Objective To investigate the effect of Tongxinluo capsule combined with metoprolol on elderly patients with coronary heart disease and angina pectoris and its influence on hemorheology and inflammatory factors.Methods 135 elderly patients with angina pectoris of coronary heart disease were selected,and they were randomly divided into treatment group (68 cases) and control group (67 cases).The treatment group was treated with Tongxinluo capsule combined with metoprolol,while the control group was treated with metoprolol.The two groups were treated for 8 weeks.The curative effect of the two groups was compared,the number and duration of angina pectoris,the changes of hemorheology and inflammatory factors before and after treatment were compared.Results The total effective rate of the treatment group (94.12％) was higher than 76.12％ of the control group (P ＜ 0.05).After treatment,the frequency and duration of angina pectoris in the treatment group were (6.03 ± 1.21) times/week and (3.02 ± 0.76) min/time,respectively,which were significantly lower than those in the control group [(9.87 ± 1.46) times/week and (4.86 ± 0.98) min/time] (t =16.649,12.201,all P ＜ 0.05).After treatment,the whole blood viscosity at high shear rate [(3.76 ± 0.41) mPa/s],whole blood viscosity in low shear [(8.13 ± 0.76) mPa/s],plasma viscosity [(1.23 ± 0.08) mPa/s],erythrocyte aggregation index [(2.06 ± 0.27)],fibrinogen [(2.46 ± 0.41) g/L] in the treatment group were lower than those in the control group[(4.53 ± 0.52) mPa/s,(9.61 ± 0.89) mPa/s,(2.09 ± 0.27) mPa/s,(2.63 ± 0.35),(3.53 ± 0.62) g/L] (t =9.562,10.396,25.170,10.604,11.844,all P ＜ 0.05).After treatment,the interleukin-6 (IL-6) [(8.49 ± 1.76) pg/mL],intercellular adhesion molecule-1 (ICAM-1)[(85.25 ± 8.92) pg/mL],C reactive protein (CRP) [(8.74 ± 1.76) mg/L] in the treatment group were lower than those in the control group[IL-6 (11.32 ± 2.10) pg/mL,ICAM-1 (103.42 ± 10.72) pg/mL,CRP (14.98 ± 2.24)mg/L] (t =8.491,10.712,18.012,all P＜0.05).Conclusion Tongxinluo capsule combined with metoprolol in the treatment of elderly patients with coronary heart disease angina pectoris has obvious curative effect,and can improve the patients'blood rheology and inflammatory reaction.

Anti-N-methyl-D-aspartate receptor encephalitis is an autoimmune syndrome of central nervous system.The main clinical manifestations include psychiatric symptoms,movement disorders and seizures.It is often misdiagnosed as viral encephalitis.Tumors,especially the ovarian teratoma,play an important role in the disease.The prevalence in children is beyond imagination.Anti-NMDAR antibodies are specific diagnostic tests.Immune suppression is the main treatment.The first-line treatments include corticosteroids,intravenous immunoglobulin,and plasmapheresis.The second-line treatments include biological agents and cytotoxic drugs.Early diagnosis and treatment are essential for neurologic recovery.Overall prognosis is good.

ObjectiveTo investigate the relationship between carotid atherosclerosis and progressing stroke.Methods103 patients with acute cerebral infarction within the first 24 hours from onset were tested with carotid color doppler ultrasonography during the first week from admission. Univariate and multiple logistic regression analyses were performed to examine the relationship between carotid intima media thickness (IMT), plaque structure, the degree of artery stenosis and the early deterioration of cerebral infarction.ResultsPrevalence of carotid plaque and thickness of IMT in patients with progressing stroke were higher than that in non progressing patients. In logistic regression, presence of carotid plaque was independent predictors of progressing stroke. Plaque size, extent of artery stenosis and IMT were not included in the regression model.ConclusionPlaque structure and its chemical feature may be the cause of progressing stroke.

Objective To investigate the association between body mass index and postoperative complications in patients with colorectal cancer.Methods 120 patients with colorectal cancer were prospectively studied.According to the body mass index,all patients were assigned to study group (BMI ＜ 18.5kg/m2) or control group (BMI ≥ 18.5kg/m2),60 cases in each group.All patients received elective colorectal cancer resection.The operation situation,postoperative complications,postoperative recovery and postoperative stress reaction of the two groups were observed.Results There were no significant differences in the operation time,the number of lymph node dissection and the amount of bleeding between the two groups during the operation (all P ＞ 0.05).Compared with the control group,the total infection rate of the study group was significantly higher(11.67％ vs.1.67％,x2 =4.324,P =0.038);the incidence of postoperative complications was significantly increased (25.00％ vs.5.00％,x2 =7.908,P =0.005).There were no significant differences in other complications such as wound infection,anastomotic leakage,anastomotic obstruction,adverse cardiovascular events and stress ulcer (all P ＞ 0.05).Compared with the control group,the postoperative anal exhaust time of the study group was significantly prolonged [(51.48 ± 9.47) h vs.(43.73 ± 8.63) h,t =5.382,P =0.000];and the length of hospital duration was significantly prolonged [(20.35 ± 3.21) d vs.(16.28 ± 3.48) d,t =6.462,P =0.000].There were no significant differences in recurrence rate,mortality rate and progression free survival between the two groups after 1 year (all P ＞ 0.05).There were no significant differences in preoperative IL-6 and CRP levels between the two groups (all P ＞ 0.05).Compared with the control group,the IL-6 level of the study group at 7-day after operation was significantly higher[(165.56 ±45.39) ng/L vs.(122.58 ± 29.58) ng/L,t =6.459,P =0.000];CRP level was significantly higher [(23.49 ± 8.48) mg/L vs.(15.37 ±6.53)mg/L,t =4.285,P=0.002].Conclusion Body mass index less than 18.5 kg/m2 is a risk factor for postoperative infection and complications in patients with colorectal cancer,and is associated with increased stress response and prolonged hospital stay.

