Objective To explore the clinical effect of trimetazidine in the treatment of coronary heart disease(CHD)patients with heart failure.Methods 80 CHD patients with heart failure cases in our hospital from April 2015 to January 2016 were selected as the research subjects.According to the random lottery method,they were divided into two groups.The control group(n =40)adopted routine comprehensive treatment,the treatment group(n =40)was given trimetazidine on the basis of conventional treatment.The clinical curative effect and heart function index before and after the treatment,exercise tolerance and the change of vascular endothelial function were compared between the two groups.Results The total effective rate of the treatment group was 97.50%(39 /40),which was higher than 77.50%(31 /40)of the control group(χ2 =3.98,P =3.98).After treatment,the systolic blood pressure, left ventricular end systolic diameter and left ventricular end -diastolic diameter in the treatment group were less than the control group,while the left ventricular ejection fraction was greater than the control group,the differences between the two groups were statistically significant (all P <0.01 ),the above index before treatment had no statistically significant differences (all P >0.05 ).The 6 min walking distance of the treatment group after treatment was (375.67 ±28.48)m,which of the control group was (306.18 ±25.71)m,the difference was statistically significant (t =11.451,P =11.451),and the 6 min walking distance before treatment had no statistically significant difference (t =0.013,P =0.013).In the treatment group after treatment,the vascular endothelial function index was (2.32 ± 0.36 )mg/L,which of the control group was (2.95 ±0.16 )mg/L,the difference was statistically significant (t =10.114,P =10.114),while the two groups before treatment had no statistically significant difference in endothelial function index (t =0.126,P =0.126).Conclusion The clinical effect of trimetazidine in the treatment of CHD patients with heart failure is sure,and it can effectively relieve symptoms of heart failure patients,improve the cardiac function,improve their exercise tolerance,which can be used as an ideal drug in CHD patients with heart failure.

Objective To investigate the widespread of the liver cancer risk factors in Wuwei city,where low-incidence for liver cancer and offer the cause clue to first-level prevention. Methods Investigate the risk factor and family history of the Wuwei city resident who wlth liver cancer by using case-control study.Estimate the liver cancer heredity mode with the method of Penrose and simple segregation analysis,calculate the degree of heritability with the metllod of Falconer,s regression.Detect the content of the resulting and promoting cancer fungi,volatility N-second nitroso compound in the meal,nitrate and nitrite in the drinking water and the vitamin C in the health adults'serum by means of culturing appraisement,experiment examination etc.Results The risk factom of liver cancer in the Wuwei city were history of viral 'hepatitis type B,kinsfolk tumor,the eating salting or mildewed foods,cirrhosis,drinking surface water,well water,or wine.By using segregation analysis and estimation of heredity mode show that the morbidity of liver cancer discrepancy to the monogenic inheritance mode,maybe the polygenic inheritance mode in Wuwei city.The h~2 of index case first degree relative was 58.74%.Picking out 8 kinds of nitrosamine,14 kinds of resulting and promoting cancer fungi from resident meal.The content of nitrate and nitrite was (38.97±3.14) mg/L,(0.086±0.043) mg/L respectively in shallow well water,the vitamin C in the health adults'serum in summer was(5.74±2.79)mg/L.Conclusion It can be seen that the history of viral hepatitis type B,kinsfolk tumor,eating salting or mildewed foods,cirrhosis,addicted to drink;higher content of nitrate and nitrite in the drinking water and strong carcinogens such as volatility N-nitroso compound in the meal,and also lackingprotection factors such as vitamin C are the risk factors of the Wuwei city resident who with liver cancer,Theinherit susceptivity is the internal environment of resulting cancer change.

Objective To compare the influence of tracheotomy after two wet fluid on airway and provide the basis for clinical treatment and care. Methods A total of 30 patients with severe brain injury stay neurosurgery tracheotomy were divided into 0.45% sodium chloride group and ambroxol hydrochloride group with 15 cases each by random digits table method, two airway humidification liquid (0.45%sodium chloride,0.9% sodium chloride + ambroxol hydrochloride) were each instilled in the trachea inner sleeve. Blood gas analysis was performed and the levels of serum lung surface active substances related protein-A (SP-A protein), interleukin-6, interleukin-8, tumor necrosis factor-alpha(TNF-α) were measured by enzyme linked immunosorbent assay (ELISA) before 1 d and after 3,7,14 d of tracheotomy. Results There were significant differences in arterial blood oxygen partial pressure, arterial carbon dioxide partial pressure, oxygenation index after 14 d of tracheotomy between ambroxol hydrochloride group and 0.45% sodium chloride group:(110.72±26.75) mmHg(1 mmHg=0.133 kPa) vs.(89.39±21.98) mmHg, (30.44±6.75) mmHg vs. (35.12±7.28) mmHg, 333.23±80.56 vs. 270.93±77.21, t=29.49,-8.63,7.44, P<0.01.There were significant differences in the levels of serum SP-A protein, interleukin -6, interleukin -8, TNF-α after 14 d of tracheotomy between ambroxol hydrochloride group and 0.45% sodium chloride group:(191.34 ±1.21) ng/L vs. (61.92 ±12.0) ng/L, (2.62 ±0.23) ng/L vs. (5.42 ±0.16) ng/L, (124.56 ±2.10) ng/L vs. (185.91 ±1.48) ng/L, (31.32±1.38) ng/L vs.(69.13±1.16) ng/L, t=75.72,-13.51,-23.89,-20.97, P<0.01. Conclusions The airway humidification effect of ambroxol hydrochloride group is better than 0.45%sodium chloride group, it can improve the wetting effect, and better protect the lung tissue, reduce the incidence of lung infection, make it an ideal airway humidification liquid.