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Concurrent chemoradiotherapy is the main treatment for locally advanced cervical cancer, and the incidence of vaginal injury is inevitable after radiotherapy. However, insufficient attention has been paid to the treatment and prevention of acute radiation-induced vaginal injury. Therefore, the mechanism, treatment and prevention of acute vaginal side effects after radiotherapy in cervical cancer were reviewed in this article, aiming to reduce the incidence of vaginal injury, complete the course of radiotherapy and improve the quality of life.
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Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.
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Objective Previous studies suggested that overerpression of Slit2 results in abnormal Alzheimer's disease-like behavior and cognition impairment in mice. The aim of this study is to investigate the relationship between overerpression of Slit2 and accumulation and clearance of amyloid-β in aging mice by comparing the differential expression of genes for accumulation and clearance of amyloid-β in aging Tg-Slit2 and Tg-2576 mice. Methods 14-month old male C57BL/6, Tg-Slit2 and Tg-2576 mice were used to detect the expression of Aβ1 - 40 and Aβ1 - 42 in brain by immunohistochemistry. Further, the total RNA in the brain of these mice were extracted, identified and inversely transcripted to cDNA, then the cDNA was detected by PCR array. The expression of genes in the brain of Tg-Slit2 and Tg-2576 mice were analyzed. Results Comparing with the Tg-2576 mice in the same age, accumulation of Aβ was not found in the brain of Tg-Slit2 and C57BL/6 mice. The result from PCR array analysis showed that comparing with the same aged C57BL/6 mice, there were 16 up-regulated genes and 8 down-regulated genes in the brain of Tg-Slit2 mice and 14 up-regulated genes and 17 down-regulated genes in the brain of Tg-Slit2 mice. The expression of amyloid beta precursor protein (APP) in the brain of the three group mice was not changed. The expression of presenilin 2 ( Psen2) related with Aβ production was significantly up-regulated in the Tg-2576 mice. In addition, the expression of low density lipoprotein receptor-related protein ( LRP) 6 and 9 were markedly decreased in the Tg-2576 mice. Notably, these genes were not changed in the brain of the aging Tg-Slit2 mice. Conclusions The accumulation of Aβ in the brain are not found in 14-month Tg-Slit2 mice, In addition, different from Tg-2576 mice, the significant changes of expression of Aβ-related genes is not found in the brain of Tg-Slit2 mice.
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Objective To investigate the changes of coagulatory function in septic rats induced by cecal ligation and puncture(CLP). Methods Cecal ligation and puncture(CLP)were performed to induce sepsis in SD rats. Coagulation indexes were detected at 8,16 and 48 h after operation, and histopathological changes of the lung, kidney, liver and spleen were examined using HE staining. Results The 12-day survival rate of the CLP-induced septic rats was 30%,with an acute onset and high mortality. In the acute phase of disease development of the CLP rats, the activated partial thromboplastin time(APTT)was prolonged(P<0.05)at 8 h,the prothrombin time(PT)was prolonged at 16 h (P<0.05), the factor XII activity in the endogenous coagulation pathway and the factor VII activity in the extrinsic coagulation pathway showed a transient inhibition, the thrombin time(TT)was prolonged at 48 h(P<0.01), and the content of fibrinogen(FIB)was increased gradually from 16 h(P<0.001). Among the other important coagulation and anticoagulation indexes,the number of platelets(PLT)was decreased gradually from 8 h(P<0.01),while the number of vWF:Ag increased gradually from 8 h(P<0.001). The D-dimer amount gradually increased from 16 h(P<0.05),and the amount of PS:Ag significantly decreased until 48 h(P<0.001). However, there was no significant change in the antithrombin-III(AT-Ⅲ)content. The histopathological examination showed that there are different degrees of damages in the lung,kidney,liver and spleen tissues,but no obvious venous thrombosis and bleeding were found. Conclusions In the acute phase,there is coagulatory dysfunction in the septic rats,however,no histopathological changes such as venous thrombosis and bleeding were observed in the lung,kidney,liver and spleen tissues due to coagulatory dysfunction.
