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.

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.

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.

OBJECTIVE:To investigate the effects of atorvastatin combined with valsartan on efficacy,safety and related indi-cators in patients with chronic nephritis. METHODS:86 patients with chronic nephritis were randomly divided into control group (43 cases)and observation group(43 cases). All patients were given low-salt,low-protein and high-quality diet with protein intake of 0.8 g/(kg·d),appropriately given Cyclophosphamide tablet,Prednisone tablet,Penicillin V potassium tablet and other conven-tional treatment. Based on it,control group was given 160 mg valsartan,once a day in early morning. Observation group was addi-tionally given 20 mg atorvastatin,once a day before bedtime. They were treated for 6 months. Clinical efficacy,24 h protein amount (24 h pro),serum creatinine (Scr),blood urea nitrogen (BUN),glomerular filtration rate (GFR),C-reactive protein (CRP),total cholesterol (TC),triglyceride (TG ),low density lipoprotein (LDL) and high density lipoprotein (HDL) in 2 groups were observed,and incidence of adverse reactions was followed-up for 9 months. RESULTS:The total effective rate in ob-servation group was significantly higher than control group,the difference was statistically significant(P<0.05). Before treatment, there were no significant differences in 24 h pro,Scr,BUN,GFR,CRP,TC,TG,LDL and HDL between 2 groups(P>0.05). After treatment,24 h pro,Scr,BUN and CRP in 2 groups were significantly lower than before,and observation group was lower than control group,GFR was significantly higher than before,and observation group was higher than control group,the differenc-es were statistically significant(P<0.05). TC and LDL in 2 groups were significantly lower than before,HDL was higher than be-fore,the differences were statistically significant(P<0.05);but there were no significant differences in the TG between 2 groups and before and after treatment(P>0.05). And there was no significant differences in the incidence of adverse reactions between 2 groups (P>0.05). CONCLUSIONS:Based on the conventional treatment,the efficacy of atorvastatin combined with valsartan is superior to valsartan alone in the treatment of chronic nephritis,and it can significantly improve renal functions,with similar short-term safety.

Inflammatory bowel disease (IBD) could lead to the complexity of intra-abdominal pathology and patients' malnutrition,which might greatly increase the risk of operation.Laparoscopic minimally invasive surgery is playing an important role in the treatment of IBD,with the advantages of faster postoperative recovery,shorter duration of hospital stay and lower incidence of postoperative complications.And some new techniques for IBD have been reported in the western countries,such as single-incision laparoscopic surgery,natural orifice transluminal endoscopic surgery,robot-assisted laparoscopic surgery and so on.However,the new techniques are not widely used in China,and it is necessary to carry out a series of clinical practices,which should be carefully selected for IBD patients undergoing minimally invasive surgery.

Compared with the regeneration ability of normal liver,that of liver with cirrhosis is so weak that its reserve function is insufficient,resulting in a great increase of chance of liver failure after partial hepatectomy,and limiting the development of major hepatectomy.It has been demonstrated that the hepatocytes of cirrhosis still possess the suppressed ability of regeneration.The morphological structures as well as physiological functions of regenerated hepatocytes are not complete.The important mechanisms leading to the impairment of regeneration ability include pathophysiologic changes such as excessive deposition of extracellular matrix and the capillarization,the imbalance of energy metabolism of hepatocytes and disruptive secretion of sinus endothelial cells and so on.The clinical observation is that many factors can stimulate the regeneration of liver with cirrhosis,including radiofrequency ablation,partial hepatectomy,associated liver partition and portal vein ligation for staged hepatectomy,splenectomy,drugs,cell transplantation,tokines et al.It is of great significance to promote the regeneration ability of liver with cirrhosis associated with various approaches reasonably for enhancing the security of partial hepatectomy and treatment of end-stage liver diseases.

In recent years, the incidence of the allergic skin diseases is increasing as the growing of the pressure, the changes of the environment and other factors. The clinical features of the allergic skin diseases are easily repeated and in long course. It is found that the incidence of clinical allergic skin diseases, in addition to the season, diet and emotional relevant, is also closely linked to the physical deterioration of patients. Therefore, in addition to the emphasis on the treatment of the current symptoms of patients, adjustment and treatment of phsical constitution of patients and improvement of the adaptability of patients to environmental changes should attract attention, thereby reducing the frequency of incidence and alleviating the symptoms. The application of the abdominal acupuncture combined with body acupuncture for the improvement of the symptoms and physical constitution of allergic skin disease patients has obvious efficacy, which should be applied and promoted in clinic.

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.

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.