Objective To investigate the clinical effects of enalapril combined with atorvastatin in the treatment of diabetic nephropathy .Methods 108 patients with diabetic nephropathy from August 2014 to August 2016 were selected and randomly divided into the observation group and the control group, 54 cases in each group.The control group were treated with enalapril based on the conventional diabetes treatment, and the observation group were treated with atorvastatin based on the control group, the changes of FPG, 2 hPG, HbAlc, SBP, DBP, UAER, SCr and Ccr were observed and compared between the two groups.Results After treatment, the control group and the observation group patients with diabetes indicators FPG, 2 hPG and HbAlc in the control group, were significantly lower than before treatment, the difference was statistically significant (P <0.05), but there was no statistically significant difference between the two groups after treatment.The control group and the observation group patients with diabetic nephropathy , SBP, DBP, UAER, Scr, Ccr were significantly lower than before treatment, the difference was statistically significant (P<0.05), and after treatment, UAER, Scr and Ccr in the observation group were significantly lower than those in the control group, the difference was statistically significant ( P<0.05).Conclusion Enalapril combined with atorvastatin can effectively delay the progression of the disease, protect renal function based on good control of blood glucose in the treatment of diabetic nephropathy.

Objective To study the risk factors of the complications of laparoscopic gynecologic operation,and put forward the basis for the prevention and control of complications. Methods The related factors of complications in 112 patients in our hospital from June 2011 to December 2013 were retrospectively analyzed. Results There were 26 patients with complications,the incidence rate was 23. 2%,of which 5 cases with subcutaneous emphysema,5 cases with massive hemorrhage,8 cases with postoperative infection,4 cases with deep venous throm-bosis of the lower extremity,1 cases with pleural effusion,1 cases with intestinal injury,2 cases with intestinal obstruction. Univariate analysis and multivariate regression analysis showed that the type of surgery, work experience of doctors,previous abdominal surgery,history of endometriosis were an independent risk factor for complications of laparoscopic surgery (P<0. 05). Conclusion Excessive blood loss and postoperative infection in laparoscopic gynecologic operation are the most common,patients with a history of endometriosis and abdominal operation are more likely to get complications. And the higher level the operation is,or less experience the surgeon has,the more risk to happen complication.

Medical humanistic education becomes “remarkable leaning” because many problems arise from the development of contemporary medicine such as the meaning of life,the medical aim,the medical model and doctor-patient relationship etc.Multi-channel and multi-modal development of medical humanistic education has become a must to understand medicine and makes it develope soundly,and all-directional resultant force and the environment of medical humanistic education,striving for studies,is an exploration and even a mission and responsibility

Corticosteroids are widely used to treat ocular fundus diseases such as inflammatory disease,macular edema and choroidal neovascularization.To increase local drug concentration and reduce systemic side effects,corticosteroids are often delivered by periocular or intravitreal iniection.However there are still more and more clinical complications with the expanded scope of application of these drugs.In order to achieve the best risk-benefit ratio,fully understanding the pharmacological characteristics,indications,contraindications and complications of corticosteroid is critical for clinicians to prescribe this drug to their patients.

Objective To investigate the effects of solution focused approach on the hope level of patients with epilepsy. Methods A total of 83 patients with epilepsy were randomly divided into the observation group and the control group, 42 cases in the observation group, 41 cases in the control group. The control group was given traditional nursing care, the observation group was given nursing intervention based on solution focused approach. Two groups were surveyed with Herth Hope Index (HHI), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) before and after the intervention. Results Before the intervention, HHI of the observation group and the control group scored 24.95 ± 1.92 and 24.56 ± 3.23 respectively. After intervention the scores increased to 28.85 ± 1.81 and 25.31 ± 3.35. After intervention, HHI and each dimension of the observation group scored higher than those before intervention and the control group, the difference was statistically significant (t=-4.75, 5.84, P < 0.01). Before the intervention, SAS scores in the observation group and the control group were 56.41 ± 5.97 and 56.28 ± 6.14, SDS scores were 53.72 ± 8.41 and 53.47 ± 8.26, there was no statistically significant difference between the 2 groups (t=0.09, 0.13, P > 0.05). After intervention SAS scores the observation group and the control group were 41.65 ± 6.22 and 49.72 ± 5.86, SDS scores were 44.57 ± 5.83 and 49.73 ± 6.24, there was significant difference between 2 groups (t=5.67, 3.20, P < 0.01). Intra group comparison of the observation showed that there was significant difference in SAS and SDS scores before and after the intervention (t=10.27, 5.36, P < 0.01). Intra group comparison of the control group also showed statistical difference in SAS and SDS scores (t=4.65, 2.17, P<0.05 or 0.01). Conclusions The solution focused approach can improve the psychological status of patients with epilepsy, improve the level of hope, promote the rehabilitation of patients.