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Objective To establish and analyze a mouse model of Staphylococcus aureus?induced arthritis ( Staphy?lococcus aureus septic arthritis, SA) , and provide an animal model for arthritis mechanism research and drug development. Methods Mice were immunosuppressed with cyclophosphamide, then intravenously inoculated with Staphylococcus au?reus. The gross characteristics of the joints were observed, the arthritis indexes were analyzed, and the pathological scores of the model mice were evaluated. Results From the first day after bacterial inoculation, the mouse joints were swollen. Pathological examination revealed lesions varying from mild and disarranged joint synovial hyperplasia to synovial thickening and intra?articular invasion, and increased neutrophil infiltration. Conclusions A mouse model of Staphylococcus aureus?induced arthritis is successfully established in this study. This model can be developed in a relatively short time, can not only simulate the clinical symptoms and signs and disease progression of human arthritis, but also to a certain extent reflects the etiology, infection and immunological mechanisms of human arthritis.
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Objective The purpose of this study was to establish and evaluate a mouse model of sepsis for studying the mechanism of sepsis and development of anti-inflammatory drugs.Methods The sepsis in mice was induced by cecal ligation and puncture ( CLP) .The survival rates, microbial load, liver and kidney damages, cytokines and pathological changes were detected to evaluate the mouse models.Results The death of mice was closely related with the ligated sites. The mice with 50%cecal ligation displayed about 40% of 12-day survival rate, however, all the mice with 75% cecum ligation died within 4 days (P<0.01).Compared with the sham surgery group, the mice with 50% cecal ligation had a high microbial load in the blood and abdominal cavity.Leukopenia was also emerged (P<0.001).CLP mice demonstra-ted elevated levels of serum ALT, AST and BUN (P<0.01).The levels of IL1α, IL6, IL10, MIP1α, MIP1β, and TNFαwere increased a lot.The liver and lung showed obvious pathological injury at 48 h post CLP.Conclusions The established mouse model of CLP shows typical characteristics of sepsis and is an ideal tool for further study of anti-inflam-matory drugs.
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Objective To analyze the changes of WBC classification,sugar and protein in cerebro-spinal fluid(CSF)and pathogenic bacteria of neonatal purulent meningitis.Methods Thirty-one neonates with bacterial meningitis in our department of neonatology from June 201 1 to June 2013 were enrolled,and the clinical features,pathogenic bacteria,laboratory examination of CSF were analyzed.Results Fever (90.3%),convulsions(67.7%)and changed consciousness(58.1 %)were common clinical symptoms.The incidences of other nervous system abnormal signs such as gastrointestinal dysfunction(25.8%),abnormal breathing(16.1 %),cervical resistance(16.1 %),bulging fontanel(9.7%)were lower.The Gram -negative bacteria was more than Gram -positive in both blood and CSF culture.The escherichia coli was the most common bacteria,with positive rate of 38.1 %(8 /21 )in blood culture and 55.5%(5 /9)in CSF culture.The germiculture positive rate in CSF was lower than in blood culture (29.0% vs.67.7%).Polymorphonuclear leukocyte(PMN)[(79.61 ±12.06)%]was the most predominant cell of the leukocyte classification in CSF within 1 week in all cases,PMN was still predominant in 1 to 2 weeks in 7 cases,while only 2 cases in 2 to 3 weeks still dominated by PMN,PMN was not the predominant cell 3 weeks later.Conclusion In the typi-cal neonatal purulent meningitis,PMN was the predominant cell in CSF within the first week,but the propor-tion of monocyte gradually increased and was dominant later.Escherichia coli was a common bacteria caused by this disease.
