OBJECTIVE:To explore the effects of olmesartan medoxomil on blood pressure variability(BPV)and vascular en-dothelial function of patients with mild and moderate essential hypertension. METHODS:Sixty patients with mild and moderate es-sential hypertension were included in study group,and other 60 healthy volunteers were included in control group. Study group was given olmesartan medoxomil 20 mg orally,qd,for 4 weeks,followed by same dose if their SBP≤140 mmHg and DBP<90 mmHg till 12th weekend;those patients with SBP>140 mmHg or DBP≥90 mmHg received double dose till 12th weekend. Aver-age blood pressure,BPV,FMD and NMD of study group were measured before and after treatment as well as the changes in se-rum concentrations of NO and ET,and then compared with control group. RESULTS:Compared with before treatment,average blood pressure,BPV and ET level of study groups were decreased significantly after treatment,serum level of NO was increased significantly,while FMD and NMD were improved significantly,with statistical significance (P<0.05);there was no statistical significance,compared with control group (P>0.05). There were 3 cases of mild diarrhea and 2 cases of mild dry cough,and they relieved after medication withont speical treatment. CONCLUSIONS:Olmesartan medoxomil can play a good effect on de-creasing blood pressure and is tolerable. It can also improve the vascular endothelial function.

Objective: To build a relationship model of perceived academic self-efficacy, learning stress, and learning burnout of high school students. Methods: 674 high school students were surveyed with Learning Stress Scale of High School Students, The Perceived Academic Self -efficacy Scale, Scale of Learning Burnout of High School Students. Results: Learning stress had a direct effect on a low level of learning efficacy, perceived alienation to teacher and physical exhaustion (The direct effect value were -0.22,0.12,0.27). At the same time, perceived basic ability and perceived control partially mediated the impact of learning stress on the low level of learning efficacy, perceived alienation to teacher and physical exhaustion (the mediated effect value were -0.155 and-0.264, 0.066 and 0.299, 0.089 and 0.233). Perceived basic ability and perceived control fully mediated the relationship between learning stress and emotional exhaustion (the mediated effect value were 0.033 and 0.387). Conclusion: The students with a higher level of stress reported suffering more learning burnout than those with a lower level of stress, and vice versa.

As the structure of shoulder joint is complex, proper method s should be adopted to treat the injured shoulder joint according to the type an d position of the trauma. Conservative treatment has been widely used to treat t he slightly displaced or stable fractures (including those of the proximal humer us, clavicle and shoulder blade), and most of the fresh dislocations of shoulder joint and acromioclavicular joint if the injuries are not serious. As for the o bvious unstable shoulder fractures, recurrent dislocation of shoulder joint, sev ere dislocation of acromioclavicular joint, dislocation of shoulder joint accomp anied with fracture, and rotator cuff tear, an operation should usually be the r ight choice. In either conservative or operative treatment, earlier systematic f unctional rehabilitation should be widely used in order to achieve satisfactory functional recovery of should joint.

