Erratum: Ultrafast Doublon Dynamics in Photoexcited 1T-TaS_{2} [Phys. Rev. Lett. 120, 166401 (2018)]

This corrects the article DOI: 10.1103/PhysRevLett.120.166401.

Akebia Saponin D Regulates the Metabolome and Intestinal Microbiota in High Fat Diet-Induced Hyperlipidemic Rats

Hyperlipidemia is a major component of metabolic syndrome, and regarded as one of the main risk factors causing metabolic diseases. We have developed a therapeutic drug, akebia saponin D (ASD), and determined its anti-hyperlipidemia activity and the potential mechanism(s) of action by analyzing the metabolome and intestinal microbiota. Male Sprague-Dawley rats were fed a high fat diet to induce hyperlipidemia, and then given ASD orally for 8 weeks. Lipid levels in serum were determined biochemically. Metabolites in serum, urine and feces were analyzed by UPLC-Q/TOF-MS, and the structure of the intestinal microbiota was determined by 16S rRNA sequencing. The ASD treatment significantly decreased the levels of TC, TG and LDL-c and increased the serum level of HDL-c. Metabolomics analysis indicated that the ASD treatment mainly impacted seven differential metabolites in the serum, sixteen differential metabolites in the urine and four differential metabolites in feces compared to the model group. The ASD treatment significantly changed eight bacteria at the genus level compared to the model group. In conclusion, ASD treatment can significantly alleviate HFD-induced hyperlipidemia and the hypolipidemic effect of ASD treatment is certainly associated with a systematic change in the metabolism, as well as dynamic changes in the structure of the intestinal microbiota.

Effects of dietary crude protein levels and cysteamine supplementation on meat quality and related indices of finishing pigs

The aim of this study was to investigate the effects of dietary crude protein levels and cysteamine (CS) supplementation on meat quality and related indices in longissimus dorsi muscle of finishing pigs. One hundred and twenty barrows were randomly allocated to a 2 × 2 factorial arrangement with five replicates of six pigs each. The primary variations were crude protein levels (14% or 10%) and CS supplemental levels (0 or 140 mg kg−1). After 41 d, 10 pigs per treatment were slaughtered. The results showed that low-protein level diets (LPDs) decreased Warner–Bratzler shear force (P < 0.01) and increased the content of intramuscular fat (P < 0.01). The mRNA expressions of lipogenic genes were up-regulated (P < 0.01), and the mRNA expressions of lipolytic genes were down-regulated (P < 0.01) in pigs fed LPD. LPDs increased the mRNA expressions of μ-calpain, and decreased the mRNA expression of calpastatin (P < 0.01). In addition, CS supplementation increased the mRNA expression of μ-calpain (P < 0.01). In conclusion, LPD improved the meat quality probably through regulating the lipogenesis, lipolysis, and the proteolysis process in muscle. The CS supplementation did not affect the meat quality of finishing pigs. Moreover, no significant interaction between dietary protein levels and CS supplementation for the meat quality of finishing pigs was observed.

A Neuronal Pathway that Commands Deceleration in Drosophila Larval Light-Avoidance

When facing a sudden danger or aversive condition while engaged in on-going forward motion, animals transiently slow down and make a turn to escape. The neural mechanisms underlying stimulation-induced deceleration in avoidance behavior are largely unknown. Here, we report that in Drosophila larvae, light-induced deceleration was commanded by a continuous neural pathway that included prothoracicotropic hormone neurons, eclosion hormone neurons, and tyrosine decarboxylase 2 motor neurons (the PET pathway). Inhibiting neurons in the PET pathway led to defects in light-avoidance due to insufficient deceleration and head casting. On the other hand, activation of PET pathway neurons specifically caused immediate deceleration in larval locomotion. Our findings reveal a neural substrate for the emergent deceleration response and provide a new understanding of the relationship between behavioral modules in animal avoidance responses.

