OBJECTIVE:To observe the clinical efficacy and safety of triple therapy of aspirin,clopidogrel and urinary kallidi-nogenase in the treatment of recurrent transient ischemic attack. METHODS:180 patients with recurrent transient ischemic attack were randomly divided into control group and observation group. Control group was orally treated with Aspirin enteric-coated tab-lets 100 mg,once a day + Clopidogrel hydrogen sulfate tablets 75 mg,once a day. Based on the treatment of control group,obser-vation group was additionally treated with Urinary kallidinogenase for injection 0.15 PNA unit adding into Sodium chloride injec-tion 100 ml by intravenous injection,once a day. The treatment course for both groups was 2 weeks. The clinic data was observed, including clinical efficacy,and LDL,HDL TC and TG levels before and after treatment,recurrence rate of cerebral ischemia,inci-dence of cerebral infarction and adverse reactions after 6 months of follow-up. RESULTS:The total effective rate in observation group was significantly higher than control group,and the recurrence rate of cerebral ischemia and incidence of cerebral infarction were significantly lower than control group(P<0.05). After treatment,HDL level in 2 groups were significantly higher than be-fore,and observation group was higher than control group;levels of LDL,TC and TG were significantly lower than before,and observation group was lower than control group(P<0.05). There were no severe adverse reactions in groups during treatment. CON-CLUSIONS:Triple therapy of aspirin,clopidogrel and urinary kallidinogenase has significant efficacy in the treatment of transient ischemic attack,with good safety.

Objective To explore the effect and related mechanism of Zuogui Jiangtang Jieyu Prescription on neuroinflammation of nucleus accumbens in rats with diabetes mellitus(DM)complicated with depression based on dopamine receptor.Methods DM,depression and DM complicated with depression models were respectively established through a combination of high-fat feeding and streptozotocin intraperitoneal injection,as well as chronic unpredictable mild stress+solitary cage feeding.The rats were divided into control group,depression group,DM group,DM complicated with depression group,positive group,D1R agonists group,D2/3R agonists group and Zuogui Jiangtang Jieyu Prescription group.Depression and learning and memory abilities in rats were assessed using open field experiments,forced swimming experiments and water maze experiments.Neuronal damage in nucleus accumbens was detected through HE and Nissl staining.Serum contents of 5-hydroxytryptamine(5-HT),dopamine(DA),interleukin(IL)-1β and IL-18 were detected by ELISA.The expressions of D1R,D2R,D3R and Iba1/NLRP3 in nucleus accumbens were detected by immunofluorescence.The protein expressions of D1R,D2R,D3R,NLRP3,ASC,Caspase-1 p20 and IL-1β in nucleus accumbens were detected by Western blot.Results Compared with the control group,the changes of fasting blood glucose(FBG)in rats of DM complicated with depression group significantly increased(P<0.01),the total distance and number of activities in the open field experiment,the time ratio of staying in the original platform quadrant and the number of times crossed the original platform in the water maze experiment significantly decreased(P<0.05,P<0.01),the forced swimming immobility time and the escape latency period in the water maze experiment were prolonged(P<0.05,P<0.01),the contents of serum 5-HT and DA significantly decreased(P<0.01),the contents of IL-1β and IL-18 significantly increased(P<0.05,P<0.01),neurons in the nucleus accumbens showed nuclear condensation,degeneration,and increased necrotic cells,with loss of Nissl bodies,the expressions of D1R,D2R and D3R were significantly decreased(P<0.01),while the expressions of NLRP3,ASC,Caspase-1 p20 and IL-1β protein significantly increased(P<0.05,P<0.01).Compared with the DM complicated with depression group,the changes of FBG significantly decreased in the Zuogui Jiangtang Jieyu Prescription group,learning and memory abilities were enhanced,depression-like behavior was improved,and the damage to neurons in the nucleus accumbens was reduced,the contents of serum 5-HT and DA significantly increased(P<0.01),the contents of IL-1β and IL-18 significantly decreased(P<0.01),the expressions of D1R,D2R and D3R in the nucleus accumbens increased(P<0.05,P<0.01),and the expressions of NLRP3,ASC,Caspase-1 p20 and IL-1β protein decreased(P<0.05,P<0.01).Conclusion The dopaminergic system dysfunction and neuroinflammation are the key mechanisms of DM complicated with depression.Zuogui Jiangtang Jieyu Prescription may improve neuroinflammation by regulating the dopamine receptor to inhibit the activation of microglial NLRP3 signaling in the nucleus accumbens.