The risk prediction value of paraquat poisoning dose, urine protein and myocardial enzymes / 中华劳动卫生职业病杂志

Objective: To explore the value of paraquat (PQ) intake, urine protein and myocardial enzyme indexes in judging the prognosis of patients with acute PQ poisoning. Methods: From September to December 2021, all 201 patients with acute PQ poisoning admitted to Guangzhou Twelfth People's Hospital from January 2010 to December 2019 were selected as the research objects. Based on follow-up results 60 days after poisoning, the research objects were divided into survival group (n=78) and death group (n=123) . The differences in information about poisoning, treatment plan, PQ intake, urine protein, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase between the two groups of patients were compared and analyzed. Logistic regression and Cox regression were used to analyze the correlation between poisoning outcome and PQ intake, urine protein and myocardial enzymes. ROC curve and principal component analysis were used to explore high-efficiency indicators for predicting the outcome of acute PQ poisoning. Results: The PQ intake[50 (20, 100) ml], urine protein (total rank 15570.50) , creatine kinase[ (336.36±261.96) U/L], creatine kinase isoenzyme[ (43.91±43.74) U/L], lactate dehydrogenase [ (346.01±196.50) U/L], α-hydroxybutyrate dehydrogenase content[ (271.23±11.92) U/L] of patients in the death group were all higher than the survival group[15 (10, 20) ml, 4730.50, (187.78±178.06) U/L, (18.88±15.50) U/L, (190.92±60.50) U/L, (152.60±48.34) U/L, respectively] (P<0.05) . The outcome of acute PQ poisoning was positively correlated with PQ intake, urine protein, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase (P<0.05) . Multivariate logistic regression and multivariate Cox regression analysis showed that creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase and α-hydroxybutyrate dehydrogenase was positively correlated with the prognosis of patients with acute PQ poisoning (P<0.05) . ROC curve analysis and principal component analysis showed that the combined indexes of PQ intake, urine protein and myocardial enzymes had the highest efficacy and weight in judging the prognosis of patients (AUC=0.91, weight coefficient=0.19, sensitivity=0.76, specificity=0.89) . When the combined score was ≥4, the probability of accurately predicting the death of patients was as high as 91% (positive predictive value=0.91) . Conclusion: PQ intake, urine protein combined with creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase has high value in predicting the prognosis of patients with acute PQ poisoning.

Modified Fired Glycyrrhizae Decoction as adjunct therapy on the hemodynamics and myocardial enzymes of the patients with coronary arrhythmia after bifurcation lesion surgery / 国际中医中药杂志

Objective:To explore the effects of modified Fired Glycyrrhizae Decoction on hemodynamics and levels of myocardial enzymes in coronary arrhythmia (CA) after bifurcation lesion (BCL) surgery.Methods:According to simple random method, 100 patients with CA after BCL surgery in the hospital who met the inclusion criteria were divided into two groups between May 2019 and May 2021, 50 in each group. The control group was treated with intravenous drip of amiodarone and routine treatment, while the observation group was treated with modified Fired Glycyrrhizae Decoction on basis of control group. Both groups were treated for 2 weeks. Before and after treatment, TCM syndromes were scored. The quality of life was assessed by World Health Organization Quality of Life Scale (WHOOLQ-100). The plasma or serum specific viscosity, fibrinogen and ESR were detected by non-invasive hemodynamic detector. The levels of cardiac troponin (cTnT), creatine kinase (CK) and brain natriuretic peptide (BNP) were detected by ELISA. The disappearance time of symptoms was observed. The adverse reactions were recorded. And the clinical responsive effect was evaluated.Results:The difference in total response rate between observation group and control group was not statistically significant [92.0% (46/50) vs. 90.0% (45/50); χ2=0.12, P=0.727]. After treatment, scores of fluster and shortness of breath, panic and irritability, and mental fatigue in the observation group were significantly lower than those in the control group ( t=7.38, 9.88, 4.87, P<0.01), and scores of physical function, independence and social relations were significantly higher than those in the control group ( t=8.69, 6.32, 5.76, P<0.01). After treatment, levels of plasma specific viscosity, fibrinogen and ESR in the observation group were significantly lower than those in the control group ( t=13.59, 8.30, 8.80, P<0.01). After treatment, levels of serum cTnT [(33.45±3.44) mg/L vs. ( 39.71±4.02) mg/L, t=8.37], CK [(70.49±7.32) U/L vs. (82.15±8.41) U/L, t=7.40] and BNP [(223.41±20.36) ng/L vs. (244.58±20.74) ng/L, t=5.15] in the observation group were significantly lower than those in the control group ( P<0.01). The disappearance time of palpitation, chest tightness and dizziness in the observation group was significantly earlier than those in the control group ( t=10.44, 11.91, 5.75, P<0.01). During treatment, differences in incidence of adverse reactions between observation group and control group was statistically significant [4.0% (2/50) vs. 32.0% (16/50); χ2=4.00, P=0.046]. Conclusion:The modified Fired Glycyrrhizae Decoction combined with routine western medicine can improve clinical symptoms, hemodynamics and levels of myocardial enzymes in CA patients after BCL surgery, and improve the clinical curative effect.

Changes in myocardial enzyme spectrum, procalcitonin and C-reactive protein levels in neonates with hyperbilirubinemia / 中国基层医药

