Clinical efficacy of ateplase combined with heparin in the treatment of acute moderate- and high-risk pulmonary thromboembolism and its effects on arterial blood gas analysis and myocardial enzyme level / 中国基层医药

Objective:To investigate the clinical efficacy of alteplase combined with heparin in the treatment of acute moderate- and high-risk pulmonary thromboembolism and its effects on arterial blood gas analysis and myocardial enzyme level.Methods:Seventy-eight patients with acute moderate- and high-risk pulmonary thromboembolism who received treatment in Dongyang People's Hospital from January 2015 to January 2022 were retrospectively included in this study. They were divided into observation ( n = 39) and control ( n = 39) groups according to different treatment methods. The control group was treated with heparin, while the observation group was treated with alteplase based on heparin. All patients were treated for 7 days. Clinical efficacy as well as arterial blood gas analysis, myocardial enzymes, pulmonary artery pressure, and tricuspid annular plane systolic excursion pre- and post-treatment were compared between the two groups. Results:The total response rate in the observation group was significantly higher than that in the control group (94.87% vs. 76.92%, χ2 = 5.18, P < 0.05). After treatment, the partial pressure of carbon dioxide in the observation group was significantly lower than that in the control group [(36.24 ± 5.12) mmHg vs. (44.25 ± 3.78) mmHg, 1 mmHg = 0.133 kPa, t = 7.86, P < 0.05]. After treatment, the partial pressure of oxygen in the observation group was significantly higher than that in the control group [(78.82 ± 5.1) mmHg vs. (71.23 ± 4.89) mmHg, t = 6.66, P < 0.05]. After treatment, lactate dehydrogenase, creatine kinase, and creatine kinase isoenzyme in the observation group were (107.42 ± 15.45) U/L, (37.21 ± 10.84) U/L, and (12.28 ± 3.54) U/L, respectively, which were significantly lower than (189.94 ± 21.20) U/L, (65.42 ± 6.57) U/L, and (19.29 ± 3.08) U/L in the control group ( t = 19.64, 13.89, 9.33, all P < 0.001). After treatment, the pulmonary arterial pressure in the observation group was significantly lower than that in the control group [(32.24 ± 3.86) mmHg vs. (37.79 ± 5.17) mmHg, t = 5.37, P < 0.001]. Tricuspid annular plane systolic excursion in the observation group was significantly higher than that in the control group [(14.07 ± 1.27) mm vs. (12.63 ± 1.16) mm, t = 5.22, P < 0.001]. Conclusion:Ateplase combined with heparin has an obvious effect on acute moderate- and high-risk pulmonary thromboembolism. It can improve arterial blood gas analysis and reduce myocardial enzyme levels.

Creatine supplementation for post-exercise muscle damage / Suplementação com creatina para danos musculares pós-exercício / Suplementación con creatina para daños musculares después del ejercicio

ABSTRACT Introduction: Exercise-induced muscle damage (EIMD) can occur from recent or unusual physical activity, leading to a temporary reduction in muscle function. And increased pain. Several articles indicate the positive impacts of creatine on EIMD. Objective: Evaluate the impact of creatine on EIMD. Methods: Online searches were performed in Scopus, Embase, Medline and Google scholar until March 2022. Results: Thirteen studies met the inclusion criteria. To assess the quality of the studies, the Cochrane collaboration system was used for risk and bias analysis. Due to the high heterogeneity of interventions and studies designed, a meta-analysis was not performed. The current paper reveals that creatine intake is preferable to inactive recovery and only a rest period between several harmful and exhausting physical activities. Conclusion: Benefits were attenuated in EIMD markers that reduce muscle operation and muscle strength loss after exercise. Level of evidence II; Therapeutic studies - Manuscript review.

RESUMO Introdução: O dano muscular induzido pelo exercício (EIMD) pode acontecer por atividade física recente ou não habitual e leva a uma redução temporária da função muscular. e aumento da dor. Vários artigos indicam impactos positivos da creatina sobre a EIMD. Objetivo: Avaliar o impacto da creatina sobre a EIMD. Métodos: Foram feitas pesquisas eletrônicas em Scopus, Embase, Medline e Google scholar até março de 2022. Resultados: Treze estudos preencheram os critérios de inclusão. Para avaliar a qualidade dos estudos, o sistema de colaboração Cochrane foi utilizado na análise de risco e viés. Devido à alta heterogeneidade de intervenções e estudos desenhados, a meta-análise não foi realizada. As informações do documento atual revelam que a ingestão de creatina é preferível a uma recuperação inativa e apenas um período de repouso entre diversas atividades físicas prejudiciais e exaustivas. Conclusão: Os benefícios evidenciaram-se atenuados nos marcadores EIMD que reduzem a operação muscular e a perda de força muscular após os exercícios. Nível de evidência II; Estudos terapêuticos - Revisão de manuscritos.

RESUMEN Introducción: el daño muscular inducido por el ejercicio (EIMD) puede producirse por una actividad física reciente o inusual y provoca una reducción temporal de la función muscular y un aumento del dolor. Varios artículos indican impactos positivos de la creatina en la EIMD. Objetivo: Evaluar el impacto de la creatina en la EIMD. Métodos: Se realizaron búsquedas electrónicas en Scopus, Embase, Medline y Google scholar hasta marzo de 2022. Resultados: Trece estudios cumplieron los criterios de inclusión. Para evaluar la calidad de los estudios, se utilizó el sistema de colaboración Cochrane para el análisis de riesgos y sesgos. Debido a la gran heterogeneidad de las intervenciones y de los estudios diseñados, no se realizó un metanálisis. La información del presente documento revela que la ingesta de creatina es preferible a una recuperación inactiva y sólo un período de descanso entre varias actividades físicas perjudiciales y agotadoras. Conclusión: Los beneficios se mostraron atenuados en los marcadores EIMD que reducen el funcionamiento muscular y la pérdida de fuerza muscular después del ejercicio. Nivel de evidencia II; Estudios terapéuticos - Revisión de manuscritos.

