Objective To investigate the clinical efficacy of irbesartan hydrochloride and its effect on serum levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in patients with essential hypertension.Methods From 86 patients with essential hypertension who were treated in our hospital from July 2014 to September 2016 were randomly divided into experimental group and control group.43 patients in the control group were treated with irbesartan tablets.Group 43 patients were treated with irbesartan hydrochlorothiazide tablets,and the clinical efficacy,blood pressure and serum TNF-α,IL-6 factor and the incidence of adverse reactions were compared between the two groups.Results The effective rate was 93.02％in experimental group the total effective rate control group was 76.74％,the total effective rate of the experimental group was significantly higher than the control group,the difference was statistically significant(P<0.05).Before and after treatment,the systolic and diastolic blood pressure were higher in the experimental group and the control group,and there was no significant difference between the two groups.After eight weeks of treatment,Systolic and diastolic blood pressure were decreased,and the degree of decline in the experimental group was more obvious,the difference between the two groups was significant,statistically significant(P<0.05).There was no significant difference in serum TNF-α and IL-6 between the experimental group and the control group before treatment.After eight weeks of treatment,the serum TNF-α,IL-6 factor decreased,and the degree of decline in the experimental group was more obvious,the difference between the two groups was significant,statistically significant(P<0.05).The incidence of adverse reactions was 2.33％in 43 patients,43 cases of ankle edema in the control group,3 cases of dizziness and headache,2 cases of mild uric acid and two cases of adverse reaction.The incidence of adverse reactions was 16.28％,The incidence of adverse reactions in the experimental group was significantly lower than the control group,the difference was statistically significant(P<0.05).Conclusion The treatment of essential hypertension with irbesartan hydrochloride is obvious,and the serum TNF-α and IL-6 are decreased and the safety is high.

Objective To investigate the protective effects of ulinastatin on the hearts of rats with anoxia-induced cardiac arrest-cardiopulmonary resuscitation(CA-CPR) and the mechanism of improving cardiac dysfunction .Methods Twenty male Sprague Dawley(SD) rats were randomly divided into three experimental groups :sham operation group (group A ,n= 8 ,only anesthesia , tracheotomy tube and vascular puncture) ,control group(group B ,n= 6 ,normal saline 4 mL · kg -1 injected via vein) ,Ulinastatin treatment group(group C ,n=6 ulinastatin 50 000 U/kg+normal saline 3 mL · kg -1 injected via vein);Factors including mean arte-rial pressure(MAP) ,left ventricular end diastolic pressure(LVEDP) ,the maximum rising and falling rates of left ventricular deep pressure(± LVdp .dt-1max) ,brain natriuretic peptide(BNP) ,cardiac troponin T(cTNT) ,IL-12 and TNF-αwere observed at setting time before and after cardiopulmonary resuscitation in rats .Results Compared with those of the group A and before CA-CPR ,the concentrations of IL-12、cTNT、TNF-α、BNP、and LVEDP increased(P<0 .01)while ± LVdp .dt-1max decreased(P<0 .01) at 6 h after CA-CPR in group B ,C .Compared with those of group B ,the concentrations of IL-12、CTNT、TNF-α、BNP and LVEDP of 6 h after CA-CPR in group C were lower and ± LVdp .dt-1max was higher(P<0 .01) ,The concentrations of MAP of 6 h after CA-CPR in group B was lower Compared with that of group A ,C and before CA-CPR(P<0 .01) .Conclusion Ulinastatin can improve cardiac dysfunction by depressing mediators of inflammation and reducing myocardial injury .

OBJECTIVE: To investigate the effect of Xuebijing injection on the cardiac function and calcium ions of cardiocyte in rats after anoxia-induced cardiac arrest-cardiopulmonary resuscitation(CA-CPR).METHODS: CA-CPR model was induced in rats and then the model rats were randomized to 4 groups,i.e.sham group,model group,Xuebijing injection high dose group(4 mL?kg-1),and Xuebijing injection lowdose group(Xuebijing injection 2 mL?kg-1).Mean arterial pressure(MAP),?LVdp/dt max,average fluorescence intensity of calcium and pathological changes of cardiocytes were observed at 0 and 6 hours after resuscitation,respectively.RESULTS: Compared with model group,Xuebijing ingection high dose group at 6 h showed significantly increased MAP(P

Quality indicator is defined as the measure used to access the degree of inherent characteristics meeting the requirements .It is a powerful tool to improve laboratory quality to monitor and evaluate performance throughout critical steps in the total testing process .Targeted quality improvement can be obtained by quantizing quality levels in each phase when the quality indicators applied .Establishing and monitoring the quality indicators enables laboratory to compare over time between providers , and evaluate the effectiveness of delivered services and improving patient safety .