[Effects of PSMB5 on proliferation and bortezomib chemo-resistance in human myeloma cells and its related molecular mechanisms]

Objective: To investigate the effects of proteasome beta 5 subunit (PSMB5) on proliferation and bortezomib (BTZ) chemo-sensitivity of multiple myeloma (MM) and its related molecular mechanisms. Methods: We used two MM cell lines, RPMI 8226 and BTZ drug-resistant cell line RPMI 8226/BTZ100 (hereinafter referred to as BTZ100) , as the research object. PSMB5 was overexpressed or knocked down in two myeloma cell lines via lentivirus transfection. CCK8 assay was used to detect the impact of PSMB5 on cell viability and bortezomib sensitivity in human myeloma cells; Using flow cytometry to test the effects of PSMB5 on apoptosis rate of human myeloma cells under the treatment of bortezomib; Apoptosis-related gene expression of Bax, Bcl-2, p-Akt and cleaved caspase-3 were detected by Western blot. Results: ①PSMB5 overexpression and knockdown were successfully constructed in RPMI 8226 and BTZ100 cells. ②PSMB5 expression was positively correlated with cell proliferation of RPMI 8226 and BTZ100 cells (P<0.05) . ③The cell viability was lower after PSMB5 knockdown in RPMI 8226 cells than control cells under the same concentration of BTZ[IC(50) at 24 h: (7.01±0.47) and (9.64±0.55) nmol/L respectively, t=6.289, P=0.003]. The cell viability was higher after PSMB5 overexpression in RPMI 8226 cells than control cells under the same concentration of BTZ[IC(50) at 24 h: (10.99±0.58) and (9.51±0.37) nmol/L respectively, t=3.724, P=0.020) . PSMB5 expression was negatively correlated with the sensitivity of RPMI 8226 cells to BTZ. The results of BTZ100 cells were similar. ④The expression of PSMB5 was negatively correlated with the apoptosis of RPMI 8226 and BTZ100 under the treatment of BTZ. ⑤Meanwhile, PSMB5 knockdown could increase the expression of pro-apoptosis gene Bax and cleaved caspase-3 and decrease the expression of anti-apoptotic gene Bcl-2 and p-Akt. PSMB5 over-expression has the opposite results. Conclusion: PSMB5 knockdown could improve the bortezomib sensitivity of MM cells via activation of apoptosis signaling. PSMB5 may be a potential therapeutic target for MM.

A disinhibitory mechanism biases Drosophila innate light preference

Innate preference toward environmental conditions is crucial for animal survival. Although much is known about the neural processing of sensory information, how the aversive or attractive sensory stimulus is transformed through central brain neurons into avoidance or approaching behavior is largely unclear. Here we show that Drosophila larval light preference behavior is regulated by a disinhibitory mechanism. In the disinhibitory circuit, a pair of GABAergic neurons exerts tonic inhibition on one pair of contralateral projecting neurons that control larval reorientation behavior. When a larva enters the light area, the reorientation-controlling neurons are disinhibited to allow reorientation to occur as the upstream inhibitory neurons are repressed by light. When the larva exits the light area, the inhibition on the downstream neurons is restored to repress further reorientation and thus prevents the larva from re-entering the light area. We suggest that disinhibition may serve as a common neural mechanism for animal innate preference behavior.

Strong anisotropic nodal lines in the TiBe family

Using first-principles calculations and k·p model analysis, we find that Dirac nodal lines (DNLs) exist in low energy band structures of real materials of the body-centered cubic TiBe family.

Effect of Methylprednisolone on Liver Injury and Endotoxin Levels Following Brain Death in Rats

BACKGROUND AND AIM

Brain death impairs liver function in potential donors and is associated with inflammatory activation. Methylprednisolone treatment after brain death has been shown to reduce inflammatory activity. The aim of the present study was to evaluate the effects of methylprednisolone on liver injury and endotoxin levels in brain-dead rats.

METHODS

Thirty-two rats were randomly divided into 4 groups: a sham-operation group (Sham group), a brain death with methylprednisolone treatment group (Methy group), a brain death with saline treatment group (Saline group), and a brain death group (BD group). The rats were anesthetized and induced by gradually increasing the intra-cranial pressure using a Fogarty catheter balloon for brain death. All of the animals were observed and ventilated for 6 h prior to being euthanized. Hepatic pathologic histology (Knodell histology activity index), liver inflammatory cytokine levels, liver function and endotoxin levels were assessed.

RESULTS

After brain death, methylprednisolone markedly alleviated the Knodell histology activity index of liver injury (P < .05). Additionally, significant reductions in the levels of TNF-α, IL-1β, and IL-10 were observed in the Methy group compared to those in the Saline and BD groups (P < .01), whereas no significant differences were found between the Saline and BD groups (P > .05). Interestingly, although the rate of liver injury after brain death in the methylprednisolone treatment group improved, the endotoxin level did not decline in the Methy group compared to the levels in the Saline and BD groups (P > .05).

