吲达帕胺联合氨氯地平治疗高血压合并冠心病患者的临床疗效

目的观察吲达帕胺联合氨氯地平治疗高血压合并冠心病的临床疗效。方法将我院2015年7月—2017年4月收治的128例高血压合并冠心病患者随机分为观察组和对照组,每组64例,对照组应用硝苯地平控释片治疗,观察组联合应用吲达帕胺与氨氯地平治疗,比较两组治疗前后血压及血脂水平,记录治疗期间不良反应发生情况。结果治疗后两组血压和血脂水平均低于治疗前,且观察组上述观察指标降低更加显著(P<0.05)。两组不良反应发生率之间对比,差异无统计学意义(P>0.05)。结论吲达帕胺联合氨氯地平可以改善高血压合并冠心病患者血压和血脂水平,且安全性较高。

硝苯地平缓释片联合依那普利在治疗高血压合并冠心病的效果

探析高血压合并冠心病患者的有效药物治疗方法,就依那普利与硝苯地平缓释片联合干预的效用进行揭示。方法:纳选符合本次研究样本选取标准的102例原发性高血压合并冠心病患者作为样本主体,录入时间在2019年1月-2021年12月,根据其药物使用方案差异性将其分成对照组及观察组(51例/组),分别施以单独硝苯地平缓释片及依那普利与硝苯地平缓释片联合干预,观察对比干预3个月后的患者病情情况及药物副作用发生情况。结果:观察组内显效及有效占比分别为78.43%及13.73%(总有效率92.16%)与对照组的58.82%、17.64%(总有效率76.47%),即p<0.05;2组患者干预前的血压与心率值两两对比未见明显差异(P>0.05);接受不同用药方案干预后,观察组舒张压(75.29±6.43)mmHg、收缩压(122.29±6.72)mmHg明显较低于对照组,数据对比可见P<0.05;观察组不良反应发生率为3.92%明显低于对照组的13.73%,即p<0.05;干预前两组患者的血脂水平无明显差异性(t=0.697,P>0.05),接受干预后,两组患者的血脂水平均得到改善,且观察组患者的改善程度明显优于对照组(t=26.957,P<0.05);观察组患者心功能各评价指标(心输出量(CO),t=19.562、左心室射血量(LVEF),t=18.624、每博量(SV),t=20.014)均明显优于对照组,即P<0.05。结论:依那普利和硝苯地平缓释片进行联合用药是临床干预高血压合并冠心病患者的理想手段,使患者的治疗总有效率得以提升,同时对控制冠心病发展有积极作用,且具有较高的用药安全性,值得做进一步推广使用。

高血压合并2型糖尿病行吲达帕胺联合缬沙坦对血压与尿微量白蛋白的影响

目的观察高血压合并2型糖尿病行吲达帕胺联合缬沙坦对血压与尿微量白蛋白的影响。方法选取本院2013年1月—2014年6月收治的高血压合并2型糖尿病患者共86例,随机分为观察组与对照组;观察组43例予吲达帕胺联合缬沙坦治疗,对照组43例予吲达帕胺治疗;观察治疗前后两组血压、肾功能及血生化相关指标。结果观察组治疗后SBP、DBP均显著低于治疗前,差异有统计学意义(P<0.01);治疗后观察组SBP(130.14±7.69)mm Hg,DBP(75.15±6.65)mm Hg,均显著优于对照组(P<0.05);治疗后观察组m Alb(16.35±3.42)mg/g,BUN(5.12±1.03)mmol/L,Cr(96.58±7.21μmol/L)均显著优于对照组,差异有统计学意义(P<0.05);观察组治疗前后的血生化指标比较,差异无统计学意义(P>0.05)。结论高血压合并糖尿病行吲达帕胺联合缬沙坦治疗能够有效降低患者血压,恢复尿微量白蛋白水平,临床疗效显著。

非洛地平缓释片与美托洛尔联合治疗高血压并发慢性心力衰竭患者的疗效观察

对高血压合并慢性心力衰竭患者采用非洛地平缓释片与美托洛尔治疗,观察其疗效。方法:对近五年我院血压合并慢性心力衰竭患者66例研究,分为两组并采用不同的治疗方式。结果:观察组的心功能指标较好,且血压稳定,治疗有效率高,P<0.05。结论:非洛地平缓释片联合美托洛尔治疗高血压并发慢性心力衰竭患者的疗效显著,具有重大推广价值。

