Objective To compare the efficacy and safety of domestic and imported losartan on patients with reversal hypertension left ventricular hypertrophy ( LVH). Methods 118 patients with reversal hypertension left ventricular hypertrophy were randomly divided into two groups. The treatment group of 60 cases were treated by oral domestic losartan and the control group of 58 cases were received oral valsartan imports. The dose was 80mg once day with 6 months for a course of treatment. Before and after treatment, we observed the blood pressure, left ventricular hypertrophy changes in echocardiographic parameters and to monitor the blood, urine routine, liver and kidney function and other indicators,and to record adverse reactions. Results Two groups had lowering blood pressure effect. It was significant difference between before and after treatment( P 0.05 ). Conclusion Domestic and imported valsartan can lower blood pressure in the treatment of reversal hypertension left ventricular hypertrophy, and reverse LVH, without affecting heart rate,and at the same time with fewer adverse reactions.

OBJECTIVE:To discuss the general pattern and features of adverse drug reactions(ADRs) of defibrase.MET-HODS:The cases of ADRs of defibrase reported in the national medical journals during 1999 and 2003 were collected and analyzed.RESULTS:ADRs of defibrase mainly included bleeding,urticaria,high fever,positive cutantest,liver function injury,ecchymoma,purpura haemorrhagica,incision hemorrhea,and arterial embolism.CONCLUSION:Great importance should be attached to ADRs of defribrase in clinic in order to ensure the safety of drug use.

Objective To investigate the significances of karyotyping analysis on umbilical cord vein blood lymphocytes in the diagnosis of abnormal karyotypes in middle to late period of pregnant fetus.Methods A volume (0.5 ～ 1 ml) of umbilical cord vein blood was extracted from pregnant women in third trimester pregnancy with prenatal detection indications,and collected in sterilized anticoagulant tube.Lymphocytes were cultured and collected for karyotyping analysis after fixed and dropped on slides.Data were analyzed statistically.Results Lymphocytes were cultured successfully in 1 211 cases out of total 1 213 cases collected.Totally 142 abnormal karyotypes were found,which includes 81 cases (detection rate 6.68 ％) of non-heteromorphic abnormal chromosomes and 61 cases (detection rate 5.03％) of heteromorphic chromosomes.Among these abnormal karyotypes,50 cases (accounting for 35.21％ in total abnormal cases) of aneuploidy include 4 cases of chimerical karyotype.Structural abnormalities were found in 31 cases (accounting for 21.83％ in total abnormal cases) samples including 11 cases of translocations,17 cases of inversion and 3 cases of deletion.Conclusions Based on our findings,karyotyping analysis on umbilical cord vein blood lymphocytes could be an effective method for detect abnormal karyotypes in middle to late period of pregnant fetus and played an important role in prenatal diagnosis.

A 50?year?old woman presented with intermittent dull pain in the forehead and mild dizziness occasionally after her forehead was subjected to a mild bump accidentally 20 days prior to the presentation, and was diagnosed with angioneurotic headache in a local hospital. After the treatment with oral sibelium tablets, the condition wasn′t relieved obviously. Computed tomography (CT) scan showed multiple localized bone destruction and low?density area in the frontal and bilateral parietal bones with adjacent soft tissue swelling. Magnetic resonance imaging(MRI)revealed equal T1 signals and slightly long T2 signals for multiple nodules in the frontal and bilateral parietal bones, high signals on diffusion?weighted imaging (DWI), obvious enhancement on contrast?enhanced MRI, and linear enhancement in adjacent meninges. Whole?body bone scintigraphy showed multiple increased radionuclide uptake in the skull. Laboratory examination demonstrated that specific antibodies to Treponema pallidum (Tp) were positive, and the serum rapid plasma reagin(RPR)titer was 1∶128. Cerebrospinal fluid(CSF)examination showed normal CSF pressure, nucleated cell counts(8 × 106/L)and glucose level(4.0 mmol/L), slightly high chloride flux(129.1 mmol/L), high protein level(0.9 g/L), high CSF?RPR titer of 1∶16 and presence of specific antibodies to Tp. Histopathological examination revealed hyperemia of adjacent tissues in the cranial osteolytic area, hyperplasia of interstitial fibrous tissue, endothelial cell swelling, and infiltration of inflammatory cells mainly containing plasma cells. The treatment regimen for neurosyphilis was given, and headache was relieved after 1 week of treatment, basically disappeared after 2 weeks, and completely disappeared after 4 weeks, and no similar headache occurred thereafter. Finally, the patient was diagnosed with acquired syphilitic skull osteomyelitis complicated by syphilitic meningitis.

Objective To investigate and observe the expression of Peroxiredoxin Ⅵ in iechemia cortex of rats and the intervention effect of Xingnao Kaiqiao Acupuncture(XKA) therapy. Methods Through western blotting,we detected the expression of Peroxiredoxin Ⅵ in xingnao kaiqiao group , comparison group, model group and sham operation group in middle cerebral artery occlusion (MCAO)model of rats. Results At 6h, the expression of Peroxiredoxin Ⅵ in xingnao kaiqiao group , comparison group and sham operation group was increased than that in moddle group,of which Xingnao Kaiqiao group increased obviously(P < 0.05). At 24h, as compared with modlegroup, the expression of Peroxiredoxin Ⅵ in xingnao kaiqiao group and comparison group increased significantly (P < 0.05). Conclusion Xingnao Kaiqiao Acupuncture therapy could raise the expression of Peroxiredoxin Ⅵ in focal cerebral ischemia of rats, and the effect is better that of traditional acupuncture therapy in the earlier period.It is benefit to elevating the ability of antioxygen of focal cerebral ischemia of rats.

