Objective To evaluate the effect of different regimens of antiplatelet drugs on the major adverse cardiac events (MACEs) in elderly patients undergoing selected percutaneous coronary intervention (PCI) in direction of the adenosine diphosphate (ADP) -induced platelet aggregation index. Methods The 1230 cases aged 60-80 years, mean (67. 2±10. 2) years undergoing selected PCI with the drug eluting stent were enrolled. The 615 cases of the ADP guided group according to the ADP-induced platelet aggregation index. After the first loading dose of clopidogrel (300 mg) , once the decrease of ADP-induced platelet aggregation index was more than 50% as compared with the basic level, the dose of 75 mg each day would be maintained for one year. If the decrease of the index was less than 50%. the another 300 mg of clopidogrel would be given again, until up to 900 mg on the 3th day. If the decrease of the index was still not enough, the combination of clopidogrel 75 mg, cilostazol 100 mg and aspirin 100 mg each day would be suggested. The rest 615 patients in the routine dosage group took the routine dose of clopidogrel (the first loading dosage 300 mg was taken, then 75 mg each day for one year ) . The MACEs, including cardiac death, myocardium infarction, revascularization and stent thrombosis, were observed for 12 months. Results After the first 300 mg of clopidogrel, only 45% of patients reached the standards. Until reaching 900 mg, 67.5% of patients in the ADP guided group were eligible. The tailored clopidogrel loading dose in the ADP guided group yielded a better effect on the inhibition of platelet aggregation (the routine dose vs. the tailored loading dose: 45% vs. 67. 5% , P=0. 028). After one year follow up, the MACEs were less in ADP guided group than in routine dosage group (2. 8% vs. 4. 9% , P = 0. 035). All of patients had no major bleeding, and the minor bleeding and other drug adverse events in two groups had no significant differences. Conclusions The patients undergoing selected PCI should receive ADP -induced platelet aggregation test in order to assess the inhibition effect of clopidogrel on the platelet aggregation. It is safe and effective to modify the antiplatelet drugs regimen during the peri-PCI procedure in direction of ADP-induced platelet aggregation.

To learn reading respiratory waveform and ring is a key step to good use of respirator, which will help clinicians to analyze the status of the use of respirator and real time changes in patient's lung mechanics from the changes of respiratory wave and ring, for making use of respirator reasonably, scientifically and objectively to provide advanced methods. This article only explains the physical basis of respiratory wave and ring.
Respiration ; Respiration, Artificial ; methods ; Respiratory Mechanics

OBJECTIVE: To observe the effects of conventional drug therapy combined with acupuncture and conventional drug therapy on the morbidity of post-stroke depression and recovery of neurological function in patients with acute stroke, and provide new ideas for prevention and treatment of post-stroke depression. METHODS: Sixty patients were randomly divided into an observation group and a control group, 30 cases in each one.Conventional drug therapy was given in the control group;on the basis of conventional drug therapy,acupuncture was applied at Baihui (GV 20), Sishencong (EX-HN1), Neiguan (PC 6), Hegu (LI 4), Taixi (KI 3), etc. The treatment was given once every day, 6 times a week for 4 weeks in the two groups. The 24 Hamilton depression rating scale (HAMD), modified Edinburgh-Scandinavian stroke scale (MESSS) scores were recored before treatment, after 1 week of treatment, and after 4 weeks of treatment in the two groups,and the morbidity of post-stroke depression was compared between the two groups. RESULTS: After 1 week of treatment, the HAMD scale scores of the two groups were higher than those before treatment (both <0.05), and the MESSS scores were lower than those before treatment in the two groups (both <0.05). After 4 weeks of treatment, the HAMD scale scores in the observation group were lower than that before treatment (<0.05), and significantly better than that in the control group (<0.01), but there was no significant difference in the control group before and after treatment (>0.05). The MESSS scores were lower than those after 1 week of treatment in the two groups (both <0.05), and the score in the observation group was significantly lower than that in the control group (<0.01). After 4 weeks of treatment, the morbidity of post-stroke depression in the observation group was 23.3% (7/30), which was lower than 66.7% (20/30) in the control group (<0.05). CONCLUSION Early acupuncture intervention on stroke patients can not only promote the recovery of neurological function, but also reduce the morbidity of post-stroke depression effectively.
Acupuncture Therapy ; Depression ; therapy ; Humans ; Stroke ; Treatment Outcome