Effects of Yizhi Tiaoshen acupuncture on learning and memory function and the expression of phosphorylated tau protein in the hippocampus of Alzheimer's disease model rats / 中国针灸

OBJECTIVE@#To observe the effects of Yizhi Tiaoshen (benefiting mental health and regulating the spirit) acupuncture on learning and memory function, and the expression of phosphorylated tubulin-associated unit (tau) protein in the hippocampus of Alzheimer's disease (AD) model rats, and explore the effect mechanism of this therapy on AD.@*METHODS@#A blank group and a sham-operation group were randomly selected from 60 male SD rats, 10 rats in each one. AD models were established in the rest 40 rats by the intraperitoneal injection of D-galactose and okadaic acid in the CA1 region of the bilateral hippocampus. Thirty successfully-replicated model rats were randomly divided into a model group, a western medication group and an acupuncture group, 10 rats in each one. In the acupuncture group, acupuncture was applied to "Baihui" (GV 20), "Sishencong" (EX-HN 1), "Neiguan" (PC 6), "Shenmen" (HT 7), "Xuanzhong" (GB 39) and "Sanyinjiao" (SP 6); and the needles were retained for 10 min. Acupuncture was given once daily. One course of treatment was composed of 6 days, with the interval of 1 day; the completion of treatment included 4 courses. In the western medication group, donepezil hydrochloride solution (0.45 mg/kg) was administrated intragastrically, once daily; it took 7 days to accomplish one course of treatment and a completion of intervention was composed of 4 courses. Morris water maze (MWM) and novel object recognition test (NORT) were used to assess the learning and memory function of the rats. Using HE staining and Nissl staining, the morphological structure of the hippocampus was observed. With Western blot adopted, the protein expression of the tau, phosphorylated tau protein at Ser198 (p-tau Ser198), protein phosphatase 2A (PP2A) and glycogen synthase kinase-3β (GSK-3β) in the hippocampus was detected.@*RESULTS@#There were no statistical differences in all of the indexes between the sham-operation group and the blank group. Compared with the sham-operation group, in the model group, the MWM escape latency was prolonged (P<0.05), the crossing frequency and the quadrant stay time in original platform were shortened (P<0.05), and the NORT discrimination index (DI) was reduced (P<0.05); the hippocampal cell numbers were declined and the cells arranged irregularly, the hippocampal neuronal structure was abnormal and the numbers of Nissl bodies decreased; the protein expression of p-tau Ser198 and GSK-3βwas increased (P<0.05) and that of PP2A decreased (P<0.05). When compared with the model group, in the western medication group and the acupuncture group, the MWM escape latency was shortened (P<0.05), the crossing frequency and the quadrant stay time in original platform were increased (P<0.05), and DI got higher (P<0.05); the hippocampal cell numbers were elevated and the cells arranged regularly, the damage of hippocampal neuronal structure was attenuated and the numbers of Nissl bodies were increased; the protein expression of p-tau Ser198 and GSK-3β was reduced (P<0.05) and that of PP2A was increased (P<0.05). There were no statistically significant differences in the above indexes between the acupuncture group and the western medication group (P>0.05).@*CONCLUSION@#Acupuncture therapy of "benefiting mental health and regulating the spirit" could improve the learning and memory function and alleviate neuronal injure of AD model rats. The effect mechanism of this therapy may be related to the down-regulation of GSK-3β and the up-regulation of PP2A in the hippocampus, and then to inducing the inhibition of tau protein phosphorylation.

