【Objective】To investigate the effect of trimetazidine on left atrial volume index(LAVI) in patients with chronic heart failure(CHF).【Methods】65 CHF Patients were randomized into trimetazidine group(n=33) and control group(n=32).The control group received conventional therapy,and the trimetazidine group received trimetazidine 20mg tid in addition to conventional therapy,with a follow up of 6 months.Echocardiographic examinations were performed before and 6 months after the study,and LAVIs were measured.【Resluts】Before and 6 months after the study,LAVIs were 43±11.6 mL/m2 vs 34±12.8 mL/ m2 in the trimetazidine group(P<0.05),and 42±10.9 mL/m2 vs 40±8.8mL/m2 in the control group(P>0.05),respectively.【Conclusion】In CHF Patients,addition of trimetazidine to conventional therapy improved LAVI.

【Objective】To explore the impact of psychological intervention on depression in patients with chronic congestive heart failure(CHF) associated with depression and heart function.【Methods】Chronic congestive heart failure with depression were randomLy divided into psychological intervention group(45 cases) and control group(45 cases).The control group was given conventional cardiovascular medications,the intervention group received a comprehensive psychological intervention on the basis of conventional cardiovascular medications,in severe cases of depression taking the amount of antidepressant drugs.All patients were followed up for 3 months.【Resluts】(1)Compared between two groups 3 months after treatment,depression of the treatment group than the control group significantly reduced(P0.01);(2)The NYHA functional grade significantly improved(P 0.05),LVEF significantly increased in treatment group(P 0.05).【Conclusion】With depression in patients with chronic congestive heart failure(CHF),psychological intervention can reduce depression and further improve heart function.

Objective To investigate the effect of one-hour postload plasma glucose concentration(1h PG) during oral glucose tolerance test(OGTT) on P wave dispersion(PWD).Methods With a cutoff point of 8.6 mmol/L for the 1h PG,60 subjects with normal glucose tolerance(NGT) were divided into two groups,NGT<8.6 mmol/L(n=45) and NGT≥8.6 mmol/L(n=45).PWD,blood lipid were measured,and echocardiography were performed in the two groups,data of both groups were compared to each other.Results PWD increased in the group of NGT≥8.6 mmol/L,compared to the group of NGT<8.6 mmol/L(42 ±12 vs.34±11,P<0.05).Conclusion PWD increased in NGT subjects with 1 h PG≥8.6 mmol/L and may be the predictor of AF.

Objective: To investigate the effect of Pravastatin on maintenance of sinus rhythm and improving cardiac function in patients with normal blood lipid level complicated with chronic heart failure and paroxysmal atrial fibrillation.Methods: A total of 68 patients with normal blood lipid level complicated with chronic heart failure and paroxysmal atrial fibrillation were divided into treatment group(35 cases) and control group(33 cases).Aminodarone was used in the control group,based on the control group,Pravastatin(20 mg/d) was given in the treatment group.All patients were followed up for 6 months.Results: Compared between the two groups 6 months after treatment,the NYHA functional grade significantly improved(P0.05),LVEF significantly increased in the treatment group(P0.05).The recurrence rate of paroxysmal atrial fibrillatio in the treatment group decreased significantly compared with that in the control group(P0.05).Conclusion: Long-term administration of Pravastatin can inhibit the in flammatory reaction,improve cardiac function and reduce the relapse rate of paroxysmal atrial fibrillation in patients with normal blood lipid level complicated with chronic heart failure and paroxysmal atrial fibrillation.

