Objective To investigate the impact of metoprolol and tongxinluo on the levels of hypersensitivity C -reactive protein (hs -CRP)and NT -proBNP in patients with coronary heart disease.Methods 84 patients with coronary heart disease were randomly divided into the observation group(n =42)and the control group(n =42). The control group was given metoprolol treatment,and the observation group was given metoprolol and tongxinluo treat-ment for 3 months.The echocardiography before and after treatment was inspected.The levels of serum hs -CRP were measured with immune reflection method and the levels of BNP were measured with ELISA.Results The total effective rate,adverse reaction rate of the control group were 95.24%,4.76%,and those of the observation group were 76.19%,23.81%,the differences were statistically significant (P <0.05).The ventricular septal thickness (IVST),left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVDD),left ventricular systolic touch the inside diameter (LVSD)of the observation group were improved than the control group (P <0.05),while the IVST,LVEF,LVDD,LVSD of the observation group after treatment were better than the control group (t =3.996,4.123,3.852,4.256,all P <0.05).The levels of serum hs -CRP and NT -proBNP of the observation group were lower than the control group (t =5.225,7.856,all P <0.05).Conclusion Metoprolol combined with Tongxinluo capsule can improve cardiac function,reduce serum hs -CRP and plasma BNP levels,improve clinical outcomes of patients.

The tissue chip is a special tissue section,which has several tens to thousands mini tissues of regular arrangement on the one glass slide.According to the deficiencies in experimental teaching section of morphology at present,the author introduced the characteristics and values of the tissue chip and explored its application prospect in experimental teaching of morphology.

Vasovagal syncope (VVS)is the most common clinical unexplained syncope,and its pathogenesis has not been fully understood yet.The contradictory reflection of cardiac autonomic nervous system caused by riggerring Bezold-Jarisch reflex,which could cause dilated blood vessels,blood pressure and cardiac output decreased,insufficient blood supply to the brain relate with syncope occurrence.Currently,most people consider it mainly relatel to the age and gender of patients,history of syncope,family history,mental and psychological factors,dietary habits and other factors,but the exact risk factors of VVS remains further study of multi-center and a large sample of data.

ObjectiveTo explore clinical characteristics of fatality cases of hand foot and mouth disease caused by enterovirus 71 (EV71),and to improve the diagnosis and treatment of the disease.Methods Sixteen children infected with EV71 were retrospectively reviewed.Clinical manifestation,laboratory data and death causes were analyzed.ResultsAll cases were younger than four years,and the mean age was 18.9 months.Seasonal variations in incidence were observed,with a peak in incidence during the summer season.These cases typically presented with a brief duration of febrile illness,nonspecific neurological signs including headache,vomiting,limb tremor and convulsions.After two to four days,they all got sudden deterioration,manifested with tachycardia,poor peripheral perfusion,tachypnea and transient hypertension.After intubation,they all had pink frothy or blood from the endotracheal.Tweleve of them died from pulmonary edema or pulmonary hemorrhage,and acute refractory cardiac dysfunction.The other four of cases died from brain stem encephalitis.Atypical presentation such as absence of skin rash should alert the physician.Total white cell count,blood glucose and cardiac troponin I were raised significantly.The protein raised in cerebrospinal fluid.ConclusionHand foot and mouth disease caused by EV71 progresses rapidly.The primary site of attack is the central nervous system,particularly the brainstem,and the cause of death are neurogenic pulmonary edema and/or hemorrhage,acute refractory cardiac dysfunction.

Objective To evaluate the health intervention effect of the health examinees in order to explore their effective on cutting down the incidence of disease and improving people'S lifestyle.Methods Chi-square test were used to analyze the health effective of 49 825 health examinee in the health physical examination center of shandong provincial hospital from the year 2003 to 2005.Results The incidence of handling health knowledge,controlling risk factors,exercising, accepting health education and health examination in regularity increase(P<0.05);abnormal rate of health examinees decreases in the three years.Conclusion Health intervention based on health examination is an effective way to improve lifestyle and to prevent,control chronic disease.

Objective To investigate the clinical effects of phacoemulsification combined with goniosynechialysis on the treatment of primary angle-closure glaucoma (PACG) with cataract. Methods The retrospective review included 71 patients (98 eyes) with PACG and cataract treated in Tianjin Huanghe Hospital. Patients were underwent phacoemulsification and intraocular lens implantation combined goniosynechialysis. Among these patients, there were 21 males (30 eyes) and 50 females (68 eyes). Patients ranged in age from 53 to 94 years old, everage (73.94 ± 6.43) years old. They were divided into acute angle-closure glaucoma with cataract group (47 patients, 64 eyes) and chronic angle-closure glaucoma with cataract group (24 patients, 34 eyes). The visual acuity, intraocular pressure (IOP), anterior chamber angle, anterior chamber depth (CCT), topical and oral medications and surgical complications were observed before and after surgery in two groups. All the patients were followed up for 6 months. Results At the end of follow-up, postoperative visual acuity, IOP, CCT, anterior chamber angle and IOP-lowing medicine (topical and oral medications) were all improved in the two groups compared with those of preoperative levels (all P < 0.01). There were no statistical differences in preoperative or postoperative average visual acuity, IOP and anterior chamber angle between two groups (all P > 0.05). Values of CCT were significantly higher before and after operation in chronic angle-closure glaucoma with cataract group than those of acute angle-closure glaucoma with cataract group (P < 0.05). No drug-control rate of intraocular pressure was 76.5% (26/34) for chronic angle-closure glaucoma with cataract group than that of acute angle-closure glaucoma with cataract group (100%, 64/64). There was no need on topical medication in acute angle-closure glaucoma with cataract group. There were 14 eyes had corneal edema and 8 eyes appeared iris fibrous exudation in two groups, while no other serious complications. Conclusion For patients with PACG and cataract, the combined surgery of phacoemulsification and goniosynechialysis is a safe and effective therapy that can improve visual acuity and reduce IOP with fewer complications.

