Myocardial Infarction in Diabetics, Pre-Diabetics and Non- Diabetics: A Prospective Study

Vascular diseases are one of the major public health problems in the developed world, resulting in devastating symptoms involving coronary artery occlusion, cerebrovascular accidents, peripheral vascular insufficiency, and acute myocardial infarction (AMI). These diseases affect millions of people annually, resulting in extensive morbidity and mortality. It is a well-established fact that individuals with pre-diabetes and diabetes are at a higher risk of cardiovascular events including myocardial infarction. The other risk factors for development of coronary artery disease include hypertension, obesity, hyperlipidemia, family history and sedentary life style. In this study we analyzed the data of all patients admitted for the first time for acute myocardial infarction (MI) and evaluated the load of non-diabetics, prediabetics and diabetics among them. In this study patients were analyzed for their biochemical and physiological parameters and cardiac markers at the time of admission. Methods: This was a prospective cohort study jointly conducted by department of physiology and medicine of a tertiary care medical college situated in an urban area. The patients admitted in intensive care unit and diagnosed to be having acute myocardial infarction were included in this study on the basis of a predefined inclusion and exclusion criteria. Various physiological (pulse rate, blood pressure, heart rate and respiratory rate) and biochemical (HbA1c, Plasma glucose, lipid profile and cardiac markers) were studied. Number of diabetics, pre-diabetics and non-diabetics landing in myocardial infarction and correlation of abnormal blood glucose level to severity of myocardial infarction was studied. The statistical analysis was done using SSPE 21.0 software. P value less than 0.05 was taken as statistically significant. Results: Total 89 patients were included in this study. Out of these 89 patients 34 (38.20%) patients were non- diabetic whereas 33 (37.08%) and 22 (24.72%) patients were pre-diabetic and diabetic respectively. The mean age of diabetic, pre-diabetic and non-diabetic patients were found to be comparable with no statistically significant difference amongst them (P>0.05). Gender distribution showed that there were 71 (79.78) males and 18 (20.22%) females with a M:F ratio of 1:0.25. Heart rate as well as systolic and diastolic blood pressure and total cholesterol levels were found to be higher in diabetic patients as compared to pre diabetic and non-diabetic population. Analysis of myocardial enzyme (CK-MB and Troponin I) levels showed that they were also higher in diabetic patients as compared to pre-diabetic and non- diabetic population. Mortality was found to be statistically significantly high in patients with diabetes (P<0.05). Conclusion: The diastolic blood pressure, total cholesterol, triglyceride, LDL cholesterol CK-MB, Troponin I showed an increase in diabetic group of AMI patients. Though the mean age of myocardial infarction was found to be comparable in diabetics, pre diabetics and non-diabetic patients there was statistically significant higher mortality rates in diabetic patients with myocardial infarction.

Study on Protective Effect of Total Flavonoids from the Leaves of Mongolian Medicine Choerospondias axillaris on Myocar- dial Ischemia Reperfusion Injury Model Rats / 中国药房

OBJECTIVE： To investigate the protective effect of total flavonoids from the leaves of Choerospondias axillaris （TFLC） on myocardial ischemia reperfusion injury （MIRI） model rats. METHODS： Male SD rats were randomly divided into sham operation group， model group， positive control group （verapamil， 0.02 g/kg）， TFLC low-dose and high-dose groups （0.1， 0.4 g/kg）， with 10 rats in each group. Administration groups were intragastrically given relevant medicine （2 mL/100 g）； sham operation group and model group were given constant volume of normal saline intragastrically， once a day， for consecutive 7 d. After last medication， MIRI model was induced by modified ligation method. The times and duration of ventricular tachycardia （VT） and ventricular fibrillation （VF） in rats were recorded with biological function experiment system during reperfusion period.The activity of CK and contents of TNF-α， IL-6， NF-κB and NO in serum were determined by ELISA double antibody clip art assay. The morphological characteristics of myocardial tissue was observed by HE staining. The myocardial infarction scope （i.e. the ratio of myocardial tissue mass to ventricular mass） was measured by TTC method. RESULTS： Compared with sham operation group， the times and duration of VT and VF were increased or prolonged significantly in model group； CK activity， serum contents of TNF-α， IL-6 and NF-κB were enhanced or increased significantly， while NO content was decreased significantly （P＜0.05 or P＜0.01）. Obvious myocardial infarction focus， serious cell structure damage， disorderly muscle fibers arrangement， cell nucleus pyknosis and accompanied inflammatory cell infiltration were all observed in cardiac tissue； the mass of infarcted myocardial tissue and ventricular as well as the scope of myocardial infarction increased significantly （P＜0.01）. Compared with model group， the times and duration of VT and VF were decreased or shortened significantly in administration groups； CK activity， serum contents of TNF-α， IL-6， NF-κB were decreased significantly， while NO content was increased significantly （P＜0.05 or P＜0.01）. The above symptoms of myocardial injury were improved；the mass of infarcted myocardial tissue and ventricular as well as the scope of myocardial infarction was significantly reduced （P＜0.05 or P＜0.01）. CONCLUSIONS： TFLC can relieve MIRI-induced ischemic arrhythmia and myocardial damage， reduce the release of inflammatory factors， promote the recovery of myocardial and endothelial cell function， reduce the scope of myocardial infarction and has a certain protective effect.

