Objective:To explore the lipid-regulating effect and safety of atorvastatin combined fenofibrate therapy in patients with coronary heart disease (CHD)complicated diabetes mellitus (DM).Methods:A total of 100 pa-tients with CHD complicated DM were enrolled.Based on routine treatment,patients were randomly and equally di-vided into statin group (n=50,received 20mg atorvastatin,once/night)and combined treatment group (n=50,re-ceived 20mg atrovastatin once/night,combined fenofibrate 200mg once/d).Serum levels of total cholesterol (TC), triglyceride (TG),low density lipoprotein cholesterol (LDL-C)and high density lipoprotein cholesterol (HDL-C) were measured before,six and 12 weeks after treatment,levels and standard-reaching rates of above blood lipid were observed before and after treatment;adverse reactions and clinical events were recorded.Results:Compared with before treatment after six-week treatment,there were significant reductions in serum levels of TC,TG and LDL-C in both groups,and they further decreased after 12-week treatment (P <0.05~ <0.01),compared with statin group after 12-week treatment,there were significant reductions in levels of TC [(4.35±0.71)mmol/L vs. (4.09±0.56)mmol/L],TG [(2.35±0.62)mmol/L vs.(1.65±0.49)mmol/L]and LDL-C [(2.01 ±0.39) mmol/L vs.(1.85±0.22)mmol/L]in combined treatment group,P <0.05 or <0.01;HDL-C level significantly rose in both groups after treatment,and it′s more significant after 12 weeks,but there was no significant difference between statin group and combined treatment group (P >0.05).After 12-week treatment,standard-reaching rates of LDL-C,TG,HDL-C,all standard-reaching of above three indexes and non HDL-C (70%,68%,80%,58% and 70%)in combined treatment group were significantly higher than those of statin group (50%,46%,48%,10% and 48%)respectively,P <0.05 or <0.01. No severe adverse reactions were observed in two groups during treatment. Conclusion:Atorvastatin combined fenofibrate treatment is more effective than atorvastatin monotherapy in patients with coronary heart disease complicated diabetes mellitus.It can improve blood lipid level more comprehensively, contribute to comprehensive standard-reaching of blood lipids,and possess better safety and tolerance.

〔Abstract〕 The paper introduces the informatization management system in specialist clinic blood-taking room, which compares with the process before informatization from the aspects of error rates of blood samples, patients satisfaction, hospital labor costs and so on to highlight the advantages of informatization management.The progressiveness, existing problems and corresponding countermeasures are discussed, informatization management could improve work efficiency and patients satisfaction.

Objective: To analyze the relationship between meteorological factors and the number of daily heart failure (HF) patients for emergency room (ER) visit at Fengxian district of Shanghai in order to provide the experience for prevention and control of HF morbidity. Methods: Daily number of HF patients treated in ER of our hospital from 2012-01 to 2014-12 with corresponding meteorological, air pollution data at the same period were collected and analyzed by Spearman correlation study and multiple stepwise regression analysis. Results:①The differences of temperature, humidity, air pressure at 24-, 48-hour before and 48-hour after ER visit were positively related to the number of HF patients; the number of HF patients was signiifcantly related to the differences of temperature and air pressure at 48-hour before ER visit,P<0.001.②Multiple stepwise regression analysis showed that the most affecting meteorological factor for ER visit of HF patients was the daily lowest temperature,P<0.05, the second factor was the daily average relative humidity,P<0.05. Conclusion: Radical changes of temperature, relative humidity and air pressure elevated the number of HF patients for ER visit; daily lowest temperature and decreased relative humidity were the important factors for elevating the number of HF patients for ER visit.

Objective To determine the dose of ropivacaine leading to convulsion and the convulsant action of midazolam. Methods Twenty healthy adult rabbits weighing 2.5-3.5kg were randomly divided into two groups with ten animals in each group: ropivacaine group(R) and midazolam-ropivacaine group(MR). Middle artery of ear was cannulated for MAP, HR monitoring and blood sampling for blood gas analysis and determination of plasma lactate and ropivacaine concentrations. Edge vein of ear was cannulated for administration of drugs. In both groups animals received intravenous infusion of 0.75% ropivacaine at a rate of 0.5m1/min until convulsion occurred. In MR group midazolam 0.8 mg/kg was given intravenously before ropivacaine.Results The dose of ropivacaine leading to convulsion was 4.86mg/kg for R group and 12.26mg/kg for MR group. Plasma ropivacaine concentration was 11 .52pg/ml in group Rand 16.77pg/ml in MR group. Convulsion lasted for 7.25 mm(R group) and 8.59mm(MR group) . Plasma lactate concentration increased significantly during convulsion in R group but remained unchanged in MR group. Blood pH decreased significantly during convulsion in R group but there was little change in PaCO2 and PaO2. Blood pH, PaO2 and PaCO2 did not change significantly during convulsion in MR group. There was no significant change in MAP and HR during convulsion in R group. In MR group MAP and HR decreased by 31 % and 35% respectively during convulsion and returned to baseline value gradually after ropivacaine infusion was stopped. All animals survived the experiment in both groups. Conclusions Ropivacaine is less cardiovascular toxic. Pretreatment with 0 . 8mg/kg midazolam greatly increases the dose of ropivacaine leading to convulsion. Midazolam can effectively prevent and treat CNS toxicity of ropivacaine.

Many provinces are carrying on Public Hospital Personnel Filing System Reform while facing a series of barriers cause a slow progress or the results not up to expectations.Supporting policies' adjustment is called to ensure the smooth progress of the reform.

