Objective To investigate the effect of valsartan and amlodipine on urinary microalbumin in elderly hypertensive patients. Methods 100 elderly patients with hypertension treated in our hospital from May 2015 to October 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The patients in the control group received oral valsartan, and the patients in the experimental group were treated with valsartan and amlodipine. The treatment time of the experimental group and the control group was 12 weeks. The clinical indexes of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the experimental group and the control group did not have obvious adverse reactions. There were 2 cases of headache in the experimental group, 1 cases of vertigo, and 2 cases of vertigo in the control group. However, there was no significant difference in the incidence of adverse reactions between the experimental group and the control group, and there was no statistical significance. The antihypertensive effect of the experimental group was significantly higher than that of the control group, with statistical significance (P<0.05). After treatment, the urinary microalbumin in the experimental group and the control group was significantly lower than that in the treatment group, and the level of microalbuminuria in the experimental group was lower than that in the control group, with statistical significance (P<0.05). Conclusion The clinical effect of treatment of elderly patients with hypertension better combined with valsartan and amlodipine, antihypertensive effect is stronger, can significantly improve the patient's urinary albumin, with further clinical promotion and application significance.

To investigate the effect of Yisui Jiedu Recipe (YSJDR), a compound traditional Chinese herbal medicine, on cytokines and their corresponding just another kinase 2-signal transducers and activators of transcription 5 (JAK2-STAT5) signal transduction pathway in bone marrow hematopoietic cells from patients with myelodysplastic syndrome-refractory anemia (MDS-RA).

Objective To summarize and learn the biological properties and clinical features of interdigitating dendritic cell sarcomas (IDCS).Methods The first IDCS patient concurrent with acute myelomonocytic leukemia (AML-M4) described herein,to our knowledge,was studied and 62 IDCS cases reported previously in the literature were reviewed.Results The patient had a history of breast cancer as well as radiotherapy and chemotherapy of it,and the patient showed poor response to 4 cycles of sequential chemocherapy regimens.Based on the laboratory results,IDCS and AML-M4 in this patient were both of myelogenous origination.Furthermore,review of the 62 IDCS patients reported previously showed that as high as 17 ％ of the patients had malignant disease and received radiotherapy or chemotherapy before they got IDCS,and patients of this group had worse prognosis compared with counterpart.Conclusion IDCS has poor prognosis,and therapy-related type worse.Prophylactic measures and stringent screening of the second cancer in those who received chemoterapy or radiotherapy are appropriated and necessary.

Objective To summarize the diagnostic and therapeutic experience of a patient with chronic graft versus host disease (cGVHD) related polymyositis (PM) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods A patient with acute lymphocytic leukemia in com- plete remission received sibling allo-HSCT,and cyclosporine and methotrexate were adopted to pre- vent GVHD.Results Eleven days after HSCT,WBC＞0.5?10~9/L,13 days after HSCT,PLT＞20?10~9/L;27 days after HSCT,chromosome analysis of bone marrow cells showed 99% donor type. Seventeen days after HSCT,Ⅰ~0 acute GVHD of skin occurred,and it was cured by intravenous injec- tion of dexamethasone and methotrexate.Eight months after HSCT,cGVHD of liver happened.Al- though treated by tacrolimus and azathioprine,enzymes of liver were still elevated.At last,tacrolimus combined with sirolimus were used,and enzymes of liver subsided gradually.However,the serum creatine phosphokinase (CK) began to rise from 9 U/L to 3010 U/L,and fatigue all over the patient occurred.Finally,the symptom relapsed,and disability involved with the origin of limbs appeared. The electromyogram and magnetic resonance imaging of concerned muscles confirmed the PM diagno- sis.Although treated with methylprednisolone and plasma exchange,the patient died due to asphyxia, while the CK as high as 21 010 U/L.Conclusion PM is a rare kind of manifestations of cGVHD. When the key muscle tissue was involved,the prognosis is poor.