Herbal Textual Research on Gentianae Macrophyllae Radix in Famous Classical Formulas / 中国实验方剂学杂志

In this paper， through consulting relevant records in materia medica， medical and prescription books， and combining with modern literature， the name， origin， producing area， collection and processing of Gentianae Macrophyllae Radix in famous classical formulas from The Catalogue of Ancient Famous Classical Formulas （The First Batch） was systematically sorted out and textual research was carried out， in order to provide a basis for the development of the famous classical formulas containing Gentianae macrophyllae Radix. After textual research， it was found that Gentianae Macrophyllae Radix was the rectification of name in the past dynasties. In addition， there were other names such as Qinjiao， Qingua and Qinzhua. Gentiana macrophylla， G. straminea， G. dahurica and G. siphonantha were the main origin of this herb in ancient literature. Among them， G. macrophylla is the mainstream. In the Southern and Northern dynasties， G. straminea and G. macrophylla produced in northern Sichuan were recommended as the best. In the early Tang dynasty， G. macrophylla from the Liupan Mountain area at the border of Shanxi and Gansu provinces was the mainstream. During the Northern Song dynasty， G. siphonantha from Linxia and Qilian Mountain of Gansu province and G. macrophylla from eastern Shaanxi province were two new producing areas. In the Ming and Qing dynasties， the abundant base and production areas of Gentianae Macrophyllae Radix were gradually formed. In the past dynasties， harvesting was carried out in spring and autumn， and stored mainly by aeration drying or shade drying treatment. The processing methods are mainly the raw products after the net selection， cutting and drying， in addition to the frying， processing with wine and milk. G. macrophylla is recommended as the first choice for the herbal medicine involved in the famous classical formulas. Among them， wild products produced in Gansu and Shaanxi are the best， and raw products are recommended to be used. At the same time， it is suggested that G. siphonantha should be added to the subsequent edition of Chinese Pharmacopoeia as one of origins of Gentianae Macrophyllae Radix.

Discussion on moxibustion practice of the Han medical bamboo slips unearthed in Wuwei and Juyan regions of Gansu province / 中国针灸

Through collecting the relevant moxibustion records of Han medical bamboo slips unearthed in Wuwei and Juyan regions of Gansu province, the situation and characteristics of clinical practice of moxibustion were summarized. In Wuwei Han medical bamboo slips, the contraindications of moxibustion were recorded, with age and time involved. Juyan Han medical bamboo slips mainly recorded the methods of moxibustion at the acupoints located on the back of the body, with clear emphasis and requirement of acupoint selection, single acupoint moxibustion and moxibustion quantity (the numbers of moxa cone) included. These records on bamboo slips initially display the practice and development of moxibustion in Gansu and other northwestern regions of China in the Han Dynasty, providing a certain instruction for the literature research of moxibustion of the excavated Han medical bamboo slips.

Quantitative analysis of total content differentiation and driving factors of phenolic acids in Angelicae Sinensis Radix of Gansu Dao-di herbs from perspective of geographical space / 中国中药杂志

Dao-di herbs, produced in a specific region and screened through long-term clinical application, is characterized by high stable quality, good efficacy, and high popularity. With favorable climate conditions, Gansu gives birth to the Dao-di herbs Angelicae Sinensis Radix which is widely used in clinical practice, and multiple regions in Gansu, with similar ecological environment produce Angelicae Sinensis Radix. In this study, the spatial correlation and difference of phenolic acid content in Angelicae Sinensis Radix from Dao-di producing areas, emerging producing areas, and emerging planting areas in Gansu were analyzed based on ArcGIS to explore the "quality(chemical type)" characteristics of genuine Angelicae Sinensis Radix. Moreover, spatial distribution law and main driving factors of the total phenolic acid content in Angelicae Sinensis Radix in Gansu were analyzed based on geodetecctor. This study is expected to lay a basis for Dao-di research and production regionalization of Angelicae Sinensis Radix.

