Objective To study the Effect of Losartan on QT Interval dispersion of the Essential Hypertension Patients Methods Of 96 hypertension cases classified the left ventricular hypertrophy(LVH) group(64 cases) and Non left ventricular hypertrophy(non LVH) group(32 cases) according to echocardiogram 40 cases were chosen at random and received routine anti hypertension treatment,while the other 56 cases were treated with Losartan on the basis of the routine anti hypertension treatment In contrast to 30 healthy control persons,all the persons were examined QTd and QTlcd before and 6 months after treatment Results 1 The QTd in hypertension with left ventricular hypertrophy is remarkably longer than that of non left ventricular hypertrophy and healthy person;2 Left ventricular hypertrophy was reversed and QTd was decreased remarkably after treatment 6 months with Losartan Conclusions Left ventricular hypertrophy in hypertension is related to QTd prologing;Losartan can reverse left ventricular hypertrophy and diminish the QTd in hypertension significantly,and then decrease the incidence of cardiovascular affairs
Cardiovascular diseases (CVDs) are the leading cause of death in China. Conventional diagnostic methods are dependent on advanced instruments, which are expensive, inaccessible, and inconvenient in underdeveloped areas. To build a novel dried blood spot (DBS) detection strategy for imaging CVDs, in this study, a total of 12 compounds, including seven amino acids [homocysteine (Hcy), isoleucine (Ile), leucine (Leu), valine (Val), phenylalanine (Phe), tyrosine (Tyr), and tryptophan (Trp)], three amino acid derivatives [choline, betaine, and trimethylamine N-oxide (TMAO)], L-carnitine, and creatinine, were screened for their ability to identify CVD. A rapid and reliable method was established for the quantitative analysis of the 12 compounds in DBS. A total of 526 CVD patients and 200 healthy volunteers in five provinces of China were recruited and divided into the following groups: stroke, coronary heart disease, diabetes, and high blood pressure. The orthogonal projection to latent structures-discriminant analysis (OPLSDA) model was used to characterize the difference between each CVD group. Marked differences between the groups based on the OPLSDA model were observed. Based on the model, the patients in the three training sets were mostly accurately categorized into the appropriate group. In addition, the receiver operating characteristic (ROC) curves and logistic regression of each metabolite chosen by the OPLSDA model had an excellent predictive value in both the test and validation groups. DBS detection of 12 biomarkers was sensitive and powerful for characterizing different types of CVD. Such differentiation may reduce unnecessary invasive coronary angiography, enhance predictive value, and complement current diagnostic methods.
Objective To evaluate and select essential medicine for acute cholecystitis using evidence-based methods based on the burden of disease.Methods By means of the approaches,criteria,and workflow set up in the second article of this series,we referred to the recommendations of evidence-based or authority guidelines from inside and outside China,collected relevant evidence from domestic clinical studies,and recommended essential medicine based on evidence-based evaluation.Data were analyzed by Review Manager(RevMan) 5.1 and GRADE profiler 3.6 to evaluate quality of evidence.Results (1) Three guidelines were included(two foreign guidelines,one domestic guideline;two based on evidence,one based on expert consensus).(2) Results of two RCTs(n=200,low quality) and two CCTs(n=230,low quality) indicated efficiencies of ampicillin/sulbactam,piperacillin/tazobactam,ciprofloxacin combined with metronidazole,and ceftazidime combined with metronidazole were 92.5%,92.6%,92.5% and 91.3%.A result of three RCTs(n=661,low quality) indicated that lavofloxacin had efficiencies of 82.2% to 95.8% which were 84.4% to 94.7% when combined with metronidazole.A result of three RCTs(n=553,low quality) indicated that for acute cholecystitis,ceftriaxone had an efficiency of 90.0%,cefuroxime 73.7% and cefoperazone/sulbactam 95.6%(Efficiency: ceftriaxone 93.3%,cefuroxime 82.5% and cefoperazone/sulbactam 92.3%,when combined with metronidazole).A result of one RCT(n=72,low quality) indicated that cephazoline had an efficiency of 70.9% with bacteria resistance rates of 70% for G+ and 87% for G.Conclusion (1) We offer a strong recommendation for piperacillin/tazobactam and cefoperazone/sulbactam used in the treatment of acute cholecystitis(mild,moderate and severe).We offer a strong recommendation for meropenem,imipenem/cilastatin and metronidazole as alternatives for severe acute cholecystitis.(2) We offer a weak recommendation for ceftazidime and cefepime used in the treatment of severe acute cholecystitis and a weak recommendation for cefotiam,ampicillin/sulbactam and cefuroxime used in the treatment of acute cholecystitis(mild and moderate).We offer a weak recommendation for lavofloxacin and ciprofloxacin used in the treatment of acute cholecystitis(mild and severe) and a weak recommendation for ceftriaxone used in the treatment of acute cholecystitis(mild,moderate and severe).(3) We make a recommendation against cephazoline as routine use.(4) More large-scale,multi-center,double-blinded RCTs are needed in clinical and pharmacoeconomic studies of acute cholecystitis and outcome indicator should be improved in order to produce high-quality local evidence.
