Objective To study the therapeutic effect of diltiazem and felodipine in treatment of hypertension after renal transplantation.Methods Sixty patients with hypertension after renal transplantation who were treated with tacrolimus as basic immunosuppressive therapy were divided into two groups by random digits table method with 30 cases each.The diltiazem group took diltiazem 90 mg orally once a day.The felodipine group received felodipine 2.5 mg orally twice a day.The drug dosages were adjusted according to the level of blood pressure.The patients were followed up for 1 year.The artery pressure,concentration-to-dose ratio of tacrolimus and renal function was detected and compared.Results Blood pressure was significantly decreased in both groups after 1 year treatment.Blood pressure was found to be significantly lowered from (153.6± 7.5)/ (97.7 ±6.7) mm Hg (1 mm Hg=0.133 kPa) to (119.1 ± 26.4)/ (72.6± 19.3) mm Hgin felodipine group; and from (152.0 ± 7.6)/(95.4 ± 6.9) mm Hg to (120.3 ± 25.5)/(73.2 ± 22.5) mm Hg in diltiazem group.There was no significant difference in blood pressure before and after treatment between two groups (P ＞ 0.05).The concentration-to-dose ratio of tacrolimus was increased after treatment in diltiazem group[(173.2 ± 59.3) g/L vs.(119.3 ± 78.3) g/L] (P ＜ 0.05),but there was no significant difference before and after treatment in felodipine group (P ＞ 0.05).The serum creatinine had no significant difference in two groups (P ＞ 0.05).Conclusion Diltiazem and felodipine can be used safely and effectively in the treatment of hypertension after renal transplantation,and diltiazem can lower the dose of tacrolimus.

Objective To explore the function of high-intensity focused ultrasound in the treatment of allergic rhinitis.Methods To treat 46 patients who have allergic rhinitis for a long time with the instrument of CZB high-intensity focused ultrasound. Results We made a follow-up visit for 3 momths after the surgery,the symptom of stuffy nose van- ished from the 46 patients who were treated with the high-intensity focused ultrasound,and they haven't appeared sneezes again. Only 6 patieats have a little dear nasal mucus in the early morning. They don't have any complication and the se- quda. Conclusion The trearment with high-intensity focused ultrasound has the actual effect. Under reasonable therapeutic dose,the patients does not have the complication,and it is easy to do,it is really a kind of physical therapy method that can be promoted.

Objective To investigate the effects of ginkgolide B on neuronal cell apoptosis,superoxide dismutase activity,malondialdehyde,interleukin-1beta,tumor necrosis factor-alpha,and interleukin-6 levels in serum of rats with intracerebral hemorrhage in order to explore the role of ginkgolide B in suppressing the neuronal cell apoptosis.Methods A total of 175 male Wistar rats were randomly (random number)divided into sham operation group,intracerebral hemorrhage group,as well as low,medium and high dose treatment groups.The rat model of intracerebral hemorrhage was made with infusion of autologous whole blood to caudate nucleus in the right basal ganglia region.Ginkgolide B in dose of 5 mg/kg,10 mg/kg and 20 mg/kg was given to rats in the low,middle and high dose treatment groups by intraperitoneal injection once a day for 5 days after intracerebral hemorrhage.The rats with intracerebral hemorrhage in the sham operation groups received intraperitoneal administration of 1 mL saline.Animals were sacrificed by decapitation 2,6,12,24,48,72 h and 5 days after intracerebral hemorrhage.Brains were taken and blood samples were collected.Neuronal cell apoptosis was measured by using terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling(TUNEL),and superoxide dismutase activity in serum was determined by using xanthine oxidase method,and serum malondialdehyde level was detected by using thiobarbituric acid reactive substance assay,and interleukin-1beta,tumor necrosis factor-alpha,and interleukin-6 levels in serum were assayed with enzyme linked immunosorbent assay(ELISA).Statistical analysis was carried out by using one-way analysis of variance and least-significant difference test.Results As 2 h,6 h,12 h,24 h,48 h,72 h,and 5 days after intracerebral hemorrhage,the differences in the number of apoptotic neuronal cell,superoxide dismutase activity in serum,serum malondialdehyde,interleukin-1 beta,tumor necrosis factor-alpha and interleukin-6 levels between the low dose treatment group and intracerebral hemorrhage group were not significant statistically(P ＞0.05).As 12 h,24 h,72 h,and 5 days after intracerebral hemorrhage,the number of apoptotic neuronal cell,superoxide dismutase activity in serum,serum malondialdehyde,interleukin-1 beta,tumor necrosis factor-alpha and interleukin-6 levels in the medium dose and high dose treatment groups were significantly statistically lower than those in the intracerebral hemorrhage group(P ＜ 0.05),but these differences in above biomarkers were not significant statistically among these three groups 2 and 6 hours after intracerebral hemorrhage(P ＞ 0.05).Conclusions Ginkgolide B may lessen neuronal cell apoptosis by means of inhibition of free radical production and inflammatory reactions after intracerebral hemorrhage.

