Objective:To observe and study the short-term efficacy of levocarnitine combined with trimetazidine in the treatment of elderly heart failure of ischemic cardiomyopathy. Methods:Totally 106 elderly patients with ischemic cardiomyopathy and heart failure were randomly divided into the observation group and the control group with 53 ones in each. All the patients were given anti-platelet, anti-myocardial ischemia and lipid-lowering therapy as well as the conventional therapy on myocardial ischemia. The control group was treated with trimetazidine,20mg,po,tid,while the observation group was additionally treated with 2g levocarnitine with 0. 9% sodium chloride injections,100ml,ivd,qd. The treatment course was 4 weeks. The improvement of heart function and the changes in cardiac function indices( including LVEDD,LVESD and LVEF)and cardiac ischemia markers( CKMB,TüI and BüP)before and after the treatment were compared between the two groups. The incidence of adverse drug reactions,the rate of re-hospitalization and mortality in the two groups were also compared. Results:The significant efficiency and total effective rate in the observation group were much higher than those in the control group(P<0. 05 or 0. 000 1). After the treatment,LVEDD and LVESD in the two groups were declined, LVEF was increased(P<0. 05),and the changes in the observation group were more notable than those in the control group(P<0. 05 or 0. 000 1). After the treatment,the contents of CKMB,TüI and BüP in the two groups were lower than those before the treat-ment(P<0. 05),and the decrease in the observation group was more notable than that in the control group(P<0. 05). There were no significant differences in the incidence of adverse reactions,re-admission rate and mortality between the two groups(P>0. 05). Conclusion:Levocarnitine combined with trimetazidine on the basis of the conditional therapy in the treatment of elderly patients with ischemic cardiomyopathy and heart failure can effectively improve heart function with better clinical efficacy,which is worthy of promo-tion in clinic.

Adult olfactory neurogenesis plays critical roles in maintaining olfactory functions. Newly-generated neurons in the subventricular zone migrate to the olfactory bulb (OB) and determine olfactory discrimination, but the mechanisms underlying the regulation of olfactory neurogenesis remain unclear. Our previous study indicated the potential of APPL2 (adaptor protein, phosphotyrosine interacting with PH domain and leucine zipper 2) as a modulating factor for neurogenesis in the adult olfactory system. In the present study, we report how APPL2 affects neurogenesis in the OB and thereby mediates olfactory discrimination by using both in vitro neural stem cells (NSCs) and an in vivo animal model-APPL2 transgenic (Tg) mice. In the in vitro study, we found that APPL2 overexpression resulted in NSCs switching from neuronal differentiation to gliogenesis while APPL2 knockdown promoted neurogenesis. In the in vivo study, APPL2 Tg mice had a higher population of glial cells and dampened neuronal production in the olfactory system, including the corpus callosum, OB, and rostral migratory stream. Adult APPL2 Tg mice displayed impaired performance in olfactory discrimination tests compared with wild-type mice. Furthermore, we found that an interaction of APPL2 with Notch1 contributed to the roles of APPL2 in modulating the neurogenic lineage-switching and olfactory behaviors. In conclusion, APPL2 controls olfactory discrimination by switching the fate choice of NSCs via interaction with Notch1 signaling.