Objective To detect the level of visfatin in the peripheral blood ofpafients with coronary atherosclerotic heart disease (coronary heart disease),and investigate the conelation between the level of visfatin and the lesion degree of coronary heart disease.Methods Two hundred and twenty patients who were diagnosed as coronary heart disease by coronary artery angiography from January to June 2011 (coronary heart disease group) were enrolled in this study,including 74 cases with stable angina pectoris(stable angina pectoris group),60 cases with unstable angina pectoris (unstable angina pectoris group),and 86 cases with acute myocardial infarction (myocardial infarction group).And 20 healthy persons with normal coronary artery angiography were selected as control group.The biochemical parameters of triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were detected by biochemistry autoanalyzer.The level of serum visfatin was detected by ELISA analysis.The serum biochemical parameters and serum visfatin among all the groups were compared and the correlation between them was analyzed.ResuIts The level of serum visfatin of coronary heart disease group [(34.07 ±5.51) μg/L] was significantly higher than that of control group [(13.22 ±3.17) μg/L](P＜0.05).TC and LDL-C of different coronary heart disease groups had no significant differences compared with that of control group (P ＞ 0.05).TG,H DL-C and serum visfatin of stable angina pectoris group,unstable angina pectoris group and myocardial infarction group [(1.44 ±0.27) mmol/L,(1.16 ±0.12) mmol/L,(21.36 ± 3.35) μg/L; ( 1.84 ±0.32) mmol/L,(1.01 ± 0.08) mmol/L,(27.78 ±4.47) μg/L; (2.31 ±0.34)mmol/L,(0.93 ± 0.06) mmol/L,(33.14 ± 5.66) μ g/L] had statistical significance compared with those of control group [(0.93 ±0.25) mmol/L,(1.48 ± 0.24) mmol/L,(13.22 ±3.17) μg/L](P＜0.05 or ＜0.01).TG,C,ensini score and serum visfatin of unstable angina pectoris group were significantly higher than those of stable angina pectoris group and HDL-C was obviously lower than that of stable angina pectoris group (P ＜0.05).Gensini score and serum visfatin of myocardial infarction group were significantly higher than those of unstable angina pectoris group and HDL-C was obviously lower than that of unstable angina pectoris group (P ＜ 0.05).Spearman correlation analysis showed that the level of serum visfatin of coronary heart disease group was positively correlated with TG and Gensini score (P ＜0.05 or ＜0.01 ) and negatively correlatedwith HDL-C (P ＜ 0.01 ),and had no correlation with TC and LDL-C (P ＞ 0.05).Conclusions The highlevel expression of visfatin in the peripheral blood may be a risk factor of coronary heart disease.The changes of serum visfatin can reflect the lesion severity degree of coronary artery.

The relationship between hyperlactatemia and metabolic acidosis, which may involve shock resuscitation,homoiostasis, and nutritional support, remains a hot topic. On one hand, increased production of lac-tate due to anaerobic glycolysis during tissue hypoperfusion can aggravate metabolic acidosis; on the other hand,the utilization of lactate at organ and cell levels may lower blood lactate level, and thus alleviate metabolic acidosis.The ultimate blood lactate level depends on the balance of these two action mechanisms.

Objective To compare the efficacy and complications of early transabdominal preperitoneal patch (TAPP) implantation and open tension-free repair in the treatment of adult inguinal hernia .Methods 84 adult patients with inguinal hernia were divided into two groups by random number table ,and 42 cases in each group .The control group was given Lichtenstein technique ,while the observation group underwent TAPP .The surgery situation, postoperative visual analogue scale (VAS) scores,postoperative morbidity and recurrence rate were compared between the two groups.Results The operative time,ambulation time,average length staying hospital and postoperative VAS scores of the observation group were (42.21 ±3.13) min,(1.13 ±0.21) d,(4.28 ±0.62) d and (2.28 ±0.22) points,which were significantly less than (65.72 ±3.62)min,(2.03 ±0.30)d,(7.87 ±0.83)d and (4.56 ±0.31) points of the control group(t=7.29,8.02,8.32,9.29,all P<0.05).The incidence rate of postoperative complica-tions and recurrence rate of the observation group were 11.90% and 2.38%,which were significantly lower than 26.19%and 16.66%of the control group(χ2 =12.52,14.39,all P<0.05).Conclusion The effect of TAPP in the treatment of adult inguinal hernia is remarkable ,and it is safe and minimally invasive ,which is easy to operate ,it has low recurrence rate ,rapid postoperative recovery and has better clinical value .