Objective To evaluate the clinical efficacy of laparoscopic surgery combined with GnRH agonist in the treatment of endometriosis. Methods From January 2008 to January 2012, 205 patients with endometriosis underwent conservative laparoscopy surgery in our hospital .According to whether the patients accepted the therapy of GnRH-a and the time of the treatment after surgery, patients were divided into three groups:group A was treated with conservative laparoscopic surgical (73 cases), group B was given GnRH-a for 3 months after surgery (68 cases), and group C received GnRH-a for 6 months after surgery (64 cases).These patients were followed up for 24 months after surgery .The recurrence rate and pregnancy rate were compared among the three groups . Results The postoperative recurrence rates within one year were 4.4%(3/68) in the group B and 3.1% (2/64) in the group C, which were all lower than that of the group A (13.7%, 10/73).There was no difference between the group A and B (χ2 =3.628, P=0.057), while the rate of group C was significantly lower than that of the group A (χ2 =4.771, P=0.029).The cumulative recurrence rates in the group B and C were respectively 13.2%(9/68) and 10.9%(7/64), which were significantly lower than that of the group A [27.4%(20/73); χ2 =4.322, P=0.038; χ2 =5.839, P=0.016].There were no differences about the natural pregnancy rate within 2 years postoperatively among the three groups (χ2 =0.812, P=0.666), but for those who underwent IVF-ET after laparoscopy, the pregnancy rates in group B and C were respectively 78.9% (15/19) and 80.0% (16/20), which were significantly higher than that of the group A [47.6% (10/21); χ2 =4.177, P=0.041; χ2 =4.630, P=0.031]. Conclusions Laparoscopic surgery combined with GnRH-a is highly effective in the treatment of endometriosis , which can effectively reduce the recurrence rate .Application of GnRH-a for 3-6 months after laparoscopic surgery can improve the pregnancy rate in those who accept the treatment of IVF-ET.

Objective To study the effectiveness of Ginsenoside on serum IL-17 and IL-23 in patients with systemic lupus erythematosus.Methods According to the digital table,86 patients with systemic lupus erythematosus (SLE) were randomly divided into two groups,the control group (n =43 cases) and the observation group (n =43 cases).The patients in the control group were treated through prednisone,while the patients in the observation group were treated through prednisone plus ginsenoside.They were all treated for three months,systemic lupus erythematosus activity index(SLEDAI),serum complement 3 (C3),IL-17 and IL-23 were evaluated.Results SLEDAI after treatment were significantly decreased,compared with the control group,the observation group decreased more significantly (t =2.73,P ＜ 0.05).Mtertreatment,serum C3 were significantly elevated,compared with thecontrol group,the observation group increased more significantly(t =3.04,P ＜0.05).After treatment,serum IL-17 and IL-23 were significantly reduced,and after treatment compared with the control group,the observation group decreased more significantly (t =2.13,3.06,all P ＜ 0.05).The rates of adverse reactions were 25.6％ in the control group and 7.0％ in the observation group.There was a statistically significance between two groups (x2 =4.89,P ＜ 0.05).Conclusion Ginsenoside can decrease serum IL-17 and IL-23 in patients with systemic lupus erythematosus.

Objective　To evaluate the effects of the excimer laser in situ keratomileusis (LASIK) for treatment of high myopia.Methods　LASIK was performed on 308 eyes of 186 patients who were followed up for one year. The patients were divided into two groups (group A and group B) according to preoperative diopters.Results　One year after surgery, in group A(-6.0～-10.0D) the uncorrected visual acuities of 0.5 and 1.0 were in 95.76% and 77.58% of the eyes, the mean residual refraction was -0.32D±0.46D. In group B(-10.25～-20.0D) the uncorrected visual acuities of 0.5 and 1.0 were in 62.24% and 37.06% of the eyes, the mean residual refraction was -0.92D±1.13D.Conclusion　It is an effective and safe refraction surgery to correct high myopia with LASIK.

Objective To explore the relationship between hepatic stem cells and hematopoietic stem cells by detecting the expression of OV6 and CD34 in rat hepatic oval cells. Methods Healthy SD rat were fed with chemical carcinogen 3’-me-DAB for 4 weeks, then the rat hepatic tissue samples were obtained. The rats fed with normal forage served as normal controls. The expressions of OV6 and CD34, specific markers for oval cells and hematopoietic stem cells respectively, in rat hepatic stem cells were detected by immunocytochemical staining (ABC method). Results The oval cells positive for OV6 and CD34 were found in the limiting plate of portal area, mainly located around the Hering canal. In addition, some oval cells positive for OV6 and CD34 were found migrating to hepatic lobule, scattering in the hepatic cords. A great many mononuclear stem cells positive for OV6 and CD34 were also found in the hepatic parenchyma. Conclusion 3’-me-DAB could stimulate the proliferation of hepatic oval cells and hematopoietic stem cells and cause the hematopoietic stem cells derived from bone marrow to migrate to hepatic parenchyma and differentiate.

Objective To investigate the changes in the detection rate of gastric ulcer,duodenal ulcer and gastric cancer by gastroscopy after 10 years' eradicative treatment of Helicobacter pylori,in order to learn the characteristic alternations of these diseases and the significance of eradicative treatment of Helicobacter pylori.Methods The clinical and endoscopic data of gastric ulcer,duodenal ulcer and gastric cancer at our hospital in January 1994 to December 1995 and January 2004 to December 2005 were collected and analyzed.Results The detection rate of gastric ulcer,duodenal ulcer,and gastric cancer by gastroscopy during the period of January 2004 to December 2005(5.53%,10.07% and 4.03%,respectively) was significantly lower than that during the period of January 1994 to December 1995(8.17%,11.21% and 6.21%,respectively,P