Objective To investigate the clinical efficacy of amlodipine combined with atorvastatin in treatment of hypertensive patients complicated with coronary heart disease.Methods 80 hypertension patients complicated with coronary heart disease were randomly divided into the observation group 40 cases,control group 40 cases.Control group was given amlodipine treatment,the observation group was given amlodipine and atorvastatin calcium therapy.The clinical efficacy of two groups were compared.Results The hypertension excellent and good rate of the observation group was 95.0％,77.5％ in the control group.The excellent and good rate of coronary heart disease in the observation group was 87.5％,75.0％ in control group.The excellent and good rate of hypertension and coronary heart disease between two groups had statistically significant differences(x2 =23.12,18.98,all P ＜ 0.05).The incidence rate of adverse reaction in observation group was 10％,control group 10％,which showed no significant difference between the two groups (P ＞ 0.05).Conclusion Amlodipine combined with atorvastatin calcium has the exact clinical efficacy in the treatment of hypertension and coronary heart disease,it can improve the patients' quality of life and worthy of clinical application.

Objective To study the effects of different concentrations of hypertonic saline (HS) and 20%mannitol on decreasing intracranial pressure (ICP) in patients with moderate-sever traumatic brain injury (TBI). Methods A total of 60 patients were randomly assigned into 7.5%HS group, 3%HS group and 20%mannitol group, 20 patients in each group. All of patients were treated with conventional treatment according to the diagnostic and treatment practices of TBI. When ICP was above 20 mmHg for more than 5 minutes, patients were administered corresponding hypertonic dehydrator. The levels of ICP, mean arterial pressure (MAP), cerebral perfusion pressure (CPP), urine volume per hour and serum sodium were monitored continuously within 6 hours after the initiation of therapy. Results All agents could significantly decrease the ICP (P<0.05), but the onset time in 7.5%HS group was less than that of the other two groups (P<0.05), and the decreased magnitude of ICP and the effective time of decreasing ICP in 7.5%HS group were more than those of the other two groups (P < 0.05). Both 7.5%HS and 3%HS could increase MAP and CPP. There was no statistical difference in serum sodium between both groups , but the diuretic effect in both groups was worse than that of 20%mannitol group. Conclusion The rapidly infusion of 7.5%HS could significantly decrease the ICP, increase the MAP and CPP without obvious side-effect in patients with moderate-sever TBI, and which is a safe and effective therapy for intracranial hypertension after traumatic brain injury .

Objective To determine the effect of moderate hypothermia on coagulation in patients with severe traumatic brain injury (sTBI) and investigate the clinical significance of thrombelastogram (TEG) monitoring.Methods Seventy-five patients with sTBI were randomly assigned to hypothermia group (conventional treatment + moderate hypothermia within 24 hours posttrauma,n =38) and control group (conventional treatment alone,n =38).TEG aided in monitoring coagulation function by measuring clot reaction time (R),clot formation time (K),clotting rate (α),maximal amplitude (MA),and percent fibrinolysis at 30 minutes after MA (LY30).Meantime,the intracranial pressure,vital signs,blood gas values,and blood electrolytes were also measured.Outcome was evaluated by using Glasgow outcome scale (GOS).Results The two groups were similar on admission with respect to R,K,α,MA,and LY30 (P ＞ 0.05),but the coagulation index in hypothermia group was significantly different from that in control group at days 1,2,3 and 7 posttreatment (P ＜ 0.05).Moreover,moderate hypothermia therapy demonstrated decrease of intraeranial pressure (P ＜ 0.01),with no severe complications,low mortality and improved outcome in comparison with control group.Conclusion Moderate hypothermia improves the hypercoagulability in patients with sTBI without increasing the risk of hyperfibrinolysis and protects brain tissue by decreasing intracranial pressure.

Objective To study the effect of limited fluid resuscitation (LFR) on coagulation in patients with severe traumatic brain injury (sTBI) and investigate its clinical significance.Methods Seventy-nine patients were assigned to low volume group (≤ 2 000 ml,40 cases) and high volume group (＞ 2 000 ml,39 cases) according to the random number table.LFR was performed for all patients.Prothrombin time (PT),partial thromboplastin time (APTT),thrombin time (TT) and fibrinogen (FIB) level were measured in both groups at different time points.Mean heart rate,blood pressure,blood gas values and blood electrolytes were monitored.Meantime,NICU days,hospital length of stay and incidence of multiple organ dysfunction syndrome (MODS) were recorded.Glasgow Outcome Scale (GOS) was evaluated.Results In constrast to high volume group,PT,APTT and TI were shortened and FIB was elevated in low volume group (P ＜ 0.05).But there were no significant differences between the two groups in NICU days [(13.84 ±3.02)d vs (15.28 ±3.79)d],hospital length of stay [(36.85 ±6.73)d vs (40.01 ± 7.21) d],MODS incidence (15.0％ vs 17.9％) and mortality (27.5％ vs 38.5％) (P ＞ 0.05).The chances of good recovery in low volume group was higher than that in high volume group (22.5％ vs 7.3％) (P＜0.05).Mean heart rate,blood pressure,blood electrolytes,and blood gas values did not differ significantly between the two groups (P ＞ 0.05).Conclusion For patients with sTBI,low volume LFR can ameliorate coagulation disorders and improve prognosis,indicating a safe and effective therapy.

