Angiotensin converting enzyme gene and exercise-induced silent myocardial ischemia in type 2 diabetes mellitus / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between angiotensin converting enzyme (ACE) gene and exercise-induced silent myocardial ischemia (SI) in patients with type 2 diabetes mellitus.</p><p><b>METHODS</b>One hundred and eight patients suffering from type 2 diabetes mellitus with normal rest electrocardiograph and 50 healthy individuals were selected randomly. SI was diagnosed with treadmill exercise test and ACE genotypes were detected with PCR.</p><p><b>RESULTS</b>(1) The control group and type 2 diabetes mellitus group had similar distribution of ACE genotypes and alleles (P>0.05). Compared with the non-SI group, the SI group had significantly higher ACE D allele prevalence (Chi-square=4.501, P<0.05); however, the two groups had similar prevalence of ACE genotypes (P>0.05). (2) There were no significant differences in clinical characteristics and serum lipoproteins among the three ACE genotypes (II, DD,ID) of type 2 diabetes mellitus (P>0.05). (3) The prevalence of SI in DD group was found to be 68.2%, which was significantly higher than that in II genotype group (39.5%, Chi-square=4.593, P<0.05).</p><p><b>CONCLUSION</b>ACE D allele increases the risk of SI in type 2 diabetes mellitus.</p>

Care and treatment of the open cardiac traumas / 解放军医学杂志

Objective To explore the clinical features and urgent treatment strategies of open stabbing and penetrating wound of the heart. Methods In recent five years, 22 cases of cardiac trauma patients were sent to our emergency department, among them 19 sustained penetrating wounds produced by sharp instruments, 3 with perforating wounds, produced by firearm in 2 and sharp instrument in one. Emergent thoracotomy was performed in all the patients. The injury involved right auricle in 4, left auricle in 1, right ventricle in 11, left ventricle in 3, and perforating wounds of both right and left ventricles in 3 patients. Results Among them 19 survived, and their cardiac and pulmonary recovered 2 weeks after the operation. Three patients with injury of the great vessel died, one of them died 8 hour after the operation. Conclusion When the patients who presented open wounds on the anterior or posterior chests, showing a low or undetectable blood pressure, which could not raised even with fluid resuscitation with two venous lines or in some of them displaying signs of Beck's triad, open cardiac injury should be seriously suspected, and emergent thoracotomy should be taken in order to rescue the patients.