Objective To investigate the relationship of serum angiotensin converting enzyme (ACE) level and primary hypertension target organ damage.Methods According to target organ damage,essential hypertension patients were divided into 3 groups:primary hypertension with coronary artery disease,primary hypertension with cerebral infarction and primary hypertension with kidney injury.There were 60 subjects in each complication group.There were 60 healthy adults in the normal control group.Serum ACE level was detected and compare among the 4 groups.Results Serum ACE level in normal control group was (21.36 ± 6.86) U/L,while that in primary hypertension with coronary artery disease,primary hypertension with cerebral infarction and primary hypertension with kidney injury were (36.09 ±4.87) U/L,(39.15 ±7.03) U/L and (28.34 ±7.23) U/L respectively.Serum ACE level was higher in each complication group than in normal control group (F =343.997,P ＜ 0.01).In the complication groups,serum ACE level was the lowest in the group of primary hypertension with kidney injury.Conclusion High active ACE is associated with target organ damage in primary hypertension,especially kidney injury.

OBJECTIVE: To explore the correlation among platelet activation, inflammatory factor changes and vascular restenosis following intravascular stent implantation.METHODS: Chinese Journal Full-Text Database and Pubmed were retrieved using search terms of intracranial arterial, stents,stenosis, elevated platelet activation, and inflammatory factors from January 1999 to June 2009. The language was restricted within Chinese and English. Simultaneously, platelet activation and inflammatory factor changes were acted as evaluation indexes. Accordingly, clinical research regarding treating intracranial artery stenosis with intravascular stent implantation was included. The animal experiment or other treatment methods were excluded.RESULTS: A total of 650 papers were obtained by initial search with computer. According to inclusion criteria, the related papers were analyzed. Platelet activation, inflammatory reaction and inflammatory factor were the focuses of research concerning restenosis following intravascular stent implantation. Platelet thrombus was the main factor to cause acute vascular occlusion, and the activated platelet aggravated the damage of endothelial cells, which induced over proliferation of smooth muscle cell. As a kind of foreign body, the stent implantation was closely associated with complication, such as formation of thrombosis, acute vascular occlusion, vasovagal reflex and immune reaction, which lead to reconstruction of vessel wall and in-stent restenosis.CONCLUSION: It is effective to cure vascular restenosis by undergoing antiplatelet therapy prior to implantation, controlling inflammatory reaction, as well as inhibiting vascular smooth muscle cell proliferation following intravascular stent implantation.

Japan,one of the countries near China,has obtained great success in medical education through a long time exploration.Professor of R.Harsha Rao from America concluded the drawbacks in the early medical education in Japan,then proposed corresponding blueprint including reforming education systems,breaking the limitation in subjects and establishing comprehensive education system.Japanese medical education has been well promoted,the experience can be used in our country's medical education reforms.

BACKGROUND:Bal oon kyphoplasty is a new technique of microtraumatic surgery of spine developed in recent years, and brings a new pathway for the treatment of osteoporotic vertebral fracture in the elderly.
OBJECTIVE:To investigate the therapeutic effect of percutaneous bal oon kyphoplasty on osteoporotic vertebral fracture, and to explore the main point of injecting bone cement.
METHODS:A total of 22 patients with osteoporotic vertebral fracture at the age of 60-78 years underwent percutaneous bal oon kyphoplasty under C-arm fluoroscopy. In accordance with the standards of WHO, antalgic effects were evaluated. The injection time, manner and dose of bone cement were analyzed.
RESULTS AND CONCLUSION:Al patients were fol owed up for 1-12 months. Postoperative pain was completely lessened in 15 patients, and partial y relieved in 7 cases, with an effective rate of 100%. Spinal mobility increased. No incision surgery was needed in al patients. No complications such as pulmonary embolism or nerve injury appeared. These results indicate that percutaneous bal oon kyphoplasty for treatment of osteoporotic vertebral fractures is minimal y invasive and simple, has less complication and effectively reconstructs vertebral body strength, and can better al eviate the pain, is an effective minimal y invasive spinal treatment technology. To strictly understand the main treatment point can obtain satisfactory clinical curative effects, including precise diagnosis of the disease, identification whether patient’s pain is induced by fractures, preoperative intraoperative exact localization of the affected vertebra, perfect puncturing technique, suitable postoperative treatment and nursing. It is also important to strictly master the time of injecting bone cement and the dose of bone cement. Bone cement injection was commonly done in drawing-wire stage. Too early injection easily induced leakage and toxic reaction. Too late injection affected the expansion of bone cement and therapeutic effects. The injection of bone cement should be finished under a perspective environment, which can effectively avoid bone cement leakage.

