OBJECTIVE:To investigate the effects of tirofiban combined with atorvastation before PCI on the miRNA expres-sion of peripheral blood and vascular endothelial function in acute myocardial infarction(AMI)patients. METHODS:A total of 80 patients with AMI selected from our hospital as reaserch objects during Jan. 2015-Jun. 2016 were divided into control group and ob-servation group according to random number table,with 40 cases in each group. Both groups received anticoagulant therapy. Con-trol group was given Aspirin enteric-coated tablets 300 mg+Clopidogrel sulfate tablets 75 mg+ Atorvastatin calcium tablets 20 mg orally 30 min before PCI. Observation group was additionally given Tirofiban hydrochloride for injection with initial dose of 0.5 mg+0.9％ Sodium chloride injection 100 mL,iv,then adjusted to pump injection of 0.4 μg/(kg·min),30 min later adjusted to pump injection of 0.1 μg/(kg·min),for consecutive 24 h. The levels of peripheral miRNA (miRNA-1,miRNA-133a,miR-NA-208b,miRNA-499),the levels of brachial artery diameter and vascular endothelial function indexes(vWF,ET-1,NO)were observed in 2 groups before medication and after PCI,and the occurrence of ADR was recorded. RESULTS:Before treatment, there was no statistical significance in above indexes between 2 groups(P>0.05). After treatment,miRNA expression,the levels of vWF and ET-1 were decreased significantly in 2 groups,and observation group was significantly lower than control group,with statistical significance (P<0.05). The brachial artery diameter and NO levels of 2 groups were increased significantly,and observation group was significantly greater or higher than con-trol group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLU-SIONS:For AMI,tirofiban combined with atorvastation before PCI can reduce miRNA expression,increase brachial artery diame-ter and protect vascular endothelial function with good safety.

Objective:To evaluate the efficacy of cerebral-placental-uterine ratio(CPUR)in predicting late-on-set fetal growth restriction(FGR).Methods:From May 2020 to May 2021,1255 women with singleton pregnancy who underwent prenatal examinations at the University of Hong Kong Shenzhen Hospital were selected for fetal growth and Doppler measurements at 35-37 +6 weeks of gestation.Pregnant women with birth weight of newbo-rns＜the 10th percentile were the FGR group.The pulsatility index(PI)of uterine artery(UtA),umbilical artery(UA)and fetal middle cerebral artery(MCA)were analyzed separately and in combination.ROC curve was used to analyze the cerebral-placental-uterine ratio(CPUR),cerebral-placental ratio(CPR),cerebral-uterine ratio(C-UtA)for predicting late-onset FGR;and to evaluate the sensitivity,positive and negative predictive value and of CPUR in the prediction of late-onset FGR.Results:The area under the curve(AUC)of CPUR,CPR,C-UtA and mean UtA-PI for FGR grope were 0.88,0.86,0.84 and 0.72.Under certain cut-off values and 87% specificity,the specificity of CPUR,CPR,C-UtA and mean UtA-Pifor predicting FGR group was 43.2%,46.6%,39.8% and 23.9%,respectively.The positive predictive values of CPUR,CPR,C-UtA and mean UtA-PI,UA-PI for predicting FGR group were 90.5%,71.9%,83.3%,63.6%and 5.2%,respectively.Conclusions:CPUR is more effective in predicting late onset FGR than CPR,C-UtA and mean UtA-PI.It can effectively increase the detection rate of fetal growth restrictionand reduce the FGR risk.

【Objective】 To explore the clinical effect of PRP on refractory ulcer of diabetes foot on the basis of routine treatment. 【Methods】 Sixty-four patients who suffered from diabetes foot and treated in our hospital from January to December 2020 were divided into the routine treatment group (44 cases) vs PRP plus routine treatment group (20 cases, using liquid or gel PRP for diversified treatment) according to a simple random sampling method. The general conditions of the two groups were evaluated to compare the wound surface, wound healing rate, treatment time, wound healing speed rate, adverse reactions and healing conditions after the treatment. 【Results】 The wound surface[0.05(0.00, 0.70)vs 0.35(0.00, 4.54)], wound healing rate[0.99(0.84, 1.00)vs 0.80(0.26, 1.00)] and wound healing speed rate[0.16(0.04, 0.27)vs 0.06(0.01, 0.18)] in PRP group were significantly higher than those in routine treatment group (P<0.05). The treatment duration[18.00(8.75, 24.75)vs 17.00(9.25, 28.00)] between the two groups was not statistically significant (P>0.05), so was the adverse reactions to treatments[0(0/20)vs 2.27(1/44)](P>0.05). The response rate[100(20/20)vs 61.36(27/44)] of PRP group was significantly better than that of routine group, and the difference was statistically significant (P<0.05). 【Conclusion】 The therapeutic effect of PRP group was significantly superior to that of routine treatment group.