Objective To investigate the influence of combined irbesartan/hydrochlomthiazide on morning blood pressure surge(MBPS)and left ventricular mass(LVM) in essential hypertension.Methods After 4-8 weeks' run-in period,if blood pressure wagn't up to the standard,the 120 patients were given irbesartan/hydrochlorothiazide once daily from 150 mg/12.5 mg for 12 months to 300 mg/25mg for another 12 months.MBPS was conducted by arnbuhry blood pressure monitoring(ABPM)and LVM was determined by echocardiography at the end of placebo baseline and 12 months later.Results (1)After treatment the patients with MBPS(+)decreased and patients with MBPS(-) increased.(2)After treatment the extents of MBPS were reduced in MBPS(+)patients[systolic blood pressure(SBP)difference(16.1±1.8)mm Hg(1mm Hg=0.133 kPa)vs(29.4±2.8)mm Hg,diastolic blood pressure(DBP)difference(10.2±2.3)mm Hg vs(21.2±2.2)mm Hg,P<0.01]with little change in MBPS(-)patients[SBP difference(11.2±2.4)mm Hg vs(10.1±1.2)mm Hg,DBP difference(5.9±1.9)mm Hg vs(6.8±3.2)mm Hg]compared with before treatment.(3)LVM indexes of all patients were significantly reduced.Conclusion Irbesartan/hydrochlorothiazide can effectively attenuate the extent of MBPS, and has advantages on reversing left ventricular hypertrophy.

Objective To assess the effect of repetitive transcranial magnetic stimulation (rTMS) at different frequencies on behavioral and psychological symptoms and cognitive function in patients with Alzheimer's disease.Methods Seventy-two patients were randomly divided into a high frequency group,a low frequency group and a control group (n =24 for each),and given 10 Hz,1 Hz or sham rTMS over the left and right dorsolateral prefrontal cortex at an intensity was 80％ of each patient's movement threshold.The stimulation was for 30 min a day,five days a week.During the 4 weeks of treatment,risperidone was used at a fixed dose of 1 mg per day for all patients.Before and after the treatment,all 3 groups were assessed using the behavioral pathology in Alzheimer's disease rating scale (BEHAVE-AD) and the mini-mental state examination (MMSE).Results Two weeks after the treatment,the average BEHAVE-AD score of the high frequency group had decreased significantly from (16.75±6.26) to (13.84± 6.10),significantly lower than the low frequency and the control groups' averages.Two weeks later,the average BEHAVE-AD scores of the 3 groups were significantly lower than before the treatment,but the decrease of the high frequency group was of significantly greater compared to the other 2 groups.Four weeks after the treatment the average MMSE score of the high frequency group was significantly better than before the treatment (P＜0.01),and better than the low frequency and the control group's averages.The effectiveness rates of the high frequency group,the low frequency group and the control group were 88％,58％ and 54％ respectively,all significantly different.Conclusion High frequency (10 Hz) rTMS combined with risperidone can improve the behavioral and psychological symptoms and cognitive function of AD patients,while low frequency (1Hz) rTMS does not have obvious effects.

Objective To determine whether the 12-lead-resting electrocardiogram(ECG) is a predictor of left vertricular(LV) recovery after successful recanalization of chronic total coronary occlusions(CTO).Methods The 12-lead-resting ECG was evaluated for Q-wave areas and parameters of QT dispersion.Impairment of regional wall motion was evaluated by real-time three-dimensional echocardiography(RT-3DE) at baseline and at follow-up.Results The wall motion score index(WMSI) was improved from 1.56?0.31 to 1.12?0.21(P0.05).Conclusion In patients with recanalization of CTO,recovery of regional wall motion is reliably predicted by analysis of the12-lead-resting ECG.

Objective To explore the influence of studying in the elderly university on the cognitive function for elderly. Methods Elderly university group (EUG) was consised of 105 subjects aged ≥60 who studied in the elderly university for one year. Controlled group(CG) was consisted of 105 elderly over 60 years of age who were siblings for subjects and would not studied in elderly university. Meanwhile, it was excluded if they were working. Two groups were excluded depression patients before study. The assessment tools were composed of Center for epidemiological survey of depression scale (CES-D), activity of daily living scale(ADL), mini-mental state examination (MMSE)and Wechsler's adult intelligence scale(WAIS). There were no significant statistics difference in scales of CES-D, ADL, MMSE and WAIS between two groups. Results There were no significant statistics difference of CES-D, ADL and MMSE between two groups after a year, however, the scales of ADL for controlled group after one year was higher than that before one year( t = 2. 191, P = 0.031 ). The MMSE mark shows one(0.95% )sustain cognitive impairment in EUG after one year; meanwhile there were six elders of (5.77%)come up to critical value of cognitive impairment in CG, the difference was almost statistical significance (P=0. 058 ). The WAIS mark demonstrated the total scale, VQ scale and PQ scale was declining. The score of total scale and perform scale of WAIS in CG were (110.3 ±8.2 )and (110.9 ±7.7) respectively. The score of total scale and perform scale of WAIS in CG were ( 107.8 ± 9.6 ) and ( 107.9 ± 13.4 ) respectively. There were significant difference between two groups(P=0. 044, P=0. 049). Furthermore, after one year the score of total scale of WAIS in CG( 110. 6 ± 7.4 ) outstanding be lower than that one year ago(P = 0. 022 ). There was no significant means for the total scale , verbal scale and perform scale of WAIS in CEG before and after year.Conclusion The program of continue education may play a positive role to stay or to improve the descending of the cognitive function in the elderly.

