Aspirin can effectively prevent ischemic cerebrovascular disease. However, as the existence of "aspirin resistance" phenomenon, ischemic events still occur in some patients during the aspirin treatment. This article mainly reviews the mechanisms, screening methods and treatment measures of aspirin resistance.

Objective To investigate the related risk factors for small artery occlusion (SAO) and its 2 subtypes. Methods The clinical and imaging data in 291 patients with first-ever stroke who met the TOAST criteria of large artery atherosclerotic stroke (LAA) or SAO were collected from the Nanjing Stroke Registry Prog-am from December 2009 to November 2010. All the patients were divided into a LAA group (n = 120) and a SAO group (n = 171). The latter was redivided into either a lacunar infarction with ischemic leukoaraiosis (ILA) subgroup (n = 84)or an isolated lacunar infarction (ILI) subgroup (n = 87). The risk factors of the LAA group and SAO group and its subgroups were compared. Multivariate logistic regression analysis was conducted and the independent risk factors were screened. Results The mean age in the SAO group was larger than that in the LAA group. The proportion of the patients with hypertension and the serum homocysteine (Hcy) level were significantly higher than those in the LAA group (all P ＜0. 05). Multivariate logistic analysis showed that the advanced age (odds ratio, [OR] = 1.041,95% confidence interval [CI] 1.02-1.06, P = 0.045), hypertension (OR = 2. 912,95% CI 1. 11-6. 46, P =0. 031) and increased plasma Hcy (OR = 1. 109, 95% CI 1. 11-1. 32, P =0. 001) were the independent risk factors for SAO. The advanced age (OR = 1. 047,95% CI 1.00-1.09, P = 0.043), hypertension (OR = 2. 632, 95% CI 1.08-6.41, P= 0.033) and increased plasma Hcy (OR = 1. 211, 95% CI 1. 11-1. 32, P ＜0. 001) were the independent risk factors for ILA, while the hypercholesterolemia (OR =0. 136, 95% CI 0. 05-0. 37, P ＜0. 001) was the independent risk factor for ILI. Conclusions The advanced age, hypertension and increased plasma Hcy level may play important roles in the pathogenesis of SAO. The hypercholesterolemia is an independent risk factor for ILI, while advanced age, hypertension and increased plasma Hcy level are the independent risk factors for ILA.

Objective To investigate the relationship between isehemic lesion patterns and Suzuki's vessel grades in adult moyamoya disease(MMD).Methods Forty-four consecutive MMD patients,12 with transient ischemic attack(TIA),30 with cerebral infarct(CI)and 2 with combined TIA and CI,who were diagnosed in Jinling hospital between January of 2004 and July of 2009,were retrieved from Nanjing Stroke Registry Program.Ischemic lesions patterns of CI type of MMD were further divided into two paired subgroups including subcortical subgroup versus cortical subgroup, and subgroup of anterior cerebral circulation versus subgroup of posterior cerebral circulation.In addition,the ipsilateral vessel grades of all symptomatic hemispheres were evaluated by Suzuki's 6-grade system according to the results of cerebral angiography of internal carotid arteries.The percentage of number of hemispheres with ischemic events among the paired groups,including TIA group versus CI group,subcortical subgroup versus cortical subgroup,and subgroup of anterior cerebral circulation versus subgroup of posterior cerebral circulation,were analyzed respectively with changes of the Suzuki's grading.Results For above-mentioned each paired groups.the percentage of number of hemispheres with ischemic events was gradually decreased in the former (namely,11/26,2/13,1/8,0 and 0;15/15,9/11,1/7,0 and 0;15/15,10/11,4/7,0 and 0)and increased in the latter(namely,15/26,11/13,7/8,2/2 and 1/1;0,2/11,6/7,2/2 and 1/1;0,1/11,3/7,2/2 and 1/1 ) from grade 2 to grade 6, and the differences were statistically significant (Z = -2. 33 and P =0. 019,Z = - 4.49 and 0. 00, Z = - 3.66 and 0. 01, respectively ). Moreover, the mean value of Suzuki' s grade was lower in the former than the latter for above-mentioned three groups (2. 29 vs 2. 97, 2. 44 vs 4. 18 and 2. 62 vs 4. 13, respectively). Conclusion The ischemic lesion patterns of adult MMD is changing with the change of Suzuki' s vessel grading. The higher the Suzuki' s grade, the greater the likelihood of ischemic lesions involving the cortical areas of posterior cerebral circulation.

