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Hypertension is a common cardiovascular disease. Chinese guidelines for the management of hypertension, the global practice guidelines for hypertension of the International Hypertension Society (ISH) and the guidelines for the treatment of adult hypertension drugs of the World Health Organization have been issued successively, which play an important role in guiding the clinical medication of hypertension. Calcium channel blockers (CCB), angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARBs), angiotensin receptor neprilysin inhibitor (ARNI), thiazide diuretics and β-receptor blockers are commonly used in clinical antihypertensive drugs. The goal of hypertension drug control, the application timing of hypertension drugs, the selection of combined medication scheme, the drug selection of hypertension complicated with other diseases, and the medication of gestational hypertension are all problems that clinicians need to master.
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Objective To investigate if there were connections between sporadic Parkinson's disease (PD) and three single nucleotide polymorphisms (SNPs) in transmembrane protein 175 (TMEM175 rs34311866), methylcrotonoyl-coenzyme A carboxylase 1 ( MCCC1 rs12637471 ) and alpha-synuclein (SNCA rs356182) in Northern Chinese Han population , and provide basic data for PD genetic research. Methods The research recruited 310 sporadic PD patients in northern Chinese Han population from the Department of Neurology, the First Hospital of China Medical University between 2008 and 2012, and 339 controls without nervous system manifestations from other departments of the First Hospital of China Medical University during the same period.We applied cleaved amplification polymorphism sequence-tagged sites polymerase chain reaction-restriction fragment length polymorphism method to detect the genotype distributions of the SNPs in the northern Chinese Han population , and calculated relevance with PD of the SNPs by chi-square test.Results According to the data, the allele A of SNCA rs356182 had positive effects on the onset of PD in northern Chinese Han population compared with controls (patient group A%＝20.97%(130/620), control group A% ＝29.20%(198/678), χ2＝11.632, P＝0.001); allele G of MCCC1 rs12637471 (χ2＝0.009, P＝0.926) and allele C of TMEM175 rs34311866 (χ2＝1.369, P＝0.242) showed no significant differences between PD and control groups.Conclusion SNCA rs356182 was related with PD, and TMEM175 rs34311866 (M311Y) as well as MCCC1 rs12637471 showed no correlation with PD in the northern Chinese Han population.
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Objective To study the potential roles of acoustic immittance,distortion product otoacoustic e-mission (DPOAE),and the brainstem response audiometry (ABR)in the diagnosis of children with acute non-sup-purative otitis media (AN-SOM).Methods A retrospective analysis was administered to 182 cases with AN-SOM at the otolaryngology department between March 2014 and March 2015.We compared the results of the acous-tic immitance of 218 symptomatic ears and 146 asymptomatic ears,and also the proportion of DPOAE abnormity and ABR abnormity.We analyzed the specialty of symptomatic ears and asymptomatic ears in 3 terms of audiology test results.Results The proportions of abnormal tympanograms,DPOAE,ABR for symptomatic ear were 64.7%, 72.0%,and 57.8%,which were significantly higher than those of in 41.8%,39.7%,and 35.6% in asymptomatic ear.The difference were statistically significant(P<0.05).A further analysis of audiologic results showed that at least one abnormal result was as high as 196 ears (89.9%)in the asymptomatic ear,90 ears (61.6%)showed no symptoms.The differences were statistically significant(P<0.05).The results of audiology tests showed that tym-panograms in symptomatic ears showed diversity,that were 60.6% for type B or C,35.3% for type A,4.1% for the As.Conclusion The early detections by using acoustic immitance,DPOAE and ABR are very important to the diagnosis of children with acute non-suppurative otitis media.It can improve the sensitivity,and reduce the misdi-agnosis.
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Objective To observe the efficacy of antithrombotic treatment of acute ST-segment elevation myocardial infarction patients with failure primary percutaneous coronary intervention because of high thrombus burden,and its effect on elective percutaneous coronary intervention.Methods Eight acute ST-segment elevation myocardial infarction patients were enrolled,who suffered from failure of primary percutaneous coronary intervention because of high thrombus burden.Summarize the antithrombotic strategies in perioperative and postoperative period,the operative strategies and the follow-up coronary intervention were recorded and reviewed.Results All the patients were male and most of them had acute inferior myocardial infarction with right coronary occluded because of high thrombus burden.Four patients received thrombus aspiration and balloon dilation.One patient received thrombus aspiration and the other three patients did not receive coronary intervention.Tirofiban were given in perioperative period to all the patients.Low molecular weight heparin was given to 6 patients.Dual antiplatelet therapy was given to 6 patients (aspirin 100 mg/day plus clopidogrel 75 mg/day) and 1 patient required up-titration of aspirin to 200 mg/day.Coronary angiography were repeated (29.00 ± 23.25) days later,and the thrombus in the culprit vessels disappeared in two patients,and coronary stent implantation was performed in three patients.Conclusions The routine antithrombotic strategies play limited roles in thrombus clearance in acute ST segment elevation myocardial infarction patients with failure primary percutaneous coronary intervention because of high thrombus burden.The time for the thrombus to be totally organized and the timing of elective percutaneous coronary intervention are still uncertain and need to be further studied.
