OBJECTIVE:To observe the efficacy and safety of atorvastatin calcium combined with metoprolol in the treatment of chronic congestive heart failure (CHF). METHODS:207 CHF patients were randomly divided into control group (102 cases) and observation group (105 cases). Control group received cardiac,diuretic,vasodilating and oxygen inhalation,Metoprolol tar-trate tablet with initial dose of 6.25 mg,2-3 times a day,then increased 6.25-12.5 mg based on the improvement,2-3 times a day. Observation group additionally received 80 mg Atorvastatin tablet,twice a day. The treatment course for both groups was 16 w. Clinical efficacy,cardiac functions [left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),mi-tral early diastolic and late diastolic peak flow velocity ratio(E/A)],blood lipids [lipoprotein(a)Lp(a),triglyceride(TG),total cholesterol(TC)] levels before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant (P<0.05). Before treatment,there were no significant differences in cardiac functions and blood lipids in 2 groups(P>0.05). Af-ter treatment,the LVEF and E/A in 2 groups were significantly higher than before,and observation group was higher than control group,LVESD,Lp(a),TG and TC were significantly lower than before,and observation group was lower than control group,the differences were statistically significant (P<0.05). And there was no significant difference in the incidence of adverse reactions (P>0.05). CONCLUSIONS:Based on conventional treatment,the efficacy of atorvastatin calcium combined with metoprolol is su-perior to metoprolol in the treatment of CHF,with better safety.

ObjectiveTo study the feasibility,safety and effect of laparoscopic splenectomy and selective pericardial devascularization in the treatment of portal hypertension.MethodsThis study included 7 patients diagnosed as posthepatitie cirrhosis and portal hypertension with a history of up GI bleeding receiving laparoscopic splenectomy and selective pericardial devascularization.ResultsThe operation was successful in all 7 patients without conversion to laparotomy.There were no postoperative severe complications.The average operation time was 4.2 h,mean blood loss was 430 ml.All patients recovered well,and were followed-up for 0.5 ～ 2.0 years,and there was no rebleeding in this period.ConclusionsLaparoscopic selective pericardial devascularization is feasible,safe,minimally invasive.The short to mid term result was satisfactory.

Peritoneum is one of the common site of colorectal cancer metastasis. Traditionally, peritoneal carcinomatosis is associated with a poor prognosis without effective surgical treatment. Recently, the attitude towards the treatment strategies for colorectal peritoneal metastasis has changed significantly with advances in surgical techniques, hyperthermic intraperitoneal chemotherapy and multi-disciplinary treatment. As to the prognosis, colorectal peritoneal metastasis has an inferior outcome to non-peritoneal metastasis under the palliative systemic treatment. However, the complete peritoneal cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy can achieve a long-term survival in selective patients with colorectal peritoneal metastasas. The prognostic factors include peritoneal carcinomatosis index, completeness of cytoreduction, the presence of extra-peritoneal metastasis (liver etc), peritoneal surface disease severity score and Japanese peritoneal staging. In terms of the treatment, complete peritoneal cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy and systemic treatment (including chemotherapy and targeted therapy) may be the best modality of multi-disciplinary treatment for colorectal peritoneal metastasis.

Objective To investigate the early diagnosis of vitiligo and its differential diagnosis from other depigmentated diseases using polarized light dermoscopy(PD)imaging analysis.Methods Patients with localized depigmented macules were enrolled into this study.PD was used to observe the micromorphology,feature and color of skin lesions.Histopathology was performed to confirm the diagnosis of all cases except for those of pityriasis versicolor which were confirmed by clinical and laboratory examination.Results Of the 176 patients.97 were diagnosed as vitiligo.Residual perifollicular pigmentation Was observed in 91.94%(57/62)of patients with progressing vitiligo and 62.86%(22/35)of those with stable vitiligo,with significant difference between the two groups of patients(P<0.05).However.residual perifollicular pigmentation was absent in the 79 non-vitiligo depigrnented cases.The presence of telangiectasia,early reservoirs of pigmentation and perilesional hyperpigmentation were related to the stage of vitiligo and treatment history of patients.Conclusions PD,which efficiently eliminates the interference of reflected light on skin lesions of vililigo,is an imaging technique that allows for the visualization of minor structures and features of the skin lesions that are indiscernible to naked eyes.In a nutshell,the application of PD has offered references to the early diagnosis of vitiligo and its differential diagnosis from other depigmentation diseases.

