In the PROFESS and TRANSCEND trials,telmisartan(80 mg daily),compared with placebo,reduced systolic blood pressure by about 4 mmHg,but did not influence the primary composite cardiovascular endpoint.The difference between the ACCOMPLISH and ALLHAT trials in the amlodipine-diuretic comparison might be attributed to the combination of amlodipine with an angiotensin converting enzyme inhibitor in the ACCOMPLISH trial,which provided further evidence that by smoothly controlling blood pressure over 24 hours amlodipine prevent vascular events better than other antihypertensive drugs.

Objective To investigate the clinical efficacy of electroacupuncture plus weak laser fat dissolution technique in treating female patients with obesity and overweight of stomach heat dampness stagnation type. Methods Forty-seven female patients diagnosed with simple obesity and overweight of stomach heat dampness stagnation type were randomly allocated to a treatment group of 25 cases and a control group of 22 cases. The treatment group received electroacupuncture plus weak laser fat dissolution technique and the control group, weak laser fat dissolution technique alone. Body weight, body mass index (BMI), waist circumference, abdominal circumference, hip circumference, body fat percentage (F%), visceral fat index (VFI) were measured in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant differences in body weight, BMI, waist circumference, abdominal circumference, hip circumference difference values between before and after one course of treatment, between after one and two courses of treatment and between after two and three courses of treatment in the treatment group compared with the control group (P<0.01,P<0.05). There were statistically significant differences in visceral fat index difference values between after one and two courses of treatment and between after two and three courses of treatment in the treatment group compared with the control group (P<0.05). The total efficacy rate was 92.0%in the treatment group and 36.4%in the control group; there was a statistically significant difference between the two groups (P<0.01). Conclusion Electroacupuncture plus weak laser fat dissolution technique is an effective way to treat female simple obesity of stomach heat dampness stagnation type.

OBJECTIVETo explore the curative effect of surgery and selerotherapy for massive venous malformations of the tongue.

METHODSFrom January 2005 to December 2014, subtotal resection or debulking for 15 cases of massive venous malformation in the tongue was undertaken with multiple sessions of pre- and post-operative injection therapy of pingyangmycin, lauromacrogol and absolute ethanol.

RESULTSAll signs associated with the lesions including eating, sleep and speech disorders disappeared after treatment. Complete or near complete resolution was achieved in 9 cases, and a significant reduction in size in a further 6 cases after surgical excision and peri-operative sclerotherapy.

CONCLUSIONSFor massive venous malformations of the tongue, surgical excision combined with multiple sessions of sclerotherapy is a good treatment option.

Bleomycin ; analogs & derivatives ; therapeutic use ; Combined Modality Therapy ; methods ; Ethanol ; therapeutic use ; Humans ; Injections, Intralesional ; Polyethylene Glycols ; therapeutic use ; Sclerosing Solutions ; therapeutic use ; Sclerotherapy ; Tongue ; blood supply ; Treatment Outcome ; Vascular Malformations ; therapy ; Veins ; abnormalities

ObjectiveTo study the effect of astragaloside Ⅳ(AS-Ⅳ) on glucose-induced podocyte adhesion and its possible mechanism. MethodsConditionally immortalized mouse podoeytes were treated with 10, 50, 100 mg/L AS-Ⅳ and with 100 mg/L AS-Ⅳ for 3, 6, 12, 24 h. Cell attachment was measured by fluorescence and centrifugation cell adhesion assays, respectively. Expression of α3β1 integrin mRNA and protein was examined by real-time PCR and Western blot. ResultsHigh glucose induced a significant reduction in adherent podocytes compared to normal glucose group (P<0.05). AS-Ⅳ improved high glucose-induced podocyte adhesion in a time- and dose-dependent manner. Real-time PCR and Western blot analysis revealed that high glucose-induced down-regulation of α3β1 integrin in podocytes were significantly meliorated by AS-Ⅳ (P<0.05). ConclusionAstragaloside Ⅳ improved high glucose-induced podocyte adhesion which may be mediated through α3β1 integrin up-regulation.

Objective To explore the change of instant blood pressure after different rehabilitation exercises for stroke patients. Methods60 stroke patients were divided into Groups A, B and C. Group A raised both arms and ante flexed shoulders >70° in seat intermittently40～50 times in 3 minutes; Group B raised both arms and ante flexed shoulders >70° in seat continually for 3 minutes (isometric); Group Cwalked slowly more than 45 steps in 3 minutes. The brachial artery blood pressure and pulse of patients were monitored before and immediatelyafter training. Results The blood pressure of Group B raised significantly after training (P<0.05). Groups A and C did not raise significantlyafter training (P>0.05). The pulse of all the groups raised and there was no significant difference among them after training (P>0.05).Conclusion Continuous persistent isotonic contraction can cause elevation of blood pressure, which patients with hypertension should avoid.