Objective:To investigate the changes in myocardial enzyme spectrum, procalcitonin, and C-reactive protein levels in neonates with hyperbilirubinemia.Methods:A total of 150 neonates with hyperbilirubinemia who received treatment in the 1 st Affiliated Hospital of Wenzhou Medical University during January-December 2019 were included in this study. They were allocated to mild (total bilirubin level 221-256.5 μmol/L, n = 68) and moderate-to-severe hyperbilirubinemia (total bilirubin level > 256.5 μmol/L, n = 82) groups according to different serum total bilirubin levels. An additional 70 healthy neonates who were born concurrently served as controls. Myocardial enzyme spectrum (creatine kinase, creatine kinase-MB, lactate dehydrogenase, alpha-hydroxybutyrate dehydrogenase), procalcitonin, and C-reactive protein levels were compared among groups. The correlation between myocardial enzyme spectrum, procalcitonin, and C-reactive protein levels and the severity of hyperbilirubinemia was investigated. The factors related to hyperbilirubinemia in neonates were analyzed using logistic regression analysis. Results:Serum levels of creatine kinase, creatine kinase-MB, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were (1130.23 ± 385.42) U/L, (194.82 ± 60.33) U/L, (993.45 ± 271.46) U/L, and (493.76 ± 105.65) U/L, respectively in the moderate-to-severe hyperbilirubinemia group, which were significantly higher than those in the mild hyperbilirubinemia and control groups [(682.23 ± 258.53) U/L, (82.67 ± 24.43) U/L, (486.38 ± 112.57) U/L, (252.63 ± 38.73) U/L; (368.13 ± 104.20) U/L, (27.90 ± 8.29) U/L, (402.13 ± 102.20) U/L, (228.53 ± 34.30) U/L; F = 67.12, 56.23, 66.57, 44.34, all P < 0.01]. Serum levels of creatine kinase, creatine kinase-MB, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were significantly higher in the mild hyperbilirubinemia group than those in the control group (all P < 0.05). Premature infants, intrauterine distress, neonatal asphyxia, amniotic fluid pollution, sepsis, omphalitis, erythrocyte glucose-6-phosphate dehydrogenase defect, and delayed passage of meconium are the risk factors for neonatal hyperbilirubinemia ( OR = 6.13, 5.40, 5.29, 4.26, 7.79, 6.99, 5.79, 5.44, all P < 0.05). Breastfeeding is an independent protective factor for the development of neonatal hyperbilirubinemia ( OR = 5.87, P < 0.05). Conclusion:Myocardial enzyme, procalcitonin, and C-reactive protein levels increase in neonates with hyperbilirubinemia with the aggravation of the disease. Close monitoring of high-risk factors of neonatal hyperbilirubinemia (including preterm infants, intrauterine distress, neonatal asphyxia, amniotic fluid pollution, sepsis, omphalitis, erythrocyte glucose-6-phosphate dehydrogenase defect, and delayed passage of meconium) and strengthening perinatal health care and high-risk pregnancy management can reduce the incidence of pathological jaundice.

Clinical study of Jianxin-Pinglyu Pills combined with routine western medicine therapy for the patients with diabetes mellitus and ventricular arrhythmia / 国际中医中药杂志

Objective:To evaluate the effect of Jianxin-Pinglyu Pills combined with routine western medicine therapy on the patients with diabetes mellitus and ventricular arrhythmia (VA). Methods:A total of 92 patients with type 2 diabetes mellitus (T2DM) and VA who met inclusion criteria and treated in the hospital were enrolled between June 2019 and December 2020. According to random number table method, they were divided into observation group ( Jianxin-Pinglyu Pills on basis of control group) and control group (routine treatment), 46 cases in each group. Both groups were continuously treated for 2 months. Before and after treatment, TCM symptoms (chest pain and palpitation, chest distress and shortness of breath, dry mouth and thirst, fatigue) were scored. The fingertip blood was collected to detect levels of fasting blood glucose and 2 hPG. The 24 h dynamic electrocardiogram examination was conducted by electrocardiograph. The standard deviation of NN intervals (SDNN), standard deviation average of NN intervals (SDANN), the root mean square of successive R-R interval (RMSSD) and the percentage of adjacent NN intervals over 50 ms (PNN50) were statistically analyzed. The creatine kinase (CK) and creatine kinase isoenzymes (CK-MB) were detected by biochemical analyzer. The plasma brain natriuretic peptide (BNP) were detected by chemiluminescence immunoassay. The adverse reactions were recorded, and clinical curative effect was evaluated. Results:The differences in total response rate between observation group and control group were statistically significant [93.5% (43/46) vs. 78.3% (36/46); χ2=4.390, P=0.036]. After treatment, TCM symptoms (chest pain and palpitation, chest distress and shortness of breath, dry mouth and thirst, fatigue) in observation group were significantly lower than those in control group ( t=4.319, 2.714, 3.196, 4.667, P<0.01 or P<0.05), levels of fasting blood glucose and 2 hPG were significantly lower than those in control group ( t=2.025, 6.462, P<0.05 or P<0.01). After treatment, SDNN [(119.72 ± 5.86) ms vs. (115.27 ± 6.10) ms, t=3.568], SDANN [(112.80 ± 13.36) ms vs. (98.62 ± 14.51) ms, t=4.876], RMSSD [(46.87 ± 5.44) ms vs. (42.58 ± 5.73) ms, t=3.683] and PNN50 [(6.84 ± 0.66)% vs. (6.21 ± 0.64)%, t=4.648] in observation group were significantly higher than those in control group ( P<0.01), while the levels of CK [(263.82 ± 52.18) U/L vs. (306.59 ± 48.45) U/L, t=4.074] and CK-MB [(2.02 ± 0.62) g/L vs. (3.25 ± 0.49) g/L, t=10.556] were significantly lower than those in control group ( P<0.01), and level of plasma BNP [(126.99 ± 49.02) ng/L vs. (188.26 ± 54.30) ng/L, t=5.681] was significantly lower than that of control group ( P<0.01). During treatment, difference in incidence of adverse reactions between observation group and control group was not statistically significant [10.9% (5/46) vs. 4.3% (2/46); χ2 =0.619, P=0.432) ]. Conclusion:Jianxin-Pinglyu Pills combined with routine western medicine can effectively relieve clinical symptoms in patients with T2DM and VA, control hyperglycemia, improve heart rate variability, control levels of myocardial enzymes and plasma BNP, and safety.

