Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Female ; Humans ; Injury Severity Score ; Male ; Maxillofacial Injuries ; epidemiology ; physiopathology ; prevention & control ; Young Adult

The 2010 Chinese guidelines for the management of hypertension is an update of the previous versions in 2005 and 1999. A guideline committee of nearly 100 members appointed by the Chinese Hypertension League (CHL) and the National Centre for Cardiovascular Disease (NCCD), in collaboration with the Chinese societies of cardiology, nephrology, neurology, gynecology and endocrinology, convened on several occasions and discussed the guidelines, drafted by a core writing group. The prevalence of hypertension has been increasing in China for decades, and reached 18.8% in the year 2002. The rates of awareness, treatment and control for hypertension patients remain low compared to high income countries, in spite of substantial improvements since 1991. In some communities, the control rate of hypertension increased up to 60%. The mortality rate of stroke, which is the major complication of hypertension in the Chinese population, gradually decreased during the period, more so in urban areas than in rural areas for the middle-aged and elderly populations; in the younger age groups, however, it increased. As hypertension is a "cardiovascular syndrome", the management strategy should be based on the overall risk of cardiovascular disease estimated with all related risk factors, target organ damage and co-morbidity of patients. The target blood pressure is set at SBP/DBP < 140/90 mm Hg (1 mm Hg = 0. 133 kPa) in uncomplicated hypertension; < 150/90 mm Hg for the elderly (> or = 65 years) or, if tolerable, < 140/90 mm Hg; and < 130/80 mm Hg for those with diabetes, coronary heart disease or renal disease. For these high risk patients, the management should be individualised. In general, lifestyle modification, such as sodium restriction, smoking cessation, moderation of body weight and alcohol consumption, and increasing dietary potassium intake and physical activity, should be implemented for prevention and control of hypertension. Five classes of antihypertensive drugs, including calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin type II receptor blockers, diuretics and beta-blockers, as well as single pill combinations of these agents, can be used for initial and maintenance of antihypertensive treatment. Several populations require special attention in the prevention and control of hypertension, such as children and adolescents, the elderly, pregnant women, and patients with various cardiovascular complications. Since health-care policies and resources vary substantially from one place to another, two levels of recommendations of management are proposed: a sophisticated and a basic, allowing doctors-in-charge to manage their patients in a more feasible way.
China ; Humans ; Hypertension ; prevention & control

Electromyography ; Electrophysiology ; Genetic Testing ; Humans ; Neuromuscular Diseases ; diagnosis ; genetics

Objective To study the expression of connexin (Cx) genes and the effects of a variety of inducers on the expression changes of Cx and mutations of Cx coding sequences in human gastric cancer. Methods Northern Blot, RT PCR and PCR single strand conformational polymorphism were used. Results 1.There were regular expression patterns of Cx genes in human normal gastric epithelium, paracancerous tissues and gastric cancers. 2.RA and DMSO can induce the expression of Cx43 in gastric cancer and decrease of Cx46 expression by RA and TPA induction. 3.There was no any mutation in Cx43 coding sequences. Conclusion 1.Cx32 gene may be a specific gene in genome of gastric epithelium constructing gap junctional intercellular communication. 2.Cx43 is a inducible gene in gastric cancer cells. 3.The down regulation of Cx43 expression is not caused by mutation of Cx coding sequences in human gastric cancers. 4.The authors proposed a hypothesis on the variation of expression of Cx genes in human gastric cancer.

Objective To evaluate the methods and outcome of laparoscopic degradable bio-patch repair of umbilical hernia in adults. Methods From January 2003 to October 2008, 21 adult patients underwent elective laparoscopic patch repair of umbilical hernia. There were 15 women and 6 men. The mean age was 56 years old (range of 36-73). The diameter of hernia ring was from 3 to 7.5 cm averaging at 5.2 cm. All patients received general anesthesia. Preoperative bowel preparation routinely started one day before the operation. The patients received prophylaxis systemic antibiotics 30 minutes before the operation. An appropriate size of prosthetic patch (Composix E/X, Bard, USA) was that extended the defect margin for about 3-5 cm. The mesh was then inserted into the peritoneal cavity and spreaded flattening, with the polyplypylene side facing outside and it's center coinciding with that of the defect. The mesh was fixed to the abdominal wall with staple tacks in two rings, which was 3-5 cm along the hernia ring and 1-2 cm along the edge of the mesh. Results There was no conversion to open repair. The operative time was 30 to 96 rain and the average was 52 min. Two patients suffered from a transient postoperative tympanites and which subsided 2 to 3 days after the operation. One patient had a severe pain in the repair area around the umbilical and underwent oral medicine treatment, which disappeared one week after operation. There was no seroma and incision or mesh infection occurred. The postoperative hospital stay was 3 to 8 days and the average was 4. 2 days. The follow-up time was 3 months to 5 years and the average was 32 months. No ileus or hernia recurrence during the follow-up. Conclusion Laparoscopic patch repair of umbilical hernia in adults is a safe and effective procedure.

