To comprehensively improve the level of standardized screening, diagnosis and treatment of hypertension, the Clinical practice guidelines for the management of hypertension in China has been jointly initiated by Chinese Society of Cardiology, Chinese Medical Association, Hypertension Committee of Cross-Straits Medicine Exchange Association, Cardiovascular Disease Prevention and Rehabilitation Committee, and Chinese Association of Rehabilitation Medicine. This guideline addresses several important clinical problems in the field of screening, diagnosis evaluation and treatment of hypertension, fully assesses the latest high-quality clinical research evidences available, and gives clear recommendations. It also advocates the new concepts and perspectives, such as moving forward the diagnosis and treatment of hypertension, promoting the target of blood pressure reduction, simplifying the risk stratification of cardiovascular diseases, and paying attention to the screening of secondary hypertension, which will help promote the prevention and treatment of hypertension in China.

Cerebral palsy (CP) is one of the most common causes of physical disability among children all over the world.It is often accompanied by hypophrenia,epilepsy,abnormal behaviors,visual auditory disorder,emotional disturbance,facial disfunction,developmental delay,malnutrition,poor lung function,hypoimmunity,and so on.Also hip abnormalities are important issues.The hip subdislocation,dislocation and pain largely influence the daily life of the patients.Early detection and therapy offer a great hand to ease the degree of disability and enhance rehabilitation effect.Surgical management and rehabilitation training have significant count on maintaining the hip function and improving daily life quality.The lesion severity,treatment timing,individual differences and cooperation degree of parents are main factors of prognosis.This contribution summarizes the symptoms,radiographic parameter changes and treatments of CP.

The blood and urine estrogen (E2) and progesterone (P) were measured in 133 patients with fibrocystic disease (FCD) of breast and 17 healthy subsjects during menstrual cycle phases. According to the characteristics of the secretion, the patients were divided into five types. Type A (54 patients): The secretion peak of E2 and P appeared beforehand and secretion of P was prolonged and E2 decreased significantly in ovulatory phase. Type B (16 patients): The secretion peak of E2 disappeared in ovulatory phase although the secretion of P was normal. Type C (16 patients): The secretion peak of P deferred its disappearance and maintained at higher level till pre-menstrual period and sc did E2: the secretion of E2 decreased in ovulatory phase. Type D (41 patients): The secretion peak of E2 in ovulatory phase was normal but could not return to normal level in pre-menstrual period, in the mean time the secretion of P also deferred its disappearance. Type E (6 patients): There was no secretion of P and the blood and urine concentrations of E2 deccreased in all phases. The average value of E2 in the patients with FCD was compared with that of healthy subjects. The concentration of E2 in all the patients increased in follicular and pre-menstrual phases. However, the concentration of E2 in ovulatory phase was much lower in the patients than in healthy subjects.

This paper presents a review of the change of cytochrome P450 2C (CYP2C) in human development process and the effect of its gene polymorphism on clinical medication. The relevant literature at home and abroad was reviewed, analyzed, and summarized. The expression and activity of CYP2C9 and CYP2C19 enzymes are different at different ages, which has a direct effect on clinical drug use in pediatric patients. It has vital significance to further research the change rules of CYP2C9 and CYP2C19 and the influence of gene polymorphism on drug metabolism in the process of development for improving the efficacy and rationality of pediatric medication.

Objective To explore the value of OMOM capsule endoscopy in the diagnosis of gastrointestinal diseases in the elderly patients.Methods A retrospective analysis of the clinical data on 86 elderly patients completed OMOM capsule endoscopy during May 2008 to April 2013 were performed.Results All the patients were well tolerated,and capsules were successfully excreted.The mean detention time in gastrointestinal was 50.64 min,the mean run time was 315.86 min.Thirty-eight (44.19％,38/86) patients gained positive diagnosis.In 45 patients with unknown reason,28 patients (62.22％,28/45) gained positive diagnosis.In 28 patients with abdominal pain and diarrhea,5 patients gained positive diagnosis.In 4 patients with other reason,no patients gained positive diagnosis.Conclusions The manipulation of OMOM capsule endoscopy is simple,safe and effective.And the elderly patients can tolerate well.Obscure gastrointestinal bleeding is the main reason to check,and has a higher diagnostic yield.

