Objective To compare the efficacy and safety of candesartan cilexetil and enalapril in the treatment of senile hypertension.Methods 100 patients with hypertension were randomly divided into the treatment group and control group according to digital table method.The treatment group were received candesartan cilexetil 4 ～ 8mg once daily for 8 weeks,and control group were received enalapril 10 ～ 20mg once daily for 8 weeks,and the efficacy and adverse reactions were watched.Results The SBP and DBP were (134.42 ± 6.39) mmHg and (82.00 ± 5.05) mmHg for candesartan cilexetil and (137.70 ± 5.27) mmHg and (81.76 ± 5.03) mmHg for enalapril after 8 weeks.A significant reduction of blood pressure was achieved in both groups than before treatment (tcan =35.85,30.88;tena =37.92,31.67,all P ＜ 0.01).After treatment pulse pressure was (56.06 ± 4.91)mmHg for candesartan cilexetil and (60.04 ± 4.40) mmHg for enalapril.Compared with before treatment,pulse pressure was significantly reduced in the treatment group (t =16.93,P ＜ 0.01) and was no significant difference in control group (t =6.34,P ＞ 0.05).The incidence of adverse reactions of patients with treatment group was obviously lower than that of the control group.Conclusion Candesartan cilexetil is effective and safe in senile hypertension patients,and it could be used as a first-line treatment.

BACKGROUND:To date, rivaroxaban has been a clinical y common anticoagulant in China;however, effective prophylaxis for venous thrombosis is associated with a markedly higher incidence of perioperative hemorrhagic complications. Although it has been reported that aspirin effectively prevents deep vein thrombosis and pulmonary embolism, the use of aspirin as a routine drug for venous thrombosis after total knee arthroplasty is stil controversial.
OBJECTIVE:To compare the efficacy and safety of aspirin and rivaroxaban for prevention of deep vein thrombosis after total knee arthroplasty.
METHODS:Total y 324 patients with osteoarthritis who underwent primary unilateral total knee arthroplasty were randomly divided into three groups. Twelve hours after the surgery, three groups were given aspirin, rivaroxaban and low-molecular-weight heparin respectively. Al three groups were treated for 14 days, and al of the patients were fol owed for 4 weeks.
RESULTS AND CONCLUSION:Compared with the low-molecular-weight heparin group, the incidence of deep vein thrombosis was lower (P<0.05), but hidden blood loss and wound complications were more common (P<0.05) in the rivaroxaban group. There were no significant differences between the low-molecular-weight heparin group and aspirin group in the incidence of deep vein thrombosis, hidden blood loss, wound complications or incidences of lower limb swel ing and subcutaneous ecchymosis (P>0.05). The results confirmed that rivaroxaban has a positive anticoagulation effect but leads to increases in wound complications in patients;there are no differences in efficacy and safety between aspirin and low-molecular-weight heparin, so aspirin as part of a multimodal anticoagulation therapy after total knee arthroplasty has good clinical safety and efficacy.

This study investigated the expression of hemeoxygenase-1 (HO-1) in rats with acute lung rejection and its implication. A valid rat orthotopic left lung transplantation model (SD rat-->Wistar rat) was established by using an improved three-cuff anastomosis technique. The rats were divided into control group, CoPP (HO-1 inducer)-treated group and ZnPP (HO-1 inhibitor)- treated group. The severity of acute rejection was graded on the basis of the morphologic changes of the lung samples stained with HE. The expression of HO-1 protein in lung tissue was detected by using immunohistochemistry and Western blot, and HO-1 mRNA activity was assayed by RT-PCR. The results showed that the expression of HO-1 protein was significantly increased with the acute rejection grading in rats (P<0.01). As compared with control and ZnPP-treated groups, the severity of acute rejection was not alleviated and the grade not reduced significantly in CoPP-treated group (P>0.05). It was concluded that HO-1 protein might be involved in the pathological process of post-graft acute rejection. The expression of HO-1 protein was increased gradually with aggravation of acute rejection, and HO-1 protein might be used as an index to monitor acute rejection after lung transplantation.
Graft Rejection/*enzymology ; Heme Oxygenase (Decyclizing)/genetics ; Heme Oxygenase (Decyclizing)/*metabolism ; Lung Transplantation ; RNA, Messenger/genetics ; RNA, Messenger/metabolism ; Rats, Sprague-Dawley ; Rats, Wistar

