OBJECTIVE:To investigate the status of the use of angiotensin Ⅱ receptor blocker(ARB)in the outpatient of our hospital,and provide reference for the clinical rational drug use. METHODS:Totally 2 460 prescriptions of hypertension treated by ARB drugs in the outpatient of our hospital in 2013 were statistically collected,and the use of such drugs were comprehensively an-alyzed. RESULTS:The ratio of ARB in the treatment of hypertension in the outpatient of our hospital in 2013 was 36.22%,and the common ARB drugs were Irbesartan tablets,Irbesartan and hydrochlorothiazide tablets,Valsartan capsules and Telmisartan tab-lets. The prescriptions of hypertension in our hospital were mostly two-drug combination,the common combination of ARB drugs were ARB+calcium channel blocker(CCB)and ARB+potassium-sparing diuretics;the three-drug combination of ARB drugs were ARB+β-receptor blockers (β-RB)+CCB and ARB+CCB+potassium-sparing diuretics. Among 2 460 prescriptions of hypertension treated by ARB drugs,1 103 prescriptions were irrational,accounting for 44.84%;77 prescriptions were ARB combined with po-tassium-sparing diuretics with no clear indication,accounting for 6.98%;39 prescriptions were ARB combined with ACEI with no clear indication,accounting for 3.54%;330 prescriptions were ARB combined with β-RB with no clear indication,accounting for 29.92%;617 prescriptions had inappropriate frequency of ARB use,accounting for 55.94%;and 40 prescriptions were other irra-tional use,accounting for 3.63%. CONCLUSIONS:ARB drugs are commonly used for hypertension patients in outpatient of our hospital. However,there are still many problems of irrational use in clinical treatment. Therefore,hospital should take appropriate interventions to promote the rational drug use through the joint efforts of physicians,pharmacists and hospitals.

Objective To study the effects of glucocorticoid receptor (GR) signal pathway and downstream cytokineson androgen-independent growth of prostate cancer (PC) cells.Methods The human androgen-dependent PC (ADPC) cell line LNCaP and androgen-independent PC (AIPC) cell line DU145 were cultured in vitro.Immunocytochemistry was used to examine the expressions of the androgen receptor (AR),GR,HSPg0 and interleukin-6 (IL-6).The GR antagonist RU486 was used to treat cultured cells,and the effects of RU486 on the proliferation of both cell lines were analyzed by MTT assay.Expressions of HSP90 and IL-6 mRNA and protein were assessed by RT-PCR and Western blotting respectively.Results LNCaP cells were AR-positive and GR-negative,whereas DU145 cells were GR-positive and AR-negative.The expressions of HSP90 and IL-6 were significantly stronger in DU145 cells than in LNCaP cells (P＜0.01).RU486 had no obviously effects on the growth of LNCaP cells,but exerted a significant time-and dose-dependent growth inhibition on DU145 cells.RU486 treatment in DU145 cells also resulted in a dose-dependent decrease in the expressions of HSP90 and IL-6 mRNA and protein.Conclusions GR signal pathway may be the main survival pathway for DU145 cells.Abnormal hyperactivation of GR signal pathway and its promoting the expressions of HSP90 and IL-6 may contribute to the progression of ADPC to AIPC after androgen ablation.

Objective: To analyze the factors affecting the complication of pulmonary atelectasis among children with tracheobronchial tuberculosis (TBTB), so as to provide the reference for the prevention and treatment of pulmonary atelectasis complicated by TBTB. Methods: Children with TBTB admitted to Department of Paediatrics, Linping Division of the Second Affiliated Hospital of Zhejiang University School of Medicine were selected as the study subjects from October 2018 to March 2023. Subjects's basic information, etiological examination results and laboratory testing results were collected using a self-designed questionnaire, and factors affecting the complication of pulmonary atelectasis among children with TBTB were identified using a multivariable logistic regression model. Results: A total of 120 children with TBTB were included, with the age of 6 months to 12 years. There were 33 children at ages of less than one year (27.50%), 71 girls (59.17%) and 25 children with TBTB and pulmonary atelectasis (20.83%). Multivariable logistic regression analysis identified less than one year of age (OR=1.720, 95%CI: 1.126-3.358), type Ⅵ of TBTB (OR=1.669, 95%CI: 1.101-2.236), high level of C-reactive protein (OR=1.887, 95%CI: 1.088-2.686) and high level of procalcitonin (OR=1.844, 95%CI: 1.034-2.654) as risk factors for the complication of pulmonary atelectasis in children with TBTB. Conclusion Less than one year of age, type Ⅵ of TBTB, high level of C-reactive protein and high level of procalcitonin may increase the risk of pulmonary atelectasis in children with TBTB.

