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Objective To compare the effects of ticagrelor and clopidogrel on levels of inflammatory factors after emergent percutaneous coronary intervention (PCI) combined with thrombus aspiration in patients with acute myocardial infarction (AMI). Methods Two hundreds and sixteen patients with AMI undertaking emergent PCI plus thrombus aspiration admitted to Cangzhou Central Hospital from April 2014 to April 2017 were enrolled, and they were randomly assigned into a ticagrelor group and a clopidogrel group, each group 108 cases. After admission, the clopidogrel group received 300 mg aspirin and 300 mg clopidogrel loading, after operation, aspirin 100 mg and clopidogrel 75 mg were given, once a day maintaining for 12 weeks; ticagrelor group after admission received 300 mg aspirin and 180 mg ticagrelor loading and after operation 100 mg aspirin (once per day) and 90 mg ticagrelor (twice per day) were given, maintaining for 12 weeks. Venous blood was taken immediately after admission and 24 hour and 1, 4, and 12 weeks after PCI plus thrombus aspiration, and the plasma levels of C-reactive protein (CRP), interleukin-6 (IL-6) and soluble CD40 ligand (sCD40L) were measured by double antibody enzyme linked immunosorbent assay (ELISA). Results Twenty-four hours after the operation, the levels of inflammatory factors, CRP, IL-6 and sCD40L were significantly higher than those before operation, the levels of the above inflammatory factors continued to decrease at the time points 1, 4, and 12 weeks later, reaching the lowest level at 12 weeks, and the above levels in ticagrelor group were significantly lower than those in clopidogrel group [CRP (μg/L): 2.96±0.63 vs. 4.44±0.34, IL-6 (ng/L): 2.50±0.51 vs. 2.81±0.21, sCD40L (ng/L): 519.60±12.53 vs. 570.25±11.55, all P < 0.05]. Conclusion The anti-inflammatory effect of ticagrelor is greater and more durable than that of clopidogrel after emergent PCI plus thrombus aspiration in patients with AMI.
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Objectives To examine the clinical effects of α-lipoic acid(ALA)combined with epalrestat in elderly patients with diabetic peripheral neuropathy(DPN)and its influence on plasma levels of high-sensitivity C-reactive protein(hs-CRP)and homocysteine(Hcy).Methods A total of 120 DPN patients aged over sixty years were randomly divided into the control group and the treatment group with 60 cases in each group.The control group received 0.6 g ALA in 250 ml saline given by an intravenous drip once a day and the treatment group was additionally given 50 mg epalrestat orally three times a day.Both groups were treated for two weeks.Improvement in clinical symptoms,nerve conduction velocity,and peripheral blood levels of hs-CRP and Hcy were compared between the two groups before and after treatment.Results TSS scores of all items and the total scores of the two groups decreased after treatment,with greater margins seen in the treatment group than in the control group(each P＜0.05).NCV increased in both groups after treatment (each P＜ 0.05),with greater increase in the treatment group(each P＜0.05).Levels of hs-CRP and Hcy were significantly reduced (each P＜0.05).A statistically significant difference was observed in hs-CRP(t =2.620,P=0.010) but not in Hcy(t =0.380,P =0.700)between the two groups.Conclusions ALA combined with epalrestat can significantly improve the symptoms of patients with DPN,with better outcomes than ALA alone,and effectively decrease the peripheral blood level of hs-CRP.
