Objective: To study and analyze the influence of atorvastatin combined trimetazidine on levels of blood lipids,inflammatory factors and cardiac function in patients with coronary heart disease (CHD).Methods: A total of 128 CHD patients treated in our hospital from May 2015 to Oct 2016 were selected.According to random number table, they were randomly and equally divided into trimetazidine group (received trimetazidine based on routine treatment) and combined treatment group (received atorvastatin based on trimetazidine group).Both groups were treated for three months.Levels of blood lipids, inflammatory factors and cardiac function were measured and compared between two groups before and after treatment.Results: Compared with trimetazidine group after treatment, there were significant reductions in levels of triglyceride [(2.11±0.73) mmol/L vs.(1.83±0.77)mmol/L], total cholesterol [(5.14±0.96)mmol/L vs.(4.35±0.73)mmol/L], low density lipoprotein cholesterol [(2.35±0.68) mmol/L vs.(1.90±0.34) mmol/L], N terminal pro B type natriuretic peptide [(296.61±28.96) pg/ml vs.(187.53±32.63) pg/ml], fibrinogen [(4.44±0.34) g/L vs.(3.63±0.54) g/L] and high sensitive C reactive protein [(2.41±0.96) mg/L vs.(1.96±0.82) mg/L], left ventricular end-diastolic dimension [(59.25±6.17)mm vs.(48.43±4.28)mm] and left ventricular posterior wall thickness [(11.01±1.08)mm vs.(9.05±1.04)mm], and significant rise in level of high density lipoprotein cholesterol [(1.32±0.25)mmol/L vs.(1.47±0.38)mmol/L] and left ventricular ejection fraction [(41.28±7.04)% vs.(48.66±7.54)%] in combined treatment group, P<0.05 or <0.01.Conclusion: Atorvastatin combined trimetazidine can significantly improve blood lipid, inflammatory factor levels,cardiac function and cardiac structure in CHD patients.The therapeutic effect is significant, which is worth extending.

Objective To investigate the change and its clinical significance of the deceleration capacity (DC) of heart rate in elderly patients with coronary heart disease (CHD).Methods A total of 105 elderly CHD patients and 86 elderly non-CHD patients were selected.All patients underwent 24 h ambulatory electrocardiographic recording.DC,heart rate variability (HRV) time domain index,heart rate turbulence (HRT) parameters including turbulence onset (TO) and turbulence slope (TS),and the occurrence of ventricular arrhythmias were off-line calculated.Results The values of DC,HRV and HRT were decreased in elderly patients with CHD.DC had positive correlations with standard deviation of normal-to-normal intervals (SDNN),the square root of the mean squared successive differences between normal-to-normal RR intervals (rMSSD) and percentage of adjacent normal-to-normal intervals that differed more than 50 ms (pNN50) (r=0.60,0.51,0.49,0.41,respectively,all P ＜0.05) and had a negative correlation with the occurrence of ventricular arrhythmias (r=-0.34,P＜0.05).The value of DC was much decreased in elderly CHD patients with type 2 diabetic or acute myocardial infarction.Conclusions The decreased DC value is correlated with heart rate variability,turbulence slope and the occurrence of ventricular arrhythmias in elderly CHD patients.The deceleration capacity of heart rate is a better noninvasive method for screening and predicting sudden death in high-risk elderly patients with CHD.

Delirium is defined as an acute imbalance state in the higher nervous center.It is more of ten been an accompanied syndrome,or may be a complication associated with the diagnosis and treatment of cancer.Delirium occurs frequently in cancer patients,especially in terminal patients.No more attention was paid on it yet.Its clinical feature,diagnosis and treatment were described.

Objective To explore the relationship between high-sensitivity C-reactive protein (hs-CRP) and the occurrence of certain diseases such as coronary heart disease (CHD) and acute myocardial infarction (AMI).Methods Sixty-one CHD patients, 45 AMI patients (patients group, excluding high hs-CRP level diseases caused by other etiological factors) and 35 healthy controls (control group) were enrolled in the study. The serum level of hs-CRP and myocardial zymogram was measured in the Hitachi 7060 automatic analyzer by latex-enhance immunoturbidimetry for all subjects, and cTnI of AMI group was detected with immunofluorescence method at the same time. The difference of hs-CRP level was compared and analyzed between control group and patients group; control group before and after treatment. Moreover, the relationship between hs-CRP and myocardial zymogram as well as cTnI was analyzed.Results The level of hs-CRP was significantly higher in patients group than that in control group (P<0.01). There was statistical difference of hs-CRP level before and after treatment in control group (P<0.01). hs-CRP was positively correlative with myocardial zymogram and cTnI.Conclusion The serum level of hs-CRP is significantly elevated in CHD and AMI patients, indicating the measurement of hs-CRP contributes to auxiliary diagnosis, therapeutic effect observation, and prognosis evaluation.

Oxidative stress is involved in cirrhotic portal hypertension and a close relationship exists between oxidative stress and hyperdynamic circulation.This article elaborates on the function of various reactive oxygen species (e.g.,superoxide anion and hydrogen peroxide) and corresponding anti-oxidants (e.g.,NAD(P) H oxidase inhibitor,the scavengers of superoxide anion,hydrogen peroxide,and vitamin C or E) on the occurrence and development of hyperdynamic circulation in cirrhotic portal hypertension.We observed that the level of reactive oxygen species in cirrhotic portal hypertension was elevated over normal.The potential clinical value is that inhibition or removal of these reactive oxygen species can relieve hyperdynamic circulation and reduce complications for cirrhotic portal hypertension.

