Objective: To explore the effect of valsartan on inflammatory cytokines in patients with hypertension combining paroxysmal atrial ifbrillation (PAF).
Methods:A total of 60 patients with hypertension combining PAF converted to sinus rhythm were studied and the patients were divided into 2 groups. Control group, the patients received felodipine and Valsartan group. n=30 in each group, all patients were treated for 6 months. In addition, there was a Normal group including 30 healthy subjects. The levels of high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and left atrial diastolic diameter (LADd), the sinus rhythm maintenance rate were examined and compared before and after treatment among different groups.
Results: Compared with Normal group, the levels of hs-CRP, IL-6 and LADd were obviously higher in patients at both Control group and Valsartan group, all P<0.01. With 6 months of treatment, the levels of hs-CRP, IL-6 and LADd were decreased in both groups of patients than they were before, all P<0.01;compared with Control group, such effects were more obvious in Valsartan group, all P<0.01. The sinus rhythm maintenance rate in Valsartan group was signiifcantly higher than that in Control group, P<0.05.
Conclusion: Valsartan may inhibit inflammatory response and improve atrial structure remodeling, therefore better maintain the converted sinus rhythm in patients with hypertension combining PAF. The anti-inlfammatory effect of valsartan might be independent from its anti-hypertension effect.

Objective To evaluate the efficacy and safety of sorafenib in combination with interferon-alpha(IFN-α)as the first-line treatment in patients with advanced renal cell carcinoma.Methods Since Dec 2007 to Jun 2008,137 legal patients with advanced renal cell carcinoma (RCC)were enrolled in the trail from 22 hospitals in China.All the patients continuously received the treatment of sorafenib plus IFN-α untill disease progressed or patients were unable to tolerate.The primary end points were objective response,disease control rate and adverse effects rate.Results This interim analysis was based on the data collected from the study initiation date to 2009/3/20.The overall response rate(ORR),including complete response (CR) and partial response(PR),was 32.8%(45/137).The median follow-up time was 11.9 months,only 25 patients progressed at the cut off time.The most common adverse events were hand-foot skin reaction(48.2%),alopecia(23.4%),rash (20.4%),diarrhea(19.7 0A),fever(16.8%),lassitude(10.2%),etc.The incidence of 3 or 4 grade hand-foot skin reaction was 8.8%.Conclusions Sorafenib in combination with IFN-α as the firstline treatment in patient with advanced RCC could be effective and safe.

Objective To study and evaluate islet cell adenoma of preliminary diagnosis.Method Retrospective analysis Wag done on 22 patients clinical data of preliminarily diagnosed islet cell adenoma.They were divided into two groups according to final diagnosis,group of islet cell adenoma(n=16)and group of reacfional hypoglycemia n=6).Results There were significant differences between the two groups in term of fames,cold sweat,cataphora,Whipple triad,hungry test,the ratio offasting blood insulin and fasting blood glucose exceeding 0.3 (I/G＞0.3) (P＜0.05).No statistical differences were found on blood glucose level in hypoglycemia onset,psychiatric symptom.Conclusion The clinic data is helpful for preliminary diagnosis,and Whipple triad,hungry test,I/G＞0.3 above all.

Objective: To observe the clinical effect of tuina plus medications on infantile diarrhea induced by rotavirus infection. Methods: After 55 cases of confirmed sick infants were divided into two groups by the order of their visits, 30 cases in the medication group were treated by intravenous infusion of Ribavirin and oral administration of Smecta; 25 cases in the tuina plus medication group were treated by the manual techniques of tonifying Pijing(脾经) and clarifying Dachangjing (大肠经), rubbing the abdomen and kneading the navel clockwise, pushing Shangqijiegu (上七节骨), kneading Guiwei (龟尾), and pinching the skin of the spine, in combination with same medications used as in the medication group. Results: The total effective rate was 96% in the tuina plus medication group, P < 0.01, in comparison with the medication group. Conclusion: tuina has a good therapeutic effect in the treatment of infantile diarrhea induced by rotavirus infection and is importantly significant for shortening the course, enhancing the therapeutic effect and lowering down the medical cost.