Lactate: a biological marker of physical activity in colombian weightlifting athletes / Lactato: um marcador biológico da atividade física em atletas colombianos de halterofilismo / Lactato: un marcador biológico de la actividad física en atletas colombianos de halterofilia

ABSTRACT Introduction Blood biomarkers are measurable metabolic products that allow objective monitoring of the training process, and their analysis provides an opportunity to improve athletic performance. Objective To evaluate blood lactate concentrations in a group of the Valle League weightlifting athletes as a tool to determine the effects of training and its direct relationship to performance during competition. Methods This is an observational cross-sectional study. Lactate levels of 32 weightlifting athletes belonging to the Valle Weightlifting League were evaluated. Blood samples were taken from the ear lobe to quantify the lactate concentration, using a Scout Lactate analyzer. Samples were taken before and after a high intensity training section consisting of four maximum repetition (MR) sports gestures, in which 5 series and 15 repetitions were performed for each sports gesture, with a rest period of 40 seconds between each exercise. The software program SPSS, version 25, was used to determine the lactate concentrations. Results An average lactate concentration 22.46 mg/dL was obtained for the athletes at rest, and an average of 98.30 mg/dL in the final lactate concentration, after high intensity exercise. Significant differences were found between the initial and final lactate concentrations. Conclusion Lactate concentration increases with physical activity; it varies from one individual to another; and it can be used as a biomarker of intensity of physical activity in the field of sports. Level of evidence; II type of study: Prognostic Studies Investigating the Effect of a Patient Characteristic on a disease outcome.

RESUMO Introdução Os biomarcadores sanguíneos são produtos metabólicos mensuráveis que permitem a monitorização objetiva do processo de treino, e sua análise é uma oportunidade para melhorar o desempenho atlético. Objetivos Avaliar as concentrações de lactato no sangue de um grupo de atletas de halterofilismo da Liga Valle como ferramenta para determinar os efeitos do treino e sua relação direta com o desempenho durante a competição. Métodos Este é um estudo transversal e observacional. Foram avaliados os níveis de lactato em 32 atletas da Liga de Halterofilismo Valle. A amostra de sangue foi retirada do lóbulo da orelha com o intuito de quantificar a concentração de lactato com o analisador Scout Lactate. As amostras foram colhidas antes e depois de uma seção de treino de alta intensidade, que consistiu em quatro gestos esportivos de repetição máxima (RM), nos quais foram realizadas 5 séries e 15 repetições para cada gesto esportivo, com um período de repouso de 40 segundos entre cada exercício. O software SPSS, versão 25 foi usado para determinar as concentrações de lactato. Resultados A concentração média de lactato nos atletas em repouso foi 22,46 mg/dl e a concentração média final foi de 98,30 mg/dl depois de exercício de alta intensidade. Foram encontradas diferenças significativas ao comparar a concentração inicial com a concentração final de lactato. Conclusões A concentração de lactato aumenta com a realização da atividade física, é variável de um indivíduo para outro e pode ser usada como biomarcador de intensidade da atividade física na área dos esportes. Nível de Evidência II; Estudos prognósticos - Investigação do efeito de característica de um paciente sobre o desfecho da doença.

RESUMEN Introducción Los biomarcadores sanguíneos son productos metabólicos mensurables que permiten la monitorización objetiva del proceso de entrenamiento, y su análisis es una oportunidad para mejorar el desempeño atlético. Objetivos Evaluar las concentraciones de lactato en la sangre de un grupo de atletas de halterofilia de la Liga Valle como herramienta para determinar los efectos del entrenamiento y su relación directa con el desempeño durante la competición. Métodos Este es un estudio transversal y observacional. Fueron evaluados los niveles de lactato en 32 atletas de la Liga de Halterofilia Valle. La muestra de sangre fue retirada del lóbulo de la oreja con el objetivo de cuantificar la concentración de lactato con el analizador Scout Lactate. Las muestras fueron tomadas antes y después de una sección de entrenamiento de alta intensidad, que consistió en cuatro gestos deportivos de repetición máxima (RM), en los que se realizaron 5 series y 15 repeticiones para cada gesto deportivo, con un período de descanso de 40 segundos entre cada ejercicio. El software SPSS versión 25 fue usado para determinar las concentraciones de lactato. Resultados La concentración promedio de lactato en los atletas en reposo fue 22,46 mg/dl y la concentración promedio final fue de 98,30 mg/dl después del ejercicio de alta intensidad. Fueron encontradas diferencias significativas al comparar la concentración inicial con la concentración final de lactato. Conclusiones La concentración de lactato aumenta con la realización de actividad física, es variable de un individuo para otro, y puede ser usada como biomarcador de intensidad de la actividad física en el área de los deportes. Nivel de evidencia II; Estudios pronósticos - Investigación del efecto de característica de un paciente sobre el resultado de la enfermedad

Values of serum neuron-specific enolase, circulating tumor cells and lactate dehydrogenase levels in the diagnosis and treatment of small cell lung cancer / 中国基层医药

