AIM:To evaluate the efficacy of Wuling Capsule(xylaria) in treating senile systolic hypertension. METHODS: Sixty-four patients with senile systolic hypertension were randomly divided into two groups.Both the treated group and the control group were treated with anti-hypertensive for 4 weeks,but the treated group received Wuling Capsule.Therapentic effects were evaluated with HAMA.Noninvasive resting blood pressure was taken every day after treatment,and dynamic blood pressure before and after treatment. RESULTS: HAMA in both groups decreased somewhat but blood pressure in the treated group was lower than that in the control group,remission rate of the treated group was greater than that in the control group.Treatment period of the treated group was shorter than that of the control group. CONCLUSION: Wuling Capsule can relief anxiety in senile hypertension patients,and it can rise the control rate of blood pressure,and also shorten the treatment period.

OBJECTIVETo explore the molecular biological mechanism of ZHU's Tiaojing Cuyun Recipe (TCR) for treating anovulatory infertility patients with Shen deficiency syndrome (SDS) by observing its clinical efficacy.

METHODSUsing randomized blocking methods, 80 patients were assigned to the treatment group (40 cases) and the control group (40 cases). Patients with regular menstrual cycle started medication from the 5th day of menstruation. Those with irregular menstrual cycle first took progesterone till withdrawal bleeding ,and then started medication from the 5th day of vaginal bleeding. Patients in the treatment group took ZHU's TCR, one dose per day, while those in the control group took Clomifene Citrate (CC), 50 mg per day. Three menstrual cycles consisted of one therapeutic course, a total of 2 courses. Clinical efficacy such as pregnancy rates and abortion rates were observed. Ovulation indices (the maximal diameter of mature follicles, luteinized follicles, ovulational follicles, and the endometrial thickness on the ovulation day), SDS, and integrals of menstrual symptoms were monitored before and after treatment. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) , and estradiol (E2) were determined using chemiluminescent immunoassay before treatment and after on therapeutic course. Serum levels of activin A (ACTA), inhibin B (INHB), and follistatin (FS) were detected using double antibody sandwich ELISA.

RESULTSCompared with the control group, the pregnancy rate was obviously elevated and the abortion rate was obviously lowered in the treatment group (P <0. 05). Ovulation rates of mature follicles and luteinizing follicles decreased more in the treatment group (P < 0.05). Compared with before treatment, integrals for SDS were lower, the maximal diameter of pre-ovulational follicles was increased, and integrals for menstrual symptoms in non-pregnant patients of the two groups were obviously lowered. Meanwhile, the endometrial thickness on the ovulation day was increased in the treatment group after treatment, but reduced in the control group (P < 0.05, P < 0.01). Compared with the control group, integrals for SDS were decreased, and the maximal diameter of pre-ovulational follicles was lowered in the treatment group after treatment (P < 0.05, P < 0.01). Integrals for SDS and the difference in the endometrial thickness on the ovulation day were increased, but the difference in the maximal diameter of pre-ovulational follicles were reduced (P < 0.05, P < 0.01). In the treatment group serum levels of E2 and ACTA increased more after one therapeutic course than before treatment (P < 0.01), but serum levels of INHB and FS decreased more after one therapeutic course than before treatment (P < 0.05). In the control group serum levels of FSH and ACTA increased more, and the serum level of FS decreased more after one therapeutic course than before treatment (P < 0.05, P < 0.01). Compared with the control group, serum levels of FSH and ACTA increased more, and serum levels of INHB decreased more in the treatment group after one therapeutic course than before treatment (P < 0.05, P < 0.01).

CONCLUSIONSZHU'sTCR could improve SDS of anovulatory infertility patients, regulate the follicular development, and elevate the pregnancy rate. Its actions might be associated with regulating their sex hormones, expressions of ovary local factors such as INHB, ACTA, and FS.

Activins ; Clomiphene ; Drugs, Chinese Herbal ; therapeutic use ; Estradiol ; Female ; Follicle Stimulating Hormone ; Follistatin ; Humans ; Infertility, Female ; complications ; therapy ; Inhibins ; Luteinizing Hormone ; Medicine, Chinese Traditional ; Ovarian Diseases ; Ovarian Follicle ; Ovulation ; Progesterone

