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 evaluate CT diagnosis and differential diagnosis of thoracic granulomatous diseases.Methods 13 cases of thoracic granulomatous diseases(tuberculoma 5,mycosis 3,sarcoidosis 2,Wegener's granuloma 2,eosinophilic granuloma 1) proved surgically-pathologically together with clinical and imaging data undergone analysis,especially put emphasis on CT features.Results ①Pulmonary granulomatous lesions commonly presented as nodules or masses,single or multiple,all the lesions had cavity,as well known pulmonary tuberculoma,pulmonary mycosis and Wegener's granuloma.②Cavity associated with mobile mass inside presented as air meniscus or air sing sign were the imaging characteristics of pulmonary aspergilloma.③Hilar and mediastinal lymphadenectasis always presented as bilaterally and symmetrically that was the typical sign of stage I sarcoidosis.④The multiple,multiplicity together with necrosis and cavity were the characteristics of wegener's granuloma.⑤Nodules and pneumtoceles were the major specific signs of pulmonary eosinophilic granuloma.Conclusion To analyse CT specific features and in combination with clinical data,it can improve the diagnostic accuracy of pulmonary granulomatous diseases.

Objective:To systematically evaluate the correlation of high sensitivity C-reactive protein (hs-CRP) with contrast-induced nephropathy (CIN) in patients following coronary angiography (CAG) or percutaneous coronary intervention (PCI).Methods:PubMed, web of science, CBM, CNKI and Wanfang Data were searched for studies on hs-CRP levels in patients undergoing CAG or PCI patients from the incipience of the database to March 7, 2021. Meta-analysis was performed by RevMan 5.3 and Stata 12.0 software.Results:Fourteen related studies were included involving 11 885 patients undergoing CAG or PCI (1 034 cases with CIN and 10 851 cases without CIN). The results of meta-analysis showed that the level of hs-CRP in CIN group was significantly higher than that in non-CIN group (WMD=3.77,95 %CI:2.80—4.74, P<0.001, I2=93%), patients with higher levels of hs-CRP before CAG or PCI were more likely to develop CIN. Sensitivity analysis shows that the results of this study had good stability. The results of subgroup analysis show that the differences in sample size, study population, geographical location and the definition of CIN were statistically significant. Conclusion:Available evidence shows that high hs-CRP level is a risk factor for CIN in patients undergoing CAG or PCI, large sample trials are still needed to support this conclusion.

Objective To investigate the value of interleukin(IL)-6 and kidney injury molecule(Kim)-1 in the early prediction of contrast-induced pnephropathy(CIN)after percutaneous coronary intervention(PCI)in patients with coronary heart disease.Methods A total of 730 patients with coronary heart disease who underwent PCI were retrospectively collected,divided into CIN group(n=46)and non-CIN group(n=684),and the medical records of the two groups were compared,and the relationship between Kim-1 and IL-6 of renal injury and CIN was analyzed by binary regression,and the receiver operating characteristic(ROC)curve was used to explore the predictive value of these two markers on CIN after PCI for coronary heart disease.Results There was no significant difference between two groups in terms of preoperative IL-6(P=0.467)and Kim-1(P=0.643),and 48h and 72h after PCI,IL-6 and Kim-1 in CIN group was higher than that in non-CIN group(P＜0.001),and IL-6 and Kim-1 in CIN group was higher than that in before surgery(P＜0.001).48h postoperative IL-6(OR=1.884,P=0.002),48h postoperative Kim-1(OR=1.409,P＜0.001)and 72h postoperative IL-6(OR=1.377,P＜0.001)and 72 hours postoperative Kim-1(OR=1.092,P=0.004)were independent risk factors for CIN.The ROC curve showed that when used as a diagnostic marker for CIN,the area under the curve(AUC)of IL-6(48h),IL-6(72h)were 0.837,0.782,AUC of 48h Kim-1 and 72h Kim-1 were 0.820 and 0.827,respectively.Conclusion IL-6 and Kim-1 are independent risk factors for CIN after PCI for coronary heart disease.IL-6 and Kim-1 were positively correlated with the occurrence of CIN after PCI for coronary heart disease.IL-6 and Kim-1 have good diagnostic sensitivity and specificity for CIN after PCI for coronary heart disease.