Application of dexmedetomidine in intracranial arterial stenting and its influence on the serum myocardial enzyme,cTnI and LVEF / 中国基层医药

Objective To analyze the application of dexmedetomidine in intracranial arterial stenting and its influence on the serum myocardial enzyme ,cardiac troponin I(cTnI) and left ventricular ejection fraction (LVEF). Methods From March 2015 to March 2017,94 cases with intracranial arterial stenting in the People's Hospital of Lishui were divided into control group and observation group by the random number table method ,with 47 cases in each group.The control group was treated with conventional anesthesia ,the observation group was treated with dexme-detomidine.The enzyme creatine phosphate kinase isoenzyme (CK -MB),creatine phosphate kinase (CK),cTnI, LVEF,inflammatory factor, neural function, brain oxygen metabolism and complications in the two groups were compared.Results After surgery,the CK-MB,CK,cTnI levels of the observation group were lower than those of the control group[(35.27 ±4.41) U/L,(488.30 ±61.03) U/L,(3.85 ±0.49) μg/L vs.(46.40 ±5.79) U/L, (611.21 ±76.40)U/L,(4.72 ±0.59)μg/L],the LVEF of the observation group was higher than that of the control group[(45.60 ±5.72)%vs.(43.12 ±5.39)%],the differences were statistically significant (t＝10.484,8.619, 7.777,2.163,all P＜0.05).The interleukin -6(IL-6) and interleukin -8(IL-8),tumor necrosis factor -α (TNF-α),S-100β,specificity enolization enzyme(NSE),cerebral metabolic rate of oxygen(ERO2),arterial blood oxygen saturation(PaO2),carotid venous blood oxygen saturation (SjvO2) of the observation group were better than those of the control group(t＝5.794,6.177,15.065,6.964,5.606,3.147,2.116,2.807,all P＜0.05).The inci-dence rate of complication of the observation group was lower than that of the control group (χ2＝17.091,P＜0.05). Conclusion Application of dexmedetomidine in intracranial arterial stenting can protect myocardium , inhibit the serum levels of myocardial enzyme ,cTnI rise,and is conducive to the recovery of LVEF.

Effect of long-term crotonaldehyde exposure on heart damage in male rats / 中华劳动卫生职业病杂志

Objective@#To observe the effect of long term crotonaldehyde exposure on heart damage in male rats, and to explore the possible mechanism of toxic action.@*Methods@#24 specific pathogen free healthy male wistar rats were randomly divided into 4 groups with 6 rats in each group. Rats were treated with with 8.5, 4.5, 2.5 and 0.0 mg/kg body weight crotonaldehyde by gavage, once a day for consecutive 150 days. After the last treatment, they were anesthetized and collected blood samples by cardiac puncture. The heart was rapidly separated after cervical dislocation. The cardiac organ coefficient was calculated and the histopathology changes in heart were observed by HE staining. At the same time, the activities of creatine kinase (CK) , lactate dehydrogenase-L (LDH-L) in serum were determined by automatic biochemical analyzer. Moreover, the levels of cardiac troponin (cTnT) , Angiotensin Ⅱ (Ang Ⅱ) , Brain natriuretic peptide (BNP) , Aldosterone (ALD) and interleukin (IL) -6, 8, 1β, interferon (IFN) -γ and tumor necrosis factor (TNF) -α in heart were determined by enzyme linked immunosorbent assay.@*Results@#At the 90d, 120 d, and 150 d exposure, compared with the control group, the body weight gain in 4.5 and 8.5 mg/kg groups were decreased. Moreover, the heart weight in 4.5 and 8.5 mg/kg groups, and heart coefficient in 8.5 mg/kg group were decreased (P<0.05) . With the increasing dosage of crotonaldehyde, the degree of pathological changes in the heart of exposed rats were aggravated. The major pathological changes of heart in 4.5 and 8.5 mg/kg groups could be summarized as lymphocyte infiltration, abnormal cardiac muscle fiber arrangements, necrosis and fibrous connective tissue hyperplasia. Compared with the control group, the serum CK activity in 4.5 mg/kg group, CK and LDH-L activitivies in 8.5 mg/kg group were increased (P<0.05) ; Compared with the control group, the levels of ALD and ANGII in the heart of 4.5 and 8.5 mg/kg groups were increased, BNP level were decreased, and cTNT level in 8.5 mg/kg group were increased (P<0.05) . Compared with the control group, the levels of IL-1β、IL-6、IL-8 in 4.5 mg/kg group and IL-1β、IL-6、IL-8、TNF-α、IFN-γ in 8.5 mg/kg group were increased (P<0.05) .@*Conclusion@#Crotonaldehyde could up-regulate cardiac inflammatory cytokines and alter the balance ofangiotensin-aldosterone-brain natriuretic peptide causing heart damage.