Objective To explore the characteristics of ventilatory efficiency and exercise capacity during cardiopulmonary exercise testing in patients with idiopathic pulmonary fibrosis (IPF).Methods Pulmonary function test,arterial blood gas analysis and cardiopulmonary exercise testing were performed in 28 IPF patients (IPF group) from April 2012 to April 2013 and 28 healthy volunteers (control group).And the relevant parameters were measured and compared.Results No significant differences existed in age [(57.8 ±9.8) vs.(59.2 ±5.5) years],gender or body mass index (BMI) [(23.8 ±2.7) vs.(25.0 ± 2.8) kg/m2,P ＞ 0.05].The paramneters of pulmonary function test,such as forced vital capacity ％ predicted (74.8 ± 14.6 vs.101.8 ± 10.8),forced expiratory volume in 1 second ％ predicted (73.8 ± 14.6 vs.97.0 ± 10.1),maximum voluntary ventilation ％ predicted (77.5 ± 14.9 vs.95.4 ±24.5),total lung capacity ％ predicted (75.6 ± 12.4 vs.99.8 ± 5.4),residual volume ％ predicted (80.7 ± 15.4 vs.95.8 ± 11.3),diffusing capacity of lung for carbon monoxide ％ predicted (66.2 ± 13.7 vs.103.2 ± 17.3) in the IPF group,were significantly lower than those of the control group (P ＜ 0.01).The parameters of arterial blood gas analysis,such as PaO2 [(72.7 ± 7.3) vs.(92.6 ± 3.8) mmHg] and SaO2 (94.3 ± 2.1 vs.98.3 ± 0.7),were lower than those of the control group (P ＜ 0.01).Thus P(A-a) O2 in the IPF group was higher than that in the control group (33.3 ± 5.7 vs.17.8 ± 1.9,P ＜0.01).These results strongly suggested that IPF group had restrictive ventilatory dysfunction and impaired gas exchange.The IPF patients had higher VE/VCO2-slope (37.4 ± 5.3 vs.25.7 ± 2.5,P ＜ 0.01) and lowest VE/VCO2 (39.2 ±6.7 vs.30.6 ± 2.7,P ＜ 0.01) than the controls; VE/VCO2 and VD/VT during every period were significantly higher in the IPF group than those in the control group (P ＜ 0.01) ; during peak exercise,peakLoad％pred (70.4 ±±29.9 vs.104.8 ±29.7,P ＜0.01) and peakVO2％pred (68.7 ±29.8 vs.98.7 ±36.4,P =0.001) were significantly lower in the IPF group than those in the control group.In the IPF group,VE/VCO2@AT,VE/VCO2-slope and lowest VE/VCO2 had a negative correlation with DLCO％pred (r=-0.589,P ＜0.01; r=-0.481,P＜0.05; r=-0.527,P＜0.05).In the IPF group,VE/VCO2@AT,VE/VCO2-slope and lowest VE/VCO2 had a negative correlation with peakVO2％ pred (r =-0.548,P ＜ 0.05 ; r =-0.539,P ＜ 0.05 ; r =-0.564,P ＜ 0.05).So the exercise tolerance and ventilation efficiency of the IPF group decreased significantly.Conclusion Cardiopulmonary exercise testing reveals that the ventilation efficiency of IPF patients decreases significantly so as to seriously affect their exercise tolerance

