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 To determine the level of awareness about thrombolytic therapy for acute ischemic stroke among community residents in Yuzhong district,Chongqing,China.Methods We used multi-stage sampling to select 1500 households distributed in 3 Street of Yuzhong district,and then one member of each household answered the survey.A trained interviewer conducted a face to face survey about the questions regarding stroke warning signs and thrombolytic therapy in acute stroke.Results A total of 1101 participants completed the survey.Only 257 (23.3％,95％ CI 20.8-25.8) participants were aware of thrombolytic therapy for acute stroke and 59.9％ of them (154/257,95％ CI53.9-65.9) knew the time window of thrombolytic therapy.The rate of thrombolytic therapy awareness was higher among people with young age,well-educated,with higher household income with health insurance,and those who knew all 5 stroke warning signs.People aged ≥75 years had higher rate of awareness of the time window.Multivariate logistic regression analysis showed that age,education level,health insurance and knowledge of stroke warning signs were independently associated with the rate of thrombolytic therapy awareness.Conclusions In this population-based survey the community residents had poor awareness of thrombolytic therapy for acute ischemic stroke.It is necessary to improve the level of public knowledge about thrombolytic therapy for acute stroke by health education.

Objective To investigate the efficacy and toxicity of neoadjuvant regional arterial chemotherapy in the treatment of advanced gastric cancer. Methods The clinical data of 158 patients with advanced gastric cancer and with the same clinical stages who were admitted to Renji Hospital of Shanghai Jiaotong University from February 2002 to May 2005 were retrospectively analysed. Preoperative regional arterial chemotherapy was applied to 76 patients (test group) and the remaining 82 patients only received surgical treatment (control group). The chemotherapy regimen was epirubicin (50 mg/m2) + cisplatin (60 mg/m2) + 5-fluorouracil (1000 mg/m2).This regimen was modified to oxaliplatin (130 mg/m2) + 5-fluorouracil (1000 mg/m2) since 2003, and surgery was performed 6-11 days after the chemotherapy. All patients received postoperative intravenous chemotherapy.The clinical effects, radical resection rate, operative complications and long-term survival of the two treatment methods were evaluated. All data were analysed using the chi-square test and Kaplan-Meier analysis. Results The radical resection rate was significantly higher at 86% (65/76) in the test group compared with 71% (58/82)in the control group ( x2 = 5.01, P ＜ 0. 05 ). The toxicity of the chemotherapy in the test group was mild. The postoperative complication rate was 20% (15/76) in the test group and 16% (13/82) in the control group, with no significant difference between the two groups (x2 = 0.41, P＞0.05). The median survival time was 41 months in the test group and 23 months in the control group. The 5-year overall survival rate was higher in the test group (44.6%) than that in the control group (29.1%) (x2 =3.95, P＜0. 05). Conclusions Neoadjuvant regional arterial chemotherapy is well tolerated by patients with advanced gastric cancer. It is also effective for increasing the radical resection rate and improving the long-term survival.

OBJECTIVE: To investigate the application of CT hepatic volume measurement combined with CT perfusion imaging (CTPI) by Spiral CT in evaluating the hepatic functional reserve in cirrhosis. METHODS: CT volume measurement of livers was performed in 32 patients with cirrhosis and 20 patients with normal livers. CTPI had been taken in 25 patients with cirrhosis and 20 patients with normal livers. The hepatic volume, parameter of blood flow perfusion, and liver volume-perfusion index were observed and analyzed. Correlations between graded fractions of hepatic function and liver volume, parameter of perfusion, and liver volume-perfusion index were also analyzed. RESULTS: The values of liver volumes (LV, LVs) reduced gradually (P<0.01) among the groups of hepatic function Grade A, B, and C. The values of the hepatic portal perfusion (HPP), total liver perfusion (TLP), hepatic arterial perfusion index (HAI), and portal perfusion index (PPI) of the cirrhosis group were significantly lower than those of the normal ones (P<0.01). The values of the HPP reduced gradually among Grade A, B, and C (P<0.05 or P<0.01). The values of PPI reduced significantly between Grade C and Grade A, B (P<0.05 or P<0.01). The liver volume-perfusion indexes (VPI, VPIs, VPPI, VPPIs) reduced gradually among Grade A, B, and C (P<0.05 or P<0.01). The correlation between liver volume-perfusion indexes and graded fractions of hepatic function was higher than other indexes, among which the correlation of VPPIs was the highest. CONCLUSION Changes of volume and blood flow perfusion of the liver are related to the clinical grade of hepatic function. The CT volume measurement combined with CTPI will be a more comprehensive way in evaluating hepatic functional reserve.
Adult ; Aged ; Female ; Humans ; Liver ; diagnostic imaging ; pathology ; physiopathology ; Liver Cirrhosis ; diagnostic imaging ; pathology ; physiopathology ; Male ; Middle Aged ; Perfusion ; Tomography, Spiral Computed ; methods

