OBJECTIVE:To compare therapeutic efficacy and safety of indapamide separately combined with benazepril,irbe-sartan or amlodipine for grade 2 essential hypertension(EH). METHODS:A total of 150 patients with grade 2 EH were randomly divided into benazepril group(50 cases),irbesartan group(50 cases)and amlodipine group(50 cases). 3 groups were given Indap-amide tablet 2.5 mg orally,once a day. Benazepril group was additionally given Benazepril hydrochloride tablet 10 mg orally,once a day;irbesartan group was additionally given Irbesartan tablet 150 mg orally,once a day;amlodipine group was additionally giv-en Amlodipine tablet 5 mg orally,once a day. 3 groups were treated for 12 weeks. The levels of systolic pressure,diastolic pres-sure,heart rate,total cholesterol(TC),three triacylglycerol(TG)and serum potassium as well as the occurrence of ADR were ob-served in 3 groups before and after treatment. RESULTS:The total response rate of berazopril group,irbesartar group and a mloelip-ire group had no significant difference(90.0% vs. 88.0% vs. 92.0%,P>0.05). There were no statistical significances in the levels of systolic pressure,diastolic pressure,heart rate,TC,TG and serum potassium among 3 groups before treatment(P>0.05). Af-ter treatment,systolic pressure and diastolic pressure of 3 groups were significantly lower than before,with statistical significance (P<0.01);but there was no statistical significance among 3 groups(P>0.05). There were no statistical significance in heart rate, TC,TG of 3 groups before and after treatment and the level of serum potassium in benazepril group and irbesartan group (P>0.05). After treatment,the level of serum potassium in amlodipine group was significantly lower than before,with statistical signifi-cance (P<0.05). The incidence of ADR in irbesartan group was significantly lower than benazepril group and amlodipine group, with statistical significance (P<0.05);but there was no statistical significance between benazepril group and amlodipine group (P>0.05). CONCLUSIONS:The indapamide separately combined with benazepril,irbesartan or amlodipine have similar therapeu-tic efficacy for grade 2 EH,but the safety of irbesartan is better than those of benazepril and amlodipine.

Objective To investigate the clinical effects of Huayutongmai decoction in treating patients with carotid atherosclerotic plaques .Methods Prospectively analyzed 102 cases with carotid atherosclerotic plaques were divided into the control group and observation group according to random number table method ,51 cases were in each group.The patients in the control group were given the Simvastatin Tablet only ,and the patients in the observation group were given the treatment of Huayutongmai decoction .The CAD,IMT,volume of plaque,PI and lipid levels were detected.The clinical efficacy and adverse reaction were observed after treatment of three months .Results After treatment of three months,the CAD,IMT,volume of plaque,PI(t=0.97,1.83,0.65,1.43) and levels of lipid(TG, TC,HDL-C,LDL-C and AI,t=1.86,1.88,1.42,1.85,1.14) of the observation group were better than those of the control group,but with no significant(all P>0.05).Conclusion Huayutongmai decoction in treating patients with carotid atherosclerotic plaques has better clinical efficacy ,can improve lipid metabolism ,eliminate and stabilize CAS to some extent ,which is worthy of clinical application .

Objective To observe the clinical therapeutic effect of Wenxintang in treating unstable angina pectoris. Methods Sixty patients of Yangqikuixu, Tanyuzuluo type suffered with unstable angina pectoris were randomly divided into two groups. 30 patients in the control group were treated with IsMo-20, Metoprolol and Aspirin, while another 30 patients in the treated group were treated with Wenxintang include the three medicines above. Each group was observed for 4 weeks respectively. Results The total effective rate in relieving angina in the treated group and the control group was 86.67% and 66.67% respectively, that in improving ECG changes was 69.23% and 47.82% respectively, the difference of the two parameters between the two groups was significant (P

Pain has been defined as an unpleasant sensory and emotional experience that is associated with actual or potential tissue damage,or is described in terms of such damage.Pain individual difference increases the complexity of clinical diagnosis and treatment of pain.China started relatively late on pain research and standardized pain treatment.It is necessary for further research on pain related to the clinical problem,the development of pain translational medicine,and improvement of clinical quality.The paper carries on the review.