Objective To analyze the frail status and influencing factors of inpatients in geriatrics department.Methods A total of 170 patients aged ≥ 65 years in Geriatrics Department in our hospital were selected.Frailty was defined according to the Clinical Frailty Scale (CFS),and patients were divided into non-frail group and frail group.The differences in comorbidity,physical function,nutrition,cognitive,psychological,geriatrics syndromes,medication,social support and other aspects were analyzed between the two groups by using Comprehensive Geriatrics Assessment(CGA),and correlationof the factors with frailty was evaluated.Results There were 83 (49.0％)patients in frail group and 87 (51.0％)in non-frail group.In frail group versus non-frail group,Charlson comorbidity index was(2.7±2.0)vs.(1.9±1.1),and cumulative illness rating scale was(10.8±3.7) vs.(8.0±2.6) (all P＜0.05);mini-nutrition assessment was(11.2±2.3)vs.(13.0±1.3),and simple cognitive score was(2.7±1.3)vs.(4.1±0.9)(all P＜0.05).Grip,five chair rising,timed get-up and go test,walking speed,SPPB showed statistically significant differences (all P＜ 0.05) between frail group and non-frail group:(20.7±6.6)kg vs.(27.96.7)kg,(30.4±17.5)vs.(12.9±4.1),(23.7± 9.9)vs.(11.7± 3.3),(0.5 ± 0.2)m/s vs.(0.9± 0.2)m/s,(5.6 ± 2.3) vs.(10.3±1.8)respectively.The incidences of incontinence,visual impairment,hearing impairment,sleeping disorder,oral problems,chronic pain,anxiety or depression and fall history were higher in frail patients than in non-frail patients.Living alone,the widowed,nursing staff employment proportion were higher in frail group than in non-frail group.Level of education was lower in frail group than non-frail group.Logistic regression analysis showed that BMI,the walking speed and the number of geriatrics syndromes had a significant impact on frailty(OR=0.789,0.000,2.745,all P＜0.05).Conclusions Incidence rate of frailty in elderly hospitalized patients is high.To identify frailty of hospitalized patients,comprehensive geriatric assessment can be used for understanding frail characteristics and its influencing factors for hospitalized old patients,so as to provide evidence for the reasonable treatment programs.

ObjectiveTo explore the procedures and methods for genetic diagnosis in one nonsyndromic variants of congenital neutropenia (NSVCN) patient and its pathogenic mutation.Methods Genomic DNA was prepared from one NSVCN patient who had progressed to chronic myelomonocytic leukemia and ELA2,HAX1,WASp and GFI1 genes were amplified and sequenced.Results A novel compound heterogeneous mutation consisting of two frame-shift mutations (c.430-1insG and c.655- 9del5bp) was found in HAX1 gene.ConclusionA practically genetic diagnosis procedure for NSVCN has been established,and the novel HAX1 gene mutation may contribute to the etiology of NSVCN.

Objective:To investigate the effects of chronic anger stress on rats' aging process and the mechanism of the neuroendocrine-immune network. Methods:After the aging and brain aging rats induced by D-galactose(D-gal) were stimulated by anger, observation of the effects of chronic anger stress on the rats' spatial learning and memory was made, the contents of norepinephrine(NE), 5-hydroxytryptamine(5-HT)in brain tissue and serum, the levels of adrenocorticotropic hormone (CORT) in serum were assayed, the spleen index was measured. Results:Compared with the D-gal group, in the D-gal group stimulated by anger, the rats' ability of spatial learning and memory declined, the contents of NE in brain tissue and serum increased, the contents of 5-HT declined, the levels of CORT in serum increased, and the spleen index declined. Conclusion: The rats' aging and brain aging were aggravated and the aging process were accelerated by chronic anger stress. The possible mechanism were the sustained excitability of the HPA axis and SAS, disturbances of neuroendocrine system and immunological function repression.

