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.

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 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

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 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 explore the prognostic effect of hyperintense vessel sign (hyperintense vessel sign,HVS) in fluid-attenuated inversion recovery (FLAIR) on endovascular recanalization of acute ischemic stroke.Methods The clinical and imaging data of the patients with acute middle cerebral artery (MCA) occlusion treated by endovascular therapy from January 2013 to october 2015 were analyzed retrospectively.The inclusion criteria:(1)＜8 h after symptom onset;(2) The preoperative MRI included conventional non-enhanced MR,FLAIR,diffusion-weighted imaging (DWI),magnetic resonance angiography (MRA) and DWI-ASPECTS (Alberta Stroke Program Early CT Score) ≥7;(3) acute MCA occlusion verified by conventional angiography and recanalizations (TICI score of 2b and 3) were obtained after endovascular therapy;(4) postoperative similar MR examinations were performed within one week.The patients were divided into group A (HVS score＜5) and B (HVS score≥5).The clinical outcomes and radiological characteristics were compared between two groups.Results There were 15 patients in group A and 33 patients in group B.No significant differences were noted in onset-to-MRI interval (4.8±0.7 h vs 4.6± 0.6 h),MRI-to-recanalization interval (2.1 ±0.5 h vs 2.2±0.5 h) and preoperative DWI-ASPECTS score (7.8± 0.9 score vs 8.2± 1.0 score) between the two groups (all P＞0.05).Significant differences were noted in NIHSS score at admission (14.6±2.6 score vs 10.1±2.2 score),grade of collateral circulation (1.6±0.3 score vs 2.4± 0.4 score),postoperative DWI-ASPECTS score (5.6±0.8 score vs 7.3±0.9 score),postoperative extension of DWI-ASPECTS score (2.2±0.4 score vs 0.9±0.2 score),the incidence of cerebral hemorrhage transformation (26.7％ vs 12.1％) and mRS score at 3 months (3.2±0.5 score vs 2.3±0.4) score between the two groups (all P＜0.05).Conclusion HVS score is clearly associated with collateral circulation and high HVS score indicates better functional outcomes than low HVS score.

Objective To investigate the application value of apparent diffusion coefficient (ADC) in monitoring the response to chemotherapy of primary bone lymphoma(PBL). Methods Sixteen consecutive patients with PBL confirmed by pathology were enrolled in this retrospective study.All patients underwent a controlled MRI including a DWI sequence before chemotherapy and after the first chemotherapy session. The ADC values of PBL lesions were measured before and after the first chemotherapy session. All patients were divided into responders and non-responders groups according to the combined response assessment criteria. The difference in ADC values between the responders and non-responders groups before and after chemotherapy and the rate of change of ADC values were compared using Wilcoxon test. The paired t test was used to compare ADC values before and after chemotherapy in each group. Results Twenty-three cases of PBL lesions were diagnosed in 16 patients before the chemotherapy. After the first chemotherapy session, 10 patients (12 lesions) and 6 patients (11 lesions) were categorized into the responder and non-responder group, respectively. The mean pre-treatment ADC value of the responder group and non-responder group were 737.1(301.7,928.4)× 10-6mm2/s and 749.2(624.4, 1186.5)× 10-6mm2/s, which had no statistically significant difference (Z=1.51,P=0.132). The mean post-treatment ADC value of the responder group and non-responder group were 1843.0(721.5,2745.8)× 10-6mm2/s and 1026.3(382.8,2100.8)× 10-6mm2/s, which had no statistically significant difference (Z=-1.75,P=0.079). The post-treatment ADC value of the responder group significantly increased [156.7(60.9,227.5)%] while the post-treatment ADC value of the non-responder group slightly increased [31.7(-44.7,147.4)%]. The difference in the percentage changes of ADC values in the responder and non-responder groups before and after the treatment was statistically significant(Z=-3.66,P<0.001). Conclusion The measurement of the percentage changes of ADC values enable a good short-term response evaluation for PBL.

Objective To explore the clinical value of guide-wire shaping in subclavian vein catheter-ization.Methods Totally 400 patients requiring right subclavian vein catheterization were equally divided into two groups according to the clinic date: intervention group ( with guide-wire shaping , n =200 ) and control group (without guide-wire shaping, n=200).The catheterization was carried out by the same doctor .The rates of ectopic wire were compared between the two groups .Results The overall success rate of catheteriza-tion was 98.25%(393/400) [98.5% (197/200) in intervention group and 98.0% (196/200) in control group, P=0.500].The incidence of catheter displacement was 1.02%(2/197) in intervention group, which was significantly lower than that [7.14% (14/196)] in control group (P=0.002).Conclusion As a sim-ple procedure , guide-wire shaping can effectively prevent catheter displacement during catheterization .

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.