Objective To find out early lesion of rentanl function in elderly patients with dipper essential hyperten-sion and morning blood pressure surge( MBPS) , and to find out the value of homocysteine( Hcy) with high-sensitiv-ity C reactive protein ( hs-CRP) in detecting early lesion of rentanl function in hypertensive patients. Methods Totally 168 elderly paritents with dipper essential hypertension were divided into MBPS group( observation group, n=73) and non-MBPS group (control group, n=95) according to the accompanying MBPS or not. The cystatin C ( Cys C) , urinary microcalbumin ( U-mAlb) ,urinary transferring( U-TRF) ,Hcy, hs-CRP,serum creatinine( SCr) , blood urea nitrogen(BUN), blood glucose(Glu),cholesterol(TCH),triglyceride(TG), high density lipoprotein cholesterol( HDL-C) and low density lipoprotein cholesterol( LDL-C) were tested. The differences in Cys C, Hcy, hs-CRP, the U-mAlb positive incidence and the U-TRF positive incidence between the two groups were analyzed. Results There were no statistical concernments in SCr, BUN, GLu, TCH, TG,HDL-C,and LDL-C between the two groups. The amplitude of variation in morning systolic pressure peak was higher in MBPS group than in non-MBPS group(P=0. 000). The obvious varieties in the Cys C, Hcy,and hs-CRP were higher in MBPS group than in non-MBPS group ( P=0. 000 ) . The U-mAlb positive incidence was higher in MBPS group than in non-MBPS group(χ2 =18. 014,P =0. 000). The U-TRF positive incidence was higher in MBPS group than in non-MBPS group(χ2 =19. 694,P=0. 000). Conclusion MBPS has a great effect on Cys C,U-mAlb,U-TRF,Hcy and hs-CRP. MBPS is apt to cause early lesion of rental function in elderly patients with dipper essential hypertension. And Hcy and hs-CRP can be used to diagnose the early renal insufficiency.

Angiotensin Ⅱ receptor blockers(ARBs)decrease blood pressure,reverse vascular remodeling,and activate angiotensinⅡsubtype 2(AT2)receptors in order to improve the levels of angiotensinⅡ(AngⅡ),dilate blood vessels,protect against proliferation,and regulate lipid by blocking angiotcnsinⅡtype 1(AT1)receptors.Further understanding the action mech-anism of ARB in neuroprotection may provide a new idea for the treatment of ischemic stroke in clinical practice.

OBJECTIVE:To observe the efficacy and safety of azithromycin sequential therapy in the treatment of mycoplasma pneumonia in children. METHODS:67 children with mycoplasma pneumonia were randomly divided into control group(34 cases) and observation group (33 cases). All children received conventional treatment,such as fever,cough,supplemented by nutrition support;based on it,control group received 10 mg/kg Azithromycin for injection,adding into 5% Glucose injection by intrave-nous drip in 200 ml,once a day;observation group received azithromycin(the same dosage with control group)after intravenous drip 5 d,switched to 10 mg/(kg·d)Azithromycin dry suspension,orally,then stopped 4 d after continuous 3 d. The treatment course was 7-10 d. Clinical efficacy,disappearance time of fever,cough and lung rales,and lung indexes before and after treat-ment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:There were no significant differences in the to-tal effective rate,disappearance time of fever,cough and lung rales in 2 groups(P>0.05). After treatment,the lung function in-dexes were significantly higher than before,the differences were statistically significant(P<0.01),but there was no significant dif-ference between 2 groups (P>0.05). The incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant (P<0.05). CONCLUSIONS:Based on conventional treatment,azithromycin se-quential therapy shows similar efficacy to without sequential therapy in the treatment of mycoplasma pneumonia in children,but with better safety.

Objective To investigate the correlation between serum S100B, IL-6 and intracranial pressure in patients with severe craniocerebral injury.Methods 81 cases of patients with severe brain injury in our hospital from August 2012 to April 2016 were selected,intracranial pressure was monitored immediately after admission to calculate the average daily ICP level ,and venous blood were collected after craniocerebral injury 6,12,24,48, 72 hours.Detection of serum S100B protein and IL-6 levels,and the correlation analysis with the level of intracranial pressure.Results Patients with severe craniocerebral injury S100B levels increased gradually after injury, reached the peak at 24 hours, then decreased gradually; while patients with IL-6 and intracranial pressure after injury gradually increased, the difference was statistically significant in different time points among the S100B,IL-6 and intracranial pressure levels (P<0.05).Conclusion The changes of intracranial pressure after severe craniocerebral injury were proportional to the levels of serum S100B and IL-6,S100B and IL-6 can reflect the changes of intracranial pressure,intracranial pressure changes predicted by S100B plasma concentration in 48 hours were more sensitive than those in the same concentration of IL-6.

Study of traditional Chinese medicine (TCM) syndromes is a key to the research of TCM modernization, and the core is the classification and diagnostic criteria of syndromes. The purpose of this article is to review the usage of classification algorithms of data mining in TCM syndrome researches, and comprehensively analyze the main features of algorithms and their applications. The appropriate classification algorithm should be chosen according to different research purposes. Rough sets and cluster analysis are suitable for exploratory research without requiring a prior knowledge. Fuzzy sets theory, neural networks and decision tree are suitable for syndrome diagnostic criteria research when the classification goal is clear, because they require a prior knowledge. Among them, fuzzy sets theory could be used in combination with other classification algorithms. Thus, some new methods such as fuzzy clustering, fuzzy rough sets or fuzzy decision tree might be more suitable for TCM algorithm classification research. It is suggested that some novel classification algorithms need to be developed to fit the condition of TCM syndrome, based on the interdisciplinary theories and technologies.

