Objective To find out the classification of diseases contracted by patients of the emergency department.Methods A retrospective investigation and analysis was made of the medical records of 82 598 emergency cases in our hospital. Results Injury and poisoning, respiratory disease, and disease of digestive system were the first three kinds of disease treated by the emergency department; male emergency cases outnumbered female ones; the volume and visiting hours of emergency cases in a typical day take the shape of humps, with 19 to 21 hours being the climax; the ages of emergency cases averaged 41.5, with patients of the age group running from 19 to 35 being the largest in number in 16 kinds of disease. Conclusion ①It is imperative to determine the priorities of technology construction and the orientation of talent cultivation in the emergency department according to the disease spectrum of emergency cases. ②It is necessary to attach importance to the education of males in health, safely and precautions. ③It is essential to fully recognize the great significance that enhancement of the expertise of the emergency department carries with regard to the health of the population. ④It is important to rationally plan work in accordance with the rush hours of emergency cases's visits.

Background A preliminary study determined an application of manganese ion eyedrops in tracing observation of visual system in vivo,but whether manganese ion has toxic effects on ocular anterior segment tissues is still unclear.Objective This study was to investigate the toxic effects of different concentrations of manganese ion eyedrops on ocular anterior segment tissues.Methods Thirty-two clean New-Zealand white rabbits were divided into 1.00 mol/L MnCl2 group,0.50 mol/L MnCl2 group,0.25 mol/L MnCl2 group and normal control group according to random number table.The experimental eye was randomly chosen from each rabbit for eyedrops application.The manganese ion eyedrops at concentration of 1.00 mol/L,0.50 mol/L or 0.25 mol/L was topically administered in any lateral eye of each rabbit in the 1.00 mol/L MnCl2 group,0.50 mol/L MnCl2 group,0.25 mol/L MnCl2 group,and normal saline solution was used in the same way in the normal control group.In 2 hours,1 day and 3,7,14,21,28 days after eyedrops application,the irritative response of ocular surface was examined under the slit lamp microscope,and corneal damage was evaluated by corneal fluorescence staining,and corneal endothelial cell density (ECD) and corneal thickness were assessed using corneal specular microscope.The eyeball samples were prepared in 3,7,14 and 28 days after eyedrops application and hematoxylin and eosin staining was performed for histopathological examination of conjunctiva,cornea,trabecular meshwork and ciliary body tissue.The use and care of experimental animals complied with the Statement of ARVO.Results Severe hyperemia and edema in palpebral conjunctiva appeared in the 1.00 mol/L MnCl2 group and 0.50 mol/L MnCl2 group,and the symptoms reached a maximum level 1 day after eyedrop application and disappeared 7 days after eyedrops application in the 1.00 mol/L MnCl2 group.These symptoms were milder in the 0.50 mol/L MnCl2 group in comparison with the 1.00 mol/L MnCl2 group.There were no ocular irritative response in the 0.25 mol/L MnCl2 group.Significant differences were found in the corneal fluorescence scores among the groups 2 hours,1 day,3 and 7 days after eyedrop application (X2 =17.350,19.200,12.200,10.140,all at P＜0.05),with the highest score in the 1.00 mol/L MnCl2 group.The ECD was not significantly different among the groups and different time points (Fgroup =0.38,P＞0.05;Ftime =1.79,P＞0.05).The corneal thickness value was significantly different among the groups and different time points (Fgroup =18.22,P＜0.05;Ftime =116.75,P ＜ 0.05).The corneal thickness value was elevated during 2 hours to 3 days after administration of eyedrops in the 1.00 mol/L MnCl2 group and closed to normal from 7 days to 28 days.The corneal thickness value was higher from 2 hours to 14 days than that in 28 days after administration of eyedrops in the 1.00 moL/L MnCl2 group,and the corneal thickness value was higher in 2 hours to 1 day than that in 28 days after administration of eyedrops in the 0.50 mol/L MnCl2 group (all at P＜0.05).Inflammatory cell infiltration and stromal edema were exhibited in conjunctival,trabecular meshwork and ciliary body tissue in the 1.00 mol/L MnCl2 group 3 days and 7 days after eyedrops application,and only inflammatory cell infiltration in conjunctival tissue in the 0.50 mol/L MnCl2 group 3 days after eyedrops application.No obvious abnormity was seen in the 0.25 mol/L MnCl2 group.Conclusions 1.00 mol/L manganese ion eyedrops has a remarkable toxic effect on ocular anterior segment tissue in rabbit.With the lowing of drug concentrations,the toxic effects were reduced.The manganese-enhanced MRI using 0.25 mol/L manganese ion eyedrops is feasibility bacause of its non-toxicity to ocular tissues.

