Objective To investigate use of oral antihypertensive drugs among community hypertensive patients in Shanghai and find out factors related to their unreasonable use to direct their clinical use. Methods Seven hundred and three hypertensive patients were surveyed with questionnaire by stratified cluster sampling at three neighborhoods and one village of Dahua community, Baoshan district, Shanghai during April to June 2009 to understand their use of antihypertensive agents, including kinds and forms of drugs, rationale of drug use. Results Five hundred and eighty-two (82. 8% ) of 703 hypertensive patients interviewed were using antihypertensive drugs, 271 (38. 5% ) of them used only one kind of non-compound antihypertensive drug, 182 (25.9%) used one kind of compound agent, 311 (53.4%) used two or more kinds of drugs in combination, including 117 patients ( 16. 8% ) used two kinds of agents combined and 12 patients ( 1.6% ) used three kinds of agents combined. Two hundred and sixty-six (47.5%) patients took orally calcium-channel blockers and 205 ( 35.2% ) used compound agents. Conclusions Frequency of combined use of two or more kinds of antihypertensive agents is reasonable and significantly higher than that of use of one kind of drug at Dahua community in Shanghai. Calcium channel blocker plays a predominant role in treatment for hypertension, non-long-acting compound agents are used in a higher proportion. But,guidelines for hypertension prevention and treatment are not so well complied with in local hypertensive patients. So, it is suggested that training for community physicians and management for standard use of antihypertensive agents at community should be strengthened further.

AIM: To investigate the effects of homocysteine (Hcy) on apoptosis and expression of caspases-3 in cultured human vascular smooth muscle cells (HVSMCs). METHODS: HVSMCs were cultured in vitro. The rate of apoptosis in HVSMCs was detected by flow cytometry. The expression of caspases-3 mRNA in HVSMCs was detected by reverse-transcription polymerase chain reaction (RT-PCR). RESULTS: The rates of apoptosis in HVSMCs incubated with 500 ?mol/L Hcy for 0 h, 6 h, 12 h, 24 h and 48 h were 2.39%?0.47%, 2.45%?0.64%, 7.58%?1.02%, 13.37%?4.71% and 17.69%?3.13%, respectively. The ratio of the absorbance of caspases-3 mRNA/GAPDH was 0.24?0.08, 0.29?0.10, 0.89?0.26, 1.37?0.24 and 1.82?0.53,respectively, suggesting that Hcy induces the apoptosis and expression of caspases-3 mRNA in HVSMCs in a time-dependent manner. The rates of apoptosis in HVSMCs incubated with 0, 100, 200, 500 or 1 000 ?mol/L Hcy for 24 h were 2.68%?0.23%, 2.79%?0.12%, 8.45%?2.41%, 13.37%?4.71% and 23.75%?5.56%, respectively, revealing that Hcy induced the apoptosis in HVSMCs in a concentration-dependent manner. CONCLUSION: Hcy induces the apoptosis in HVSMCs by regulating the expression of caspases-3, which may be one of the mechanisms involved in atherosclerotic effects of Hcy.

Objective:To explore the effect of puerarin on uterine estrogen receptor(ER)? expression in ovariectomized rats.Methods:Ovariectomized rats were given with puerarin in different doses and premarin for 30 days,and then the expression of E2 was observe by ELISA and the expressions of uterine ER? were observed by using immunohistochemical methods.Results:The expressions of serum E2 in ovariectomized rats were decreased(P

Objective To analyse the effect of dual antiplatelet drugs on fibulin-5, vWF and P-selection in serum of patients with acute cerebral infarction.Methods Diagnosed 60 patients with acute cerebral infarction in our hospital and collected. All patients were randomly divided into experimental group and control group, 30 cases in each group.The control group was treated with conventional treatment and aspirin, and the experimental group was treated with clopidogrel on the basis of control group.After treatment, the serum levels of Fibulin-5, vWF, P-selection and adverse reactions were detected in all patients.ResuIts After treatment, compared with control group, the serum Fibulin-5 level was significantly lower in experimental group ( P<0.05 );the serum vWF level in experimental group was significantly lower ( P<0.05 );the serum P-selectin level in experimental group was significantly lower (P<0.05);there was no significant difference in the incidence of adverse reactions between two groups. ConcIusion Dual antiplatelet drugs can reduce serum vWF, P-selectin and fibulin-5 in serum of patients with acute cerebral infarction, adverse reactions do not significantly increase, have guiding significance to clinical application.

Objective To investigate the safety and feasibility of early intervention treatment for aneurysmal subarachnoid hemorrhage in the elderly. Methods Within 6 to 72 hours after hemorrhage,89 aneurysms were detected by overall brain angiogram in 84 elderly patients(aged above 60 years)Who were diagnosed as subarachnoid hemorrhage on CT.HUNT-HESS grade was as following:26 cases of grade Ⅱ,31 cases of grade Ⅲ,25 cases of grade Ⅳ,2 cases of grade Ⅴ.Interventional embolization treatment was performed immediately.Aceording to the structure of the aneurysm,pure coil embolization,balloon assisted technique and combined with stent technique were performed.Anhydration,fluid expansion,vessel dilatation,lumbar puncture and/or lumbar drainage were performed after procedure.At the same time,the complications were treated. Results Eighty-three aneurysms were embolized successfully in 89 patients.The Success rate of the technique was 93.3%.The Glasgow Outcome Seale(GOS)score at 3 months post procedure showed a good result in 68 patients.medium disability in 7 patients,severe disability in 4 patients,death in 5 patients (1 case was related to the technique). Conclusions Interventional embolization iS a safe and effective therapeutic approach in elderly patients with subarachnoid hemorrhage.