Clinical efficacy of creatine phosphate sodium combined with ribavirin in treating infantile viral myocarditis and its effect on myocardial enzyme levels in children / 吉林大学学报(医学版)

Objective:To investigate the clinical efficacy of creatine phosphate sodium combined with ribavirin in the treatment of infantile viral myocarditis,and to elucidate its mechanism of the effects on myocardial enzyme levels in the children.Methods:A total of 96 children with viral myocarditis were selected;according to the random number grouping method,they were divided into observation group and control group (n=48).The myocardial enzymes and cardiac troponin Ⅰ (cTnI) of the patients in two groups were detected,and anti-infection,supplementation of electrolytes,and nutritional support for myocardial treatment were performed;then intravenous infusion therapy of ribavirin was used.On this basis,the patients in observation group were given intravenous infusion of creatine phosphate sodium for 14 d.After treatment,the total effective rate of treatment of the patients in two groups,the levels of myocardial enzymes and cTnI and electrocardiogram were compared before and after treatment.Results:The total effective rate of the patients in observation group was 87.50％ (42/48),and it was 70.83％ (34/48) in control group;there was significant difference (x2 =4.04,P=0.04).After treatment,the levels of lactate dehydrogenase (LDH),hydroxybutyrate dehydrogenase (HBDH),aspartate transaminase (AST),creatine phosphokinase (CPK),creatine kinase isoenzyme-MB (CK-MB) and CTnI of the patients in two groups after treatment were lower than before treatment (P＜0.05).The indicators mentioned above of patients in observation group were lower than those in control group (P ＜0.05).The total improvement rate of electrocardiogram in the observation group (89.58％) was significantly higher than that in control group (72.92 ％),and the difference was statistically significant (x2 =4.38,P =0.04).Conclusion:The total effective rate of creatine phosphate sodium combined with ribavirin in the treatment of infantile viral myocarditis is higher,and they can significantly reduce the levels of myocardial enzymes and improve the cardiac function;it is worth to apply in the clinical treatment.

Several clinical hotspots in the diagnosis and treatment of myocardial injury and myocarditis in children / 中国小儿急救医学

Myocardial injury and myocarditis are the two diagnostic words frequently used by pediatricians,myocardial enzymes and cardiac troponin are also frequently detected in laboratory tests. But up to now,some pediatricians still lack a comprehensive understanding of the clinical significance of cardiac enzymes and their isoenzymes. There are still some misunderstandings about how to interpret the test results correctly. Currently,it is not uncommon for myocardial injury and myocarditis to be over-diagnosed and over-treated. In addition,new biochemical markers of myocardial injury ( cardiac troponin and highly sensitive troponin) are not well understood. This paper discussed the above clinical hot issues and introduced the relat-ed progress. It is expected that correct cognition can guide the diagnosis and treatment of myocardial injury and myocarditis in children in the future.

Clinical efficacy of creatine phosphate sodium combined with ribavirin in treating infantile viral myocarditis and its effect on myocardial enzyme levels in children / 吉林大学学报(医学版)