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Objective To investigate the expressions of serum cystatin C CysC),retinolbinding protein (RBP),serum and urinary β2-microglobulin (β2-MG) and their effects on predicting renal damage in primary hypertension in elderly patients.Methods A total of 149 patients were divided into 3 groups of hypertension grade 1 (n =50),hypertension grade 2 (n =50) and hypertension grade 3 group (n=49).92 healthy controls who took physical examination were selected as control group.The levels of serum CysC,RBP,serum and uric β2-MG,blood urea nitrogen,creatinine and other biochemical indexes were detected.The complications of hypertension were observed.The differences in renal function indexes between groups and their correlations were analyzed.Results There were 86 cases with hyperlipidemia (57.7％),71 cases with atherosclerosis (47.7％),59 cases with type 2 diabetes mellitus (39.6％),56 cases with coronary heart disease (37.6％),and 49 cases with cerebral vascular disease (32.9％) in 149 hypertensive patients.The levels of serum CysC,RBP,serum and uric β2-microglobulin were increased in hypertensive patients as compared with healthy controls (P＜0.05 or 0.01),and the extents of increments in the above indexes were positively correlated with blood pressure level [CysC:(1.2± 0.5) mg/L,(1.7±0.6) mg/L,(2.2±0.9) mg/L;RBP:(53.1±10.2) mg/L,(65.2±16.3)mg/L,(75.8±17.5) mg/L;serum β2-MG:(2.7±1.5) mg/L,(4.0±2.1) mg/L,(4.9±2.0) mg/L;uric β2-MG:(178.3±73.9) ng/L,(237.9±78.6) ng/L,(277.5±87.5) ng/L;respectively,P＜0.05or 0.01].Conclusions Elderly hypertensive patients are complicated with a variety of diseases.The levels of serum CysC,retinol-binding protein,serum and uric β2 microglobulin have significant diagnostic values on renal impairment caused by hypertension,and can be considered as sensitive factors for early renal impairment in essential hypertension.
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Objective To evaluate the clinical efficacy and safety of flexible fiberoptic bronchoscopy (FFB) and bronchoalveolar lavage (BAL) in treatment of neonatal atelectasis.Methods Eligible patients, who were diagnosed as neonatal pulmonary atelectasis and admitted consecutively to the neonatal intensive care unit of the Children's Hospital of Hebei Province from January 2013 to January 2015, were included in the study.They were randomly assigned to FFB group (n=30) and control group (n=28).Newborns in the FFB group received BAL under FFB, while those controls received tracheal irrigation after intubation.The duration of lung recruitment, oxygen exposure and antibiotic administration, hospital stay, culture results of respiratory secretions, prognosis and total expenses during hospitalization were compared between the two groups.Complications of FFB were also recorded.Chi-square test and t-test were performed for statistical analysis.Results (1) In the FFB group, atelectasis occurred in the upper fight lobe (n=26), upper lobes of both sides (n=1), lower right lobe (n=2) and lower left lobe (n=1), while in the control group, atelectasis occurred in the upper right lobe (n=26), lower left lobe (n=1) and middle right lobe (n=2) (x2=0.094, P ＞ 0.05).(2) The positive rate of bacteria culture results showed no difference between bronchoalveolar lavage fluid in FFB group and tracheal secretions in the controls [43％(13/30) vs 32％(9/28), x2=0.770, P ＞ 0.05].(3) The duration of lung recruitment, antibiotic administration and hospital stay of the FFB group were all shorter than those of the control group [(4.7±3.4) vs (7.4±6.6) d, (14.0±4.5) vs (20.3±10.9) d, (15.1±4.7) vs (21.8±12.3) d, t=-5.718, 8.604 and 7.733, all P ＜ 0.05].(4) Among babies in the FFB group, nine experienced fever and returned to normal after physical cooling;three showed more shadow in chest X-ray with aggravated dyspnea during a short period, and relieved 12 hours later;two had minimal hemorrhage from tracheal mucous membrane;one showed crying hoarse.Serious complications, such as pneumothorax, massive bleeding or cardiac arrest, did not occurred.No death or refuse of treatment was reported.Conclusion FFB and BAL is much more effective than tracheal irrigation after intubation in treatment of neonatal atelectasis without any severe complications.