The effect of isosorbide dinitrate on cardiac function after cardiopulmonary resuscitation in a porcine model / 中华急诊医学杂志

Objective To assess the effect of isosorbide dinitrate on the improvement of cardiac function after cardiopulmonary resuscitation (CPR) by regulating myocardial cells apoptosis..Methods Total of 30 domestic pigs were divided into three groups randomly (random mumber) after anesthetization:the sham group (n=6),the control group (n=12),and the isosorbide dinitrate group (n=12).Cardiac arrest of ventricular fibrillation was induced by programed electrical stimulation in the control and isosorbide dinitrate groups.Isosorbide dinitrate was infused at the rate of 2 μg/(kg·min) in the isosorbide dinitrate group.Coronary perfusion pressure (CPP) and cardiac output (CO) were recorded at baseline,2,6,12 and 24 h after restoration of spontaneous circulation (ROSC).Myocardial enzyme and heart fatty acid binding protein (H-FABP) was tested at the same time points.At 24 h after ROSC,the animals were sacrificed to obtain the myocardium for pathological section and Western blot.The expression of Bcl-2,Bax and activated Caspase-3 were tested and apoptosis was tested by TUNEL and apoptosis index was calculated.Results Right atrial pressure (RAP) increased after ROSC and decreased in the isosorbide dinitrate group compared with the control group (P＜0.05).CPP at 12,24 h after ROSC and CO at 24 h after ROSC in the isosorbide dinitrate group increased significantly compared with the control group (both P＜0.05).HE staining revealed that the injury of myocardial cells was ameliorated in the isosorbide dinitrate group.Apoptosis index of the isosorbide dinitrate group significantly decreased than the control group [(37.8±15.5)％ vs (13.1±0.5)％,P＜0.05].The expression of Bax and activated Caspase-3 decreased while Bcl-2 and Bcl-2/Bax increased after ROSC in the isosorbide dinitrate group compared with the control group (all P＜0.05).Conclusions Isosorbide dinitrate could improve the isehemia/reperfusion injury and cardiac function after ROSC by inhibiting apoptosis regulated with Caspase-3 pathway.

Diagnostic value of 12 leads ECG combined with detection of myocardial enzyme spectrum for atypical myocardial infarction / 中国医学装备

Objective: To explore the diagnostic value of 12 leads electrocardiogram (ECG) combined with detection of myocardial enzyme spectrum for atypical myocardial infarction. Methods: 80 patients with atypical myocardial infarction were enrolled in the observation group, and 80 patients with typical myocardial infarction in the same period were enrolled in the control group. Both of two groups were implemented the routine 12 leads ECG examination using FX-8322 ECG instrument, and the changes of Q wave and ST segment were recorded. And the series of indicators of serum myocardial enzymes (CK, CK-MB and cTnI) were detected by using AU2700 automatic biochemical analyzer. The test results of the first symptoms, ECG characteristics, myocardial enzyme spectrum and diagnostic accuracy of the two groups were compared. Results: In 80 patients of observation group, the painless first symptom was 20%, and the atypical pain was 75%, the typical upper abdominal and back pain accounted for 5%. In 80 patients of control group, all of them were typical upper abdominal and back pain, and the differences of these indicators between the two groups were significant (x2=8.889, x2=48.000, x2=72.381, P<0.05). For characteristics of ECG, the 22.5% of 80 patients of observation group hasn't been changed at ST-T segment, and the 17.5% of them was no pathological Q wave +T wave erect +ST segment elevation, and the percentage of pathological Q wave +T wave erect +ST segment elevation in observation group was 60.0%. On the other hand, the 100.0% of 80 patients of control group was pathological Q wave+T wave inverted +ST segment elevation, the differences of these indicators between the two groups were significant (x2=10.141, x2=7.671, x2=20.000, P<0.05). The results of myocardial enzyme spectrum detection indicated that the levels of serum CK, CK-MB and cTnI in the observation group were significantly lower than those in the control group (t=59.766, t=20.735, t=13.352, P<0.05), respectively. The diagnostic accuracy rate of ECG in observation group was 87.5%, which was significantly lower than 100% in control group (x2=5.333, P<0.05). The accuracy rate of ECG combined with myocardial enzyme spectrum in the observation group was 100%, which was not statistically significant compared with that in control group. Conclusion: 12 leads ECG is effective in diagnosing typical myocardial infarction, but it is necessary to combine myocardial enzyme spectrum detection for atypical myocardial infarction so as to increase the diagnostic accuracy rate.

Detection and clinical value of serum myocardial enzyme and immune function in children with bronchial asthma / 国际检验医学杂志

Objective To investigate the changes of serum myocardial enzyme and immune function in chil-dren with bronchial asthma,and to evaluate the clinical value of level detection.Methods 100 children with bronchial asthma were divided into acute attack group and remission group,50 cases in each group,50 healthy children were selected as control group;the level of serum myocardial enzyme(AST,LDH,CK,CK-MB)and Tlymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+)were compared between the 3 groups,and to ana-lyze the correlation between levels and disease.Results The levels of AST,LDH,CK,CK-MB,CD4+and CD4+/CD8+in the children with asthma exacerbation and remission were significantly higher than those in the control group,and levels of acute attack group was significantly higher than the remission group,the difference was statistically significant(P<0.05).The level of CD8+in the acute attack group and remission group was significantly lower than that in the control group,and the level of the acute attack group was signif-icantly lower than that of the control group,the difference was statistically significant(P<0.05).Severity of bronchial asthma was significant positive correlation with AST,LDH,CK,CK-MB,CD4+and CD4+/CD8+(P<0.05),the severity of bronchial asthma was negatively correlated with the level of CD 8+(P<0.05).Conclu-sion There were different degrees of myocardial damage and abnormal immune function in children with bronchial asthma.With the aggravation of the disease,the level of myocardial enzyme and immune function of children with asthma were more significantly abnormal.