Objective: To investigate the clinical efficacy of creatine phosphate sodium combined with ribavirin in the treatment of infantile viral myocarditis, and to elucidate its mechanism of the effects on myocardial enzyme levels in the children. Methods: A total of 96 children with viral myocarditis were selected; according to the random number grouping method, they were divided into observation group and control group (n=48). The myocardial enzymes and cardiac troponin I (cTnl) of the patients in two groups were detected, and anti-infection, supplementation of electrolytes, and nutritional support for myocardial treatment were performed; then intravenous infusion therapy of ribavirin was used. On this basis, the patients in observation group were given intravenous infusion of creatine phosphate sodium for 14 d. After treatment, the total effective rate of treatment of the patients in two groups, the levels of myocardial enzymes and cTnl and electrocardiogram were compared before and after treatment. Results: The total effective rate of the patients in observation group was 87. 50% (42/48), and it was 70. 83% (34/48) in control group; there was significant difference (X2 = 4. 04, P=0. 04). After treatment, the levels of lactate dehydrogenase (LDH), hydroxybutyrate dehydrogenase (HBDH), aspartate transaminase (AST), creatine phosphokinase (CPK), creatine kinase isoenzyme-MB (CK-MB) and CTnl of the patients in two groups after treatment were lower than before treatment (P<0. 05). The indicators mentioned above of patients in observation group were lower than those in control group (P < 0.05). The total improvement rate of electrocardiogram in the observation group (89.58%) was significantly higher than that in control group (72.92%), and the difference was statistically significant (X2 = 4. 38, P=0. 04). Conclusion: The total effective rate of creatine phosphate sodium combined with ribavirin in the treatment of infantile viral myocarditis is higher, and they can significantly reduce the levels of myocardial enzymes and improve the cardiac function; it is worth to apply in the clinical treatment.

The effect of Succinate injection combined with Bifico on the myocardial enzymes changes of the children with rotavirus enteritis / 国际中医中药杂志

Objective To observe the effect of Succinate injection combined with Bifico on the myocardial enzymes changes of the children with rotavirus enteritis.Methods A total of 146 children with rotavirus enteritis were enrolled and included in this study. Children were randomly divided into the control group (n=73) and the observation group (n=73). The control group was received Bifico on the basis of routine treatment, and observation group was received Succinate injection combined with Bifico. The IL-17, IL-6, TNF-?, LDH, CK, and CKMB was detected by ELISA. The rates of clinical effects was compared.Results After treatment, the IL-17 (22.35 ± 4.21 ng/mlvs. 30.24 ± 6.07 ng/ml,t=2.395), IL-6(31.26 ± 6.14 ng/mlvs. 43.72 ± 8.22 ng/ml,t=2.347), TNF-? (35.62 ± 6.24 ng/mlvs. 49.18 ± 8.72 ng/ml,t=2.421), LDH (135.16 ± 31.25 U/Lvs. 174.08 ± 40.22 U/L,t=2.373), CK (37.82 ± 7.39 U/Lvs. 50.21 ± 11.16 U/L,t=2.385), and CKMB (90.14 ± 11.63 U/Lvs. 113.22 ± 18.35 U/L,t=2.392) in the observation group were lower than those in the control group (P<0.05). The rates of clinical effects was 94.5% (69/73) in the observation group and 83.6% (61/73) in the control group. There was significant difference between the two groups (χ2=2.352,P=0.047).Conclusions The Succinate injection combined with Bifico could reduce the inflammatory indices and alleviate the myocardial injury in the RVE patients.

The Significance of Detecting Serum CRP, Myocardial Enzymes, Liver Function Index in Pediatric Patients with Rotavirus Infectious Diarrhea / 现代生物医学进展

Objective:To explore the significance of detecting serum CRP,myocardial enzymes,liver function index in pediatric patients with rotavirus infectious diarrhea.Methods:110 pediatric patients with rotavirus infectious diarrhea and 85 age-matched patients with bacterial infectious diarrhea who were both treated in our hospital from January,2014 to May,2016 were enrolled in the present study.Another 20 healthy patients who had physical examination in our hospital were considered as control group.The differences of serum CRP,IL-6,hs-cTnT,CK,CL-MB,AST,ALT level and the incidence of parenteral injury were compared.Results:The incidence rate of lower respiratory tract infectivity,rash,myocardial damage and hepatic injury in RV group were significantly lower than the bacterial infectious group (P＜0.05),the level of serum CRP,IL-6 in RV group and bacterial infectious group were significantly higher than the control group,and those of RV group were significantly lower than bacterial infectious group (P ＜0.05);the level of hs-cTnT,CK,CL-MB,AST,ALT in RV group were significantly higher than bacterial infectious group and control group (P＜0.05),and those indexes of bacterial infectious group were no significantly differences compared with healthy control (P ＞ 0.05).Conclusion:The combined detection of serum CRP,myocardial enzyme and liver function indexes were of certain significance in the early distinguishing diagnosis of bacterial infectious diarrhea from rotavirus infectious diarrhea.

