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Objective:To investigate the clinical value of serum miR-208a in early differential diagnosis of acute coronary syndrome(ACS).Methods:One hundred ACS patients admitted to our department from January 2016 to January 2018 were randomly divided into the non-ST elevation myocardial infarction(NSTEMI)group(n=50)and the unstable angina(UA)group(n=50). Fifty healthy people during the same period were included as the control group(control). Serum levels of miR-208a, cardiac troponin-T(cTnT)and creatine kinase MB isoenzyme(CK-MB)were detected immediately, 4 h, 12 h and 24 h after admission and compared among the three groups of NSTEMI, UA and control.Receiver operating characteristic(ROC)curve was used to analyze the early diagnostic value of above serum indexes in NSTEMI and UA group, and the correlations of miR-208a level with cTnT and CK-MB were analyzed.Results:Serum miR-208a and cTnT levels had significant differences( P<0.05), while serum CK-MB level had no significant difference( P>0.05)among the NSTEMI and UA groups immediately after admission and the control group in the fasting state.There were significant differences in serum miR-208a, cTnT and CK-MB levels between NSTEMI group and UA group at different time points( P<0.05). After further multiple comparisons, the results showed that serum miR-208a and cTnT levels had statistical differences( P<0.05)and serum CK-MB level had no difference( P>0.05)between the NSTEMI group and the UA group immediately after admission.The above three biochemical indexes showed statistically significant differences between the NSTEMI group and the UA group at 4 h, 12 h and 24 h after admission( P<0.05). ROC curve analysis showed that miR-208a had a high diagnostic value in ACS(AUC>0.9, P=0.004), and the best diagnostic cut-off point was 9.278.The cTnT had a medium diagnostic value in ACS(0.7<AUC<0.9, P=0.013), and the diagnostic cut-off point was 5.147 μg/L.CK-MB had a low diagnostic value in ACS(0.5<AUC<0.7, P=0.031), and the diagnostic cut-off point was 82.716 u/l.Serum miR-208a level was positively correlated with cTnT level in ACS patients( P<0.05), and there was no correlation between serum miR-208a level and CK-MB level( P>0.05). Conclusions:Serum miR-208a has a higher value in early diagnosis of ACS than cTnT and CK-MB, and it has a better differentiation ability of NSTEMI than UA.
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Objective To investigate the correlation between myeloperoxidase(MPO)levels and adverse cardiac events in patients undergoing coronary stent implantation.Methods A total of 76 patients undergoing coronary stent implantation from January 2015 to June 2016 in the cardiac surgery department of our hospital were enrolled in this study.Serum levels of MPO,high sensitivity C-reactive protein(hs-CRP),and interleukin 6 (IL-6)were detected by enzyme-linked immunosorbent assays(ELISA).After a one-year follow-up,the receiver operating characteristic(ROC)curve was used to determine the predictive value of the difference in MPO before and after the operation(△MPO)on the long-term prognosis of patients after coronary stent implantation.The correlations of △MPO with the traditional risk factors for coronary heart disease and adverse cardiac events were analyzed using multi factor Logistic regression analysis.Results Serum levels of MPO,hs-CRP and IL 6 increased in patients after coronary stent implantation,compared with those before treatment (P ＜ 0.05).The results of ROC curve analysis showed that the area under the curve(AUC)value of serum △MPO was 0.786,the 95 ％ confidence interval was 0.471～ 1.000 and the predictive value of serum △MPO for adverse cardiac events was significant(P ＜0.05).There was a significant correlation between △MPO and age,and the incidence of adverse cardiac events increased with increased △MPO levels.Logistic regression analysis showed that serum △MPO levels could preliminarily diagnose the cardiovascular risk after coronary stent implantation and independently predict the occurrence of adverse cardiac events.Conclusions MPO levels in peripheral blood are notably elevated in patients after coronary stent implantation when compared with pre-treatment levels.Serum △MPO levels can preliminarily diagnose adverse cardiac events after coronary stent implantation and can be used as a marker to predict adverse cardiac events.
