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Objective We aimed to analyze and predict the risk of white matter lesions (WMLs) in hypertensive patients with different traditional Chinese medicine (TCM) syndromes, and to explore the relationship and influencing factors between them. Methods From September 2019 to December 2021, 309 patients were enrolled from the cardiovascular departments of the Affiliated Hospital of Gansu University of Traditional Chinese Medicine according to the inclusion and exclusion criteria, and they were divided into four syndromes: phlegm and blood stasis syndrome, kidney qi deficiency syndrome, liver fire hyperactivity syndrome, and yin deficiency and yang hyperactivity syndrome. Diastolic blood pressure (DBP), homocysteine acid (Hcy), uric acid (UA), and serum cystatin C (Cys C) were measured. The ARWMC and Fazekas scales were used to assess the site, score, and the degree of WMLs (mild, moderate, or severe) in hypertensive patients with different syndromes, and the correlation between risk factors and different syndromes was summarized. Results There were significant differences in DBP, Hcy, UA, and Cys C among different TCM syndrome types (P<0. 05). WMLs were assessed by the Fazekas and ARWMC scales, and there was no significant difference in the distribution of WMLs sites among different syndrome types. There was no significant difference in the Fazekas scores of WMLs, but there was a significant difference in the ARWMC ratings among different syndrome types (P<0. 05). The WMLs Fazekas and ARWMC risk classification analysis of different TCM syndrome types were significantly different (P<0. 05). According to the Fazekas scale assessment, there were differences in WMLs among all of the syndrome types (P<0. 05). Spearman rank correlation analysis showed that the WMLs degree was positively correlated with age, Hcy, Cys C, and UA in the phlegm and blood stasis syndrome group (rs =0. 22, 0. 23, 0. 18, 0. 24, P<0. 05). The WMLs degree was negatively correlated with HUA and HHcy (rs =-0. 19, -0. 21, P<0. 05). The degree of WMLs was positively correlated with UA (rs =0. 48, P<0. 05), and negatively correlated with HUA (rs = -0. 47, P<0. 05). The degree of WMLs in yin deficiency and yang hyperactivity syndrome group was positively correlated with age, HUA, and Cys C (rs = 0. 37, 0. 27, 0. 27, P <0. 05), and negatively correlated with UA (rs = -0. 32, P < 0. 05). The degree of WMLs in the kidney qi deficiency syndrome group was positively correlated with Hcy (rs = 0. 33, P <0. 05), but negatively correlated with HHcy and DBP (rs = -0. 32, -0. 30, P < 0. 05). The phlegm and blood stasis syndrome had more risk factors with a statistically significant difference (P < 0. 05) compared with the liver fire hyperactivity syndrome, yin deficiency and yang hyperactivity syndrome, and kidney qi deficiency syndrome. According to the ARWMC rating, there were differences in WMLs among all syndrome types (P<0. 05). Spearman rank correlation analysis showed that the WMLs degree was positively correlated with UA (rs =0. 57, P<0. 05) and negatively correlated with HUA (rs =-0. 58, P<0. 05) in patients with hypertension and the ARWMC rating. The degree of WMLs was positively correlated with UA (rs = 0. 34, P <0. 05), and negatively correlated with HUA (rs =-0. 44, P<0. 05). The degree of WMLs in the kidney qi deficiency syndrome group was positively correlated with Cys C (rs =0. 26, P<0. 05), and negatively correlated with diabetes mellitus and HUA (rs =-0. 30, -0. 28, P<0. 05). There were more risk factors with statistically significant differences (P<0. 05) in the kidney qi deficiency syndrome compared with phlegm and blood stasis syndrome, liver fire hyperactivity syndrome, and yin deficiency and yang hyperactivity syndrome. Conclusion The phlegm and blood stasis syndrome and kidney qi deficiency syndrome may be TCM syndrome types with higher incidences of WMLs in hypertensive patients. [ABSTRACT FROM AUTHOR]

