Objective:To observe the clinical efficacy of Xueshuantong combined with the conventional treatment and the impact on fibrinogen (FIB) and D-dimer in the patients at acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Meth-ods:Totally 218 cases of AECOPD inpatients were divided into the observation group and the control group randomly .The control group received the conventional therapy , while the observation group was intravenously treated with 250 mg Xueshuantong lyophilized powder dissolved in 250 ml 10%glucose injection additionally .The treatment course was 14 days.The changes of FEV 1 , FEV1/FVC, FIB and D-dimer in the two groups after the treatment were compared , and then the clinical efficacy of the two groups was evaluated . Results:After the treatment, the levels of FEV1 , FEV1/FVC, FIB and D-dimer in the two groups were significantly improved when compared with those before the treatment , and the changes in the observation group were more significant than those in the control group (P<0.05).The total effective rate of the control group was 80.73%, and that of the observation group was 89.91% (P<0.05). Conclusion:Anticoagulant therapy using Xueshuantong on the basis of the conventional therapy can significantly reduce the amount of fibrinogen and D-dimer serum fiber in AECOPD patients , which is helpful to improving the hypercoagulable and fibrinolysis state and the lung function of AECOPD patients .

Objectives To assess whether prodromal transient ischemic attack (TIA) has beneficial effects on type 2 diabetic patients and those had acute fasting hyperglycemia with the first-ever acute anterior circulation infarction.Methods One hundred and seventy patients with first-ever ischemic acute anterior circulation infarction were involved.According to whether they had type 2 diabetes mellitus,patients were divided into group A (non-diabetic patients) and group B (diabetic patients).Mean infarct volume was also compared between patients with pro-TIA and without pro-TIA in group A and B,and each group with acute hyperglycemia too.Results In group A,prodromal TIA was associated with a smaller infarct volume (M: 2.61 cm3 vs 5.99 cm33 Z=-2.69,P=0.007).On the contrary,in group B,there was no significant difference in infarct volume (M: 3.25 cm3 vs 11.0 cm3,Z=-1.699,P=0.08) between patients with and without prodromal TIA.In group A patients absent with acute fasting hyperglycemia,infarct volume significantly smaller in patients with prodromal TIA than in those without (M: 2.69 cm3 vs 6.46 cm3,Z=-2.34,P=0.019) ; In patients with acute fasting hyperglycemia,there was no a significant difference in infarct volume (M: 2.61 cm3 vs 5.69 cm3 ,Z=-1.218,P=0.27).However,among group B patients present or absent with acute impaired fasting glucose,there was no significant difference in infarct volume in patients with or without prodromal TIA.Conclusion Diabetes mellitus and the acute fasting hyperglycemia might prevent the ischemic preconditioning.

Objective To study the effect of motor imagery therapy combined with conventional physical training on hemiplegia lower extremity function in stroke patients with hemiplegia.Methods Thirty hemiplegic patients meeting the eligible criterions were randomly divided into two groups: a treatment group (n = 13 ) and a control group ( n = 17).All subjects accepted conventional rehabilitative treatment.Patients in treatment group were treated with motor imagery therapy after physical training, while the patients in control group were treated with physical training only.Motor function was measured by the percentages of changes in maximum loading on affected lower limb (PL%), Barthel index (BI), 5m maximum back and forth walking speed (5m MBFWS), Berg balance scale ( BBS), Fugl-Meyer motor assessment ( lower limb) (FMA-L) before the beginning of training and at the end of sixweek training.Results In both groups, all measurements at the end of training improved significantly ( P < 0.01 )compared to that at the beginning of training.After the whole training course, PL% and 5m MBFWS (m/s) in treatment group were significantly better compared to those in control group( P < 0.05 ), and the other measurements were not statistically significant between two groups( P > 0.05 ).Conclusion Motor imagery therapy had positive effect on hemiplegia lower extremity function of sub-acute stroke patients.

Objective To study the impact of therapy strategy on outcomes of patients suffering from severe sepsis and/or septic shock. Method A total of 195 patients diagnosed as severe sepsis or septic shock were enrolled for prospective study from June 2008 to December 2009. Patient's clinical manifestation,treatments and outcomes were studied by using SSC database. Patients were divided into control group and treatment group. In control group, patients enrolled from June 2008 to December 2008, were treated with conventional medical care In treatment group, patients enrolled from January 2009 to December 2009 were treated with a novel algorithm of mandatory treatment for sepsis In-hospital mortality of two groups was compared. SPSS15.0 software was used for analysis of data. Chi-square test and unpaired t-test were used for comparisons between groups. Results Compared to the control group The need for blood lactate test was significantly grown in treatment group [98.2% (115/117) versus 2.56% (2/78), P ＜ 0.001]. Antibiotics was administered to 69.2% (81/117) patients of treatment group within 3 hours after their arrival at the emergency department compared to 35.8% (28/78) in the control group (P ＜ 0. 001). Blood cultures made before antibiotics given were 47.9% (56/117) in the treatment group compared to the control group 25.6%(20/78), P = 0. 003. The rate of fluid resuscitation was 80.3% (53/66) in the treatment group and 27%(10/37) in the control group, P ＜0.001. The rate of CVP (8 mmHg was 27.3% (18/66) in the treatment group and 8.1% (3/37) in the control group, P = 0. 023. In-hospital mortality was 29.1% (34/117) in the treatment group and 44.8% (35/78) in the control group, P =0. 032. Conclusions The algorithm of mandatory treatment for sepsis improved the therapeutic efficacy of the treatment for severe sepsis and septic shock, decreasing in-hospital mortality.

