Objective To analyze and investigate the correlation between the CYP2C19 gene polymorphism and clopidogrel cura-tive effect in the patients with coronary heart disease (CHD) to provide valuable reference information for the future clinical work. Methods A total of 128 cases of CHD undergoing PCI in our hospital from January 2015 to January 2016 were selected as the re-search subjects.All of them were treated with clopidogrel ,the loading dose was 300mg ,and the maintenance dose was 75mg.The subjects were divided into the clopidogrel resistance group and response group.The drug-metabolizing CYP2C19 genotype was com-pared between the two groups and the effect of CYP2C19 genotype on the clopidogrel response was observed.Results Among the subjects ,27 cases were clopidogrel resistance.A total of 16 cases of CYP2C19 slow metabolic gene carriers were detected.There was statistically significant difference between the patients with chronic metabolic genotype VASP-PRI with fast metabolic geno-type and intermediate metabolic genotype(P<0.05).The incidence rate of adverse end point events had statistical difference be-tween the clopidogrel resistance group and clopidogrel response group(P<0.05).Conclusion In the risk factors of clopidogrel re-sistance ,slow metabolism CYP2C19 genotype and clopidogrel resistance will increase the risk of clinical adverse endpoint events oc-currence ,clinic should give adequate attention.

Objective: MRI images were used to study the efficacy of anterior repositioning splint (ARS) in the treatment of different types of disc displacement with reduction (DDWR) in temporomandibular joint. Methods: From September 2020 to December 2021, 26 patients with DDWR were enrolled in the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Zhengzhou University. There were 5 males and 21 females with an average age of (20.8±5.8) years. ARS was used for 3-6 months. The changes of joint clicking, opening type and joint pain before and after treatment were compared. The changes of disc position, disc-condyle angle and condylar bone mass before and after treatment were compared by MRI. Paired t-test was performed on the disc-condyle angle before and after treatment, Fisher's exact test was performed on the change of disk position, and other count data were expressed as rate (%). Results: After ARS treatment, the effective rates of joint clicking,abnormal opening, joint pain and disc displacement were 97%(35/36), 14/18, 7/9 and 95%(36/38). MRI analysis found that there was a significant difference between the disc position before and after treatment (P<0.001), MRI analysis showed that the anterior disc displacement (48%, 25/52) and the anterolateral disc displacement (17%, 9/52) were the most common before treatment. In contrast, the normal superior disc (75%, 39/52) and the anterior disc displacement (17%, 9/52) were the most common after treatment, no significant changes were seen after treatment in the anteromedial disc displacement. The disc-condylar angle was (36.09±19.02) ° before ARS treatment and (3.94±10.12) ° after ARS treatment(t=9.23, P<0.001). After treatment, 46% (12/16) of the patients showed new bone formation, and the height of the condyle recovered. Conclusions: The clinical efficacy of ARS in the treatment of anterior disc displacement and anterolateral displacement of temporomandibular joint is remarkable, which can restore the disc-condylar relationship of most patients with indications.
Adolescent ; Adult ; Arthralgia ; Female ; Humans ; Joint Dislocations/therapy* ; Magnetic Resonance Imaging ; Male ; Splints ; Temporomandibular Joint ; Temporomandibular Joint Disc/diagnostic imaging* ; Young Adult