Objective To compare effect of ticagrelor and clopidogrel on bleeding in elderly patients after stenting.Methods 48 elderly patients after stenting who were diagnosed with acute coronary syndrome in the hospital were collected.All patients were divided into clopidogrel group and ticagrelor group according to different therapy, 24 cases in each group,and were given corresponding drug treatment in each group.After treatment, the platelet inhibition rate, cardiovascular events and bleeding events were observed.Results After treatment, compared with clopidogrel group, the platelet inhibition rate was higher in ticagrelor group(P<0.05), the incidence of cardiovascular events was lower in ticagrelor group (4.16%vs.25.00%;P<0.05), but there was no obvious difference in incidence of bleeding events of ticagrelor group (4.16% vs.8.32%).Conclusion In elderly patients after stent implantation, ticagrelor could inhibit platelet aggregation better than clopidogrel, prevent the occurrence of cardiovascular events, and would not increase the risk of bleeding.

Background lnterleuldn-18(IL- 18) plays a key role in the development,progression and outcome of coronary artery disease and its complications.However,its variability relation to the characterization of atherosclerotic plaque and percutaneous coronary intervention are still unknown.Methods Fifty four patients with coronary artery disease [22 patients with stable angina (SA) and 32 patients with acute coronary syndrome (ACS)] were enrolled in this study.All patients underwent percutaneous coronary intervention (PCI).The stability of the plaques at the criminal vessels was assessed with analogical IVUS.Serum IL-18 levels were measured at the time points of 5 rain before PCI,and Oh,6h,24h and lmonth after PCI in all patients.Results ACS group consisted mainly of lipidic unstable plaques while SA group of fibrous stable plaques.Moreover,compared with those in SA group,eccentricity index (EI) and remodeling index (RI) were significantly higher in ACS group.Positive remodeling was seen in ACS group while negative or no remodeling in SA group.Further,serum IL-18 levels were significantly elevated in patients with ACS than those in SA group before PCI,increased at Oh,6h,24h after PCI (P＜0.05)and were not significant different at 1 month after PCI from those before PCI.Conclusions There is significant difference in the composition and structural characteristics of atherosclerotic plaques between ACS and UA groups.PCI triggersd and enhances the inflammatory response in a short time.Serum levels of IL- 18 are the predictors of progression of unstable plaque in atherosclerosis.Post-operative complications of PCI might be reduced by inhibiting IL- 18.(J Geriatr Cardiol 2008;5:21-24)

Objective:To study the clinical efficacy of acupuncture at Zusanli (ST 36)combined with Traditional Chinese Medicine (TCM) enema in the treatment of gastroparesis syndrome after gastrointestinal tumor operation.Methods:A total of 96 patients with gastroparesis syndrome after gastrointestinal tumor surgery in our hospital from June 2016 to May 2021, who met the inclusion criteria, were randomly divided into three groups by random drawing, with 32 in each group. The control group took mosapride citrate tablets orally, the TCM enema group added TCM enema on the basis of the control group, and the combined group added acupuncture Zusanli (ST 36)on the basis of the TCM enema group. All three groups were treated continuously for 4 weeks. The main syndromes were scored before and after treatment. The levels of serum gastrin (GAS), motilin (MTL) and somatostatin (SS) were detected by radioimmunoassay. The gastric electrophysiological parameters (waveform response area, waveform frequency and average amplitude) were detected by intelligent dual channel gastrointestinal electrograph, the adverse reactions during treatment were recorded, and the clinical efficacy was evaluated.Results:The total effective rate was 96.9% (31/32) in the combined group, 81.3% (26/32) in the TCM enema group and 68.8% (22/32) in the control group. There was significant difference among the three groups ( χ2=8.72, P=0.013). The scores of abdominal fullness and distention, fatigue, belching acid reflux, dry mouth and bitter mouth in the combined group were significantly lower than those in the TCM enema group and the control group ( F values were 16.39, 13.21, 11.28 and 10.23, respectively, P<0.001). After treatment, the levels of GAS [(140.62±15.19) ng/L vs. (128.79±14.34) ng/L, (115.98±12.40) ng/L, F=21.09], MTL [(268.66±28.21) ng/L vs. (245.89±25.24) ng/L, (230.78±22.43) ng/L, F=30.29] and SS [(70.58±8.17) ng/L vs. (65.50±7.76) ng/L, (59.73±7.05) ng/L, F=33.19] in the combined group were significantly higher than those in the TCM enema group and the control group ( P<0.01). The waveform response area [(172.62±17.14) μV/s vs. (158.56± 15.32) μV/s, (145.48±14.13) μV/s, F=20.24], waveform frequency [(3.86±0.61) cpm vs. (3.29±0.50) cpm, (3.01±0.63) cpm, F=13.17] and average amplitude [(86.51±8.98) μV vs. (75.70±7.93) μV, (68.65±7.46) μV, F=28.11] were significantly higher than those in TCM enema group and control group ( P<0.01). During the treatment period, the incidence of adverse reactions was 18.8% (6/32) in the combined group, 15.6% (5/32) in the TCM enema group and 12.5% (4/32) in the control group. There was no significant difference between the three groups ( χ2=0.47, P=0.789). Conclusion:Acupuncture at Zusanli (ST 36) combined with TCM enema can improve the TCM syndrome scores, gastrointestinal hormone level and gastric electrophysiological parameters of patients with gastroparesis syndrome after gastrointestinal tumor operation, improve the curative effect with safety.

