Objective To explore the clinical significance and influence of left ventricular remodeling and serum MMP-2,TIMP-2 levels after treated by irbesartan on hypertension patients.Methods The control group was only treated with conventional therapy,and the treatment group was given irbesartan besides conventional therapy.To observe the changes of LVMI,RWT and serum MMP-2,TIMP-2 levels before and after treated in the two groups.Results The hypertension group LVMI,RWT and serum MMP-2,TIMP-2,MMP-2/TIMP-2 levels were higher than the healthy control group (P ＜ 0.01).The levels of LVMI,RWT and serum MMP-2,TIMP-2,MMP-2/TIMP-2 after irbesartan treatment were significantly lower than before treatment in the treatment group(all P ＜ 0.01),and the levels of LVMI,RWT and serum MMP-2,TIMP-2,MMP-2/TIMP-2 had statistically significant differences between the two groups(all P ＜ 0.05).The serum levels of MMP-2,T IMP-2,MMP-2/TIMP-2 were positively correlated with LVMI,RWT in patients with hypertension.Conclusion Irbesartan can reverse hypertension myocardial fibrosis so as to improve left ventricular remodeling,the mechanism may be through inhibiting myocardial remodeling by reducing the expressions of MMP-2,TIMP-2 and down-regulating the MMP-2/TIMP-2 ratio.

Objective To investigate the association of serum levels of C1 q/TNF-related protein (CTRP 9) and ghrelin with coronary artery disease, and observe the effects of Rosuvastain on serum CTRP 9 and ghrelin. Method Serum levels of CTRP 9 and ghrelin in 120 patients with coronary artery disease and 80 healthy controls were measured. Then 120 patients were randomly divided into control group and Rosuvastatin group. Patients in both groups were given regular treatment. In addition, patients in Rosuvastatin group were treated with Rosuvastatin (10 mg/d) for 4 weeks. Serum levels of CTRP 9 and ghrelin in the two groups were examined before and after treatment. Results Serum levels of CTRP 9 and ghrelin were significantly decreased in patients with coronary artery disease compared with those in controls (P<0.05). Logistic regression analysis revealed that reduced levels of serum CTRP 9 and ghrelin were independent risk factors of coronary artery disease. After 4 weeks of treatment with Rosuvastatin, serum levels of CTRP 9 and ghrelin were significantly increased (P<0.05). However, no significant differences of serum CTRP 9 and ghrelin were found in control group before and after regular treatment (P>0.05). Conclusion Serum levels of CTRP 9 and ghrelin are significantly decreased in patients with coronary artery disease and they are independent protective factors of coronary artery disease. Rosuvastatin may improve the levels of CTRP 9 and ghrelin for patients with coronary artery disease.

Objective To observe the different effects caused by different injection sites in bladder ,in cases of female overac‐tive bladder cured by botulinum toxin type A injection .Methods Forty cases were divided into 2 groups randomly .Cases of group A accepted botulinum toxin type A injection only on detrusor .Cases of group B accepted botulinum toxin type A injection on detru‐sor and trigone of urinary bladder .The following parameters were recorded to evaluate the effects 4 weeks later :average daytime u‐rination frequency ,urination frequency at night ,average quantity of each urination ,frequency of urgency ,bladder capacity at first de‐sire ,maxima bladder capacity ,OABSS scores and QOL scores .Results After 4‐week treatment with botulinum toxin type A ,all pa‐rameters ,average daytime urination frequency ,urination frequency at night ,average quantity of each urination ,frequency of urgen‐cy ,bladder capacity at first desire ,maxima bladder capacity ,OABSS scores and QOL scores in cases of group A had a better im‐provment than those of cases of group B .Conclusion Botulinum toxin type A injection on bladder is a new effective method for fe‐male refractory overactive bladder .Injection on detrusor and trigone of urinary bladder is better than injection only on detrusor .

Objective To evaluate the diagnostic value of MSCT in peripheral pulmonary neuroendocrine carcinoma.Methods CT findings of 42 peripheral pulmonary neuroendocrine carcinoma confirmed pathologically were compared among different pathological types.Results As for lymphatic metastases,small cell carcinoma was more commom than other pathological types(P＜0.05).Most of peripheral pulmonary neuroendocrine carcinoma had homogeneous density(29 cases) and was lobulated(30 cases).The specula sign,vessel convergence sign,pleural indentation sign and obstructive pneumonia in this group were rare(8 cases,4 cases,7 cases,8 cases respectively).Most lesions had enhancement lightly.CT values of the lesions and the enhanced degree were similar in different pathological types and there was no difference among them(P＞0.05).Conclusion msct is of definitive value in diagnosis or differentitating diagnosis in the different pathological types of peripheral pulmonary neuroendocrine carcinoma.