Objective　To evaluate the results of radical resection for the treatment of Budd-Chiari syndrome (BCS) caused by short segmental lesions in inferior vena cava (IVC), and major hepatic veins (MHV).　Methods　In this series, resection of IVC occlusive segment and orthotopic artificial vascular graft transplantation were performed in 42 patients. Resection of major hepatic vein, hepatic venous plasty and orthotopic transplantation with artificial vascular graft were performed in 10 patients. Resection of major hepatic vein, anastomosis between hepatic vein and right artrium in 3 cases. Percutaneous transhepatic angioplasty in 10 cases.　Results　One patient died of complication. 58 cases were followed up for an average of 30 months. 3 cases in interventional group suffered recurrence and one in surgical group had recurrence.　Conclusions　The treatment of BCS by resecting inflicted segment of IVC or hepatic veins and orthotopic artificial vascular graft transplantation effect a radical cure in most cases.

Cerebral microbleed is a cerebral small vessel disease.The detection rate is 4.5％ to 84.9％in different populations.Vascular cognitive impairment is the general name of various cerebrovascular diseases and their risk factors caused varying degrees of cognitive impairments.Studies have shown that cerebral microbleed is closely associated with vascular cognitive impairment.This article reviews the relationship between cerebral microbleed and vascular cognitive impairment in different populations,different degrees and different locations.

Objective [WT5”BZ]To evaluate the results of radical resection for the treatment of Budd Chiari syndrome (BCS) caused by short segmental lesions in inferior vena cava (IVC), and major hepatic veins (MHV).[WT5”HZ]Methods [WT5”BZ]In this series, resection of IVC occlusive segment and orthotopic artificial vascular graft transplantation were performed in 42 patients. Resection of major hepatic vein, hepatic venous plasty and orthotopic transplantation with artificial vascular graft were performed in 10 patients. Resection of major hepatic vein, anastomosis between hepatic vein and right artrium in 3 cases. Percutaneous transhepatic angioplasty in 10 cases.[WT5”HZ]Results [WT5”BZ]One patient died of complication. 58 cases were followed up for an average of 30 months. 3 cases in interventional group suffered recurrence and one in surgical group had recurrence.[WT5”HZ]Conclusions [WT5”BZ]The treatment of BCS by resecting inflicted segment of IVC or hepatic veins and orthotopic artificial vascular graft transplantation effect a radical cure in most cases.

Objectives To evaluate methods to diagnose Budd-Chiari syndrome with inferior vena cava (IVC) thrombosis.Methods 31 cases underwent phlebography, 28 cases received color Doppler sonography preoperatively. Radical thrombectomy was carried out in 28 cases. Results IVC thrombi was found by phlebography in 24 cases, and by color Doppler sonograhy in 25 cases. There was no intraoperative death, nor acute pulmonary embolism.All patients were discharged uneventfully. Follow-up of 6 to 80 months found recurrence in 3 cases.Conclusions Large or lateral thrombi can be easily diagnosed by phlebography. Fresh or floating thrombi often missed by phlebography could be rushed out by blood stream at the time IVC was incised.The thrombi adhered to the IVC wall could be taken out with large balloon catheter or manually.

Clinical practice has proved that regulating activities ofqi and recovering function ofthe liver in governing conveyance and dispersion, can make the chronic kidney disease(CKD) patients' symptoms improved actually.In this paper, we explore the ‘treatment ofchronic kidney disease through the liver' from the aspects ofanalyzing the relationship ofthe liver wood and kidney water's physiology and pathology, the theoretical origin ofthe treatment ofkidney disease through the liver, the liver and multi-system ofmodern medicine and so on.‘Treatment ofchronic kidney disease through the liver' is to apply regulating activites ofqi throughout the whole treatment course.It can help the liver restore the balance ofvarious systems steady state, the internal environment stability, so as to protecting the kidney function.It belongs to harmonizing therapy, the clinical specific prescription is Xiaochaihu Tang

Objective To establish and evaluate a diagnostic technique based on the AllGlo~(TM) probe for the invasive aspergillosis. Methods With the self-designed AllGlo~(TM) probes and primers and the standards, two standard curves of the real-time PCR based on AllGlo~(TM) probes were established respectively for A. flaws and A. fumigatus,then its specificity, sensitivity and reproducibility were evaluated respectively. Results The findings indicated that the standard curve of A. flavus was Y = - 3. 003X + 36. 825, and A. fumigatus' was Y = - 3. 052X + 38.016, and their interassay coefficient of variation respectively were 15.60% and 12. 94% , suggesting a good reproducibility. The lowest spore concentration they could be detected was 10 CFU/ml, which equated to 100-1000 copies of internal transcribed spacer (ITS)2 genes, suggesting a good sensibility. They didn't have cross-positive reaction with other fungus, human genome and bacteria, which indicated a good specificity. Conclusion The diagnostic technique based on the AllGlo?probe for the invasive aspergillosis possessed a good sensitivity, good specificity and deadly accuracy.

β2-Microglobulin is a small molecule protein, consisting of a polypeptide chain.Previous studies have confirmed that serum β2-microglobulin is a biomarker that reflects early renal function injury, and renal function injury is closely correlated with ischemic stroke.Studies in recent years have shown that the level of serum β2-microglobulin increases significantly in patients with ischemic stroke.Thus, it can be used as a biomarker for the risk of ischemic stroke.