Objective To observe high residual platelet reactivity in patients with acute coronary syndrome and diabetes mellitus receiving dual antiplatelet therapy with clopidogrel or ticagrelor and its influence on prognosis. Methods A total of 175 patients with acute coronary syndrome and diabetes mellitus in Wuhan Asia Heart Hospital were included in this retrospective study, and all patients were divided into two groups : ticagrelor group ( n = 22 ) and clopidogrel group ( n = 153 ) . The platelet aggregation function was tested by light transmission platelet aggregation (LTA). The high residual platelet reactivity was defined as maximum platelet aggregation rate ﹥46. 0%. The differences of high residual platelet reactivity and the effect of high residual platelet reactivity on cardiovascular events were compared between the two groups. Results The number of patients with high residual platelet reactivity in the clopidogrel group were 99 patients (64. 7%), and 8 patients(36. 4%) in the ticagrelor group (P=0. 011) . For stent thrombosis developed in three months, 3 patients were from the high residual platelet reaction group ( n=107 ) , none from the normal residual platelet reaction group ( n =68 ) ( P =0. 016 ) . For bleeding events at 3 months, there were 2 patients (1. 9%, 2/107) from the high residual platelet reaction group and 2 patients (2. 9%, 2/68) were from the normal residual platelet reaction group (P=0. 631). Conclusions Ticagrelor significantly decreases high residual platelet reactivity than clopidogrel. High residual platelet reactivity increases stent thrombosis risk for ACS and type 2 diabetes mellitus.

BACKGROUND: Poly(ethylene glycol)-b-poly(L-lactide)-b-poly(L-glutamic acid) (PEG-PLA-PGL) tri-block copolymers have good applied foreground in constructing tissue engineering scaffold materials. Whether endothelial cells survive and grow on the materials has a direct influence on the application as a biodegradable material for the scaffold of endothelial cell vector.OBJECTIVE: To explore the cytocompatibility of PEG-PLA-PGL tri-block copolymers with human umbilical vein endothelial cells (HUVECs).DESIGN: Randomized control observation.SETTING: the Second Hospital of Jilin University.MATERIALS: The experiment was carried out in the Department of Pathobiology, School of Basic Medical Sciences, Jilin University from February to October in 2006. Human umbilical cord about 20 cm length came from one neonatal infant who was delivered normally after enough months in the Department of Gynecology and Obstetrics, the Second Hospital of Jilin University. Human umbilical cord was sampled in the informed consents of the infant's family member. The experimentation was authorized by the medical ethic committee of the hospital. PEG-PLA-PGL membranes were provided by Changchun Institute of Applied Chemistry, Chinese Academy of Sciences. Inverted microscope and phase-contrast microscope were bought from Olympus Company (Japan).METHODS: HUVECs cultivated and grew steadily, were inoculated onto PEG-PLA-PGL membranes, serving as the experiment group. While the culture medium without PEG-PLA-PGL membranes were taken as the control group.①Cytocompatibility of PEG-PLA-PGL membranes with HUVECs was evaluated by observing cellular growth through phase-contrast microscope.②The proliferation index of cells was detected by MTT method in 1, 3, 5 and 7 days after inoculation.MAIN OUTCOME MEASURES: ①Cytocompatibility of PEG-PLA-PGL membranes with HUVECs;②The proliferation index of cells in l, 3, 5 and 7 days after inoculationRESULTS: ①Cytocompatibility of PEG-PLA-PGL membranes with HUVECs: The observation result of phase contrast microscopy showed that, endothelial cells planted on the PEG-PLA-PGL membranes began to attach and stretch after being planted 4-6 hours. Three days later, cells grew in colonies rapidly, after 5 days, colonies began to fuse and seemed like cobble-stone. The cells were shuttle or polygon in shape after passages. There were no significant differences between the experiment and control group. Cells cultured on PEG-PLA-PGL membranes for 15 days grew in inserts with membranes, but they didn't grow into patches through scanning electron microscope.②The proliferation index of cells: No significant differences of the proliferation index of cells were detected by MTT method in 1, 3, 5 and 7 days after inoculation between experiment group and control group (P＞0.05).CONCLUSION: Endothelial cells grow well in PEG-PLA-PGL membranes, and the two have good cytocompatibility.

