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Objective@#To evaluate the efficacy and safety of low dose sublingual nifedipine dripping pills (5 mg) in treating moderate and severe hypertension in comparison with normal dose (10 mg) of sublingual nifedipine dripping pills.@*Methods@#This study was designed as a randomized, double-blind, positive drug parallel controlled, multi-center, non-inferiority clinical trial. Patients with moderate and severe hypertension were enrolled by 14 clinical trial centers, randomly divided into the trial group (sublingual 5 mg nifedipine dripping pills) and the control group (sublingual 10 mg nifedipine dripping pills). The changes in blood pressure were monitored continuously within 2 hours after the initial administration, repeated the dose in 20 minutes interval after the initial administration for up to additional 3 doses (maximum 4 doses) if the antihypertensive efficacy was not satisfactory. The efficacy of antihypertensive therapy between the two groups was evaluated by repeated administration rates and blood pressure changes at 60 minutes post the initial administration, and the safety of treatment was evaluated by recording adverse event rate of the two groups.@*Results@#The anti-hypertensive effective rates at 60 minutes after sublingual administration were 83.5% (202/242) and 86.7% (208/240) respectively between the trial group and control group (χ2=1.307, P=0.253) . On the aspect of antihypertensive effectiveness at 60 minutes after single dose of sublingual administration, the anti-hypertension effective rates of the trial group and the control group were 85.6% (154/180) and 87.2% (164/188) respectively (χ2=0.221, P=0.639). Prevalence of the repeated administration was also similar between the two groups (25.6%(62/242) in the trial group and 21.7% (52/240) in the control group, χ2=1.043, P=0.307). On the safety aspect, there was no adverse events/reactions in the trial group, but there were 15 cases of adverse events/reactions occurred in control group (6.25%, χ2=15.611, P<0.001).@*Conclusions@#In the treatment of moderate to severe hypertension, the antihypertensive efficacy of low dose nifedipine dripping pills is similar to that of conventional dosage, and the safety profile of low dose nifedipine dripping pills is better than that of the conventional dose.
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Objective To investigate the clinical value of the index of microcirculation resistance(IMR) in the prediction of major adverse cardiac events after PCI in the patients with ST segment elevation myocardial infarction.Methods Forty-eight inpa tients with acute ST segment elevation myocardial infarction(STEMI) in the cardiology department CCU of our hospital from December 2013 to June 2015 were selected,including 38 males and 10 females,and divided into 3 groups according to the measured IMR value after PCI operation:the group A,IMR≤25(n=18);group B,IMR 25 ～ 32 (n =16);group C,IMR≥32 (n =14).Serum NT-ProBNP was collected,and the data in cardiac color ultrasound after PCI and at postoperative 1 year:left ventricular ejection fraction(LVEF) and left ventricular end diastolic diameter(LVEDD),and major adverse cardiac events within 1 years after PCI were also collected.Results The serum of concentrations NT-ProBNP were compared among the three groups[(2 734.83 ± 1 009.40) vs.(4 929.68±611.52) vs.(7 480.64±2 082.78)],and the difference among 3 groups was statistically significant (F=35.449,P=0.000).The difference of LVEF among the three groups had statistal significance[(54.00-±-5.99) vs.(52.31 ± 4.35)vs.(49.29 ±4.68),F=3.376,P=0.043)],and there was no statistical difference among the three groups in LVEDD(P＞0.05).The difference of LVEF at postoperative 1 year among 3 groups had statistical significance[(57.28 ± 5.21)vs.(54.43 ±3.69)vs.(46.43±5.33),F=16.744,P=0.000],and the difference of LVEDD (48.94±1.95)vs.(50.63±2.68)vs.(52.14±2.69) among 3 groups was statistically significant(F=6.875,P=0.002).The differences in the major adverse cardiac events,cases of cardiac death and cases of heart failure after postoperative 1 year among 3 groups were statistically significant(x2 value=6.707,P=0.035;x2 value=6.084,P=0.048);the occurrence of again ACS,again PCI and malignant arrhythmia had no statistical difference among 3 groups(P＞0.05).Conclusion Measurement of IMR after PCI in the patients with STEMI can effectively predict the heart function and the risk of major adverse cardiac events within 1 year.
