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.

Virus-like particles (VLPs) structurally mimic the authentic virus whereas contain no viral genome. VLPs technique plays an important role in basic research such as virus assembly and virus morphology diversity. With special immunology properties, VLPs vaccine can induce immune response effectively. VLPs can act as adjuvant by regulating dendritic cells. Other adjuvant or polypeptide can be integrated into VLPs to construct chimeric vaccines. With the capability of packaging nucleic acid or other small molecules, VLPs can be used for vehicles to deliver these substances under suitable conditions. VLPs can substitute natural virus in immunology assay.

Objective To evaluate the clinical value of multi-slice spiral CT in diagnosing tracheobronchial foreign bodies in chil-dren.Methods 139 patients with airway foreign body confirmed by bronchoscopy were examined with 128-slice spiral CT,and then the CT data was reconstructed by using multiple-planar reconstruction(MPR),curved planar reconstruction (CPR),volume render-ing(VR),minimum intensity projection(MinIP)and virtual endoscopy (VE).The CT results were compared with bronchofibersco-py findings.Results Among the 139 cases,the foreign bodies located at trachea in 13 cases,right bronchia in 75 cases,left bronchia in 48 cases,and bilateral bronchia in 3 cases.137 cases (98.6%)were correctly diagnosed,and 2 cases (1.4%)were missed on CT.Although the difference of the results at trachea and right main stem bronchus was statistically significant (P <0.05),the over-all results was not significant difference between CT and bronchoscopy examination (P =0.340).Associated findings included em-physema in 74 cases,pneumonia in 48 cases,atelectasis in 22 cases,mediastinal displacement in 57 cases,lung interstitial emphyse-ma in 4 cases,pneumomediastinum and pneumoderma in 4 cases,bronchiectasis in 2 cases,and pleural effusion in 4 cases.Conclu-sion MSCT and its postprocessing techniques can accurately and intuitively display the tracheobronchial foreign body and complica-tions,which has important value for clinical application.

Objective To investigate the expression of aquaporin-4 (AQP4) in contused brain and contralateral side and correlation of AQP4 level with brain edema.Methods A total of 70 health adult SD rats were divided into sham operation group (n =10) and brain contusion group (n =60) according to the random number table.Except for no impact in sham operation group,the remaining operations were the same in both groups.Ten rats in brain contusion group were separately sacrificed at 1,6,24,48 and 72 hours,and 7 days.Pathological changes in brain tissues of rats were detected and immunohistochemistry staining and Western-blot were used to measure AQP-4 expression.Results There were no abnormalities of brain tissue structure in sham operation group with AQP4 expressed mainly in glial cells and vascular endothelial cells.With respect to the injured side in brain contusion group,mixed brain edema that consisted of angioedema and cellular edema occurred along with tissue necrosis,massive inflammatory cell infiltration,and microgial proliferation.AQP4 was apparently expressed in gliocytes and vascular endothelial cells,which showed a fall at 1 hour,the lowest at 6 hours,the peak at 24 hours,slow fall at 48 hours,a second peak at 72 hours,and then a fall until 7 days.Level of AQP4 other than that at 1 hour had significant difference compared with sham operation group (P ＜ 0.01).Whereas the contralateral side in brain contusion group showed no pathological abnormalities at 1 hour,but cellular edema emerged at 6 hours followed by mixed brain edema mainly characterized as cellular edema at 24 hours,continued cellular edema but alleviated angioedema at 48 and 72 hours,and alleviated cellular edema at day 7.AQP4 was up-regulated in gliocytes and vascular endothelial cells,which decreased at 1 hour (1.313 ± 0.01),minimized at 6 hours (0.922 ± 0.03),peaked at 24 hours (2.848 ± 0.020),fell at 48 hours,peaked again at 72 hours (2.662 ± 0.02) and fell to almost normal level at day 7.By contrast with sham operation group,level of AQP4 had significant difference other than that at 1 hour and 7 days (P ＜ 0.01).Conclusions After brain contusion,angioedema and subsequent cellular edema emerge in the contused side.Pathological changes are delayed in non-contused side with cellular edema ahead of angioedema.Level of AQP4 is closely related with traumatic brain edema.

