Objective:This study aims to compare the therapeutic effect and safety between tolvaptan and furosemide in treatment of acute left heart failure complicated with hyponatremia.Methods:This randomized controlled study enrolled 95 patients with acute exacerbation of chronic heart failure complicated with hyponatremia admitted Putian First Hospital between July 2018 and September 2022.They were divided into furosemide group(n=49,routine fu-rosemide intravenous injection)and tolvaptan group(n=46,tolvaptan p.o.).After 7d treatment,clinical thera-peutic effect,cardiac function,electrolyte,serum creatinine(SCr)and incidence of adverse drug reactions were compared between two groups.Results:After 7d treatment,patients in two groups had significant lower level of N terminal pro natriuretic peptide(NT-proBNP),and significant higher left ventricular ejection fraction(LVEF)and blood sodium level(P＜0.05 or＜0.01).Compared with patients in furosemide group,those in tolvaptan group had significant lower SCr level[125.00(107.50,164.00)μmol/L vs.113.00(85.00,130.50)μmol/L],and significant higher blood potassium level[3.60(3.20.4.20)μmol/L vs.3.90(3.60,4.60)μmol/L](P＜0.05 or＜0.01).There were no significant difference in therapeutic effect,cardiac function and incidence of adverse drug reactions between two groups after treatment(P＞0.05 all).Conclusion:Tolvaptan p.o.is safe and effective in treatment of acute heart failure,and its effect is not inferior to intravenous injection of furosemide,especially for those with hyponatremia,which could be applied for short-term treatment of acute heart failure.

Objective:This study aims to compare the therapeutic effect and safety between tolvaptan and furosemide in treatment of acute left heart failure complicated with hyponatremia.Methods:This randomized controlled study enrolled 95 patients with acute exacerbation of chronic heart failure complicated with hyponatremia admitted Putian First Hospital between July 2018 and September 2022.They were divided into furosemide group(n=49,routine fu-rosemide intravenous injection)and tolvaptan group(n=46,tolvaptan p.o.).After 7d treatment,clinical thera-peutic effect,cardiac function,electrolyte,serum creatinine(SCr)and incidence of adverse drug reactions were compared between two groups.Results:After 7d treatment,patients in two groups had significant lower level of N terminal pro natriuretic peptide(NT-proBNP),and significant higher left ventricular ejection fraction(LVEF)and blood sodium level(P＜0.05 or＜0.01).Compared with patients in furosemide group,those in tolvaptan group had significant lower SCr level[125.00(107.50,164.00)μmol/L vs.113.00(85.00,130.50)μmol/L],and significant higher blood potassium level[3.60(3.20.4.20)μmol/L vs.3.90(3.60,4.60)μmol/L](P＜0.05 or＜0.01).There were no significant difference in therapeutic effect,cardiac function and incidence of adverse drug reactions between two groups after treatment(P＞0.05 all).Conclusion:Tolvaptan p.o.is safe and effective in treatment of acute heart failure,and its effect is not inferior to intravenous injection of furosemide,especially for those with hyponatremia,which could be applied for short-term treatment of acute heart failure.

Objective:This study aims to evaluate the effectiveness and safety of drug coated balloon(DCB)and drug elu-ting stent(DES)during primary percutaneous coronary intervention(PCI)in patients with ST segment elevation myocardi-al infarction(STEMI).Methods:Clinical data of 142 STEMI patients who underwent emergency PCI in our hospital from Jan 2018 to Dec 2021 were retrospectively analyzed.According to intervention strategy,patients were divided into obser-vation group(n=62,DCB therapy)and control group(n=80,DES therapy).Incidence rates of target lesion revascular-ization and major adverse cardiovascular events(MACE)within one week,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd)and incidence rate of slow-flow after PCI,above indexes(except slow-flow),late lumen loss(LLL)and incidence of hemorrhea etc.within nine-month follow-up were compared between two groups.Results:There were no significant difference in postoperative LVEDd,LVEF,incidence rates of slow-flow,target lesion revascularization and MACE within one week between two groups,P＞0.05 all.After nine-month follow-up,there were no significant difference in LLL[0.25(0.16,0.50)mm vs.0.30(0,0.82)mm],incidence rates of target lesion revascularization(6.3％vs.4.8％),MACE(31.7％vs.33.9％)and hemorrhea(8.5％vs.3.2％)be-tween control group and observation group,P＞0.05 all.Conclusion:In patients with ST segment elevation myocardial in-farction undergoing emergency percutaneous coronary intervention,short-and long-term prognosis of drug coated bal-loon are not inferior to those of drug eluting stent,which is safe and effective.

