ABSTRACT
Objective:To compare the effects of different doses of ticagrelor on microcirculation, inflammatory factors and cardiac function in older adult patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:A total of 250 older adult patients with coronary heart disease who received PCI in The First People's Hospital of Wenling, China between March 2019 and March 2020 were included in this study. They were randomly assigned into group A and group B, with 125 patients per group. The group A was subjected to staged exercise and oral ticagrelor (45 mg once, twice a day). The group B was given staged exercise and oral ticagrelor (90 mg once, twice a day). Platelet function (maximum platelet aggregation rate, P2Y12 reaction unit), microcirculation (the index of microcirculatory resistance, circulatory flow reserve), inflammatory factor levels (high-sensitivity C-reactive protein, tumor necrosis factor alpha, interleukin-6), cardiac function recovery (left ventricular ejection fraction, 6-minute walk test, maximal oxygen consumption), cardiovascular adverse events, and bleeding events were compared between the two groups.Results:After treatment, maximum platelet aggregation rate and P2Y12 reaction unit in group B were (28.79 ± 3.52)% and (132.36 ± 12.16) U, respectively, which were significantly lower than those in group A [(33.45 ± 4.60)%, (146.79 ± 13.52) U, t = 8.99, 8.87, both P < 0.001]. After treatment, the index of microcirculatory resistance in group B was significantly lower than that in group A [(26.43 ± 4.51) vs. (29.68 ± 5.14), t = 5.31, P < 0.001]. Circulatory flow reserve in group B was significantly higher than that in group A [(2.16 ± 0.62) vs. (1.61 ± 0.50), t = 7.72, P < 0.001]. After treatment, tumor necrosis factor alpha, interleukin-6 and high-sensitivity C-reactive protein in group B were (39.54 ± 6.74) ng/L, (19.68 ± 4.06) ng/L, (5.98 ± 1.35) mg/L, respectively, which were significantly higher than those in group A [(28.26 ± 6.15) ng/L, (15.33 ± 3.87) ng/L, (4.83 ± 1.28) mg/L, t = 13.82, 8.67, 6.91, all P < 0.001]. After treatment, left ventricular ejection fraction, 6-minute walk test, maximal oxygen consumption in group B were (37.39 ± 5.10)%, (443.28 ± 29.64) m, (19.69 ± 3.57) L/min, respectively, which were significantly higher than those in group A [(34.64 ± 4.86)%, (410.45 ± 25.76) m, (17.33 ± 3.27) L/min, t = 4.36, 9.34, 5.45, all P < 0.001]. There was no significant difference in total incidence of cardiovascular events between the two groups (χ 2 = 0.05, P > 0.05). The incidence of bleeding events in group A was significantly lower than that in group B (4.80% vs. 13.60%, χ 2 = 5.79, P < 0.05). Conclusion:Compared with ticagrelor 90 mg/d, ticagrelor 180 mg/d can more greatly improve platelet function and microcirculation, reduce inflammatory reaction, promote the recovery of cardiac function, and reduce bleeding events in older adult patients with coronary heart disease after percutaneous coronary intervention.
ABSTRACT
Objective To investigate the effect of abdominal paracentesis drainage (APD) on pancreatic cell apoptosis in severe acute pancreatitis. Methods Male adult SD rats were randomized into the sham operation (SO) group, SAP group, and APD group, with 18 rats in each group. In the SAP group, 5% sodium sulfonate was pumped into the retrograde pancreatic bile duct to prepare the SAP model. On this basis, a gastric tube was introduced into the right lower abdomen for drainage, namely the APD group. Blood from the abdominal aorta and pancreatic tissues were collected at 6, 12, and 24 h time points in each group. The changes of serum amylase, inflammatory factor, and endotoxin were detected by ELISA. The HE staining was used to evaluate the pancreatic tissue injury. The apoptosis of pancreatic tissue was detected by TUNEL. Western blot and immunohistochemistry were used to detect the expression of apoptosis-related proteins and PI3K/AKT signaling pathway. Results Pancreatic tissue necrosis and edema were significantly lower in the APD group than in the SAP group, and the pathological score was decreased (P<0.05). Serum amylase, TNF-α, IL-1β, IL-6, and endotoxin levels in the APD group were significantly lower than those in the SAP group (P<0.05). The number of pancreatic cell apoptosis in the APD group was significantly higher than that in the SAP group (P<0.05), and the expression levels of pancreatic apoptotic proteins cleaved-caspase-3 and Bax were significantly increased in the APD group, while the expression levels of anti-apoptotic protein Bcl-2 were significantly decreased (P<0.05). Compared with the SAP group, the expression levels of PI3K/AKT signaling pathway key molecules p-PI3K, p-AKT, and NF-kB p65 were significantly decreased in the APD group (P<0.05). Conclusions Our data indicate that APD attenuates the severity of SAP by enhancing cell apoptosis via suppressing PI3K/AKT signaling pathway. This study provides a new theoretical basis for the treatment of severe acute pancreatitis with APD technology.