Objective To investigate the potential effect of hypoxia on adhersion and invasion of human cervical carcinoma cells HeLa. Methods Reverse transcription-polymerase chain reaction (RT-PCR) was used to investigate the level of HIF-1? mRNA and E-cadherin mRNA of HeLa cells cultured under normoxia, 5%O2, 3%O2, 1%O2. The invasiveness of HeLa cells was investigated by transwell chamber assay. Results Under the condition of normoxia, 5%O2, 3%O2 and 1%O2, the optical density ratio of HIF-1? mRNA/?-actin was (0.423?0.116), (0.764?0.111), (1.687?0.126) and (0.215?0.099), showing that the level of HIF-1? mRNA had a tendency of first inceasing and then decreasing with the decreasing oxygen content. The optical density ratio of E-cadherin/?-actin was (1.045?0.171), (0.719?0.114), (0.386?0.105) and (0.157?0.063), showing a decreasing tendency with the decreasing of oxygen content. The invasiveness of HeLa cells was (112.5?20.7), (254.3?27.5), (333.6?45.2) and (124.5?24.6), showing that the invasiveness of HeLa cells had a tendency of first inceasing and then decreasing with the decreasing oxygen content. Conclusion Moderate hypoxia up-regulates the mRNA levels of HIF-1?, and down-regulates the mRNA levels of E-cadherin, and enhances the tumor invasiveness. The possible mechanism is the increasing mRNA levels of HIF-1?.

Objective To evaluate clinical significance of laparoscopic adrenalectomy for treatment of primary aldosteronism.Methods From Jan.1999 to Dec.2009,227 patients(92 males and 135 females)with a confirmed diagnosis of primary aldosteronism underwent laparoscopic adrenalectomy.The median age was 42years old,ranging from 22 to 69 years old.The median disease duration was 4.6 yeas,ranging from 2 months to 15 years.5 cases underwent peritoneal laparoscopic adrenalectomy and 222 cases underwent retropefitoneal laparoscopic adrenalectomy.All cases had hypokalemia,hpertension,high plasma aldosterone and low plasma rennin preoperatively.Of all the cases,there were 205 cases with aldosterone-producing adenomas among whom 80 cases underwent total adrenalectomy and 125 cases underwent partial adrenalectomy.There were 22 cases with unilateral adrenal hyperplasia and all of them underwent total unilateral adrenalectomy.Results Procedures were successfully performed in all the 227 cases.The operation duration ranged from 15 to 156 min(39 min as the median)and the blood loss ranged from 5 to 220 ml(20 ml as the median).The hospitalization time ranged from 5 to 9 days (6.9±1.2 days as the median).All the cases were followed up from 6 months to 2 years(1.2 years as the median).Postoperative potassium level resumed normal in all cases.Blood pressure resumed normal in 180 cases(80%).No adrenocortieal insufficiency and any other complication occurred.Conclusion Retropreitoneal laparoscopic partial or total adrenalectomy for treatment of primary aldosteronism is a safe and feasible procedure.

Objective To summarize clinical characteristics of ectopie pheochromocytoma in order to improve the diagnosis and treatment of this disease.Methods Clinical data of 36 cases of pathologically proved ectopic pheochromocytoma treated in Tianjin Medical University General Hospital from 1990 to 2010 were retrospectively analyzed.Hypertension was observed in 28 cases.5 cases had hypertension at the end of urination. 1 case was proved to have ectopic pheochromocytoma by physical examination.Abdominal pain occulted in 2 patients.Urinary VMA was measured in all the 36 cases,and 32 esges had an elevation of VMA(88.9%).The lesions were localized mainly by abdominal ultrosonggraphy,CT,MRI and 131 I-MIBG.All cages underwent operation,including 4 laparoscopic surgery.Results Of the 36 patients with ectopic pheochromocytoma,34 cases had sinsle tumor,and 2 cases had multiple tumors.The diameter of the lesions was from 3.4 cm to 18.2 cm in size.Postoperative pathological examination showed 27 cases of ectopic pheochromocytoma were benign and 9 cases were malignant.Conclusions VMA level is an important marker to detect ectopic pheochromocytoma.Tumor localization is difficult.131 I-MIBG is of great value for localization of the lesion.Meticulous preoperative preparation is extremely important.Surgical resection of the tumor is the best therapy.Laparoscopic surgery can be the new choice for treatment of ectopic pheochromocytoma.Patients with malignant ectopic pheochromocytoma may be treated with 131 I-MIBG after surgery.

