Objective To investigate the prevalence of aspirin resistance(AR)in the patients with metabolic syndrome and the clinical characteristics.Methods A total of 221 patients with metabolic syndrome received 200 mg of aspirin daily for 10 days and no other antiplatelet agent.The blood samples were analyzed by platelet aggregation test(pAgT)using arachidonic acid(AA).We identified aspirin resistance when arachidonic acid induced aggregation≥20%.Results 17.6%of the patients showed AR.The AR fibrinogen level was significantly higher than AS patients(2.6?0.4 vs 2.4?0.4,P=0.017).Patients who were AR had no statistically significant difference in blood pressure,age,fasting blood glucose,blood fat and BMI compared with aspirin-sensitive patients(AS).There was also no difference in sex,smoking and history of myocardial infarction or ischemic stroke between AR and AS patients.When stratified by sex,we found history of myocardial infarction was predictor for AR in male(50.0% vs 14.5%,P=0.020)and so was diastolic blood pressure higher than 85mmHg in female(34.0% vs 15.5%,P=0.043).Conclusion The AR accounts for 17.6%(39/221)of all.In this research.AR patients have higher level of fibrinogen than AS.History of myocardial infarction and higher level of diastolic blood pressure may be the predictor for AR in male and female individually.

0.05). Conclusion: ?-adrenergic activation inhibits TNF-? (but not IL-6) production induced by LPS in monocytes. The inhibitory effects were not different between early staged hypertensive patients and healthy subjects.

Objective To study the application of 64-slice spiral CT coronary artery angiography in children.Methods 21 pediatric patients were undergone 64-slice spiral CT coronary artery angiography.6 of 21 patients underwent selective coronary artery angiography.All patients underwent echocadiogram.Results 12 patients were showed having abnormal coronary artery,including double openings at right coronary artery in 3,RCA an LCX origin together from right aortic sinus in 2,LAD and right coronary artery trunk origin together from right aortic sinus in 2 and LAD and LCX origin directively from left aortic sinus respectively in 2,left coronary artery trunk origin from pulmonary artery trunk in 1 case,normal origin of coronary artery but their branches to be tortuous and expansive in 1 case,left coronary artery trunk closed up and right coronary artery to be tortuous in 1 case.Coronary artery simple or multiple tumor-like dilation in 6 cases with Kawasaki disease,3 patients with normal CT coronary artery angiography.In comparing with DSA,the accuracy of 64-SCT in diagnosis pediatric coronary artery disease was 100%.Conclusion As a minimally invasive examination,64-SCT coronary angiography is a valuable method to detect and diagnose the pediatric coronary artery diseases.

Objective Aspirin has been used extensively in primary and secondary prevention of cardiovascular disease,particularly for subjects at high risk such as metabolic syndrome.However,the responsiveness to aspirin treatment may vary among individuals.The present study was conducted to investigate the profile and prevalence of aspirin resistance in patients with metabolic syndrome.Methods In 221 consecutive patients,platelet aggregation induced by arachidonic acid (0.5mg/ml) was assessed after 10 days of aspirin treatment (200mg/d).Aspirin resistance was defined as mean optical platelet aggregation =20%.Results Aspirin resistance occurred in 39 patients (17.6%).Serum fibrinogen level was higher in patients with than in those without aspirin resistance (2.6_+0.4g/l vs 2.4±0.4g/L,P=0.017).The 2 groups,aspirin resistance group and no aspirin resistance group,did not differ significantly,with regard to gender,age,body mass index,waist-hip ratio,blood pressure level,serum cholesterol level and history of myocardial or cerebral infarction.Multivariate logistic regression analysis revealed that only serum fibrinogen level entered the model (odds ratio 2.973,p=0.023).Subgroup analysis further showed that aspirin resistance occurred more in male patients with myocardial infarction (50% vs14.5%,P=0.02) and in female patients with diastolic blood pressure=85mmHg (34% vs 15.5%,P=0.043).But after multifactor logistic regression,in women blood pressure=85mmHg was not a predictor any more.Conclusions In patients with metabolic syndrome,aspirin resistance is not uncommon,especially for men with history of myocardial infarction.Patients with aspirin resistance have an increased serum fibrinogen level.(J Geriatr Cardio12008;5:7-10)