Objective:To investigate the values of serum neuron specific enolase (NSE), circulating tumor cells (CTC) and lactate dehydrogenase (LDH) levels in the diagnosis and treatment of small cell lung cancer (SCLC).Methods:Ninety patients with SCLC who received treatment in the Second Affiliated Hospital of Zhejiang Chinese Medical University, China between December 2017 and December 2019 were retrospectively included in the observation group. Ninety healthy subjects who concurrently received lung examination in the same hospital were included in the healthy control group. An additional 90 patients with benign lung disease were included in the benign lung disease group. Serum NSE, CTC and LDH levels were determined in each group. The values of serum NSE, CTC and LDH levels in the diagnosis of SCLC were analyzed. Serum NSE, CTC and LDH levels were compared between before and after chemotherapy and their values in the treatment of SCLC were analyzed.Results:There were significant differences in serum NSE, CTC and LDH levels between three groups ( F = 359.789, 188.873 and 768.704, all P < 0.001). Serum NSE, CTC and LDH levels in the benign lung disease group were significantly greater than those in the healthy control group and significantly lower than those in the observation group. The receiver operating characteristic curve (ROC curve) analysis showed that the AUC values of serum NSE, CTC and LDH levels in the diagnosis of SCLC were 0.995, 0.953 and 0.987, respectively. The diagnostic accuracy was very high. The value at the maximum tangent point of Youden's index of serum NSE, CTC and LDH levels at the left-upper corner of the ROC curve was taken as the most appropriate cut-off value. The sensitivity and specificity of the most appropriate cut-off value of serum NSE, CTC and LDH levels in the prediction of SCLC were 100.0%/94.4%/91.1% and 94.4%/88.3%/100.0%, respectively. Therefore, serum NSE, CTC and LDH levels were of high values in the predication of SCLC. After chemotherapy, serum NSE, CTC and LDH levels in patients with SCLC were significantly lower than those before chemotherapy [NSE: (12.26 ± 3.26) μg/L vs. (18.36 ± 4.64) μg/L; CTC: (3.54 ± 1.08) counts/5 mL vs. (7.34 ± 1.30) counts/5 mL; LDH: (24.61 ± 9.66) U/L vs. (50.29 ± 16.29) U/L, t = 10.205, 12.864, 21.330, all P < 0.001). Serum NSE, CTC and LDH levels in SCLC patients in whom treatment was effective were significantly lower than those in SCLC patients in which treatment was not effective ( t = 8.111, 7.347, 10.731, all P < 0.001). Spearman correlation results showed that serum NSE, CTC and LDH levels were significantly negatively correlated with curative effects ( r = -0.562, -0.562, -0.758, all P < 0.05). Conclusion:Serum NSE, CTC and LDH levels are highly expressed in SCLC patients, which can be used as markers for early clinical diagnosis and treatment of SCLC.

Protective effects of levosimendan combined with lyophilized recombinant human brain natriuretic peptide on myocardium in patients with acute myocardial infarction complicated by heart failure / 中国基层医药

Objective:To investigate the protective effects of levosimendan combined with lyophilized recombinant human brain natriuretic peptide (rhBNP) on myocardium in patients with acute myocardial infarction complicated by heart failure.Methods:140 patients with acute myocardial infarction complicated by heart failure who received treatment in Changxing People's Hospital from June 2018 to June 2020 were included in this study. They were randomly assigned to receive either routine treatment (control group, n = 70) or routine treatment, levosimendan combined with rhBNP (study group, n = 70). Serum levels of creatine kinase (CK)-MB, cardiac troponin I (cTnI), lactate dehydrogenase (LDH), high-sensitivity C-reactive protein (hs-CRP), which were associated with myocardial injury, were measured in each group. In addition, the changes in cardiac ultrasound indexes left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) were observed. Clinical effects on heart failure were evaluated. Adverse drug reactions were monitored during the treatment. Results:After treatment, CK-MB, cTnI, LDH and hs-CRP levels in the study group were (56.73 ± 12.15) U/L, (0.41 ± 0.19) μg/L, (126.83 ± 15.26) U/L and (1.59 ± 0.27) mg/L, respectively, which were significantly lower than those in the control group [(78.52 ± 14.07) U/L, (0.68 ± 0.21) μg/L, (187.25 ± 23.04) U/L, (2.84 ± 0.41) mg/L, t = 5.569-12.418, all P < 0.05]. LVEDD and LVESD in the study group were significantly lower than those in the control group, while LVEF in the study group was significantly higher than that in the control group ( t = 4.435-6.426, all P < 0.05). Total effective rate in the study group was significantly higher than that in the control group [88.57% (62/70) vs. 72.86% (51/70), χ2 = 5.552, P < 0.05]. There was no significant difference in total incidence of adverse drug reactions between study and control groups [11.43% (8/70) vs. 8.57% (6/70), χ2 = 0.317, P > 0.05]. Conclusion:Levosimendan combined with rhBNP can effectively alleviate myocardial injury in patients with acute myocardial infarction complicated by heart failure, improve myocardial function, is highly safe, and thereby deserves clinical application.

Expression of a Lactobacillus casei L-lactate dehydrogenase mutant in Pichia pastoris for asymmetric reduction of phenylpyruvate / 生物工程学报

To improve the productivity of L-phenyllactic acid (L-PLA), L-LcLDH1(Q88A/I229A), a Lactobacillus casei L-lactate dehydrogenase mutant, was successfully expressed in Pichia pastoris GS115. An NADH regeneration system in vitro was then constructed by coupling the recombinant (re) LcLDH1(Q88A/I229A) with a glucose 1-dehydrogenase for the asymmetric reduction of phenylpyruvate (PPA) to L-PLA. SDS-PAGE analysis showed that the apparent molecular weight of reLcLDH1(Q88A/I229A) was 36.8 kDa. And its specific activity was 270.5 U/mg, 42.9-fold higher than that of LcLDH1 (6.3 U/mg). The asymmetric reduction of PPA (100 mmol/L) was performed at 40 °C and pH 5.0 in an optimal biocatalytic system, containing 10 U/mL reLcLDH1(Q88A/I229A), 1 U/mL SyGDH, 2 mmol/L NAD⁺ and 120 mmol/L D-glucose, producing L-PLA with 99.8% yield and over 99% enantiomeric excess (ee). In addition, the space-time yield (STY) and average turnover frequency (aTOF) were as high as 9.5 g/(L·h) and 257.0 g/(g·h), respectively. The high productivity of reLcLDH1(Q88A/I229A) in the asymmetric reduction of PPA makes it a promising biocatalyst in the preparation of L-PLA.