Objective To investigate the value of image analysis technology of polari-light dermoscopy (PD) in diagnosing head and face tumors. Methods We randomly collected the head and face tumors from the patients in this hospital, and then diagnosed them with naked eyes and PD, respectively. After making sure the diagnosis by histopathology, we analyzed the results retrospectively. Results We summarized the diagnostic signs of 211 head and face tumors on dermoscopy, which shown a great specificity. Its diagnosis rate reached to 92.89 %, obviously higher than that (69.67 %)with naked eyes. Due to clinical misdiagnosis and erroneous treatment, the recurrence rate of skin lesions was 19.91 %. The top 3 of head and face tumors, in turn, was seborrheic keratosis, melanocytic tumor and basal cell carcinoma. Conclusions PD is a non-invasive image analysis technology, which is especially applicable to the early diagnosis of head and face tumors. It can make sense in decreasing blind biopsy, directing surgical excision areas effectively, and selecting reasonable remedy. It also has great significance in the recovery and beauty of skin lesions.

Objective To study the safety and feasibility of laparoscopic total splenectomy (LTS) and laparoscopic partial splenectomy (LPS) in the diagnosis and treatment of benign splenic tumors by comparing the perioperative and follow-up data between these two operative approaches.Methods We retrospectively analyzed the clinical data of 57 patients who underwent laparoscopic surgery for benign splenic tumors from December 2009 to April 2016.These patients were divided into the LTS and the LPS groups.The clinical data including the preoperative,intraoperative,postoperative and follow-up data were analyzed.Results When compared with the LPS group,the LTS group had shorter operation time [(97.0 ± 22.1)min vs.(135.0 ± 24.6) min,P ＜ 0.05] and less blood loss [(33.3 ± 19.5) min vs.(90.6 ± 55.1)min,P ＜ 0.05],but there were no significant differences between the two groups in the length of hospital stay,the duration of drainage tube placement,the amount of postoperative analgesics as well as the incidences of pulmonary infection,postoperative pancreatic fistula and other complications after surgery.These incidences were low in the two groups.Conclusion Laparoscopic surgery,including LTS and LPS,were safe and feasible in treating benign splenic tumors.

The origin place and quality of the traditional medicinal materials have been revolutionized in the last hundred years. The cultivated one, loom larger and larger, have become popular, with a result of declined quality, varied origin place, lack of criterion to measure quality, and confused definition usage, etc. The famous-region drug, with a high quality, should be defined not only as the origin place, but also as specific germplasm, ecological condition, and modes of production. On the basis of defining the concept of genuine medicinal materials, optimizing germplasm resources and origin place and strengthening the research of quality formation would be a main route to improve the quality of cultivated medicinal materials and promote the healthy development of traditional Chinese medicine industry.

With the increase in population and depletion of resources, the wild resources of Chinese materia medica are not enough to meet the demand of human, so the cultivated resources become a major source, resulting in severe degradation of herbal medicine quality. It poses a serious threat to traditional Chinese medicine with thousands of years of history. The cultivation is the most basic and effective means to solve the shortage of resources, and improving the quality of the cultivated medicinal materials is the key to deal with this problem. In this paper, the current production and developments of herbal medicine were discussed, the problems of blindly expanding planting area, lack of enough attention to germ plasm resource and advanced production technology were prevalent. The idea of improving the quality and yield of cultivated medicinal materials was put forward. On the premise of improving the quality and yield of medicinal materials, the cultivation of Chinese medicinal materials should optimize the planting area, standardize the cultivation of fine high-quality germplasm, improve the production technology of high-quality medicinal materials, and expand the application market of Chinese materia medica to expand Chinese traditional culture.

Epidermalgrowthfactorreceptor-tyrosinekinaseinhibitor(EGFR-TKI)resistanceinnon-small cell lung cancer(NSCLC)has become more and more common,which includes primary and secondary resistance.The primary resistance is mainly related with EGFR gene mutation,and the secondary resistant is mainly related with T790M,MET and other genes.

Complement system is an important constituent in immune system.Membrane attack complex (C5b-9)is the final ingredient in the complement activation.Recently,a few studies showed that C5b-9 deposition was found in the diabetics with chronic complications,indicating that complement activation might be involved in the pathogenesis of diabetic complications.Our aim is to summarize some newly published works and show a prelimimary work we did in this area.We hope that more attention should be paid to the role of autoimmune mechanism in diabetic complications.