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Objective To observe the skin ultrastructure change of electric shock death rats and to test the expression changes of hypoxia-inducible factor-2α （HIF-2α） and heart type-fatty acid-binding protein （H-FABP） of myocardial cells, in order to provide basis for forensic identification of electric shock death. Methods The electric shock model of rats was established. The 72 rats were randomly divided into control group, electric shock death group and postmortem electric shock group. Each group was divided into three subgroups, immediate （0 min）, 30 min and 60 min after death. The skin changes of rats were observed by HE staining, the changes of skin ultrastructure were observed by scanning electron microscopy, and the expression of HIF-2α and H-FABP in rats myocardium was tested by immunohistochemical staining. Results The skin in the electric shock death group and postmortem electric shock group had no significant difference through the naked eye or by HE staining. Under the scanning electron microscope, a large number of cellular debris, cells with unclear boundaries, withered cracks, circular or elliptical holes scattered on the cell surface and irregular edges were observed. A large number of spherical foreign body particles were observed. Compared with the control group, the expression of HIF-2α in all electric shock death subgroups increased, reaching the peak immediately after death. In the postmortem electric shock group, HIF-2α expression only increased immediately after death, but was lower than that of electric shock death group （P<0.05）. Compared with the control group, the expression of H-FABP in all subgroups of electric shock death group and postmortem electric shock group significantly decreased. The expression of H-FABP in all subgroups of electric shock death group was lower than that of the postmortem electric shock group （P<0.05）. Conclusion Electric shock can increase HIF-2α expression and decrease H-FABP expression in the myocardium, which may be of forensic significance for the determination of electric shock death and identification of antemortem and postmortem electric shock.
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Animals , Rats , Autopsy , Basic Helix-Loop-Helix Transcription Factors/metabolism , Fatty Acid Binding Protein 3/metabolism , Myocardium/metabolism , Myocytes, Cardiac/metabolism , Skin/ultrastructureABSTRACT
Objective To investigate the prognostic value of heart-type fatty acid-binding protein (H-FABP)in pediatric patients with severe sepsis and septic shock. Methods A prospective observational study was carried out in consecutive pediatric patients with severe sepsis and septic shock admitted between October 2016 and September 2017. Data of patient's demographics, clinical characteristics, blood biochemical markers including H-FABP, N-terminal B-type natriuretic peptide (NT-BNP), creatine kinase isoenzyme(CK-MB) and cardiac troponin I(cTnl), Lactate dehydrogenase (LDH) and Lactic acid (Lac), complications and survival status were collected and analyzed. The receiver operating characteristic (ROC) curve was mainly used to evaluate the power of a continuous variable for 28-day survival rate, and Kaplan-Meier analysis was used to compare 28-day survival curves in pediatric patients with severe sepsis and septic shock. Results A total of 78 cases with severe sepsis (n=33) and septic shock (n=45) were enrolled in this study. There were 64 survival cases and 14 non-survivor within 28 days after admission. The plasma levels of H-FABP, NT-BNP, LDH, CK-MB were significantly higher in non-survivor than those in survivor (49.10±65.14) vs. (5.06±4.29) ng/ml; (131.63±130.91) vs. (37.30±29.24) U/L; (2 403.88±415.97) vs.(2 971.57±279.49) U/L; (5 872.93±6 383.28)pg/ml vs. (1 656.86±2 715.73) pg/ml; respectively, all P＜0.05). The area under the receiver operating characteristic curve (AUC) of H-FABP was 0.858 (95％ confidence interval [CI]: 0.716-1.0; P=0.002), which was superior to CK-MB (AUC=0.841,95％CI: 0.696-0.986; P=0.003);LDH (AUC=0.818, 95％CI: 0.610-1.000; P =0.005) and NT-BNP (AUC=0.728, 95％CI: 0.535-0.921;P=0.045). A Kaplan-Meier curve showed a significantly lower survival rate in patients with H-FABP greater than 7.7 ng/mL than the patients with H-FABP less than 7.7 ng/mL. Conclusions H-FABP is an effective prognostic indicator in pediatric patients with severe sepsis and septic shock with superiority to traditional myocardial enzyme.
