Blood pressure remains the single most important modifiable risk factor for the primary and secondary prevention of stroke. The landmark trial of the Perindoprii Protection Against Recurrent Stroke Study (PROGRESS) has suggested that the antihypertensive treatment with angiotensin-converting enzyme inhibitor (ACEI) perindopril at least 2 weeks after stroke may reduce the risks of recurrent stroke and other cardiovascular events. Although most systematic reviews have suggested that the efficacy of almost all types of antihypertensive drugs is similar in the prevention of stroke,there are also some important exceptions. The Ongoing Telmisartan Alone and in Combination with Ramipril Global End point Trial (ONTARGET) has demonstrated that the angiotensin receptor blockers (ARB) telmisartan was equivalent to ramipril for preventing cardiovascular events in patients with vascular disease or diabetes; while in a similar population,ramipril was quite effective for preventing stroke. It is speculated according to the moderating effects of ARB on the renin-angiotensin-aldosterone system that its protective effects against stroke is superior to other antihypertensives. However,many clinical trials have suggested that ARB does not have unique role in stroke prevention. Therefore,whether ARB should be regarded as the first-line drags for stroke prevention in both primary and secondary prevention settings has been controversial.

Evidence-based medicine,personalization,standardization are the three common sense of cancer care in the 21st century.The model of cancer treatment has changed from experience-guided treatment into gene guided personalized treatment.Recently,personalized treatment of cancer develops fast,particularly in molecular profile for prognosis,molecular marker for efficiency of target drug and so on.

There has been controversies on whether using intravenous or intraarterial thrombolytic therapy around the onset of acute ischemic stroke within 3 hours.This article summarizes the main arguments of different neurologists.

dence is weak. And whether it is ethical to have a placebo arm in reperfusion trials in the 3- to 6-hour time window remains controversy. This article discusses them.

Carotid artery and coronary atberosclcrotic lesions often coexist. How to manage the two kinds of lesions, especially to reduce the risk of perioperative stroke, whether it is necessary to treat carotid artery lesions first or simultaneously before coronary artery bypass grafting, and whether stent angioplasty can replace carotid endarterectomy in the treatment of carotid disease has been controversial. This article discusses them.

ObjectiveTo explore clinical manifestations and CT performance characteristics of amalgamative AIDS tuberculosis. MethodsThe clinical data and CT manifestations of 28 patients who were already diagnosed with AIDS amalgamative tuberculosis were analyzed. ResultsThe common clinical manifestations of AIDS amalgamative tuberculosis: were cough, sputum, fever, night sweats, angular, difficult breathing, diarrhea, superficial lymph node enlargement,etc. The CT manifestations:were diffuse com grain of venereal change, the spot piece infiltrating kitchen,lung door ormediastinumlymphnodeenlargement, pleuraleffusion. Emptyandcalciticationwererare.ConclusionThe clinical manifestations and CT performance characteristics of amalgamative AIDS tuberculosis were not typical,whose performance was related with the body's immune state. When AIDS patients appoare diffuse lung in corn grain, spot piece infiltration sex pathological change focal, lung door or mediastinum lymph node enlargement, the possibility of amalgamative tuberculosis pleural effusion should first be diagnosed.

Problem-based learning ( PBL ) has become the major teaching method to cultivate medical student's autonomous learning and their ability to solve problems.It's basic elements are the scene authenticity and problem construction.Thoratic surgery clinical probation is the most important part of clinical teaching.The author summerized and analysized the PBL teaching experience in thoratic surgery and had some new understanding and experience on the problem construction,and therefore made some exploration and improvement to it and got some good teaching effect.

ObjectiveObserving the distribution and the change of the quantity of SP,VIP in the colon tissue of 'cathartic colon'rats.MethodsWe divided the 32 wistar rats weighted (200 ±10)g into 2 groops randomly:the blank group( n =8) and model group( n =8).we induced the 'cathartic colon'rats with the suspension of dahuang.The blank group were given the distilled water for contrast.After one week during the time Dahuang was stopped.We killed them,measured the carbon powder propulsion rates in the intestine and then took Specimen after the 8 rats were fasted 24 hours as well as the blank group,but water were given.We compared the variation of SP,VIP distribution between two groups.ResultsThe carbon powder propulsion rates in the model group were slower than that in the saline control group.The distribution of SP,VIP are all more than that in the blank group.ConclusionThe distribution of SP,VIP are all more than that in the blank group.

ObjectiveTo study and compare the nursing effect of different nursing modes in patients with dysuria after transurethral electrovaporization of the prostate. Methods50 patients with dysuria after transurethral electrovaporization of the prostate from January 2007 to March 2011 were selected as research objects,and they were randomly divided into group A and group B with 25 cases in each group,group A was taken care with routine nursing method,group B adopted evidence-based nursing mode,then the rate of self- maturate,usage rate of catheter,time of indwelling catheter,maximum flow rate,relapse of dysuria,satisfaction degree,treatment compliance and quality of life before and after the nursing of two groups were analyzed and compared. ResultsThe rate of self-maturate and satisfaction degree of group B were higher than those of group A,usage rate of catheter and relapse of dysuria were lower than those of group A,time of indwelling catheter was shorter than that of group A,treatment compliance and quality of life were all better than those of group A,there were significant differences. ConclusionsThe nursing effect of evidence-based nursing mode in patients with dysuria after transurethral electrovaporization of the prostate is good,it can significantly improve the quality of life and is popular among patients.

There are many controversies for how to treat the occurrence of ischemic stroke on the basis of infective endocarditis would be more reasonable,especially there is no consensus on whether to treat with anticoagulants.The article discusses about this.