Objective To investigate the clinical efficacy of felodipine combined with irbesartan in the treat-ment of hypertension and its effect on atherosclerosis in remission .Methods 100 patients with hypertension were divided into the observation group and the control group .The control group was given the felodipine treatment ,the obser vation group was given felodipine treatment based on the control group .The treatment effect ,changes of blood control and carotid artery intima-media thickness were compared between the two groups .Results The total effective rate of the observation group was 90.0%,which was significantly higher than 72% of the control group (χ2 =3.85,P<0.05).After treatment,the systolic pressure,diastolic pressure of the observation group were significantly lower than those in the control group(t=4.21,5.05,all P<0.05).After treatment,the size,thickness of carotid artery plaque of the observation group were significantly lower than those of the control group (t =1.98,5.05,all P <0.05). Conclusion Felodipine combined with irbesartan can significantly improve the therapeutic effect of hypertensive patients,and can improve the control of blood pressure ,slow the progression of atherosclerosis .

Objective To explore the feaibility of laparoscopic hepatectomy(LH) for hepatolithiasis.Methods Eight patients with hepatolithiasis were treated by laparoscopic cholecystectomy(LC) and common bile duct exploration(LCBDE) and LH.Laparoscopic resection of left lateral lobe of liver was performed in 7 cases,and left hemihepatectomy in 1 case.Results Procedures were all successful with operation time of(285.00?37.42) minutes,and bleeding volume(306.25?29.73)mL.The postoperative hospital stay was(7.88?1.36) days.No complications occurred.No residual stone was found in any patient.Conclusions LH was safe and effective for hepatolithiasis,and gives better results when combined with choledoscopic stone removal.

OBJECTIVE: To establish an HPLC method for the determination of the contents of the related substances in metoclopramide.METHODS: The sample was separated on C18 column with the mobile phase consisted of acetonitrile-0.02 mol?L-1 phosphonic acid solution(19∶81) at a flow rate of 1.0 mL?min-1.The detection wavelength was set at 275 nm;the column temperature was kept under room temperature and the injected volume was 20 ?L.The contents of the related substances in metoclopramide were computed by self-control method of main constituent.RESULTS: Under the above described chromatographic conditions,metoclopramide was completely separated from its impurities.A good linearity between impurities' peak area and metoclopramide(contrast solution) concentration was achieved when the concentrations of impurities were over the range of 0.05%～4.0%.The lowest detectable limit of metoclopramide was 0.3 ng,and the contents of the related substances were all less than 0.26%.CONCLUSION: The method is convenient,accurate,sensitive and,specific,and it can be used for the determination of the related substances in metoclopramide.

Objective To evaluate the role of 64-slice spiral CT with diphase dynamic scanning in predicting the T staging of gas-tric carcinoma in different locations and assessing the sensitivity of metastasis of lymph nodes.Methods 185 patients with gastric carcinoma proved by pathology underwent diphase 64-slice CT scan and performed a TNM staging according to UICC classification. The results were compared with surgical pathological findings.Results The detection sensitivity for earlier stage gastric carcinoma was 92.0% and 99.4% for the advanced stage gastric carcinoma,While the overall accuracy rates of T and N staging were 85.4%, 69.2% respectively.Compared with the pathologic findings,the accuracy rate of CT scan for T1,T2,T3,T4 staging was 72.0%, 69.6%,90.8% and 83.3% respectively.The differences were statistically significant between T1 and T3,T2 and T3.The accuracy rate of T staging was 86.0%,84.8% respectively when the lesions were located in cardia and in antrum and this difference was not statistically significant.When the lesions were located in the body of the stomach,the differences were also not statistically signifi-cant with the accuracy rate of T staging was 89.5%,86.4% ,87.2% respectively for the lateral wall of the lesser curvature,the posterior wall of the lesser curvature and both the lesser curvature and larger curvature involved.As for the N staging,The accuracy rate of N0,N1,N2,N3 was 54.3%,87.5%,68.1% and 53.6%.The differences were significant statistically between N0 and N1, N1 and N3.Conclusion There was a high accuracy in the preoperative TNM staging of the gastric carcinoma with 64-slice spiral CT. The accuracy rate of T staging of the gastric carcinoma is not relative to the lesion’s location.

