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Objective:To investigate optimal antiplatelet therapy options based on the CYP2C19 genotype in elderly patients with acute coronary syndrome(ACS).Methods:Elderly patients with ACS admitted to our hospital from January 2018 to March 2019 were enrolled and received CyP2C19 gene testing.Patients with the intermediate metabolic genotype of CYP2C19 were randomly divided into two groups: the Ticagrelor group and the double-dose Clopidogrel group.After a one-year follow-up, the risk of bleeding and incidences of cardiovascular events in the two groups were analyzed.Results:468 elderly patients meeting the criteria, 214 had the intermediate metabolic genotype of CYP2C19, accounting for 45.7% of the total, and were randomly divided into the ticagrelor treatment group( n=107)and the double-dose Clopidogrel treatment group( n=107). There were significant differences between the Ticagrelor treatment group and the double-dose Clopidogrel treatment group in incidences of minor bleeding, massive hemorrhage, recurrent angina and recurrent acute myocardial infarction(11.2% vs.22.4%, 2.8% vs. 9.4 %, 4.7% vs.13.1%, 3.7% vs. 11.2%, P<0.05). The double-dose Clopidogrel group not only had a higher risk of cardiovascular events, but also a higher risk of bleeding. Conclusions:For elderly ACS patients with the intermediate metabolic genotype of CYP2C19, a standard dose of ticagrelor is recommended.
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Objective To observe the postconditioning cardioprotective effects of atorvastatin (ATV) on ischemia-re?perfusion injury in isolated rat heart, and the role of phosphatidylinositol-3-kinase , protein kinase B(PI3K-Akt), mitochon?drial ATP-sensitive potassium (mito-KATP channel) and mitochondrial permeability transition pore (mPTP) thereof. Meth?ods Healthy male Wistar rats were randomly divided into 9 groups:ischemia reperfusion (I/R) control group, atorvastatin postconditioning (ATV) group, ATV plus PI3K inhibitor LY294002 (ATV+LY294002) group, LY294002 group, ATV plus mi?to-KATP channel inhibitor 5-hydroxydecanoate (ATV+5-HD) group, 5-HD group, ATV plus mPTP inhibitor ATR (ATV+ATR) group, ATR group and ethanol group. Model rats were given 30-min ischemia followed by 120-min reperfusion. The myocardial infarction size, hemodynamic parameters, creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), nic?otinamide adenine dinucleotide (NAD+) and the expression of myocardial protein kinase B (Akt) and myocardial phospho-pro?tein kinase B (p-Akt) were evaluated. Results Compared with the control group, atorvastatin reduced the myocardial in?farction size, CK-MB and LDH(P<0.05), increased NAD+(P<0.05). There were no significant differences in the myocardi?al infarction size, CK-MB, LDH and NAD+between ATV+LY294002 group, ATV+5-HD group and ATV+ATR group. The hemodynamic parameters were improved in ATV group compared with those in control group. Western blot analysis con? firmed the significant phosphorylation of Akt in ATV group, ATV+5-HD group and ATV+ATR group compared with those of control group. There were no significant differences in the phosphorylation of Akt between ATV +LY294002 group, LY294002 group, ATR group and 5-HD group. Conclusion Atorvastatin postconditioning could attenuate the ischemia-re?perfusion injury through activating the PI3K-Akt, promoting mito-KATP channel opening and inhibiting mPTP opening.
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OBJECTIVE: To observe the effects of Xinfeng Capsule (XFC), a compound Chinese herbal medicine, on behaviors and myocardial ultrastructure in adjuvant arthritis (AA) rats. METHODS: Fifty-five rats were randomly divided into normal control group, untreated group, methotrexate (MTX) group, Tripterygium wilfordii glycosides tablet (TGT) group and XFC group. There were 11 rats in each group. Except for those in the normal control group, the rats in the other groups were all intracutaneously given 0.1 ml Freund's complete adjuvant in the right hind limb. Changes of behaviors and myocardial ultrastructure of the rats in different groups were observed. RESULTS: Voix pedis' swelling and arthritis index in XFC, MTX and TPT groups were all obviously improved as compared with the untreated group. After XFC treatment, the autonomic activities were obviously increased, number of errors in exercise period and test period were obviously decreased, step-down latency (SDL) was lengthened and escape latency (EL) was shortened. Overall structure of myocardial myofibril and the majority of cristae was intact in XFC group. The effects of XFC in improving the behaviors and myocardial ultrastructure were better than those of MTX and TPT. CONCLUSION: Changes of behaviour and myocardial ultrastructure of AA rats can be observed. XFC can improve the myocardial ultrastructure of AA rats as well as their behaviors.