Objective To evaluate the raliability and validity of walking impairment questionnaire applied to assess the walking ability of patients with type 2 diabetes. Methods One hundred and twenty-six patients with type 2 diabetes were selected. WIQ, SF-36 and 6-minute walk test were used to collect da-ta that was conducted for reliability analysis, correlation analysis and independent-samples t test to evaluate the reliability and validity. Results The internal consistency determined by Cronhach's α was 0.867 for the total WIQ score. Significnat correlations were found between WIQ and 6MWD, also between WIQ and physical domains of SF-36. compared with patients over seventy-one years old, the score of WIQ including the distance, speed, stair climbing and total score is significantly higher than that in patients aged seventy-one or less than seventy-one years old. Conclusions The Chinese version of WIQ is a simple, valid and reliable, clinically relevant tool to assess the walking ability of patients with type 2 diabetes.

Objective:To evaluate the spiral CT in the diagnosis of esophageal neoplasm by comparing it with conventional CT and barium meal examination.Methods:Spiral CT contrast enhancement scanning and image processing with MPR an d CTVE were performed in 15 cases.A comparison was made between the images of spiral CT and the ones of conventional CT and the images of barium meal examinat ion.Results:① On axial images with spiral CT,all lesions of 15 patients showed almo s t the same pictures as seen with conventional CT.Images clearly showed the posit ion,size,shape of the esophageal neoplasm with local extension and the relation with the adjacent structures as well as lymth node metastases.②MPR could we ll display esophageal structure through different angle and direction.The appea rances of inner wall and lesions on CTVE of esophageal neoplasm were similar to those of fiberaptic endoscopy.③Barium meal examinatiuon was a very effective sc reening method.Conclusion:Compared with conventional CT and barium meal examination,application of spiral CT provides clinicians with more useful informations.

Purpose To investigate the effects of hypoxia inducible factor-2α (HIF-2ot) siRNA on proliferation and chemotherapy sensitivity of breast carcinoma MCF-7.Methods RNA interference was used to silence the expression of HIF-2α in MCF-7 cells.The changes of HIF-2α gene expression were detected by immunocytochemistry and RT-PCR.Under hypoxia environment simulated by CoCl2,MTT assay and flow cytometry (FCM) were used to measure cell growth inhibition rate and cell apoptosis of MCF-7 cells under different dosages of chemotherapeutic agents (5-fluorouracil,adriamycin,and paclitaxel).Results Expression of HIF-2α in MCF-7 were down-regulated by HIF-2α siRNA (P ＜ 0.05).The proliferation inhibition and apoptosis rates were evidently increased after transfection with HIF-2α siRNA (P ＜ 0.05),chemotherapy drug sensitivity was enhanced.Conclusion HIF-2α siRNA can induce the apoptosis and inhibit the proliferation and enhance the sensitivity of breast carcinoma MCF-7 cell line to chemotherapeutic agents.Blocking HIF-2α maybe a very promising strategy for breast carcinoma gene therapy in combination with chemotherapy.

The arteries of the foot in one hundred Chinese adult specimens were dissected and examined. 1. The dorsalis pedis artery was absent in 4%, and it originated from an abnormal origin in 5%, its course and relationship with the tendon of the extensor hallucis longus and deep peroneal nerve were also described. 2. The anterior medial and anterior lateral malleolar arteries originated more commonly at the level of the ankle joint, and sometimes they may originate from the dorsalis pedis artery. 3. The origin and number of the medial tarsal artery were variable, but that of the lateral tarsal artery were more constant. 4. The arcuate artery was present in 35%, but only 17% was typical in form, from which the 2nd-4th dorsal metatarsal arteries were giving off. 5. The sources of the dorsal metatarsal arteries were the most variable. The first dorsal metatarsal arteries which arose from dorsal or plantar aspect were similar in percentages. The 2nd-4th dorsal metatarsal arteries often originated from the plantar aspect, but it was not uncommon that they came equally from dorsal and plantar aspects. 6. The artery of the tarsal sinus was usually present, it may be divided into two categories, namely the proximal and the distal artery, with their distinct origins and courses. 7. The arterial trunks in the sole of the foot were more constant. The posterior tibial artery usually branched into its two main branches near the lower border of the laciniate ligament. 8. The lateral plantar artery was greater than the medial in 82%. And 71% of the plantar arch was formed chiefly by the deep plantar branch of the dorsalis pedis artery. 9. The plantar metatarsal arteries originated usually from the plantar arch, sometimes the neighbouring arteries may have a common trunk. The course of the Ist-3rd plantar metatarsal arteries was constant, but that of the 4th may be variable. Finally, some questions about the arteries of the foot, present in previous literatures, were briefly discussed.