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.

objectives To explore the clinical significance of the triple screening method and fetal sonographic markers in Down syndrome screening. Methods The retrospective study included maternal blood serum triple-marker screening per-formed in normal singleton pregnancies at 14+1 to 19+6 weeks and ultrasonography screening for fetal chromosomal trisomy at 18+1 to 23+6 weeks from 2010 to 2013. Results In 24 368 pregancies, Karyotype analysis reveal 35 Down syndromes, the incidence is 0.14%(35/24 368). 25/35 were pregnancies with an expected date of delivery lower than 35 years old and 10/35 were pregnan-cies with an expected date of delivery higher than 35 years old. In 1 215 pregnancies, second-trimester serum screening showed high risk (cutoff>1:380), 14 were confirmed as Down syndromes ( sensitivity 40%;specificity 95.06%). In 1 142 pregnant women showed ultrasonography abnormalities, of which 11 were found to have Down syndrome (sensitivity 60%;specificity 91.09%). In 112 pregnancies, second-trimester serum screening and ultrasonography showed high risk, 4 were conformed as Down syn-drome (sensitivity 11.43%;specificity 99.56). Conclusions The most effective method of screening for Down syndrome is by maternal serum biochemistry. Ultrasonography is important in screening fetal trisomy 21. combined screening methods can improve the detection rate of trisomy 21.

Three-tier architecture develops the traditional C/S architecture and stands for application's future.This paper compares C/S architecture with three-tier architecture and designs one medical information query system using three-tier architecture technique.

To explore the impact of normal range plasma calcium level changes on fibrinogen and homocysteine (Hcy) in non-diabetic elderly patients. Methods: A total of 1030 non-diabetic patients≥65 years were retrospectively studied. According to adjusted plasma calcium concentration (Cac), the patients were divided into 4 quartiles as Q1 group, Q2 group, Q3 group and Q4 group. The relationship between Cac and plasma levels of fibrinogen and Hcy were compared. Results: ① Plasma levels of fibrinogen and Hcy were increased by Cac elevation accordingly, P=0.010 and P<0.001 respectively. ② Cac was obviously related to the prevalence of high fibrinogen (OR=1.75, P=0.019) and high Hcy (OR=1.82, P=0.026). ③ Cac was positively related to fibrinogen (Standardized β=0.15, P<0.001) and Hcy (Standardized β=0.08, P=0.009). Conclusion: Normal range plasma calcium level changes were related to the elevation of plasma fibrinogen and Hcy in non-diabetic elderly patients.

The liquid-chromatography-mass technology was used in the metabolomic analysis of mouse's blood 1 hour after exhaustive exercise,in order to explore the potential mechanism of Rhodiola in fatigue elimination of exhaustive exercise mouse.The exhaustive mouse model was made by loaded-swimming.A total of 24 mice were randomly divided into theRhodiola + exercise group,exercise group andno-exercise group.The dose of Rhodiola was 0.4375 g·kg-1·d-1.The loaded-swimming was conducted after two successive weeks of medication.Blood was collected 1 h after swimming for the sample preparation.The enzyme assay and anthrone colorimetry were used to test blood lactate acid and glucose,respectively.UFLC-Q-TOF was used to detect metabolic profiles of each group.The principal component analysis (PCA),orthogonal partial least squares discriminant analysis (OPLS-DA) and heat map analysis were used to compare differences among groups with score chart and to obtain the characteristics biomarkers by load chart.The results showed that the blood lactate acid level of theRhodiola+ exercise group was significantly lower than that of theexercise group.And the glucose level of theRhodiola+ exercise group was significantly higher than that of theexercise group.The metabolomic analysis showed that there were no obvious changes on 1,25-(OH)2D3,diacylglycerol (DG) and inositol triphosphate (IP3).All three materials in theRhodiola + exercise group were significantly lower than those of theexercise group.They were much closer to theno-exercise group.And all three materials were related to the increasing of muscle tension.It was concluded that Rhodiola had the function of promoting fatigue eliminating.This effect may be related to cell membrane protection,regulation of 1,25-(OH)2-D3→IP3,DG pathway,and relieving of muscle tension after exercises.