Objective To investigate the alteration of mast cell(MC)in elderly patients with reflux esophagitis(RE). Methods Twenty eight elderly and 15 non-elderly patients with RE were recruited.Lower esophageal mucosal mast cells and the percentage of degranulated mast cells were countered after immunohistochemieal staining.The ultrastrueture of mast cells was observed by eleetromieroscope. Results The number of mast cells in lower esophageal mucosa in elderly patients with RE was significantly more than that in non-elderly patients with RE(10.24±2.56 VS.5.07±0.18,P＜0.01),and the percentage of degranulated mast cells in lower esophageal mucosa was also significantly higher in elderly patients with RE than in non-elderly patients with RE[(24.7±4.6)%vs.(13.5±5.5)%,P＜0.01].The more severe the esophageal mucosallesions,the more the numberof mast cells. Under the electromicroscopy, more Golgi apparatus, mitochondria and endoplasm-reticulum were found in mast cells.Special secreting particles were also found in cytoplasm,more vacuole were left behind after mast cells degranulation in elderly patients with RE.Conclusions Increased numbers of mast cells and mast cell activation may be involved in the pathogenesis of elderly RE.

Objective:To evaluate the effect of early mobilization on mortality in intensive care unit (ICU) patients with mechanical ventilation after discharge by Meta-analysis.Methods:Databases including SinoMed, China National Knowledge Infrastructure (CNKI), Wanfang data, PubMed, the Cochrane Library, Web of Science, and Embase were searched from inception to September 17th, 2020, to collect randomized controlled trials (RCT) about early mobilization on mortality of patients with mechanical ventilation in ICU after discharge, the references included in the literature were traced. The control group was given routine care, the experimental group was given early mobilization on the basis of the control group, including passive or active mobilization on the bed, sitting on the bed, standing by the bed, transferring to the bedside chair and assisting walking. The literature screening, data extracting, and the bias risk assessment of included studies were conducted independently by two reviewers. Stata 12.0 software was then used to perform Meta-analysis. Funnel plot was used to test publication bias.Results:A total of 10 RCT studies involving 1 323 patients were included, with 660 patients in the control group and 663 patients in the experimental group. The results of literature quality evaluation showed that 7 studies were grade A and 3 studies were grade B, indicating that the overall quality of included literatures was high. The Meta-analysis results showed that early mobilization did not increase the mortality of patients with mechanical ventilation in ICU after discharge [odds ratio ( OR) = 0.92, 95% confidence interval (95% CI) was 0.75-1.13, P = 0.449]. Subgroup analysis results showed that early mobilization had a tendency to reduce the mortality of ICU patients with mechanical ventilation at 3, 6 and 12 months after discharge, but the difference was not statistically significant (3-month mortality: OR = 1.02, 95% CI was 0.74-1.40, P = 0.927; 6-month mortality: OR = 0.95, 95% CI was 0.70-1.27, P = 0.712; 12-month mortality: OR = 0.60, 95% CI was 0.33-1.10, P = 0.101). Funnel plot showed that the distribution of included literatures was not completely symmetrical, suggesting that publication bias might exist. Conclusions:Early mobilization does not increase the mortality of ICU patients with mechanical ventilation after discharge. Although it tends to have a favorable outcome in reducing mortality, and has a trend to reduce the mortality. However, due to the small number of included literatures, small sample size and differences in the specific implementation of early mobilization among various studies, a large number of high-quality RCT studies are still needed for further verification.

Palmitoleic acid (16:1delta9), an unusual monounsaturated fatty acid, is highly valued for human nutrition, medication and industry. Plant oils containing large amounts of palmitoleic acid are the ideal resource for biodiesel production. To increase accumulation of palmitoleic acid in plant tissues, we used a yeast (Saccharomyees cerevisiae) acyl-CoA-delta9 desaturase (Scdelta9D) for cytosol- and plastid-targeting expression in tobacco (Nicotiana tabacum L.). By doing this, we also studied the effects of the subcellular-targeted expression of this enzyme on lipid synthesis and metabolism in plant system. Compared to the wild type and vector control plants, the contents of monounsaturated palmitoleic (16:1delta9) and cis-vaccenic (18:1delta11) were significantly enhanced in the Scdelta9D-transgenic leaves whereas the levels of saturated palmitic acid (16:0) and polyunsaturated linoleic (18:2) and linolenic (18:3) acids were reduced in the transgenics. Notably, the contents of 16:1delta9 and 18:1delta11 in the Scdelta9D plastidal-expressed leaves were 2.7 and 1.9 folds of that in the cytosolic-expressed tissues. Statistical analysis appeared a negative correlation coefficient between 16:0 and 16:1delta9 levels. Our data indicate that yeast cytosolic acyl-CoA-delta9 desaturase can convert palmitic (16:0) into palmitoleic acid (16:1delta9) in high plant cells. Moreover, this effect of the enzyme is stronger with the plastid-targeted expression than the cytosol-target expression. The present study developed a new strategy for high accumulation of omega-7 fatty acids (16:1delta9 andl8:1delta11) in plant tissues by protein engineering of acyl-CoA-delta9 desaturase. The findings would particularly benefit the metabolic assembly of the lipid biosynthesis pathway in the large-biomass vegetative organs such as tobacco leaves for the production of high-quality biodiesel.
Fatty Acid Desaturases ; genetics ; metabolism ; Fatty Acids, Monounsaturated ; metabolism ; Plants, Genetically Modified ; Recombinant Proteins ; genetics ; metabolism ; Saccharomyces cerevisiae ; enzymology ; Saccharomyces cerevisiae Proteins ; genetics ; metabolism ; Tobacco ; genetics ; metabolism