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Objective To investigate the value of plasma H-FABP level and Acute Physiology and Chronic Health Evaluation(APACHE Ⅱ) in severity and prognosis estimation for patients with acute pumonary embolism(APE).Methods Totally 160 APE patients were hospitalized from January 2010 to January 2015 and enrolled in this study.According to the severity of the disease,these patients with APE were divided into low-risk group,moderate-risk group and high-risk group.According to clinical prognosis,these patients with APE were divided into survival groups and death groups.Plasma levels of H-FABP were measured by enzyme linked immunosorbent assay(ELISA),and APACHE Ⅱ score were analyzed.The differences of Plasma H-FABP levels and APACHE Ⅱ score were compared and which the relationship with severity and the prognosis of APE were also assessed.Results With the increased severity in patients,the H-FABP and APACHE Ⅱ score were significantly increased (P ＜ 0.05);the H-FABP and APACHE Ⅱ score were significantly higher in death group as compared with survival group(P ＜0.05).The H-FABP levels and APACHE Ⅱ score were positive correlated(r =0.71,P =0.000).ROC curves analysis results showed that the area under curve of H-FABP was 0.854 (95 ％ CI:0.784-0.927),and optimal operating point (OOP)was 13.3 μg/L,which had 81.0％ sensiticity and 79.4％ specificity;ACU of APACHE Ⅱ was 0.861 (95％ CI:0.812-0.932),and OOP was 19.2,which had 77.8％ sensiticity and 80.4％ specificity.The AUC was 0.914 (95％ CI:0.825-0.948),and the sensitivity was 88.9％,specificity was 87.6％ when the two cutoff values were both achieved,which were higher than the single H-FABP and APACHE Ⅱ score.Conclusion The H-FABP and APACHE Ⅱ score can effectively assess severity and prognosis of APE patients,meanwhile,it provide an objective basis for the clinical individual treatment and reducing the mortality rate of APE patients.
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Objective To study the predictive value of heart-type fatty acid-binding protein (H-FABP) in the improvement of survival rate in patients with severe sepsis.Methods There was a prospective case-control study in 50 patients with severe sepsis from October 2014 to October 2015.According to the international guidelines for severe sepsis and septic shock set in 2012,all patients were divided into sepsis group (n =16),severe sepsis group (n =14) and septic shock group (n =20),and these patients were further divided into to survival group (n =22) and non-survival group (n =28) as per patients surviving within 28 days.Gender,age,ethnic,and Acute Physiology and Chronic Health Evaluation score (APACHE Ⅱ) were recorded.H-FABP,B-type natriuretic peptide (BNP),creatine kinase (CK),creatine kinase isoenzyme (CK-MB),and troponin-T (cTn-T) were determined within 6 hours after admission.The statistical software SPSS21.0 was used to do t test,test,and the receiver operating characteristic curve for comparison between groups.Results H-FABP in septic shock group was higher than severe sepsis group and sepsis group (P ＜ 0.01).The 28-day mortality of septic group (80％) and severe sepsis group (71.4％) were higher than sepsis group (12.5％) (P ＜ 0.01).Non-survival' s H-FABP,BNP,cTn-T,CK,CKMB was higher than survivals (P ＜ 0.05).Through the ROC of H-FABP (AUC=0.748,P=0.003,95％ C I:0.605-0.890) and BNP (AUC =0.714,P=0.010,95％ CI:0.573-0.856),it shows that H-FABP is better than BNP.when H-FABP take 9.902 ng/mL,the sensitivity of 82.1％,specificity of 63.6％.H-FABP,BNP has a certain value in 28-day mortality prediction.Conclusions Sepsis shock has significantly higher 28-day mortality than sepsis and severe sepsis.Compared with BNP,H-FABP has greater predictive value in sepsis patients,it will increase along with the aggravation of the disease;it can also predict 28-day mortality.
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Objective To analyse the influence of esmolol on plasma N terminal pro-brain natriuretic peptide ( NT-proBNP) , heart-type fatty acid binding protein ( H-FABP) and cardiac function in acute cerebral infarction patients with myocardial enzyme abnormalities.Methods 86 acute cerebral infarction patients with myocardial enzyme abnormalities from September 2010 to July 2014 in our hospital were selected and divided into experimental group and control group randomly (43 cases in each group).All patients were accompanied by myocardial enzyme abnormalities, patients in control group were given basic treatment, while patients in experimental group were given esmolol hydrochloride intravenous injection on the basis of control group.Plasma NT-proBNP, H-FABP levels and cardiac function were analyzed in two groups.Results Myocardial enzyme levels had no significant difference between two groups on admission.Plasma NT-proBNP levels also had no statistical differences after admission hospital of 6 h, 15 h and 3 d , and experimental group was significantly lower than control group ( P<0.05 ) after admission hospital of 5 day and 7 days.H-FABP levels had no statistical differences after admission hospital of 6 h, 15 h, and the experimental group was significantly lower than the control group (P<0.05) after admission hospital of 3, 5, 7 days.Cardiac function with Killip classification showed no significant difference when on admission and after admission hospital of 3 days, and the experimental group was significantly better than control group (P<0.05) after admission hospital of 5, 7 days.Conclusion Acute cerebral infarction patients with myocardial enzyme abnormalities given esmolol on the basic treatments significantly reduce NT-proBNP and HAFBP levels, and improve cardiac function, which is worthy of promotion in clinical applications.
