Objective To investigate the effects of irbesartan hydrochlorothiazide combined with candesartan cilexetil in the treatment of elderly patients with hypertension and its protective effect on cardiac function.Methods 180 elderly patients with hypertension were selected,and they were randomly divided into observation group and control group according to the digital table,90 cases in each group.The observation group was given irbesartan hydrochlorothiazide combined with candesartan treatment,the control group was given candesartan.The heart function improvement after treatment,clinical efficacy and patients in hospitalization,complications,critical events and new death of the two groups were compared.Results After treatment,the heart rate,EVDD,SBP and other indicators of the two groups declined,which of the observation group[(56.14 ± 6.15)mm,(112.12 ± 20.12)mmHg,(70.45 ± 8.69/min)]were lower than the control group[(60.12 ± 6.78) mm(119.45 ± 21.45) mmHg,(82.12 ± 9.12/ min)],there were significant differences between the two groups (t1 =4.124,P =0.000;t2 =2.364,P =0.019;t3 =8.788,P =0.000).The total effective rate of the observation group was 93.33％,which was higher than 74.44％ of the control group,there was significant difference between the two groups (x2 =11.879,P =0.000).Conclusion Irbesartan hydrochlorothiazide combined with candesartan in the treatment of elderly hypertensive patients can effectively improve the heart function of patients,has significant effect.

Objective We sought to evaluate the effect of structured health education on quality of life and the end point of patients with coronary disease with evidence-based method.Methods The Cochrane Library,Cochrane Database of Systematic Reviews (CDSR),Medline (OVID),Pubmed and Web of Science were searched to collect the randomized controlled trials (RCT) which mentioned the structured health education to CHD patients,the quality of the RCTs was evaluated by Jadad Score,then effective data were extracted and analyzed by Meta-analysis with RevMan 5.2 software.Results A total of 12 eligible studies of RCT were included in the study with Jadad Score evaluations at B level or above.There were 20 476 cases in the intervention group,14 522 cases in the control group.Meta-analysis showed that the quality of life scores of the intervention group were significantly higher than those of the control group,weighted mean difference was 3.29,95％ CI (0.49-6.09).No significant difference was found in cardiac morbidity outcomes,re-hospitalization and the mortality rate,relative risk,95％ confidence interval were respectively 0.72(0.50-1.04),0.98(0.86-1.11),0.77(0.58-1.03).Conclusions The structured health education can improve the quality of life of patients with coronary disease,but has no obvious effect on the cardiac morbidity outcomes,re-hospitalization and mortality rate.We suggest transitional care to be carried out in future research to decrease the incidence rates of them.

Objective To study the application of photodynamic therapy (PDT) for dental caries prevention using whole body luminescence fiber,and to investigate the effects of PDT on the content of Ca and P in rat molar enamel.Method The rat dental caries model was established by inoculating with S.mutans.Eighty male rats were randomly divided into five groups,including three experimental groups:17 mW (8 mW/cm2) PDT (group A),34 mW (15 mW/cm2) PDT (group B),68 mW (30 mW/cm2) PDT (group C),a positive control group:20 g/L NaF solution (group D),and a negative control group:0.9％ physiological saline (group E).The experimental groups were treated by 40 μg/mL hematoporphyrin monomethyl ether (HMME) and 650 nm diode laser irradiation.The experiments were conducted for 4 weeks.The contents of Ca and P in the molars of each group were measured by inductively coupled plasma emission spectrometry.Results The contents of Ca and P in group B,C and D after PDT were significantly higher than those in group A and E (all P＜0.05).The contents of Ca and P in group A showed no significant difference before and after PDT,while those in groups B and C showed significant increase after PDT (all P＜O.05).The increment of Ca in group A after PDT was lower than that in group D (P＜0.05),while those in group B and C were significantly higher than those in group D (all P＜0.05).There was no significant difference in the increment of Ca and P between group B and C after PDT.Conclusions In the range of the experimental parameters,the PDT promoted effect of tooth remineralization is better than 20 g/L NaF.The levels of Ca and P in the tooth enamel can be promoted by PDT treatment,and the contents of Ca and P are related to the pewer of PDT.The effect of low power PDT on the remineralization of enamel is not obvious.The contents of Ca and P in the tooth enamel are increased with laser power of PDT.When the laser power increased to a certain value,the change in contents of the two elements is not obvious.PDT can maintain the tooth remineralization microenvironment.

Objective:To investigate whether the increased plasma fibrinogen level is an independent predictor of cardiogenic embolism in patients with nonvalvular atrial fibrillation (NVAF).Methods:Ninety-eight patients with NVAF hospitalized for cardiac causes were evaluated,and 24 of them had a history of ischemic stroke.The relationship between fasting plasma fibrinogen level and ischemic stroke were analyzed.Results:After adjusting traditional cardiovascular risk factors.the patients with NVAF who had the history of ischemic stroke were significantly older than those without(mean [SD] age 73.6 [8.4]vs.69.1[10.3] years,P=0.017).1he prevalence of hypertension was significantly higher(83.3%va.66.2%,P=0.011).The proportion of patients with left ventricular systolic dysfunction was significantly higher(63.1% vs.45.9%,P=0.006),and plasma fibrinogen level increased significantly (mean [SD] 365 [108]vs.312[82] mg/dL,P=0.008).Conclusions:Plasma fibrinogen level is independently associated with a history of ischemic stroke in older patients with NVAF hospitalized for cardiac causes.

