Objective:To compare the effect between benazepril and candesartan combination and single medication in either one of them for treatment of hypertension-combined with microalbuminuria(MCA). Methods:A total of 95 patients were divided into three groups.Benazepril group(n=31),patients were treated with Benazepril 10～20 mg/day;Candesartan group(n=32),patients were treated with Candesartan 4～8 mg/day;and Combination group (n=32),patients were treated with benazepril 10 mg/day and candesartan 4 mg/day.The medication lasted for 8 weeks.Blood pressure(BP),plasma urinary albumin and creatinine ratio(A/C),endothelin-1(ET-1),nitrogen monoxide(NO)and potassium were examined and compared before and after the medication respectively. Results:The levels of BP,plasma A/C and ET-1 were decrease and NO was increased in all three groups(P0.05,respectively). Conclusion:Effect of benazepril and candesartan combination in patients with hypertension-combined microalbuminuria was better than single medication in either benazepril or candesartan.

Fructose-1,6-diphosphate (FDP) is a very important mesne product which links the glucose and hepatin with the oxidation in energy metabolism and keeps the glycolysis functional, which is made use of widely. In addition, FDP has the ability to stabilize the cell membrane, abate inflammatory response, and restrain the oxygen free radical and cell apoptosis, it can protect cell in both structure and function. Recent researches proved that FDP is effective on myocardium protection and cardiac function reviving. This article reviews these research progresses.

Objective To introduce the clinical apply of middle and small skin defect in finger injury with lateral arm free perforator flap.Methods (1) Ten cadavers were injected with a modified lead oxide-gelatin mixture.Later,CT scan,three-dimensional reconstruction of the cutaneous perforator vessels on the later arm.Then simulate the flap design.All cadavers were dissected before CT scanning.(2) Eighteen cases of middle and small skin defects in finger injury were treated with lateral arm free flap.The defect area were from 3 cm × 4 cm to 6 cm × 9 cm.Results Our research showed that the average caliber diameter of perforators of profunda brachial artery(PBA) was (0.71 ± 0.15) mm,and Posterior radial collateral artery(PRCA) was (0.94±0.22)mm.The results of pedicle length of perforator of PBA was (2.74 ±0.42) cm:(2.96 ±0.37) cm,and PRCA was (4.78 ±0.63) cm:(4.86 ±0.51) cm.3D reconstructive results showed that the perforators of PBA and PRCA dominated the lateral upper arm area.The flap of 18 cases survived after the operation.The wound of providing area was directly sutured or skin grafting and got healing.All cases were followed up for 6 months to 3 years,and the average follow-up time was 11 months.There was a little swelling on the outlooks of the flap,but the texture and sensation of the flap was good.Conclusion The lateral arm free perforator flap has a stable vessel pedicle,good texture and sensation,so it was a good method to repair middle and small skin defect in finger injury.

Objective To investigated the prevalence of obesity and metabolic syndrome (MS) and the relationship of non-alcoholic fatty liver disease (NAFLD) with MS in Hangzhou of Zhejiang province. Methods A total of 3500 subjects who were negative for hepatitis B surface antigen marker were selected to take physical examinations. Body height, body weight, blood pressure, alanine aminotransferase,fasting blood glucose,high-density lipoprotein cholesterol,and triglyeerides were recorded. B-ultrasonography of the liver and gallbladder was undertaken. Results The prevalence of MS in the NAFLD or normal control group was 25.49% and 8. 61%, respectively ( P ＜ 0. 05 ). In multivariate logistic regression analyses, MS patients were 3. 927 times more likely to be NAFLD-related. Increased body mass index (BMI) and triglyceride were significantly associated with NAFLD among MS patients. Conclusion BMI and triglyceride level may be the main risk factors of NAFLD-related MS.

Objective To study the clinical characteristics of septicemia and septic shock in elderly patients with liver disease. Methods Fifty-two patients over 60 years old with liver disease and positive blood culture, admitted form 1999 to 2003, were enrolled for analysis. Results Septic shock was found in 8 patients (15.4%). The course of sepsis was complicated by progressive deterioration of hepatic and renal functions. 18 patients (34.6%) died or left the hospital in a critical condition. 52 strains of pathogenic bacteria were isolated, among which 71.2% were G +germ, 26.9% G -germ and 1.9% fungi. Conclusion Septicemia and septic shock can exacerbate liver disease. Early diagnosis and treatment should be emphasized to lower the mortality.

Objective To investigate the feasibility of total hip arthroplasty through a small anterolateral incision. Methods Total hip arthroplasty through a small anterolateral incision was performed in 53 cases (58 hip joints) from February 2003 to December 2003, including 5 cases of simultaneous replacement of bilateral joints, 6 cases of total hip revision, and 4 cases of hip joint rigidity. The surgical modification features were as follows: the patient was placed in recumbent position, with the involved buttock region slightly hanging over the side of the surgical bed and normally drooping; the involved leg was placed in 10? of adduction, which was helpful to the exposure of the greater trochanter; after the exposure of the neck of the femur and the greater trochanter, osteotomy was performed firstly, then the femoral head was dislocated and removed. Results The length of incision was 7~12 cm (mean, 8.5 cm). The operation time was 70~140 min (mean, 88 min). The blood loss was 250~660 ml (mean, 470 ml). No severe complications occurred. Postoperatively, weight-bearing and mobilization exercise were begun in 6~14 days. All the cases were followed for 4~40 weeks (mean, 28 weeks). The Harris hip scores showed excellent outcomes in 37 cases, good in 12, fair in 4, with a rate of excellent or good results of 92.5% (49/53). Conclusions Total hip arthroplasty through a small anterolateral incision is a feasible procedure that is characterized with minimal invasion, less blood loss and quick recovery. It can be applied in total hip replacement for artificial hip joint revision, hip joint rigidity, or congenital dislocation of hip joint.