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Objective To study the effect of corrected TIMI frame count (CTFC) of infarction related artery on systolic function of infarct area of myocardium after primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods One hundred and six patients with AMI having undergone successful PCI in Cangzhou Central Hospital were selected, and they were divided into two groups (each, 53 cases). The standard of fast or slow flow was in accord to the CTFC of infarction related artery (IRA) measured soon after successful PCI. The patients with greater value of CTFC were enrolled in the slow flow group, while the patients with smaller such value were assigned in the fast flow group. At 6, 12, 24 and 48 hours after PCI, the venous plasma MB isoenzyme of creatine kinase (CK-MB) level was measured. And at 1 week, 1 month and 3 months after PCI, the left ventricular ejection fraction (LVEF) was measured by cardiac ultrasound, and the levels of radial strain (RS) and longitudinal strain (LS) of the infarct area were measured via speckle tracking imaging (STI). The differences in CTFC, CK-MB, RS and LS between the two groups were analyzed, and the correlations between the strains and CTFC, CK-MB were analyzed by Pearson linear correlation method. Results After successful PCI, the CK-MB of fast flow group was higher than that of the slow flow group at 6 hours. However, the CK-MB of slow flow group was higher than that of the fast flow group after 12 hours, appearing separate phenomenon, and the statistical significance occurred beginning from 24 hours after PCI (U/L, 24 hours:98.43±11.65 vs. 86.43±18.97, 48 hours:51.09±8.94 vs. 49.80±6.92, both P 0.05). RS and LS in fast flow group were higher than those in slow flow group, and the statistically significant difference appeared from 1 month after PCI (1 month RS:29.74±6.66 vs. 26.86±5.61, LS:-16.37±3.91 vs. -15.27±3.22, 3 months RS: 30.03±6.31 vs. 27.63±5.67, LS: -17.74±3.96 vs. -15.75±4.17, all P 0.05). Both RS and LS at 1 week, 1 month and 3 months were of significantly positive correlation with CTFC of each group (fast flow group:r value of CTFC and RS was respectively-0.526,-0.515,-0.532, r value of CTFC and LS was respectively-0.532,-0.541,-0.572;slow flow group:r value of CTFC and RS was respectively-0.691,-0.685,-0.702, r value of CTFC and LS was respectively-0.621,-0.584,-0.605, all P<0.01). Conclusion CTFC has some relationship with the recovery of the systolic function in area of infarct myocardium after PCI, and can be regarded as an important index to predict the long-term prognosis in patients with AMI.
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Objective To observe the therapeutic effect of Qili Qiangxin capsule combined with glucocorticoid for treatment of patients with dilated cardiomyopathy accompanied by refractory heart failure. Methods A prospective study was conducted. Forty-eight patients with dilated cardiomyopathy and refractory heart failure in Hebei Cangzhou Central Hospital were enrolled,and they were randomly divided into three groups:control group,treatmentⅠand treatmentⅡgroups(each,16 cases). All groups were treated with conventional anti-heart failure western treatment, meanwhile additionally prednisone was given to treatment groupⅠand groupⅡ,firstly 40 mg/d,then the dosage of 5 mg was decreased in every 5 days until reaching 5 mg per day;in treatment groupⅡ,besides the same treatment of group I,the traditional Chinese medicine therapy Qili Qiangxin capsule 4 granules(one capsule 0.3 g)each time and 3 times a day was added,2 months being the therapeutic course in all the patients. The clinical efficacy and cardiac functional indexes,such as the left ventricular end-diastolic volume(LVEDV),the left ventricular end-systolic volume(LVESV),the left ventricular ejection fraction(LVEF)and the plasma B type brain natriuretic peptide (BNP),etc. were observed in 1 week and 2 months after treatment. Meanwhile the electrocardiogram(ECG),aspartate transaminase(AST),alanine aminotransferase(ALT),urea nitrogen(BUN),serum creatinine(SCr),blood routine, urine routine examination and the adverse effects were investigated. Results The total effective rates in treatment groupⅠand treatment groupⅡwere significantly higher than those in the control group〔after treatment for 1 week:81.2%(13/16),81.2%(13/16)vs. 43.8%(7/16);after 2 months:87.5%(14/16),93.7%(15/16)vs. 50.0%(8/16), all P<0.05〕. After treatment,the LVEDV,LVESV and BNP were lowered and the LVEF was increased in the three groups,and the above indexes in treatment groupⅡwere improved more significantly than those in groupⅠ〔LVEDV (mL):142.4±33.0 vs. 174.8±52.5,LVESV(mL):111.6±23.7 vs. 132.4±29.0,LVEF:0.421±0.037 vs. 0.390±0.045,BNP(μg/L):1.944±0.751 vs. 3.038±1.905,all P<0.05〕. Conclusion Qili Qiangxin capsule combined with glucocorticoid may effectively improve the cardiac function and clinical symptoms in near and forward future in patients with dilated cardiomyopathy accompanied by refractory heart failure,thus it may elevate the patients' life quality.