Objective:To investigate the effect of atorvastatin on the blood lipid and uric acid levels of elderly patients with coronary heart disease complicated with diabetes mellitus.Methods:116 patients with coronary heart disease and diabetes were randomly divided into the control group and the experimental group,58 cases in each group.Both groups of patients were given blood glucose control,blood pressure and other symptomatic treatment.The control group was treated with Aspirin Enteric-coated Tablets 0.3～0.6 g/times,3 times/d,oral,clopidogrel tablets,2 tablets each time,1 time/d,oral,nitroglycerin,0.25～0.5 g/time,3 times/d,with service;the experimental group was given atorvastatin on the basis of control group,10～20 mg/time,1 time/d,treatment for 4 weeks.During the treatment,the dosage was timely adjusted according to the conditions of patients.The serum low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),triglyceride (TG),total cholesterol (TC),uric acid (UA),glycosylated hemoglobin (HbA1c) levels before and after treatment and the clinical treatment efficiency were observed and compared between two groups.Results:Compared with before treatment,the serum LDL-C,TG,TC,UA,HbA1c levels were decreased ahter treatment in both groups of patients,the HDL-C level was increased (P＜0.05);compared with the control group,the serum LDL-C,TG,TC,UA,HbA1c levels were lower,HDL-C level was higher in the experimental group (P＜0.05);compared with the control group,the effective rate of clinical treatment of the experimental group were higher (P＜0.05).Conclusion:Atorvastatin could effectively reduce the blood glucose,blood lipid,uric acid levels of elderly patients with coronary heart disease complicated with diabetes.

ObjectiveTo investigate the laws of distribution and combination of traditional Chinese medicine (TCM) syndromes of patients with diastolic heart failure (DHF); To research the relevance between TCM syndromes and DHF.Methods A four diagnostic information survey was conducted among 124 DHF patients in order to analyze their basic information and information about TCM four diagnostic methods. Statistical analysis method was used to determine the syndrome types of the DHF patients and the features of syndrome combination.ResultsMost DHF patients were in their sixties or seventies, the number of female patients was larger than that of male patients, and their heart function was in II or III grade. Qi deficiency, phlegm turbidity, Qi stagnation, blood stasis, water stagnation, Yang deficiency and Yin deficiency were the common syndromes. Two-card combination and three-card combination were more common, mainly with Qi deficiency, phlegm turbidity or blood stasis as the main patterns of manifestation. Conclusion This research could provide a clinical basis for the establishment of the standard for the TCM syndromes DHF.

Objective To explore the impact of nutritional risk on short-term clinical outcomes after laparoscope-assisted radical gastrectomy for gastric cancer.Methods The retrospective case-control study was conducted.The clinical data of 150 patients who underwent laparoscopic gastrectomy at the First Affiliated Hospital of Wenzhou Medical University between June 2014 and April 2016 were collected.According to nutritional risk screening 2002 (NRS 2002),42 and 108 patients were respectively divided into the nutritional risk group (NRS 2002 score ≥3) and non-nutritional risk group (NRS 2002 score ＜3).Laparoscope-assisted radical subtotal gastrectomy or total gastrectomy was performed based on tumor location.Observation indicators:(1) postoperative short-term clinical outcomes:postoperative complications,duration of postoperative hospital stay,hospital expenses,unplanned readmission within 30 days after discharging.Postoperative complications meant total complications within 30 days postoperatively,grade Ⅰ-Ⅴ of Clavien-Dindo grade was complication classification.Grade Ⅱ and above of Clavien-Dindo grade were analyzed in this research.(2) Risk factors analysis affecting occurrence of postoperative complications of patients.Measurement data with normal distribution were represented as x±s and analyzed using the independent-sample t test.Measurement data with skewed distribution were described as M (Qn) and analyzed using the Mann-Whitney U test.Categorical variables were described as number and percentage and analyzed by the chisquare test.Ranked data were analyzed by the Mann-Whitney U test.Univariate analysis was done by the chi-square test.P＜0.1 of univariate analysis was used to multivariate analysis.COX regression model in multivariate analysis was built using progressive condition method.Results (1) Postoperative short-term clinical outcomes:number of patients with total complications,number of patients with severe complications,duration of postoperative hospital stay,hospital expenses and number of patients with unplanned readmission within 30 days after discharging were 9,2,11 days (9 days,16 days),57 825 yuan (51 894 yuan,66 908 yuan),2 in the nutritional risk group and 16,3,11 days (9 days,13 days),55 067 yuan (49 395 yuan,62 423 yuan),8 in the non-nutritional risk group,respectively,with no statistically significant difference between the 2 groups (X2=0.952,0.010,Z=-1.133,-1.691,X2 =0.048,P＞0.05).Results of univariate analysis showed that age was a risk factor affecting incidence of complications after laparoscope-assisted radical gastrectomy for gastric cancer (X2 =4.468,P＜ 0.05).Results of multivariate analysis showed that preoperative hypoproteinemia was an independent risk factor affecting incidence of complications after laparoscope-assisted radical gastrectomy for gastric cancer (OR =2.797,95％ confidence interval:1.053-7.435,P＜0.05).Conclusion There is little poor impact of nutritional risk on short-term outcomes after laparoscope-assisted radical gastrectomy for gastric cancer,preoperative hypoproteinemia is an independent risk factor affecting occurrence of grade Ⅱ and above of postoperative complications.