AIM:To investigate the changes of connexin 43 (Cx43) via establishing a model of sympathomi-metic atrial fibrillation ( AF) .METHODS:The mongrels ( n=15) were randomly divided into control group , rapid atrial pacing (RAP) group and isoprenaline (ISO) perfusion+RAP group (ISO+RAP group).All mongrels’ hearts were taken out rapidly by median sternotomy to establish the cardiac model with Langendorff perfusion in vitro.The atrial effective re-fractory period ( AERP) and AF inducability were tested .The expression and distribution of tyrosine hydroxylase ( TH) were analyzed by immunohistochemistry .Total protein level of Cx 43 and phosphorylation of Cx 43 were determined by West-ern blot.The distribution of Cx43 were also observed by immunofluorescence staining .The cell apoptosis was analyzed by TUNEL staining.The generation of reactive oxygen species ( ROS) in the mitochondria was measured by fluorescence spec-trophotometry .RESULTS:No significant change of AERP was found between control group and RAP group , while that in ISO+RAP group was significantly decreased (P<0.05) and induced AF.Compared with control group, the expression of TH, apoptotic index and the generation of ROS increased gradually (P<0.05), while the content of Cx43 decreased grad-ually both in the total protein and the phosphorylation levels in RAP group and ISO +RAP group (P<0.05).The fluores-cence intensity of Cx43 was also attenuated and Cx43 were lateralized apparently in RAP group , while Cx43 were character-ized as punctate distribution in ISO +RAP group.CONCLUSION:Sympathetic nerves may activate autophagosome at in-tercalated discs and trigger cell apoptosis , resulting in remodeling and downregulation of Cx 43 via oxidative stress , thus having effects on mediating and maintaining AF .

Objective To investigate the perception of Mandarin's tones by children with speech development disorders so as to provide a theoretical basis for clinical rehabilitation.Methods Thirty children with speech development disorders (DPDs) aged 4 to 6 were matched with 30 healthy counterparts as a control group.Both groups underwent the tone perception experiment,which included tone identification and discrimination tasks.The speech stimuli were 11 computer-simulated voices expressing a continuum of sounds from Mandarin speech ranging from /bá/ to /bà/.The two groups were compared in their ability to identify and differentiate the tones.Results Both groups showed typicalS-shaped identification curves in a category pattern.The category boundaries of the control group were between stimulus steps 6 and 7,significantly different from those of the experimental group where the boundary fell between stimulus steps 5 and 6.On the distinguishing curve,both groups presented obvious peak values.The stimulus steps of the peaks and the crossing points of the identification curves were consistent.In addition,the average ahsolnte value (b1) of the identification curve and the peaks' degree of steepness (DP) of the DPD group's distinguishing curve were significantly lower than those of the control group.At the same time,the average boundary width (Wcb) was significantly higher than that of the control group.Conclusion Children with speech development disorders perceive Mandarin tones with categories different from those of normal children.They may have difficulty in perceiving tones,which might be an important factor leading to pronunciation errors.

Objective To report a multiple metastatic renal cell carcinoma (RCC) case successfully treated with cytoreductive nephrectomy after neoadjuvant Sunitinib,and discuss the efficacy and treatment regime of neoadjuvant targeting therapy.Methods A 51 years man presented with painless gross hematuria for one week and admitted into our hospital in August 2010.Abdominal CT demonstrated a 6.6 cm ×6.3 cm left lower pole renal tumor associated with renal vein tumor thrombus,bulky hilar lymph nodes and extensive local invasion.The patient was also found to have lung and right tibial metastasis.The clinical stage was T3bN1 M1.Percutaneous biopsy confirmed clear cell renal carcinoma.Neoadjuvant Sunitinib 50 mg daily was administered with 4 weeks on,2 weeks off schedule for two cycles.Cytoreductive nephrectomy was preformed 2 weeks after discontinuation of neoadjuvant Sunitinib.Imaging evaluation was performed to assess the primary tumor and metastatic sites.The patient was followed up till present.Results After two cycles of neoadjuvant treatment,CT scan revealed 23％ size reduction of left renal tumor to 5.1 cm ×4.4 cm,renal vein tumor thrombus regression,local perirenal invasion improvement,lung metastasis resolution and static right tibial metastasis.According to RECIST criteria,the objective response was stabilization of disease (SD).Cytoreductive nephrectomy was successfully performed to remove the primary tumor in December 2010.Pathology revealed Fuhrman Ⅱ renal cell carcinoma with major necrosis in primary tumor and thrombus localized in renal vein.During 6 months of post-operative follow-up,there was no local recurrence,lung metastasis had vanished completely and tibial metastasis had not progressed.Local recurrence and other distant metastasis were not demonstrated in 20mon follow-up till now.Disease control of this patient was partial response (PR) by RECIST.Conclusions Neoadjuvant Sunitinib treatment could result in downstaging of primary tumor and facilitate cytoreductive nephrectomy,thus eventually increase patient overall survival.