Effects of Lactobacillus acidophilus tablets combined with infantile diarrhea paste on serum myocardial enzyme and isozyme levels in children with acute diarrhea / 中国生化药物杂志

Objective To investigate the effects of Lactobacillus acidophilus tablets combined with infantile diarrhea paste in the treatment of acute diarrhea in children.Methods Retrospective study of a total of 92 children with acute diarrhea from our hospital were collected and randomly divided into experimental group and control group with 46 cases in each group.Patients in the control group were treated by conventional treatment, patients in the experimental group were treated by Lactobacillus acidophilus tablets combined with infantile diarrhea paste.The serum myocardial enzyme, isozyme, inflammatory factors and the levels of T lymphocyte were determined, and the clinical efficacy before and after treatment was compared.Results The clinical effective rate of the control group ( 82.61%) was lower than the experimental group ( 95.65%) , with statistical significance ( P<0.05 );compared with the control group, after treatment the serum myocardial enzyme and isozyme of the experimental group decreased, after treatment the serum TNF-α, IL -6 and I -10 levels decreased, after treatment the CD3 +, CD4 + and CD4 +/CD8 +levels increased, CD8 + level decreased, with statistical significance ( P<0.05 ) , There was no adverse reactions such as gastrointestinal discomfort and skin irritation happened in two groups of patients.Conclusion Lactobacillus acidophilus tablets combined with infantile diarrhea paste in the treatment of children with acute diarrhea could reduce serum myocardial enzymes and isozyme levels, improve immune ability and the effect is remarkable.

The combination of CRP,myocardial enzymes measurement and blood gas analysis in neonatal pneumonia / 国际检验医学杂志

Objective To investigate the clinical significance of combined detection of C‐reactive protein(CRP) ,myocardial en‐zyme spectrum and blood gas analysis in neonatal pneumonia ,and provide the basis for its diagnosis and treatment .Methods 152 neonatal pneumonia patients treated in the hospital from October 2013 to August 2014 were enrolled in the study as observation group .According to the condition and pathogenic examination results ,those patients were divided into severe pneumonia group(n=101) ,mild pneumonia group(n=51) and viral pneumonia group(n=76) ,bacterial pneumonia group(n=62)and other pneumonia group(n=14) ,simultaneously combined determination of CRP and myocardial enzymes and blood gas analysis were performed .The differences among the groups were analyzed and compared with 50 cases of healthy full‐term newborns(control group) .Results The myocardial enzyme spectrum and blood gas analysis of severe pneumonia and mild pneumonia group were abnormal in varying degrees .Except the detection results of aspartic acid amino transferase(AST) ,lactate dehydrogenase(LDH) ,alpha hydroxybutyrate dehydrogenase(HBDH) in mild group were not significantly different from that in control group(P>0 .05) ,the rest test itmes were all significantly different(P<0 .01) .C‐reactive protein (CRP) concentration increased significantly in bacterial pneumonia and was higher than other group(P<0 .01) .Blood gas analysis showed that in severe pneumonia group ,mixed acid poisoning was the major‐ity ,and the children with mild pneumonia group were mainly respiratory acidosis .Conclusion Neonatal pneumonia may cause myo‐cardial damage and pulmonary ventilation and gas exchange dysfunction ,and the detection of CRP and myocardial enzyme spectrum and blood gas analysis help early detection of myocardial injury and to know the injury degree ,master and correct acid‐base disturb‐ance ,hypoxemia ,improve the pulmonary ventilation function ,differential diagnosis of bacterial and non‐bacterial pneumonia .

Effect of Ezetimibe with loaded dose on hematologic parameters and re-infarction in patients undergoing PCI / 中国生化药物杂志

Objective To investigate the prevention effect of Ezetimibe with loaded dose on hematologic parameters and re-infarction in patients undergoing PCI.Methods 240 cases of patients with non ST segment elevation myocardial infarction performed PCI from October 2012 to October 2014 were selected and randomly divided into two groups,the control group received conventional dose Ezetimibe 10 mg every time,qd,the study group received loading dose ezetimibe 20 mg every time, qd, both two groups treatment 30 days.The inflammatory factors, myocardial injury and vascular endothelial function were compared before, 24 h and 30 d after the operation, and patients were followed up for two years,record adverse reactions. Results Compared with before treatment,levels of serum inflammatory factor,myocardial injury and vascular endothelial function index in different time points had differences by single factor analysis of variance(P<0.05),and compared with the control group, levels of serum hs-CRP,TNF-α,IFN-γand IL-6 in the study group were lower, levels of serum CK-MB,cTnI and BNP were lower,the contents of ET in serum were lower,and the contents of NO were higher(P<0.05).The improvement degree in the study group of myocardial microcirculation perfusion after treatment was higher(P<0.05).No case shedding phenomenon occurred during the two year follow-up, and there was no statistical significance in the incidence of cardiovascular events between two groups.Conclusion Loading dose of ezetimibe can protect myocardium,and it can inhibit the inflammatory reaction and vascular endothelial injury caused by operation,it also can improve myocardial microcirculation.

