Objective To investigate the effect of different loading doses of atorvastatin in patients with stable plaques.Methods Consecutive 174 patients with stable plaque who underwent coronary arteriongraphy (CAG) and intravascular unltrasound(IVUS) were randomly assigned to receive 10 mg atorvastatin treatment (group 10 mg,n =47),20 mg atorvastatin treatment(group 20 mag,n =45),40 mg atorvastatin treatment (group 40 mg,n =43) and 80 mg atorvastatin treatment (group 80 mg,n =39).The endpoints including low density lipoprotein-cholesterol(LDL-C),high density lipoprotein-cholesterol (HDL-C),high-sensitivity C-reactive protein (hs-CRP) levels,necrotic and plaque volumes,were assessed after 3-6 months' follow-up.Results Mean LDL-C,HDL-C,hs-CRP,the percentage of necrotic,plaques volumes were similar at baseline (P ＞ 0.05).During 3-6 months of follow up:(1)LDL-C levels in group 10 mg,20 mg,40 mg,80 mg were lower than at baseline (t =3.12,4.23,3.26 and 5.21 respectively,P ＜ 0.01).There was significant difference between the 20 mg group and the 40 mg group(P ＜ 0.05) ; (2) There was no significant difference of HDL-C levels in 10 mg,20 mg and 40 mg groups after atorvastatin treatment.However,its level was significantly higher in the 80 mg group after atorvastatin treatment than other dose groups(P ＜ 0.05) and were higher than at baseline(t =2.35,P ＜ 0.01) ;(3)the 80 mg group's hs-CRP levels decreased significantly after treatment than at baseline((3.59 + 1.07)mg/L vs (6.10 + 2.12) mg/L,t =2.37,P ＜ 0.01);(4)According to the VH of IVUS,the percentage of necrotic in 10 mg group became higher than at baseline ((16.54 + 1.76) ％ vs.(7.83 + 1.03) ％,t =2.38,P ＜0.01) and conformed to unstable plaques diagnostic criteria(＞ 10％).There was no significant difference in group 20 mg,40 mg and 80 mg with at baseline (t =1.24,0.21,0.69 respectively,P =0.069,0.846,0.643respectively) ; (5)Plaques volumes in group 10 mg,20 mg were not larger than at baseline.However,in group 40mg and 80 mg.Plaques volumes were smaller than at baseline ((30.69 ± 8.12) mm3 vs (37.09 + 12.01)mm3,t=l.29,P=0.019;(24.99±l.01) mm3 vs (36.47+14.68) mm3,t =2.62,P＜0.01).Conclusion The effects of atorvastatin on stable plaques vary with doses.(1) For LDL-C,the use of atorvastation 20 mg/d can make LDL-C reaching standard,and atorvastation 40 mg/d was superior to 20 mg/d and similar to 80 mg/d.(2)For HDL-C,atorvastation 80 mg/d can make it higher.(3)Atorvastation 80 mg/d can make hs-CRP lower.(4)Atorvastation≥20 mg/d can make plaques stable and atorvastation 80 mg/d was superior to 20 mg/d and 40mg/d.Atorvastation 40-80 mg/d can make plaques dwindled.

BACKGROUND:Traditional analgesia method can relieve the pain after total knee arthroplasty, but the prognosis is poor and drug dependence is strong. Therefore, it is of great significance to study the analgesic drugs in perioperative period of total knee arthroplasty. OBJECTIVE:To explore the analgesic effect of gabapentin combined with continuous femoral nerve block on total knee arthroplasty. METHODS: A total of 48 patients with knee osteoarthritis receiving total knee arthroplasty in the Department of Orthopedics, Affiliated Hospital of Inner Mongolia Medical University from October 2013 to October 2014 were enroled in this study. Using general anesthesia, femoral nerve block was conducted before anesthesia. Analgesia pump was connected after arthroplasty. Patients were randomized to two groups. The control group received multimodal analgesia, and the experimental group received gabapentin combined with continuous femoral nerve block analgesia. Patient’s pain was scored by using resting, activity visual analog scale. Postoperative quality of life, range of motion of knee joint and complications were observed. RESULTS AND CONCLUSION:No significant difference in preoperative resting pain and activity pain was detected between the two groups (P > 0.05). Visual analog scale scores were decreased with time prolonged after arthroplasty in both groups. Visual analog scale scores of resting pain and activity pain were significantly lower in the experimental group than in the control group at 1, 3 and 7 days and 1 month (P < 0.05). Range of motion was significantly larger in the experimental group than in the control group at 3-7 days after arthroplasty (P< 0.05). Activity of daily living score, physical function score, mental function score and social function score were significantly higher in the experimental group than in the control group (P < 0.05). The complication rate was significantly lower in the experimental group than in the control group (17%, 46%,P < 0.05). These data indicate that during perioperative period of total knee arthroplasty, analgesic effect of gabapentin combined with continuous femoral nerve block is ideal. In particular, in patients with acute pain within 48 hours, their combination can promote early rehabilitation of the patient’s knee, and few side effects are found.