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Objective To investigate the effects of erythropoietin (EPO) on myocardial apoptosis and protein kinase B (AKT) expression in rats of chronic heart failure (CHF). Methods Thirty male adult SD rats were randomly divided into two groups, sham-operated (Sham) group (n=6) and model (Model) group (n=24). The abdominal aortic coarctation was used to build CHF model. Sixteen survived rats after operation were randomly divided into two groups including EPO group and con-trol (Control) group. EPO group was received 3 000 U/kg EPO intraperitoneal injection 3 times/week for 4 weeks, and Sham group and Control group were received same volume of normal saline. The echocardiography was used to evaluate cardiac function after 4 weeks, 8 weeks and 12 weeks of treatment. After 12 weeks, all rats were sacrificed after 24 h fasting. The cell morphology and myocardial apoptosis were observed, and apoptosis index (AI) was calculated. Myocardial P-AKT/AKT pro-tein expression was detected by Western blot assay. Results Echocardiography showed that ventricular hypertrophy was found in model group after four weeks, heart failure 8 weeks. Compared with Control group, left ventricular ejection fraction (LVEF) was significantly higher after EPO intervention for 4 weeks (P < 0.05), systolic interventricular septum thickness (IVSs), end-systolic left ventricular posterior wall thickness (LVPWs), diastolic interventricular septum thickness (IVSd), af-ter left ventricular end-diastolic wall thickness (LVPWd) were significantly lower (P<0.05). The value of AI was significant-ly lower in EPO group than that of Control group (23.87%±1.45%vs 35.58%±2.81%, P<0.01). The OD value of P-AKT/AKT was significantly decreased in Control group (0.35±0.06) than that of Sham group (0.81±0.17), the value was significant-ly increased in EPO group (1.61±0.16) than that of Control group (P<0.01). Conclusion EPO can improve heart function, inhibit myocardial apoptosis,and promote pro-phosphorylation of AKT in rats with chronic heart failure.
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Objective To investigate the distribution of 3279 and 924 Foxp3 genotypes in Guangdong population and to explore the correlation between Foxp3 gene polymorphism and essential hypertention . Methods Two hundred and six essential hypertention patients and 291 healthycontrols from October 2013 to September 2014 in the third affiliated hospital of guangzhou medical university were enrolled in the study. The Foxp3 3279 and 924 genotypes was identified by PCR-SSP assay. The plasma lipid level and other risk factor were detemined in all subjects. The relationship between genotypes and pathogenesis of EH was analyzed. Results There were sigificant differences in frequecncies of allele and genotype distribution in Foxp3 3279 genotypes between the two groups. The frequecies of AC+CC and allele were significantly higher in the EH group than those in the control group (P<0.05). Result of logictics analysis showed that AC+CC genotype significantly increase the risk of EH (OR = 1.552,95%CI为1.021 ~ 2.357, P < 0.05), but the polymorphism of Foxp3 924 genotype frequecncy was not assosiated with EH. Conclusion The Foxp3 3279 gene polymorphisms is associated with EH . However, the Foxp3 924 gene polymorphisms is not associated with EH.
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<p><b>OBJECTIVE</b>To investigate the effect of edaravone on oxidative stress and myocardial fibrosis induced by isoproterenol in rats.</p><p><b>METHODS</b>Fifty male SD rats were randomly divided into 5 groups, including a control group, a myocardial fibrosis model (established by injections of isopropyl adrenaline for 10 days) group, and 3 edaravone groups with edaravone treatment at low, medium, or high doses for 14 days. After the treatments, the rats were examined for the degree of myocardial fibrosis, left ventricular mass index (LVMI), collagen volume fraction (CVF), and myocardial contents of collagen I (Col I), collage III (Col III), hydroxyproline (Hyp), superoxide dismutase (SOD), malondialdehyde (MDA), and nitric oxide (NO); The expression of transforming growth factor-β1 (TGF-β1) in the myocardial tissues was examined by immunofluorescence assay and Western blotting.</p><p><b>RESULTS</b>Compared with the control rats, the rat models of myocardial fibrosis showed significantly increased CVF and LVMI (P=0.000), which were lowered by edaravone treatments in a dose-dependent manner (P<0.05). The myocardial contents of Col I, Col III and Hyp also increased in the model group (P=0.000) and were lowered dose-dependently by edaravone; the contents of MDA was higher (P=0.000) and SOD and NO were lower in the model group (P=0.000), and edaravone treatments obviously increased SOD and NO contents (P<0.05). The model rats showed significantly increased myocardial expression of TGF-β1 (P=0.000), which was markedly lowered by edaravone treatments (P=0.000). The myocardial content of MDA was positively correlated while SOD and NO were negatively with LVMI, CVF, Col I, Col III and Hyp; TGF-β1 was positively correlated with LVMI, CVF, Col I, Col III, Hyp and MDA but negatively with SOD and NO.</p><p><b>CONCLUSION</b>Edaravone can relieve oxidative stress and inhibit TGF-β1 activation to ameliorate myocardial fibrosis in rats.</p>