Objective:To analyze the effect of endoscopic submucosal tunnel dissection on patients with large esophageal superficial neoplasms.Methods: Chosen patients with large esophageal superficial neoplasms in our hospital as research object, randomly divided into control group treated by endoscopic mucosal dissection (ESD) and observation group treated by endoscopic submucosal tunnel dissection(ESTD), compared surgery related indicators, complications and treatment outcomes.Results: 1)Observation group patients’ tumor stripping rate (23.17±4.73)/min was significantly higher than control group patients’ (12.65±2.19)/min; Intraoperative blood loss(9.14±0.67)ml, total length of hospital stay (7.34±1.89) d, were significantly less than control group patients with intraoperative blood loss(21.38±3.14)ml, total length of hospital stay (13.21±3.05)d, t value was 4.965, 5.395, 4.932, respectively(t=4.965,t=5.395,t=4.932;P<0.05); 2)Observation group patients esophageal bleeding ESTD rate(5.26%), esophageal stricture rate(31.58%), mediastinal emphysema rate(5.26%), esophageal perforation rate of 0, were significantly less than control group patients with esophageal bleeding rate(31.58%), esophageal stricture rate(5.26%), mediastinal emphysema rate(21.05%), esophageal perforation rate (26.32%), t value were 4.378, 4.378, 4.471, 5.758, (t=4.378,t=4.378,t=4.471,t=5.758;P<0.05); 3)Observation group patients with no recurrence during the follow-up period, control group patients with local recurrence rate of 21.05%, t value 8.623,P<0.05(t=8.623, P<0.05).Conclusion: Endoscopic tunnel mucosal stripping technique can effectively improve the complete tumor removal rate, during the process of optimization operation at the same time reduce the occurrence of complications, to the improvement of the prognosis of patients with positive clinical significance.

After 160 cases of chronic type Ⅲ prostatitis were divided into the treatment group (n= 80) and control group (n = 80), in the treatment group, first Zhibian (BL 54) was punctured toward Shuidao (ST 28) and then Qihai (CV 6), Guanyuan (CV 4), Shuidao (ST 28)Baihui (GV 20), Fengchi (GB 20), Sishencong (Ex-HN 1), Sanyinjiao (SP 6) and Taichong (LR 3) were punctured, and at the same time, digital computerized microwave apparatus was inserted into the anus for microwave treatment. Afterward, moritatherapy was applied for psychological consultation for the patients. In the control group, compound sinomin and Phenoxybenzamine Hydrochloride Tablets were used orally. The results showed that the therapeutic effects were respectively 92.5% and 68.8% in two groups, with statistic significance (P ＜ 0.01).

Objective To compare the effects of surgical versus non-surgical treatment for femoral neck fractures in elderly patients,in order to provide guidance on treatment options.Methods The clinical effects and complications of different approaches from 42 patients with femoral neck fractures who had received treatment at our department from February 2006 to August 2011 were retrospectively analyzed.Results Of the 42 cases,13 cases were treated with artificial hip replacement,18 cases with hollow lag screw fixation,and 11 cases with tibial traction.No death occurred in patients treated with surgery,and 4 patients who had received non-surgical treatment died within 6 months of the followed-up.Conclusions Very elderly patients with femoral neck fractures generally perform well under appropriate perioperative care.Surgical treatment can produce good therapeutic effects,shorten the time for bed rest,improve the quality of life and reduce the mortality rate.