AIM:To explore the surgical effect of total hip joint replacement on the severe degenerative arthritis secondary to congenital hip dysplasia.METHODS:The experiment was carried out in the Department of pedics,General Hospital of Chinese PLA between June 1998 and December 2005.①116 adult patients(128 hips) with arthritis secondary to dysplastic hip received total hip replacement,including 13 males(15 hips) and 113 females(106 hips),aged from 16 to 66 years(average of 42.6 years).According to Crowe classification system,there were 57 cases(60 hips) of typeⅠ,20(23 hips) of typeⅡ,16(20 hips) of type Ⅲ and 23(25 hips) of type Ⅳ.②The acetabula were reconstructed at the true acetabular location.Except one case,all patients were given biological fixation of cementless acetabular cups including 83 hips with routine total hip replacement,and 27 hips with smaller cup;11 hips with routine total hip replacement after granular bone grafting,and 7 hips with a smaller cup after autologous femoral grafting on the superior margin of acetabula.119 biological prostheses were used to reconstruct the femoral cups including 4 common cemented shafts,6 long cemented shafts,and 4 S-ROM prostheses.③Harris hip score was adopted to evaluate the hip function,and X-ray photographs were used to observe the location of prostheses.RESULTS:①The Harris hip scores increased from 38.5 preoperatively to 88.5 postoperatively.②No prosthesis displacement,dislocation of hip joint or repair was found in patients,and the length of treated limbs meanly prolonged by 2.3 cm.Additionally,the incision healed primarily.③Radiographically,the positions of the prostheses were normal,and the bone grafts fused with the host bone successfully.The average bone coverage was 95%(90%-100%);radiolucentline was observed at between the acetabular cup and host acetabula in 2 cases,and 1 at femur.④Adverse effects:Sciatic nerve tension injury was found in 1 case and recovered in 4 months,the femoral nerve tension injury in 1 case and recovered in 3 months,and hip rest pain remained in 4 cases.CONCLUSION:In the treatment of arthritis secondary to dysplastic hip with total hip replacement,it is better to reconstruct the acetabulum at the true acetabular location.Moreover,the individualized appropriate selection of femoral prostheses is a key factor to obtain good curative effects.

Objective To study the effects of glucosamine sulfate on nitric oxide(NO)production induced by interleukin(IL)-1β in human osteoarthritis chondrocytes(HOC),and explore the possible mechanism.Methods Chondrocytes were harvested from 10 osteoarthritis patients undergoing total knee replacement(TKR)operation.Human recombinant IL-1β(5 μg/L)and glucosamine sulfate GS in different concentrations(0.2 mmol/L,2.0 mmol/L,20.0 mmol/L)were administrated into cell culture medium for 24 h.The content of NO was detected by enzyme-linked immunosorbent assay(ELISA).The mRNA and protein expression of inductive nitric oxide synthetase(iNOS)were measured by RT-PCR and Western blot,respectively.Results Stimulation of HOC with IL-1β enhanced production of NO and expressions of iNOS mRNA and protein(t=-14.81,-45.38,all P＜0.01).Pretreatment with 2.0 and 20.0 mmol/L GS showed a dose-dependent inhibition of IL-1β induced NO production(F=12.43,P＜0.05)and the expression levels ofiNOSmRNA(F=142.28,P＜0.05)and protein(F=78.08,P＜0.01).20.0 mmol/L GS alone did not influence NO production(t =-0.17,P＞ 0.05).Conclusions GS may inhibit the synthesis of NO induced by IL-1β in HOC through down-regulate mRNA and protein expressions of iNOS.

To investigate the clinical efficacy of massage manipulation reposition for treatment of child hip-joint semiluxation, sixty-seven cases of child hip-joint semiluxation were treated by massage manipulation reposition. Sixty-two cases were cured and 5 cases improved. The total effective rate was 100%. Massage manipulation reposition is an effective method for treating child hip-joint semiluxation.

Homeobox gene Six1,as a transcription factor has been proved to participate in most malignant tumors.Its overexpression is associated with the genesis and development of breast cancer intimately.Overexpression of Six1 in mammary cells is sufficient to induce activation of stem cells.Similarly,Six1-overexpressed tumors could activate the TGF-β pathway and Wnt/β-catenin pathway,lead to malignant transformation by inducing epithelial-mesenchymal transition and mammary tumorigenesis.Research on the role of sixl will improve understanding the mechanisms of breast cancer initiation and development.

