Objective:To explore the lipid-regulating effect and safety of atorvastatin combined fenofibrate therapy in patients with coronary heart disease (CHD)complicated diabetes mellitus (DM).Methods:A total of 100 pa-tients with CHD complicated DM were enrolled.Based on routine treatment,patients were randomly and equally di-vided into statin group (n=50,received 20mg atorvastatin,once/night)and combined treatment group (n=50,re-ceived 20mg atrovastatin once/night,combined fenofibrate 200mg once/d).Serum levels of total cholesterol (TC), triglyceride (TG),low density lipoprotein cholesterol (LDL-C)and high density lipoprotein cholesterol (HDL-C) were measured before,six and 12 weeks after treatment,levels and standard-reaching rates of above blood lipid were observed before and after treatment;adverse reactions and clinical events were recorded.Results:Compared with before treatment after six-week treatment,there were significant reductions in serum levels of TC,TG and LDL-C in both groups,and they further decreased after 12-week treatment (P <0.05~ <0.01),compared with statin group after 12-week treatment,there were significant reductions in levels of TC [(4.35±0.71)mmol/L vs. (4.09±0.56)mmol/L],TG [(2.35±0.62)mmol/L vs.(1.65±0.49)mmol/L]and LDL-C [(2.01 ±0.39) mmol/L vs.(1.85±0.22)mmol/L]in combined treatment group,P <0.05 or <0.01;HDL-C level significantly rose in both groups after treatment,and it′s more significant after 12 weeks,but there was no significant difference between statin group and combined treatment group (P >0.05).After 12-week treatment,standard-reaching rates of LDL-C,TG,HDL-C,all standard-reaching of above three indexes and non HDL-C (70%,68%,80%,58% and 70%)in combined treatment group were significantly higher than those of statin group (50%,46%,48%,10% and 48%)respectively,P <0.05 or <0.01. No severe adverse reactions were observed in two groups during treatment. Conclusion:Atorvastatin combined fenofibrate treatment is more effective than atorvastatin monotherapy in patients with coronary heart disease complicated diabetes mellitus.It can improve blood lipid level more comprehensively, contribute to comprehensive standard-reaching of blood lipids,and possess better safety and tolerance.

This paper presents the results of the gross dissection and the histologic observation on the thyroid and parathyroid glands of Rhinopithecus. Specimens used in the studies are composed of R. roxellanae (1 (?), subad.), R. bieti (2 ♀♀, ad.; 1 ♀,juv.) and R. brelichi(2(?)(?),ad.). Besides the position and shape of the gross anatomy of the thyroid and parathyroid glands, attention was paid to the cellular types of the parathyroid glands. Material used for the histologic investigation is stained with HE and the modified Mallory-Azan methods and observed under the light microscopy. The principal results are summarized as follows:1. The thyroid gland consists of two lateral obes. The dimension of the gland measured 18.0?9.0, 15.0?8.0 and 14.0?6.0 mm. in bieti;23.0?9.0 mm. in roxellanae; 25.0?9.0 and 30.0?1.0 mm in brelichi; and one isthmus measures 3.0?10.0, 2.0?10.0 and 2.0?6.0 mm. in bieti; 4.0?6.0 mm. in roxellanae; 5.0?12.0 and 5.0?14.0 mm. in brelichi.The total weight of the gland is 1.0, 0.5 and 0.3g in bieti; 0.9g in roxellanae; 0.9 and 1.8g in brelichi.The isthmus connects the lower edges of two lateral lobes. There is no pyramidal lobe.2. The blood supply is derived from the superior thyroid arteries. There are no inferior thyroid arteries in three kinds. The thyroid venous drainage is by the superior and inferior thyroid veins, there is no median thyroid vein.3. The sizes and shapes of the thyroid vary with species. Each animal possesses two parathyroid glands, one of each side, but their position is also variable in the different animals.4. The follicular epithelium of the thyroid contains two cellular types, viz. the typical follicular epithelial cells and C cells.5. The parathyroid gland of Rhinopithecus is histologically similar to that of Macaca mulatta and man, which contains four basic cellular elements. There is an intermediary cellular type probably a variant of the oxyphil cells.6. Grey blue granules are present in the pale oxyphil cells of the parathyroid glands of both brelichi and bieti.7. There are less oxyphil cells among the parenchymal cells of the parathyroid gland in the subadult roxellanae than in both bieti and brelichi.

The standard administration and the management of the teaching files have been built firstly in the teaching and research apartment of medicine.A variety of databases to achieve files informatics and a series of teaching resources have been reinforced for recent years.Informatics technology,curriculum construction and teaching methods have been conformed to take full advantage of the teaching files.

Based on the present standardized training model for medicine residents,we analyzed the problems we met in the performance and discussed how to innovate the standardized management.

