OBJECTIVE:To evaluate the efficacy and safety of telmisartan in the treatment of hypertension.METHODS:The efficacy and safety of telmisartan versus losartan in treating hypertension reported in 5 studies were comprehensively evaluated with the meta-analysis in homogeneity test and combined test.RESULTS:Of the five randomized controlled trials(RCT) in which 771 patients who met the inclusion criteria were included,two studies were of high methodological quality according to Jadad scale.Meta analysis indicated that there was statistical significance between telmisartan and losartan in effectiveness(OR=1.55,95% confidence interval(1.12,2.16),P0.05).CONCLUSION:The effectiveness of telmisartan in the treatment of hypertension is significantly higher than that of losartan;however,there is no signficant differce in safety between the two drugs.

The success of total hip replacement relies on detailed preoperative pla nning and reliable localization during operation.Currently,great advances have been made in the research and application of localization s ystem.The traditional preoperative planning is based on plain radiographs of the p elvis and femur as well as the profile outline of each prosthetic component.Now image-gu ided system(IGS)is used to perform virtual implantation.Surgeons used to localize during total hip replacement only wi th eyes or unreliable localization d evices,but now they begin to use imag e-guided system for surgical navigation during operation.[

Objective To evaluate the efficacy of dexmedetomidine combined with nicardipine for controlled hypotension in patients undergoing orthopedic surgery.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 32-64 yr,weighing 45-76 kg,scheduled for orthopedic surgery under general anesthesia,were randomly allocated into 2 groups (n =30 each):nicardipine group (group N) and dexmedetomidine + nicardipine group (group DN).A loading dose of dexmedetomidine 1 μg/kg was injected intravenously 10 min before induction of anesthesia,followed by infusion at 0.5.μg ·kg-1 ·h-1 until 30 min before the end of operation in group DN.While the equal volume of normal saline was given in group N.BIS value was maintained at 40-49 during operation.Controlled hypotension was performed with iv infusion of nicardipine at a rate of 2.5 μg· kg-1 · min-1,MAP was reduced to 60-65 mm Hg,then the infusion rate was adjusted to maintain MAP at this level,and nicardipine infusion was stopped while closing the skin.The amount of anesthetics and nicardipine consumed,blood loss,volume of fluid infused,and allogeneic blood transfusion during operation and the operation time,emergence time and extubation time were recorded.Results No patient received allogeneic blood transfusion in both groups.Compared with group N,the amount of anesthetics and nicardipine consumed was significantly decreased,the emergence time and extubation time were significantly shortened (P ＜ 0.05),and no significant change in the volume of fluid infused and blood loss was found in group DN (P ＞ 0.05).Conclusion Dexmedetomidine combined with nicardipine can reduce the requirements for nicardipine and anesthetics during operation,shorten the time for recovery from anesthesia and improve the efficacy of nicardipine for controlled hypotension when used for controlled hypotension in patients undergoing orthopedic surgery.

Objective To explore the risk factors analysis of infection after total hip replacement and its early diagnosis .Methods 86 patients with total hip replacement were selected ,the clinical data and surgical process were obtained retrospective ,to analysis the risk factors analysis of infection after total hip replacement .Results The age of infected patients with total hip replacement was significantly higher than non-infected patients (P< 0 .05) .The surgery time and postoperative drainage time in infected patients were significantly longer than non-infected patients(P<0 .05) .The risk of infection of patients who had long-term application of hormone ,complicated with diabetes mellitus ,history of hip surgery and lower serum albumin content were significantly higher (P<0 .05) .Intraoperative blood loss ,sex ,patient bone cement application and antimicrobial drug use had no obvious relation with post-operative infection(P>0 .05) .After the early diagnosis and treatment ,the joints function of infected patients were recovery good , and without serious effects .Conclusion The infection after total hip replacement is associated with a variety of factors ,it should give positive prevention in the clinical work .For suspected patients should be early diagnosis ,and should choose suitable treatment according to the patient′s specific situation .