Objective To evaluate the clinical efficacy and safety of endovascular treatment for intracranial venous sinus thrombosis based on individual condition. Methods Twelve patients with intracranial venous sinus thrombosis were treated with endovascular management according to the severity and course of disease after they failed to respond to anticoagulant therapy. The clinical signs and symptoms,cerebrospinal fluid pressure and arteriovenous circulation time were observed and followed up (including MRV). Intravenous thrombolysis and mechanical thrombus maceration were carried out in all 12 patients,while intravenous thrombolysis, mechanical thrombus maceration in combination with intra-arterial thrombolysis were employed in 3. After the treatment, anticoagulant therapy was carried out for 6 months.The patients were followed up for 12 to 24 months. Results Of the twelve patients, clinical signs and symptoms included slight headache (2 cases), mild hemiplegia (1 case), ambiopia or blurred vision (3 cases). The cerebrospinal fluid pressure returned to under 26 cm H2O (1 cm H2O =0.098 kPa)following treatment from 28 to 38 cm H2O [ mean (32. 4 ±3.0) cm H2O] in preoperative measurement and the arteriovenous circulation time returned to below 10 s in all patients following treatment. Neither recurrence of thrombosis nor new symptoms of neurologic dysfunction was observed. No procedure-related intracranial or systemic hemorrhagic complications occurred both during and after the operation with the exception of a subcutaneous bleeding at the venopuncture site. Conclusion Endovascular treatment is effective and safe for patients with intracranial venous sinus thrombosis.

Objective To investigate the protective effects of Naoxintong capsule on cerebral ischemia-reperfusion injury in rats.Methods 45 SD rats were randomly divided into 5 groups: sham operation group (n=5), ischemia-reperfusion group (n=10), small dose of Naoxintong capsule group (n=10), large dose of Naoxintong capsule group (n=10), CoQ-10 group (n=10). The the cerebral ischemia-reperfusion model was established by occluding bilateral carotid arteries of animal. The moisture content and activity of ATPase in brain tissue of model rat were observed respectively at ischemia 30 min plus reperfusion 30 min and ischemia 30 min plus reperfusion 60 min.Results The activities of Na+-K+-ATPase, Ca2+-ATPase and Mg2+-ATPase decreased (P<0.01), contents of water in brain tissues increased (P<0.01) in the ischemia-reperfusion group, compared with the sham operation group. The activities of Na+-K+-ATPase, Ca2+-ATPase and Mg2+-ATPase increased (P<0.01), contents of water in brain tissues decreased (P<0.01) in the Naoxintong capsule group, compared with the ischemia-reperfusion group.Conclusion Naoxintong capsule can protect the brain tissue from ischemia-reperfusion injury.

Objective To identify departments involved, and the appraisal and compensation of such disputes in Beijing, for preventive recommendations. Methods A retrospective descriptive statistical analysis was carried out to retrieve and extract keywords from the first-instance judgments totaling 445 cases of medical damage liability disputes from 2014 to 2016 in Beijing. This analysis covered the age, disease, departments involved, liability judgment among other information. These cases were published at the website of China judgment documents. Results Patients with musculoskeletal connective tissue diseases, circulatory system disease and tumor accounted for the most lawsuits. The departments involved with more disputes were the department of gynecology and obstetrics (80/445, 18. 0％), orthopedics (69/445, 15. 5％), and emergency department(45/445, 10. 1％). 83. 8 percent of the disputes were found with medical quality problems;and 84. 3％ were lost with compensations. Conclusions It is imperative to elevate the diagnosis and treatment level on musculoskeletal connective tissue diseases, circulatory system disease and tumors, and take precautions against disputes at such key departments as gynecology and obstetrics department, orthopedics department, and emergency department. Other precautions include normalized medical record writing, medical risk disclosure, higher medical quality and patient safety.

