Blood pressure lowering efficacy of telmisartan and amlodipine taking on the morning or at bedtime: ABPM results / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the blood lowering effect of telmisartan and amlodipine taking on the morning or at bedtime in hypertensive patients.</p><p><b>METHODS</b>A total of 108 individuals with hypertension (grade 2 or above) were randomized to receive telmisartan and amlodipine in one of the following four therapeutic schemes: Group A (26 cases): both medications taken on the morning; Group B (28 cases): both medication taken at bedtime; Group C (27 cases): telmisartan on the morning and amlodipine at bedtime; or Group D (27 cases): amlodipine on the morning and telmisartan at bedtime. ABPM was performed before and after 8 weeks treatment.</p><p><b>RESULTS</b>BP was significantly reduced in 4 groups and the value of 24 hours SBP/DBP decline for each group after treatment was 29.94/16.32, 31.37/18.35, 29.49/17.30 and 25.80/15.51 mm Hg (1 mm Hg = 0.133 kPa) respectively (P < 0.05 vs. baseline). SI (smooth index) of 24 hours SBP/DBP was 1.79/1.34, 2.07/1.54, 1.70/1.43 and 1.55/1.32 respectively (P > 0.05). The night-time BP decline and the distributive difference of dipper, non-dipper, extreme dipper and reverse dipper pattern were similar among groups at both baseline and after various treatment regimens (all P > 0.05) . Morning blood pressure surge (MBPS) after treatment in group B declined more significantly than other groups (P < 0.05).</p><p><b>CONCLUSION</b>Telmisartan/amlodipine administered either on the morning or at bedtime can effectively reduce blood pressure. The efficacy of BP lowering is independent of the drug taking time. There is a trend both in better BP lowering and less BP variability when two medications are administered at bedtime.</p>

3D Simulation of New Sacroliliac Internal Fixation System and Comparing Evaluation / 医用生物力学

Objective Creating a 3D finite element model of a full pelvis with sacroiliac joint fracture. Comparing the biomechanical properties of the model where the fracture part was fixated by using a new sacroliliac anatomy type Bar-plate internal fixation system to iliosacral screw fixation and front reconstruction plate fixation. Methods A specially designed biomechanical semi-automatic mesh generator was employed to generate the complete pelvis finite element model from CT datas. Then, one side of sacroiliac joint related ligaments was deleted to simulate the case of sacroiliac joint fracture. Using a new sacroliliac bar-plate internal fixation system with anatomic plate (SABP) to fix the fracture part, and the comparing models using iliosacral screw fixation (SS) and front reconstruction plate fixation (SP) were also generated. Finally, all models were simulated under same loading conditions. Results Using SABP fixation, the maximal displayment of the sacroiliac joint decreases about 40% and 42% compared to SS fixation and SP fixation, respectively. The minimal value of maximal stress for main loading transfer regions was reached by SABP fixation and t he maximal stress of SABP decreases about 33%-70% compares to SS in regions of fracture hip cortical bone and cartilages bone, and decreases about 60%-75% to SP in regions of sacral cortical bone and fracture hip cortical bone. Conclusion The new sacroliliac anatomy type Bar-plate internal fixation system has better biomechanical properties than other internal fixations, and deserves to be put into clinical application.