Quality Regionalization of Angelica sinensis in Genuine Producing Area / 中国实验方剂学杂志

Objective:To study on the quality regionalization of <italic>Angelica sinensis</italic>，in order to guide the rational cultivation of <italic>A. sinensis</italic>. Method:Through visits and field surveys，a total of 857 batches of <italic>A. sinensis</italic> were collected from different counties of Dingxi，relevant geographic information such as longitude，latitude，altitude of each sampling point were obtained by using the global positioning system（GPS），the content of 8 indexes in <italic>A. sinensis </italic>was detected by UPLC， and based on national ecological environment factor data，the suitability analysis of the quality of <italic>A. sinensis</italic> was performed by using MaxEnt，ArcGIS，SPSS. Result:The suitable areas of <italic>A. sinens </italic>were concentrated in central and southern Dingxi. In the suitable areas，the content of ferulic acid，coniferyl ferulate，senkyunolide H decreased from south to north，the content of chlorogenic acid decreased from north to south，the content of senkyunolide A，senkyunolide I decreased from east to west，the distribution regularity of butenyl phthalide was not strong，the highest-content areas were in western Min county，Qingyuan town of Qingyuan county，Shangwan Township and Huichuan town. The content of ligustilide was consistent in the suitable area，and the highest content were in the middle of Weiyuan county and the northern Tongwei county. The results showed that it had a higher index components and comprehensive quality in Min county，Zhang county，southern Weiyuan county and northern Tongwei county. Conclusion:In this study，the quality suitability areas of <italic>A. sinensis</italic> in Dingxi were graded. The chemical components and the quality suitability zoning maps were generated. The findings could provide references for the comprehensive utilization of <italic>A. sinensis</italic>，the selection and construction of high-quality <italic>A. sinensis</italic> raw material base，and the scientific guidance for the production and regional development of <italic>A. sinensis</italic> in Dingxi.

Analysis on projects of ethnomedicine and ethnopharmacology funded by National Natural Science Foundation of China from 1986-2018 / 中国中药杂志

Through summarizing the applications and funding for research related to ethnomedicine and ethnopharmacology in the department of Health Sciences of the National Natural Science Foundation of China( NSFC) from 1986 to 2018,and analyzing the categories,numbers,funds and research contents of all funded projects including Mongolian,Uygur,Tibetan,Zhuang,Miao,the study is aimed to provide certain reference for the declaration of ethnic medicine project. The results showed that the national medicine project application numbers and the amount of funding growth after 2011 have increased significantly,but the overall level of research remained to be further promoted,and the lack of suitable for the study of ethnic medicine features and ways,has yet to mainland medical universities and research institutions to give more attention and jointly promote the development of basic research in the field of ethnic medicine.

Research advances in neurobiological mechanism of acupuncture for amblyopia / 针灸推拿医学（英文版）

Amblyopia greatly affects the physical and mental development of children. Acupuncture is effective for amblyopia, though its mechanism remains unclear. This article summarized the mechanism of acupuncture treatment of amblyopia from the perspectives of morphology of neurons in visual cortex, visual electrophysiology, and molecular biology, etc. It was found that acupuncture may treat amblyopia through repairing the morphological and ultrastructural damages of neurons in visual cortex, promoting the electrical activities in visual pathway and visual cortical neurons, and modulating the synthesis and expression levels of factors involved in visual system. Nevertheless, further studies are required to unveil the mechanism of acupuncture treatment of amblyopia.

Effects of acupuncture on neuro-electrophysiological activities in hippocampal CA1 and CA3 areas of rats with post-traumatic stress disorder / 针灸推拿医学（英文版）

