ObjectiveTo determine the effect of telmisartan on the levels of serum adiponectin and C-reactive protein(hs-CRP)in elderly hypertensive patients with unstable angina pectoris. MethodsOne hundred and twenty elderly hypertensive patients with unstable angina pectoris were randomized into two groups, telmisartan(n=60) and perindopril(n=60) groups.The levels of hs-CRP,adiponectin, lipid factors, fasting plasma glucose (FPG), insulin and insulin sensitivity index (ISI) were measured before and 6 months after telmisartan and perindopril treatments.ResultsAt the end of 6 months, the telmisartan group showed more reduction in plasma levels of hs-CRP and more increment in serum adiponectin concentrations and ISI significantly. The frequency of cardiovascular events was significantly lower in the patients of the telmisartan group than that of the perindopril group.ConclusionsCompared with perindopril, telmisartan significantly decreases plasma levels of hs-CRP and increases serum adiponectin concentrations in elderly hypertensive patients with unstable angina pectoris. It also significantly decreases the frequency of cardiovascular events in these patients.

Objective To investigate the effects of antihypertension and reversing left ventricular hypertro- phy by carvedilol or bisoprolol in patients with mild to moderate essential hypertension.Methods 40 cases of mild to moderate essential hypertension patients were selected for this random single-blind,paralleling controlled clinical study.Results Patients were randomized to take 12.5～25mg carvedilol tablet orlce daily or bisoprolol 2.5～5mg once daily if DBP was still in the range of 12.0～14.6kPa(90～110mmHg)after 2 weeks' placebo baseline. Carvedilol group included 20 cases,bisoprolol group included 20 cases,and the course was 24 weeks.Blood pressure and heart rate were measured and symptoms and signs were recorded.At the end of placebo and in 24 weeks heart ultrasound,blood routine,serum glucose,blood lipid,hepatic function and renal function were examined.SBP,DBP and heart rate of patients in two groups decreased obviously.There were significant differences between the two groups.Ventricular hypertrophy of carvedilol group improved than that in pretherapy.There were significant differ- ences between the two groups.Conclusion Carvedilol was well-tolerated with less side effects such as mild headache,tiredness,dizziness,slightly elevating of serum glucose.Carvedilol could well treat the mild moderate essen- tial hypertension effectively and safely by 12.5～25mg once daily.

OBJECTIVETo investigate the relationship between B-type natriuretic peptides (BNP) and subclinical target organ damage in essential hypertensive (EH) patients.

METHODSA total of 317 EH patients were divided into 3 groups according to BNP levels, namely normal (BNP<600 ng/L) group (n=102), moderate (600-883.5 ng/L) group (n=116), and elevated BNP (>883.5 ng/L) group (n=99). The blood pressure, left ventricular mass index (LVMI), the intima media thickness (IMT) of the common carotid artery, the plaque size in the coronary artery (CS) and microalbuminuria levels were analyzed in these patients.

RESULTSThe EH patients with moderate and elevated BNP showed significantly higher LVMI, IMT, CS and microalbuminuria levels than those with normal BNP level (LVMI: 102.8∓23.12 and 123.9∓26.47 vs 91.09∓18.71 g/m2; IMT: 0.95∓0.32 and 1.16∓0.37 vs 0.84∓0.28 mm; microalbuminuria: 31.36∓20.55 and 36.73∓22.07 vs 23.21∓18.68, P<0.01). After adjustment, BNP was positively correlated to LVMI, IMT, CS and microalbuminuria level (r=0.45, 0.43, 0.39 and 0.41, respectively, P<0.01). Multivariate logistic regression analysis showed that age, systolic blood pressure, BNP, FPG, and microalbuminuria, LDL-C, and BMI were all related to the occurrence of subclinical target organ damages.

CONCLUSIONBNP is positively correlated to subclinical target organs damages in EH patients.

Adult ; Aged ; Aged, 80 and over ; Albuminuria ; pathology ; Carotid Artery, Common ; pathology ; Carotid Intima-Media Thickness ; Female ; Humans ; Hypertension ; blood ; pathology ; Hypertrophy, Left Ventricular ; pathology ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood

OBJECTIVETo compare with the clinical applications of routine-subtraction and dual-energy subtraction cervical arteries computed tomographic angiography (CTA) for cervical arteries imaging.

METHODSScanning was performed in 45 patients with clinically suspected cervical arteries disease with dual-source CT. The data of two different energy were collected only at one scanning. The data post processing include: conventional bone-removal digital subtraction (routine-subtraction) was performed with plain and 80 kV enhanced scanning. Volume render (VR) and maximum intensity projection (MIp) reconstruction were finished. Direct bone-removal digital subtraction (dual-energy subtraction) was performed with 80 and 140kV enhanced scanning that have different energy, and saving the data of subtraction. VR and MIp reconstruction were finished. The image quality, which was divided into four grades, was compared between these two groups. The effective radiation dose was also compared.

