Objective To investigate effect of Irbesartan on plasma endothelin-1 (ET-1) and nitrogen monoxide (NO) in elderly patients with moderate to severe essential hypertension.Methods Forty patients with essential hypertension who were ≥60 years of age and had been treated with two or more antihypertensive drugs but whose systolic pressure were ≥160 mmHg and or whose diastolic pressure were ≥100mmHg,entered into the present study. Irbesartan 150mg daily was added to their original treatment for 6 week. ET-1 and NO were measured before and 6 week after treatment.used forty-two healthy adults as controls. Results In the treatment group,ET-1 was significantly decreased and NO was significantly increased after 6 weeks,addition of Irbesartan.As compared with controls,ET-1 of treatment group was higher both before and after addition of Irbesartan ( P

Objective To evaluate curative effects of treatment with Cyclosporine and methotreate in RA patients. Methods 118 cases RA patients,randomly divide into 57 cases of MTX(control)group to adopt 15 mg.per week, for six months,and 61 cases of MTX+CsA group to adopt cotreatment with the MTX 15 mg.per week and CsA 3 mg (kg?d)to observe post-treatment of the clinical signs and index of chemical analysis.Results the results show that the clinical signs and index of chemical of two groups both obviously improvement(P

Objective To investigate the clinical value of enhanced recovery after surgery (ERAS) in patients undergoing postoperative early enteral nutrition (EEN) with radical resection for hilar cholangiocarcinoma.Methods The clinical data of 48 patients with hilar cholangiocarcinoma who were admitted to the Drum Tower Clinical Medical College of Nanjing Medical University from July 2006 to September 2014 were retrospectively analyzed.All the 48 patients underwent radical resection for hilar cholangiocarcinoma,including 24 patients receiving postoperative EEN (EEN group) and 24 patients receiving total parenteral nutrition (TPN group).The serologic indices and liver function were detected regularly after operation.Ten percent of albumin (Alb) 10 g was administered by intravenous infusion when Alb ＜ 30 g/L.The indexes of all the 48 patients were compared in the 2 groups at postoperative day 3 and 7,including the serologic indices and liver function,the exhaust time,the volume of Alb infusion,the complications (incisional infection,abdominal infection,pleural effusion,peritoneal effusion and bile leakage) and the duration of hospital stay.The patients were followed up by outpatient examination and telephone interview till September 2014.The measurement data with normal distribution were presented as x ± s,comparison between groups and count data were analyzed using the t test and chi-squared test,respectively.Results Patients in the 2 groups were cured successfully and discharged,and no patient died perioperatively.Patients in the EEN group had a good tolerance for EEN and no occurrence of EEN-related complications was detected.The level of the GGT was (108 ± 73) U/L in the EEN group,which was significantly lower than (225 ± 121) U/L in the TPN group at postoperative day 3 (t =4.041,P ＜ 0.05).The level of the GGT was (142 ± 86) U/L in the EEN group,which was no significantly different from (183 ± 107)U/L in the TPN group at postoperative day 7 (t =1.477,P ＞ 0.05).The postoperative time to anal exsufflation and the duration of hospital stay were (73 ± 18) hours and (15 ± 4) days in the EEN group,which were significantly different from (97 ± 21) hours and (18 ± 4) days in the TPN group,and the volume of Alb infusion was (44 ± 29)g in the EEN group,which was significantly lower than (101 ± 92) g in the TPN group (t =4.295,2.615,2.916,P ＜ 0.05).All the 48 patients were followed up for 1 to 71 months (mediantime,10 months),no patients received reoperation or re-admitted to the hospital due to complications.Conclusion The application of postoperative EEN in enhanced recovery of patients undergoing radical resection for hilar cholangiocarcinoma is safe and effective,it could accelerate the recovery of enteral function,shorten the postoperative duration of hospital stay and reduce the supplement of extrinsic Alb,which is helpful for the fast recovery of patients.

Objective:To investigate the clinical efficacy of mizolastine in the treatment of dermatographism. Method:32 patients were randomly allocated to two groups.Their efficacy was compared with ketotifen.A two-period cross trial was adopted.Result:The clinical efficacy of mizolastine in the treatment of dermatographism corresponded to ke- totifen,the ADRs were markedly lower than ketotifen.Conclusion:Mizolastine is effective in the treatment of dermatogra- phism.

