Objective To investigate the effect of telmisartan on serum adiponectin, endothelial cell differentiation and carotid atherosclerosis in patients with essential hypertension.Methods A total of 126 patients with essential hypertension enrolled in our hospital from April 2012 to September 2016 were randomly divided into the conventional group (n=61) and telmisartan group (n=65), telmisartan group was given compound telmisartan ; Conventional group was treated with compound losartan.After treatment, blood pressure, adiponectin, nitric oxide, endothelin and carotid intima-media thickness were measured. Results The systolic blood pressure and diastolic blood pressure of telmisartan group were slightly higher than those in the conventional group;The levels of ADPN and NO in the telmisartan group were higher than those in the conventional group, while the EL and IMT were lower than those in the conventional group(P<0.05). The effective rate of telmisartan group was higher than that of the conventional group (P<0.05).Conclusion Telmisartan can effectively control and reduce the blood pressure in patients with essential hypertension, repair vascular endothelial differentiation and inhibit the progression of atherosclerosis.

Objective To investigate a safe and effective method to correct the over rotation of nasal tip in rhinoplasty. Methods 16 cases, including 11 of primary and 5 of secondary over rotation of nasal tip, were corrected with strut grafts using autologous cartilage or combined with Medpor to reconstruct the supporting structures underneath to improve the upward and forward strength of the nasal tip in order to increase the nasal height and to correct the over rotation of of nasal tip. The shield and cap grafts were also used for the patients whose nasal tip were too low, with vertical dome division technique. Results 16 cases were corrected satisfactorily, the nasal lip angles were normal and there were no complications by follow-up from 6 months to 1 year. Conclusion It is necessary to provide powerful forward and upward strength to correct the over rotation of nasal tip effectively and safely, and proper cartilage grafts can im-prove the height of the nasal tip and correct the over rotation of the nasal tip further.

5 cases diagnosed with Dandy-Walker Syndrome from May 2006 to November 2009 were investigated and relevant literature reviewed. Dandy-Walker Syndrome was characterized by retarded motordevelopment and cerebellar signs. The latter was observed in 3 cases in our series. The disorder, mostly influencing childhood, typically causes the fourth ventricle enlarged, and the cauda cerebelli atrophic or even absent. MRI is the most optimal radiological method to diagnose it.

Objective:To observe the impact of rehabilitation training,acupuncture-moxibustion combined with Danshen Chuanxiongqin acupoint injection on the patients with shoulder-hand syndrome (SHS) after cerebral infarction (CI).Methods:82 patients with SHS after CI from March 2014 to March 2016 in our hospital were randomly divided into the group A and the group B (n=41).Patients in the group A received comprehensive drug therapy,acupuncture and rehabilitation training,the group B was given Danshen Chuanxiongqin acupoint injection therapy based on the group A.Before and after treatment,the upper limb movement function score (FMA),digital pain score (NRS),the degree of swelling in the shoulder joint,shoulder joint of motion (ROM),and neural function defect scale (CNFDS),daily life activities ability (MBI) and quality of life scores (WHOQOL) of patients in two groups were compared and analyzed.Results:After treatment,the scores of NRS,shoulder swelling,upper extremity CNFDS were significantly higher than those before treatment,the ROM,while the upper extremity FMA,MBI and WHOQOL of both groups were significantly decreased (P＜0.05),these index improved more significantly in group A than those of group B (P＜0.05).Conclusion:Rehabilitation training,acupuncture-moxibustion combined with Danshen Chuanxiongqin acupoint injection was more effective in the treatment of SHS after cerebral infarction than rehabilitation training and acupuncture-moxibustion.

Objective To investigate the application of the parietal branches of superficial temporal artery island flap in the complex scalp defects.Methods A parietal branches of superficial temporal artery island flap on the ectatic scalp flap was designed to repair the complex scalp defects in 25cases and the repairing effect was observed.Results The island flaps were survived completely in 24patients,in which 1 patient had partial necrosis because of the flap tension was too large,but healed after local dressing and debridement.After followed up 6～ 12 months,the color and texture of the flap were the same to the surrounding normal scalp,and the shape was satisfactory.The flap donor site of hair growth was good,with well healing and no obvious complications.Conclusions The parietal branches of superficial temporal artery island flap can repair the complex scalp defects with the flexible flap design and movement.The flap survives well and the repair area is large.The flap and the surrounding scalp connects good.Therefore,it is a good method strongly recommended for small area complex scalp defects repair in clinics.