Objective:To explore the clinical value of 2D-STI and RT-3DE in evaluation of left ventricular longitudinal systolic function and synchrony in hyperthyroidism patients.Methods:From July 2018 to August 2019, 93 patients with hyperthyroidism were selected as hyperthyroidism group, and 93 healthy volunteers were selected as control group at the same time.2D-STI and RT-3DE were performed to obtain the parameters of left ventricular longitudinal systolic function and synchrony, and the differences between the two groups were compared.Results:There were no statistically significant differences in left atrial diameter(LAD), left ventricular end systolic diameter(LVEDS), diastolic diameter of left ventricle(LVEDD), interventricular septum thickness(IVST) and left ventricular ejection fraction(LVEF) between the two groups (all P>0.05).2D-STI showed that the longitudinal systolic peak of multiple segments of left ventricle in the hyperthyroidism group was significantly earlier than that in the control group[posterior basal segment: (15.27±3.21)% vs.(20.38±4.19)%, t=9.336, P<0.001; lateral basal segment: (16.54±4.68)% vs.(21.26±5.65)%, t=6.204, P<0.001; anterior septal basal segment: (12.84±5.26)% vs.(18.43±6.06)%, t=6.718, P<0.001; posterior middle segment: (16.44±5.13)% vs.(22.75±6.06)%, t=7.664, P<0.001; middle anterior septum: (12.03±4.41)% vs.(19.25±5.16)%, t=10.257, P<0.001; apical inferior wall: (14.36±5.06)% vs.(21.46±6.28)%, t=8.489, P<0.001; apical cap: (9.43±5.28)% vs.(12.35±6.43)%, t=3.384, P<0.001]. Compared with the control group, the 2D-STI synchronization parameter Tls-16-SD of the hyperthyroidism group was significantly longer[(82.45±15.25)%, (52.45±10.65)%, t=15.553, P<0.001]. RT-3DE showed that the peak longitudinal contraction of multiple segments of left ventricle in hyperthyroidism group was significantly lower than that in the control group[front wall basal segment: (11.48±5.33)% vs.(19.17±6.49)%, t=8.830, P<0.001; side wall basal segment: (15.62±3.77)% vs.(22.08±4.56)%, t=10.529, P<0.001; the middle section of the bottom wall: (15.65±3.37)% vs.(18.39±4.25)%, t=4.871, P<0.001; the middle section of the posterior interval: (14.39±5.36)% vs.(19.62±3.38)%, t=7.959, P<0.001; the apex of the front wall segment: (11.17±5.54)% vs.(18.29±6.24)%, t=8.228, P<0.001; apical segment of ventricular septum: (14.67±5.38)% vs.(20.53±4.34)%, t=8.175, P<0.001]. RT-3DE synchronization parameter Tmsv-16-SD in the hyperthyroidism group was significantly longer than that in the control group[(84.36±16.08)%, (55.27±11.17)%, t=14.328, P<0.001]. Conclusion:2D-STI and RT-3DE can objectively evaluate left ventricular longitudinal systolic function and synchrony in patients with early hyperthyroidism.

The present study was performed to establish the UPLC fingerprints of Bolbostemmatis Rhizoma and determine the contents of three saponins by quantitative analysis of multi-components by single marker(QAMS), and provide basis for quality evaluation of Bolbostemmatis Rhizoma. The analysis was carried out on an analytical column of Waters Cortecs T3(2.1 mm×100 mm,1.6 μm)with gradient elution by acetonitrile-0.1% phosphoric acid solution, at a flow rate of 0.3 mL·min~(-1). The detection wavelength was 203 nm, the column temperature was 30 ℃ and the injection volume was 1 μL. The UPLC fingerprints of Bolbostemmatis Rhizoma were established and evaluated by similarity calculation, cluster analysis and principal component analysis. The relative calibration factors of toberoside B and toberoside C were determined with toberoside A as internal reference. The content was calculated by relative calibration factors to develop a method of QAMS. Comparing the results of QAMS with those of ESM, the accuracy and feasibility of one-eva-luation and multi-evaluation can be determined. RESULTS:: showed that the fingerprints of 19 batches of Bolbostemmatis Rhizoma have four common peaks with similarities ranging from 0.754 to 1.000. Cluster analysis and principal component analysis classified 19 batches of Bolbostemmatis Rhizoma into three categories, which was consistent with the similarity evaluation results. The relative deviation between the content of tubeicosides B and C in 19 batches of Bolbostemmatis Rhizoma determined by QAMS and ESM is less than 5.0%, indicating that there was no significant difference between the two methods. Therefore, the UPLC fingerprints combined with QAMS and similarity evaluation can be effectively used to evaluate the quality of Bolbostemmatis Rhizoma.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Principal Component Analysis ; Quality Control ; Rhizome