Objective To investigate influence of lafutidine combined with omeprazole in serum pepsinogen subgroup levels of patients with chronic atrophic gastritis. Methods One hundred and thirty-eight patients with chronic atrophic gastritis were selected in the First Affiliated Hospital of Changchun Traditional Chinese Medicine University from Dec. 2010 to Dec. 2013,who were randomly divided into two groups. Sixty-nine patients treated omeprazole( oral 1 pill/times,1 times/d)as control group,and another 69 patients were treated lafutidine( oral 2 pills/times,2 times/d ) combined with omeprazole as observation group. Both Course of treatment was 8 weeks. Changes of serum pepsinogen subgroups,improvement of clinical symptoms,treatment effect and adverse reactions were compared between two groups. Results After treatment,the levels of pepsinogen I,pepsinogen I/pepsinogen II increased significantly while pepsinogen II decreased significantly in two groups. Pepsinogen I,pepsinogen I/pepsinogen II in observation group were(89. 46 ± 13. 25)μg/L,10. 21 ± 1. 27,significantly higher than control group(( 62. 34 ± 11. 90 )μg/L,6. 45 ± 0. 93;t =7. 358,9. 125;P=0. 017,0. 004). Pepsinogen II in observation group was(8. 76 ± 3. 24)μg/L,significantly lower than control group((9. 68 ± 4. 76 )μg/L,t =4. 035,P =0. 049 ). Stomachache disappearance rate,abdominal distention disappearance rate,loss of appetite disappearance rate,total efficiency in observation group were 89. 9%, 85. 5%,84. 1% and 98. 6% respectively,significantly higher than control group( 73. 9%,65. 2%,60. 9% and 82. 6%),and the differences were statistically significant( P ﹤ 0. 05 ). Incidence of adverse reaction in observation group was 5. 8%,higher than control group( 2. 9%),but the difference was not statistically significant(χ2 =0. 697,P﹥0. 05). Conclusion Lafutidine combined with omeprazole can significantly improve clinical symptoms of patients with chronic atrophic gastritis,which can also significantly improve serum pepsinogen subgroup levels. Lafutidine combined with omeprazole have significant clinical effect and high safety, which is worthy of clinical application.

Objective: To observe the effect of superior technology using three dimension radiation treatment plans (3D-RTPS) in the reduction of postradiation xerostomia in patients with head and neck cancer. Methods: 3D-RTPS of conventional radiation and new superior technique were applied in the patients of 3 kinds of head and neck cancer (tumor in middle, lateral, between middle and lateral area of head and neck). Superior technology including superior ray entrance, multi fields, conformal irradiation and application of wedges. Analysis of 3D dose distributions and dose volume histograms (DVH) was used to evaluate the dose and volume in tumor, parotids and spinal cord in the patients. Tumor dose of 55.6～68.6 Gy (average 58.8 Gy) was given to the patients in conventional radiation group in 8 patients, 53.5～68.5 Gy (average 58.3 Gy) to new radiation technique group in 12 patients. Whole saliva flow rate and subjective xerostomia scores were assessed in patients during radiation course and follow-up. Results: The dose in contralateral parotids in patients with tumor in lateral area, between lateral and middle area in conventional radiation and new radiation technique groups were 51.8～64.3 Gy and 0.4～1.4 Gy, respectively. The dose in parotids in patients with tumor in middle area in conventional radiation and new radiation technique groups were 51.8 and 24.7 Gy respectively. The rate of xerostomia at the end of radiotherapy and in 4～6 months follow-up after radiotherapy in patients of new radiation technique group were 8.3 % (1/12) and 0 respectively. Those in patients in conventional radiation group were 87.5 % (7/8) and 50 % (4/8) respectively. Conclusion: Superior technology using 3D-RTPS can reduce the rate of postradiation xerostomia in patients with head and neck cancer.

