Objective To investigate the effects of the milrinone in adjuvant treatment of intractable heart failure.Methods 60 cases of patients with intractable heart failure were randomly divided into observation group and control group according to hospitalization sequence,30 cases each group.The control group was given conventional therapy for heart failure,the observation group based on the use of milrinone.Changes of cardiac function index,NT-proBNP were compared between two groups before and after medication,and recorded the adverse reactions and the efficacy evaluation.Results After taking drugs,HR,LVEDD of the two groups were significantly decreased(t =5.31,5.92,4.61,4.22,all P ＜ 0.05),SV,LVEF and 6 minutes walking distance increased significantly(t =7.22,4.78,8.78,4.56,4.11,4.05,all P ＜ 0.05) ; group HR,LVEDD were significantly lower than those in the control group(t =4.31,4.92,all P ＜0.05).SV,LVEF and 6-minute walking distance was significantly higher than that in the control group(t =4.31,4.92,4.11,all P ＜ 0.05).After taking drugs,the observation group NT-proBNP levels decreased significantly than before treatment (t =14.55,P ＜ 0.05),and significantly lower than that in the control group (t =7.12,P ＜ 0.05).No significant change in NT-proBNP levels before and after treatment in control group was found (t =1.03,P ＞ 0.05).The observation group in the total effective rate was 93.33 ％ (28/30),the control group was 63.33％ (19/30),the difference was statistically significant(x2 =5.26,P ＜ 0.05).5 cases of adverse reactions to the observation group,4 patients in the control group,no significant difference in the adverse reactions was found between the two groups (x2 =0.67,P ＞ 0.05).Conclusion Low dose,short-term use of milrinone can make the heart function of patients with refractory heart failure was obviously improved,significantly improve the efficacy with higher safety.

Objective To discuss the efficacy and safety of sitagliptin combined with metformin in treatment of type 2 diabetes mellitus(T2DM).Methods One hundred patients with T2DM were divided into two groups by random digits table method with 50 cases each.The patients in study group were given phosphate sitagliptin (100 mg,day 1 oral) combined with metformin (500 mg,day 3 oral).The patients in control group were given repaglinide (1 mg,day 3 oral) combined with metformin (500 mg,day 3 oral).They were treated for 12 weeks and fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS),body mass index (BMI) and the incidence of hypoglycemic events were detected before and after treatment.Results After treatment,the level of FPG,2 h PG,HbA1c was significantly lower than that before treatment in two groups,and there was significant difference (P ＜ 0.01).The level of B MI after treatment was significantly decreased [(24.45 ± 2.13) kg/m2 vs.(25.46 ±2.62) kg/m2] and FINS was significantly increased [(13.36 ± 1.89) mU/L vs.(12.36 ± 1.80)mU/L] compared with that before treatment in study group (P ＜ 0.05 or ＜ 0.01).But the level of BMI and FINS had no significant difference before and after treatment in control group (P＞ 0.05).The incidence of hypoglycemic events had significant difference between study group and control group [0 vs.12％ (6/50)] (P ＜ 0.05).Conclusions Sitagliptin combined with metformin is safe and effective in treatment of type 2 diabetes mellitus,which is the preferred solution treatment.The risk of hypoglycaemia events is obviously reduced,also it can control and reduce weight and other advantages.

Objective To compare the clinical effect of UK and rt-PA intravenous thrombolytic therapy for acute myocardial infarction.Methods By SAS statistical analysis system,72 patients with acute myocardial infarction were randomly divided into rt-PA group and UK group,each group had 36 cases.The coronary artery recanalization rate,bleeding events,adverse cardiovascular events,mortality,and cardiac troponin T(cTnT) level were recorded.Results In rt-PA group,0.5h,1 h,2h after the start of thrombolytic therapy,the coronary artery recanalization rate was significantly higher than that in the control group,the difference was statistically significant (x2 =7.32,6.12,5.81,all P ＜ 0.05).In rt-PA group,3 cases had bleeding events,2 cases died,and in UK group,5 cases had bleeding events,3 cases died,,there was no statistically significant difference between the two groups (x2 =1.22,P ＞ 0.05).In rt-PA group,there were 6 cases with adverse cardiovascular events,14 cases in the control group,the difference was statistically significant (x2 =4.56,P＜0.05).2 cases died in rt-PA group,3 cases died in UK group,the mortality between the two groups had no statistically significant difference (P ＞ 0.05).The cTnT level in the hospital 6h,12h was significantly higher than admission in two groups (t =6.67,6.30,4.11,4.22,4.40,all P ＜ 0.05).In rt-PA group,cTnT level in the hospital 6h,12h was significantly lower than that in UK group (t =5.92,6.61,all P ＜0.05).Conclusion Compared with UK,rt-PA in the treatment of acute myocardial infarction can increase recanalization rate,decrease adverse events and myocardial injury,it is worthy of clinical application.

