Objective To investigate the clinical value of detecting D-Dimer(DD) combined with cTnⅠ in the early diagnosis of acute myocardial infarction(AMI).Methods The plasma DD and cTnⅠ were determined and compared in 47 patients with AMI(observation group) and 41 patients excluding cardiovascular diseases(control group).Results The positive rates of DD and cTnⅠ in observation group were higher than the control(78.72% vs 9.75%,87.23% vs 0,both P<0.01).The separate test of DD and cTnⅠ in observation group,sensitivity were 78.72%,87.23% respectively,specificity were 90.24%,100% respectively.While the union test,sensitivity and specificity were 93.61%,95.12%.Conclusion Determining plasma DD combined with cTnⅠ can obviously enhance the early diagnosis rate ofAMI.

Objective To investigate the clinical value of detecting platelet parameters and high sensitivity C-reactive protein(hs CRP) in patients with acute myocardial infarction(AMI).Methods The platelet four parameters,including platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW) and platelet-large cell ratio(P-LCR) Hs-CRP were detected in 46 patients with AMI and 32 health examiners(control group).Results The levels of PLT in the AMI group were lower than that of the control group,while the levels of MPV,PDW and P-LCR in AMI group were higher than that of the control group(P < 0.01).The level of Hs-CRP in AMI group were higher than that of the control group(P < 0.01).Conclusion The levels of platelet parameters and Hs-CRP are closely correlated with the occurrence and progress of AMI.They may be used as important indexes of the attack and severity degree of AMI.

AIM: To investigate the effects of deep-frozen treatment on the immune response of bone-patellar tendon-bone(BPB) xenograft rejection.METHODS: A muscle pocket model was used to study the immune response of rat to deep-frozen treated BPB xenograft from guinea pig,autograft and fresh xenograft served as controls.The expression of T-cell surface activation antigen CD25 in the peripheral blood and the morphological changes of the implants were used to measure the immune response.RESULTS: The expression of CD25 in CD4+,CD8+ cells greatly increased 3 d after fresh BPB xenograft,the obvious difference to that of autograft(P0.05) was observed.It reached a peak level 14 d after fresh BPB xenograft and didn't decrease 35 d after transplantation.The expression of CD25 in CD4+,CD8+ cells was greatly inhibited in deep-frozen treated BPB xenograft.Its expression was delayed and just had a small increase 14 d after transplantation.The P values were all less than 0.05 compared to those of fresh xenograft at every time-point after transplantation.Histologic examination showed that there were a few lymphocytes surrounding the bone and tendon tissue in deep-frozen treated BPB xenograft,but the lymphocytes hadn't invaded into the tissues.No tissue necrosis,but a clear tendon structure and regular fibrogen arrangement were observed.There were large amount of fragmentary lymphocytes infiltrating into or surrounding the bone and fibrogen tissues after fresh xenograft,the bone was broken into pieces,the tendon structure was unclear and the fibrogen arrangement was irregular,quite a few of inflammatory cells such as acidophilic granulocytes and macropolycytes were found in some slices.CONCLUSION: Deep-frozen treatment markedly reduces BPB xenograft antigenicity and inhibits the immune rejection.

OBJECTIVE:To investigate the relation between CD4(+) and CD8(+) T lymphocyte infiltration and apoptosis of the neurons in the local traumatic brain tissue after brain trauma in rats. METHODS:In rat models of brain trauma, the changes in the number of CD4(+) and CD8(+) T lymphocytes and the apoptosis of neurons in the local traumatic brain tissue were observed by immunohistochemistry at different time points after brain trauma. RESULTS:Twenty-four hours after brain trauma, a significant increase in the number of CD4(+) and CD8(+) T lymphocytes occurred in the injured brain tissue, both reaching the highest levels on day 10, at the point of which the number of CD4(+) cells increased by about 15 folds and that of CD8(+) cells by about 20 folds compared with the control groups. The CD4(+) and CD8(+) T lymphocytes both began to decrease 30 days after the injury. A similar pattern of alterations was found in the apoptosis of neurons in the local brain tissue. Correlation analysis demonstrated a close positive correlation between the changes in CD4(+) and CD8(+) lymphocyte numbers and the number apoptotic neurons in the injured brain tissue. CONCLUSIONS:Brain trauma induces obvious increases in CD4(+) and CD8(+) T lymphocytes and enhanced cellular immune response in the injured brain tissue to mediate neuronal apoptosis and further exacerbate the brain tissue injuries.

This paper puts forward the design principles and construction plan of web-based emergency medicine course through analysis of the features and status of the course,which include the design according to course frame,teaching aim,students,and the design of navigation system etc.The paper points out the advantage for the network-based course.It will benefit to improve the self-learning ability of students and teaching effect by developing web-based emergency medicine course.

