Objective To investigate the effect of valsartan combined with amlodipine in treatment of elderly patients with essential hypertension and diabetes,and to provide a reference for the development of clinical treatment. Methods 339 patients with essential hypertension complicated with diabetes in our hospital were randomly divided into 3 groups:A group,B group and C group,each group in 113 cases.A group was treated with amlodipine tablets,B group was treated with valsartan capsules,and C group was treated with amlodipine tablets combined with valsartan capsules.After 3 months of continuous treatment,blood pressure,blood glucose,blood lipids and uric acid were com-pared among the three groups before and after treatment.Results The three groups of patients before treatment, systolic blood pressure and diastolic blood pressure had no significant difference;The three groups of patients after treatment,systolic blood pressure and diastolic blood pressure were significantly lower than before treatment;After treatment in C group,the systolic blood pressure was (135.70 ±8.17)mmHg,which was significantly lower than (139.42 ±8.29)mmHg in A group and (139.52 ±7.48)mmHg in B group,the difference was statistically significant (t =3.77,3.81,all P <0.05);The three groups of patients after treatment of diastolic blood pressure had no significant difference,and there were no statistical significance among the three groups before treatment in the fasting blood glucose,fasting insulin,ISI level difference;Of A group after treatment,the fasting blood glucose,fasting insulin,ISI levels were (7.63 ±0.89)mmol/L,(16.11 ±2.39)mIU,(-4.26 ±0.35),there were no significant difference before and after treatment;Of B group and C group after treatment,fasting blood glucose,fasting insulin and ISI were significantly lower than before treatment (t =4.45,4.83,6.74,6.61,4.48,4.93,all P <0.05)and A group after treatment(t =4.23,448,5.24,515,409,3.95,all P <0.05),and the differences were statistically significant,and before and after treatment the total cholesterol,triglyceride,high density lipoprotein cholesterol and low density lipo-protein cholesterol levels among the three groups had no statistical significance;the level of uric acid of C group after treatment(282.04 ±81.31)μmol/L was significantly lower than that in A group and B group(t =4.94,4.68,all P <0.05).Conclusion Valsartan combined with amlodipine can effectively reduce the community elderly patients with primary hypertension in patients with diabetes mellitus blood pressure levels,promote the stability of blood glucose level,improve the uric acid metabolism and on renal function have protective effect.

Several signaling pathways are involved in clonal proliferation of lymphoma cells and disease progression. It has been shown that cyclic adenosine monophosphate (cAMP) signaling pathway, as an important intra-cellular messenger delivery system, is related to modulation of multiple physiological processes including cell prolifer-ation, secretion, metabolism and apoptosis. Manipulating the cAMP signaling pathway can induce cell cycle arrest and apoptosis of various malignant lymphoid cells, which involves mitochondria-dependent apoptosis and cAMP-modulated protein kinases as well as changes of intracellular mediators. In-depth research and analysis of cAMP-induced apoptosis in lymphoma cells would provide potential targets and possible therapeutic means for the treatment of lymphoma.

Objective To reveal the average pass rate of a general hospital's ethic review and common problems.Methods The records generated by the ethics committee of a hospital in 3 consecutive years were reviewed and analysed with ridit of CMH and Bootstrap statistical methods.Results The pass rate for drug clinical trial is 36.09%,medical instruments 18.42%,and subject evaluation 14.29%.Among the problems,those concerning informed consent take up 63.59%,of protocol 14.56%,of CRF 7.77% and of the others 22.820%.The domestic applicants had more problems than those abroad.Besides,the pass rate of drug trials decreased with year from 45.83% in 2006 to 19.44% in 2008,which was statistically significant (P=0.029).In terms of drug clinical trial,the pass rate of revised projects in foreign countries was significantly higher than the domestic ones (P=0.028).ConclusionEthics Committee in a hospital plays a very important role in clinical researches.And informed consent and research protocol are very important in the ethic review.

Objective To measure the extent of malrotation of femur fractures with CT scan after fixation with interlocking intramedullary nailing , and to discuss the methods which can help to correct the malrotation of femur fracture during the operation. MethodWith CT scan, the anteversion of femur fracture after the close reduction and fixation with interlocking intramedullary nailing in 56 cases was measured, and the difference of anteversion between the fracture side and the contralateral side was evaluated. The increase of anteversion represented internal rotation of the distal fragment, whereas the decrease of anteversion meaned external rotation. According to AO classification system, the type A of infratrochanteric fractures happened in 9 cases, type A of femoral shaft fractures happened in 12 cases, type B in 15 cases,type C in 7 cases,and 13 cases of femoral supercondyle fractures were type A. ResultThe results of measurement showed that the femoral anteversion after fixation with interlocking intramedullary nailing was changed in all patients. The anteversion of the femoral shaft fracture ranged from 13.35?to 47.21?. The aneversion of infrotrochanteric fractures ranged from -7.12?to 36.35?, and the supercondyle fracture of femur from -11.10?to 39.22?. For the extent of malrotation of distal femoral fracture, the internal rotation was more obvious than the external rotation. The number of Internal rotation cases accounted for 60.71%, and the external cases accounted for 39.29%. The maximum internal malrotation happened in femoral shaft fracture, from 1.37?to 29.82?with average malrotation 12.34?. and the minimum internal malrotation happened in infratrochanteri fracture, from 0.81?to 23.21?,with the average malrotation 8.32?. The medium internal malrotation was femoral supercondyle fracture, from 1.72?to 27.11? with the average malrotation 8.38?. The maximum external malrotation happened in femoral shaft fracture, from 1.11?to 21.12?with the average of them 9.33?. The minimum external malrotation happened in infratrochanteri fracture, from 1.31?to 16.23?with the average 7.71?. The medium external malrotation was seen in femoral supercondyle fracture, from 0.97?to 17.96?with average 8.22?. For these three parts of femoral fracture, the partnership T test was done between the fracture side and the contralateral side, the results showed that there were significant differences among of them,P

