Objective To study the efficacy of trimetazidine combined with perindopril in treating congestive heart failure (CHF). Methods One hundred and eighteen patients with CHF were randomly divided into experimental group and control group. All patients were given conventional medical treatment. Patients in the control group was treated with additionally with perindopril. The initial dose was 2 mg/d, and gradually increased to target dose of 4 mg/d. The experimental group was additionally treated with trimetazidine 20 mg orally 3 times a day for 12 weeks based on the regimen in the control group. The changes of left ventricular ejection fraction ( LVEF) , left ventricular end of diastolic volume ( LVEDV) , left ventricular end of systolic volume ( LVESV), stroke volume (SV),cardiac output (CO)and cardiac function (NYHA) were observed. Results In the experiment group, after treatment,LVEF,LVEDV,LVESV,CO and SV were(46. 89 ±8. 00)% ,(129. 20 ±25. 00)ml, (70.90 ±32. 00)ml, (4. 32 ±0. 65 ) L/min and (55. 06 ± 13. 27) ml, respectively, which were significantly improved compared to those before treatment (29.60 ± 11. 00)% ,(164. 40 ± 31. 00) ml, (95. 60 ± 33. 00) ml, (2.91 ±0.56) L/min and (37. 69 ± 13. 62) ml .respectively) ( P < 0.01 or P < 0. 05). After treatment, the LVEF, LVEDV, LVESV, CO and SV were (46.89 ± 8. 00)% , (34. 70 ± 9. 00)% ,( 129. 20 ± 25. 00) ml, ( 148. 20 ±29. 00) ml and (70.90 ± 32. 00)ml in the experiment group, respectively, which were significantly higher than those in the control group (81. 10 ±31.00)ml, (4. 32 ±0.65) L/min, (3. 14 ±0.60) L/min, (55. 06 ±13.27 )ml and (49. 56 ± 14. 29) ml, respectively) (P <0. 01 or P <0. 05). The overall effective rate in the experiment group was 93. 2% .which was significantly higher than that in the control group (66. 1% ) ( P < 0.01). No obvious adverse effect was observed. Conclusions The effect of trimetazidine combined with perindopril in treating congestive heart failure is satisfactory. It is safe and effective for CHF.

Objective To investigate cell injury and apoptosis of L-6TG cells induced by simulated ischemia-reperfusion,and to explore its regulating mechanism.Methods Cultured L-6TG cells were randomly divided into control group(C)and simulated ischemia-reperfusion group(IR).The L-6TG cells of C group were cultivated under normal condition in mimicking reperfusion solution,while the L-6TG cells of IR group were cultivated in mimicking ischemic solution for 4 hours,and then cultivated in mimicking reperfusion solution for 4 hours.Superoxide dismutase(SOD),xanthine oxidase(XOD)and free calcium in L-6TG cells were determined in each group;mitochondrial respiration was measured by MTT method.Apoptosis was identified by flow cytometer with propidium iodide(PI)staining method and agarose gel electrophoresis;the immunohistochemical method was used to determine the expression of bcl-2 and caspase-3,and their profiles were half-quantitatively analyzed by automatism image analytical system.Results Compared with the L-6TG cells of C group,after suffering from ischemia and reperfusion each for 4 hours,XOD,free calcium in L-6TG cells and apoptotic percentage were all increased significantly(287.88?8.47 vs 42?3.94 U/g prot,1.547?0.017 vs 7.23?0.28 lnMCF,7.23%?0.28% vs 0.69%?0.07%,P

In the study we determined the content of malondialdehyde(MDA) , which is the metabolite of lipid peroxide(LPO) , in plasm and lung homogenate by thiobarbituric acid(TBA) colorimetry, and the content of phosphatidyl-choline(PC), which is the major functional composition of pulmonary surfactant (PS).and total phospholipid (TPL) by thin-layer chromatogra-phy and inorganic phosphorus quantitative analysis in rabbits with lung injury induced by oleic acid. The results showed that the MDA level wasincreased in plasm and lung homogenate; PC and TPL were decreased in lung homogenate. Administrating of 654-2 before and after (0. 5 h)lung injury could both inhibit the production LPO and prevent the decrease of PS. The findings suggest that the decrease of PS may be due to the increase of LPO and that G54-2 could modify the process.

