Objective To evaluate the efficacy and safety of self-management anticoagulation treatment for low pulmonary embolism severity index (PESI) outpatient with acute pulmonary embolism (APE).Methods Sixty-eight patients with APE of PESI grade Ⅰ-Ⅱ were divide into inpatient group and outpatient group with 34 cases each by random digits table.All the patients were treated with low molecular heparin followed by oral anticoagulation,and self-management was used in outpatient group.The efficacy was observed within 14 days and 3 months.The efficacy outcome included recurrent venous thromboembolism (VTE),standardization time of international normalized ratio (INR),VTE-related emergency department visit times,bleeding events and total mortality.Results There were 2 cases(5.9％,2/34) in inpatient group and 1 case (2.9％,1/34) in outpatient group with recurrent VTE,and there was no statistical significance between two groups (P ＞ 0.05).Standardization time of INR in inpatient group [(8.5 ± 2.9) d] was shorter than that in outpatient group [(16.1 ± 4.4) d],and there was significant difference (P＜ 0.01).There was no significant difference in the VTE-related emergency department visit times between two groups (P ＞ 0.05).There was 1 case with major bleeding and 1 death respectively in outpatient group.Conclusion It is effective and safe to give early self-management anticoagulation treatment to APE patients with PESI grade Ⅰ-Ⅱ,which could shorten time spending in hospital and release burden both physically and mentally.

Objective To investigate the cognitive behavioral characteristic longitudinally of the patients after subcortical infarction engaged in feature and binding working memory tasks.Methods The behavioral performances were recorded from 28 patients after subcortical infarction at the 1 st week (W1),3 rd moth (M3) and 6th month (M6) while performing color,location,and color-location binding delayed match-to-sample working memory task.25 healthy volunteers(controls) were investigated once using the same task protocol during the study period.Computer recorded the behavior reaction time and accuracy.Single factor variant analysis of repeated measurement was adopted.Results The accuracy of three memory tasks of M3 ((64.92 ± 5.47) ％ ; (92.88 ± 2.98) ％ ;(82.35 ±7.44)％) was improved than that of W1 ((61.06 ±7.78)％; (90.59 ±2.95)％; (77.06 ±5.58) ％) and the difference had statistically significant (P ＜ 0.05).But the reaction time of M3 ((868.31 ±118.91)ms; (833.37 ± 120.99) ms; (918.72 ± 101.28) ms) was shortened than that of W1 ((914.02 ±110.53) ms; (859.89 ± 139.94) ms; (1150.17 ± 92.02) ms) and the difference also had statistically significant (P ＜ 0.05).In the location-memory task,the correct rate of M6 ((93.91 ± 2.86) ％) was improved than that of M3 ((92.88 ± 2.98) ％) and the reaction time of M6 ((813.24 ± 119.54) ms) was shortened than M3 ((833.37 ±120.99) ms).M6 and M3 to be compared in the color memory task,the correct rate ((64.50 ± 4.49) ％ ; (64.92 ± 5.47) ％) and the reaction time ((866.47 ± 123.87) ms; (868.31 ± 118.91) ms) had no significant difference (P ＜ 0.05).But in the color-location binding task,the correct rate of M6 ((78.49 ± 7.85) ％) and M3 ((82.35 ± 7.44)％) to be compared had significant decreased nearly the level ((77.06 ± 5.58)％) of the stroke beginning.All behavioral performances of patients were worse than that of control subjects except the compare result of location-memory task in M6((93.91 ± 2.86) ％ ; (813.24 ± 119.54) ms).Conclusion Feature memory and binding memory had been damaged in different degrees in the patient after subcortical infarction.The binding memory had the secondary damage what might be related to the secondary nerve fiber degeneration after infarction.