Protective effect of salvianolic acid B on cardiomyocytes of suckling rats with oxidative stress injury and its mechanism / 吉林大学学报(医学版)

Objective: To investigate the protective effect of salvianolic acid B on the cardiomyocytes of the suckling rats with oxidative stress injury, and to clarify its mechanism. Methods: The cardiomyocytes of Wistar suckling rats were primary cultured in vitro and randomly divided into normal control group, model group, low dose of salvianolic acid B group, and high dose of salvianolic acid B group. Except normal control group, the suckling rat cardiomyocytes were induced to oxidative stress injury by being exposed to H2O2 at the dose 100 μmoL · L-1; 20 and 40 μmol · L-1 salvianolic acid B were separatly added into low and high doses of salvianolic acid B groups. After co-culturing for 4 h, the morphological changes of cardiomyocytes were observed by light microscope; the survival rate of cardiomyocytes was examined using MTT. The levels of reductive glutathione (GSH), the activity of superoxide dismutase (SOD) and the level of malondialdehyde (MDA) in the cardiomyocytes were detected with spectrophotometry. The levels of lactate dehydrogenase (LDH) and creatine kinase (CK) in culture medium were determined by ELISA. Results: Compared with normal control group, the cardiomyocytes in model group partially suspended in the culture medium, the number of adherent cells was decreased, the pseudopod contraction and the volume were decreased, and the self-discipline throb of cardiomyocytes was slow. Compared with model group, the number of cardiomyocytes in 20 and 40 μmol · L-1 salvianolic acid B groups were increased significantly, the pseudopod contraction was reduced, and self-discipline throb was enhanced. Compared with normal control group, the survival rate of cardiomyocytes in model group was decreased (P<0. 01), the level of GSH in cardiomyocytes was decreased (P<0. 01), the level of MDA was increased (P<0. 01), the activity of SOD was decreased (P< 0. 01), and the levels of CK and LDH in culture medium were increased (P<0. 05 or P<0. 01). Compared with model group, the survival rates of cardiomyocytes in 20 and 40 μmol · L-1 salvianolic acid B groups were increased (P<0. 05 or P<0. 01), the levels of GSH and the activities of SOD were increased (P<0. 05 or P<0. 01), the levels of MDA were decreased (P<0. 05 or P<0. 01), and the CK and LDH levels in culture medium were decreased (P<0. 05 or P<0. 01). Conclusion; Salvianolic acid B can protect the cardiomyocytes against oxidative stress injury, and its mechanism may be associated with the inhibition of lipid peroxidatic reaction and the enhancement of antioxidant ability of cardiomyocytes.

Effects of seven sevoflurane and propofol anesthesia on heart rate and myocardial enzymes in elderly patients with coronary heart disease / 中国生化药物杂志

Objective To investigate the effects of seven halothane and propofol anesthesia on heart rate and myocardial enzymes in elderly patients with coronary heart disease (CHD), and to analyze the safety of clinical application of the two kinds of anesthetic drugs.MethodsA total of 70 cases of elderly patients with coronary heart disease treatment January 2012 to December 2014 general anesthesia surgery as the research object, randomly divided into A group and B group were 35 patients in.A group were treated with seven sevoflurane anesthesia, group B patients were given propofol anesthesia, observe the change of the two groups of patients before and after anesthesia hemodynamic index and myocardial enzyme etc.index.ResultsA group of patients with HR 5min after induction and 10min were significantly lower than before the surgery, and the difference was statistically significant (P<0.05);HR stabilized after the induction of 15min and 20min, and compared with before surgery had no significant difference;patients in group B HR and 10min 5min after induction there was no obvious change compared with that before operation, no statistical significance;and after the induction of 15min and 20min HR increased, the difference was statistically significant (P<0.05).A group and B group in patients with systolic and diastolic blood pressure were lower than before anesthesia in varying degrees, and group B more significantly, the difference was statistically significant (P<0.05).A group and B group of patients after 6 h, cTnl and CK-MB in 12h and 24h than 15min before surgery has increased significantly, and A group cTnl and CK-MB were lower than B group, the difference was statistically significant (P<0.05).ConclusionThe clinical application of seven sevoflurane anesthesia for elderly patients with coronary heart disease during propofol is feasible, but seven halothane on blood pressure and heart rate of patients affected with propofol, improve the myocardial enzyme level, and better reduce the damage of perioperative myocardial, more suitable for anesthesia in elderly coronary heart disease.

Effects of Compound Danshen injection on acute viral myocarditis / 中国生化药物杂志

Objective To analyse effects of Compound Danshen injection on acute viral myocarditis.Methods-128 patients with acute viral myocarditis were divided into two groups from May 2015 to February 2017 in Yuhang District, the Second People's Hospital.The two groups received the conventional treatment plan, the observation group was given compound Danshen injection, the evaluation of compound Danshen injection on the disease effect.Results①Total efficiency of observation group was 93.75%,higher than that of control group 76.56%(P<0.05).②Serum TNF-ɑ and IL-6 level of observation group were[(72.4±10.4), (36.15±4.68)]ng/L,lower than that of control group[(95.0±12.7), (46.23±5.24)ng/L](P<0.05).③Serum AST,CK-MB and LDHI level of observation group were[(43.19±3.25), (17.34±3.31), (168.4±13.9)]U/L,lower than that of control group[(0.47±0.08)μg/L, (9.05±1.93)mg/L)](P<0.05).Whole blood viscosity,plasma viscosity and FIB level of observation group were[(5.95±1.91)mPa·s, (1.49±0.17)mPa·s, (3.20±0.58g/L)],lower than that of control group[(52.09±4.61), (25.55±3.86),(201.5±15.4)U/L](P<0.05).④There was no obvious adverse reaction in the control group and the observation group had 3.13% adverse reactions.ConclusionCompound Danshen injection can reduce the level of inflammation in patients with acute viral myocarditis,protect myocardial cells and improve treatment effect.