Effect of simulated geomagnetic activity on myocardial ischemia/reperfusion injury in rats

Abstract Objective: To study the response of myocardial ischemia/reperfusion injury (MI/RI) in rats to simulated geomagnetic activity. Methods: In a simulated strong geomagnetic outbreak, the MI/RI rat models were radiated, and their area of myocardial infarction, hemodynamic parameters, creatine kinase (CK), lactate dehydrogenase (LDH), melatonin, and troponin I values were measured after a 24-hour intervention. Results: Our analysis indicates that the concentrations of troponin I in the geomagnetic shielding+operation group were lower than in the radiation+operation group (P<0.05), the concentrations of melatonin in the shielding+operation group and normal+operation group were higher than in the radiation + operation group (P<0.01), and the concentrations of CK in the shielding + operation group were lower than in the radiation + operation group and normal + operation group (P<0.05). Left ventricular developed pressure (LVDP) and ± dP/dtmax in the radiation+operation group were lower than in the shielding + operation group and normal+operation group (P<0.01). Left ventricular end-diastolic pressure (LEVDP) in the shielding + operation group was higher than in the normal + operation group (P<0.05). There was no significant difference in area of myocardial infarction and LDH between the shielding + operation group and the radiation + operation group. Conclusion: Our data suggest that geomagnetic activity is important in regulating myocardial reperfusion injury. The geomagnetic shielding has a protective effect on myocardial injury, and the geomagnetic radiation is a risk factor for aggravating the cardiovascular and cerebrovascular diseases.

Niveles enzimáticos de lactato deshidrogenasa en saliva según la condición periodontal / Enzyme levels of lactate dehydrogenase in saliva according to the condition periodontal

Objetivo: Comparar los niveles enzimáticos de lactato deshidrogenasa (LDH) en la saliva según la condición periodontal. Material y métodos: Estudio descriptivo, transversal. Se incluyeron 40 pacientes entre 23 y 73 años de edad, de una clínica especializada en odontología. Hubo 10 pacientes en cada grupo: uno control (periodontalmente sanos) y tres de estudio. Las muestras de saliva no estimulada (2 ml) fueron recogidas en frascos para muestra de esputo, directamente de la boca; se trasladaron a tubos Eppendorf de 2 ml y se centrifugaron a 300 rpm por 10 minutos. Para evaluar la actividad enzimática, fueron colocados en el analizador automático “Vitalab Selectra II” (vital cientific, Holanda) con el reactivo LDH-P UV AA líquido, para muestras de suero o plasma. El dinucleótido de nicotinamida y adenina (NADH) consumido, fue directamente proporcional a la actividad de LDH en la muestra de saliva. Los datos se analizaron con las pruebas de Kruskal-Wallis y post hoc de Dunn-Bonferroni. Resultados: Se encontró diferencias significativas en los niveles de LDH entre los pacientes con periodontitis crónica generalizada frente a los periodontalmente sanos y en fase de mantenimiento (p<0,01). También hubo diferencia significativa (p=0,006) entre los valores de LDH de los pacientes con periodontitis crónica localizada y los periodontalmente sanos. Conclusiones: Los niveles enzimáticos de LDH están disminuidos en los pacientes en fase de mantenimiento periodontal respecto a los pacientes con periodontitis crónica generalizada, así mismo estos valores son muy cercanos a los pacientes periodontalmente sanos y con periodontitis crónica localizada.

Objective: To compare those levels enzyme of lactate dehydrogenase (LDH) in the saliva according to the condition periodontal. Material and methods: Descriptive, cross-sectional study. It was included 40 patients between 23 and 73 years, of a clinic specializing in dentistry. There were 10 patients in each group: one control (periodontally healthy) and three study. Not stimulated saliva samples (2 ml) were collected in vials for sample of sputum, directly from the mouth; they moved to 2 ml Eppendorf tubes and centrifuged at 300 rpm for 10 minutes. To assess enzymatic activity, they were placed in the automatic Analyzer “Vitalab Selectra II” (life science, the Netherlands) with reagents LDH-P UV AA liquid for serum or plasma samples. The dinucleotide of NICOTINAMIDE and adenine (NADH) consumed, was directly proportional to the activity of LDH in the saliva samples. The data were analyzed with post hoc Bonferroni-Dunn and Kruskal-Wallis tests. Results: It was found significant differences in the levels of LDH among patients with generalized chronic periodontitis versus periodontally healthy and in phase of maintenance (p<0.01). Also there was difference significant (p= 0.006) between the values of LDH of them patients with localized chronic periodontitis and the periodontally healthy. Conclusions: Enzyme LDH levels are decreased in patients during periodontal maintenance in respect to patients that have generalized chronic periodontitis, also these values are very close to periodontally healthy patients and localized chronic periodontitis.

