Objective To analyze the dTP value in the patients with coronary heart disease (CHD) complicating diabetes mellitus (DM) and its relationship with major adverse cardiovascular events (MACE) and rehospitalization.Methods Two hundreds and seventy CHD patients were selected as the research subjects,including 136 cases of non-MD and 134 cases of DM.Their clinical condition was recorded.The indicators such as height,body mass,blood pressure and heart rate were measured.ECG,echocardiography,coronary angiography and other examiantions were carried out.The various indicators were detected.11-dh-TXB2 and 6-k-PGF1a levels were detected in the two groups and then dTP value was calculated.The 1-year follow-up was performed,MACE and rehospitalization were recorded.Epdate software was used for building a database and SPSS 17.0 software was applied for conducting the statistical analysis.Results The dTP level in the f non-DM and DM patients were 1.8 ± 0.6 and 2.0 ± 0.7 respectively,the difference was statistically significant (P＜ 0.05).For the non-DM CHD group,hs-CRP,systolic blood pressure,diastolic pressure,lesions number and severe lesions number were correlated with dTP level(P＜0.05).For the complicating DM CHD group,hs CRP,blood glucose,CHO level,lesions number and severe lesions number were correlated with dTP level(P＜0.05).After 1-year follow-up,MACE had 33 cases (24.3％) in the non-DM group and 44 cases (32.8％) in the DM group respectively,the difference was not statistically significant (P＞0.05).The rehospitalized cases had 12 cases (8.8％) in the non-DM group and 24 cases (17.9 ％).in the DM group respectively,the difference was statistically significant (P＜ 0.05).The dTP levels of MACE occurrence and non-MACE occurrence were 2.3 ± 0.8 and 1.8 ± 0.6 respectively,the difference was statistically significant (P＜0.05).The dTP levels of rehospitalized patients and non-rehospitalized patients were 2.4 ± 1.0 and 1.9 ±-0.6 respectively,the difference was statistically significant(P＜0.05).Conclusion The dTP level in the patients with CHD complicating DM is significantly increased,suggesting that platelet is obviously activated,moreover higher dTP level increases the risk of MACE and rehospitalization.So the anti-platelet therapy should be strengthened.

Objective To analyze Clopidogrel Resistance (CR) and influencing factors of coronary heart disease (CHD) with diabetes (DM) patients and evaluatc the relationship of CR and major adverse cardiovascular events (MACE) and readmission of CHD with DM patients.Methods 270 CHD patients were enrolled.Clinical conditions of CR were measured by adenosine diphosphate (ADP) induced maximum platelet aggregation rate (MPAR).After 1-year follow-up,MACE events and rehospitalization were recorded.Results CR of NDM and DM patients were 45 (33.1％) and 78 cases (58.2％) respectively,and the difference was significant (P ＜ 0.001).Factors of CR of CHD DM patients included heart rate,TG level,the number of severe coronary artery disease.MACE events of CS and CR patients were 35 (23.8％) and 47 patients (38.2％) respectively,and the difference was significant (P =0.010).The readmitted patients of CS and CR groups were 15 cases (10.2％) and 27 patients (22.0％) respectively,and the differcnce was significant (P =0.008).The MACE of CR and CS patients in DM group were 32 (41.0％) and 12 cases (21.4％) respectively,and thc difference was significant (P ＜ 0.05).The Readmitted cases of CR and CS patients in DM group were 19 (24.4％) and 5 (8.9％) respectively,and the diffcrcnce was significant (P ＜ 0.05).Conclusions CR of CHD DM patients increased significantly.The influencing factors of CR of CHDDM are including heart rate,TG level,the number of severe coronary artery disease.MACE events and rehospitalization rate were significantly increased in CHD patients with DM AR.Therefore,it should be further strengthened the anti-platelet therapy for CHD patients with DM.

Objective:To explore the feasibility and clinical efficacy of watertight suture technique in skull base reconstruction after expanded endoscopic endonasal excision of tuberculum sellae meningioma.Methods:Fourteen patients with tuberculum sellae meningioma accepted expanded endoscopic endonasal excision of tuberculum sellae meningioma in Department of Neurosurgery, First Affiliated Hospital of Xinxiang Medical University from January 2018 to May 2022 were chosen. During reconstruction of skull base, femoral fascia was used to repair the dural defect of sellar base with watertight suture, and then the sellar base was covered with a larger layer of femoral fascia for reinforcement; no nasal septum mucosal flap was used. The clinical data and treatment efficacy of these patients were retrospectively analyzed.Results:Total resection showed by imaging was achieved in all 14 patients. During the surgery, Valsalva ventilation test confirmed that at least 12 stitches were needed to achieve watertight suture status; watertight suture status was achieved in 13 of the 14 patients, without cerebrospinal fluid (CSF) leakage; watertight suture status was not achieved in one patient due to tumor invasion of the sella floor dura and having an extensive excision, and CSF leakage appeared transiently after surgery but disappeared 2 weeks after surgery (bed rest). Among the 11 patients with visual damage and optic field defect, 9 patients improved obviously and 2 patients did not improve. Follow-up was performed for 5-53 months, with an average of (26.8±8.4) months; no tumor recurrence or CSF leakage were found in these patients; up to the last follow-up, the 2 patients with visual damage and optic field defect did not improve.Conclusion:Skull base reconstruction using watertight suture technique after expanded endoscopic endonasal excision of tuberculum sellae meningioma is reliable.

Objective:To explore the feasibility and clinical efficacy of resection of jugular foramen schwannomas via anterolateral approach. Methods:A retrospective analysis was conducted on clinical data of 15 patients with jugular foramen schwannomas admitted to Department of Neurosurgery, First Affiliated Hospital of Xinxiang Medical College from January 2018 to July 2022. Three patients had Samii type B, 7 had type C and 5 had type D. Resection of the schwannomas was performed via anterolateral approach. After surgery, regular follow-up was performed through outpatient review, telephone, or WeChat to evaluate tumor progression and neurological functions. Results:Adequate surgical exposure was obtained in all 15 patients. Total resection was obtained in 14 patients and subtotal resection in 1 patient. Posterior cranial nerve palsy was worsened in 1 patient and new-onset facial paralysis (House-Brackmann grading Ⅲ) was noted in 1 patient, without cerebrospinal fluid leakage, subcutaneous effusion or death. Choking and cough during drinking water, and dysphagia disappeared or relieved 3 months after surgery in patients with aggravated posterior cranial nerve palsy, but no significant recovery from hoarseness was noted 6 months after surgery. A patient with new-onset facial paralysis improved to House-Brackmann grading I 3 months after surgery. Up to the last follow-up, no tumor recurrence was observed in 15 patients.Conclusion:Resection via anterolateral approach is effective in jugular foramen schwannomas for its adequate surgical exposure, high total resection rate, and low postoperative complications.