ObjectiveTo analyze and evaluate the responsiveness and feasibility of the quality of life instrument for patients with systemic lupus erythematos(SLE).Methods143 cases of SLE patients were measured by QLICD-SLE before and after treatment and the data were analyzed with the traditional hypothesis test and combining the effect size,standardized response mean,the relative efficiency,the standard effect size and the feasibility analysis methods.Results(1)Paired t test before and after treatment indicated that there were significant differences between after treatment and before treatment in physical(t=2.39,P<0.05) and specific module domain(t=2.22,P<0.05),while there were no significant promotion in the scores of psychological function,social function and total score after treatment.There were no significant changes of SES,SRM and CR after treatment.(2)Most patients could understand the meaning of the instrument well and spent 15-20 minutes to finish it.The rate of recovery and completed were 98.0% and 97.8% respectively.ConclusionsThe QLICD-SLE can detect clinical change of treatment with good responsiveness and feasibility.

Objective To assess the differences in carotid artery stiffness properties and endothelium-independent dilation (EID)between elderly and young patients,and evaluate the echotracking (ET)system for vascular stiffness at different ages.Methods A total of 79 outpatients with multiple cardiovascular risks were recruited.Clinical data including medical history,height,weight,blood pressure,fasting blood glucose and blood lipid were collected.We evaluated the arterial stiffness parameters of carotid artery and EID using an ultrasonic ET system in 46 elderly subjects,compared with 33 sex-matched non-elderly subjects.The impaired EID function was defined as brachial artery nitroglycerin mediated dilation (NMD)below 4％.Results All stiffness parameters including pressure-strain elasticity modulus stiffness index β (Ep),pulse wave velocity β (PWVβ)and augmentation index (AI)were significantly increased in elderly group compared with the non-elderly group [(138.9±64.7)kPa vs.(100.6±30.8)kPa,(10.9±4.7)vs.(8.2±2.3),and (6.9±1.4)m/s vs.(6.1±0.9)m/s,P＜0.05 respectively],while the exception of arterial compliance (AC)was reduced (0.9±0.3)mm2/kPa vs.(1.0±0.5)mm2/kPa(P＜0.05).The incidence of impaired EID in elderly group was higher than in non-elderly group [56.5％ (26 cases) vs.33.3％ (11 cases),P＜0.05].ET parameters including Ep,stiffness index β,PWVβ,AC and AI were related to age (r=-0.44,-0.45,-0.40,-0.40,0.34,all P＜0.01)； Ep,stiffness index β,PWVβ and AC were also related to impaired EDI (r=-0.38,-0.40,-0.34,-0.29,all P＜0.01).Conclusions Arterial stiffness properties and EID measured by ET system was more serious in elderly with multiple cardiovascular risks than in non-elderly subjects.As a convenient and accurate assessment of stiffness parameters,ET system is optimal option for measuring arterial stiffness and EID in elderly people.

Objective:To investigate the effects of a deep deltoid ligament injury on postoperative ankle function and pain in patients with pronation-external rotation ankle fractures.Methods:Thirty patients with pronation-external rotation ankle fractures without deep deltoid ligament injury admitted to Weihai Municipal Hospital from March 2019 to March 2020 were included in the control group. Thirty patients with pronation-external rotation ankle fractures with deep deltoid ligament injury admitted to the same hospital from April 2020 to June 2021 were included in the observation group. Both groups received reduction and internal fixation of pronation-external rotation ankle fractures. American Orthopaedic Foot and Ankle Society score, pain, and quality of life were compared between the two groups.Results:At 1 and 3 months after surgery, American Orthopaedic Foot and Ankle Society scores in the observation group were (69.87 ± 2.89) points and (75.66 ± 4.27) points, which were significantly lower than (81.45 ± 4.78) points, and (93.62 ± 3.54) points in the control group ( t = 11.35, 17.37, both P < 0.01). At 1 and 3 months after surgery, Visual Analogue Scale (VAS) scores in the observation group were (7.16 ± 1.15) points and (5.84 ± 0.52) points, respectively, which were significantly higher than (6.42 ± 0.54) points and (4.28 ± 0.16) points in the control group ( t = 3.19, 15.70, both P < 0.05). At 3 months after surgery, the scores of physical health, mental health, social relationship, and surrounding environment in the observation group were (19.18 ± 1.96) points, (18.67 ± 1.82) points, (17.42 ± 2.54) points, (19.65 ± 2.43) points, respectively, which were significantly lower than (21.65 ± 3.58) points, (23.57 ± 3.56) points, (20.09 ± 3.95) points, (22.38 ± 3.67) points in the control group ( t = 3.31, 6.71, 3.11, 3.39, all P < 0.05). Conclusion:Deep deltoid ligament injury affects the recovery of pronation-external rotation ankle fracture and affects the quality of life. Therefore, it is necessary to repair deep deltoid ligament injury in time in patients with pronation-external rotation ankle fractures.