Objective Jizhipingchuan soft capsula is mainly used to treat acute bronchitis and acute attack of chronic bron-chitis.This paper investigate the antitussive, antiasthmatic and expectorant effects of Jizhipingchuan soft capsula according to its func-tions. Methods The antitussive effect of Jizhipingchuan soft capsula was observed in cough mouse model induced by ammonia and in guinea cough pig model induced by citric acid, and the latent period of asthma was observed in guinea pig induced by acetylcholine chloride and histamine phosphate.Its expectorant effect was evaluated by the excretion of phenol red in mice and the exudation phlegm in rats. Results Jizhipingchuan soft capsula could decrease the frequence of cough induced by ammonia in mice and induced by cit-ric acid in guinea pig.It could prolong the latent period of cough in guine pig and also prolong the latent period of asthma in guine pig induced by acetylcholine chloride and histamine phosphate.Jizhipingchuan soft capsula could significantly increase the amount of phe-nol red secreted in mice and the phlegm exudation of rats. Conclusion Jizhipingchuan soft capsula showed definite antitussive, an-tiasthmatic and expectorant effects.

ObjectiveTo report 18 cases of Bowen dis ea se and erythroplasia of Queyrat.MethodsClinicopatholog ical data of 18 cases of Bowen disease and erythroplasia of Queyrat were present ed.10 cases (mean age 49 year)underwent circumcision and local resection and 8 c ases electric coagulation.Results15 cases have been fo llowed up for 4～48 months.2 cases had new disease at an untreated area and the o ther 13 have been free of the disease.Recurrence ocurred in 2 were cured with 5% 5-fluorouracil cream external application.ConclusionsThe result of the surgical treatment for Bowen disease and erythroplasia of Qu eyrat is good and an alternative therapy with 5-fluorouracil for external appli cation may be considered.Adequate biopsy including deeper tissue is necessary fo r differential diagnosis between carcinoma in situ and invasive penile carcinoma or a variety of lesions of the male genitalia.

Objective To study the clinical and pathological features of a case of retroperitoneal desmoplastic small round cell tumor. Methods One case of desmoplastic small round cell tumor was presented with review of the literature. Results A 11 years old child complained of abdominal pain and a 9.0 cm?6.0 cm?3.0 cm cystic tumor located in the left retroperitoneal space near the left kindey was resected.The connective tissue was significantly proliferated around the tumor cell nests. Immunohistochemical staining revealed CD 99 (+) and EWS/WT1 (+). After resection of the tumor,chemotherapy was performed with DDP?ifosfamide and VP16. No tumor recorrence has been noted 16 months after operation. Conclusions Desmoplastic small round cell tumor has specific clinicopathologic stigmata occuring usually in young males and the tumor was characterized by expression of MIC2 gene product CD 99 and the EWS/WT1 protein. Surgical resection with cheomotherapy is the treatment of choice.

Objective Use the automatic microbiological analysis system which for the streptococci (ATB rapid 32 Strep) to identify streptococci, and compare the examination speed and accuracy with the internationally recognized bacterium identification golden method API 20 Strep (streptococci identification biochemistry system) to enable the clinical microorganism room use ATB rapid 32 Strep identification system correctly, and provide the etiology basis to clinical promptly.Methods Isolate the bacterium from patient blood, cerebrospinal fluid, pig heart, pork and so on, then separate the streptococci in form to the blood plate, lay them in carbon dioxide incubator, after 35 ℃ 24 hours. Use ATB rapid 32 Strep,API 20 Strep and the traditional manual method to identify 18 strains of bacterias and carry on the medicine sensitive experiment.Results ATB rapid 32 Strep identified 16 strains as streptococcus suis II, 2 strains as streptococcus bovis II; API 20 Strep identified 17 strains as streptococcus suis II, 1 strain can not be identified; the tradition manually method identified all of the 18 strains as streptococcus group D . These 18 strains all sensitive to the Chloramphenicol , clindamycin, erythromycin, levofloxacin, penicillin, quinupristin/dalfopristin, cefotaxime, vancomycin and sulfafurazole , and resistant to the tetracyclin.Conclusion ATB rapid 32 Strep can identify the streptococcus suis in 4 hours , and the coincidence rate with API 20 Strep is 94.4%.So ATB rapid 32 Strep is one kind of system which could identify bacterium simply,quickly,accurately,and provide infectious disease etiology information for clinical immediately, satisfy the requirement of clinician and the microorganism examines.

