氯吡格雷联合丹红注射液治疗冠心病不稳定型心绞痛的临床疗效分析

目的:探讨氯吡格雷联合丹红注射液治疗冠心病不稳定型心绞痛的临床疗效。方法:将我院2015年1月——2015年12月收治的120例冠心病不稳定型心绞痛患者随机分为实验组和对照组,每组60例,其中对照组氯吡格雷+常规治疗,实验组则在氯吡格雷+常规治疗的基础上加用静脉滴注丹红注射液,从中比较两组患者的治疗效果并观察不良反应。结果:实验组总有效率高于对照组,差异有统计学意义(P0.05),且两组均未发现明显不良反应。结论:冠心病不稳定型心绞痛患者在常规治疗+氯吡格雷的基础上加用丹红注射液,可提高临床疗效,不良反应少,值得临床推广应用。     

氯吡格雷联合阿司匹林治疗老年冠心病的临床疗效观察

目的:探讨氯吡格雷联合阿司匹林治疗老年冠心病(CHD)的临床疗效和安全性。方法:60例老年CHD患者随机分为治疗组和对照组。对照组采用阿司匹林治疗,治疗组采用氯吡格雷联合阿司匹林治疗,治疗4周后观察血小板聚集率(PAG)和凝血功能。结果:治疗4周后,治疗组PAG显著下降,APTT显著上升,与治疗前和对照组比较均有显著性差异(P<0.05);两组治疗前后PT、PA变化差异无统计学意义(P>0.05)。两组均未出现不良反应。结论:阿斯匹林联合氯吡格雷治疗老年CHD患者,较单用阿斯匹林治疗更能有效地抑制血小板聚集和预防血栓形成,并能得到更好的临床疗效。     

氯吡格雷联合阿司匹林对冠心病心绞痛患者血清hs-CRP,TNF-α及IL-6水平的影响

目的:探讨氯吡格雷与阿司匹林对冠心病心绞痛患者血清炎症因子水平的影响及其临床疗效。方法:选择2014年3月-2016年3月在我院确诊为冠心病心绞痛患者69例作为研究对象,根据治疗方法不同,将患者随机分成研究组(39例)和对照组(30例)。对照组患者采用阿司匹林治疗,研究组患者在此基础上联合使用氯吡格雷治疗。观察并比较两组患者治疗前后血清高敏C-反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及白细胞介素-6(interleukin-6,IL-6)水平的变化情况,以及临床疗效。结果:治疗前两组患者血清hs-CRP,IL-6及TNF-α水平比较,差异无统计学意义(P0.05);治疗后两组患者血清hs-CRP,IL-6及TNF-α水平均低于治疗前,且研究组低于对照组,差异具有统计学意义(P0.05)。研究组患者临床总有效率(94.7%)高于对照组(88.9%),差异具有统计学意义(P0.05)。结论:氯吡格雷联合阿司匹林治疗冠心病心绞痛的临床效果显著,能够降低患者血清hs-CRP,IL-6及TNF-α炎症因子水平,值得临床推广应用。     

不同剂量氯吡格雷治疗急性ST段抬高心肌梗死的临床研究

目的:观察标准治疗基础上联合不同剂量氯吡格雷治疗急性ST段抬高心肌梗死的疗效及安全性。方法:2004年9月至2008年3月就诊我院的124例12小时以内发病的ST段抬高型心肌梗死患者,随机分为3组,3组均在入院后前3天给予阿司匹林300mg/d,此后给予阿司匹林100mg/d,A组常规不给予氯吡格雷治疗,B组给予氯吡格雷75mg/d,C组入院即刻给予氯吡格雷300mg,继之75 mg/d治疗,随访30天。观察溶栓血管再通率、梗死后心绞痛发作、心力衰竭事件及死亡、再发心肌梗死、或脑卒中的联合终点。结果:与A组相比,B组、C组患者溶栓成功率提高、梗死后心绞痛发作减少。P<0.05:进一步分析发现C组与B组差异无统计学意义,P>0.05。三组均无主要和次要出血事件发生,轻微出血发生率无统计学差异,P<0.05。结论:ST段抬高的急性心肌梗死患者在标准治疗的基础上早期加用氯吡格雷75 mg/d或先予300 mg负荷量,继之75 mg/d口服,均可提高溶栓成功率,降低梗死后心绞痛发生,而氯吡格雷负荷剂量组并不优于普通剂量组,且两组安全耐受性好。     

