OBJECTIVE:To study the effect of long-term follow-up of Valsartan and amlodipine tablets(Ⅰ)on blood pressure control and renal protection of patients with refractory hypertension. METHODS:120 patients with refractory hypertension were di-vided into control group and observation group according to the patients’wishes,with 60 cases in each group. All patients accepted the triple therapy of amlodipine+valsartan+hydrochlorothiazide and life-style intervention;at the time of discharge from hospital, the blood pressure was well controlled. After discharge from hospital,control group was given amlodipine;observation group was given Valsartan and amlodipine tablet (Ⅰ) orally,1 tablet each time,qd,and dose increasing according to blood pressure,with maximal dose no more than 2 tablets. With 18 months of follow-up,blood pressure and renal function indexes of 2 groups were ob-served at different time points,and blood pressure control rate and the rate of renal function injury were also observed at the last follow-up;the occurrence of ADR was observed. RESULTS:2 cases and 3 cases were follow-up loss in observation group and con-trol group,respectively. With 12 and 18 months of follow-up,24 h systolic pressure,24 h diastolic pressure and 24 h urine protein of 2 groups increased significantly while creatinine clearance rate decreased significantly compared with before discharge;but the in-dexes of observation group was better than that of control group,with statistical significance(P<0.05). At last follow-up,the rate of blood pressure in observation group was significantly higher than in control group(84.5% vs. 52.6%),the rate of renal function injury was significantly lower than control group(8.6% vs. 24.6%),with statistical significance(P<0.05). There was no statisti-cal significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Valsartan amlodipine tablet(Ⅰ)has obvi-ous advantages in long-term follow-up of blood pressure control of patients with refractory hypertension. It can significantly reduce the incidence of renal function injury with good safety.

Objective To investigate the effect of Jinqi Jiangtang tablet on the activation of T helper type 17 (Th17) and the expressions of interleukin (IL)-17 and IL-23 in kidney of diabetic rats. Methods A total of 45 male SD rats were randomly divided into normal control group (NC, n=15) and experimental group (n=30). Diabetes was induced by tail vein injection with streptozotocin (STZ, 45 mg/kg). The well-established 28 diabetic model rats were then randomly divided into diabetes group (DM, n=14) and Jinqi Jiangtang tablet administration group (Jinqi, n=14). The rats in Jinqi group were given Jinqi Jiangtang tablet solution by gavage at a single dose of 2.1 g·kg-1·d-1 for 18 weeks, while NC group and DM group were given 0.9%NaCl in the same way. All rats were sacrificed after 18 weeks. The circulating Th17 frequencies were assessed using flow cytometry. Serum IL-17 and IL-23 levels were measured by enzyme-linked immunosorbent assay. The pathological changes in kidney were studied by electron microscope. The expressions of IL-17 and IL-23 in kidney were detected using immunohistochemistry. Results (1) Compared with the group NC, the circulating Th17 frequencies were significantly increased in group DM and group Jinqi. The circulating Th17 frequencies were significantly lower in group Jinqi than those in group DM. (2) Compared with the group NC, the serum IL-17 and IL-23 levels were significantly increased in group DM and group Jinqi. The serum IL-17 and IL-23 levels were significantly lower in group Jinqi than those in group DM. (3) In group DM, irregular thickening of glomerular basement membrane, fusion of epithelial cell foot processes and mesangial expansion were observed by electron microscope. The above-mentioned pathological changes were improved inthe group Jinqi. (4) Compared with the group NC, the expressions of IL-17 and IL-23 in the renal cortex were significantly increased in group DM and group Jinqi, and those were significantly lower in group Jinqi than those in group DM. Conclusion The activation of Th17 and the increased expressions of IL-17 and IL-23 in kidney play a potential role in diabetic nephropathy. Jinqi Jiangtang tablet can improve diabetic nephropathy through inhibiting the activating Th 17 and decreasing the expression of IL-17 and IL-23 in kidney.