Objective To evaluate the changes of platelet activity before and after anti-platelet treatment in patients with coronary heart disease, and their responsiveness to clopidogrel through detecting the phosphorylation levels of vasodilator stimulated phosphoprotein (VASP). Methods Twenty-eight cases of healthy people were selected as control group . Patients with chronic stable angina pectoris (CSA, n=95) were randomly divided into A (48 cases) group and B (47 cases) group, and were given clopidogrel 75 mg/d or 150 mg/d respectively; Patients with non ST segment elevation acute coronary syndrome (NST-ACS, n=67) were all given 300 mg loading dose of clopidogrel at the first time, then randomly divided into C (33 cases) group and D (34 cases) group, and given clopidogrel 75 mg/d and 150 mg/d respectively. Blood were taken to examine the phosphorylation levels of serum VASP by ELISA before taking clopidogrel, at time point of loading dose and the fifth day of clopidogrel administration . Results Before treatment, phosphorylation levels of serum VASP were lower in A, B, C, D groups than those in the normal control group(P< 0.05). After treatment of clopidogrel for 5 days: (T) In group A and group B, phosphorylation levels of serum VASP did not change compared to that before treatment (P > 0.05). (2) In group C and group D, phosphorylation levels of serum VASP were significantly increased at loading dose and the fifth day of clopidogrel administration than those before treatment (P < 0.05), but there were no significant differences in phosphorylation level of VASP was lower group between group C and group D after serum treatment (P > 0.05). Conclusion The phosphorylation level of serum VASP was lower in patients with coronary heart disease than that in normal control group. Clopidogrel can improve the phosphorylation level of serum VASP in NST- ACS patients . [ABSTRACT FROM AUTHOR]

Objective To analyze the biomechanical effect of the volume and distribution of bone cement on the adjacent vertebrae using 3D finite analysis. Methods Using Mimics 10.0, Geomagic studio 11.0, HyperMesh 11.0, and Abaqus 6.9 softwares, a geometric reconstruction of the vertebral body was developed using the CT 3D reconstruction data. The finite model was established according to the volume and distribution of bone cement. The loading was performed to investigate the force distribution of the adjacent vertebrae. Results Under the vertical loading, the von Mises stress on the cortical bone of T12 was 29. 49 MPa in the unilateral 2 ml bone cement perfusion. The von Mises stress on the lower endplate was higher to 3. 93 MPa in the unilateral across the midline 2 ml bone cement perfusion. The von Mises stress on cortical bone of L2 was 15. 29 MPa in the unilateral bone cement perfusion. The von Mises stress on the upper endplate was 4. 53 MPa in the unilateral across the midline 2 ml bone cement perfusion. Under the lateral bending load, the von Mises stress on cortical bone of T12 was 114. 83 MPa in the unilateral across the midline 4 ml bone cement perfusion. The von Mises stress on the lower endplate was 8. 62 MPa in the bipedicular 4 ml bone cement perfusion. The von Mises stress on cortical bone of L2 was 96. 41 MPa in the unilateral across the midline 4 ml bone cement perfusion. The von Mises stress on the upper endplate was 9. 80 MPa in the unilateral across the midline 4 ml bone cement perfusion. Under the rotating load, the von Mises stress on cortical bone of T12 was 119. 42 MPa in the unilateral 2 ml bone cement perfusion. The von Mises stress on the lower endplate was 8. 77 MPa in the unilateral 2ml bone cement perfusion. The von Mises stress on cortical bone of L2 was 146. 31MPa MPa in the unilateral 2 ml bone cement perfusion. The von Mises stress on the upper endplate was 7. 84 MPa in the unilateral 2 ml bone cement perfusion. Conclusion The volume and distribution of bone cement are the most important determinant in adjacent vertebrae fractures. The direction of the mechanical loading is also closely related. [ABSTRACT FROM AUTHOR]