目的 观察依达拉奉治疗急性外伤性脑出血的疗效和安全性.方法 将93例急性外伤性脑出血患者随机分为治疗组46例和对照组47例.两组均根据出血量给予不同剂量的脱水剂,控制血压及血糖,并给予脑细胞活化剂.治疗组在此基础上.采用依达拉奉注射液30 mg加入生理盐水250 ml中静脉滴注,2次/d,共14 d.结果 治疗组在治疗后第7、14、21天的神经功能缺损评分及日常生活活动能力评分均显著优于对照组(P<0.05和P<0.001);治疗组的显效率和总有效率均高于对照组,两组比较有显著性差异(P<0.05和P<0.01);治疗组未见明显副作用.结论 依达拉奉急性外伤性脑出血安全有效.

Objective: To observe the effect of ulinastatin in treating acute pancreatitis(AP) and its safety.Methods: 131 cases with AP were randomly divided into treatment group and control group.Two group received routine treatment.In addition,the treatment group were given ulinastatin for five to ten days.Results:①There was not significant difference in total effectiveness rate between two groups in light type(100% vs 97.2%,P0.05),but the cured rate of treatment group in light type was significantly higher than that of control group(73.5% vs 47.2%,P0.05).②The total effectiveness rate of treatment group in severe type was significantly higher than that of control group(87.1% vs 63.3%,P0.05),the cured rate of treatment group in severe type was significantly higher than that of control group too(61.3% vs 33.3%,P0.05).The rate of complication in treatment group was significantly lower than that of control group(6.5% vs26.7%,P0.05),and had few side effects occurred.Conclusion: Ulinastatin can evidently inhabit AP in early stage without obvious side effects.

Objective: To assess the clinical effect and side effect of combining tanreqing with lomefloxacin for the treatment of senile pulmonary infection.Methods: Ninety-six senile patients with pulmonary infection were divided randomly into study group and control group,each with 48 cases.On the basis treated with anti-asthmatic and sputum-dissolving agents as well as lomefloxacin in the two groups,tanreqing was added for the therapy of patients in study group.Results: The effectual rate in study group was significantly higher than that in control group(85.4% vs 60.4%,P0.01).The total effective rate in study group was significantly higher than that in control group(95.8% vs 79.2%,P0.05).there were no obvious side effects.Conclusion: Combining tanreqing and lomefloxacin for the therapy of senile patients with pulmonary infection is effective and safe.

目的:应用Meta分析方法进一步了解碟脉灵注射液治疗急性脑梗死的临床疗效和安全性.方法:①于2006-03检索中国期刊网全文数据库1994-01/2006-12关于碟脉灵注射液(苦碟子制剂)治疗脑梗死的文章27篇,主题词包括碟脉灵注射液和急性脑梗死.文献纳入标准:论文内容包含有碟脉灵注射液治疗急性脑梗死的对照研究;治疗效果以改良的爱丁堡一斯堪的那维亚量表的量化性质反映出来.②应用Meta分析方法对检索出的符合要求的11项研究进行同质性检验,计数资料采用四格表数据的Meta分析方法(Peto法)计算比值比(OR)和95%可信区间(CI).计量资料计算合并检验统计量(Z)及合并效应指数(d平均).结果:最初纳入文献27篇,最终纳入Meta分析的文献11篇.①同质性检验结果:χ2=6.66,自由度为10,P＞0.05.②两组疗效合并效应量的检验结果:碟脉灵治疗组的总有效率明显高于对照组[90.0%,80.2%,χ2=29.32,P＜0.01(OR=2.51,95%CI:1.78～3.50)].③临床神经功能缺损评分结果显著性检验:碟脉灵治疗组的Z1=31.25,P＜0.01;对照组的Z2=18.16,P＜0.01.表明两组患者经治疗后神经功能缺损均有显著改善,且碟脉灵治疗组的疗效优于对照组(Z1＞Z2);效应大小评估:碟脉灵治疗组的d平均=1.84(d平均=0.8为大效应),对照组的d平均=1.32,提示两组治疗的效应均很大,且碟脉灵治疗组的效应大于对照组.④碟脉灵治疗组均未见明显不良反应出现.结论:碟脉灵注射液治疗急性脑梗死的疗效显著优于目前常用药物,且无明显不良反应.

目的:为临床减少急腹症误诊的发生提供借鉴.方法:通过回顾我院近5年来以急性阑尾炎收入院的病例,找出出院诊断为其他急腹症的病例17例,分析总结其误诊原因.结果:误诊病例中,结肠肿瘤2例,妇科疾病10例,泌尿系统结石3例,肠系膜静脉栓塞1例,带状疱疹1例.结论:完整的病史询问是避免误诊的前提条件,急诊科医生应向全科医生方向培养,应将尿HCG检查和腹部B超检查作为急腹症女性病人的常规检查,CT检查是确诊急性阑尾炎的有效手段.