Mastering peripheral nerve block technique is a basic requirement for residents stan-dardization training. Ultrasound-guided nerve block has broken through the limitation of traditional blind operation, promoted the quality and safety of anesthesia, and improved the quality of the peripheral nerve block teaching. However, the safety of ultrasound-guided nerve block technique must be based on the speci-fication training. In the teaching experience, we have used theoretical study, simulation training and clinical practice to explore a new method for upgrading the quality of resident doctor training.

Humans ; Infant, Newborn ; Mastocytosis, Cutaneous

Objective To study the risk factors for cerebral infarction resulting from transient ischemic attack (TIA).Methods The clinical data of 144 hospitalized patients with TIA were evaluated.Results 50 patients (34.7%) suffered from cerebral infarction(CI) following the onset of TIA in 144 patients.11 cases with CI resulted from vertebra-basilar artery system,37 cases resulted from internal carotid artery system. There was significantly different in two artery systems( P

[Objective] To discuss the efficacy of Telbivudine treating chronic hepatitis B.[Method] Randomly divide 164 cases into treatment group 85 and control one 79,respectively taking Telbivudine and Ramivudine for anti virus for 48 w,then observe their efficacy.[Result] The ALT normalization and HbeAg positive rates were separately 87.50% and 71.15% for both groups; HBV DNA reduction rates and HbeAg postive-5.3 and-4.2log10 copies/ml,negative-6.6 and-5.5 log10 copies/ml;HbeAg negative rates respectively 28.57% and 23.08%;HbeAg serum conversion rates 23.21% and 15.38%;resistance rates of HbeAg positive 3.57% and 11.53%,negative 3.45% and 14.81%;the difference was very obvious(P

Objective To study the relationship between infection and hypokalemic paralysis and its clinical features.Methods A systemic analysis was made on the infection courses,clinical manifestations, serum levels of potassium and creatine phosphokinase,the results of electrophysiological and virological examinations in present 34 patients and 115 cases reported in literature with hypokalemic paralysis.Results There were differences in the clinical manifestations and denominations among the present and reported cases. No definite evidences for virus infections were found among patients who were characterized by acute flaccid paralysis accompanied with hypokalemia in the infection curses. The prognosis of the disorder was better after the patients were given potassium, and most of them didn't recur.Conclusion No enough evidences showed that this disorder was an independent disease.It should be named as "concomitant infectious hypokalemic paralysis" appropriately. It was probably a syndrome accompanied by infection on the base of hereditary susceptibility.

Objective to investigate the clinical diagnosis of female hypertension with chest pain.Methods The clinical coronary angiography data of 77 female cases of hypertension with chest pain diagnosed as coronary heart diseased (CHD) and angina pectoris were analysed retrospectively.The comparison of the risk factors and clinical features in the two groups was made.Results Clinically,it was difficult to differentiate hypertension with chest pain and coronary heart failure,but dynamic EDG and typical angina pectoris suggested the possibility of coronary heart disease.Conclusion Coronary angiography is still essential to diagnose CHD.

Objective To analyse the changes of nitric oxide and nitric oxide synthase in rat retina under acute high ocular pressure and study the effect of nitric oxide in rat retinal damage under hypertension. Methods Sixty Wistar rats were divided randomly into five groups:Ocular hypertension 30 min,60 min,90 min and 12 h,24 h after reperfusion.Elevation of the ocular pressure in the anterior chamber of the rat eye caused retina ischemic damage.The changes of retinal nitric oxide content were observed indirectly by measuring NO 2 -/NO 3 - content in retina.The distribution and changes of neuronal constitutive nitric oxide synthase (ncNOS)were studied by immunocytochemical localization of ncNOS. Results ncNOS positive neurons were distributed in the inner nuclear layer (INL),ganglion cell layer (GCL) and the inner plexiform layer of the normal and ischemic rat retina.During acute high IOP 30 min,60 min and 90 min,NO content decreased gradually and ncNOS immune activity weakens.During reperfusion,NO content increased remarkably (P