Objective To investigate the effect of combined anti-platelets drugs on platelet activation in the elderly patients with acute coronary syndrome (ACS).Methods Totally 72 elderly patients with ACS were divided randomly into two groups according to age ≤ 80 years and ＞ 80 years.Aspirin 100 mg/d plus clopidogrel 75 mg/d were used in all the patients for 2 weeks.The positive glycoprotein Ⅱb/Ⅲa and P-selectin expressions on the surface of platelets were assessed with flow cytometry (FCM) after the platelets were activated by adenosine diphosphate (ADP) and arachidonic acid.Results The expressions of GP Ⅱb/Ⅲa and P-selectin were (73.5± 11.0,71.2±8.7) ％ at baseline and (51.3±9.1,57.3±12.4)％ after anti-platelets medicine more than 14 days in group of age≤80 years.than 14 days.The expression of GP Ⅱb/Ⅲa and P-selectin were (78.3 ±12.7,75.8±8.6)％ on the surface of platelet at baseline in group of age＞ 80 years,after anti-platelets medicine treatment were (41.2±8.5,47.3±10.3)％.The positive expressions of GP Ⅱb/Ⅲa and P-selectin in group of age＞ 80 years were decreased compared with those in group of age≤ 80 years after combination of medicines treatment (P＜0.05).Conclusions Combined aspirin and Clopidogrel treatment have a more strong effect in inhibiting the activation of platelets in the elderly patients more than 80-year with ACS.

Fifty six elderly patients with acute coronary syndrome (ACS) were divided into nonsmoking group (n =30) and smoking group (n =26).All patients received aspirin 100 mg/d + Clopidogrel 75 mg/d for 14 d.The expression of glycoprotein Ⅱ b/Ⅲa and P-Selectin on the surface of platelets in both groups were assessed with flow cytometry (FCM).The positive expression rates of GP Ⅱ b/Ⅲ a and P-Selectin before treatment were (67.86 ± 12.14)％,(70.37 ± 10.15)％ in non-smoking group and (79.47 ± 11.62) ％,(81.26 ± 9.74) ％ in smoking group.The positive expression rates of GP Ⅱ b/Ⅲ a and P-Selectin after treatment were significantly decreased to (50.18 ± 8.72) ％,(49.36 ± 11.43) ％ in nonsmoking group and to (61.15±9.29)％,(57.52±10.81)％ in smoking group(P＜0.01).Also the degree of decreasing expression rates of GP Ⅱ b/Ⅲ a and P-Selectin was nore markedly in non-smoking group than that in smoking group (P ＜ 0.05).The results indicate that expressions of GP Ⅱ b/Ⅲ a and P-Selectin on the surface of platelets are increased in the elderly smoker patients with ACS,and smoking may decrease the effect of anti-platelet agents.

Objective To compare the safety and efficacy of varied treatments for cardioversion of paroxysmal atria] fibrillation (AF) in the aged patients and to explore choice of electrical cardioversion with direct current. Methods Clinical data of cardioversion with lanatoside (cedilandid) or propafenone, a sodium channel blocker prolongs refractoriness, for 57 aged patients with paroxysmal AF were summarized to observe their cardioversion and control of heart rate. And, synchronous electrical cardioversion will be offered to those with severe complications and ineffective with drug treatment within 24 h after the onset of AF. Results An emergency cardioversion ratio was 28.1 % with lanatoside within 24 h with a satisfactory control of ventricular rate, as compared with that of 62.2% with propafenone (P

