Objective To compare therapeutic effect of Losartan and hydrochlorothiazed compound prepara- tion and Losartan in patients with mild to moderate hypertension and to conduct economical evaluation. Methods The trial began with 2 weeks lead-in period and followed by 8 weeks therapy. 99 cases of mild to moderate hyperten- sion were randomly divided into two groups: compound preparation group ( n = 50) and Losartan (n = 49). The pa- tients were given Losartan 50 mg/h ydrochlorothiazed 12.5 mg compound preparation and Losartan 50 mg ,once a day. If the SeDBP≥85 mm Hg at 4th week, Losartan was added to 50 rag. Results After two, four and eight weeks treatment, systolic blood pressure and diastolic decreased obviously (P < 0.01 for each) ;The overall effective rate of of antihypertension was the same in both groups, but the different ratio of availability and validity in two groups was significant ( P < 0.05 for each). Conclusion Losartan/hydrochlorothiazed compound preparation has significant advantage in improving both systolic and diastolic pressure compared with monotherapy of Losartan. In ad- dition, the patients receiving compound preparation are well tolerated, with higher compliance.

This thesis described the necessity for practicing the tutorial system of specialist training in Chinese medical education,the essential basic elements for the construction of the tutorial system of specialist training and also the necessity for further exploration in the patterns of the tutorial system of specialist training in China.

[ABSTRACT]AIM:Tostudytheeffectsofbaicalin(BC)onglialfibrillaryacidicprotein(GFAP)andnuclear factor-κB ( NF-κB) expression and neuronal apoptosis in juvenile rat hippocampus after status convulsion ( SC) .METH-ODS:One hundred and ninety five juvenile male Sprague-Dawley rats were randomly divided into 3 groups:normal saline pretreatment group (NS group), SC group and SC with BC pretreatment group (BC group).Each of these 3 groups would be subdivided into 5 subgroups sacrificed at 4 h, 12 h, 24 h, 48 h and 72 h after SC.The rat SC model was prepared by lithium-pilocarpine chemical method .The protein expression of GFAP and NF-κB was detected by the method of immuno-histochemistry .The mRNA expression of GFAP was detected by RT-PCR.The neuronal apoptosis was observed by TdT-mediated dUTP nick end labeling ( TUNEL ) .RESULTS: Compared with NS group , the GFAP positive cells was in-creased in SC group (P<0.05).Compared with SC group, the expression of GFAP was significantly reduced in BC group (P<0.05).Compared with NS group, the NF-κB positive cells was increased in SC group (P<0.05).Compared with SC group, the expression of NF-κB was significantly reduced in BC group .RT-PCR showed that the expression trend of GFAP mRNA was similar to that of the protein .Compared with NS group , the TUNEL positive cells in the hippocampus CA1 area in SC group increased significantly 12 h after SC (P<0.01), and reached a peak at 48 h.After the intervention with BC, the TUNEL positive cells decreased significantly between 12~48 h after SC (P<0.05 or P<0.01), but the number of TUNEL positive cells remained significantly greater than that in NS group (P<0.05).CONCLUSION: The expression of GFAP and NF-κB in the hippocampus increased after SC in rats .Baicalin decreases the expression of GFAP and NF-κB in hippocampus of rats with pilocarpine-induced seizures , and reduces the number of neuronal apoptosis , sug-gesting that baicalin may protect against the brain damage caused by status convulsion .

To introduce the experiences of nursing risk management in Children's Cancer Center in Hongkong from aspects of organization structure and responsibility,clinical application of the risk management measures so to give reference to the hospital's nursing risk management in our country.

Objective To investigate CT features of subconjunctival fat prolapse and choristoma. Methods Thirty-eight patients, including 18 with subconjunctival fat prolapse and 20 with choristoma, were retrospectively analyzed. Transverse plain CT scan was performed in all the patients, and then coronal plane images was reconstructed at CT workstation. Results CT features of subconjunctival fat prolapse revealed a crescent-shaped or horn-shaped fat density mass continuous with the orbital fat in the superior temporal quadrant of the orbit. CT features of choristoma revealed a crescent-shaped or triangle fat density mass incontinuous with the orbital fat in the temporal side. Conclusion Subconjunctival fat prolapse typically occurs in bilateral superior temporal quadrant of the orbit in elderly males. Subconjunctival choristoma occurs in the unilateral temporal side in adolescent. CT is helpful to distinguish subconjunctival fat prolapse and choristoma.