Objective To evaluate the result of open rotator cuff repair and to identify potential preoperative or intraoperative factors that could affect the outcome.Methods 43 cases(44 shoulders)with rotator cuff tear who undergone open repair surgery between May 1987 and October 2002 were retrospectively studied.There were 31 shoulders ruptured in supraspinatus, 9 shoulders in supraspinatus and infraspinatus,3 shoulders in supraspinatus and subscapulafis and 1 in supraspinatus, infraspinatus and subscapularis.And there were 13 shoulders torn with small size, 18 shoulders with middle size, 10 shoulders with large size and 3 shoulders with massive size.Ruptured rotator cuff was repaired with tendon to bone suture in 25 shoulders,with tendon to tendon suture in 7 shoulders, and combined suture in 11 shoulders.One shoulder was repaired by deltoid transfer.After an average 88.2-month-long follow-up(from 52 to 250 months),we evaluate the postoperative shoulder function with University of California at Los Angeles(UCLA)score.The patient's subject satisfaction was assayed by visual analogue scale (VAS).The risk factors as age, sex,dominant side, trauma history,preoperative duration and tear size were analyzed.Results The average UCLA score was 11.5±2.8 preoperatively and 29.7±5.3 at follow-up, with 36 shoulders reaching excellent or good and 2 shoulders ranking poor.According to VAS,the subject satisfaction rate was as high as 89%,being positively related to UCLA score significantly(r=0.72,P＜0.01).Preoperative duration(r=-0.332,P=0.028)and tear size(r=-0.404,P=-0.007)was negatively relative with surgical results.Age,sex,dominant side,trauma history had no effect on prognosis.Conclusion Open rotator cuff repair could acquire satisfying outcome.Preoperative duration and tear size was negatively relative with surgical results.

Objective To determine the role of adenosine A1 receptor system in the delayed protective effects of ischemic preconditioning(IPC) in brain ischemia.Methods Thirty-five rabbits weighing 2-2.5kg were randomly divided into 7 groups: control (group Ⅰ), 3-min ischemia (group Ⅱ), 10-min ischemia (group Ⅲ), IPC (group Ⅳ), N6-cyclopentyladenosine (CPA)(group V), 8-cyclopentyl-1,3-dipropylxanthine (DPCPX)+ IPC(group Ⅵ), and DPCPX+3-min ischemia (group Ⅶ).Cerebral ischemia was produced by occlusion of both carotid arteries in combination withdrawing blood to maintain MAP at 35-40 mmHg.After 3-min IPC and 3 days of recovery , cerebral ischemia was induced and lasted 10 min (model of delayed protective effects of IPC). Adenosine A1 receptor agonist CPA or antagonist DPCPX was used instead of IPC to evaluate the role of adenosine A1 receptor in the delayed protective effects of IPC.The expression of heat shock protein 70 (HSP70) was analyzed by immunohistochemistry.Neurons density and expression of HSP70 in the hippocampal CA1 region were examined and measured 3 days later.Results (1) CPA could reduce cerebral ischemic injury, but the effects of CPA were not as good as those of IPC (about 70% of IPC).After adenosine A1 receptors being blocked by DPCPX the delayed protective effects of IPC disappeared.(2) 3-min ischemia alone did not cause neuronal injury but induced obvious expression of HSP70.DPCPX not only could make 3-min ischemia cause injury but also reduce the expression of HSP70.Conclusions (1) The delayed protective effects of IPC is related with activation of adenosine A1 receptor system.(2) One of the mechanisms of the blocking effects of DPCPX may be due to the reduction in expression of HSP70 .

Objective To observe the changes of hemodynamics during 0 375% ropivacaine epidural anesthesia period,and 0 375% bupivacaine as control in patients have undergoing breast cancer radical operation.Methods Sixty-one patients were randomly designed to receive 0 375% ropivacaine(groupⅠ,n=30)or 0 375% bupivacain(groupⅡ,n=31)epidural anesthesia respectively during breast cancer radical operation.BP,HR and SpO 2 were assessed at 5min,10min,15min and 20min after first full doses.Results The changes of BP,HR and SatO 2 at 5min,10min,15min and 20min after first full doses were obviously lower in groupⅠ than that in groupⅡ(P0 05).No severe adverse event was found during the observation.Conclusions Interference of epidural anesthesia with 0 375% ropivacaine on hemodynamics in breast cancer radical operation is slighter than that of 0 375% bupivacaine.