Antihypertensive Agents ; therapeutic use ; Blood Pressure Determination ; Humans ; Hypertension ; physiopathology ; therapy

Humans ; Hypertension ; Sympathetic Nervous System ; metabolism ; pathology

OBJECTIVETo investigate the relationship between microalbuminuria and arterial compliance in hypertensive and diabetes patients.

METHODSA total of 200 patients with essential hypertension and/or diabetes were studied. Albumin/creatinine ratio (ACR) was determined. Carotid to femoral Pulse Wave Velocity (PWV), C(1) and C(2) were measured by a Complier Colson device and DO-2020, respectively.

RESULT(1) C(1) and C(2) were lower and PWV higher in high ACR group than in normal ACR group (P < 0.01). (2) In patients younger than 60 years, C(1) was lower and PWV higher in high ACR group than that in normal ACR group (P < 0.01). In patients older than 60 years, C(1), C(2) were lower in high ACR group than in normal ACR group.

CONCLUSIONThe results indicated that compliance of large and small vessels in hypertensive and diabetic patients decreased with increasing ACR.

Adult ; Aged ; Albumins ; analysis ; Albuminuria ; Arteries ; physiopathology ; Creatinine ; urine ; Diabetes Mellitus ; physiopathology ; urine ; Elasticity ; Female ; Humans ; Hypertension ; physiopathology ; urine ; Male ; Middle Aged

Resistant hypertension(RH) is a type of hypertension that causes progression of cardiovascular and cerebrovascular diseases. Clear diagnosis and effective treatment are essential. The article provides a detailed summary of the definition, etiology, diagnosis and treatment of RH. The treatment of RH should emphasize individualization, and it is necessary to carefully discern the cause and distinguish from secondary hypertension. Ambulatory blood pressure monitoring and home blood pressure measurement are important diagnostic tools. A combination of multiple drugs(including diuretics) that are reasonable, optimal, and of tolerable doses is the key to controlling blood pressure.

OBJECTIVETo observe the relationship between the parameters of artery elasticity and coronary artery stenosis in normotensive and hypertensive patients with coronary artery disease (CAD).

METHODSSystemic vascular compliance (SVC), systemic vascular resistance (SVR), brachial artery compliance (BAC) and brachial artery resistance (BAR) were measured by Dynapulse 200M (Pulse Metric, Inc., USA) in 88 hypertensive and 41 normotensive patients with chest pain before coronary artery angiography.

RESULTS(1) The prevalence rate of severe coronary disease (> or = 2 coronary branches) was higher in hypertensives than in normotensives (64.7% vs. 27.1%, P < 0.05); (2) the peripheral artery buffering function was significantly lower in hypertensives than in normotensives [SVC: (0.85 +/- 0.10) ml/mm Hg (1 mm Hg = 0.133 kPa) vs. (1.17 +/- 0.11) ml/mm Hg; BAC: (0.047 +/- 0.011) ml/mm Hg vs. (0.063 +/- 0.010) ml/mm Hg, all P < 0.05]; (3) Lower arterial elasticity was associated with severe coronary artery stenosis.

CONCLUSIONThe non-invasive obtained artery elasticity is associated with the degree of coronary artery stenosis in hypertensive patients with CAD.

Aged ; Blood Pressure ; Coronary Angiography ; Coronary Artery Disease ; complications ; diagnostic imaging ; physiopathology ; Coronary Stenosis ; complications ; diagnostic imaging ; physiopathology ; Female ; Humans ; Hypertension ; complications ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Prevalence ; Pulse

OBJECTIVETo evaluate the clinical characteristics and therapy conditions in hospitalized patients with essential hypertension in Beijing.

METHODSPatients with essential hypertension hospitalized in 20 Beijing hospitals in recent 2 years were included in this epidemiologic retrospective survey. Data on age, blood pressure level, risk factors and complicated diseases, antihypertensive medication and heart structural and functional characteristics measured by echocardiography were collected.

