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.

Objective To evaluate the clinical curative efficacy and to explore the leaking pathway of bone cement to verte‐bral canal through treating osteoporotic vertebral burst fractures (OVBF) by using percutaneous kyphoplasty(PKP) .Methods Ac‐cording to AO classification ,45 OVBF patients with 45 vertebras in the Erdos Central Hospital from October 2005 to May 2013 were treated by using PKP .The pathway of bone cement leaking to spinal canal and intervertebral space was determined by postop‐erative CT plain scan .The postoperative vertebral height ,Cobb angle and spinal stenosis improvement were measured .The change of VAS were compared between before and after operation .Results There were 2 cases of bone cement leaking to spinal canal .The leaking passway was mainly through basivertebral foramen .The leakage of bone cement to superior intervertebral space was higher than that to lower intervertebral space .The recovery of the vertebral height ,correction of Cobb angle and pre‐and post‐operative VAS scores had statistically significant differences (P<0 .05) .The spinal stenosis rate had no statistical difference between before and after operation(P>0 .05) .Conclusion PKP for treating OVBF is not a contraindication .The main pathway of bone cement lea‐king to spinal canal is basivertebral foramen after the treatment of OVBF by using PKP ,the leakage to intervertebral space is relat‐ed with the endplate damage .

Objective To explore the role of neurotic in parental rearing patterns and interpersonal sensitive.Methods Using stratified sampling method to test 702 middle school students,symptom checklist 90 (SCL90),Egma minnen av bardndosnaupp forstran(EMBU) and Eycenck Personality Questionnaire(EPQ) were used to investigate and take one and a half years of follow-up observation on the sample of 245 students from first grade of junior and senior middle school.Correlated variables were made the correlation analysis,regression analysis,constructing the structure equation model and using tracking data to confirm.Results (1) Neuroticism,father's affective warmth and understanding,father's excessive protection,mother's rejection and deny had a direct effect,and the variation of total symptoms could be explained 40.8％ ; father's affective warmth and understanding,father's excessive protection,mother's over-interference and over-protection,mother's rejection and deny had a indirect effect on interpersonal sensitive,and explained 24.0％.(2) Effect analysis showed father's affective warmth and understanding,father's excessive protection,mother's rejection and deny impact on interpersonal sensitive by neuroticism,and father's excessive protection was the largest which accounted for 48.0％ of the total effect.The second was father's affective warmth and understanding,accounting for 47.3 ％.The last was mother's rejection and deny accounted for 42.7％,and its indirect effect increased with the age(69.1％).All of mother's over-interference and overprotection through the neurotic influence interpersonal sensitive,and the direct effect was 50.3％ between neurotic and interpersonal sensitivity.Conclusion Indirect effect of neurotic existed in relationships of parents rearing patterns and interpersonal sensitivity.

Acetylcholine ; metabolism ; Animals ; Brain ; drug effects ; metabolism ; Choline O-Acetyltransferase ; metabolism ; Cholinergic Agonists ; pharmacology ; Epithelial Cells ; metabolism ; Kidney Tubules ; cytology ; metabolism ; Lateral Ventricles ; drug effects ; Male ; Natriuresis ; Rats ; Rats, Sprague-Dawley

BACKGROUND: Prognosis is determined by degrees of outside force and time of spinal cord compression after spinal cord injury. The former factor cannot be changed, but the latter one can be changed through relieving spinal cord compression as early as possible to promote nervous function recovery.OBJECTIVE: To compare the effect of surgical intervention time on nervous function recovery within 72 hours and 10 to 14 days after cervical spinal cord injury.DESIGN: Randomized controlled and before-after controlled study.SETTING: Department of Spine Surgery of the Second Hospital affiliated to Harbin Medical University.PARTICIPANTS: A total of 32 patients with cervical spinal cord injury were selected from the Department of Spine Surgery of the Second Hospital affiliated to Harbin Medical University from April 1998 to August 2001.All patients were divided into two groups according to randomly alternative criteria. There were 16 cases including 10 males and 6 females in early surgical group (within 72 hours) and there were also 16 cases including 12males and 4 females in delayed surgical group (within 10-14 days).METHODS: Patients in early surgical group were undertaken operation at 72 hours after hospitalization, and patients in delayed surgical group were at 10-14 days after hospitalization. Frankel grade, sensory and motor scores were recorded according to criteria set by American Spinal Injury Association before operation and within 24 months after operation.MAIN OUTCOME MEASURES: ① Sensory and motor scores before and after operation; ② Frankel grade before and after operation.RESULTS: ① Improved level of sensory score (difference before and after operation) was higher in early surgical group than that in delayed surgical group (42.6±20.2, 19.2±19.1, P ＜ 0.01). ② Improved level of motor score (difference before and after operation) was higher in early surgical group than that in delayed surgical group (39.7±17.8, 17.3±18.6, P ＜ 0.01). ③Improved level of Frankel grade in early surgical group was superior to that in delayed surgical group (P ＜ 0.01).CONCLUSION: Nervous function recovery of patients with acute cervical spinal cord injury who were suffered from operation within 72 hours is superior to that of those within 10 to 14 days. Therefore, surgical intervention should be undertaken as early as possible in order to promote nervous function recovery after cervical spinal cord injury.

