The ratio of plasma aldosterone concentration to renin activity (ARR) is a sensitive parameter for screening of primary aldosteronism (PA) and for predicting prognosis after adrenalectomy in patients with PA.Study of the influencing factors for ARR,especially medications,sodium intake and posture,is of great significance for improving the screen efficacy of ARR.This paper introduces the current application of ARR in screening for PA and optimization of its determining conditions.

Cordyceps sinensis (Berk.) Sacc.; anti-tumor activity; active component; mechanism

Objective To observe and compare the analgesic efficacy of femoral nerve block (FNB)and sufentanil for positioning patients with fractured hip.Methods Sixty patients scheduled for hip fracture surgery were randomized into three groups.Fifteen minutes before positioning for subarachnoid block,the FNB group received nerve ultrasound guided FNB using 20 ml ropivacaine 0.5% .Five minutes before positioning,the S group received a dose of IV sufentanil 0.15μg/kg,the C group didn't accept any intervention.The visual analog scale(VAS)following positioning (T2 ),OAA /S scale before positioning (T1 ),MAP,HR,SpO2 entering operating room (T0 )and T1 ,T2 ,adverse reactions were recorded.The plasma concentration of noradrenaline(NA)and cortisol(Cor)by T0 and T2 were measured.Results MAP,HR,the level of NA,Cor by T2 in group C increased significantly by comparing with T0 (P <0.05),while there were no obvious change in group F,and the same to group S except NA.The obvious change of SpO2 couldn't be found at each time point in every group(P >0.05).There were no significant differences in MAP,HR,the level of NA,Cor in all instances among the three groups(P >0.05).The OAA /S of S group was higher than the other groups(P <0.05).Compared with group C,group F and S showed markedly lower VAS at T2 (P <0.05),there were no significant differences between the two group.Side effects of group S included respiratory depression in 3 patients,nausea vomiting in 1 and dizzy in 1,no adverse reaction were found in other groups.Conclusions Both FNB and intravenous sufentanil can reduce the pain of positioning patients with fractured hip,showing almost the same analgesic efficacy,FNB can more inhibit stress reaction caused by pain.

Objective To invetigate the effect and safety of sufentanil mixed levobupivacaine on postoperative analgesia in pediatric caudal block anesthesia.Method Sixty pediatric patients (2 ～ 6 years old) who were undergoing elective abdominal surgery,such as repair hernia of high ligation,were randomly divided into three groups with 20 cases each.after intravenous induction,0.25％ levobupivacaine was injected in sacrum tube in group Ⅰ,0.5 μg/ml sufentanil mixed 0.25％ levobupivacaine and 1.0 μg/ml sufentanil mixed 0.25％ levobupivacaine were injected in sacrum tube in group Ⅱ and group Ⅲ respectively.The analgesia effect,the analgesia time,recover time and adverse reaction were observed and recorded 2,4,8,12,16,24 hours after the surgery.Results The analgesia effect in group Ⅱ、Ⅲ were significantly better than the group Ⅰ when 4、8、12 hours after the operation(P ＜0.05),and the analgesia effect in groupⅢ were significantly better than the group Ⅱ when 8 hours after the operation (P ＜ 0.05).There were no significant differences in three groups when 2、16、24 hours after the operation(P ＞0.05),the analgesia time in group Ⅱ、Ⅲ were significantly longer than the group Ⅰ (P ＜ 0.05),and the analgesia time in group Ⅲ were significantly longer than the group Ⅱ (P ＜ 0.05).There were no differences in the recovery time of three groups (P ＞ 0.05).There were no adverse reactions in three groups.Conclusions 0.5 μg/ml and 1.0 μg/ml sufentanil mixed 0.25％ levobupivacaine may be used on postoperative analgesia in pediatric caudal block anesthesia safely and analgesia effect and time were more better and longer than 0.25％ levobupivacaine singly.The analgesia effect in group with 1.0μg/ml sufentanil mixed 0.25％ levobupivacaine was the best in three groups with the fewest side effects.

Objective:To study the curative efficacy of metformin combined with Jinlida granules in the treatment of gestational diabetes mellitus and its effects on the serum vascular endothelial growth factor (VEGF),adiponectin (APN) and homocysteine(Hcy) levels.Methods:94 patients of gestational diabetes mellitus who were treated from July 2014 to July 2016 in our hospital were selected.According to random number table,those patients were divided into the observation group (n=47) and the control group (n=47).On the basis of routine treatment,such as control diet,reasonable exercise and healthy diet,etc,the control group was treated with metformin,while the observation group was combined with Jinlida granules on the basis of the control group.The changes of blood glucose,blood lipid and serum VEGF,APN and Hcy before and after treatment were compared between the two groups,the incidence of maternal complications and neonatal adverse outcomes were compared.Results:Compared with before treatment,the blood glucose,blood lipid of both groups after treatment were significantly improved (P ＜0.05),the fasting plasma glucose (FBG),postprandial 2h blood glucose (2hPG),glycosylated hemoglobin (HbAlc),total cholesterol (TC),triacylglycerol (TG),low density lipoprotein cholesterol(LDL-C) of observation group were significantly lower than those of the control group,the serum high density lipoprotein cholesterol (HDL-C) level was significantly higher than that of the control group(P＜0.05);after treatment,the serum VEGF,APN and Hcy levels were significantly improved than those before treatment in both groups (P＜0.05),and the serum VEGF,and Hcy levels of observation group were lower than those of the control group,the serum APN level was higher than that of the control group (P ＜ 0.05);the incidence of gestational hypertension,hydramnios,cesarean section and premature delivery of observation group was significantly lower than that of the control group (P ＜0.05);the incidence of giant child,neonatal Jaundice and neonatal respiratory distress in the observation group was significantly lower than that of the control group (P＜0.05).Conclusion:Metformin combined with Jinlida granules was effective for the gestational diabetes mellitus,which could effectively control the blood glucose,blood lipid levels and might be related to the regulation of serum VEGF,APN and Hey levels.

