ABSTRACT
A 50?year?old woman presented with intermittent dull pain in the forehead and mild dizziness occasionally after her forehead was subjected to a mild bump accidentally 20 days prior to the presentation, and was diagnosed with angioneurotic headache in a local hospital. After the treatment with oral sibelium tablets, the condition wasn′t relieved obviously. Computed tomography (CT) scan showed multiple localized bone destruction and low?density area in the frontal and bilateral parietal bones with adjacent soft tissue swelling. Magnetic resonance imaging(MRI)revealed equal T1 signals and slightly long T2 signals for multiple nodules in the frontal and bilateral parietal bones, high signals on diffusion?weighted imaging (DWI), obvious enhancement on contrast?enhanced MRI, and linear enhancement in adjacent meninges. Whole?body bone scintigraphy showed multiple increased radionuclide uptake in the skull. Laboratory examination demonstrated that specific antibodies to Treponema pallidum (Tp) were positive, and the serum rapid plasma reagin(RPR)titer was 1∶128. Cerebrospinal fluid(CSF)examination showed normal CSF pressure, nucleated cell counts(8 × 106/L)and glucose level(4.0 mmol/L), slightly high chloride flux(129.1 mmol/L), high protein level(0.9 g/L), high CSF?RPR titer of 1∶16 and presence of specific antibodies to Tp. Histopathological examination revealed hyperemia of adjacent tissues in the cranial osteolytic area, hyperplasia of interstitial fibrous tissue, endothelial cell swelling, and infiltration of inflammatory cells mainly containing plasma cells. The treatment regimen for neurosyphilis was given, and headache was relieved after 1 week of treatment, basically disappeared after 2 weeks, and completely disappeared after 4 weeks, and no similar headache occurred thereafter. Finally, the patient was diagnosed with acquired syphilitic skull osteomyelitis complicated by syphilitic meningitis.
ABSTRACT
Objective To compare the efficacy and safety of domestic and imported losartan on patients with reversal hypertension left ventricular hypertrophy ( LVH). Methods 118 patients with reversal hypertension left ventricular hypertrophy were randomly divided into two groups. The treatment group of 60 cases were treated by oral domestic losartan and the control group of 58 cases were received oral valsartan imports. The dose was 80mg once day with 6 months for a course of treatment. Before and after treatment, we observed the blood pressure, left ventricular hypertrophy changes in echocardiographic parameters and to monitor the blood, urine routine, liver and kidney function and other indicators,and to record adverse reactions. Results Two groups had lowering blood pressure effect. It was significant difference between before and after treatment( P 0.05 ). Conclusion Domestic and imported valsartan can lower blood pressure in the treatment of reversal hypertension left ventricular hypertrophy, and reverse LVH, without affecting heart rate,and at the same time with fewer adverse reactions.