[Objective] To compose carbonated hydroxyapatite cement with chemica l materials,and by adding the pore agent to develop a new bone substitute,which can be solidified in situ to form porous carbonated hydroxyapatite.[Method](1)A new type of carbonated hydroxyapatite cement(CHC)was prepared.The powder of cement was composed of calcium carbonate,tricalcium phosphate and calcium phosphate dibasic.The liquids were prepared by 0.2mol/L sodium phosphate buffer,solide phase to liquid phase was 1g to 0.4 ml;(2)To prepare an in situ setting porous carbonated hydroxyapatite cement,add the pore agent into the powder of cement,pore generate CO2 during situ setting of cement;(3)The chemcial composition,chemcial constitution mechanical property,setting time,interval porosity of the PCHA were tested.and then the physio-chemical character,manipulatity,histocompatibility were evaluated.[Result]Addition of pore agent could succeed to prepare a new bone substitute which could set in situ and transform into porous carbonated hydroxyapatite.The setting time was 13~15 minutes which was suitable to clinical application.The pore size and porosity character could be controlled by adjustment of the component.The checking results demonstrated that the self-setting composition of this cement was carbonated hydroxyapatite which was similar with the mineral phase of natural cancellous bone,the carbonic acid radical was 5.6% in the solidify production.Contain of the porosity was 36% with interconnect pore,the compressive strength was 5.6?2.2 MPa which was equal to strength of cancellous bone,and the cytotoxicity tests showed an exellent biocompatibility.[Conclusion]The porous carbonated hydroxyapatite cement is a good bone substitute which seems to be the cancellous bone with good porosities,exellent biocompatibility.

[Objective]To treat the femoral neck fracture using cannulated screw and BMP release system in animals,and to evaluate the possibility of treating femoral neck fracture and provide experimental basis for clinical application.[Method]Eighteen mongeral were used in this study.The model of bilateral femoral neck dislocation fracture was established.The control side was fixed using cannulated screw,and the experiment side was fixed with cannulated screw and injectable BMP release system.At 4,8,12 weeks,6 animals were sacrificed at one time point respectively.Results were obtained through histology,radiography,scintimetry and gross observation.[Result]The fracture line was vague at four weeks,and at eight weeks the fracture line almost disappeared.It was healed completely at twelve weeks.Radiological study showed that the healing of the fracture in experimental side was better than that of the control side.There was the same result of observation in histology.[Conclusion]The cannulated screw combined with BMP used in the experiment is effective and feasible.It may not only provide strong internal fixation but also infuse growth factor into site of fracture.It would accelerate the reconstructing of the vascular supply to the femoral head after the fracture and promote the restoration of bone.