OBJECTIVETo study the differences of HPLC fingerprints with the total quantum statistical moment for the Buyang Huanwu decoction (BYHWD) processed by various ways, and to verify the additive properties of total quantum statistical moment.

METHODThe extracts of BYHWD were obtained by water extraction and alcohol precipitation firstly, and then were dissolved with five solvents of different solubility parameter from 11.4 Cal(1/2) x cm(-3/2) to 23.40 Cal(1/2) x cm(-3/2) respectively. Their chromatographic fingerprints were determined by HPLC, finally the total quantum statistical moment parameters and its superposition properties were manual calculated and analyzed by their expressions.

RESULTAs a contrast as the whole prescription, the similarities of the various processed samples with butanol (11.4 Cal(1/2) x cm(-3/2)), methanol (13.5 Cal(1/2) x cm(-3/2)), 68% methanol (16. 67 Cal(1/2) x cm(-3/2)), 34% methanol (20.03 Cal(1/2) x cm(-3/2)) and distilled water (23.40 Cal(1/2) x cm(-3/2)) were 0. 074, 0. 973, 0. 934, 0. 991, 0. 993, respectively and while the RSD of these total quantum zero moment, center moment and variance of each chromatographic fingerprints for them were 63.04%, 16.22%, 69.38%, which showed significant difference in these chromatographic fingerprints. The total quantum statistical moment parameters of the superimposed chromatographic fingerprint with each sole samples were 3.203 x 10(5) mAu x s, 29.85 min, 389.97 min2, whereas the whole prescription's were 6.548 x 10(4) mAu x s, 29.44 min, 389.00 min2, that suggested that the absolute difference percentages between the superimposed and the whole were 2.209%, 1.389%, 0.2484%, respectively.

CONCLUSIONThe total quantum statistical moment of the chromatographic fingerprints is of characteristics with additive properties, it can be used in static and dynamic quality controlled analyses in the Chinese medicine multiple component systems.

Objective To improve the diagnosis and treatment of infective endocardits(IE)by exploring the causes,pathogenic microorganism,clinical characteristics and therapeutic results of patients with IE.Methods From January 2006 to January 2016,89 cases with IE in Ganzhou People's Hospital were collected,and the clinical charac-teristics were analyzed retrospectively.Results Among the IE patients,40.5%had congenital heart diseases,33.7%had rheumatic heart diseases,18.0% were post－PCI or operative endocarditis,and patients without basic cardiac diseases accounted for 7.9%.The most common clinical manifestations were fever (86.5%),followed by anemia (85.4%).The blood culture positive rate was 63.4%.Streptococci viridians were the most common causative organ-isms(44.2%),followed by coagulase －negative staphylococci(21.2%).Eighty－six patients received echocardio-graphy examination,vegetation was observed in 61cases (68.5%).The hospital mortality rate was 10.1%,mostly due to refractory congestive heart failure and sepsis.Conclusion Congenital heart disease showed an upward trend, rheumatic heart disease decreased significantly.Intermittent fever,anemia are the main clinical manifestations.Blood culture positive rate is not high,Streptococcus viridians is the most common causative organism.Echocardiography is the main basis for the diagnosis.

Objective:To study the application effects of situation video feedback combined with problem-based learning (PBL) on the clinical clerkship teaching of cardiac surgery for medical students in experimental class of organ-systems-based curriculum (OSBC).Methods:Medical students of Batch 2016 and 2018 OSBC reform experimental class of Jianghan University were selected as the research objects. The study group used situation video feedback combined with PBL teaching method to conduct cardiac surgery clerkship teaching, and the control group used conventional teaching method. At the end of the clerkship, the self-made "Clerkship Satisfaction Questionnaire" was distributed for questionnaire survey and the theoretical test was carried out at the same time. After the course, the theoretical examination was conducted, and the results were compared. SPSS 17.0 was used for t-test and Chi-square test. Results:The clerkship satisfaction investigation results showed that the study group was more satisfied than the control group in such 10 aspects as improving the interest of learning, learning efficiency, the ability of teamwork, clinical thinking, interpersonal communication, combining theory with practice, active knowledge acquirement, language expression, understanding knowledge point, and confidence to become a real doctor. Moreover, there were significant differences in improving the interest of learning, the ability of clinical thinking, and combining theory with practice ( P<0.05). The two theoretical test scores of the study group [(77.46±4.73) points and (79.80±7.53) points] were significantly higher than those of the control group [(70.68±5.16) points and (75.94±8.16) points] ( P<0.05). Conclusion:Situation-based video feedback combined with PBL can improve the clinical clerkship teaching effect of cardiac surgery for medical students under the teaching mode of OSBC.

OBJECTIVETo explore the once sampling quantitation of Houttuynia cordata through its DNA polymorphic bands that carried information entropy, from other form that the expression of traditional Chinese medicine polymorphism, genetic polymorphism, of traditional Chinese medicine.

METHODThe technique of inter simple sequence repeat (ISSR) was applied to analyze genetic polymorphism of H. cordata samples from the same GAP producing area, the DNA genetic bands were transformed its into the information entropy, and the minimum once sampling quantitation with the mathematical mode was measured.

RESULTOne hundred and thirty-four DNA bands were obtained by using 9 screened ISSR primers to amplify from 46 strains DNA samples of H. cordata from the same GAP, the information entropy was H=0.365 6-0.978 6, and RSD was 14.75%. The once sampling quantitation was W=11.22 kg (863 strains).

CONCLUSIONThe "once minimum sampling quantitation" were calculated from the angle of the genetic polymorphism of H. cordata, and a great differences between this volume and the amount from the angle of fingerprint were found.