Subject(s)
Animals , Male , Rats , Antipyrine , Pharmacology , Cardiomyopathies , Drug Therapy , Collagen , Metabolism , Disease Models, Animal , Drugs, Chinese Herbal , Heart , Hydroxyproline , Metabolism , Isoproterenol , Malondialdehyde , Metabolism , Myocardium , Pathology , Oxidative Stress , Rats, Sprague-Dawley , Superoxide Dismutase , Metabolism , Transforming Growth Factor beta1 , MetabolismABSTRACT
Objective To summarize experience to prevent the main postoperative complications after hypospadias repairs. Method The clinical data of 189 cases of hypospadias repairs was from May 2005 to August 2010,retrospectively analyzed. Results One hundred and seventy-four cases were surgically cured by single-stage operation. All cases had been followed up for 4-36 (18.5 ± 5.5) months, the cases who had become adults were normal penile development and erectile function. Postoperative complications occurred in 15 cases,9 cases of them were urethral fistulas,6 cases were urethral strictures,all were cured or improved after symptomatic treatments. Conclusions Some methods are necessary to raise single-stage urethroplasty success rate and decrease the incidence of fistulas and strictures, such as preoperative antibiotic prophylaxis,appropriate procedure,intraoperative suprapublic urinary diversion,the good blood supply of the flap, modified enswathement, postoperative manage and nursing.
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Objective To investigate the effect and safety of administering magnesium sulphate as a technique of controlled hypotension during functional endoscopic sinus surgery. Methods Seventy-five patients arranged for selective functional endoscopic sinus surgery under general anesthesia, were randomly assigned into three groups: control group, magnesium sulphate group and nitroglycerin group(n=25). The patients of magnesium sulphate group received 10% magnesium sulphate 40 mg/kg before the induction of anaesthesia, and then 15 mg·kg~(-1)·h~(-1) by continuous infusion during the operation. The same volume of 5% glucose was administered to the patients in control group. Constant infusion of nitroglycerin beginning with 1 μg·kg~(-1)·min~(-1) was administered to the patients in nitroglycerin group. The hemodynamic indexes, amount of bleeding, fluid intake, operation time, recovery time, quality of surgery field, muscle relaxation and adverse reaction were recorded. Concentration of Mg~(2+) in magnesium sulphate group were compared before and after surgery.Results The patients in the magnesium sulphate group maintained balanced heart rates during the operation, while the heart rates of patients in control group and nitroglycerin group increased significantly (P<0.01). The patients of magnesium sulphate group had lower amount of bleeding and shorter operation time compared with control group (P<0.01). The quality of surgery field in magnesium sulphate group was significantly better than that in control group (P<0.01). Time for 75% recovery of myokymia and recovery index in magnesium sulphate group was higher than those in control group and nitroglycerin group(P<0.01). No adverse reaction was observed in all groups. Conclusion Magnesium sulphate can be effective and safe for controlled hypotension during functional endoscopic sinus surgery.
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0.05). The onset time of 0.2mg/kg and 0.4mg/kg cisatracurium was significantly shorter than that of 0.1mg/kg cisatracurium and 0.5mg/kg atracurium (P
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Objective: To compare cumulative dose technique with single dose technique for determining dose-re sponse relationship of rocuronium during balanced anesthesia. Method: Thirty-four ASA grade Ⅰ-Ⅱ patients, aged 23- 65 years, undergoing elective surgery,were randomly allocated to single dose group(n=24) or cumulative dose group (n=10). Single dose group was further divided into 4 subgroups receiving 150,200,250 or 300?g/kg of rocuronium re spectively. In cumulative dose group, the initial dose of 150 or 200 ?g/kg rocuronium was followed by a second dose de termined individually to produce about 90% neuromuscular block. The ulnar nerve was stimulated at the wrist to mea sure the accelography of thumb adduction. The relationship between probit-transformed depression of first twitch height of TOF and the logarithm dose of rocuronium was analysed using linear regression. Result: ED_50 and ED_95 of rocuronium were 193.6?69.1 and 367.2?72. 7?g/kg respectively in single dose group, and 213.0?55.1 and 418.5? 61.7?g/kg respectively in cumulative dose group. No statistically significant differences were found in the slope,inter cept,ED_50 and ED_95 values between two groups. Conclusion: The two-dose cumulative technique can be used as effec tively as traditional single dose technique in determining the dose-response relationship of rocuronium.