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Objective To evaluate the effects of ulinastatin on hemorrhagic shock and resuscitation ( HS∕R)?induced acute lung injury in rats. Methods Fifteen SPF adult Sprague?Dawley rats, aged 2-3 months, weighing 300-400 g, were divided into 3 groups ( n=5 each) using a random number table:sham operation group ( group S ) , HS∕R group and ulinastatin group ( group U ) . Carotid arteries were cannulated for blood pressure monitoring and blood?letting. HS∕R was induced by blood?letting and maintained for 1 h, followed by resuscitation with autologous blood transfusion and infusion of normal saline. After cannulation of carotid arteries ( T0 ) , at 5 min after hemorrhagic shock ( T1 ) , before resuscitation ( T2 ) , at 5 min after the expected blood pressure was achieved following resuscitation ( T3 ) , and at 30 min, 1?5 h and 2?5 h after resuscitation ( T4?6 ) , arterial blood samples were collected for determination of interleukin?6 ( IL?6 ) and tumor necrosis factor?α ( TNF?α) concentrations ( by enzyme?linked immunosorbent assay) . Arterial blood samples were collected at T0 , T2 and T6 for blood gas analysis. The pH value, partial pressure of arterial carbon dioxide ( PaCO2 ) , HCO-3 and base excess ( BE) value were recorded, and oxygenation index ( PaO2∕FiO2 ) was calculated. Lungs were removed at T6 , and pulmonary specimens were obtained for examination of pathological changes which were scored, and nucleus was extracted for determination of nuclear factor?kappa B ( NF?κB ) p65 expression by enzyme?linked immunosorbent assay. Results Compared with group S, the pH values, HCO-3 , BE values and OI were significantly decreased, and PaCO2 , plasma IL?6 and TNF?α concentrations, expression of NF?κB p65 in lung tissues, and pathological scores were increased in U and HS∕R groups. Compared with group HS∕R, the plasma concentrations of IL?6 and TNF?α, expression of NF?κB p65 in lung tissues, and pathological scores were significantly decreased, and no significant changes were found in parameters of blood gas analysis in group U. Conclusion Although ulinastatin can alleviate HS∕R?induced acute lung injury, it is insufficient to improve lung oxygenation in rats.
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This study aimed to explore the short-term efficacy and safety of primary percutaneous coronary intervention [PCI] in female diabetic patients complicated with acute myocardial infarction [AMI]. A total of 169 diabetic patients with AMI who underwent primary PCI were selected and divided into group A [52 females] and group B [117 males]. The clinical data, characteristics of coronary artery lesions, lengths of hospital stay, and incidences of complications were then compared between two groups. The average age, history of hyperlipidemia, double branch lesions, triple branch lesions, and left main lesions were significantly higher in group A than in group B [P < 0.05]. Smoking history, PCI history, and pre-infarction angina were distinctly lower in group A than in group B [P < 0.05]. Thrombolysis in myocardial infarction 3 [TIMI3] flow and TIMI myocardial perfusion grade 3 [TMPG3] after PCI were markedly lower in group A than in group B [P < 0.001]. Group A had a higher incidence of complications, such as severe arrhythmia, cardiac function Killip III/IV, cardiogenic shock, major, moderate and mild bleed event, as well as a 30-day mortality rate, compared with group B [P < 0.05]. In summary, our study demonstrated that female diabetic patients with AMI had lower TIMI3 flow and TMPG3 following PCI than male patients, while there was higher incidence of complications and 30-day mortality rate. Therefore, more attention should be paid to the therapy of diabetic women with acute myocardial infarction as well as the control of risk factors
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Humanos , Masculino , Femenino , Infarto del Miocardio , Diabetes MellitusRESUMEN
Objective Hospital material management system of sterile supply has its particularity which is in close relation with medical quality.The study was to greatly improve the quality and efficiency of sterile supply department with the application of material management system. Methods The material management system integrated with the hospital net was applied in the man-agement of material distribution, inventory and statistics. Results It provided exact and detailed data for sterile supply department and clinical departments. Conclusion The application of information system in hospital net can provide exact and overall cost ac-counting information for involved departments, greatly improving the efficiency of material management.