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<p><b>OBJECTIVE</b>To analyze the drug resistance and drug resistance genes of imipenem-resistant Pseudomonas aeruginosa (IRPA) strains isolated from burn wards.</p><p><b>METHODS</b>From June 2011 to June 2012, 30 strains of IRPA were isolated from wound excretion, sputum, and venous catheter attachment from burn patients hospitalized in Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine. Drug resistance of the IRPA to 12 antibiotics commonly used in clinic, including ceftazidime, amikacin, ciprofloxacin, etc., was tested with K-B paper agar disk diffusion method. Metallo-β-lactamase (MBL)-producing IRPA was detected by synergism test with imipenem-2-mercaptoethanol. Plasmid of IRPA was extracted, and it was inserted into competent cells, producing transformation strains (TSs). Drug resistance of TSs to imipenem and the MBL-producing TSs were detected. The genes blaIMP, blaVIM, blaOXA-1, blaOXA-2 and blaOXA-10 of IRPA and the TSs were detected by polymerase chain reaction. The drug resistance of IRPA producing MBL or OXA enzyme was summed up.</p><p><b>RESULTS</b>The sensitive rates of the 30 strains of IRPA to the 12 antibiotics were equal to or above 60.0%. Six strains of MBL-producing IRPA were screened. Twenty-four TSs were resistant to imipenem, and 6 strains among them were MBL-producing positive. Among the 30 strains of IRPA, 6 strains and their corresponding TSs carried blaVIM; 20 strains and their corresponding TSs carried blaOXA-10; no strain was detected to carry blaIMP, blaOXA-1 or blaOXA-2. Two strains and their corresponding TSs were detected carrying both blaVIM and blaOXA-10. No significant difference of drug resistance was observed between strains producing only MBL or OXA enzyme, with the same high resistance to β-lactam antibiotics and some degree of sensitivity to aminoglycoside antibiotics. Strains producing enzymes MBL and OXA were all resistant to the 12 antibiotics.</p><p><b>CONCLUSIONS</b>IRPA strains isolated from burn wards of Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine are multidrug-resistant, and they mainly produce type B and D carbapenemases.</p>
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Humans , Burns , Microbiology , Cross Infection , Microbiology , Drug Resistance, Multiple, Bacterial , Genetics , Imipenem , Microbial Sensitivity Tests , Pseudomonas aeruginosa , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical manifestation, diagnosis, and treatment of patients with Marjolin's ulcers.</p><p><b>METHODS</b>The clinical materials of 21 patients with Marjolin's ulcers hospitalized from January 2007 to January 2013 were retrospectively analyzed, including age, gender, injury causes, duration time of primary disease in developing Marjolin's ulcer, duration of ulcer, lesion site, ulcer area, symptoms and signs of ulcer region, bacterial culture results before operation, histopathological type, grade of carcinoma cell differentiation, depth of invasion, treatment, and outcome.</p><p><b>RESULTS</b>(1) The age of 21 patients at the time of diagnosis of Marjolin's ulcers was 19-74 (47 ± 13) years, and the ratio of male to female was nearly 0.9:1.0. (2) The main primary lesions were flame burns and high temperature liquid scald, respectively occurred in 12 cases (57.1%) and 7 cases (33.3%). The time for development of Marjolin's ulcers from primary injury was 10-56 (40 ± 14) years. (3) Ulceration on top of scar lasted for longer than one year in 12 patients (57.1%). (4) Lesion site was mainly located in the limbs in 13 patients (61.9%), and on head and face in 6 patients (28.6%), respectively. (5) Ulcer area ranged 0.25-74.25 (39 ± 25) cm(2). Foul excretion, bleeding, intensified pain, and gradual enlargement of ulceration were observed in the lesion of most patients. (6) Bacterial culture of wound excretion before operation showed positive results in 16 patients (76.2%).