糖尿病合并高血压中医诊疗标准

文章所讨论的糖尿病合并高血压诊疗标准是在中华中医药学会2007年发布的《糖尿病中医防治指南》的基础上,研究、整合、优化以往中医糖尿病标准方面的研究成果,结合临床实际,研究而形成的能够被学术界普遍认可的诊疗标准,本文确定了糖尿病合并高血压属中医"眩晕"、"风眩"范畴,对糖尿病合并高血压的临床表现、理化检查、处理原则、辩证施治、成药治疗、辅助疗法、西医治疗等分别进行阐述,旨在进一步推广和发挥中医药在治疗糖尿病合并高血压时的特色与优势,规范糖尿病合并高血压的诊疗行为,促进糖尿病合并高血压中医药临床疗效的进一步提升。

综合护理干预对重度妊娠高血压综合症影响的效果分析

目的探讨综合护理对重度妊娠期高血压疾摘的护理效果。方法将我院120例重度姓娠高血压综合症患者平均分成观察组和对照组．各60例，对照组采用一般护理，观察组在对照组基础上实施综合护理。结果观察组终止妊娠方式、胎儿存活率以及Apgar评分均明显优于对照组（P〈0．05）。结论综合护理可以有效控制重度妊娠高血压综合症患者病情，提高患者的生活质量。

Association of Glu298Asp Polymorphism of the En-dothelial Nitric Oxide Synthase Gene with Essential Hypertension in Elderly People

Objective: To investigate the association of Glu298Asp polymorphism of theeNOS gene with essential hypertension in elderly people. Methods: Ninety-five cases of essentialhypertension were randomly chosen from outpatients and inpatients as the study group, and an equalnumber of sexes, age-matched healthy people as the control group. Their height, weight and bloodpressure were recorded and their fasting plasma lipid concentrations were measured. Glu298Asppolymorphism of the eNOS gene was measured using the methods of PCR and RFLP. Results: Theconstituent ratio of Genotype Glu/Asp in the study group (26.3%) was higher than that in the controlgroup (12.6%, x^2 = 5. 67, P<0.05), the allelic frequency of 298Asp in the study group (13.2%) wassignificantly higher than that in the control group (6.3%, x^2 = 5.06, P<0.05). Conclusion: Glu298Asp variant of the eNOS gene may be an independent predictor in essential hypertension.

Establishment of a model for pregnancy-induced hypertension syndrome resulting from cold-stress in rats

Objective: To establish a model for pregnancy-induced hypertension syndrome in rats. Methods: Adult female Wistar rats were randomized into non-pregnant control (NN), non-pregnant cold-stress control (NC), pregnant control (PN) and pregnant cold-stress (PC) groups. The rats of NN and PN groups were put under 25 ℃ and those of NC and PC groups under (4±2)℃ for 4 h every morning respectively in the whole experimental period. The blood pressure, urine protein, body weight, haematocrit, weight of the placenta and weight and length of the fetus were recorded and the histological changes of the placenta and the kidneys were also studied. Results: The blood pressure and urine protein of the rats of the NC and PC groups after 2 weeks of cold-stress were more significantly increased than the rats of the NN and PN groups. In addition, the weight of the placenta and the weight and length of the fetus were more significantly lower in the former than the latter. Obvious changes of anoxia and ischemia were observed in the tissues of the kidneys and every layer of the placenta. Conclusion: Our findings of hypertension syndrome induced with repeated cold-stress in pregnant rats can be applied to illustrate the pathogenesis of pregnancy-induced hypertension syndrome in human beings.

Second-trimester maternal β-human chorionic gonadotropin level associated with subsequent development of pregnancy-induced hypertension

Objective:To determine whether maternal β-human chorionic gonadotropin(β-hCG) level in second-trimester may be associated with subsequent development of pregnancy-induced hypertension(PIH).Methods:Seven hundred and sixty-two women in mid-trimester were to have maternal urine β-hCG standardized concentrations and maternal serum β-hCG measurements.Their case histories were recorded and reviewed from mid-trimester to delivery.The relation was observed between maternal urine,serum markers and subsequent development of PIH.Results:Among 762 women,504 cases were normal pregnancies,42 cases had PIH,94 cases had premature rupture of membrane (PROM),69 cases had preterm delivery (PD),53 other cases were excluded by various reasons.The levels of maternal urine,serum β-hCG in PIH were (61.75±9.78) IU/L and (304.56±54.17) ng/mg respectively,which were higher significantly than normal pregnancy group ([20.65±7.61] IU/L and [146.34±47.81] ng/mg,P<0.05).When maternal serum,urine β-hCG levels ≥2 MOM(multiple of mean),the incidences of developing PIH were increased significantly as compared with those of β-hCG <2 MOM women.The incidence of PIH increased from 5.1% in pregnancies with urine β-hCG ≥2 MOM to 11.7% in cases with urine β-hCG ≥4 MOM.Conclusion:The elevation of maternal mid-trimester urine,serum β-hCG levels is not only an early signal for dysfunction of placenta but also a dangerous signal for development of PIH.Second-trimester maternal urine β-hCG measurement proves to be superior to serum marker in clinical prediction.