RESULTSTotal 5106 hospitalized patients (mean age 63.78 years) with essential hypertension were recorded. Mean blood pressure was 145.97/84.23 mm Hg (1 mm Hg = 0.133 kPa). Among them, 75.5% complicated with at least one risk factor, 30% suffered from heart failure. The atria enlargement and left ventricular diastolic dysfunction were the two most common echocardiographic pathological changes. Left ventricular hypertrophy is positively correlated with blood pressure. Logistic regression analysis showed that increased systolic blood pressure, diastolic blood pressure and plasma creatinine, old age and decreased HDL-cholesterol were risk factors of left ventricular hypertrophy. Only 32.1% patients achieved the goal blood pressure level (<140/90 mm Hg) and 38.1% patients were treated with monotherapy. The most commonly used antihypertensive drugs were calcium channel blockers and diuretics.

CONCLUSIONSIt is of importance to strictly follow the therapy guidelines on hypertension treatment and use combined drug therapy to increase the rate of patients reaching goal blood pressure level and reduce hypertensive complications.

Aged ; Blood Pressure ; China ; epidemiology ; Female ; Humans ; Hypertension ; epidemiology ; physiopathology ; therapy ; Hypertrophy, Left Ventricular ; epidemiology ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors

OBJECTIVE To strictly manage the whole process for cleaning the laminar air flow(LAF) operating center to achieve the modernized hospital environment′s standard requests.METHODS Right before the use of the LAF operating center,scientific management was conducted strictly according the regulations and standards issued by state Ministry of Health.RESULTS Fulfilling the standards of the process for cleaning operating center was all for the goal of improving the efficiency of management.CONCLUSIONS A management is made efficient from checking all the things before use,monitoring them,and training people so that they can efficiently carry out their tasks.The purpose of the scientific management is to reach the expected quality.

OBJECTIVEThough myasthenia gravis (MG) is a typical autoimmune disorder, there was some controversy on the treatment of the childhood-onset MG. By observing the efficacy of different therapies, the authors analyzed the affecting factors of prognosis in childhood-onset MG.

METHODThe retrospective data of 155 patients with childhood-onset MG (age of MG onset was less than 15 years) were collected from Department of Neurology, Beijing Tongren Hospital (January 2000 - February 2010). The patients were non-randomly divided according to their treatment into 3 groups (glucocorticoid, thymectomy and glucocorticoid combined with thymectomy groups). Postintervention status meeting the criteria of Myasthenia Gravis Foundation of America (MGFA) "complete stable remission, CSR", "pharmacologic remission, PR", "minimal manifestations, MM", or "Improved, I" was regarded as desirable response, which was used as primary indicator of observation. The authors assessed the efficacy of three therapies and analyzed the influencing factors of prognosis by using Chi-square test and Logistic regression.

RESULTAt 3 months of treatment, glucocorticoid group showed the highest effective rate. At the end of 1 year or 2 years of treatment, glucocorticoid combined with thymectomy group showed the highest effective rate respectively. The generalization rate of MG at 2 years, 10 years and 20 years in childhood-onset ocular MG patients were 4.3%, 10.7%, and 41.5%, respectively. Of patients with generalization of MG, 48.1% occurred within 2 years, 92.6% within 20 years. Univariate analysis showed that in childhood-onset ocular MG patients, variables such as age at onset (> 10 years), LG-MG and with chronic fatigue were significantly associated with general MG conversion. Whereas multivariate analysis showed that patients with age at onset (> 10 years) and chronic muscle fatigue were apt to convert to generalized MG.

CONCLUSIONGlucocorticoid appeared to have an effect that leads to early remission of symptoms in childhood-onset MG patients and glucocorticoid combined with thymectomy appeared to have better long-term effect. For those childhood-onset ocular MG patients with longer course of disease, older age of onset, chronic fatigue, or LG-MG, physicians should try to prevent the generalization of MG by immunosuppressive therapies.

