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<p><b>OBJECTIVE</b>To compare the efficacy and safety of 5 mg perindopril arginine salt and 4 mg perindopril tert-butylamine salt for patients with mild to moderate essential hypertension.</p><p><b>METHODS</b>The study was designed as multicenter, randomized, double-blind, active controlled trial with two parallel groups enrolling 524 participants with mild to moderate essential hypertension. After 2-week run-in period, 186 patients were enrolled and randomly treated with 5 mg perindopril arginine salt and 183 patients were enrolled and randomly treated with 4 mg perindopril tert-butylamine salt. The random sequence was generated by the I.R.I.S., and a balance was made in each center. After double-blind treatment for 8 weeks, the dose could be doubled for patients with uncontrolled BP ((SBP) ≥ 140 mmHg (1 mmHg = 0.133 kPa) or diastolic blood pressure (DBP) ≥ 90 mmHg) and patients were treated for another 4 weeks.</p><p><b>RESULTS</b>The sitting SBP was similarly decreased by (19.9 ± 17.2) mmHg in perindopril arginine group and (18.5 ± 14.7) mmHg (P = 0.000 5) in perindopril tert-butylamine group post 8 weeks treatment. Dose was doubled in 109 patients (59.9%) in perindopril arginine group and 116 patients (63.7%) in perindopril tert-butylamine group. At 12 weeks post therapy, the sitting SBP decreased by (19.8 ± 16.2) and (19.6 ± 16.3) mmHg respectively in the 2 groups. The decrease of sitting DBP was also similar in both groups (-12.0 ± 10.0) mmHg and (-11.0 ± 8.9) mmHg (P < 0.000 1), respectively. The control rate or response rate was also similar between the two groups (control rate over 8 weeks was 38.5% vs. 31.3%, 95% CI (-2.6-16.9), control rate over 12 weeks was 36.3% vs. 35.7%, 95% CI (-9.3-10.4), response rate over 8 weeks was 64.3% vs. 63.2%, 95% CI (-8.8-11.0), response rate over 12 weeks was 65.9% vs. 64.8%, 95% CI (-8.7-10.9)). Incidence of adverse events was low and similar in both therapy groups.</p><p><b>CONCLUSIONS</b>The results show that perindopril arginine salt 5 mg is as efficient as perindopril tert-butylamine 4 mg on lowering BP for patients with mild to moderate essential hypertension. Both drugs have good safety profile and are well tolerated by patients in this cohort.</p>
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Humans , Antihypertensive Agents , Arginine , Blood Pressure , Butylamines , Double-Blind Method , Essential Hypertension , Hypertension , Perindopril , Sodium ChlorideABSTRACT
Objective To study the efficacy of gamma globulin in the early treatment of severe or almost severe hand -foot -mouth disease.Methods 80 children with severe or almost severe hand -foot -mouth disease were randomly divided into treatment group and control group by the random number table.The treatment group received the treatment of early gamma globulin,whereas patients in the control group received conventional therapy.The effective rate of the treatment group was higher than that of the control group(95.0%vs 77.5%,χ2 =5.165,P <0.05).The recovery time of body temperature and hemogram,rash and other adverse symptoms disap-peared in the treatment group were significantly shorter than those of the control group[(2.1 ±0.9)d vs (3.0 ± 1.1)d,(1.9 ±0.8)d vs (2.8 ±1.1)d,(4.1 ±1.3)d vs (6.2 ±2.1)d,(2.6 ±0.8)d vs (4.8 ±1.5)d,t =3.934,3.723,5.378,7.357,all P <0.05].Conclusion Early application of gamma globulin is effective and safe in treating severe hand -foot -mouth disease,which can relieve symptoms,control the disease quickly and improve prognosis.
