Objective To explore the effect of candesartan combined with levamlodipine besylate on hypertension and target organ protection.Methods One hundred and twenty-two patients with hypertension and proteinuria from February 2011 to July 2013 were divided into observation group (61 cases) and control group (61 cases) by random number table method.Patients in both groups were given oral candesartan 8 mg/d,and the observation group was treated with levamlodipine besylate 2.5 mg/d on this basis.Six months after treatment,the blood pressure levels,carotid intima-media thickness (IMT),interventricular septum thickness (IVST),left ventricular posterior wall thickness (LVPWT),left ventricular end diastolic diameter (LVEDD),left ventricular mass index (LVMI) and renal function between 2 groups were observed.Results After 6 months of treatment,the total effective rate in observation group was 86.9％ (53/61),and in control group was 72.1％ (44/61),there was significant difference (P ＜ 0.05).Systolic blood pressure and diastolic blood pressure levels in two groups after treatment were decreased,in observation group which were lower than those in control group,and there was significant difference (P ＜ 0.05).IVST,LVEDD,LVPWT,LVMI and carotid IMT in 2 groups after treatment was lower than that before treatment,in observation group which was obviously lower than that in control group [(8.5 ± 1.3) mm vs.(9.2 ± 1.2) mm,(39.6 ± 4.8)mm vs.(44.3 ± 3.9) mm,(8.4 ± 1.4) mm vs.(9.1 ± 1.3) mm,(89.4 ± 9.3) g/m2 vs.(97.3 ± 8.9) g/m2,(8.3 ± 0.3) mm vs.(8.7 ± 0.5) mm],and there were significant differences (P ＜ 0.05).Urea nitrogen between 2 groups before and after treatment had no significant difference(P ＞ 0.05).The serum creatinine,creatinine clearance rate,total 24 h urinary albumin and microalbuminuria in 2 groups was significandy improved compared with that before treatment,and in observation group after treatment was obviously improved compared with that in control group [(94.6 ±25.5) μmol/L vs.(118.5 ±38.4) μmol/L,(102 ±24) ml/min vs.(96 ± 18) ml/min,(1.05 ± 0.51) mg/24 h vs.(1.27 ± 0.22) mg/24 h,(155 ± 36) mg/L vs.(185 ± 41) mg/L],there were significant differences (P ＜ 0.05).Conclusions The effect of candesartan combined with levamlodipine besylate in treatment of hypertension and proteinuria is better than monotherapy.Combination therapy in reversing left ventricular,improving carotid IMT,protecting kidney function and reducing proteinuria has significant effect,and has no obvious adverse reactions.It is worthy of clinical application.

OBJECTIVE： To discuss about the key and entrance points of the development strategy of Chinese materia medica in the new century.METHODS： Some important items,such as difficult problems which Chinese materia medica facing to at present,new way to research into its effective substance bases,innovation on the theory and “ molecular targets” of Chinese materia medica,were analyzed.RESULTS ＆ CONCLUSION： Chinese materia medica industry would become a most important pharmaceutical industry in China and really walk up to the whole world if traditional Chinese herb medicine supplies“ international language” for its exchange,qualitative and quantitative standards on judging the essence of its prescriptions and builds up its“ earmark” of Chinese materia medica industry.Based on the train of thought of this paper,suggestions how to promote the development of Chinese materia medica in the new century are put forward.

The failure of islet β cell is the core pathogenic mechanism of diabetes,which is also the key target for type 2 diabetic mellitus treatment.A large amount of basic and clinical researches have been confirmed that glucagon like peptide-1 and its analogue liraglutide have abilities to significantly improve islet β cell function besides the glucose-dependent lowering hyperglycemia effects.Furthermore,liraglutide is approved to improve β cell function,thus providing a new choice for treatment of type 2 diabetes.

Objective To study the applied value of invasive arterial blood pressure monitoring in the diagnose and treatment of coronary artery intervention. Methods The dynamic changes of ECG, the non-invasive blood pressure, the invasive arterial blood pressure monitoring and the clinical performance were ob-served in 163 patients in the process of coronary artery intervention (CAI). Then the invasive arterial blood pressure change and the non-invasive blood pressure change were compared. Results The change rates of invasive arterial blood pressure were higher than that of non-invasive arterial blood pressure. The difference of both changes had statistical significance. The invasive blood pressure decreased and wave forms changed in 26 cases. These reflected sensitively the patients' condition and the issues in the process of CAI. Conclusions To strengthen the invasive arterial blood pressure monitoring can improve the success rate of CAI more effec-tively and reduce the complication.

Tumor dormancy is a well-known clinical phenomenon and the underlying mechanisms are poorly understood.It has been speculated that one of the major factors accounting for the dormant behavior is impaired angiogenesis.As stimuli result in the imbalanced concentration between the pro-angiogenic factors and anti-angiogenic factors,the tumors would escape from dormancy.However,why a dormant(silent)tumor be-comes angiogenic has not been explained and the molecular events that participate in it are under investigation.Despite all that,anti-angiogenic therapy is a very promising strategy to induce tumor dormancy.