Objective: To study and analyze the influence of atorvastatin combined trimetazidine on levels of blood lipids,inflammatory factors and cardiac function in patients with coronary heart disease (CHD).Methods: A total of 128 CHD patients treated in our hospital from May 2015 to Oct 2016 were selected.According to random number table, they were randomly and equally divided into trimetazidine group (received trimetazidine based on routine treatment) and combined treatment group (received atorvastatin based on trimetazidine group).Both groups were treated for three months.Levels of blood lipids, inflammatory factors and cardiac function were measured and compared between two groups before and after treatment.Results: Compared with trimetazidine group after treatment, there were significant reductions in levels of triglyceride [(2.11±0.73) mmol/L vs.(1.83±0.77)mmol/L], total cholesterol [(5.14±0.96)mmol/L vs.(4.35±0.73)mmol/L], low density lipoprotein cholesterol [(2.35±0.68) mmol/L vs.(1.90±0.34) mmol/L], N terminal pro B type natriuretic peptide [(296.61±28.96) pg/ml vs.(187.53±32.63) pg/ml], fibrinogen [(4.44±0.34) g/L vs.(3.63±0.54) g/L] and high sensitive C reactive protein [(2.41±0.96) mg/L vs.(1.96±0.82) mg/L], left ventricular end-diastolic dimension [(59.25±6.17)mm vs.(48.43±4.28)mm] and left ventricular posterior wall thickness [(11.01±1.08)mm vs.(9.05±1.04)mm], and significant rise in level of high density lipoprotein cholesterol [(1.32±0.25)mmol/L vs.(1.47±0.38)mmol/L] and left ventricular ejection fraction [(41.28±7.04)% vs.(48.66±7.54)%] in combined treatment group, P<0.05 or <0.01.Conclusion: Atorvastatin combined trimetazidine can significantly improve blood lipid, inflammatory factor levels,cardiac function and cardiac structure in CHD patients.The therapeutic effect is significant, which is worth extending.

Objective To explore the relevant factors of macrosomia in order to own better antepartum prevention and obsterical measure.Methods Retrospective analysis was conducted in the total of 349 complete macrosomia cases in this hospital,the relevant factors of macrosornia( except diabetes melitus) were compare and analyzeed.Results There was significant correlation between macrosomia and age of pregnant woman,gestional weeks,body mass index.Conclusion In order to reduce the incidence rate of macmsomia,decrease the rate of uterine-recision delivery and save the life for the mother and the infant,some effective measures should be carried out for pregnant ladies who are foreseen to have a macrosomia.

Objective To find out the effect of tooth preparation and bonding agents on cementation of metal full crown,to provide research basis for clinical practice of full crown restoration .Methods 60 dissociation teeth were randomly divided into six groups ,10 teeth in each group .Different adhesive materials or different polymerization angle were used in different groups ,the six groups were 3 polymerization angle zinc group ,3 polymerization angle glass ionomer group,3 polymerization angle resin cement group ,5 polymerization angle zinc group ,5 polymerization angle glass ionomer group ,and 5 polymerization angle resin cement group .In the first three groups ,polymerization angle was 3,and in the latter three groups ,polymerization angle was 5.The retentive force values of all groups were tested and compared.Results The metal crown retentive force of 3 polymerization angle zinc group[(198.5 ±11.6)N]was sig-nificantly better than that of 5 polymerization angle zinc group[(138.2 ±14.1)N](t=7.46,P<0.05).Polymeriza-tion angle showed no statistically significant effect on metal crown retentive force values of glass ionomer groups and resin cement groups (t=1.52,2.03,all P>0.05).Bonding zinc retention of 3 degree of polymerization group was (198.5 ±11.6)N,glass ionomer and resin cements were (302.7 ±19.2) N and (352.7 ±21.8) N.Bonding zinc retention of 5 degree of polymerization group was (138.2 ±14.1)N,glass ionomer and resin cements were (317.4 ± 23.8)N and (362.9 ±22.6) N.Different adhesives showed statistically significant effects on metal crown retentive force values of 3 polymerization angle groups and 5 polymerization angle groups (F=7.88,8.42,all P<0.05). Conclusion A suitable adhesive,standard operation can get the best cementation effect ,and improve clinical repair effect.

The Smart phone and its applications have influenced our lives in almost every aspect.The Chinese Medical Association has been working on the development of smart phone applications for scientific conferences.With an example of an international conference organized by the Chinese Medical Association in 2013,the article talks about the functions,effects,advantages,problems,solutions and trends of a scientific meeting application.It aims to help conference organizers to improve their abilities in organizing conferences,reduce costs,enhance communication and keep up with international standard.

Objective To investigate distribution of Klebsiella pneumoniae infection and its drug resistance change in elderly pa‐tients during 2011 and 2013 .Methods API system was used to identify bacteria ,collected from clinical samples of elderly patients during 2011 and 2013 .Drug sensitivity was tested by using disk diffusion method .Results The isolation rate of Klebsiella pneu‐moniae from 2011 to 2013 was 9 .93% ,11 .56% and 13 .37% .During these three years ,the isolation rate of strains was the highest in Intensive Care Unit ,and the specimens mainly distributed in sputum .There was an increasing tendency of the resistance rates of Klebsiella pneumoniae to commonly used antibiotics ,though the resistant rate to piperacillin/tazobactam ,ceftazidime ,meropenem and amikacin was below 30% .Conclusion Observation on changes of drug resistance of Klebsiella pneumoniae and reduction of risk factors for bacteria infection ,might be important for prohibiting the increasing of drug resistance of Klebsiella pneumoniae .