OBJECTIVE:To observe the clinical efficacy and safety of Calcitriol soft capsules combined with Telmisartan tab-lets in the treatment of early diabetic nephropathy(DN),and the effect on the levels of inflammatory factors. METHODS:Totally 110 patients with early DN were randomly divided into observation group and control group. The control group was orally given Telmisartan tablets with the initial dose of 40 mg,qd,and the maximum dose was 80 mg,qd;the observation group was orally giv-en Calcitriol soft capsules 0.25μg based on the treatment of control group,qd. The course was 1 month. The clinical data was com-pared,including the clinical efficacy and 24 h urinary protein,serum creatinine(Scr),urinary albumin excretion rate(UAER),se-rum C reactive protein (CRP),tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) before and after treatment. The adverse reactions were observed. RESULTS:After treatment,the total effective rate in observation group was significantly higher than con-trol group,with significant difference (P<0.05);the 24 h urinary protein,Scr,UAER,and levels of CRP,TNF-α and IL-6 in observation group were significantly lower than control group and before treatment,with significant differences(P<0.01 or P<0.05). There were no obvious adverse reactions in 2 groups. CONCLUSIONS:Calcitriol soft capsules combined with Telmisartan tablets has better efficacy than only Telmisartan tablets in the treatment of DN,and can more effectively improve the levels of CR, TNF-αand IL-6,which is helpful to delay progression of patients.

Objective To study the curative effect of anterior cervical discectomy with fusion (ACDF)and anterior cervical corpectomy with fusion (ACCF)for multi segment cervical spondylosis;and to provide effective anterior surgery for the disease.Methods According to digital table,106 cases with multi segment cervical spondylosis were randomly divided into ACCF group of 54 cases and ACDF group of 52 cases.The ACDF group was treated with ACDF,and the ACCF group was treated with ACCF.The operation time,bleeding volume and excellent rate of cervical functional improvement of the two groups were observed,and the bone graft fusion,cervical vertebra height change and the change of cervical curvature of the two groups were evaluated.Results The operation time of the ACDF group was higher than that of the ACCF group,the amount of bleeding of the ACCF group was lower than that of the ACDF group,and the differences werestatistically significant (t =2.857,9.097,all P <0.05 ).After 6 months and 12 months,the segments of the ACDF group were higher than those of the ACCF group,the differences were statistically significant (t =8.157,6.330,all P <0.05).After 6 months and 12 months,the section curvature increases and cervical vertebra increased curvature of the ACDF group were lower than those of the ACCF group,the differences were statistically significant (t =4.707,4.575,4.083,3.987,all P <0.05).The complication rate of the ACDF group was 11.5%(6 /52),which of the ACCF group was 13.0%(7 /54),the difference was not statistically significant (χ2 =0.050, P >0.05).Conclusion For multi segment cervical spondylosis,there are no significant differences in efficacy and stability between ACDF and ACCF;ACCF surgery field is more clear and easy to operate,the operation time is short, and there is the phenomenon of titanium mesh sinking.In the maintenance of cervical curvature,ACCF is better than ACDF.

[Objective]To investigate new methods of the management of closed rupture of Achilles tendon surgery to reduce postoperative skin necrosis.[Method]Small incisions and Absorbable sutures were used to manage 39 cases of closed Achilles tendon rupture,with proximal stump a Bunnell-type suture and remote stump percutaneous repair.[Result]In the 39 cases,three developed slight skin necrosis,of which two healed by changing dressings,the other one healed by debriding and sutureing.Follow-up of 10 months to 36 months was available for 35 cases.According to Arner-Lindholm efficacy evaluation standard,29 cases (82.9%) had excellent result,4(11.4%) had good result,with the good to excellent result of 94.3%.[Conclusion]Small incisions and Absorbable sutures used to manage the closed Achilles tendon rupture,with proximal stump a Bunnell-type suture and remote stump percutaneous repair is an effective and reliable methord for closed Achilles tendon repture,with small invasion,less impact on the skin blood supply,less skin necrosis,less re-rupture reinfection,and faster recovery.