Objective To observe the effect of strengthen rosuvastatin in the treatment of patients with paroxysmal atrial fibrillation in coronary artery disease and the influence on serum inflammatory factor, to provide reference for clinical treatment.Methods 176 coronary artery disease patients with paroxysmal atrial fibrillation were randomly divided into observation group and control group, 88 cases in each group.The control group was given rosuvastatin,10mg/d,qd.The observation group was given rosuvastatin,20mg/d,qd.The LAD and LVEF were detected by color-Doppler before treatment and after 6 months treatment.The fasting blood was exsanguinated for testing BNP,hs-CRP,TNF-α,IL-6.The incidence rates of sinus rhythm maintenance and embolic events were recorded. Results After treatment,the LAD of the observation group and control group were (41.50 ±4.61)mm and (42.21 ± 5.20)mm respectively,which were significantly lower than before treatment (t=3.959,3.863,all P<0.05),the LVEF were (76 ±6)% and (73 ±5)% respectively,which were significantly higher than before treatment (t =7.744,6.837,all P<0.01),there were no statistically significant differences between the two groups after treatment (t=1.140,0.579,all P>0.05).The BNP,hs-CRP,TNF-α,IL-6 levels of the observation group and control group after treatment were (173.44 ±32.45)ng/L and (203.33 ±42.16)ng/L,(4.54 ±1.34)mg/L and (5.44 ± 1.35)mg/L,(15.34 ±3.26) ng/L and (19.45 ±2.23) ng/L,(10.85 ±0.77) ng/L and (13.27 ±1.23) ng/L respectively,which were significantly lower than before treatment (t=5.855 and 3.533,3.857 and 3.534,6.436 and 4.545,5.743 and 3.925,all P<0.05),the BNP,hs-CRP,TNF-α,IL-6 levels of the observation group after treatment were significantly lower than the control group(t=3.546,3.214,3.176,3.414,all P<0.05).The total effective rate,sinus rhythm maintenance rate,embolic events incidence rate of the observation group and the control group were 93.18%(82/88) vs 79.55% (70/88),68.18% (60/88) vs 43.18% (38 /88),2.27%(2/88) vs 18.18%(16/88).The total effective rate,sinus rhythm maintenance rate of the observation group were significantly higher than the control group (χ2 =11.965,11.144,all P<0.01),the embolic event incidence rate was significantly lower than the control group (χ2 =12.129,P<0.01).Conclusion Strengthen rosuvastatin can effectively reduce the serum inflammatory factors and BNP,improve left atrial remodeling and left atrial function,the clinical efficacy and prognosis are significantly improved, it is worthy of clinical use in the treatment of patients with paroxysmal atrial fibrillation in coronary artery disease.

Objective Tofollowupandanalyzetheoccurrenceofcerebrovascularischemiceventsin patientswithinternalcarotidarteryocclusion(ICAO).Methods Atotalof144consecutivepatients with ICAO admitted to the Department of Neurology,the Air Force General Hospital from January 2007 to January 2012 were enrolled retrospectively. All patients were confirmed as unilateral ICAO with DSA and they were divided into either a symptomatic group (n=74)or an asymptomatic group (n=70)according to whether they had the symptoms of ischemic cerebrovascular disease or not. Both patients of the 2 groups were followed up for at least 2 years. Their transient ischemic attack (TIA)and endpoint events were observed,including new symptomatic cerebral infarction,death from any cause,as well as patency of collateral circulation,andthefollow-upresultsbetweenthetwogroupswerecompared.Results Twenty-one patients (28. 4%)of the symptomatic group had new attack of cerebral infarction,10 cases (13. 5%)had TIA,and 4 cases (5. 4%)died;9 patients (12.9%)of the asymptomatic group had new attack of cerebral infarction,4 cases (5 . 7%)had TIA,and no patients died. Risk of recurrent stroke in patients of the symptomatic group was higher than that of the asymptomatic group (P=0. 025). Kaplan-Meier curves showed that the incidence of endpoint event of the symptomatic group was higher than that of the asymptomatic group (χ2 =8. 428,P =0. 004). There was significant difference in the patent ratio of the primary collateral circulation between the symptomatic group and the asymptomatic group (64. 9%[48/74] vs. 91. 4%[64/70];P=0. 000);the patent ratio of the primary collateral circulation in patients with new cerebral infarction was significantly lower than that in patients without new cerebral infarction (60. 0%[18/30]vs.82.5%[94/114];P=0.013).Conclusion ThepatientswithsymptomaticICAOaremore likely to have cerebral infarction,and they are likely to die. After ICAO,the primary collateral circulation patent has a significant effect on the prognosis.