15 cases of malignant tumours of gastrointestinal tract and ovary were treated by chemotherapy through intraperitoneal puncture and perfusion under B-ultrasound guidance.The results were satisfactory.The success rate of intraperitoneal puncture under B-ultrasound guidance was 100%.The method is introduced in detail and the advantage of the application of B-ultrasound guid-ance was discussed.The authors considered that it is safe,reliable,less in complication,easy to oper-ate:less in agopy and easy to be used clinically.

Objective To study the effects and advantages of the treatment for simple bone cysts of the long bones in children with AO titanium elastic nail and autologous bone marrow injection. Methods Eighteen patients with a simple bone cyst at humerus or femur were managed with AO titanium elastic in-tramedullary nail combined with autologous bone marrow injection. There were eleven boys and seven girls in total, with the mean age of 8.1 years, ranged from 6 to 12 years. Twelve cysts was located in the proximal end of humerus, five in the proximal end of femur and one in the middle part of the shaft of femur. Twelve cysts were active and six inactive according to Neer standard. Radiographic evaluation was performed three, six, twelve and eighteen months after operation during the 11 to 23 months follow-up by taking anteroposteri-or and lateral X-ray pictures. Then we measured residual radiolucent areas on X-ray pictures and did statistic research with group comparison. Results Six cysts (33.3%) healed completely, and twelve (66.7%) healed with residual radiolucent areas which were visible on X-ray pictures 3 to 6 months after operation. Residual radiolucent areas on X-ray pictures gradually reduced during the different phases and it has statistical signif-icance by group comparison. There was no recurrence or major complication except for one patient with mild irritation of skin caused by the end of the nail up to now. Conclusion The treatment for simple bone cysts of the long bones in children combined with AO titanium elastic nail and autologous bone marrow injection not only has satisfactory healing rate but also can provide early stability to the long bones, and accelerate the healing of cysts which allows early mobilization and thus obviates the long-term need for a plaster cast and decreases the prevalence of the most common complication: a pathological fracture.

OBJECTIVE:To observe therapeutic efficacy of ursodeoxycholic acid(UDCA)combined with S-adenosyl methio-nine (SAMe) in the treatment of mild intrahepatic cholestasis (ICP) of pregnancy. METHODS:213 pregnant patients with mild ICP were selected and randomly divided into combination group (107 cases) and single drug group (106 cases). Combination group received UDCA combined with SAMe,and single drug group was given UDCA alone. Therapeutic efficacy and pregnancy outcome were compared between 2 groups. RESULTS:Compared to before treatment,TBA,CG,DBIL,ALT and AST of 2 groups were decreased after treatment,and the decrease of combination group was more significant than that of single drug group, with statistical significance(P<0.05). The time of itching control [(3.8±1.4)d] in combination group was lower than(5.3±1.5) d in single drug group,with statistical significance (P<0.05). After 3 and 5 days of treatment,itching degree score of combina-tion group was lower than that of single drug group,with statistical significance(P<0.05). There was no statistical significance in fetal distress rate,neonatal asphyxia rate,amniotic fluid contamination rate,cesarean section rate and neonatal 1 min Apgar score between combination group and single drug group(P>0.05);the preterm birth rate of combination group was 11.22%,which was significantly lower than 20.75% of single drug group,with statistical significance(P<0.05). CONCLUSIONS:Compared to UD-CA alone,UDCA combined with SAMe in the treatment of patients with ICP can control the clinical symptoms timely,recovery laboratory index as soon as possible and obtain better therapeutic efficacy.

The increase of blood-brain barrier (BBB) permeability is a key link in causing the pathological changes in vasogenic brain edema and inflammatory reaction. In recent years, a number of studies have indicaded that a lot of mediators participated in the structural and functional changes and damage of BBB during the process of cerebral ischemia-reperfusion.

Through making a summary of using the portable X-ray machine in the earthquake relief,the equipment of the advantages and disadvantages in the field are analyzed and introduces the problems and solutions in application,and gives some improved suggestions for tripod.

[Objective]To observe the effect of treating hallux valgus with modified Mitchell operation.[Method]A total of 18 cases(28 feet) of hallux valgus were treated with modified Mitchell operation from Apr.2000 to Oct.2003.The average preoperative hallux valgus angle(HVA) was 30.5 according to the X-ray images,while the average intermetatarso-phalangeal angle(IMA) was 13.5.The difference between the modified Mitchell operation and normal one was that only one transverse osteotomy need to be carried out in the distal metatarsal without lateral ridge left.The distal position of osteotomy was extended according to the sum of IMA and then moved to the metatarso side by 2~3 mm.Absorbable screws were used for fixation.[Result]All 28 feet were followed up for 10~32 months.It showed excellent result in 24 feet,good in 3,and bad in 1,with the total satisfactory rate of 92.9%.According to the postoperative weight-loading X-ray checking result,the average HVA was 15.5,with an average improving of 15;the average IMA was 8.5,with an average improving of 5.[Conclusion]The modified Mitchell operation can correct the metatarso-varus without destroying the biomechanical status.The loading function of great toe could be resumed by the removing of the first metatarso head.