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The optimal duration of dual antiplatelet therapy (DAPT) as a routine treatment in stroke patients is still controversial. The efficacy and safety of DAPT may vary with different regiments, initiating treatment time and race. Our study assessed the efficacy and safety of DAPT in patients with stroke and to determine the factors influencing the efficacy and safety of DAPT. Relevant studies published up to May 2019 from PubMed, Embase, Web of Science and the Cochrane Library. Randomized controlled trials comparing DAPT with mono antiplatelet therapy (MAPT) for stroke secondary prevention were included. The primary endpoints were stroke recurrence, ischemic stroke recurrence and all-cause death. Subgroup analysis was made according to regiment, initiating treatment time and race. Eighteen studies (n=33353) were included. Comparing with MAPT, short-term DAPT reduced stroke recurrence (RR = 0.68, 95% CI = 0.60-0.77) and ischemic stroke recurrence (RR = 0.67, 95% CI = 0.59-0.77) but increased major bleeding (RR = 1.82, 95% CI = 1.11-2.98). Long-term DAPT had no superiority compared with MAPT. Aspirin plus clopidogrel comparing with aspirin and early initiating treatment time comparing with MAPT decreased stroke recurrence (RR = 0.74, 95% CI = 0.67-0.83; RR = 0.69, 95% CI = 0.61-0.78) and ischemic stroke recurrence ( RR = 0.71, 95% CI = 0.64-0.79; RR = 0.68, 95% CI = 0.59-0.77) but also increased major bleeding (RR = 1.70, 95% CI = 1.38-2.09; RR = 1.75, 95% CI = 1.07-2.85). DAPT reduced stroke and ischemic stroke recurrence in non-Asian group but only reduced ischemic stroke recurrence in Asian group. As stroke secondary prevention, short-term DAPT rather than long-term DAPT could be a better choice. Patients could benefit more from aspirin plus clopidogrel or given DAPT within 72 h after symptoms onset. Race may be a factor influencing the efficacy of DAPT.

Early administration of antiplatelet agents in acute ischemic stroke patients (AIS) receiving intravenous thrombolysis (IVT) is a potential therapeutic strategy, however, safety and efficacy are not well established. We hypothesize that antiplatelet pretreatment (AP) before IVT have a similarly role as initiation of AP within the first 24 hours following IVT. We aimed to explore the effect of AP on platelet aggregation and clinical outcomes in thrombolysis-treated AIS patients. We enrolled AIS patients treated with IVT at the Neurology Department of the Nanjing First Hospital from January 2016 to June 2018. Prior use of antiplatelet agent was recorded. Light transmittance aggregometry was used to estimate the maximum platelet aggregation (MPA). Linear regression model was performed to investigate the factors associated with MPA. Multivariate logistic regression was used to analyse the association between AP and clinical outcomes. A total of 59 patients were included; 23 (38.9 %) were taking antiplatelet agent before stroke. Prior AP (β = -20.209, SE mean=6.574; P=0.004) was significantly lower the arachidonic acid-induced MPA at the time point of 3h after thrombolysis. AP did not increase of the risk for sICH (OR=3.41, 95%CI 0.16-7.20, p=0.436) or mortality (OR=3.55, 95%CI 0.39-8.52, p=0.260). There were no associations between AP and improved clinical outcomes (all P>0.05). In thrombolysis-treated AIS patients, AP was associated with lower MPA after thrombolysis. AP is safe in these patients, however, further studies are required to confirm the efficacy.

This paper investigates the effect of solders with different grain sizes (5-15 ?m, 2-15 ?m, 2-11 ?m) on the mechanical and thermal reliability of flip-chip LED chip Au/Sn Ag Cu/Cu solder joints during reflow soldering. The lead-free solder SAC305 was selected as the solder. The microstructure of the IMC interface and the inferred surface of the solder joint is observed, and the microstructure evolution of the solder joint is analyzed. The void ratio of the solder joints under different grain sizes is tested to characterize the influence of the contact area between the chip and the solder joints on the shear stress. In addition, the solder joints were aged for 1000 h under a relative humidity of 85 °C/85%. The photoelectric thermal performance of the FC-LED filament and the influence of high temperature and high humidity aging on the reliability of the filament were tested and analyzed. The results show that when the size of the solder paste is small and the uniformity is poor within a certain range of solder size, the voids in the flux layer are large and concentrated, and the void ratio is significantly higher, which leads to a decrease in the mechanical reliability of the solder joints. The thermal resistance test results show that the cavity will cause excessive thermal resistance, poor heat dissipation, a significant increase in junction temperature, and a decrease in thermal reliability, which in turn leads to severe light aging and ultimately changes in photoelectric performance. When the grain size is 5-15 ?m, the uniformity of the particle size is good. After the filament is aged for 1000 h at high temperature and humidity, the light maintenance rate remains at 65.6%, and the filament performance is stable and reliable. It has certain reference value in the actual production process.

From the seeds of Annona muricata one new cyclopeptide, annomuricatin B: cyclo-(prolyl-asparaginyl-alanyl-tryptophyl-leucyl-glycyl-thryl) has been isolated. The structure was elucidated by chemical and spectral methods. From the seeds of Annona muricata one new cyclopeptide, annomuricatin B [cyclo-(prolyl-asparaginyl-alanyl-tryptophyl-leucyl-glycyl-thryl)], has been isolated. The structure was elucidated by chemical and spectral methods.