目的观察75岁以上老年人急性心肌梗死(acute myocardial infarction,AMI)静脉溶栓治疗的疗效。方法48例75岁以上采用尿激酶溶栓治疗的患者与同期94例<75岁的AMI患者溶栓治疗做对照。结果≥75岁组的再通率为68.7%,<75岁组为72.3%;轻度出血分别为6.3%和5.3%,重度出血均为0%;心率失常分别为41.6%和49.9%;病死率为6.3%和5.3%。两组患者12h静脉溶栓治疗再通率无显著性差异,并发症及病死率也无显著性差异(P>0.05)。结论75岁以上老人静脉溶栓治疗是安全有效的。

Objective To study the effective method of improving the diagnosis and treatment of blunt liver injury.Methods The clinical data of 135 cases with blunt liver injury hospitalized in Daxing District People' s Hospital from January 2000 to October 2010 were reviewed retrospectively.Results By standard grading of American Society of Trauma Surgery (AAST) in 1994,36 cases were grade Ⅰ,42 cases gradeⅡ,33 cases gradeⅢ,14 cases grade Ⅳ,10 cases gradeⅤ.Fifty-one cases were treated by non-operative therapy,among which 42 cases were crued,9 cases underwent operative surgery.Ninety-three cases were treated by operative therapy,seven cases died.The morbidity related to blunt liver injury was 5.19％.Conclusions Non-operative therapy may be used firstly in patients with stable hemodynamics,but close monitoring should be done for changes of the life signs.Timely and reasonable choice of time and the way of surgery is important to avoid complications and reduce the mortality rate.

s Objective: To investigate the comorbidity of depression and anxiety in primary school students. Methods:565 pupils ranged from 2 to 6 grade in a primary school were tested by The Screen for Child Anxiety Related Emotional Disorders (SCARED) and Depression Self-Rating Scale for Children (DSRSC). Results: There were 140 pupils with a total score higher than cut-off point of SCARED; 97 pupils with a total score higher than cut-off point of DSRSC; 43 pupils with total scores higher than cut-off point of both SCARED and DSRSC, and the positive rate of comorbidity of anxiety and depression was 7.61%. 30.71 percent of children with anxiety disorder was considered co-morbiding depression; 44.33 percent of children with depressive disorder was considered comorbiding anxiety. Chil-dren with comorbidities had higher scores in Withdrawn(mean rank 297.7 ) than Anxiety group(220.8) and Depressive group(202.2);Somatic Complaints(268.2)than Anxiety group (232.2 ) and Depressive group(206.2 ) , Anxious/Depressed (277.2 )than Anxiety group (227.7 ) and Depressive group(219.2 )of CBCL(?~2 =16.72～22.71,P

Objective To analyze the appropriate time selection of pregnancy and delivery in women with systemic lupus erythematosus (SLE ). Methods Twenty-nine pregnancies in women with SLE in our hospital from 1998 to 2003 were retrospectively analyzed regarding the selection of appropriate time of pregnancy and delivery. Results All patients did not take any cytotoxic medicine for at least 6 months before pregnancy. Twenty-three conceptions occurred when SLE was inactive for at least 1 year. Two conceptions occurred when SLE was active without doctors' agreement SLE was diagnosed during pregnancy in the remaining 4 cases. The condition of all patients fluctuated and the gestational time at delivery ranged from 30 to 38 weeks after we modified the doses of glucocorticoid (prednisone). Among totally 29 living neonates, eight were premature neonates, three were FGR and one had serious congenital heart disease. Two neonates died of complications in early stage of neonatal period. None of the 29 neonates from all patients had neonatal lupus. Conclusion Pregnancy safety will be improved obviously if the condition of SLE is controlled and the patients are given reasonable doses of glucocorticoid and intensive monitoring. If pharmacotherapy does not work well and the condition threatens the safety of mother and fetus, or the fetus has matured, termination of pregnancy should be done on time, which reduces maternal complications and improves the perinatal mortality rate. The gestational time should be 34 to 38 weeks.

Objectives To determine the effects of Matrine (Ma) on signal transducers and activators of transcription (STAT) 1, 3, connective tissue growth factor (CTGF) and platelet -derived growth factor (PDGF) in glomerular mesangial cells (MC) induced by lipopolysaccharide (LPS), and to explore the protective mechanisms of Ma. Methods Ma were added to cultured glomerular mesangial cells which were exposed to LPS for 12, 24 and 48 hours. Real time polymerase chain reaction were used to determine STAT1, 3, CTGF, PDGF mRNA, The protein expression of STATI, 3 and p-STAT1, 3 were observed by Western blot. Results Compared with the control group, MC proliferation of the LPS group (10μg/ml) significantly increased, which were suppressed in the Ma (320 μg/ml) group (P < 0.01) at 12, 24, 48 hours. The expression of STAT1, 3, CTGF, PDGF mRNA and the levels of p-STAT1 , p-STAT3 protein was significantly increased in MC under LPS medium at 12, 24, 48 hours, which were obviously lower in Ma group than those of the LPS group, especially at 24, 48 hours. Conclusions The protective mechanisms of Matrine is considered to down-regulate the expression of STAT1, 3, CTGF and PDGF.