Objective To evaluate the effects of anterior approach preperitoneal repair for inguinal hernia with modified Kugel mesh.Methods Clinical data of 35 cases receiving inguinal hernia repair with modified Kugel mesh from May 2004 to June 2006 were reviewed.The critical surgical procedures:the hernial sac was dissected at high position,then reversed and reduced into abdominal cavity;a 10 cm?10 cm preperitoneal space was dissociated around the internal ring,into which a modified Kugel mesh was placed.The mesh was fixed to the conjoined tendon by superior tape,and to the shelving edge of inguinal ligament by inferior tape.Results The operation time was(47?10)min.No analgesic requirement in any case.The postoperative hospital stay was(6?4)days.All the wounds healed uneventfully without any seroma or infection.No recurrent case was found in the follow-up of 1-25 months(mean:13.2 months)in the 35 cases.Conclusions Modified Kugel mesh used in inguinal herniorrhaphy causes less pain and swelling response to the wound,therefore it is quite suitable for repairing Ⅲ and Ⅳ type hernia.

Objective To evaluate the therapeutic effectiveness of echo-guided percutaneous radiofrequency ablation(RFA) by using a LeVeen needle electrode combination in the treatment of large liver tumor,and to discuss the relationship between the amount as well as the distribution pattern of the electrodes and the therapeutic effectiveness.Methods During the period of Feb.2006-Dec.2008,echo-guided RFA was performed in 113 patients with large and unresectable liver tumor,with a total of 118 lesions.According to the size of the tumor,the patients were divided into four groups.The tumor’s diameter of Group A(n = 64) was 4.0-5.0 cm,Group B(n = 28) was 5.1-6.0 cm,Group C(n = 11) was 6.1-7.0 cm and Group D(n = 10) was 7.1-9.3 cm.Based on the tumor’s diameter,the amount of the electrodes to be used and the sites to be ablated were determined.After the procedure,the follow-up checks with MRI or CT scanning were carried out to observe the necrotic extent and the local recurrence.Results Two months after the treatment,the complete necrosis rate of the tumor in Group A,B,C and D was 88.4%,78.6%,63.6% and 40.0%,respectively,with an overall necrosis rate of 79.7% in total 118 lesions.During a follow-up period of 3-36 months,the local recurrence rate in Group A,B,C and D was 5.5%,10.0%,28.6% and 50.0%,respectively.Severe complications,including intrahepatic infection(n = 2),puncture passage bleeding(n = 1),symptomatic pleural effusion(n = 4) and biloma(n = 2),occurred in 9 cases.No death related to RFA treatment occurred.Conclusion Echo-guided percutaneous radiofrequency ablation by means of multi-sites superimposition method with a LeVeen needle electrode combination is an safe and effective therapy for the hepatic tumors with the diameter over 4 cm.

Objective To study the effects of lovastatin in the therapy of primary hypercholesterolemia on insulin sensitivity,vascular endothelial function and microcirculation in patients with coronary heart disease.Methods Forty-five patients,diagnosed as coronary heart disease and primary hypercholesterolemia,were treated by lovastatin for 8 weeks.Serum lipids,fasting plasma glucose (FPG),fasting insulin(FINS),nitric oxide(NO),endothelin(ET),6-keto-prostacyclin F 1?(6-keto-PGF 1?),thromboxane B 2(TXB 2) and nail-fold microcirculation (NFM) were measured and the score value of NFM and insulin sensitivity(IS) index were calculated in treatment group before and after 4-week and 8-week treatment with lovastatin.Forty healthy persons were taken as control.Results In treatment group,ET,TXB 2,and the score value of NFM were higher and NO,6-keto-PGF 1? and IS index were lower than those in control group.After 4-week lovastatin treatment,compared with baseline value,ET,TXB 2,and the score value of NFM significantly decreased,which were 63.19?18.72 vs 53.16?15.23 (P

The effects of ketotifen, cimetidine & erythromycin on thebphy-lline pharmacokinetics in rabbits were studied. The results suggested that the elimination half-life of theophylline decresed from 2.74 ? 0.75 to 2.33 ? 0.56 h & the clearance of theophylline increased from 0.15?0.036 to 0.13 ? 0.047 1/kg?h-1 by ketotifen.The elimination half-life of theophylline increased from 2 .08 ? 0.33 to 2.6l?0.45 h & the clearance decreased from 0.2l?0.03 to 0.16?0.03 1/kg?h-1 by cimetidine.The elimination half-life of theophylline increased from 2.39 ? 0.43 to 3.54?0.89 h & the clearance decreased from 0.15?0.03 to 0.12?0.03 1/kg?h-1 by erythromycin.

Objective To evaluate the safety、feasibility and the long-term effectiveness of polyurethane stent placement for treatment of nasolacrimal duct obstruction. Methods Fifty-three cases (64 eyes) with complete nasolacrimal duct obstruction received the lacrimal stent placement. Dacryocystography was performed before and after the procedure. The average follow-up period was 48.3 months (range, 13-78months), the long-term patency and the effectiveness after stents removal were analyzed. Results Stent placement was technically successful in 62eyes, and the success rate was 96.9% with no severe complications. On long-term follow up, the stent patency rate was 76.8% at 1 year. However, it decreased to 33.3% at 3 years and 28.6% at 5 years. Nine stents were removed when the symptoms recurred, including granulation tissue in 4 stents and mucous material in 5. After removal, 2 nasolacrimal ducts were patent, and 2 kept patent after stents replacement, but all reoccluded within 6 months. Conclusions Interventional placement of polyurethane stent in the obstructed nasolacrimal duct is a simple and safe outpatient procedure, but the long-term patency is not encouraging, and the right stent removal time has not yet been approved.