Clinical efficacy and safety of tirofiban combined with dual antiplatelet therapy in patients with progressive stroke / 中国医师进修杂志

Objective:To investigate the efficacy and safety of tirofiban combined with dual antiplatelet therapy for progressive stroke, and obtain the effective time and speed of intravenous tirofiban.Methods:The patients with progressive stroke from June to December 2018 in the Second Hospital of Liaocheng Affiliated to Shandong First Medical University were divided into 2 groups: 28 patients were treated with dual antiplatelet (dual antiplatelet group) and 22 patients were treated with tirofiban combined with dual antiplatelet (tirofiban group). The demographic characteristics, risk factors of cerebral infarction, new infarct location and possible pathogenesis were recorded. The beginning of tirofiban, National Institutes of Health stroke scale (NIHSS) score at different time points, complications, and intravenous infusion effective time, maintenance dose and speed were recorded. NIHSS score was recorded for 14 d and modified Rankin scale (mRS) score was recorded for 90 d after discharge.Results:After 14 d of continuous treatment in the dual antiplatelet group, the NIHSS score decreased (2.92±1.13) scores. One case had gastrointestinal hemorrhage, and there were no intracranial hemorrhage complications. After 14 days of continuous treatment in the tirofiban group, the NIHSS score decreased (3.46±1.71) scored. One case had skin and mucosa hemorrhage, and there were no intracranial hemorrhage complications. In tirofiban group, the effective time of intravenous infusion was 42.2 to 135.7 (86.6 ± 42.3) h, and the infusion speed was 0.15 to 0.45 (0.31 ± 0.12) mg/h. Compared with the dual antiplatelet group, the NIHSS score and 90-day mRS score of tirofiban group decreased significantly: (3.36 ± 1.71) scores vs. (4.75 ± 2.30) scores and (2.93 ± 1.04) scores vs. (3.52 ± 1.83) scores, and there were statistical differences ( P<0.05). Conclusions:Intravenous tirofiban combined with dual antiplatelet therapy for progressive stroke may be a relatively effective method.

Clinical value of bone densitometry in partial androgen deficiency in aging male patients / 中国医师进修杂志

Objective To explore the characteristics of bone mineral density (BMD) and the incidence of osteoporosis in partial androgen deficiency in aging male (PADAM) patients.Methods Fifty-six PADAM patients (PADAM group) and 51 healthy persons (control group) were selected according to their age and body mass index (BMI),and measured their BMD in the second to fourth lumber and the neck of femur with the dual-energy C X-ray BMD measuring instrument.MES-01S20 muscle function analyzer was used to determinate the distribution and mechanical properties of muscle.The biochemical and bone metabolic markers and sexual hormones were collected and observed by multivariate stepwise regression analysis.Results Compared with control group,BMD significantly decreased in the Ward triangle,femoral neck and big rotor (P ＜ 0.01 ) and no significant change in lumbar in PADAM group (P ＞ 0.05 ),and the fracture strength of femoral neck (FS) and the lower-limb muscular strength (MS) also significantly decreased (P ＜ 0.01 ).The incidence of osteopenia were 48.2% (27/56) and 35.3% ( 18/51 ),osteoporosis were 30.4% (17/56) and 21.6% ( 11/51 ) respectively in PADAM group and control group.There was significant difference between two groups (P＜0.05).The BMD was positively correlated to BMI at the first to fourth lumber and negatively correlated to age,positively correlated to BMI and serum level of andrusol at the proximal left femur in the patients with PADAM.Conclusion BMD and the resistance to fracture aresignificantly lower in PADAM patients,and aging lower BMI and androgen deficiency are the risk factors of low BMD in PADAM patients.There is the potential of osteoporotic fracture risk,and it is important to strengthening the prevention and treatment of fractures in elderly PADAM patients.

Comparison of surgical treatment and non-surgical treatment for dderly patients with humeral surgical neck fracture / 中国基层医药

ObjectiveTo compare the clinical efficacy of surgical treatment and non-surgical treatment of humerus surgical neck fracture for elderly patients. Methods106 elderly patients who were diagnosed of fracture of surgical neck of humerus were selacted as the research object, of which 56 patients underwent surgical treatment using locking compression plate ( Operation group ), 50 patients underwent non - surgical treatment using skin traction smoothing method( Control group) ,all the patients were followed up for 6 to 10 months,the clinical efficacy and complications were eorpared. ResultsOperation group, good rate of 83.9％, significantly higher than contra group,good rate of 60.0％ ,the difference was statistically significant ( x2 = 7.61, P ＜ 0.01 ). Operation group, no postoperative complications,5 cases of non- surgical complications, two groups had significant differences in complications (x2 =3.86, P ＜ 0.05 ). ConclusionSurgical treatment of humeral surgical neck fractures in elderly rehabilitation had better efficacy, fewer complications.