Objective To investigate the apoptosis induction effects and the possible mechanism of YM155 on triple negative breast cancer MDA-MB-231cells.Methods MDA-MB-231 cells were treated with dif-ferent concentrations of YM 155, and the survival rate of the cells was determined by CCK-8 assay and the half maximal inhibitory concentration ( IC50 ) value of YM155 was calculated .The apoptosis rate was examined by An-nexin V-FITC/PI double staining.mRNA expression of survivin and bcl-2 in MDA-MB-231cells was detected by RT-PCR.The protein expression of survivin , bcl-2, caspase-3, and PARP were detected by Western blot .Re-sults YM155 significantly inhibited the growth of MDA-MB-231 cells in a dose-and-time-dependenct way .IC50 was(1.749 ±0.265) ng/ml and(0.823 ±0.125) ng/ml respectively at 24 and 48 hours.The apoptosis rate of cells treated with 0.5 ng/ml, 1.0 ng/ml, and 1.5 ng/ml YM155 was (10.93 ±0.94)%,(31.10 ±1.51)%, and(46.83 ±2.92)%respectively, which had significant difference compared to that of the control group (6.4 ± 1.2)%(P<0.01).YM155 could significantly decrease mRNA and protein expression of surviving , besides, it reduced bcl-2 expression and increased caspase-3 and PARP protein expression .Conclusions YM155 can ef-fectively induce the apoptosis of MDA-MB-231 cells by downregulating survivin and activating caspase pathway . Bcl-2 might play a role in the apoptosis .

Objective:To explore the correlation between enhanced CT quantitative parameters and malignant biological behavior and prognosis of colon cancer.Methods:From February 2017 to October 2019, 100 patients with colon cancer in Anhui Wanbei Coal-Electrivity Group Gernal Hospital were selected as the research subjects, and all performed enhanced CT examination. The serum tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) levels were detected. According the mean value of CEA, CA19-9, the patients were divided into different group, and CEA< 28.36 pmol/L was considered to below level, ≥ 28.36 pmol/L was high; CA19-9<40.26 pmol/L was considered to below level, ≥ 40.26 pmol/L was high. The quantitative parameters of enhanced CT in patients with colon cancer with different serum CEA and CA19-9 levels and different pathological indicators (CT scan value, enhanced value, degree of enhancement) were compared. The correlation between serum tumor marker levels, malignant biological behavior of colon cancer and quantitative parameters of enhanced CT were explored. After 12-months′ followed-up, the clinical data of patients with different prognosis and enhanced CT parameters were counted. The factors affecting the prognosis of colon cancer patients and the predictive value of enhanced CT quantitative parameters on the prognosis of patients were explored.Results:The CT scan value, enhancement value and enhancement degree of colon cancer patients with low levels of serum CEA and CA19-9 were lower than those with high levels: (30.16 ± 5.14) HU vs. (38.51 ± 5.72) HU, (55.74 ± 8.12)HU vs. (78.62 ± 8.97) HU, (25.58 ± 3.60) HU vs. (40.11 ± 3.14) HU, the differences were statistically significant ( P<0.05). There was a positive correlation between serum CEA and CA19-9 levels in patients with colon cancer and CT scan value, enhancement value, and degree of enhancement ( P<0.05). The CT enhancement value and enhancement degree of colon cancer patients were related to Dukes staging, differentiation degree, lymph node metastasis and lymphatic infiltration in colon cancer patients. The CT scan value was related to Dukes staging, lymph node metastasis and lymphatic infiltration of colon cancer patients ( P<0.05). The risk factors for death of colon cancer patients included age, Dukes staging, degree of differentiation, lymph node metastasis, lymphatic invasion, CT scan value, enhancement value, and degree of enhancement ( P<0.05). The area under the curve (AUC) of CT scan value, enhancement value, and enhancement degree combined to predict the prognosis of colon cancer patients was 0.873, which was greater than the single prediction of each parameter. The best sensitivity and specificity of combined prediction were 76.92% and 88.37%, respectively. Conclusions:There is a certain correlation between the enhanced CT quantitative parameters and the malignant biological behavior of patients with colon cancer. The increased detection value is risk factor for the prognosis.