Objective:To investigate the effects of curcumin on apoptosis and radiosensitivity of human chordoma cell line CM-319 and its mechanism.Methods:CM-319 cells were cultured in vitro and divided into curcumin 0 μmol/L group, curcumin 5 μmol/L group, curcumin 10 μmol/L group, curcumin 20 μmol/L group, si-NC group, si-UHRF1 group, curcumin+pcDNA group, curcumin+pcDNA-UHRF1 group.Flow cytometry was usedtodetect cell apoptosis, Western Blot was used to detectthe protein expression of Bcl-2, Bax, Cleaved Caspase-3 and UHRF1, qRT-PCR was used to detect the expression of UHRF1 mRNA, and clone formationexperiment was used to detect the sensitivity of CM-319 cells to radiation.Results:Compared with the curcumin 0 μmol/L group, the apoptosis rate of CM-319 cellsinthe curcumin 5 μmol/L group, curcumin 10 μmol/L group and curcumin 20 μmol/L groupincreased 12.61%±1.57%, 18.42%±1.54%, 29.37%±2.65% vs 7.24%±0.73% ( t=9.305, 19.680, 24.153; all P<0.05), and the protein expression of Bcl-2 decreased 0.62±0.06, 0.51±0.05, 0.33±0.03 vs 0.76±0.07 ( t=4.556, 8.719, 16.939; all P<0.05), while the protein expression of Bax 0.41±0.04, 0.55±0.05, 0.69±0.06 vs 0.26±0.03 ( t=9.000, 14.920, 19.230; all P<0.05) and Cleaved Caspase-3 0.37±0.04, 0.49±0.05, 0.62±0.06 vs 0.24±0.03 ( t=7.800, 12.862, 16.994; all P<0.05) increased, and the expression of UHRF1 mRNA decreased 0.82±0.08, 0.67±0.07, 0.42±0.04 vs 1.01±0.09 ( t=4.734, 8.946, 17.972; all P<0.05), the protein expression of UHRF1 decreased 0.61±0.06, 0.48±0.05, 0.31±0.03 vs 0.83±0.08 ( t=6.600, 11.130, 18.258; all P<0.05), and were dose-dependent, and the sensitization ratios were 1.433, 1.708, and 2.183, respectively. Compared with the si-NC group, the protein expression of UHRF1in CM-319 cells in the si-UHRF1 group decreased 0.35±0.04 vs 0.79±0.08 ( t=14.758, P<0.05), the apoptosis rate of CM-319 cells increased 21.49%±2.11% vs 8.24%±0.83% ( t=17.531, P<0.05), the protein expression of Bcl-2 decreased 0.34±0.03 vs 0.71±0.07 ( t=14.575, P<0.05), while the protein expression of Bax 0.62±0.06 vs 0.25±0.03 ( t=16.547, P<0.05) and Cleaved Caspase-3 0.58±0.05 vs 0.23±0.03 ( t=18.007, P<0.05) increased, and the sensitization ratio was 1.727. Compared with the curcumin+pcDNA group, the apoptosis rate of CM-319 cells in the curcumin+pcDNA-UHRF1 groupreduced 13.59%±1.25% vs 28.31%±3.01% ( t=13.549, P<0.05), the protein expression of Bcl-2 increased 0.63±0.06 vs 0.31±0.03 ( t=14.311, P<0.05), while the protein expression of Bax 0.42±0.04 vs 0.71±0.07 ( t=10.791, P<0.05) and Cleaved Caspase-3 0.38±0.04 vs 0.65±0.05 ( t=12.650, P<0.05) decreased, and the sensitization ratio was 0.539. Conclusion:Curcumin can induce apoptosis of CM-319 cells and enhance the radiosensitivity of CM-319 cells, , and the mechanism is related to the down-regulation of UHRF1 expression.

Aim To investigate the effects of Vam3 on ATP-induced inflammatory response in macrophages and the underlying mechanisms. Methods LPS primed mouse peritoneal macrophages were stimulated with ATP,and IL-1βlevel in supernatants was meas-ured by ELISA.Activity of caspase 1 was measured u-sing caspase 1 activity assay kit.Reactive oxygen spe-cies (ROS )level was detected with fluorescent probe DCFH-DA.MTT assay was used to detect cell prolifer-ation,and intracellular Ca2+concentration was meas-ured using laser scanning confocal microscope.Results Extracellular ATP led to increase in IL-1βrelease, caspase 1 activity and ROS production.It also led to rapid increase in intracellular Ca2+concentration and induced cell death.These effects were inhibited by Vam3 .Conclusion Vam3 inhibits ATP-induced in-flammatory response in macrophages,which may sug-gest the blocking effect of Vam3 on caspase 1 ~IL-1βinflammatory signaling pathway in macrophages.

Objective To investigate the changes of VCAM-1 and ICAM-1 levels in tumor and peripheral blood in pancreatic cancer patients. Methods 28 cases with pancreatic cancer were selected from August 2013 to Octorber 2014 as experiment group,28 cases with acute pancreatitis who needed removal of pancreas as control group,28 healthy people as normal group.ICAM-1 and VCAM-1 in tissue were compared and sVCAM-1 and sICAM-1 in serum were compared.Results ICAM-1 and VCAM-1 in tissue of experiment group were significantly higher than normal group(P<0.05), sICAM-1,sVCAM-1 in serum of experiment group were higher than control group and normal group(P<0.05),there were no correlation between CEA and sICAM-1,sVCAM-1 in serum of experiment group(r=0.116,P>0.05;r=0.093,P>0.05),there were positive correlation between CA19-9 and sICAM-1,sVCAM-1 in serum of experiment group(r=0.573,P<0.01;r=0.435,P<0.05).Compared with pre-operation, the serum concentrations of sVCAM-1 and sICAM-1 were lower(P<0.05).Conclusion ICAM-1 and VCAM-1in pancreatic cancer patients are significantly higher than that in acute pancreatitis patients and healthy people, the correlation of ICAM-1 and VCAM-1 expression in pancreatic cancer, early diagnosis and treatment of pancreatic cancer has important significance.

Objective To study the differences of clinical characteristics in the children patients with pneumonia under differ‐ent body mass indexes(BMI) to provide the basis for its clinical research .Methods 160 children patients with pneumonia in the Shandong Armed Police Corps Hospital were selected and divided into the normal BMI group (15 .00