Background:The efficacy and safety of ticagrelor following percutaneous coronary intervention for patients with acute coronary syndrome remains unclear. This study sought to evaluate clinical outcomes of ticagrelor as part of dual-antiplatelet treatment for these patients. Methods: PubMed, MEDLINE, Embase, and other Internet sources were searched for eligible citations. The primary end point was major adverse cardiovascular and cerebrovascular events, consisting of cardiovascular death, myocardial infarction, and stroke. The secondary end point was the occurrence of definite/probable stent thrombosis (ST). The risk of bleeding was chosen to be the safety end point. Results: Eleven clinical trials -six randomized trials and five observational trials -were finally analyzed. A tendency toward reduction in the risk of major adverse cardiovascular and cerebrovascular events was observed only with respect to ticagrelor (OR 0.83, 95% CI 0.66-1.03; P=0.091), which might have resulted from the lower risk of cardiovascular death (OR 0.78, 95% CI 0.68-0.89; P,0.001). The overall incidence of ST differed significantly between the ticagrelor group and the clopidogrel group (OR 0.74, 95% CI 0.59-0.93; P=0.009), but the risk of bleeding, regardless of major or minor bleeding, increased significantly. Conclusion: As part of dual-antiplatelet treatment following percutaneous coronary intervention, ticagrelor significantly reduced the risk of cardiovascular death and ST in acute coronary syndrome patients, but at the cost of bleeding. More powerful relevant randomized trials are still warranted to guide clinical decision-making.
This study aimed to investigate the protective mechanism of Xuebijing injection (XBJ) against heat stroke (HS) in rats. Adult male Sprague Dawley rats were randomly divided into normal control (NC), normal saline-treated HS (NS-HS) and XBJ-treated HS (XBJ-HS) groups. At 47 and 57 min from the initiation of heat stress (42.5–43.5°C), the plasma levels of certain cytokines [interleukin (IL)-1β, IL-6 and tumor necrosis factor-α], biochemical indicators (creatinine, blood urea nitrogen, aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase) and coagulation indicators (activated partial thromboplastin time, prothrombin time, fibrinogen degradation products and D-dimer) were detected, and microscopy of the liver tissue of the rats was conducted. At 47 and 57 min after the initiation of the heat stress, the levels of the cytokines, coagulation indicators and biochemical indicators in the NS-HS group were significantly higher than those in the NC group (P<0.05). In the NS-HS group, the levels of the aforementioned indices were significantly reduced compared with those in the NC and NS-HS groups (P<0.05). In the NS-HS group, serious liver cell congestion, nuclear swelling and central vein dilation were visible, along with the appearance of bubbles in the liver tissue. In the XBJ-HS group, only a small number of congestive liver cells were identified, with occasional nuclear swelling but no bubbles, which was similar to the observations in the NC group. Early intervention treatment of HS with XBJ is able to reduce the systemic inflammatory response and coagulation activity and decrease the tissue ischemia and injury degree, thus extending the survival time of rats with HS.
Background: Patients with hematuria and/or proteinuria found during routine examination are commonly encountered. To define the clinicopathological characteristics and outcome of these patients, 142 patients with definite pathological diagnosis were studied retrospectively.Methods: All the 142 patients were divided into three groups: pure hematuria (HU, n = 13), concomitant hematuria and proteinuria (HUPU, n = 79), and proteinuria alone (PU, n = 50). Results: At the time of renal biopsy, 26% of the patients had renal insufficiency and 48% of the patients had hypertension. Pathologically, IgA nephropathy (n = 67) was the most common. A total of 51 patients were enrolled into the follow-up group. Finally, urinary abnormalities disappeared in 18% of the patients, 22% of HU developed proteinuria, 21% of HUPU and 23% of PU appeared to have a distinct increase of proteinuria, and 15% of PU developed hematuria. Seven patients with normal blood pressure before became hypertensive and 6% of the patients with normal renal function initially developed renal insufficiency. The renal outcome was associated with proteinuria and tubulointerstitial lesions. Conclusion: Because renal pathologic change does not always coincide with clinical manifestations, patients with hematuria and/or proteinuria found during routine examination do not necessarily imply a favorable outcome, so renal biopsy is quite important. Besides, early treatment and careful follow-up are helpful in these patients.
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