Objective To investigate the efficacy of docetaxel combined with capecitabine in the treatment of patients with locally advanced breast cancer and its effect on immune function.Methods 160 patients with locally advanced breast cancer were randomly divided into observation group and control group.The control group was treated with capecitabine.The patients in the observation group were treated with docetaxel combined with capecitabine.The clinical effective rate, median time to progress, median survival time, one year survival rate and immunoglobulin protein expression levels were observed.Results The clinical effective rate and stable rate in the observation group were 88.75% and 95.00%, which were significantly higher than 68.75% and 87.50% in the control group, the differences were statistically significant (x2=5.89,4.17,all P<0.05).After treatment, the median time to progression, median survival time and one year survival rate of the observation group were significantly higher than those of the control group (t=3.43,5.09,6.23,all P<0.05).Compared with before treatment, after treatment, the IgG,IgM and IgA levels in the observation group significantly decreased(t=2.34,3.16,3.27,all P<0.05), while those of the control group were not significantly changed (t=0.79,0.22,0.27,all P>0.05).Conclusion Docetaxel combined with capecitabine in the treatment of patients with locally advanced breast cancer can improve the clinical efficacy and stability, prolong the survival time of patients.Compared with using single agent chemotherapy, combined use has no significant effect on human immune function, the effect is better than the use of capecitabine alone, which is worthy of promotion in clinical use.

OBJECTIVE:To analyze problems occurred in the practical use of clinical medicine cabinet and raise countermeasures.METHODS:The application data of drugs in clinical medicine cabinet were analyzed with the help of Hospital Information System(HIS).RESULTS:Low application frequency and unclear medicine sign were the common problems occurred in the practice of clinical medicine cabinet management;furthermore,the storing condition remained to be improved.CONCLU-SION:Management of clinical medicine cabinet should be regulated and strengthened to promote safe and effective drug use in the clinic.

Objective To observe the efficacy and safety of oxycontin treatment in cancer patients with mod-erate to severe chronic cancer pain.Methods This study was performed by study group and control groups.120 cases of patients with moderate to severe chronic pain were enrolled in study group and treated with oxycontin(10mg/time, once every 12 hours).50 cases of patients with moderate to severe chronic pain were randomly allocated to control group and treated with tramadol hydrochloride sustained-release tablets(100mg/time,once every 12 hours).Clinical efficacy and adverse reactions of patients in the study group and control group were evaluated after therapy for three weeks.Results There was 35 cases of complete remission,80 cases of partial remission,and 5 cases of mild remis-sion,and the overall response rate was 95 .8% in the study group.In addition,there was 4 cases of complete remis-sion,4 0 cases of partial remission,4 cases of mild remission and 2 cases of no effect,and the overall response rate was 88.0%,there was statistically significant difference(P=0.004).Meanwhile,the rates of adverse reactions in the study group and the control group were 16.7% and 14.0%,respectively,there was no statistically significant differ-ence(χ2 =0.188,P>0.05 ).Conclusion Oxycontin can effectively safely treat cancer patients with moderate to severe chronic pain.

