Objective: To explore assessment value of heart rate variability (HRV) of Holter for cardiac autonomic nervous function in patients with acute stroke.Methods: A total of 80 cases with acute stroke treated in our hospital were regarded as stroke group, and another 80 inpatients without cardio-and cerebrovascular diseases were enrolled as control group simultaneously.Holter was used to perform 24h ambulatory heart rate monitoring on two groups, and the results were compared between two groups.Results: Compared with control group, there were significant reductions in standard deviation of normal to normal RR intervals calculated over the 24 h period [SDNN, (129.89±5.42) ms vs.(92.58±4.36) ms], standard deviation of normal to normal RR intervals in all 5 min segments of the entire recording [SDANN, (118.85±5.79) ms vs.(77.36±4.82) ms], root-mean square of differences between successive normal to normal intervals [rMSSD, (27.04±1.18) ms vs.(7.31±1.09) ms] and adjacent normal RR interval difference >50ms stroke accounted for a percentage of 24h total RR interval [PNN50, (8.97±1.48)% vs.(2.62±0.54)%] in stroke group, P<0.01 all;in stroke patients, there were no significant difference in above indexes between cerebral infarction patients and cerebral hemorrhage patients, P>0.05 all.Conclusion: HRV indexes possess significant assessment value for cardiac autonomic nervous function in patients with acute stroke.They can predict patient′s status changes, and help to prevent and identify severe cerebrovascular disease in time.

Objective: To compare therapeutic effects of clopidogrel and loading dose ticagrelor on aged patients with ST elevation myocardial infarction (STEMI).Methods: A total of 160 aged STEMI patients undergoing emergency percutaneous coronary intervention (PCI) were selected.According to random number table, they were randomly and equally divided into clopidogrel group (received loading dose aspirin and clopidogrel therapy) and ticagrelor group (received loading dose aspirin and ticagrelor therapy).Coronary TIMI flow grade, incidence rate of no-reflow after PCI, and incidence of cardiac adverse events and bleeding events in one month after PCI were compared between two groups.Results: Compared with clopidogrel group after PCI, there was significant rise in percentage of coronary TIMI flow grade 3 (71.25% vs.90.00%), and significant reduction in incidence rate of no-reflow (28.75% vs.10.00%) in ticagrelor group,P<0.05 all.Compared with clopidogrel group on one month after PCI, there were significant reductions in incidence rates of cardiogenic death (13.75% vs.3.75%), in-stent thrombosis (6.25% vs.0) and recurrent myocardial infarction (10.00% vs.1.25%), but significant rise in incidence rate of dyspnea (3.75% vs.12.50%) in ticagrelor group, P<0.05 all.There was no significant difference in incidence of bleeding events between two groups, P>0.05 all.Conclusion: Loading dose ticagrelor can effectively improve coronary blood flow, reduce no-reflow and its safety is good in aged patients with ST elevation myocardial infarction, which is worth extending.

Objective To observe the effect of smoking on the great saphenous vein tension. Methods The rings of great saphenous vein in 3mm long of selected from 31 patients with coronary artery bypass grafting were divided into three groups :smoking over 10 years( group A, n = 12 ), ex-smoking over 1 years ( group B, n =9 ) and non-smoking( group C, n =10). The changes of the tone were measured in organ chamber at 37℃ with a constant supply of oxygen when vasoconstriction induced by phenylephrine ( 10 -9 - 10 -5 mmol/L), and vasodilatation by acetylcholine ( 10 -9 - 10 -5 mmol/L) or nitroglycerin( 10 -9 - 10 -4 mmol/L)after the rings were precontracted by 10 -5 mmol/L phenylephrine. Results Vasoconstriction induced by phenylephrine and vasodilatation by nitroglycerin is no significant difference among three groups. Compared with group A, vasodilatation by acetylcholine was significantly increased in group B or C, while there is no significant difference between group B and C. Conclusion Smoking has a deleterious effect on the endothelial function of great saphenous vein, however, smoking cessation over 1 year may help to restore the endothelial function impaired by smoking.