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Objective To evaluate right ventricular(RV)function by tissue Doppler imaging(TDI)and Tei index in patmnts with coronary artery disease(CAD).Methods One hundred twenty patients who underwent coronary angiography(CAG)were enrolled.Based on clinic evidences,such as CAG,disease history,symptom,ECG,and myocardial enzymes,all patients were divided into three groups:control group,angina group and myocardial infarction(MI)group.TDl was performed on the lateral and septal tricuspid annular.RV Tei index was obtained either from the pulse-wave Doppler(PW-Tel)and from TDI(TDI-Tei).Results There were significant differences in RV PW-Tei,TDI-Tei,Ea,and Ea/Aa among three groups.PW-Tei was 0.363±0.086.0.463±0.078 and 0.569±0.066,and TDI-Tei was 0.400±0.058,0.520±0.078 and 0.628±0.059 for the control group,angina group and MI group,respectively.Ea and Ea/Aa were gradually decreased following the severity of CAD.Sa was no difference between the control group and angina group,while Sa was much lower in mvocardial infarction group than in other groups.RV PW-Tei had a good correlation with the lateral and septal TDI-Tei.The lateral and septal TDI-Tel were significant correlated with motion velocities.Conclusions TDI can be used to comprehensively evaluate RV function in patients with CAD.TDI-Tei can sensitive reflect the damage level of overall RV function in patients with different degree CAD.
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Objective To observe effects of Xinfeng capsule (XFC) on platelet parameters,ultrastructure,p-selectin and therapeutic effect on rheumatoid arthritis (RA) patients in active phase.Methods Platelet parameters,p-selectin and reactive indexes of 60 RA patients in active phase were detected.RA patients were divided into XFC treated group (35 examples) and Zhengqing Fengtongning (ZQF) control group (25 examples) randomly.After a course of treatment,the therapeutic effect and changes of platelet parameters,p-selectin,reactive indexes of two groups were observed.Setting up a normal control (20 examples) and detecting above-mentioned indexes.Observing platelet ultrastructure of two examples with transmission electron microscope of per groups.Results Compared with normal control group,PLT,PCT,MPV,CD62P of RA patients in active phase was obviously increased.Platelet ultrastructure was obviously damaged.The excellence rate of XFC exceeded ZQF control group.After being treated,platelet ultrastructure of the two groups were obviously improved,and XFC group was better than ZQF group.Compared with ZQF group,PLT,PCT,CD62P were obviously decreased in XFC group.PLT,PCT were positively correlated with CD62P,IgG,ESR,CRP,RF,arthrpain,arthrocele.And PLT was positively correlated with arthrtenderness,morning stiffness time.Conclusion PLT and PCT of RA patients in active phase were increased,and have correlation with reactive indexes.It suggests that PLT,PCT can reflect reactiveness of RA as objective indexes.XFC can not only treat inflammation and delay the aggravation of RA patient by improving platelet ultrastructure.
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Objective:To observe effects of Xinfeng Capsule(XFC)on platelet parameters(platelet count,thrombocytocrit,mean platelet volume,platelet distribution width),p-select,platelet ultrastructure and its therapeutic effect on rheumatoid arthritis(RA)patients in active phase.Methods:To detect platelet parameters,p-select and reactive indexes(ESR,?1-AGP,CRP,RF)of 60 RA patients in active phase.Patients were divided into XFC treated group(35 examples),Zhengqingfengtongning(ZQF)control group(25 examples)according to random digits table.After a course of treatment,to observe therapeutic effect and the changes of platelet parameters,p-select,reactive indexes of two groups.Setting up a normal control(20 examples)and detecting above-mentioned indexes.To observe platelet ultrastructure with transmission electron microscope.Results:1.Compared with normal control group,PLT,PCT,MPV,Ps of RA patients in active phase increased obviously(P0.05).But the excellence rate of XFC exceeded that of control group(P
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Objective:To observe the effects of effects of Xinfeng capsule(XFC) on platelet parameters(platelet count,thrombocytocrit,mean platelet volume,platelet distribution width) and on the serum levels of cytokines(IL-1?,TNF-?,IL-10) in adjuvant arthritis(AA) rats.Methods:40 SD masculine rats were averagely divided into groups of normal control,model control,XFC treatment,methotrexate(MTX) and tripterygium wilfordii polycoride tablet(TPT) alone,with 8 in each.Except for the rats of normal group,the others were intracutaneously injected with 0.1 ml of Freund′s complete adjuvant in the right hindlimb.The changes of platelet parameters (PLT,PCT,PDW,MPV) were observed by Sysmex XT-2000i automatic cytoanalyze and serum cytokines(IL-1?,TNF-?,IL-10)were analyzed with ELISA kit.Results:1.Compared with those of normal control,platelet count,thrombocytocrit,IL-1?、TNF-? of AA rats were obviously increased and IL-10 was obviously decreased in the model groups(P0.05).3.PLT and PCT of the rats were positively correlated with serum contents of IL-1? and TNF-?,as well as voix pedis′swelling and arthritis index(AI).In addition, IL-10 concentration in the serum was negatively correlated with PLT and PCT(P