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OBJECTIVE To analyze antibiotic resistance pattern and use pulsed-field gel electrophoresis(PFGE) to study the molecular epidemiology of Pseudomonas aeruginosa isolated from burn unit. METHODS P.aeruginosa had been isolated and tested by K-B method from clinical samples and antibiotic resistance was analyzed and studied retrospectively. RESULTS The drug resistance of P.aeruginosa to nine antibiotics was high,the multiple drug resistance rate was 30%. CONCLUSIONS The resistance rates to commonly used antibacterials in P.aeruginosa are high and the resistance pattern is wide.PEGE is a better genotyping method to study molecular epidemiology and analytic homology.

OBJECTIVE To compare the three methods on relatedness analysis of Acinetobacter baumannii strains in hospital infection.METHODS Twenty-seven A.baumannii strains caused hospital infection were analyzed by pulsed field gel electrophoresis(PFGE),amplified fragment length polymorphism(AFLP) and multiple gene cluster analysis.RESULTS PFGE analysis showed 19 strains isolated from clinic were with identical clone;AFLP analysis showed 19 strains isolated from clinic were with identical clone;but multiple gene cluster analysis showed 3 clones including 11 strains carried with 8 positive genes(TEM,OXA-23group,ADC,aac(3)-Ⅰ,aac(6′)-Ⅰ,ant(3″)-Ⅰ,qacE△1-sul1 and intⅠ1),6 strains with 7 positive genes(TEM,ADC,aac(3)-Ⅰ,aac(6′)-Ⅰ,ant(3″)-Ⅰ,qacE△1-sul1 and intⅠ1) and 4 strains with 6 positive genes(TEM,ADC,aac(3)-Ⅰ,ant(3″)-Ⅰ,qacE△1-sul1 and intⅠ1).CONCLUSIONS The resolving ability of multiple gene cluster analysis is higher than that of PFGE and AFLP in relatedness analysis of A.baumannii strains from hospital infection.

Objective Structured Clinical Examination(OSCE)is a popular and objective clinical examination mode in recent years.Teaching Section of Internal Medicine of the First Clinical College of Harbin Medical University adopts the OSCE assessment approach in the internship phase exam of the clinical overseas students to check the study effect in internal medicine internship and objectively and scientifically evaluates their overall quality through multimedia technology,standardized patient,multi-functional simulation man and other means.

Objective To evaluate the clinical efficacy and safety of different courses of topical tacrolimus 0.1％ ointment in facial corticosteroid-dependent dermatitis and to observe the rebound in patients after treatment with these regimens.Methods A total of 104 patients with facial corticosteroid-dependent dermatitis were randomly divided into 3 groups to be treated with topical tacrolimus 0.1％ ointment twice daily for 4,8 and 16 weeks respectively.The patients were followed up every 2 weeks within the early 4 weeks of treatment and every 4 weeks thereafter.The rebound phenomena was observed in patients on week 4 after the withdrawal of tacrolimus.Results Finally,90 patients completed this trial,including 32 patients in the 4-week group,29 patients in the 8-week group and 29 patients in the 16-week group.No significant differences were observed between the 4-,8- and 16-week groups in the total reponse rate (75.00％,82.76％,86.21％,respectively,x2 =1.35,P ＞ 0.05).The rebound rate in the 16-week group significantly differed from that in the 4- and 8-week group (20.69％ vs.46.88％ and 41.38％,both P＜ 0.05),while no statistical difference was noted between the 4- and 8-week groups.Local burning and itching were reported in 31.73％ of these patients,and all of these irritant reactions occurred within the first week of treatment.Conclusions Topical tacrolimus 0.1％ ointment is safe and effective for the treatment of facial corticosteroid-dependent dermatitis.The total response rate does not increase with the extended treatment course,and 4 weeks of treatment is enough for the marked and stable improvement of facial corticosteroid-dependent dermatitis,but the rebound rate is likely to be reduced by extended treatment course.