RESULTSFor normal vessels, no abnormality was found in 24 of 45 cases, with the common carotid artery and its branches clearly displayed with both two methods. The image quality was not significantly different between dual-energy subtraction CTA and routine subtraction CTA (P>0.05) . For stenotic vessels, 45 stenotic vessels in 21 cases were clearly displayed clearly with both two methods (P>0.05) . The effective radiation dose was decreased by 17.3 % for dual-energy subtraction CTA when compared with routine-subtraction CTA (P<0.01) .

CONCLUSIONSBoth routine-subtraction and dual-energy subtraction CTA can clearly display normal and stenotic vessels. The radiation exposure dose is relatively lower in dual-energy CTA. The dual-energy subtraction CTA has better effectiveness when used for non-cooperation patients.

Adult ; Aged ; Aged, 80 and over ; Angiography, Digital Subtraction ; methods ; Carotid Artery Diseases ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Radiation Dosage ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; methods

OBJECTIVETo investigate the effect of metoprolol succinate sustained-release tablets on cardiac function, serum vascular endothelial growth factor (VEGF) and C-reactive protein (CRP) in elderly hypertensive patients and its relation with pulse pressure (PP).

METHODSA total of 330 elderly hypertensive patients with chronic heart failure receiving basic therapy were included. Before initiation and 3 months after the maximal tolerated dose of metoprolol succinate sustained-release tablets, the parameters of blood pressure, clinical features, radionuclide ventriculographic and laboratory findings of the patients were analyzed.

RESULTSAs the PP was elevated, the serum levels of VEGF, hs-CRP and BNP increased and the cardiac systolic and diastolic functions decreased. In patients with PP of 59-68 mmHg and > 68 mmHg, 3 months of treatment with the tablets caused significantly increased LVEF by (3.32 ± 2.35)% and (4.12 ± 3.05)% and LVPER by 0.37 ± 0.26 and 0.53 ± 0.37, respectively; PP were decreased by 8.2 ± 3.1 mmHg and 9.4 ± 4.3 mmHg and VEGF by 18.39 ± 8.43 pg/ml and 26.79 ± 14.32 pg/ml, respectively. The treatment also resulted in lowered hs-CRP and BNP in these patients by 0.26 ± 0.13 mg/L and 0.33 ± 0.16 mg/L and by 140.36 ± 68.62 ng/L and 155.39 ± 73.58 ng/L, respectively.

CONCLUSIONObvious elevation of PP is associated with a better response to metoprolol succinate sustained-release tablets in elderly hypertensive patients with chronic heart failure, and 3 months of treatment with the tablets can significantly improve the cardiac function and lower the levels of VEGF, hs-CRP and BNP in these patients.

Adrenergic beta-Antagonists ; administration & dosage ; therapeutic use ; Aged ; Aged, 80 and over ; Blood Pressure ; C-Reactive Protein ; metabolism ; Chronic Disease ; Delayed-Action Preparations ; Female ; Heart Failure ; blood ; drug therapy ; etiology ; Humans ; Hypertension ; blood ; complications ; drug therapy ; Male ; Metoprolol ; administration & dosage ; analogs & derivatives ; therapeutic use ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Vascular Endothelial Growth Factor A ; blood

Anastomosis, Surgical ; Anastomotic Leak/surgery* ; Drainage ; Gastrectomy ; Humans ; Suction

Content and type of triacylglycerols(TAGs) in edible oils are closely related with our health,it is of significance to develop a fast and high-efficiency method for the determination of TAGs. In this manuscript, a fast and direct method for qualitative analysis of TAGs was established using matrix-assisted laser desorption/ionization Fourier transform ion cyclotron resonance mass spectrometry (MALDI-FTICR-MS). 2,5-DHB was employed as matrix and dichloromethanewas used as solvent for dissolving edible oils. With laser power of 15%,laser frequency of 100 Hz and 100 laser shots, repeatability was evaluated using relative standard deviation (RSD) and less than 10% was obtained. Different kinds of edible oils could be directly distinguished from each other using MS and MS/MS results. With confidence level of 95%, principal component analysis(PCA) results show that 34 different kinds of edible oils were clearly classified. Using this method 5% doped canola in olive was identified directly,indicating that MALDI-FTICR-MS has the potential for rapid analyzing and screening edible oils.

OBJECTIVETo explore the indication and efficacy of transanal local excision for low rectal cancer.

METHODSA total of 40 consecutive patients undergoing transanal local excision of low rectal cancer were analyzed retrospectively.

