Objective To investigate clinical therapeutic effect of valsartan/amlodipine compound preparation on patients with hypertension. Methods From Juue 2011 to June 2013, a total of 110 columns with hypertension as the research object, according to randomly divided into two groups.Valsartan/amlodipine compound preparation(group A) and amlodipine combined with metoprolol group(group B), continuous administration for 24 weeks, patients symptoms, former state, improve heart function and blood clots compared curative effect were monitored.Results After 24 weeks of treatment with valsartan/amlodipine compound preparation group, compared with group B, SBP and DBP were decreased significantly, the TC, TG and Glu content were also decreased significantly, clinical symptoms improved ratio was 90.91%(P<0.05).Cardiac function improvement recovery was 89.09%(P<0.05).D-Dimer level was decreased significantly(P<0.05), the former state blood clots were effectively prevented.Conclusion The high blood pressure in treatment with valsartan/amlodipine compound preparation has more therapy advantages in clinical treatment .

Objective: This trial was designed to study the profile of the pharmacokinetics of desflurane in balance anesthesia. Method:Forty ASA physical status Ⅰ and Ⅱ patients undergoing abdominal surgery were admitted to this study. All patients were anesthetized with balance anesthesia technique,which received delivered concentration(FD)of 6% desflurane in a fresh gas(O_2: N_2O=1:2)inflow of 3L/min until end-tidal target concentration(FA)of 3% des flurane was obtained, then the FD was adjusted to maintain the target concentration, 30 min later the inflow was decreased to 1.5L/min. As well as nitrous oxide,oxygen and carbon dioxide concentrations were measured at the common gas outlet and the endotracheal tube connector respectively. At same time fentanyl and atracurium were given as necessary. The SpO_2,BP,and HR were also measured. We observed the time of target concentration reached during wash-in period, and also the time of FA: FAO = 1/2 during wash-out period at the end of operation. Result: During the first 30 min of 3L/min flow administration,the target concentration was obtained at 2.9 min,and was kept stable during the whole procedure,even during low flow(1.5L/min)it was not required to increase the FD to maintain FA at the target concentration. The wash-out time of FA:FAO= 1/2 was 2.0 min from stopping adminstration. The time of spontaneous breath recovery, open eye, extubation.reciting of name and birthday and discharge from recovery room was 6, 5.8.6,9.0,12.0 and 30 min respectively. The parameters of cardiac function were stable during operation. Con clusion: During the balance anesthesia with desflurane.even at relative low flow.the FD of desflurane provides a reasortable surrogate of FI and FA. The lower solubility of desflurane favors its safe use in low-flow technique.and the anesthesia depth can be controlled more easy.

Objective To investigate the effect of artifictal circadian rhythm of melatonin on the postoperative cellular immune function in patients undergoing gynecological operation Methods Eighteen ASA Ⅰ or Ⅱ patients,aged 25-50 yr,weighing 45-80 kg,scheduled for elective gynecological operation,were randomly divided into 3 groups (n =6 each):control group (group C),placebo control group (group P) and melatonin group (group M).In group M.melatonin 6 mg was given orally at 10 min before lights-out (21:00) on 1 day before operation,on the day of operation and on 1 day after operation,while placebo was given orally instead of melatonin in group P.The operation was performed under epidural anesthesia.Patient-controlled epidural analgesia with ropivacaine was used for postoperative analgesia.VAS score was maintained ＜ 5.Blood samples were collected from the peripheral vein at 1 day before operation (baseline),the end of operation and 1 day after operation to measure CD4+,CD8+ and CD3+ cell count by flow cytometry.The ratio of the number of CD4+ cells to the number of CD8+ cells was calculated.Results There were no significant differences in the number of CD4+,CD8+ and CD3 + cells and ratio of the number of CD4 + cells to the number of CD8 + cells between groups C,P and M (P ＞0.05).Conclusion Artificial circadian rhythm of melatonin exerts no influence on the postoperative cellular immune function in patients undergoing gynecological operation.

[Objective]To discuss the fractures classification,operative route,internal fixation and operative therapeutic effection of acetabular fractures.[Method]Thirty-four cases of acetabulum fractures and femoral head dislocation were involved from November 2001 to August 2006 in our hospital throught operative treatment.The classification according of AO system:type A fractures 24 cases,type B 10 cases.Applicated Kocher-Langenbeck operative route was applied in 20 cases,Gibson route 2cases,illioinguinal route 4 cases and anteriorcombined posterior route 4 cases.Thirty-two cases were adopted reconstruction plates and screws and 2 cases steel-wire cerclage to fix fracture.All patients were followed up.[Result]Acorrding to evaluation system of AAOS:excellent in 12 cases,good in 12 cases,fair in 4 cases,poor in 6 cases.Total exellence rate were 71%.[Conclusion]Combinate full-scale imageology information,correct classification of fracture according of AO,reasonable surgical approach and fixation,correct subtle technique during the operation and effective fracture resetting are keys to improve the effect of acetabular fractures.