Objective To explore the expression profile of Wnt4 in rat kidney during renal development and its effect on renal development. Methods Rats with embryonic age of 18 days (E 18 d) , 20 days (E 20 d) as well as postnatal age of 0 day (P 0 d), 1 day (P 1 d), 3 days (P 3 d), 5 days (P 5 d) and 7 days (P 7 d) were selected. Expression levels of Wnt4 in rat kidney during renal development were quantified by immunohistochemistry and Western blot in all time points. Results Immuno?histochemistry analysis showed that during E 18 d to P 7 d, Wnt4 mainly expressed in proximal tubules, ureteric bud, comma shaped bodies and S shaped bodies of nephrogenic zone;the expression in the distal tubule was weak;the expression in renal corpuscle decreased with time;Western blot analysis showed that the expression of Wnt4 in rat kidney began to decrease from E 18 d and reached bottom at P 1 d then rise again until P 7 d when it dropped again. Conclusion During renal development, Wnt4 proteins were involved in the development of the nephrogenic zone through regulating canonical Wnt/β-catenin signaling pathway, and was involved in extension of proximal tubules by inducing the non canonical Wnt/PCP signaling pathway. Expression of Wnt4 protein in rat kidney was closely related to nephron formation and development of proximal tubules.

Purpose To construct expression vector of Fas extracellular region gene(eFas) ,to express and purify recombination protein and to prepare polyclonal antibody, which have laid a foundation of studying its function. Methods The eFas gene encoding sequence was acquired through overlapping PCR, and pET-22b ( + )/eFas expression vector was constructed. Then this vector was transformed into E. coli Rosetta-gami. Re-combinant protein was expression being induced by IPTG,and was purified using Ni-NTA matrix of affinity chromatograph. The purity of recombination protein was identified by SDS-PAGE. Hereafter, the purified eFas recombinant protein was immunized to New Zealand white rabbit in order to prepare polyclonal antibody. The titer of polyclonal antibody was determined by ELISA. Results The encoding sequence and expression vector of eFas was obtained while the interest protein was mainly expressed in the inclusion body. The eFas fusion protein's expression quantity accounts for more than 30% proportion of total E. coli protein. The eFas protein we obtained was provided with the purity of at least 95 % . Conclusion The successful constrution, expression and purification of FasL fusion protein and preparation of polyclonal antibody will provide some material for further studies of Fas.

Objective To discuss the effect and advantage of the navigation-assisted system in total knee arthroplasty (TKA) of the knees with anatomical abnormality. Methods The study involved five patients with anatomical abnormality of the knees who were treated with arthroplasty under the navigation-assisted system from December 2007 to October 2008. Meanwhile, five patients with normal anatomy of the knees treated with total knee arthroplasty without using the navigation-assisted system were used as control. The α, β, γand δ angles were measured based on the X-ray images and the active range of the knee joint was determined. Results No complication caused by navigation occurred. There was no significant difference in the α, β, γ and δ angles between the two groups, but the range of extremum in the navigation group was less than that of the control group. The mean postoperative active range of the knee joint in the navigation group ( 112.67°) was higher than that of the control group ( 106.98° ), while the preoperative active range of the knee joint of the navigation group [(70.87 ± 10.87)°] was significantly lower than that of the control group [( 105.08 ± 30.67)°]. Conclusions Compared with conventional methods, navigation-assisted TKA showas no obvious advantage in short-term outcome but has great advantages in improving the accuracy and the joint movement, especially for the knees with anatomical abnormality.

BACKGROUND:Bone marrow mesenchymal stem cells have particularly applied prospects in tissue engineering. However, the death of transplanted cells limits the tissue regeneration. To search a new drug of anti-free radicals and protecting bone marrow mesenchymal stem cells is of great significance. OBJECTIVE:To investigate the protective effects of mangiferin on bone marrow mesenchymal stem cells against hypoxia. METHODS:Rat bone marrow mesenchymal stem cells were cultured in vitro and hypoxia cellmodel was established by cobalt chloride. cells were divided into normal control group, hypoxia group (treated with cobalt chloride), and mangiferin groups (cobalt chloride+20, 40, 80, 160 μmol/L mangiferin). After 12 and 24 hours of hypoxia, superoxide dismutase, malondialdehyde, and catalase levels in the cellsupernatant were determined. After 3, 6, 12, 24 hours of hypoxia, reactive oxygen species change was detected in each group. RESULTS AND CONCLUSION:Mangiferin significantly improved the survival rate of bone marrow mesenchymal stem cells exposed to hypoxia, increased the intracellular superoxide dismutase and catalase activities, decreased intracellular malondialdehyde and reactive oxygen species levels, thereby effectively protecting bone marrow mesenchymal stem cells against hypoxia. These findings indicate that mangiferin has effective protection against hypoxia and strong antioxidant ability, and can significantly reduce oxidative damage.