H7N9 avian influenza is the latest subtype of influenza virus to emerge in the world. By April 17, 2013 in Shanghai, a total of 31 confirmed cases were reported, and 11 of these patients died. The epidemiological characteristics and the clinical progress of this new human flu infection are still not clear. Thirteen confirmed patients have now been treated in Shanghai Public Health Clinical Center. Among the first batch of patients, hospitalised at the beginning of April 2013, two who were admitted with the same estimated date of onset of disease had very different outcomes. After active treatment at the Centre, one recovered by April 18, 2013, but one patient entered critical condition and died on April 11, 2013. The clinical and laboratory characteristics in hospital are here analysed and compared to learn more about H7N9 avian influenza. Confirmation that the observed differences are valuable for prognosis and treatment decisions for H7N9 patients awaits authentication by analysis of more patients.
Influenza in Birds ; Influenza A Virus, H7N9 Subtype ; Communicable Diseases ; Laboratories

Objective: To study the relationship between motor coordination, social communication impairment, and restricted/repetitive behaviors (RRBs) in children with autism spectrum disorder (ASD). Methods: A total of 123 ASD children aged 2-12 were recruited from rehabilitation service institutions for autistic children in Guangzhou, including 105 boys and 18 girls. The Developmental Coordination Disorder Questionnaire, Social Communication Questionnaire, and Restrictive Behavior Scale Revised were collected to measure motor coordination, social communication skills and RRBs, respectively. Multiple linear regression was used to explore the association between motor coordination and core symptoms. Results: In children aged 2-5 years old, those without motor coordination deficits scored lower in social interaction (7.73±4.00) than others (9.76±2.90)( Z=-2.29, P <0.05). In children aged 6-12 years old, those without motor coordination deficits scored lower in restricted, repetitive, and stereotyped patterns of behavior (4.22±1.93), repetitive sensory-motor behaviors (3.91±2.63), and insistence on sameness (13.52±10.59) than those with motor coordination deficits (6.11±1.54, 14.00±8.49, 31.33±15.05)( Z=-2.48, -3.83, -3.28, P <0.01)。Multiple linear regression analysis showed that fine motor/handwriting and control during movement were negatively correlated with the severity of social communication impairment and RRBs respectively among children aged 2-5 and 6-12( β=-0.85--0.03, -2.98--0.17, P <0.05). Conclusion Among autistic children, those with motor deficits suffered from more severe core symptoms. Motor assessment should be included in the ASD screening, diagnosis and management. Motor intervention should also be promoted in the rehabilitation in order to improve the prognosis and life quality.

Objective:To explore the effectiveness of clinical pathway (CP) and team-based learning (TBL) teaching method in standardized residency training of gynecology.Methods:The research included 40 residents as objects who took standardized training in gynecological rotation in Luohe Central Hospital from July 2017 to July 2019, and they were randomized into experimental group and control group. The combination of CP and TBL teaching method was used in the experimental group ( n=20), while the traditional teaching method was applied in the control group ( n=20). All residents were tested for the professional theory and clinical skill after training. After the training, a survey about the teaching satisfaction and the effectiveness of teaching methods was conducted for both groups. Statistical analysis was performed by SPSS 23.0 software. Results:The average scores of professional theory and clinical practice skills in the experimental group were (85.55±5.96) points and (89.90±6.40) points respectively, which were better than the average scores of the control group [(76.36±6.68) points and (75.50±4.81) points, respectively], and there were significant differences between two groups ( P<0.05). The results of the questionnaire survey showed that the experimental group residents had a higher degree of satisfaction and a higher evaluation of the teaching method than the control group. Conclusion:CP and TBL teaching is beneficial to improve the quality of standardized residency training of gynecology, and it is suggested to make wide popularization and application in the training.