Deshidrogenasa láctica como factor pronóstico en neumonías / Lactic dehydrogenase as a prognostic factor in pneumonias

Resumen ANTECEDENTES: la pandemia de influenza en 2009 renovó el interés por identificar oportunamente casos sospechosos de influenza mediante estudios de laboratorio rutinarios, uno de los más estudiados es la deshidrogenasa láctica (DHL). OBJETIVO: determinar si los pacientes con neumonía por influenza A (H1N1) tienen alteraciones particulares en estudios rutinarios de laboratorio, particularmente en concentraciones de DHL y analizar la implicación pronóstica. MATERIAL Y MÉTODO: estudio de casos y controles de pacientes con diagnóstico confirmado de neumonía por influenza A (H1N1) [caso], y pacientes con neumonía bacteriana (control) atendidos de diciembre de 2013 a julio de 2014. RESULTADOS: se analizaron 31 casos, 45% (n = 14) tenían diagnóstico de neumonía por el virus de la influenza A (H1N1), el 55% restante (n = 17) se consideró de causa bacteriana. La media de edad fue de 38 años (límites: 16-62). Las concentraciones de DHL al momento del diagnóstico fueron, en promedio, de 578.77 UI/L (límites: 191-1096), fue mayor en el grupo con neumonía por influenza A (H1N1) [573 vs 624.7 UI/L, p = 0.366]. En el análisis global las concentraciones de DHL > 350 UI/L al diagnóstico y fin del tratamiento repercutieron fuertemente de manera negativa en la mortalidad (OR: 84.0, IC95%: 4.4754-1576.6044 y OR: 154.0, 8.6261-2749.3255). La supervivencia general fue de 18 días, menor en el grupo de A (H1N1) [4 vs 25 días, p = 0.016). CONCLUSIONES: las concentraciones de DHL > 350 UI/L pueden considerarse un biomarcador de gravedad y repercuten negativamente en la supervivencia de pacientes con neumonía, sin poder discriminar al posible agente etiológico.

Abstract BACKGROUND: The 2009 influenza pandemic renewed interest in timely identification of suspected influenza cases through routine laboratory studies, the most studied is lactic dehydrogenase (DHL). OBJECTIVE: To determine if patients with influenza A (H1N1) pneumonia present particular alterations inside routine laboratory studies, particularly in DHL levels and analyze the prognostic implication. MATERIAL AND METHOD: A case-control study of patients with confirmed diagnosis of influenza A (H1N1) pneumonia (case), and patients with bacterial pneumonia (control) treated from December 2013 to July 2014. RESULTS: Thirty-one cases were analyzed, 45% (n = 14) had a diagnosis of influenza A (H1N1) pneumonia, the remaining 55% (n = 17) was considered of bacterial etiology. The mean age was 38 (16-62) years old. The DHL level at diagnosis time was on average 578.77 IU/L (191-1096), higher in the group with influenza A (H1N1) pneumonia (573 IU/L vs 624.7 IU/L, p = 0.366). In the overall analysis, the levels of DHL > 350 IU/L at diagnosis time and at the end of treatment had a negative impact on mortality (OR: 84.0, 95%CI: 4.4754-1576.6044, and OR: 154.0, 8.6261-2749.3255). Overall survival was 18 days, lower in the A (H1N1) group (4 vs 25 days, p = 0.016). CONCLUSIONS: DHL > 350 IU/L can be considered a severity biomarker, also has a negative impact on the survival of patients with pneumonia without being able to discriminate the possible etiological agent.

SERUM VALUES OF ALKALINE PHOSPHATASE AND LACTATE DEHYDROGENASE IN EWING'S SARCOMA

ABSTRACT Objective: To study the relationship between the serum levels of alkaline phosphatase (AP) and lactate dehydrogenase (LDH), and the percentage of tumor necrosis (TN) in patients with Ewing´s Sarcoma (ES) . Methods: This is a case series with retrospective evaluation of patients with diagnosis of ES divided into 2 groups: Group 1, patients whose serum levels of alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were obtained in the staging phase before preoperative chemotherapy (CT), and Group 2, patients whose values were measured after completion of the preoperative CT. The percentage of tumor necrosis (TN) of surgical specimens extracted in surgery was also evaluated . Results: Eighty four medical records from 1995 to 2015 were included. Both AP as LDH decreased in the patients studied, the pre CT value being higher than the post CT value. The average decrease of LHD was 272.95 U/L and AP was 10.17 U/L. The average tumor necrosis was 65.12 %. There was no statistical correlation between serums levels and the tumor necrosis percentage . Conclusion: The serum levels values of AP and LDH are not predictors for chemotherapy-induced necrosis in patients with ES. Level of Evidence IV, Case Series.

Time-course of changes in indirect markers of muscle damage responses following a 130-km cycling race / Comportamento das respostas dos marcadores indiretos de dano muscular após uma competição de ciclismo de 130-km

Abstract The purpose of the present investigation was to identify the effects of a 130-km cycling race on indices of biochemical indirect markers of muscle damage and muscle soreness responses during a 72-hour recovery period. Fifteen endurance-trained male cyclists which were competing for more than 2 years and were involved in systematic training at least of 3 days/wk underwent a collection of indirect biochemical markers of muscle damage (CK, LDH, Myo) and delayed onset of muscle soreness (DOMS), at five different moments of data collection: before (PRE) and immediately after (POST) a 130-km cycling race, and 24, 48, 72 hours following the cycling race. CK and LDH plasma concentrations significantly increased POST-race (p < 0.001) and remained high throughout the 72 hour recover period (CK: p < 0.05; LDH: p < 0.001). Myo increased significantly POST-race (p < 0.001) and returned to the PRE-race values 24 hours thereafter (p < 0.05). DOMS increased significantly POST-race (p < 0.001) and returned to the PRE-race values at 48 hours after (p > 0.05). A 130-km cycling race has a noteworthy effect on indices of biochemical indirect markers of muscle damage and muscle soreness responses, indicating that 72 hour recovery period do not seems to be enough for long-distance cyclist, and reinforce the propositions of scientific literature about the need of a sufficient recovery period for cycling endurance athletes.

