Objective To discuss the application of partial antiplatelet drug genotype detection and thromboelastography-platelet mapping(TEG-PM)in guiding the selection of antiplatelet regimens in patients with intracranial aneurysms(IAs)after receiving stenting.Methods A total of 106 patients with IAs in the First Affiliated Hospital of Kunming Medical University,who underwent implantation of stent and received the testings of platelet-endothelial aggregation receptor 1(PEAR 1)and clopidogrel-related gene-cytochrome P450 enzyme 2C19(CYP2C19),and some of whom received TEG-PM testing from January 2019 to August 2022,were collected for this study.The patients were divided into group A(gene detection group,according to the drug-related gene detection results to adjust the medication)and group B(combination group,according to the two testing results to guide the medication).The patient's gender,age,testing data were collected,and the occlusion of IAs,stent intimal hyperplasia,drug-related hemorrhagic and ischemic complications during follow-up period were recorded.Results A total of 123 IAs lesions in 106 patients were treated.The patient's mean age was(53.67±6.66)years,67 patients were female.Group A had 41 patients and group B had 65 patients.No statistically significant differences in the baseline data,IAs features,stent types used,and medication regimen existed between the two groups(all P＞0.05).In Group A,the ischemic complications and hemorrhagic complications occurred in two patients each.In Group B,no ischemic complications occurred and 4 patients developed hemorrhagic complications.The difference in the incidence of related complications between the two groups was not statistically significant(P=0.287 and P=0.782 respectively).There were no statistically significant differences in the postoperative one-month and 3-month intimal hyperplasia grade and the aneurysm occlusion rate between the two groups(all P＞0.05).The postoperative 6-month overall intimal hyperplasia grade in Group A was slightly higher than that in Group B,and the difference was statistically significant(P=0.034).Conclusion In order to improve the precision and individualized treatment of antiplatelet therapy,it is suggested that clinicians should adopt TEG-PM-guided conventional double-antibody therapy first when making selection of testing items.For patients with insufficient inhibition rate indicated by TEG-PM,testing of the genes associated with antiplatelet drugs should be used.Based on the genetic test results it is necessary to determine the reasons for the insufficient inhibition rate as well as to adjust the medication promptly according to the specific situation of the patient,so as to ensure the effectiveness of antiplatelet therapy and achieve the purpose of individualized precision therapy.

Objective To investigate the clinical efficacy of atmospheric oxygen coupled with hyperbaric oxygen (HBO) in the treatment of neurologic impairment with hemorheology in senile patients following hypertensive cerebral infarction.Methods Ninety-three senile patients with hypertensive cerebral infarction treated in our hospital were recruited as research subjects,and were divided into the observation group (48 cases) and the control group (45 cases) in accordance with different treatment methods.The observation group was treated with atmospheric oxygen couple with hyperbaric oxygen therapy,while the control group was only given HBO therapy.Then,differences in the clinical efficacy and changes in hemorheology were closely observed and compared between the 2 groups.Results Total efficacy of the observation group (97.9％) was significantly higher than that of the control group (82.2％),and statistical significance could be noted,when comparisons were made between them (P ＜ 0.05).There was no statistical significance in neurological deficit scores and Barthel scores for the 2 groups before treatment (P ＞ 0.05).However,those scores of the observation group after treatment [(7.4 ±4.1),(56.3 ± 15.2)] were significantly superior to those of the control group [(11.2 ± 5.4),(43.3 ± 10.7)],and statistical significance could be seen when comparisons were made between them(P ＜ 0.05).Following treatment,the parameters of blood pressure and changes in hemorheology of the observation group were significantly superior to those of the control group,with statistical significance (P ＜ 0.05).Conclusions In the treatment of neurologic impairment with hemorheology of senile patients,atmospheric oxygen coupled with HBO could achieve better clinical efficacy,and this treatment regimen was of positive significance for the recovery of neural function and improvement of life quality of the patients.