Objective To discuss the surgical strategy of parasagittal and falcial meningiomas in the middle 1/3 cortex area and raise resective rates of tumors and surgical effects.Methods The clinical,imaging and operative data of 74 cases of parasagittal and falcial meningiomas in the middle cortex area which underwent operation were reviewed and followed up.Results Of 74 tunors,67 were resected with Simpson Ⅱ grade,7 with Simpson Ⅲ,none of them with Simpson Ⅰ.Superior sagittal sinus and the vein of central suleus and feeders of cortex were reserved well.Severe brain injury was not occurred in 66 cases with tumors debulking(Simpson Ⅱ 61 cases,Simpson Ⅲ 5 cases),the neuro-functions of patients were normal or transient slight weakness of contralateral lower extremities postoperatively.Tumors of 8 cases were "turned over" and resected by piecemeal (Simpson Ⅱ 6 cases,Simpson Ⅲ 2 cases),weakness and paralysis of contralateral lower extremities occurred in 7 cases and 1 cases respectively after surgery.Followed-up ranged from 6 months to 4 years and 2 months,4 cases were lost to follow-up.Neuro-function of all cases with weakness of contralateral lower extremities recovered after one month.Muscle strength of the cases with paralysis of contralateral extremity recovered to grade Ⅳ 6 months later,no recurrence and death.Conclusion The measures,including piecemeal tumor reseeted mierosugically,good protection of the vein of central sulcus,excellent management of superior sagittal sinus,and avoiding damage to functional cerebral cortex during operations,are best ways for raising the tumor resection rate and nearo-function reserved.

Objective To evaluate the methylation status at CpG site -55 in the interferon-gamma (IFN-7) gene promoter and its effect on IFN-7 expression in chronic hepatitis B. Method The authors recruited 30 patients with UBeAg-positive chronic hepatitis B (CHB), 30 HBeAg-negative CHB patients, and 30 healthy blood donors. Pyrosequeneing was used to determine the methylation status at CpG site -55 in the IFN-γ gene promoter following bisulfite treatment of DNA in peripheral blood mononuclear cells (PBMCs). The expression of IFN-γ was analyzed by real-time RT-PCR and ELISA. HBV DNA in PBMCs was detected by nested PCR. Results The methylation level at CpG site -55 in the IFN-γ gene promoter was significantly increased, resulting in subsequent down-regulation of the expression of this cytoldne in CHB. The methylation level at CpG site -55 was significantly higher in HBeAg-positive patients than in HBeAg-negative ones (P<0.01) and was also significantly higher in PBMCs from HBV DNA-positive patients than from HBV DNA-negative ones (P<0.01) ; the methylation level at CpG site -55 was positively correlated with the amount of HBV DNA in serum (P<0.01). Oonclusion IFN-γ gene expression appears to be regulated by methylation of the IFN-γ gene promoter in CHB; the methylation level at CpG site -55 is associated with HBV infection.

Objective:To explore the changes in early postpartum pelvic floor muscle strength following the implementation of the new labor process.Methods:This retrospective cohort study selected 1 834 primiparous women with singleton, full-term pregnancies who delivered at Peking University First Hospital from February 2011 to March 2016 and had a pelvic floor re-examination 6-8 weeks postpartum. Out of these, 738 cases who followed the old labor process before 2014 were categorized as the old process group, and 1 096 cases who followed the new labor process after 2014 were categorized as the new process group. Basic data, childbirth information, and postpartum pelvic floor muscle strength of the two groups were compared. Data were statistically analyzed using t-test, Chi-square test, Mann-Whitney U test, Wilcoxon rank-sum test, and ordered multicategory logistic regression to assess the impact of the new and old labor process and other factors on pelvic floor muscle strength. Results:The total duration of labor, as well as the duration of the first, second, and third stages of labor, were longer in the new process group than in the old process group [549.0 min (360.0-768.0 min) vs. 482.5 min (328.0-635.0 min), 465.0 min (297.5-672.5 min) vs. 420.0 min (285.0-555.0 min), 42.0 min (24.0-74.0 min) vs. 27.0 min (18.0-45.0 min), with Z-value of－5.72,－3.95, and－9.28, all P<0.05). The rates of vaginal delivery and labor analgesia were higher in the new process group [72.1% (790/1 096) vs. 67.2% (496/738), χ2=7.41; 67.4% (739/1 096) vs. 53.4% (394/738), χ2=36.82; both P<0.05]. There were no statistically significant differences in the comparison of Class Ⅰ and Class Ⅱ muscle strength grades between the two groups (all P>0.05). Conclusion:There was no significant decline in early postpartum pelvic floor muscle strength following the implementation of the new labor process standards.

Chemotherapy based on cisplatin or its combination therapy is a common cancer treatment method. However， the non-specific side effects of cisplatin， poor pharmacokinetic properties of small molecule drugs， and susceptibility to drug resistance greatly limit the clinical application of cisplatin as first-line anti-tumor drug. With the development of nanocarrier technology， liposomes have become an ideal carrier for delivering cisplatin drugs due to their excellent properties of targeting， reducing toxicity， and enhancing efficacy. This paper reviews the status of cisplatin liposome both domestically and internationally which have entered clinical trials， including L-NDDP，SPI-077®， Lipoplatin®，LiPlaCis，SLIT and ILC， etc. Currently， only Lipoplatin® and ILC are showing good potential in cancer therapy. Although cisplatin liposome has made some progress in reducing systemic toxicity and improving treatment efficiency in clinical research， there is still potential for further improvement in tumor targeting and reducing side effects. In the future， more low-toxicity and efficient cisplatin liposomes can be developed through formulation technologies such as co-delivery liposome， stimuli-responsive liposome and targeting liposome.

Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.