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Objective To investigate the associations of a single-nucleotide polymorphisms (SNPs) in the interleukin (IL)-6 gene with the migraine of a Han Chinese northeastern population.Methods We collected 252 patients of the migraine attack,who were diagnosed at People' s Hospital of Liaoning Province from March 2012 to June 2013,all being Han nationality in the northeast of China.At the same time,we collected 270 healthy people over the same period who had health examination or were healthy workers of People' s Hospital of Liaoning Province.We used polymerase chain reaction and gene sequencing to analyze the genotype and allele frequencies of the-572G/C (rs1800796) IL-6 polymorphisms between migraine cases (n =252;including migraine without aura (MO) group (n =168) and migraine with aura group (n =84);the male group (n =109) and the female group (n =143)) and control group (n =270;the male group (n =116) and the female group (n =152)),as well as analyzed the genotype and allele frequencies distribution between the subgroups.Results We found higher frequencies of the distribution of the C/C genotype and the C allele of the-572G/C polymorphism in migraine cases than in control group (32.54％ (82/252) vs 19.63％ (53/270),x2 =12.061,P =0.002;55.56％ (280/504) vs 45.37％ (245/540),x2 =10.818,P =0.001),higher distribution frequencies of the C/C genotype and the C allele in female group (21.83％ (55/252) vs 12.59％ (34/270),x2 =10.187,P =0.006;33.73％ (170/504) vs 26.48％ (143/540),x2 =10.073,P =0.002).Between MO group and controls,these distribution frequencies had statistically significant difference (24.60％ (62/252) vs 19.63％ (53/270),x2 =18.172,P=0.000;39.88％ (201/504) vs 45.37％ (245/540),x2 =17.307,P=0.000).After correction by conditional Logistic regression,the frequency distribution difference of the C/C genotype between the migraine cases and controls remained statistically significant (OR =22.861,95％ CI 5.218-27.098,P =0.023).Conclusion Our data indicate that the SNPs of the IL-6 are associated with migaine and the C/C genotype increases the migraine susceptibility in a Han Chinese northeastern population.
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555 medical vocational students were surveyed with questionnaire to data regarding their employment intentions. The study showed that the employment rate in basic-level medical organizations and the degree of job satisfaction of college students were low. The main factors were economic benefits, living environment, hospital equipment status, self-awareness. Therefore, in order to encourage medical vocational students to choose basic-level medical organizations, it is important to train health talents which is suitable for the grass-roots level, develop basic-level medical organization service qualities and pays more attention to the employment guidance in higher vocational schools, which can help medical vocational students cultivate proper views of employment.
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BACKGROUND: It is controversial whether bone marrow mesenchymal stem cells can retain in cardiac injured position, or differentiate into cardiomyocytes or not. OBJECTIVE: To study the effects of recombinant human growth hormone and bone marrow mesenchymal stem cells (BMSCs) intravenous transplantation on myocardium and angiogenesis in rats with congestive cardiomyopathy. METHODS: BMSCs were collected from rats by density gradient centrifugation and adhesive-screening method. Models of cardiac failure were established using adriamycin induction in the model, cell transplantation, growth hormone and combination groups. Following model establishment, cell transplantation group received BrdU-labeled BMSCs (8×10~(13)/L) via vein. Growth hormone group underwent subcutaneous injection of human growth hormone 2 U/kg per day, for 14 consecutive days. Combination group received injection of human growth hormone and BMSC transplantation. At week 4, samples were collected. Immunohistochemical staining for BrdU+MHC and BrdU+Actin was used to determine homing of BMSCs to evaluate the differentiation of transplanted cells into cardiomyocytes and vascular endothelia cells. Hematoxylin-eosin staining was utilized to detect vascular density. RESULTS AND CONCLUSION: Compared with the cell transplantation group, positive rate of Brdu immunohistochemistry was increased in the combination group (P < 0.001). The number of cardiomyocytes and vascular endothelia cells was significantly increased following Brdu+MHC and Brdu+Actin staining (P < 0.001). Compared with the model group, total vascular density, microvessel density and capillary density were significantly increased in the growth hormone, cell transplantation and combination groups (P < 0.001). No significant difference was determined among growth hormone, cell transplantation and combination groups (P > 0.05). Intravenous transplantation of BMSCs could repair cardiomyocytes and vascular endothelial cells by homing into the heart. BMSCs could survive in damaged area and differentiate into cardiomyocytes or vascular endothelial cells and increase the vascular density significantly. Growth hormone could improve microenvironment and raise rates of differentiating into cardiomyocytes or vascular endothelial cells.