Objective:To observe the effects of acupuncture on the characteristics of neuro-electrophysiological activity in hippocampal CA1 and CA3 areas of rats with post-traumatic stress disorder (PTSD).Methods:Fifty Sprague-Dawley (SD) rats were randomly divided into a blank group,a model group,a grasping group,a Western medicine group and an acupuncture group,with 10 rats in each group.Except for the blank group,rats in the other 4 groups all received the combined stress modeling method.Rats in the Western medicine group were intragastrically administrated with paroxetine hydrochloride,those in the acupuncture group received acupuncture intervention,those in the grasping group received grasping fixation,and those in the model group and the blank group did not receive any interventions.After 14 d of intervention,the interspike interval (ISI) and power spectral densities (PSD) were analyzed and mapped by in vivo multiple channels to record the neuron clusters discharge in the hippocampal CA1 and CA3 areas.Results:Compared with the blank group,ISI was prolonged in the CA1 and CA3 areas of the model group and the grasping group,and the concentrated PSD distribution area moved down (P＜0.05 or P＜0.01).Compared with the grasping group,the ISI of the CA1 and CA3 areas in the Western medicine group and the acupuncture group was shortened,and the concentrated PSD distribution area moved up (P＜0.05 or P＜0.01).The ISI and PSD distributions in the CA1 and CA3 areas of the acupuncture group were not statistically different from those in the Western medicine group (both P＞0.05).Conclusion:Both acupuncture and paroxetine hydrochloride can significantly regulate the neuro-electrophysiology activity of hippocampal CA1 and CA3 areas in PTSD rats,which may be one of the mechanisms of acupuncture intervention to promote PTSD recovery.

UPLC Fingerprints and Genetic Diversity of Gentiana straminea Maximfile Qilian Mountain Areas of Gansu Province / 中国药学杂志

OBJECTIVE: To establish the UPLC fingerprints of G.straminea, and analyze its differences of indications ingredient and genetic diversity. METHODS: The main chemical composition of dry root were measured by UPLC. Similarity evaluation system for chromatographic fingerprint of TCM(Version 2004 A) was used to analyze the relative peak area of common peaks from differently populations,and cluster analysis of common peaks was carried out by SPSS19.0. Genomic DNA of dry leaves collected were extracted and amplified by ISSR markers. The genetic diversity and genetic distance were calculated by Popgen 32. RESULTS: Twelve Common peaks were selected as the fingerprint peaks from 18 populations of G.straminea,and three groups were divided according to the clustering results of chemical composition. It had the highest levels that was gentiopicroside content and total content of five kinds of chemical components in Shandan County, Zhangye City.Six primers produced 73 bands, among which 72 were polymorphic bands, the average percentage of polymorphie bands(PPB) was 98.63%; Shannon's information index() was 0.366 3;Nei's genetic diversity index(H) was 0.231 6. The genetic differentiation coefficient(Gst) and gene flow(Nm) of wild populations were 0.344 1 and 0.953 0. CONCLUSION: UPLC Fingerprint of G.straminea can be used as the quality evaluation system.The genetic diversity among species of G.straminea is at higher level, but the level of genetic diversity within populations is higher than that between populations,and genetic variance mainly existed among populations.

Comparative study on populations genetic diversity between wild and cultivated Angelica sinensis / 中草药

Objective To compare the populations genetic diversity between wild and cultivated populations of Angelica sinensis. Methods ISSR markers were used to analyze the genetic diversity of 1 038 samples, which included 48 cultivated populations and seven wild populations. Shannon’s information index (I) and other parameters of genetic information were calculated by Popgen 1.32. Using independent sample t-test in SPSS19.0 to examine whether there was significant difference. The AMOVA analysis of the genetic variation of two groups was carried out by using GenAlEx 6.5; UPGMA dendrogram relationship between wild and cultivated populations were clustered by Ntsys, and the correlation of genetic distance and geographic distance was analyzed by using the mental test in GenAlEx 6.5. Results The average percentages of polymorphie bands (PPB) of wild and cultivated populations were 83.77% and 96.10%; Shannon’s information indexes (I) were 0.221 7 and 0.282 8; The average values of Nei’s genetic diversity index (He) were 0.344 4 and 0.434 30, and there had extremely significant differences (P < 0.001). The genetic differentiation coefficient (Gst) and gene flow (Nm) of wild populations were 0.299 1 and 1.171 8, which of cultivated populations were 0.733 4 and 0.181 7. The variation percentage was 15.85% between groups of wild and cultivated. The variation percentage among populations was 54.3%, and the variation percentage within populations was 54.3%; The genetic distance varied from 0.014 4 to 0.730 7. Conclusion The genetic diversity of wild populations was lower than the cultivated populations; The level of genetic differentiation among wild populations was obviously lower than the cultivated populations; The total genetic variation of A. sinensis mainly existed among populations; It has a distant relationship between wild and cultivated populations, and has correlation between genetic distance and geographic distance.