[Objective] To discuss the importance of causa morbi and early diagnosis and treatment on the prognosis and lapsing of hypoglycemia.[Method] Select 33 cases and make detailed enquiry and analysis to their causa morbi, occurrence time length and complications, supplement timely glucose injection, if necessary, administer glucocorticoid for treatment; observe the patients ’clinical symptoms relieve, and compare the usage of glucose and glucocorticoid, the in-hospital period and relative indexes of prognosis and lapsing.[Result] In the group, 28 cases are drug-induced hypoglycemia, occupying 84.85%;30 cases have the period less than 6h from occurrence to diagnosis, among which, 1 had cerebrovascular accident and consulted with neurology department, relieved with treatment, but with sequela of hemiplegia; 1 case had too long time of dizziness before coming to hospital(>24h), couldn ’t be better over treatment, the relatives gave up the treatment and went out of hospital; 1 was tested of islet celltumor and transferred to upper hospital, without recurring hypoglycemia being fol owed up.[Conclusion] Drug-induced hypoglycemia is the main reason for hypoglycemia, with much harm;early diagnosis, remov-ing causa morbi and active rescuing wil have good prognosis.

Accurate alignment of knee implants is essential for the success of total knee replacemem.Recently,computer-aided navigation systems have become available,and the results showed more accurate and consistent installation of knee implants.The technology has evolved rapidly with widespread and continue to be developed.The current computer environmem and graphical user interface will become more user friendly and thus gain more widespread acceptance among experienced surgeons With this technology growing and systems evolving,computerized navigation will become the standard of care in knee reconstructive surgery.The key of future studies is to evove less invasive tracker anchoring systems,electronic balancers and computerized saws.A hybrid technique between image-based and image-free methods may develop to produce image-enhanced navigation.It should be an intermediary step between current technology and a fully robotic system.

Persistent pulmonary hvpertension of newborn(PPHN) is a life-threatening condition which occurs at a rate of 2/1 000-6/1 000.The etiology of PPHN is still unknown and its treatment remains a major challenge for neonatologist.Impaired pulmonary artery relaxation,reduced blood vessel density and pulmonary vascular remodeling are the main pathological changes in PPHN.The general managements include mechanical ventilation,sedation,surfactant and hemodynamic support.Inhaled nitric oxide is the main vasorelaxant used in the treatment of PPHN.Several other vasorelaxants have been studied such as phosphodiesterase inhibitors,prostacyclin,endothelin-1 inhibitors.Even with the introduction of several new therapeutic modalities there has been no significant change in survival rate.

Objective To investigate the effect on short-term continuous subcutaneous insulin infusion (CSII) treatment on beta-cell function,serum triglyceride(TG),C-reactive protein(CRP) and serum insulin like growth factor-1 (IGF-1) of newly diagnosed type 2 diabetes mellitus(T2DM) patients.Methods Thirty-two newly diagnosed T2DM patients with fasting plasma glucose(FPG) ＞ 11.1 mmol/L were treated with CSII for 2 weeks.FPG,2 h postprandial blood glucose (2hPG),fasting insulin (FINS),2 h postprandial insulin (PINS),fasting C peptide (FC-P),2 h postprandial C peptide (PC-P),glycosylated hemoglobin (HbA1 c),Homa-β,Homa-R,TG,CRP and IGF-1 were measured and compared before and after CSII.Results (1) Compared with that of before treatment,the levels of FPG,2hPG,HbA1c,PINS and PC-P in patients after treatment were dramatically improved(t =12.04,11.57,7.61,20.77,6.16; P ＜ 0.05),and Homa-β increased from (23.0 ±16.2) to (71.0±23.8)(t=9.46,P＜0.05),while Homa-IR significantly decreased from (6.8 ±2.1) to (3.9 ± 2.6) (t =4.81,P ＜ 0.05).(2) The levels of TG and CRP significantly decreased from (1.50 ± 0.32) mmol/L,(3.14±1.14) to (1.29±0.31) mmol/L,(1.95 ±0.52) mg/L(t =26.73,23.62;P ＜0.05).The levels of IGF-1 significantly increased from (341 ± 16) μg/L to (471 ± 17) μg/L (t =8.65,P ＜ 0.05).Conclusion The excellent glycemic control,improvement of lipid metabolism,anti-inflammatory and improvement of beta-cell function can be achieved with short-term CSII intensive therapy in newly diagnosed T2DM patients with severe hyperglycemia.

Objective To evaluate percutaneous kyphoplasty in the treatment of fresh osteoporotic vertebral compression fractures. Methods Thirty patients,aged 65 -81 years (mean 72 years),were enrolled in this prospective and consecutive Cohort study. All patients suffered from solitary fresh osteoporotic thoracolumbar vertebral compression fracture (T8 -L4) without neurological dysfunction. Percutaneous kyphoplasty with balloon dilatation was performed and a follow-up of 12 months was made. Results Significant improvement in kyphotic angle was obtained after the treatment,which was reduced from 12.5? before the surgery to 6.6? after the surgery. The visual analog scale concerning the back pain was also reduced from 8.2 before the surgery to 1.6 after the surgery. Conclusion For the treatment of fresh osteoporotic vertebral compression fractures,percutaneous kyphoplasty can achieve excellent therapeutic results.