Objective To analyze the therapeutic values of valsartan combined with benazepril in the treatment of patients with congestive heart failure.Methods 102 cases of patients with congestive heart failure in Nine 0 Third Hospital were enrolled in the study.They were randomly divided into the control group and the observation group, with 51 cases in each group.Both groups were given cardiac diuretic, anti-infection and other basic treatment and the control group was given benazepril on the basis of basic treatment while the observation group was additionally given valsartan on the basis of treatment in the control group.The curative effects were compared and the changes of cardiac function indexes were detected before and after treatment between the two groups.Results The effective rate of treatment was 80.39% in the control group, which was lower than that in the observation group with 96.08% (P<0.05).After treatment, the observation group LVEF increased significantly, LVESd and LVEDd decreased significantly, and each index was significantly better than that of the control group (P<0.05).Conclusion Valsartan combined with benazepril in the treatment of congestive heart failure can effectively relieve the clinical symptoms and improve the cardiac function, therefore it is worthy of clinical promotion.

BACKGROUND: Defatting is to reduce the special cell surface antigens by clearing fat and lipoprotein, so as to decrease immunological rejection, improve the biocompatibility of allograft bone, and increase osteogenic potential. However, the effect of defatting on biomechanical performance of bone remains controversial.OBJECTIVE: To explore the influence of defatting on the biomechanics of bovine cortical bone samples.DESIGN, TIME AND SETTING: Randomized, self-controlled observation was performed in Futian People's Hospital of Guangdong Medical College between 2006 and 2008.MATERIALS: Eight pairs of healthy adult bovine femora were used. Bone blocks, 50 mm long and 10 mm wide, were selected from each pair of femora, and burnished into 24 pairs of 7 mm×7 mm×40 mm rectangular bovine cortical bone samples.METHODS: The 24 pairs of cortical bone samples were randomly divided into two groups (n=12). One of each pair was selected as test group sample, and the other as control group sample. The samples of test group were defatted In 500 mL chloroform and methanol mixture (1:1) for 24 hours, while control samples were immerged in deionized water for 24 hours. Six samples from each group were selected for axial compressive test and three-point bending test.MAIN OUTCOME MEASURES: Load and deflection of every sample.RESULTS: Axial compressive test showed that the maximum load and the maximum strain of defatted samples were significantly decreased compared with control group, but the fragility and elastic modulus were increased (P < 0.05). In three-point bending test, the maximum load and the maximum stress of defatted sampled were significantly decreased, the maximum deflection was decreased, and the elastic modulus was increased (P < 0.05).CONCLUSION: The mechanical strength of cortical bone decreased but the fragility increased after defatting.

Thirty seven patients with congestive heart failure (CHF) were divided into cilazapril group (n=19) and general treatment group (n=18). Serum levels of interleukin-6 (IL-6) ,interleukin-8 (IL-8) , interleukin-10(IL-10) and tumor necrosis factor-α(TNF-α) , left ventricular ejection fraction (LVEF) ,left ventricular end-diastolic diameter (LVEDD), cardiac output (CO) and fractional shortening (FS) were measured before and after treatment. Serum levels of cytokines were also measured in 40 healthy individuals (control group). Results: The serum levels of IL-6, IL-8, IL-10 and TNF-α in CHF patients were significantly higher than those in the control group ( all P<0.01 ) ; After treatment, the serum IL-6, IL-8 and TNF-α were significantly decreased (P<0.01 ,P<0.05 ) in the cilazapril group. The LVEF, FS, CO were significantly increased in the Cilazapril group ( P<0.01 ) ; And the serum levels of IL-6 were significantly decreased in the cilazapril group as compared with the general treatment group ( P<0.05 ), however, after treatment, the EF, LVEF, FS and CO had no statistical differences in the cilazapril group as compared with the general treatment group. In the control group only LVEF and FS improved(P<0.01) ; Cytokine levels showed no changes. It suggests that cilazapril can reduce the serum levels of pro-inflammatory cytokines, increased the serum levels of anti-inflammatory cytokine, protect and improved cardiac function in the patients with congestive heart failure.

