Objective To evaluate the diastolic function and relationship between diastolic function and early diastolic synchrony in patients with dilated cardiomyopathy (DCM) by real-time three-dimensional echocardiography (RT-3DE) volume-time curves (VTC) after cardiac resynchronization therapy (CRT).Methods Thirty-nine patients with DCM were enrolled by RT-3DE VTC before and 1 week,6 months,12 months after CRT,draw the left ventricular (LV) 16,12,6 segments LV diastolic early volume standard deviation of the time (Tedv-SD),and with the R-R interval normalized as early diastolic unsynchronized index (DDI) ;draw end-systolic volume (LVESV),LV end-diastolic volume (LVEDV),LV ejection fraction (LVEF) ;and calculate the diastolic peak filling rate(PFR),the ratio of early diastolic volume and enddiastolic volume(EDVearly/EDV).Results LVEDV,LVESV had no significant improvement.Compared with the before and 1 week after CRT,but the improvement was statistically significant after 6 months and 12 months (P ＜0.05,P ＜0.01); LVEF after 1 week,6 months and 12 months were statistically significant (P ＜0.05) ;Compared with before,PFR after 6 months was significantly increased (P ＜0.05),EDVearly/EDV at 12 months after CRT was significantly reduced (P ＜ 0.01); There was a significantly shortened in each segment (Tedv-SD)/R-R 1 week after CRT (P ＜0.01),but the parameters had no obvious improvement later.Correlation analysis:△ DDI and △ EDVearly/EDV reduction was significant positive correlation (r =0.52,P ＜0.01),△DDI and PFR has negative correlation (r =-0.40,P ＜ 0.05),△ EDVearly/EDV and △PFR also had a good relationship (r =-0.56,P ＜0.01).Conclusions The LV synchrony and diastolic function were improved after CRT in patients with DCM; PFR,EDVearly/EDV can be used as evaluation of left ventricular diastolic function effectively targets.

Objective Systematic review the effect and side effect of Probucol on contrast-induced acute kidney injury (CIAKI), and to evaluate the characteristics and strength of the protective effect. Methods Electronic search studies from databases published in English and Chinese before March 2014, and hand searches of relevant randomized controlled trials of references. Features, the quality of research and valid data of included studies were extracted, then using RevMan 5.0 software to conduct a Meta-analysis base on Cochrane systematic review methods. Results A total of 11 literatures described eight randomized controlled trials involving 1938 cases of patients evaluated the effect of Probucal on CIAKI. A total of seven studies involving 1,298 patients, compared the incidence of CIAKI, the total incidence rate was 10.9%(141/1298), CIAKI incidence was 5.7%(37/652) in the Probucal group and 16.1%(104/646) in the control group (RR 0.37, 95%CI 0.26~0.53). Lower postoperative creatinine values was observed in Probucol group, compared with the control group on the first day Weighted Mean Difference (WMD-6.76, 95%CI-9.33~-4.20)μmol/L, the second day (WMD-16.90, 95%CI-22.61~-11.19)μmol/L, the third day(WMD-11.05, 95%CI-17.65~-4.45)μmol/L, and lower peak postoperative creatinine than the control group[(WMD- 14.58, 95%CI- 19.00 ~ - 10.16)μmol/L]. Probucol group with lower postoperative urinary KIM-1[(WMD-3.64 , 95%CI-3.72~-3.57) ng/ml], and the serum CysC was also low. Conclusions Preoperative or postoperative oral Probucol has a protective effect on CIAKI, can reduce the rise of postoperative renal injury indicators of coronary angiography or coronary intervention, such as serum creatinine and CysC, and CIAKI can be reduced by about 60%, no significant side effects observed.

Objective To explore the effect of lactulose oral solution in the treatment of patients with chronic functional constipation and its influence on the level of MTL and NO.Methods 54 cases of patients were selected with primary glaucoma who were treated in our hospital from June 2013 to October 2014 as research objective,and they were randomly divided into research group(29 cases)and control group(25 cases)according to the number table method.All of the patients were given treatment as diet adjusting,defecating exercise and so on.The research group got extra treatment as taking lactulose oral solution 10 g,2 to 3 times per day,for 6 weeks.Results MTL in the research group before treatment was 203.71ng/mL,and it was 371.03ng/mL after treatment for 6 weeks,there was statistically significance on difference of MTL levels between before treatment and after treatment(P <0.05).NO in the research group before treatment was 120.52ng/mL,andit was 69.01ng/mL after treatment for 6 weeks,there was statistically significance on difference of NO levels between before treatment and after treatment(P <0.05).MTL in the control group before treatment was 206.21ng/mL,which was 279ng/mL after treatment for 6 weeks,there was statistically significance on difference of MTL levels between before treatment and after treatment(P <0.05).NO in the control group before treatment was 123.92ng/mL,which was 98.75ng/mL after treatment for 6 weeks,there was statistically significance on difference of NO levels between before treatment and after treatment(P <0.05 ).MTL levels in the research group after treatment was higher than that in the control group when NO levels was lower than that in the control group,the difference was statistically significant(P <0.05).Conclusion Lactulose can improve the secretion of gastrointestinal hormones in plasma such as promoting the secretion of MTL and reducing the synthesis of NO.