BACKGROUND: A new material of porous carbonated hydroxyapatite cement (PCHC) is discovered using foaming technique.The new material characterizes original solidification and forms porous structure.OBJECTIVE: To investigate the biomechanical effect of PCHC on repairing cancellous bone defect.METHODS: Among 30 New Land rabbits, 25 ones were considered as surgery group, whose bilateral condyles of femur was used to establish bone defect model (5.5 mm diameter and 12 mm depth). PCHC was implanted into the left side, which was considered as the experimental group, and carbonated hydroxyapatite cement (CHC) was implanted into the right side, which was considered as the control group. Another 5 rabbits were used as normal mechanical control group. Both PCHC and CHC were dip in simulated body fluid (SBF) to test mechanical intension. PCHC and CHC were then implanted into muscles of back in the surgery group. Rabbits Were-sacrificed after 2, 4, 8, 12, and 16 weeks postoperatively. Mechanical analysis was tested following intra-bone and intramuscular implantation, and compressive strength was then tested following dipping into SBF.RESULTS AND CONCLUSION: PCHC: Intra-bone mechanical strength was lower at 2 weeks, the lowest at 4 weeks, but then closed to intension of normal cancellated bone at 8 weeks, higher than normal cancellated bone at 12 weeks, and recovered to the level of normal cancellated bone at 16 weeks. CHC: Intra-bone strength was higher than that of PCHC at 2 weeks, decreased at 4 weeks, gradually increased at 8, 12, and 16 weeks, but still lower than intension of normal cancallated bone. Compressive strength of both PCHC and CHC was not changed following dipping in SBF; however, compressive strength was changed remarkably following intramuscular implantation. The results demonstrated that PCHC characterized by immobilization in situ and mechanical supporting. Thus it could be used for one kind of bone substitute material to repair the bone defect.

Objective To define the indications and evaluate the results of various surgical treatment options in patients with nonparasitic hepatic cysts. Methods The clinical data of 284 patients with nonparasitic hepatic cysts treated in our hospital from January 1995 to December 2005 were retrospectively analyzed. Results Percutaneous aspiration and sclerotherapy were performed in 161 cases and complications occurred in 9 (5.59%), recurrence in 53 (32.92%) and the mortality was 0%.Open surgery was conducted in 71 cases and the complications occurred in 16 (22.54%), recurrence in 8 cases (11.27%) and the mortality was 2.82%. Laparoscopic surgery was employed in 52 cases and complications occurred in 7 ( 13.46%), recurrence in 6 (11.54%) and the mortality was 1.92%.Conclusion There is currently no general agreement in the literature concerning when nonparasitic hepatic cysts should be treated. Laparoscopic surgery was more favorable than other therapeutic options.However, we should choose individually suitable methods according to different clinical symptom of patients.

Objective To observe the effect of combined therapy of external point application and herbal concentrate-granules on patients with asthma (hot wheezing in TCM).Methods 60 patients suffering from onset period of bronchial asthma were randomized to a control group and a treatment group.The control group was given budesonide inhaler and theophylline sustained release tablets.The treatment group was given combined therapy of external point application and herbal concentrate-granules.The course of treatment was 10 days.To observe the value ofFEV1％,ACT scores and TCM syndrome scores etc.Results After treatment,the value of FEV 1％ [treatment group:(82.83 ± 11.35) ％,control group:(83.85 ± 16.72) ％] and ACT [treatment group:(19.86±2.32),control group:(19.66±2.54)] in both groups were markedly increased with statistical significance (P＜0.01); and the difference between the two groups were also significant; TCM syndrome scoring [treatment group:(4.27±3.65),control group:(5.05±4.14)] was notably decreased in both groups compared with the values before the treatment with statistical significance (P＜0.01); but the difference between the two groups was not significant (P＞0.05).Conclusion The combined therapy of external point application and herbal concentrate-granules can treat bronchial asthma in the acute clinical course and improve lung function.

