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Objective:To investigate the correlation between triglyceride-glucose (TyG) index and high on-treatment platelet reactivity (HTPR) during clopidogrel treatment in patients with ischemic stroke.Methods:Patients with ischemic stroke who received maintenance dose of clopidogrel (75 mg/d) in the Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine from January 2017 to March 2021 were retrospectively included. The highest quartile (Q4) of the TyG index was defined as insulin resistance. Platelet reactivity was assessed by thromboelastogram and clopidogrel HTPR was defined as the clot strength induced by adenosine diphosphate (MA ADP) >47 mm. Multivariate regression model was used to analyze the independent correlation between TyG index and platelet reactivity. Results:A total of 83 patients were included. The TyG index showed a linear correlation with MA ADP. The patients were divided into 4 groups according to the quartile of TyG index. The incidence of clopidogrel HTPR increased significantly with the increase of the quartile of the TyG index ( Ptrend=0.017). Multivariate analysis showed that there was a significant independent correlation between insulin resistance and clopidogrel HTPR (odds ratio 4.597, 95% confidence interval 1.285-16.446; P=0.019). Conclusions:In patients with ischemic stroke treated with clopidogrel, the incidence of clopidogrel HTPR gradually increases with the increase of the quartile of the TyG index. The insulin resistance assessed by the TyG index is independently associated with clopidogrel HTPR.
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Essential palatal tremor is relatively rare in clinical practice, which manifests involuntary and rhythmic contraction of soft-palate along with auditory click. The cause is unknown and there is no specific treatment at present. This article reports a female patient with essential palatine tremor, who presented with involuntarily beating of soft palate, disappeared during sleep, had sensory tricks, and gradually developed mental and psychological problems such as anxiety disorders. After treatment with integrated traditional Chinese and Western medicine, the symptoms improved. The clinical features of the case were analyzed, relevant literature was reviewed, and the possible etiology and characteristics of the disease were explored, so as to provide reference for clinical diagnosis and treatment.
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Objective To explore the distribution of syndromes and the characteristics of damp-induced disease in patients with multiple sclerosis in Lingnan area,and to improve the reference for TCM treatment of MS patients.Methods A retrospective analysis of the general information of 268 patients with multiple sclerosis (MS) admitted to our hospital from March 2015 to 2016 was conducted.And the information on four diagnoses of Chinese medicine,including the main manifestations,tongue pulse,frequency were for the cluster analysis.The Multivariate logistic regression analysis was used to analyze the factors influencing MS syndromes.The distribution and dynamic changes of the symptoms of the patients at the initial diagnosis,4 weeks after treatment and 8 weeks after treatment were observed,and the dynamic changes of the syndrome form were analyzed.Results In the course of the development of MS patients,the sigle syndrome and 6 syndromes can appear simultaneously.Among them,there were syndrome of the wind,wet,phlegm,heat and blood stasis.At the 4 and 8 weeks after treatment,2nd syndromes gradually increased,but the 3rd syndromes and 4th syndromes remain unchanged,and the 5th syndrome significantly decreased.The syndrome is complicated and changeable from the side of the development process.The results of multi factor Logistic regression analysis showed that purple tongue was an important factor of blood stasis [OR (95％ CI)=2.357(1.996-3.017)],and the yellow greasy coating was an important factor of hot dampness [OR (95％ CI)=3.654(3.125-4.876)],and the thin and weak pulse was the important factor of the deficiency of liver and kidney[OR (95％ CI)=3.983(2.349-4.218)];deficiency pulse was an important factor affecting Qi and blood deficiency syndrome[OR (95％ CI)=2.852(2.068-3.192)];limb twitching was an important factor affecting kidney yang deficiency syndrome [OR (95％ CI)=3.850(1.037-16.524)],and the above data were statistically significant (P＜0.05).For patients with damp heat attacking vesselssyndrome,the most frequent clinical symptoms were the spinal sensory disorders,cranial nerve disorders and cerebellar symptoms,emotional disorders and mental disorders,consciousness disorders and epilepsy,two bowel movements and weakness.Conclusions The wind,wet,phlegm,heat and blood stasis of the MS patients in south of the Five Ridges gradually increase.With the treatment,the syndrome combination was gradually simplified,the essential contradiction gradually revealed,the single syndrome gradually merged,the 2 syndrome gradually increased,the 3 syndrome and the 4 syndrome remained constant.