Objective To study the effects of combination therapy (psychological intervention+clopidogrel+aspirin) for coronary heart disease. Methods 88 cases were selected from January 2016 to April 2017 in patients with coronary heart disease in our hospital. In a randomized approach, patients were divided into treatment groups and control groups, with 44 cases per patient. Patients in the control group were treated with aspirin, and the treatment group was treated with a combination therapy (psychological intervention+clopidogrel+aspirin). The treatment effect, angina and adverse reaction were observed and compared. Results Comparing the therapeutic effect of two groups of patients, the treatment group total effective rate was 97.73%, control group total effective rate was 79.55%, significant difference was statistically significant (P<0.05); Compared two groups of patients with angina, the treatment group patients with onset time (4.32±1.18) shorter, longer time interval (5.03 ±1.34), less number of attacks (1.67±0.49), with statistical significance (P<0.05); Compared to the adverse reactions in the two groups, the incidence of adverse reactions in the treatment group was 4.55%, compared with 18.18% in the control group. Statistical significance (P<0.05). Conclusion Psychological intervention in combination with clopidogrel and aspirin enteric-coated metformin hydrochloride in the treatment, in the clinical treatment of patients with coronary heart disease angina pectoris, shows good therapeutic effect, has higher application value.

Objective To explore carotid atherosclerosis and its relative factors of maintenance peritoneal dialysis patients. Methods The general clinical conditions,hematobiochemical parameters and color ultrasound parameters of 27 maintenance peritoneal dialysis patients and 24 controll patients were collecled. General clinical conditions included body weight, height and BMI. Hematobiochemical paremeters included Hb, Alb, LP (a), TC, TG, HDL-C,LDL-C, CRP, plasma fibrinogen, C3, Apo-A 1, Apo-B, LP (a). Color ultrasound parameters included plaque incidence rate,thickness of vascularendothelium(IMT). Results Compared with the controll group,maintenance peritoneal dialysis patients: plaque incidence rate, thickness of vascularendothelium (IMT) increased significantly, Age, TC, TG,LDL-C,LP (a), dialysis time increased significantly in plaque-positive group(all p ＜ 0. 05), while Hb, Alb andPAB decreased significantly (all P ＜ 0.0 5) , CRP increased significantly (P ＜ 0.0 1) . Conclusions In maintenance peritoneal dialysis group,CRP,LP(a) had positive relationship with C-IMT. CRP had negative relationship with ALb. CRP had not relationship with age and dialysis time. There were relationships among malnutrition,inflammation and atherosclerosis in maintenance peritoneal dialysis patients. Interdiction of the relationship may played a very important role in ameliorating the prognosis of the maintenance peritoneal patients.

The current United States Pharmacopeia–National Formulary (USP–NF) includes more than 250 mono-graphs of fixed dose combinations (FDCs), and some of them need to be updated due to incompleteness of impurity profiles and obsolescence of analytical methodologies. A case study of metoprolol tartrate and hydrochlorothiazide tablets is presented to summarize challenges encountered during the USP monograph modernization initiative of FDCs and to highlight an "adoption and adaptation" approach employed for method development. To this end, a single stability-indicating HPLC method was devel-oped to separate the two drug substances and eight related compounds with resolution 2.0 or higher between all critical pairs. Chromatographic separations were achieved on a Symmetry column (C18, 100 mm × 4.6 mm, 3.5 μm) using sodium phosphate buffer (pH 3.0; 34 mM) and acetonitrile as mobile phase in a gradient elution mode. The stability-indicating capability of this method has been demon-strated by analyzing stressed samples of the two drug substances. The developed HPLC method was validated for simultaneous determination of metoprolol tartrate and hydrochlorothiazide and relevant impurities in the tablets. Moreover, the developed method was successfully applied to the analysis of commercial tablet dosage forms and proved to be suitable for routine quality control use. The case study could be used to streamline USP's monograph modernization process of FDCs and strengthen compendial procedures.

