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Objective To observe the relationship between different degree of cerebral edema and multiple organ dysfunction syndrome (MODS) of exertional heat stroke (EHS) patients. Methods The patients with EHS admitted to intensive care unit (ICU) of the 159th Hospital of PLA from June 2015 to June 2017 were enrolled. The electrical impedance perturbation coefficient (EIDC) of bilateral cerebral hemispheres were monitored at 2, 24 and 72 hours after the onset of the disease by BORN-BE non-invasive dynamic cerebral edema monitor, and the patients were divided into 9+ group, 10+ group and 11+ group according to the resistance of the measured mean impedance coefficients. Fasting venous blood of the patients were acquired after 2 hours and 72 hours of the disease, the levels of serum interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), nitric oxide (NO), nitric oxide synthase (NOS), cardiac troponin I (cTnI), MB isoenzyme of creatine kinase (CK-MB), creatinine (Cr), β2-microglobulin (β2-MG), alanine aminotransferase (ALT) and aspartate transaminase (AST) were detected. The occurrence of MODS within 72 hours was recorded. Linear regression analysis of the correlation between EIDC and MODS was done. Results All 124 EHS patients were male; the age was (22.10±4.43) years. Among them, 20 in EIDC 9+ group, 61 in 10+ group, and 43 in 11+ group. There were no significant differences in the levels of IL-1β, TNF-α, NO, NOS, cTnI, CK-MB, Cr, β2-MG, ALT, AST after onset of 2 hours among different EPIC groups; all the indexes of 72 hours were significantly higher than those of 2 hours in each group; and the higher the EIDC, the more obvious increase of each index [EIDC 9+ group, 10+ group, 11+ group at 72 hours IL-1β (ng/L): 12.05±3.75, 18.49±7.94, 23.21±10.44;TNF-α (ng/L): 13.10±3.18, 18.92±7.23, 23.40±10.17; NO (μmol/L): 99.50±12.10, 111.41±17.75, 120.81±15.58;NOS (kU/L): 47.95±8.33, 56.70±12.12, 63.37±12.60; cTnI (ng/L): 92.75±20.92, 107.20±18.96, 117.30±14.53;CK-MB (U/L): 73.55±9.25, 83.23±13.19, 93.49±12.25; Cr (μmol/L): 165.30±9.41, 176.62±9.83, 180.09±10.14;β2-MG (mg/L): 16.45±2.68, 19.07±3.68, 22.05±3.93; ALT (U/L): 500.10±87.05, 563.90±91.28, 612.16±90.61, AST (U/L): 414.30±53.35, 470.51±73.83, 512.09±81.29, respectively, two-two comparison all P ＜ 0.05], the higher of the MODS incidence [40.00 % (8/20), 65.57% (40/61), 83.72% (36/43), x2= 12.199, P = 0.002]. Linear regression analysis showed that the degree of cerebral edema was positively correlated with the incidence of MODS (R2= 0.905, P = 0.002). Conclusion The higher of the EIDC, the more severe of cerebral edema, the stronger of the inflammatory reaction, and the more severe damage of heart, liver, kidney and other organs in EHS patients within 72 hours.
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Objective:To observe the effects antiarrhythmic peptide 10 (AAP10) aon acute ventricular arrhythmia and the phosphorylation state of ischemic myocardium connexin.Methods:Acute total ischemia and partial ischemia models were established by ceasing perfusion and ligating the left anterior descending coronary artery in SD rats. The effects of AAP10 (1 mg/L) on the incidence rate of ischemia-induced ventricular arrhythmia were observed. The ischemic myocardium was sampled to detect total-Cx43 and NP-Cx43 by immunofluorescent staining and western blotting. the total-Cx43 expression was detected through image analysis system by semi-quantitative analysis.Results: AAP10 could significantly decrease the incidence of ischemia-induced ventricular tachycardia and ventricular fibrillation. During ischemic stage, total ischemia (TI) and AAP10 total ischemia (ATI) groups were compared with partial ischemia (PI) and AAP10 partial ischemia (API) groups. The rates of incidence for arrhythmia in the ATI and API groups (10% and 0%) were lower than those in the TI and PI groups (60% and 45%). The difference between the two groups was statistically significant (P=0.019, P=0.020). The semi-quantitative analysis results of the ischemic myocardium showed that the total-Cx43 protein expression distribution areas for TI, ATI, PI and API groups were significantly decreased compared with the control group. On the other hand, the NP-Cx43 distribution areas of TI, ATI, PI and API groups were significantly increased compared with the control group (P>0.05). AAP10 could increase the total-Cx43 expression in the ischemic area and decrease the NP-Cx43 expression. Western blot results were consistent with the results of immunofluorescence staining.Conclusions:AAP10 can significantly decrease the rate of incidence of acute ischemia-induced ventricular tachycardia and ventricular fibrillation. Acute ischemic ventricular arrhythmias may have a relationship with the decreased phosphorylation of Cx43 induced by ischemia. AAP10 may stimulate the phosphorylation of Cx43 by increasing the total-Cx43 expression and decreasing the NP-Cx43 expression in the ischemic area, so as to decrease ventricular arrhythmia.
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Objective: To investigate the predictive value of an early inflammatory response factor, Rho kinase activity for left ventricle remodeling (LVR) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: A total of 120 acute STEMI patients treated in our hospital from 2010-10 to 2013-06 were studied, all patients were ifrst time received primary percutaneous coronary intervention (PCI) with stent implantation. Rho kinase activity and B-type natriuretic peptide (BNP) were measured before PCI, echocardiography was conducted at 24 hours and 12 months after STEMI respectively to clarify LVR diagnosis. The patients were divided into 2 groups as LVR group, n=97 and Non-LVR group, n=23, the above indexes were compared between 2 groups. Results: The level of Rho kinase was higher in LVR group than that in Non-LVR group, P Conclusion: High Rho kinase activity could predict LVR in acute STEMI patients with primary PCI and stent implantation.
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Mid-ventricular hypertrophic obstructive cardiomyopathy (MVHOCM) is a rare type of cardiomyopathy thatcan be accompanied by apical aneurysm.We presented here a case report of MVHOCM with cornary artery disease.The sixty-fouryears old man was sent to hospital because of ventricular tachycardia.Large inversion T wave was showed on electrocardiography in the presence of abnormal coronary arteries and normal cardiac enzyme.Echoeardiogmphy showed an hourglass appearance of the leftventricle with an aneurysm in the apex and a pressure gradient between the outflow tract of left ventricle and the middle of the leftventricle was revealed by left-heart catheterization.