Objective To study the time relationships between apoptosis of neurons and endotheliocytes with the expression of Bcl 2 and Bax after reperfusion of focal cerebral ischemia in rats. Methods Coronal sections of brain were analyzed using an in situ terminal deoxynucleotidyl transferase mediated biotinylated deoxyuridine triphosphate nick end labeling(TUNEL)and immunohistochemical staining methods to observe apoptosis of neurons and endotheliocytes,and expression of Bcl 2 and Bax after reperfusion(2,6,12,24hours and 2,3,7,14,21 days)of focal cerebral ischemia. Results 1.In the ischemic penumbra,apoptotic cells were increased at 2h after reperfusion,peaked at 12 24?h,then decreased successfully for 7 14?days.The time of apoptotic endothelial cells was 12?h later than that of apoptotic neurons.2.The expression of Bcl 2 protein began at 2?h after reperfusion,peaked at 12 24?h,and decreased for 7 14?days.3.Bax protein expressed from 6?h after reperfusion;peaked at 24 48?h,and lasted for 14days.4.The time phase of Bcl 2 expression was similar to the Bax is but later than it. Conclusion\ Apoptosis was a pattern of cell death after cerebral ischemia/reperfusion.The time of apoptotic endothelial cells was later than that of apoptotic neurons.Bcl 2 and Bax play a regulatory role in the apoptotic process.\;[

Object To study the promoting effects of Mycena anoectochila, M dendrobii and M. orchidicola on growth of Dendrobium candidum Wall. ex Ldl. and Anoectochilus roxburghii (Wall ) Ldl Methods The protocorm and plantlet of D candidum and A roxburghii were grown in dual culture with endophytic fungi to observe the proliferation of protocorm and the growth of plantlet. Results The growth of plantlet of D candidium, which was inoculated three endophytic fungi, increased markedly 3 5 times more than those of the control one M dendrobii and M orchidicola also promoted multiplication on protocorm of D candidum (P

Objective To investigate the clinical features,pathology and prognostic factors of young patients with cervical cancer less than 35 years old.Methods One hundred and twenty cases cervical cancer less than 35 years old were selected as study group,while 120 cases of cervical cancer over 35 years old as control group in the same period.The clinical features and pathology were compared between two groups and risk factors were analyzed.Results The proportion of contact vaginal bleeding,menstrual disorders,mild cervical erosion,HPV infection,and the number of pregnancy preserving ovarian surgery in study group were significantly higher than that in control group(60.8％(73/120)vs.47.5％(57/120),30.0％(36/120)vs.11.7％(14/120),57.5％(69/120)vs.23.3％(28/120),81.7％(98/120)vs.60.0％(72/120),52.5％(63/120)vs.25.8％(31/120)),the differences were statistically significant(x2=4.30,12.23,29.90,13.63,17.91;P＜0.05).The incidence of irregular vaginal bleeding in study group was significantly lower than that in control group(6.7％(8/120)vs.15.8％(19/120)),the differences was statistically significant(x2=5.05,P＜0.05).The main pathological types of two groups were squamous cell carcinoma,non squamous cell carcinoma rate in study group was significantly higher than that in control group(27.5％(33/120)vs.15.0％(18/120)),the differences was statistically significant(x2=5.60,P＜0.05).Pelvic lymph node metastasis rate in study group was 68.3％(82/120),significantly higher than that in control group(55.0％(66/120),x2=4.49,P＜0.05).Multivariate analysis of prognostic factors in young patients with cervical cancer showed that clinical stage,pathological type,depth of cervical invasion and pelvic lymph node metastasis were independent risk factors for the prognosis of young patients with cervical cancer(Wald x2=4.02,6.93,8.92,10.87;OR=3.22,5.57,6.84,5.48;95％CI=1.13-8.62,1.24-11.75,2.82-17.35,1.88-12.35,P＜0.05).Conclusion There are some differences in the clinical features and pathological characteristics of young patients with cervical cancer and middle-aged and elderly patients with cervical cancer.More attention should be paid on the high clinical staging,non squamous cell carcinoma,deep cervical infiltration positive pelvic lymph node metastasis patients,focus on the investigation and prevention,improve the individual treatment and prevention and control system.

skeletal muscle;energy metabolism;training adaption;mitichondrial content

Respirator is one of medical equipment in the first-aid, the clinical risk of it is much higher than the general medical equipment and diagnostic or patient monitor equipment. As a result, the quality control of it is particularly important. Several issues of the quality control of the respirator, such as the pre -purchase technical feasibility study, acceptance and installation after arrival, respirator use and management, respirator-reported loss demonstration and cost- benefit analysis of it are discussed from the angle of clinical engineers and technical personnel.

A new retinoscope with the ultrasonic distance measure instrument is designed for directly displaying the dioptre of artificial myopia caused by retinoscopy distance.Optometrist can obtain real dioptre of the patient if only adding the direct dioptre of artificial myopia to neutral dioptre obtained at roll-back point.This instrument can obviously increase the accuracy of refraction.