Results Among the 2080 subjects, there was a positive correlation between BMI (r = 0. 1276,P＜0.01) and ACR, and WC (r = 0.0840, P ＜0.01) and ACR. WHR and ACR was irrelevant ( P ＞ 0. 05 ). In univariate analysis, there was significant difference in BMI ≥ 28 kg/m2 ( OR = 2. 02 ) and WC ≥85 cm (male) or≥80 cm (female) (OR = 1.69 ) between NAU group and MAU group (P ＜ 0. 05 ).There was no significant difference in BMI 24-＜ 28 kg/m2, and WHR ≥0. 90 (male) or ≥0. 85 (female)between NAU group and MAU group( P≥0. 05 ). Multivariate logistic regression analysis revealed that BMI ( OR = 1.06) was an isolated independent risk factor of MAU from age ( OR = 1.01 ), female ( OR = 1.42),systolic blood pressure (OR=1.01), TC (OR=1.93) and HDL-C (OR=0.54). Conclusions Obesity is an independent risk factor of MAU among partial community population in Beijing. The correlation between different obesity indexes and MAU also differs.

Objective: This study aims to investigate the positive practice environments evaluation of doctors in public hospital and provide suggestions for Chinese health care reform from the perspective of health service providers.Methods: Using self-designed questionnaire, a national cross-sectional survey was performed in 77 public hospitals across seven provinces/ metropolis, involving a total of 3564 doctors.Positive practice environment includes organizational management and doctor-patient two-dimension relationships.Results: The doctor''s mean score of positive practice environment evaluation was 18.02±4.86 (out of 40).Doctors had a higher evaluation (score) of organizational management than doctor-patient relationship.In the organizational management dimension, the personal advice got the lowest scores(2.24±1.04);and in doctor-patient relations, evasion of medical risk got the lowest scores(1.59±0.81).There was a difference in the positive practice scores of physicians in different regions, and the scores of doctors from the western China were the lowest (P<0.001.Doctors from western medicine hospitals had lower evaluation of positive practice environments than ones from Chinese Traditional Medicine hospitals(P=0.002.Conclusion: As per the analysis conducted in this investigation, the current medical practice environment of doctors in China is not a promising one.Doctor-patient relationship is worse than organizational management.Hospitals should adopt a participatory decision-making model in management and establish a broadband performance based compensation to motivate junior doctors.Besides, government should establish reasonable compensation incentive mechanism, with the aim of promoting doctor-patient trust.

Objective To prepare dual-targeted microbubbles carrying both anti-CD34 monoclonal antibody and anti-ICAM-1 monoclonal antibody,to identify its basic characteristics,and to investigate its targeting performance in vitro.Methods ICAM-1-targeted microbubbles (MgIcAM-1),CD34-targeted microbubbles(MBcD34) and dual-targeted (with both monoclonal antibodies) microbubbles (MBD) were prepared by biotin-avidin bridging chemistry method.The targeted microbubbles were observed under light microscrope and characterized by a Mastersizer 3000,DFY software,laser confocal microscopy,and flow cytometry.The targeting specificity and attachment capability of dual-targeted microbubbles to endothelial progenitor cells (EPCs) and damaged human umbilical vein endothelial cells (HUVECs) were assessed in vitro.Results The morphous,diameter,surface potential,concentration,and the antibody-binding rates of microbubbles were not statistically significant in MBIcAM-1,MBCD34,and MBD (P ＞0.05).Echo intensity in MBD significantly increased compared with MBICAM1,MBCD34,and MBiotin (P ＜ 0.01).The targeting experiment in vitro showed that the attachment rate of MBD to EPCs and damaged HUVECs significantly increased compared with MBiotin (P ＜0.01),while no remarkable difference in attachment rate was found between MBD and MBcD34 in EPCs,and between MBD and MBIcAM-1 in damaged HUVECs (P ＞0.05).Conclusions Dual-targeted microbubbles carrying both anti-CD34 monoclonal antibody and anti-ICAM-1 monoclonal antibody are prepared successfully.The study in vitro has proved that the dual-targeted microbubbles can specifically bind to both EPCs and damaged HUVECs.

Objective:To evaluate the bone alteration subject to remodeling and analyze the esthetic result following immediate implant placement of incisors.Methods:In this study,20 patients (1 3 women,7 men)were involved,who needed implants for incisors of maxilla.The patients received 23 im-mediate implants totally.On the day of surgery and 6 months after the implants were placed,Cone beam CT (CBCT)was taken.The thickness of the alveolar ridge and the vertical change of marginal bone levels onthe mesial and distal aspects of theimplants were measured using the computer software (Planme-caRomexis Viewer 3.6.0.R).The evaluation of esthetic result by labial convexity score (LCS)and pa-pilla index score (PIS)were analyzed pre-operation and one year after the final crown was delivered.The statistics with paired-t test for the measurement data and Willcoxon test for rating data were done by SPSS 20.0.Results:The survival rate in the two-year follow-up was 1 00%.The measuring point 1 (MP1 ), MP2,MP3 and MP4 (0,2,4,6 mm apical to the implant platform,respectively)got significant altera-tions after 6 months of the follow-up.These differences were statistically significant (P<0.05 ).The major alteration happened at MP1 and MP4,which got (-0.89 ±2.06)mm and (-0.75 ±1 .28)mm reduction of the alveolar,respectively.The marginal alveolar ridge resorption was (-0.42 ±1 .24)mm and(-0.91 ±1 .96)mm for Ankylos System and Replace System,respectively,and the difference was not statistical significant .The esthetic results were quite acceptable.Before treatment,1 8 incisors rated 3 for LCS,and 2 incisors rated 4 for LCS;after final restoration,only 5 incisors rated 3 for LCS,and 1 4 incisors rated 2 for LCS.Before treatment,1 5 incisors rated 3 for PIS;after final restoration,1 3 incisors rated 3 for PIS.There was no statistically significant difference for the PIS pre-operation and 1 year after final restoration,while there was statistically significant negative change for LCS.Conclusion:Even fol-lowing the proper surgical technique,the alveolar ridge wall still can’t be maintained after immediate im-plant placed in fresh socket of incisors.The inter-dental papilla could be well maintained,while due to the remodeling of labial bone,labial convexity will inevitably collapse.Therefore immediate implant still has esthetic risk.