Objective To investigate the effects of continuous hemofihration on gastrointestinal dysfunction for treating patients with intra-abdominal hypertension.Methods A total of 37 patients were divided into two groups randomly (random number),namely control group (n =17) and continuous blood filtration (CBF) group (n =20).The patients of control group were treated with routine treatment,and the patients of CBF group were given CBF for 72 hours in addition to the routine treatment.The intra-abdominal pressure (IAP),gastrointestinal (GI) symptoms,and SOFA score were documented at 0 hour,24 hours,72 hours and 7 days after treatment.Results The MAP of patients in the CBF group was not significantly changed (P =0.218),while the IAP was decreased significantly (P =0.001) and the abdominal perfusion pressure (APP) increased significantly after CBF (P =0.036).Compared with the control group,there were more than 2 GI symptoms markedly relieved after CBF for 24 hours (P =0.049).The SOFA score of CBF group decreased significantly (P =0.037).There were no differences in 28-day and 60-day mortality between two groups.Conclusions The CBF can decrease IAP,increase APP,improve splanchnic blood circulation,and ameliorate gastrointestinal dysfunction.But CBF does not reduce the mortality in comparison with routine treatment.

ObjectiveTo identify the risk factors related to the mortality of severe acute pancreatitis.Methods Clinical data of 57 cases of severe acute pancreatitis in our hospital from August 1997 to February 2004 were collected and analyzed retrospectively. There were 32 males and 25 females. The median age was 51 years. Cases were divided into death group and survival group according to their outcome. The characteristics, severity and surgical therapy were analyzed. ResultsEleven patients died, the mortality was 19.3%。 Thirty cases underwent surgery, 8 died, the mortality was 26.3%.Factors which were of significant differences between the two groups by univariate analysis were age, Ranson score, APACHEⅡscore, ascites, MODS, ARDS, heart failure and renal failure. Multivariate logistic regression showed that independent risk factors included age, ascites, MODS. ConclusionsIn case of severe acute pancreatitis,the independent risk factors related to mortality were age, ascites and MODS.

Objective To investigate the necessity to test the hearing of patients whose initial symptom is tinnitus with pure tone audiometer. Methods To analyze the results of pure tone audiometer of 218 tinnitus patients.Results Among 218 cases of tinnitus patients,a total of 123 patients with abnormal hearing,among 95 cases of patients with normal hearing, except for 50 cases of tinnitus, no other cause of disease. Conclusion Among the normal hearing tinnitus patients, we should do further hearing test for them if they are not identified a clear cause of disease,such as auditory brainstem response,otoacoustic emission and other necessary checks to clear the reasons for tinnitus or the position of the unusual auditory system. It is important for early diagnosis and treatment of tinnitus. But the pure-tone audiometer should be a routine examination when tinnitus patients come for the first visit.

Objective A new type adsorbent for removal of bacterial ET was prepared by immobilizing L-serine covalently onto polyvinylidene difluoride membrane (PVDF-Ser) to study the effect of hemoperfusion on sepsis induced lung injuries in a pig model. Method Endotoxemia were induced in thirteen pigs by injecting endotoxin (1 μg/(kg·h) ) intravenously for 2 h. One hour later, the pigs were treated with absorber of PVDF-Ser volumn (group hemoperfusion) or empty adsorber (group control) for 2 h. Extravascular lung water indexed to body weight and alveolar capillary permeability, levels of serum endotoxin, tumor necrosis factor-α, interleukin-6, malondialdehyde, glutathione, myeloperoxidase activity, and lung histological changes and myeloperoxidase immunohistochemical analysis were measured. Results Hemoperfusion treatment with PVDF-Ser volumn significantly improved extravascular lung water, pulmonary alveolar capillary permeability and lung injuries ( P ＜ 0. 05). In addition, hemoperfusion attenuated both serum and pulmonary cytokines, and decreased lung malondialdehyde and myeloperoxidase levels ( P ＜ 0. 05). Conclusions Hemoperfusion with the adsorber of PVDF-Ser volumn effectively reduced inflammatory responses and improved lung injuries and oxidative stress in endotoxemia. It has a high potential of clinical application for treatment of patients with severe sepsis.