Adolescent ; Child ; Child, Preschool ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Male ; Myasthenia Gravis ; diagnosis ; therapy ; Prognosis ; Retrospective Studies ; Thymectomy ; Young Adult

OBJECTIVETo evaluate the effect of Xinkeshu Tablet (XKS) on heart rate variability (HRV) in patients with coronary heart disease (CHD).

METHODSSixty patients with their diagnosis of CHD confirmed by coronary angiography were randomized into two groups equally. Besides the conventional treatment for CHD, XKS and Metoprolol were given respectively to patients in the treated group and the control group for 8 weeks. Symptoms and 24 h dynamic ECG were observed before and after treatment.

RESULTSEpisode of angina pectoris decreased obviously in both groups after treatment, from 8.8 +/- 3.2 times per week (the same hereafter) to 4.4 +/- 2.1 in the treated group (P<0.05), and from 8.4 +/- 3.1 to 3.9 +/- 2.0 in the control group (P <0.05). HRV analysis showed that after treatment the average heart rate lowered from 85.44 +/- 2.89 beat/min to 77.32 +/- 2.17 beat/min in the treated group and from 83.80 +/- 4.30 beat/min to 76.70 +/- 2.93 beat/min in the control group (both P < 0.05), showing no significant difference in extent of lowering between groups (P > 0.05). The time-domain indexes elevated in both groups, showing no statistical difference between groups (P >0.05). As for the frequency-domain indexes, low frequency (LF), high frequency (HF) and total power raised, while LF/HF and very low frequency lowered in both groups, but the changes were more significant in the treated group (P <0.05).

CONCLUSIONXKS could improve HRV in patients of CHD and reduce the episode of angina pectoris in them.

Cardiovascular Agents ; pharmacology ; therapeutic use ; Coronary Disease ; drug therapy ; Depression, Chemical ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Heart Rate ; drug effects ; Humans

BACKGROUNDAliskiren is a novel blood pressure-lowering agent acting as an oral direct renin inhibitor. The aim of this study was to assess the effect of aliskiren on arterial stiffness, compared with that of ramipril in mild to moderate essential hypertensive patients.

METHODSFollowing a two week placebo run-in period, patients with a mean sitting diastolic blood pressure (ms-DBP) ≥ 95 and < 110 mmHg (1 mmHg = 0.133 kPa), and a mean sitting systolic blood pressure (ms-SBP) < 180 mmHg were randomly allocated to treatment with aliskiren (150 mg/d, n = 20) or ramipril (5 mg/d, n = 20) for eight weeks. Blood pressure, plasma renin activity, and the brachial-ankle pulse wave velocity (ba-PWV) were measured before and after eight weeks of treatment.

RESULTSEight weeks of treatment significantly decreased systolic blood pressure and diastolic blood pressure in both the aliskiren group and ramipril group. The hypotensive effect did not differ between the two groups. Plasma renin activity decreased after aliskiren treatment and increased after ramipril treatment. There was no significant difference in baseline ba-PWV between the aliskiren and ramipril groups (P = 0.892). The ba-PWV was significantly reduced in both the aliskiren group (1535 (1405 - 1666) vs. 1464 (1360 - 1506) cm/s) (P < 0.01) and the ramipril group (1544 (1433 - 1673) vs. 1447 (1327 - 1549) cm/s) (P < 0.01). No statistically significant difference was found in the decline of ba-PWV between the two groups (P = 0.766).

CONCLUSIONSThe current study revealed that aliskiren (150 mg/d) could ameliorate arterial stiffness and its effect was similar to ramipril (5 mg/d) in mild to moderate hypertensive patients, indicating that in addition to lowering blood pressure, aliskiren had beneficial effect on vascular protection.

Adult ; Amides ; therapeutic use ; Antihypertensive Agents ; therapeutic use ; Female ; Fumarates ; therapeutic use ; Humans ; Hypertension ; drug therapy ; physiopathology ; Male ; Middle Aged ; Ramipril ; therapeutic use ; Vascular Stiffness ; drug effects