Background and Aim Morbidity due to hypertension morbidity is increasing in the Chinese population, and the blood pressure control rate is low. The aim of this trial is to optimize the hypertension treatment plan, promote blood pressure goals and reduce cardio-cerebrovascular events. Objective and Methods Patients are eligible for inclusion if they are diagnosed with essential hypertension, aged 50-79 years with at least one cardiovascular risk factor and sign the consent forms. This project is a multi-centre, randomized, controlled and blind-endpoint trial. 12 000 patients will be randomly assigned to low-dose Amlodipine and Telmisartan or Amlodipine and diuretics. Patients whose blood cholesterol is between 4.0-6.1mmol/L will also be randomized into small dose of statin-based regimen or standard management regimen; and patients will be randomly assigned to intensive lifestyle intervention group or standard intervention group according to the community area where they live. The primary study outcome is a composite of non-fatal stroke/myocardial infarction and cardiovascular death. Patients will be followed-up for 4 years. Expected Results The cumulative primary outcome is estimated to be 500 cases, and the hypertension control rate is expected to reach 70%. Cardiovascular events are expected to be reduced by 20% in the optimized treatment group and poor lifestyle will be markedly improved. A total of 150 clinical centres in China will join in the study, which will be completed at the end of 2011.
ObjectiveTo explore the surgical method and effectiveness of the great toenail bed flap supplied with the fibular dorsal artery of great toe in repair of the finger nail bed central longitudinal defect.MethodsBetween May 2012 and February 2017, 7 cases (7 fingers) with the finger nail bed central longitudinal defects were repaired with the great toenail bed flap supplied with the fibular dorsal artery of great toe. There were 3 males and 4 females; the age ranged from 17 to 35 years (mean, 27 years). The cause of injury included cutting injury in 2 cases, electric shaving injury in 3 cases, and frictional injury in 2 cases. The defect located at thumb in 3 cases, index finger in 3 cases, and middle finger in 1 case. The defect area ranged from 12 mm×8 mm to 21 mm×13 mm. The time from injury to admission was 1-2 hours (mean, 1.5 hours). The area of the great toenail bed flap ranged from 14 mm×10 mm to 23 mm×15 mm. The wound of donor site was directly sutured in 3 cases and repaired with full thickness skin graft in 4 cases.ResultsAll the great toenail bed flaps and skin grafts at the donor sites survived; and all wounds healed by first intention. All patients were followed up 9 to 36 months (mean, 23 months). The finger nails were smooth and shiny and recovered ideal appearance. At 9 months after operation, the two-point discrimination of the skin ranged from 7 to 9 mm (mean, 8 mm). According to the standard evaluation for nail bed repair issued by Zook etc., 6 cases were rated as excellent and 1 case as good, and the excellent and good rate was 100%.ConclusionIt is an ideal method to repair the finger nail bed central longitudinal defect with the great toenail bed flap supplied with the fibular dorsal artery of the great toe.