Objective To observe the treatment effect of renal function and blood pressure in patient with blood pressure morning surge.Methods 34 patients take levoamlodipine 2.5 mg/q orally.35 patients take Fosinopril 10 mg/q orally.35 patients take Fosinopril lOmg/q and levoamlodipine 2.5 mg/q orally,continuing 12 months. Blood pressure,urinary albumin excretory rate,scrllm creatinine,urinary creatinine and calculated creatinine clearance at base line were measured.Results Blood pressure (P<0.01) and urinary albumin excretory rate (P<0.01) were decreased by compare to pretherapy in three groups.Post-treatment,urinary albumin excretory rate was reduced from 103.8±44.2 to (84.6±37.5)μg/min in the first group,from 102.9±45.4 to(82.7±38.4)μg/min in the second group,and from 109.8±40.5 to(51.2±40.1)μg/min in the last group.The difference for urinary albumin excretory rate was significant between prior treatment and post-treatment in every group (P<0.05).It is the same between the first group and the second.The difference for urinary albumin excretory rate was significant between the first group and the third group (P<0.01).The difference was significant between the second groud and the third group (P<0.01).Post-treatment,calculated creatinine clearance rate was increased from 84.6±7.4 to 88.2±7.1 in the first group,from 81.4±2.5 to 84.5±4.2 in the second group,and from 79.1±6.8 to 109.6±16.1 in the last group.The difference for calculated creatinine clearance rate was significant between prior treatment and post-treatment in the third group (P<0.01).Conclusion Blood pressure (P<0.01) and urinary albumin excretory rate were decreased by three methods.Three methods all protect renal function,and the third method is the best.

Objective To explore and analysis feasibility of the prevention of edaravone on myocardial ischemia after beating cor-onary artery bypass grafting .Methods From June 2011 to December 2012 ,78 patients which accepted beating heart coronary artery bypass grafting were randomly divided into treatment group (39 cases) and control group(39 cases) .After induction of anesthesia , the treatment group were continued to intravenous edaravone 60 mg ,while the control group were continued infusion of equivalent saline .The serum superoxide dismutase(SOD) ,malondialdehyde(MDA) levels were compared between the two groups at different times which were before surgery (T1) ,after incision 1 h(T2) ,surgery (T3) ,and after 24 h(T4) ,plasma brain natriuretic peptide (BNP) ,troponin I(cTnI) levels were compared at T1 and T4 .Left ventricular ejection fraction(LVEF) were also be compared .Re-sults The two groups of patients before treatment ,there were not statistically significant difference between the two groups on SOD ,MDA ,CK-MB ,BNP and cTnI(P> 0 .05) .At T2 ,T3 ,T4 point ,the SOD activity of the treatment group was significantly higher than that of control group(P<0 .05) .The MDA ,CK-MB value were significantly lower than that of control group (P<0 . 05) .At T4 ,the BNP and cTnI in the treatment group were less than that of control group (P<0 .05) .The postoperative LVEF% in treatment group were significantly higher than that of control group (P<0 .05) .Postoperative ventilator treatment time and ICU stay time and total hospitalization time of the treatment group were all significantly less than that of control group (P<0 .05) .Con-clusion For the beating heart coronary artery bypass surgery patients ,edaravone can effectively scavenge oxygen free radicals and reduce the release of enzymes ,reduce injury caused by myocardial ischemia-reperfusion and protect myocardial cells .

Objective To test serum differentially expressed proteins between early-stage (stage IB-ⅢA) and late-stage (stage Ⅳ) lung cancer patients by proteinchip technology and investigate its clinical value. Methods SELDI-TOF-MS and WCX-2 protein chip were used to detect the serum protein of 30 cases of early stage lung cancer patients and 30 cases of late stage lung cancer patients. The data were analyzed by using Biomarker Wizard software. Results There are ten different proteins in the serum between the two groups of lung cancer patients. Four protein markers 7978, 8139, 15 951 and 16 133 are over expressed and seven protein markers 2867, 6885, 8701, 8840, 13 781 and 13 955 are low expressed in the late group. Conclusion SELDI-TOF-MS proteinchip technology is a convenient, sensitive and high-throughput analysis method which can screen several relatively specific protein markers for late stage lung cancer from the serum samples. This selected protein markers can predict metastasis of lung cancer patients.