Objective To explore the changes in regional cerebral blood flow(rCBF)and cerebral hemodynamics in patients with CCVI.Methods Twenty patients diagnosed as CCVI were enrolled to undergo single photon emission computed tomography(SPECT)rCBF imaging or transcranial Doppler uhrasonography(TCD)examination.All the patients were free from cerebral structural abnormalities as demonstrated by X-CT or magnetic resonance imaging(MRI).Cranial arteries blood flow velocity,pulsating index(PI)were measured by TCD and compared with the mean of rCBF as measured by SPECT.Results On SPECT images, decreased rCBF lesions were found in 95 percent of patients(19/20).The areas of hypoperfusion were mainly located in frontal,temporal,parietal lobes and fondues nodus.Increased cranial arteries blood flow velocity was found in the anterior cerebral artery(ACA)and middle cerebral artery(MCA)in 80 percent of patients (16/20).There were no correlations among rCBF,the decreased percentage of rCBF,average velocity,and PI of cranial arteries.Conclusions By performing SPECT rCBF and TCD on CCVI patients,the degree of changes in rCBF and hemodynamics Can be evaluated easily,which is valuable for early clinical diagnosis and treatment of CCVI.

Objective To explore the correlation between health value and health-promoting lifestyle in elderly people at nursing home. Methods Totally 130 elderly people from nursing home were investigated with health value scale and health-promoting lifestyle profile II to understand the status of their health value and health-promoting lifestyle and the correlation between them. Results The mean score of health value was 7.78±1.58, which was in the middle level;The mean score of health-promoting lifestyle was 132.78±14.99. Among all dimentions. nutrition scored highest, while health responsibility and physical activity scored lowest. The health value was positively correlated with the health-promoting lifestyle among nursing home elderly people (P<0.01). Their own health status and health value were influencing factors of health promoting-lifestyle, which could be explained at 43.5%of the variance. Conclusions The nursing home for elderly people were good in health value and average in health-promoting lifestyle. The elderly with a higher health value had better health-promoting lifestyle. Health care workers should improve elderly people′s level of health value, and give more help and guidance to the elderly people for physical activity and health responsibility, making them establish healthy lifestyle.

Objective Abstract: Objective To study the intestinal bacterial translocation and changs in endotoxin level of portal vein blood after hepatic inflow blocking. Methods Under aseptic condition, mechanically blocking of the hepatoduodenal ligement was adopted in rabbit model, both endotoxin level of the portal blood and positive bacterial cultures in the mensenteric lymph nodes were observed at 15, 20, 30 and 60 min respectively after the blocking. Results Both endotoxin level and positive bacterial cultures increased significantly (P

Objective To prospectively assess the diagnostic accuracy of MR inflow inversion recovery (IFIR) fast imaging employing steady-state acquisition (FIESTA) for detection of renal artery stenosis (RAS),as compared with renal artery CT angiography (CTA) performed as the reference standard.Methods Thirty patients [18 males,12 females; mean age (65.0±12.1) years] with arterial hypertension and suspected RAS were examined by 3.0-T 3D MR IFIR-FIESTA and renal artery CTA within a week.The IFIR-FIESTA image quality,the IFIR-FIESTA and CTA in display of second-order and third-order branches of renal artery were assessed by two experienced readers.The sensitivity,specificity,accuracy,and negative predictive value (NPV) of IFIR-FIESTA were calculated on artery-by-artery and patient-by-patient bases by the two readers.The inter-observer agreement between the two readers in determining the presence and grade of renal artery stenosis was assessed.Results The scores of qualification of IFIR-FIESTA image quality by reader A and B were (2.16±1.02) and (2.00 ± 0.14),there was no significant difference between them (Z=-0.037,P=0.971).IFIR-FIESTA and CTA in display of second-order and third-order branches of renal artery had no significant difference (x2 =0.298,P=0.585).In the assessment of all 64 main renal arteries by reader A,IFIR FIESTA on artery-by-artery basis had sensitivity,specificity,accuracy,and NPV of 100％,96％,97％,and 100％,respectively; the above parameters assessed by reader B were 100％,90％,93％,and 100％,respectively.There was excellent inter-observer agreement (Kappa=0.803) with the presence or absence of hemodynamically significant RAS.In the assessment of all 30 patients by reader A,IFIR-FIESTA on patient-by-patient basis had sensitivity,specificity,accuracy,and NPV of 100％,95％,97％,and 100％; the above parameters assessed by reader B were 100％,85％,90％,and 100％,respectively; there was good inter observer agreement (Kappa=0.724) with the presence or absence of hemodynamically significant RAS.Conclusions Compared with CTA,MR IFIR-FIESTA can excellently assess RAS without contrast material and radiation exposure,therefore,it can be used for screening of RAS,especially should be widely applied to elderly patients with arterial hypertension.