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.

Delirium is defined as an acute imbalance state in the higher nervous center.It is more of ten been an accompanied syndrome,or may be a complication associated with the diagnosis and treatment of cancer.Delirium occurs frequently in cancer patients,especially in terminal patients.No more attention was paid on it yet.Its clinical feature,diagnosis and treatment were described.

This paper discussed the importance and urgency of enhancing medical students' law education through analyzing the status of student' s knowledge on the medical law,changes in the environment of physician practicing and damages and disputes between the doctors and patients made by the student' s lawbreaking.Meanwhile,suggestions were proposed including establishing a law teaching group consisted of professional and pluralistic teachers,disseminating the law concept,adopting appropriate methods in appropriate periods.

Pancreatic cancer is a commonly malignant gastrointestinal tumor with an obviously increasing incidence all over the world.Those patients without specific symptoms at early stage had mostly lost the opportunity of surgical therapy when pancreatic cancer was detected at advanced stage,and their prognosis is poor.Therefore,it is rather crucial to improve the early diagnosis of pancreatic cancer.Tumor marker is a considerable tool for early tumor detection and screening.It will help to improve the diagnostic rate of early pancreatic cancer and promote the prognosis of pancreatic cancer if we could find out tumor markers and screen one or a group of pancreatic cancer tumor markers.

In order to study the influencing factors of clinical teaching quality,students studying in non-affiliated hospitals,clinical teachers,teaching management personnel in hospitals and university were investigated as study subjects with Delphi Method.Suggestions were put forward that non-affiliated hospitals should improve the construction of the teaching staff,emphasize the teaching management,and strengthen students' education and management for improving clinical teaching quality in non-affiliated hospitals.

Objective To investigate the change and its clinical significance of the deceleration capacity (DC) of heart rate in elderly patients with coronary heart disease (CHD).Methods A total of 105 elderly CHD patients and 86 elderly non-CHD patients were selected.All patients underwent 24 h ambulatory electrocardiographic recording.DC,heart rate variability (HRV) time domain index,heart rate turbulence (HRT) parameters including turbulence onset (TO) and turbulence slope (TS),and the occurrence of ventricular arrhythmias were off-line calculated.Results The values of DC,HRV and HRT were decreased in elderly patients with CHD.DC had positive correlations with standard deviation of normal-to-normal intervals (SDNN),the square root of the mean squared successive differences between normal-to-normal RR intervals (rMSSD) and percentage of adjacent normal-to-normal intervals that differed more than 50 ms (pNN50) (r=0.60,0.51,0.49,0.41,respectively,all P ＜0.05) and had a negative correlation with the occurrence of ventricular arrhythmias (r=-0.34,P＜0.05).The value of DC was much decreased in elderly CHD patients with type 2 diabetic or acute myocardial infarction.Conclusions The decreased DC value is correlated with heart rate variability,turbulence slope and the occurrence of ventricular arrhythmias in elderly CHD patients.The deceleration capacity of heart rate is a better noninvasive method for screening and predicting sudden death in high-risk elderly patients with CHD.

Objective:To observe clinical therapeutic effect of recombinant human erythropoietin (rhEPO)on pa-tients with heart failure complicated chronic kidney disease.Methods:A total of 84 patients with heart failure com-plicated renal insufficiency were selected.They were divided into routine treatment group (n=42)and rhEPO group (n=42,received rhEPO based on routine treatment)according to random number table method.Echocardiographic examination results and renal function were compared between two groups after 12-week treatment.Results:Com-pared with routine treatment group,there were significant rise in left ventricular ejection fraction [LVEF,(37.2± 10.3)% vs.(45.4 ± 11.4)%]and left ventricular fractional shortening [LVFS,(19.6 ± 4.3)% vs.(24.5 ± 3.8)%],and significant reductions in left ventricular end-diastolic diameter [LVEDd,(6.12±0.67)mm vs.(5.01 ±0.54)mm],24h urinary protein [(0.76±0.1)g vs.(0.24±0.09)g],24h urine microalbumin [(319.6±39.6) mg vs.(107.3±26.7)mg],blood urea nitrogen [(10.3±1.9)mmol/L vs.(6.2±1.5)mmol/L]and serum creati-nine [(97.2±16.8)μmol/L vs.(79.3±15.7)μmol/L]in rhEPO group,P<0.01 all.Conclusion:Recombinant human erythropoietin could significantly improve heart,renal function in patients with heart failure complicated re-nal insufficiency.

Surgical treatment of cirrhotic portal hypertension and its accompanied abdominal diseases is one of the medical problems currently.Accurate evaluation of the hepatic function reserve,degree of portal hypertension and accompanied abdominal disease is important to decrease the postoperative morbidity and mortality as well as to raise the efficacy.The surgical procedure selection should be based on the analysis of portal vein hemodynamics of patients.There are clear indications for portosystemic shunt,devascularization and combinative surgery with shunt and devascularization.Treatment for portal hypertension should be carried out when treating the accompanied abdominal diseases.The principle of operation,operation time,operation mode,operation sequence,staging indications and the key techniques of operation were discussed in the article.Only these principles be mastered,proper selection of surgical procedures and desired treatment effect with minimal trauma can be achieved.

The significance of strengthening the construction of teaching staff in non-affiliated hospitals was discussed. Combined with the problems in strengthening the construction of teaching staff, some countermeasures were put forward, such as emphasizing on teaching, enhancing teaching awareness, improving teaching institutions and teaching rules, selecting teaching staff with high standards, strengthening teacher's teaching ability, establishing teaching quality guarantee system and teaching stimulating mechanism.

Objective To establish a human umbilical artery EC-SMC co-culture model, and mimic the morphological and functional characteristics of human arterial wall, for further reseach of the pathological mechanism and therapy of atherosclerosis and imflammatory damage. Methods We secceeded in the primary culture of human umbilical artery endothelial cells (HUAEC) and human umbilical artery smooth muscle cells (HUASMC) by collagenase perfusion digestion and tissue planting, respectively. HUASMCs were incubated in a medium with ascorbic acid at the concentration greater than 50 μg/mL to produce collagen, which was considered as the extracellular matrix for ECs. Then HUAECs were seeded directly upon HUASMCs in a saturate density for sufficient direct physical interaction between ECs and SMCs. The morphological characteristic of EC-SMC co-culture was identified by immunofluorescence staining, and the function of EC-SMC co-culture was identified by Dil-Ac-LDL uptake test. Results The morphological identification showed that the entire surface of HUASMCs was covered by a confluent monolayer confluent monolayer, which indicated that the model had simulated the morphological characteristic of human arterial wall. The results of Dil-Ac-LDL uptake test showed that there was a fluorescent signal in HUAECs. Compared with EC monoculture, the Dil-Ac-LDL uptake of HUAECs was increased significantly in the co-culture system. All the reseach results indicated that there was an interaction between HUAECs and HUASMCs in the co-culture system. Conclusions In the present study, human umbilical artery EC-SMC co-culture model was constructed successfully, which could mimic the morphological characteristic and basic functions of human arterial wall.