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 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 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 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 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 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 investigate the protective effects of the 14-3-3 protein overexpression on the injury of PC12 cell induced by MPP~+ and its mechanisms.Methods For expression in mammalial cells, pcDNA3.1(+)-14-3-3 plasmid was constructed and transfeeted into PC12 cell with Lipofectamine~(TM)2000. The overexpression of transfected 14-3-3 gene in PC12 cell was determined by immunofluorescence and Western blotting.The effects of 14-3-3 overexpressing on the cells viability,apoptotie ratio and the activity of superoxide dismutase(SOD)as well as glutathione peroxidase(GSH-Px)of PC 12 cell treated with MPP~+ were measured by MTT assay,flow cytometry analysis and microplate reader respectively.Results The expression of 14-3-3 protein in transfection group(1.19?0.06)increased evidently compared with control group(0.75?0.05).And the antioxidant enzyme activity assession,MTT assay and flow cytometry analysis shows that the overexpression of 14-3-3 protein elevates the activity of SOD(transfection group:(9.13? 0.41)U/mg protein,MPP~+ group:(6.45?0.52)U/mg protein)and GSH-Px(transfection group: (89.66?3.42)?mol/mg,protein MPP~+ group:(82.73?4.15)?mol/mg protein),increases the cell viability(transfection group:0.78?0.06,MPP~+ group:0.54?0.07),and inhibits cell apoptosis (transfeetion group:11.87%?3.26%,MPP~+ group:36.30%?2.39%)of PC12 induced by MPP~. Conclusion The overexpression of 14-3-3 protein could elevate the activity of antioxidant enzymes SOD and GSH-Px,reduce oxidant stress,alleviate MPP~+ toxicity,and thus inhibit the apoptosis of PC12 cell induced by MPP~+.