ObjectiveTo observe the effect of amlodipine besylate combined with benazepril in treatment of old patients with primary hypertension and left ventricular hypertrophy,and analyze the safety.MethodsOne hundred and eight old patients with primary hypertension and left ventricular hypertrophy were divided into observation group(54 cases) and control group(54 cases) by random digits table.The patients in observation group were treated with amlodipine besylate combined with benazepril and the patients in control group were only treated with amlodipine besylate.The levels of blood pressure,interventricular septal thickness(IVST),left ventricular posterior wall (LVPW),left ventricular end-diastolic dimension (LVEDD) and left ventficular mass index(LVMI) before and after treatment for 6 months were measured and compared between two groups.The adverse effects after treatment were compared too.ResultsAfter treatment,the levels of 24hSBP,24hDBP,IVST,LVPW,LVEDD and LVMI were significantly decreased in both groups (P ＜ 0.05).Moreover,the levels of 24hSBP,24hDBP,IVST,LVPW,LVEDD and LVMI after treatment in observation group were significantly lower than those in control group(P ＜ 0.05).There was 1 case ( 1.9％ ) of dry cough,2 cases (3.7％) of mild ankle edema in observation group,while only 2 cases (3.7％) of mild ankle edema in control group.There was no significant difference in adverse effects between two groups (P ＞ 0.05).ConclusionsCompared with amlodipine besylate single treatment,amlodipine besylate combined with benazepril in treatment of old patients with primary hypertension and left ventricular hypertrophy can more effectively control blood pressure and reverse left ventricular hypertrophy.The adverse effects are not increased,which can be applied in clinic.

Objective:To establish a nomogram model for predicting the risk of intracranial hemorrhage in patients with acute cerebral infarction after mechanical thrombectomy.Methods:The clinical data of 251 patients with acute cerebral infarction who underwent mechanical thrombectomy in Shengjing Hospital Affiliated to China Medical University from January 2017 to December 2019 were retrospectively analyzed. Logistic regression model was used to analyze the independent risk factors of intracranial hemorrhage after mechanical thrombectomy. A nomogram prediction model based on independent risk factors was established to verify the prediction and accuracy of the model.Results:The analysis results of logistic regression model were as follows: age ( OR=1.303, 95% CI:1.184-1.433), the time from infarction to re-canalization ( OR=4.306, 95% CI:2.497-7.425), preoperative NISS score ( OR=7.584, 95% CI:2.221-25.900), preoperative computer tomography (CT) low-density lesions ( OR=7.954, 95% CI:1.176-53.792) were independent risk factors for intracranial hemorrhage after mechanical thrombectomy in patients with acute cerebral infarction ( P<0.05). Based on the above 4 independent risk factors, a nomogram predictive model of intracranial hemorrhage risk after mechanical thrombectomy was established. The Bootstrap internal verification method proved that the model had good prediction accuracy, and the receiver operating characteristic (ROC) curve analysis testified that area under curve (AUC) area was 0.966. Conclusions:The risk nomogram prediction model has good accuracy, discrimination and good prediction ability, which can improve the diagnostic efficacy of intracranial hemorrhage after mechanical thrombectomy in patients with acute cerebral infarction.

Objective To explore the efficacy of case analysis and problem discussion in teaching the course of introduction to clinical medicine for law majors and to discuss their influence on cultivating students' ability and quality.Methods Totally 58 students were randomly divided into three groups:trial group A(n =20),trial group B (n =16) and control group (n =22).Trial group A was further randomly divided into six groups.Teaching contents included iron deficiency anemia and acute leukemia.Trial group A and trial group B adpoted case analysis and problem discussion while control group practiced traditional classroom teaching.Results of theoretical test were processed through one-way analysis of variance and the least significant difference,using SPSS 11.5 software.Self-evaluation of teaching effects on students'specialized learning,logic thinking and knowledge of diseases were analyzed by Chi-square test and Fisher's exact test.Influences of different teaching methods on self learning ability,summarizing ability,team cooperation consciousness and lateral thinking were evaluated after lecture.Results Exam results showed no difference between trial group A and control group (P =0.564),the students in trial group A had a significant higher score than those in trial group B (P =0.004).100％ and 75.0％ students in trial group A considered the course of introduction to clinical medicine helpful concerning knowledge of diseases and students' specialized learning,higher than those of 77.3％ and 40.9％ in control group,with statistical differences(P =0.049,P =0.026).Positive evaluation rates of self learning ability,summarizing ability,team cooperation consciousness and lateral thinking were 100％,70.0％,80.0％,60.0％ in trial group A ;75.0％,68.8％,62.5％,81.3％ in trial group B;22.7％,36.4％,4.5％,27.3％ in control group.Except for summarizing ability,students in trial group A and B were significantly better than those in control group(P＜0.05).Conclusions The teaching method of case analysis and problem discussion meets the needs of versatile legal personnel training and it can stimulate students' study interest as well as improve their professional quality and ability.

Objective To investigate the clinical efficacy and summarize the experience of treating patients with hepatic injuries in a primary-care hospital.Methods The clinical data of 230 patients with hepatic injuries from January 2002 to December 2014 were retrospectively analyzed.Results 124 patients were treated with surgery and 106 patients (including two patients who were transferred to another hospital) were managed by conservative treatment.Of 230 patients,204 patients recovered well and 26 patients died.63 cases of severe hepatic injuries (grades Ⅲ,Ⅳ,Ⅴ and Ⅵ),the mortality rate reached 25.4％.Concltsions The important points to success in managing these patients are early diagnosis and adequate assessment of liver injury,proper choice of treatment and using the simplest and the most effective means in surgery to control bleeding.