An integrated hydrological, ecological, and economical model (HEE) was developed at basin scale to evaluate the interactions among resources, agriculture, and rural development. Hydrological module in the integrated model was adapted from SWAT, the Soil and Water Assessment Tool, to simulate the water balance in terms of soil moisture, evapotranspiration, streamflow, and groundwater table change. Ecological module was integrated into the hydrological module to compute the ecosystem production of biomass and yield for different land use types. Economical module estimated the monetary values of crop yield and other ecosystem services. The model was implemented in a holistic approach, and able to produce simulation results at daily time steps with a spatial resolution of hydrological response unit (HRU). The integrated model was calibrated by data for the period of 1983-1991, and run for the period of 1986-1995 with the calibrated parameters for the upper and middle parts of the Yellow River basin, a semi-arid area in northwest China. The average efficiency of the model in simulating monthly streamflow was 0.63 during the calibration period, which indicated an acceptable calibration. Preliminary simulation results revealed that water use in the study area had largely reduced the streamflow in many parts of the area except for that in the riverhead. Spatial distribution of biomass, crop yield, and water productivity showed a strong impact of irrigation on agricultural production. In general, the simulation results from this study indicated that the model was capable of tracking the temporal and spatial variability of pertinent water balance variables, ecosystem dynamics, and regional economy, and provided a useful simulation tool in evaluating long-term water resources management strategies basin scale.
Objective To understand the relative factors of infantile cytomegalovirus hepatitis.Methods Two hundred and fifteen cases of infantile cytomegalovirus hepatitis and their parents were investigated by self-designed questionnaire.The data investigated included the age(1-3 months and 4-12 months),sex(male and female),residence(urban and rural),parents' level of education(junior high school and below,high school and above),and mothers' status of human cytomegalovirus infection.Human cytomegalovirus DNA levels in infants and their mothers' milk were detected by FQ-PCR.The relative factors influencing infantile cytomegalovirus hepatitis were analyzed by logistic regression analysis.Results The detection of human cytomegalovirus DNA in mothers' milk was positive in 161 cases(74.9%) and negative in 54 cases(25.1%).The among detection of human cytomegalovirus DNA in infant urine was positive in 118 cases(73.3%) and positive in 25 cases(46.3%).There was statistically significart difference in urinary human cytomegalovirus-DNA positive rate(P0.05).Logistic regression analysis showed that infant age,residence,parents' level of education,and mothers' status of human cytomegalovirus infection affected the occurrence of infantile cytomegalovirus hepatitis.Conclusion Improving living conditions,raising quality of the parents,and pre-pregnancy diagnosis and treatment as early as possible are the effective measures to reduce the incidence of infantile cytomegalovirus hepatitis.
