Objective: To investigate the application effect of metoprolol in the treatment of atrial fibrillation complicated with chronic heart failure(CHF). Methods: From February 2015 to February 2019, 398 elderly patients with atrial fibrillation and CHF in Wangjiangshan Branch of the People's Hospital of Zhejiang Province were selected in the study.The patients were divided into two groups according to the digital table, with 199 case in each group.The control group was treated with rest, digitalis inhalation, diuretics, angiotensin converting enzyme inhibitors, nitrate and enteric-coated aspirin.The observation group was treated with metoprolol on this basis.The effective rate of treatment, heart rate changes before and after treatment, left ventricular ejection fraction and 6-minute walking distance in the two groups were observed and analyzed. Results: The effective rate of the observation group was 88.94%(177/199), which was significantly higher than 71.86%(143/199) in the control group, the difference was statistically significant (χ²=18.433, P=0.000). The highest heart rate, the lowest heart rate and the resting heart rate in the observation group after treatment were significantly better than those in the control group[(115.12±0.35)times/min vs.(122.12±16.22)times/min, (90.21±18.12)times/min vs.(94.12±11.11)times/min, (97.00±9.64)times/min vs.(102.03±11.20)times/min], the differences were statistically significant(t=4.246, 4.783, 4.662, all P<0.05). The LVEF and 6-minute walking distance of the observation group after treatment were significantly better than those of the control group[(45.0±2.0)% vs.(41.0±3.0)%, (340.09±31.45)m vs.(302.43±29.45)m], the differences were statistically significant(t=4.246, 7.662, all P<0.05). Conclusion Digitalis combined with metoprolol can effectively control the heart rate of atrial fibrillation combined with CHF, improve ventricular function and increase cardiac endurance.The combined therapy is worthy of promoting in this disease.

Objective To investigate in children with type 1 diabetes mellitus and provide evidence for nursing education. Methods From January to December 2016, 450 patients with T1DM were enrolled in this research,all of them were outpatients of diabetes clinic of Beijing Children′s Hospital Affiliated to Capital Medical University. The clinical data of the patients were collected through questionnaires and physical examinations to assess the insulin treatment and related factors. Results Among 450 patients, 221 were males and 229 were females, aged 9.40 (0.83-17.97) years old; body mass index was 17.43 (12.81-28.22) kg/m2; course of disease was 2.32 (0.05-12.89) years; daily insulin dosage was 0.66 (0.11-1.78) IU·kg-1·d-1; glycosylated hemoglobin (HbA1c) was 7.54 (4.4-14.9)%, of which HbA1c<7.5% accounted for 55.8%(251/450). 7.5%-9.0% accounted for 30.0(135/450)% , and >9.0% accounted for 14.2% (64/450). 44.9% ,47.1% ,8.0% (202, 212,36 cases) patients were treated respectively with routine treatment, multiple daily injection or continuous subcutaneous insulin infusion. There was no significant difference in HbA1c between patients with different insulin regimens (P>0.05), but there were significant differences in age, course of disease, body mass index and insulin dosage (P< 0.05). Conclusion Because children with type 1 diabetes have different physiological and psychological characteristics in different stages, the content of health education should be adjusted according to the patient's condition.

In Korea and China, ilaprazole is a widely used proton pump inhibitor in the treatment of gastric ulcers. In this study, a specific and sensitive LC-MS/MS method has been developed and validated for the quantification of ilaprazole enantiomers in the rat plasma, using R-lansoprazole as the internal standard. The enantioseparation was achieved on a CHIRALPAK AS-RH column (4.6 mm × 150 mm, i.d. 5μm), with a mobile phase composed of 10 mM ammonium acetate aqueous solution and acetonitrile (60:40, V/V), at a flow-rate of 0.5 mL/min. The method was validated over the concentration range of 0.5-300 ng/mL for both, R- and S -ilaprazole. The lower limit of quantification was 0.5 ng/mL for both enantiomers. The relative standard deviation (RSD) of intra- and inter-day precision of R-ilaprazole and S-ilaprazole was less than 10.9％, and the relative error accuracy (RE) ranged from -0.5％-2.0％. Finally, the method was successfully evaluated in rats in a stereoselective pharmacokinetic study of the ilaprazole racemate.

BACKGROUNDIt has been indicated that autologous hematopoietic stem cell transplantation (AHST) is a promising treatment to adults with type 1 diabetes, however, the application of AHST therapy to children with type 1 diabetes still needs more data. The aim of this study was to assess the clinical effect of immune intervention combined with AHST and conventional insulin therapy in the treatment of children with newly diagnosed type 1 diabetes.

METHODSThis 1:2 matched case-control study was comprised of 42 children who were newly diagnosed with type 1 diabetes in the Department of Endocrinology, Beijing Children's Hospital from 2009-2010. The case group included 14 patients, who were treated with AHST within the first 3 months after being diagnosed with diabetes at request of their parents during 2009-2010. The control group included 28 patients with newly diagnosed type 1 diabetes at the same period of hospitalization. We compared the baseline and follow-up data of them, including ketoacidosis onset, clinical variables (glycosylated hemoglobin (HbA1c), insulin dosage and serum C-peptide).

RESULTSThe clinical characteristics of the patients was comparable between the case group and the control group. At 6-12 months ((10.7±4.2) months) after AHST treatment, we found 11 patients in the case group did not stop the insulin therapy, three cases stopped insulin treatment for 2, 3 and 11 months, respectively. No diabetic ketoacidosis (DKA) occurred after transplantation in all the patients in the case group. HbA1c in the control group was significant lower than that in the case group (P < 0.01), while the insulin dosage and serum C-peptide were not significant different between the two groups (P > 0.05). In order to eliminate the honeymoon effect, we performed final follow-up at the 3-5 years ((4.2±1.8) years) after AHST treatment, and found that HbA1c in the control group was still lower than that in the case group (P < 0.01); however, the insulin dosage and serum C-peptide were not significantly different between the two groups (P > 0.05). Moreover, the insulin dosage was not significant different from baseline to follow-up period in the case group.

CONCLUSIONAHST treatment showed no advantage in effectiveness in children with newly diagnosed type 1 diabetes, both in insulin dose and long term blood glucose control.

Adolescent ; Case-Control Studies ; Child ; Child, Preschool ; Diabetes Mellitus, Type 1 ; drug therapy ; therapy ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Hypoglycemic Agents ; therapeutic use ; Infant ; Insulin ; therapeutic use ; Male ; Transplantation, Autologous ; Treatment Outcome