Objective:To explore a fast and accurate method to diagnose children's pneumonia according to respiratory signals, so as to avoid the cancer induction caused by traditional X-ray examination.Methods:A Mach Zehnder optical fiber sensor was used to build a respiratory signals(RSPs) detection system, and the RSPs of the monitored children were extracted according to the vibration signal generated by the children's lung rales. Preprocessing methods such as the discrete cosine transform(DCT) were used to compress and denoise the RSPs. Multi-feature extraction of RSPs was conducted through signal processing methods such as the Hilbert transform and autoregressive (AR) model spectrum estimation. A support vector machine (SVM) classification model was constructed to classify the collected RSPs.Results:The accuracy rate of the proposed RSP classification of children with or without pneumonia was 94.41%, which was higher than the previous methods.Conclusions:The children's pneumonia diagnosis system based on an optical fiber sensor has a higher detection accuracy, and is expected to be widely used in clinical practice.

Objective :To study correlation between brachial‐ankle pulse wave velocity (baPWV ) and cardiac auto‐nomic nervous function in patients with type 2 diabetes mellitus (T2DM) and its influencing factors .Methods :A to‐tal of 293 T2DM patients ,who hospitalized in our hospital from May 2015 to May 2016 ,were selected .According to baPWV level ,patients were divided into normal baPWV group (n＝198 ,≤1400cm／s) and abnormal baPWV group (n＝95 ,＞1400cm／s).Blood pressure ,heart rate ,blood glucose ,renal function and heart rate variability (HRV) indexes were measured and compared between two groups .Multi‐factor Logistic regression analysis was used to ana‐lyze influencing factors of baPWV .Results :Compared with normal baPWV group , there were significant rise in age ,levels of systolic blood pressure (SBP) ,diastolic blood pressure (DBP) ,central venons pressure (CVP) , pe‐ripheral arterial pressure (PAP ) , percentage of peripheral neuropathy and mean heart rate and significant reduc‐tions in HRV indexes :lgTF (total frequency) ,lgHF (high frequency) ,lgSDNN (standard deviation of normal to normal RR intervals calculated over the 24 h period) and lgrMSSD (root‐mean square of differences between succes‐sive normal to normal intervals) and slgnificant rise in lgSDANN (standard deviation of normal to normal RR inter‐vals in all 5 min segments of the entire recording ) in abnormal baPWV group , P＜0. 05 or ＜0.01 .Multi‐factor Lo‐gistic regression analysis indicated that SBP ,DBP ,PAP ,CVP , heart rate SDANN and peripheral neuropathy were independent risk factors for baPWV (OR＝1.031－2. 108 , P＜0.05 or ＜0.01) ,while TF ,HF and rMSSD were its independent protective factors (OR＝0. 468－0. 595 , P＜0.05 or ＜0. 01) in T2DM patients .Conclusion :In patients with type 2 diabetes mellitus , abnormal pulse wave velocity is closely correlated with cardiac autonomic nervous function damage ,and it′s affected by blood pressure and blood glucose etc .

Objective :To explore preventive effect of sodium bicarbonate combined Vit C on contrast-induced nephropathy (CIN) in patients with early diabetic nephropathy (DN) undergoing percutaneous coronary intervention (PCI).Methods : A total of 420 patients with coronary heart disease complicated early DN treated in our department from Sep 2014 to Jul 2016 were selected ,randomly and equally divided into routine PCI group and combined treatment group (received sodium bicarbonate combined Vit C based on routine PCI group ) . Levels of serum creatinine (SCr ) ,glomerular filtration rate (GFR) ,creatinine clearance rate (Ccr) and blood urea nitrogen (BUN) after contrast use and incidence rate of CIN were measured ,recorded and compared between two groups ,and independent risk factors for CIN were analyzed .Results : After contrast use ,compared with routine PCI group ,there were significant reductions in levels of SCr [(110-32 ± 12-35) μmol／L vs.(100-30 ± 9-73) μmol／L] and BUN [ (11-23 ± 2-43) mmol／L vs.(7-16 ± 3-14) mmol／L] ,and significant rise in GFR [ (30-67 ± 9-56) ml·min－1 ·1-73m－2 vs.(37-26 ± 7-69) ml·min－1 ·1-73m－2 ] and Ccr [ (62-31 ± 19-73) ml／min vs.(68-07 ± 21-48) ml／min] in combined treatment group , P＜0-01 all ; percentages of SCr rise ≥44-2μmol／L (6-7% vs.1-9%) and SCr increase ≥25% (9-0% vs.2-9%) significantly reduced in combined treatment group , P＝0-016 ,0-007- Multi-factor Logistic regression analysis indicated that contrast dose was independent risk factor for CIN in DN patients (OR＝1-688 , P＝0-001) , while use of sodium bicarbonate combined Vit C was its independent protective factor (OR＝0-693 , P＝0-021).Conclusion : For patients with early DN undergoing PCI ,sodium bicarbonate combined Vit C can significantly reduce incidence rate of CIN ,effectively protect kidney function ,which is worth extending .

OBJECTIVEThere are scant data about normal reference values of blood glucose (BG) in children. This study was conducted to learn the BG profile of children and adolescents in Beijing area.

