成长

新中国诞生5岁时，母亲在一个贫穷的农家出生．后来，几个舅舅陆续上学，但母亲一直未能踏进校门，因为，姥爷认为．女孩读书没用。母亲曾为自己的命运抗争．但姥爷是家庭的权威．所以母亲只能默默地期翼……

Effect of amlodipine combined with telmisartan or compound amiloride on plasma ET-1 concentration and left ventricular diastolic function of essential hypertension patients with left ventricular hypertrophy

Objective： To observe the effect of different combination antihypertensive therapies on plasma endothelin-1 （ET-1） concentration and left ventricular diastolic function of essential hypertension patients with left ventricular hypertrophy （LVH） Methods： A total of 111 patients with essential hypertension were selected, including 60 cases （34 males, 26 females） aged （60.7±5.6） years with simple hypertension, and 51 cases （28 males, 23 females） aged （61.8±7.0） years with essential hypertension complicated with LVH. Essential hypertension patients with LVH were randomly divided into the group of amlodipine （2.5 mg/d） combined with telmisartan （40 mg/d, n=26） and the group of amlodipine （2.5 mg/d） combined with amiloride （half tablet/d, n=25）,and the treatment lasted for 1 year. Echocardiography was performed before and after the treatment. Left ventricular mass index （LVMI）, left ventricular isovolumic relaxation time （IVRT） and other indicators were detected, and plasma ET-1 concentrations were measured for comparative analysis. And 56 patients （31 males, 25 females） aged （59.3±6.7） years with normal blood pressure in the same period in our hospital were selected as the normal control group. Results： The general clinical characteristics were similar between hypertensive LVH group, simple hypertensive group and normal healthy control group. Plasma ET-1 concentrations, LVMI and IVRT of hypertensive LVH group were significantly higher than those of normal control group and simple hypertension group, and the difference was statistically significant. The patients＇ baseline blood pressure, ET-1, LVMI, interventricular septal thickness （IVST）, left ventricular posterior wall thickness （LVPWT）, left ventricular end-diastolic diameter （LVEDd） and other clinical parameters showed no significant difference （P〉0.05） between the group of amlodipine combined with telmisartan and the group of amlodipine combined with amiloride. It was found that compared with that before treatment, blood pressure could be effectively controlled （P〈0.05）, and LVMI, IVST, LVPWT and IVRT （P〈0.05） were all lowered, and ET-1 （P〈0.01） was significantly reduced after 1 year of antihypertensive therapy in both the group of amlodipine combined with telmisartan and the group of amlodipine combined with amiloride. The group of amlodipine combined with telmisartan was better in lowering blood pressure and reducing LVMI, IVST, LVPWT, IVRT and ET-1 than the group of amlodipine combined with amiloride （P〈0.05）. Conelus｜on： Amlodipine-based combination antthypertensive therapy could reverse LVH and improve left ventricular diastolic function partly by lowering blood pressure and ET-1, and the effect of amlodipine combined with telmisartan was superior to that ofamlodipine combined with amiloride

Impacts of land-use change on ecosystem service value in Changsha,China

Changsha,a typical city in central China,was selected as the study area to assess the variations of ecosystem service value on the basis of land-use change. The analysis not only included the whole city but also the urban district where the landscape changed more rapidly in the center of the city. Two LANDSAT TM data sets in 1986 and 2000 and land use data of five urban districts from 1995 to 2005 were used to estimate the changes in the size of six land use categories. Meanwhile,previously published value coefficients were used to detect the changes in the value of ecosystem services delivered by each land category. The result shows that the total value of ecosystem services in Changsha declines from $1 009.28 million per year in 1986 to $938.11 million per year in 2000. This decline is largely attributable to the increase of construction land,and the conversion from woodland and water body to cropland to keep the crop production. In the five districts,there is $6.19 million decline in ecosystem service value between 1995 and 2005. Yuelu District has the highest unit ecosystem service value while Yuhua District has the lowest one. This may be attributed to the greater conversion from cropland and grassland to woodland and water body with the increase of construction land in Yuelu District. It is suggested that the increase rate of construction land should be controlled rigorously and the area of woodland and water body should be increased or at least retained in the study area.

Apoptosis,myocardial fibrosis and angiotensin Ⅱ in the left ventricle of hypertensive rats treated with fosinopril or losartan

Objective To investigate the different effects of an angiotensin Ⅱ type 1 (AT 1) receptor antagonist, losartan, and an angiotensin converting enzyme (ACE) inhibitor, fosinopril, on cardiomyocyte apoptosis, myocardial fibrosis, and angiotensin Ⅱ (AngⅡ) in the left ventricle of spontaneously hypertensive rats (SHRs) Methods SHRs of 16 week old were randomly divided into 3 groups: SHR L (treated with losartan, 30 mg·kg 1 ·d 1 ), SHR F (treated with fosinopril, 10 mg·kg 1 ·d 1 ), and SHR C (treated with placebo) Each group consisted of 10 rats Five rats, randomly selected from each group, were killed at the 8th and 16th week after treatment Cardiomyocyte apoptosis, collagen volume fraction (CVF), perivascular collagen area (PVCA) and AngⅡ concentrations of plasma and myocardium were examined Results Compared with the controls at the 8th and 16th week, systolic blood pressures were similarly decreased in both treatment groups Left ventricular weight and left ventricular mass indexes were significantly lower in both treatment groups However, the latter parameter at the 16th week was reduced to a less extent in the fosinopril group than that in the losartan group Compared with the controls, cardiomycyte apoptotic index was significantly reduced at the 8th week only in the fosinopril group, and at the 16th week in both treatment groups The index of the fosinopril group was lower than that of the losartan group at the latter endpoint examined Compared with the controls, the left ventricular collagen volume fraction and perivascular collagen area at the 8th and 16th weeks were significantly reduced in the SHRs treated with either fosinopril or losartan However, the collagen volume fraction at the latter endpoint in the fosinopril group was lower than that in the losartan group Compared with the controls at endpoints, plasma and myocardium Ang Ⅱ levels were significantly increased in the losartan group However, plasma Ang Ⅱ concentrations were not altered, and myocardium AngⅡ concentrations at the 8th and 16th weeks were significantly reduced in the fosinopril group Conclusions Both losartan and fosinopril could effectively inhibit cardiomyocyte apoptosis and myocardial fibrosis and reverse heart hypertrophy Fosinopril may be more effective in these cardioprotective effects, suggesting that the effects of both drugs are related to the inhibition of myocardium renin angiotension aldsterone system

Research progress of sacubitril/valsartan in heart failure patients with preserved ejection fraction

With the launch of sacubitril/valsartan(ARNI),there are new options for the treatment of heart failure(HF).However,ARNI is currently only used in HF patients with reduced ejection fraction(HFrEF).No evidence shows that no modern treatment can reduce mortality in HF patients with preserved ejection fraction(HFpEF).Therefore,it is urgently necessary clarify whether ARNI can be used in the treatment of HFpEF.In the present study,we summarized the research progress of ARNI in the treatment of HFpEF.

Opportunity in Diversity

Four years ago,Nurahmet Memet was a farmer in northwest China’s Xinjiang Uygur Autonomous Region.Today,he no longer leads a hardscrabble life in southern Kargilik County,next to the Taklamakan Desert,and instead has become a successful company manager and businessman after relocating to central Xinjiang.