The influence of Clopidogrel combined with Aspirin in treatment of young people with cerebral artery stenosis and blood plasma P-selectin / 中国基层医药

Objective To study the influence of Clopidogrel combined Aspirin to treat cerebral artery stenosis of young people and P-selectin in blood plasma. Methods 142 cases were randomly divided into therapy group (70 cases) and control group (72 cases). The two groups were given Aspirin ( 0. 1/d, Bayer company) by peroral administration or nasal feeding( deglutation disturbance) and simultaneously given tatin drug, Venoruton injection, Citicoline and Salvia Miltiorrhiza injection. The therapy group were added clopidogrel(75mg/d,Shenzhen Salubris Pharmaceuticals Co, Ltd). Venous blood was taken suction to detect platelet packing fraction, P-selectin and Doppler ultra-sound and carotid artery blood flow velocity before medication,24 hours after medication ,7 days after medication. Results Platelet packing fraction, P-selectin were significantiy decreased in the two groups than before treatment( P <0. 05)and therapy group were sigrificantly lower than control group( P < 0. 01 ). The control group after 7 days of treatment, transcranial Doppler ultrasound and carotid artery blood flow velocity significantly improved ( P < 0. 05 ), but the treatment group more significantly (P < 0. 01 ). Conclusion Blood plate was activated in patients of cerebral artery stenosis of young people, Clopidogrel combined with Aspirin could improve the blood rheology and hemodynamics, reduce the volume of cerebral lesions and improve the prognosis of patients.

Study of bone mineral density and its influential factors in partial androgen deficiency in aging male patients / 中国医师杂志

Objective To explore the characteristics and its influential factors of bone mineral density (BMD) changes in partial androgen deficiency in aging male patients.Methods 186 aging male patients with partial androgen deficiency and 125 healthy persons were selected, and their BMD in the first to fourth lumber spine and the proximal left femur was measured with the dual-energy X BMD measuring instrument.The biochemical and bone metabolic markers and sexual hormones were collected, and the relationship between changes of BMD in the patients with partial androgen deficiency, age, BMI, sexual hormones and bone metabolic markers were observed by multivariate stepwise regression analysis.Results There was no significant difference in BMD at the lumbar spine between two groups( P ＞ 0.05 ), but BMD in PADAM group was lower than control groups at the hip[Neck: (0.831 ±0.136) g/cm2 vs (0.954 ±0.143) g/cm2,War's: (0.712 ± 0.127 ) g/cm2 vs ( 0.811 ± 0.149 ) g/cm2,Troch: ( 0.697 ± 0.124 ) g/cm2 vs ( 0.764 ±0.131 )g/cm2, P ＜ 0.05 )].The incidence of PADAM and control group with osteopenia were 48.9% and 36%, and the osteoporosis was 33.3% and 20.8%, respectively.The bone mineral density was positively correlated to BMI at the first to fourth lumber spine and the proximal left femur in the patients with PADAM and negatively correlated to age and serum level of androgen.Conclusion BMD in PADAM group was significantly decreased, and age and low BMI and androgen deficiency wwere the risk factors of low BMD in PADAM patients.

Effect of Lovastatin on carotid atherosclerotic plaques, levels of blood lipid and serum C-reactive protein / 临床神经病学杂志

Objective To observe the effect of Lovastatin on carotid atherosclerotic plaque(CAP),levels of blood lipid and serum C-reactive protein(CRP) in patients with cerebral infarction(CI).Methods 120 CI patients with CAP were randomly divided into Lovastatin group and control group.At the basic of low fit diet for the two groups,Lovastatin was taken with 20 mg once a day for 6 months in Lovastatin group.Then,the changes of paque score,the levels of CRP and blood-lipid were observed 8 weeks and 6 months after treatment.Results (1)6 months later,the plaque score(4.20?3.77) in the Lovastatin group was significantly lower than pro-treatment(4.77?2.31)and the control group(6.86?1.89) (all P

Diagnostic value of MRA,TCD and ultrasonography in carotid territory TIAs / 临床神经病学杂志

Objective To evaluate the diagnostic values of MRA,TCD and ultrasonography in carotid territory transient ischemic attacks (TIAs). Methods 42 patients with carotid territory TIAs were examined by MRA, TCD and ultrasonography. Results MRA showed abnormalities of carotid arteries in 12 cases (28.6%) and abnormalities of intracranial arteries in 32 cases (76.2%). 8 cases presented abnormalities both in carotid arteries and intracranial arteries. Abnormalities of intracranial arteries were detected by TCD in 30 cases (71.4%) and abnormalities of carotid arteries were detected by ultrasonography in 16 cases (38.1%).Conclusion MRA, TCD and ultrasonography are useful in the evaluation of etiological factors of carotid territory TIAs.