Objective To evaluate the effect of irbesartan and nifedipine controlled-release tablets on morning blood pressure surge in patients with essential hypertension. Methods Ninety patients with essential hypertension were randomly divided into irbesartan group ( group A, n = 45) and nifedipine group (group B, n =45). Irbesartan tablets 150 mg/d and nifedipine controlled-release tablets 30 mg/d were respectively given in group A and group B for 4 weeks. The levels of diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arterial pressure ( MAP ) and morning blood pressure surge ( MBPS ) before and after treatment were measured by ambulatory blood pressure monitoring. Results The DBP, SBP, MAP and MBPS levels of two groups after treatment for 4 weeks were all decreased (P < 0.01). All the indexes of group B decreased more significant compared to group A (P < 0.05 ). Conclusion To control blood pressure and prevent morning blood pressure surge, nifedipine controlled-release tablets are better than irbesartan.

Female patients, 50 years old, have a recurrent unilateral aggravating headache for 5 years. Without runny nose, sneezing, nasal hemorrhage, smell or vision loss. Prefessional examination: there is a visible hoar neoplasm in the right middle nasal meatus With smooth surface and rich in vascular. The nasopharyngeal MRI shows that there is a occupancy lesion in the right nasal cavity and sinuses, well-demarcated, about 21. 5 mm x 25.5 mm x 37.0 mm. Angiofibroma is the most likely diagnosis. Postoperative pathological section shows that tumor are hypercellular, which contains big nucleus. Cells are spindle or short fusiform shape, there are stripes and nuclear division in some cells. There are vortex structures in partial region. Immunohistochemical examination shows: CD34(++), Ki-67 (< 5%), CD68(-), Des (-), NSE(+), S-100(++), SMA(-), EMA (+). Histopathologic diagnosis: atypical meningioma, some were differentiated to rhabdoid meningioma. The final diagnosis is malignant meningioma in nasal cavity and paranasal sinuses.
Female ; Humans ; Meningeal Neoplasms ; diagnosis ; pathology ; Meningioma ; diagnosis ; pathology ; Middle Aged ; Nasal Cavity ; pathology ; Paranasal Sinus Neoplasms ; diagnosis ; pathology ; Paranasal Sinuses ; pathology

Objective The objective of this study was to evaluate the clinical significance of coronary stenting in patient aged more than 70 years old.Methods The results of coronary stenting (14 with acute myocardiac infarction) were analyzed and compared them to 36 patients aged from 50 to 60 years old. Results The clinical success rate of coronary stenting for elderly group was 96.8%. The reanginal rate during 3 to 44 (21 ? 14) months' follow up of was 23% . No significant difference in the success and reanginal rate was observed between the two groups and no death case was found in the 14 elderly patients with acute myocardiac infarction.Conclusion Our data suggest that coronary stenting is a very safe and effective method of coronary revascularization in elderly patients.

0.05).② On diagnosing ACS,the area under ROC curve of sCD40L was 0.773,the sensitivity,specificity and validity are 82.8%,61.9% and 85.7%,respectively,which were all highest among so much indexes.Conclusion High serum sCD40L levels may suggest vulnerable plaque,and it's somewhat valuable in diagnosing ACS.

Objective:To evaluate the value of cardiac MR feature tracking (CMR-FT) on the early assessment of left ventricular subclinical myocardial dysfunction in patients of hypertensive heart disease (HHD).Methods:From October 2018 to November 2019, 16 HHD patients with left ventricular hypertrophy (HHD-LVH), 24 HHD patients without left ventricular hypertrophy (HHD-nonLVH) and 24 age-and gender-matched normotensive controls who underwent 3.0 T CMR examination were retrospectively enrolled. Imaging protocol included cine sequence and late gadolinium enhancement. Left ventricular function variables were measured using Argus software, mainly including left ventricular end-diastolic volume index (LVEDVI), left ventricular mass index (LVMI), left ventricular maximal wall thickness (LVMWT), the ratio of left ventricular mass to left ventricular end-diastolic volume (M/V). CMR-FT was performed using commercial software CVI 42, with parameters including global radial, circumferential, longitudinal strains (GRS, GCS, GLS), peak systolic radial, circumferential, longitudinal strain rate (SRSR peak, SCSR peak, SLSR peak) and peak diastolic radial, circumferential, longitudinal strain rate (DRSR peak, DCSR peak, DLSR peak) derived. One-way analysis of variance with scheffe correction or Kruskal-Wallis test was performed for multiple comparisons. Pearson or Spearman analysis was used for linear or monotonic nonlinear correlations. Results:HHD-LVH group had higher LVEDVI, LVMI, LVMWT and M/V than HHD-nonLVH group and control group ( P<0.05). Compared with control group, GRS, GCS and GLS were statistically impaired in HHD-LVH group, and DRSR peak, DCSR peak and DLSR peak were statistically reduced in HHD-LVH group and HHD-nonLVH group(all P<0.05). Correlation analysis showed that LVMI correlated linearly with GRS ( r=-0.384, P=0.002), GCS ( r=0.392, P=0.001) and GLS ( r=0.491, P<0.0001),LVMWT correlated nonlinearly with GRS ( r=-0.362, P=0.003), GCS ( r=0.384, P=0.002) and GLS ( r=0.422, P=0.001), LVEDVI correlated nonlinearly with GRS ( r=-0.295, P=0.018) and GCS ( r=0.264, P=0.035). Conclusion:CMR-FT derived left ventricular strain parameters could be served as early indicators for the assessment of subclinical myocardial dysfunction in HHD patients, which have great potential in guiding appropriate intervention therapy and improving cardiac remodeling.