CONCLUSION

The present study verified that methylprednisolone was protective for liver injury in rats subjected to brain death. This protection appeared to be due to reduced inflammatory activity with no influence on the endotoxin level.

Two agroinfection-compatible fluorescent protein-tagged infectious cDNA clones of papaya leaf distortion mosaic virus facilitate the tracking of virus infection

Papaya leaf distortion mosaic virus (PLDMV, the genus Potyvirus) is an emerging threat to papaya production. Here, agroinfection-compatible fluorescent protein-tagged PLDMV infectious cDNA clones driven by the Cauliflower mosaic virus 35S promoter were successfully constructed using one-step Gibson assembly. The clones were directly transformed into Agrobacterium tumefaciens to prevent potential problems such as plasmid instability during propagation in Escherichia coli. Ninety-five percent of papaya seedlings infected with PLDMV-GFP or PLDMV-mCherry developed systemic symptoms typical of those caused by wild-type PLDMV. Green and mCherry red fluorescence was observed in leaves, stems, and roots of infected papaya plants. The fluorescent protein-tagged agroinfectious PLDMV cDNA clones were stable in papaya for more than 90 days and during six serial passages at 30-day intervals. The availability of these infectious clones will contribute to research on PLDMV-host interactions and can be applied in the papaya breeding program for PLDMV resistance.

[Application of da Vinci robot's bilateral axillo-breast approach in thyroid surgery of obese patients]

Objective:To discuss the effect of obesity on the operation of thyroid gland surgery and surgical results.Method:The clinical data of 446 patients who underwent robot thyroid surgery through bilateral axillo-breast approach (BABA) from the General Hospital of Jinan Military region from February 2014 to November 2017 were analyzed retrospectively, and the patients were divided into BMI<25 kg/m²; group, BMI 25-30 kg/m²; group and BMI>30 kg/m²; group according to body mass index (BMI). The operative complications were compared between the three groups of benign and malignant patients, such as operation time, postoperative lead flow, postoperative hospitalization time, tumor size (malignant), lymph node metastasis (malignant), cosmetic satisfaction score, laryngeal nerve injury and parathyroid function decrease. Statistical methods using Variance analysis and χ² test to compare the differences between the two groups of indicators, difference is statistically significant (P<0.05).Result:The difference of operation time, postoperative average hospitalization time and postoperative drainage fluid volume in 3 groups was not statistically significant（P>0.05）. ①Intraoperative and postoperative pathological results were benign: BMI<25 kg/m²; group 69 cases, BMI 25-30 kg/m²; group 48 cases, BMI>30 kg/m²; group 8 cases, temporary recurrent laryngeal nerve injury were 1 case, 0 case and 0 case respectively, temporary parathyroid function decrease 3 cases, 2 cases and 1 case. ②Intraoperative and postoperative pathological results were malignant:BMI<25 kg/m²; group 180 cases, BMI 25-30 kg/m²; group 119 cases,BMI>30 kg/m²; group 22 cases, temporary recurrent laryngeal nerve injury were 2 cases,1 case and 0 case respectively, temporary parathyroid dysfunction in 64 cases,29 cases and 5 cases respectively.③1 patient in BMI<25 kg/m²; group had lymphatic leakage after operation, 1 patient in BMI 25-30 kg/m²; group had subcutaneous tunnel hemorrhage, and 1 patient had lymphatic leakage during operation.Conclusion:For overweight or obese patients, the da Vinci robot thyroid operation is reliable, does not increase the risk of surgical complications, but also has a good cosmetic effect.

[Relationship between upper airway volume and polysomnography parameters of patients with obstructive sleep apnea hypopnea syndrome]

