Objective:To compare the effect between benazepril and candesartan combination and single medication in either one of them for treatment of hypertension-combined with microalbuminuria(MCA). Methods:A total of 95 patients were divided into three groups.Benazepril group(n=31),patients were treated with Benazepril 10～20 mg/day;Candesartan group(n=32),patients were treated with Candesartan 4～8 mg/day;and Combination group (n=32),patients were treated with benazepril 10 mg/day and candesartan 4 mg/day.The medication lasted for 8 weeks.Blood pressure(BP),plasma urinary albumin and creatinine ratio(A/C),endothelin-1(ET-1),nitrogen monoxide(NO)and potassium were examined and compared before and after the medication respectively. Results:The levels of BP,plasma A/C and ET-1 were decrease and NO was increased in all three groups(P0.05,respectively). Conclusion:Effect of benazepril and candesartan combination in patients with hypertension-combined microalbuminuria was better than single medication in either benazepril or candesartan.

Fructose-1,6-diphosphate (FDP) is a very important mesne product which links the glucose and hepatin with the oxidation in energy metabolism and keeps the glycolysis functional, which is made use of widely. In addition, FDP has the ability to stabilize the cell membrane, abate inflammatory response, and restrain the oxygen free radical and cell apoptosis, it can protect cell in both structure and function. Recent researches proved that FDP is effective on myocardium protection and cardiac function reviving. This article reviews these research progresses.

Objective To introduce the clinical apply of middle and small skin defect in finger injury with lateral arm free perforator flap.Methods (1) Ten cadavers were injected with a modified lead oxide-gelatin mixture.Later,CT scan,three-dimensional reconstruction of the cutaneous perforator vessels on the later arm.Then simulate the flap design.All cadavers were dissected before CT scanning.(2) Eighteen cases of middle and small skin defects in finger injury were treated with lateral arm free flap.The defect area were from 3 cm × 4 cm to 6 cm × 9 cm.Results Our research showed that the average caliber diameter of perforators of profunda brachial artery(PBA) was (0.71 ± 0.15) mm,and Posterior radial collateral artery(PRCA) was (0.94±0.22)mm.The results of pedicle length of perforator of PBA was (2.74 ±0.42) cm:(2.96 ±0.37) cm,and PRCA was (4.78 ±0.63) cm:(4.86 ±0.51) cm.3D reconstructive results showed that the perforators of PBA and PRCA dominated the lateral upper arm area.The flap of 18 cases survived after the operation.The wound of providing area was directly sutured or skin grafting and got healing.All cases were followed up for 6 months to 3 years,and the average follow-up time was 11 months.There was a little swelling on the outlooks of the flap,but the texture and sensation of the flap was good.Conclusion The lateral arm free perforator flap has a stable vessel pedicle,good texture and sensation,so it was a good method to repair middle and small skin defect in finger injury.

Objective To investigated the prevalence of obesity and metabolic syndrome (MS) and the relationship of non-alcoholic fatty liver disease (NAFLD) with MS in Hangzhou of Zhejiang province. Methods A total of 3500 subjects who were negative for hepatitis B surface antigen marker were selected to take physical examinations. Body height, body weight, blood pressure, alanine aminotransferase,fasting blood glucose,high-density lipoprotein cholesterol,and triglyeerides were recorded. B-ultrasonography of the liver and gallbladder was undertaken. Results The prevalence of MS in the NAFLD or normal control group was 25.49% and 8. 61%, respectively ( P ＜ 0. 05 ). In multivariate logistic regression analyses, MS patients were 3. 927 times more likely to be NAFLD-related. Increased body mass index (BMI) and triglyceride were significantly associated with NAFLD among MS patients. Conclusion BMI and triglyceride level may be the main risk factors of NAFLD-related MS.