The dynamica changes of the activity of serum tumor necrosis factor(TNF)was determined in 24 patients with severe burns,and the changes of cardiac and hepatic enzymes,plasma lactate and glucose,serum protein,WBC count etc were determined as well.It was found that TNF was produced in large amounts to damage and degenerate the vascular endothe-lium.Consequently intravascular emboli were more liable to occur to result in tissue hypoxia.TNF could also induce the release of polymorphonuclear neutrophils(PMNs)from the bone marrow.PMNs by chemotacsis accumulated in the inflammatory tissues to produce large amounts of toxic products,which could damage the cells and tissues directly to result in multiple organ failure.Furthermore,TNF,through the mediation of pyrogen and cachectin,could induce febrile reaction,exhaustion of glycogen reserve,and increment of muscular protein catabolism.Eventually the energy consumption of the host would be incresed and his defensive function weakened.

Objective To study the effect of gallic acid isolated from Pu-erh Tea on the peroxisome proliferators activated receptors function.Method The appropriate concentration of gallic acid added to three cell models was decided to be 50 ?g/ ml,and the activity of gallic acid on peroxime prolipevators activated receptors PPAR?,PPAR?,PPAR? was studied.Results Gallic acid could activate PPAR?,as high as 2.436 fold and the effect corresponded to that of positive drug which value was 2.438.gallic acid had no effect on PPAR? and PPAR?.Conclusion Gallic acid in Pu-erh Tea had good activity on PPAR? and this could offer scientific basis for study of the anti-diabetes and anti-hyperlipidenmia mechanism of Pu-erh Tea.

BACKGROUND: A few mesenchymal stem cells (MSCs) can be found in peripheral blood.OBJECTIVE: To isolate rabbit peripheral blood MSCs and induce its differentiation into osteoblasts.DESIGN, TIME AND SE'I-I'ING: The cytological in vitro study was performed at the Central Laboratory of Shangdong Provincial Hospital from June to December 2008.MATERIALS: A total of 6 New Zealand rabbits were purchased from Shandong Academy of Agricultural Sciences. α-MEM and L-DiEM were bought from Hyclone.METHODS: Full-thickness skin (3 cm×3 cm) (dorsal muscular layer was left) was incised at various sites of rabbit back, every 3days. Incised skin was dressed following orthotopic transplantation. Each rabbit received four consecutive wounds. Peripheral blood was collected from femoral vein before injury and 1 week after injury. MSCs were harvested from peripheral blood by density gradient cantrifugation. MSCs were divided into 2 groups, which were respectively incubated in α-MEM supplemented with 10% fetal bovine serum and L-DiEM. Cells at passage 2 and 1 ×105/cm2 were incubated in a 12-well plate and induced with H-DiEM containing osteogenic inductor.MAIN OUTCOME MEASURES: The following parameters were measured: cell morphology before and after injury; colony forming efficiency of MSCs; outcome of osteogenic induction.RESULTS: Following primary medium change and before injury, obtained cells were normal. Twenty-four hours following incubation and after injury, MSCs were spindle or polygonal, and adhered to the wall. 5-6 days later, cell colonies appeared.Compared with the L-DiEM group, the number of primary culture colony formation in α-MEM group was significantly greater (P < 0.05). Peripheral blood MSCs were spindle, tdangle or polygonal, with the presence of processes, 2-3 nuclei and cell division phase, and slowly proliferated following osteogenic induction. At day 7 after differentiation of MSCs into osteoblasts, positive rate of alkaline phosphates was above 80%. At day 21, calcium deposition was detected by Alizarin Red S (positive staining).CONCLUSION: MSCs could be harvested from peripheral blood of wounded rabbits, with characteristics of osteogenic differentiation, α -MEM was more suitable than L-DiEM for peripheral blood MSCs to growin vitro.

Objective：To investigate the changes of calcitonin gene-related peptide immunoreactive (CGRP-IR)nerve fibers in rat dental pulps during acute inflammation. Methods： Rat acute pulpitis model was established by silk thread ligation and the change of CGRP-IR nerve fibers was observed with immunohistochemical method.Results： In radical pulp,the CGRP-IR nerve fibers became denser and more heavily stained；in the coronal pulp,the number of CGRP-IR nerve fibers decreased,but the background staining was heavier. Conclusion： During acute inflammation,the amount of CGRP increases in dental pulps, and is released into the surronding tissue in a large scale in the coronal region.