Ticagrelor to Reduce Myocardial Injury in Patients With High-Risk Coronary Artery Plaque

ObjectivesThe goal of this study was to determine whether ticagrelor reduces high-sensitivity troponin I concentrations in patients with established coronary artery disease and high-risk coronary plaque.BackgroundHigh-risk coronary atherosclerotic plaque is associated with higher plasma troponin concentrations suggesting ongoing myocardial injury that may be a target for dual antiplatelet therapy.MethodsIn a randomized, double-blind, placebo-controlled trial, patients with multivessel coronary artery disease underwent coronary ¹⁸F-fluoride positron emission tomography/coronary computed tomography scanning and measurement of high-sensitivity cardiac troponin I. Patients were randomized (1:1) to receive ticagrelor 90 mg twice daily or matched placebo. The primary endpoint was troponin I concentration at 30 days in patients with increased coronary ¹⁸F-fluoride uptake.ResultsIn total, 202 patients were randomized to treatment, and 191 met the pre-specified criteria for inclusion in the primary analysis. In patients with increased coronary ¹⁸F-fluoride uptake (120 of 191), there was no evidence that ticagrelor had an effect on plasma troponin concentrations at 30 days (ratio of geometric means for ticagrelor vs. placebo: 1.11; 95% confidence interval: 0.90 to 1.36; p = 0.32). Over 1 year, ticagrelor had no effect on troponin concentrations in patients with increased coronary ¹⁸F-fluoride uptake (ratio of geometric means: 0.86; 95% confidence interval: 0.63 to 1.17; p = 0.33).ConclusionsDual antiplatelet therapy with ticagrelor did not reduce plasma troponin concentrations in patients with high-risk coronary plaque, suggesting that subclinical plaque thrombosis does not contribute to ongoing myocardial injury in this setting. (Dual Antiplatelet Therapy to Reduce Myocardial Injury [DIAMOND]; NCT02110303)     

气象因素对青岛市区居民脑出血发病的影响

目的探讨气象因素变化对居民脑出血发病的影响。方法对连续5年间市区4家大医院1154例脑出血患者的发病时间特点进行分析,用构成比、方差分析和圆分布分别分析发病的月分布、季节差别和年度集中趋势,对8项月气象指标和2项候(每5天)气象指标及其变化对同期脑出血发病的影响进行单变量和多变量分析。结果(1)脑出血冬季高发,夏季低发;(2)脑出血发病有集中的趋势,平均角分别是12月、1月和2月(P<0·05);(3)单因素相关分析显示脑出血的月发病人数与3项温度指标均呈负相关,与3项气压指标均呈正相关;候发病例数只与候平均温度的候际差呈负相关(r=-0·35284,P<0·05);(4)多变量逐步回归分析显示脑出血与月平均气压、月平均相对湿度和月平均风速有关,脑出血的候发病例数只与候平均最低温度的候际差相关(P<0·05)。结论脑出血发病有明确的季节性,年度发病集中趋势是冬季的3个月份。脑出血发病与气温和气压突变有关,尤易于被降温诱发。多种气象因素相互协同或拮抗共同影响脑出血的发病。     

不同色彩背景对选择反应和运算能力的影响研究

目的: 对不同色彩背景下认知操作的任务完成绩效进行比较研究. 方法: 95名青年男性,完成不同色彩背景下的连续相加和字母选择认知测验. 结果: 认知任务均受到了色彩背景的影响,并且不同的色彩背景之间统计学上存在差异. ①在操作时限为2 min的简单选择任务中,彩色背景下测试成绩之间无统计学差异,而非彩色之间以及非彩色与彩色背景之间有统计学差异(F=2.257,P＜0.05);②在连续相加任务中,操作时限为9 min,非彩色与彩色背景之间均有统计学差异(F=2.115, P＜0.05). 结论: 在视屏操作过程中,不同的背景色会影响到操作功能的反应速度和准确性,并且与任务难度及操作时间有关.     

正常人亮暗背景下不同对比度的视力变化

目的:观察正常人眼在亮、暗背景下不同对比度的视力变化.方法:54例(108眼)正常视力的成年男性,用多功能电子视力测量仪(MFVA-100)比较亮、暗背景下不同对比度(100%、25%、10%、5%)的logMAR视力,并分析亮、暗背景下视力的相关性.结果:背景亮度相同时,随对比度的下降各组视力呈下降趋势,低对比度组视力明显低于高对比度组(P＜0.001);对比度相同时,暗背景组视力明显低于亮背景组(P＜0.001).亮背景100%对比度组视力与暗背景各组视力之间均无线性相关,与亮背景25%、10%、5%对比度组视力呈正线性相关(P＜0.001);暗背景100%对比度组与暗背景25%、10%、5%对比度组视力呈正线性相关(P＜0.001).随着对比度的降低,各组视力的波动幅度增加,暗背景下对比度5%时差异最大.结论:正常人眼亮背景下的视力优于暗背景,随着对比度降低,视力渐趋下降,个体差异增加,亮、暗背景之间的视力变化无线性相关.     

