城口县卫生人才现状与思考

我县地处大巴山区,全县卫生事业的发展受到诸多不利因素的影响。近年来,由于卫生人才奇缺,医务人员结构比例严重失调,已影响到全县干部队伍的稳定,拖了脱贫致富的后腿。现就我县的卫生技术人才问题谈几点看法: 一、人才严重流失,卫生技术骨干奇缺文革中后期,我县有几十名医学本科大学生和专科生,当时很多区乡卫生院都能承担起重危病人的抢救治疗工作,对保证人民的身体健康起到了积极作用,受到了很高的评价。然而相隔十五年的今天,全县只剩下四名医学本科大学生和16名专科生,一方面一批批有能力,有经验的科技骨干陆续外     

Cardioprotective effects of trimetazidine on patients with dilated cardiomyopathy and left bundle branch block

Background The effects of trimetazidine on patients with dilated cardiomyopathy(DCM) and left bundle branch block(LBBB) are not clear. Methods Sixty consecutive patients with DCM, LBBB and heart dysfunction(35% ≤ LVEF ≤ 45%) were randomly allocated to heart failure therapy plus trimetazidine group(20 mg three times a day; 30 patients) or heart failure therapy alone group(30 patients). During follow-up of 6months, QRS morphology, plasma NT-proBNP, 6-minute walk test(6MWT) and echocardiographic indexes were measured. Results At the 6th month, a significant functional improvement was noted in patients receiving trimetazidine added to heart failure treatment. In patients from the trimetazidine group, an increase of left ventricular ejection fraction(LVEF) was noted(from 38 ± 5.5% to 47 ± 7.1%, P = 0.020). The increase of LVEF in the trimetazidine group was associated with a more significant reduction of the left ventricular endsystolic diameter(LVESD) compared with the control group at 6-month follow-up. The NT-pro BNP levels decreased significantly in the trimetazidine group(3.11 ± 0.47 at baseline and 2.77 ± 0.45 at 6-month followup, P 0.01) and the 6MWT increased significantly in the trimetazidine group(325 ± 44 m at baseline and419 ± 56 m at 6-month follow-up, P 0.01). The differences in NT-pro BNP levels(2.77 ± 0.45 vs 2.96 ±0.46, P = 0.036) and 6MWT(419 ± 56 m vs 366 ± 54 m, P = 0.032) between the two groups were significant at 6-month follow-up. Conclusions Trimetazidine can improve LV function caused by DCM and LBBB. The positive effects of trimetazidine on LV function are especially evident in patients with optimization of drug therapy for heart failure, which strongly suggests an additive effect of these therapy modalities.