Objective To review clinical characteristics and treatment of multiple endocrine neoplasia type 2A (MEN-2A).Methods The clinical data of 13 patients with MEN-2A admitted to our hospital between 1988 and 2011 were retrospectively reviewed.All 13 cases were diagnosed as pheochromocytoma with medullary thyroid carcinoma,presenting no hyperparathyroidism,including 8 cases who had medullary thyroid carcinoma before pheochromocytoma and 5 cases who had medullary thyroid carcinoma and pheochromocytoma simultaneously.All 13 cases underwent resection for pheochromocytoma; 9 cases had bilateral adrenal resection,including 4 cases undergoing laparoscopic resection for pheochromocytoma.Thyroidectomy with bilateral dissection of regional lymph nodes was performed in 10 patients,and nodule enucleation was performed in 3 remaining patients.Results Adrenal pathology reported pheochromocytoma in all cases,including 3 malignant cases.Thyroid pathology reported medullary thyroid carcinoma in all cases.All 13 patients were followed-up visit,10 cases survived and 3 died from distant metastasis of medullary thyroid carcinoma.Conclusions MEN-2A is a rare disease.Surgery is the only treatment for this disease ; when patients have both pheochromocytoma and medullary thyroid carcinoma,to first remove the pheochromocytoma is preferable.

Objectives To explore the long-term prognosis, treatment (especially dietary treatment) of classic maple syrup urine disease. Methods The complications and dietary treatment were observed by follow-up study of a classic MSUD patient. Results The patient have obvious damage in nervous system. However, reasonable dietary leucine tolerance therapy after the neonatal period can effectively reduce the metabolic crisis and complications. A mutation in BCKDHB gene was detected in the patient by genetic testing. Conclusion It is suggested that dietary restriction and monitoring of branched-chain amino acids are helpful to reduce the development of acute metabolic crisis and complications and improve the quality of life.

Objective To evaluate the effect of individualized diet nursing on nasogastric gavage-indueced complications after operations on laryngeal cancer? Methods Sixty patients having undergone surgical operation on laryngeal cancer were randomly divided into experiment group and control group in equal number? The control group received nutritional support by conventional enteral nutrition and the experiment group was managed by individualized diet nursing with nasogastric feeding? On days 3 and 10 after operation,the two groups were compared in terms of body constitution,results of experimental tests and complications?Result Compared to the control group,the experiment group showed no significant difference in terms of body constitution and results of experimental tests(P > 0?05)but significantly lower rate of complications on days 3 and 10(P < 0?05)? Conclusion The individualized diet nursing for laryngeal cancer patients may ensure their needs for nutrition,meanwhile reduce the incidences of complications from enteral nutrition,and thus promote their recovery?

Objective:To observe the clinical effect of different background volumes of ropivacaine in continuous tibial nerve block of postoperative analgesia after calcaneal surgery.Methods:This study was a prospective,randomized,controlled study.Sixty cases of calcaneal visual analogue scale (ASA)ⅠorⅡundergoing elective surgery were selected and randomly assigned to two groups,thirty cases in each group.The patients received popliteal fossa posterior tibial nerve block using ultrasound guided.The con-tinuous stimulation catheter was inserted after successful position and the 0.2%ropivacaine was injected. The background volumes of the A and B groups were 5 mL/h and 3.2 mL/h.The VAS score,the senso-ry block and motor block of tibial nerve and common peroneal nerve,and the satisfaction of the patients at h 12,h 24 and h 48 were recorded after catheter insertion.Results:The VAS scores at the three time points (h 12,h 24 and h 48)on the two groups of the patients were compared,and the difference was not statistically significant (P >0.05).The difference of the sensory block and the motor block of the tibial nerve at the three time points (h 12,h 24 and h 48)on the two groups of the patients were also compared,and the difference was not statistically significant (P>0.05).The difference of the sensory block and the motor block of common peroneal nerve at h 48 hs was statistically significant,group A was higher than the group B (P<0.05).The difference of the patient satisfaction at the three time points (h 12,h 24 and h 48)on the two groups was not statistically significant (P>0.05).Conclusion:The use of 0.2% ropivacaine with the background volume of 3.2 mL/h in continuous tibial nerve block can pro-vide good analgesia and reduce the incidence of the sensory block and motor block of the common perone-al nerve.

Objective To explore the teaching effects of theory and practice integrated teaching model in small class teaching of ENT nursing. Methods Two classes of nursing students from grade two were randomly selected as experiment group and control group with 120 students in each group. The experiment group was treated with theory and practice integrated teaching model in small class and the control group with traditional practice. The teaching effects of the two groups were compared by test results as well as questionnaire survey . Result The teaching effect in the experiment group was significantly better than that of the control group (P<0.05). Conclusion The theory and practice integrated teaching model in small classes can promote the students' interest in learning and mobilize their initiative and enthusiasm to master theoretical knowledge and specialist skills.