Objective To obtain and anlysis the diffuse idiopathic skeletal hyperostosis(DISH) related miRNAs under 3-D adhesion for cell culture.Methods From January 2012 to January 2014,4 ossific ligamenta flava tissues were obtained from DISH patients and 4 normal ligamenta flava tissues were obtained from trauma patients surgically.Fibroblasts were separated by using collagenase technique and then cultured on human acellular amniotic membrane (HAAM).Each sample was identified by immunofluorescence before harvested.Total RNA was extracted and then quantified by microfluidics analysis.The small RNAs (＜300 nt) were isolated by using a YM-100 Microcon centrifugal filter.μParafloTM MiRNA microarray assay was performed using a service provider to identify miRNAs whose expression was significantly different between the two groups.Part of differential expression miRNAs were verified by qRT-PCR.Targets of miRNAs were obtained using PicTar 2005,miRanda v5,TargetScan 5.1,their function were analyzed by using Gene Ontology.Functional pathway analysis of miRNAs was performed using KEGG Pathway Analysis.TRANSFAC 7.0 public and Patser were used to get the distribution of transcription factor binding sites.Results When grown on HAAM,fibroblasts kept their morphology,distributed in the way of cluster,lived in multi-level of HAAM,and established linkage.Collagen Ⅰ and Ⅲ were tested positive in normal group cells.Collagen Ⅰ,Ⅱ,Ⅲ and Osteocalcin were tested positive in DISH group cells by immunefluorescence.In total 15 miRNAs showed differential expression,12 were up-regulated and 3 were down-regulated.The result of qRT-PCR was consistent with MiRNA microarray assay.Totally 67 target genes were predicted which participated in cell differentiation,cell adhesion,mineralization et al,and had function in regulating MAPK,Wnt,TGF-β,Focal adhesion signal pathway et al.In total 10 transcription factors were predicted in differentially expressed miRNAs.Conclusion HAAM can provide fibroblasts with 3D adhesion growth,Some differentially expressed miRNAs may participate in the pathogenesis of DISH.

Objective To investigate the frequency of c-kit mutation and prognosis in t (8;21) acute myeloid leukemia (AML) patients with trisomy 4. Methods A total of 145 de novo t(8;21) AML patients from February 2005 to January 2013 were analyzed retrospectively. Detection of exons 8 and 17 mutation of c-kit by PCR and cytogenetic analysis by R-banding technologies were performed on bone marrow samples of all patients at diagnosis. Clinical data were collected and analyzed statistically. Results Among 145 t (8;21) AML patients, 12 cases (8.3 %) were trisomy 4, 91.7 % (11/12) of them were identified with c-kit mutation, which was significantly higher than that without trisomy 4 [26.3 % (35/133), P< 0.01]. The follow-up data showed that the patients with trisomy 4 were correlated with the lower overall survival (OS) rate (15 % vs 56 %, P< 0.01) and disease-free survival (DFS) rate (0 vs 51 %, P< 0.01) when compared with patients without trisomy 4. Furthermore, the subgroup of patients with both trisomy 4 and c-kit mutation had a worse OS and DFS (P< 0.05). Conclusions Trisomy 4 is associated with high frequency of c-kit mutation and demonstrates poor prognosis in t(8;21) AML patients. Trisomy 4 or it combined with c-kit gene mutation is the main influencing factor on the survival of the patients with t(8;21) AML.

Objective: To observe whether an Xingnaojing 醒脑静 injection could improve the prognosis of patients, by increasing rifampicin penetration through the blood-brain barrier. Methods: Patients with severe tuberculous meningitis were enrolled in this study. The concentrations of Xingnaojing in cerebrospinal fluid and blood in patients treated with Xingnaojing and control were determined by high performance liquid chromatography. The changes in cerebrospinal fluid and the improvement of clinical symptoms and signs, were evaluated two weeks after admission. The long-term prognosis of the patients in the two groups were evaluated by the Glasgow Outcome Scale (GOS). Results: The concentration of rifampicin in cerebrospinal fluid was significantly higher in the Xingnaojing group (1.77±0.17 μg/mL), than in the control group (1.27±0.16 μg/mL, p<0.05). The difference in concentration of rifampicin in the blood was not significant (P>0.05). The short-term effective rate of the Xingnaojing group was 92.5% (37/40), which was significantly higher than that of the control group (80%, 32/40, p<0.05). After 6 months, 75% (30/40) of the Xingnaojing group had good prognosis according to the GOS score, whereas that of the control group was 50% (20/40) showing significantly better long-term treatment effect of the Xingnaojing group compared to the control group (P<0.05). Conclusion: Xingnaojing injection improved rifampicin penetration into the central nervous system. The increase in rifampicin concentration in cerebrospinal fluid improved outcomes in patients with severe tuberculous meningitis.