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Objective:To observe and compare differences of levels of homocysteine (Hcy),von Willebrand factor (vWF) and tissue factor procoagulant activity (TF-PCA) between patients with coronary heart disease (CHD) and healthy resi-dents,and analyze relationship between above 3 indicators and coronary heart disease onset.Methods:Clinical data of 95 CHD emergency patients (CHD group),who were treated in our department of cardiology from Apr 2013 to Dec 2015,and 95 healthy residents (healthy control group) were retrospectively analyzed.According to state of an illness,CHD group was further divided into stable angina pectoris (SAP) group (n＝33),unstable angina pectoris (UAP) group (n＝31) and acute myocardial infarction (AMI) group (n＝31).Levels of Hcy,vWF and TF-PCA were measured and compared among all groups and different time after onset in CHD patients.Multifactor Logistic regression analysis was used to analyze influ-encing factors of CHD types.Results:Compared with healthy control group,there were significant rise in levels of Hcy [ (9.22 ± 3.45) μmol/L vs.(17.80 ± 6.94) μmol/L],vWF [(122.40 ± 10.18)% vs.(160.13 ± 10.48)%] and TF-PCA [ (30.12 ± 10.49) s vs.(69.45 ± 8.26) s] in CHD group,P＝0.001 all.Compared with SAP group,there were signifi-cant rise in levels of Hcy [ (14.30 ± 3.15) μmol/L vs.(20.50 ± 4.97) μmol/L vs.(25.77 ± 6.10) μmol/L],vWF [ (141.56 ± 9.45)% vs.(168.23 ± 11.29)% vs.(185.56 ± 11.40)%] and TF-PCA [ (45.13 ± 11.52) s vs.(53.16 ± 18.45) s vs.(64.49 ± 11.59) s] in UAP group and AMI group,and those of AMI group were significantly higher than those of UAP group,P＜0.05 or ＜0.01.As onset time went by,there were significant reductions in levels of Hcy,vWF and TF-PCA in CHD patients,and all of them accorded with 1h＞12h＞24h＞48h,there existed significant difference be- tween any two time points,P＝0.001 all.Multifactor Logistic regression analysis indicated that Hcy,vWF and TF-PCA were independent risk factors for CHD type (OR＝2.586～5.058,P＝0.001 all).Conclusion:Levels of Hcy,vWF and TF-PCA significantly rise in CHD patients,the more severe disease is,the higher levels are.Along with time goes by,their levels significantly reduce.Combined detection of them can be used for predicting CHD type.The Hcy,vWF and TF-PCA are independent risk factors for CHD type.
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<p><b>OBJECTIVE</b>To explore the feasibility and the result for the surgical treatment of spastic cerebral paralysis of the upper limbs in patients who underwent the selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy.</p><p><b>METHODS</b>From March 2004 to April 2008, 27 patients included 19 boys and 8 girls, aging 13-21 years with an average of 15 years underwent selective cervical dorsal root cutting off part of the vertebral lateral mass fixation with exercise therapy. The AXIS 8 holes titanium plate was inserted into the lateral mass of spinous process through guidance of the nerve stimulator, choosed fasciculus of low-threshold nerve dorsal root and cut off its 1.5 cm. After two weeks, training exercise therapy was done in patients. Training will include lying position, turning body, sitting position, crawling, kneeling and standing position, walking and so on. Spastic Bobath inhibiting abnormal pattern was done in the whole process of training. The muscular tension, motor function (GMFM), functional independence (WeeFIM) were observed after treatment.</p><p><b>RESULTS</b>All patients were followed up from 4 to 16 months with an average of 6 months. Muscular tension score were respectively 3.30 +/- 0.47 and 1.25 +/- 0.44 before and after treatment;GMFM score were respectively 107.82 +/- 55.17 and 131.28 +/- 46.45; WeeFIM score were respectively 57.61 +/- 25.51 and 87.91 +/- 22.39. There was significant improvement before and after treatment (P < 0.01).</p><p><b>CONCLUSION</b>Selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy was used to treat spastic cerebral paralysis of the upper limbs is safe and effective method, which can decrease muscular tension and improve motor function, which deserves more wide use.</p>