Objective To study the influenc of metoprolol succinate sustained-release tablets therapy on ventricular rate and heart function of patients with chronic atrial fibrillation(CHF)and chronic heart failure(HF).Methods A total of 69 patients with chronic atrial fibrillation and chronic heart failure were randomly divided into treatment group(35 cases)and control group(34 cases).The general therapy included digoxin,diuretics,angiotensin-converting enzyme inhibitors(ACEI)or angiotensin-Ⅱ-receptor antagonists(ARB)and anticoagulants for a 6-momth follow-up period.The patients of treatment group was treated with metoprolol succinate sustained-release tablets above the base of the general therapy.The ventricular rate at rest and the ventricular rate after 6-minute walk,left ventricular end diastolic dimension(LVEDD),left ventricular end systolic dimension(LVESD),left ventricular ejection fraction(LVEF)and the distance of 6-minute walk were examined before and 6 months after therapy.After 6 months,to compare the changes of clinical manifestations.Results ①The ventricular rate at rest decreased significantly in both two groups(P＜0.01),the ventricular rate after 6-minute walk decreased significantly in treatment group 6 month after treatment(P＜0.01),but there was no significant difference betwen before and after treatment in control group on the ventricular rate after 6-minute walk(P＞0.05),and the ventricular rate after 6-minute walk was decreased more in tretment group than that in control group(P＜0.01).②The LVEF,LVEDD,LVESD and the distance of 6-minute walk in both groups had significant improvement as compared with before treatment(P＜0.01～0.05),with the treatment group showing a better improvement than in control group(P＜0.05).③The total responsive rate in the treatment group(93.8%)was significantly higher than in control group(77.4%)(P＜0.05).Conclusion Based on the medication of digitalis,diuretics and ACEI or ARB,metoprolol succinate sustained-release tablets therapy can effectively control ventricular rate,significantly improve heart function and also reverse left ventricular in patients with chronic atrial fibrillation and chronic heart failure.

Objective To evaluate the effect of bisoprolol on BODE index in patients with coronary heart disease and concomitant chronic obstructive pulmonary disease(COPD).Methods Oral bisoprolol,with the initial dose of 1.25 mg/d,increased gradually to 5 mg/d,was administered to 42 cases of coronary heart disease patients complicated with stable mild to moderate COPD.Before the administration of bisoprolol and 60 days after,four relevant variables of BODE index,including FEV1% of predicted(FEV1% pred),the distance walked in 6 minutes(6MWD),score on the the MMRC dyspnea scale(MMRC)and Body mass index (BMI),were measured,and BODE index were constructed with the four variables above.Results Before and after the administration of bisoprolol,the results were:FEV1% pred(68.05±7.32 vs.67.38 ±7.13);6MWD(322.83±65.72 vs.320.43±62.34);MMRC(2.13±0.57 vs.2.18±0.65);BMI(20.58±3.52vs.20.26±3.07);BODE index(3.51±1.97 vs. 3.54±2.01).(all P>0.05).Conclusion Bisoprolol had no significant effect on BODE index in patients with coronary heart disease and concomitant stable mild to moderate COPD.

Objective:To investigate the effect of candesartan cilexetil in preventing recurrence of essential hypertension complicated with atrial fibrillation(AF) .Methods:78 patients with essential hypertension complicated with AF who were recovered the sinus rhythm through electrotherapy or medicines were randomly divided into observation group and control group.Aminodarone were used in all patients to keep the sinus rhythm.Candesartan cilexetil 4～8 mg/d was added in observation group,and Norvasc 5～10 mg/d was added in control group.The follow-up lasted one year.The recurrent rates of AF in two groups were observed during one year,the inner diameter of left atrium was measured by echocardiogram and the blood pressure was observed in two groups before and after treatment.Results:The recurrent rate of AF in observation group decreased significantly compared with that in control group(P0.05) .After treatment the inner diameter of left atrium in observation group decreased significantly compared with that before treatment(P0.05) .The inner diameter of left atrium after treatment showed significant difference between the two groups(P0.05) .After treatment there was no significant difference in the blood pressure between the two groups(P0.05) .Conclusions:Long term treatment of candesartan cilexetil may reverse the enlargement of left atrium of patients with essential hypertension complicated with AF,and reduce the onsets of AF.

目的:探讨肺癌骨转移的临床病理特点.方法回顾性分析60例患者的临床资料.结果肺癌骨转移单发者点31.50%,多发者68.50%.肺癌骨转移患者中腺癌50.00%,鳞癌25.00%,小细胞未分化癌16.67%,腺鳞癌8.00%.骨转移部位为肋骨37.00%,胸椎23.00%,骨盆20.00%,腰椎11.00%,其余为肩岬骨、胸骨、四肢等.腺癌以胸椎、骨盆转移为主,小细胞以肋骨、骨盆、胸椎转移为主.在行X线、CT、MRI检查的病人中,骨转移以溶骨性破坏56.42%,在骨性破坏26.28%,混合性避孕药破坏16.30%.结论肺癌骨转移以多发性、溶骨性骨破坏为特征.腺癌骨转移发生率最高,其次为鳞癌和小细胞肺癌.