In order to culture the qualified clinicians, we should think about how to improve the quality of clinical practice of obstetrics and gynecology. It is of great importance to emphasize the teachers and students to value the teaching work together. Importance should be attached to the advantage of subject of academy, to make the clinical practice closer to practical, which has a perfect effect and will benefit our work.

Objective To detect the mRNA and protein expression of downstream quinine nicotinamide adenine dinucleotide (NADH) dehydrogenase 1 (NQO1) and heme oxygenase 1 (HO-1) induced by blood nuclearrelated factor E2 (Nrf2) in the peripheral blood of those exposed to arsenic in the endemic area of coal arsenic poisoning in Guizhou Province,and to discuss its role in the process of occurrence and development of liver injury due to coal arsenic poisoning.Methods Jiaole and Changqing villages in coal-burning-borne arsenism areas in Xingren County of Guizhou were selected as the survey sites,and 161 cases of arsenic-exposed residents were selected as the arsenic exposed group based on physical examination.They were divided into non-patient group (21 cases) and patient group (140 cases) according to the Diagnostic Criteria of Endemic Arsenism (WS/T 211-2001),and the patient group was further divided into mild hepatosis group (52 cases),moderately severe hepatosis group (36 cases) and non-apparent hepatosis group (52 cases) according to the Diagnostic Criteria of Occupational Chronic (GBZ 59-2010).Moreover,45 residents from one village neighboring to non-epidemic area were selected as controls.Peripheral blood samples were collected from all subjects.And mRNA expression of NQO1 and HO-1 were detected by RT-qPCR.Content of NQQ1 and HO-1 were detected by enzyme linked immunosorbent assay (ELISA).Results (①)Results of mRNA expression of NQ01 and HO-1:the relative expression level of mRNA of NQO1 and HO-1 in peripheral blood went up gradually as the degree of liver injury of population exposed to arsenic increased (F =5.548,10.961,all P ＜ 0.05);thereinto,the relative expression level of mRNA of NQO1 of mild hepatosis group (median:0.918) was higher than that of the control group (0.576,P ＜ 0.05),the relative expression level of mRNA of NQO1 of moderately severe hepatosis group (1.243) was higher than those of control group,non-patient group (0.653),non-apparent hepatosis group (0.636) and mild hepatosis group (all P ＜ 0.05);the relative expression level of mRNA of HO-1 of non-patient group (1.059),non-apparent hepatosis group (1.225),mild hepatosis group (1.553) and moderately severe hepatosis group (1.604) were higher than that of control group (0.767,all P ＜ 0.05);the relative expression level of mRNA of HO-1 of mild hepatosis group was higher than that of non-patient group (P ＜ 0.05);the relative expression level of mRNA of HO-1 of moderately severe hepatosis group was higher than those of non-patient group and non-apparent hepatosis group (all P ＜ 0.05).②)Results of protein expression of NQO-1 and HO-1:the level of protein expression of NQO1 and HO-1 in serum went up gradually as the degree of liver injury of population exposed to arsenic increased (F =19.685,17.725,all P ＜ 0.05).Thereinto,the protein expression of NQO1 and HO-1 of non-apparent hepatosis group,mild hepatosis group and moderately severe hepatosis group [NQO1:(6.272 ± 0.744),(6.336 ± 0.628),(6.714 ± 0.540) U/L;HO-1:(45.150 ± 4.813),(45.283 ± 5.049),(48.610 ± 5.365) U/L] were higher than those of control group and non-patient group [NQO1:(5.550 ± 0.730),(5.750 ± 0.427) U/L;HO-1:(39.856 ± 5.249),(42.375 ± 3.014) U/L,all P ＜ 0.05],the protein expression of NQO1 and HO-1 of moderately severe hepatosis group were higher than those of non-apparent hepatosis group and mild hepatosis group (all P ＜ 0.05).Conclusion The expression of mRNA and protein of NQO1 and HO-1 is closely related to the occurrence and development of liver injury due to arsenic exposure in coal arsenic poisoning areas.