Predictive value of HIT-antibodies detection for new thrombosis in heparin-induced thrombocytopenia / 中华检验医学杂志

Objective To investigate the predictive value of HIT-antibodies(HIT-Ab) detection for new thrombus in suspected Heparin-Induced thrombocytopenia (HIT). Methods Retrospective cohort study. 472 suspected HIT patients were collected from July 2016 to November 2018, and all subjects under-went a 4Ts score and were sent for HIT-Ab tests. According to the results of HIT-Ab, there were four groups:412 cases of negative HIT-Ab (0-0.9 U/ml), 45 cases of weak-positive HIT-Ab (1.0-4.9 U/ml), 12 cases of moderate-positive HIT-Ab (5.0-15.9 U/ml), and 3 cases of strong-positive HIT-Ab (≥16.0 U/ml) respective-ly. Ultrasound or CT examination was used to confirm new thrombosis as a standard to evaluate the value of HIT-Ab for predicting new thrombus. The diagnostic efficacy of HIT-Ab for HIT was evaluated in clinically confirmed HIT. Results The incidence rates of new thrombus in each group were: 15.8％ in Negative HIT-Ab group (62/412), 48.9％in Weak-positiveHIT-Ab group (22/45), 75.0％in Moderate-positive HIT-Ab group (9/12), and100％in Strong-positive HIT-Ab group (3/3)(P<0.00). When HIT-Ab≥1.0 U/ml, the speci-ficity for diagnosing new thrombus was 93.0％, the sensitivity was 34.2％, the negative predictive value (NPV) was 84.2％, and the positive predictive value (PPV) was 56.5％. The diagnostic rates of HIT in each group were:negative 0％(0/412), weak-positive 62.2％(28/45), moderate-positive (12/12) and strong-positive (3/3) were 100％. When HIT-Ab≥ 1.0 U/ml, the specificity for HIT diagnosis was 96.0％, the sensitivity was 100％, NPV was 100％, and PPV was 71.5％. Conclusions In suspected HIT patients, the incidence of new thrombosis increases with the elevated HIT-Ab level. HIT-Ab detection can be used as a crucial tool for new thrombosis prediction and HIT diagnosis in suspected HIT patients. Clinicians can develop treatment strategies based on HIT-Ab levels.

Effect of levosimendan on cardiomyocyte apoptosis after coronary microembolization in swine / 中华老年心脑血管病杂志

Objective To study the effect of levosimendan on cardiomyocyte apoptosis after coronary microembolization (CME) in swine,Methods Fifteen healthy swines were randomly divided into sham operation group,CME group and levosimendan treatment group (5 in each group).Their cardiac function was assessed by echocardiography,their cardiomyocyte apoptosis was assyed with TUNEL staining,and Caspase-3 expression was detected by Western blot at 12 h after operation.Results The LVEF was lower,the left ventricular minor axis was shorter and the cardiac output volume was smaller while the LVEDD was longer in CME group than sham operation group (P＜0.05).The cardiac function was significantly better in CME group than in sham operation group (P＜0.05).The cardiomyocyte apoptosis rate and Caspase-3 expression level were significantly higher in CME group than in sham operation group (P＜0.05).The cardiomyocyte apoptosis rate was significantly higher while the Caspase-3 expression level was significantly lower in levosimendan treatment group than in CME group (6.820％±-1.974 ％ vs 10.558％±2.425％,P＜0.05).Conclusion Pretreatment with levosimendan can effecively reduce the cardiomyocyte apoptosis and improve the cardiac function after CME by inhibiting the Caspase-3 expression in cardiomyocytes.

The mediating role of spiritual health between life meaning and life practice in college students / 中华行为医学与脑科学杂志

Objective To explore the relationship among life meaning,spiritual health and life practice of college students.Methods Sense of Life Meaning Scale,Spiritual Health Scale and Life Practice Scale were applied to 708 college students.Results Life meaning was positively correlated with spiritual health and life practice,and spiritual health was positively correlated with life practice (r =0.51-0.79,P＜0.01).Spiritual health played fully mediating role between life meaning and life practice (x2=287.27,df=24,GFl=0.91,RMSEA=0.12),and accounted for 87％ of the mediating role.Conclusion Spiritual health serves as a mediator in the effect of life meaning on spiritual health in college students.

The relativity analysis of carotid artery atherosclerosis and various coronary artery disease / 中国医师杂志

Objective To determine the relationship between the aggravation of CAAS and coronary atherosclerosis (CAS) ;and to summarize the pathologic character of CAAS of the patients with various coronary artery disease. Methods Review the result of coronary angiography and carotid artery ultrasonography and the related risk factors of the patients who were diagnosed as CAD through coronary angiography ( CAG). The patients were divided into the scleratheroma group and the non scleratheroma group. The patients were divided into stable angina pectoris( AP) group, unstable angina pectoris(UAP) group and acute myocardial infarction (AMI) group according to the criterion of coronary artery disease of WHO. The patients were divided into group A (coronary artery of single vessel lession) ,group B( coronary artery of double vessel lession ) , group C( coronary artery of triple vessel lession )and group D(left main vessel lession ).The aggravation of CAAS was graded. Results There were 198 patients with various CAAS among 228 patients with coronary artery disease ( 86. 8%). CAAS was much related with hypertension and non-related with age, sex, BMI, smoking, drinking, hyperlipoidemia, hyperuricosuria and diabetes mellitus. The aggravation of CAAS much graver with much graver CAS. But only the plaque number of Group A was more than Group D( P ＜0. 05). The grading integral and Crouse integral of CAAS of AP group was not remarkable less than UAP group. The grading integral of CAAS of AP group was less than AMI group and the Crouse integral of AP group was more. But there was no remarkable difference. The number of all plaque,plaque and plaque of AP group was not remarkable less than UAP group and AMI group. There was the plaque among the three group. Conclusion Carotid artery atherosclerosis (CAAS) is relative to coronary artery disease ( CAD).

Correlation between fractional anisotropy values of diffusion tensor imaging and working memory impairment in patients with depression / 中华行为医学与脑科学杂志

Objective To investigate whether there are correlations between working memory impairmentand fractional anisotropy values and to explore the neuropathology underlying that the patients of depression suffered from memory impairment.Methods Thirty depression patients and 30 healthy controls group-matched by age,educational level were conducted the study.Mean correct reaction time(mRT)was recorded when they performed a One-Back Working Memory Task and fractional anisotropy(FA)values was recorded when they performed the diffusion tensor imaging.Statistics analysis was done respectively for mRT and FA values between two groups.Results Relative to mean correct reaction time((612.45±54.08)ms)of controls,the mean correct reaction time ((720.25±57.02)ms)of patients with depression was much longer(P＜0.05)and the patients with depression had a lower FA values in the white matter of both frontal lobe,anterior cingulate gyrus,supramarginal gyrus,splenium of corpus callosum(P＜0.05),and the FA values in the white matter of both frontal lobe were significantly negative correlated with mRT(r=-0.604,P＜0.05).Conclusion The impairment of white matter region may be one of the neuropathology underlying that the depression patients suffer from memory impairment.