Objective To investigate the expressions of BMP-2 and bFGF in ankylosing spondylitis(AS)patients in active stage.Methods Five patients with active AS were admitted from July 2006 to March 2007,including 4 males and 1 female,with average age of 31.4 years.Five patients with pelvic fracture served as control,including 3 males and 2 females,with average age of 34.5 years.Using immunohistochemistry,the expressions of BMP-2 and bFGF were detected in the frozen synovial tissues of cacroiliac joint in active AS patients and in the pelvic fracture patients,and the results were compared by analyzing the gray scale of the pictures.Results The positive expressions of BMP-2 and bFGF in the synovial tissues of cacroiliac joint in the patients with active AS were stronger than those in pelvic fracture patients(P

Objective To observe the effects of inducing ossification in necrotic femoral head by VEGF. Methods Healthy rabbits were lesioned into necrotic femoral head by liquid nitrogen and randomly assigned for AdhuVEGF_(121) gene transfection into the necrotic femoral head and AdTrackCMV transfection. The alkaline phosphatase (ALP) activity before transfection and day 1, week 1, 2, 4, 6, 8, 12 after transfection and the expression of collagen Ⅰ at week 2, 4, 8, 12 was examined by enzymology and immunohistochemical techniques. Results The ALP activity of the AdhuVEGF_(121) group was significantly higher than AdTrackCMV group (P

[Objective]To explore the feasibility and efficiency of treatment of lumbar degenerative disease with unilateral decompression,interbody fusion and percutaneous pedicle screw fixation under endoscopic system.[Method]From June 2004 to March 2007,20 patients underwent minimally invasive transforaminal lumbar interbody fusion(TLIF) or posterior lumbar interbody interbody fusion(PLIF),which consisted of 11 male and 9 female patients.The mean age was 46.2 years(range,31～70),and the preoperative diagnosis consisted of postoperative recurrent lumbar disc herniation(n =8),far lateral lumbar disc herniation(n =4),spinal stenosis(n = 3),lumbar instability(n = 3),and discogenic lumbar pain(n =2).One-level decompression and intebody fusion with unilateral pedicle screw fixation under endoscopic system was performed in all of cases(12 at L4、5,and 8 at L5S1).A paramedian,muscle-sparing approach was performed through a tubular retractor docked unilaterally on the facet joint.A total facetectomy was then conducted,exposing and removing the disc(TLIF),or microendoscopic discectomy(MED) was performed(PLIF).The intervertebral space preparation were completed through the X-tube or METRx system.Interbody fusion was achieved with autograft bone and interbody cages.Unilateral pedicle screw-rod placement was accomplished.[Result]There was no conversions to open surgery.Operative time averaged 115 minutes(range,100～165 min).Blood loss averaged 130 ml(range,50～180 ml).Mean length of postoperative hospital stay was 11 days(range,7～15 days).All patients presenting with preoperative low back pain and /or lower extremity radicular pain(n= 20) had resolution of symptoms postoperatively.Complications included two cases of new radiculopathy postoperatively(one from graft dislodgement,the other from hematoma formation).Twenty patients were followed up 10～39 months(average 21.6 months).The preoperative,1 month postoperative and last follow-up Oswestry Disability Index(ODI scores were 42.05+8.36,21.33?6.37 and 12.31?3.75 separately(P

Objective To investigate the expressions and role of bone morphogenetic protein(BMP) 2,basic fibroblast growth factor(bFGF),Core-binding factor al(Cbfa1)in the process of pathological bone formation in ankylosing spondylitis.Methods The expressions of BMP-2,bFGF and Cbfa1 in the synovial tissues of AS patients'sacroiliac ioint were detected using in situ hybridization.They were compared with those of patients with hip replacement and the gray scale of cells was analyzed with image analysis.Results The positive expressions of BMP-2,bFGF and Cbfal in the synovial tissues of patients'sacroiliac joint with AS were stronger than those of the control group(P＜0.01).Conclusion BMP-2,bFGF and Cbfal are important factors in the process of pathological bone formation in patients with AS.They areclosely correlated with the process of bone formation in patients'sacroiliac ioint with AS.Reduction of the expressions of BMP-2,bFGF and Cbfa1 with AS can block the process of pathological bone formation.

Objective To observe the role of vascular endothelium growth factor (VEGF) in promoting vascular reconstruction and bone repair in the necrotic region of femoral head in rabbits. Methods The femoral head necrosis model was made by liquid nitrogen frozen. The necrotic femoral head was transfected by adenovirus human VEGF121 (Ad-hVEGF121) to observe the bone formation in subchondral necrotic region by means of histological method, measure BMD value by SPA-2 analyser and measure bone trabecular morphology by image analysis. Results Revascularization level, bone formation rate, bone quality and quantity and mineralization level in subchondral necrotic region of gene transfection group were significantly higher than the control groups that had more subchondral bone resorption compared with gene transfection group. Conclusions VEGF may have effect in promoting bone formation and revascularization in subchondral necrotic region of femoral head, indirectly protecting the necrotic bone trabecula from being absorbed and avoiding descending of subchondral mechanics function.