Objective To explore the effect of valasartan, an angiotensin Ⅱ type 1 (AT 1) receptor antagonist, on the plasma levels of calcitonin gene-related peptide (CGRP) in patients with essential hypertension. Methods 29 outpatients with essential hypertension were treated with valasartan 80mg/day for 6 weeks. 28 age-matched normal blood pressure people were taken as controls. The plasma levels of CGRP were measured in all patients before and after treatment and in controls. Results The plasma levels of CGRP in hypertensive patients were significantly lower than those in controls (minimal value: 0.00 vs 39.95pg/ml; maximal value: 24.07 vs 155.59pg/ml; P

目的探讨康复指导对发育性髋关节脱位患儿术后康复的作用。方法在术前和术后,根据手术特点,对48例(63髋)发育性髋关节脱位患儿进行髋关节康复指导。结果经1—2.5年随访 ,48例患儿(63髋)的康复优良率达95%。结论康复指导可促进发育性髋关节脱位患儿术后髋关节的康复。

Objective To analyze the findings of recurrent/residual caner after thyroidectomy for thyroid cancer in both ultrasonography (US) and contrast-enhanced CT (CECT),and to assess the diagnostic value of combination of these two modalities.Methods Forty-six patients with recurrence/ residue of thyroid cancer underwent both high-frequency US and CECT examinations and were enrolled in this study.The imaging features on US and CECT were reviewed and diagnostic accuracies for local residual lesions and cervical lymph node metastasis were evaluated according to pathological results.Results In 46 patients,the average period between thyroidectomy and diagnosis of recurrent/residual cancer was (14.6 ± 12.1) months(range,7 days-10 years).Twenty patients had local recurrent tumors at the surgical bed and the average size of tumors was 2.1 cm(range,0.5-4.6 cm).On US finding,the recurrent/residual tumors were hypoechoic in 60 ％ of cases,had microcalcification in 40 ％.Cervical lymph node metastasis were found in 40 patients,and 75％ of them were located in zone V[.The smallest size of abnormal lymph node which can be detected by US was 3 mm.In cases of lymph node metastasis,12 cases (30％) became cystic,10 (25 ％) presented microcalcifications,and 5 (12.5 ％) showed microcalcifications and cystic change within a lymph node.Microcalcifications,cystic change and hyperechoic appearance within a lymph node suggested malignant.The detection rate of US and CECT in the local recurrent/residual cancer were 90％ and 90％,respectively.The detection rate of cervical lymph nodes metastasis were 80 ％ and 72.5 ％,respectively.The diagnostic accuracy of US and CECT in local recurrence,cervical lymph node metastasis and both were 65％,67.5％ and 65.2％ vs 75％,55％ and 65.2％,respectively (P ＞ 0.05 for all comparisons).the diagnostic accuracy of combination of US and CECT were increased to 86.4％,77.5％ and 91.3％,respectively.US combined with CECT significantly improved the diagnostic capability compared with US or CECT alone(P ＜0.05).Conclusions US should be used as the first choice of imaging examination for post-thyroidectomy of thyroid cancer.US combined with CECT could further increase the diagnostic accuracy in recurrent/residual thyroid cancer.

Analyze the problems of medical insurance real-time settlement in outpatient department.Explore the situation of stringent management of health medical insurance agencies,accuracy of the information,significant increasing costs that medical insurance agencies refused to pay and severe environment to doctors.And management strategy such as regulating doctors' behavior strictly,upgrading hospital information systems,increasing hospital staff to excavate the hospital potential and publicizing the new policy of medical insurance comprehensively.

Humans ; Myofibroma ; pathology ; Stomach Neoplasms ; pathology

AIM:To establish the quality standard for Shengxue Micro Capsules(melanteritum,Cortex Cinnamo-(mi,) Endoconcha Sepiae,Colla Corii asini,Placenta Hominis). METHODS: The melanteritum,Endoconcha sepiae was identified by physic-chemical analysis. Cortex Cinnamomi was identified by TLC.UV was employed for the assay of FeSO_4.GC was used to determine Cinnamaldehyde of Shengxue Micro Capsules. RESULTS: Green vitriol,Endoconcha sepiae could be identified by physico-chemical analysis.Cortex Cinnamomi could be identified by TLC.The linear range of FeSO_4 was within 0～20 mg,r = 0.999 8;The average recovery of assay was(96.7%.) The linear range of cinnamaldehyde was within 0.157 5～0.551 4 ?g,r = 0.999 8;The average(recovery) of assay was 101.52%. CONCLUSION: The method is simple, reproducible.It could be used for(quality) control of Shengxue Micro Capsules.