Objective To investigate the clinical,endoscopic and pathologic features in the differential diagnosis between Crohn' s disease (CD) and intestinal tuberculosis (ITB).Methods The complete clinical data of 107 patients with CD and 69 patients with ITB in our hospital from January 2011 to January 2012 were retrospectively analyzed.The diagnostic value of the clinical and endoscopic scoring system was evaluated.Results CD occurred mainly in male.The salient features of CD included long duration of disease high incidence of colectomy.Comparing with patients with ITB,patients with CD have more cases of diarrhea,hematochezia,abdominal mass,intestinal obstruction,intestinal hemorrhage,perianal lesions,and extraintestinal manifestations (all P ＜ 0.05).It's more frequent to have positive results of anti-Saccharomyces cerevisiae antibody (ASCA),perinuclear antineutrophil cytoplasmic antibody (pANCA) and fecal occult blood in CD patients,as well as low albumin,high C-reactive protein (CRP),elevated platelet count and hematocrit (P ＜ 0.05 or P ＜ 0.01).The salient features of ITB included low fever,night sweats,active parenteral tuberculosis,increased erythrocyte sedimentation rate (ESR),chest X-ray abnormalities,the positive PPD (purified protein derivatives tuberculin) and T-SPOT (P ＜ 0.05 or P ＜0.01).Based on the imaging,CD often involved the small intestine,such as the intestinal stricture and abdominal abscess (P ＜ 0.05),while mesenteric lymphadenopathy was more common in ITB (P ＜ 0.05).The endoscopic examination showed that some patterns of disease involvement such as fissure-shape ulcer [41.12％ (44/107) vs 5.80％ (4/69)],cobblestone sign [15.89％ (17/107) vs 4.35％ (3/69)],lesions over four segment [24.30％ (26/107) vs 7.25％ (5/69)],rectum involvement [17.76％ (19/107) vs 5.80％ (4/69)],ileocecal valve stenosis [21.50％ (23/107) vs 8.70％ (6/69)] and mucosal bridge [5.61％ (6/107) vs 0(0/69)] were more frequent in CD patients than those in ITB patients(P ＜ 0.01 or P ＜0.05).However circular ulcers[37.68％ (26/69) vs 9.35％ (10/107)],rat-bite-like ulcers[24.64％ (17/69) vs 12.15％ (13/107)],persistent open ileocecal valves [39.13％ (27/69) vs 19.63％ (21/107)],tuberous and polypoid lesions [36.23％ (25/69) vs 20.56％ (22/107),37.68％ (26/69) vs 22.43％ (24/107)] were more common in ITB (P ＜ 0.01 or P ＜ 0.05).In terms of pathological findings,certain characteristic features such as transmural inflammation [5.61％ (6/107) vs 0 (0/69)],fissure-liked ulcers [14.02％ (15/107) vs 4.35％ (3/69)],non-caseous granulomas [5.61％ (6/107) vs 0(0/69)],lymphoid hyperplasia [16.82％ (18/107) vs 5.80％ (4/69)] and crypt abscess [9.35％ (10/107) vs 1.45％ (1/69)] were more common in CD than those in ITB(P ＜ 0.05).According to the clinical and endoscopic scoring system,the positive diagnostic rate of CD was 50.47 ％ (54/107)and of ITB was 66.67 ％ (46/69) (P ＜ 0.05).Conclusions The differential diagnosis between CD and ITB should be considered carefully based on clinical,endoscopic,pathological characteristics.The clinical and endoscopic scoring system may contribute to distinguish CD and ITB.

Objective To investigate the effects of Shouwu-Yizhi capsule on learning and memory, and the expressions of presenilin 1(PS1),β-amyloid precursor protein (APP) mRNAs in the hippocampus following cerebral ischemia reperfusion in rats. Methods Sprague–Dawley rats were randomly divided into a Shouwu-Yizhi group, a piracetam group, a model group, and a sham operation group with 20 rats in each group. Focal cerebral ischemia reperfusion model was induced by middle cerebral artery occlusion for 2 hours. Seven days after ischemia reperfusion, the rats in the Shouwu-Yizhi and piracetam groups were administered intragastrically Shouwu-Yizhi solution (52 mg/ml) and piracetam solution (28 mg/ml) for 28 days, both in dose of 1 ml/(100 g?d) for 28 days;and the rats in the model and sham operation groups were given intragastrically equivalent volumes of normal saline. Learning and memory were tested using the Morris water maze, and the expressions of PS1 and APP mRNAs were measured using real-time quantitative fluorescent PCR. Results Water maze test showed that the escape latency (12.98±0.70s vs. 9.43±0.78s) was significantly shorter, and the frequency of crossing platform (5.08±0.39 vs. 7.62±0.43) significantly lower in the model groupthan those in the sham operation group; the escape latency (9.77±0.58s vs. 12.98±0.70s) was significantly shorter and the frequency of crossing platform (7.40±0.44 vs. 5.08±0.39) significantly lower in the Shouwu-Yizhi group than those in the model group(all P<0.01). The expressions of PS1 (0.99±0.01 vs. 1.08± 0.03)and APP (1.06±0.03 vs. 1.12±0.04) mRNAs in the hippocampus in the Shouwu-Yizhi group were significantly decreased than those in the model group (P<0.05 or 0.01). Conclusion Shouwu-Yizhi capsule may inhibit the expressions of PS1 and APP mRNAs in the hippocampus, and improve the learning and memory following cerebral ischemia reperfusion in rats.