Objective To investigate the correlation of cystatin C(Cys C) serum level and its gene polymorphism among Zhuang population with Metabolic Syndrome(MS) of Guangxi district.Methods The levels of serum Cys C in Zhuang MS patients,Han MS patients,Zhuang normal people and Han normal people(each of 100 cases)were detected by Immunoturbidimetric Assays.Cys C +148,Cys C+73 and Cys C-82 genotyping were conducted by using PCR-RFLP.Results The clinical data and serum Cys C levels of four groups were significantly different(P＜0.05),The clinical data and serum Cys C levels of two CHD groups were significantly different from those in the two normal groups(P＜0.05);(2) There was a positive correlation between Cys C levels and creatinine(Cr) level in peripheral blood(r=0.551,P=0.000);(3) There was no significant difference in the genotype frequencies of Cys C+73,Cys C+ 148 and Cys C-82 in 4 groups(x2 =3.139,0.791;x2 =4.841,P=0.564;x2 =3.207,P=0.782);(4)Cys C level in MS patients of Cys C+73 GG genotype was significantly lower than that of AG and AA genotype,and the difference was statistically significant (P ＜ 0.05).But there was no significant difference in Cys C level between AG type and AA type.Conclusion The high level of Cys C caused by impaired renal function may be a risk factor for MS patients in Zhuang and Han population in Guangxi.Cys C+73 locus gene polymorphism and the relationship between MS patients in Guangxi Zhuang population need further study.

Purpose To evaluate the diagnostic value of high-frequency ultrasonography (HFUS) in the diagnosis of rheumatoid arthritis (RA) Achilles tendinopathy.Materials and Methods The Achilles tendon HFUS findings in 67 cases including a total of 93 feet were analyzed retrospectively,among which,11 cases including 22 feet were set as healthy control group (group A),36 cases including 40 feet as RA Achilles tendon group (group B) and 20 cases including 31 feet as non RA Achilles tendon group (group C).HFUS was used to observe the gray-scale imaging (GSI) and power Doppler imaging (PDI) features of the Achilles tendon:① the positive rate of Achilles tendon GSI abnormality.② The thickness and width of the starting point,mid point and ending point of Achilles tendon.③ The detection rate of retrocalcaneal bursal effusion.④ The detection rate of blood flow signal in the internal Achilles tendon.⑤ The level of blood flow signal.The data of each group were compared and analyzed.Restlts ① The positive rate of Achilles tendon GSI abnormality:there was no significant difference between group A and group B (x2=0.064,P＞0.05).Compared with group A and group B,group C had higher rate of abnormalities (x2=31.601 and 39.256,P＜0.05).② The thickness and width of Achilles tendon:the thickness of each point increased in group C than that in group A and group B (P＜0.05),and there was no significant difference in width between groups (P＞0.05).③ The detection rate of retrocalcaneal bursal effusion:negative in group A.The detection rate of group B (55％) was higher than that of group C (19.4％),the difference was statistically significant (P＜0.05).④ The detection rate of blood flow signal in the Achilles tendon:negative in group A.The detection rate of group B (97.5％) was higher than that of group C (45.2％),the difference was statistically significant (P＜0.05).⑤ The level of blood flow signal:level Ⅰ signal detection rate in group B (7.5％) was lower than that in group C (35.5％),while level Ⅱ signal detection rate in group B (35.0％) was higher than that of group C (9.7％),the differences were statistically significant (P＜0.05).Level Ⅲ signal was detected in only group B (45.0％) while not detected in group C.In addition,aspiration biopsy was performed on 3 patients of whom the fat pad of Achilles tendon was involved by level Ⅲ blood flow signal in PDI,and the pathological findings were consistent with ultrasonic manifestations.Conclusion HFUS is of great value in the diagnosis of RA Achilles tendinopathy and it can also be used to distinguish from non-RA Achilles tendinopathy.Moreover,it helps to achieve early diagnosis and early treatment in clinic to avoid Achilles tendon rupture and other bad progresses.

The loss of endothelial connective integrity and endothelial barrier dysfunction can lead to increased vascular injury, which is related to the activation of endothelial inflammasomes. There are evidences that low concentrations of aspirin can effectively prevent cardiovascular diseases. We hypothesized that low-dose aspirin could ameliorate endothelial injury by inhibiting the activation of NLRP3 inflammasomes and ultimately prevent cardiovascular diseases. Microvascular endothelial cells were stimulated by lipopolysaccharide (2 μg/mL) and administrated by 0.1-2 mmol/L aspirin. The wild type mice were stimulated with LPS (100 μg/kg/day), and 1 h later treated with aspirin (12.5, 62.5, or 125 mg/kg/day) and dexamethasone (0.0182 mg/kg/day) for 7 days. Plasma and heart were harvested for measurement of ELISA and immunofluorescence analyses. We found that aspirin could inhibit NLRP3 inflammasome formation and activation in dose-dependent manner and has correlation between the NLRP3 inflammasome and the ROS/TXNIP pathway. We also found that low-concentration aspirin could inhibit the formation and activation of NLRP3 inflammasome and restore the expression of the endothelial tight junction protein zonula occludens-1/2 (ZO1/2). We assume that aspirin can ameliorate the endothelial layer dysfunction by suppressing the activation of NLRP3 inflammasome.