Objective To explore the application value of aspirin and clopidogrel dual antiplatelet treatment combined with ABCD3-Ⅰ scores in treatment of transient ischemic attack (TIA).Methods Risk factors were evaluated and imaging was performed in 48 h in one hundred and twenty patients with first attack of TIA [magnetic resonance imaging (MRI),magnetic resonance angiography (MRA),diffusion weighted imaging (DWI) scan].According to the ABCD3-Ⅰ evaluation method,the patients were divided into low risk group,moderate risk group and high risk group.Single resistance group was given aspirin 100 mg/d; double resistance group was given aspirin 100 mg/d combined with clopidogrel 75 mg/d.Then the incidence of ischemic stroke in each group within 7 days was observed,and the effects of dual anti-platelet and aspirin monotherapy were compared.Results Within 7 d after TIA,low-risk single resistance group and low-risk double resistance group had no stroke; 9 cases (42.9％,9/21) had stroke in moderate-risk single resistance group,2 cases (2/19) had stroke in moderate-risk double resistance group,and there was significant difference (P ＜ 0.05) ; 9 cases (9/18) had stroke in high-risk single resistance group,3 cases (15.0％,3/20) had stroke in high-risk double resistance group,and there was significant difference (P ＜ 0.05).Three patients in single resistance group and 4 cases in double resistance group showed gastrointestinal adverse reactions such as nausea,acid reflux,and there was no significant difference between 2 groups (P ＞ 0.05).Each group during treatment showed no bleeding tendency,and liver and kidney function in patients was normal.Conclusion In patients of the moderate risk and high risk of ABCD3-Ⅰ scores,dual anti-platelet may have an advantage over single druge in the prevention of ischemic stroke.

Objective To explore the value of ABCD3-Ⅰ score in predicting prognosis of transient ischemic attack (TIA).Methods A total of 106 TIA patients were evaluated according to ABCD2,ABCD3 and ABCD3-Ⅰ criteria.The occurrence of cerebral infarction within 7 d and 90 d was observed.The patients with ABCD3-Ⅰ 0-3 scores were as low risk group (36 cases),the patients with ABCD3-Ⅰ 4-7 scores were as moderate risk group (36 cases),the patients with ABCD3-Ⅰ 8-13 scores were as high risk group (34 cases).Results The occurrence of cerebral infarction within 7 d and 90 d in high risk group was lower than that in low risk group and moderate risk group [within 7 d:23.5％(8/34) vs.2.8％(1/36) and 5.6％ (2/36),within 90 d:38.2％ (13/34) vs.2.8％ (1/36) and 11.1％ (4/36)],and there was significant difference (P ＜0.01).Symptom duration time ≥10 min in ABCD3-Ⅰ score,concomitant diabetes,double TIA,ipsilateral carotid artery stenosis ≥50％,high sign in diffusion weighted imaging were the risk factors for the occurrence of cerebral infarction within 7 d and 90 d in TIA patients (P ＜ 0.05).The area under the receiveroperating characteristic curve for predicting the occurrence of cerebral infarction within 7 d and 90 d in TIA patients by ABCD3-Ⅰ score was higher than that by ABCD2 and ABCD3 score (0.914 vs.0.614 and 0.877,0.869 vs.0.633 and 0.773).Conclusion The ABCD3-Ⅰ score is a simple and effective way to judge the short-term prognosis of TIA and can help to identify the different risk levels,so it is helpful in stratification treatment.

OBJECTIVE: To evaluate the efficacy and safety of thread-dragging through fistula method in treating patients with simple anorectal fistula. METHODS: In this multi-centered, prospective, and randomized controlled clinical trial, 244 patients with simple low or high anorectal fistula were randomly divided into study group (with the method of thread-dragging through fistula) and control group (with the method of incision or thread-drawing). The healing time and curative rate of anorectal fistula, and the integral calculus of clinical symptom and life quality evaluations before and after treatment were all examined. The maximal anal canal squeeze pressure was measured to compare the therapeutic safety between these two groups. The health economical benefits were also assessed to determine which therapeutic method was more economical. RESULTS: The curative rate of simple low and high anorectal fistula were of no significant differences between the study group and the control group. The healing time of simple low anorectal fistula in the study group and the control group were (22.26+/-8.67) d and (31.41+/-11.39) d respectively, while the healing time of simple high anorectal fistula in the study group and the control group were (24.73+/-8.15) d and (32.20+/-12.60) d respectively, and there revealed significant differences between these two groups. Each integral calculus of clinical symptom evaluation in the study group was not obviously different from those in the control group besides the integral calculus of anal sphincter function. The integral calculus of life quality between the study group and the control group of simple low anorectal fistula had no significant differences. The integral calculus of anal sphincter function and confidence in treatment in the study group of high anorectal fistula were better than those in the control group. The hospitalization expense of the study group was remarkably lower than that of the control group. The maximal anal canal squeeze pressure in the study group after treatment was not reduced obviously as compared with that in the same group before treatment, while it was decreased significantly in the control group after treatment as compared with those in the same group before treatment and in the study group after treatment. CONCLUSION: The method of thread-dragging through fistula in treating simple low and high anorectal fistula can shorten the course of the disease, save the hospitalization expenses, improve the life quality of the patients, and protect the anal sphincter function.