Objective To evaluate the feasibility of the joint method containing salvia tetramethylpyrazine,trimetazidine,alprostadil in the treatment of unstable angina.Methods 70 unstable angina patients met the inclusion criteria were randomly divided into the observation group of 35 cases and the control group of 35 cases.The control group was given trimetazidine 20mg,tid,and alprostadil 100mg,1 qd.The observation group were given salvia tetramethylpyrazine 10ml on the basis of the control group,qd.Two groups were treated for 14d.The frequency and duration of angina attack was observed.The ECG was monitored.Clinical efficacy differences was compared before and after treatment.Results The total effective rate of the observation group was 100％.The effective rate were 86％.The control group were respectively 91％ and 60％.The total effective rate of observation group was significantly higher than the control group(x2 =6.838,P ＜ 0.05).The effective rate of observation group was significantly higher than the control group (x2 =5.851,P ＜ 0.0 5).The angina frequency,angina duration,stroke output quantity (SV),eiectionfraction(EF) of the observation group and the control group after treatment improved significantly than before treatment,after the treatment the angina frequency,angina duration,stroke output quantity (SV),ejection fraction (EF) of the observation group and the control group were respectively (2.69 ± 0.46) time/min vs (6.46 ± 0.62) time/min,(3.26 ± 0.32) min vs (5.54 ± 0.42) min,(49.7 ± 3.4) ml vs (43.2 ± 2.8) ml,(69.2 ± 5.9) ％ vs (55.3 ±4.8) ％,the angina frequency,angina duration of the observation group was significantly lower than the control group,and the stroke output quantity(SV),ejection fraction(EF) of the observation group were significantly higher than the control group(all P ＜ 0.05).Condusion The joint method containing salvia tetramethylpyrazine,trimetazidine,alprostadil have exact clinical efficacy,reduce the time of angina attack frequency and duration,effectively improve myocardial blood supply,improve heart function,which is worthy of clinical use.

Objective To discuss the surgery procedure and treatment effect of reconstruction of the soft tissue of the thumb/finger defects by the second toe tibial toe pulp skin flap. Methods Ten patients with the soft tissue of pulp of the thumb/finger defects were treat by the same side of the second toe tibial toe pulp skin flap, all the patients have the soft tissue defect of finger pulp with exposed phalanx. Crush them in 4 cases, the machine cut wound in 6 cases. A fixed 2 cases, delayed operation 3-7d after injury to repair in 8 patients. The side of skin flap varied from 2.0 cm × 2.2 cm to 2.0 cm × 3.5 cm. Results Ten fingers in 10 cases all survived. Necrosis in edge part of the shin graft occurred in 2 cases, which was healed through changing of dressing. All cases were followed form 4 months to 16 months. The blood-supply, texture and elasticity of transferred flaps and the shape of fingers pulp were excellent. Good function recovery of the fingers was achieved. Pain and temperature sence were regained. Two point discrimination of the finger pulp was 5-9 mm.Primary healing occurred in all cases. It did not disturb dressing shoes and walking. Conclusion It is a reliable approach for soft-tissue coverage of the thumb/finger using the second toe tibial toe pulp skin flap based on distal perforators of digital artery or ulnar artery. The advantages include simply procedures, reliable blood supply without sacrificing main aneries and possibilities of sensoly recovery.

Objective:To investigate the effect of early selective reduction of twin pregnancies or spontaneous reduction on the improvement of clinical outcome in IVF-ET treatment.Methods:The clinical data of 6535 cycles(6535 cases)of single or twin pregnancy obtained from fresh and frozen-thawed embryo transfer(FET)of IVF or ICSI-ET in the Department of Reproductive Medicine,Women and Children's Hospital Affiliated to Xiamen Univer-sity from November 2011 to December2021 were analyzed retrospectively,The propensity score matching(PSM)method(1∶4)was used to include the study subjects.The surgical reduction group and the spontaneous single-ton group were included in 128 cycles and 510 cycles,respectively.The spontaneous reduction group and the ini-tial singleton group were included in 511 cycles and 2038 cycles,respectively.The pregnancy outcomes of each groups were compared.Results:After PSM,the number of transferred embryos in the surgical and spontaneous reduction group was higher than that in the initial singleton group.The gestational week of delivery was earlier than that of the initial singleton group,and the birth weight of the newborn was lower than that in the initial single-ton group.The rate of premature delivery and low birth weight was higher than that in the initial singleton group,and the difference was statistically significant(P＜0.05).The incidence of pregnancy complications(postpartum hemorrhage,gestational diabetes,hypertensive disorders of pregnancy)and the rate of cesarean section were not significantly different(P＞0.05).The abortion rate and neonatal birth defect rate were missing after adjusting the PSM model.According to the calculation before adjustment,the early abortion rate of the surgical reduction group and the spontaneous reduction group were significantly lower than that in the initial singleton group(P＜0.05),and the late abortion rate of the spontaneous reduction group was lower than that in the initial singleton group,the difference was statistically significant(P＜0.05).There was no significant difference in the neonatal birth defect rate between the surgical/spontaneous reduction group and the initial singleton group(P＞0.05).Conclusions:Patients with multiple pregnancies caused by assisted reproductive technology(ART)may have a relatively poor prognosis in the perinatal period even if the effect of early pregnancy reduction surgery or spontaneous reduction is limited.Reducing the number of embryos transferred cannot completely reverse the pregnancy outcome.Limiting the number of embryos transferred is the fundamental solution to the adverse outcomes of ART assisted pregnancy.