Objective To analyze the use of antibiotics in perioperative period of cesarean section,and to summarize the experience of scientific intervention to promote rational drug use.Method 192 cesarean section included in the study were inpatients in December 2015 to December 2016 in our hospital,were grouped according to the order of admission,divided into control group(95 cases)and observation group(97 cases),were given routine perioperative antibiotic treatment.The observation group was treated with scientific medication intervention,and the control group was not intervened.The two groups of white blood cell count,postoperative body temperature and hospitalization time were counted,the infection types and infection rate were counted,and the treatment costs of the two groups were counted.Results The white blood cell count of the observation group was significantly higher than the control group,postoperative body temperature recovery time and hospitalization time was significantly shorter than the control group,the difference was significant(P<0.05); after two groups appeared infection phenomenon,including urinary tract infection,incision infection and puerperal infection as well as intrauterine infection,and two groups in different types of infection and the infection rate by comparison there was no statistically significant difference; statistical analysis and comparison of treatment related costs of the two groups of patients,to observe antibacterial drug group,the total cost of expenses and hospitalization costs were significantly lower than that of the control group,and patients with antimicrobial drugs accounted for the total proportion of drugs were significantly lower than the control group,the difference was statistically significant(P<0.05).Conclusion Cesarean section perioperative use of antibiotics in the process,through the implementation of scientific intervention can obtain ideal effect,promote rational and normative clinical medication,reduce hospitalization expenses and antimicrobial drug costs,promote the recovery of patients after surgery,and does not increase the infection after operation.

Objective To explore the pattern of cognitive impairments mainly caused by the white matter lesions(WML) in the frontal lobe in patients with subcortical ischemic vascular disease (SIVD).Methods Fifty SIVD patients were divided into severe WML group (visual score >3, n=27) and mild WML group(visual score ≤3, n=23) according to their severities of the WML in frontal lobe .Seven patients without SIVD were collected as controls .All patients underwent a set of neuropsychological battery ,and the results were analyzed .Results There was no statistical significance among three groups on basic data .Compared with mild WML group and control group , non frontal white matter scores and numbers of lacunes in frontal lobe of severe WML group were significantly higher ( all P=0.000).Compared with mild WML group,the Montreal cognitive assessment scale in severe WML group were significantly lower ( P=0.047 ) , and scores related to the executive function were significantly lower ( P=0.006 ) , even after adjusting the numbers of lacunes in frontal lobe ,there was statistically significant difference (P=0.038). Multiple regression confirmed that the Z scores of executive functions were mainly affected by white matter lesions located in the frontal lobe ( P=0.000 ) .Conclusion WML located in the frontal lobe mainly affect the executive function in patients with SIVD .

Objective To analyze the results of one-stage combined anteroposterior surgery in lateral position for serious thoracolumbar fracture dislocation. Methods A retrospective review was performed for surgically treated thoracolumbar fractures from October 1998 to September 2005. Of all the 192 patients, the 34 serious cases were treated with one-stage combined anteroposterior surgery. There were 25 males and 9 females, 34.2 years old on the average (ranging from 18 to 56 years). Segments involved: T11 in 2 cases, T12 in 5 cases, L1 in 11 cases, L2 in 8 cases, L3 in 5 cases, L4 in 2 cases and L4,5 in 1 case. According to the Classification of Magerl, there were 12 cases of type A3, 2 cases of B1, 2 cases of B2, 12 cases of C1, 4 cases of C2 and 2 cases of C3. During the operation the patients were in lateral position. Laminectomy and pedical screw insertion were performed posteriorly first; anterior corpectomy, reduction and strut graft were accomplished through an additional anterior approach. The final fixation was finished by clapping the strut graft with pedical screw system. Operative notes, preoperative and postoperative neurological status, ASIA scales, radiographs, CT scans, and follow-up records were reviewed. Results All these surgeries were performed successfully without any neurological deterioration. 32 of 34 patients were followed-up for 6 to 60 months (13 months on average). Neurological status improved at least 1 ASIA grade in 24 patients with preoperative incomplete paraplegia. 6 patients complained intercostals nerve injury symptom which alleviated with conservative treatment. During follow-up, lumbar physical lordosis was reconstructed and no evident correction loss, pseudoarthrosis or implant failure was noted. Conclusion One-stage combined anteroposterior surgery can be accomplished in a lateral position. It was proved to be an effective treatment for serious thoracolumbar fracture dislocation.