Nano-cryopreservation may become a new way in the next generation of cryopreservation technology. However, research using nanoparticles in oocytes vitrification has not been reported in the literature. In this study, HA nanoparticles with different diameters were added into cryoprotectant and M II-stage porcine oocytes were vitrified by Cryotop. The results showed that nanoparticles improved the survival rate of cryopreserved M II-stage porcine oocytes, but the difference between nanoparticles with different diameters of was not significant. In order to study the mechanism of nano-cryopreservation, the cooling rate of cryoprotectant was measured by ultra-fast temperature measurement system and the melting enthalpy of cryoprotectant was measured by differential scanning calorimeter (DSC). The results showed that the adding of nanoparitcles could not increase the cooling rate of cryoprotectant, but could decreases the amount of ice crystals during freezing and warming. Therefore, the mechanical injury within and outside cells might be effectively reduced.
Animals ; Cell Survival ; physiology ; Cryopreservation ; methods ; veterinary ; Cryoprotective Agents ; pharmacology ; Durapatite ; pharmacology ; Female ; Fertilization in Vitro ; methods ; veterinary ; Metaphase ; Nanoparticles ; Oocytes ; cytology ; Swine ; Vitrification

This study investigated the expression of hemeoxygenase-1 (HO-1) in rats with acute lung rejection and its implication.A valid rat orthotopic left lung transplantation model (SD rat→Wistar rat) was established by using an improved three-cuff anastomosis technique.The rats were divided into control group,CoPP (HO-1 inducer)-treated group and ZnPP (HO-1 inhibi-tor)-treated group.The severity of acute rejection was graded on the basis of the morphologic changes of the lung samples stained with HE.The expression of HO-1 protein in lung tissue was de-tected by using immunohistochemistry and Western blot,and HO-1 mRNA activity was assayed by RT-PCR.The results showed that the expression of HO-1 protein was significantly increased with the acute rejection grading in rats (P<0.01).As compared with control and ZnPP-treated groups,the se-verity of acute rejection was not alleviated and the grade not reduced significantly in CoPP-treated group (P>0.05).It was concluded that HO-1 protein might be involved in the pathological process of post-graft acute rejection.The expression of HO-1 protein was increased gradually with aggravation of acute rejection,and HO-1 protein might be used as an index to monitor acute rejection after lung transplantation.

Objective:To investigate the relationship between double mutations of myosin heavy chain gene (MYH6) p.Gly743Arg and p.Glu1389Lys and the cardiac phenotype.Methods:Patients carrying double mutations in the MYH6 gene p.Gly743Arg and p.Glu1389Lys were screened from 52 unrelated left ventricular hypertrophy (LVH) who were admitted to the Second Hospital of Chongqing Medical University from 2015 to 2020, and the genetic testing of peripheral blood of patients by second-generation whole-exome sequencing assay technology and genomic DNA of their family members Sanger sequencing was performed to validate the genomic DNA of the family members. The cardiac phenotype was evaluated by electrocardiogram, coronary computed tomography angiography (CTA), echocardiography, and cardiac magnetic resonance imaging (MRI) as adjuncts.Results:All whole-exome gene were detected in 52 unrelated patients with LVH, of which 1 patient (1.9%) had double mutations in MYH6 gene p.Gly743Arg and p.Glu1389Lys (proband). Two members of the maternal line of this patient carried p.Glu1389Lys mutation, but there was no obvious clinical phenotype. Two members of the paternal line carried p.Gly743Arg mutation and had obvious clinical phenotype of bradycardia, but there was no LVH. The male proband, aged 21 years old, presented with LVH and sinus bradycardia but no coronary artery stenosis on CTA before treatment, MRI showed that the left ventricular end diastolic diameter was 58 mm. After treatment with angiotensin receptor-enkephalinase inhibitor (ARNI), electrocardiogram showed that the heart rate increased significantly (from 43 bpm to 72 bpm). Echocardiography showed that the left ventricular end diastolic diameter decreased significantly (from 60 mm to 49 mm).Conclusions:The p.Glu1389Lys mutation of the MYH6 gene may not manifest the phenotype of heart disease. MYH6 gene p.Gly743Arg mutation may be manifested asymptomatic sinus bradycardia, but there is no LVH phenotype. The cardiac disease phenotype caused by the double mutations of p.Gly743Arg and p.Glu1389Lys in the MYH6 gene is more obvious. Asymptomatic LVH and sinus bradycardia can appear in adolescence, but the LVH phenotype can be reversed in a short period of time after ARNI treatment.

China ; Dissent and Disputes ; Humans ; Negotiating ; Physician-Patient Relations