Objective:To explore therapeutic effects of trimetazidine combined atorvastatin calcium on chronic heart failure (CHF) .Methods:According to random number table ,a total of 80 CHF patients were randomly and equally divided into routine treatment group and combined treatment group (received trimetazidine and atorvastatin calcium based on routine treatment group) .NYHA class improvement ,6min walking distance (6MWD) ,left ventricular ejection fraction (LVEF) , left ventricular end‐systolic dimension (LVESd ) , plasma levels of brain natriuretic peptide (BNP ) , C reactive protein (CRP) and adverse drug reactions (ADR) were compared between two groups before and six months after treatment .Re‐sults:Compared with routine treatment group after treatment ,there was significant rise in total effective rate of heart function improvement (77.5% vs .95.0% ) in combined treatment group , P=0.023. Compared with routine treatment group ,there were significant rise in 6MWD [ (346.6 ± 47.3) m vs .(396.4 ± 49.2) m] and LVEF [ (44.5 ± 4.8)% vs . (49.3 ± 5.4)% ] ,and significant reductions in LVESd [ (54.2 ± 4.1) mm vs .(51.1 ± 4.3) mm] ,plasma levels of BNP [ (348.4 ± 61.3) pg/ml vs .(251.4 ± 53.6) pg/ml] and CRP [ (9.1 ± 2.2) mg/L vs .(6.4 ± 1.6) mg/L] in combined treatment group , P<0.05 or <0.01. No severe ADR was found in two groups .Conclusion:Trimetazidine combined ator‐vastatin calcium can significantly improve cardiac function and exercise capacity ,improve quality of life and ventricular re‐modeling in CHF patients ,it's safe and reliable ,which is worth extending .

Objective To investigate the distribution and drug resistance change of Pseudomonas aeruginosa in the hospital of traditional Chinese medicine to provide a reference for the prevention and control of hospital infections.Methods Various submitted specimens from the inpatients in our hospital from Jan.2012 to Dec.2014 were performed the isolation and culture,bacterial identification and drug susceptibility analysis.Results In these 3 years,the detection rate of Pseudomonas aeruginosa positive strains was gradually increased year by year;the detection rate of sputum specimens was highest;which were mainly isolated from the patients in the respirtion department and cardiology department;the drug resistance rate of non-restricted,restricted and special antibacterial drugs showed an overall downward trend.Conclusion The sseudomonas aeruginosa isolated rate is increased year by year,the antimicrobial drugs classification management achieves initial results,and the overuse or unreasonable use of antibacterial drugs should be prevented.

