RESUMO
Objective To observe the therapeutic effect of low dose tolvaptan combined with furosemide in ederly patients with CHF and diuretic resistance (DR).Methods Eighty-five elderly patients with CHF and DR were divided into observation group (n=43) and control group (n=42).The patients in observation group were treated with cardiotonics and hypotensors plus oral tolvaptan (15 mg/d) combined with intravenous furosemide (40 mg/d).The therapeutic effect of low dose tolvaptan combined with furosemide was assessed.Results The average urinary volume was larger,and the LVEDV was significantly lower in two groups after treatment than before treatment (P＜0.05).The urinary volume was significantly larger while the LVEDV was significantly lower in observation group than in control group (2.89±0.87 L/d vs 2.43±0.49 L/d,P=0.01;103.6±21.5 ml vs 116.7±24.3 ml,P=0.01).The total effective rate was significantly higher in observation group than in control group (86.0％ vs 71.4％,P=0.01).Conclusion Low dose tolvaptan combined with furosemide can effectively improve the DR and therapeutic effect in elderly CHF patients,and is thus worth popularization in clinical practice.
RESUMO
Based on carbon metabolic pathway analysis of Escherichia coli MG1655, an aerobic succinate fermentation platform was constructed by knocking out five genes (ptsG, poxB, pta, iclR and sdhA), which was named E. coli QZ1111. Flask cultivation results showed that E. coli QZ1111 could accumulate succinate with a concentration of 26.4 g/L under aerobic conditions. The byproduct acetate was only 2.3 g/L. The production ratio of succinate and acetate reached 11.5:1.