Objective To measure the parameters of ealeaneal quantitative ultrasound(QUS)in nomal Hubei Yichang subjects.which were compared between different age groups after standardization by body mass index(BMI).Methods Calcaneal parameters were measured by UBIS5000 in 2912 normal Hubei Yichang subjects,from 20 to 82 years old women 1450,men 1462).Results The peak values of broadband ultrasound attenuation(BUA)and stiffness(STI)of the calcaneal were both in 45-49 year group for women.The peak value of BUA was in 50-54 year group for men.Standardized by BMI,the peak value of BUA、STI and sound of speed(SOS)were both in 20-24 year groups for women and men.Conclusion BUA、SOS and STI of the calcaneal may change with age.After the influence of body mass is eliminated,the change still exists obviously,and the parameters may gradually reduce with increasing age.

Objective To evaluate the impact of chemotherapy compliance on the therapeutic efficacy of induction chemotherapy plus concurrent chemoradiotherapy versus induction chemotherapy plus radiotherapy alone for patients with locally advanced nasopharyngeal carcinoma (NPC). Methods Based on intention to treat analysis (ITT) for 400 patients, 314 patients were analyzed by per protocol (PP) analysis. The patients were divided into induction chemotherapy plus concurrent chemoradiotherapy group (IC/CCRT, 127 patients) or induction chemotherapy plus radiotherapy group (IC/RT, 187 patients). The patients who completed 2 cycles of induction chemotherapy and at least 2 cycles of concurrent chemotherapy in the IC/CCRT group and the patients who completed 2 cycles of induction chemotherapy in the IC/RT group were analyzed. Radiotherapy was given by two-dimensional technique with γ-ray, X-ray and electron beams. The chemotherapy regimen was FUDR plus carboplatin for induction chemotherapy and carboplatin alone for concurrent chemotherapy. Results The follow-up rate was 96.2%. 295 patients were followed to at 3 years. Based on PP analysis, Grade 3/4 toxicity was found in 23.6% of the patients in IC/CCRT group and 13.4% in the IC/RT group (χ~2 =5,50,P=0.019). No grade 4 toxicity was found in the IC/RT group. The median follow-up time was 3.9 years, and no significant difference was found between the two groups in 3-year overall survival (78.1% : 84.6% ;χ~2 = 0. 61, P =0. 435), disease-free survival (74.3 % : 70.1% ;χ~2= 0. 12, P= 0.731), Iocoregional relapse-free survival (89.7% : 89.5% ; χ~2= 0. 10, P= 0.748), or distant metastasis-free survival (78.9%:76.5% ;χ~2=0.05,P=0.825). Conclusions With more severe toxicities, the IC/CCRT regimen does not improve the overall survival in locally advanced NPC patients compared with the IC/RT regimen.

Objective To assess the test-retest reliability of the Chinese version of Overactive Bladder Symptom Score (OABSS) and its correlation with other overactive bladder symptom (OAB)evaluation tools among Chinese OAB patients. Methods Fifty OAB patients completed the OABSS,PPBC, IPSS forms and a three-day voiding diary card for twice in day 0 and day 14±2, respectively.Test-retest reliability was examined using internal correlation coefficient (ICC) and weighted Kappa coefficients between first and second application of OABSS. The internal reliability was evaluated using Cronbach's α coefficient method. Pearson or/and Spearman correlation coefficients were calculated for testing the correlation between OABSS and IPSS, IPSS QOL, PPBC as well as clinical variables in the three-day voiding diary cards. Results ICC of OABSS total score was 0.9172, weighted Kap-pa coefficients of individual scores in OABSS were 0.5902-0.9274;Cronbach's α coefficients were 0. 3069 and 0. 3285, respectively. In the first and second application of OABSS, the Pearson correlation coefficients were 0. 2643-0. 6900 between OABSS and clinical variables in the three-day voiding diary card (except for average daily frequency of urination);the Pearson correlation coefficients were 0. 4734 and 0. 4929, and the Spearman correlation coefficients were 0. 4133 and 0. 4149 between OABSS and IPSS total score;the Spearman correlation coefficients were 0.4083 and 0.4127 between OABSS and PPBC. Conclusions The Chinese version of OABSS manifest test-retest reliability among Chinese OAB patients. It has also a high correlation with IPSS total score, PPBC and clinical variables in the three-day voiding diary cards.