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Objective To explore the application value of single-door laminoplasty via Y type nano-bone plate in treating multilevel cervical spondylotic myelopathy (MCSM) and analyze the short-term efficacy.Methods From January 2013 to December 2016,79 cases of MCSM were treated with single-door laminoplasty via Y type nano-bone plate to evaluate the improvement of post-operative neurological function by the Japanese Orthopaedic Association (JOA) evaluation system.We also measured cervical curvature of cervical X-ray and C5 sagittal diameter of the spinal canal before operation and 6 months after operation to understand the maintenance and enlargement of the spinal canal.The improvement degree of spinal cord compression was evaluated by preoperative and postoperative cervical MRI.Osseous healing on the open door side and the door shaft side was observed with the aid of three-dimensional spiral CT.Results Follow-up ranged from 6 to 36 months,with an average of (20.4±7.9)months.Preoperative JOA score was (8.6 ± 1.3) points and JOA score 6 months after operation was (14.3 ± 1.5)points (P ＜ 0.05).JOA improvement rate was (68.6 ± 15.8)％;postoperative follow-up X-ray and threedimensional spiral CT showed that the spinal canal had satisfying enlargement,the door shaft side all had osseous healing,the open door side osseous healing was not obvious,and there was no lamina collapse or reclosing.Sagittal diameter of theC spinal canal was (8.9±l.1)mm before operation and (15.1±l.1)mm 6 months after operation (P＜0.05).The spinal canal enlargement rate was (70.8±22.3)％,cervical curvature was (14.8± 7.0)°preoperatively and (15.1±6.7)°postoperatively with no significant difference (P＞0.05).Conclusion EOLP via Y type nano-bone plate is safe and efficacious in treating MCSM.It not only provides a good immediate fixation,but also provides the possibility for the open door side lateral osseous fusion.
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Objective To analyse the difference of effects of different tidal volume mechanical ventilation strategies in infants with severe congenital heart disease after curative.Methods Sixty-eight cases were chosen from CICU of Anhui Provincial Children's Hospital during Oct 2010 to Jan 2012.Thirty-two cases in A group were used in ventilation strategy by lower tidal volumes (6 ～ 10 ml/kg),36 cases in B group were used in ventilation strategy by larger tidal volumes (10 ～ 15 ml/kg).The time of mechanical ventilation,duration of ICU stay and postoperative complications were compared between the two groups.Results The time of mechanical ventilation of B group was shorter than that of A group [(8.6 ± 2.5) d vs (11.7 ± 3.2) d],duration of ICU stay of B group was shorter than that of A group [(11.4 ± 4.8) d vs (15.6 ± 5.7) d],there were statistical differences between two groups(P ＜ 0.0l).The incidence rate of ventilator associated pneumonia and pneumothorax were 6.3％ and 3.1％ in A group,which were 5.6％ and 5.6％ in B group,there were no statistical differences between two groups (P ＞ 0.05).Conclusion The effects of mechanical ventilation with larger tidal volumes is better than that with lower tidal volumes in infants with congenital heart disease postoperative therapy.
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Objective To review the early postoperative complications and its treatment in infants with tetralogy of Fallot(TOF).Methods From January 2004 to March 2007,35 infant patients with TOF,aged 4 to 12 months,underwent corrective procedure with hypothermic cardiopulmonary bypass(CPB) and general anaesthesia in Anhui provincial children's hospital.Of all the patients,30 cases received radical surgery and the other 5 cases with initial palliation.Results The early postoperative complications occurred in 10 cases,of which 6 cases comlplicated with low cardiac output,2 cases had severe arrhythmia,2 cases manifested as perfusion lung,2 cases were symptomized by residual right ventricular outflow tract(RVOT) obstruction and 1 case suffered from residual ventricular septal defect(VSD).There were 3 cases of early postoperative death with 8.6% of hospital mortality.Conclusion The operative mortality can be effectively reduced by careful preparations for surgery,reliable surgical procedure,effective myocardial protection and timely treatment for postoperative complications.This study demonstrated that repair of TOF in infancy can be done with excellent results.