Objective:To study the relationship among upper airway volume of naso-pharyngeal, yelo-pharyngeal,glosso-pharyngeal, hypo-pharyngeal area which measured by spiral computed tomography three-dimensional reconstruction technique, apnea hypopnea indexes, and the lowest oxygen saturation in patients with OSAHS.Method:①fifty-one patients with OSAHS were received polysomnography, and then were divided into groups by the AHI,LSaO₂ values. ②To measure upper airway volume at normal breath and Müller maneuver state using spiral computed tomography three-dimensional reconstruction technique of CT measurement, and to calculate volume change rate and observe the upper airway compliance. ③To analyses the relationship between upper airway volume and AHI,LSaO₂ values.Result:The smallest upper airway volume of OSAHS was at the velo-pharyngeal level; the volume of velo-pharyngeal level were negatively correlated with AHI during normal respiration and Müller's maneuver state and were positively correlated with LSaO₂; the volume of hypo-pharyngeal were negatively correlated with AHI during normal respiration; the volume of glosso-pharyngeal were positively correlated with LSaO₂ during Müller's maneuver state.Conclusion:①The volume of velo-pharyngeal level with OSAHS patients can reflect the severity of AHI,LSaO₂. ②The measurement of upper airway volume using spiral computed tomography three-dimensional reconstruction technique is good method to evaluate the upper airway compliance of OSAHS patients.

[Comparison of percutaneous endoscopic lumbar discectomy versus transforaminal lumbar interbody fusion in treating upper lumbar disc herniation]

Objective: To compare the efficacy of percutaneous endoscopic transforaminal discectomy (PTED) and transforaminal lumbar interbody fusion (TLIF) in the treatment of high lumbar disc herniation. Methods: The clinical data of patients with high lumbar disc herniation from February 2010 to February 2015 were retrospective analyzed. According to the inclusion criteria, a total of 63 cases were enrolled, including PTED group 33 cases, TLIF group 30 cases. The improvement of the two groups before and after surgery was assessed by visual analogue scale (VAS) and Oswestry dysfunction index (ODI). The operative time, intraoperative blood loss, drainage volume at 48 h postoperatively, hospitalization time, number of fluoroscopy, complication, recurrence rate and postoperative recovery were compared between the two groups. The follow-up period was 12 to 33 months. Results: The operation time, intraoperative blood loss, drainage amount and hospitalization time in PTED group were significantly less than those in TLIF group[(71±19) vs (121±22) min, (30±21) vs (317±50) ml, 0 vs (93±29) ml, (3.5±1.9) vs (12.5±2.1) d]. The number of fluoroscopy in PTED group was significantly higher than TLIF group[(16.2±8.3) vs (6.7±4.2)](all P<0.05). There was no significant difference in VAS score and ODI improvement rate between the two groups after operation (both P>0.05). There was no significant difference between the two groups in the excellent rate of surgery and the recurrence rate (both P>0.05). Conclusions: PTED has the advantages of less trauma and bleeding, rapid postoperative recovery in the treatment of upper lumbar disc herniation compared with TLIF, and the curative effect and recurrence rate are similar with TLIF. Therefore, PTED is an effective method for the treatment of upper lumbar disc herniation.

[Trend of clinical features in patients with acute coronary syndrome undergoing emergent percutaneous coronary intervention]

Objective: To investigate the clinical features and change trend of patients with acute coronary syndrome(ACS) undergoing emergent percutaneous coronary intervention(PCI). Methods: In this retrospective study, we retrieved all medical records of 4 907 ACS patients who underwent emergent PCI in Fuwai hospital from January 1,2010 to December 31,2016. We analyzed the clinical features and change trend in these patients. According to clinical diagnosis, patients were grouped as ST-elevated myocardial infarction(STEMI) group (3 719 cases) and NSTE-ACS group (patients with non-STEMI and unstable angina, 1 188 cases). Results: The ACS patients were aged (59.5±11.8) years old. There were 3 772 males and 1 135 females. The annual number of ACS patients underwent emergent PCI increased from 412 patients in 2010 to 1 067 patients in 2016. The number of NSTE-ACS patients increased from 11.4% (47/412) in 2010 to 26.5% (283/1 067) in 2016. Compared with STEMI group, patients in NSTE-ACS group were significantly older ((61.2±10.9) years old vs. (58.9±12.1) years old,P<0.01).The percent of female patients (30.1% (358/1 188) vs. 20.9% (777/3 719), P < 0.01), history of hypertension (69.1% (821/1 188) vs. 60.4% (2 248/3 719,P <0.01), previous PCI (25.8% (307/1 188) vs. 12.4% (461/3 719), P <0.01), and previous coronary artery bypass grafting (3.0% (36/1 188) vs. 1.0% (37/3 719), P <0.01) were all significantly higher in NSTE-ACS group than in STEMI group. On the other hand, NSTE-ACS patients presented less chronic renal failure (2.9% (35/1 188) vs. 4.3% (173/3 719), P <0.05) and hepatic dysfunction (8.5% (101/1 188) vs. 13.3% (495/3 719), P<0.01) as compared to ACS patients. In coronary angiography, NSTE-ACS patients had a higher prevalence of left-main disease (14.0% (166/1 188) vs. 7.8% (291/3 719), P<0.012 5) and triple vessel disease (47.8% (568/1 188) vs. 43.5% (1 619/3 719), P<0.012 5). There were no differences in prevalence of diabetes mellitus (31.9% (1 187/3 719) vs. 34.8% (414/1 188),P>0.05) and acute renal failure (0.1% (38/3 719) vs. 0.6% (7/1 188),P>0.05) between STEMI group and NSTE-ACS group. Conclusions: This single center retrospective analysis reveals that there is an increasing trend of NSTE-ACS patients from 2010 to 2016. Furthermore, there are more high-risk clinical characteristics in NSTE-ACS patients than in STEMI patients.