Objective: To observe the effect of electroacupuncture (EA) at Lower He-Sea points on the expression levels of interleukin-1β (IL-1β) in the serum and gallbladder tissues, and nuclear factor-κB (NF-κB) in gallbladder tissues of the guinea pigs with acute cholecystitis (AC), and to explore whether Yanglingquan (GB 34), the Lower He-Sea point pertaining to Dan Fu (gallbladder), is relatively specific for the Dan Fu (gallbladder) disorders. Methods: Eighty-two healthy guinea pigs were randomly divided into 6 groups according to the random number table method, a blank group, a model group, a Yanglingquan (GB 34) group, a Zusanli (ST 36) group, a Shangjuxu (ST 37) group, and a Xiajuxu (ST 39) group, with 12 guinea pigs in the blank group while 14 in the other groups, respectively, half males and half females in each group. Except for the blank group, guinea pigs in the other groups were injected with E. coli into the gallbladder to establish AC models. Guinea pigs in the blank group were fed routinely without special treatment; those in the model group were daily tied up for 30 min without EA treatment; those in the 4 groups receiving EA treatment were acupunctured at the corresponding Lower He-Sea points after daily binding and stimulated with the SDZ-V EA instrument. After successful modeling and treatment for 5 d, blood was collected from the abdominal aorta of the guinea pigs, and the gallbladder tissues in each group were isolated for hematoxylin-eosin (HE) staining to observe the morphological changes. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum IL-1β level, and immunohistochemistry (IHC) was used to detect the expression levels of NF-κB and IL-1β in gallbladder. Results: On the 3rd day after modeling, the guinea pigs in the five groups with modeling were mentally depressed with decreased appetite, significantly reduced activities, slouch, lassitude, slack and matted fur, and loose stools; two guinea pigs were selected from each group (one male and one female, not included in the final statistics) to isolate the gallbladder after sacrifice; macroscopic observation showed that the gallbladder wall was differently thickened; the bile color was dark green and opaque with particles suspended or accumulated; light microscope observation showed that the submucosal blood vessels of the gallbladder were congested, along with mucosal edema, ulceration, necrosis, shedding, and a large number of inflammatory cells infiltrating in the lamina propria, indicating that the AC model was successfully prepared. Compared with the model group, the gallbladder tissue injuries of the four groups receiving EA treatment were all differently repaired, the serum IL-1β levels were reduced (P<0.01 or P<0.05), and the IL-1β levels in the gallbladder tissues were reduced (P<0.01 or P<0.05). Compared with the model group, the NF-κB expression level in the Yanglingquan (GB 34) group was significantly reduced (P<0.01), but was not statistical different in the Zusanli (ST 36) group, Shangjuxu (ST 37) group and Xiajuxu (ST 39) group (all P>0.05). Compared with the Yanglingquan (GB 34) group, the gallbladder tissues of the Zusanli (ST 36) group, Shangjuxu (ST 37) group and Xiajuxu (ST 39) group were more severely damaged, and the expression levels of serum IL-1β, the NF-κB and IL-1β in the gallbladder tissues were increased (P<0.01 or P<0.05). Intervention effect of Yanglingquan (GB 34) on AC guinea pigs was superior to that of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39). Conclusion: EA at the Lower He-Sea points of the stomach, large intestine, small intestine and gallbladder can produce curative effects on AC guinea pigs and reduced the inflammatory symptoms. Intervention effect of Yanglingquan (GB 34) on AC guinea pigs is superior to that of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39). The mechanism of EA at Yanglingquan (GB 34) in treating AC may be regulating IL-1β and NF-κB to control the inflammatory response and improve the gallbladder tissue damage.

Objective:To investigate the efficacy and security of umbilical Chinese materia medica paste on the endotoxemia of cirrhosis patients.Methods:Based on the TAL blood cell matrix color test,80 cases of cirrhosis patients with endotoxemia positive were divided into two groups by randomly number:40 in the received regular treatment period for both groups was one month.The clinical symptoms was given to the level of treatments;Additionally,Chinese materia medica paste on umbilicus was given to the treatment group,the endotoxin,ammonia and complement component 3 in serum,cruor function,liver function,and blood routine test were statistical analysised and efficacy compared in both groups after treatment.Results:After treatment,endotoxin decreased significantly in the treatment group and the control group(P

With the advent of continuous development of radiofrequency ablation(RFA), this technique has been increasingly used in the treatment of renal cell carcinomas during recent years, with a significant therapeutic effect clinically. RFA is characteristic with the advantages of safety, convenience, minimal invasion, less complications and suffering. The improvement of the electrode needle, the radiofrequency techniques and the combination of other treatments are the key of the development of RFA in the near future. And more reasonable criteria for evaluating the therapeutic effects including imaging techniques are also needed to be set up.

Objective To treat the spontaneous bacterial peritonitis (SBP) of liver cirrhosis and to indicate the factors of early diagnosis and progrosis . Methods There were 107 patients, we observed age,sex,causes of liver cirrhosis,incidental rate of SBP and infection rate in thethe hospital,bacteria examination and drug allergy test. By setting control group, we compared liver function,blood routine,ascites routine,B supersonic examination,Child-pough Grading and complications. Results Cirrhosis mainly resulted from HBV infection(83.2%);Most of patients were male;Cirrhosis patients associated with SBP accounted for 21.6%,in which infection rate in the hospital accounted for 16.8%;becteria positive rate of ascites cultivation was 14%,most bacteria were monobacteria,G -bacillus(66.7%);Drug allergy test indicated drug resistance rate exceeds 50%,in the followorder penicillin,amino-group,oxygen-fluonine killer.Comparing with control group,cases of Child-pough grade C were abviously more( p

Targeting characteristic information processing of TCM pulse diagnosis, this article studied the application of fuzzy mathematics in objectifying pulse diagnosis. By analyzing limitations of traditional analytic methods, this article offered the scientific evidence of using mathematical algorithm in pulse diagnosis. At the same time, combined with actual clinical data, it also verified the correctness of introduction mathematical algorithm in TCM pulse diagnosis.

