BACKGROUND: Early clinical researches suggest that mediodespidine capsule can decrease blood pressure of patients with primary hypertension on the basis of yanggan qinggan pinggan technique.OBJECTIVE: To observe the effect of mediodespidine capsule on primary hypertension and angiotensin Ⅱ (Ang- Ⅱ ) of patients in the types of yin deficiency, yang excess and liver fire.DESIGN: Randomized controlled case observation.SETTING: Department of Cardiology, First Affiliated Hospital, Hunan University of Traditional Chinese Medicine.PARTICIPANTS: Patients were selected from the Inpatient Department and Out-patients Clinic of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine between April 1999 and April 2000. Inclusion criteria: Patients, who were diagnosed with the criteria of primary hypertension, who belonged to the types of yin deficiency, yang excess and liver fire, who could endure this test, who were coincidence with the criteria of mental-stress test, were all consent. Exclusion criteria: Patients who had severe congestive heart failure, atrophic arthritis and unable tolerance were excluded. There were 60 cases in total, including 29 males and 31females. All patients were divided into mediodespidine group and verapamil group with 30 in each group on the basis of randomly digital table.METHODS: Patients who had positive results of awaken mental-stress test were involved in this study. Cases in mediodespidine group were treated with mediodespidine capsule, which was made of tall gastrodia tuber, spine date seed and fourstamen stephania root at the dosage of 0.43 g/pill and were provided by the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine (wei yao ji zi: 05-047, batch number: 990503), five pills each for 3 times a day. Cases in verapamil group were treatedwith verapamil (40 mg/pill, Shanghai Huanghe Liya PharmaceuticalCompany Limited,batch number: 980301B) 80 mg each for 3 times a day. The course in both groups was 4 weeks. ① Effect of blood pressure: Average value of blood pressure tested for 3 successive days were regarded as the blood pressure before treatment, and average value of blood pressure tested for 3 times after treatment was regarded as the blood pressure after treatment. ② Effect of symptom:Scores were recorded as four levels according to main symptoms, such as vertigo, headache, pain and weakness of waist and knees, before and after treatment. ③ Values of Ang- Ⅱ were measured with radioimmunoassay before and after cold pressor test. Effect on Ang- Ⅱ was evaluated with effect of decompression, effect of clinical symptom and criteria of clinical effect.MAIN OUTCOME MEARUSES: Clinical symptoms, values of blood pressure, heart rate and Ang- Ⅱ before and after cold pressor test.RESULTS: A total of 60 patients with primary hypertension were involved into the final analysis.① Totally effective rate of clinical symptoms of patients in mediodespidine group was higher than that of patients in verapamil group, but the effect of decompression was not significant between the two groups (P ＞ 0.05). ② There was remarkably significant difference of heart rate in both groups before and after treatment (P ＜ 0.01), especially the decrease in verapamil group was great, and there was significant difference (P ＜ 0.05). ③ Values of systolic pressure and diastolic pressure were decreased in both groups after cold pressor test (P ＜ 0.01), but there was no significant difference between the two groups (P ＞ 0.05). ④ There was no significant difference in clinical effect between the twogroups (P ＞ 0.05).⑤ After treatment, concentration of Ang- Ⅱ at basic level in both groups was decreased, and there was significant difference between them (P ＜ 0.01);concentration of Aug-Ⅱ was decreased in both groups after cold pressor test as compared with that before treatment, but there was no significant difference between them (P ＞ 0.05).CONCLUSION: Mediodespidine capsule can decrease blood pressure stably, and the effect is stronger than that of verapamil at the aspect of decompression and improving symptoms. Blood pressure of patients with primary hypertension in the types of yin deficiency and yang excess or liver fire can be decreased by decreasing the level of plasma Ang-Ⅱ to a certain degree.

Objective To investigate the situation of the activities of daily living(ADL)for elderly people in Changsha,and analyze the influencing factors. Methods Questionnaire survey on ADL was held in 2239 elderly people(ranging from 60 to 91 years old),and the influencing factors including age,sex,family structure,marital status,education level,occupation,common chronic diseases and medical care consciousness were analyzed. Results Going to the toilet irregularly hadthe highest injury rate in physical self-maintenance viability(18.2%).But in instrumental ADL,the highest injury rate occurred while shopping(26.3%).Advanced age,living alone,losing spouse,sickness and the lack of medical care awareness were the major factors that influenced the ADL of the elderly people. Conclusions The ADL is an important indicator which reflects the health condition of elderly people.Advanced age,living alone,losing spouse,having many chronic diseases and lacking in medical care awareness are risk factors.