In recent years,chimeric antigen receptor T -cells(CAR-T cells)therapy becomes the new rapid development of adoptive tumor immunotherapy .Its main characteristic is to identify specific T cell receptor of tumor antigen by genetic engineering modification and give its targeting ,killing and persistent treatment .The CAR-T was mentioned for the first time in 1989,and has developed to the fourth generation .CD19-CAR-T treatment technique shows activity in phase I clinical trials of multiple research centers .CAR-T therapy is ex-pected as a new way to cure relapse/refractory hematological malignancies .

Objective:To analyze the clinical features of 63 azoospermic patients with microdeletion of azoospermia factor C region(AZFc) and their relationship with sex hormones.Methods:The clinical data of 63 azoospermic patients with AZFc microdeletion were retrospectively analyzed, including age, height, body weight, body mass index(BMI), testicular volume, and sex hormones.Results:Compared with normozoospermic men, height, body weight, and testicular volume revealed statistical differences in azoospermic patients with AZFc microdeletion( P<0.05). There were significant differences in FSH, LH, testosterone(T), and prolactin levels between two groups( P<0.05). BMI was negatively associated with FSH level( r=-0.251, P=0.04)and positively associated with estradiol(E 2)level( r=0.327, P=0.009). Age had a negative association with T level( r=-0.256, P=0.04). Testicular volume revealed a negative association with FSH level( r=-0.289, P=0.02). There were no association of height with T, E 2, FSH, and LH levels( P>0.05). Conclusion:It is more likely that azoospermic patients with AZFc microdeletion present overweight and earlier decreased androgen level. The adjustment of lifestyle and testosterone supplementation might be beneficial to the long-term quality of life in these patients.

Objective To investigate the role of fluid therapy in treatment of septic shock in children.Methods A total of 48 pediatric patients with septic shock were enrolled.Twenty-seven patients were treated with volume expansion and 21 patients were treated with fluid resuscitation.There were no differences in use of antibiotics,inotropic and vasoactive agent in two groups.The time needed for haemodynamic stability,occurrence of pulmonary edema.length of PICU stay,and mortality were compared between two groups.Results Compared with volume expansion group,the time needed for haemodynamic stability significantly decreased in fluid resuscitation group ((216.10± 168.13) minutes vs (121.63 ± 75.59) minutes) (P < 0.05). There were no significant difference in occurrence of pulmonary edema between volume expansion group and fluid resuscitation group (14.8% vs 9.5% . P > 0.05) .Compared with volume expansion group,length of PICU stay significantly decreased in fluid resuscitation group ((6.188 ±3.250) days vs (3.944±2.711) days,P < 0.05).Compared with volume expansion group,mortality significantly decreased in fluid resuscitation group (40.7% vs 14.3%,P < 0.05) . Conclusions Rapid fluid resuscitation was associated with early reach of haemodynamic stability,short stay in PICU,improved survival rate and no increase in the risk of complication in pediatric patient with septic shock.

Objective To study the clinical efficacy of robotic sacral hysteropexy in treatment of uterine prolapse.Methods From January 2012 to December 2013,3 patients undergoing robotic sacral hysteropexy in treatment of uterine prolapse in General Hospital of People's Liberation Army were studied retrospectively.Operation time,blood loss and postoperative recovery exhaust time and pelvic organ prolapse quantification (POP-Q) staging were evaluated.Results Three patients were treated by robotic sacral hysteropexy successfully.The mean operation time was 221 minutes (210-240 minutes),mean blood loss was 45 ml.One case with Ⅱ degree perineal laceration patients simultaneously perineal repair,neither intranor post-operative complications occurred.The mean postoperative recovery exhaust time was 16 hours.At three months of follow-up,all 3 patients got satisfaction.Although one patient at the first six months of postoperation had leakage of urine when coughing,instruct exercise pelvic floor muscle function and acupuncture one month their symptoms disappear.Conclusion Robotic sacral hysteropexy pave the way for an effective option in the management of uterine prolapse.

Objective: To investigate the protective effect of shenduqing Granules on chronic renal insufficiency in rats. Methods: The rat model of chronic renal insufficiency was made by feeding 0.75% adenine forage. The blood biochemical indexes, ion concentration in serum of rat was measured and the pathological changes of rat kidney were observed. Results: Shenduqing Granules obviously increased thymus index (TI). The weight of rat kidney in the treatment group was lighter than that of the model group. The kidney histomorphological study showed that Shenduqing Granules obvionsly reduce the pathological changes. The drug crystals were also reduced. Conclusion: Shenduqing Granules has the potential protection against chronic renal insufficiency in rats.