Objective To compare the clinical effect of unarmed cardiopulmonary resuscitationand cardiopulmonary resuscitationmachine in the emergency room.Methods One hundred cases patients with cardiopulmonary arrest in Hainan Agricultural Reclamation General Hospital from February 2014 to February 2016 were analyzed.The control group(n=50) were given unarmed cardiopulmonary resuscitation,while thetest group(n=50) were given ardiopulmonary resuscitation machine.Two groups' before and after cardiopulmonary resuscitation of arterial blood gas index(oxygen saturation (SaO2),C02 partial pressure (PaC02),oxygen partial pressure(Pa02)),cardiopulmonary resuscitation effectiveness and the success rate,and complications were compared.Results Before cardiopulmonary resuscitation,there were no significant differences on arterial blood gas index (SaO2,PaCO2,PaO2) between the two groups (t =0.069,0.097,0.121,P ＞ 0.05).After cardiopulmonary resuscitation,the SaO2,PaO2 of the test group were higher than that of the control group ((98.60± 8.51) ％ vs.(86.37 ± 7.84) ％,(13.84 ± 1.40) kPa vs.(8.69± 1.21) kPa),while PaCO2 of test group was lower than the control group ((3.24 ± 0.56) kPa vs.(6.41 ± 0.87) kPa),the differences were significant(t =7.474,21.665,19.679,P ＜ 0.05).The cardiopulmonary resuscitation of effective rate,success rate of test group were higher than the control group (84.00％ (42/50) vs.62.00％ (31/50),26.00％ (13/50)vs.10.00％(5/50),x2=6.139,4.336,P＜0.05).The total complication rate of the test group was lower than the control group(8.00％ (4/50) vs.28.00％ (14/50)),the difference was significant (x2 =6.775,P ＜0.05).Conclusion The clinical effect of cardiopulmonary resuscitation machine is significantly superior to unarmed cardiopulmonary resuscitation,which can effectively improve the patient's arterial blood gas state,improve the efficiency and success rate of cardiopulmonary resuscitation,and reduce the complications.

Tolvaptan is a novel oral selective arginine vasopressin V2 receptor antagonist.Tolvaptan improves heart failure signs and symptoms without serious adverse events.Tolvaptan has no effect on all-cause mortality and cardiovascular death or admission rate for heart failure.But in heart failure patients with hyponatremia,tolvaptan can decrease cardiovascular death and admission rate for heart failure.

Objective:To investigate the influencing factors for orthostatic hypotension(OH)in elderly patients with hypertension.Methods:This was a case-control study.A total of 224 patients with hypertension aged over 65 years were included.After resting for more than 5 minutes, subjects had their blood pressures measured in the supine and standing position at 0 min, 1 min, 2 min and 3 min.OH was defined as a fall in systolic BP of more 20 mmHg(1 mmHg=0.133 kPa)and/or diastolic BP below 10 mmHg of baseline within 3 min in the upright position.Subjects were divided into the OH group( n=34)and the non-OH group( n=190). Baseline data, comorbidities and differences in medications were compare between the OH group and the non-OH group, and the influencing factors for OH were analyzed. Results:The proportion of drinkers was higher in the OH group than in the non-OH group(29.4% or 10/34 vs.7.4% or 14/190, χ2=14.649, P<0.01). Both systolic pressure(139.0±22.1 mmHg vs.124.5±16.3 mmHg, t=-3.661, P<0.01)and diastolic pressure(77.6±6.3 mmHg vs.69.2±9.0 mmHg, t=-6.696, P<0.01)in the supine position were higher in the OH group than in the non-OH group.The proportions of patients with diabetes(47.1% or 16/34 vs.25.3% or 48/190, χ2=6.731, P<0.05)and stroke(41.2% or 14/34 vs.24.2% or 46/190, χ2=4.233, P<0.05)were higher in the OH group than in the non-OH group.The proportion of patients receiving α receptor blockers was higher in the OH group than in the non-OH group(23.5% or 8/34 vs.4.2% or 8/190, χ2=16.228, P<0.01). After adjusting for factors such as alcohol consumption, diabetes, stroke and other differences between the OH and non-OH group, logistic regression found patients with alcohol intake( OR=5.274, 95% CI: 1.990~13.982, P<0.01), diabetes( OR=2.744, 95% CI: 1.213~6.208, P<0.05)and using α receptor blockers( OR=8.812, 95% CI: 2.835~27.383, P<0.01)had a higher risk of OH. Conclusions:OH is very common in elderly patients with hypertension.Alcohol consumption, diabetes mellitus and the application of α receptor blockers can increase the risk of OH.

