OBJECTIVE:To evaluate the status quo and tendency of the utilization of lipid-lowering drugs in our hospital.METHODS:The utilization of lipid-lowering drugs in our hospital between 2005 and 2008 was analyzed statistically by ranking consumption sum and DDDs.RESULTS:The consumption sum of lipid-lowering drugs had a sharp increase during 2007～2008 as compared with 2005～2006,its proportion in the drugs for cardiovascular diseases increased to some degree.During 2007～2008,Statins took the first two places on the annual consumption list,its use gained popularity and its DDDs increased.The application of Fibrates also took an upward trend.CONCLUSION:The use of lipid-lowering drugs in our hospital had been on the rise,with Statins and Fibrates took the predominant places,which is in line with the requirement of evidence-based medicine.

The effect of traditional therapy is limited for liver cancer,gene therapy gets more and more recognition in recent years.Oncolysis virus is a kind of conditionally replicating virus,with special reproductivity in cancer cells,and then kills them.Gene agents are usually introduced into tumor tissue by intra-tumor and intra-arterial injection,and the technique of interventional therapy is able to satisfy the demand excellently.So,some breakthrough is expected in treating liver cancer by skillfully combining oncolysis virus and interventional technique

Objective To study the clinical features and treatment of horizontal canal benign paroxysmal positional vertigo (HC-BPPV).Methods The clinical features of 27 patients with HC-BPPV and the treatment results with otolith repositioning maneuver of Barbecue rotation were analyzed retrospectively.Results All the patients with HC-BPPV had vertigo attack and this kind of vertigo attack presented with some characters such as brief, positioning, latency and no fatigability. Geotropic nystagmus was seen in 21 patients and apogeotropic nystagmus was seen in 6 patients when head was turned to either side in supine position. After Barbecue rotation, all symptoms disappeared in patients with geotropic nystagmus and did not change in patients with apogeotropic nystagmus.Conclusions The diagnosis of HC-BPPV is based on typical clinical features and test of turning head to either side in supine position. Geotropic nystagmus is associated with canalithiasis and apogeotropic nystagmus is associated with cupulolithiasis, and the therapy of Barbecue rotation is very effective to HC-BPPV patients with geotropic nystagmus.

Objective To evaluate the results of direct anastomosis between the main pulmonary artery and right ventricle in the repair of complex congenital heart disease. Methods Between March 2001 and June 2004, seventeen patients with complex congenital heart disease underwent direct anastomosis between the main pulmonary artery and right ventricle. Among them, eleven patients were under 3 years old. Six patients had pulmonary atresia and ventricular septal defect (VSD), 4 had transposition of the great arteries and VSD, 4 persistent truncus arteriosus and 3 TOF with coronary artery straddling RVOT. Twelve patients underwent one stage complete corrective repair and 5 patients received staged procedures. Results There was 1 operative death with hospital mortality of 5.9%. Three out of 5 staged patients succeeded in the second corrective repair. At follow-up ranging from 1 to 40 months, all patients were growing well and their heart function were in NYHA class 0 or I. Conclusion Direct anastomosis between the main pulmonary artery and right ventricle can provide good results in the repair of certain complex congenital heart disease, especially in infant patients without suitable homograft.

Objective To summarize clinical characteristics, diagnosis and surgery of abnormally origination of left coronary artery from the pulmonary artery. Methods Clinical data of 10 patients with left coronary artery abnormally originating from pulmonary artery were analyzed, including 5 men and 5 women, aged from 13 to 40 years. Definite diagnosis was made by ultrasonic cardiogram (UCG) and cardiac catheter examination. Three cases were simply abnormal origination, six cases combined with MI, and one case combined with both MI and ventricular aneurysm of left ventricular apex. Ligation of the abnormal coronary artery was done in four patients, three were given pulmonary artery inner tunnel plasty under extrocorporeal circulation. Open implantation of left coronary artery to ascending aorta were done in 3 patients, while plasty of mitral valve were performed in 5 and ventricular aneurysm resection in 1. Results One patient died postoperatively. The follow-up ranged from 1 month to 11 years. One patient received replacement of mitral valve 16 months after first surgery due to severe MI. All the followed-up patients presented no myocardial ischemia or infarction, no residual shunt or late death. Cardiac function was rehabilitated to grade 1. Conclusion Obvious blood dynamics and cardiovascular morphology changes existed in patients with left coronary artery abnormally originating from pulmonary artery. Early diagnosis and surgery should be done. Proper surgical approach is the key to success.