With the traffic accident, sudden disaster and safety accidents occur year after year, the injured patients often complicated with multiple injuries, how to maximize the treatment of the injury to improve the survival rate, is an important problem faced by orthopedic surgeons.In recent years, damage control orthopaedics (DCO) technology has been gradually developed, DCO aims to control the patients' primary injury, to prevent further deterioration of the disease, compared with the traditional treatment, it can effectively reduce the second strike and complications, is conducive to the recovery of patients.In this paper, the development of DCO concept, the theoretical basis of DCO, the adaptation of DCO, the implementation steps of DCO and the best time, the application of DCO in the treatment of severe multiple injuries and the prospect of DCO application are reviewed.

Objective To assess the difference in left atrial properties between elderly and younger control subjects and the role of left atrium remodeling in patients of different ages with atrial fibrillation.Methods A total of 194 patients with non-valvular atrial fibrillation were enrolled from September 2014 to June 2016.Based on age,patients were divided into an elderly group (≥60 years,n=129) and a younger group (＜60 years,n=65).We evaluated remodeling parameters for the left atrium using an Ultrasound Cardiography (UCG) system in 125 elder subjects,together with 64 control subjects.All remodeling parameters were recorded,including left atrial diameter (LAD),left atrial square (LAS),left atrial pressure (LAP) and left ventricular end-diastolic dimension (LVEDD).Results The elderly group had more female patients and more patients with persistent atrial fibrillation.Meanwhile,scores of CHA2DS2Vsc and levels of N-terminal pro-brain natriuretic peptide (NT-ProBNP) were significantly increased in elderly patients (both P＜0.05).Moreover,the elderly group was associated with increased values of LAD and LAS[(39.1±4.4)mm vs.(37.1±5.3)mm,P＜0.01;and(23.3±4.5)cm2 vs.(21.4±4.8)cm2,P＜0.01;respectively],compared with those in the control group.Spearman's correlation analysis showed that LAD,LAS and LAP were all markedly related to age (r=0.213,P＜0.05;r=-0.175,P＜0.05;r=0.170,P＜0.05;respectively),persistent onset of atrial fibrillation (r=0.401,P＜0.05;r=0.446,P＜0.05;r=0.160,P＜0.05;respectively),and impaired heart function,measured by left ventricular ejection fraction (r=-0.4371,P＜0.05;r=-0.403,P＜0.05;r=-0.364,P＜0.05;respectively) and NT-ProBNP (r=0.485,P＜0.01;r=0.483,P＜ 0.01;r =0.293,P＜ 0.01;respectively).Conclusions Left atrial remodeling properties measured by the UCG system in the elderly with non-valvular atrial fibrillation are more serious than those in mid-aged and young subjects.As a convenient and accurate assessment of remodeling parameters,the UCG system is an excellent option for measuring left atrial remodeling in the elderly population.

3-hydroxybutyrate(3HB),an anionic small molecule acid metabolite with a hydroxyl group,is a chiral molecule that exists in two enantiomeric forms.It is associated with cell growth,proliferation,and anti-oxida-tive stress,and demonstrates good biosafety when used within a specific range.In addition to epilepsy treatment,with the popularity of ketogenic diet in recent years,exogenous supplementation of 3HB for human has been gradu-ally found to be associated with a variety of metabolic diseases.This review describes the physiological function,physicochemical characteristics,toxicology and biological safety of 3HB,and its applications as potential drug mol-ecules in epilepsy,weight-loss(or weight control),systemic inflammation,hemorrhagic shock,cancer,inflammatory bowel disease,atherosclerosis,diabetes,osteoporosis,neurological diseases(e.g.,Parkinson's disease,Alzheimer's disease and Huntington's disease),muscular dystrophy,COVID-19,anti-aging and many other medical fields.This review also focuses on the discussion and prospect of the new methods and the potential limitations of exogenous 3HB supplementation for clinical transformation.