Objective:To explore influence of diltiazem hydrochloride on expression of serum microRNA in aged pa‐tients with dilated cardiomyopathy (DCM ) . Methods :A total of 120 aged DCM patients (DCM group ) and 60 healthy aged people (normal control group) were enrolled .DCM group was further randomly and equally divided in‐to routine treatment group (n=60) and diltiazem group (n=60 ,received additional diltiazem hydrochloride based on routine treatment) .Left ventricular end -diastolic dimension (LVEDd) ,left ventricular posterior wall thickness (LVPWT) and left ventricular ejection fraction (LVEF) were observed and compared between routine treatment group and diltiazem group before and after treatment ,cardiac function improvement was compared between these two groups after treatment .Changes of expression amount of serum miR -1 ,-133 ,-499 and -208 were com‐pared among three groups before ,six and 12 weeks after treatment .Results:Compared with before treatment ,after treatment ,there were no significant changes in LVEDd ,LVPWT and LVEF in routine treatment group , P>0.05 all;there were significant reductions in LVEDd [(69.41 ± 6.42) mm vs .(61.32 ± 5.31) mm] and LVPWT [(20.98 ± 1.98) mm vs .(12.05 ± 2.42) mm] and significant rise in LVEF [(32.81 ± 4.71)% vs .(50.52 ± 6.88)% ] in dilt‐iazem group , and LVEDd , LVPWT were significantly lower than those of routine treatment group [LVEDd:(67.25 ± 4.21) mm ,LVPWT :(18.49 ± 2.86) mm] ,and LVEF was significantly higher than that of routine treat‐ment group [ (47.77 ± 3.92)% ] , P<0.05 all .For cardiac function improvement ,markedly effective rate (71.7%vs .56.7% ) and total effective rate (98.3% vs .85.0% ) of diltiazem group were significantly higher than those of routine treatment group , P<0.05 both . Compared with normal control group , the 4 kinds of miR expression sig‐nificantly reduced in routine treatment group , and compared with routine treatment group , those of diltiazem group were significantly rose , P<0.01 all , but compared with 6‐week , miR expression had downtrend during 12‐week , the miR‐208 expression was most significant ( P< 0.01 ) .Conclusion:Diltiazem could effectively modulate serum microRNA expression in aged CDM patients ,which provided molecular biological basis for studying diltiazem mech‐anism .

OBJECTIVE:To observe clinical efficacy of Felodipine sustained-release tablets(Ⅱ)in the treatment of elderly es-sential hypertension and its improvement effect on arterial elasticity,left ventricular remodeling and the quality of life. METHODS:A total of 96 elderly patients with essential hypertension in our hospital during Aug. 2014-Dec. 2015 were divided into observation group (50 cases) and control group (46 cases) according to random number table. Observation group was given Felodipine sus-tained-release tablets(Ⅱ)5 mg orally,qd,with empty stomach in the morning;control group was given Irbesartan tablets 150 mg, qd,with empty stomach in the morning. Both groups received treatment for 12 weeks. Clinical efficacies of 2 groups were observed as well as 24 h ambulatory blood pressure (ABP),indexes of arlerial elasticity [carotid-radial pulse wave velocity (CR-PWV),carot-id-femoral pulse wave velocity (CF-PWV)], indexes of left ventricular remodeling [diastolic interventricular septum thickness (IVST),diastolic left ventricular posterior wall thickness(LPWT),left ventricular end diastolic diameter(LVIDd)] before and after treatment. The physiological function (PF),social function (SF),role-physical (RP),body pain (BP),mental health (MH),role-emotional(RE),vitality(VT)and general health(GH)score of SF-36 were observed in 2 groups before and after treatment. The occurrence of ADR was compared between 2 groups. RESULTS:There was no statistical significance in total response rate be-tween 2 groups (P>0.05). There was no statistical significance in 24 hABP,CR-PWV,CF-PWV,IVST,LPWT,LVIDd,SF-36 score between 2 groups before treatment(P>0.05). After treatment,the levels of 24 hSBP,24 hDBP and 24 hMAP in 2 groups were decreased significantly,and 24 hSBP and 24 hMAP of observation groups were significantly lower than those of control group,with statistical significance (P<0.05). There was no statistical significance in 24 hDBP (P>0.05). The levels of CR-PWV,CF-PWV, IVST and LPWT in observation group were decreased significantly,and the levels of CR-PWV and LPWT in control group were also decreased significantly. The levels of CR-PWV,CF-PWV,IVST,LPWT and LVIDd in observation group were significantly lower than control group,with statistical significance (P<0.05). SF-36 scores of 2 groups were increased significantly,and the scores of BP,VT,MH and GH in observation group were significantly higher than control group,with statistical significance (P<0.05). There was no statistical significance in scores of PF,SF,RP and RE. There was no statistical significance in the incidence of ADR be-tween 2 groups(P>0.05). CONCLUSIONS:Felodipine sustained-release tablets(Ⅱ)exhibit significant effect and small blood pres-sure fluctuation in the treatment of elderly essential hypertension,and can improve the quality of life with good safety.