Objective To study the effect of clopidogrel on intimal hyperplasia of rabit arta injured by balloon and its mechanism.Methods Twelve New Zealand rabbits were established as atherosclerosis plaques rupture models and were evenly divided in to the high-cholesterol group and the clopidogrel group.Another 6 rabbits were set as the control.Serum cholesterol and triglyceride levels were taken in the beginning,before and after surgery.Meansurement alsincluded the changes in macrophage count and collagen levels in the plaques,changes of plasma fibrinogen and P-selectin levels as well as changes in activity of t-PA and PAI-1.The changes of intima thickness and the degree of stenosis were recorded.Results Compared to the control group,the high-cholesterol group and the clopidogrel group had higher average macrophages count and collagen levels in the plaques.The clopidogrel group had less macrophages count in the plaques than the high-cholesterol group;however,the clopidogrel group had higher levels of collagen in the plaques than the high-cholesterol group.The plasma level of P-selectin reduced in the clopidogrel group after plaques rupture.The activity of t-PA remained uncharged in the clopidogrel group but increased in the high cholesterol group.Compared to pre-treatment level,the activity of PAI-1 increased in the high-cholesterol group but reduced in the clopidogrel groups after atherosclerosis plaques rupture.The thickness of vessel intima increased in both the high-cholesterol group and the clopidogrel group,however,the degree of intima thickening and vessel stenosis is less in the clopidogrel group compared to the high-cholesterol group.Conclusion Clopidogrel relieves inflammation reaction by inhibitting thrombogenesis and the movement of macrophages in atherosclerosis plaques,thus minimizes the degree atherosclerosis and vessel intima hyperplasia.

The method of simultaneous administration of several probe substrates is called “Cocktail" approaches. The objective of the article is to review the application of this technique in characterizing the activity of multiple drug-metabolizing enzymes and in clinical researches. This paper also shows Five-drug and Six-drug Cocktail set for evaluating in vivo activity of drug-metabolizing enzymes.

Objective This study is to identify the presence of superoxide anion-generating system in human lens epithelial cells using arachidonic acid (AA) as the stimulator.Design Experimental study.Participants Human lens epithelial cells B3 (HLE B3). Methods Confluent human lens epithelial cells (HLE B3) were subjected to stimulation by AA and its derivatives.The generation of su- peroxide anion was quantified with a luminometer (LumiStar BMG) immediately upon AA and its derivatives addition.Cells preloaded with superoxide dismutase (SOD) or mannitol were used as negative controls and cells mixed with 3% ethanol (solvent for AA) were used as baseline.Cells were preloaded with inhibitors 30 minutes before luminometer measurement.A time-and concentration-depen- dent study on the AA-stimulated activation of mitogen-activated protein kinase (MAPK) was carried out using western blot analysis. Main Outcome Measures Superoxide generation,phosphorylation of MAPK.Results AA at dosage of 30-150 mM proportionally in- duced luminescence in HLE B3 cells,but was ineffective in cells preloaded with SOD or mannitol.DPI,a non-specific NADPH oxidase inhibitor eliminated AA-induced superoxide anion generation partially.Leinoleic acid,stearic acid,eicosa-11Z,14Z,17Z-trienoic acid (20:3) and eicosa-11Z,14Z-dienoic acid (20:2) were ineffective.The generation of superoxide anion was not contributed by cyclooxyge- nase or the cytochrome p450 pathway since indomethacin (inhibitor for cyclooxygenase) or ketoconazole (inhibitor for cytochrome p450) could not eradicate the stimulatory effect of AA.While CDC,a specific inhibitor for lipoxygenase could eliminate superoxide generation partially.The specific inhibitor for 5-lipoxygenase AA861 completely blocked the generation of superoxide anion.Western blot analysis of the cell lysate showed that AA at the concentrations of 30-150 mM progressively activated ERK and JNK.They were transiently ac- tivated between 2.5-30 minutes.The activations of ERK and JNK were dose-dependent and time-dependent.Conclusions Inhibition of superioxide anion generation may be a new approach to block lens epithelial cell proliferation and post-capsule opacification.