ABSTRACT
To compare the polysaccharides( LBLP),total flavonoids( LBLTF) and total phenols( LBLTP) of Lycium barbarum leaves from 14 production areas from Ningxia,Qinghai and Gansu at different harvesting time. Our results showed that there were significant difference of LBLP,LBLTF and LBLTP among different production areas. The LBLP collected from Xiangride township production area,Dulan,Qinghai was as high as 15. 02%. The LBLTF collected from Dagele township production area,Geermu,Qinghai was as high as28. 63%. The LBLTP collected from Keluke township production area,Delingha,Qinghai was as high as 16. 7%. There were also significant difference of these 3 components between different harvest periods. The average LBLP in May( 10. 20%) was significantly higher than that in June( 8. 49%). However,the average LBLTF( 17. 71%) and LBLTP( 12. 77%) in June was significantly higher than that in May( 14. 15%,11. 19%). The LBLTF and LBLTP have a positive correlation with the altitude of production areas,but there was no significant association between LBLP and altitude. The LBLP,LBLTF and LBLTP in different production areas and harvesting time was significant difference,the results provide some references for furthermore development and utilization of L. barbarum leaves.
Subject(s)
Analysis of Variance , China , Flavonoids , Geography , Lycium , Chemistry , Phenols , Plant Leaves , Chemistry , Polysaccharides , SeasonsABSTRACT
Objective@#To evaluate the preliminary clinical outcome of socket shield technique in maxillary anterior region.@*Methods@#Nine patients were treated with socket shield technique in Peking University School and Hospital of Stomatology from February 2012 to December 2015 were enrolled in this study. Ten implants were placed and restored immediately. After 12-48 months' follow-up (averaged 32 months), the peri-implant hard and soft tissue were clinically evaluated.@*Results@#No implants were lost during the observation period, resulting a cumulate 32-month survival. The pink esthetic score (PES) was 13.5. Mesial and distal bone loss were 0.17 mm and 0.22 mm respectively.@*Conclusions@#To achieve good esthetic results, socket shield technique may be an option for maxillary anterior region immediate implant placement.
ABSTRACT
OBJECTIVE:To investigate the utilization and trend of endocrine therapeutic drugs after breast cancer surgery,and to provide reference for rational drug use in clinic. METHODS:In retrospective study,the data of endocrine therapeutic drugs use in outpatients after breast cancer in a Third Grade Class A Hospital during 2014-2016 was calculated,sorted and analyzed statistically. RESULTS:The age of outpatients receiving endocrine therapy after breast cancer ranged from ＞40 to 60. Among endocrine therapeutic drugs used within 3 years,3 kinds of them were aromatase inhibitor(AI),3 kinds were anti-estrogen and 2 kinds were gonadotropin releasing hormone(GnRH)analogues. The amount of Toremifene citrate tablets(imported)in prescription was much more than the others. The proportion of anti-estrogen drugs alone in prescription was the highest(81.11%). The AI and GnRH analogues were mostly used in drug combination prescription,and commonly combined with anti-osteoporosis drugs. The comsuption sum of endocrine therapeutic drugs was increased year by year,increasing by 52.48% in 2015,40.60% in 2016. The consumption sum of AI ranked the highest proportion among three categories of endocrine drugs(44.71%,48.62%,48.62%,each year respectively). The consumption sum of imported drugs was significantly higher than that of domestic drugs. The consumption sum of Toremifene citrate tablets(imported)increased continuously in 3 years,and took the first place in 2016. The consumption sum of Leuprorelin acetate microspheres for injection(imported)had the largest growth rate when applied to the clinic. Top types in the list of DDC were all imported types;Fulvestrant injection(imported)ranked top 1,and Tamoxifen citrate tablet(domestic) was the bottom of the list. DDDs of endocrine therapeutic drugs also increased year by year,among which Toremifene citrate tablets,Tamoxifen citrate tablets,Anastrozole tablets and Letrozol tablets ranked top 4 places during the 3 years,while Tamoxifen citrate tablets DDDs decreased year by year. B/A values of these drugs were between 0.25 and 9.00. B/A values of domestic varieties were basically more than or equal to 1,of which Tamoxifen citrate tablets was the largest;B/A values of the imported varieties were basically less than or equal to 1. CONCLUSIONS:The consumption sum of endocrine therapeutic drugs after breast cancer surgery increased year by year in 3 years,and DDDs is also increasing year by year. The imported drugs took up the dominant place. Toromiphene citrate tablets had replaced Tamoxifen citrate tablets as the first choice of endocrine therapeutic drugs in the hospital. The frequency of AI and GnRH analogues use had also increased. And the combination of 2 kinds of endocrine therapeutic drugs and endocrine therapeutic drugs combined with anti-osteoporosis drug had become a trend of clinical treatment. The choice of therapeutic drugs should take into account of effectiveness,safety,economics,cost and therapeutic efficacy,so as to guarantee the greatest benefit of the patient.