ABSTRACT
OBJECTIVE:To compare clinical efficacy and safety of clopidogrel and ticaprelor in the treatment of acute non-ST elevation myocardial infarction (NSTEMI).METHODS:A total of 160 NSTEMI patients admited in cardiovascular disease department of our hospital during Oct.2013-Nov.2015 were divided into observation group and control group according to random number table,with 80 cases in each group.Both groups received routine treatment and continues intravenous pump of Tirofiban hydrochloride sodium chloride injection at 0.05 μg/(kg·h).Control group was additionally given oral loading-dose of Clopidogrel hydrogensultate tablet 300 mg,adjusted to 75 mg,qd,on the basis of routine treatment.Observation group was additionally given oral loading-dose of ticaprelor 180 mg,adjusted to 90 mg,bid,on the basis of routine treatment.Both groups received 1 month of treatment.The rate of platelet aggregation,LVEF,LVEDD,fibrinogen levels,the incidence of MACE and bleeding events were compared in 2 groups before and after treatment.RESULTS:Before treatment,there was no statistical significance in the rate of platelet aggregation between 2 groups (P＞0.05).After 1 week and 1 month of treatment,the rates of platelet aggregation in 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).After 1 week of treatment,there was no statistical significance in the levels of LVEF or LVEDD between 2 groups (P＞0.05).After 1 month of treatment,LVEF of observation group was significantly higher than that of control group,LVEDD was significantly lower than control group,with statistical significance (P＜0.05).There was no statistical significance in the level of fibrinogen before treatment and after 3 d of treatment (P＜0.05).After 1 week and 1 month of treatment,the levels of fibrinogen in 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).The incidence of MACE in observation group was 11.25％,which was significantly lower than 25.00％ of control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of bleeding (3.75％ vs.7.50％) between 2 groups (P＞0.05).CONCLUSIONS:Compared with clopidogrel,ticaprelor effectively inhibits platelet aggregation in NSETMI patients,reduces the level of fibrinogen,improves cardiac function and prognosis and doesn't increase the risk of bleeding with good safety.
ABSTRACT
Objective To evaluate the value of utility of bronchoscopy in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients with Bacteria sputum negative pulmonary tuberculosis.Methods Bronchoscopy was conducted to 65 AIDS patients with bacteria sputum negative pulmonary tuberculosis in the first hospital of Changsha. The patients’ bronchoalveolar lavage fluid through the electronic bronchoscopy, mycobacterium tuberculosis (MTB) culture, brushings and biopsy pathology were analyzed.Results 65 cases, bronchoscope alveolar lavage lfuid smear positive acid-fast stain 14 cases (21.54%), BAL mycobacterium tuberculosis culture positive 20 cases (30.76%), a bronchoscope brush positive 24 cases (36.92%), 35 cases of bronchoscopy biopsy, according to the performance under the bronchoscope positive 21 cases (60.00%), bronchoscopy combined different methods conifrmed 43 cases (66.15%).Conclusions Bronchoscopy in AIDS with bacteria sputum negative pulmonary tuberculosis diagnosis, it has important application value.
ABSTRACT
The surgical treatment of hepatocellular carcinoma have advanced greatly in recent years: associating liver partition and portal vein ligation for staged hepatectomy can bring hope and relief to patients with advanced liver cancer and less future liver remnant; the application range of laparoscopic hepatectomy and robotic hepatectomy were amplified; hepatectomy following anatomic or non-anatomic direction should be decided by particular situations; the precise preoperative assessment of liver reserve function ensured the success of extended hepatectomy; the further discussion of United Network for Organ Sharing criteria for liver transplantation made the appearance of University of California at San Francisco, Up-to-seven and Hangzhou criteria; bridge therapy can decrease tumor progression and the dropout rate from the liver transplantation waiting list; downstaging treatment is used in selected patients with more advanced liver cancer who are beyond the accepted transplant criteria to acquire the chance of liver transplantation and increase survival rates.
