Objective To compare effects of irbesartan and captopril on left ventricular function in elderly patients with cardiovascular disease and cardiac functional reserve .Methods 100 cases of elderly patients with car-diovascular disease were chosen ,according to a list of numbers randomly divided into the two groups ,50 cases in each group,a group with irbesartan treatment ,as the irbesartan group and the other group received captopril ,as the capto-pril group compared the two groups of patients left ventricular function and cardiac functional reserve .Results (1) Left ventricular function after the irbesartan group therapy LVDd indicators ,IVSd,LVPWd,LVEF,VE/VA,LVM was significantly better than before treatment ,the difference was statistically significant (t=31.23,18.36,28.12,46.36, 51.13,16.03,all P<0.05),the captopril group before and after treatment was significantly better than the treatment of various indicators,the difference was statistically significant (t=24.53,21.36,31.12,14.33,18.19,16.45,all P<0.05);(2) The irbesartan group of patients after treatment resting heart rate ,exercise heart rate,6min walking distance improved significantly over the treatment of former CCRI and CRI ,the difference was statistically significant (t=39.09,23.77,39.01,23.18,22.45,all P<0.05),after treatment with captopril treatment was significantly better than the indexes,the difference was statistically significant (t=91.21,37.16,26.74,46.33,36.74,all P<0.05),6min walking distance from the irbesartan group therapy ,CRI better than the captopril group ,the difference was statistically significant(t=39.02,42.14,all P<0.05).Conclusion Irbesartan and captopril on improving left ventricular function in elderly patients with cardiovascular disease and cardiac reserve function has a significant effect,irbesartan 6min walking distance test and cardiac reserve indices better .

Objective To explore the optimal surgical treatment strategy of advanced gallbladder carcinoma (Nevin Ⅲ - Ⅴ ), with an aim to prolong patients' overall survival. Methods 17 patients with advanced gallbladder carcinoma were reviewed. Their preoperative diagnosis, surgical treatment, complications and survival time were studied. Results The diagnosis of advanced gallbladder carcinoma was done using different medical imaging techniques, but incorrect diagnosis still happened. There is a wide range of surgical treatment for advanced gallbladder carcinoma. Controversy still exists as whether lymph node resection should be done. In our patients, 35.3% of the 13a lymph nodes and 23. 5% of the 8 lymph nodes were positive for metastasis, which showed that lymph node resection should be carried out. Extended surgery was sometime required to ensure a R0 resection.The main complications of surgery were intraabdominal infection, bile leakage and paralytic ileus.Conclusion An aggressive surgical approach for advanced gallbladder carcinoma is required to ensure a R0 resection, which contributed to better overall survival.

ObjectiveTo explore the relationship between the status of vitamin A and the level of AntiHBs in infants.Methods One hundred and ninty eight infants met the criteria were recruited into an investigation through local vaccination service.Two milliter venous blood was drawn from each studied child,and the infants' feeding information of successive 72 hours was collected through the 24-hour dietary recall method and 2-day diet records method.The nutrients intakes were analyzed with a NCCW software for calculation.The concentration of serum vitamin A and Anti-HBs was analyzed by HPLC and ECLIA,respectively.The logarithm of anti-HBs concentrations was compared among sub-clinical vitamin A deficiency (87 cases ),suspicious subclinical vitamin A deficient group (51 cases )and normal group (60 cases )and the relationship between the logarithm of anti-HBs concentrations and vitamin A were analyzed.ResultsThere were only 19.7％ of children whose average daily intake of vitamin A reached the 80％ of recommended nutrient intakes(RNI).The incidence rate of vitamin A malnutrition was 67.2％.The serum Anti-HBs GMC was 402.8 U/L The positive rate was 98.0％.There were significant differences on Anti-HBs Ig GMC between Sub-clinical vitamin A deficiency (SVAD) group,suspicious SVAD group and normal group( F =15.88,P ＜ 0.001 ).The correlation coefficient between the level of serum vitamin A and Anti-HBs lg GMC was 0.441 ( P =0.01 ).ConclusionThe results show that the level of serum vitamin A may have influence on the maintenance of an effective anti-HBs level against hepatitis B virus.