Establishing a predictive model for aspirin resistance in elderly Chinese patients with chronic cardiovascular disease.

BACKGROUND: Resistance to anti-platelet therapy is detrimental to patients. Our aim was to establish a predictive model for aspirin resistance to identify high-risk patients and to propose appropriate intervention. METHODS: Elderly patients (n = 1130) with stable chronic coronary heart disease who were taking aspirin (75 mg) for > 2 months were included. Details of their basic characteristics, laboratory test results, and medications were collected. Logistic regression analysis was performed to establish a predictive model for aspirin resistance. Risk score was finally established according to coefficient B and type of variables in logistic regression. The Hosmer-Lemeshow (HL) test and receiver operating characteristic curves were performed to respectively test the calibration and discrimination of the model. RESULTS: Seven risk factors were included in our risk score. They were serum creatinine (> 110 µmol/L, score of 1); fasting blood glucose (> 7.0 mmol/L, score of 1); hyperlipidemia (score of 1); number of coronary arteries (2 branches, score of 2; ≥ 3 branches, score of 4); body mass index (20-25 kg/m(2), score of 2; > 25 kg/m(2), score of 4); percutaneous coronary intervention (score of 2); and smoking (score of 3). The HL test showed P ≥ 0.05 and area under the receiver operating characteristic curve ≥ 0.70. CONCLUSIONS: We explored and quantified the risk factors for aspirin resistance. Our predictive model showed good calibration and discriminative power and therefore a good foundation for the further study of patients undergoing anti-platelet therapy.

[The experimental study of simvastatin on improving aspirin resistance in diabetic rats].

OBJECTIVE: The purpose of the present study was to investigate the effects of the combination of aspirin, simvastatin in diabetic rat on platelet function. METHODS: Eight-week-old male Wistar rats were selected and randomly divided into diabetic group (n=48) and normal control group (n=48). Diabetic rats were injected with 1% STZ (65mg/kg, dissolved in 0.l mmol/L, pH 4.5 citrate buffer) to induce diabetic model and the rats in normal control group were injected with the same dose of citrate buffer. A rat with blood glucose greater than 16.8 mmol/L and along with diabetic symptoms of polydipsia, polyuria and weight loss was considered the successful model of diabetes. Diabetic rats and normal Wistar rats were randomly divided into 4 groups and given aspirin(10 mg/kg), simvastatin(2 mg/kg), combination of aspirin(10mg/kg) and simvastatin(2 mg/kg), PBS for 8 weeks, respectively. The platelet function and the expression of CD62P were evaluated. The levels of nitric oxide (NO), endothelin (ET), thromboxane B2(TXB2), prostacyclin (PGI2), adiponectin (APN), TXB2 were detected in the serum. The expressions of heme oxygenase-1(HO-1), HO-2, endothelial nitric oxide synthase(e-NOS), p-eNOS, B-cell lymphoma-2(Bcl-2), cyclooxygenase-2(COX-2) in thoracic aorta were evaluated by Western blot. RESULTS: Compared with control rats, diabetic rats had high platelet aggregation and activation (P<0.05), which treated aspirin also showed lower aspirin sensitivity (P<0.05). The combination of drugs upregulated the expression of HO-1, eNOS, p-eNOS, BCL-2, APN levels and decreased the expression of COX-2, and had a greater inhibitory effect on platelet aggregation and activation. The combination of drugs improved endothelial function, adjusted TXA2/PGI2 levels and increased NO levels, which resulted in a great potential antiplatelet effect. CONCLUSIONS: These results suggest that simvastatin may improvethe effect of aspirin on anti-platelet function in diabetic rats.

Correlation between sex hormone levels and obesity in the elderly male.

OBJECTIVE: To investigate the levels of sex hormones and androgen receptor (AR) in elderly male patients and to explore a possible correlation with obesity. METHODS: The cross-sectional study included 314 Elderly males (age ≥ 65 year). Of these subjects, 104 were healthy (age range 65-92 year; mean 71.38 ± 5.154 year), 74 were obese (65-87 year; 71.32 ± 4.74 year), and 111 were overweight (65-85 year; 71.43 ± 5.03 year). The following parameters were measured: total testosterone (TT), free testosterone, dehydroepiandrosterone sulfate, sex hormone-binding globulin (SHBG), estradiol (E2), luteinizing hormone, follicle-stimulating hormone and AR. RESULTS: (i) The levels of TT and SHBG in the obesity group were significantly lower than those in non-obese subjects. (ii) Body mass index (BMI) negatively correlated with TT and SHBG. (iii) Multiple regression analysis revealed that TT (ß: -0.230; p = 0.045) and SHBG (ß: -0.163; p = 0.02) were statistically correlated with BMI. CONCLUSION: Testosterone levels in the obese population were significantly lower than in the non-obese population and there is a significant association between testosterone levels and the extent of obesity.

[Analysis of Liqi decoction for treatment of false intestinal obstruction caused by retroperitoneal hematoma].

OBJECTIVE: To study the efficiency of Liqi decoction on false intestinal obstruction caused by retroperitoneal hematoma. METHODS: Seventy-five patients were randomly divided into two groups involving Liqi groups and control group. In Liqi group, therer were 45 patients including 28 males and 17 females with an average age of (41.45+/-13.58) years, 32 cases of pelvic fracture, 13 cases of lumber fracture and Liqi decoction were given oral for 2 to 3 days. In control group, there were 30 cases including 19 males and 11 females with an average age of (43.28+/-9.49) years, 24 cases of pelvic fracture, lumber fracture in 6 cases, and 30 cases was fasting and enema, 14 cases were gastrointestinal decompression. RESULTS: According to New Chinese Medicine Clinical Research on the Guiding Principles, the efficacy of intestinal obstruction was evaluated, in Liqi group the results were excellent in 25 cases, good in 13, fair in 7, and in control group,excellent in 5, good in 7, fair in 18. The fineness rate were compared between two groups by chi2 test, the difference was significant (P<0.05). CONCLUSION: Liqi decoction is a simple and effective way to treated the retroperitoneal hecatomb caused by pseudo-obstruction.