AIM To evaluate the possible role of endogenous nitric oxide (NO) in the development of lung injury after hind limbs ischemia reperfusion (LIR), and the effect of taurine on endogenous NO on the model of lung injury following LIR. METHODS Wistar rats were divided into three groups: control group, ischemia reperfusion group (IR) and taurine+IR (Tau+IR). The changes of PaO 2 ,PaCO 2,lung index (LI) and lung permeability index (LPI) were observed. The content of malondialdehyde (MDA), NO and endothelin (ET) in both plasma and the lung as well as the content of nitric oxide synthase (NOS) and taurine in the lung were detected. The immunohistochemical method was used to detect level in the expression of NOS protein. RESULTS Taurine improved the pulmonary respiratory following LIR significantly, lightened lung edema, decreased the content of ET in both plasma and lung tissue, increased the content of NO in both plasma and lung tissue and promoted the level in the expression of NOS protein. CONCLUSION Using taurine may lighten lung injury following LIR and this protective effect may due to increasing the content of endogeneous NO and decreasing the level of ET.

Objective To observe the protection effect of ischemic preconditioning to small intestines injury after limbs ischemia reperfusion ,and investigate the role of nitrogen monoxidum in the process .Methods 52 male Wistar rats were randomly divided in-to Sham group ,limbs ischemia-reperfusion (IR) group ,IPC + IR group and Nω-nitro-L-arginine methylester (L-NAME) group . The value of diamine oxidase (DAO) and nitrogen monoxidum (NO) in plasma and gut tissue ,the content of fluorescein isothiocya-nate lipopolysaccharide (FITC-LPS) in plasma ,and the value of cyclic guanosine monophosphate (cGMP) and malondialehyde (MDA) in gut tissue were measured ,respectively .The expression of P-selection and Caspase-3 were measured by immunohisto-chemistry .The apoptosis of intestinal cells was detected by terminal deoxynucleotidyl transferase -mediated dUTP nick end labe-ling (TUNEL) and the results were analysed quantitatively by automatic image analytical system .Results Compared with the LIR group ,the values of DAO and FITC-LPS in plasma decreased obviously in the IPC group ,and the level of NO in plasma increased obviously (P<0 .01) .The values of DAO ,NO and cGMP in gut tissue increased obviously ,the level of MDA and the expression of Caspase-3 and the apoptosis index (AI) were significantly decreased in IPC group (P<0 .01) .Compared with the IPC group ,the value of DAO and FITC-LPS were higher and the level of NO was lower in plasma of the L-NAME group (P<0 .01) .The values of DAO ,NO and cGM P in gut tissue obviously decreased ,the level of MDA significantly increased ,and the expression of Caspase-3 and the AI significantly upregulated in L-NAME group than those in IPC group (P<0 .01) .Conclusion IPC can improve the small intestine injury and the apoptosis following hind limbs ischemia reperfusion which may correlated with the increase in the level of NO .

AIM: To investingate the potential role of apoptosis in the development of acute lung injury(ALI) following limbs ischemia-reperfusion(LIR) in rats and the effects of raurine. METHODS: The model of LIB injury in rats was made. By using TUNEL, electrophoresis, reverse-transcription polymerase chain reaction(RT-PCR) and immunohistochemistry techniques, pulmonary apoptosis, Fas/FasL expressions and Ca~(2+), reactive oxygen species (ROS),the ratio of DNA double chain in tissue were detected in different groups.RESULTS: The rapid appearance of apoptosis in alveolar epithelial cells and pulmonary vascular endothelial cells were observed after LIR in rats. The ratio of DNA double chain decreased and tissue Ca~(2+) increased. The expression of Fas/FasL mRNA and protein was up-regulated in lung tissue of rats after LIR, which was related to the elevation of alveolar epithelial cells and pulmonary vascular endothelial cell apoptosis. Taurine decreased alveolar epithelial cell and pulmonary vascular endothelial cell apoptosis not by down-regulating expression of Fas/FasL system. CONCLUSIONS: These results suggest that the excessive apoptosis and Fas/FasL system expression may play a role in the pathogensis of ALI following LIB in rats, and taurine decreases alveolar epithelial cell and pulmonary vascular endothelial cell apoptosis.