Discipline evaluation is an effective and boosting mean of constructing high level key disciplines,but if there is something wrong or flaws with the means,indicators,process,ways,the effect may be just the opposite.Therefore,establishing scientific evaluation system is an important premise to construct key disciplines,promote discipline development and improve the level of academy construction.This article which is aimed at current situation of discipline evaluation system,puts forward some major principles to establish scientific evaluation for discipline,it is significant to play a right evaluation guide and promote the discipline construction.Carrying out discipline evaluation needs to have right guiding thought,establish and perfect indicator system of discipline evaluation,strengthen orderly management of evaluation work,offer scope to stimulate function of discipline evaluation.Only in these ways,can we construct a batch of characteristic and competitive key disciplines.

Objective To investigate the effects of clearing liver and purging the heart decoction( CLPHD) combined with methimazole on hormone levels in hyperthyroid rats. Methods Rats were administered with levothyroxine (600 μg·kg-1 ) for 3 weeks to establish the hyperthyroid model,and the serum contents of T3,FT3,T4,FT4,TSH and TRAb in hyperthyroid rats treated with CLPHD combined with methimazole were detected. Results Methimazole, CLPHD, and the combination therapy significantly reduced food intake,water intake and body temperature of the hyperthyroid rats. All treatments reduced levels of FT3, T4 and FT4 in hyperthyroid rats. Compared with the CLPHD mono-therapy, the combination therapy significantly lowered serum T4 in hyperthyroid rats,but not the TRAb level. Conclusion CLPHD combined with methimazole can obviously improve the function of thyroid gland in hyperthyroid rats.

BACKGROUND:Polyester fabric as a common clinical consumable item is characterized by simple drawing, low cost, and high toughness and ductility, and can serve as a good repair material. OBJECTIVE:To investigate the clinical efficacy of polyester fabrics used for huge chest wal repair. METHODS: Totaly 46 patients with chest wal tumors, aged 39-73 years, including 29 males and 17 females. These patients were randomly and equaly divided into observation group and control group. After the removal of chest wal tumors, patients in the observation group underwent polyester fabric repair of huge chest wal defects, and those in the control group were treated with autologous pedicle flap for repair of huge chest wal defects. The clinical efficacy and patient satisfaction were recorded in the two groups. RESULTS AND CONCLUSION: After treatment, al the patients could feel up to their daily work, and there were no death and serious complications. Only two cases developed postoperative local effusion, and then recovered after wound drainage. Thoracic appearance was good in al patients, and the patients did not feel discomfort at the reconstruction site during breathing and movement. At the end of 6-24 months of folow-up, X-ray review showed good reconstruction of the thorax, and there were no loose transplants, foreign body rejection, chest wal deformity, recurrence and serious complications. Clinical efficacy and patient satisfaction were better in theobservation group than the control group (P < 0.05). These results show that polyester fabrics for the repair of huge chest wal defects are effectively, safe and reliable.

Objective To study the feasibility and care mode of remote fetal monitoring at primary hospital. Methods A questionnaire survey was administered to 71 hospitals of different levels in Jiangsu province.Question-naire content included human resources status of midwifery,the remote fetal monitoring system and its clinical applica-tion;anonymous questionnaire survey was conducted to 130 maternal women by random cluster sampling;investigation of remote fetal monitoring device type,operation mode,clinical usage and existing problems was done through the doc-ument retrieval of VIP and Wanfang data platform.Results In grade Ⅱhospital,obstetricians sufficient and insuffi-cient were 10 cases (24.39%),31 cases(75.6%),respectively,and in grade Ⅲ hospital were 8 cases (61.53%), 5 cases (38.46%),respectively,there was statistically significant difference between grade Ⅱ and grade Ⅲ hospital (χ2 =4.572,P <0.05);In grade Ⅱ and grade Ⅲ hospital midwives were obviously insufficient,but there was no sta-tistically significant difference between grade Ⅱ and grade Ⅲ hospital(χ2 =0.219,P >0.05).Different cultural lev-el,place of residence,occupation of maternal demand for the development of remote fetal monitoring were urgent and higher degree of acceptance,but the cognition was not comprehensive,college degree or above,technical personnel and urban pregnant women that their need for remote fetal monitoring were the most urgent.There were significant differ-ences(all P <0.01).The use of remote fetal monitoring equipment was mostly at tertiary hospital nationwide.3G net-work way to transfer data had short time and small scope.Conclusion The existing monitoring system and service mode can not meet the requirements of the implementation of remote fetal monitoring,medical personnel professional quality and maternal comprehensive quality are the main influencing factors.The primary hospitals should actively pro-mote the application of remote fetal monitoring,maternal health care services and health education should arouse the attention of the whole society.

Objective To identify mutations of CACNA1A gene in a family with hemiplegic migraine.Methods Total genomic DNA was extracted from a family with 3 affected members and 1 000 healthy controls.The proband and his patient sister were subjected to exome sequencing.Ten family members including 3 patients were subjected to linkage analysis.The coding exons of the CACNA1A gene were amplified and sequenced in affected and normal individuals. Bioinformatics analysis were performed.Results A novel CACNA1A mutation was identified in the 3 patients.The nonsense mutation of A to G was detected at nucleotide 1168 ( c.1168A >G) which converted the Asn codon ( AAT) to Asp (GAT) in exon 8.Conclusion The mutation(N390D) detected in the present study is considered to result in the Chinese Hemiplegic migraine family.