Comparison Between Serum hsCRP and LDL Cholesterol for Search of a Better Predictor for Ischemic Heart Disease

Acute myocardial Infarction is one of the major causes of morbidity & mortality in world and atherosclerosis is the major cause of ischemic heart disease. In order to determine the better clinical marker of atherosclerosis, we estimated serum low-density lipoprotein (LDL-C) and high sensitivity C-reactive protein (hsCRP). Hundred patients of myocardial infarction and 100 controls irrespective of age and sex were studied for these parameters over a period of 2 years. The statistical analysis showed that the serum hsCRP was significantly raised in myocardial infarction cases than controls (P < 0.01) but LDL-C was not (P > 0.05). We conclude that the serum hsCRP has better predictive value for risk of atherosclerosis.     

脑缺血动物实验研究进展

脑缺血是严重危害人类健康的重要疾病,脑缺血的动物实验研究是研究脑缺血性疾病的重要手段。近年开展脑缺血动物实验在方法学上不断更新并取得不少新发现,但脑缺血对脑细胞功能的影响及造成脑细胞衰亡等方面的病理生理及发病机制尚未确切,需深入研究。现从脑缺血动物实验研究出发,综述近年脑缺血的动物实验模型及脑缺血的病理生理、发病机制的研究进展,祈为今后脑缺血及其相关疾病临床研究与治疗提供新的实验方法及理论依据。     

脑梗死诊治临床教学体会

随着生活方式的转变,我国脑血管病的发病率逐年上升,脑梗死不仅是神经科的常见病、多发病,而且也是我国致残率和死亡率较高的病种之一。因此,提高脑梗死的诊治水平迫在眉睫,笔者就近年来脑梗死临床教学中的点滴体会,总结如下。     

Non-commutability of results of highly sensitive troponin I and T immunoassays

Introduction:

The measurement of cardiospecific troponins is pivotal in the diagnostic and prognostic approach of patients with suspected acute myocardial infarction (AMI). However, no information is available on the commutability of results between the novel highly-sensitive (HS) troponin T (TnT) and I (TnI) immunoassays.

Materials and methods:

The study population consisted in 47 consecutive patients presenting at the emergency department (ED) of the Academic Hospital of Parma with suspected AMI. TnI was measured with the novel prototype Beckman Coulter HS-AccuTnI immunoassay on Access 2, whereas TnT was measured with the Roche HS-TnT immunoassay on Cobas.

Results:

Eight out of the 47 patients (17%) were finally diagnosed as having an AMI. The overall correlation between TnT and TnI for total patient group was acceptable (r = 0.944; P < 0.01). Nevertheless, when the analysis of data was carried out in separate groups according to the final diagnosis of AMI, two different equation results were obtained, i.e., HS-TnT = HS-AccuTnI × 0.349 + 20 (r = 0.823; P < 0.01) in non-AMI patients, and HS-TnT = HS-AccuTnI × 0.134 + 67 (r = 0.972; P < 0.01) in those with AMI.

Conclusions:

This study suggests the existence of two biological relationships between TnI and TnT in plasma, depending on the source of release from the myocardium. Moreover, the non-commutability of data between HS-TnT and HS-AccuTnI jeopardizes the clinical decision making, makes it impossible to calculate the delta or reference change value using the two biomarkers and to finally establish a reliable kinetics of troponin release from the injured myocardium.     

Biochemical markers of myocardial injury

The serum markers of myocardial injury are used to help in establishing the diagnosis of myocardial infarction. The older markers like aspartate amino-transferase, creatine kinase, lactate dehydrogenase etc. lost their utility due to lack of specificity and limited sensitivities. Among the currently available markers cardiac troponins are the most widely used due to their improved sensitivity specificity, efficiency and low turn around time. Studies have shown that cardiac troponins should replace CKMB as the diagnostic ‘gold standard’ for the diagnosis of myocardial injury. The combination of myoglobin with cardiac troponins has further improved the accuracy in the diagnosis of acute coronary syndromes and thereby reducing the hospital stay and patients' money. Among the other new markers of early detection of myocardial damage, heart fatty acid binding protein, glycogen phosphorylase BB and myoglobin/carbonic anhydrase III ratio seem to be the most promising. But the search for the most ideal marker of myocardial injury is still on.     

