Objective To compare effect of ticagrelor and clopidogrel on bleeding in elderly patients after stenting.Methods 48 elderly patients after stenting who were diagnosed with acute coronary syndrome in the hospital were collected.All patients were divided into clopidogrel group and ticagrelor group according to different therapy, 24 cases in each group,and were given corresponding drug treatment in each group.After treatment, the platelet inhibition rate, cardiovascular events and bleeding events were observed.Results After treatment, compared with clopidogrel group, the platelet inhibition rate was higher in ticagrelor group(P<0.05), the incidence of cardiovascular events was lower in ticagrelor group (4.16%vs.25.00%;P<0.05), but there was no obvious difference in incidence of bleeding events of ticagrelor group (4.16% vs.8.32%).Conclusion In elderly patients after stent implantation, ticagrelor could inhibit platelet aggregation better than clopidogrel, prevent the occurrence of cardiovascular events, and would not increase the risk of bleeding.

OBJECTIVETo compare the clinical efficacy on the motor impairment of knee joint after tracture operation between the combined therapeutic method of relaxing needling manipulation and exercise therapy and the simple exercise therapy.

METHODSSixty-four patients after the operation for the fracture of femoral shaft were randomized into a relaxing needling combined with exercise therapy group (group A) and an exercise therapy group (group B), 32 cases in each one. In the group A, the relaxing needling manipulation was applied to the local painful area of knee or the stiff soft tissues. Additionally, the exercise therapy was used in combination. In the group B, the exercise therapy was applied simply. Hospital for special surgery (HSS) pain score, the range of movement (ROM) of knee joint and Lysholm score were compared before and 60 days after treatment in the patients of the two groups. The efficacy was compared between the two groups.

RESULTSAfter treatment, HSS pain score, ROM and Lysholm score were all improved in the two groups, presenting the significant differences as compared with those before treatment (all P<0. 05). The results in the group A were better than those in the group B (all P<0. 05). The total effective rate was 96. 9% (31/32) in the group A, which was better than 75. 0% (24/32) in the group B (P<0. 05).

CONCLUSIONThe combined therapeutic method of relaxing needling manipulation and exercise therapy achieves the significant efficacy on the motor impairment of knee joint after the operation for the fracture of femoral shaft, superior to the simple exercise therapy.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Exercise Therapy ; Female ; Fractures, Bone ; physiopathology ; surgery ; therapy ; Humans ; Knee Joint ; physiopathology ; Male ; Middle Aged ; Treatment Outcome

Background lnterleuldn-18(IL- 18) plays a key role in the development,progression and outcome of coronary artery disease and its complications.However,its variability relation to the characterization of atherosclerotic plaque and percutaneous coronary intervention are still unknown.Methods Fifty four patients with coronary artery disease [22 patients with stable angina (SA) and 32 patients with acute coronary syndrome (ACS)] were enrolled in this study.All patients underwent percutaneous coronary intervention (PCI).The stability of the plaques at the criminal vessels was assessed with analogical IVUS.Serum IL-18 levels were measured at the time points of 5 rain before PCI,and Oh,6h,24h and lmonth after PCI in all patients.Results ACS group consisted mainly of lipidic unstable plaques while SA group of fibrous stable plaques.Moreover,compared with those in SA group,eccentricity index (EI) and remodeling index (RI) were significantly higher in ACS group.Positive remodeling was seen in ACS group while negative or no remodeling in SA group.Further,serum IL-18 levels were significantly elevated in patients with ACS than those in SA group before PCI,increased at Oh,6h,24h after PCI (P＜0.05)and were not significant different at 1 month after PCI from those before PCI.Conclusions There is significant difference in the composition and structural characteristics of atherosclerotic plaques between ACS and UA groups.PCI triggersd and enhances the inflammatory response in a short time.Serum levels of IL- 18 are the predictors of progression of unstable plaque in atherosclerosis.Post-operative complications of PCI might be reduced by inhibiting IL- 18.(J Geriatr Cardiol 2008;5:21-24)