Objective To study the relationship between expression of matrix metalloproteinases-7 (MMP-7) and clinicopathological characteristics in patients with primary non-smaU cell lung cancer(NSCLC). Methods MMP-7 in 20 normal people and 60 advanced NSCLC patiens were detected with reverse-transcription-polymerase-chain-reaction. Gelatum image analysator analyzed the result. Results The amount of MMP-7 was less in normal people (30.000) than in NSCLC patients(41.231) significantly(P<0.05); the level of MMP-7 was no correlated with gender, age, pathology pattern, tumor size, was inverse correlation with differentiation, and was positive correlation with clinical stages(P <0.05). Conclusion The level of MMP-7 is closely correlated with tissue differentiation and clinical stages of NSCLC, which may serve as a parameter for determining tumor invasion and metastatic.

BACKGROUND: Craniocerebral injury can cause a series of visceral complications, among which cardiovascular complication is paid special attention.OBJECTIVE: To investigate the effects of craniocerebral injury on changes of circulatory and local angiotensin Ⅱ (Ang Ⅱ ) and local angiotensin Ⅱ receptor 1 (AT1) in the heart.DESIGN: Randomized controlled experiment taking animals as subjects.SETTING: Beijing Tiantan Hospital, and the College of Basic Medicine,Capital University of Medical Sciences.MATERIALS: The experiment was conducted at the Central Laboratory of Capital University of Medical Sciences and the Central Laboratory of Beijing Tiantan Hospital from 2003 to 2004. Totally 40 healthy male Wistar rats were divided randomly into craniocerebral injury group and control group with 20 in each group.METHODS: Rats in craniocerebral injury group were treated with weightdrop method to establish the model of craniocerebral injury, while rats in control group received no impact. Twenty-four hours after hitting, 10 rats in each group were selected to assay their Ang Ⅱ and AT1; the other 10 in each group were selected to observe their myocardial forms.myocardium of rats assayed with light microscope after hematoxylin-eosin staining and transmission electron microscope.It was significantly higher in craniocerebral injury group than in control ity: It was obviously higher in craniocerebral injury group than in control Ⅱ and AT1: The area of positive reactant and gray value in craniocerebral toxylin-eosin staining: Strong acidophil staining was found on myocardial cellular plasma in craniocerebral injury group. The results showed that cytoplasm shrank obviously; muscle fiber broke, decreased or disappeared.Focal hydropic degeneration, lysis or necrosis was observed in myocardium.Ultrastructural pathological observation revealed pathological damage of myocardium.CONCLUSION: Craniocerebral injury in rats can cause myocardial damage, and changes of angiotensin system may be one of the factors.

Objective To evaluate the efficacy and drug-related toxicities of pemetrexed disodium in the treatment of advanced pulmonary adenocarcinoma.Methods A total of 41 patients who had received pemetrexed disodium and cisplatin therapy were retrospectively reviewed.The patients were given respectively pemetrexed disodium (500 mg/m2,1st day) and cisplatin (200 mg/m2,1-4 day) until disease progressed.The clinical outcomes and adverse reactions were observed.Results The CR rate was 7.3 ％ (3/41),PR rate was 22.0 ％ (9/41),SD rate was 31.7 ％ (13/41),PD rate was 39.0 ％ (16/41),the DRR was 29.3 ％ (12/41),DCR rate was 61.0 ％ (25/41),the median PFS was 5 months.The age,sex,smoking history,staging and timing of treatment had not the statistics difference on ORR and DCR.The sex,smoking history,staging and timing of treatment had not the statistical difference on PFS (P ＞ 0.05).The main toxicities were fatigue,nausea,vomiting and myelosuppression.Conclusion The pemetrexed disodium and cisplatin are feasible and welltolerated for advanced pulmonary adenocarcinoma patients.

