Objective: To analyze the current status of anticoagulant therapy for in-hospital patients with acute coronary syndromes (ACS) at county hospitals of China and to explore the relationship between anticoagulant therapy and clinical outcomes in real medical environment. Methods: 99 county hospitals from15 provinces of China were selected for this prospective registry study and 12373 eligible ACS patients without interventional therapy admitted from 2011-09 to 2014-06 were enrolled. The basic condition, previous history, initial assessment, anticoagulants (unfractionated heparin/low molecular weight heparin) application, severe bleeding events and in-hospital mortality were collected in all patients. Multiple logistic regression analysis was conducted to explore the relationship between anticoagulant therapy and clinical outcomes including in-hospital mortality, severe bleeding events and combined endpoints; meanwhile, possible confounders were adjusted. Results: A total of 9985/12373 ACS patients received anticoagulant therapy and 2388 did not. Anticoagulant therapy was conducted in 92.7% (4237/4570) patients with ST-segment elevation myocardial infarction (STEMI), 90.8% (1639/1805) with non-ST-segment elevation myocardial infarction (NSTEMI) and 68.5% (4109/5998) with unstable angina (UA); there were differences by regions and genders,P<0.01and no difference by age. Multivariable analysis indicated that anticoagulant therapy decreased the risk of in-hospital mortality in ACS patients at 53% (OR= 0.47, 95% CI 0.36-0.62), such reduction in STEMI patients was at 55% (OR=0.45, 95% CI 0.32-0.64), in NSTEMI patients was at 58% (OR=0.42, 95% CI 0.24-0.75); while it had no real effect in UA patients,P>0.05. Meanwhile, it did not increase the risk of severe bleeding events in ACS patients,P>0.05. Conclusion: Anticoagulant therapy has been widely used in STEMI and NSTEMI patients at county hospitals of China and obviously decreased the in-hospital mortality; while the application rate was relatively low in UA patients. The general safety of anticoagulant therapy has been good in ACS patients.

Objective To investigate the effect of Erhuang decoction on TGF-β1 expression of lung tiusses and the concentrations of IL-33 in asthmatic rats. Methods Fifty Sprague-Dawley rats were randomly divided into five groups equally:Control group, Asthmatic group, Budesonide aerosol group, High-dose Erhuang decoction group ( 68 g/kg)and Low-dose Erhuang decoction group(17 g/kg). The model of asthma was established by ovalbumin (OVA) sensitizing and challeng-ing. Then Erhuang decoction and budesonide aerosol was used respectively for intervention therapy. Histologic HE staining were used to observe the general pathologic alteration and to analyze the total bronchial wall area (Wat) and the muscle wall area(Wam). The protein expressions of TGF-β1 in the lung tissues were detected by immunohistochemistry. The concentra-tions serum IL-33 and BALF were tested by sandwich ELISA. Results There was significant reduction in the infiltrated inflammatory cells in all drug intervention groups compared with asthma group;The Wat and Wam in asthmatic group was significantly higher in than those in Budesonide aerosol group,High-dose Erhuang decoction group and Low-dose Erhuang decoction group ( Watμm2/μm:54.99±8.82, 52.28±7.61, 58.53±7.63 vs 79.50±5.64, P＜0.05;Wamμm2/μm:22.74±2.73, 20.63±1.72, 21.20±4.50 vs 30.16±1.68, P＜0.05);Compared with control group, BALF and serum IL-33 concentration were significantly higher in asthmatic group. Compared with asthmatic group, all the indicators were significantly decrease in the treatment groups after drug intervention (P＜0.05). Andthere was no significant difference between the treatment groups in all the indicators. TGF-β1 expression in lung tissues in asthmatic group were significantly higher than that in control group (12.60 ± 2.25 vs 1.67 ± 0.17). Compared with asthmatic group, there was significantly reduction of TGF-β1 expression in the Budesonide aerosol group (5.51±2.48), High-dose Erhuang decoction group (5.22±2.52) and Low-dose Erhuang decoction group (6.92 ±2.18) (P＜0.05). There were no significant difference between the treatment groups. TGF-β1 expression and se-rum IL-33 concentration in asthmatic rats were positively correlated with Wat and Wam. Conclusion The effects of Er-huang decotion on ameliorating the progression of airway remodeling about asthmatic rats may be partially by regulating TGF-β1 and IL-33.

Three hundred and ninety five patients with bronchial asthma were randomly divided into 4 groups:patients in group A received inhaled beclomethasone dipropionate(BDP)100μg and Zhichuan decoction;patients in group B were given inhaled BDP 200μg;patients in group C took Zhichuan decoction only;patients in group D were given inhaled BDP 100 μg.Methacholine airway reactivity,pulmonary ventilation function,serum acidophilia cationic protein and symptom score were determined before and after treatment.All above indicators were significantly improved in groups A and B,which suggests that Zhichuan decoction could reduce hormone dosage in control of airway chronic inflammation,reduction of airway reactivity and improvement of pulmonary ventilation function of patients with bronchial asthma.