Objective To study the clinical characteristics of septicemia and septic shock in elderly patients with liver disease. Methods Fifty-two patients over 60 years old with liver disease and positive blood culture, admitted form 1999 to 2003, were enrolled for analysis. Results Septic shock was found in 8 patients (15.4%). The course of sepsis was complicated by progressive deterioration of hepatic and renal functions. 18 patients (34.6%) died or left the hospital in a critical condition. 52 strains of pathogenic bacteria were isolated, among which 71.2% were G +germ, 26.9% G -germ and 1.9% fungi. Conclusion Septicemia and septic shock can exacerbate liver disease. Early diagnosis and treatment should be emphasized to lower the mortality.

Objective To explore the expression profile of Wnt4 in rat kidney during renal development and its effect on renal development. Methods Rats with embryonic age of 18 days (E 18 d) , 20 days (E 20 d) as well as postnatal age of 0 day (P 0 d), 1 day (P 1 d), 3 days (P 3 d), 5 days (P 5 d) and 7 days (P 7 d) were selected. Expression levels of Wnt4 in rat kidney during renal development were quantified by immunohistochemistry and Western blot in all time points. Results Immuno?histochemistry analysis showed that during E 18 d to P 7 d, Wnt4 mainly expressed in proximal tubules, ureteric bud, comma shaped bodies and S shaped bodies of nephrogenic zone;the expression in the distal tubule was weak;the expression in renal corpuscle decreased with time;Western blot analysis showed that the expression of Wnt4 in rat kidney began to decrease from E 18 d and reached bottom at P 1 d then rise again until P 7 d when it dropped again. Conclusion During renal development, Wnt4 proteins were involved in the development of the nephrogenic zone through regulating canonical Wnt/β-catenin signaling pathway, and was involved in extension of proximal tubules by inducing the non canonical Wnt/PCP signaling pathway. Expression of Wnt4 protein in rat kidney was closely related to nephron formation and development of proximal tubules.

Objective To investigate the feasibility of total hip arthroplasty through a small anterolateral incision. Methods Total hip arthroplasty through a small anterolateral incision was performed in 53 cases (58 hip joints) from February 2003 to December 2003, including 5 cases of simultaneous replacement of bilateral joints, 6 cases of total hip revision, and 4 cases of hip joint rigidity. The surgical modification features were as follows: the patient was placed in recumbent position, with the involved buttock region slightly hanging over the side of the surgical bed and normally drooping; the involved leg was placed in 10? of adduction, which was helpful to the exposure of the greater trochanter; after the exposure of the neck of the femur and the greater trochanter, osteotomy was performed firstly, then the femoral head was dislocated and removed. Results The length of incision was 7~12 cm (mean, 8.5 cm). The operation time was 70~140 min (mean, 88 min). The blood loss was 250~660 ml (mean, 470 ml). No severe complications occurred. Postoperatively, weight-bearing and mobilization exercise were begun in 6~14 days. All the cases were followed for 4~40 weeks (mean, 28 weeks). The Harris hip scores showed excellent outcomes in 37 cases, good in 12, fair in 4, with a rate of excellent or good results of 92.5% (49/53). Conclusions Total hip arthroplasty through a small anterolateral incision is a feasible procedure that is characterized with minimal invasion, less blood loss and quick recovery. It can be applied in total hip replacement for artificial hip joint revision, hip joint rigidity, or congenital dislocation of hip joint.

Objective To evaluate the influence of precise liver resection techniques on intestinal permeability in the diseases needing liver resection.Methods Eighty-seven patients needing liver resection were randomized to receive the precise liver resection (n =58,PLR group) or the conventional liver resection (n =29,CLR group).D-lactate and and endotoxin in abdominal fluid were detected in all the patients.The abdominal fluid bacteria cultures were performed.Results The postoperative hospitalization time,the needed time of blood routine,temperature,and oppetite resuming were significantly shorter in PLR group than those in CLR group (t ≥7.36,P ＜ 0.01) ; The postoperative abdominal effusion was significantly less in PLR group than that of CLR group(t ≥ 14.17,P ＜0.01).The abdominal fluid concentrations of D-lactate and endotoxin in operation or at 1d after operation were significantly higher than those at 5d after operation in both groups(t ≥10.41,P ＜0.01).Those parameters decreased significantly at 2d after operation,returned to the normal level at 3d after operation in PLR group,and those parameters were significantly lower in PLR group than those in CLR group at the same time phase after postoperative 2 or 3 days (t ≥9.23,P ＜0.01) ; Those parameters began to drop at 3d after operation,returned to the normal level at 5d after operation in CLR group.The positive rate of abdominal fluid bacteria cultures was significantly lower in PLR group than that in CLR group(13/29) (x2 =23.51,P ＜ 0.01).Conclusions The precise liver resection techniques had an important influence on intestinal permeability in the diseases needing liver resection.