Resumo O objetivo do presente estudo foi identificar os efeitos de uma competição de ciclismo de 130-km nos índices de marcadores bioquímicos indiretos de dano muscular e na dor muscular durante um período de 72 horas de recuperação. Quinze ciclistas do sexo masculino que estavam em treinamento competitivo por mais de dois anos e que estavam em treinamento sistemático, pelo menos três dias por semana, foram submetidos à coleta de marcadores bioquímicos indireto de dano muscular (CK, LDH e Mioglobina) e dor muscular em cinco momentos distintos de coleta: antes, depois, 24, 48 e, 72 horas após uma competição de ciclismo. A CK e a LDH aumentaram imediatamente após a corrida (p < 0,001) e mantiveram-se elevadas durante as 72 horas de recuperação (CK: p < 0,05; LDH: p < 0,001). A Mioglobina aumentou logo após a competição (p < 0,001) e retornou aos valores basais 24 horas após (p < 0,05). A dor muscular aumentou logo após a competição (p < 0,001) e retornou aos valores basais após 48 horas de recuperação (p > 0,05). Uma competição de ciclismo de 130-km teve efeitos notáveis sobre os índices de marcadores bioquímicos indiretos de lesão muscular e dor muscular, indicando que um período de 72 horas de recuperação pode não ser o suficiente para ciclistas de longa distância, isto também reforça as proposições da literatura científica sobre a necessidade de um período de recuperação suficiente para os atletas de ciclismo de fundo.

Serum values of alkaline phosphatase and lactate dehydrogenase in osteosarcoma

OBJECTIVE: To study the relationship between the pre and post chemotherapy (CT) serum levels of alkaline phosphatase (AP) and lactate dehydrogenase (LDH), and the percentage of tumor necrosis (TN) found in specimens after the pre surgical CT in patients with osteosarcoma. METHODS: Series of cases with retrospective evaluation of patients diagnosed with osteosarcoma. Participants were divided into two groups according to serum values of both enzymes. The values of AP and LDH were obtained before and after preoperative CT. The percentage of tumor necrosis (TN) of surgical specimens of each patient was also included. RESULTS: One hundred and thirty seven medical records were included from 1990 to 2013. Both the AP as LDH decreased in the patients studied, being the higher in pre CT than post CT. The average LHD decrease was 795.12U/L and AP decrease was 437.40 U/L. The average TN was 34.10 %. There was no statistically significant correlation between the serums values and the percentage of tumoral necrosis. CONCLUSION: The serum levels values of AP and LDH are not good predictors for the chemotherapy-induced necrosis in patients with osteosarcoma. Level of Evidence IV, Case Series

Analysis of clinical features and prognosis of 27 patients with mantle cell lymphoma / 天津医药

Objective To study the clinical features, effects of therapeutic regimen and prognosis of patents with mantle cell lymphoma (MCL). Methods Clinical data of 27 MCL patients admitted in Tianjin Medical University Cancer Institute&Hospital from January 2008 to December 2014 were retrospectively analyzed. Cox regression analysis was used to analyze influencing factors of prognosis of MCL. Results The median age was 68 years old for 27 patients, and the male-to-female ratio was 4.4∶1. Ann Arbor staging showed that 25 cases were stageⅢ-Ⅳ(92.6%), 8 cases were heptosplenomegaly (29.6%), 7 cases showed extranodal involvement (25.9%). ECOG scoring showed that 4 cases with scores of 2-4 (14.8%), 8 cases were 0-3 (29.6%), 14 cases were 4-5 (51.9%) and 5 cases were 6-11 (18.5%). The Ki-67 index≤30%was found in 9 cases (33.3%), and>30%was found in 18 cases (67.7%). Patients with B symptom was found in 10 (37.0%). The elevated lactate dehydrogenase (LDH) was found in 17 cases (63.0%). The increased Beta 2- microglobulin was found in 8 cases (29.6%). Seven patients were found with bone marrow involvement. The total effective rate (ORR) was 81.8%in group with R-CHOP method, and the ORR was 68.8%in group with CHOP method. Multivariate analysis showed that age, LDH and Ki-67 were independent factors influencing the prognosis of MCL (P60 years, elevated LDH and Ki-67 index>30%are with poor prognosis.

Upper Limb Ischemia: Clinical Experiences of Acute and Chronic Upper Limb Ischemia in a Single Center

BACKGROUND: Upper limb ischemia is less common than lower limb ischemia, and relatively few cases have been reported. This paper reviews the epidemiology, etiology, and clinical characteristics of upper limb ischemia and analyzes the factors affecting functional sequelae after treatment. METHODS: The records of 35 patients with acute and chronic upper limb ischemia who underwent treatment from January 2007 to December 2012 were retrospectively reviewed. RESULTS: The median age was 55.03 years, and the number of male patients was 24 (68.6%). The most common etiology was embolism of cardiac origin, followed by thrombosis with secondary trauma, and the brachial artery was the most common location for a lesion causing obstruction. Computed tomography angiography was the first-line diagnostic tool in our center. Twenty-eight operations were performed, and conservative therapy was implemented in seven cases. Five deaths (14.3%) occurred during follow-up. Twenty patients (57.1%) complained of functional sequelae after treatment. Functional sequelae were found to be more likely in patients with a longer duration of symptoms (odds ratio, 1.251; p=0.046) and higher lactate dehydrogenase (LDH) levels (odds ratio, 1.001; p=0.031). CONCLUSION: An increased duration of symptoms and higher initial serum LDH levels were associated with the more frequent occurrence of functional sequelae. The prognosis of upper limb ischemia is associated with prompt and proper treatment and can also be predicted by initial serum LDH levels.