Objective To explore whether combined olmesartan angiotensin Ⅱ receptor type 1 blocker(ARB) and angiotensin-converting enzyme inhibitor(ACEI) temocapril have synergistic effect on reversal of left ventricular hypertrophy (LVH) in stroke-prone spontaneously hypertensive rats (SHRsp). Methods Fourty-four SHRsps and 11 Wistar-Kyoto rats(WKY) were divided randomly into 5 groups:WKY-control group, SHRsp-control group, SHRsp-olmesartan 10 mg/(kg?d)group, SHRsp-temocapril 10 mg/(kg?d)group, and SHRsp-Olmesartan 3 mg/(kg?d)+temocapril 3 mg/(kg?d) group for 6 weeks. Hearts weight were measured and histologically studied. The mRNA expression of angiotensin Ⅱ receptor type 1(AT1R) and integrin ?1 in myocardium was detected by RT-PCR. Results Olmesartan, temocapril and the their combination significantly reduced systolic blood pressure in a similar magnitude. Combination therapy was shown not greater effect in reversal of LVH than by olmesartan alone, although the effect by both of them was greater than temocapril monotherapy. The mRNA levels of AT1R and integrin ?1 in SHRsp were significantly decreased by treatment with olmesartan, temocapril, or combination therapy. Olmesartan and combination therapy result in greater decreases in expression of AT1R and integrin ?1 mRNA in myocardium than that by temocapril. Conclusion Compared with olmesartan alone, the combination of ARS and ACEI didn't show synergistic effect on reversal of left ventricular hypertrophy as were down-regulation of AT1R and suppression of integrin ?1 mRNA in myocardium.

Objective To observe the influence degree of morphology after treating the rabbit's nasal muco-sa with focused ultrasound technology.Methods By using the High Intensity Focused Ultrasound,a straight line scan for a rabbit's turbinate under the certain dose parametem had been done.And then the rabbit's turbinate was treated with low temperature plasma radiofrequency ablation.A comparison test after one month and three months was carried out.A comparison between the changes of rabbit mucosa morphological of the two kinds of treatment methods through general morphology and light microscopy observation had been taken.Results The experimental results showed that there were no significant changes in appearance and color between the use of focused ultrasound treatment of rabbit's inferior turbinate and scan the rabbit's inferior turbinate under certain dose parametem after one month and three months later.Under the lisht microscope showed a complete rabbit nasal epithelium.And after the treatment by using low-temperature plasma mdiofrequeney ablation instrument,the rabbit's turbinate became narrow,gray in color and there were some secretions compared witk normal rabbit's turbinate.Under the light microscopy,the rabbit nasal epi-thelium showed broken and part of the conical slices completely disappeared.Conclusion Under certain parameters,the focused ultrasonic energy could not undermine the nasal epithelium;thereby the function of mucociliary system is fully retained

Objective To analyze the clinical characteristics of Klebsiella pneumoniae infection in preterm infants. Methods Clinical data of 75 preterm infants infected with Klebsiella pneumoniae treated in BaYi Children's Hospital from February 6,2008 to February 10,2010 were retrospectively analyzed.The difference of auxiliary examination between early-onset and late-onset infection group were compared by two independent samples t test.Spearman correlation analysis and non-conditional Logistic regression analysis were used to analyze the high risk factors and the prognostic factors of Klebsiella pneumoniae infection in preterm infants. Results The incidence of Klebsiella pneumoniae infection was 2.8％ (75/2721) in preterm infants,and the mortality rate was 9.3％ (7/75). There were 71 cases of Klebsiella pneumoniae sepsis and 4 cases of Klebsiella pneumoniae pneumonia.Among 75 cases,63 cases were early-onset infection (onset age≤72 h) and 12 were late-onset infection (onset age＞72 h).All patients presented with poor response,heart rate during quiet sleep ＞ 160/min and low oxygen saturation.The mean corpuscular volume and mean corpuscular hemoglobin concentration in early-onset Klebsiella pneunoniae infection cases were higher than those in late-onset neonates [(128.87±24.60) fl vs (113.72±13.54) fl,t=-2.07,P＜0.05and (38.11±2.15) pg vs (36.98±1.05) pg,t=-2.76,P＜0.05].Low birth weight and caesarean section were associated with early-onset Klebsiella pneumoniae sepsis (r=0.250 and -0.240,P＜0.05). The prognosis of Klebsiella pneumoniae infection was associated with hospital stay and duration of premature rupture of membranes (r=0.368 and 0.318,P＜0.05). Conclusions There were no specific clinical manifestations for Klebsiella pneumoniae infection in preterm infants.Preterm infants with low birth weight,long duration of premature rupture of membranes,delivered by caesarean section and received invasive operation are likely to develop Klebsiella pneumoniae infection.