Construction of NTCP-Huh7 cell lines and their susceptibility to HBV / 医学研究生学报

ObjectiveThe transient expression of the functional receptor sodium taurocholate cotransporting polypeptide (NTCP) leads to the inefficiency and instability of the hepatitis B virus (HBV)-associated hepatocellular carcinoma cell model. The aim of this study was to construct NTCP-Huh7 cell lines by transfecting GV358-NTCP into Huh7 cells and identify their susceptibility to HBV.MethodsThe recombinant plasmid GV358-NTCP was obtained by ligation of GV358 and NTCP, and then transfected into Huh7 cells for the construction of NTCP-Huh7 cells. The NTCP-Huh7 cells (NTCP-Huh7 group) and Huh7 cells (Huh7 group) were infected with HBV and co-incubated with HBV for 18 hours, and the co-incubation was continued after change of the culture medium. At 2, 4, 6, 8, 10, and 12 days of incubation, the supernatant and cells were collected for measurement of the contents of HBsAg, HBeAg, HBcAg and HBV DNA in the supernatant and HBV cccDNA in the cells as well as for determination of HBV susceptibility of the NTCP-Huh7 recombinant cells.ResultsWestern blot showed stably expressed NTCP proteins in the NTCP-Huh7 cells. At 8 days of incubation, the levels of HBsAg and HBeAg were significantly higher in the NTCP-Huh7 group (0.866±0.040 and 0.603±0.053) than in the Huh7 group (0.237±0.063 and 0.209±0.112) (P<0.05), reaching the peak at 8 days and also remarkably higher in the former than in the latter group at 4, 6 and 10 days (P < 0.05). So were the levels of HBV DNA and HBV cccDNA in the NTCP-Huh7 than in the Huh7 group at 4, 6, 8, 10 and 12 days (P < 0.05). Immunofluorescence assay revealed the core antigen of HBV in the NTCP-Huh7 but not in Huh7 cells.ConclusionNTCP-Huh7 cells obtained by transfection of the GV358-NTCP recombinant plasmid into Huh7 cells are susceptible to HBV infection.

Clinical efficacy of compound glycyrrhizin tablets in the treatment of children with nonalcoholic fatty liver disease / 中国当代儿科杂志

Department of Pediatrics, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. zhuchuanlong@jsph.org.cn.

Ecology suitability study of Ephedra intermedia / 中国中药杂志

The study aims at predicting ecological suitability of Ephedra intermedia in China by using maximum entropy Maxent model combined with GIS, and finding the main ecological factors affecting the distribution of E. intermedia suitability in appropriate growth area. Thirty-eight collected samples of E. intermedia and E. intermedia and 116 distribution information from CVH information using ArcGIS technology were analyzed. MaxEnt model was applied to forecast the E. intermedia in our country's ecology. E. intermedia MaxEnt ROC curve model training data and testing data sets the AUC value was 0.986 and 0.958, respectively, which were greater than 0.9, tending to be 1.The calculated E. intermedia habitat suitability by the model showed a high accuracy and credibility, which indicated that MaxEnt model could well predict the potential distribution area of E. intermedia in China.