Objective: To study the pharmacological action of Mahuang Compound Capsule(MCC) (Herba Ephedrae, Semen Armeniacae Amarum, Fructus Schisandrae, etc.). Methods: The study was carried out through the observation of ammonia induced cough model in mice and acrolein induced cough model in guinea pigs treated with MCC, its effects on asthma model of guinea pigs induced by histamine and acetylcholine mixture and on isolated tracheas smooth muscle of guinea pigs were also studied. Results: MCC administrated orally showed significant antitussive effect in ammonia induced cough model in mice and acrolein induced cough model in guinea pigs. MCC could effectively prevent guinea pigs from asthma induced by histamine and acetylcholine mixture. The water extracts could antagonize histamin phosphate that contract the isolated tracheas of guinea pigs. Conclusions: MCC has antitussive and anti asthma effects.

Objective:To summarize the 10 year clinical experience of treating tibiafibular fractures with rectangle shaped intramedullary nails(RIN). Methods:From January 1987 to December 1996, 4 682 cases (3 278 male and 1 404 female) of tibiafibular fractures from 9 hospitals were treated with RIN . Three kinds of reduction methods including open reduction, semi open reduction and closed reduction were used during operation. Results:Results showed 2 173 cases (62.89%) got excellent result, 947 got good (27.40%), 214 got moderate (6.19%), 121 got poor (3.50%). The total healing rate was 90.29%. Conclusion:RIN has excellent biological characteristics which can provide a flexible interfixation when treating tibiafibular fractures, and the operation is simple, it also can be used for severe open fractures. RIN is one of the good techniques in treating tibiafibular fractures.

OBJECTIVE: To investigate the expression of microtuble-associated protein 1 light chain 3 (LC3) in laryngeal squamous cell carcinoma (LSCC). METHOD: The expression of LC3 in 50 cases of LSCC, 45 cases of para-carcinoma, 10 cases of laryngeal papilloma and 16 cases of polyp of vocal cord were detected by immunohistochemistry (MaxVision method). Expression level of LC3 mRNA was assayed by RT-PCR in 41 of LSCC, 41 of para-carcinoma tissue and 11 of polyp of vocal cord. RESULT: The positive rates of LC3 protein expression were 60.0%, 93.3%, 90.0%, 93.8% in LSCC tissue, para-carcinoma, laryngeal papilloma and poly of vocal card tissues, respectively. The positive rates of LC3 were significantly lower in LSCC than in para-carcinoma and poly of vocal cord (chi2 = 18.135, P < 0.01). The mRNA levels of LC3 were significantly lower in LSCC than in para-carcinoma and poly of vocal cord (0.57 +/- 0.08 )vs (0.99 +/- 0.11) and (1.07 +/- 0.05) , F = -255.872, P < 0.01. The expression of LC3 were related to tumor location and pathological grade (P < 0.05), but not related to age, T stage, clinical stage and lymphoid metastasis (P > 0.05). CONCLUSION Expression of LC3 are down-regulated in LSCC. The change of autophagic capacity may play an important role in occurrence and development of LSCC.
Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Microtubule-Associated Proteins ; genetics ; metabolism ; Middle Aged ; Neoplasm Staging

OBJECTIVE: To investigate therapeutic effects of Jinsangsanjie capsule on vocal fold polyps and vocal nodules. METHOD: Seventy-five patients with vocal fold polyps and vocal nodules were treated by taking Jinsangsanjie capsule orally. After the therapeutic course, they were all followed up for 1 month. RESULT: The effective rate of vocal nodule group was 93.8%, the effective rate of vocal fold polyp group was 89.7%, the effective rate of vocal nodule with acute congestion group was 100%, the effective rate of vocal fold polyp with acute congestion group was 100%, and the effective rate of hypertrophy of vocal cords with chronic congestion group was 66.7%. CONCLUSION Jinsangsanjie capsule has definite efficacy for treatment of vocal fold polyps and vocal nodules and deserved to be recommended.
Adult ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Laryngeal Diseases ; drug therapy ; Male ; Middle Aged ; Phytotherapy ; Polyps ; drug therapy ; pathology ; Treatment Outcome ; Vocal Cords ; pathology

OBJECTIVE: The aim of the study is to explore the establishment of paired-standardized patients (PSPs), which can cover the deficiency of standardized patients. METHOD: The outpatients and standardized patients consist of PSPs. The standard case of PSPs is established by the combination of PSPs and the laboratory and imaging information of the true patients. Then we apply the PBL model and PSPs to the clinic teaching in otorhinolaryngology. RESULT: The study of the ten standard cases of PSPs, which we have established, has enhanced the confidence and interest of medical students in clinical practice. CONCLUSION PSPs can cover the deficiency of standardized patients, which includes lacking of change and lively. At the other hand, PSPs can practice the medical students' clinical skills and the way of evidence-based medicine and can stimulate them to form the good habit of self-regulated learning.
Evidence-Based Medicine ; Humans ; Otolaryngology ; education ; Outpatients ; Problem-Based Learning ; Reference Standards

OBJECTIVE: The aim of the study is to cover the shortages of PBL, such as time-consuming, abstract, lacking of the course of clinic practice, and to introduce PBL to the teaching of otorhinolaryngology. METHOD: By the improvement of the international classic teaching model of PBL, we put forward "four-stage gradual expanding approach of PBL" and establish "four-stage gradual expanding approach of PBL in otorhinolaryngology". RESULT: Through the four stages of watching PBL, simulation PBL, internship PBL, practice PBL, we have accomplished the organic integration of theory teaching and clinical practice. CONCLUSION This teaching method is more adaptive to the teaching of otorhinolaryngology, and it can help the medicine students to establish the whole concept of medicine and can stimulate them to form the good habits of self-regulated learning and life-long learning efficiently.
Educational Technology ; Otolaryngology ; education ; Problem-Based Learning ; methods