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Objective:To analyze the mid-term efficacy of sodium tanshinone ⅡA sulfonate injection combined with clopidogrel in the treatment of angina pectoris and its effect on vascular endothelial function and micro-inflammatory state.Methods:One hundred patients with coronary heart disease and angina pectoris admitted to Pan′an County People′s Hospital from June 2015 to June 2019 were divided into two groups according treatment methods, with 50 patients in each group. On the basis of conventional symptomatic treatment, test group was given clopidogrel (75 mg once a day) combined with sodium tanshinone ⅡA sulfonate injection. In control group , clopidogrel (75 mg once a day) and aspirin (150 mg once a day) were given. One cycle was four weeks. The expression levels of vascular endothelial-associated cytokines and peripheral blood CD 4+Foxp3 + Treg cells were detected and compared between the two groups. Results:The frequency and duration of angina pectoris before treatment in two groups had no significant differences ( P>0.05); after treatment, the frequency and duration of angina pectoris significantly decreased in the two groups ( P<0.05), the levels of frequency and duration of angina pectoris in test group were lower than those in control group [(0.4 ± 0.1) times/d vs. (0.6 ± 0.2) times/d , (3.4 ± 1.2) times/d vs. (5.8 ± 1.2) times/d, and there were significant differences ( P<0.05). The total effective rate in two groups had no statistical significance [98.0%(49/50) vs. 92.0%(46/50)]( P>0.05). Before treatment, the levels of nitric oxide (NO), endothelin (ET), thrombomodulin (TM) and CD 4+Foxp 3+ Treg in two groups had no significant differences ( P>0.05). After treatment, the levels of NO, TM in two groups increased and the levels of ET, CD 4+Foxp 3+ Treg in two groups decreased, and there were significant differences ( P<0.05). The levels of NO, TM in test group were higher than those in control group [(82.5 ± 5.1) ng/L vs. (71.9 ± 4.) ng/L, (32.4 ± 3.6) μmol/L vs. (25.2 ± 3.6) μmol/L], the levels of ET, CD 4+Foxp 3+ Treg in test group were lower than those in control group [(39.4 ± 5.2) μmol/L vs. (46.7 ± 5.4) μmol/L, (9.4 ± 1.8)% vs. (10.6 ± 1.7)%], and there were significant differences ( P<0.05). Conclusions:Sodium tanshinone ⅡA sulfonate injection combined with clopidogrel in the treatment of angina pectoris can improve cardiovascular endothelial function, inhibit myocardial inflammation and immune response.
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Objective To investigate effect of different anesthesia on cesarean section perioperative coagula-tion function and D -dimer,to provide a reference for clinical treatment.Methods 120 cases of cesarean section patients were selected,according to the anesthesia they were divided into observation group and control group.Obser-vation group (70 cases) used combined spinal epidural anesthesia,the control group(50 cases) used epidural anes-thesia.The prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT),fiber clinical indicators fibrinogen (Fbg),DD,analgesia and its complications were compared between the two groups.Results Before surgery,PT,APTT,TT,Fbg had no statistically significant differences between the two groups (P >0.05).6h, 24h after operation, PT,APTT,TT of the observation group were (13.23 ±1.86) s,(31.18 ±5.94) s,(15.52 ± 2.55)s;(12.85 ±1.94)s,(29.74 ±5.52)s,(14.68 ±3.15)s,which were lower than the control group,the differ-ences were statistically significant (t =3.294,4.546,4.143,3.656,3.435,3.115,all P 0.05).In the observation group,the incidence rates of pain level 2,3 were 41.43%,30.00%,compared to the control group showed no significant difference (P >0.05). Deep vein thrombosis was not found in the observation group,the control group confirmed one case of femoral vein thrombosis,the incidence of venous thrombosis in the two groups showed no significant difference ( P >0.05). Conclusion Combined spinal epidural anesthesia,epidural anesthesia can both prevent cesarean section patients from perioperative hypercoagulable state,reduce the incidence of thrombotic complications,epidural anesthesia is the preferred method.
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Objective To investigate different fentanyl medication methods on propofol intravenous anesthe-sia painless abortion,to provide a reference for clinical treatment.Methods 1 20 patients undergoing painless abor-tion were selected,according to the random number table they were divided into Ciliao point group,subcutaneous group,intravenous injection group,40 cases in each group.Intravenous injection group used intravenous anesthetic propofol,Ciliao point group used Ciliao hole injection anesthesia,subcutaneous group used fentanyl anesthesia subcu-taneous injection.The anesthesia,analgesia and other clinical indicators of complications were compared among the three groups.Results The anesthesia excellent and good rate of Ciliao point group was 97.50%,which was higher than the subcutaneous group,intravenous injection group,the differences were significant(χ2 =4.1 32,3.894,all P 0.05).Postoperative 4h,8h,VAS scores of Ciliao point group were (2.32 ±0.56)points,(1 .1 3 ±0.23)points,which were lower than those in the subcutaneous group,intravenous injection group,the differences were significant (t =8.656,8.843,6.587,6.335,all P <0.05).The propofol use times,the amount of Ciliao point group were (1 .1 4 ±0.1 4),(1 1 6.37 ±1 4.35)mg respectively,which were less than those in the subcutaneous group,intravenous injection group,the differences were significant (t =6.645,5.587,6.1 32,5.854,all P <0.05).The incidence rate of adverse reaction of Ciliao point group was 2.50%,which of the subcutaneous group was 20.00%,which of the intravenous group was 25.00%,the differences were statistically significant (χ2 =6.596,7.454,all P <0.05).Conclusion Fentanyl uased at Ciliao point can enhance the clinical effect of anesthesia with less postoperative pain and reduce incidence of adverse reac-tions,it is worthy of clinical application.