Objective To evaluate the clinical effects of autologous bone marrow transplantation(ABMT) in the treatment of patients with acute leukemia.Methods A retrospective study was accomplished on the ABMT in the treatment of 35 patients with acute leukemia from Oct 1999 to Oct 2004.The median age of the patients was 32.5(9～55) years.Of the 35 patients,26 cases were acute non-lymphocytic leukemia(ANLL) and 9 cases were acute lymphoblastic leukemia(ALL).The patients were pretreated with melphalan(140～180mg/m~2),cyclophosphamide(120mg/kg) and arabinosylcytosin(3g/m~2).Results All patients engrafted successfully.The median follow-up duration was 756(186～1950) days.The 3-year probabilities of disease-free-survival(DFS) for ANLL and ALL were(65.4%?8.9)% and(33.3?13.6)% respectively,and the probabilities of relapse were(30.6?9.2)% and(60.7?25.5)%,respectively.Conclusion To decrease relapse and increase DFS,patients with acute leukemia who have no chance for allogene haemopoietic stem cell transplantation are recommended for ABMT.

Clinical practice course during the physical diagnosis studying is very important for the medical undergraduate students. It’s a bridge between the medical basic knowledge and clinical work. Several aspects such as moral education,learning attitude,scientific schedule,mas-tering the basic medical knowledge and physical examination,typical case and communicating skill must be emphasized in the clinical practice course.

Objective To investigate insulin-like growth factor-1(IGF-1) on the protective effect of infant myocarditis.Methods The serum levels of IGF-1 was detected by two-site enzyme-linked immunosorbent assy ( ELISA) and CK-MB by electrochemiluminescence at the acute and convalescent in 50 infant with myocarditis,and 50 normal healthy children as the controls.Results The serum levels of IGF-1 in acute myocarditis was significantly lower than those of healthy children and the convalescen[(22.90 ±9.30) mg/L vs (45.69 ±10.95) mg/L, (38.99 ±9.06)mg/L,all P<0.01],while the CK-MB was significantly higher than those of the control group and the convalescent[(77.48 ±8.71)mg/L vs (14.99 ±7.62)mg/L,(17.99 ±6.31)mg/L,all P<0.01.IGF-1 and CK-MB was negative correlation (r=-0.62,P<0.01).Conclusion IGF-1 is involved in the repair process of myocardial injury in myocarditis infant,and play some protective role in the mechanism.

OBJECTIVETo investigate the effect of tanshinone II(A) on the expression of different components in the renin-angiotensin system of left ventricles of renal hypertensive rats.

METHODThe renal hypertension model was established in rats by the two-kidney-one-clip (2K1C) method. In the experiment, all of the rats were randomly divided into four groups (n = 15 per group) before the operation: the sham-operated (Sham) group, the hypertensive model (Model) group, the low-dose tanshinone II(A) group and the high-dose tanshinone II(A) group. At 5 week after the renal artery narrowing, the third and fourth groups were administered with 35 mg kg(-1) x d(-1) and 70 mg x kg(-1) x d(-1) of tanshinone II(A), respectively. The blood pressure in rats was determined by the standard tail-cuff method in each week after the operation. After the drug treatment for 8 weeks, all the rats were put to death, and their left ventricles were separated to determine the ratio of left ventricle weight to body weight (LVW/BW), the myocardial collagen content, and the expressions of different components in myocardial RAS, including angiotensin converting enzyme (ACE), angiotensin converting enzyme 2 (ACE2), angiotensin 1-type receptor (AT1R), Mas receptor mRNA expression and angiotensin II (Ang II) and angiotensin (1-7) [Ang (1-7)] content.

