Objective To investigate the efficacy,adverse effect and the incidence of cardiovascular and cerebrovascular events by comparative study on simvastatin combined with ezetimibe on therapy of lowing blood lipids in metabolic syndrome patients.Methods One hundred and twenty metabolic syndrome patients were divided into experiment group (n=60) and control group (n=60).The experiment group was treated with 20 mg of simvastatin associated 10 mg of ezetimibe daily.The control group was treated with conventional-dose 20 mg of simvastatin.The period of treatment was 4 years in both groups.The efficacy,adverse effect and the occurrence of cardiovascular and cerebrovascular events were observed and analyzed.Results Blood lipid were significantly decreased in both groups after the treatment.There was significant difference on total cholesterol ( TC ) [ ( 3.05±1.17 ) mmol/L vs (4.94 ± 1.13 ) mmol/L,P ＜ 0.05 ],low density lipoprotein cholesterol ( LDLC) [ (2.12±1.03) mmol/L vs (3.16 ± 1.11 ) mmol/L,P ＜0.05] and triglyceride(TC) (1.02±0.29) mmol/Lvs (1.65 ± 0.32)mmol/L,P ＜ 0.05 ) between experiment group and control group.There were 3 cases of cardiovascular events in experiment group and 10 cases in control group,5 cases of cerebrovascular events in experiment group and 13 cases in control group.The incidence of cardiovascular and cerebrovascular in experiment group was significantly lower than that in control group (x2 =4.08 and 4.37,respectively,P ＜ 0.05 ).Conclusion Combination therapy with simvastatin and ezetimibe is more effective and it can significantly decrease the incidence of cardiovascular and cerebrovascular events in metabolic syndrome patients.

Background:Colorectal polyps(CRP)has nonspecific clinical manifestation,and is closely related to the pathogenesis of colorectal cancer. Studies have shown that abnormalities of serum uric acid(UA),serum lipids are closely related to pathogenesis of CRP,but is still in controversial. Aims:To investigate the correlation between serum UA,TG, TC,LDL-C,HDL-C and incidence of CRP. Methods:A total of 142 CRP patients from Jan. 2016 to Oct. 2016 at Qingdao Municipal Hospital were enrolled,and 116 patients without CRP were served as controls. The serum levels of UA, TG,TC,LDL-C,HDL-C were determined,and correlation between UA and serum lipids was analyzed. Results:Compared with controls,serum levels of TG,UA were significantly increased in CRP patients(P<0.05),HDL-C level was significantly decreased(P<0.05),however,no significant differences in TC,LDL-C levels were found between the two groups. Serum UA level was positively correlated to TG,TC,LDL-C levels in patients with CRP(r=0.32,r=0.21, r=0.15;P<0.05),and negatively correlated to HDL-C level(r= -0.07,P<0.05). Conclusions:Increased serum TG and UA levels and decreased serum HDL-C level may be correlated to the pathogenesis of CRP. The interaction between serum UA,TG,TC,LDL-C and HDL-C may increase the risk of CRP.

This study was aimed to investigate the effect of Compound Danshen injection in treatment of dysphagia by electromyography (EMG) guided on new Renying point caused by bulbar paralysis after stroke.A total of 60 patients with dydphagia caused by cerebral palsy after stroke were randomly divided into the experimental group and the control group (30 patients in each group).Patients in the control group were conducted with routine treatment,local low frequency electrical stimulation and rehabilitation training.Patients in the experimental group were treated with acupoint injection therapy guided by EMG on the basis of treatment of the control group.Four weeks were one treatment course.Observations were made on changes of indexes,such as water swallow test,swallowing ability evaluation,and etc.between two groups.The results showed that the cure rate of the experimental group was 76.67％,which was higher than that of the control group (50.00％).The treatment efficiency of the experimental group (93.33％) was higher than that of the control group (80.00％),with statistical significance (P ＜ 0.05).It was concluded that clinical effects of EMG guided injection on new Renying point in the treatment of dysphagia caused by bulbar paralysis in the experimental group was better than that of the control group.It is worthy widely applied and distributed in clinical practices.