Objective To study the distribution rule of sense and motor fibers in the normal trigeminal nerve roots by electrophysiologic monitoring.Methods Twenty patients accepted microvascular decompression because of primary mimetic convulsion, collected in our hospital from January 2011 and December 2013, was studied their normal trigeminal nerve roots through electroneurophysiology;during the operation, the trigeminal nerve roots were divided into 8 areas: Ⅰ area is the external lateral area, Ⅱ area is the external upper area, Ⅲ area is the middle upper area, Ⅳ area is the internal upper area, Ⅴ area is the internal lateral area, Ⅵ area is the internal bottom area, Ⅶ area is the middle bottom area, and Ⅷ area is the external bottom area;and then, one mm diameter bipolar stimulator was adopted to give 0.2 mA electrical stimulation on these areas, respectively;and the compound nerve action potential (CNAP) at the foramina supraorbitale (V1), foramina infraorbitale (V2) and foramina mentale (V3) was recorded as the CNAPV1, CNAPV2 and CNAPV3 respectively;the compound muscle action potential (CMAP) at the masseter muscle (MM) and temporal muscle (TM) was recorded as CMAPMM and CMAPTM respectively;and finally, the distribution rules of the sense and motor fibers inside the trigeminal nerve roots were judged according to the laws of CNAP and CMAP emergence.Results During the operation, all patients could get stable CNAP and CMAP wave patterns at periphery according to the electrical stimulation on trigeminal nerve roots;the CNAPV1, CNAPv2 and CNAPV3, CMAPMM and CMAPTM seldom appeared in the Ⅰ, Ⅱ and Ⅷ areas of trigeminal nerve roots, but more often appeared in the Ⅳ, Ⅴ and Ⅵ areas, enjoying significant differences (P＜0.05);motor fiber located in the internal lateral area of the nerve, and the sense fiber located in the middle and external lateral area.By stimulating the sense taproot fiber, CNAP could be recorded, and by stimulation the motor taproot fiber, CMAP and several CNAP from V1, V2 and V3 could be recorded.Conclusion Electrical stimulation on motor taproot implies that there are anastomosing fibers existting in both motor and sense fibers;according the 8 areas being divided, motor fiber locating in the internal lateral area of the nerve, and sense fibers locating in the middle and external lateral areas can be concluded.

OBJECTIVE： To systematically evaluate the efficacy of Compound xuanju capsules combined with chemical medicine versus chemical medicine alone in the treatment of polycystic ovarian syndrome （PCOS）， in order to provide evidence-based medicine guidelines for clinical medication. METHODS： Retrieved from PubMed， Embase， Cochrane library， CBM， VIP， CJFD and Wanfang database from database establishment to Apr. 5， 2019， randomized controlled trials （RCTs） about therapeutic efficacy （total response rate， ovulation rate， pregnancy rate， FSH level， LH level， testosterone level， degree of endometrial thickening） of Compound xuanju capsules combined with chemical medicine （trial group） versus chemical medicine alone （control group） in the treatment of PCOS were collected. After data extraction and quality evaluation of included studies with modified Jadad scale， Meta-analysis was conducted by using STATA 14.0 software. Trial sequential analysis （TSA） was conducted by using TSA 0.9 software. RESULTS： A total of 15 RCTs were included， involving 1 259 patients. The results of Meta-analysis showed that the total response rate [RR＝1.27，95％CI（1.13，1.44），P＜0.001]， ovulation rate [RR＝1.18，95％CI（1.03，1.37），P＜0.001]， pregnancy rate [RR＝1.34，95％CI（1.11，1.61），P＜0.001]， serum hormone level {FSH [SMD＝－0.66，95％CI （－0.51，  －0.82），P＜0.001]， 95％CI（－1.76，－1.41），P＜0.001]， LH [SMD＝－1.24，95％CI（－1.39， －1.08），P＜0.001]， testosterone [SMD＝－1.59，95％CI（－1.76，－1.41），P＜0.001]} and endometrial thickness [SMD＝1.20，95％CI（1.04，1.37），P＜0.001] of the trial group were better than those of the control group， with statistical significance. The results of TSA were reliable. CONCLUSIONS： In the treatment of PCOS， Compound xuanju capsules combined with chemical medicine is better than chemical medicine alone in improving total response rate， pregnancy rate， ovulation rate and endometrial thickness， and reducing serum hormone levels.