ABSTRACT
Objective To investigate the association of chest pain patients with primary level in high-sensitivity troponin T (hs-cTnT) level no more than 14 ng/L in the onset of acute myocardial infarction in pa-tients with chest pain. Methods We enrolled 3 096 participants from January 2012 to December 2013 in West China Hospital, Sichuan University. All patients were classified two groups (hs-cTnT > 14 ng/L, hs-cTnT ≤14 ng/L and no ischemia on ECG) according to hs-cTnT levels and ECG. We evaluated the risk of myocardial in-farction and death and negative predictive value in 30 days. Results Thirty-seven patients were diagnosed in having acute myocardial infarction (AMI) and 4 patients were dead in the hs-cTnT > 14 ng/L group in 30 days in the absolute risk 2.35(1.86-2.74) and 0.29(0.12-0.53); 9 patients were diagnosed as having AMI and no patients were dead in the hs-cTnT ≤ 14 ng/L group in 30 days in the absolute risk 0.58 (0.42-0.74). Conclu-sion Chest pain patients whose primary levels no more than 14 ng/L in hs-cTnT with no ischemia on ECG can be ruled out AMI in negative predictive value 99.6%. the levels of hs-cTnT which were dynamic monitored at least 5 h and still no more than 14 ng/L can rule out AMI directly.
ABSTRACT
Objective To research the levels of thyroid hormone in patients with Sheehan′s syndrome .Methods The difference of thyroid‐stimulating hormone(TSH) or free triiodothyronine(fT3 ) or free thyroxine(fT4 ) levels was compared between 100 pa‐tients with sheehan′s syndrome and 100 cases of female healthy controls included in this study .The difference for TSH or fT3 or fT4 levels was compared between before and after treatment in Sheehan′s syndrome patients .The difference of TSH or fT3 or fT4 levels was compared when time from a large bleeding to disease onset below 1 year ,1‐5 years and over 5 years respectively in Shee‐han′s syndrome patients .Results The difference of TSH or fT3 or fT4 levels between patients with Sheehan′s syndrome and female healthy controls had obvious statistical significance .TSH :1 .60(0 .79 -2 .86)mU/L versus 3 .08(1 .97 -5 .08)mU/L ,fT3 :2 .09 (1 .44-3 .69)pmol/L versus 4 .86(4 .49-5 .40)pmol/L ,fT4 :8 .01(3 .45 -12 .64)pmol/L versus 14 .56(13 .63 -16 .11)pmol/L (P<0 .001 for comparisons respectively) .The difference of TSH or fT3 or fT4 levels between before and after treatment had obvi‐ous statistical significance .TSH :1 .60(0 .79-2 .86)mU/L versus 1 .16(0 .57-2 .11)mU/L ,fT3 :2 .09(1 .44-3 .69)pmol/L versus 3 .27(2 .38-4 .11)pmol/L ,fT4 :8 .01(3 .45 -12 .64)pmol/L versus 14 .32(10 .48 -15 .92)pmol/L(P<0 .05 for comparisons re‐spectively) .Time from a large bleeding to disease onset were below 1 year ,1-5 years and over 5 years ,TSH levels were respective‐ly 2 .85(2 .21-3 .51)、1 .82(1 .24-2 .98) and 1 .52(0 .65-2 .64)mU/L(P<0 .05 for comparisons) .The fT3 levels were respective‐ly 3 .74(2 .24-4 .45) ,2 .54(1 .87-3 .32) and 1 .89(1 .13-3 .11)pmol/L(P<0 .05 for comparisons) .The fT4 levels were respec‐tively 12 .21(10 .45-14 .32) ,8 .52(5 .13-12 .34) and 7 .85(3 .12 -10 .12)pmol/L(P<0 .05 for comparisons) .Conclusion TSH could serve as an identifiable index for sheehan′s syndrome and primary hypothyroidism .The time from a large bleeding to the dis‐ease onset is longer ,the anterior pituitary function is more serious .Thyroid hormone should be monitored regularly in order to pre‐vent the happening of hyperthyroidism during the process of the treatment .For postpartum hemorrhage patients ,thyroid hormone should be early detected and combine with the clinical manifestations .They should early diagnose and timely treat in order to pre‐vent the sheehan′s syndrome and its crisis .
ABSTRACT
Objective To investigate the diagnostic threshold value and diagnostic performance of high-sensitivity troponin T (hs-cTnT)for elderly patients with acute myocardial infarction(AMI).Methods 835 emergency department patients with chest pain were recruited in the study,then these patients were divided into elderly group (≥65 years old)and control group(<65 years old).Hs-cTnT concrentrations were compared between the two groups;The difference of hs-cTnT concentrations between AMI pa-tients and non-AMI patients were compared in elderly group and control group respectively;The optimal threshold values of the hs-cTnT for acute myocardial infarction were determined by receiver operating characteristic(ROC)curve.Results The hs-cTnT con-centrations of non-AMI patients in elderly group were 18.4(14.5-32.5)ng/L,which were higher than those of non-AMI patients in control group[3.2(3.0-8.2)ng/L],and the difference were statistically significant(P <0.05);The hs-cTnT concentrations of AMI patients in elderly group were 136.1 (51.6 - 384.1 )ng/L,which were higher than those of AMI patients in group 68.5 (25.6-217.1)ng/L,and the difference were statistically significant(P <0.05).According to the ROC curve,the optimal threshold value for AMI diagnosis in elderly group by using hs-cTnT was 32 ng/L,which was higher than that in control group(14 ng/L). The specificity and the positive predictive value of the optimal threshold value determined by ROC were apparently higher than the 99th percentile(P 99 )in elderly group respectively,the difference were statistically significant(P <0.05).Conclusion The hs-cTnT levels were positively related with age.The optimal threshold value of hs-cTnT for AMI(32 ng/L)was higher than the P 99 (14ng/L)in elderly group.
ABSTRACT
Objective: To investigate the negative mood status of nurses and patients in different hospitals. Methods: Mood of the nurses and patients from a tumor hospital and a general hospital were assessed with SDS, SAS and by professional assessment with HAMA and HAMD. Results: The rates of anxiety and depression of nurses and patients were both significantly higher than that of the normal group, however, there was no correlation between the bad mood of the patients and the nurses. Negative mood status of the nurses was significantly associated with job stress (r=0.335, 0.392,P