Objective Study of Shuxuening combined with sodium phosphocreatine on acute severe carbon monoxide poisoning with ischemia modified albumin level and its curative effect in patients. Methods 66 cases of ASCOP patients were randomly divided into routine group and treatment group, all patients were detected for myocardial enzymes, cTnI, IMA before treatment, after treatment 6 h and 3 d. Results IMA was significantly decreased before treatment, while no significant changes occurred in myocardial enzymes and cTnIn levels. After treatment for 6 h, IMA in treatment group was higher than conventional group (P < 0.05). Myocardial enzymes and cTnI gradually increased, the two groups had no difference (P>0.05). After treatment for 3d, cTnI level of normal group increased obviously compare with the treatment group (P>0.05). Myocardial enzymes, IMA restored to the normal level (P>0.05). The level of cTnI after treatment for 3 d improved compare with 6 h. Conclusion Treatment of early ASCOP patients by Shuxuening combined with sodium phosphocreatine significantly improve the recovery of myocardial injury poisoning. The level of IMA can be used as evaluation index of myocardial ischemia and drug treatment.

Objective To compare the efficacy and safety of twice-daily tacrolimus (Tacrolimus BID; Prograf) vs once-daily prolonged release tacrolimus (Tacrolimus QD; Advagraf), combined with steroids and mycophenolate mofetil in preventing acute rejection in De Novo renal transplantation patients. Methods 241 patients from 11 centers were randomized into two groups with 3 months observation period post-transplantation. Advagraf was administered as a single oral dose in the morning (initially 0. 1-0. 15 mg/kg every day) and Prograf was administered in two equal oral doses 12h apart (initially 0. 1-0. 15 mg/kg). Study visits were scheduled for days 1, 3, 7, 14, 28, 56, 84post-transplantion. The efficacy, safety, compliance and adverse effects were compared between two groups. Results Totally 223 patients completed the study. The two groups were comparable in age,gender and primary disease. There were 12 episodes of acute rejection in each group. There was no graft loss or patient death in both groups. The incidence of drug related adverse events was 32. 1 %and 33. 3% respectively in the control and experimental groups. Dosage was decreased in both groups and there was significant difference in each group. The trough level was similar at the initiate period.Twenty-eight days post-transplantation the trough level in the Advagraf group was lower than in the Prograf group. Conclusion Advagraf has the same efficacy, safety and drug related adverse effects as Prograf. It is practical and feasible for Advagraf substitute for Prograf in clinical practice.

Objective: To explore the effect of previous treatment on the efficacy of multidrug resistant pulmonary tuberculosis (MDR-TB) patients. Methods: From February 2015 to February 2017, 64 cases with MDR-TB who received treatment in the First Hospital of Ninghai were collected.All patients received antituberculous therapy for 6 months.The clinical data were retrospectively analyzed.The factors that influence the efficacy of MDR-TB patients were evaluated by multivariate logistic regression analysis. Results: After standard chemotherapy for MDR-TB patients, the incidence of chest radiographic lesions in primary and relapsed MDR-TB patients was 18 cases(81.82%) and 21 cases(50.00%), respectively.There was statistically significant difference between the two groups (χ²=22.835, P<0.05). The cavity closure rate of MDR-TB patients after primary treatment and relapse was 54.55% and 40.48%, respectively, and there was significant difference between the two groups (χ²=8.693, P<0.05). After standard chemotherapy for MDR-TB patients, the cure rates of primary and recurrent MDR-TB patients were 18 cases(81.82%) and 23 cases (54.76% ), respectively, there was statistically significant difference between the two groups (χ²=21.791, P<0.05). Conclusion The effect of initial treatment of MDR-TB is better than recurrent MDR-TB, so it is necessary to strengthen the surveillance of drug resistance in patients with tuberculosis and to find the disease as soon as possible.Early treatment of MDR-TB is the best option for patients.