幼龄SD大鼠重复给药毒性试验背景数据的建立

目的:对本研究室幼龄SD大鼠4周重复给药毒性试验中正常对照组的各项指标进行统计整理,建立本研究室的数据背景资料,为儿科药物非临床安全性评价提供参考.方法:从本研究室2015-2019年进行的儿科药物重复给药毒性试验中,选取全部正常对照组幼龄SD大鼠的数据,包括体重、摄食量、生殖发育(龟头包皮腺裂开和阴道张开时间)、骨骼...     

《素问玄机原病式》学术思想探讨

《素问玄机原病式》一书,发挥《内经》病机学说,弥补了原“病机十九条”过于简略之不足,创造性地继承和发展了《内经》理论,特别是首倡“六气皆从火化”之说;关于“相火”的论述,则为后世相火理论的形成奠定了基础;它还总结了温热病的治疗原则,对后世温病学派的形成产生了重要影响。     

新疆民营医院法定代表人职业背景及融资特点分析调查

通过对新疆46家民营医院法定代表人职业背景、融资情况及新疆民营医院管理模式的调研,发现新疆民营医院法定代表人存在年纪轻,少数民族少,新疆本地法定代表人占半;医疗专业为主,学历、专业素质、职业化程度较低;缺乏专业化培训等特点,新疆民营医院管理模式以院长负责制为主,融资以民间借贷为主,融资风险自担,融资目的单一,缺乏软实力投入。     

3.0T磁共振肝脏背景抑制磁共振扩散成像技术的初步探讨

目的 讨论3.0T磁共振肝脏DWIBS的最佳成像参数.方法 22名健康志愿者作为受试者,使用3.0T双梯度超导磁共振扫描仪,在其他的参数不变条件下,SE-EPI序列以不同的b值、呼吸方式、背景抑制方式、信号平均次数,分别行DWIBS扫描.以表观扩散系数值、质量指数、信噪比、背景噪声为指标,用SPSS13.0进行统计学分析.结果 ①随着b值增大,ADC值逐渐变小(P<0.05),图像质量指数以b=300时最高(P<0.05),b=300与b=600的信噪比无明显差异(P>0.05),但与b=900间差异有显著性(P<0.05).背景噪声以b=900最高,但与b=300、b=600无明显差异(P>0.05);②自由呼吸和呼吸触发进行比较,两种方式的ADC值的变化较小(P>0.05),但呼吸触发方式的质量指数和信噪比均高于自由呼吸方式(P<0.05);③同时SPIR序列与STIR序列行背景抑制进行比较,ADC值、信噪比及背景噪声均有变化.两者的ADC值不同,SPIR序列上ADC值大(P<0.05).SPIR序列上较高(P<0.05)SPIR的SNR、质量指数优于STIR(P<0.05),但STIR的背景噪声优于SPIR(P<0.05);④NSA增大时,图像的信噪比与质量指数明显提高(P<0.05),但扫描时间明显增加.结论 b逐渐值大,图像信噪比与质量指数逐渐变差,ADC值逐渐减小,在使用呼吸触发方式、SPIR背景抑制方式和适当的NSA次数(NSA=3)时,可获得较高的DWIBS图像.     

数字化可视人体图像的目标提取

目的 探讨数字化可视人体图像的目标提取.方法 利用归一化阈值分割排除大部分背景,再结合边缘跟踪对目标边界附近保留的边缘特征进行识别、连接、去噪,构建一种准确、有效的目标提取算法.结果 基于边缘和阈值混合的分割技术有效地去除了数字化人体图像的背景.结论 通过与其他几种分割算法的比较,本计算法实际使用效果较好.     

Comparison of PASL,PCASL, and background‐suppressed 3D PCASL in mild cognitive impairment

We compared three implementations of single‐shot arterial spin labeled (ASL) perfusion magnetic resonance imaging: two‐dimensional (2D) pulsed ASL (PASL), 2D pseudocontinuous ASL (PCASL), and background‐suppressed (BS) 3D PCASL obtained in a cohort of patients with mild cognitive impairment (MCI) and elderly controls. Study subjects also underwent ¹⁸F‐fluorodeoxyglucose positron emission tomography (¹⁸F‐FDG PET). While BS 3D PCASL showed the lowest (P < 0.001) gray matter–white matter cerebral blood flow (CBF) contrast ratio, it provided the highest (P < 0.001) temporal signal‐to‐noise ratio. Mean relative CBF estimated using the PCASL methods in posterior cingulate cortex (PCC), precuneus, and hippocampus showed hypoperfusion in the MCI cohort compared to the controls consistent with hypometabolism measured by ¹⁸F‐FDG PET. BS 3D PCASL demonstrated the highest discrimination between controls and patients with effect size comparable to that seen with ¹⁸F‐FDG PET. 2D PASL did not demonstrate group differentiation with relative CBF in any ROI, whereas 2D PCASL demonstrated significant differences only in PCC and hippocampus. Mean global CBF values did not differ across methods and were highly correlated; however, the correlations were significantly higher (P < 0.001) when either the same labeling (PCASL) or the same acquisition strategy (2D) was used as compared to when both the labeling and readout methods differed. In addition, there were differences in regional distribution of CBF between the three modalities, which can be attributed to differences in sequence parameters. These results demonstrate the superiority of ASL with PCASL and BS 3D readout as a biomarker for regional brain function changes in MCI. Hum Brain Mapp 38:5260–5273, 2017. © 2017 Wiley Periodicals, Inc.