Objective:To compare the differences in dosimetric parameters of target areas between 125I seed implantation with degradable catheters and by hand under the assistance of a real-time intraoperative treatment planning system (TPS). Methods:Forty-two simulated lesions were divided into a degradable catheter group and a free-hand group, with twenty-one lesions in each group. 125I seeds were implanted according to the TPS.The pre-plan and post-implant dosimetric parameters were collected, including the minimum dose ( Dmin), maximum dose ( Dmax), mean dose ( Dmean), conformal index (CI), external index (EI), homogeneity index (HI), minimum prescription dose delivered to 90% of the target volume ( D90), and the mean percentage of volume receiving 90% of the prescription doses ( V90). The Bland-Altman method was employed to analyze the consistency of pre-plan and post-implant dosimetric parameters and the Wilcoxon rank-sum test was used for the comparison of the two groups. Results:According to the Bland-Altman analysis, the dosimetric parameters of the two groups were all in agreement before and after seed implantation except for the Dmin and V90 of the free-hand group.Furthermore, the degradable catheter group had smaller error ranges of Dmax ( Z=-3.824, P<0.005), CI ( Z=-1.962, P<0.005), HI ( Z=-2.352, P<0.005), D90 ( Z=-2.453, P<0.005), and V90 ( Z=-3.159, P<0.005). Conclusions:The dosimetric parameters of 125I seed implantation with degradable catheters under the assistance of real-time TPS have good pre-plan and post-implant consistency and smaller error ranges.

Objective To explore the application of artificial TiMesh in supporting the serious smashing hollow fractured skull to restore its complete cranial cavity structure. Methods We retrospectively analyzed the data of 21 patients with serious smashing hollow fractured skull, admitted to our hospital from January 2004 to November 2009: surgical approaches and follow-up results were reviewed; the results of such examinations as X-ray, CT, ECT were analyzed to determine the skull plastic situation and particle bone survival situation. Results No serious postoperative complications were found in these 21 patients and the reconstruction was very successful with survival particle bones.Conclusion The artificial TiMesh, being able to conform to the physiological anatomy of human being,supports the serious smashing hollow fractured skull to restore its complete cranial cavity structure with satisfied reconstruction results and little postoperative complications.

Follicular dendritic cell (FDC) sarcoma is rare and is classified either as conventional type or inflammatory pseudotumor (IPT)-like variant. Extranodal presentation is uncommon and nearly all gastrointestinal FDC tumors are of the conventional type. IPT-like variant tumors occur almost exclusively in the liver and spleen and are consistently associated with Epstein-Barr virus (EBV). Here we report the case of a 78-year-old woman with an IPT-like FDC sarcoma presenting as a pedunculated colonic polyp. Histologically, scanty atypical ovoid to spindle cells were mixed with a background of florid lymphoplasmacytic infiltrate, which led to an initial misdiagnosis of pseudolymphoma. These atypical cells expressed CD21, CD23, CD35, and D2-40, and were positive for EBV by in situ hybridization, confirming the diagnosis. The patient was free of disease five months after polypectomy without adjuvant therapy. Although extremely rare, the differential diagnosis for colonic polyp should include FDC sarcoma to avoid an erroneous diagnosis. A review of the 24 cases of IPT-like FDC sarcoma reported in the literature reveal that this tumor occurs predominantly in females with a predilection for liver and spleen, and has a strong association with EBV.
Aged ; Colonic Polyps* ; Dendritic Cell Sarcoma, Follicular* ; Dendritic Cells, Follicular ; Diagnosis ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Granuloma, Plasma Cell ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Liver ; Pseudolymphoma ; Sarcoma ; Spleen ; Taiwan

OBJECTIVETo determine weather or not the mtDNA(4568) deletions in guinea-pig contribute to the development of presbycusis.

METHODSForty-four guinea-pigs were divided into 2 groups: group A (young control group, normal hearing, 22 guineas) and group B (aged group). The group B was subdivided into group B(1) (old normal hearing, 6 guineas) and group B(2) (old hearing loss, 16 guineas). First the guineas were tested by auditory brainstem response (ABR), and then the Cortis's tissues, auditory nerve tissues, brain and blood were harvested and the total DNA was extracted. The mtDNA(4568) deletion was analyzed by PCR.

RESULTSHearing loss was occurred with age. The mtDNA(4568) deletion incidence of aged group in all tissues was significant higher than that of young control group (P< 0.05). The incidence of mtDNA deletion in Cortis's and auditory nerve with presbycusis (B(2) group) were significant higher than that of aged normal hearing group (B(1) group) (P< 0.05). The incidence of mtDNA deletion in brain and blood was not significantly different between presbycusis and aged normal hearing group (P> 0.05).

CONCLUSIONmtDNA(4568) deletion of guinea-pig possibly contributes to aging and mtDNA(4568) deletion in Cortis's and auditory nerve tissues of guinea-pig may be associated with presbycusis. There is no enough evidence to prove that the mtDNA(4568) deletions in brain and blood are related with presbycusis.