Evidence-based medicine is advocated by WHO and adopted by developed countries for many years. In China, however, the selection of essential medicine and various medical insurance reimbursement schemes medicine is usually based on experts' experience of prescription practice which is under heavy critics resulting from the lack of related comparative efficacy and evidence-based research. The efficacy of Jian'ganle in prevention of drug-induced liver injury (DILI) caused by antituberculotics was evaluated in this study by comparison with Hugan Pian, glucuronolactone and reduced glutathione. Evidence was provided for relevant sectors such as Ministry for Human Resources and Social Security of the People's Republic of China and National Health and Family Planning Commission of the People's Republic of China to select and renew the Essential Medicine List (EML), the new rural cooperative medical scheme in China (NRCMS) list or the reimbursement list of industrial injury insurance. A total of 189 patients with initial pulmonary tuberculosis were divided into four groups who took antituberculotics combined with Jian'ganle, Hugan Pian, glucuronolactone and reduced glutathione respectively. Their liver function profile including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), total protein (TP), albumin (A) and globulin (G) were detected at admission as baseline and after treatment. The Jian'ganle group was compared with the three others by chi-square tests. In an aspect of maintaining bilirubin indexes normal, Jian'ganle was more efficacious than glucuronolactone. And Jian'ganle had a little more efficacy than reduced glutathione to maintain protein indexes normal as well. And the therapeutic regimen of antituberculotics combined with Jian'ganle was the best in treating tuberculosis and preventing DILI at the same time. The study showed that among the four hepatinicas which demonstrated similar prevention of DILI caused by antituberculotics, Jian'ganle has more advantages over the three others to some extent, which provides a reliable basis for health sectors to select and renew the EML, NRCMS List or the reimbursement list of industrial injury insurance.

Aim To evaluate the effect and safety of azithromycin injection produced in China and cefazolin in the treatment of respiratory tract infections.Methods 50 patients with respiratory tract infections were divided randomly into two groups. Patients in the test group recieved azithromycin in the dosage of 250 mg?d-1,qd for 5 d iv with double dosages at the first time and patients in the control group recieved cefazolin in the dosage of 2.0 g,bid,iv for 5～10 d. Results No statistical significant differences of overall clinical effect were observed between two groups .The fully recovery,effective and side reaction rates for the test group were 46.67%,90% and 3.3%,respectively,and for control group the data were 60%,95%,and 0%, respectively.Conclusion Azithromycin injection produced in China is effective and safe in the treatment of respiratory infections.

Air ; analysis ; Hydrobromic Acid ; analysis ; Ion-Selective Electrodes ; Workplace

Objective To study transmission characteristics of Acinetobacter baumannii (A.baumannii )clone and clinical features of infected patients in a respiratory intensive care unit (RICU),so as to guide the effective pre-vention and control of A.baumannii transmission.Methods 40 A.baumannii strains isolated from RICU patients were performed homology analysis by pulsed-field gel electrophoresis (PFGE)and cluster analysis,relationship of strains was determined,antimicrobial resistance and clinical data were analyzed.Results 40 A.baumannii strains were divided into 11 genotypes(A-K),the main epidemic strains were type A,B and E.The resistant rate to imipen-em was the lowest(70.00%),the next was levofloxacin (77.50%).The average age of 40 infected patients was 67 years old,the average length of hospital stay was 41 days,12 patients died because of invalid treatment.There was overlapping hospitalization among patients infected with type A and E strains;among patients infected with type B strain,there was no overlapping hospitalization among the last 6 and first 6 infected patients.Conclusion The main epidemic strains of A.baumannii were type A,B and E,antimicrobial resistant rate is high;the infected patients are with high average age and long length of hospital stay.It is important to reduce the transmission of A.baumannii through rational use of antimicrobial agents,strict aseptic operation,and intensified disinfection and sterilization of hospital environment and medical devices.

Objective To analyze the significant impact factors of postoperative hemorrhage after pancreaticoduodenectomy.Method The clinical data of 154 patients who underwent pancreatieoduodeneetomy from Jan.2009 to Jun.2012 were retrospectively analyzed.Results The incidence of postoperative hemorrhage was 10.4％ (16/154).The mortality caused by this complication was 12.5％ (2/16).Among these patients,intra-abdominal hemorrhage occurred in seven patients,and gastrointestinal hemorrhage occurred in nine patients.One patient suffered from both these complications.There were five and two patients presenting with early or delayed intra-abdominal hemorrhage,respectively.Early and delayed gastrointestinal hemorrhage occurred in three and six patients,respec tively.Statistical analysis showed that infection (P=0.002,P＜ 0.01) and pancreatic fistula (P=0.048,P＜0.05) are significantly associated with postoperative hemorrhage.Conclusions Postoperative hemorrhage after pancreaticoduodenectomy is a severe complication.Adequate hemostasis and prevention of pancreatic fistula and infection are the key points in reducing postoperative hemorrhage.Proper treatments should be used according to the site,type of onset and severity of hemorrhage.