Objective To explore the experience of diagnosis and treatment of laparoscopic abdominal inci-sion hernia repair.Methods The clinical data of 15 patients treated with laparoscopic incision hernia repair were ret-rospectively analyzed.Results All 15 cases were successful in operation by laparoscopy.The operation time was 60~180 mins,and the mean operation time was (117 ±30.46) mins,the post-operation aerofluxus time was 1~2 days and the mean time of post-operation hospital stay was (16.53 ±3.46) days.During the operation no association with serosal layer damage or massive hemorrhage occurred;no postoperative seroma infection,intestinal fistula,infec-tion of incision,patches or deaths occurred.Ten patients(66.67%) had abdominal wall nail regional pain to different degree.2~11 months′postoperative follow-up indicated no recurrent cases.Conclusion Laparoscopic adoption of stapler or stapler with sutures through abdominal wall to repair incisional hernia is safe and effective.Compared with the open surgery,laparoscopic incisional hernia repair has the advantage of minor injury,quicker recovery,and lower recurrence rate.

Objective Our aim was to study the influence of integration courses combining the death education and resilience cultivation on nursing students.Methods 290 nursing students were randomly divided into the control group and the intervention group with 145 students in each group.The students in the intervention group was provided with the integration courses for 20 class hours based on the curricula of the control group.The influence on the resilience,death anxiety,feeling of sense of life,coping style of students was observed.Results Measurement results showed that the students of two groups had no differences in the four aspects before education,but after education the two groups students showed significant difference,including the average score of resilience and death anxiety,total score of feeling of sense of life as well as the dimensions score of life goals and life value t value was 5.703,3.294,3.649,4.130 and 2.129,P ＜ 0.05.In addition,the mean effectiveness of positive coping styles,problem solving and seeking social support of the two groups showed significant difference too,and all the difference had statistical sense,t value was 1.992,1.977 and 3.344,P ＜ 0.05.Conclusions The integration course can reduce death anxiety as well as improve the resilience of nursing students.

[Objective]To investigate the clinical features,reasons of missed diagnosis and treatment for ipsilateral fractures of femoral neck and shaft.[Method]Twelve cases of ipsilateral fractures of femoral neck and shaft treated from 1999 to 2005 were retrospectively reviewed.Seven cases' neck fractures were diagnosed separately before operation,2 cases' were diagnosed during operation and 3 were diagnosed after operation.Among the 12 cases,3 cases were treated with reconstructive intramedullary nail to fix both shaft and neck fractures;2 cases were treated with DHS to fix both shaft and neck fractures;1 case was treated with retrograde interlocking intramedullary nail to fix shaft fracture and with canulated screws to fix neck fracture;2 cases were treated with interlocking intramedullary nails and canulated screws;1 case combined supracondylar fracture of femur,was treated with LISS-DF to fix shaft and supracondylar fracture,canulated screws to fix the neck fracture;the neck fractures were found in 3 cases after shaft fixation with plate,then fixed with canulated screws.[Result]All cases were followed up for 1~6 years,with an average of 3.4 years.All femoral shaft fractures were united and 11 neck fractures were united,1 neck fracture was malunion,1 case was osteonecrosis of femoral head.[Conclusion]The ipsilateral fracture of femoral neck and shaft is rare,and the neck fracture is easy to miss diagnosis.The orthopaedic surgeons should consider the femoral neck fractures by analyzing the mechanism of high energy injury patient with femoral shaft fracture.Pelvic X-ray should be taken conventionally or CT scan when necessary.The surgical treatment for ipsilateral fractures of femoral neck and shaft depends on the position of femoral shaft,and the situation of femoral neck.