Objective:To study the efficacy and safety of natural calcined bone repair material(NCBM)in repairing bone defect af-ter tooth extraction.Methods:A randemized,double-blinded,parallel,positive control(Bio-Oss)and multi-center clinical trial was employed.Imaging examination was used as the main efficacy evaluation index,surgical wound healing,rejection reaction,bone me-tabolic changes,bone infection signs were the subordinate efficacy evaluation indexes,the incidence of adverse reactions was observed for safety evaluation.Results:280 cases were included,269 cases completed the trial.In NCBMand Bio-Oss group the effective rate of imaging examination was 93.08% and 93.70%(P >0.05)respectively.The wound healing time of the 2 groups was less than 7 days,no rejection reaction,bone metabolic change and bone infection sign were observed.The incidence of adverse events in NCBM and the Bio-Oss group was 0.72% and 2.14%(P >0.05)respectively.Conclusion:The efficacy and safety between natural cal-cined bone repair material is not inferior to Bio-Oss in repairing bone defect after tooth extraction.

Objective To evaluate the changes in the expression of CC-chemokine ligand 3 (CCL3) and CC-chemokine receptor 5 (CCR5) in the spinal cord during hyperalgesia induced by remifentanil in rats with incisional pain.Methods Thirty-two male Sprague-Dawley rats,aged 2-3 months,weighing 240-260 g,were randomly divided into 4 groups (n=8 each) using a random number table:control group (group C),incisional pain group (group Ⅰ),remifentanil group (group R) and remifentanil+incisional pain group (group R+I).A 1-cm longitudinal incision was made in the plantar surface of the left hindpaw in anesthetized rats.While the model of incisional pain was established,remifentanil was infused for 60 min at 1 μg · kg-1 · min-1.At 24 h before infusion of remifentanil (baseline) and 2,6,24 and 48 h after the end of infusion,the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured.The rats were sacrificed after the last measurement of pain threshold,the lumbar segment (L4-6) of the spinal cord was removed for determination of CL3 and CCR5 mRNA expression (by real-time PCR) and CL3 and CCR5 expression (by Western blot).Results Compared with group C,the MWT was significantly decreased,the TWL was shortened,and the expression of CCL3 and CCR5 mRNA and protein was up-regulated in I,R and R+ I groups.Compared with I and R groups,the MWT was significantly dccreascd,the TWL was shortened,and the expression of CCL3 and CCR5 mRNA and protein was up-regulated in group R+I.Conclusion The mechanism by which remifentanil induces hyperalgesia is related to up-regulated expression of CCL3 and CCR5 in the spinal cord of rats with incisional pain.

Objective To evaluate the effects of hydrogen on apoptosis in hippocampal neurons caused by sevoflurane anesthesia in neonatal rats.Methods Forty-eight healthy male Sprague-Dawley rats,aged 7 days,weighing 12-20 g,were randomly divided into 3 groups (n=16 each) using a random number table:control group (group C);sevoflurane anesthesia group (group S);hydrogen group (group H).In C and S groups,the rats inhaled 30％ oxygen and 3％ sevoflurane for 6 h,respectively.In group H,3％ sevoflurane and 2％ hydrogen were inhaled for 6 h.Eight rats in each group were randomly selected and sacrificed at 7 days after birth (after the end of oxygen,sevoflurane or hydrogen inhalation),and the hippocampus was removed for determination of the expression of activated caspase-3 and myelin basic protein by Western blot.At 28 days after birth,8 rats were selected,and Y-maze and Morris water maze tests were performed to evaluate the cognitive function.The total number of entries into each arm,the number of spontaneous alternation,escape latency and time of staying at the platform quadrant were recorded.Results Compared with group C,the percentage of spontaneous alternation was significantly decreased,the escape latency was prolonged,and the time of staying at the platform quadrant was shortened,and the expression of activated caspase-3 was significantly up-regulated,and the expression of myelin basic protein was down-regulated in group S.Compared with group S,the percentage of spontaneous alternation was significantly increased,the escape latency was shorten,and the time of staying at the platform quadrant was prolonged,and the expression of activated caspase-3 was significantly downregulated,and the expression of myelin basic protein was up-regulated in group H.There was no significant difference in the number of entries into each arm in Y-maze test between the three groups.Conclusion Hydrogen can inhibit apoptosis in hippocampal neurons caused by sevoflurane anesthesia in neonatal rats.

Objective:To compare the outcomes of guide bone regeneration by calcined bovine bone and Bio-Oss graft material in alveolar ridge preservation after tooth extraction.Methods:280 patients were divided into two groups randomly.Each patient had single tooth extracted.The sockets were filled with calcined bovine bone in 140 patients and Bio-Oss graft in another 140 patients. After shaping,all the sockets were covered with Bio-Gide membrane.Buccal mucoperiosteal flap was released and sutured to close the alveolar sockets.The patients were regularly examined at the 1st,12th and 24th week after surgery.Physical examination and X-ray evaluation were applied to compare the outcomes of the two materials in alveolar ridge preservation.Results:No infection and re-jection occurred.The radiographic results showed the width and height of the alveolar bone were preserved well at the 12th and 24th weeks.No statistically difference was found in the two groups at the 1st and 24th weeks(P>0.05).Conclusion:The two graft ma-terials can effectively preserve alveolar bone after tooth extraction.