Objective To study the changes of nitric oxide synthase in placenta during fetal cardiac bypass. Methods Eight pregnant ewes (gestation 120～140 d)were divided equally into control group and bypass group. Bypass group underwent fetal cardiac bypass with centrifugal pump and placenta. Fetal hemodynamic date and blood gas value were recorded before and after bypass. Placenta vascular resistance was calculated. Fetal serum nitric oxide (NO), serum endothlin-1(ET-1) and nitric oxide synthase (NOS) of placenta tissue were assayed. Transcriptions of endothelial NOSmRNA in placental tissue were assayed with RT-PCR technique. Results Acidosis and pressure of oxygen decreased after bypass appeared in fetal lamb of bypass group. Placenta vascular resistance of bypass group elevated significantly (P

Objective To evaluate the outcomes of one-stage repair of aortic coarctation (CoA) and associated cardiac anomalies in infants through a midline sternotomy. Methods Between June 2002 and August 2005, 36 patients (27male, 9 female) underwent surgery for CoA. The age was from 18 days to 8 years[mean (14.3?9.5) months], 27 patients (75%) were younger than 1 year and 18 patients (50%) were younger than 3 months. The body weight was from 3.0 to 23 kg [mean(6.6?3.0)kg]. 27 patients were symptomatic infants and 8 patients were asymptomatic of adults. One patient had recoarctation after repair through a left thracotomy one year ago. The associated cardiac anomalies included ventricular septal defect, patent ductus arteriosus, secundum atrial septal defect, hypoplasia of the aortic arch, transposition of great arteries and subaortic stenosis. 36 cases underwent one-stage operation of extended end-to-end anastomosis through a midline sternotomy. Results One patient died postoperatively with a mortality of 2.8 %. The cause of death was heart and lung function failure. 35 cases were followed up from 4 months to 3 years .One late death occurred. 34 cases were in good condition and no recoarctation. Conclusion Outcomes of one-stage repair of CoA and associated cardiac anomalies in infants through a midline sternotomy is excellent. Technique of extended end -to-end anastomosis may potentially reduce the incidence of recoarctation.

Objective To observe the relationship between blood stasis syndrome and clinical pathology in patients with IgA nephropathy (IgAN). Methods Clinical and pathological materials of 42 patients with blood stasis syndrome,and 73 patients with non blood stasis syndrome were analyzed. Result Patients with blood stasis syndrome are often female and accompanied with renal dysfunction. Compared with patients of non blood stasis syndrome,Lee’s grades were obviously higher,degrees of fibrinogen-related antigen (FRA) deposited in renal were stronger,and scores or ratio of tubular atrophy significantly were higher. Conclusion Blood stasis syndrome of IgAN is correlated with certain renal pathological changes. Blood stasis is the main etiological factor.

Objective To evaluate the clinical features and treatment of posterior semicircular canal benign paroxysmal positional vertigo(PC-BPPV).Methods To retrospectively analyse the clinical features and therapy results of 120 patients with PC-BPPV from January 2003 to November 2004 in the Chang Zheng Hospital of the Second Military Medical University.Results Vertigo attack of PC-BPPV had such characters as brief period,positioning,latency and fatigability.Geotropic rotatory nystagmus occurred in 108 patients and apogeotropic rotatory nystagmus in 12 patients in the test of Dix-Hallpike,and the former received the repositioning maneuver therapy of Epley and the later received the therapy of Semont maneuver.The symptoms disappeared completely in 88 patients after a single session and 12 patients after twice、6 patients after triple sessions of Epley repositioning maneuver therapy in the former,no effectiveness in 2 patients;the symptoms remitted in 8 patients after once,2 patients after twice and 1 patient after triple sessions therapy of Semont repositioning maneuver in the later,no change in 1 patient.The total success rate was 97.5%(117/120).Fifteen patients had relapse during follow-up and the recurrence rate was 12.5%(15/120).They also responded to repositioning maneuver therapy.Conclusion The diagnosis of PC-BPPV is based on the typical clinical features and the test of Dix-Hallpike.The repositioning maneuver therapy is safe and effective for PC-BPPV and should be used for all patients when the diagnosis is clearly made.

Purpose: To evaluate the effect and safety of combination chemotherapy with oxaliplatin( L-OHP) plus 5-fluorouracil(5-FU)/folinic acid( CF) in advanced colorectal cancer( ACRC). Methods: 31 patients with ACRC entered the study. L-OHP 130 mg/m2 , iv infusion for 4 hours on day 1; CF 200 mg/m2 , iv infusion for 2 hours followed by 5-FU 500mg/ m , iv infusion for 4 hours from day 1 to day 5, repeated every 3 weeks. Results: There were 10 partial responses, 7 stable disease, 9 progressive disease, the response rate being 38. 5% . The main adverse effect was neuro-sensory toxicity which was seen in 90. 3% of the patients. Vomitting and diarrhea was observed in 58. 1% and 45. 2% of the patients respectively. Bone marrow suppression was mild. Conclusions: L-OHP combination with 5-FU/CF yields an encouraging response with acceptable toxicity in our study. Furthermore clinical reseach is worthwhile.