Point Zigong is an empirical point for acupuncture treatment of gynecological diseases. Now it is widely applied to clinical treatment and has a marked therapeutic effect. The therapeutic effect of point Zigong stimulation on gynecological diseases is closely related to the anatomical position, morphostructure specificity and action effect of the acupoint. In the present study on this acupoint, the single acupoint is seldom applied and the mechanism is not completely clear. It is needed to conduct a thoroughstudy in the future.

Objective To evaluate the effect of single CVVH and HDF on endothelial system. Methods Group CVVH:20 patients with multiple organ dysfunction syndrome ( MODS) underwent CVVH for 12h.Vascular access was through two-lumen catheter in femoral vein;Group HDF:Twenty patients with end stage renal disease (ESRD) on maintenance hemodialysis underwent HDF for 4h.Vascular access was through internal arteriovenous fistula.Group control:Healthy people were examined at our hospital.The se-rum levels of sVCAM-1, sICAM-1, vWF and MMP-9 were measured by enzyme-linked immunosorbent assay ( ELISA) after centrifugation in treatment group before and after treatment.Four cytokines were also meas-ured in fasting healthy subjects in the morning.Results The levels of serum sVCAM-1, sICAM-1, vWF, MMP-9 were significantly higher in Group CVVH and HDF than control group before and after treatment( P<0.05).Group CVVH:The serum levels of sICAM-1 and sVCAM-1 were significantly lower in post-treat-ment than pre-treatment, But the serum levels of vWF and MMP-9 showed no obvious changes after CVVH;Group HDF:the levels of four cytokines showed no obvious changes after single HDF.Conclusions Endo-thelium becomes impaired in MODS and ESRD patients, Endothelium may be protected by CVVH through the partial removal of cytokines harmful to endothelium in MODS patients.Single HDF therapy does not pro-tect endothelial function obviously in MHD patients.

Primary esophageal small cell carcinoma (PESCC) is a rare disease first described by McKeown in 1952. PESCC is characterized by high malignancy, distant metastasis, and poor prognosis. The incidence of PESCC has significantly increased world-wide in recent years. However, practice guidelines that concern the histological origin, clinical diagnosis methods, therapies, and prog-nosis of PESCC are still not well established because of the paucity of cases and lack of large prospective randomized research. This ar-ticle aims to outline recent advances in the clinical and therapeutic aspects of PESCC as well as review the different opinions concerned to better understand PESCC and solve clinical problems.

Background and purpose:Rectal small cell carcinoma is high malignant tumor and prone to early metastasis. It is rare in the clinical and its prognosis is poor. The aim of this article was to analyze clinical characteristics and summarize the diagnosis,treatment and prognosis of rectal small cell carcinoma.Methods:Clinical data of 16 cases with rectal small cell carcinoma conifrmed by pathology from Jan. 2001 to Jan. 2013 in the Tumor Hospital Affiliated to Zhengzhou University Hospital were analyzed retrospectively.Results:Among the 16 rectal small cell carcinoma patients (mean age is 58.5 years), 9 were male, 7 were female; 4 cases in stageⅡ, 7 cases in stageⅢ and 5 cases in stageⅣ. Ten cases underwent surgical treatment, of which 6 cases underwent radical surgery, 4 cases underwent palliative surgery;6 cases received chemotherapy alone, 2 cases received chemoradiotherapy, 2 cases did not receive any treatment postoperatively. Five cases were lost opportunity for operation, of which 3 cases underwent chemotherapy alone and 2 cases underwent chemoradiotherapy. One case did not receive any treatment. Among 10 cases of resection of the lesions, 5 cases had vascular invasion and 7 cases had local lymph node metastasis. All patients received 7-65 months of follow-up. The median survival was 15.4 months. The 6 months, 1 year, 2 years, 3 years and 5 years survival rates were 58.4%, 46.2%, 26.6%, 13.1% and 6.2% respectively. The prognosis of patients was associated with tumor staging, presence of vascular invasion and lymph node metastasis, and type of operation (P<0.05); but not related to age, gender and tumor size (P>0.05).Conclusion:The biologic behavior of rectal small cell carcinoma which is a rare disease and similar to small cell lung cancer, and its prognosis is poor. Treatment methods include surgery, radiotherapy and chemotherapy. The overall result is poor.