Objective: In order to provide references for drawing up related health policy reasonably, the current status of medical insurance payment in third level hospital. Methods: Through analyzing the payment situation of medical insurance in third level hospital from 2010 to 2012, to understand the related situation of gross prepayment system in large publich hospital since this year. Results: In recent years, the coverage rate of health insurance in the whole city is increasing continuously, while the rising extend of annual gross prepayment limit is not obvious, refusal in medical insurance fund is serious and the accounting method of prepay limit is not scientific. Conclusion: While satisfying the quality of patients’ visiting, it needs to implement gross prepay accounting method, enhance medical management and reduce the economic burden of the hospital.

Objectives: To investigate the effect of the addition of glutamine to WMO solution on the small bowel preservation. Methods:According to preservation solutions, the rats were divided randomly into three groups: University of Wisconsin solution(UW group), WMO solution (WMO group) and WMO solution with the addition of glutamine(WMO G group). And each group was redivided into two subgroups in terms of preservation time of 8 h or 12 h. The intestine was perfused by intubation via abdomial aorta, then the gut was flushed with metronidazole solution(4℃,5%). The proliferation of small intestine was observed through tissue culture. The histology, immunohistochemistry (TUNEL, PCNA) of intestinal mucosa and determination of ATP were used to evaluate the results. Results: Compared with UW group and WMO group, ATP contents of WMO G group were significantly higher, particularly in 12 h subgroup. Apoptosis in WMO G group was slighter than those in UW group and in WMO group. The difference in the two latter was not obviously, although pathological change in UW group was slighter than that in WMO group. The number of positive PCNA cells in WMO G group was more than that in other groups. Conclusions: The addition of glutamine to WMO solution could decrease injury of small bowel induced by cold ischemia, provide energy for the small bowel,and promote the proliferation of small bowel mocosal cell.

Objective To investigate the effects of Yindan-Xinnaotong combined with aspirin on lipidemia levels and hemorrheology in patients with stroke. Methods A total of 62 patients with stroke were randomized into a treatment group (31 cases) and a control group (31 cases). The patients in the control group were treated with aspirin and those in the treatment group were treated with aspirin and Yindan-Xinnaotong capsule (4 capsules each time, 3 times/d) for 30 days. The lipidemia levels and hemorrheology were evaluated before and after the treatment. Results After the treatment, whole blood viscosity (4.15 ± 0.14 mPa?s vs. 5.25 ± 0.40 mPa?s;t=14.452, P<0.01), plasma viscosity (1.70 ± 0.30 mPa?s vs. 2.70 ± 0.25 mPa?s;t=14.258, P<0.01), fibrinogen (3.71 ± 0.51 g/L vs. 5.80 ± 0.41 g/L;t=17.783, P<0.01) and thrombosis index (0.75 ± 0.31 vs. 1.30 ± 0.21;t=8.178, P<0.01) in the treatment group were significantly lower than those in the control group. After the treatment, the serum levels of total cholesterol (3.31 ± 1.19 mmol/L vs. 5.04 ± 1.30 mmol/L;t=5.465, P<0.01), triacylglycerol (0.63 ± 0.31 mmol/L vs. 1.34 ± 0.05 mmol/L;t=12.589. P<0.01) in the treatment were significantly lower than those in the control group, the serum level of high-density lipoprotein cholesterol in the treatment group was significantly higher than that in the control group (1.83 ± 0.49 mmol/L vs. 1.28 ± 0.45 mmol/L;t=4.603, P<0.01), and there was no significant difference in the serum level of low-density lipoprotein cholesterol between the two groups (2.22 ± 0.61 mmol/L vs. 2.11 ± 0.95 mmol/L; t=0.543, P>0.05). Conclusion Yindan-Xinnaotong combined with aspirin can improve the lipidemia and hemorrheology in stroke patients.

Taking Liaoning University of Traditional Chinese Medicine as an example, a survey of seven-year program students in-formation quality is made.Based on the survey result, it discusses the content, teaching method and approach reform of Traditional Chi-nese medicine literature and information retrieval course for seven-year program students, so as to make better contribution to improving the information literacy of the seven-year program students.