Effects of Tanshinone on myocardial enzymes and heart function of acute myocardial infarction / 国际中医中药杂志

Objective To investigate the effects of sodium tanshinone ⅡA injection on myocardial enzymes and heart function of patients with acute myocardial infarction, and to explore its therapeutic mechanism. Methods A total of 217 patients with acute myocardial infarction in Taihe Hospital emergency department were randomly divided into control group (n=110) and the Tanshinone group (n=107). The control group was treated by thrombolysis, vascular dilation, antihypertension, anti-shock and other conventional treatment. On the basis of control group treatment, Tanshinone group added the intravenous injection 20mg sodium tanshinone injection. The ELISA was used to test serum creatine kinase (CKMB), superoxide dismutase (SOD), malondialdehyde (MDA) and cardiac troponin I (CTNI) and other enzymes indexes before and after treatment. The heart function were assessed by measuring the left ventricular patient of maximum rising/ falling rate (± LVdp/dtmax),left ventricular end-diastolic diameter (LVDD), left ventricular ejection fraction (LVEF),systolic blood pressure (SP), diastolic blood pressure (DP), pulse pressure (PP ) and heart rate (HR) and other indicators. Results After treatment, the CK-MB (10.76 ± 1.02 mmol/L vs. 15.17 ± 1.21 mmol/L, t=3.724), CTNI (0.11 ± 0.02 ng/ml vs.1.51 ± 0.05 ng/ml, t=2.570), MDA (4.54 ± 0.23 nmol/ml vs. 9.98 ± 1.37 nmol/ml, t=5.035) in the Tanshinone group were significantly lower than those in the control group (P<0.05). The SOD (452.27 ± 21.56 U/L vs. 209.50 ± 15.43 U/L, t=3.935), LVDD (50.74 ± 5.36 mm vs. 44.91 ± 5.31 mm, t=2.454) and LVEF (4.59% ± 0.17% vs. 3.64% ± 0.11%, t=4.052) in the Tanshinone group were significantly higher than those in the control group (P<0.05). The heart function of +dp/dtmax (3742 ± 162 mmHg/s vs. 3948 ± 193 mmHg/s, t=3.731), -dp/dtmax (3512 ± 135 vs. 3847 ± 181, t=3.025), PP (30.5 ± 5.3 mmHg vs. 35.8 ± 5.1 mmHg, t=2.902), DP (99.2 ± 8.8 mmHg vs. 117.3 ± 10.8 mmHg, t=4.079) in the Tanshinone group were significantly lower than those in the control group (P<0.05). The total effective rate was 98.14% (105/107), the control group was 87.2%(96/110), and there was significant difference between the 2 groups (χ2=10.417, P<0.05). Conclusions The Tanshinone ⅡA sodium injection can improve myocardial enzymes and heart function of patients with acute myocardial infarction, which refered to its protective effect on acute myocardial infarction.

Effect of Reduning Injection combined with spleen aminopeptide oral solution on children with hand-foot-and-mouth disease and its regulative effect on myocardial enzyme and inflammatory level / 药物评价研究

Objective To investigate the effect of Reduning Injection (RI) combined with spleen aminopeptide oral solution on children with hand-foot-and-mouth disease and its regulative effect on myocardial enzyme and inflammatory level.Methods Totally 184 cases treated in Children's Hospital of Kaifeng City from September,2014 to September,2016 were randomly divided into observation group and control group with each group of 92 cases.Control group was given conventional therapy,on the basis of which,observation group was given RI combined with spleen aminopeptide oral solution.Clinical effect and levels of inflammatory cytokine and myocardial enzyme were compared between the two groups.Results The total effective rate in observation group was 93.48％,which was significantly higher than that in control group (80.43％) (P ＜ 0.05).After therapy,the levels ofhs-cTnT,CK-MB,CK,TNF-α,IL-6,CRP,CD3+,CD4+,CD8+,IgA,IgM,and IgG in observation group showed no statistical difference compared with healthy group.Index mentioned above of control group were significantly improved,however there were still statistical difference compared with healthy group (P ＜ 0.05).Conclusion RI combined with spleen aminopeptide oral solution could effectively decrease the levels of inflammatory cytokine as well as myocardial enzyme,which deserves clinical expansion.

Analysis of Early Monitoring for Heart Damage Caused by Anthracyclines Chemotherapy Drugs after Breast Cancer Surgery / 中国药房

OBJECTIVE:To investigate the early changes of ECG,cTnⅠ,LDH,α-HBDH and CKMB in patients with anthra-cyclines chemotherapy-induced heart damage after breast cancer surgery,and to explore their significances in the diagnosis of early heart damage. METHODS:Medical information of 152 cases of anthracyclines chemotherapy after breast cancer surgery in our hos-pital during Jan. 2015-Jun. 2016 were analyzed retrospectively. According to diagnosis criteria of drug-induced cardiotoxicity,the occurrence of heart damage was evaluated during hospitalization and 1-year follow-up. According to evaluation results,those pa-tients were divided into heart damage group(50 cases)and control group(102 cases). The early changes of ECG,cTnⅠ,LDH, CKMB and α-HBDH were analyzed before chemotherapy(T0),24 h after first chemotherapy(T1),24 h after second chemothera-py(T2),24 h after forth chemotherapy. RESULTS:At T1,T2,T3,the proprotion of ECG abnormalities in heart damage group was significantly higher than control group;the serum levels of cTnⅠ,LDH,CKMB andα-HBDH in heart damage group were signifi-cantly higher than control group, with statistical significance (P<0.01). CONCLUSIONS:For anthracyclines chemotherapy drugs-induced heart damage after breast cancer surgery,early regular monitoring of ECG,cTnⅠ,LDH,CKMB and α-HBDH can improve the efficiency of early diagnosis of heart damage,and improve prognosis.

Effects of astragalus polysaccharide on cardiac dysfunction in rabbits with severe scald injury / 中华烧伤杂志