OBJECTIVE: To review the characteristics changes of calcium phosphate cement (CPC) as drug delayed release carrier before and after carrying different drugs, analyze dynamic principle and influential factors of drug delayed release system, and summarize new advances of CPC in animal experiments and clinical studies.DATA SOURCES: A computer-based online search of CNKI (www.cnki.net/index.htm) and PubMed (http://www.ncbi.nlm.nih.gov/PubMed) was performed for articles published between 1985 and 2009 with the key words of "calcium phosphate cement, CPC, drug delivery system, release" in Chinese and English.DATA SELECTION: Articles highly related with CPC; articles concerning CPC as drug delivery system. Repetitive articles were excluded.MAIN OUTCOME MEASURES: Changes in physico-chemical properties and drug release dynamics of CPC as delivery carrier of different drugs.RESULTS: CPC is an outstanding skeletal defect restorative material. Considering physico-chemical properties, drug release dynamics and histocompatibility, CPC is good delayed release carrier of drugs. However, its clinical application is limited only in bone defect repair of unloading sites due to its bad compressive strength and adhesivity. Therefore, studies on these aspects require exploration.CONCLUSION: CPC as a drug delivery system is a novel administration method. It can repair bone defect and release drug to achieve favorable treatment effects. CPC has been extensively used in osteomyelitis, bone tuberculosis, bone tumor, bone fracture, bone nonunion, and artificial joint replacement.

OBJECTIVE To analyze the profile of the pathogens and their drug resistance isolated from children with lower respiratory tract infection in Wenzhou area from Jan 2004 to Dec 2006.METHODS Lower respiratory tract secretions were obtained from children with lower respiratory tract infection for bacterial culture.The K-B method was applied for the antibiotic susceptibility test.RESULTS Total 1605 strains were isolated.The isolating rates of Gram-positive cocci,Gram-negative bacilli and fungi were 24.9%,61.2% and 14.0%,respectively.60.5%,and 54.6% of the isolates of Escherichia coli and Klebsiella pneumoniae produced extended-spectrum beta-lactamases(ESBLs).The rate of Penicillin-resistant Streptococcus pnenmoniae(PRSPN)was 30.6%.20.5% isolates of Staphylococcus aureus were MRSA.All isolates of Enterobacteriaceae and Gram-positive cocci were susceptible to imipenem and vancomycin in vitro.CONCLUSIONS Gram-negative bacilli are still the primary pathogens resulting in lower respiratory tract infection in children.Fungi and muti-drug-resistant bacteria are on the rise trend.

BACKGROUND:There are objections to the efficacy and safety of total hip arthroplasty and artificial femoral head arthroplasty in the treatment of femoral neck fracture.
OBJECTIVE:To assess the efficacy and safety of one-stage total hip arthroplasty and femoral head arthroplasty for > 60-year-old patients with femoral neck fractures.
METHODS:According to the search strategy of Cochrane colaboration network, we searched PubMed (1966 to December 2014), EMbase (1974 to December 2014), Cochrane Library (Issue 3, 2011), China Biology Medicine database(1978 to December 2014), China National Knowledge Infrastructure (1994 to December 2014), VIP database (1989 to December 2014), and Wanfang Database (1979 to December 2014). Twenty-one articles on total hip arthroplasty and hemiarthroplasty for elderly femoral neck fractures were included. Two reviewers independently evaluated the quality of the included studies and extracted the data. In case of disagreement, settlement was made by negotiation. Meta-analysis was performed by RevMan 5.0 software in the included studies.
RESULTS AND CONCLUSION:(1) Literature analysis: five randomized controled studies, three quasi-randomized controled studies, and thirteen retrospective cohort studies were included, containing 2 250 patients. (2) Meta-analysis: No significant differencein rate of dislocation, deep infection rate and mortality rate in 1 year after replacement was detected between total hip arthroplasty and hemiarthroplasty for elderly femoral neck fractures (dislocation rate:RR=1.38, 95%CI: 0.81-2.34; deep infection rate RR=1.12, 95%CI: 0.60-2.11; mortality rateRR=0.90, 95%CI: 0.69-1.18). Reoperation rate was higher in the hemiarthroplasty group than in the total hip arthroplasty group (RR=0.46, 95%CI: 0.32-0.66). Harris score on the affected side between1 and 4 years was significantly higher in the total hip arthroplasty group than in the hemiarthroplasty group (MD=5.64, 95%CI: 2.82-8.46). (3) Results suggested that if physical conditions permit, compared with hemiarthroplasty group, femoral neck fractures patients aged > 60 years old in the total hip arthroplasty group had better hip function, but no significant difference was found in dislocation, deep infection and mortality between both groups.