Objective:To analyze the influencing factors of the public hospital′s WeChat official accountcommunication effect, for references for improving the public hospital′s WeChat official account′s public opinion guidance in health dissemination field.Methods:The communication data of all the tweets on the official account of a tertiary hospital from 2018 to 2021 were obtained, taking the tweets reading times as the evaluation index of the communication effect of the WeChat official account. The number of sharing times, the number of title words, punctuation points, the first launch platform and content type were took as factors that may affect comounication effectiveness for single factor analysis and multiple linear regression analysis.Results:A total of 1 102 tweets were included, with an average reading times of 10 670, and an average sharing times of 411. The top 10 tweets in terms of reading times were mainly about the treatment of major diseases, emergencies, common misconceptions and health popular science. The sharing times and the hand-painted entries were positively correlated with the reading times( P<0.05), while the number of title words and punctuation was negatively correlated with the reading times( P<0.05). The reading times of tweets varied with different title sentence structures, initial platforms, source departments, and content types, and the differenceswere statistically significant( P<0.05). The sharing times, hand-painted entries, title sentence structures and content typeswere the influencing factors of the public hospital′s WeChat official account communication effect( P<0.05). Conclusions:The tweets of a public hospital′s WeChat official account with high reading times focused on the hot issues that people pay attention to, and there were many factors influencing the communication effect. The author suggested that the WeChat official account of public hospitals should focus on the needs of the people, promote the construction of high-quality content, and further strengthen the design level of copywriting to improve its audience and communication power.

Objective To discuss the influence of Qihong Fang (Wolfberry and Hawthorn Decoction) on heart in aged rats with cold-congealing and blood-stasis pattern.Methods SD rats (n =48) were divided randomly into normal control group,model group,vitamin E group (13.5 mg/kg),low-dose Qihong Fang group (45 mg/kg),mid-dose Qihong Fang group (90 mg/kg) and high-dose Qihong Fang group (180 mg/kg).The aged rat model of cold-congealing and blood-stasis pattern was established through 28-d ozone leading to aging and 14-d ice water leading to cold-congealing and blood-stasis pattern in other 5 groups except of control group.On the 29th d,the blood samples were collected from abdominal aorta for isolating serum and plasma,and heart was separated too.The vitalities of serum total superoxide dismutase (T-SOD),Cu-Zn SOD,Mn-SOD,catalase (CAT),glutathione peroxidease (GSH-PX),content of malondialdehyde (MDA),and prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT) and fibrinogen (FIB) were detected.The morphologic changes of heart cells were observed after HE staining,fiber deposition quantity was observed after Masson staining,expression of transforming growth factor β1 (TGF-β1) was detected by using immunohistochemistry technique for reviewing aging model of cold-congealing and blood-stasis pattern,and protective effect of Qihong Fang on heart was observed in rats.Results Compared with normal control group,the vitalities of T-SOD,Cu-Zn-SOD,Mn-SOD,CAT and GSH-PX decreased significantly (P ＜ 0.05),MDA content increased significantly (P＜ 0.05,PT and APTT decreased significantly (P ＜ 0.05),and FIB content increased significantly (P ＜0.05) in model group.After Masson staining,morphometry observation by light microscope showed deposition of heart collagen fibers increased significantly (P ＜ 0.05),and expression of TGF-β1 increased significantly (P ＜ 0.05).Compared with control group,the vitalities of T-SOD,Cu-Zn-SOD,CAT and GSH-PX increased significantly (P ＜ 0.05),MDA content decreased significantly (P ＜ 0.05),PT and ATPP increased significantly (P ＜ 0.05),FIB content decreased significantly (P ＜ 0.05),deposition of heart collagen fibers decreased significantly (P ＜0.05),and expression of TGF-β1 decreased significantly (P ＜ 0.05) in mid-dose and high-dose Qihong Fang groups.Conclusion Qihong Fang has a protective effect on heart in aged rats with cold-congealing and blood-stasis pattern.