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Objective To investigate the effects of biatrial infusion on pulmonary artery pressure (PAP)after cardiopulmonary bypass (CPB) in patients undergoing mitral valve replacement.Methods Twenty NYHA Ⅱ or Ⅲ patients aged 22-53 yr weighing 34-57 kg undergoing mitral valve replacement complicated by pulmonary hypertension (mean pulmonary artery pressure (MPAP) ＞ 50 mm Hg) were randomly divided into 2 groups ( n = 10 each): infusion via right atrium group (group R) and infusion via both atria group (group B). After induction of anesthesia, a three cavity floating Swan-Ganz catheter was placed via right internal jugular vein to monitor CVP,PAP, pulmonary capillary wedge pressure (PCWP) and CO. The patients received infusion of prostaglandin E1 30-150 ng· kg- 1 · min - 1 and phenylephrine 0.2-0.6 μg· kg- 1 · min- 1 via central veins in group R and infusion of prostaglandin E1 30-150 ng·kg-1 ·min-1 via central veins and phenylephrine 0.2-0.6 μg·kg-1 ·min-1 via left atrium in group B. MAP, HR, MPAP, PCWP, CVP and CO were recorded 5 min before administration (T0), and 5,10, 30 and 60 min after administration (T1-4). Pulmonary vascular resistance index (PVRI), systemic vascular resistance index (SVRI) and CI were also calculated. Results D:\1111111111\MDB\zhmzxzz98201008.mdbCompared with the value at T0, MAP, MPAP, PCWP and PVRI were significantly decreased, while CI was increased at T1-4 in group R, and MAP, CI and SVRI were significantly increased, while HR, MPAP, PCWP, CVP and PVRI decreased at T1-4 in group B ( P ＜ 0.05).MAP, CI and SVRI were significantly higher, while HR, MPAP, PCWP, PVRI and CVP lower in group B than in group R ( P ＜ 0.05). Conclusion Biatrial infusion can effectively reduce PAP and pulmonary vascular resistance after CPB in patients undergoing mitral valve replacement.
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BACKGROUND:Previous research has shown that stem cells at different age stages had various proliferation and differentiation in vitro.Therefore,biological characteristics of bone marrow-derived mesenchymal stem cells at different age stages play a key role in evaluating differentiation into myocardial cells and determining proliferation and differentiation parameters in vitro.OBJECTIVE:To compare in vitro proliferation,surface marking,and differentiation into myocardial cells of bone marrow-derived mesenchymal stem cells from different aged rats.DESIGN,TIME AND SETTING:An in vitro contrast cytological observation was performed at the Laboratory of Biochemistry and Molecular Biology,Shanxi Medical University from May 2008 to May 2009.MATERIALS:A total of 15 healthy male Wistar rats were divided into three groups:1-month-old,3-month-old,and 12-month-old groups,with 5 rats in each group.METHODS:Bone marrow-derived mesenchymal stem cells were cultured using adherence screening method.At the third passage,cells differentiated into myocardium-like cells by the induction of 5-azacytidine.MAIN OUTCOME MEASURES:Cell proliferation was observed using MTT;cell surface marking was detected using flow cytometry;cardiac-specific myosin heavy chain mRNA expression was measured using RT-PCR.RESULTS:Bone marrow-derived mesenchymal stem cells were adherent in each group,and the proliferation curve was similar to each other.Under the same culture condition,the proliferation in the 1-month-old and 3-month-old groups was faster than 12-month-old group (F=28.71,P ＜ 0.05).The third-passage cells strongly expressed CD44 and CD71 but weakly expressed CD34 and CD45.At 2 weeks after 5-azacytidine induction,cardiac-specific myosin heavy chain mRNA was observed in all groups;however,the cardiac-specific myosin heavy chain mRNA expression in both 1-month-old and 3-month-old groups was significantly greater than 12-month-old group (t=5.140,2.827,P ＜ 0.05).CONCLUSION:With the age increasing of rats,proliferation,survival time,and differentiation of bone marrow-derived mesenchymal stem cells were weakened.
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ObjectiveTo explore the effects of recombinant human growth hormone(rhGH)on myocardial inflammatory cytokine expression and heart function in rats with acute myocardial infarction (AMI). MethodsRats with AMI induced by left anterior descending coronary branch ligation were randomized to rhGH and control groups compared with sham-operated group. The effects of 4 weeks of therapy with GH starting 24 hours after myocardial infarction on myocardial cytokines expression and heart function were studied. Myocardial inflammation was examined by analyzing the myocardial cytokine production including the pro-inflammatory cytokines: interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α and the anti-inflammatory cytokine: IL-10. Echocardiography was used to evaluate heart function. ResultsThe levels of TNF-α, IL-1β, IL-6 and IL-10 in the infarcted and non-infarcted region of control group were markedly elevated compared to sham-operated group (all P＜0.05). After 4 weeks therapy, rhGH reduced the expression of TNF -α, IL-1β, IL-6 and increased IL-10 expression in the infarcted and non-infarcted region of rhGH group compared to control group (all P＜0. 05 ). Echocardiography showed that rhGH markedly improved left heart function (P＜0. 05 ). ConclusionsEarly rhGH treatment can improve heart function and myocardial inflammatory cytokine expression after AMI. One of immunopharmacologic mechanisms underlying the beneficial effects of rhGH on heart function improvement may involve the attenuation of pro-inflammatory cytokines and the increase of anti-inflammatory cytokine levels in cardiac myocytes.