Objective To investigate the value of ABCD3-I score in predicting the outcome of acute minor ischemic stroke. Methods Totally 255 patients were valued by ABCD, ABCD2, ABCD3, ABCD3-I and ESSEN score then the clinical characters, outcome and early progression of these patients were investigated. Results Forty-eight patients had poor outcome after 90 days. Univariate logistic regression indicated that the differences of hypertension, diabetes, cardiovascular disease, stenosis of criminal artery, abnormal signal in diffusion weighted imaging (DWI) and other clinical symptoms between poor outcome group and good outcome group were statistically significant (P<0.05). The AUC of ABCD, ABCD2, ABCD3, ABCD3-I and ESSEN score in predicting outcome of acute minor stroke was 0.791 0, 0.798 3, 0.827 9, 0.930 0 and 0.735 9 respectively. There was difference among patients with different ABCD3-I scores both in outcome and early progression. Conclusion ABCD3-I score can predict the outcome of acute minor stroke and supply a new method for personalized treatment.

Objectlve investigate the role of Toll-like receptor 2 (TLR2) on polymorphonuclear neutrophil (PMN) during perioperative period in the development of postoperative systemic inflammatory response syndrome (SIRS) in patients undergoing orthotopic liver transplantation (OLT).Methods Twenty patients (18 male and 2 female, aged 33-58 yr and weighing 52-73 kg) with ASA Ⅲ or Ⅳ (NYHA Ⅱ or Ⅲ )undergoing OLT were studied. Blood samples were collected from the central vein for determination of TLR2 expression on PMN and plasma TNF-α, IL-1β and IL-8 concentrations before induction of anesthesia (T1, baseline), at 25 min of anhepatic phase (T2), 3 h (T3) and 24 h after beginning of reperfusion of the allograft (T4). The expression of TLR2 was measured by flow cytometry and the serum concentrations of TNF-α, IL-1β and IL-8 were measured by enzyme linked immunosorbant assay (ELISA). The patients were divided into SIRS and non-SIRS group depending on whether the patients developed SIRS or not within 7 days after operation. The diagnosis of SIRS was based on the criteria laid down by ACCP and SCCM in 1992.Results Ten patients developed SIRS within 7 days after operation. There was no significant difference in Child-Turcotte-Pugh (CTP) scores between the two groups. Compared with non-SIRS group, the TLR2 expression on PMN and the serum IL-1β concentration were significantly increased at T4 and the serum IL-8 concentration was significantly increased at T3 in SIRS group.There was positive correlation between serum TNF-α concentration and TLR2 expression on PMN in SIRS group ( r= 0.607, P ＜0.05).Conclusion The expression of TLR2 on PMN increases significantly at 24 h after beginning of reperfusion of allograft and may play an important role in the development of postoperative SIRS.

Objective To compare the effect of 89Sr radionuclide therapy and radiotherapy in the treatment of metastatic cancer pain of vertebral column. Methods 80 patients with cancer pain of vertebral metastasis in the second People's hospital of Yibin from April 2015 to April 2017, were randomly divided into the control group treated by radiotherapy treatment (n=40) and the the observation group treated by 89Sr radionuclide therapy(n=40), and the effect of treatment were compared between two groups. Results In the observation group, the total effective rate of pain response in patients with metastatic cancer pain of vertebral column was 85.0％, and the control group was 82.5％. There was no significant difference between two groups. The onset time of treatment in the observation group was (6.5±1.7)d, significantly shorter than that of the control group (12.9±2.6)d, and the difference was statistically significance (P<0.05). Conclusion The application of 89Sr radionuclide therapy in the treatment of vertebral metastatic pain is equivalent to the radiotherapy in improving the pain response, but the efficacy could be achieved in a short period of time, so it is worth popularizing widely in clinical practice.

Objective: To analyze the relationship between inflammatory factors and relevant risk factors in patients of essential hypertension (EH) combining acute coronary syndrome (ACS) with its clinical significance. Methods: Our research included 3 groups: EH group, n=79 patients with standard criteria, EH+ACS group, n=85 and Control group, n=48 normal subjects. Blood levels of lipoprotein-associated phospholipase A2 (Lp-PLA2), tryptase (TPS) and relevant clinical, biochemical parameters were measured; risk factors for cardiovascular disease were examined and the relationship between above parameters, risk factors and ACS occurrence in EH patients was studied by Logistic regression analysis. Results: The OR values were all greater than 1 in fibrinogen (Fbg), high-sensitivity C-reactive protein (hs-CRP), TPS, atherosclerotic plaque, Lp-PLA2 and EH grading. Fbg was the most significant independent risk factor (OR=22.242, 95% CI 6.458-76.609, P<0.0001), the standardized partial regression coefficient b'as absolute value (b') was 1.079 which was the highestone in above 6 variables with the strongest impact for ACS occurrence in EH patients. Conclusion: Fbg, hs-CRP, TPS, atherosclerotic plaque and EH grading were the independent risk factors for ACS occurrence in EH patients; Fbg was the highest risk factor for ACS occurrence with the strongest impact, which provided a new direction for ACS prevention and treatment.