Objective@#To investigate the effects of astragalus polysaccharide (AP) on cardiac dysfunction in rabbits with severe scald injury.@*Methods@#Sixty-four New Zealand white rabbits were divided into pure scald group and AP group according to the random number table, with 32 rabbits in each group. Rabbits in the two groups were all inflicted with 30% total body surface area full-thickness scald on the back. Immediately after injury, rabbits in two groups were intraperitoneally injected with lactated Ringer′s solution once for antishock. Rabbits in AP group were intraperitoneally injected with 10 mL AP solution with the dosage of 200 mg/kg 10 min after injury and the following 6 days respectively, once a day. Rabbits in pure scald group were injected with 10 mL normal saline instead. Eight rabbits of each group were respectively selected before injury hour (BIH) 1 and on post injury day(PID) 1, 3, 7, and 14 to collect blood samples from ear marginal vein, and then sacrificed immediately to collect hearts at each time point post injury. The morphology of myocardium was observed after HE staining. The serum content of cardiac troponin I (cTnI) was detected by enzyme-linked immunosorbent assay (ELISA). The serum content of aspartate transaminase (AST), creatine kinase (CK), CK isoenzyme-MB (CK-MB), lactate dehydrogenase (LDH) was detected by fully automatic chemistry analyzer. The content of angiotensin Ⅱ (Ang Ⅱ) in serum and myocardium was detected with radioimmunoassay and the content of endothelin 1 (ET-1) in serum and myocardium was detected by ELISA. Another 8 normal rabbits were sacrificed to detect the content of Ang Ⅱ and ET-1 in the myocardium as the value of the two groups of scalded rabbits at BIH 1. The serum content of superoxide dismutase (SOD) and malondialdehyde (MDA) was detected by ELISA. The values of whole blood viscosity (ηb), reductive viscosity of whole blood (ηr), plasma viscosity (ηp), hematocrit (HCT), erythrocyte rigidity index (TK), erythrocyte aggregation index (EAI), and erythrocyte sedimentation rate (ESR) were detected by fully automatic hematology analyzer. Data were processed with analysis of variance of factorial design, independent sample t test, and Dunnett test.@*Results@#(1) Compared with those in pure scald group, the degrees of cardiomyocyte swelling, steatosis, necrosis and rupture of muscle fiber were significantly alleviated in rabbits of AP group on PID 1 and 3. There was no obvious increase in cell size, no breakage of muscle fiber or infiltration of inflammatory cells in myocardial interstitium on PID 7. The myocardial tissue structure and muscle fiber arrangement returned to normal condition on PID 14, with no interstitial fibroblast hyperplasia or excessive extra cellular matrix deposition. (2) Serum content of cTnI, CK, and LDH of rabbits in AP group was significantly lower than that in pure scald group on PID 1, 3, and 7 (with t values from 2.69 to 13.99, P<0.05 or P<0.01), while there was no significant difference between the two groups on PID 14 (with t values from -0.32 to 0.68, P values above 0.05). Serum content of AST and CK-MB of rabbits in AP group was significantly lower than that in pure scald group on PID 1 and 3 (with t values from 2.21 to 12.65, P<0.05 or P<0.01), while there was no significant difference between the two groups on PID 7 and 14 (with t values from 0.03 to 1.67, P values above 0.05). (3) Serum content of Ang Ⅱ of rabbits in AP group was significantly lower than that in pure scald group from PID 1 to 14 (with t values from 3.38 to 32.58, P values below 0.01). Serum content of ET-1 of rabbits in AP group was significantly lower than that in pure scald group from PID 3 to 14 (with t values from 3.54 to 11.02, P values below 0.01), while there was no obvious difference on PID 1 (t=0.39, P>0.05). Content of Ang Ⅱ and ET-1 in myocardial tissue of rabbits in AP group was significantly lower than that in pure scald group from PID 1 to 7 (with t values from 1.27 to 13.79, P values below 0.01), while there was no obvious difference on PID 14 (with t values respectively 0.07 and 0.81, P values above 0.05). (4) Serum content of SOD of rabbits in AP group was respectively (15.65±2.64), (14.67±0.74), and (8.43±0.56) ng/mL on PID 1, 3, and 7, which was significantly higher than (6.35±0.83), (2.62±0.75), and (2.84±0.41) ng/mL in pure scald group (with t values from -29.79 to -9.10, P values below 0.01); while there was no obvious difference on PID 14 [with (4.02±0.26) ng/mL in pure scald group and (4.11±0.52) ng/mL in AP group, t=-0.01, P>0.05]. Serum content of MDA of rabbits in AP group was respectively (1.31±0.61), (1.72±0.64), and (0.65±0.42) μmol /mL on PID 1, 3, and 7, which was significantly lower than (1.68±0.57), (2.34±0.79), and (1.06±0.32) μmol/mL in pure scald group (with t values from 1.63 to 3.16, P<0.05 or P<0.01), while there was no obvious difference on PID 14 [with (0.31±0.09) μmol/mL in pure scald group and (0.24±0.08) μmol/mL in AP group, t=2.11, P>0.05]. (5) Values of ηb1 and EAI of rabbits in AP group were significantly lower than those in pure scald group from PID 1 to 7 (with t values from 2.718 to 11.170, P<0.05 or P<0.01), while there were no obvious differences on PID 14 (with t values respectively 2.078 and -1.423, P values above 0.05). Values of ηb2 and ηr2 of rabbits in AP group were significantly lower than those in pure scald group on PID 3 and 7 (with t values from 2.178 to 19.205, P<0.05 or P<0.01), while there were no obvious differences on PID 1 and 14 (with t values from -0.730 to 1.320, P values above 0.05 ). Values of ηr1 and ESR of rabbits in AP group were significantly lower than those in pure scald group on PID 3, 7, and 14 (with t values from 3.021 to 8.058, P values below 0.01), while there were no obvious differences on PID 1 (with t values respectively 1.200 and 1.263, P values above 0.05 ). Value of ηp of rabbits in AP group was significantly lower than that in pure scald group on PID 1 (t=2.430, P<0.05), while there were no obvious differences on PID 3, 7, and 14 (with t values from 0.002 to 1.446, P values above 0.05 ). Value of HCT of rabbits in AP group was close to that in pure scald group on PID 1 (t=1.079, P>0.05), and the values were significantly lower than those in pure scald group on PID 3 and 14 (with t values respectively 3.849 and 4.208, P values below 0.01), while the value was significantly higher than that in pure scald group on PID 7 (t=-4.925, P<0.01). Value of TK of rabbits in AP group was lower than that in pure scald group on PID 7 (t=2.847, P<0.05), while there were no obvious differences on PID 1, 3, and 14 (with t values from -1.102 to 0.875, P values above 0.05).@*Conclusions@#AP can alleviate the damage of myocardium of rabbits with severe scald by reducing the production of vasoactive substances Ang Ⅱ and ET-1, decreasing oxidative stress injury by increasing the content of SOD and decreasing the production of MDA, improving blood flow performance and microcirculation perfusion.