Early diagnostic efficiency of cardiac troponin for acute severe myocardial contusion / 中华创伤杂志

Objective To detemine the value of cardiac troponin in early diagnosis of severe myocardial contusion in the dog.Methods Twelve dogs weighing (11.4 ± 1.5) kg were subjected to severe myocardial contusion by impacting the chest area with BIM-Ⅱ biological impact machine.Electrocardiogram,cTnT and cTnI were measured before,immediately,and 2,4,6 and 8 hours after injury.Animals were then killed and the serum was separated for gross examination and triphenyl tetrazolium chloride (TTC) staining.Results Supraventricular tachycardia,ventricular tachycardia,ventricular premature beat,myocardial ischemia,atrial fibrillation,and ventricular fibrillation were seen on the electrocardiogram 2,4,6 and 8 hours after the injury,which suggested a high sensitivity but low specificity.cTnT and cTnI levels revealed no specific changes at postoperative 2 and 4 hours,but cTnT and cTnl were significantly increased to (0.130 ± 0.052) ng/ml and (1.615 ± 0.371) ng/ml at postoperative 8 hours,significantly higher than that immediately after operation (P ＜ 0.01).Sensitivity and specificity of cTnT and cTnI were both 100％,while the specificity of the TTC staining was (39.78 ± 9.07)％.Conclusion Cardiac troponin is of high sensitivity and specificity in early diagnosis of severe myocardial contusion and has good correlation with pathological changes,which exhibits great potential in clinical application.

Effect of Zhigancao Decoction compared with Zhenwu Decoction on hemodynamics, serum MMP-9 , TIMP-1 and myocardial enzymesin in aged patients with chronic heart failure / 中国生化药物杂志

Objective To compare the effect of Zhigancao Decoction and Zhenwu Decoction on hemodynamics, matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1) and myocardial enzyme of elderly patients with chronic heart failure.Methods 40 elderly patients with chronic heart failure in the first affiliated hospital of the medical college, Shihezi university were selected and randomly divided into Zhigancao Decoction group (n=20) and Zhenwu Decoction group (n =20) .The both of two groups were given conventional treatment, then were treated with respective drug according to different groups with two courses, one course of two weeks.The hemodynamic, MMP-9, TIMP-1 and myocardial enzyme spectrum indexes of two groups were compared post-treatment.Results After treatment, the indexes of hemodynamics in two groups were improved, hemodynamic indexes of Zhigancao Decoction recovered better than those of Zhenwu Decoction (P<0.05) .The serum MMP-9, MMP-9/TIMP-1 of Zhigancao Decoction group were lower and TIMP-1 was higher than those of Zhenwu Decoction group (P<0.05).The myocardial enzyme indexes in both groups were lower post-treatment, and the above indexes in Zhigancao Decoction were lower than those in Zhenwu Decoction group (P<0.05) . Conclusion Zhigancao Decoction could obviously improve the symptoms of chronic heart failure in elderly patients, which has the guiding significant in the clinical treatment.

Effect of berberine combined with levofloxacin on myocardial enzymes, isozymes and serum inflammatory factors in children with diarrhea / 中国生化药物杂志

Objective To analyse effect of berberine combined with levofloxacin on myocardial enzymes, isozymes and serum inflammatory factors in children with diarrhea.Methods 58 patients who were diagnosed with pediatric infectious diarrhea in our hospital were collected.All patients were randomly divided into experimental group and control group, 29 cases in each group.two groups of patients were given routine treatment, including infusion, maintaining water and electrolyte balance, supplemental calories etc.On the basis of routine treatment, control group was intravenous dripped with levofloxacin injection 200mL,one times per day,and experimental group was treated with berberine hydrochloride tables 0.2 g orally on the basis of control group.The treatment period was one week of two group.After one week of treatment, the serum levels of myocardial enzymes, isozymes, inflammatory factors and clinical curative effect were detected in all patients.Results Compared with control group post-treatment,the serum AST,ALT and LDH levels were lower than that of experimental group(P<0.05);the serum CK and CK-MB levels were lower than that of experimental group(P<0.05);the serum TNF-α,IL-6 and IL-10 levels were lower than that of experimental group(P<0.05);the total effective rate was higher in experimental group(P<0.05).Conclusion The berberine combined with levofloxacin can significantly reduce the serum myocardial enzymes, isozymes and serum inflammatory factors in children with diarrhea, improve clinical curative effect.