Objective To investigate the effects of Xuebijing injection on the transcription factors GATA-3 and T-bet of rats after cardiopulmonary resuscitation (CPR). Method The rat models of CPR was made by using asphyxia method. Thirty SD rats were randomly (random number) divided into three groups at random: sham operation rats (B group), conventional CPR rats (C group) and Xuebijing (4 mL/kg) treated rats (D group). The levels of serum IL-12, IL-4, TNF-α and IFN-γ were measured by using ELISA. The expressions of T-bet and GATA-3 mRNA in serum were detected by RT-PCR. The analysis of variance was used to compare the means of different groups including t-test and Wilcoxon test. Results Compared with group B, the levels of serum IL-12, TNF-α and IFN-γ in group C and group D were significantly elevated after CPR for 6 hours (P<0.01). In group C, the expression of GATA-3 mRNA and GATA-3/T-bet decreased (both P < 0.05), while the expression of T-bet mRNA increased (P<0.01) after CPR for 6 hours. In group D, the expressions of GATA-3 mRNA and T-bet mRNA as well as GATA-3/T-bet increased after CPR for 6 hours. The levels of IL-12, IFN-γ and TNF-α in group D were lower than those in groupC (P<0.01). Compared with group C, the expression of GATA-3 mRNA and GATA-3/T-bet were significantly elevated and the expression of T-bet mRNA decreased in group D. ConclusionsThe transcription factors GATA-3 and T-bet may fail to get balance after CPR. The Xiebijing injectio can modulate the balance between GATA-3 and T-bet, and the levels of IL-12,IFN-γ and TNF-α.

Objective To explore the correlation between heart rate recovery after exercise test and disease severity in patients with chronic obstructive pulmonary disease(COPD)and assess its impact on the exercise capacity of COPD patients.Methods Arterial blood gas analysis, pulmonary lung function test and cardiopulmonary exercise testing were performed in 60 patients with stable COPD and 50 healthy volunteers.Based on the heart rate recovery after exercise test, COPD patients were divided into normal heart rate recovery group(n =41)and abnormal heart rate recovery group(n =19).Results The COPD patients had lower exercise capacity(peak oxygen uptake as percentage of predicted value, peak VO2％ pred)(66 ± 15vs.89±11, P＜0.01), peak heart rate [(134±21)vs.(149±13)beats/min, P＜0.01], heart rate recovery[(18 ± 9)vs.(27 ± 10)beats/min, P ＜ 0.01] and higher resting heart rate [(83 ± 13)vs.(77 ± 13)beats/min, P ＜0.01] than the controls.Compared with normal heart rate recovery group, forced expiratory volume in one second as percentage of predicted(FEV1 ％ pred)and exercise capacity decreased more significantly in abnormal heart rate recovery group(38 ± 15 vs.52 ± 16, P＜0.05 and 57 ± 12 vs.71 ±14, P ＜0.01).Heart rate recovery was significantly correlated with FEV1％ pred and peak V O2％ pred(r=0.42, P ＜ 0.01 and r =0.52, P ＜ 0.01).Multivariate regression analysis showed that heart rate recovery and FEV1 ％ pred could be used as independent predictors of exercise capacity in COPD patients.Conclusion In COPD patients, heart rate recovery is correlated with the degree of disease severity and it may be an independent predictor of exercise capacity.