Objective To promote rational use of traditional Chinese medicine ( TCM ) decoction pieces by rational drug use monitoring sys-tem.Methods Adopting rule builder system of clinical rational drug use system to build rational use TCM decoction pieces rules.The prescription quality of TCM decoction pieces will be placed in the four stages of PDCA cycle.By means of prescription analysis ( P ) to find the problem , rule builder(D) to carry out problem, prescription intervention(C) to check problem, prescription comment(A) to summarize problem.The prescrip-tion quality continuous improvement with cycling continuously of PDCA.Results Intervention of alertting , warning and intercepting through the doctor ’ s prescribed interface , the number of irrational TCM decoction pieces prescriptions dropped from 6.91%to 5.35%after intervening ,but the overdose prescriptions are still widespread.Conclusion The comment and intervention system of TCM decoction pieces prescriptions based on in-telligence inference engine obviously improved the prescription quality.It can be widyly used in TCM decoction pieces prescriptions quality management.

Objective To observe the effects of infrasound(IS)of different frequencies and intensities on the pathological morphology of the gastric mucosa(GM)in rats.Methods One hundred and forty male Sprague- Dawley rats were randomly and evenly divided into a control group(group A),an 8 Hz 90 dB group(group B),an 8 Hz 130 dB group(group C)and a 16 Hz 130 dB group(group D).IS with these frequencies and intensities was administered daily for 2 h to all groups except group A,which received sham infrasound.The other 70 rats were ran- domly and evenly divided into a second control group(group E)and an exposure group(group F),in which the rats were continuously stimulated by IS at 8 Hz and 130 dB for 2 h a day for 14 d.The pathological morphology of the GM in each group was observed at 1 d,7 d,14 d,21 d and 28 d after IS exposure.Results①Compared with group A,GM lesion scores were significantly increased in groups B,C and D at 1 d,7 d,14 d,21 d and 28 d(P＜0.01),but not in group B at 1 d.②Compared with group B,the GM lesion scores in group C were obviously in- creased at 1 d,7 d,14 d,21 d and 28 d,while scores were also obviously improved in group C in comparison with those in group D at 14 d,21 d and 28 d(P＜0.01).③The GM lesion scores in group F decreased gradually after IS,but were still higher than those in group E at 1 d,7 d,14 d,21 d and 28 d after IS.④The ultrastructures of the chondrosome and endocytoplasmic reticulum in GM cells were deformed after 8 Hz and 16 Hz IS.Conclusion 8 Hz 90 dB,8 Hz 130 dB and 16 Hz 130 dB IS can all result in GM damage in rats.The injury severity was closely related to the frequency,intensity and duration of the IS.Rats can adapt to IS after several exposures,and the damage tends to recover automatically.

Objective To observe the effects of exposure to infrasound on auditory function of guinea pigs as reflected by the brain stem response (ABR) and distortion product otoaeoustic emission(DPOAE).Methods Seventy-two Guinea pigs were used in this study,of them,12 served as controls and 60 were divided into 2 experi- mental subgroups.ABR and DPOAE were detected after exposure to infrasound stimulation at 16 Hz,90 dB or 16 Hz,130 dB for 2 hours a day for 1 ,7,14,21 and 28 days.Results The threshold of ABR after exposed to infrasound at 16 Hz,90 dB in 1 day and 28 days was higher than the controls (P0.05),but significant difference was observed with 16 Hz 130 dB infrasound exposure on the 21st and,28th days when compared with the controls (P