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.

Oxidative stress is involved in cirrhotic portal hypertension and a close relationship exists between oxidative stress and hyperdynamic circulation.This article elaborates on the function of various reactive oxygen species (e.g.,superoxide anion and hydrogen peroxide) and corresponding anti-oxidants (e.g.,NAD(P) H oxidase inhibitor,the scavengers of superoxide anion,hydrogen peroxide,and vitamin C or E) on the occurrence and development of hyperdynamic circulation in cirrhotic portal hypertension.We observed that the level of reactive oxygen species in cirrhotic portal hypertension was elevated over normal.The potential clinical value is that inhibition or removal of these reactive oxygen species can relieve hyperdynamic circulation and reduce complications for cirrhotic portal hypertension.

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.

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.

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.

Objective To investigate the changes of serum levels of high-sensitivity C-reactive protein to distinguish community-acquired pneumonia caused by bacteria or mycoplasma pneumoniae in children.Methods To examine the serum levels of hs-CRP of patients with bacteria ( n =50),mycoplasma pneumoniae ( n =50),Virus ( n =50) by the Immunofluorescence method.and The levels of white blood cell(WBC),count of polymorphonuclear neutrophils(PMN) and neutrophil percentage(N) were analyzed.Results The levels of hs-CRP increased to different degrees in patients with bacterial pneumonia or mycoplasma pneumoniae pneumonia.the level of WBC,PMN and N have significant difference btween two groups also( all P ＜0.01 ).The area under the ROC curve(AUC) of hs-CRP was bigger than that of WBC,PMN and N(0.935 vs 0.783,0.807,0.747) and it was Significant difference(all P＜0.05).Conclusion Serum bs-CRP was a better biomarker in the early diagnosis of bacteria and it could effectively dstinguish community-acquired pneumonia caused by bacteria or mycoplasma pneumoniae in Children.

ObjectiveTo investigate the clinical value of intrafascial hysterectomy with intact ascending uterine artery.MethodsA total of 78 cases of simple hysterectomy patients were divided into group A (underwent intrafascial hysterectomy with intact ascending uterine artery) and group B(underwent modified intrafascial hysterectomy) with 39 cases each by random digits table.The operation time,the amount of hemorrhage,the postoperative complications,the ovarian function and the quality of sexuality were studied and compared.ResultsThree cases were lost in group B.There were no statistical differences in operation time,the amount of hemorrhage,postoperative hemorrhage,postoperative pyrexia,the quality of sexuality between two groups(P ＞0.05).There were significant differences in follicule-stimulating hormone and estradiol level in group B compared with those before operation (P＜ 0.05).There was significant difference in climacteric symptom between two groups [ 5.13％ (2/39) vs.22.22％ (8/36) ](P ＜ 0.01 ).The ascending uterine arteries and the ovarian branch of both sides were showed 100％ in group A.ConclusionsIntrafascial hysterectomy with intact ascending uterine artery has less influences on the blood flow of the ascending uterine arteries and the ovarian branch,there is slight influence on ovarian function and has no obvious influence on the quality of sexuality.The forward clinical effects should be studied further.

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.