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Objective To observe the change and clinical significance of the heart type fatty acid binding protein (H-FABP) in ST Segment Elevation Myocardial Infarction (STEMI) after percutaneous coronary intervention (PCI).Methods Of 178 STEMI patients were recruited and were separated as ST segment drop group (137) and ST segment non-drop group (41).All the patients received H-FABP and cTnI tests,and re-tested H-FABP on 1 h,6 h,12 h and 24 h after the PCI,and re-tested cTnI on 12 h and 24 h after the PCI.Also,the ST segment drop amplitude (ΣSTR) was measured 2 h after the PCI.Results The demographics of both groups were similar.In both groups,the H-FABP on 6 h after PCI was significantly higher than the value measured prior to PCI.In the ST segment drop group,the H-FABP was reduced to normal value on 24 h after PCI,while it was not in the ST segment non-drop group.Conclusions The H-FABP elevation is associated with the severity of coronary lesions in ST segment elevation myocardial infarction,and the PCI may be involved in the H-FABP changes.ΣSTR≥50％ and normal HFABP may be used as index for judgment of myocardial injury and myocardial reperfusion.
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Objective Discusstheinfluence of early diagnosis of myocardial damage and heart-type fatty acid binding protein(h-FABP)on patients with severe head injury after rehabilitation.Methods The sorum h-FABP was detected using enzyme-linked immunosorbent one-step quantitative detection,cTnI using solid-phase enzyme-linked immunosorbent assay(ELISA),CK-MB using the method of immunosuppressive.Results The sorum levels of h-FABP,cTnl and CK-MB in severe head injury patients levels were significantly higher than that of healthy control group(P<0.01),the positive serum h-FABP in severe head injury patients Was significantly higher than cTnI,CK-MB or ECG(P<0.01);8 cases died in47 cases of severe head injury patients,the mortalisty rate was 17.02%(8/47),the mortality rate of abnormal sentrum h-FABP,cTnI and CK-MB group was significantly higher than the normal group(P<0. 01);The serum h-FABP in predicting the death of severe head injury patients was high in sensitivity and negative predictive value,but lower in specificity and accuracy.Condusiom The serum h-FABP quantitative assay as a high-sensitive indicators to minor myocardial dsmage can be used an objective indicators forjudging severity ofacute severe head injury,evaluating incidence of accidents.
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Heart fatty-acid-binding protein(H-FABP) is small molecular weight cytosolic protein that is abundant in the heart and has tissue specificity. Concentration of H-FABP changes regulation in serum after the myocardial damage. In addition it has a positive correlation with the degree of myocardial damage. It is an early diagnostic biochemical marker of acute myocardial ischemia. The advance of H-FABP in the research on physiochemical nature,and its application for myocardial injury and prospective study of sudden cardiac death in forensic science were reviews.
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Objective To observe the effect of tanshinoneⅡA (TⅡA) on arrhythmia and levels of ischemia modified albumin (IMA) and heart type-fatty acid binding protein (H-FABP) in rats with myocardial ischemia-reperfusion injury.Methods Forty Wistar rats were equally randomized into 5 groups:pseudo-operation group (normal saline),model group (normal saline),and high-,middle-and low-dose TⅡA groups (in the dose of 20,10 and 5 mg?kg-1?d-1 respectively).The rats were treated for 7 days,and received operation 2 hours after the last medication.Rats in pseudo-operation group received threading without ligation,while animal model of myocardial ischemia-reperfusion injury was established by ligating the left-anterior coronary artery for 15 minutes and then loosening for 30 minutes.During the operation,electrocardiogram was traced continuously to observe the arrhythmia.HE staining was used to observe the pathological changes of myocardium.Levels of IMA and H-FABP in myocardium were determined by enzyme-linked immunosorbent assay (ELISA).Results Ischemic changes of the myocardium and arrhythmia occurred,myocardial IMA level increased and H-FABP level decreased in the model rats.TanshinoneⅡA obviously attenuated arrhythmia caused by ischemia-reperfusion injury (P