Reducing lactate secretion by ldhA Deletion in L-glutamate- producing strain Corynebacterium glutamicum GDK-9

L-lactate is one of main byproducts excreted in to the fermentation medium. To improve L-glutamate production and reduce L-lactate accumulation, L-lactate dehydrogenase-encoding gene ldhA was knocked out from L-glutamate producing strain Corynebacterium glutamicum GDK-9, designated GDK-9ΔldhA. GDK-9ΔldhA produced approximately 10.1% more L-glutamate than the GDK-9, and yielded lower levels of such by-products as α-ketoglutarate, L-lactate and L-alanine. Since dissolved oxygen (DO) is one of main factors affecting L-lactate formation during L-glutamate fermentation, we investigated the effect of ldhA deletion from GDK-9 under different DO conditions. Under both oxygen-deficient and high oxygen conditions, L-glutamate production by GDK-9ΔldhA was not higher than that of the GDK-9. However, under micro-aerobic conditions, GDK-9ΔldhA exhibited 11.61% higher L-glutamate and 58.50% lower L-alanine production than GDK-9. Taken together, it is demonstrated that deletion of ldhA can enhance L-glutamate production and lower the unwanted by-products concentration, especially under micro-aerobic conditions.

Co-ingestion of carbohydrate and pea protein does not enhance muscle recovery after strenuous exercise / A ingestão simultânea de carboidratos e proteína da ervilha não melhora a recuperação muscular após a realização de exercício extenuante

OBJECTIVE: To assess the influence of carbohydrate and added pea protein concentrate supplementation on muscle recovery after a military operation called Leader's Reaction Test. METHODS: Twenty-four soldiers from the Brazilian Army were divided into three equal groups (n=8). They received either carbohydrate (0.8.g/kg body weight/h), carbohydrate+carbohydrate (1.0.g/kg body weight/h), or carbohydrate+protein (0.8 g/kg body weight/h of carbohydrate + 0.2 g/kg body weight/h of protein), immediately, 60, and 120 minutes after the Leader’s Reaction Test. Prior, immediately after and 24 hours after the Leader’s Reaction Test, maximal isometric strength and body composition were assessed. Blood samples were also collected for later analysis of concentrations of lactate dehydrogenase and creatine kinase. RESULTS: Twenty-four hours after the Leader's Reaction Test, maximal creatine kinase levels were significantly lower than its levels immediately after (501.00 ± 422.09 versus 275.29 ± 242.08 U/L (carbohydrate); 616.88 ± 291.45 versus 334.57 ± 191.61 U/L (carbohydrate+carbohydrate); and 636.75 ± 340.67 versus 382.88 ± 234.42 U/L (carbohydrate+protein), p=0.004). The maximal isometric strength and lactate dehydrogenase levels were not significantly different during the time trials. CONCLUSION: The present findings suggest that carbohydrate+protein co-ingestion did not improve the recovery of muscle function nor did it attenuate post-exercise muscle damage markers over carbohydrate alone. .

OBJETIVO: Avaliar a influência da suplementação com carboidratos adicionada ao concentrado proteico de ervilha na recuperação muscular, após uma operação militar prática chamada Teste de Reação de Líderes. MÉTODOS: Vinte e quatro soldados do Exército Brasileiro foram divididos em três grupos iguais (n=8). Eles receberam a suplementação com carboidrato (0,8 g/kg de peso corporal/h) ou carboidrato mais carboidrato (1,0 g/kg de peso corporal/h) ou carboidrato mais proteína (0,8 g/kg de peso corporal/h de carboidrato + 0.2 g/kg de peso corporal/h de proteína), imediatamente, 60 e 120 minutos após o Teste de Reação de Líderes. Avaliaram-se a força isométrica máxima e a composição corporal antes do Teste de Reação de Líderes, imediatamente após e 24 horas após o teste. Amostras de sangue foram coletadas para análise posterior das concentrações de lactato desidrogenase e creatina quinase. RESULTADOS: Vinte e quatro horas após o Teste de Reação de Líderes, as concentrações de creatina quinase estavam significativamente reduzidas em comparação ao momento imediatamente posterior (501.00 ± 422,09 versus 275.29 ± 242.08 U/L (carboidrato); 616.88 ± 291,45 versus 334.57 ± 191,61 U/L (carboidrato+carboidrato) e 636.75 ± 340.67 versus 382.88 ± 234,42 U/L (carboidrato+proteína), p=0,004). A força isométrica máxima e os níveis de lactato desidrogenase não foram significativamente diferentes em nenhum momento. CONCLUSÃO: Os resultados sugerem que, em comparação à ingestão do carboidrato isoladamente, a coingestão de carboidrato e proteína não melhora a recuperação da função muscular nem atenua a liberação ...

The utility of lactate dehydrogenase in the follow up of patients with diffuse large B-cell lymphoma

Background: Serum lactate dehydrogenase is a non-specific marker for lymphoma whose prognostic significance is well established for both indolent and aggressive lymphomas at the time of diagnosis. The performance characteristics of this enzyme in predicting relapse in patients with diffuse large B-cell lymphoma has not been well studied. Methods: This study compared serum lactate dehydrogenase levels in 27 patients with diffuse large B-cell lymphoma who relapsed after sustaining a complete response versus 87 patients who did not relapse. For relapsed patients, the serum lactate dehydrogenase level at relapse was compared with the level three months before (considered baseline). For non-relapsed patients, the last two levels during follow-up were compared. For statistical analysis the T-test was used to compare differences in mean values between groups. The sensitivity, specificity, positive and negative predictive values for serum lactate dehydrogenase in detecting relapse compared to confirmatory imaging were calculated. Results: At relapse, only 33% patients had increases in serum lactate dehydrogenase above the upper limit of normal. The mean increase was 1.2-fold above the upper limit of normal for relapsed vs. 0.83 for those who did not relapse (p-value = 0.59). The mean increase in serum lactate dehydrogenase, from baseline, was 1.1-fold in non-relapsed vs. 1.3 in relapsed patients (p-value = 0.3). The likelihood ratio of relapse was 4.65 for patients who had 1.5-fold increases in serum ...

