OBJECTIVE:To investigate the effectiveness and economics of 10 mg/d rosuvastatin and 20 mg/d atorvastatin in the treatment of hyperlipidemia (HLP). METHODS:The information of 180 HLP patients selected from Tianmen Municipal First People's Hospital during Mar. 2015-Feb. 2016 were divided into group A and B according to medication regimen,with 90 cases in each group. Group A was given Atorvastatin calcium tablet 20 mg,qd;group B was given Rosuvastatin calcium tablet 10 mg,qd. Treatment course of 2 groups lasted for 8 weeks. Blood lipid indexes before and after treatment,lipid-lowering efficacy,the rate of qualified blood lipid and the occurrence of ADR after treatment were compared between 2 groups. Cost-effectiveness analysis was adopted for economic evaluation. RESULTS:Before treatment,there was no statistical significance in the levels of blood lipid in-dexes between 2 groups (P>0.05). After treatment,TC and LDL-C levels of 2 groups were significantly lower than before treat-ment,and those of group B were significantly lower than those of group A,with statistical significance(P<0.05). Total response rate of lipid-lowering in group B(97.78％)was significantly higher than group A(86.67％),and the rate of qualified blood lipid (66.67％)was also significantly higher than group A(51.11％),with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). The costs of group A and B were 488.32,436.24 yuan,and cost-effectiveness ratios were 5.63,4.46;incremental cost-effectiveness ratio was -4.69. The plan of group B had cost-effective-ness advantage. The results of cost-effectiveness analysis were supported by sensitivity analysis. CONCLUSIONS:In the view of short-term efficacy,10 mg/d rosuvastatin plan is better than 20 mg/d atorvastatin plan in lowering lipid and has cost-effectiveness advantage,and both have similar safety.

Objective To explore the surgical features of retroperitoneoscopic excision of adrenal myelolipoma with diameter larger than 6 cm. Methods We retrospectively analyzed clinical data of 28 cases of giant adrenal myelolipoma from March 2010 to December 2015.The diameter of tumor was 6.0-13.7 cm (mean, 8.5 cm).There were 10 left-sided cases and 18 right-sided cases. During the retroperitoneoscopic excision of adrenal myelolipoma , four trocars were used .Two silk sutures were twisted as a loop to entangle one side of the tumor and then pulled it .Blood vessel on the surface of tumor was sealed and cut by ultrasonic scalpel . Adrenal gland was totally or partially removed and the tumor was resected completely . Results The operations were successful in all the 28 cases without hemorrhage during or after the surgery , conversion to open surgery , or injury of adjacent organs .The operation time was 52-117 min (mean, 67.5 min) and the blood loss was 45-110 ml during operation (mean, 60.5 ml).Patients took food 1-2 days after operation and ambulated 3-5 days after operation .The indwelling time of retroperitoneal drainage tube was 3-6 d (mean, 4.1 d).The postoperative hospitalization time was 6 -9 d (mean, 7.5 d). Conclusions Giant myelolipoma leads to seriously changed normal anatomy and is hard to be exposed during operation .Only when the important anatomical landmarks , large blood vessels and adrenal glands are focused , can the operation be safe and controllable .