Objective To investigate the methods used for evaluating the severity of the patients with acute pancreatitis induced by hyperlipidemia in order to find out some simple and practical biomarkers for predicting the severity of the illness.Methods Sixty-two patients with acute pancreatitis resulted from hyperlipidemia were selected from the in-patients of our hospital from January 2007 to July 2011 and were divided into two groups,namely the mild acute pancreatitis group(MAP,n =32)and the severe acute pancreatitis group(SAP,n =30)as per the Chinese Acute Pancreatitis Guideline.Two groups were comparable verified by the test of homogeneity of variance after grouping.Arterial blood gas analyses were done immediately after admission:Venous blood was taken from forearm for determining renal function and blood coagulation at 6 o＇lock of next day after admission.The data of base excess(BE),creatinine(CR),C-reactive protein(CRP),fibrin(FIB)and D-Dmmer(D-D)were documented.The contrast CT imaging of pancreas was done within 48 hours after admission in all patients.APACHE Ⅱ scores and computed tomography severity index(CTSI)were calculated.The differences in BE,CR,CRP,FIB and D-D between 2 groups were analyzed by using t-test,and the correlation among them and APACHE Ⅱ score and CTSI were analyzed by Spearman test done with SPSS 18.0 software.As BE ＜-4.5 mnol/L,CR ＞ 120μmol/L,CRP ＞ 100 mg/L,FIB ＞5.5 g/L and D-D 800 ng/L were set respectively as a positive screening criterion,positive prediction value(PPV),negative prediction value(NPV),sensitivity and specificity of each marker and combined markers were calculated after they were set at different positive scales in order to get the optimal predictors for evaluating the severity of acute pancreatitis induced by hyperlipidemia.Results The absolute values of BE,CR,CRP,FIB and D-D in group SAP were much higher than those in group MAP(P ＜ 0.01).Each of them had good correlation with APACHE Ⅱ score and CTSI,especially BE and D-D more significant.Each of them used separately for predicting the severity of acute pancreatitis showed PPV and NPV with high specificity but the sensitivity was hot high.The joint use of BE,CR and CRP,and joint use of FIB and D-D could be more valid as PPV and NPV with high specificity for predicting the severity of acute pancreatitis,but the sensitivity decreased.Conclusions BE,CR,CRP,FIB and D-D were good biomarkers for quickly and accurately evaluating and predicting the severity of the acute pancreatitis caused by hyperlipidemia.

Objective To develop a Quick Cognitive Screening Scale for Elder(QCSS-E) and examine its reliability and validity.Methods In the light of rating model of MMSE and MoCA,a screening scale was developed to assess cognitive function,which contained 47 items across twelve domains.Five hundred community subjects were interviewed with the QCSS-E,then 150 subjects were retested after two weeks,and 75 subjects were assessed with MMSE and CCAS.The test-retest reliability,internal consistency reliability,empirical validity and constmct validity of QCSS-E were calculated.Results The test-retest reliability and Cronbach's α coefficient were 0.972 and 0.814 for QCSS-E total score,0.656-0.911 and 0.679-0.746 for domain scores.There were low to moderate correlation of 0.133-0.612 among domain scores,correlation domain scores with total score ranged from 0.303-0.664.QCSS-E scores decreased with increasing agc,increased with the level of education increasing,and decreased with the aggravation of brain damage.The QCSS-E was significantly correlated with MMSE(r=0.886) and CCAS (r=0.899).Factor analysis got two factors accounting for 49.4％ of variance,which were named vulnerability factor and resistance to damage factor.Conclusion The stability,internal consistency,and validity of the QCSS-E are good and meet with psychometric standard.

Objective To investigate the effects of fluoxetine and pyrrolidine dithidarbamate (PDTC) on the lipopolysaccharide(LPS)-induced interleukine-6(IL-6) release in cultured rat astrocytes.Methods The purified astrocytes were cultured in 48-well tissue culture plate and classified into control group,LPS group,fiuoxetine group and PDTC group.Control group and LPS group were cultured as usual,and fluoxetine group and PDTC group were cultured with fluoxetine or PDTC at different concentrations for 48 hours,and then LPS group,Fluoxetine group and PDTC group were incubated with 1 ug/ml LPS for 24 hours.Finally,the levels of IL-6 in the cell supernatant were detected by enzymatic linked immunosorbent assay (ELISA) method.Results The level of IL-6 in LPS group ((1975.46 ± 171.54) pg/ml) was significantly higher than that in control group((10633 ± 782.15)pg/ml) (P ＜ 0.01).The levels of IL-6 were (6198.6 ± 379.4) pg/ml,(4973.6 ± 132.5) pg/ml and (4747.9 ±473.9) pg/ml respectively when the concentrations of fluoxetine were 10 μM,20 μM and 40 μM,and (4821.6 ±180.8) pg/ml,(4735.7 ±620.0)pg/ml and (3525.9 ± 240.0)pg/ml respectively when the concentrations of PDTC were 100 μM,150 μM and 200 μM.There was significant difference in the levels of IL-6 between LPS group and fluoxetine group (P ＜ 0.05),as well as between LPS group and fluoxetine group (P ＜ 0.05).Conclusion LPS can induce IL-6 release from astrocytes,while fluoxetine or PDTC at some concentrations can suppress LPS-induced IL-6 release.