Objective To investigate the effects of normobaric hyperoxia intervention on learning and memory abilities of valproic acid(VPA) autism model rats and the morphology of pyramidal cells in hippocampus CA1 area.Methods Animal model groups of autism were obtained in male offspring of the Wistar rats that received intraperitoneal injection of 600 mg/kg VPA at the 12.5 day after pregnancy.According to the eye opening time,behavior,weaning weight and the learning and memory abilities which were evaluated by the Y electricity maze test at the 28th day after birth,40 male VPA autism model rats were randomly selected 20 only and divided into normobaric hyperoxia model group (group A,n =10),atmospheric air model group (group B,n =10).Normal control groups were obtained in male offspring of Wistar rats that received intraperitoneal injection of equivalent physiological saline at the same period pregnancy.(group C,n =10).Rats in group A were treated with oxygen for 1 h per day and lasted 1 week;group B and C were treated with normal air.The learning and memory abilities of three groups were assessed at the 35th day after birth.The immunohistochemistry methods and image analysis were used to observe the pyramidal cells of autism model rats in hippocampal CA1 region.The effect of normobaric hyperoxia therapy on pyramidal cell of autism model rats in hippocampal CA1 region were evaluated by HE staining technique.Results The trying times of group A after treatment were less than those before treatment (31.15 ± 0.99 vs 31.54 ± 0.97,t =2.739,P =0.018).The memory times were more than those before treatment (3.00± 0.58 vs 2.69 ± 0.48,t =-2.309,P =0.040).The trying times of group A after treatment were less than those in group B after treatment (P =0.016).The memory times of group A were not different from that in group B after treatment(P=0.810).The morphology of pyramidal cells in hippocampal CA1 region showed that the pyramidal cells of the autism model rats had apoptosised.The number of apoptotic cells reduced and the number of normal form cells increased after the normobaric hyperoxia intervention compared with the autism model rats.Conclusion Normobaric hyperoxia intervention can improve the learning and memory abilities of the autism model rats.The apoptosis of the pyramidal neurons in hippocampal CA1 might be reduced after the normobaric hyperoxia intervention.

Objective To investigate the therapy effect of fermented cordyceps powder on diabetic cardiomyopathy, and the effect on expressions of NLRP3, Caspase-1 and interleukin (IL)-1βin myocardium of diabetic rats. Methods A total of 45 male SD rats were randomly divided into normal control group (group CON), diabetes group (group DM) and fermented cordyceps powder administration group (group CS, 1 g · kg-1 · d-1). Diabetes rat model was induced by tail vein injection with streptozotocin (45 mg/kg) in group DM and group CS. The rats in group CS were given fermented cordyceps powder solution by gavage at a single dose of 1 g·kg-1·d-1 for 18 weeks. Rats of group CON and group DM were given 0.9%NaCl in the same way. All rats were sacrificed after 18 weeks. The pathological changes in myocardium were observed by HE staining and electron microscope. The expression of NLRP3 in myocardium was detected by Western blotting. The expression levels of NLRP3, Caspase-1 and IL-1βin myocardium were detected by immunohistochemistry. Results (1) Myocardial necrosis and fibrosis and mitochondrial damages were observed under electron microscope in group DM. The above-mentioned pathological changes were improved in the group CS. (2) The result of Western blotting showed that the expression of NLRP3 in myocardium was significantly increased in group DM and group CS than that in group CON, and the expression of NLRP3 was significantly lower in group CS than that in group DM. (3) The result of immunohistochemistry showed that, compared with the group CON, the expressions of NLRP3, Caspase-1 and IL-1β in myocardium were significantly increased in group DM and group CS, and which were significantly lower in group CS than those in group DM. Conclusion Fermented cordyceps powder can improve diabetic cardiomyopathy through decreasing the expressions of NLRP3, Caspase-1 and IL-1βin myocardium.

OBJECTIVE To investigate the prevalence of multidrug resistance(MDR) mechanisms of Staphylococcus haemolyticus against oxacillin,gentamycin and erythromycin.METHODS Agar dilution method was performed to detect the minimal inhibition concentration(MIC) of 3 antimicrobial agents against 63 strains of S.haemolyticus,and the resistance genes of mecA,aac(6′)+aph(2″),ermA,ermB,ermC and msrA/msrB were investigated by PCR in all clinical isolates.RESULTS mecA Gene was detected in 62 isolates of meticillin-resistant S.haemolyticus(MRSH),and aac(6′)+aph(2″) gene was found in 50 isolates resistant to gentamicin,and the most prevalence erythromycin resistance gene in S.haemolyticus was msrA/msrB(58.7%),followed by ermC(31.7%).Among the 43 MDR strains,the more commonly encountered three genes were mecA,aac(6′)+aph(2″) and msrA/msrB(58.1%)or ermC(20.9%),and 8 isolates(18.6%) were found harboring four genes of mecA,aac(6′)+aph(2″),ermC and msrA/msrB.CONCLUSIONS The mecA,aac(6′)+aph(2″),msrA/msrB and ermC genes are main resistance mechanisms against oxacillin,gentamicin and erythromycin in mutidrug resistant S.haemolyticus.

OBJECTIVE To investigate the susceptibilities of Staphylococcus aureus and Enterococcus isolated from Shenzhen Hospital during 2005 to 2006 to 17 antimicrobial agents.METHODS The minimal inhibitory concentrations(MICs) of 17 antibacterial agents were determined by agar dilution method,WHONET5.3 software was used to analyze the data.RESULTS The prevalence of meticillin-resistant S.aureus(MRSA) was 20.7%.Vancomycin and teicoplanin remained very high activity against MRSA(100%),with the MIC50 and MIC90 of 0.5 and 1 ?g/ml,respectively.Fluoroquinolones(ciprofloxacin,levofloxacin and gatifloxacin),trimethoprim/sulfamethoxazole,erythromycin,and clindamycin showed very low activity against MRSA(0-33.3%).The most active agent against Enterococcus faecalis was vancomycin and teicoplanin(100.0%),followed by piperacillin/tazobactam,imipenem and ampicillin(97.2-100.0%).E.faecium showed high resistance to various agents,except to vancomycin and teicoplanin(susceptible rate 100.0%).Cross-resistance to fluoroquinolones was found among MRSA,MSSA,E.faecalis,and E.faecium.CONCLUSIONS MRSA and E.faecium isolated from our hospital showed high resistance to multiple antimicrobial agents except vancomycin and teicoplanin.