TGF-β signaling in vascular biology and dysfunction

Transforming growth factor （TGF）-β family members are multifunctional cytokines that elicit their effects on cells, including endothelial and mural cells, via specific type I and type II serine/threonine kinase receptors and intracellular Smad transcription factors. Knock-out mouse models for TGF-β family signaling pathway components have revealed their critical importance in proper yolk sac angiogenesis. Genetic studies in humans have linked mutations in these signaling components to specific cardiovascular syndromes such as hereditary hemorrhagic telangiectasia, primary pulmonary hypertension and Marfan syndrome. In this review, we present recent advances in our under- standing of the role of TGF-β receptor signaling in vascular biology and disease, and discuss how this may be applied for therapy.

Synthesis and Adsorption Study of BSA Surface Imprinted Polymer on CdS Quantum Dots

A new bovine serum albumin （BSA） surface imprinting method was developed by the incorporation of quantum dots （QDs） into molecularly imprinted polymers （MIP）, which can offer shape selectivity. Preparation and adsorption conditions were optimized. Physical appearance of the QDs and QDs-MIP particles was illustrated by scanning electron microscope images. Photoluminescence emission of CdS was quenched when rebinding of the template.The quenching of photoluminescence emissions is presumably due to the fluorescence resonance energy transfer between quantum dots and BSA template molecules. The adsorption is compiled with Langmuir isotherm, and chemical adsorption is the rate-controlling step.The maximum adsorption capacity could reach 226.0 mg/g, which is 142.4 mg/g larger than that of undoped BSA MIP. This study demonstrates the validity of QDs coupled with MIP technology for analyzing BSA.

Inflammation and oxidative stress caused might lead to left ventricular diastolic and hypertension by nitric oxide synthase uncoupling systolic dysfunction in patients with

Objective To investigate the role of oxidative stress, inflammation, hypercoagulability and neuroendocrine activation in the transition of hypertensive heart disease to heart failure with preserved ejection fraction （HFPEF）. Methods We performed echocardiography for 112 patients （≥ 60 years old） with normal EF （18 controls and 94 with hypertension）, and determined protein carbonylation （PC）, and tetrahydrobiopterin （BH4）, C-reactive protein （CRP）, interleukin-6 （IL-6）, tumor necrosis factor-α （TNF-α）, fibrinogen, plasminogen activator inhibitor type-I （PAI-I）, von Willebrand factor, chromogranin A （cGA） and B-type natriuretic peptide （BNP） levels from their blood samples. Results We found that 40% （38/94） of the patients with hypertension （HT） had no diastolic dysfunction （HTDD-）, and 60% （56/94） had diastolic dysfunction （HTDD＋）. Compared to the controls, both patient groups had increased PC and BH4, TNF-α, PAI-I and BNP levels, while the HTDD＋ group had elevated cGA and CRP levels. Decreased atrial and longitudinal left ventficular （LV） systolic and diastolic myocardial deformation （strain and strain rate） was demonstrated in both patient groups versus the control. Patients whose LV diastolic function deteriorated during the follow-up had elevated PC and IL-6 level compared to their own baseline values, and to the respective values of patients whose LV diastolic function remained unchanged. Oxidative stress, inflammation, BNP and PAI-I levels inversely correlated with LV systolic, diastolic and atrial function. Conclusions In patients with HT and normal EF, the most common HFPEF precursor condition, oxidative stress and inflammation may be responsible for LV systolic, diastolic and atrial dysfunction, which are important determinants of the transition of liT to HFPEF.

Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage

AIM: To study retrospectively the influence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in patients with early acute pancreatitis (AP) (during the first week after admission) on physiological functions, and the association of the presence of IAH/ACS and outcome. METHODS: Patients (n = 74) with AP recruited in this study were divided into two groups according to intra-abdominal pressure (IAP) determined by indirect measurement using the transvesical route via Foley bladder catheter during the first week after admission. Patients (n = 44) with IAP ≥ 12 mmHg were assigned in IAH group, and the remaining patients (n = 30) with IAP < 12 mmHg in normal IAP group. For analysis of the influence of IAH/ACS on organ function and outcome, the physiological parameters and the occurrence of organ dysfunction during intensive care unit (ICU) stay were recorded, as were the incidences of pancreatic infection and in-hospital mortality. RESULTS: IAH within the first week after admission was found in 44 patients (59.46%). Although the APACHE Ⅱ scores on admission and the Ranson scores within 48 h after hospitalization were elevated in IAH patients in early stage, they did not show the statistically significant differences from patients with normal IAP within a week after admission (16.18 ± 3.90 vs 15.70 ± 4.25, P = 0.616; 3.70 ± 0.93 vs 3.47 ± 0.94, P = 0.285, respectively). ACS in early AP was recorded in 20 patients (27.03%). During any 24-h period ofthe first week after admission, the recorded mean IAP correlated significantly with the Marshall score calculated at the same time interval in IAH group (r = 0.635, P < 0.001). Although ACS patients had obvious amelioration in physiological variables within 24 h after decompression, the incidences of pancreatitic infection, septic shock, multiple organ dysfunction syndrome (MODS) and death in the patients with ACS were significantly higher than that in other patients without ACS (pancreatitic infection: 60.0% vs 7.4%, P < 0.001; septic shock: 70.0% vs 11.1%, P < 0.001; MODS: 90.0% vs 31.5%, P < 0.001; mortality: 75.0% vs 3.7%, P < 0.001). CONCLUSION: IAH/ACS is a frequent finding in patients admitted to the ICU because of AP. Patients with IAP at approximately 10-12 mmHg and early signs of changes in physiologic variables should be seriously considered for urgent decompression to improve survival.

Fathal pulmonary hypertension after distal splenorenal shunt in schistosomal portal hypertension

Mansonic schistosomiasis is the main cause of portal hypertension in Brazil. Hepatosplenic (HS) form is manifested by hepatomegaly mainly on the left hepatic lobe associated with large splenomegaly and bleeding due to esophageal varices with high mortality rates.

Early recognition of abdominal compartment syndrome in patients with acute pancreatitis

AIM： To assess the value of widely used clinical scores in the early identification of acute pancreatitis （AP） patients who are likely to suffer from intra-abdominal hypertension （IAH） and abdominal compartment syndrome （ACS）.METHODS： Patients （η = 44） with AP recruited in this study were divided into two groups （ACS and non-ACS） according to intra-abdominal pressure （IAP） determined by indirect measurement using the transvesical route via Foley bladder catheter. On admission and at regular intervals, the severity of the AP and presence of organ dysfunction were assessed utilizing different multifactorial prognostic systems： Glasgow-Imrie score, Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE-Ⅱ） score, and Multiorgan Dysfunction Score （MODS）. The diagnostic performance of scores predicting ACS development, cut-off values and specificity and sensitivity were established using receiver operating characteristic （ROC） curve analysis.RESULTS： The incidence of ACS in our study population was 19.35%. IAP at admission in the ACS group was 22.0 （18.5-25.0） mmHg and 9.25 （3.0-12.4） mmHg in the non-ACS group （P 〈 0.01）. Univariate statistical analysis revealed that patients in the ACS group had significantly higher multifactorial clinical scores （APACHE Ⅱ, Glasgow-Imrie and MODS） on admission and higher maximal scores during hospitalization （P 〈 0.01）. ROC curve analysis revealed that APACHE Ⅱ, Glasgow-Imrie, and MODS are valuable tools for early prediction of ACS with high sensitivity and specificity, and that cut-off values are similar to those used for stratification of patients with severe acute pancreatitis （SAP）.CONCLUSION： IAH and ACS are rare findings in patients with mild AR Based on the results of our study we recommend measuring the IAP in cases when patients present with SAP （APACHE Ⅱ 〉 7; MODS 〉 2 or Glasgow-Imrie score 〉 3）.

A Clinical Study on Haunglian Fire-Purging Mixture In Treatment of 46 Cases of Primary Hypertension

In order to observe the therapeutic effects of Huanglian Fire-Purging Mixture (黄连清降合剂) on primary hypertension, 46 cases of primary hypertension in the treatment group were treated with Huanglian Fire-Purging Mixture to clear away heat from the liver, relieve mental stress, purge fire and remove toxin;and the other 26 cases of primary hypertension in the control group were treated with Niuhuang Bolus for Lowering Blood Pressure (牛黄降压丸). The effect in the treatment group was obviously superior to that in the control group (P＜0.05). The Huanglian Fire-Purging Mixture shows noticeable effects 3-6 hours after medication. The mixture can improve the clinical symptoms, the left ventricular diastolic function and myocardial ischemia, correct dyslipoproteinemia and dysglycemia, and reduce blood viscosity. And it is safe and with no obvious adverse reactions.

