Objective:To explore therapeutic effect of atorvastatin on aged patients with mild to moderate hyperten-sion.Methods:A total of 427 aged patients with mild to moderate hypertension treated in our hospital from Jul 2011 to Jul 2013 were randomly divided into routine treatment group (n=210)and atorvastatin group (n=217,received atorvastatin additionally based on routine treatment)according to number table.All patients were treated with a continuous 24 months.Therapeutic effect of controlling blood pressure,changes of blood pressure level and high sensitive C reactive protein (hsCRP)level and occurrence of adverse reactions during treatment were compared be-tween two groups.Results:Compared with routine treatment group,there was significant rise in total effective rate of long-term (24 months)controlling blood pressure (76.8% vs.85.9%),and significant reductions in blood pres-sure [(145.3±10.1/88.6±6.7)mmHg vs.(136.9±6.8/83.0±5.2)mmHg]and hsCRP [(2.02±0.29)mg/L vs. (1.60±0.18)mg/L]level in atorvastatin group,P<0.05 or <0.01. There was no significant difference in inci-dence rate of adverse reactions during treatment between two groups (P>0.05).Conclusion:Atorvastatin combined antihypertensive drugs can well control blood pressure and reduce inflammatory reactions,which is suitable for long term use in aged patients with hypertension.

Objective The objective of the present study was to establish a template for the self assessment of hearing aids outcomes according to the evaluation of a large group of hearing aid users .Methods In total ,1 724 subjects participated in the study .The Chinese version of International Outcome Inventory for Hearing Aids (IOI-HA) was used as the evaluation tool .IOI -HA is a seven -item questionnaire ,each item is designed to assess a specific outcome domain .Each item was designed with a five -point rating scale ,a higher rating indicates better outcome .According to the subjects'self reported hearing difficulty when they were not wearing hearing aids (unaid-ed) ,the subjects were divided into two groups :self reported hearing difficulty to be no ,mild ,moderate group ,and self reported hearing difficulty to be moderately severe or severe group ,respectively .Templates for each group were established according to the analysis of the item ratings .Results One thousand two hundred and forty -seven sub-jects accept the investigation ,with a response rate of 72 .3% ,and 1203 completed responses were included in the fi-nal analysis .The Chinese version of IOI-HA scores showed a skewed distribution ,with a mean score ranging from 3 .52 to 4 .19 .The total IOI-HA scores ranged from 9 to 35 ,and the mean total score was 26 .30 .Results showed that for the self reported hearing difficulty (unaided) to be none ,mild or moderate group ,the mean scores for the i-tem of daily use ,benefit ,residual activity limitation ,satisfaction ,residual participation restrictions ,impact on others ,and quality of life were 4 .14 ,3 .67 ,3 .76 ,3 .58 ,3 .56 ,3 .93 and 3 .69 ,respectively .The corresponding mean scores for the self reported hearing difficulty (unaided) to be moderately severe or severe group were 4 .19 ,3 .63 ,3 .64 ,3 . 65 ,3 .52 ,3 .89 ,and 3 .79 ,respectively .A template for the Chinese IOI -HA was established according to the above data .Conclusion The template for the Chinese version of IOI -HA could be served as an effective tool to measure the general effectiveness of the hearing aid outcomes and hearing aid fitting in China ,which would also facilitate the international outcome comparison cross culture .

Objective To investigate the effects of angiotensin Ⅱ (Ang Ⅱ) stimulating on cholesterol influx in human renal proximal tubular epithelial cells (HK-2) and the relation to low-density lipoprotein receptor (LDLr) pathway.Methods HK-2 cells were cultured and divided into the control group (incubated with serum-free medium) and Ang Ⅱ group (treated by 10-7 mol/L of Ang Ⅱ for 24 hours).The effects of Ang Ⅱ on lipid accumulation were examined by Oil red O staining and a quantitative assay of intracellular cholesterol.The expression of LDLr,sterol regulatory elementbinding protein (SREBP) cleavage activating protein (SCAP) and SREBP-2 mRNA and protein were examined by real-time PCR and Western blotting.The cotranslocation of SCAP-SREBP-2 from endoplasmic retieulum to Golgi in HK-2 cells was examined by immunofluorescent staining under confocal microscopy.Results Ang Ⅱ treatment increased intracellular lipid accumulation in HK-2 cells,which was associated with increased mRNA and protein expression of LDLr,SCAP,and SREBP-2 in HK-2 cells induced by Ang Ⅱ.Furthermore,results from confocal microscopy observation demonstrated that Ang Ⅱ increased the translocation of SCAP/SREBP-2 complex from endoplasmic reticulum to Golgi,thereby up-regulating LDLr gene transcription.Conclusion Ang Ⅱ disrupts LDLr feed-back regulation to increase cholesterol uptake and induce intracellular lipid accumulation.