</p><p><b>RESULTS</b>of bacterial culture of blood were negative in all patients. (7) Pathological examination revealed squamous cell carcinoma in 20 cases and basal cell carcinoma in 1 case, and mostly of high or medium differentiation. Cancer cells in nearly 40% patients had invaded the subcutaneous tissue or deeper area. (8) All patients were treated by surgery, among them autologous skin grafting was done after excision of lesion in 11 patients, and in 5 patients the defects were closed with skin flaps after excision of lesion, and in 5 patients limbs harboring the lesion were amputated. Twelve patients (57.1%) received postoperative rehabilitation treatment. Two patients with pulmonary metastasis received chemotherapy. (9) Most of the flaps and skin grafts survived well after surgery, and a few cases with failure of skin grafting or transplantation of flaps underwent skin grafts again. Patients were followed up for 6 months to 5 years, in 4 patients recurrence occurred after surgery, and 2 of them died. The other patients survived without recurrence.</p><p><b>CONCLUSIONS</b>Squamous cell carcinoma was the most common pathological type of Marjolin's ulcer admitted to our unit. A recurrent ulcer with long course should be considered as Marjolin's ulcer, and it should be scrutinized pathologically. Currently, surgery remains the optimal treatment for Marjolin's ulcer. Regular follow-up should be carried out after resection of the lesion to detect carcinoma recurrence and metastasis.</p>
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Female , Humans , Male , Burns , Carcinoma, Squamous Cell , Pathology , General Surgery , Cicatrix , Retrospective Studies , Skin Neoplasms , Pathology , General Surgery , Skin Transplantation , Skin Ulcer , Pathology , General Surgery , Surgical Flaps , Treatment OutcomeABSTRACT
Objective To investigate the effectiveness of the comprehensive quantitative assessment system in the review of senior clinical titles so as to set up a comprehensive appraisal system for clinicians.Methods A retrospective analysis was made to compare the objective parameters for performance appraisal of the applicants for senior titles before and after the adoption of the comprehensive quantitative assessment system,namely,between 2003 to 2006 and 2007 to 2010.Results The parameters were improved in aspects of clinical practice,education and research.And the average age of applicants was lowered.Conclusion The new assessment system works well for clinician appraisal,and produces a positive guiding effect of the senior title review on hospital development.Suggestions are also made to solve the existing problems and to improve the system.
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AIM:To investigate the effect of ginkgo leaf extract on oxidative stress and haemodynamics of diabetic nephropathy(DN).METHODS:The patients of DN were divided into ginkgo leaf extract treatment group and control group.The changes of serum superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),malondialdehyde(MDA) and hemorheology indexes were observed.RESULTS:Before treatment,serum SOD,GSH-Px,MDA and hemorheology indexes had no significant difference between ginkgo leaf extract treatment group and control group.After treatment,the serum levels of T-SOD and GSH-Px were increased;the level of MDA,hemorheology indexes,erythrocyte aggregation index and platelet aggregation rate were decreased significantly in ginkgo leaf extract treatment group compared with those in control group(P
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<p><b>OBJECTIVE</b>To evaluate the diagnostic value of the changes in serum CK and its isozymes in the muscular infection and necrosis in electrical injured patients.</p><p><b>METHODS</b>Seventeen patients were divided into A and B groups according to the causes, i.e. electrical injury as A and electrical arc flame burn as B groups. Obvious muscle necrosis was identified in A but not in B groups. The serum CK-MM concentration was determined after injury, before and after the operations. Simultaneously, the blood and urine routine, the hepatic and renal function and wound bacterial counting were determined and compared with those in 20 healthy people.</p><p><b>RESULTS</b>1. The serum CK-MM in A group increased evidently after injury and 1 day after wound debridement to the 6 times that in normal control. The enzyme decreased to normal at 3 post-operative days in 15 cases and remained at relative high level in 2 cases due to the wound infection and lowered down to normal level after wound re-debridement. 2. The serum CK-MM in B group increased slightly before and after skin grafting.</p><p><b>CONCLUSION</b>CK-MM could be employed as the index for the infection and necrosis of the muscle in electrical injured patients due to its high specificity and sensitivity.</p>
