Objective To evaluate the impact of carvedilol and metoprolol on left ventricular (LV)dyssynchrony in idiopathic dilated cardiomyopathy(IDC).Methods In this study,we randomly assigned 65 IDC patients from January 2009 to June 2011 to re-ceive carvedilol or metoprolol succinate.All patieats were divided in to carvedilol group(n=33)and metoprolol group(n=32)Echo-cardiographic measurements and N-terminal pro-brain natriuretic peptide levels were obtained at baseline and 6 month after thera-py.Then long-term follow up the survival rate of patients were observed.Results In carvedilol group,reduction in LVEDS and in-crease in LVEF was higher compared to metoprolol group.Also improvement in LV dyssynchrony achieved and survival rate with carvedilol was higher than metoprolol.However,Improvements in LV mechanical dyssynchrony was similar in two groups.Im-provements in LV mechanical dyssynchrony achived with both drugs were accompanied by reduction in NT-pro-BNP levels in both carvedilol and metoprolol groups(P >0.05).Conclusion Carvedilol is an effective drug improves the intraventricular dyssynchro-nyfor for IDC patients with left ventricular dyssynchrony,and could increasea the survival rate.

Objective To investigate the impact of pain care standard training on the pain-related knowledge and attitude of junior nurses in orthopedics department.Methods The standard pain care training was done for the junior nurses in the orthopedics department. The scores of questionnaires related to pain-related knowledge and attitude were collected and compared between pre-and post-training. Result There was significant statistical difference in the measurements related to the junior nurse’s knowledge and attitude between pre-and post-standard training(P<0.05).Conclusion The standard pain care training can enhance junior nurses knowledge,improve the attitude towards pain,and set up apporiate pain management behavior.

Objective To understand the association between peripheral leukocytes telomere length (TL) and sleep in middle-aged and old adults.Methods A total of 176 middle-aged and old adults were investigated by using the Pittsburgh Sleep Quality Index and questionnaire.TL was measured by fluorescence quantitative PCR.The correlation and regression analysis between sleep and telomere length was performed.Results TL had a mean T/S ratio of 0.995 ± 0.23.There was a negative correlation between TL and age (r=-0.241,P=0.003).With increasing age,sleep quality became worse (r=-0.230,P＜0.01),the time to fall asleep became longer (r=0.227,P＜0.01),sleep duration was shorter (r=-0.486,P＜0.01),sleep efficiency became worse (r=-0.226,P＜0.01).After controlling for the effects of gender,age,marital status,income level,residence,smoking,drinking,physical exercise and disease status,multiple linear regression analysis indicated that sleep quality (β3=0.057,P＜0.01),time to fall asleep (β =-0.046,P＜0.01),sleep duration (β3=0.086,P＜0.01) were independent influencing factors of telomere length,suggesting that the people who had better sleep quality,the shorter time to fall asleep,the longer sleep time would have longer telomere length.Conclusions Sleep is a relevant factor affecting TL in middle-aged and elderly population.Good sleep may delay aging by slowing TL.We encourage to conduct health education about the importance of sleep quality in community.