Objective To analyze the results and indications of anterior, posterior or combined surgery for thoracolumbar burst fractures. Methods A retrospective review of surgically managed thoracolumbar burst fractures from 1998 to 2003 was performed. There were 76 males and 13 females, and the age of the patients were from 17 to 51 years with an average of 36.8 years. The fractures were located at T11 in 10, T12 in 21, L1 in 29, L2 in 18 and L3 in 11. According to Magerl classification, type A fractures were 68, and type C were 21. Of the 89 patients, 41 received posterior surgeries, 40 anterior surgeries, and 8 combined anterior and posterior surgeries. Operative notes, preoperative and postoperative neurological status, radiographs, CT scans, and follow-up records were reviewed. Results All of the 89 cases had successful surgery. Seventy-eight patients were followed-up for 6 to 48 months (average 12 months). Neurological status improved at least 1 ASIA grade in all of the 65 patients who had preoperative incomplete paraplegia. In the posterior surgeries, pedicle screws broken in 2 cases, deep infection in 1 case which was cured after debridement. The correction of anterior vertebral body height and Cobb's angle averaged 9.4 mm and 14.8? postoperatively, and the correction loss averaged 0.5 mm and 7.5? respectively at 6 months after surgery. And the correction loss was most evident at the above disc spaces, then the below disc spaces. In the anterior surgeries, leakage of cerebrospinal fluid in 2 cases which cured with dressing change, the other cured after debridement, implant removal and posterior fixation. The spinal canal was enlarged, and the spine recovered normal curvature. No evident correction loss, pseudoarthrosis or implant failure was noted at follow-up. Conclusion The choice of anterior, posterior or combined surgery for thoracolumbar burst fractures depends on neurological status and column stability. The vertebral compression, canal encroachment, posterior column stability and concomitant displacement should be considered in the choice of appreciate surgical approach.

Objective To explore the value of left parasternal anterior mediastinaotomy (Chamberlain procedure) in the diagnosis of mediastinal lymph node enlargement with unknown causes and anterior mediastinal space-taking lesions. Methods By using the Chamberlain procedure, biopsy was performed in 32 cases of enlarged mediastinal lymph nodes with unknown causes or mediastinal space-taking lesions, which were found by CT scans. Results All of the 32 cases were pathologically diagnosed, with a diagnostic accuracy of 100%. Three patients with pericardial effusion received concurrent pericardial fenestration and then their symptoms relieved. Four patients underwent concurrent lung biopsy. The operating time was (48?15) min, the blood lose was ( 40.6?23.5) ml, and the postoperative hospital stay (3.6?1.4) days. No deaths or postoperative complications occurred. Conclusions Chamberlain procedure is a safe and valuable method in the diagnosis of mediastinal space-taking lesions with unknown causes or enlargement of the fifth and sixth groups of mediastinal lymph nodes, which routine mediastinoscope cannot reach. Some other simple therapies, such as lung biopsy or pericardial fenestration, can also be employed at the same time.

[Objective] To investigate the relationship of thyroid hormones with excess-heat syndrome and deficiency-heat syndrome. [Methods] Serum levels of thyroid hormones and thyroid-stimulating hormone (TSH) in 30 healthy volunteers (Group A) , 27 cases of excess-heat syndrome (Group B) and 35 cases of deficiency-heat syndrome (Group C) were detected by radioimmunoassay. [Results] Serum levels of triiodothyronine (T3) and thyroxine (T4) were higher and reverse T3 (rT3) lower in Group C than those in Group A (P 0.05). [Conclusion] Serum thyroid hormones level in deficiency-heat syndrome is different from that of excess-heat syndrome may be related to the hypothalamus-pituitary-thyroid function.

Objective To observe the characteristic changes of tongue temperature on patients of different hepatopathy tongue of blood stasis and different blood stasis syndrome types (BSS). Methods The diagram of tongue temperature was gotten in Thermoviewer SAT-HY6000A. Results The temperature of whole tongue of normal group fell down in turn as follows:root of tongue, margin of the tongue, middle surface of tongue, apex of tongue. The temperature of tongue of all the hepatopathy group was sharp dropped compared with normal group (P