Objective To determine the relationship of cytochrome P-450 epoxygenase metabolites of arachidonic acids with impaired endothelium-dependent vasorelaxation in the healthy elderly. Methods A case-control study was employed.The study enrolled 60 healthy young adults (group A) and 60 healthy senior citizens (group B) of Han population in Shanghai. Serum contents of 14,15-dihydroxyeicosatrienoic acid (14,15-DHET) (a stable metabolite of 14,15-EET), 6-Kote-PGF1a (a stable metabolite of prostaglandin) and TXB2 (a stable metabolite of thromboxane A2) were measured using ELISA kits. The endothelium-dependent vasorelaxation (EDV) and endothelium-independent vasorelaxation (NEDV) in brachial arteries were determined by color Doppler ultrasound. Results Compared with group A, group B had significant higher levels of hemoglobin A1c, triglyceride and cholesterol levels (P＜0.01), and significant lower levels of 14,15-DHET and 6-Kote-PGF1a (P＜0.001), leading to increased values of TXB2/6-Kote-PGF1a and TXB2/14,15-DHET. There was bigger basal interior diameter of brachial arterials with reduced EDV and NEDV response (P＜0.01 and P＜0.05, vs. group A respectively) in group B. Moreover, the age was negatively correlated with 14,15-DHET and TXB2/14,15-DHET. Conclusions Our results indicate that the impaired EDV and NEDV in aging are associated with reduced production of arachidonic acid metabolites through cytochrome P-450 epoxygenase pathway and cyooxygenase pathway of endothelium in the healthy elderly.

Objective:To investigate hypoxia location in condylar cartilage in the early growth stage of rats.Methods:40 Sprague-Dawley rats were breastfed from 1 4 d to 21 d of age.1 0 rats were sacrificed at 1 2,24,48 and 96 h respectively after initiation of normal food at 21 d of age.The rats were administered pimonidazole hydrochloride (HP-1 )at a dose of 60 mg/kg by intraperitoneal injection 2 h before sacrifice.The expression of HP-1 in the whole condylar cartilage was detected by immunohistochemical staining.Results:HP-1 was mainly expressed in the chondrocytes of the fibrous and proliferative layer of cartilage,primarily concentrated in the weight-bearing area of joint-anterior aspect of the condyle and posterior aspect of the articular eminence at all time points.The highest expres-sion was observed at 24 h after initiation of normal food (P <0.01 ).Conclusion:In the early growth stage of rats,dietary loading may directly induce hypoxia in uper layer of condylar cartilage,the hyoxia level may change with time of dietary loading.

Serum high sensitivity C-reactive protein(hs-CRP)and glycosylated hemoglobin(HbA1c )were detected in 89 type 2 diabetes patients with chronic periodontitis.The patients were divided into HbA1c≥ 7.0% and <7.0% groups according HbA1c levels.Serum hs-CRP,probing depth(PD),attachment loss(AL)in HbA1c ≥ 7.0% group were all significantly higher than those in <7.0% group (P <0.01 ),and serum hs-CRP was positively correlation with PD and AL in all patients.In patients with type 2 diabetes,high HbA1c and chron-ic periodontitis serum hs-CRP is positively correlation with periodontal disease.

Objective:To investigate therapeutic effect of cisplatin sequential recombinant human vascular endostatin thoracic perfusion in treatment of malignant pleural effusion.Methods:A total of 80 patients with malignant pleural effusion in Maoming People's Hospital from January 2018 to February 2021 were enrolled, and all patients were divided into 2 groups according to the random number table methods, each group with 40 cases. The control group was treated with small-bore catheter minimally invasive drainage combined with cisplatin thoracic perfusion, and the study group was treated with small-bore catheter minimally invasive drainage combined with cisplatin sequential recombinant human vascular endostatin thoracic perfusion. And then the clinical efficacy, expressions of vascular endothelial growth factor (VEGF) expression, pain degree and adverse reactions were compared of both groups.Results:The treatment efficacy rate of the study group was higher than that of the control group [90% (36/40) vs. 75% (30/40)], and the difference was statistically significant ( χ2 = 5.04, P < 0.05). After treatment, the level of VEGF in pleural fluid and serum of the study group was lower than that of the control group [(304±106) pg/ml vs. (598±159) pg/ml,(103±43) pg/ml vs. (189±49) pg/ml], and the difference was statistically significant ( t = 6.62, P < 0.001; t = 6.23, P < 0.001). After treatment, the visual analogue scale (VAS) score of the study group was lower than that of the control group [(3.7±0.3) scores vs. (4.4±0.7) scores], and the difference was statistically significant ( t = 2.10, P < 0.05). The incidence of adverse reactions including stethalgia, fever, nausea and vomiting in both groups had no statistically significant differences (all P > 0.05). Conclusions:Cisplatin sequential recombinant human vascular endostatin thoracic perfusion combined with small-bore catheter minimally invasive drainage can effectively ameliorate clinical symptoms, inhibit the expression of VEGF, and alleviate pain degree with no serious adverse reactions in patients with malignant pleural effusion.