Analysis of commercial specifications and grades of wild and cultivated Gentianae Macrophyllae Radix based on multi-indicative constituents / 中国中药杂志

The study is aimed to analyze the commercial specifications and grades of wild and cultivated Gentianae Macrophllae Radix based on multi-indicative constituents. The seven kinds of main chemical components containing in Gentianae Macrophyllae Radix were determined by UPLC, and then the quality levels of chemical component of Gentianae Macrophyllae Radix were clustered and classified by modern statistical methods (canonical correspondence analysis, Fisher discriminant analysis and so on). The quality indices were selected and their correlations were analyzed. Lastly, comprehensively quantitative grade division for quality under different commodity-specifications and different grades of same commodity-specifications of wild and planting were divided. The results provide a basis for a reasonable division of specification and grade of the commodity of Gentianae Macrophyllae Radix. The range of quality evaluation of main index components (gentiopicrin, loganin acid and swertiamarin) was proposed, and the Herbal Quality Index (HQI) was introduced. The rank discriminant function was established based on the quality by Fisher discriminant analysis. According to the analysis, the quality of wild and cultivated Luobojiao, one of the commercial specification of Gentianae Macrophyllae Radix was the best, Mahuajiao, the other commercial specification, was average , Xiaoqinjiao was inferior. Among grades, the quality of first-class cultivated Luobojiao was the worst, of second class secondary, and the third class the best; The quality of the first-class of wild Luobojiao was secondary, and the second-class the best; The quality of the second-class of Mahuajiao was secondary, and the first-class was the best; the quality of first-class Xiaoqinjiao was secondary, and the second-class was the better one between the two grades, but not obvious significantly. The method provides a new idea and method for evaluation of comprehensively quantitative on the quality of Gentianae Macrophyllae Radix.

Quality regionalization study on Gentianae Macrophyllae Radix / 中国中药杂志

The 79 samples of Gentianae Macrophyllae Radix were collected based on the distributed information by document literature. Based on sample information, and using the regression model of Gentianae Macrophyllae Radix index component and environmental factors, and combined with the prediction results of ecological suitability by MaxEnt and principal component analysis results of index component, the space distribution of Gentianae Macrophyllae Radix was estimated with the spatial analysis function of ArcGIS. The results showed that it had a higher comprehensive quality in south of Shaanxi, south of Gansu, middle of Sichuan and southeast of Xizang. The study results were coinciding with the producing regions of Gentianae Macrophyllae Radix. It can provide reference for Gentianae Macrophyllae Radix resource conservation, development and utilization.

Genetic diversity analysis on Angelica sinensis from different habitats in Gansu province based on ISSR / 中草药

Objective: To investigate the genetic diversity of Angelica sinensis from different habitats in Gansu province. Methods: ISSR markers were used to analyze the genetic diversity of 41 populations of A. sinensis. Nei's genetic diversity index (H) and other parameters of genetic information were calculated by Popgene 32. UPGMA dendrogram relationship was clustered by Ntsys. Results: Eight primers produced 154 bands, among which 119 were polymorphic bands, the average percentage of polymorphie bands (PPB) was 77.27%. H and Shannon's information index (I) were 0.222 9 and 0.337 4, the genetic differentiation coefficient (Gst) and gene flow (Nm) were 0.6839 and 0.231 1 within the population levels. The genetic distance varied from 0.042 9 to 0.327 8. Conclusion: The genetic diversity among species of A. sinensis is at higher level, but the level of genetic diversity between populations is higher than that within populations. There is a great degree of genetic differentiation among populations, and gene flow does not almost exist between populations.

ISSR analysis of genetic diversity in wild populations of ephedra intermedia / 中国药学杂志

OBJECTIVE: To investigate the genetic diversity of Ephedra intermedia in different wild populations.

Genetic diversity analysis on Ephedra intermedia from Gansu based on ISSR / 中草药

Objective: To investigate the genetic diversity of Ephedra intermedia from different populations in Gansu. Methods: ISSR markers were used to analyze the genetic diversity of 11 populations of E. intermedia. Nei's genetic diversity index (H) and other parameters of genetic information were calculated by POPGEN 32. UPGMA relationship dendrogram was clustered by NTSYS. Results: Twelve primers produced 185 bands, among which 150 were polymorphic bands, and the percentage of polymorphic loci (PPL) was 85.71%. H and Shannon's information index (I) were 0.211 4 and 0.332 1, and genetic differentiation coefficient (Gst) and gene flow (Nm) were 0.259 3 and 1.428 6 within the population levels. The genetic distance varied from 0.014 4 to 0.159 8. Conclusion: The genetic diversity among the populations of E. intermedia is at higher level, but the level of genetic diversity within populations than between populations. Genetic variance of E. intermedia mainly exists among populations. The genetic distance of E. intermedia is associated with geographical distance.