Clinical efficacy of compound herba Houttuyniae granules used in elderly mycoplasma pneumonia and the change of IL-6, serum myocardial enzymes and vascular endothelial growth gactorand / 中国基层医药

Objective To study the clinical efficacy of compound herba Houttuyniae granules used in mycoplasma pneumonia in the elderly and analyze the change of IL-6,serum myocardial enzymes and vascular endothelial growth factor before and after the treatment.Methods According to treatment methods,80 elderly patients with mycoplasma pneumonia,were divided into the control group and treatment group,40 cases in each group,the control group were given Ribavirin granules,the treatment group was given on the basis of the control group and compound herba Houttuyniae granules.The therapeutic effects and the incidence of adverse drug reactions were observed,and the change of IL-6,serum myocardial enzymes and vascular endothelial growth factor of the two groups before and after the treatment were compared.Results After 7-days'treatment,the efficiency of the treatment group(97.5％) was significantly higher than that of the control group(72.5％) (x2 =9.804,P ＜0.05).After the drug treatment,the rate of adverse drug reactions was 5.0％ in the treatment group,which was significantly lower than the 32.5％ in the control group(x2 =9.928,P ＜ 0.05).Before treatment,the IL-6,serum myocardial enzymes and vascular endothelial growth factor were not significantly different between the two groups (all P ＞ 0.05).After treatment,the IL-6,serum myocardial enzymes and vascular endothelial growth factor of the treatment group were significantly lower than those of the control group (all P ＜ 0.05).Conclusion The treatment of compound herba Houttuyniae granules used in elderly mycoplasma pneumonia is efficient and the incidence of adverse reactions was low.It can improve the clinically relevant outcome measures and is worthy of clinical application.

Multiple factor analysis of preoperative myocardial enzymes in stanford type B aortic dissection / 国际外科学杂志

Objective To investigate preoperative myocardial enzymes and realative influencing factors in Stanford B type aortic dissection.Methods From Jan.2004 to Sep.2013,151 consecutive patients with Stanford type B aortic dissection were admitted to hospital,aged from 31 to 76 average:(51.51 ± 10.90)year sold.Ninty-five healthy people with similar age and sex were taken as the control group.Fasting venous blood collected more than 12h was collected,myocardial enzymes indexes such as CK,CKMB,LDH,HBDH were measured by Roche modular automatic biochemical analysis system.Primary entry tear and extent of aortic dissection was measured by Toshiba Aquilion ONE 320 slice CT.Degree of aortic valve insufficiency was measured by Philips Sonos 5500 Color Doppler ultrasonic diagnostic apparatus.Results Compared with control group,the level of myocardial enzymes (LDH,HBDH) of aortic dissection group increased significantly(P ＜ 0.01).part myocardial enzymes indexes(CK,LDH,HBDH) of acute stage group existed difference(P ＜ 0.05).Myocardial enzymes indexes only CK existed difference between acute stage group and subacute stage group and chronic stage group(F =18.72,P =0.000),no difference between subacute stage group and chronic stage group.LDH,HBDH of each sub group of aortic dissection group were higher than that of control group,P ＜ 0.01.Trough correlation analysis,CK negatively correlated with disease course of aortic dissection and patients sex [(r =-0.446 ; P =0.000) ; (r =-0.303 ; P =0.000)],CKMB negatively correlated patients sex [(r=-0.203;P=0.020)],LDH negatively correlated with patients sex [(r =-0.171 ;P =0.049)],positively with left ventricular end-diastolic diameter and left ventricular end-systolic diameter [(r =0.202 ; P =0.022) ; (r =0.271 ; P =0.002)].HBDH positively correlated with left ventricular enddiastolic diameter and left ventricular end-systolic diameter [(r =0.385 ;P =0.002) ; (r =0.515 ; P =0.000)],negatively with degree of aortic insufficiency [(r =-0.528 ;P =0.006)].Conclusions Myocardial enzymes rise in preoperative Stanford B aortic dissection,more representing skeletal muscle injury.Be affected by stage of aortic dissection,lower limb skeletal muscle injury aggravates more seriously in acute stage group persists entering the sub acute stage.