Reversible Posterior Leukoencephalopathy Syndrome in Children with Nephrotic Syndrome:a Case Report

REVERSIBLE posterior leukoencephalopathy syn- drome （RPLS） is a rare neurological syndrome charac- terized by headache, altered mental status, seizures, and visual disturbance,associated with reversible white matter cnanges,- n been commonly reported in patients with severe hypertension and pre-eclampsia. Here we report a case with nephrotic syndrome complicated by RPLS.

MICROVASCULAR DECOMPRESSION FOR HEMIFACIAL SPASM - TECHNICAL NOTES AND COMPLICATION PREVENTION : EXPERIENCE OF 338 CASES

Objective To summarize our clinical experience of microvascular decompression (MVD)for medically intractable hemifacial spasm(HFS) patients with emphasis on microsurgical manipulation and to improve cure rate and avoid surgical complications. Methods Three hundred and thirty-eight patients with HFS underwent MVD under general anesthesia . With the help of 'zero retraction' technique, prosthesis can be properly inserted between offending vessel loop and affected facial nerve REZ in a 'rolling ball' fashion under operative microscope. Results Surgical intervention achieved high relief rate of 91 .4% and no major complications, with low recurrence rate of only 3.2% after averaging more than two years' follow-up ( M = 32 months). Conclusion It is possible to approach to the facial nerve REZ with 'zero retraction', which is fundamentally important to clear from cranial nerve and cerebellar injury. Skilled microsurgical technique along with correct recognition and mobilization of offending vessels are a must to assure MVD a highly efficacious and low risk treatment of choice for HFS patients.

Relationship of serum vitamin D level on geriatric syndromes and physical performance impairment in elderly hypertensive patients

Objective To investigate the relationship among serum vitamin D levels, physical performance impairment, and geriatric syndromes in elders with hypertension. Methods According to the concentration of vitamin D levels, a total of 143 elderly patients with hypertension were classified into vitamin D deficient group （vitamin D 〈 20 ng/mL, n = 94） and vitamin D appropriate group （vitamin D 〉 20 ng/rnL, n = 49）. Geriatric syndromes and physical performance were assessed by using comprehensive geriatric assessment （CGA）. Correlation among vitamin D levels, geriatric syndromes and physical performance was analyzed. Results No statistical differences were found in various aspects of geriatric syndromes between the two groups （P 〉 0.05）. While correlation analysis indicated that vitamin D levels had a positive association with ADL score （r = 0.235, P 〈 0.01） and a negative association with Morse fall scale score （r = 0.238, P 〈 0.01）. Patients with deficient vitamin D level had longer time both in the Five Time Sit to Stand Test （5tSTS）, （15.765 ± 5.593） and the four-meter walk test [7.440 （5.620, 9.200）], a weaker hand-grip in the grip strength test （28.049 ± 9.522）, and a lower Tinetti performance-oriented mobility assessment （Tinetti POMA） [26 （22, 27）] and Balance subscale of the Tinetti performance-oriented mobility assessment （B-POMA） score [ 14 （12, 16）], compared with appropriate vitamin D level [（13.275 ± 3.692）; 5.810 （4.728, 7.325）]; （31.989 ± 10.217）; [26.5 （25, 28）]; [15 （14, 16）, respectively, all P 〈 0.05]. Furthermore, results of logistic regression indicated that vitamin D was significantly associated with 5tSTS （OR = 1.2, 95% CI = 1.050-1.331, P 〈 0.01）, Tinetti POMA （OR = 3.7, 95% CI：1.284-10.830, P 〈 0.05） and B-POMA （OR = 0.8, 95% CI：0.643-0.973, P 〈 0.05）. Conclusions In elderly hypertensive patients, serum vitamin D deficient level is associated with physical performance impairment. However, no statistical significance was found between vitamin D and geriatric syndromes. Further study is required to investigate possible mechanisms for the association between vitamin D and physical performance.

Heterogeneous genetic architecture by gender for precision medicine of cardiovascular disease

It is well-known that gender differences exist in the onset, progression, and prognosis of cardiovascular diseases （CVDs）, and that risk factors such as high blood pressure and lipid profiles vary between men and women, Cur- rently, sex differences are stressed as important variables to take into account when examining the etiology of CVD. Genome-wide association studies of CVD have employed the sex as a covariate in their analytical models, but generally disregarded potential genetic heterogeneity （GHS） attributable to sex.