Objective To investigate the effect of Williams life skills training (WLST) on preoperative anxiety and trait coping strategies in patients undergoing general anesthesia for elective surgery. Methods A total of 120 patients undergoing general anesthesia for elective surgery were randomly divided into observation group and control group according to random number table method with 60 cases each. The control group was given general preoperative nursing intervention, on the basis of which the observation group gave WLST. Before and after the intervention, the Amsterdam Preoperative Anxiety and Information Scale and Trait Coping Style Questionnaire were used to evaluate the patients. Results Before intervention, there was no significant difference between the two groups (P>0.05). After intervention, the preoperative anxiety and information needs scores of the observation group was (10.02 ± 2.53) and (4.02 ± 1.05) points respectively, while in the control group was (15.89 ± 3.20) and (7.96 ± 1.62) points respectively, the difference was statistically significant (t=7.952, 8.447, P<0.05), and negative coping score was (29.07 ± 6.14) points lower than the control group (33.86 ± 7.12) points, positive response score was (33.89 ± 7.64) points higher than the control group (29.77 ± 6.71) points, the difference was statistically significant (t = 7.647, 7.981, P <0.05). Conclusion WLST can effectively improve preoperative anxiety in patients undergoing general anesthesia and improve their coping ability, which is conducive to the successful implementation of anesthesia and surgery.

Background: Central mediated abdominal pain syndrome (CAPS) related functional gastrointestinal disorders (FGIDs) is a commonly seen disease. Although the efficacy of antidepressants in treatment of CAPS has been reported, yet there is still lack of typical representative drugs and sufficient clinical data. Aims: To evaluate the efficacy of duloxetine in CAPS. Methods: A total of 143 patients with CAPS from Jan. 2017 to Dec. 2019 at Qingdao Municipal Hospital were enrolled and randomly divided into duloxetine group and placebo group. Brief pain inventory (BPI) was used to evaluate the efficacy. Results: Compared with placebo group, duloxetine significantly improved the average pain, the most painful in the past 24 hours, as well as the minimum pain and present pain in the patients with CAPS, and the impact on daily life, emotion, interest in life, walking ability, sleep, interpersonal relationship, working was significantly improved in duloxetine group. 6.8% of patients in duloxetine group had treatment-induced adverse events, including nausea, dry mouth, constipation, and headache. Conclusions: Duloxetine can improve CAPS, and the safety in use is well.

Objective: To analyze the status of domestic surgical treatment of synchronous peritoneal carcinomatosis from colorectal cancer in China. Methods: Clinicopathological data of patients who underwent surgery from October 2003 to October 2018 in 16 domestic medical centers was retrospectively analyzed. Excel database was created which covered 77 fields of 7 parts: baseline information of patients, laboratory tests, imaging tests, chemoradiotherapy information, intra-operative findings, postoperative pathology and follow-up data. The Wilcoxon rank-sum test was used for comparison of the measurement data between groups. The χ² test was used for comparison of the categorical data between groups. The survival curve was calculated by the Kaplan-Meier method. Results: Of the 1 003 patients, there were 575 male and 428 female patients with the age of (58.5±14.1) years (range: 18 to 92 years). In a total of 920 patients, the carcinoma of sigmoid colon was performed in 292 cases (31.8%) with the highest ratio. The proportion of patients with liver metastasis and lung metastasis were 27.9% (219/784) and 8.3% (64/769). Preoperative detection of carcino-embryonic antigen level was the most common method in China (87.74%, 880/1 003), and the positive rate was 64.5% (568/880). The correct rate of preoperative imaging tests was 40.7% (280/688). The ratio of peritoneal carcinomatosis index (PCI) scores between 0 and 10 was the highest (59.6%, 170/285). Two hundred and sixty-two (27.0%) patients were performed by totally laparoscopic operation in 971 patients. The resection of primary tumor was performed in 588 of the 817 patients (72.0%). In a total of 457 cases, 253 (55.4%) patients were performed cytoreduction which group scored completeness of cytoreduction (CCR) 0. The postoperative hyperthermic intraperitoneal chemotherapy was implemented in 70 of the 334 cases (21.0%). Among 1 003 cases, 562 cases (56.03%) had complete follow-up data and the median overall survival was 15 months. The primary tumor resection and the CCR scores were affected by the PCI scores. The patients underwent primary tumor resection (187/205 vs. 26/80, χ²=105.085, P=0.000) and the patients were performed cytoreduction which scored CCR 0 or CCR 1 (162/204 vs. 8/78, Z=-10.465, P=0.000) had significant difference between the groups of PCI<20 and ≥20. There was a close correlation between the surgical method and the CCR scores (Z=-3.246,P=0.001).When the maximum degree of tumor reduction was planned, most surgeons would choose laparotomy. The overall survival time was longer in patients with primary tumor resection (P=0.000). The median survival time was 18.6 months in the group of primary tumor resection. Conclusions It is difficult to diagnose the synchronous peritoneal carcinomatosis from colorectal cancer before the operation. Primary tumor resection has an obvious effect to prolong the survival time. It is necessary to standardize the treatment of peritoneal metastasis.