Research on the impact of pidotimod combined with antiviral drugs on immunologic function and myocardial enzyme spectrum in children with infectious mononucleosis / 中国生化药物杂志

Objective To investigate the effect of pidotimod combined with antiviral drugs on immunologic function and myocardial enzyme spectrum in children with infectious mononucleosis.Methods 94 cases of children with infectious mononucleosis selected in Wenzhou Children's hospital were randomly divided into control group and research group,47 cases in each group.The control group were given conventional antiviral treatment; On this basis,the research group were given pidotimod,2 weeks for one period of treatment.Before and after treatment,immune function,cell factors and myocardial enzyme spectrum were tested,the clinical symptoms,signs,the curative effect and complications were observed and compared.Results Compared with before treatment,after treatment,serum CD4+,CD4+/CD8+ IgA and IgG increased,CD8+ decreased,TNF alpha,IL-6,AST,LDH,CK,CK-MB decreased(P<0.05).Compared with the control group,in the research group,CD4+,CD4+/CD8+,IgA and IgG content is higher,CD8+ content is lower,the TNF alpha,IL-6,AST,LDH,CK,CK-MB content is lower(P<0.05).The time of antipyretic,angina fade,narrow lymph nodes,liver and spleen shrinks and length of hospital stay in the research group were shorter than that in the control group(P<0.05).The effective rate was 74.47％in the control group,lower than 91.49％of research group(P<0.05).Conclusion The curative is exact that pidotimod combined with antiviral drugs on the treatment of infectious mononucleosis.It could improve immune function,reduce myocardial enzyme spectrum and inflammation.

Clinical Observation of Serum 25-Hydroxy-vitamin D Levels in 3340 Hospitalized Children / 中国药师

Objective:To investigate the baseline levels of 25-hydroxy-vitamin D [25-(OH) D] in 3340 hospitalized children, analyze the 25-( OH) D levels in children with different diseases, age and gender in different seasons, and study the correlation between the 25-( OH) D levels and the clinical indicators. Methods:Totally 3340 hospitalized children were randomly selected, the 25-( OH) D levels were detected by an ELISA method, and Pearson correlation analysis of 25-( OH) D levels and clinical indicators such as liver function, myocardial enzymes, immunoglobulins, lymphocyte subtypes and thyroid function was performed. Results: The serum 25-(OH) D level in 3340 cases (1850 male, 1490 female) was (33. 00 ± 13. 42) ng·m1 -1, and that in those with neonatal diseases was the lowest followed by those with primary nephrotic syndrome, Henoch-schordeinpurpura and juvenile idiopathic arthritis. The ser-um 25-( OH) D levels in the premature was higher than that in full term infant. Except the newborn, the level of serum 25-( OH) D gradually reduced along with the age increase, while the percentage of insufficiency gradually increased. The serum 25-( OH) D level between the male and the female had no significant difference. The 25-( OH) D levels of hospitalized children were the highest in sum-mer. The serum level of 25-( OH) D was positively correlated with body mass index ( BMI) , alanine transaminase ( ALT) , aspartate transaminase (AST), creatine kinase (CK), creatine-phosphokinase (CK-MB), lactate dehydrogenase(LDH), free T4 (FT4) and free T3 (FT3), and negative correlation with alkaline phosphatase(ALP), immunoglobulin E (IgE) and immunoglobulin M (IgM). Conclusion:The incidence of vitamin D insufficiency is high in hospitalized children. The level of vitamin D is different among various diseases. The level of serum 25-( OH) D may have certain relevance with BMI, allergies, myocardial damage and thyroid function.

Protective effects of salvianolic acid B on isoproterenol induced myocardial ischemic rats and its relation with NLRP3 expression / 中国药理学通报

Aim To evaluate the protective effects of salvianolic acid B on the ISO-induced myocardial is-chemic injury model of rats and the influence of regula-ting NLRP3 associated protein on myocardial ischemia. Method All rats were randomly divided into control group, model group and Sal B 5, 10, 15 mg · kg-1 groups. For 7 days, rats in Sal B groups were given by introperitoneal injection of 5, 10, 15 mg·kg-1 Sal B, rats in control group and model group were given the same volume of normal saline. Rats were subcutane-ously multi-point injected ISO ( 30 mg · kg-1 ) for 2 days on the fifth administrating day. The myocardial protective effect of Sal B was evaluated from electrocar-diogram( ECG), myocardial tissue pathological chan-ges, serum myocardial enzymes, oxidation index and inflammatory cytokine, myocardial tissue of NLRP3 related protein expression. Results Sal B could re-duce the degree of myocardial tissue necrosis and the infiltration of inflammatory cells, reduce T-wave values of ECG(P<0. 05 or P<0. 01). Compared with model group, CK values, GOT values and IL-1β values of rats in different dose groups were significantly lower, and MDA values and LDH values of rats in middle-and high-dose groups were significantly lower ( P<0. 05 or P<0. 01 ) . However, T-SOD values of rats middle-and high-dose groups were significantly higher ( P <0. 05 or P<0. 01). Meanwhile,the NLRP3, Caspase-1 and IL-1β protein level in myocardial tissue of the rats in different dose groups compared with model group had reduced ( P <0. 05 or P <0. 01 ) . Conclu-sion Sal B has protective effects on myocardial ische-mic rats, its mechanism may be related with inhibition of decreasing the expression of NLRP3 inflammasome associated protein, which can suppress the generation of inflammatory cytokines.