Surgical treatment of cirrhotic portal hypertension and its accompanied abdominal diseases is one of the medical problems currently.Accurate evaluation of the hepatic function reserve,degree of portal hypertension and accompanied abdominal disease is important to decrease the postoperative morbidity and mortality as well as to raise the efficacy.The surgical procedure selection should be based on the analysis of portal vein hemodynamics of patients.There are clear indications for portosystemic shunt,devascularization and combinative surgery with shunt and devascularization.Treatment for portal hypertension should be carried out when treating the accompanied abdominal diseases.The principle of operation,operation time,operation mode,operation sequence,staging indications and the key techniques of operation were discussed in the article.Only these principles be mastered,proper selection of surgical procedures and desired treatment effect with minimal trauma can be achieved.

Objective:To observe clinical therapeutic effect of recombinant human erythropoietin (rhEPO)on pa-tients with heart failure complicated chronic kidney disease.Methods:A total of 84 patients with heart failure com-plicated renal insufficiency were selected.They were divided into routine treatment group (n=42)and rhEPO group (n=42,received rhEPO based on routine treatment)according to random number table method.Echocardiographic examination results and renal function were compared between two groups after 12-week treatment.Results:Com-pared with routine treatment group,there were significant rise in left ventricular ejection fraction [LVEF,(37.2± 10.3)% vs.(45.4 ± 11.4)%]and left ventricular fractional shortening [LVFS,(19.6 ± 4.3)% vs.(24.5 ± 3.8)%],and significant reductions in left ventricular end-diastolic diameter [LVEDd,(6.12±0.67)mm vs.(5.01 ±0.54)mm],24h urinary protein [(0.76±0.1)g vs.(0.24±0.09)g],24h urine microalbumin [(319.6±39.6) mg vs.(107.3±26.7)mg],blood urea nitrogen [(10.3±1.9)mmol/L vs.(6.2±1.5)mmol/L]and serum creati-nine [(97.2±16.8)μmol/L vs.(79.3±15.7)μmol/L]in rhEPO group,P<0.01 all.Conclusion:Recombinant human erythropoietin could significantly improve heart,renal function in patients with heart failure complicated re-nal insufficiency.

The significance of strengthening the construction of teaching staff in non-affiliated hospitals was discussed. Combined with the problems in strengthening the construction of teaching staff, some countermeasures were put forward, such as emphasizing on teaching, enhancing teaching awareness, improving teaching institutions and teaching rules, selecting teaching staff with high standards, strengthening teacher's teaching ability, establishing teaching quality guarantee system and teaching stimulating mechanism.

Objective To investigate the changes of serum levels of high-sensitivity C-reactive protein to distinguish community-acquired pneumonia caused by bacteria or mycoplasma pneumoniae in children.Methods To examine the serum levels of hs-CRP of patients with bacteria ( n =50),mycoplasma pneumoniae ( n =50),Virus ( n =50) by the Immunofluorescence method.and The levels of white blood cell(WBC),count of polymorphonuclear neutrophils(PMN) and neutrophil percentage(N) were analyzed.Results The levels of hs-CRP increased to different degrees in patients with bacterial pneumonia or mycoplasma pneumoniae pneumonia.the level of WBC,PMN and N have significant difference btween two groups also( all P ＜0.01 ).The area under the ROC curve(AUC) of hs-CRP was bigger than that of WBC,PMN and N(0.935 vs 0.783,0.807,0.747) and it was Significant difference(all P＜0.05).Conclusion Serum bs-CRP was a better biomarker in the early diagnosis of bacteria and it could effectively dstinguish community-acquired pneumonia caused by bacteria or mycoplasma pneumoniae in Children.

ObjectiveTo investigate the clinical value of intrafascial hysterectomy with intact ascending uterine artery.MethodsA total of 78 cases of simple hysterectomy patients were divided into group A (underwent intrafascial hysterectomy with intact ascending uterine artery) and group B(underwent modified intrafascial hysterectomy) with 39 cases each by random digits table.The operation time,the amount of hemorrhage,the postoperative complications,the ovarian function and the quality of sexuality were studied and compared.ResultsThree cases were lost in group B.There were no statistical differences in operation time,the amount of hemorrhage,postoperative hemorrhage,postoperative pyrexia,the quality of sexuality between two groups(P ＞0.05).There were significant differences in follicule-stimulating hormone and estradiol level in group B compared with those before operation (P＜ 0.05).There was significant difference in climacteric symptom between two groups [ 5.13％ (2/39) vs.22.22％ (8/36) ](P ＜ 0.01 ).The ascending uterine arteries and the ovarian branch of both sides were showed 100％ in group A.ConclusionsIntrafascial hysterectomy with intact ascending uterine artery has less influences on the blood flow of the ascending uterine arteries and the ovarian branch,there is slight influence on ovarian function and has no obvious influence on the quality of sexuality.The forward clinical effects should be studied further.