Objective To investigate the influence of trimetazidine combined with atorvastatin on heart func-tion and the BNP level in patients with cornary heart failure.Methods The clinical data of 400 patients with cornary heart disease were retrospectively analyzed.194 patients in the control group were treated with conventional treatment, 206 patients in the observation group were treated with trimetazidine combined with atorvastatin on the basis of the control group.The treatment effect,cardiac function and BNP level were observed and compared.Results The effec-tive rate of the observation group was 91.26%,which was significantly higer than 76.29% of the control group (χ2 =16.667,P <0.05).After treatment,the cardiac index,stroke volume,cardiac output,left ventricular ejection fraction and BNP level of the two groups were significantly higher than before treatment,and those in the observation group were significantly higher than the control group(t =2.505,2.851,3.308,3.452,all P <0.05).Conclusion Trime-tazidine combined with atorvastatin in treatment of cornary heart failure has good curative effect,it can reduce the serum level of BNP,improve cardiac function significantly,which is of great value for clinical use.

Objective:To detect and analyze the membrane estrogen receptor(mER)in primary cultured interstitial cells of Cajal(ICC).Methods:Interstitial Cells of Cajal(ICC)'s surface binding sites for 17-?estradiol(E2)were detected by cell-impermeant ligand using confocal microscopy.Radioligand binding assay and Scatchard software were used to analyzed the characteristics of mER.Results:Immunofluorescence shows the staining pattern of nonfixed,nonpermeabilized ICC incubated with E2BSAFITC.The radioligand binding assay were analyzed by Scatchard software,The Bmax of mER was 45.75 fmol/mg protein and the kD was 0.717 3 nmol/L.Conclusion:A form of the estrogen receptor is present within the cell membrane of ICC and maybe capable of mediating rapid effect of estrogen.

Owing to the advanced age,limb hemiplegia,dehydration,and vessel wall injury,stroke may be easy to cause venous thromboembolism (VTE).VTE mainly include deep vein thrombosis (DVT) and pulmonary embolism (PE).DVT refers to abnormal blood clotting in the veins and impedes venous return.The dislodgement of emboli from the vessel wall can form a thrombotic embolism,and cause PE,myocardial infarction,and stroke; it can not only prolong hospitalization,but also increase the mortality.This article reviews the incidence,risk factors,treatment,and prevention of DVT after a stroke.

Objective To explore the distribution and characterization of class 1 integrons in E.coli from healthy feces,and to elucidate the status of gene-cassettes.Methods Routine method was used to isolate E.coli,antibiotics susceptibility was tested by the disk diffusion method;class 1 integron was detected by PCR assay;PCR products were sequenced and analyzed.Results Of 97 samples,76 isolates were identified,and 25 isolates were multiple-drug resistant.The antibiogram was sulfamethoxazole-trimethoprim,ampicillin,streptomycin,tetracycline,erythromycin.14 of 25 isolates carried class 1 integrons,and the size of integrons differed from 1 800 bp(10 strains) to 750 bp(4 strains).The sequenced PCR product demonstrated that the 1 800 bp integron laboured aadA1-dfrA14-orf gene cassette conferred the resistance to sulfamethoxazole-timethoprim,streptomycin and aminoglycoside;the 750 bp integron laboured dfrA14 gene cassette conferred the resistance to sulfamethoxazole-trimethoprim.Conclusion The different kinds of class 1 integrons exist in E.coli from the healthy students,and determine the multiple-resistant antibiotics.

With the full coverage of China 's basic medical insurance, medical costs showed a rapid growth trend. It is becoming more and more important to control the cost of medical treatment. Strengthening the control of medical insurance providers is the experience of international health insurance management and an important direction of China's basic medical insurance system reform. Many areas explore the reform of basic medical insurance payment actively and accumulated a lot of typical experience. When exploring the reform of basic medical insurance payment, the practical experience proposes that we should avoid the shortcomings of the post-payment system and prospective payment system, and push a combination of a variety of payment methods such as the capitation, the Pay per bed day, the DRGs etc. , and the promotion of comprehensive reform of public hospitals to establish a classification diag-nosis and treatment.

The human gastrointestinal tract is colonized by complex and diverse microbiota which maintains an ecological balance under normal circumstances.Short bowel syndrome causes damage to the normal flora which predisposes the patient to colonic dysbacteriosis and small intestine bacterial overgrowth.Small intestine bacterial overgrowth may lead to digestive and absoptive disfunctions, mucosal inflammation, and may delay or prevent weaning from total parenteral nutrition.Moreover, small intestine bacterial overgrowth may be one of the causes of intestinal failure-associated liver disease, and eventually lead to various body dysfunctions.In this review, the bacterial translocation in short bowel syndrome were summarized, providing the theoretic proofs to treatment and prevention.