Objective To investigate the diagnosis and treatment of congenital mesenteric hiatal hernia in aduls.Methods The retrospective cross-sectional study was conducted.The clinical data of 11 adult patients with congenital mesenteric hiatal hernia who were admitted to the First Affiliated Hospital of Henan University from January 1999 to January 2016 were collected.All patients underwent abdominal X-ray and ultrasound examinations.Patients diagnosed as with intestinal obstruction or suspected intra-abdominal hernias underwent abdominal CT examination,and then were finally confirmed during surgery.Patients diagnosed as with mesenteric hiatal hernia received necrotic tissues resection and tissue repair (small intestine resection and anastomosis) if there was necrosis of hernia contents,and closing mesenteric hiatus.Patients without small intestine necrosis received closure of mesenteric hiatus after retraction of the hernia contents.Observation indicators:(1) clinical manifestations,(2) imaging findings,(3) treatment,(4) pathological examination,(5) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative complications up to March 2017.Results (1) Clinical manifestations:all 11 patients were acute onset,with incentives of satiation,postprandial exercise and diarrhea.The time from onset to admission was 2.0-30.0 hours,with an average time of 9.8 hours.The main symptoms included abdominal pain,nausea and vomiting,exhaust reduction and other intestinal obstruction performances.Eleven patients received physical examination,and 10 showed abdominal bulge,including 9 with intestinal type.Eleven patients had abdominal tenderness,and 9 combined with rebound tenderness.Abdominal percussion of 11 patients showed hyperresonant without shifting dullness,and active,muted and fading bowel sounds were detected in 1,3 and 7 patients,respectively.(2) Imaging examination:of 11 patients receiving abdominal X-ray examination,2 had intestinal loop and 4 had the intestinal obstruction performances such as typical gas-liquid plane.Abdominal ultrasound examination of 11 patients showed no specific findings due to abdominal intestinal gas,and 10 with peritoneal effusion.Of 11 patients,1 didn't receive abdominal CT scan due to preoperatively misdiagnose with acute appendicitis and 10 underwent abdominal CT scan.Nine patients were diagnosed with intestinal torsion by abdominal CT scan and then underwent enhanced CT scan,and 8 with small mesenteric vascular torsion and swirling sign were diagnosed with small intestine torsion and partial necrosis of small intestine.(3) Treatment:1 patient preoperatively misdiagnosed with acute appendicitis was converted to exploratory laparotomy,and 10 patients underwent exploratory laparotomy due to complete intestinal obstruction or progressive increase in symptoms.Intraoperative exploration showed that intestinal mesenteric hiatus and colon mesenteric hiatus were respectively in 8 and 3 patients,and hiatuses were round or oval,with a diameter of 2.0-8.0 cm and an average of 4.4 cm.Hernia contents were small intestine.The partial small intestine in 10 patients were resected and then mesenteric hiatus was closed due to necrosis of the small intestine,with removal length of 110-250 cm and an average of 176 cm,and length of remaining small intestine was 80-230 cm,with an average of 159 cm.The hernia into small intestine in 1 patient without complete necrosis was retracted to abdominal cavity after symptomatic treatment,and closing mesenteric hiatus.Eleven patients were cured and out of hospital after operation,without nosocomial complications.(4) Pathological examination:small intestine ischemic necrosis was detected in 10 patients after partial small intestine resection.(5) Follow-up situations:all patients were followed up for 12-24 months,without malnutrition,short bowel syndrome and other complications.Conclusions Without history of abdominal trauma or surgery,with incentives of the satiation,postprandial exercise and diarrhea,abnormal retroperitoneal small intestine shadow and small intestinal torsion diagnosed by CT scan and absent intestine sign by enhanced CT scan can be helpful to diagnose congenital mesenteric hiatal hernia in adults and small intestinal necrosis.Surgery is the only effective method in the treatment of congenital mesenteric hiatal hernia in adults.

Objective To investigate an evaluation program for external quality assessment ( EQA) of quality indicators ( QIs) and develop a software .Methods According to GB/T 27043-2012 ( ISO/IEC 17043:2010,IDT) mode 3, 28 provincial centers for clinical Laboratories were organized by National Center for Clinical Laboratories to launch an investigation on “QIs in clinical laboratory” with the use of Clinet-EQA online .Participants were asked to collect data of April 2014 and report related results online .Mean, median, the 5 th, 25 th, 75 th and 95 th percentiles of defectpercentages for biochemistry , immunology, blood and body fluid and microbiology were calculated , respectively .Sigma values were also calculated . Meanwhile , 25 th of sigma value and 75 th of defect percentages were chosen as preliminary quality specifications for each QI so that laboratories can evaluate related process quality .Results Take incorrect sample type rates for example , 4 771 laboratories were involved in this study .Among four subjects , incorrect sample type rates were lowest (0.01%, 6σ) for immunology tests, followed by blood and body fluids tests (0.06%, 4.7σ) and biochemistry tests (0.06%, 4.7σ), and were highest for microbiology tests (0.33%, 4.2σ).Evaluation reports will besent back to participants so that they can understand national , provincial , and their own sigma levels well .Preliminary quality specifications of incorrect sample type for biochemistry, immunology, blood and body fluid, and microbiology tests were 0.08% (4.6σ), 0.03%(5σ), 0.09%(4.6σ) and 0.43%(4.1σ), respectively.Conclusion Clinical laboratories were advised to establish and monitor suitable QIs within laboratory and participate in QIs EQA schemes , thus they can improve their quality continuously .

Eight newborn screening quality indicators were developed though expert discussing organized by National Center for Clinical Laboratories according to NBS quality management in USA .These indicators can not only be used to evaluate the performance throughout critical aspects of pre -examination, examination and post-examination processes for routine tests , but also be applied to monitor a series of processes from specimen collecting to results interpretation in newborn screening .Meanwhile, NCCL can use these quality indicators to carry out External Quality Assessment programs in order that the total service quality of newborn screening can be improved.