METHODThe population for survey was selected as a stratified cluster sample from 8 urban and 10 rural areas in Beijing. Fasting capillary blood glucose (FCBG) was determined in 19,593 children and adolescents aged 6 to 18 years in 4 urban and 3 rural areas using haemosaccharometer model II [Roche Diagnostic, (Shanghai) Ltd].

RESULTSThere were 1 9112 (97.5%) individuals with complete records, the mean age was 12.1 +/- 3.3 years (ranged from 6 to 18.9 years); 9514 (49.8%) were boys, 9598 (50.2%) were girls, 9792 were (51.2%) from urban areas and 9320 (48.8%) from rural areas. The average level of FCBG in boys was higher than that in girls (4.7 +/- 0.5 vs. 4.5 +/- 0.5, u = 28.0, P < 0.01). Among urban children, the trend of variation of FCBG was similar between boys and girls, the levels of FCBG increased with age, the peak of FCBG was reached at 12-13 years in urban girls, and from the age of 15 years, the level of FCBG declined. In boys, the FCBG level increased slowly from 13 years of age, there was no significant variation until 17 years old, and declined at the age of 18. Among suburban children, the trend of variation of FCBG was similar between boys and girls, both of them had two peaks, from 6 to 11 years old, FCBG of both boys and girls increased with age, and both reached the first peak at the age of 11 years. While at 13 years of age, there was an obvious drop in FCBG level. From 14 years of age on, there was a rise of FCBG in both boys and girls, and the second peak of FCBG was reached at 15 and 16 years of age in girls and boys respectively. The FCBG level of urban children was higher than that of rural children (4.7 +/- 0.5 vs. 4.6 +/- 0.5, u = 13.8, P < 0.01). The level of FCBG in overweight and obese children was higher than that of normal children. More boys, more obese and more urban children had abnormal FCBG.

CONCLUSIONSThe blood glucose level of children was associated with age, gender, obesity and district.

Adolescent ; Anthropometry ; Blood Glucose ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Sampling Studies

OBJECTIVETo investigate the cytotoxic effects of mTOR inhibitor rapamycin (Rapa) and idarubicin (IDA) on human T-cell acute lymphoblastic leukemia Jurkat cell line.

METHODSThe proliferation of Jurkat cells was observed by CCK-8 assay. The combined index was analyzed by Isobologram method. Apoptosis was detected by electron microscopy and flow cytometry with Annexin V/PI staining. Protein expressions of Caspase 3, PARP, Caspase 8, Caspase 9, Akt, p-Akt, P85S6K, p-P85S6K, P70S6K, p-P70S6K, ERK1/2 and p-ERK1/2 were determined by Western blotting.

RESULTSThe IC(50) of IDA for Jurkat cells was significantly reduced when combined with 10 nmol/L rapamycin. The combined index was <1. Both electron microscopy and Annexin V/PI staining flow cytometry revealed that rapamycin significantly increased apoptotic sensitivity to IDA. The combination of IDA with rapamycin enhanced the expressions of Caspase 3, PARP, Caspase 8 and Caspase 9. Rapamycin significantly inhibited mTOR signaling upstream Akt and downstream S6K activation triggered by IDA, and the combination of the two agents led to synergistic inhibition of ERK phosphorylation.

CONCLUSIONCombination of IDA with rapamycin exerted a synergistic anti-proliferative effect and promoted apoptosis by both extrinsic and intrinsic apoptotic pathways in Jurkat cells. Inhibition of ERK phosphorylation and mTOR signaling by rapamycin may play a certain role in this synergistic effect.

Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Cell Proliferation ; drug effects ; Drug Synergism ; Humans ; Idarubicin ; pharmacology ; Jurkat Cells ; metabolism ; pathology ; Precursor T-Cell Lymphoblastic Leukemia-Lymphoma ; metabolism ; pathology ; Proto-Oncogene Proteins c-akt ; metabolism ; Sirolimus ; pharmacology

OBJECTIVETo report the first case of non-composite combined liver and intestinal allotransplantation in China. The technical aspects of the case and pros and cons of such an approach versus composite technique were discussed.

METHODSThe patient suffered from short bowel syndrome and TPN-related liver damage. A non-composite technique was used in this case. During operation, the whole 380 cm intestine was transplanted with systemic drainage and aortic inflow, while the liver graft was placed in a piggyback fashion. Warm ischemic time of donor graft was 2 min and 30 seconds, and cold ischemic duration for intestinal and liver graft was 6 hours and 40 and 8 hours and 7 utes respectively. Postoperative immunosuppression management includes tacrolimus, methylprednisolone, MMF and Zenapax.

RESULTSThe recipient recovered smoothly with no evidence of rejection on days' follow up. Now he is maintained well on enteral nutrition.

CONCLUSIONNon-composite technique should be considered in adult recipients, especially those with a history of abdominal infections or multiple laparotomies.

Adult ; Humans ; Intestines ; transplantation ; Liver Transplantation ; Male ; Short Bowel Syndrome ; therapy ; Transplantation, Homologous ; methods ; Treatment Outcome