Effect of acupuncture on pattern-visual evoked potential in rats with monocular visual deprivation / 中国针灸

<p><b>OBJECTIVE</b>To explore electrophysiology mechanism of acupuncture for treatment and prevention of visual deprivation effect.</p><p><b>METHODS</b>Eighteen healthy 15-day Evans rats were randomly divided into a normal group, a model group and an acupuncture group, 6 rats in each one. Deprivation amblyopia model was established by monocular eyelid suture in the model group and acupuncture group. Acupuncture was applied at "Jingming" (BL 1), "Chengqi" (ST 1), "Qiuhou" (EX-HN 7) and "Cuanzhu" (BL 2) in the acupuncture group. The bilateral acupoints were selected alternately, one side for a day, and totally 14 days were required. The effect of acupuncture on visual evoked potential in different spatial frequencies was observed.</p><p><b>METHODS</b>Under three different kinds of spatial frequencies of 2 X 2, 4 X 4 and 8 X 8, compared with normal group, there was obvious visual deprivation effect in the model group where P1 peak latency was delayed (P<0.01) while N1 -P1 amplitude value was decreased (P<0.01). Compared with model group, P1 peak latency was obviously ahead of time (P<0.01) while N1-P1 amplitude value was increased (P<0.01) in the acupuncture group, there was no statistical significance compared with normal group (P>0.05). Under spatial frequency of 4 X 4, N1-P1 amplitude value was maximum in the normal group and acupuncture group. With this spatial frequency the rat's eye had best resolving ability, indicating it could be the best spatial frequency for rat visual system.</p><p><b>CONCLUSION</b>The visual system has obvious electrophysiology plasticity in sensitive period. Acupuncture treatment could adjust visual deprivation-induced suppression and slow of visual response in order to antagonism deprivation effect.</p>

Effect of aspirin plus clopidogrel therapy on aspirin resistance after off-pump coronary artery bypass surgery / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the effect of the anti-platelet effect of aspirin plus clopidogrel on off-pump coronary artery bypass (OPCAB) grafting and the possible side effects of such therapy.</p><p><b>METHODS</b>Sixty patients who underwent standard OPCAB were randomized immediately after surgery in two groups: the aspirin alone group of 30 patients who received aspirin (100 mg) daily; and the combination group of 30 patients who received clopidogrel (75 mg) plus aspirin (100 mg) daily. Platelet aggregation in response to arachidonic acid (PLAA) and adenosine diphosphate (PLADP) were measured at baseline (before surgery) and 1-6, 8, and 10 days after the medication. Postoperative bleeding and other perioperative parameters were compared between these two groups.</p><p><b>RESULTS</b>There were no significant differences between the two groups in perioperative findings including average number of distal anastomosis, operative time, postoperative bleeding, ventilation time, and intensive care unit stay (all P>0.05). The proportion of patients with the PLAA above 20% value was significantly lower in the combination group than those in the aspirin alone group (32.1% vs 62.1%, P<0.05). PLAA of two groups one and two days after taking aspirin or plus clopidogrel were (24.2±31.9)% vs. (49.6±32.6)% and (13.8±27.2)% vs. (37.6±37.4)%, respectively (P<0.05). No obvious postoperative complication was noted in both groups. Multivariate analysis showed that clopidogrel administration was independently correlated with aspirin resistance (P=0.044, OR = 0.09;95% CI=0.07-0.48).</p><p><b>CONCLUSION</b>Early combined use of aspirin plus clopidogrel after OPCAB can remarkably reduce OPCAB-related aspirin resistance and enjoy similar safety.</p>