Objective: To explore the clinical efficacy of a new drug for acute coronary syndrome (ACS), ticagrelor in treating the patients with acute ST-segment elevation myocardial infarction (STEMI), and to compare the effect between ticagrelor and clopidogrel in order to obtain the prospective information of ticagrelor in clinical practice.
Methods: A total of 307 STEMI patients were divided into 2 groups, Treatment group, the patients received ticagrelor with aspirin, n=157 and Control group, the patients received clopidogrel with aspirin, n=150. With a period of treatment, the major adverse cardiac events (MACE), rate of thrombosis re-formation and routine blood test result were compared between 2 groups.
Results: Treatment group presented the better LVDD, LVEF, platelet level and ST-segment recovery than those in Control group, P<0.05 or P<0.01. Treatment group showed slightly higher rate of side effect such as dififcult breathing and bleeding, while those reaction did not affect the treatment or special management for the patients.
Conclusion: The clinical effect of ticagrelor is similar to clopidogre for improving the platelet level and cardiac function in STEMI patients, while the clinical advantage reported in abroad should be further studied.

Objective To explore the characteristics of attenuated plaque (AP) in culprit lesions for acute coronary syndrome (ACS) in elderly patients.Methods This study included 166 ACS patients meeting the conditions from Jan.1, 2013 to Sep.31, 2014.Clinical data, vascular lesions determined by coronary angiography and intravenous ultrasound (IVUS)-demonstrated characteristics of culprit plaque, which included presence of AP, maximum attenuation arc, extravascular elastic membrane area, lumen area, plaque area, plaque burden and remodeling index, were recorded.Results Compared with non-elderly group, elderly group had a higher proportion of multiple coronary-artery lesions (50.0％ vs.35.1％, x2=6.525, P =0.038), more attenuation plaques (62.0 ％ vs.45.9％, x2 =4.245, P=0.039), a larger maximum attenuation arc[(142±80)° vs.(115±54)°, t=5.254, P=0.000], larger plaque area[(14.2±3.9)mm2 vs.(12.3 ± 4.1) mm2, t=2.325, P=0.022], more plaque burden [(81.1±14.2)％ vs.(76.4±13.5)％, t=2.025, P=0.042] and higher remodeling index [(1.19±0.17) vs.(1.09±0.13), t=4.245, P=0.031].Conclusions The onset of ACS is more closely related with the unstable plaque in elderly patients, and strengthening the measures for plaque stabilization will be helpful in the prevention and treatment of ACS in the elderly.

Naringin is mainly present in Rutaceae Citrus Pomelo,grapefruit,lime,and its variants of the peel and fruit,which belongs to dihydrogen flavonoids.Studies have shown that naringin has anti-type 1 and type 2 diabetes pharmacological effects,the mechanism of action by inhibiting diabetes-related oxidative stress injury,inflammation,abnormal metabolism of glucose,and other aspects,while a certain degree of delay in diabetes complications (including diabetic cardiomyopathy,diabetic nephropathy,diabetic retinopathy,and diabetic neuropathy).The mechanism of naringin on the mechanism of diabetes mellitus and its complications was studied in order to provide the basis for the development of antidiabetic drug.

Objective To discuss the imaging features of parietal bones atrophy,and to improve the understanding of this disease. Methods Clinical and imaging data of 8 patients with parietal bones atrophy were analyzed retrospectively.Age ranged 66-90 years with median age 76 years.CT scans were performed in all cases,and CT enhanced examination in 1 case.MRI examination were performed in 3 cases,in which MRI enhanced examination in 2 cases.Imaging characteristics were analyzed along with a review of the current literature.Results Bilateral parietal sympathetic involvements were found in 4 cases,unilateral parietal involvement in 4 cases,in which the left parietal bone was found in 2 cases and the right side in other 2 cases.The lesions ranged from 2.4 cm to 7.1 cm.On CT and MRI images,the external table of the parietal bones showed symmetrical impression,the diploe revealed thinner and the inner table was intact,which presented"Step change".Two of these patients were followed up,in which 1 case become severe atrophy,and the other case was no significant change.Nothing was showed in the relative scalp and soft tissue.Conclusion According to different degrees of thinning of parietal bones,combined with specific age,symmetrical parietal bone impression should be considered.

AIM:To investigate the effect of Huangqi-Danggui decoction(HQDG)on the brain tissue of rats with cerebral ischemia/reperfusion(I/R)injury for 7 d by regulating macroautophagy and chaperone-mediated autophagy(CMA),and to explore its mechanism.METHODS:Male SD rats were randomly divided into sham group,model group,HQDG group and Xuesaitong(XST)group.Determination of main chemical components of HQDG by liquid chro-matography-mass spectrometry.The model of middle cerebral artery occlusion/reperfusion in rats was established by the left modified thread embolism method,and the changes of cerebral blood flow were observed by laser speckle blood flow imager.Zea Longa score was used to observe the neurological deficit.HE staining was used to observe the degree of nerve cell injury.The changes of neurovascular unit and autophagosomes in brain tissue were observed by transmission electron microscopy.Immunohistochemical method was used to detect the expression of LC3,P62,lysosome-associated membrane protein-2A(LAMP-2A),heat shock protein 70(HSP70)and myocyte enhancer factor 2D(MEF2D)proteins.Western blot was used to detect the expression of autophagy-related proteins P62 and LC3-Ⅱ/LC3-I.RESULTS:Compared with the sham group,the neurological deficit score in model group was significantly higher(P<0.01).A large number of nerve cells showed necrosis and nuclear dissolution,with the cell arrangement being disordered.The number of autophagosomes increased.The protein expression levels of LC3,LAMP-2A,HSP70 and MEF2D in brain tissue increased,while the ex-pression level of P62 protein decreased(P<0.05 or P<0.01).Compared with the model group,the scores of neurological deficit in brain tissue in HQDG and XST groups were significantly lower(P<0.01).Cell damage was significantly re-duced.The number of autophagosomes further increased.The expression levels of LAMP-2A,HSP70,MEF2D and P62 proteins in brain tissue decreased,while the expression levels of LC3-Ⅱ/LC3-I protein increased(P<0.05 or P<0.01).CONCLUSION:HQDG can alleviate cerebral ischemia/reperfusion injury in rats and exert neuroprotective effects by ac-tivating macroautophagy and reducing CMA.