Objective:To observe influence of trimetazidine on cardiac function in patients With chronic heart failure (CHF).Methods:According to number table method,a total of 70 CHF patients accorded With inclusion standards Were randomly and equally divided into trimetazidine group and routine treatment group.According to patient's condition,routine treatment group received digitalis,diuretics,angiotensin converting enzyme inhibitors etc CHF routine freatment.Trimetazidine group additionally received trimetazidine based on routine treatment.The treat-ment period Was four Weeks.Plasma brain natriuretic peptide (BNP)level Was measured and patients received 6min Walking test (6MWT)before and after treatment.Results:Compared With before treatment,there Was significant decrease in plasma BNP level in tWo groups after treatment (P<0.01),compared With routine treatment group, there Was significant increase in decreasing amplitude of BNP level [(655.89±135.61)pg/ml vs.(715.60±181.22) pg/ml,P<0.05]in trimetazidine group;compared With before treatment,there Was significant increase in 6min Walking distance (6MWD)in tWo groups after treatment (P<0.01),compared With routine treatment group,there Was significant increase in increasing amplitude of 6MWD [(181.46±51.16)m vs.(226.06±65.18)m,P<0.01] in trimetazidine group.Conclusion:Treatment trimetazidine can significantly reduce plasma brain natriuretic peptide level and improve heart function based on routine treatment in patients With heart failure.

Objective To explore the pathological basis and clinical characteristics of children with congenital choledochal cyst(CCC) combined with liver damage.Methods According to the age,38 patients with CCC were divided into 2 groups:group A had 24 cases(ranged 6 months to 3 years old);group B had 14 cases(ranged 4 to 14 years old).A comparative analysis of them was conducted retrospectively in the clinical characteristics,hepatic pathological changes,perioperatively liver function and operation.Results Group A was obvious higher than group B in jaundice,white bole stool and abdominal mass,but group B was more in stomachache.Group A was obvious higher than group B in liver function lesion,alkaline phosphatase,bilirubin increase and blood coagulation disfunction(Pa

It was introduced in this paper the concrete measures of medical humanistic education which is in harmony with the teaching of human parasitology. The necessity of humanistic education for the medical students in the present age and the feasibility of humanistic education in basic medical education were discussed according to the feedback on the survey of the medical students. This study aimed to explore an ideal teaching model for medical humanistic education and comprehensively improve the humanistic accomplishment in medical students.

Objective To evaluate the utility of susceptibility weighted imaging (SWI)in the evaluation of traumatic brain injury (TBI)severities.Methods 20 mild TBI patients,20 moderate TBI patients and 20 severe TBI patients were collected.The involving brain regions,numbers and areas of hemorrhagic lesions detected by SWI were analyzed and the differences of each group were com-pared.The correlation analysis between Glasgow coma scale(GCS)scores and each above parameters were underwent.Results The differences of involving regions’number,lesions’number,lesions’area were statistically significant(P <0.05 ).Severe TBI group got the maximum number of involving regions,lesions,and the largest areas,followed by moderate group and mild group.The GCS were highly negatively correlated with the number of involving regions,number of lesions,areas of lesions detected by SWI.In descending order of relevance:GCS with areas detected by SWI(r=-0.982,P=0.000),the number of lesions detected by SWI(r=-0.941,P=0.000),the number of involving regions detected by SWI(r=-0.900,P=0.000).Conclusion The clinical applications of SWI in diagnosing TBI and evalua-ting the TBI severity is of great significance.

Objective To observe the value of diffusion-weighted imaging (DWI)and ADC value in the differential diagnosis of benign and malignant lesions of the tongue.Methods 75 patients with lingual lesions,including 32 benign lesions and 43 malignant tumors,underwent conventional MRI,contrast-enhanced MRI and DWI with b values of 0 and 1 000 s/mm2 before therapy.ADC maps were reconstructed,and the ADC values of the lingual lesions were calculated.Diagnostic performance of ADC was compared using receiver operating characteristic curves (ROC).Results The mean ADC values of benign lesions and malignant tumors were (1.84±0.47)×10 -3 mm2/s and (1.12±0.21)×10 -3 mm2/s,respectively.Malignant tumors had lower ADCs than benign lesions (t=-8.038,P <0.000).The areas under the ROC curves of ADC diagnosing benign and malignant lesions of the tongue was 0.957±0.022.The optimal cutoff values of ADC for differentiating benign and malignant lesions of the tongue was 1.30 × 10 -3 mm2/s with sensitivity of 90.7%,specificity of 93.8% and accuracy of 92%.And ADC had a high consistency compared with pathological results (Kappa values were 0.813).Conclusion Different features between benign and malignant lesions of the tongue are able to be identified with DWI,which can be applied as a complementary tool in the detection of benign and malignant lesions of the tongue.