Objective To evaluate the effect on salvage treatment of sudden deafness with comprehensive Chinese medicine therapy. Methods Fifty-three sudden deafness patients failing in conventional western medicine treatment were given comprehensive Chinese medicine therapy, and the salvage treatment followed by oral use of Chinese medicine, intravenous injection of Chinese patent medicine, acupoint injection, ear acupoint plastering, acupoint application, acupuncture, sound healing, and massage. The therapeutic effect and the relief of major accompanying symptoms were evaluated after treatment, and the relationship of disease course with clinical efficacy was also investigated. Results (1) After treatment, 4 cases were cured, 9 were markedly effective, 13 were effective, 27 were ineffective, and the total effective rate was 49.06%. (2) Except for the 2 excluded cases, the major accompanying symptoms such as tinnitus, auricular distress, and vertigo were relieved to various degrees in other cases. ( 3) Twenty-two patients had a course of disease within 14 days, and the total effective rate for them was 72.73%. A total effective rate of 32.26% was achieved in 31 cases with disease course over 14 days. It is indicated that the therapeutic effect for patients with a disease course less than 14 days was superior to that with a disease course over 14 days (P<0.01). Conclusion Comprehensive Chinese medicine therapy exerts inspiring therapeutic effect on salvage treatment of sudden deafness, and earlier intervention results into better effect.

Objective: To study the characteristics of attentional bias to emotional stimulus in medical workers of emergency department and explore the relationship between the emotional Stroop effect and mood states, thus providing a reference to the assessment and intervention of emergency medical workers’ mental health. Methods: Two kinds of emotional Stroop tasks with words and pictures and the Profile of Mood States (POMS) were administered to thirty-six medical workers of emergency department and thirty-six medical workers of other departments. Results: The reaction time to negative and positive words and pictures were all higher than the reaction time to neutral stimulus, thus showing the significant Stroop effect in medical workers. The Stroop effect to negative emotional stimulus in medical workers of emergency department was significantly smaller than that in medical workers of other departments, while the difference of Stroop effect to positive stimulus was not significant between the two groups. Correlation analyses revealed that the correlations between Stroop effect size to positive pictures and tension and angry of POMS were all negatively significant (r value was -0.314 and -0.330 respectively) , and the correlation between Stroop effect size to negative pictures and fatigue was negatively significant (r=-0.303) . Conclusions There is a significant emotional Stroop effect in medical workers. Although the ability of anti-interference to emotional stimulus in medical workers of emergency department was better than medical workers of the other departments, the long-term avoidance to negative emotional stimulus was still has a negative effect on the mood states of individuals.

Objective:To investigate the relationship between renal function and the total cerebral small vessel disease(CSVD)score in elderly patients with a mild stroke.Methods:Patients with a mild stroke(National Institutes of Health Stroke Scale score≤3)and aged 60 years and above hospitalized in our hospital from March to December 2019 were consecutively enrolled.Total CSVD scores were evaluated based on enlarged perivascular spaces, cerebral microbleeds, white matter hyperintensities of presumed vascular origin and lacunes of presumed vascular origin.The estimated glomerular filtration rate(eGFR)was derived by using the formula of chronic kidney disease epidemiology collaboration based on serum creatinine(CKD-EPI Scr). The relationship between eGFR and the total CSVD score was analyzed. Results:Of the 152 patients enrolled, 35, 38, 39, 28 and 12 had total CSVD scores of 0, 1, 2, 3 and 4, respectively.The age of patients increased and eGFR decreased with the increase of total CSVD scores(CSVD from 0 to 4, [(67.43±6.59), (68.42±6.83), (72.18±7.94), (76.46±7.75) vs.(79.92±6.17)years old, F=12.018, P<0.001]; [(92.94±12.45)ml·min -1·1.73m -2, (90.52±8.62)ml·min -1·1.73m -2, (89.45±8.48)ml·min -1·1.73m -2 and(83.90±7.19)ml·min -1·1.73m -2vs.(79.16±7.77)ml·min -1·1.73m -2, F=7.210, P<0.001]. Spearman correlation analysis showed that eGFR was negatively correlated with the total CSVD score( r=-0.399, P<0.001). After adjusting for risk factors including age, gender and hypertension, multivariate ordinary regression analysis showed that decreased eGFR was an independent risk factor for the total CSVD score( OR=0.957, 95% CI: 0.924-0.990, P=0.012). Conclusions:In elderly patients with a mild stroke, eGFR is an independent risk factor for the total CSVD score, which shows an increased burden as eGFR decreases.