BACKGROUND:Hematopoietic reconstruction of malignant tumor in hematopoietic system is related to disease itself,pretreatment program and therapeutic tool after transplantation;especially,mobilization.collection and cryopreservation of auto-peripheral blood stem cell play a key role in successful reconstruction of hematopoietic system after transplantation.OBJECTIVE:To investigate the reconstruction of hematopoietic system through mobilization, collection and cryopreservation of auto-peripheral blood stem cell in patients with malignant tumor and analyze the effective factors on quantity and quality of auto-peripheral blood stem cell.DESIGN:Case analysis based on malignant tumor in hematopoietic system.SETTING:Department of Blood,Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA;Department of Blood,Zhujiang Hospital,Nanfang Medical University.PARTICIPANTS:A total of 18 patients with malignant tumor in hematopoietic system were selected from Department of Blood,Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA.Their ages ranged from 1 6to 56 years.Among them,2 patients had acute myelogenous leukemia(AML),1 acute lymphoblastic Ieukemia(ALL),2 lymphoblastic Ieukemia (LL),2 chronic granulocytic leukemia(CGL),4 multiple myeloma(MM),and 7 non.Hodgkin lymphoma.Granulocyte colony-stimulating factor(G-CSF)was made by Chugai Pharmaceutical Company Limited (batch number:N3G31).METHODS:①All patients were mobilized with associated chemotherapy+G-CSF.Associate chemotherapy:Patients with leukemia were given 2 g/m2 arabinosyl cytosine every 12 hours from lhe first to the third days and 200 mg/m2 etoposide or 50 mg/m2 fludarabine from the first to the fifth days. In addition patients with MM were treated with arabinosyl cytosine as the same way mentioned above and with 1 g/m2 cyclophosphamide from the first to the second days. And patients with lymphoma were given 2 g/m2 cyclophosphamide from the first to the second days. When numbers of leucocyte of all patients decreased below 1.0×109L-1 after chemotherapy.G-CSF started mobilization and the collection was stopped with 5μg/(kg·d)subcutaneous injection.②When numbers of leucocyte increased to (4.0-10.0)×109 L-1,hemopoietic stem cells of peripheral blood were collected till the amount of mononuclear cells≥4.0×108/kq or numbers of CD34+ cells≥2.0×108/kg.And then,the samples were dealt with cooling device.maintained in liquid nitrogen at-196℃ and defrosted in water bath at 37-40℃.③Focal sites of patients were pretreated with local irradiation with 200 cGy/time and 5 times/week for 4 successive weeks.The total dosage was 40 Gy.At 48 hours later,(55.3±28.7)mL hemopoietic stem cells of peripheral blood were transfused back. And the duration from transfusion to collection was about(56.5±22.3)days.300 μg/d G-CSF was subcutaneously injected into all patients at 1 day after transplantation and the reaction was stopped at the phase of neutrophil≥0.5×109L-1. Finally. Refusing-staining rate of trypan blue of peripheral blood stem cell, amount of mononuclear cells, number of granulation-monophyly progenitor cell colony and percentage of CD34+ cells were detected before and after thaw.MAIN OUTCOME MEASURES:①Collection of auto-peripheral blood stem cell;②survival rate and related markers of auto-peripheral blood stem cell after cryopreservation;③hematopoietic reconstruction of auto-peripheral blood stem cell after transplantation.RESULTS:All 18 patients with malignant tumor in hematopoietic system were involved in the final analysis.The mean collection time of auto-peripheral blood stern cell was 12.6 days after chemotherapy.the collection times were 1.9.total number of leucocyte was(8.93±1.27)×1 0.L-1 on the first day,and collection rate of mononuclear cell was (138.33±28.61)%. ②Refusing-staining rate of trypan blue of auto-peripheral blood stem cell was similar before and after cryopreservation[(96.26±1.33)%, (92.75±2.04)%,P＞0.05].in addition,after cryopreservation,recovery rates of mononuclear cells,CD34+ cells and granulation-monophyly progenitor cell were(91.96±1.37)%, (85.94±0.64)%and (87.69±4.53)%,respectively.Collection rate of mononuclear cells,number of granulation-monophyly progenitor cell colony and percentage of CD34+ cells were lower in patients with myeloma than in those with leukemia and lymphoma (t=2.524-3.268.P＜0.05).③At 15 days after transplantation,15 patients had the neutrophil≥0.5× 109L-1;at 20 days after transplantation,blood platelet was≥20 × 100 L-1.granulation-monophyly progenitor cells[(18.67-26.82)× 105/kg] of 5 patients grew poorly if the course of chemotherapy was more than 10 times.Among them,3 patients had delayed hematopoietic reconstruction after transplantation of auto-peripheral blood stem cell.CONCLUSION:①High-dose chemotherapy combined with G-CSF can shorten collection time of peripheral blood stem cell and improve collection rate of mononuclear cells.②Increase of chemotherapy times before transplantation can affect quantity and quality of auto-peripheral blood stem cell and cause delayed hematopoietic reconstruction.

Objective To investigate the corrections of critical closing pressure (CrCP) with cerebral vasospasm (CVS),delayed cerebral ischemia (DCI) and outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods Patients with aSAH were retrospectively enrolled.CrCP was calculated on the basis of recorded arterial pressure and blood flow velocities at the proximal middle cerebral artery detected by transcranial Doppler.Univariate analysis and multivariable logistic regression analysis were used to identify the factors influencing CVS,DCI and poor outcome (Glasgow Outcome Scale scores 1-3).The correlations between CrCP and CVS,DCI and poor outcome was analyzed.Results A total of 104 patients with aSAH were included in the study,including 56 (53.8％) with CVS,and 36 (34.6％) with DCI.100 patients were included in the analysis of the outcome,including 47 cases of poor outcome.There were significant differences in CrCP values before and after CVS (40.2 ± 11.5 mmHg vs 33.8 ± 10.4 mmHg,1 mmHg =0.133 kPa;t =3.089,P=0.001).Multivariable logistic regression analysis showed that CrCP is the independent risk factor of CVS (odds ratio [OR] 1.149,95％ confidence interval[CI] 1.112-1.352;P =0.019),DCI (OR 13.413,95％ CI 3.458-51.710;P =0.005) and poor outcome (OR 1.832,95％ CI 1.088-3.357;P =0.042) in patients with aSAH.Conclusion Increased CrCP was independently associated with CVS,DCI,and poor outcome in patients with aSAH.