Age Factors ; Animals ; Base Sequence ; Cochlear Nerve ; metabolism ; physiopathology ; DNA, Mitochondrial ; genetics ; Evoked Potentials, Auditory, Brain Stem ; Guinea Pigs ; Organ of Corti ; metabolism ; physiopathology ; Presbycusis ; genetics ; physiopathology ; Sequence Deletion

Objective:To observe the effects of electroacupuncture (EA) of three different frequencies (2 Hz,80 Hz and 2 Hz/80 Hz) on the free radicals in hippocampus of vascular dementia (VD) model mice.Methods:A total of 100 Kunming mice were randomly divided into a sham operation group,a model group,a 2 Hz EA group,an 80 Hz EA group and a 2 Hz/80 Hz EA group,with 20 mice in each group.The ischemia-reperfusion VD model was established by repeated blockade of bilateral common carotid arteries.Mice in EA groups began EA treatment on the 4th day after the operation.Baihui (GV 20),Dazhui (GV 14),Geshu (BL 17) and Zusanli (ST 36) were punctured and then connected to EA instrument,with different waves of 2 Hz,80 Hz or 2 Hz/80 Hz (10 min/time) applied accordingly,once a day.During the jumping stand experiment,the learning performance,memory performance and hippocampal calcitonin gene-related peptide (CGRP),nitric oxide synthase (NOS),malondialdehyde (MDA),changes in superoxide dismutase (SOD) and true choline esterase (TChE) were observed.In hippocampus,the CGRP level was determined by radioimmunoassay;the MDA level was determined by thiobarbituric acid colorimetric method;the activities of NOS and TChE were determined by spectrophotometry;the activity of SOD was determined by xanthine oxidase method.Results:Compared with the sham operation group,the performances of learning and memory decreased significantly in the model group (P＜0.01);in hippocampus,the CGRP level decreased,the MDA level increased,the activities of NOS and TChE increased,and the activity of SOD decreased in the model group.Compared with the model group,the learning and memory performances of the EA groups were significantly improved (P＜0.05 or P＜0.01);in hippocampus,the CGRP level increased,the MDA level decreased,the NOS and TChE activities decreased,and the SOD activity increased (P＜0.05 or P＜0.01).Among EA groups,the 2 Hz/80 Hz EA group was superior to the 2 Hz EA group and the 80 Hz EA group (P＜0.05 or P＜0.01).Conclusion:EA can improve the cognitive impairment of mice with ischemia-reperfusion VD.The mechanism may be related to the improvement of cerebral blood circulation,regulation of the central neurotransmitters,fighting lipid peroxidation and promoting nerve cell repair.The therapeutic effects of EA with different frequencies were different,and the intervention effect by EA at 2 Hz/80Hz is the most significant.

Purpose To explore the optimal value of noise index (NI) of adaptive statistical iterative reconstruction (ASIR) in low-dose chest examination,so as to reduce the radiation dose of patients.Materials and Methods 1200 mid-age and elderly healthy individuals were randomly divided into 4 groups according to the NI difference,with 300 in each group,group A:NI=20;group B:NI=25;group C:NI=30;group D (the normal control group):NI=14.Combined with AS IR technology,the quality of the axial image was reviewed and evaluated,and the score of each subject was given and recorded based on the quality of the image and the matching degree with the disease it indicated.Results The subjective scores of images in each group were:group A (3.53±0.43),group B (3.28±0.32),group C (3.12±0.18) and group D (5.00±0),respectively.The scores of these 4 groups were all above 3,which could be used for diagnosis.The body mass index was (24.39 ± 3.09) kg/m2,(25.49 ± 2.45) kg/m2,(25.53 ± 3.21) kg/m2 and (25.55 ± 2.28) kg/m2,respectively.The number of layers was 60.64 ± 6.38,64.42 ± 5.71,61.77 ± 6.45 and 62.32±6.15,respectively,and there was no statistically significant difference between these 4 groups (P＞0.05).The effective dose (ED) was (1.66± 0.84) mSv,(1.11 ± 0.34) mSv,(0.88±0.30) mSv and (5.99± 1.37) mSv,respectively,and the differences between any two groups were all statistically significant (P＜0.05).ED of group C was the lowest,85％ lower than group D,47％ lower than group A,and 21％ lower than group B.Conclusion Using ASIR technology,setting NI=30 can ensure that the image quality meet the needs of diagnosis,and also effectively reduce the radiation dose,which is a preferable scanning scheme.