替格瑞洛与氯吡格雷对急性冠脉综合征患者经皮冠脉动脉介入术后血小板抑制效果的比较

目的:比较替格瑞洛与氯吡格雷对急性冠脉综合征(ACS)患者经皮冠脉动脉介入术(PCI)后血小板的抑制效果。方法:选择2014年3月至8月在我院经替格瑞洛联合阿司匹林治疗的ACS患者85例(替格瑞洛组),按性别、年龄2:1匹配原则随机抽取同一时间服用氯吡格雷联合阿司匹林治疗患者170例(氯吡格雷组)为研究对象,两组患者均行PCI治疗,并于服用抗血小板药物负荷剂量2天(PCI术后)进行血栓弹力图(TEG)检测,观察和比较两组患者经ADP途径及经AA途径的血小板抑制率。结果:氯吡格雷组和替格瑞洛组经ADP途径的血小板抑制率分别为(66.60±25.57)%、(82.10±18.87)%,两组比较差异有统计学意义(P0.05)。氯吡格雷组ADP抑制率50%患者占总人数的29.4%,替格瑞洛组ADP抑制率50%的患者占总人数的10.6%,两组差异有统计学意义(P0.05),氯吡格雷组ADP抑制率75%者占总人数的41.8%;而替格瑞洛组ADP抑制率75%的患者占总人数的69.4%,两组抑制率差异也存在统计学意义(P0.05)。氯吡格雷组和替格瑞洛组经AA途径的血小板抑制率分别为(88.70±23.89)%、(90.32±18.09)%,两组比较差异无统计学意义(P0.05)。结论:替格瑞洛对ACS患者PCI术后血小板的抑制作用优于氯吡格雷。     

曲美他嗪联合氯吡格雷治疗不稳定心绞痛的疗效观察

目的:观察曲美他嗪(trimetazidine,TMZ)联合氯吡格雷(clopidogrel,CPG)治疗不稳定型心绞痛(UPA)患者的临床疗效。方法:选择UAP患者76例,随机分为两组:对照组(38例)给予阿司匹林、利尿剂、血管扩张剂、血管紧张素转换酶抑制剂(ACEI)或β受体阻滞剂等常规药物;TMZ联合CPG组(38例)在常规药物治疗基础上加用TMZ(20mgtid×56d)、氯吡格雷(首次300mg,75mg/日×55d治疗。结果:治疗后与治疗前相比,TMZ联合CPG组心绞痛改善的临床显效率(52.6%)和总有效率(87%)均较对照组(26.3%和57.9%)显著提高(P<0.01),心绞痛发作频率持续时间显著减少(p<0.01),TMZ联合CPG组心率、血压、左室射血分数、左室舒张末期容积、左室收缩末期容积均有显著改善(P<0.01或P<0.05),运动耐量(NYHA分级)明显改善,TMZ联合CPG组与对照组比较差异有显著性意义(P<0.01或P<0.05),未观察药物不良反应。结论:用TMZ联合CPG治疗UAP是一种安全有效的方法。     

氯吡格雷联合阿司匹林治疗老年冠心病的临床疗效观察

目的：探讨氯吡格雷联合阿司匹林治疗老年冠心病（CHD）的临床疗效和安全性。方法：60例老年CHD患者随机分为治疗组和对照组。对照组采用阿司匹林治疗,治疗组采用氯吡格雷联合阿司匹林治疗,治疗4周后观察血小板聚集率（PAG）和凝血功能。结果：治疗4周后,治疗组PAG显著下降,APTT显著上升,与治疗前和对照组比较均有显著性差异（P〈0.05）;两组治疗前后PT、PA变化差异无统计学意义（P〉0.05）。两组均未出现不良反应。结论：阿斯匹林联合氯吡格雷治疗老年CHD患者,较单用阿斯匹林治疗更能有效地抑制血小板聚集和预防血栓形成,并能得到更好的临床疗效。     

低剂量氯吡格雷治疗不稳定型心绞痛的疗效观察

目的:探讨氯吡格雷(泰嘉)治疗不稳定型心绞痛(unstable angina pectoris,UAP)的疗效。方法:102例不稳定型心绞痛患者随机分治疗组(60例)和对照组(42例),治疗组在常规药物的基础上加氯吡格雷50mg,每天1次,连用4周。对照组用常规药物治疗。两组均观察心绞痛的发作次数、24h动态心电图。结果:治疗组显效43例(79.6%),有效5例(9.3%),对照组显效23例(48.0%),有效10例(20.8%),两组相比差异有显著性(p<0.05)。治疗组心绞痛的发作次数与对照组比较明显减少(P<0.01)、24h动态心电图与对照组比较明显改善(P<0.01)。结论:UAP患者在常规药物治疗的基础上联用低剂量氯吡格雷可取得良好效果,且安全性好。     