Objective To investigate the value of 320-slice CT in diagnosis and intervention treatment of the hepatocellular carcinoma (HCC).Methods Retrospective analysis of 41 patients with HCC was performed,who underwent 320-slice CT three-phase scans and the CTA reconstruct before the transcatheter arterial chemoembolization (TACE).The origins,the distributions and the branches of the abdominal arteries were observed,respectively.Compared to the images of the DSA,the tumor feeding artery and portal vein tumor thrombus (PVTT)were analyzed.Results Compared to the images of the DSA,there was an obvious advantage in diagnosis of small HCC with the diameter <3 cm using the 320-slice CTA.However,there were no significant differences in display of hepatic artery variations,tumor feeding arteries and PVTT between the 320-slice CTA and the DSA.Conclusion The 320-slice CT and the CTA reconstruct can be helpful for more accurate diagnosis and evaluation for HCC,it can be used to direct the intervention treatment for HCC on basis of the images of the tumor feeding artery and PVTT.

Objective To evaluate the significance of cytometric beads array(CBA)in the detection of Th1/Th2/Th17 cytokine in patients with pulmonary tuberculosis.Methods The levels of 7 cytokines (IL-2,IL-4,IL-6,IL-10,TNF,IFN-γ and IL-17A) were detected by CBA according to the instruction of BD CBA Human Th1/Th2/Th17 Cytokine Kit(BD Biosciences,USA)in the serum of 98 patients with tuberculosis(38 sputum-smear positive and 60 sputum-smear negative)and 79 healthy individuals.Then analyze the relationship and differences among these groups.Results Except IL-17A,the level of IL-2,IL-4,IL-6,IL-10,TNF,IFN-γwas higher in the patients group than control group;As to IL-2,IL-4,IL-10 and IFN-γ,the sputum-smear positive group had a higher level than control group,but the sputum-smear positive group had no difference with sputum-smear negative group.Com-pared with sputum-smear negative group,the sputum-smear positive group have a higher level of IL-6 and TNF.Conclusion IL-6 and TNF can be used to monitor the prognosis of tuberculosis.Meanwhile,CBA is sensitive,could detect several cytokines once with less sample consumption and time,thus could be applied for the monitor of tuberculosis progress.

Thirty-two patients with Meniere disease were treated by acupuncture therapy,Baihui(GV 20),Fengfu(GV 16),bilateral Fengchi(GB 20),Shenshu(BL 23),Taixi(KI 3),and Xuanzhong(GB 39)were selected.Of the 32 cases,8 cases was totally under control,12 cases were generally under control,9 cases were partly under control and 3 cases were out of control,the totaI effective rate was 90.6%.

The emergent and severe diseases always shows the characteristics of acute course, severe condition, rapid changes, and many complications. The common treatments based on syndrome differentiation usually lacked dynamics and promptness. The treatment of emergent and severe diseases emphasized the importance of early interventions, which can reverse the acute trend of the diseases and improve the outcomes. This article discuessed in five parts, including the meaning and significance of trend identification, the physiological and pathological trend of the human body, the influence factors of diseases' trend, how to carry out a trend identification and intervention strategies of trend identification. It elaborated the theory about the trend identification in the emergent and severe diseases.

AIM: To investigate the pentanucleotide repeat(PNR) polymorphism of apolipoprotein(a) in patients with coronary heart disease(CHD) in Hubei area, and evaluate the association of polymorphism of apo(a) PNR with the level of serum lipid. METHODS: Objects examined were composed of two groups: 88 patients with CHD and 153 healthy controls. Lp(a), TC,TG, HDL-C, LDL-C, ApoAⅠand ApoB of two groups were tested. Meanwhile,the PNR in the 5' control region of the Apo(a) was detected by using polymerase chain reaction (PCR) and high voltage polyacrylamid gels electropherosis. RESULTS: The serum Lp(a), TC, TG and LDL-C levels were remarkably higher in the CHD than that in control( P