Objective To investigate the value of detecting peripheral blood epidermal growth factor receptor (EGFR) gene in predicting the therapeutic efficacy of advanced non-small cell lung cancer. Methods A total of 150 patients with stage ⅢA-Ⅳ non-small cell lung cancer diagnosed in Shanxi Provincial Cancer Hospital from October 2013 to February 2015 were collected. The peripheral blood EGFR gene was detected by amplification refractory mutation system (ARMS). The relationship between the mutation rate and the clinicopathological features of patients was observed, and 80 patients were selected into the follow-up treatment according to the inclusion criteria. Forty patients (all 19 or 21 exon mutations) in group A with EGFR gene mutation were treated with gefitinib orally. Forty patients with wild type EGFR gene in group B underwent 4 cycles of NP regimen. Efficacy and progression-free survival were evaluated in both groups. Results The mutation rate of EGFR gene was 33.3 ％ (50 cases), of which 29 were exon 19, 18 were exon 21 and 3 were exon 18 and 20. The mutation rate of EGFR gene was higher in female, adenocarcinoma and non-smoker (all P<0.05). Among the 80 patients who received follow-up treatment, the effective rate [67.5％(27/40) vs. 32.5 ％ (13/40)] and disease control rate [85.0 ％ (34/40) vs. 65.0 ％ (26/40)] in group A were significantly higher than those in group B, and the median PFS was prolonged (9.00 months vs. 4.25 months),the differences were statistically significant (χ2=9.800, P=0.002;χ2=4.267, P=0.039;χ2= 15.792, P<0.001). Conclusion The detection of peripheral blood EGFR mutation can be used to predict the efficacy of tyrosine kinase inhibitors in non-small cell lung cancer.

Objective To evaluate the effect of dexmedetomidine on Toll-like receptor 4 ( TLR4)/myeloid differentiation factor 88 ( MyD88)/nuclear factor Kappa B ( NF-κB) signaling pathway in the pe-ripheral blood mononuclear cells of elderly patients with diabetes mellitus undergoing lower extremity surger-y. Methods Forty elderly patients of both sexes with type 2 diabetes mellitus, aged 65-80 yr, with body mass index of 18. 5-27. 9 kg/m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with New York Heart Association Ⅰ or Ⅱ, undergoing lower extremity surgery with tourniquets under general anesthesia, were divided into 2 groups ( n=20 each) by using a random number table method: control group ( group C) and dexmedetomidine group ( group D) . Combined intravenous-inhalational anesthesia was applied. Dexmedetomidine was infused over 15 min in a dose of 1μg/kg after induction of anesthesia, fol-lowed by a continuous infusion of 0. 5 μg·kg-1 ·h-1 until the end of surgery in group D, while the equal volume of normal saline was given instead of dexmedetomidine in group C. Before using the the tourniquet and at 15 min, 1 h and 24 h after loosing the tourniquet, arterial blood samples were collected for determi-nation of the expression of TLR4, NF-κB and MyD88 in peripheral blood mononuclear cells and concentra-tions of tumor necrosis factor-alpha ( TNF-α) , interleukin-1β ( IL-1β) , cardiac troponin I ( cTnI ) and creatine kinase-MB ( CK-MB) in plasma. Results Compared with group C, the expression of TLR4, NF-κB and MyD88 in peripheral blood mononuclear cells was significantly down-regulated, and the concentra-tions of TNF-α, IL-1β, cTnI and CK-MB in plasma were decreased at each time point after loosing the tourniquet in group D ( P＜0. 05) . Conclusion The mechanism by which dexmedetomidine reduces myo-cardial damage may be related to inhibiting TLR4/MyD88/NF-κB signaling pathway and reducing systemic inflammatory responses in elderly patients with diabetes mellitus undergoing lower extremity surgery.