Host MyD88 signaling protects against acute graft-versus-host disease after allogeneic bone marrow transplantation

Recent experimental strategies to reduce graft-versus-host disease (GVHD) have focused largely on modifying innate immunity. Toll-like receptor (TLR)-driven myeloid differentiation primary response 88 (MyD88)-dependent signalling pathways that initiate adaptive immune function are also critical for the pathogenesis of GVHD. This study aimed to delineate the role of host MyD88 in the development of acute GVHD following fully major histocompatibility complex-mismatched allogeneic bone marrow transplantation (BMT). When myeloablated BALB/c MyD88 knock-out recipients were transplanted with C57BL/6 (B6) donor cells, they developed significantly more severe GVHD than wild-type (WT) BALB/c hosts. The increased morbidity and mortality in MyD88^-/- mice correlated with increased serum levels of lipopolysaccharide and elevated inflammatory cytokines in GVHD target organs. Additionally, MyD88 deficiency in BMT recipients led to increased donor T cell expansion and more donor CD11c⁺ cell intestinal infiltration with apoptotic cells but reduced proliferation of intestinal epithelial cells compared with that in WT BMT recipients. Decreased expression of tight junction mRNA in epithelial cells of MyD88^-/- mice suggested that MyD88 contributes to intestinal integrity. Cox-2 expression in the GVHD-targeted organs of WT mice is increased upon GVHD induction, but this enhanced expression was obviously inhibited by MyD88 deficiency. The present findings demonstrate an unexpected role for host MyD88 in preventing GVHD after allogeneic BMT.

Tetramethylpyrazine‑2'O‑sodium ferulate provides neuroprotection against neuroinflammation and brain injury in MCAO/R rats by suppressing TLR-4/NF-κB signaling pathway

BACKGROUND

Neuroinflammation following cerebral ischemia is a serious risk factor in stroke patients. The purpose of this study was to investigate the neuroprotective effects of tetramethylpyrazine‑2'O‑sodium ferulate (TSF), a structurally modified compound from tetramethylpyrazine and ferulate, on cerebral ischemic injury and the underlying mechanisms.

METHODS

Focal transient cerebral ischemia was induced in rat for 2 h by middle cerebral artery occlusion (MCAO) and the protective effect of TSF was studied using different doses of the drug (10.8, 18, 30 mg/kg, intravenously); Ozagrel (18 mg/kg) was used as the positive control. The drugs were given immediately after MCAO and the efficacy and mechanisms were evaluated at 72 h of reperfusion. The level of pro-inflammatory cytokines such as TNF-α, IL-1β and anti-inflammatory molecules such as IL-10 was measured; other factors such as neurological deficit, brain water content and infarct size and the level of MCP-1, ICAM-1, iNOS, CD11b, TLR-4/NF-κBp65 were also measured.

RESULTS

TSF at the doses of 18, 30 mg/kg significantly improved neurological deficit, reduced brain water content and infarct size, accompanied by a decrease in the concentration of TNF-α, IL-1β, MCP-1, ICAM-1, iNOS and an increase in the concentration of IL-10. The amount of CD11b and ICAM-1 was found largely decreased and the expression of TLR-4 and the nuclear NF-κBp65 was weakened in TSF-treatment group.

CONCLUSIONS

Our study suggests that TSF possesses a neuroprotective effect against ischemic stroke which might be mediated through suppression of the inflammatory pathways in the brain following ischemic stroke.

