Objective To identify the prognosis factors of the patients with high-degree carotid artery stenosis and evaluate the effect of different therapy prospectively.Methods A hundred and three patients with spoke or tansient ischemic attack(TIA)suffering from severe carotid artery stenosis were included into this study consectively.They were given intra-artery intervention or antiplatelet therapy based on clinical factors and the intension of the patients or their Legally Autllorized Representative (LAR)and thus divided into 2 groups.Forty patients were transplanted with stent,63 were given only with antiplatelet drugs.The major outcome of end-point was the 2-year functional prognosis evaluated by modified Rankin score(mRS),while the minor one was the cardiovascular events in 1 year.2 year or longer after the index stroke or TIA,which was defined as stroke,TIA,acute myocardic infarction(AMI)and sudden death in this study.Results There were no statistical significances of sex,years,medical histories,blood pressure, total cholesterol,triglyceide in two groups at baseline.For the major outcome,intra-artery intervention was an independent protective factor for impaired function(mRS 3-6)with the method of binary Logistic(RR= 0.13,P=0.001,95%CI 0.036-0.460).For the minor outcome,the incidence of the cardiovascular events in 1 year and 2 year after the index stroke or TIA was lower in the intra-artery intervention group than in the antiplatelet therapy(For 1 year follow up,intervention group:antiplatelet therapy group= 12.5%:42.9%,OR=0.19,95%CI 0.07-0.55,P=0.001;For 2 year follow up,17.5%:47.6%,OR =0.23,95%CI 0.09-0.60,P=0.002).The median time of cardiovascular events in the two groups was further investigated in 55 months and 54 months separately. Kaplan-Meier analysis showed no significant difference.Survival analysis with Cox-regression showed that neither therapy of intra-artery intervention nor antiplatelet therapy was an independent factor for the cardiovascular events(RR=1.063,95%CI 0.40- 2.83,P=0.900).Conclusions For the stroke or TIA patients suffering from high-degree carotid artery stenosis,intra-artery intervention is superior pure drug therapy in achieving better theapeutical effect and reducing the incidence of the cardiovascular events after the index stroke or TIA.However,its long term effect needs further study.

OBJECTIVE To evaluate the effects of psoraleae crude polysaccharide(PPS) on metabolism and toxicity/efficacy relationship of coumarin components of Psoraleae Fructus(CCPF) by zebrafish integrated evaluation. METHODS Zebrafish(1-6 days post fertilization, dpf) was used to evaluate the safety of CCPF, PPS and their combination; the morphologies of zebrafish organs was observed and the number of deaths was recorded and the half death concentration of zebrafish(LC50) was calculated. Zebrafish(1-6 dpf) were exposed to CCPF and its combination with PPS; the dynamic changes of psoralenoside and isopsoralenoside and their metabolites psoralen and isopsoralen were analyzed. The zebrafish osteoporosis model was induced with 25 μmol·L-1 prednisolone; microscopic observation and digital imaging of zebrafish larvae of each treatment group cultured to 8 dpf were performed using alizarin red, and the bone staining area was quantitatively analyzed by image software to evaluate the anti-osteoporosis activity of above samples. RESULTS Evaluation of the safety of CCPF, PPS and their combination by interaction with zebrafish juveniles. The toxicity of the combination of CCPF and PPS to zebrafish was greater than that of CCPF or PPS alone, and the toxicity increased with the increase of the proportion of PPS: PPS reduced the poisoning concentration of zebrafish, causing serious morphological distortion of zebrafish organs, shortening the death time of zebrafish and increasing the death rate of zebrafish. PPS obviously accelerated the deglycosylation of psoralenoside and isopsoralenoside in CCPF into psoralen and isopsoralen, which were potential metabolites of liver injury. CCPF and its combination with PPS increased the mineralized area and cumulative optical density of zebrafish skull and the combination had a certain synergistic effect, which suggested that PPS increased the anti-osteoporosis activity of CCPF to some extent. CONCLUSION Based on the integrated evaluation of zebrafish, the effects of PPS on the metabolism and toxicity/efficacy relationship of CCPF are revealed, which provides an efficient method and idea for revealing the toxicity/efficacy relationship action of PPS on other structural components.