Objective To study the effect of oxymatrine on p-STAT3 and PIAS3 signaling molecule and it's mRNA expression in the proliferation of the human mesangial cells (HMCs) induced by lipopolysaccharide(LPS) and to explore their relationship. Methods HMCs were divided into three groups: control group, LPS group and oxymatrine group. HMC proliferation was detected by methyl thiazolyl tetrazolium (MTT) assay. Type Ⅳ collagen in the supernatants of the cultured HMCs was detected by ELISA at 12, 24, 48 hours respectively. At the same time, the protein and mRNA expressions of p-STAT3 and PIAS3 were measured by Western blot and real-time quantitative RT-PCR. Results The cell proliferation, the mRNA and protein expression of type Ⅳ collagen, p-STAT3 in LPS group were increased compared with the control group (P<0.01), but they were decreased in oxymatrine group (P < 0.01). The expressions of protein and mRNA of PIAS3 in LPS group were decreased significantly compared with control group (P<0.01), but they were increased in oxymatrine group (P<0.01). Conclusion Oxymatrine can down-regulate the expression of p-STAT3 and up-regulate the expression of PIAS3, which plays an important role in the process of LPS-induced HMCs proliferation.

Eighty-five endophytic fungal strains were isolated from the roots、stems and leaves of Polygala tenuifolia Willd, among which, fifty-two from natural plants and thirty-three from cultivated ones. Sev-enty-six strains were classified as twenty-three fungal genera. The inhibitory activity screening to fourteen microbe were conducted research. The results showed that some endophytic fungi had remarkble inhibitory activities to Bacillus subtilis, Shigella sonnei, Escherichia coli, Candida albicans, Fusarium kyrushuense and they were all belonged to Fusarium, Alternaria, Aphanocladium respectively. All of the endophytic fungi isolated from Polygala tenuifolia showed no inhibitory activities to Staphyloccocus aureus, Salmonel-lae enteritis, Bibrio parahemolyticus.

Objective To observe the effect of oxymatrine(OM) on the expressions of p-STAT1 and PIAS1 signaling molecules at protein and mRNA levels in the proliferation of the human mesangial cells(HMC) induced by lipopolysaccharide(LPS) and explore the relationship between them.Methods HMCs were primarily cultured from a 4-month-old aborted human fetus(with informed consent and approved by the Ethics Committee of Lanzhou University),and then divided into 3 groups,that is,control group,LPS group(10 ng/ml) and OM group(LPS 10 ng/ml and OM 320 mg/L).After cultured for 12,24 and 48 h respectively,HMC proliferation were analyzed by methyl thiazolyl tetrazolium(MTT) assay and type Ⅳ collagen in the supernatants were detected by ELISA.At the same time points,the cells lysates were collected for the mRNA and protein expressions of p-STAT1 and PIAS1 by real-time quantitative RT-PCR and Western blot analysis.Results The cell proliferation of LPS group was faster and the type Ⅳ collagen protein was increased more than the control group(P

Objective To obtain the economic data in the aspects of cost-effectiveness and cost-utility of neonatal congenital hypothyroidism(CH) screening in Foshan City and to make assessment on the effect of screening works.Methods The economic related data were collected by the screening center,literatures,official resources and questionnaire investigation.The statistical tool and Tree Age Pro health decision analysis software were used to conduct the assessment on the cost-effectiveness and cost-utility of screening works.Results The screening program invested 17.95 million Yuan in total during 2000-2007,and the gain benefits was 117.69 million Yuan,net benefit was 9 975.52 ten thousand Yuan.The cost-benefit ratio was 1.00∶6.56.Each investing 3 216 Yuan could avoid a disability-adjusted life year.Conclusion The CH screening item has good economic applicability and is worth investing more funding for further promotion and popularization.

Objective To find the effective therapeutic arrangement through investigating the clinical characteristics of chronic cardiac insufficiency with anaemia. Methods A total of 46 cases of anemia from 315patients who had been admitted to department of cardiology, the First Affiliated Hospital, Harbin Medical University for chronic cardiac insufficiency with anaemia were selected. They were divided into two groups. There were 22 patients in the first group who only accepted treatment to improve cardiac function (normal cardiac, diuretic,vasodilator therapy, etc.), and 24 patients in the second group who accepted treatment to improve cardiac function while receiving anti-anemia therapy treatment, oral ferrous sulfate tablets(0.3 g/tablet), 1 tablet each time, 3 times a day and(or) 2 times per week subcutaneous erythropoietin 3000 U. The hemoglobin(Hb), red blood cell(RBC) ,hematocrit (HCT), left ventricular ejection fraction (LVEF), fractional shortening (FS), stroke volume (SV) , cardiac output(CO) and E peak and A peak ratio(E/A) were observed before and after treatment. By logistic regression, grade grade Ⅱ , Ⅲ , Ⅳ, the incidence of anaemia were 7.9% (10/126), 19.2% (23/120) and 24.6% (17/69),respectively. Grade Ⅱ compared with grades Ⅲ, Ⅳ, the difference was statistically significant (x2 = 4.08, 3.12, all (3.49 ± 0.17) × 1012/L, (0.36 ± 0.08)%, (48.9 ± 3.11)%, (15.6 ± 1.8)%, (38.9 ± 3.7)%, (4.4 ± 1.6)% and (130.7 ±5.75)g/L, (4.12 ± 0.25) × 1012/L, (0.43 ± 0.02)%, (58.5 ± 2.65)%, (18.0 ± 2.5)%, (49.1 ± 7.7)%, (5.1 ± 1.2)%in the first and second groups, respectively. The difference between the two groups was statistically significant(t =value of Hb, RBC, HCT, LVEF, FS,SV, CO were (102.7 ± 6.93)g/L, (3.41 ± 0.12) × 1012/L, (0.35 ± 0.07)%,(47.5 ± 2.86)%, (16.0 ± 2.4)%, (38.2 ± 7.9)%, (3.7 ± 1.4)%, respectively. Compared with those after treatment,the difference was statistically significant (t = 15.632, 13.325, 5.569, 17.182, 3.186, 2.999, 3.074, all P ＜ 0.05);Ⅳ-level relative risk were 1.62, 3.14(P ＜ 0.05 or ＜ 0.01) . Conclusions Based on the standard treatment with treatment of anemia, cardiac contractile function can be improved.