阿司匹林联合氯吡格雷治疗伴有血管狭窄的脑梗死的临床观察

目的:探讨阿司匹林联合氯吡格雷治疗伴有颅内外血管狭窄的脑梗死患者血同型半胱氨酸(Hcy)、血尿酸(UA)、血流动力学及临床效果。方法:选取60例因脑梗死且伴有颅内外血管狭窄的在我院住院治疗的患者,随机分为对照组和实验组。常规治疗基础上,对照组予以阿司匹林100 mg·d-1口服,实验组于对照组基础上加氯吡格雷75 mg·d-1口服,共21 d。比较两组患者血Hcy、UA、血小板(PLT)、血流动力学水平及NIHSS评分。结果:患者在接受治疗后,Hcy、UA及血小板水平均降低,与对照组比较,实验组Hcy、UA及血小板水平较低,P0.05;实验组治疗后NIHSS评分明显优于对照组,差异有统计学意义(P0.05)。结论:阿司匹林联合氯吡格雷治疗伴有血管狭窄的脑梗死效果优于单用阿司匹林,对临床具有指导意义。     

双联抗血小板治疗急性冠脉综合征临床疗效观察

目的:探讨双联抗血小板治疗急性冠脉综合征(ACS)的临床疗效和安全性。方法:60例ACS患者随机分为治疗组和对照组。对照组给予阿司匹林单抗血小板治疗,治疗组采用阿司匹林+氯吡格雷双联抗血小板治疗,治疗3个月后评价临床疗效。结果:治疗组临床疗效总有效率为93.3%,显著高于对照组(76.7%),相比较有显著性差异(P<0.05);治疗后,两组LVEF、CO、E/A显著上升,与治疗前比较均有显著性差异(P<0.05);且治疗组与对照组比较有显著性差异(P<0.05)。结论:阿司匹林和氯吡格雷双联抗血小板药物治疗ACS,可以强化对血小板聚集的抑制,并增强抗栓效果,值得临床应用。     

Recent advances in the study of Kaposi's sarcoma-associated herpesvirus replication and pathogenesis

It has now been over twenty years since a novel herpesviral genome was identified in Kaposi's sarcoma biopsies. Since then, the cumulative research effort by molecular biologists, virologists, clinicians, and epidemiologists alike has led to the extensive characterization of this tumor virus, Kaposi's sarcoma-associated herpesvirus(KSHV; also known as human herpesvirus 8(HHV-8)), and its associated diseases. Here we review the current knowledge of KSHV biology and pathogenesis, with a particular emphasis on new and exciting advances in the field of epigenetics. We also discuss the development and practicality of various cell culture and animal model systems to study KSHV replication and pathogenesis.     

A Unique Protease Cleavage Site Predicted in the Spike Protein of the Novel Pneumonia Coronavirus (2019-nCoV) Potentially Related to Viral Transmissibility

正Dear Editor,In December 2019, a novel human coronavirus caused an epidemic of severe pneumonia(Coronavirus Disease 2019,COVID-19) in Wuhan, Hubei, China(Wu et al. 2020; Zhu et al. 2020). So far, this virus has spread to all areas of China and even to other countries. The epidemic has caused 67,102 confirmed infections with 1526 fatal cases     

Curcuminoids as inhibitors of thioredoxin reductase: A receptor based pharmacophore study with distance mapping of the active site

Curcumin is the yellow pigment of turmeric that interacts irreversibly forming an adduct with thioredoxin reductase (TrxR), an enzyme responsible for redox control of cell and defence against oxidative stress. Docking at both the active sites of TrxR was performed to compare the potency of three naturally occurring curcuminoids, namely curcumin, demethoxy curcumin and bis-demethoxy curcumin. Results show that active sites of TrxR occur at the junction of E and F chains. Volume and area of both cavities is predicted. It has been concluded by distance mapping of the most active conformations that Se atom of catalytic residue SeCYS498, is at a distance of 3.56 from C13 of demethoxy curcumin at the E chain active site, whereas C13 carbon atom forms adduct with Se atom of SeCys 498. We report that at least one methoxy group in curcuminoids is necessary for interation with catalytic residues of thioredoxin. Pharmacophore of both active sites of the TrxR receptor for curcumin and demethoxy curcumin molecules has been drawn and proposed for design and synthesis of most probable potent antiproliferative synthetic drugs.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.