Objective To explore the reasons and preventive measures of early dislocation after total hip arthroplasty in elder patients. Method A retrospective study was done to analyze dislocation time, reason and time of 168 elderly patients with early anti-dislocation after total hip arthroplasty in joint surgery. Results Only 7 patients (4.1%) had type I joint dislocation, including 2 male and 5 female patients aged 65~89 years. The dislocation happened in 4~5 weeks postoperatively, mainly resulting from hip joint over flexion when urinating in bed, sleep-turning, loaded-moving, walking and stoop and diachoresis. Conclusions For the elderly patients after total hip replacement, it is type I dislocation which happened 4 ~ 5 weeks after operation, more femal than male, reasons including over-exercrse. Effective prevention measures includes regular rehabilitation training, early precautions enhanced mental support and safety nursing.

OBJECTIVETo compare the efficacy of the patients of xerosis conjunctivitis with liver and kidney yin deficiency among the combined therapy of acupuncture and Shi's manipulation, common acupuncture and artificial tears therapy.

METHODSOne hundred and eight patients were randomized into an acupuncture group, a SHI's manipulation group and an artificial tears group, 36 cases in each group. A total of 15 cases dropped out before the end of the study, including 4 cases in the acupuncture group, 6 cases in the SHI's manipulation group, and 5 cases in the artificial tears group. In the acupuncture group, acupuncture was applied to Jingming (BL 1) and Qiuhou (EX-HN 7) on the affected side, and the bilateral Sanyinjiao (SP 6) and Taixi (KI 3). The needles were retained for 20 min. In the SHI's manipulation group, on the basis of the treatment as the acupuncture group, Shuigou (GV26) was added and stimulated with SHI's acupuncture manipulation. In these two groups, acupuncture was given 3 times a week totally for 3 weeks. In the artificial tears group, sodium hyaluronate eye drops were used, 5 times a day, for 3 weeks totally. Separately, before treatment, at the moment after the 1st treatment and 3 weeks after treatment, the subjective symptom score, Schirmer I test, breakup time (BUT) of tear film were observed in each group.

RESULTS(1) Subjective symptom score: at the moment after the 1st treatment and 3 weeks after treatment, the scores in each group were all reduced significantly as compared with those before treatment (all P < 0.05). At the moment after the 1st treatment, the score in the SHI's manipulation group and the artificial tears group was reduced apparently as compared with that in the acupuncture group (both P < 0.05). In 3 weeks of treatment, the score in the SHI's manipulation group was reduced apparently as compared with the acupuncture group and the artificial tears group (both P < 0.05). (2) For Schirmer I test, at the moment of the 1st treatment, the result in the SHI's manipulation group and the artificial tears group was improved significantly as compared with that before treatment (both P < 0.05). In 3 weeks of treatment, the result in the acupuncture group and the SHI's manipulation group group was improved significantly as compared with that before treatment (both P < 0.05). At the moment of the 1st treatment, the result in the artificial tears group was improved significantly as compared with the acupuncture group and the SHI's manipulation group (both P < 0.05). In 3 weeks of treatment, the result in the acupuncture group and the SHI's manipulation group was better than that in the artifi-cial tears group separately (both P < 0.05). (3) For BUT, the result in the acupuncture group and the SHI's manipulation group was prolonged significantly as compared with that before treatment and was prolonged apparently as compared with that in the artificial tears group (both P < 0.05) in 3 weeks of treatment.