OBJECTIVE To investigate the antimicrobial susceptibility of 9 antimicrobial agents and multidrug(resistance)(MDR) phenotype among Acinetobacter baumannii isolated from hospitalized patients.METHODS Disk diffusion method was used to detect the inhibitory zone diameter of 9(antimicrobial) agents to 221 strains of A.baumannii.according to standard from NCCLS in South China during 2002 to 2004.RESULTS 25.3% and 26.4% of isolates from ICU patients showed resistance to(imipemem) and meropemem,respectively,and the resistance rates were greater among the(isolates) from ICU(patients) than those from non-ICU inpatients by 13.4% and 12.2 %(P

Objective:To investigate the effects of icaritin(ICT)on the proliferation and osteogenic differentiation of rat bone mar-row stromal cells(rBMSCs).Methods:rBMSCs were cultured from the bone marrow of SD rats and identified by multilineage differ-entiation assays.3,6 and 9 days after the treatment of rBMSCs of passage 4 by ICT at 1 0 -9 ,1 0 -8 ,1 0 -7 ,1 0 -6 and 1 0 -5 mol/L re-spectively,the proliferation and differentiation of the cells were examined by cck-8 and alkaline phosphatase (ALP)activity assay kit respectively.The calcium nodule formation was observed by alizarin red(AR)staining 21 days after 1 0 -9 mol/L ICT treatment. Results:Primary rBMSCs showed the typical spindle-like shape with attachment growth.rBMSCs could be induced to osteogenic and adipogenic differentiation.The proliferation of rBMSCs was inhibited but ALP activity was enhanced by ICT.1 0 -9 mol/L ICT in-cresed calcium nodule formation.Conclusion:ICT can dose-dependently inhibit the proliferation,but promote the osteogenic differ-entiation of rBMSCs.

Objective To study the influence of hemodialysis on inflammatory state and immune function by analyzing the change of serum protein components in uremic patients before and after hemodialysis.Methods 75 cases of uremic patients confirmed by the Nephrology from October 2013 to May 2014 were selected as the observation group,and 15 healthy volun-teers at the same time as the control group.Then the serum protein electrophoresis pattern of observation group beford the first hemodialysis,after the first hemodialysis,after one month’s treatment and control group were compared with each oth-er.Results In the observation group before and after the first hemodialysis,the ALB levels were lower,α1 and α2 globulin levels were higher than those in control group.There was a statistically significant between the observation group before and after the first hemodialysis and control group (P <0.001).After the first hemodialysis,there were differences inα1 globulin levels compared with before the first hemodialysis (P <0.01).ALB was no significant difference after one month’s hemodi-alysis compared with before the first hemodialysis,andα1,α2 globulin were significantly reduced and the difference was sta-tistically significant (P <0.001),ALB was lower than the control group and was statistically significant (P <0.001).After one month’s hemodialysis,the levels ofγglobulin were higher than those in control group,before the first hemodialysis and after the first hemodialysis.There were significant differences (P <0.001 or P <0.01).Conclusion Regular and effective hemodialysis can improve inflammatory state and immune function of uremic patients.

Objective To assess the effectiveness and safety of radiofrequency catheter ablation for idiopathic ventricular arrhythmia in patients with idiopathic ventricular arrhythmia after radiofrequency catheter ablation treated in the First Affiliated Hospital of Xi’an Jiaotong University based on the follow-up and retrospective analysis.Methods We retrospectively analyzed the clinical data of 63 patients with idiopathic ventricular arrhythmia who underwent radiofrequency catheter ablation during January 2008 and March 2014 in the First Affiliated Hospital of Xi’an Jiaotong University.In the follow-up,Holter moniterings were reviewed to evaluate ventricular arrhythmia and echocardiography to assess the ejection fractions and left ventricular end-diastolic diameters.Results The immediate success rate of catheter ablation for the treatment of idiopathic ventricular arrhythmia was 89.29% and the long-term success was 82.14%.The ejection fractions and left ventricular end-diastolic diameters were not obviously improved after radiofrequency ablation (P > 0.05 ). The ventricular premature contractions were significantly reduced after radiofrequency ablation (P <0.05).In postoperative care, one case was found with ruptured sinus valsalva tumor and another patient was found with the complication of hematoma in femoral artery puncture.Conclusion Radiofrequency ablation for idiopathic ventricular arrhythmia is safe and effective.