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.

Objective To analyze the change and clinical significance of blood lipid and high sensitive-C reactive protein (hs-CRP) in patients with subclinical hypothyroidism.Methods Fifty patients with subclinical hypothyroidism were selected as observation group,and 50 health people with the same gender and age were selected as control group.The blood lipid and hs-CRP levels in the two groups were measured and compared.Results The total cholesterol (TC),triacylglycerol (TG),and low density lipoprotein cholesterol (LDL-C) in observation group were significantly higher than those in control group [(5.20 ±0.84) mmol/L vs.(4.79 ±0.80) mmol/L,(2.21 ±0.97) mmol/L vs.(1.78 ±0.60) mmol/L,(3.25 ±0.65) mmol/L vs.(2.83 ±0.51) mmol/L],high density lipoprotein cholesterol (HDL-C) was significantly lower than that in control group [(1.18 ± 0.15) mmol/L vs.(1.28± 0.22) mmol/L],and there were statistical differences (P ＜ 0.05 or ＜ 0.01).The hs-CPR in observation group was significantly higher than that in control group [(4.2 ± 1.1) mg/L vs.(3.0 ± 0.8) mg/L],and there was statistical difference (P ＜0.01).Conclusions Subclinical hypothyroidism can cause increased TC,TG,LDL-C and hs-CRP and decreased HDL-C,which may accelerate atherosclerosis and cardiovascular disease.It is necessary to timely screen and treat the disease.

Humans ; Infant, Newborn ; Mastocytosis, Cutaneous

Objective To observe the role of the P-glycoprotein (P-GP)in the pathogenesis of colitis in FVB and multiple drug resistance (mdr) gene, mdr1a, knockout (mdr1a~(-/-)) mice. Methods The clinical, pathological and immunohistochemical characteristics were observed in FVB control mice and mdr1a~(-/-) mice with or without inflammation of intestinal tract. The functions of T cell and B cell in these mice were analyzed. Results Approximately 26 of the 124 mdr1a~(-/-) mice were found to have symptoms of colitis such as diarrhea and weight loss in this study, and pathologic changes in these mice were similar to that in the human active ulcerative colitis. CD4~+ T cell and B cell infiltrated into the (proper) lamina were observed by immunohistochemical staining in mdr1a~(-/-) mice with colitis. There were (significant) increases in serum antibody titers of all types in mdr1a~(-/-) mice with active colitis. The levels of IgG1, IgG2a, IgG2b, IgG3, IgA and IgM were 7568, 1876, 823, 234, 897 and 189 ?g/ml, (res-)(pectively), significantly higher than those in FVB mice, which were 623, 102, 54, 42, 32 and 58 ?g/ml, (respectively) ( P

Objective To explore the association between rheumatoid arthritis (RA) with TLR4 Asp299Gly functional variant. Method The literature about RA and TLR4 Asp299Gly functional variant were searched and the meta-analysis was performed. Results Three studies enrolled 718 RA patients and 1392 controls in total. The analysis showed that the TLR4 Asp299Gly functional variant was neither associated with the susceptibility of RA [OR=1.23 (0.67, 2.25), P=0.5]; nor associated with SE or RF [OR=0.67 and 1.02 respectively]; while the TLR4 Asp299Gly functional variant was associated with the age of onset [OR=-4.35 (-7.45, -1.25), P=0.006]. Conclusion The meta-analysis reveals that the TLR4 Asp299Gly functional variant is not associated with the susceptibility of RA, but the onset of RA is earlier in the AA type than those in the AG type. Further prospective corhort studies should be carreied out in the future, especially in oriential people.

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 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