[Effect of 5F TigerⅠcatheter shaping technique in complex coronary angiography]

Objective: To observe the effect of 5 F Tiger Ⅰ catheter shaping technique in complex coronary angiography. Methods: This study was a single-center, single-blind, randomized, parallel controlled trial and subjects were consecutively enrolled if the first coronary angiography could not be completed by 5 F Tiger Ⅰ catheterization at our department from January 2016 to June 2017 (n=159). The subjects were divided into 2 groups using a random number table method: 79 patients in the control group, and 6 F Judkins and Amplatz catheters were used to perform coronary angiography through the radial artery; 80 patients in the experimental group, and 5 F Tiger Ⅰ shaping technique were used to perform coronary angiography through the radial artery. The reasons of complex coronary angiography were divided into 3 categories: class A referred the abnormal origin of left and right coronary arteries;class B referred left or right coronary artery opening higher or lower than conventional openings or opening downwards and upwards; class C referred the ascending aorta abnormalities (longer, wider, or shorter and thinner). Coronary angiography and operative complications were compared between the 2 groups. Results: X-ray exposure time of coronary angiography ((4.17±1.67) min vs. (4.78±1.51) min, P=0.017), X-ray dose (230 (175, 275) mGy vs. 267 (230, 321) mGy, P<0.001), contrast agent dose ((54.6±8.2) ml vs. (61.8±7.9) ml, P=0.001), operative time (21.6 (18.9, 25.4) min vs. 26.8 (23.4, 31.4) min, P<0.001), and number of catheters used (1.30±0.56 vs. 2.47±0.57, P=0.001) were all less in experimental group than in the control group. There was no significant difference in success rate of the coronary angiography between the experimental group and the control group(97.5% (78/80) vs. 98.7% (78/79), P=0.567). There was no significant difference in the incidence of radial artery spasm (2.5% (2/80) vs. 5.1% (4/79), P=0.396) and coronary artery spasm (1.3% (1/80) vs. 3.8% (3/79), P=0.639). In class A and C subjects, X-ray exposure time, X-ray dose, and operation time were similar between the experimental and control groups (all P>0.05), while the number of catheters used was less in the experimental group than in the control group (P<0.01). In the class C subjects, dose of contrast agent used was significantly lower in the experimental group than in the control group (P=0.001). In theclass B subjects, the X-ray dose, contrast agent dose, operation time, and number of catheters used were all less in the experimental group than in the control group (all P<0.01), and there was no significant difference in X-ray exposure time between the 2 groups (P=0.192). Conclusion: For complex coronary angiography, the imaging success rate and safety of the 5 F Tiger Ⅰshaping catheter is comparable to that of 6 F Judkins and Amplatz catheters.

[Contemporary use of ticagrelor in patients with acute coronary syndrome after discharge]

Objective: To investigate the degree and determinants of using ticagrelor among discharged patients with acute coronary syndrome (ACS). Methods: Patients with ACS in Fuwai hospital who were given ticagrelor after discharge between Jan. 2015 to Jun. 2015 were analyzed.The clinical characteristics and adherence to ticagrelor of these patients were collected by reviewing the electronic medical records and telephone interview.Date were statistically-analyzed. Results: Among all screened 404 patients, 158 (39.1%) patients prematurely stopped ticagrelor within 12 months, while 119(29.5%) patients switched from ticagrelor to clopidogrel.Unavailable locally (34.8%), economic reasons (17.7%) and hemorrhagic events (18.4%) were the main causes of the premature discontinuation of ticagrelor.Univariate analysis showed left main disease (P=0.04) and the frequency of outpatient follow-up (P<0.01) as relative factors for prematurely stopping ticagrelor outside hospital after discharge.Multivariate analysis revealed medical insurance payment (OR 1.79, 95%CI 1.03-3.11) and the frequency of outpatient follow-up (OR 0.61, 95%CI 0.43-0.86) as independent predictors of prematurely stopping ticagrelor outside hospital.Prematurely stopping ticagrelor has no significant effect on the ischemic events (myocardial infaction or stroke) (P=0.76). Conclusion: Social cinditions is the main factor for the persistence to ticagrelor among ACS patients after dischcrge.Medical insurance payment and low frequency of outpatient follow-up were independent predictors of prematurely stopping ticagrelor and it may not have impact on ischemic events.