Objective To investigate the stapled trans-anal rectal resection (STARR) and Altemeir's resection for rectum prolapse in spinalcord injury (SCI) patients. Methods Anus bowel disease of 260 SCI patients were investigated, 21 cases with rectum prolapse who wereinvalid for nonoperative treatment chose Altemeir's resection or STARR depending on the degree of rectum prolapse. They were recorded ac- cording to International Spinal Cord Injury Bowel Function Based and Extension Set before and 12 months after operation. Results 85 SCIpatients were with rectum prolapse (32.7%), 21 patients complicated with constipation and mixed hemorrhoid, 19 with rectal mucous membraneprolapse (<7 cm), 4 with rectal internal mucous intussusception, 2 were completely rectum prolapse (≥7 cm). Rectum prolapse of Ⅰdegree was found in 13 cases, Ⅱ in 5 cases, and Ⅲ in 3 cases. Patients with Ⅰ or Ⅱ degrees rectum prolapse accepted STARR, those withⅢ degrees accepted Altemeir's resection. No serious complication was found. Self-report of intestinal dysfunction affecting the quality oflife during the 12 months after operation significantly decreased (P<0.01), so as the need of drawing out defecate with hands (P<0.01), theusage of liner, plug, or antidiarrheal (P<0.001). The symptom such as endless defecate feeling, abdominal distension, abdominal pain, abdominaldiscomfort were significantly alleviated (P<0.05). Conclusion STARR and Altemeir's resection are both safe and effective operationfor rectum prolapse in SCI patients.

Objective To apply the percutaneous endoscopic gastrostomy (PEG) for deglutition disorders of the elderly. Methods 32 elderlypatients with deglutition disorders accepted PEG were reviewed. They accepted post-operative enteral nutrition and were followed upmonthly with their weight, body mass index and mini-nutritional assessment (MNA). Results 2 cases presented skin infection of stoma, nomore complications happened. Their weight, body mass index and MNA improved significantly 3 months after treatment (P<0.05). ConclusionPEG is an effective treatment for the elderly deglutition disorders.

Upper limb dysfunction can severely threaten the quality of life of the patients with breast cancer after mastectomy. This paper reviewed the researches on its pathogenesis, diagnosis, treatment, prevention and so on in the last 10 years. Early rehabilitation is very important for upper limb dysfunction after mastectomy.

AIM: To observe the degree of gastric mucosal injury following limb ischemia/reperfusion(LIR),and to investigate the mechanism of gastric mucosal injury and the influence of the series of brief ischemia/reperfusion of hind limbs of rats on gastric mucosal injury. METHODS: Referring to Rosenthal's method, the model rats which underwent 4 hours of ischemia and 4 hours of reperfusion in hind limbs were made. The indexes of gastric mucosal injury after LIR and ischemic preconditioning (IPC) + LIR were determined. The morphologic changes were observed with light microscope and transmission electron microscop respectively. The GMBF,histologic lesion score, gastric barrier mucus, phospholipids, hexosamine, nitric oxide and nitric oxide synthase in mucus were measured in different groups. RESULTS: Serious damage in gastric mucosa was observed under microscope and EM after LIR. But less serious damage was observed in the IPC group. After LIR, compared to the control group, the GMBF and the content of gastric barrier mucus, phospholipids and hexosamine in mucus decreased significantly. There was significant difference in most indexes between the control group and the IPC group, but compared to LIR group, the histologic lesion score decreased significantly and the GMBF and the content of gastric barrier mucus, phospholipids, hexosamine ,nitric oxide and nitric oxide synthase in mucus increased significantly. CONCLUSION: LIR caused the gastric mucosa injury. IPC alleviated the damage of gastric mucosa following ischemia/reperfusion in hind limbs.