OBJECTIVE: To investigate the pathogenic factors of severe acute pancreatitis (SAP) complicated by hepatic insufficiency, the prognosis and the effective preventive and therapeutic interventions. METHODS: One hundred and fifty-two patients with SAP (from January 2003 to June 2004) were divided into 2 groups, SAP with hepatic insufficiency group and SAP without hepatic insufficiency group. The related factors such as causes of disease, serum biochemical criteria, complications, mortality and course of disease were observed. RESULTS: The concentrations of serum amylase, creatinine and lactate dehydrogenase were all much higher in the SAP with hepatic insufficiency group than those in the SAP without hepatic insufficiency group (P<0.05). The incidences of complications such as acute renal failure, heart failure, gastrointestinal hemorrhage and infection were also higher in the SAP with hepatic insufficiency group than those in the SAP without hepatic insufficiency group (P<0.05). There was no significant difference in mortality between these two groups, but the course of disease in SAP with hepatic insufficiency group was longer than that in the other group (P<0.05). CONCLUSION: The causes of SAP complicated by hepatic insufficiency are related to the imbalance of internal environment and the characteristics of the liver function. To control the biliary tract diseases, intervene with traditional Chinese medicine, recover the intestinal function in time, reduce the damage of pancreatic enzyme, maintain the stability of internal environment and avoid using drugs that can induce liver injury are all important aspects of reducing the incidence of hepatic insufficiency.

BACKGROUND:Since percutaneous injection of bone cement vertebroplasty has been successful y used in treatment of spine fracture, percutaneous vertebroplasty is trying to be utilized in the treatment of vertebral hemangiomas.
OBJECTIVE:To evaluate the safety and effectiveness of percutaneous injection of bone cement vertebroplasty in the treatment of symptomatic vertebral hemangiomas.
METHODS:Total y nine patients with symptomatic thoracic vertebral hemangioma patients, including two males and seven females, had back pain. Of them, two cases suffered from nerve root irritation. Percutaneous vertebroplasty with bone cement was used alone. Postoperative clinical and radiographic fol ow-up was conducted.
RESULTS AND CONCLUSION:The success rate was 100%, and no pulmonary embolism or nerve injury appeared. Postoperative imaging showed no leakage of spinal canal or foramen. At 24 hours after treatment, the symptoms had eased;nine cases were fol owed up for 3 to 36 months, showing that the original symptoms and signs disappeared or almost disappeared, no recurrence of vascular tumors. Results indicated that the percutaneous injection of bone cement vertebroplasty for the treatment of symptomatic vertebral hemangiomas is a safe and effective treatment;it can not only relieve symptoms, but also can increase the stability of the vertebral body, and prevent compression fracture and recurrence.

0.05),but the lasting time of intestinal paralysis,renal failure,cardiac failure,encephalopathy and hypoproteinemia in the early stage group was shorter than that in the late stage group (P

Liver injury caused by various reasons can lead to the occurrence of liver fibrosis,which is the pathological process from chronic liver disease to liver cirrhosis.Liver fibrosis is caused by the increased synthesis and reduced degradation of extracellular matrix (ECM).ECM is mainly degraded by matrix metalloproteinases (MMP),and therefore,MMP play an important role in the progression and.diagnosis/treatment of liver fibrosis.This article reviews the research advances in the association between MMP and liver fibrosis.

Objective: To explore change of heart rate turbulence (HRT) in patients with coronary artery disease (CAD) and its predictive value. Methods: A total of 58 CAD patients were regard as CAD group. The 50 normal persons with negative CAG were regard as normal control group. All subjects received 24h dynamic ECG, CAG and echocardiography examination. Left ventricular ejection fraction (LVEF) and HRT indexes were compared between two groups. Results: Compared with normal control group, there was significant rise in turbulence onset [TO, (-1.34±1.09)% vs. (2.32±0.60)%] and significant reduction in turbulence slope [TS, (11.14±2.27) ms/RR vs. (3.44±0.60)ms/RR] in CAD group, P<0.01 both; in CAD group, along with coronary artery lesion aggravated (single-, double-, multi-vessel coronary disease), there was significant rise in TO [(1.35±0.52)% vs. (2.56±0.83)% vs. (3.01±1.62)%] and significant reduction in TS [(6.49±1.79) ms/RR vs. (3.33±1.02) ms/RR vs. (1.66±0.30) ms/RR], the difference was significant in two-two comparison among all groups, P<0.05 or <0.01; compared with CAD without cardiac event group, there was significant rise in TO [(1.68±0.61)% vs. (2.24±0.24)%], and significant reduction in TS [(5.87±1.22) ms/RR vs. (1.65±0.23) ms/RR] and LVEF[(66.18±2.64)% vs. (56.36±3.34)%] in CAD with cardiac event group, P<0.01 all. Conclusion: Weakened HRT phenomenon exists in CAD patients. HRT can be treated as an index evaluating severity of CAD patients’ condition and an effective predicting index for recurrent cardiac events in CAD patients.

Hepatocellular carcinoma (HCC) has a high fatality rate and most patients are in advanced stage when diagnosed with routine methods.As a molecular imaging method, positron emission tomography/computed tomography (PET/CT) has become more and more important.However, it also has certain limitations, since it always has false-negative results for well-differentiated HCC and small HCC.Therefore, a combination of various tracers can improve the sensitivity and specificity of PET/CT in the diagnosis of HCC.This article reviews the role of PET/CT in the therapeutic effect evaluation, recurrence monitoring, and prognosis of HCC.