0. 05). However, the serum CYFRA21-1 level was related to the histologic classification (P

Objective To evaluate outcomes of modified transforaminal lumbar interbody fusion (TLIF) assisted by the minimally invasive expandable access system and spinal channel endoscope for acute and chronic lumbar intervertebral disc injury.Methods From March 2013 to November 2014, 45 patients with lumbar intervertebral disc injury were managed with minimally invasive (Group A) or open TLIF (Group B).Location for disc injury was at L3/4 in 5 patients, L4/5 in 28 patients and L5-S1 in 12 patients.Group A composing 12 males and 10 females showed age of (53.70 ±3.59) years (range, 43 to 67 years).Group B composing 14 males and 9 females showed age of (54.80 ± 4.37) years (range, 42 to 68 years).Between-group comparison was conducted with respect to operation time, blood loss, postoperative drainage loss, ambulation time and postoperative complications.Clinical outcomes were evaluated using the visual analogue scale (VAS), Oswestry dysfunction index (ODI), and bone fusion rate.Results Except for the comparable operation time, group A was associated with better results in the blood loss [(152.1 ± 15.5) ml vs (409.9 ± 28.3) ml], drainage volume [(106.1 ± 14.3)mlvs (223.0 ± 19.4)ml], ambulation time[(4.5 ±1.1)d vs (8.9 ±1.4)d] and 1-week postoperative VAS [(3.0±0.7) points vs (4.7 ±0.4) points] (P ＜0.05).At the final follow-up, VAS and ODI of both groups were significantly improved compared to the preoperative levels (P ＜ 0.05), but the differences between groups were insignificant (P ＞0.05).Bone fusion rate in Group A was 95％ (21/22) versus 96％ (22/23) in Group B 6-month postoperatively (P ＞ 0.05).No nerve root injury, intervertebral space infection or other complications occurred.Conclusion Modified TLIF assisted by the minimally invasive expandable access system offers the benefits of less trauma, less bleeding and a quicker recovery for acute and chronic lumbar intervertebral disc injury and has similar long-term clinical outcomes with open TLIF.

Objective To study the type variation of microglial activation in spinal dorsal horn of rats after sciatic nerve injury.Methods Healthy adult male Sprague-Dawley rats were randomly divided into the control and experimental groups, 24 rats in each group.The experimental group underwent ligation of sciatic nerve trunk to generate nerve injury in the rats.The pain behavior in the rats was measured at the 1th, 7th and 14th postoperative days, and the changes of microglial activation in the rat lumbar spinal cord dorsal horn was detected by immunofluorescence staining.qRT-PCR assay was used to validate the activation trends of M1 and M2 types of microglia cells.Results No significant changes were found in the microglial cells in the spinal cord dorsal horn of rats in the sham-operation group during 14 days after operation.In the sciatic nerve ligation group at 1 day after operation, no significant change was observed in the number of microglial cells, but the expression of marker of M1 microglia was significantly increased.At 7 and 14 days after operation, the number of microglial cells and the expression of M1 microglia marker in the spinal cord dorsal horn were increased significantly.Conclusions Microglia activation in the spinal dorsal horn starts at the first day after sciatic nerve injury, and lasts at least for two weeks after the operation.M1 microglia activation dominates during this period.

Objective The aim of this study was to evaluate the individual and combined diagnostic value of five tumor markers in the elderly patients with pleural effusion. Methods Serum and pleural levels of cytokeratin fragment19(CYFRA21 1), neuron specific enalase(NSE), carbohydrate antigen15 3(CA15 3), carbohydrate antigen19 9(CA19 9) and carbohydrate antigen 125(CA125) were assayed in 32 elderly patients with malignant pleural effusions resulting from advanced lung cancer and in 30 elderly patients with benign pleural effusions by ELISA. Results Serum levels of CYFRA21 1, NSE, CA15 3, CA19 9 and CA125 in patients with malignant pleural effusions were (12 84?6 48) ?g/L, (22 07?11 25) ?g/L, (65 74?30 26) kU/L, (56 32?25 67)kU/L and (71 86?31 45) kU/L, respectively and were significantly higher than those patients with benign pleural effusions (P