Through occupying binding site of glycoprotein IIb/IIIa receptor,platelet glycoprotein IIb/IIIa inhibitor (GPI)inhibit the combination of fibrinogen and the receptor,then inhibit platelet aggregation.GPI is the most powerful anti-platelet drug and possesses application value in ACS now.This article made an overview on the newest research progress of safety and effectiveness of GPI in ACS.

Objective: To explore the anatomy of tibiofibular syndesmosis for the clinic treatment of tib-iofibular syndesmosis injury. Methods: Twelve embalmed adult lower legs were selected. The configurations , structures and plane which ligaments attached to were observed. Results:Tibiofibular syndesmosis consists of ligaments, plica and synostosis. It's tower-shaped. The plane which ligaments attached to has a shape of swallow's tail. Conclusion:Tibiofibular syndesmosis is strong and elastic. The fixation of injuried tibiofibular syndesmosis should be elastic.

Differentiating syndrome factor and forming syndrome type according to symptoms and signs are the rules and processes of syndrome differentiation in traditional Chinese medicine (TCM). TCM syndrome differentiation is a nonlinear complex giant system. In order to solve the key problem of determination of diagnosing weight value for syndrome factor differentiation, a new algorithm of double levels of frequency and weight based on the analysis of frequency statistics was applied, and the accurate syndrome differentiation parameters were acquired. Therefore, based on the nonlinear and multivariate analysis, a new algorithm of calculating diagnostics for syndrome factor differentiation was established.

[Objective]To explore the clinical indication and effectiveness of anterolateral mini-incision for the total hip replacement (THR).[Method]A retrospective analysis of the 34 cases of anterolateral mini-incision was conducted from May 2002 to March 2005,among the patients 23 suffered from displaced femoral neck fractures and 11 suffered from femoral head aseptic necrosis.[Result]All the patients were followed up for 12～36 months with an average of 18 months.The obvious advantages of anterolateral mini-incision for the total hip replacement were as following:less blood loss in operation,less post-operative pain and complications,and early rehabilitation training,without cinch and subsidence in X-ray.Harris score was 92.1 point.[Conclusion]Anterolateral mini-incision for the total hip replacement can be used as an effective method to treat the patients who were extenuation,without abnormalities of hip joint,deossification and osteoporis.Appropriate incision combined with precise procedure can reduce the operative trauma and speed up functional recovery.

Objective To compare the effect of the cochlear stem cells transplantation in treating the noise in-duced hearing loss model and toxic hearing loss model.Methods The Experimental guinea pigs were divided into three groups:the group of the noise induced hearing loss model treated with the cochlear stem cells,the blank con-trol group of toxic hearing loss model treated with the cochlear stem cells and noise induced hearing loss model and the blank control group of toxic hearing loss model.The cochlear stem cells suspension and physiological saline were transplanted into the cochlear inner ears of the three groups,respectively.ABR detection and immunofluorescence observation were implemented three times in 7 days,28days and 56 days after the operation,respectively.Results Nestin positive cells and Myosin ⅦA positive cells were detected in both of the two models treated with cochlear stem cells,but the number of Nestin positive cells and Myosin ⅦA positive cells detected in noise induced hearing loss model was higher than that in the toxic hearing loss model.The ABR responses decreased on the noise induced hearing loss model and toxic hearing loss model treated with cochlear stem cells transplantation,but the hearing re-covery of guinea pigs in the noise induced hearing loss model was superior to the toxic hearing loss model at 28 days and 56 days after operation.Conclusion The cochlear stem cells transplantation is more effective in treating noise in-duced hearing loss than toxic hearing loss model.

Syndrome factors as refined diagnostic units are the base of syndrome differentiation,each syndrome factor has the relative symptom and sign.By way of epidemiology and documents investigation,as well as algorithm of double levels of frequency and weight,the symptom and sign for the syndrome factor of Qi-deficiency,Blood-deficiency,Yin-deficiency and Yang-deficiency respectively were extracted correctly,and the weight values of symptoms and signs to syndrome factors were established.