Adult ; Antiretroviral Therapy, Highly Active ; Female ; HIV Infections ; drug therapy ; Humans ; Lamivudine ; administration & dosage ; Male ; Middle Aged ; Treatment Outcome ; Zidovudine ; administration & dosage

Objective To improve the efficiency of donated organs and to investigate the possi- bility and operation protocol of heart and lung transplantation from the same donor to different reci- pients.Methods The organs of heart and lung were obtained from three donors through the method of orthotopic lavage and whole cutting,and transplanted to end-stage patients with heart diseases or lung diseases.First,the donor was subjected to mechanical ventilation,thoracotomy and lavage of heart and lung.The heart and lung were cut in whole and separated.The recipients were subjected the re- trograde lavage of heart and lung.In the patients receiving unilateral lung transcription,the left and right lungs were isolated.Among 3 recipients of lung transcription,one underwent left unilateral lung transplantation and 2 bilateral lung transplantation.Three cases received orthotopic cardiac transplan- tation by using bicaval orthotopic heart transplantation (BOHT) anastomosis method.Results One recipient of left unilateral lung transplantation recovered well after operation.In one recipient under- going bilateral lung transplantation,right upper lung embolism occurred.After re-operation of cutting the right upper lung on the 9th day of the first one,he recovered from the illness.In another recipient receiving bilateral lung transplantation,anastomotic stenosis of trathea and pulmonary infection occurred after operation.After expectant treatment,he recovered from the illness,but died from serious infection 7 months after operation.One of the heart recipients was found having renal failure of first stage,and recovered from disease after hemodialysis treatment.Quality of life was good in all 3 heart recipients after operation and their heart function achieved the restoration of 0-Ⅰstage.Conclusion The treatment protocol of transplantation from the same donor to different recipients at the same time, which can make full use of the organs from donors,is feasible and has good effect.

Objective To discuss the short-term clinical effect of K-Rod pedicle dynamic fixation system for multiple segmental lumbar degeneration. Methods From January 2010 to October 2012,28 patients with multiple segmental lumbar degeneration who were accepted K-Rod pedicle dynamic fixation system were retrospectively reviewed. The short-term clinical effect were based on Oswestry disability index score,visual analogous scale ( VAS) ,improvement rate of low back pain,postoperative lumbar hyperextension, hyperbend X-ray film lumbar ROM value ( lumbar flexion mobility) ,average operation time, intraoperative blood loss. Results All of 28 cases were achieved 12 ~24 months follow-up,the difference of Oswestry disability index score and visual analogous scale ( VAS) between 12 months postoperatively and preoperatively were statistically significant,the improvement rate of low back pain was (87. 0 ± 2. 0)%,the average operation time was (99. 6 ± 16. 2) minutes,the average blood loss was (70. 5 ± 31. 5)mL,the average length of stay(ALOS) was (11. 2 ± 2. 6) days after sur-gery. Conclusion K-Rod pedicle dynamic fixation system in the treatment of multiple segmental lumbar degeneration can obtain satisfactory short-term clinical effect.

Objective To discuss the clinical effect and the notes of atlas lateral mass screws combined with posterior epistropheus ped-icle screws for the treatment of atlantoaxial joint instability. Methods In our hospital from January 2006 to January 2011,48 cases of atlan-toaxial joint instability accepted operation of the atlas lateral mass screws combined with epistropheus pedicle screws were analyzed. Results All patients with follow-up time 12~24 months,an average of 17 months,were achieved primary healing and atlanto-axial intervertebral osse-ous healing. Besides postoperative neck pillow area pain improved and nerve function get a degree of recovery,there was no inner fixed damage cases. Complications of operation include venous plexus hemorrhage was in 2 cases,cervical occipital pain and numbness increase in 3 cases,cere-brospinal fluid leak in 2 cases,vertebral artery extrusion occlusion after cerebral ischemic symptoms in 1 case. Conclusion Combination of atlas lateral mass screws and posterior epistropheus pedicle screws technique is one of the effective means of treatment of atlantoaxial joint instabili-ty and can obtain satisfactory clinical effect. Standard operation performance is the key to reduce or even eliminate surgical complications.