Objective To evaluate the reliability of lactate clearance rate in evaluating the efficacy of early fluid resuscitation in the patients with severe sepsis.Methods One hundred and forty-two patients with severe sepsis,aged 28-87 yr,were enrolled in the study.Isotonic crystalloid fluid was infused after admission to ICU to maintain central venous pressure ≥ 8 mmHg,mean arterial pressure ≥ 65 mmHg,central venous oxygen saturation (ScvO2) ≥ 70％,and urine output ≥ 0.5 ml·kg 1 ·h-1 within 6 h.The patients were divided into 2 groups according to the treatment outcome:survival group and death group.Immediately before fluid resuscitation and at 6,12 and 24 h after fluid resuscitation,blood samples were collected from the central vein for blood gas analysis and ScvO2 was recorded.Blood samples were collected from the peripheral vein for determination of the concentration of lactate and lactate clearance rate was calculated.Results Compared with survival group,the lactate clearance rate was significantly decreased at 6,12 and 24 h after fluid resuscitation,and no significant change in ScvO2 was found in death group.Conclusion Lactate clearance rate can evaluate the efficacy of early fluid resuscitation in the patients with severe sepsis.

Objective To study the role of endothelial cells on the inflammatory cytokine release in septic shock through the septic shock serum stimulating human primary endothelial cells (HPAEC) and peripheral blood mononuclear cells(PBMC).Methods PBMC isolated from healthy people by density gradient centrifugation.HPAEC cell surface markers CD144 and von Willebrand factor(vWF) molecule expression by RT-PCR and Western blot.Serum levels of IL-6,TNF-α,MCP-1 from septic shock patients and healthy human detected by ELISA.HPAEC and PBMC were stimulated with the isolated serums and LPS,respectively.ELISA was used to detect the supernatant IL-6,TNF-α,MCP-1 levels.HPAEC membrane molecules ICAM-1 expression was detected by flow cytometry with serum shock and LPS stimulation.Supernatant levels of IL-6,TNF-α,MCP-1 of HPAEC with S1P1 receptor agonist CYM-5442 pretreatment was detected by ELISA after shock serum stimulation.Results Endothelial cell markers CD144 and vWF molecules could be detected in the HPAEC.Levels of inflammatory cytokines IL-6,TNF-α,MCP-1 in patients with septic shock serum were significantly higher than healthy people (P＜0.01).PBMC and HPAEC with LPS or shock serum treatment respectively,compared with normal group,levels of inflammatory cytokines in the culture supernatant were significantly higher(P＜0.01).For PBMC,the level of inflammatory cytokines between shock group and LPS group were not significantly different (P＞0.05).But for HPAEC,levels of inflammatory cytokines in the supernatant of the shock group compared to the LPS group was significantly higher (P＜0.01).Similarly,when two cells after LPS stimulation,IL-6,TNF-α levels of HPAEC's supernatant were significantly lower than PBMC' s (P＜0.01),MCP-1 levels was no difference (P＞ 0.05).But when the stimulation of shock serum,HPAEC of IL-6,TNF-α levels and PBMC no significant difference (P ＞0.05).MCP-1 was significantly increased (P＜0.01).Shock patients serum stimulation S1P1 receptorspecific agonist CYM-5442 pretreatment of HPAEC with pretreatment of S1P1 receptor specific agonist CYM-5442,the culture supernatant of inflammatory cytokines IL-6,TNF-α,MCP-1 levels were significantly lower (P＜0.01).Conclusion Endothelial cells may play a central role on the release of inflammatory cytokine during septic shock.

Dementia is a clinical syndrome characterized by cognitive impairment and decreased daily activity.In recent years, more and more studies have shown that there are neuropsychiatric syndromes in people with normal cognitive function , thus increasing the risk of dementia.This population has been defined as mild behavioral impairment (MBI).MBI is now considered to be one of the prodromal symptoms of dementia, and there have been some researches and consensus on the definition , diagnosis and screening scale of MBI, but there are still a lot of controversies.For this reason, we systematically reviewed the research progress of MBI , to clarify the evidence on the definition , diagnostic criteria and screening methods of MBI, and to summarize the consensus and controversy of the research on the correlation between MBI and dementia, aiming to draw attention to the applicability and necessity of MBI diagnostic criteria in clinical practice.

Objective To investigate and observe the expression of Peroxiredoxin Ⅵ in ischemia cortex of rats and the intervention effect of Xingnao Kaiqiao Acupuncture(XKA) therapy.Methods Through western blotting,we detected the expression of Peroxiredoxin Ⅵ in xingnao kaiqiao group,comparison group,model group and sham operation group in middle cerebral artery occlusion(MCAO)model of rats.Results At 6h,the expression of Peroxiredoxin Ⅵ in xingnao kaiqiao group,comparison group and sham operation group was increased than that in moddle group,of which Xingnao Kaiqiao group increased obviously(P