Objective:To purify a kind of deoxyribonuclease from earthworm Eisenia foetida (named earthworm DNase, EDNase) and study its characteristics. Methods: Acetone precipitation, ion-exchange chromatography, high performance liquid chromatography, SDS-PAGE, CapiUary electrophoresis isoelectric focusing and MALDI-TOP MS were used for the study. Results: This purified protocol improved 137-fold purification and 45.6 % recovery of enzyme activity. The molecular mass of EDNase was estimated to be 63 000. Mg2+ , Mn2+ and Ca2+ were strong inhibitors of EDNase, while Na+ slightly increasd the enzyme activity. The enzyme was completely stable in the pH range from 4. 4 to 5.2 and had a pH optimum of 4.8. The optimum temperature was 37℃ and the enzyme was stable up to 40 ℃. The pI of the enzyme was 6. 20. Km and Vmax for the enzyme were 1.52 g/L and 4. 89 mg/(mL ·min), respectively, with calf thymus DNA as substrate. The enzyme was able to degrade chromosemal DNA, linear λbacteriophage DNA as well as supereoiled plasmid DNA, but didn' t display any RNase activity. Conclusion: This kind of deoxyribonuclease possesses unique characteristics, which is different from the deoxyribonucleases which we have known before.

OBJECTIVE: To evaluate the role of MHC II expression in posttrauma immune disturbances and infections. METHODS: In experimental study, peritoneal macrophages were harvested from traumatized mice and treated with GM-CSF, Ia molecules were determined by flow cytometry. In 24 trauma patients, monocyte HLA-DR expression was measured by APAAP technique. RESULTS: Marked inhibition of MHC II molecule expression was found in both traumatized mice and patients. In traumatic patients with infection, the inhibition was more severe. Treatment with GM-CSF in mice partially restored the Ia expression. CONCLUSIONS: Inhibition of MHC II molecules plays an important role in postrauma immune disturbances. There is a close relationship between HLA-DR inhibition and clinical infections.

Objective To explore the clinical significance of integrated screening of RET in a Chinese multiple endocrine neoplasia type 2A(MEN 2A)family and to evaluate the feasibility and effectiveness of prophy-lactic total thyroidectomy to MEN 2A-related medullary thyroid carcinoma ( MTC).Methods Medical history was obtained from 10 family members in a 3-generation south China family .Systemic investigations including bio-chemical tests, imaging examinations and germline RET screening were performed .3 asymptomatic mutation car-riers underwent prophylactic total thyroidectomy .Results RET screening showed a heterozygous missense muta-tion of TGC to CGC at codon 634 on exon 11 in 6 members(p.C634R), which was completely consistent with the clinical manifestations.There were 4 males and 2 females.The initial mean diagnostic age of 33.5 years(ranging from 19 years to 65 years) and the mean maximum diameter of MTC was 2.3 cm(ranging from 0.7 cm to 5.2 cm). Among them 3 members had palpable neck masses (1 case with diarrhea).Right total thyroidectomy +right level Ⅵlymph-node dissection with modified right neck dissection in one case , and bilateral total thyroidectomy +bilat-eral level Ⅵlymph-node dissection in 2 were performed .In other 3 asymptomatic mutation carriers , prophylactic total thyroidectomy +bilateral level Ⅵ lymph-node dissection were also performed .Among them, 1 case of a-symptomatic pheochromocytom ( PHEO) underwent cortical-sparing adrenalectomy before MTC .After the first op-eration, 4 patients still presented a high value of calcitonin , among whom 1 patient( T3N 1bM 0-1) underwent re-operation for 3 times after the initial operation and presented metastasis to bone after 130 months, taking vandet-anib orally up to now;2 patients underwent reoperation at 6 and 7 months after initial operation respectively (T1N 1bM0 and T2N 1bM0), and the other one patient was closely monitored and followed up for 22 months(T2N 1b M0).Moreover, The calcitonin levels dropped to normal in the other 2 asymptomatic cases(T1N0M0) who were followed up for 20 months.Conclusions Pedigree screening can work up an early diagnosis and improve the prognosis of MEN 2A.Integrated screening of RET and pre-operative calcitonin level measurement and prophylac-tic thyroidectomy for asymptomatic RET mutation carriers are reasonable and effective .