Anti-inflammatory effects of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: potential benefits for the prevention of atrial fibrillation: reply

We thank Drs Liu and Li for their interest in our randomizedtrial investigating the anti-arrhythmic effect of perindopriland losartan in the setting of lone paroxysmal atrial fibrillation(AF). While agreeing on modification of atrial remodelling asthe     

TGF-β1、Smad 3和P-Smad 2/3在病理性瘢痕中的表达

目的检测瘢痕疙瘩、增生性瘢痕和正常皮肤组织中转化生长因子-β1(TGF-β1)、Smad3和P-Smad2/3的表达情况,探讨上述细胞因子对瘢痕产生的重要性及影响。方法采用免疫组织化学的方法检测上述3种细胞因子在3种不同组织共36例标本中的表达,ImagePro-Plus6.0软件进行阳性面积测量和细胞计数。结果TGF-β1在瘢痕疙瘩和增生性瘢痕中均为增强高表达,而在正常皮肤中几乎不表达;Smad3在三组标本间表达水平无显著性差异;P-Smad2/3在瘢痕疙瘩中表达最强,增生性瘢痕次之,正常皮肤组织中最低。结论TGF-β1表达增强是病理性瘢痕产生的重要原因,P-Smad2/3的表达水平则可认为与瘢痕增生程度密切相关。     

促进医疗惠民构建和谐社会——绍兴市惠民医院工作纪实

做好医疗惠民工作是一项民主工程,对于减轻低保特困人群的医疗负担,构建和谐社会具有重要意义。文章对近2年绍兴市惠民医院的管理实践工作进行总结,作为继续完善这方面工作的参考。     

Effects of hypertension and type 2 diabetes mellitus on the risk of total cardiovascular events in Japanese patients with hypercholesterolemia: implications from the Japan Lipid Intervention Trial (J-LIT).

Hyperlipidemia, hypertension, and diabetes mellitus (DM) are well-established risk factors for cardiovascular disease. We analyzed the cardiovascular events in hyperlipidemic patients with or without DM who were administered open-labeled simvastatin in groups stratified by blood pressure level using data from the Japan Lipid Intervention Trial (J-LIT). Hyperlipidemic patients with DM (n=6,288) had significantly more cardiovascular events than those without DM (n=33,933). The incidence rates of total cardiovascular events in the Non-DM and DM groups were 15.40 and 25.76 per 1,000 patients for the 6-year period, respectively. The relative risk of total cardiovascular events in the DM vs. the Non-DM group was 1.68, and the relative risk was significantly higher in the DM than in the Non-DM group. The relative risks of total cardiovascular events were significantly higher in DM and Non-DM patients whose systolic blood pressure (SBP) was greater than or equal to 130 mmHg compared to that of Non-DM patients whose SBP was less than 130 mmHg, and in DM and Non-DM patients whose diastolic blood pressure (DBP) was greater than or equal to 80 mmHg compared to that of Non-DM patients whose DBP was less than 80 mmHg. In all groups stratified by SBP and DBP, relative risks of total cardiovascular events were higher in DM patients than in Non-DM patients. For patients with hypercholesterolemia and DM, blood pressure should be strictly controlled in order to prevent both coronary events and stroke. These results are in good agreement with the JNC 7 and the ESH/ESC guidelines for DM patients, which recommended that the SBP and DBP be less than 130 and 80 mmHg, respectively.     

Extracellular matrix remodeling in oral submucous fibrosis: its stage-specific modes revealed by immunohistochemistry and in situ hybridization

BACKGROUND: Oral submucous fibrosis (OSF) is a chewing habit-related pre-cancerous condition of the oral mucosa affecting predominantly south Asians. It is histopathologically characterized by epithelial atrophy and fibrosis of the subepithelial connective tissue. Fibrosis extends all the way into the muscle layer, leading to difficulty in mouth opening. However, the dynamics of extracellular matrix (ECM) remodeling with OSF progression is largely unknown. METHODS: Forty biopsy specimens of OSF and 10 of normal buccal mucosa were examined for expression/deposition modes of eight ECM molecules by histochemistry, immunohistochemistry, and in situ hybridization. RESULTS: In the early stage of OSF, tenascin, perlecan, fibronectin, collagen type III were characteristically enhanced in the lamina propria and the submucosal layer. In the intermediate stage, the ECM molecules mentioned above and elastin were extensively and irregularly deposited around muscle fibers. In the advanced stage, such ECM depositions decreased and were entirely replaced with collagen type I only. Their gene expression levels varied with progression of fibrosis, but the mRNA signals were confirmed in fibroblasts in the submucosal fibrotic areas. CONCLUSIONS: The results indicate that the ECM remodeling steps in OSF are similar to each phase of usual granulation tissue formation. Restricted mouth opening may be a result of loss of variety of ECM molecules including elastin into the homogeneity of collagen type I replacing muscle fibers.     

消渴病的中医护理

消渴病是临床常见病、多发病。根据《内经》“不治已病治未病……不治已乱治未乱”的思想，预防和治疗消渴病对保证人们的身心健康有重要意义。     

综合疗法治疗乳腺增生62例

我科于2005年6月～2006年12月用乳癖消结合逍遥丸内服、耳穴埋压治疗乳腺增生62例，获得满意疗效，现介绍如下。     

湿润烧伤膏治疗褥疮26例的临床体会

目的:进一步观察湿润烧伤膏对治疗褥疮的疗效,寻找最理想的治疗方法。方法:通过对26 例不同原因所致褥疮的治疗,探索湿润烧伤膏对治疗褥疮病人最合理的用药方法,创面的变化及其愈合时间。结果:25例病人创面愈合,死亡1例。结论:湿润烧伤膏治疗褥疮方法简便,实用性强,疗效显著,值得各级医院推广。     

特异性荧光偏振免疫法监测521例肾移植后环孢素A全血浓度3275次

目的通过监测肾移植后病人环孢素A(CsA)全血浓度 ,提出CsA在三联免疫抑制用药方案中的理想治疗窗。方法用特异性荧光偏振免疫法测定CsA全血浓度 ,对521例病人监测3275次 ,按术后时间及临床表现分组比较。结果肾移植后<1 ,、1～3、3～6、6～12个月、1～2和>2年的CsA全血谷浓度的理想治疗窗应分别为250～450、200～400、150～300、100～250、100～200和100～180μg/L。结论CsA全血浓度在上述范围内 ,中毒反应和排异反应明显减少