Clinical characteristics of autoimmune gastritis / 中华消化杂志

Objective To analyze the clinical characteristic of autoimmune gastritis (AIG).Methods From January 1990 to April 2010,the clinical data of 55 AIG patients were retrospectively analyzed,which included hemoglobin,lactate dehydrogenase (LDH),α-hydroxybutyrate dehydrogenase (α-HBDH),gastrin,intrinsic factor antibody (IFA),parietal cell antibody (PCA),gastrointestinal endoscopy examination and 24-hour esophageal pH recording.Another 31 megaloblastic anemia (MA) patients were selected as control.Statistical analysis was performed by independent-samples t test.Results Among 55 AIG patients,49 patients were associated with MA,and three out of four cases were identified of IFA.About 43.8％ (21/48) patients were PCA positive.Before treatment,the levels of LDH and α-HBDH of AIG patients with MA were (1045.50±853.46)U/L and (853.71±824.23) U/L which significantly increased,than those of patients without MA [(166.67±41.03) U/L,(133.67±27.90) U/L],the differences were statistically significant (t=-4.665,-2.120,both P＜0.05),however there was no significant difference when compared with the control group [(1047.52±1028.31) U/L,(1050.23±1264.37) U/L,both P＞0.05)].A total of 46 patients underwent gastroendoscopy examination,63.0％ (29/46) patients had gastric body atrophy while gastric antrum not involved; 34.8％ (16/46) patients had neither gastric body nor antrum atrophy; seven patients gastric mucosal showed intestinal metaplasia and one patient showed intestinal metaplasia with atypical hyperplasia and 2.2％ (1/46) presented both the antrum and the body atrophy.Conclusions The levels of LDH and α-HBDH increased in AIG patients might be related with MA caused marrow in-situ hemolysis.IFA is recommended as a routine test for AIG.There is still some limitations of AIG diagnosis according to histopathological features of gastric endoscopy specimen.The clinical features should be taken into consideration.

Clinical significance of serum lactic dehydrogenase alteration in patients with acute leukemia / 白血病·淋巴瘤

Objective To investigate the clinical significance of serum lactic dehydrogenase (LDH)alteration in patients with acute leukemia (AL). Methods Serum LDH of 156 AL patients including untreated 63,completely remission (CR) 46 and relapsed 47 were measured by biochemistry analyzer. R banding technique was used for karyotype analysis this three groups were divided according to poor, good and normal prognostic chromsome. The correlation between LDH level with AL periods, chromsome groups, peripheral WBC counts and leukemia subtypes were analysed. Results The LDH level of AL patients untreated (P50 399 U/L) and relapsed (P50 265 U/L) were significantly higher than those CR (P50 153 U/L), P ＜0.05. LDH level were closely correlated with peripheral WBC counts (rs=0.604) and leukemia cells of bone marrow (rs=0.538, both P ＜ 0.01), and both were also correlated with leukemia subtypes (LDH in subtypes L2, M4 were higher than other subtypes of AL, P ＜ 0.01). The refractory and relapsed AL patients had higher LDH level (P50 538 U/L) than the others (P50 294 U/L) when they were diagnosed. And those with poor prognostic chromsome also had higher LDH level (P50 778 U/L) than those with good (P50 306 U/L) and normal prognostic chromsome (P50 405 U/L, P ＜0.01). Conclusion LDH level increased obviously in untreated AL patients and decreased in CR ones. It was correlated with different periods, subtypes and grade malignancy of AL So LDH level can be considered as an important indicator for therapeutic effects and prognosis for AL patients.

Reference intervals for ALT, AST, GGT and LDH among the Han Chinese in Beijing area / 中华检验医学杂志

ObjectiveTo establish the reference intervals for ALT,AST,GGT and LDH among the Han nationality in Beijing.MethodsThe document C28-P3 issued by CLSI was a guideline about how to define,establish,and verify reference intervals in the clinical laboratory.IFCC had established multicenter enzymes reference intervals based on the guideline.Exclusion criteria were designed for screening candidate reference individual according to the document C28-P3 and the multicenter study's experience.Blood specimens were collected from 315 healthy individuals aged 20 to 60 years old,including 132 males and 183 females.Reference materials were used to ensure the accuracy of the test results of the four liver enzymes.The methods which used to test the four liver enzymes could be traced to the IFCC enzymes reference measure procedure,the reagent of ALT and AST included pyridoxal phosphate.Results There was statistically difference between males and females of the referenceranges forALT, ASTand GGT.Therefore,gender-specific reference intervals were established as ALT:8.2 -50.8 U/L (F),12.7 -71.8 U/L (M) ; AST:15.0 -36.7 U/L ( F),16.6 -51.1 U/L (M) ;GGT:9.0 -37.3 U/L (F),12.0 -50.9 U/L (M).For LDH,the reference interval was 127 -224 U/L,as no significant gender difference was found.ConclusionsThe reference intervals for the four liver enzymes based on the population of the Han nationality in Beijing are established.The upper reference limit for ALT in Beijing Han population is higher than that from other similar studies.