Xanthine oxidase as a marker of myocardial infarction

In the present communication, we report remarkably elevated levels of xanthine oxidase activity in the blood of the patients with myocardial infarction when compared to age and sex matched healthy persons. Highly significant increase of malondialdehyde, serving as an index of lipid peroxidation and thus free radical mediated damage, has also been found in the patients. We propose the measurement of the blood levels of xanthine oxidase, a very simple, reliable and less time consuming method as an indicator of myocardial infarction.     

Cardioprotective effect of liposomal prostaglandin E1 on a porcine model of myocardial infarction reperfusion no-reflow

Objective  

To evaluate whether liposomal prostaglandin E1 (lipo-PGE1) can decrease reperfusion no-reflow in a catheter-based porcine model of acute myocardial infarction (AMI).     

参麦注射液对急性心肌梗死大鼠心室重构的影响

目的：探讨参麦注射液对急性心肌梗死（AMI）大鼠心室重构的影响。方法：通过结扎冠状动脉前降支建立AMI模型大鼠，AMI后24h存活的48只大鼠随机分为四组：AMI后1周模型组；AMI后参麦注射液治疗1周组；AMI后2周模型组；AMI后参麦注射液治疗2周组。另设1周、2周假手术组各8只。治疗组每日腹腔注射参麦注射液1次，AMI模型组和假手术组大鼠腹腔注射等量的生理盐水。测量各组心室重构参数。结果：与假手术组比较，AMI后1周时，心室腔已明显扩大（P〈0．05）；到梗死后2周时，心室腔内径扩大更明显，与假手术组相比有显著性差异（P〈0．01），且心室重量指数（VWI）比假手术组明显增加（P〈0．05）。参麦注射液治疗2周后可改善心梗后心室重量指数增加、心室腔扩大的病理变化（P〈0．05）。结论：参麦注射液能改善大鼠AMI后心室重构。     

Creation of reversed phase high-performance liquid chromatographic technique to assay platelet-activating factor

INTRODUCTION Platelet activating factor (PAF), a kind of pho-spholipids compound, synthesized and secretedmainly by neutrophilic granulocyte, platelet, is ahighly potent chemical mediator in inflammationand allergic reactions and induces microvascularleakage in several tissues (Chung, 1997). PAFs arefew in vivo, have short half life (only about 30seconds) and rapidly convert to lyso-PAF that hasno bio-activity and is both the metabolite and pre-cursor of PAF (Rao, 1998). Lyso-P…     

Is decompressive craniectomy for malignant middle cerebral artery infarction of any worth？

Objective: Malignant middle cerebral artery (MCA) infarction is characterized by mortality rate of up to 80%. The aim of this study was to determine the value of decompressive craniectomy in patients presenting malignant MCA infarction compared with those receiving medical treatment alone. Methods: Patients with malignant MCA infarction treated in our hospital between January 1996 and March 2004 were included in this retrospective analysis. The National Institute of Health Stroke Scale (NIHSS) was used to assess neurological status on admission and at one week after surgery. All patients were followed up for assessment of functional outcome by the Barthel index (BI) and modified Rankin Scale (RS) at 3 months after infarction. Results: Ten out of 24 patients underwent decompressive craniectomy. The mean interval between stroke onset and surgery was 62.10 h. The mortality was 10.0% compared with 64.2% in patients who received medical treatment alone (P<0.001). The mean NIHSS score before surgery was 26.0 and 15.4 after surgery (P<0.001). At follow up, patients who underwent surgery had significantly better outcome with mean BI of 53.3, RS of 3.3 as compared to only 16.0 and 4.60 in medically treated patients. Speech function also improved in patients with dominant hemispherical infarction. Conclusion: Decompressive craniectomy in patients with malignant MCA infarction improves both survival rates and functional outcomes compared with medical treatment alone. A randomized controlled trial is required to substantiate those findings.