CONCLUSIONThe intervention of SHI's acupuncture manipulation relieves the subjective symptoms of xerosis conjunctivitis of liver and kidney yin deficiency and achieves the same efficacy as the common acupuncture and artificial tears treatment. It does not present the apparent advantages as the common acupuncture in the short term for promoting the tear secretion and tears film repair.

Acupuncture Therapy ; Adolescent ; Adult ; Conjunctivitis ; physiopathology ; therapy ; Dry Eye Syndromes ; physiopathology ; therapy ; Female ; Humans ; Kidney ; physiopathology ; Liver ; physiopathology ; Male ; Middle Aged ; Treatment Outcome ; Yin Deficiency ; physiopathology ; therapy ; Young Adult

Objective To develop a model of type 2 diabetes with early renal injury on spontaneously hypertensive rats (SHR). Methods The 6-week old SHR were fed with the diets enriched with sucrose (20%, W/W), lard (10%, W/W), cholesterol (2.5%, W/W) and chleolate (1%, W/W) to induce insulin resistance. Hyperglycemia was developed by intraperitoneal injection of streptozotocin (STZ, 35 mg/kg). Wistar-Kyoto rats (WKY) were used as normal controls. Rats with plasma glucose (PGL) ≥ 16.7 mmol/L were diagnosed as diabetes. Eight weeks after the induction of diabetes, plasma triglyceride (TG), cholesterol (CHO), glucose, systolic pressure(SP), 24-h urine protein excretion (Upro) were examined in all the rats, and the homeostasis model assessment of insulin resistance (HOMA-IR) was analyzed. Renal pathological changes were studied by immunohistochemical staining and electron microscope. Results After 2 weeks on the high sucrose and fat diets, the model rats exhibited significant increase in basal PGL, TG and CHO levels as compared to control rats (P<0.05, respectively). The insulin resistance was developed in model rats demonstrated by the higher HOMA-IR (5.03±0.38 vs 2.61±0.34, P<0.05). At the end of the experiment, model rats were associated with hypertension. Upro level was significantly increased in model rats compared with that in controls [(57.58±16.54) mg/24 h vs (5.35±1.90) mg/24 h, P<0.01]. The kidney hypertrophy index (KWI) was significantly increased in the model rats compared to controls (P <0.05). Moreover, the diabetic model rats showed glomerular hypertrophy, foot process effacement, micro villous transformation, glomerular basement membrane (GBM) thickening. Conclusion A rat model is successfully established, which presents typical features of human type 2 diabetes and can be served as an ideal model to study the diabetic nephropathy.

Objective To investigate the clinical characteristics and the optimal time of delivery in pregnant women with severe preeclampsia complicated with ascites. Methods A retrospective study was conducted on 179 severe preeclampsia mothers and their 195 neonates,presented in the First Affiliated Hospital of Wenzhou Medical College from Jan.2003 to Dec.2005,who were divided into two groups:32 complicated with ascites(ascites group)and 147 without(non-ascites group). The general conditions,mode of delivery and complications including eclampsia,hemolysis,elevated serum level of 1iver enzymes,and low platelets(HELLP syndrome),liver failure,renal failure,heart failure,hypoproteinemia,placental abruption,postpartum hemorrhage and puerperal infection,were also analyzed.Clinical data of all infants(38 from ascites group and 157 from non-ascites group)were analyzed.The incidence and mortality rate of small for gestational age(SGA)in both group within the same gestational age group and those between different gestational age groups in the ascites group were compared. Results (1)The average gestations at admission and delivery in the ascites group were earlier than the other[admission:(32.5±2.1)weeks vs(36.1±3.5)weeks;delivery:(34.1±2.3)weeks vs(37.2±1.5)weeks,P＜0.053.The rate of systemic antenatal care in the ascites group waslowcr than that of the non-ascites group(25.0%vs 53.7%,P＜0.05).More complications werefound in the ascites group than in the non-ascites group(hypoproteinemia:100.0%vs 47.0%;liver and renal failure:31.2%vs 8.2%;HELLP syndrome:9.4%vs 2.0%;postpartum hemorrhage:18.8%vs 2.0%;all P＜0.05).(2)The incidence of SGA in the ascites group was all higher than that in the non-ascites group,however,significant differences was only found between the tWO groups at＞36 weeks(7/9 vs 30.2%,P＜20.05).The perinatal mortalily rates of SGA in the ascites group at＜32 weeks and 32～34 weeks were significantly higher than that in the non-aseites group respectively(＜32 weeks:69.2%vs 19.2%,P＜0.05;32～34 weeks:2/7 vs 0,P＜0.05).(3)The highest perinatal mortality rate and the highest incidence of SGA in the ascites group were found in the groups of＜232 weeks and＞36 weeks,respectively. Conclusions The early onset of ascites and higher rate of complications in severe preeelamptie women implies the adverse maternaI and fetal outcomes.Ascites in severe preeclampsia cases should alert the clinicians.The optimal time for delivery might be at 32～36 weeks of gestations.