Extranodal natural killer (NK)/T-cell lymphoma, nasal type (ENKL) is an uncommon subtype of non-Hodgkin's lymphoma, which is aggressive and has poor prognosis. ENKL occurs predominantly in the nasal cavity and less frequently in the skin and in the gastrointestinal tract. The pathology of this disease is characterized by vascular invasion and destruction. ENKL is strongly associated with the Epstein–Barr virus, which aids in the diagnosis of ENKL. The characteristic markers on the surface of an NK/T cell and the spe-cific genetic variations are also useful in the diagnosis. At present, the treatment of ENKL is still under discussion. Although radiothera-py combined with chemotherapy on patients with early-stage ENKL and L-ASP-based chemotherapy and hematopoietic stem cell trans-plant on patients with advance-stage ENKL have achieved favorable effects, further studies are still necessary to develop the principles and methods of a standardized treatment.

Thailand established the first medical care scheme in 1975 until set up 30 Baht Scheme in 2001,which achieved the universal coverage through 26 years,which China could learn some experiences from Thailand's universal coverage.Firstly,it needed to split health services purchaser from health services provider.Secondly,changing the fee for service to multi-way for payment mechanism.Thirdly,establishing the system of gatekeeper.Lastly,encouraging independent research institutions to provide technical support to health insurance system.

Microglia, the main innate immune cells in the central nervous system, takes part in lots of physiological and pathological processes in the brain.It not only maintains brain homeostasis but also participates in the process of brain injury and repair under pathological conditions.In developmental brain, microglial synaptic pruning may eliminate weaker synapses and retain stronger synapses.Synaptic pruning also plays a vital role in mediating the formation of neural circuit under physiological condition, contributes to cell and myelin debris clearance, promotes maturation of oligodendrocytes, which surround the bare axon to form myelin sheath, and helps the regeneration of neurons and synapses.Recently, increasing number of studies on microglial synaptic pruning has advanced our understanding of the underlying mechanism for synaptic pruning and its relevant physiological functions.Here, we reviewed microglial synaptic pruning function and its potential regulatory mechanisms in brain under physiological and pathological conditions.

Objective To investigate the effect of atorvastatin combined with alendronate in the treatment of senile osteoporosis.Methods One hundred and sixty cases patients with osteoporosis were randomly divided into control group and study group,each group had 80 cases.Control group were received alendronate sodium tablets 70 mg weekly,alfacalcidol soft capsules,2 tablets daily,calcium carbonate tablets D 3,2 tablets daily.Study group received atorvastatin calcium 1 tablet daily based on control group.Twenty weeks were a course.Biochemical indicators(collagen amino terminal peptide(NTX),25-hydroxyitamin D,alkaline phosphatase(ALP),bone growth protein(BGP),parathyroid hormone(PTH),collagen type Ⅰ carboxyl terminal peptide(CTX) level),inflammatory factors(TNF α,IL-6) and visual analogue scale(VAS),bone mineral density(BMD) were compared between two groups.Results After treatment,VAS scores in both groups decreased significantly,while,VAS in study group((1.8±0.4) points) was significantly lower than that in control group((2.6±0.7) points,t=8.87,P<0.05).BMD in different parts in both groups increased significantly,while BMD in different parts in study group(femoral neck:(0.90±0.08) g/cm3,lumbar vertebra:(0.98±0.04) g/cm3,oblique eminence of cuboid bone:(0.79±0.04) g/cm3,femur:(0.98±0.07) g/cm3) were significantly higher than that in control group(femoral neck:(0.82±0.09) g/cm3,lumbar vertebra:(0.92±0.06) g/cm3,oblique eminence of cuboid bone:(0.72±0.05) g/cm3,femur:(0.90±0.06) g/cm3,t=5.94,7.44,9.78,7.76,P<0.05).NTX,PTH,CTX in both groups decreased significantly,while,NTX((10.3±2.8) nmlo/L),PTH((4.4±1.1) μg/L),CTX((0.3±0.1) μg/L) in study group was significantly lower than that in control group(NTX:(13.2±3.6) nmlo/L,PTH:(4.9±1.3) μg/L,CTX:(0.4±0.1) μg/L,t=5.69,2.63,6.32,P<0.05).And 25-hydroxy-vitamin D,ALP,BGP in both groups increased significantly,while 25-hydroxy-vitamin D in study group((20.4±3.7) ng/mL) was significantly higher than that in control group((18.6±3.5) μg/L).TNF-α,IL-6 in both groups decreased significantly(before treatment:TNF-α,IL-6 in study group were (9.0±2.3) μg/L,(167.2±55.6) μg/L,in control group were (8.9±2.5) μg/L,(162.5±68.4) μg/L),while,TNF-α,IL-6 in study group was significantly lower than that in control group((3.7±1.2) μg/L vs.(5.6±1.5) μg/L,(69.8±16.7) μg/L vs.(118.4±32.4) μg/L,(9.0±2.3) μg/L vs.(8.9±2.5) μg/L,t=8.85,11.93,P<0.05).Conclusion Atorvastatin combined with alendronate sodium can effectively improve BMD in OP patients,relieve pain and improve clinical symptoms.