Objective To evaluate and select essential medicine for acute exacerbation of chronic bronchitis(AECB) using evidence-based methods based on the burden of disease.Methods By means of the approaches,criteria,and workflow set up in the second article of this series,we referred to the recommendations of evidence-based or authority guidelines from inside and outside China,collected relevant evidence from domestic clinical studies,and recommended essential medicine based on evidence-based evaluation.Data were analyzed by Review Manager(RevMan) 5.1 and GRADE profiler 3.6 to evaluate quality of evidence.Results (1) Five guidelines were included(four foreign guidelines,one domestic guideline;three based on evidence,two based on expert consensus).(2) Medicines recommended at least twice by the National Essential Medicine List(NEML,2009 version) and Chinese National Formulary(CNF) contained: ipratropium bromide(four times),amoxicillin clavulanate potassium(three times),and corticosteroid(three times),cefuroxime(twice),ciprofloxacin(twice),levofloxacin(twice),salbutamol(twice) and dextromethorphan(twice).(3) As for domestic study evidence,a result of one RCT indicated that amoxicillin clavulanate potassium had efficiencies of 92.3% to 94.7%(n=77,low quality).A result of three RCTs(n=275,low quality) indicated that cefuroxime had efficiencies of 67.6% to 90% and an incidence of 5% as to adverse reaction that mainly included skin rashes,diarrhea,etc.A result of two RCTs(n=120,low quality) indicated that ciprofloxacin had efficiencies of 78.3% to 86.6%,bacterial clearance rates of 72.7% to 86.5% and the incidences of 8.7% to 16.2% as to adverse reaction that mainly included gastrointestinal reaction,skin rashes,etc.A result of seven RCTs(n=523,low quality) indicated that levofloxacin had efficiencies of 72.5% to 94.5%,bacterial clearance rates of 82.1% to 95.8% and the incidences of 5% to 7.5% as to adverse reaction.A result of two RCTs(n=239,low quality) indicated that salbutamol had efficiencies of 85.4% to 96.7%.A result of one RCT(n=95,low quality) indicated that ipratropium bromide had efficiencies of 98%.A result of five RCTs(n=466,low quality) indicated that the combined use of budesonide and bronchodilators had efficiencies of 93.4% to 97.8%.Conclusion (1) We offer a strong recommendation for cefuroxime,amoxicillin clavulanate potassium,ciprofloxacin and levofloxacin used in the treatment of AECB.(2) We offer a strong recommendation for glucocorticoid(budesonide,aerosol) and anticholinergic bronchodilator(ipratropium bromide) and a weak recommendation for short-acting β2-agonist bronchodilator(salbutamol) and antitussive agent(dextromethorphan) for alleviating symptoms due to AECB.(3) We make a recommendation against mucolytic agents and theophylline as routine use.(4) More large-scale,multi-center,double-blinded RCTs are needed in clinical and pharmacoeconomic studies on AECB and outcome indicator should be improved in order to produce high-quality local evidence.
Abstract Objectives To assess the efficacy and safety of focused ultrasound therapy (FU) and microwave therapy (MW) for cervical ectopy (CE). Methods We searched PubMed, EMbase, the Cochrane Library, Chinese Biomedical Literature Database (CBM), Chinese Scientific Journals Database (VIP), China Academic Journals Full‐text Database (CNKI), and WanFang Data for randomized controlled trials (RCTs) comparing FU with MW for women with symptomatic CE from inception to 30 August 2014. Two review authors (Tang XL and Gao Z) independently screened for eligible studies according to the inclusion and exclusion criteria, extracted data and assessed risk of bias of included RCTs. Then, meta‐analysis was performed using the RevMan 5.2 software. Funnel plots were used to evaluate publication bias. Results A total of 33 RCTs with 11,759 participants were included. All studies had high risk of bias. The results of meta‐analysis indicated that compared to MW, FU significantly reduced the risk of vaginal bleeding (RR = 0.09, 95%CI 0.05 to 0.17, P < 0.00001) and vaginal discharge (RR = 0.10, 95%CI 0.04 to 0.24, P < 0.00001), increased the cure rate (RR = 1.10, 95%CI 1.05 to 1.15, P < 0.0001) and the total effectiveness rate (RR = 1.04, 95%CI 1.02 to 1.06, P = 0.0005), and decreased the recurrence rate (RR = 0.13, 95%CI 0.02 to 1.00, P = 0.05); however, this last difference was not statistically significant. Conclusion Current available evidence suggests that FU is safer and more effective than MW for treating CE. However, some limitations will reduce the reliability of our results. Further well‐designed clinical trials are needed to provide further clarification.
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