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 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.

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.

Objective To find out social support status and its influencing factors in left-home-kids in rural areas. Methods 893 left-home-kids and 335 non-left-home-kids were interviewed with the social support rating scale. Results The total score of social support of left-home-kids was obviously lower than that of non-left-home-kids; in the same way, the score of female was higher than male, the score of low age group was higher than high age group, the score of kids with father or mother as the custodian was higher than that of other custodian subjects; the score of children whose left-home duration was more than five years was higher than that of lower than one year. Conclusions The social support of left-home-kids was poorer than non-lefthome-kids. There is some difference in the social support in left-home-kids with different sex, age, custodian subject, left-home duration. Social support should be given to children with low social support.

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 complete comparison between anterior cervical surgery by microendoscopic and open operation,explore feasibility and efficacy of anterior cervical decompression,interbody fusion and fixation by microendoscopic surgery,and give preliminary clinical evaluation of mieroendoscopic surgery.[Method]In a retrospective study,46 patients underwent one level cervical surgery by anterior approach.23 patients(23~64 years,41.5 years in average)were treated with microendoscopic surgery as microendoscopic group.Under general anesthesia,a transverse incision(1.6 cm)was made at right side of neck.A tubular retractor was then inserted and fixed,and a specially designed endoscope was placed inside the tubular retractor.Discectomy and interbody fusion with insertion of Cage or/and plate fixation was performed by endoscope.At fracture and dislocation patient group,titanium Cage was used in 1 case,CBK in 1 case,plate in 5 cases.At cervical disc herniation patient group,titanium Cage was used in 2 cases,CBK in 12 cases,plate in 2 cases.During the same period,23 patients(25~68 years,46.5 years in average)were treated with open surgery as open group.A transverse incision(4～5 cm)was made by right route approach.Discectomy and interbody fusion with Cage or/and plate fixation was performed by general procedure.[Result]At microendoscopic group,23 cases were followed up from 10 to 22 months(16.5 months in average),and mean operative time were 95 minutes,mean blood loss 90 ml.For fracture and dislocation patients,by Frankels classification,2 cases with complete tetraplegia showed no improvement,2 cases with incomplete tetraplegia improved from grade C to grade D postoperatively,1 case upgraded from C to E.For cervical spondylotic myelopathy patients with disc herniation,according to Odoms scoring system,10 cases had excellent outcome,5 good,1 fair.At open group,23 cases were followed up from 8~21 months(15.2 months as average),and mean operative time was 95 minutes,mean blood loss 90 ml.By Frankels classification,2 cases with complete tetraplegia had no improvement,3 cases with incomplete tetraplegia improved from C to D,1 case from D to E.According to Odoms scoring system,8 patients suffering from cervical spondylotic myelopathy with disc herniation had excellent result,6 good,2 fair.[Conclusion]Compared with open surgery,microendoscopic surgery with endoscopic instrument and technique can be used for one level discectomy,interbody fusion and internal fixation,and offer a similar short-term good clinical outcome with minimal incision,less traumatic reaction and postoperative discomfort.

Objective To evaluate the efficacy and safety of hydroxychloroquine sulfate (HCQ) on pregnancy outcomes in patients with systemic lupus erythematosus (SLE). Methods One hundred and sixty-six pregnant patients with SLE from Janurary 2010 to December 2015 were studied retrospectively . Fifty-two patients were excluded due to new-onset during pregnancy, active disease or termination of pregnancy as a result of continuous intaking of immunosuppressant. The remaining 114 SLE patients in stable condition before pregnancy were divided into the following two groups: prednisone combined with HCQ and prednisone alone. The effects of HCQ on disease activity and pregnancy outcome were analyzed. Differences between groups were analyzed by chi-square test. Results A total of 90 patients (78.9%) had successful pregnancy. Among 71 patients treated with prednisone combined with HCQ, 60 patients (84.5%) had no disease flare and 62 cases (87.3%) had successful pregnancy. Among 43 patients treated with prednisone alone, 28 patients (65.1%) had no disease flare and 28 cases (65.1%) had successful pregnancy. No abnormality of neither visual field nor fundus was observed among patients treated with HCQ. No congenital abnormalities were found among new born infants. Conclusion HCQ intake during pregnancy in SLE patients can reduce disease flare and improve the pregnancy outcome, indicating that HCQ is safe for SLE patients during pregnancy.

Objective To observe effect of Liqiao Yizhi Decoction (Decoction for inducing resuscitation to improve cognition) on mild cognitive impairment (MCI). Methods Treatment group (32 cases) was treated with Liqiao Yizhi Decoction,and the control group was treated by Piracetam. Memory,congnition and related scores of both groups were observed. Results Both groups were improved in the scores of cognition,memory and behavioral ability of MCI patients (P

AIM: To investigate whether and how N, N-dimethylsphingosine (DMS) plays a role in modulating the adhesion of monocytes to vascular endothelial cells, and identify whether human umbilical vein endothelial cell line EA.hy926 take place of the vascular endothelial cells.METHODS: Adhesion ratio was measured by flow cytometry, and immunohistochemistry was used to detect the expression of ICAM-1 and P-selectin in HUVEC: EA.hy926 cells after the effect of DMS. RESULTS: DMS inhibited the adhesion of monocytes to HUVEC: EA.hy926 cells in a time-dependent and concentration-dependent manner by reducing the expression of ICAM-1 and P-selectin. CONCLUSIONS: DMS reduced adhesion molecule expression in vascular endothelial cells. DMS may be an important contributor to reduce adhesion ratio, suggesting that DMS plays a negative role in proinflammatory and immune functions of the modified vascular endothelial cells during atherosclerosis and restenosis.