The clinical analysis of the efficacy of creatine phosphate sodium therapy in children with primary myocarditis / 中国医师进修杂志

Objective To analyze the characteristics of primary myocarditis,and investigate the clinical efficacy of creatine phosphate sodium therapy in children with primary myocarditis.Methods A retrospective analysis of 56 cases of primary myocarditis in children,divided into control group and treatment group by random digits table method,each group 28 cases.Two groups of patients received conventional treatment,the treatment group was added the use of creatine phosphate sodium,after 14 d of continuous treatment,the clinical efficacy,myocardial enzymes (creatine kinase,creatine kinase-MB,lactate dehydrogenase),troponin and ECG in both groups were observed.Results After treatment,the total effective rate in treatment group was significantly higher than that in control group [89.3％(25/28) vs.53.6％ (15/28)] (x2 =4.094,P ＜0.05).The myocardial enzymes after treatment in both groups significantly improved compared with before treatment (P ＜ 0.05),the improvement in treatment group was better than that in control group,the difference was statistically significant (P ＜ 0.05).The negative conversion ratio of troponin in treatment group was significantly higher than that in control group (16/18 vs.9/17)(x2 =6.052,P ＜ 0.05).The total effective rate of ECG in treatment group was significantly higher than that in control group (x2 =3.896,P ＜ 0.05).Conclusions Creatine phosphate sodium for the treatment of children with primary myocarditis has better clinical efficacy,physiological indicators of myocardial enzymes,such as troponin significantly improve,with some clinical significance.

Protective Effects of (-)-Epigallocatechin Gallate on Daunorubicin-induced Cardiotoxicity in Mice / 医药导报

Objective To investigate the protective effects of (-)-epigallocatechin gallate ( EGCG ) on daunorubicin ( DNR)-induced cardiotoxicity in mice. Methods The qualified mice were randomly divided into four groups:normal control group, myocardial injured model control group,high dose group (80 mg·kg-1 ) and low dose group (40 mg·kg-1 ) of EGCG. EGCG was administered intragastrically once daily for 7 days,followed by a single intraperitoneal injection of DNR (15 mg·kg-1 ) except in the normal control group. The electrocardiogram,myocardial enzymes and TNT-Hs in serum,cardiac ultrastructure of mice were detected after 48 h. Results In DNR model control group,the incidence of arrhythmia was 64. 7%. The activity of serum cardic enzymes including CK,CK-MB,LDH,α-HBDH and ALT,AST, level of TNT-Hs were significantly higher than those in the normal control group(P<0. 01),and myocardial ultrastructure was injured remarkably. The incidence of arrhythmia was 44. 4% in mice treated with high dose of EGCG and 31. 6% in mice with low dose of EGCG. Compared to the model control group, the activity of CK,CK-MB,LDH,α-HBDH and ALT,AST, level of TNT-Hs in serum decreased remarkably in EGCG groups( P<0. 05 or P<0. 01). Low can EGCG alleviated the injury to the ultrastructure of myocardium compared to the model control group. Conclusion EGCG can prevent the cardiac toxicity induced by DNR in mice.

Correlation analysis between children with viral encephalitis and serum myocardial enzymes / 中国生化药物杂志

Objective To explore the correlation between serum myocardial enzymes and children with viral hepatitis according to clinical observation and analysis,in order to guide clinical treatment.Methods 66 children with viral encephalitis admitted in Women and Children's Hospital of Ninbo City from September 2010 to December 2011 were used as observation group,the aspartate a minotransferase(AST)level,lactate dehydrogenase (LDH)level,creatine kinase levels(CK)level,MB isoenzyme of creatine kinase(CK-MB)level in serum were detected by Olym pus AU-1000 automatic biochemical analyzer.The level ofα-hydroxybutyric acid dehydrogenase(α-HBDH)was detected,too.At the same time,another 48 normal children in our hospital were used as control group,and the same indexes were detected and recorded.After obtain those datas in two groups,the differences of myocardial enzymes between observation group and control group,acute and convalescent,light and heavy encephalitis encephalitis, gammaglobulin gammaglobulin treatment and non-treatment group were compared and analyzed.Results showed that the degrees of myocardial damage were varied in children with viral inordinately,the more serious illness in children,the higher myocardial enzyme levels.Correspondingly,while the children with encephalitis were in recovery ,their cardiac enzyme levels were found significantly reduced.Adding gamma globulin may help cardiac enzymes decreasing at a faster rate,favoring patients' recovery.Conclusion Cardiac enzyme activity can be used as an important indicator of clinical observation in children with viral and their prognosis,proper treatment should be carried out when the relationship between serum myocardial enzymes and viral encephalitis are clear.