OBJECTIVE：To provide reference for the identification and proces sing end-point determination of raw Morus alba and its processed products （honey-processed M. alba ）. METHODS ：UPLC method was adopted. The determination was performed on Waters BEH Shield RP C 18 column with mobile phase consisted of acetonitrile- 0.1％ phosphoric acid solution （gradient elution ） at the flow rate of 0.30 mL/min. The column temperature was set at 30 ℃. The program wavelengths were set at 280 nm（0-4 min） and 320 nm（4-35 min）. Similarity Evaluation System for Chromatogram Fingerprint of TCM （2012 edition）was used to establish UPLC fingerprint and carry out similarity evaluation of 13 batches of M. alba and honey-processed M. alba . The chromatographic peaks were identified with reference substance fingerprint. The colorimetric value （L，a，b） of 13 batches of M. alba and honey-processed M. alba powder were determined ，and average total colorimetric value （E）was calculated. OPLS-DA and cluster analysis were adopted to analyze the differences in fingerprints and colorimetric values of M. alba before and after processing. At the same time ，the dynamic change rule of fingerprint and colorimetric value of honey-processed M. alba at different processing time points were analyzed to determine the processing end-point. RESULTS ：There were obvious differences in fingerprints before and after processing ，and the similarity of 13 batches of M. alba and honey-processed M. alba were all higher than 0.9. Totally 21 common peaks were calibrated for M. alba ，and 23 common peaks for honey-processed M. alba ；peak 1 and peak 2 were newly produced compounds of honey-processed M. alba . Peak 2，peak 7，peak 14 and peak 19 were identified as 5-hydroxymethylfurfural， mulberry glucoside A ，oxidized resveratrol ，mulberry flavonoids G. Results of OPLS-DA showed that the peak area-sample quantity ratio of peak 1，peak 2，peak 18，peak 20 and the chromaticity values （L，a，b）were the most important factors affecting the difference of raw and processed products of M. alba . When the E ranged 75.84-80.88 as the processing end-point of honey-processed M. alba ，the processing time was determined as 22-34 min. CONCLUSIONS ： The established UPLC fingerprint and colorimetric value determination method can be used to identify the raw and processed products of M. alba as well as determine the processing end-point of honey-processed M. alba .

Objective To explore the clinical characteristics and prognostic factors of severe community-acquired pneumonia (SCAP) and severe hospital-acquired pneumonia (SHAP). Methods Clinical data of patients with severe pneumonia were reviewed and analyzed retrospectively. Multivariate logistic regression analysis was conducted to investigate the potential prognostic factors. Results A total of 70 SCAP cases and 110 SHAP cases were identified. SHAP patients showed higher proportion of surgical operation (P＜0.001), radiotherapy and/or chemotherapy (P=0.006) within 1 month, higher Charlson comorbidity index (P=0.001), and more malignancies (P＜0.001) than SCAP patients, but fewer failed organs (P=0.048), lower proportion of heart failure (P=0.003), and lower level of BNPmax (P=0.037) than SCAP. SHAP patients showed more total days of hospital stay than SCAP patients [33.0 (25.0, 43.3) days versus 14.0 (5.8, 28.3) days, P＜0.001 ], and higher 180-day mortality than SCAP patients (44.6％ versus 27.5％, P=0.047). The 180-day survival rate was significantly different between SCAP and SHAP patients (χ2=4.009, P=0.045). Multivariate analysis indicated that APACHE-II score (OR=20.449, P=0.002), cancer (OR=6.183, P=0.039), maximum D-dimer level (OR=13.841, P=0.008), and renal replacement therapy (RRT) (OR=19.456, P=0.003) were associated with the outcomes of SCAP patients. Two or more organ failure (OR=6.308, P=0.028), ventilator-associated pneumonia (OR=4.491, P=0.005), and RRT (OR=11.456, P=0.002) were associated with the outcomes of SHAP patients. Conclusions SCAP doesn't show significant difference from SHAP in in-hospital mortality or 30-day mortality. SHAP is associated with higher 180-day mortality than SCAP.

Objective: This study aims to estimate the economic burden of disease of outbreak of norovirus gastroenteritis in the Pearl River Delta Region, and provide scientific evidence for the government’s decision-making and control measures. Methods: Using a unified questionnaire, a survey was conducted to the schools and students’ families which had suffered an outbreak of norovirus gastroenteritis in the Pearl River Delta Region from October 2017 to April 2018. Results: The survey found that the mean total economic burden of sick students was 720.41(95%UI=640.45-804.63)RMB. The mean economic burden of sick students who were inpatient, outpatient and self-treatment were 1 712.75(95%UI=328.50-34 00.00), 213.70(95%UI=191.83-236.33) and 58.97(95%UI=43.00-77.69)RMB, respectively. The mean economic burden of transport, extra tutoring and cost of lost labor were 53.63(95%UI=43.98-63.58), 558.49(95%UI=381.40-774.01) and 695.62(95UI=630.25-767.29)RMB. The mean total economic burden of health students was 382.62(95%UI=343.29-424.45)RMB. The mean total economic burden of school was 49 264.53(95%UI=22 363.38-79 976.25)RMB. The total economic burden of disease increases as the level of outbreak increases. The larger the epidemic level, the proportion of sick students’ financial burden gradually decreased, 56.58%,23.27% and 10.93%. Conclusion The high economic burden of disease of norovirus gastroenteritis in the Pearl River Delta Region, respectively, indicating that relevant departments should strengthen the prevention, control and education in order to mitigate the disease economic burden.