Objective: To preliminarily evaluate coronary heart disease (CAD) by dual-source CT vascular functional imaging in relevant patients. Methods: A total of 200 patients with suspected non-ST elevation acute coronary syndrome (NSTE-ACS) in our hospital from 2014-09 to 2015-10 were enrolled, 57 of them received dual-source CT angiography (DSCTA) and diagnosed for critical value of left anterior descending (LAD) stenosis; the patients were further examined by selective coronary angiography (SCA) within 1 week to conifrm the degree of stenosis. Meanwhile, fractional lfow reserve (FFR) was measured and taking FFR 0.8 as cut off point, the patients were divided into 2 groups: FFR<0.8 group,n=27 and FFR≥0.8 group,n=30. The values of left ventricular anterior wall, side wall, left ventricular cavity and the segmental thickness in diastolic and systolic stages were measured; relative CT value between ventricular anterior wall and side wall was compared, myocardium thickness at the end-diastolic stage was also compared. Results:①In FFR<0.8 group, compared with the side wall, anterior wall had decreased relative CT value (P=0.000), myocardium thickness at the end-diastolic stage (P=0.000) and myocardial wall thickening rate (P=0.001).②In FFR≥0.8 group, compared with the side wall, anterior wall had decreased relative CT value (P=0.000), myocardium thickness at the end-diastolic stage (P=0.018), while similar myocardial wall thickening rate (P=0.186).③Compared with FFR≥0.8 group, the patients in FFR<0.8group presented reduced relative CT value in anterior wall (P<0.05) and myocardial wall thickening rate (P<0.001), while similar myocardium thickness at the end-diastolic stage (P=0.964). Conclusion: CT information may provide the reference value for treating patients in clinical practice.

Objective:To compare the safety and efficacy of domestic Firebird2 TM rapamycin eluting stent and imported Endeavor Resolute stent in the treatment of coronary heart disease patients. Methods:The clinical data of 889 patients with coronary heart disease who underwent percutaneous coronary intervention (PCI) in Wuhan Asian heart hospital from 2010 to 2015 were analyzed retrospectively A case-control study was conducted. According to the type of stent used, 550 cases were divided into domestic Firebird 2TM group and 325 cases were divided into imported endeavor resolve group The incidence of major adverse cardiovascular events (MACE) was compared between the two groups. All patients was followed up for 1 year.Results:There was no significant difference in gender, age, body mass index, medical diseases, whether it was emergency PCI, previous PCI history, coronary artery bypass grafting history and left ventricular between the two groups (all P>0.05). The success rate of PCI in the two groups was 100%. The TIMI blood flow of target vessels in the two groups was grade 3. There was no stent unloading during the operation, and balloon pretreatment and post-treatment were performed. The results of one-year follow-up showed that there was no significant difference in the incidence of mace (3.1% (17/550) and 2.2%(7/325)) and the incidence of independent end points between domestic Firebird 2 TM group and endeavor group (all P>0.05); There was no significant difference in survival without mac between the two groups ( P>0.05). Conclusion:The domestic Firebird2 TM rapamycin eluting stent has the same clinical efficacy as the imported Endeavor Resolute drug eluting stent.

We reported a 59-year-old male with exertional angina pectoris, and the coronary angiography showed multiple vessel lesions. The initial strategy was coronary artery bypass grafting (CABG). The measurement of quantitative flow ration (QFR) before operation indicated that the posterior descending branch (PD) did not need to be treated. The left circumflex branch (LCX) was small, and the QFR of the left anterior descending branch (LAD) and the first diagonal branch (D1) was<0.8. Therefore, the LAD and D1 were re-vascularized. The operation strategy was changed to on-pump CABG through a small incision, and the final strategy was LIMA-D1-LAD (sequential), fractional flow reserve (FFR) of distal LAD and D1 after CABG were>0.8 by computed tomography FFR. SYNTAX scores after CABG were 20 and the functional SYNTAX scores after CABG were 3, indicating a good prognosis.