Effect of linezolid on serum myocardial enzyme and cerebrospinal fluid lactate dehydrogenase in intracranial infection mice / 中国生化药物杂志

Objective To study the effect of linezolid on serum myocardial enzyme and cerebrospinal fluid lactate dehydrogenase (CSF LDH) in intracranial infection mice.Methods The seventy-five mice were divided into five groups randomly: control group, model group, linezolid of high, medium and low dose group.The model of intracranial infection was established by injecting staphylococcus aureus into mice cranium.The mice in linezolid group were treated with different doses of linezolid, the control group and model group were treated with physiological saline.After 15 days with drug, detect the serum myocardial enzyme and CSF LDH level.Results The myocardial enzyme and CSF LDH level of model group were higher than control group obviously (P<0.01); compared with the model group, the myocardial enzyme and CSF LDH level of low dose group have no diffrence;the myocardial enzyme and CSF LDH level of medium dose group were reduced (P<0.05);the high dose group has an obvious reduction in myocardial enzyme and CSF LDH (P<0.01).And the myocardial enzyme and CSF LDH level of high dose group were lower than the low dose group significantly ( P <0.01 ) . Conclusion Linezolid has an exact effect on intracranial infection caused by staphylococcus aureus, with significant dose-effect relationship.

Clinical Observation of Kangfuxin Liquid in the Treatment of Pediatric Hand,Foot and Mouth Disease / 中国药房

OBJECTIVE:To observe clinical efficacy and safety of Kangfuxin liquid in the treatment of pediatric hand,foot and mouth disease. METHODS:128 children with hand,foot and mouth disease were randomly divided into observation group and control group,with 64 cases in each group. Control group was given routine treatment as herpes and oral care,antibiotics for infec-tive children reflected by hemogram elevation,fluid infusion and non-steroidal analgesic-antipyretic agent based on disease condi-tion. Observation group was additionally given Kangfuxin liquid,3 ml for below 3 year-old,tid and 5 ml for more than 3 year-old,tid. Clinical efficacy of 2 groups were observed as well as CRP,lactic acid,Ig,the level of myocardial enzyme before and after treatment;the time of symptoms and signs disappearance and ADR were compared between 2 groups after treatment. RE-SULTS:The total effective rate of observation group(89.06%)was significantly higher than that of control group(70.31%),with statistical significance(P0.05). CRP,lactic acid creatine kinase and lactate dehydrogenase level of 2 groups decreased significantly,while IgA and IgG levels increased significantly,and the observa-tion group was higher than the control group,with statistical significance(P<0.05). Antipyretic time,hand foot skin rash subsided time and oral ulcer healing time of observation group were significantly shorter than those of control group,with statistical signifi-cance(P<0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:Kangfuxin liquid is effective in the treatment of hand,foot and mouth disease in children,and can effectively improve CRP,Ig,lactic acid,and myocardial enzyme level with good safety.

Significance of changes in serum troponin and myocardial enzymes in children with living donor liver trans-plantation / 中华实用儿科临床杂志

Objective To explore the characteristics and its clinical significance of troponin I(cTnI),myo-cardial enzymes and intraoperative hemodynamic changes in the pediatric patients undergoing living donor liver trans-plantation. Methods Liver transplantation was performed in 50 congenital biliary atresia children who were ranged from grade Ⅲ or Ⅳ in Tianjin First Central Hospital from January 2013 to December 2014 according to the American Society of Anesthesiologists(ASA),meanwhile,the method of the combined intravenous - inhalation anesthesia was ap-plied during operation. Blood samples were drawn from central vein before skin incision(T0 baseline),at 30 min of an-hepatic phase(T1),30 min of neohepatic phase(T2),and 12 h,36 h after operation(T3,T4). Levels of cTnI,crea-tine kinase(CK),lactate dehydrogenase(LDH)and α - hydroxy butyric acid dehydrogenase(α - HBDH)were mear-sured,respectively. Furthermore,heart rate(HR),mean arterial blood pressure(MAP),central venous pressure(CVP) and arterial blood gas analysis[pH value,pa(O2 ),pa(CO2 ),and base excess(BE)]were monitored at the moment of T0,T1,T2 as well as the end of surgery. Results The levels of cTnI,CK,LDH and α - HBDH in T1 - T3 were in-creased,and there was a peak at the T2 compared with the baseline at T0(all P ﹤ 0. 05). At T3 and T4,cTnI,CK, LDH and α - HBDH levels significantly decreased compared with those at T2(all P ﹤ 0. 05),the levels of cTnI were (0. 06 ± 0. 02)μg/ L,(0. 37 ± 0. 52)μg/ L,(0. 05 ± 0. 02)μg/ L,CK levels were(344. 6 ± 209. 5)U/ L,(466. 1 ± 116. 4)U/ L,(219. 3 ± 111. 5)U/ L,LDH levels were(552. 3 ± 414. 9)U/ L,(966. 4 ± 454. 1)U/ L,(322. 8 ± 108. 8) U/ L,and α - HBDH levels were(301. 6 ± 124. 0)U/ L,(456. 4 ± 168. 4)U/ L,(146. 2 ± 80. 2)U/ L,respectively. The levels of hemodynamics significantly changed in anhepatic phase and neohepatic phase. Compared with T0:T1,HR ac-celerated,MAP,CVP decreased,BE value increased,and the differences were statistically significant(all P ﹤ 0. 05);T2,open vena cava and back to the blood volume surge,CVP,MAP increased,HR decreased but still higher than T0, BE value further increased,and the differences were statistically significant(all P ﹤ 0. 05). After the surgery,various hemodynamic indexes fell to preoperative levels,the levels of HR were(103. 1 ± 5. 9)times/ min,(128. 8 ± 8. 5) times/ min,(115. 1 ± 0. 3)times/ min,(103. 5 ± 5. 9)times/ min,MAP levels were(59. 7 ± 9. 1)kPa,(48. 7 ± 5. 4) kPa,(58. 6 ± 7. 1)kPa,(59. 1 ± 8. 6)kPa,CVP levels were(7. 5 ± 4. 3)kPa,(3. 9 ± 4. 6)kPa,(5. 8 ± 3. 5)kPa, (7. 2 ± 4. 1)kPa,BE levels were( - 1. 5 ± 5. 0)mmol/ L,( - 0. 4 ± 5. 7)mmol/ L,(1. 0 ± 3. 8)mmol/ L,(2. 4 ± 2. 2)mmol/ L,respectively. Conclusions The myocardial injury may appear during the perioperation of pediatric living donor liver transplantation and gradually aggravated during the anhepatic phase. The worst injury peaks at 12h and it gradually returns to the preoperative level 36 h postoperativelly.