ObjectiveTo study the effect of angiotensin Ⅱ type 1 receptor antagonist (ARB) losartan on reducing the incidence of stroke in patients which suffer from hypertension and atrial fibrillation(AF).MethodsProspective randomized analysis was used to divide one hundred and eighty hypertemion patients with atrial fibrillation into two groups.ARB treatment group was treated with losartan (n =90) and beta-blockers treatment group was treated with metoprolol ( n =90),all patients were treated for three years and followed up.Blood pressure,pulse pressure,incidence of stroke and myocardial infarction and mortality of cardiovascular events were evaluated.ResultsAfter antihypertensive treatment,blood pressure was reduced in two groups,the pulse pressure in losartan group was reduced obviously( all P ＜0.01 ).The incidence of stroke and myocardial infarction and mortality of cardiovascular events in losartan group were 22.2％,10.0％ and 13.3％,respectively,lower than that in metoprolol group 70.0％,40.0％ and 44.4％ ( all P ＜0.01 ).ConclusionLosartan reduced the incidence of stroke in the hypertension patients with AF.

OBJECTIVETo study the relationship between IgG titer of pregnant women and hemolytic disease of newborn(HDN) with different blood groups.

METHODSFour hundred pregnant women, including pregnant women with type O blood, were selected from May 2014 to January 2015 in our hospital for inspection and a couple of different blood groups, the IgG titer of pregnant women were detected in the inspection process. According to neonatal HDN, newborns were divided into 2 groups: HDN group(85 cases) and non-HDN group(315 cases). The incidence of postpartum neonatal hemolytic disease was tracked and the correlation of IgG titers with HDN were systematically analyzed.

RESULTSIn the production and inspection process, the IgG titer in pregnant women was divided into <1:64, 1:64, 1:128, 1:256 and greater than or equal to 1:512 five groups. the comparison of HDN incidence rate in 4 groups of IgG titer >64 and IgG titer <1:64 group showed that the prevalence of ABO hemolytic disease of newborn were 96.9%, 79.6%, 63, 7% and 28.8%, there was a certain correlation of pregnant women IgG titers with ABO hemolytic disease of the newborn, that is, with the increase of IgG titer, the incidence of hemolytic disease of newborns increased in certain degree (r=0.8832), the risk in 4 groups of neonatal HDN was higher than that in IgG titer <1:64 of IgG titer >64 HDN group.

CONCLUSIONThere is a certain corelation between prevalence of ABO-HDN and IgG titer of pregnant women. For these pregnant women, the control of the pregnant women IgG titer has a positive clinical significance to reduce the incidence of hemolytic disease of the newborn.

【Objective】 To investigate the role of thromboelastography (TEG) in the diagnosis and treatment of PICC related venous thrombosis in tumor patients, and provide basis for predicting PIC related venous thrombosis. 【Methods】 148 tumor patients who underwent PICC catheterization in our hospital from January to July 2019 were enrolled. The patients were subjected to TEG examination and ultrasound examination of limb blood vessels on catheterization side regularly one day before catheterization and 4 successive weeks after catheterization(once a week), respectively. The patients with venous thrombosis were subjected to TEG examination and vascular ultrasound regularly for 3 successive weeks(once a week) after anticoagulant therapy. The relationship between the occurrence and time of venous thrombosis and the changes of TEG parameters was analyzed. 【Results】 The pre-/post-catheterization TEG parameter of 81 patients without venous thrombosis indicated that coagulation state was normal (R value F=0.198, K value F=0.047, α value F=0.442, MAvalue F=0.079, CIvalue F=0.026, P>0.05). The TEG parameter of 67 patients, who developed asymptomatic venous thrombosis 1 to 3 weeks after catheterization(38 cases in 1 week, 16 in 2 weeks and 13 in 3 weeks), indicated the blood was hypercoagulable and the TEG parameter was statistically different from the pre-catheterization value(P<0.01). But after anticoagulant treatment, the coagulation state gradually returned to normal as the TEG parameter reached pre-catheterization value for 3 successive weeks (P>0.05). 【Conclusion】 TEG can reflect the status of PICC related venous thrombosis in tumor patients.Strengthening TEG monitor in tumor patients 1 to 3 weeks after PICC catheterization is conducive to early detection, diagnosis and treatment for PICCrelated thrombosis, thus reducing the harm of venous thrombosis to patients.