Objective To observe and research the influence of vaginal delivery and cesarean section by two kinds of mode of delivery on maternal infant outcome of re-pregnancy after cesarean section.Methods 258 patients with re-pregnancy after cesarean section were selected,they were divided into vaginal delivery group(73 cases) and cesarean section group(185 cases) according to the different delivery mode.The maternal puerperal infection rate,24h postpartum hemorrhage volume,days,cost of hospitalization,lochia time and neonatal in hospital of both two groups were compared.Results The success rate of vaginal delivery was 69.52％,the rate of cesarean section was 71.71％.In vaginal delivery group,maternal puerperal infection rate,24 h postpartum hemorrhage volume,length of hospital stay,cost of hospitalization,lochia time were 1.73 ％,(201.54 ± 107.54) mL,(3.41 ± 0.09) d,(1 540.12 ±117.21),(21.36 ± 13.12) d,which were significantly better than the second cesarean section group [8.11％,(354.64 ± 215.54) mL,(7.45 ± 0.32) d,(4 932.62 ± 786.35),(27.11 ± 17.04) d],the differences were statistically significant (x2 =4.08,t =4.75,7.24,8.91,3.98,all P ＜ 0.05).Delivery of two kinds of mode of delivery of the newborn had no significant differences in birth weight,Apgar score,the rate of infection,intracranial hemorrhage rate and the asphyxia rate(t =0.15,0.09,0.46,0.00,x2 =0.03,all P＞0.05).Conclusion Re-pregnancy after cesarean section is not the choice of cesarean section delivery clinical indications of operation,when the pregnant women with indications of trial production,in strict monitoring downlink vaginal delivery.

Objective:To explore the significance measuring serum levels of high sensitive C reactive protein (hsCRP),ho-mocysteine (Hcy)and carotid atherosclerosis lesion in patients with coronary heart disease (CHD)complicated atrial fibril-lation (AF).Methods:A total of 84 CHD + AF patients (CHD + AF group),42 CHD patients with sinus rhythm (sinus rhythm CHD group)and 40 healthy subjects (healthy control group)were selected.CHD + AF group was further divided into paroxysmal AF group (n=31),persistent AF group (n=27)and permanent AF group (n=26).Serum levels of hsCRP and Hcy and carotid intima-media thickness (IMT)were measured in all groups,and Crouse integral of atheroscle-rotic plaques was calculated.Results:Compared with healthy control group,there were significant rise in serum levels of hsCRP [(4.97±2.14)mg/L vs.(8.96±3.75)mg/L vs.(6.83±2.91)mg/L],Hcy [(15.48±4.36)μmol/L vs.(23.64 ±7.06)μmol/L vs.(17.76±4.83)μmol/L],IMT [(1.21±0.15)mm vs.(1.71±0.19)mm vs.(1.36±0.17)mm]and plaque Crouse integral [(4.13±1.06)scores vs.(7.89±1.35)scores vs.(4.96±1.21)scores]in CHD + AF group and sinus rhythm CHD group,P <0.05 or <0.01;and those of CHD + AF group were significantly higher than those of sinus rhythm CHD group,P <0.01 all,compared with paroxysmal AF group,there were significant rise in serum levels of hsCRP,Hcy,IMT and plaque Crouse integral in permanent AF group and persistent AF group (P <0.05 or <0.01),and those of permanent AF group were significantly higher than those of persistent AF group (P <0.05 or <0.01);Pearson correlation analysis indicated that in CHD + AF group,serum levels of hsCRP and Hcy were positively correlated with AF duration (r =0.619,0.527,P<0.05 both),and positively correlated with Crouse integral of carotid plaque (r =0.438, 0.561,P<0.05 both),and Crouse integral of carotid plaque was positively correlated with AF duration (r =0.624,P <0.05).Conclusion:Inflammatory reaction,oxidative stress and carotid atherosclerosis are more severe in CHD + AF pa-tients,and they aggravate along with AF duration prolongs.

Objective:To evaluate the curative effect of electroacupuncture on postapoplectic incontinence of urine.Methods:One Hundred and fifty-five patients were randomly allocated into a treatment group of 102 cases and a control group Of 51 cases.The treatment group was treated with electroacupuncture and the control group with Wlestem medicine.The curative effects were evaluated after 1-2 months.Resuits:The basic cure rate.marked eriective rate,effective rate and inelyective rate were 47.0%,27.5%,1 8.6% and 6.9% respectively,with a total effective rate of 93.1%in the treatment group and 7.9%,1 7.6%,1 7.6% and 56.9% respectively,with a total effective rate of 43.1% in the control group.There was a statistically significant difference in curative effect between the two groups(P＜0.05).The curative effect was significantly beaer in the treatment group than in the control group.Conclusion:Electroacupuncture has a good curative effect on postapoplectic incontinence ofurine.