AIM The kinetic turbidimetric Limulus test was used in the endotoxin assay of Ceftazidime injection. METHODS The validation test was fulfiled ,when the amount of endotoxin spiked in Ceftazidime injection sample(Lot.No.010202) in which concentration of its dilution solution were 10,5,2,1,0 5 g?L -1 . They were recovered in 60 08%, 82 90%, 85 22%, 94 00%, 92 67%; with the amount of endotoxin spiked in Ceftazidime sample (Lot.No. 010103, 010104, 010202),their 1 g?L -1 dilution were recovered in 109 9%, 101 7% and 86 56%. RESULTS With standard endotoxin working curve is 5 00, 0 500, 0 0500 ZU?L -1 . The 1 g?L -1 solution to Ceftazidime was effective to eliminate the interference in Limulus test. CONCLUSION The kinetic turbidimetric Limulus test provide a new way to the detection of endotoxin in Ceftazidime injection.

Objective To realize the isolation of multidrug-resistant organisms (MDROs)from ward environment, and provide evidence for clinical prevention and control of MDRO transmission.Methods Patients with MDRO in-fection in a stomatology hospital from September 2012 to July 2014 were as trial group,12 randomly selected pa-tients without MDRO infection were as control group,environmental object surface in patients’ward were taken specimens and performed culture,isolated organisms were identified and performed antimicrobial susceptibility tes-ting.Results Of 44 patients with MDRO infection,13 patients’surrounding environment were detected MDROs,the total detection rate was 29.55%(13/44).The detection rate of methicillin-resistant Staphylococcus aureus (MRSA),multidrug-resistant Acinetobacter baumannii (MDRAB),and methicillin-resistant Staphylococcus epidermidis (MRSE)were 45.45%(5/11),66.67% (2/3)and 66.67%(6/9)respectively.Detection rates of MRSA from nasal cavity and hands of MRSA-infected patients were 72.73% and 54.54% respectively,from nasal cavity and hands of patients’caregivers were 36.36%and 18.18% respectively.The difference in bacterial count between trial group and control group was not significantly dif-ferent (all P >0.05).Conclusion Isolation rate of MDROs from ward environment of MDRO-infected patients is higher than that of non-MDRO-infected patients,monitoring,cleaning and disinfection for MDRO-infected patients’surrounding environment should be strengthened,so as to prevent the spread of MDROs in hospital.

Objective To obtain the information of therapies with beta blocker in patients with heart failure in our hospital. Methods 408 hospitalized cases in 2004 and 213 outpatients from April to July in 2005 with chronic heart failure from the cardiology department were collected. Results In hospitalized cases,of 54.9% patients were prescribed beta blocker,and only 4% of them arrived at target dosage and 24.9% of them arrived at half of target dosage. 86.1% of them were given metoprolol. The maximum dosage was (54.25?34.26) mg/d,the mean was equal to the 36.17% of target dosage. Among outpatients,77.5% were taken beta blocker,and only 2.5% of them reached the target dosage and 26.6% of them reached half of target dosage; and 89.7% of them were frequently given the metoprolol,the average dosage was up to 35% of the target dosage. Conclusions There was a great gap between the clinical practice and guideline of beta blocker therapy in patients with chronic heart failure. The prescribed dose of beta blocker was lower than the target dosage.

OBJECTIVE: To establish a method for endotoxin assay in aminoglycoside antibiotics for injection.METHODS: Kinetic turbidimetric limulus test was used for endotoxin assay in aminoglycoside antibiotics for injection.The recovery rate of bacterial endotoxin was determined though pre-interference experiments in which quantitative endotoxin was added to different concentrations of aminoglycosides with the concentration optimized,then an interference test on 4 different samples was conducted.RESULTS: At a concentration of 0.5 mg?mL-1,aminoglycosides didn't interfere with the limulus test if the amount of standard endotoxin was at 5.000,0.500,and 0.050 EU?mL-1,respectively.CONCLUSIONS: The kinetic turbidimetric limulus test could be used for endotoxin assay in aminoglycoside antibiotics for injection.