RESULTSThe mean operative time was 50 (30-85) minutes. The mean intraoperative blood loss was 40 (10-100) ml. The mean hospital stay was 5 (2-10) days. The local recurrence rate was 20.0% (8/40). The 5-year survival rate was 90.0%. Local recurrence rate was 17.9% (5/28 cases) for T1, and 25.0% (3/12) for T2 lesions. However, the difference between the two groups was not statistically significant (P=0.61). Local recurrence rate was significantly lower for moderate differentiated than that for well-differentiated cancer [12.9% (4/31) vs. 44.4% (4/9), P=0.037]. Tumor diameter less than 3 cm was associated with a significantly lower local recurrence rate as compared to the counterparts (10.7% vs. 41.7%, P=0.03). No significant correlations were found between local recurrence and other variables including tumor location (P=0.93), tumor classification (P=0.53), and method of surgical excision (P=0.41).

CONCLUSIONSIndications for transanal local excision of low rectal cancer include T1 and T2 tumors with well differentiation and the diameter less than 3 cm. Clinical outcome may be favorable if patients are carefully selected for transanal local excision.

Adult ; Aged ; Aged, 80 and over ; Anal Canal ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Rectal Neoplasms ; pathology ; surgery ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVETo investigate CT findings and incidence rate of gastric bare area involvement (GBAI), left adrenal gland involvement (LAGI) and perirenal space involvement (PSI) in acute pancreatitis, and to also explore the value of these appearances in predicting complications and mortality of patients.

METHODSCT imaging data of 575 patients with AP diagnosed by clinic from October 2009 to April 2011 were analyzed retrospectively. There were 339 male and 236 female patients, aging from 16 to 93 years with a mean of (51 ± 16) years. Involvement with or without gastric bare area, left adrenal gland, perirenal space were focused, and the relationship were analyzed between these CT findings and complications and mortality of patients.

RESULTSAmong 167 patients (29.0%) with GBAI, 132 had complications and 16 died. The sensitivity and specificity of GBAI for predicting complications were 45.4% and 87.7%, respectively, and 84.2%and 72.8% for predicting mortality. In all 107 patients (18.6%) with LAGI, 81 had complications and 18 died. The sensitivity and specificity of LAGI for predicting complications were 27.8% and 90.8%, respectively, and 94.7% and 84.0% for predicting mortality. Among 335 patients (58.3%) with PSI, 201 had complications and 19 died. The sensitivity and specificity of PSI for predicting complications were 69.1% and 52.8%, respectively, and 100% and 43.2% for predicting mortality. Of all patients, 210 (36.5%) owned two or more positive CT findings among GBAI, LAGI, and PSI. One hundred ninety-eight of these patients had complications and 19 died, that predicted the sensitivity and specificity for complications were 68.0% and 95.8%, respectively, and 100% and 65.6% for mortality. The risk of complications in the patients with GBAI or LAGI was increased than normal gastric bare area or left adrenal gland 5.9 or 3.8 times respectively, and the risk of death was improved 14.3 or 94.5 times respectively. The risk of complications in those patients with two or more positive findings increased by 48.3 times. By analyzing receiver operating characteristic (ROC) curve, the combination of GBAI, LAGI, and PSI was the best way to predict the complications of AP. The area under the ROC was 0.819.

CONCLUSIONSThe CT imaging could effectively indicate the signs of GBAI, LAGI and PSI of AP. The GBAI. LAGI and PSI were related with the severity and prognosis of AP, and these findings could be clinical indicators for evaluating prognosis of AP.

Acute Disease ; Adolescent ; Adrenal Glands ; diagnostic imaging ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kidney ; diagnostic imaging ; Male ; Middle Aged ; Pancreatitis ; complications ; diagnostic imaging ; Retrospective Studies ; Sensitivity and Specificity ; Stomach ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo evaluate the effect of rosuvastatin on the functions of the surviving myocardium and arteriosclerosis plaque in patients with ST-segment elevation after acute myocardial infarction (STEMI) and percutaneous coronary intervention (PCI).

METHODSSixty-five STEMI patients were randomized to receive 40 mg simvastatin (n=32) or 10 mg rosuvastatin (n=33) before sleep in addition to conventional medications. Before PCI and after the 12-month medications, the plasma levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) were measured, and echocardiography and (99)Tc(m)-MIBI single-photon emission computed tomography (SPECT) were performed to assess the therapeutic effects.

RESULTSAt the end of 12 months, the patients in simvastatin group showed significantly reduced total cholesterol, LDL-C, CRP, TNF-α, and (99)Tc(m)-MIBI uptake fraction. In rosuvastatin group, these reductions were even more obvious; the intima media thickness (IMT) of the common carotid artery was reduced significantly after a 12-month rosuvastatin therapy, but almost remained unchanged after simvastatin therapy.

CONCLUSIONRosuvastatin therapy in addition to conventional medications can significantly reduce IMT and improve the functions of the surviving myocardium in patients with STEMI after PCI.

Aged ; Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; pathology ; Electrocardiography ; Female ; Fluorobenzenes ; therapeutic use ; Heart ; physiopathology ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; physiopathology ; therapy ; Pyrimidines ; therapeutic use ; Rosuvastatin Calcium ; Sulfonamides ; therapeutic use