Objective To study the efficacy of low dose of combined angiotensin Ⅱ type 1 receptor blockade(ARB)valsartan with angiotensin-converting enzyme inhibitor(ACEI)ramipril on the expression of the gene of angiotensin Ⅱ type 1 receptor(AT1R)and type 2 receptor(AT2R)in cardiovascular vessels and brain in SHR.Methods SHRs 7-8 weeks old were received valsartan 30 mg/(kg?d),or ramipril 1 mg/(kg?d),or valsartan 15 mg/(kg?d)combined with ramipril 0.5 mg/(kg?d)by gavage for three months.SBP,LV/BW ratio,plasma angiotensin Ⅱ,plasma and myocardial NO levels were determined.The severity of myocardial interstitial fibrosis was assessed by image analysis.ACE mRNA,AT1R mRNA and AT2R mRNA expression were detected in the LV myocardium,aorta and brain by the RT-PCR.Results Combined low dose of valsartan and ramipril was shown to reduce more significantly the expression of AT1R mRNA and ACE mRNA in myocardium,aorta and brain than valsartan or ramipril monotherapy(AT1R mRNA:P

Objective To investigate the influence of diversification continuing care on quality of life and activities of daily living of epilepsy patients secondary to cerebral hemispheric atrophy.Methods Twenty epilepsy patients with cerebral hemispheric atrophy,admitted to Second Department of Neurosurgery of Hebei Provincial People's Hospital from March 2012 to December 2014 were selected by convenience sampling method,and divided into the intervention group (12 cases) and control group (8 cases),Patients in the control group were given routine guidance discharge,and intervention group were given continuing nursing intervention.The influence of diversification continuing care on quality of life and activities of daily living of epilepsy patients were compared between two groups.Results Twelve months after discharge,QOL in the control group and the intervention group scored 58.8±20.9 and 77.2±14.3,t=2.37,P ＜ 0.05.The ADL scored 49.42±8.14 and 62.72±7.06,t=2.39,P ＜0.05.Conclusions Diversification continuing nursing intervention is helpful to improve quality of life and activities of daily living of epilepsy patients secondary to cerebral hemispheric atrophy.

OBJECTIVETo investigate the efficiency and safety of different regimens by intravesical instillation of epirubicin, a derivative of adriamycin, for the prevention of primary superficial bladder carcinoma from recurrence.

METHODSNinety patients supplemented with intravesical epirubicin instillation after operation were randomly divided into three groups: Group A--80 mg in one dose; Group B--repeated epirubicin 40 mg q wk x 4-8 sessions followed by q month to the end of the second year; or Group C--50 mg q month to the same duration. All patients were followed up for two years by observing the recurrence rates and side effects.

RESULTSThe recurrence rate of groups A, B and C at one year was 16.7%, 13.3% and 16.7%, respectively, without any significant difference observed. However, it was 50.0%, 36.7% and 36.7% at two years, at which time the recurrence rate of group A was significantly higher than those of groups B and C. The side effects rate was 23.3%, 40.0% and 33.3% for groups A, B and C, respectively. The more instillations the patients had, the more severe side effects were.

CONCLUSIONEarly postoperative single high dose intravesical instillation of epirubicin combined with repeated lower doses of the same drug every month may be an efficient and safe regimen to prevent the primary superficial bladder carcinoma from recurrence.

Administration, Intravesical ; Adult ; Aged ; Antibiotics, Antineoplastic ; administration & dosage ; adverse effects ; Combined Modality Therapy ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; prevention & control ; Postoperative Period ; Prospective Studies ; Urinary Bladder Neoplasms ; prevention & control ; surgery

Objective To analyze the correlation between the clinical characteristics and the incidence of postoperative hepatic encephalopathy in patients with cirrhosis who received transjugular intrahepatic portosystemic shunt ( TIPS) . Methods The clinical data of 80 patients with liver cirrhosis hospitalized in the Fifth Medical Center of PLA General Hospital from March 2015 to March 2017 were retrospectively analyzed. The related factors of hepatic encephalopathy complications after TIPS treatment were analyzed. Results The cumulative incidence of hepatic encephalopathy was about 23. 75%(19／80) in one year after TIPS operation. Through single factor analysis and multi factor Logistic regression analysis,it was found that the two factors of preoperative platelet level and the location of tips blood shunt were closely related to the occurrence of hepatic encephalopathy after TIPS operation. The ROC curve suggested that the AUC of preoperative platelet level and the location of tips blood shunt were 0. 657 and 0. 668, respectively. The sensitivity and specificity of the former were 70. 0%,52. 6% and the cutoff value was 51 ×109／L, respectively, while those of the latter were 70. 5% and 63. 2%, respectively. Conclusion Preoperative platelets level＞51×109／L or shunting of the left branches of the portal vein may indicate a lower incidence of hepatic encephalopathy.

Objective: To identify the etiology and source of infection in a diarrhea outbreak in Yunnan in May 2017 and to provide the evidence for formulating prevention and control measures. Methods: Epidemiological investigation was carried out on the epidemic situation of diarrhea in the village of Lvchun County in Yunnan Province, the field sampling, laboratory testing and data analysis were also performed. Results: Among the 44 patients, 11 of the 13 samples were positive for rotavirus nucleic acid in group A, and the positive rate was 84.62%. The survey showed that the water supply pipe was damaged and polluted by human and livestock manure and domestic sewage. The trend of the damaged water pipe was basically the same as the case distribution, and the rainfall was significantly related to the number of the disease. Conclusions This event was an outbreak of diarrhea caused by group A rotavirus. The direct pollution of drinking water caused by rainfall may be the risk factor of this outbreak. The health management of rural drinking water should be strengthened and the health knowledge and education of preventing intestinal infectious diseases should be promoted.