Objective To investigate the clinical efficacy of atmospheric oxygen coupled with hyperbaric oxygen (HBO) in the treatment of neurologic impairment with hemorheology in senile patients following hypertensive cerebral infarction.Methods Ninety-three senile patients with hypertensive cerebral infarction treated in our hospital were recruited as research subjects,and were divided into the observation group (48 cases) and the control group (45 cases) in accordance with different treatment methods.The observation group was treated with atmospheric oxygen couple with hyperbaric oxygen therapy,while the control group was only given HBO therapy.Then,differences in the clinical efficacy and changes in hemorheology were closely observed and compared between the 2 groups.Results Total efficacy of the observation group (97.9％) was significantly higher than that of the control group (82.2％),and statistical significance could be noted,when comparisons were made between them (P ＜ 0.05).There was no statistical significance in neurological deficit scores and Barthel scores for the 2 groups before treatment (P ＞ 0.05).However,those scores of the observation group after treatment [(7.4 ±4.1),(56.3 ± 15.2)] were significantly superior to those of the control group [(11.2 ± 5.4),(43.3 ± 10.7)],and statistical significance could be seen when comparisons were made between them(P ＜ 0.05).Following treatment,the parameters of blood pressure and changes in hemorheology of the observation group were significantly superior to those of the control group,with statistical significance (P ＜ 0.05).Conclusions In the treatment of neurologic impairment with hemorheology of senile patients,atmospheric oxygen coupled with HBO could achieve better clinical efficacy,and this treatment regimen was of positive significance for the recovery of neural function and improvement of life quality of the patients.

BACKGROUND: Umbilical cord blood-mesenchymal stem cells (UCB-MSCs) following differentiation into cardiomyocytes were transplanted into ischemic myocardium. The transplanted cells can build connection with host cells and repair the infarct myocardium. OBJECTIVE: To detect the cell-cell junction after transplantation of the cardiac-like cell derived from the canine umbilical cord blood stem cells. DESIGN, TIME AND SETTING: A randomized controlled animal study was performed from July 2006 to October 2007 at the Animal Experimental Center of Xinhua Hospital Affiliated to School of Medicine, Shanghai Jiao Tong University. MATERIALS: A total of 2 full-term pregnant canines were used for isolation of UCB-MSCs. A total of 36 adult mongrel canines were divided into cell transplantation group and model control group (n=18) according to the rule of random digits table. METHODS: The MSCs at passage 4 were transfected by Laz-Z. After 3-day culture, MSCs were induced by 10 μmol/L 5-azacytidine (5-aza). The canine models of myocardium infarction were established following 3 weeks of culture. 2 mL (1 ×107)MSCs were transplanted into dogs with acute myocardium infarction by coronary artery infusion and local injection in cell transplantation group. An equal volume of saline was used in the model control group. The specimens were harvested and detected at 2, 4 and 8 weeks, respectively. Cell junction was determined using immunohistochemistry. MAIN OUTCOME MEASURES: The following parameters were measured: gene trensfection, myogenic induction and differentiation results of UCB-MSCs; junction of transplanted cells and host cardiomyocytes. RESULTS: Following 72 hours of transfaction, mass of cells expressed LacZ gene, synthetized galactosidase, and stained blue using X-gal staining. Following 3 weeks of 5-aza induction, the antigen a-Actin, Desmin and Connexin43 were all been positively expressed, but before induction they were all negative. From the myocardial section of 8 weeks after transplantation, the junction was formed between the transplanted cells and the host myocardium as formed between the transplanted cells. In the junction, green-fluorescence positive expression of cadherin and connexin43 could be seen. However, in the model control group, only cadherin and connexin43 expressed positively, but the transplanted UCB-MSCs with red fluorescence could not been observed. CONCLUSION: The UCB-MSCs is able to differentiate into cardiac-like cell in vitro and form cell-cell junction in vivo to communicate with surrounding cells.