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BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) possess the potential in multi-directional differentiation and can differentiate into cardiomyocytes, which had self-discipline jumpiness. There are few reports on intravenous transplantation or autologous mobilization of BMSCs for treating dilated cardiomyopathy-induced heart failure. OBJECTIVE: To study the effect of BMSC intravenous transplantation combined with bone marrow stem cell autologous mobilization on cardiac function in rats with cardiomyopathy-induced heart failure. DESIGN, TIME AND SETTING: This control experiment was conducted at the National Physiological Laboratory, Molecule Laboratory, Animal Experimental Center and Central Laboratory of Shanxi Medical University from January 10th, 2007 to January 10 th, 2008. MATERIALS: Five Wistar rats served as BMSC donor. Fifty rat models of cardiomyopathy-induced heart failure were created by intraperitoneally injected with 15 mg/kg adriamycin for six weeks. Recombinant human granulocyte stimulating factor (GSF) was bought from Qilu Pharmacy Co., Ltd. CD44, CD34 and CD45 were given by Flow Cytometric Analysis Laboratory, Experimental Center, Shanxi Medical University. METHODS: BMSCs were isolated, purified and cultured in vitro. Surface marker CD45, CDD44 and CD34 were detected with f1ow cytometer. Wistar rat models were randomized into 4 groups. BMSCs and recombinant human GSF (50 ?g/kg) were injected into models by tail vein and hypodermoclysis infusion respectively in the combination treatment group (MG group). Recombinant human GSF (50 ?g/kg) was subcutaneously injected into models in the bone marrow stem cell autologous mobilization group (G group). BMSCs were injected into rat models by tail vein in the BMSC group. Rat models in the heart failure group were intact. MAIN OUTCOME MEASURES: ①Peripheral blood leukocyte and mononuclear cell counts and CD34 expression were obtained before treatment and 6 days after treatment. ②At 4 weeks, cardiac function parameters were evaluated by echocardiography and hemodynamic measurement. RESULTS: Compared with that before treatment, peripheral blood leukocyte and mononuclear cell counts significantly increased in the MG group and G group at day 6 (P
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OBJECTIVE:To improve the outpatient pharmacy counseling service.METHODS:The experience of carrying out outpatient pharmacy counseling service in our hospital over the past two years was summarized.RESULTS & CONCLUSION:Due to the practice of outpatient pharmacy counseling service,the rational drug use level in the outpatient pharmacy has been improved,and a satisfactory social benefit was achieved.It is necessary to further evolve the current outpatient pharmacy counseling service system.
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To study the changes in levels of tumor necrosis factor ? (TNF ?), interleukin 6 (IL 6) and interleukin 1? (IL 1?) produced by the peripheral blood mononuclear cells (PBMC) of patients with congestive heart failure (CHF), and to investigate the effects of captopril, one of angiotensin converting enzyme inhibitors in active form, on production of these cytokines. PBMC from 35 CHF patients and 12 healthy controls were isolated by density centrifugation with Ficoll Hypaque, and were cultured with captopril at 10 -4 ～10 -2 mol/L in the presence of lipopolysaccharide (LPS). After incubation for 24 hours, TNF ? and IL 6 contents in the culture supernatants were measured by an enzyme linked immunosorbent assay (ELISA), and IL 1? by radioimmunoassay (RIA). The results showed that PBMC from CHF patients released significantly more TNF ?, IL 6 and IL 1? compared with cells from controls ( P
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This paper analyses the 9-year opeation experience and daily records of HIS in the General Hospital of Pingdingshan Coal Group.HIS plays an irreplaceable role in hospital operation management from hardware,software to management coordination.At the same time,this article also expounds the install ation process,the new features and the benefits of the new system.
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Objective To study the effects of inorganic arsenic on the activities of GS and AChE in the central nervous system of the offspring rats. Methods Wistar rats were exposed to arsenitc through drinking water at doses of 10, 50 and 100 mg/L respectively from gestation day 6 until F1 pups 42 days old. The activities of AChE, GS in rat brain regions such as cortex and hippocampus were separately determined in F1 pups 0, 28, 42 days old. Results On the postnatal day 0, there were not any significant changes in AChE and GS activities in arsenic group rats compared with the control rats. An increase of AChE in 100 mg/L arsenic group rats hippocampus was showed on the postnatal day 28.These changes also appeared on the postnatal day 42. Conclusion Consecutive arsenic exposure from embryo to postnatal may induce the activity changes of GS,AChE in the pups brain,which may cause results in the related neurotransmitter concentration changes.