Objective To observe the clinical efficacy of Huxinkang Pills in treating patients with unstable angina pectoris (UAP) and its effects on the tumor necrosis factor-α (TNF-α) and N-terminal pro-brain natriuretic peptide (NT-proBNP). Methods Sixty patients with UAP were randomly divided into the treatment group and the control group, 30 cases in each group. Patients in the treatment group were treated with Huxinkang Pills based on the basic western medicine, while the patients in the control group were treated with Tongxinluo Capsules based on the basic western medicine. The treatment course was 4 weeks. Clinical efficacy and the change of the TNF-α and NT-proBNP levels before and after treatment were observed. Results The general efficacy, electrocardiograph efficacy, angina pectoris efficacy, TCM syndrome efficacy and glonoine reduction of the two groups had statistically difference (P<0.05) respectively, and the efficacy of the treatment group was superior to that of the control group (P<0.05). The TNF-α and NT-proBNP levels in both groups before and after treatment had statistically difference (P<0.05) respectively. The differences in TNF-α and NT-proBNP levels between both groups after treatment were all statistically significant (P<0.05), and these indexes of treatment group were superior to those of the control group (P<0.05). Conclusion Huxinkang Pills are remarkable in treating patients with UAP, and able to restrain the levels of TNF-α and NT-proBNP.

AIM To investigate the effects of ondansetron, a selective 5 Hydroxytryptamine3 (5 HT 3) receptor antagonist, on morphine physical dependence. METHODS The morphine dependent models in mice and in isolated Guinea pig ileum were used. RESULTS Pretreatment of ondansetron for 12 days significantly reduced morphine withdrawal symptoms in mice ,such as body weight loss(Groups 2～100 ?g?kg -1 ?d -1 ) or reduced both body weight loss and jumping times (Group 100 ?g?kg -1 ?d -1 ). In addition, concomitant treatment with ondansetron(1～20 ?mol?L -1 ) dose dependently suppressed the contraction induced by naloxone in Guinea pig ileum. CONCLUSION The chronic pretreatment of ondansetron can prevent morphine physical dependence to some extent.

Currently,medical ethics education is well popularized,yet not popular among medical students,interns or clinical doctors,for which its formalistic teaching content and mode are to blame.To realize its real educative effects,infiltrating medical ethics into the ideological perception among medical students,interns and clinical doctors,besides horizontal expansion in education popularity,more emphasis should be put to grasping and instructing the essence of medical ethics on a vertical level in order to make the recognition of medical ethics education as common sense among medical professionals.

Objective To evaluate the role of autophagy in activation of astrocytes in the spinal cord of rats with neuropathic pain (NP).Methods One hundred thirty-six male Sprague-Dawley rats, aged 8-10 weeks, weighing 250-300 g, were randomly divided into 4 groups (n =34 each) using a random number table: sham operation group (group S), group NP, autophagy inhibitor 3-methyladenine (3-MA) group (group MA), and autophagy activator rapamycin group (group R).NP was induced by chronic constriction injury.In 3-MA and R groups, 3-MA 15 mg/kg and rapacymin 10 mg/kg were injected intraperitoneally, respectively, at 1 h before NP.Ten rats were randomly selected, and the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured before NP and at 1, 3, 7 and 14 days after NP.Before NP and at 1, 3 and 7 days after NP, 6 rats were randomly sacrificed, the L4-6 segments of the spinal cord was harvested to detect microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ), Beclin-1 and glial fibrillary acidic protein (GFAP) expression by Western blot.Results Compared with group S, the MWT was significantly decreased, the TWL was shortened, and the expression of LC3 Ⅱ , Beclin-1 and GFAP was up-regulated at each time point after NP in group NP (P＜ 0.05).Compared with group NP, the MWT was significantly decreased, the TWL was shortened, the expression of LC3 Ⅱ and Beclin-1 was down-regulated, and the expression of GFAP was up-regulated at each time point after NP in group MA, and the MWT was significantly increased, the TWL was prolonged, the expression of LC3 Ⅱ and Beclin-1 was up-regulated, and the expression of GFAP was down-regulated at each time point after NP in group R (P＜0.05).Conclusion Autophagy is involved in the development and maintenance of NP through promoting the activation of astrocytes in the spinal cord of rats.