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Adolescent , Adult , Humans , Male , Middle Aged , Burns, Electric , Blood , Creatine Kinase , Blood , Electric Injuries , Blood , Isoenzymes , Blood , Skin TransplantationABSTRACT
By hemodynamic monitoring of liver transplantation with Color Doppler ultrasound, we observed the hemodynamic changes pre- and post-operatively and the patency of the anastomotic vessels, to detect or exclude the presence of complications, then assess the prognosis. We measured the hepatic blood flow after orthotopic liver transplantation in recent 6 cases, and observed the patency of anastomostic vessels and the hemodynamic improvement of the portal vein and hepatic arteries. The abnormal liquid and solid echoes were not found around the transplantated liver in all 6 cases. The echoes of hepatic parenchyma and tububes were normal. The direction and speed of blood flow were also normal. Five of anastomoses of portal vein in 6 cases were patent. The rest one was a little stenosed, and the speed of local blood flow was a little faster. There were 11 patent ones and 1 mildly stenosed in the 12 anastomoses of inferior venae cavae. The speed index(SI) and resistance index(RI) of hepatic arterial blood flow distal to the anastomoses were all normal. Liver transplantation is the redical therapying of portal hypertension, and the color Doppler ultrasound is the best non-invasived method for monitoring the hemodynamic changes of transplantated liver.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Liver , Diagnostic Imaging , Physiology , Liver Circulation , Liver Transplantation , Diagnostic Imaging , Monitoring, Physiologic , Ultrasonography, Doppler, Color , Vascular PatencyABSTRACT
Objective To discuss the reliability of sensory integration curing and the affecting element of curing result. Method Adopt standardized curing method to 455 children, four to twelve years old, who have sensory integration disorder. Start up parents school as well. Result The total effective rate is 85%. The more parents grasp the children sanitation knowledge, the better results are. The better results are also related to the level of disorder, intelligence quotient, age and curing period. Conclusion Sensory integrating treatment is effective in treating sensory integrating disohter in children by systematic psychological intervention for children and personal psychological intervention for parents.
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AIM: To study the expression of transforming growth factor ? 1(TGF ? 1) in the nephric tubule of spontaneous hypertensive rats and the relation of the TGF ? 1 and the renal tubulointerstitial fibrosis, and to investigate the effect of losartan on this expression and the protection effects of it on the kidney. METHODS: Same age male WKYs and SHRs were involved in this experiment. SHRs were divided into positive control (SHR C) group and losartan treatment (SHR L) group. The artenia pressure, renal function and ? 2 MG of mice was monitored before and after experiment and the expression of TGF ? 1 in nephric tubule were measured by immuonohistochemitry assay. RESULTS: Compared with the WKY group, the contents of ? 2 MG markedly increased in SHR C group (P 0.01 ). No or a few expression of TGF ? 1 occurred in WKY group. The expression of TGF ? 1 significantly increased in the positive control group with the progression of the hypertensive course, and meantime, the expression of TGF ? 1 significantly decreased in the losartan treatment group and the blood pressure also decreased. CONCLUSION: As the expression of TGF ? 1 intensively increased in hypertensive course, TGF ? 1 may be the important factor leaded to the renal tubulointerstitial fibrosis. Losartan has the effects on lowering blood pressure, reducing albuminuria, protecting renal function and delaying the renal tubulointerstitial fibrosis.