Objective To observe the positive rate of plasma cytomegalovirus DNA(CMV‐DNA) level after allogenic hema‐topoietic stem cell transplantation (allo‐HSCT) ,analysis and explore the risk factors related to CMV infection .Methods Choose 30 patients who had performed allo‐HSCT in our department from July 2012 to September 2014 .PCR were used regularly to detect the plasma CMV‐DNA levels in these patients .The regular monitoring times were as follow :the first month(once a week) ,the second to third month(twice a week) ,the fourth to sixth month(once a month) after allo‐HSCT respectively .The positive rates were coun‐ted in every period .Results Thirteen patients had CMV infection ,and the infection rate were 43 .3% .In the first month ,there were 4 cases (13 .3% )whose plasma CMV‐DNA levels were positive ,however ,the positive cases in the second month ,the third month , the fourth month ,the fifth month and the sixth month were 11(36 .7% ) ,2(6 .7% ) ,0 ,2(6 .7% ) and 0 respectively .Statistical data showed that it was in the second month after allo‐HSCT that the CMV‐DNA positive rate was higher than other periods .The anal‐ysis suggested that the positive rate of CMV‐DNA related to the administration of rabbit anti‐human thymocyte globulin(ATG) ,ba‐siliximab ,and the occurrence of acute graft versus host disease(GVHD) ,there were no relationship among gender ,age ,risk stratifi‐cation of primary disease ,HLA condition ,preparative project ,recovery time of neutrophile granulocyte .Conclusion It is necessary and beneficial to monitor blood CMV‐DNA level regularly and take treatment early to avoid CMV related comobidity after allo‐HSCT .

OBJECTIVE:To investigate therapeutic efficacy and safety of levamlodipine and telmisartan combined with hydro-chlorothiazide in the treatment of anti-dipper hypertension. METHODS:Totally 150 patients with anti-dipper hypertension were ran-domly divided into group A,B,C,with 50 cases in each group. Group A was given Telmisartan tablet 40 mg+Hydrochlorothiazide tablet 10 mg,once a day,in the morning. Group B was given Levamlodipine tablet 5 mg,once a day,in the night. Group C was given Telmisartan tablet(usage and dosage same as group A)+Hydrochlorothiazide tablet(usage and dosage same as group A)+Le-vamlodipine tablet(usage and dosage same as group B). Treatment courses of 3 groups lasted for 8 weeks. The changes of electro-lyte and 24 h ambulatory blood pressure were observed and compared among 3 groups before and after treatment. The incidence of adverse reactions was recorded. RESULTS:There was no statistical significance in the electrolyte indexes in 3 groups before and af-ter treatment(P>0.05). Before treatment,there was no statistical significance in 24 h blood pressure among 3 groups(P>0.05). Af-ter treatment,the 24 h blood pressure of the patients in the 3 groups after treatment was lower than before treatment,and group C was lower than that of the group A and group B(P<0.05). After treatment,the rate of anti-dipper rhythm reversal in group C was significantly higher than group A and B,with statistical significance(P<0.05). There was no statistical significance in the inci-dence of ADR among 3 groups(P>0.05). CONCLUSIONS:Levamlodipine and telmisartan combined with hydrochlorothiazide show good therapeutic efficacy for anti-dipper hypertension,and can reduce 24 h blood pressure and effectively reverse anti-dipper rhythm with good safety.