Objective To investigate the effect of hypertension on the large artery elasticity index (C1),the small artery elasticity index (C2) and the medial structure of the ascending aorta as well as the relationship between artery elasticity and the medial structure of the ascending aorta.Methods Sixty patients with CHD receiving coronary artery bypass graft surgery at our hospital were divided into two groups:30 patients in the hypertension group and 30 patients in the non-hypertension group.C1 and C2 were measured using the CVProfilor DO-2020 system.Sections of tissues taken from the anterior wall of the ascending aorta during the surgery were subjected to Masson's trichrome staining for the detection of vascular smooth muscle and collagen fibers and Weigert's resorcin-fuchsin staining for the detection of elastic fibers.The relative areas of vascular smooth muscle fibers,collagen fibers and elastic fibers of the ascending aorta were measured by a computer image analysis system under the light microscope.The linear correlations of C1 and C2 with the medial structure of the ascending aorta were analyzed.Results C1 in the non hypertension group was higher than that in thehypertensiongroup[11.9±1.8 (ml/mmHg×10) w 13.1±2.5 (ml/mmHg×10),t 2.22,P ＜0.05].In the media of the ascending aorta,the relative content of collagen fibers was higher,while the relative content of elastic fibers was lower in the hypertension group than in the non-hypertension group [(46.0±3.8)％ w (42.2±3.0)％,(17.5±3.5)％ vs.(19.3 2.7)％,respectively,t=4.24 and 2.20,P＜0.01 or 0.05].C1 was positively correlated with the relative content of elastic fibers but negatively correlated with the relative content of collagen fibers in both groups (r=0.52 and 0.39,respectively,P＜0.05 or 0.01).Conclusions The main pathogenic basis of hypertension-induced decline in arterial elasticity in CHD patients is increased collagen fibers and reduced elastic fibers with disorganization of the two types of components.C1 may accurately reflect the effect of hypertension on medial collagen fibers and elastic fibers in the ascending aorta.

Objective To explore the lymphcyte subsets distribution in cerebrospinal fluid in patients with HIV infection ,and to investigate the clinical significance of the lymphocyte subsets in cerebrospinal fluid in HIV central nervous system complication . Methods 34 patients with HIV infection ,including 20 patients without nervous system symptoms (simple HIV group) and 14 pa‐tients with nervous system symptoms (neurological HIV group) ,and 15 cases of healthy people (control group) were selected . Flow cytometry was used to detect lymphocyte subsets ,and immunoturbidimetry was used to detect the level of IgG in cerebrospinal fluid .Results The percentage of CD8+ T cells was higher and percentage of CD4+ T cells was lower in the simple HIV group and neurological HIV group than those in the healthy control ,with statistically significant differences (P<0 .01) .The level of IgG in pa‐tients with HIV infection was higher than that in the healthy control group (P<0 .01) .While no significant difference were found in the percentage of B cells and NK cells among the there group (P>0 .05) .There were also no significant differece between the sim‐ple HIV group and neurological HIV group in the ratio of each lymphcyte subset in cerebrospinal fluid (P>0 .05) .Conclusion The immune disorder in cerebrospinal fluid in patients with HIV infection may appear in the early time before the nervous system com‐plication .The changing trends of lymphocyte subsets are consistent with the peripheral blood ,which demonstrate that the T lym‐phocyte subsets may be correlated with the nervous system symptoms of HIV .

To investigate the mechanism of Fuzheng Huayu recipe (FZHY), a compound traditional Chinese herbal medicine, against liver fibrosis related to transforming growth factor-β1 (TGF-β1)/Smads signaling transduction.

To observe the effects of vitamin E (Vit E) on mercuric chloride (HgCl2)-induced renal interstitial fibrosis (RIF) in rats and discuss its antioxidative mechanism.

ObjectiveTo investigate the expression characteristics of Caspase-8 in gastric carcinoma tissues and its correlation with clinical pathological features.Methods The mRNA and protein of Caspase-8 in gastric carcinoma and its surrounding tissues were detected by reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry,respectively.ResultsThe Caspase-8 mRNA in gastric carcinoma tissues was obviously lower than that in its surrounding ones (0.154±0.065 vs 0.394±0.107,t =14.04,P ＜0.01),which was correlated with lymph node metastasis,tumor stage,differentiation grade (P＜0.01).The Caspase-8 protein in gastric carcinoma tissues was also significantly lower than that in its surrounding ones (31.48％ vs 85.19％,x2 =32.04,P ＜ 0.01),which was correlated with tumor stage,differentiation grade (P＜0.05).ConclusionsCaspase-8 is low-expressed in gastric carcinoma,which may play an important role in the occurrence and progression of gastric carcinoma.

Problem-based Learning (PBL) is a teaching model originating from the construc-tivism theory, which stressed the meaning construction in problem situation by collaborative learning, conversation and completing knowledge. Based on the times background, development of learning theory, teaching situation, cognitive strategies, ideological connotation about constructivism, PBL's practical significance, its teaching forms, teaching resources, internal motivation, and the teaching evaluation were analyzed deeply, which was beneficial to carrying out PBL normatively in medical education, so as to provide the theoretical support for further exploration and innovation of PBL.