RESULTCompared with the sham group, the hypertensive model group exhibited a markable increase in the content of Ang II and Ang (1-7) and the mRNA expressions of ACE, ACE2, AT1R and Mas (P < 0.01). However, the treatment with tanshinone II(A) showed the does dependence, inhibited left ventricle hypertrophy, decreased myocardial Ang II content and the mRNA expression of ACE and AT, R in renal hypertensive rats (P < 0. 01) , further increased the myocardial Ang (1-7) content and the mRNA expression of ACE2 and Mas (P < 0.01) , but without any change in the blood pressure of hypertensive rats.

CONCLUSIONThe treatment with tanshinone II(A) could inhibit left ventricle hypertrophy of renal hypertensive rats. Its mechanism may be partially related to the expression of different components in the renin-angiotensin system for regulating myocardial tissues.

Angiotensin I ; genetics ; metabolism ; Angiotensin II ; genetics ; metabolism ; Animals ; Blood Pressure ; drug effects ; Diterpenes, Abietane ; administration & dosage ; Heart Ventricles ; drug effects ; metabolism ; Humans ; Hypertension ; drug therapy ; genetics ; metabolism ; physiopathology ; Male ; Peptide Fragments ; genetics ; metabolism ; Peptidyl-Dipeptidase A ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley ; Renin ; genetics ; metabolism ; Renin-Angiotensin System ; drug effects

Objective To study the variation of acute blood pressure in different subtypes of first ischemic stroke,and investigate the influence on the prognosis.Methods A total of 710 patients with first ischemic stroke were selected.The blood pressure levels were monitored during the initial 7 hospital days.Clinical outcome was based on the combined analysis of Barthel index and the National Institute of Health Stroke Scale (NIHSS) score on the 180th day.In the subtypes of large artery atherothrombosis(LAA),cardioembolism (CE),small artery disease occlusion (SAO) were 400,160,150 cases.Logistic regression model was used to estimate the influencing factors on the prognosis.Results An U-shaped effect was observed in different subtypes between blood pressure on admission,average acute blood pressure and prognosis.In the subtypes of LAA and CE,those who had a basehne systolic blood pressure (SBP) of 140-159 mm Hg (1 mm Hg =0.133 kPa) or a baseline diastolic blood pressure (DBP) of 90-99 mm Hg on admission got good prognosis.In the subtypes of SAO,those who had a baseline blood pressure of 130/95 mm Hg on admission got good prognosis.In all subtypes,the average blood pressure of 150/95 mm Hg got good prognosis.In the subtypes of LAA and CE,those who had a baseline SBP of 120-159 mm Hg or a baseline DBP of 80-99 mm Hg within 7 d after admission got good prognosis.In the subtypes of SAO,those who had a baseline blood pressure of 140/90 mm Hg within 7 d after admission got good prognosis.In all subtypes,the average blood pressure of 140/90 mm Hg within 7 d after admission got good prognosis.Logistic regression analysis revealed that the decrease of blood pressure during the first 24 hours,deterioration within 7 d after admission,acute complication,NIHSS score on admission were the independent risk factors of prognosis,while antihypertensive therapy in the acute phase was the independent protection factor in the subtypes of LAA and CE.In the subtypes of SAO,acute complication was the independent risk factor of prognosis.Conclusions An U-shaped effect is observed in different subtypes between blood pressure on admission and prognosis.In the subtypes of LAA and CE,the decrease of blood pressure during the first 24 hours,deterioration within 7 d after admission,acute complication,NIHSS score on admission are the independent risk factors of prognosis.

China ; epidemiology ; Humans ; Occupational Diseases ; epidemiology

Objective To explore the effect on walking ability of the orthotic insole produced by the International College of Biomechanics (ICB) when it is combined with an ankle foot orthosis (AFO).Methods A total of 40 stroke survivors with hemiplegia were randomly divided into an observation group and a control group,each of 20.In addition to conventional medical treatment and rehabilitation,the control group received AFOs and walking rehabilitation training.The observation group accepted walking training with an ICB orthotic insole combined with an AFO.The experiment lasted 4 weeks.Timed up and go test (TUGT) times,10 m maximum walking speed (10 m MWS) and Berg balance scale (BBS) ratings were recorded before and after the treatment.Results Before the treatment there was no significant difference between the group averages in terms of any of the measures.After the treatment,significant improvement was observed in all of the measurements,with the improvements in the observation group significantly better than those in the control group,on average.Conclusion An ICB orthotic insole combined with an AFO results in better improvements in the walking ability of hemiplegic subjects than an AFO alone.