Objective To compare the efficacy and safety of transurethral plasmakinetic resection of prostate (PKRP) and transurethral resection of prostate (TURP) for benign prostatic hyperplasia (BPH). Methods The clinical and follow-up data of 186 patients with BPH were analyzed retrospectively. Two groups of BPH patients (90 patients in PKRP group,96 patients in TURP group) were treated by PKRP and TURP,respectively. The clinical date and therapeutic result were measured and compared for both in-tra-and inter-groups. Results In PKRP group,the operative time,intraoperative bleeding,the rates of damage of prostate surgical membranes,secondary hemorrhage (within 1 month),the rates of postoperative temporary urinary incontinence (within 2 months) were (65.3 ± 12.8)min,(213.6 ± 78.2)ml,5.6%(5/90),2.2% (2/90)and 21.1% (19/90),respectively,while in TURP group,these parameters were (83.6 ± 17.5) min,( 397.4 ± 142.7 )ml,17.7%( 17/96 ),11.5% ( 11/96 )and 36.5% ( 35/96 ),respectively. There were signif-icant differences between the 2 groups (P < 0.05 ). In PKRP group,the international prostate symptom score (IPSS),quality of life(QOL),Qmax and PVR were (4.7 ± 1.3 )scores,(1.1 ± 0.4)scores,( 18.7 ± 5.6)ml/s,(8.9 ± 2.5)ml,respectively,while in TURP group,these parameters were (5.3 ± 1.0)scores,(1.2 ± 0.5) scores,(20.4 ± 4.3 )ml/s,(11.2 ± 3.2)ml,respehively. These parameters were significantly improved after both procedures(P < 0.05),but there was no significant difference in the above parameters between the 2 groups (P > 0.05). Conclusions PKRP and TURP have similar efficacy in the treatment of BPH,but PKRP ap-pears to have an advantage of more safety and easier blood controls with less physical damage and complica-lion than those in TURP. PKRP is a better treatment option for BPH.

Objective To evaluate the safety and efficacy of the endovascular treatment of anterior circulation multiple occlusions (AMO) in acute ischemic stroke.Methods The clinical data of 10 patients with AMO treated by endovascular method from January 2011 to August 2013 were retrospectively analyzed.The proximal internal carotid artery (ICA) occlusion was treated using angioplasty in order to achieve ideal location of the guiding catheter.When necessary,stenting was performed after the reconstitution of the intracranial vessel.Recanalization was assessed according to the thrombolysis in cerebral ischemia (TICI) grade.Clinical prognosis was assessed using mRS at 3 months.The National Institutes of Health Stroke Scale (NIHSS) on admission and at discharge was compared using t test.Results The intracranial vessel was recanalized successfully (TICI ≥ 2b) in 9 cases and cervical carotid was stented in 8 cases.Adverse events were recorded in 3 patients,including one case of asymptomatic subarachnoid hemorrhage and two cases of symptomatic intra-cerebral hemorrhage.Mortality rate was 10 ％ (n=1).At the three-month follow up,mRS ≤ 2 was observed in five patients.The mean NIHSS scores was 15.7±2.2 on admission and 9.6±4.7at discharge,and the difference was statistic significant(t=2.86,P=0.02).Conclusion Endovascular therapy of AMO is technically feasible,and relatively safe and effective.

Objective To evaluate the feasibility and safety of embedding the totally implantable venous access port (TIVAP) via the access of right brachiocephalic vein (BCV).Methods The clinical data of 493 patients,who underwent the placement of TIVAP by using right BCV route during the period from March 2013 to December 2015,were retrospectively analyzed.The patients included 137 males and 356 females,with a mean age of (47.3±13.2) years old (ranging from 29 to 78 years old).The puncture success rate and TIVAP indwelling procedure-related complications were analyzed.Results The technical success rate was 100％,the success rate of initial puncturing was 99％ (488/493).The mean operation time was (22.5± 8.3) minutes (range of 18-35 minutes).Mis-puncturing of artery happened in 3 patients (0.61％,3/493);and no severe complications such as hemothorax or pneumothorax occurred.After implantation,the patients carried TIVAP for 124-986 days,with a mean of (271.1±53.8) days.The incidence of complications was 2.25％ (11/488),including hemorrhage at port site (n=2),catheter-related infection (n=l),partial thrombosis (n=2),and formation of fibrous protein sheath (n=6).No serious complications such as displacement or rupture of catheter,or catheter pinch-off syndrome (POS),etc.were observed.Conclusion The implantation of TIVAP by using right BCV route has high puncturing success rate,the technique is safe and reliable,and it can provide another option of catheter access for the clinical performance of TIVAP implantation.

Objective:To establish a database for pelvic trauma in Hunan Province,and to start the work of multicenter pelvic trauma registry.Methods:To establish the database,literatures relevant to pelvic trauma were screened,the experiences from the established trauma database in China and abroad were learned,and the actual situations for pelvic trauma rescue in Hunan Province were considered.The database for pelvic trauma was established based on the PostgreSQL and the advanced programming language Java 1.6.Results:The complex procedure for pelvic trauma rescue was described structurally.The contents for the database included general patient information,injurious condition,prehospital rescue,conditions in admission,treatment in hospital,status on discharge,diagnosis,classification,complication,trauma scoring and therapeutic effect.The database can be accessed through the internet by browser/servicer.The functions for the database include patient information management,data export,history query,progress report,video-image management and personal information management.Conclusion:The database with whole life cycle pelvic trauma is successfully established for the first time in China.It is scientific,functional,practical,and user-friendly.