Objective To investigate the natural infection status of murine norovirus ( MNV) in laboratory mice in Shanghai area and isolate MNV from mouse cecal feces .Methods To collect cecal contents and serum samples from 319 specific pathogen-free ( SPF) mice coming from different research institutions .Reverse transcription-polymerase chain reaction ( RT-PCR) and enzyme linked immunosorbent assay ( ELISA) were used to detect MNV infection in the mice , re-spectively.The positive stool samples were diluted and filtered through 0.22 μm membrane, inoculated into RAW 264.7 cells, and then identified by RT-PCR.Results There were 95 positive results in the 319 cecal samples by RT-PCR, and the positive rate was 29.78%.Among 180 serum samples which were tested by RT-PCR, 70 samples were positive by ELISA, and the positive rate was 38.89%.The infected RAW 264.7 cells showed cytopathic effect ( CPE) within 72 h. After 3 times of freezing and thawing , RT-PCR obtained a 187 bp band.Conclusions The results from the present study show that there is a high natural infection rate of MNV in laboratory mice in Shanghai area , and the strict breeding manage-ment must be strengthened .

Objective To evaluate the model for end-stage liver disease (MELD) and MELD combined with serum natrium level (MELD-Na) in predicting short-term prognosis of liver failure.Methods Clinical data of 322 patients with liver failure admitted in the First Affiliated Hospital of Xinjiang Medical University from April 2003 to April 2012 were retrospectively analyzed.MELD and MELD-Na scores were calculated at diagnosis and one week after the diagnosis,and then △MELD and △MELD-Na were determined.Receiver operating characteristics (ROC) curve and Kaplan-Meier survival curve were used to evaluate the value of the above scores in predicting 3-month prognosis.Results The 3-month mortality rates of acute/sub-acute,acute-on-chronic and chronic liver failure were 77.4％ (24/31),41.7％ (50/120) and 56.1％ (96/171),respectively,and the difference was of statistical significance (x2 =14.273,P ＜0.01).For acute/sub-acute liver failure,the areas under ROC curve (AUCs) were 0.699-0.836 for each scoring system in predicting short-term prognosis,and no significant difference was observed (Z =0.507,0.622,0.712,0.727,0.779 and 0.599,P ＞0.05).For acute-on-chronic liver failure,AUCs were 0.889 and 0.897 for △MELD and △MELD-Na in predicting short-term prognosis,which were higher than those of MELD and MELD-Na scores at the baseline (Z =3.110 and 3.500,P ＜ 0.05),but no significant difference was observed between △MELD and △MELD-Na (Z =0.310,P ＞ 0.05) ; Kaplan-Meier survival curve showed that the 3-month mortality rate for patients with △MELD ＞ 3.5 was 87.8％,and the average survival time was 34.05 d.For chronic liver failure,AUC of △MELD was 0.871 in predicting short-term prognosis,which was higher than that of △MELD-Na (Z =4.229,P ＜0.05) ; Kaplan-Meier survival curve showed that the 3-month mortality rate for patients with △MELD ＞ 4.5 was 89.9％,and the average survival time was 29.08 d.Conclusion For acute/sub-acute liver failure,MELD,MELD-Na,△MELD and △MELD-Na are all satisfactory in predicting short-term prognosis; for acute-on-chronic liver failure,△MELD and △MELD-Na are better than MELD,MELD-Na scores at the baseline; and for chronic liver failure,△MELD is the best indicator.