The clinical and experimental publish literatures of the traditional acupuncture treatment for xerophthalmia were review and selected, and the acupoints and outcomes index were analyzed. The clinical studies demonstrated that acupoints around eyes, head and face were mainly coordinated with Zangfu organs and meridians; and the experimental studies showed the effect of acupuncture work through stimulation of the lacrimal gland secretion, repairing lacrimal gland structure, inhibition of apoptosis to increase the flow of tears, extending the breakup time of lacrimal film, and relieving eye related symptoms.

Objective To explore the correlation between plantar pressure and walking function in hemiplegic stroke patients.Methods Thirty hemiplegic patients with stroke (a hemiplegic group) and thirty age-matched healthy persons (a control group) were recruited.Gait and balance function training and assessment system (model:AL-600) were used to quantify the walking velocity,peak plantar pressure at heel-strike and push-off periods and displacement of center of pressure (DCOP) of all subjects during walking.The asymmetry of gait was calculated.Two independent sample t-test were used to compare the walking velocity,peak plantar pressure and DCOP for the two groups.Pearson correlation coefficients were applied to analyze the correlation between the walking velocity and peak plantar pressure and DCOP.Results The walking velocity,the peak plantar pressure at heel-strike and push-off periods and DCOP of the hemiplegic group were significantly lower than the control group.In the hemiplegic group,the asymmetry of peak plantar pressure and DCOPx significantly increased,while that of DCOPy became bigger without significant difference.Moreover,the walking capacity of the hemiplegic group was positively correlated with the peak plantar pressure and DCOP.Conclusion Among hemiplegic stroke patients,both the peak plantar pressure at heel-strike and push-off periods lower in a way.Their capacity of weight transfer decreases,which is closely related to their walking velocity.

Objective:To investigate the expression of sal-like 4 (SALL4) gene in children with acute leukemia and analyze its clinical significance. Methods:Real-time PCR and immunohistochemistry were used to detect SALL4 mRNA and SALL4 protein ex-pressions in 50 patients initially diagnosed with acute leukemia and in 15 patients with immune thrombocytopenic purpura (ITP), which served as controls. Changes were detected in SALL4 mRNA expression from preliminary diagnosis and after complete remission of 5 acute leukemia patients. The relationship between SALL4 mRNA expression and clinical indicators was analyzed. Results: SALL4 mRNA expression is higher in initially diagnosed B-ALL [13.89 (1.00-63.15)] and AML [11.12 (2.31-56.59)] than in ITP controls [1.00 (0.29-1.71)] (P<0.01). SALL4 mRNA expression in initially diagnosed T-ALL [1.48 (0.87-4.81)] and in controls showed no significant difference (P>0.05). SALL4 protein expression is in agreement with SALL4 mRNA expression. SALL4 mRNA expression significant-ly decreased in complete remission stage [0.98 (0.22-1.09)] than in acute phase [28.64 (11.20-87.46)] in acute-leukemia patients (P<0.01). High SALL4 mRNA expression level is positively correlated with high white blood cell count, high risk classification, and high minimal-residual disease at the end of induction chemotherapy (r=0.424, r=0.40, and r=0.393, respectively;P<0.05), but not with age, gender, hepatomegaly, splenomegaly, and lymphadenectasis (P>0.05). Conclusion:SALL4 was found to play an important role in pro-moting childhood B-ALL and AML, which promises a new target for monitoring the therapeutic effects and evaluating the prognosis of childhood B-ALL and AML.