Prediction of Preterm Delivery Using Serum Ischemia Modified Albumin, Biglycan, and Decorin Levels in Women with Threatened Preterm Labor / Previsão de parto prematuro usando albumina modificada por isquemia sérica, biglicano e níveis de decorina em mulheres com ameaça de trabalho de parto prematuro

Abstract Objective The serum ischemia modified albumin (IMA), biglycan, and decorin levels of pregnant women who were hospitalized for threatened preterm labor were measured. Methods Fifty-one consecutive pregnant women with a single pregnancy between the 24th and 36th weeks with a diagnosis of threatened preterm labor were included in the present prospective cohort study. Results As a result of multivariate logistic regression analysis for predicting preterm delivery within 24 hours, 48 hours, 7 days, 14 days, ≤ 35 gestational weeks, and ≤ 37 gestational weeks after admission, area under the curve (AUC) (95% confidence interval [CI[) values were 0.95 (0.89-1.00), 0.93 (0.86-0.99), 0.91 (0.83-0.98), 0.92 (0.85-0.99), 0.82 (0.69-0.96), and 0.89 (0.80-0.98), respectively. In the present study, IMA and biglycan levels were found to be higher and decorin levels lower in women admitted to the hospital with threatened preterm labor and who gave preterm birth within 48 hours compared with those who gave birth after 48 hours. Conclusion In pregnant women admitted to the hospital with threatened preterm labor, the prediction preterm delivery of the combined model created by adding IMA, decorin, and biglycan in addition to the TVS CL measurement was higher than the TVS CL measurement alone. Clinical trial registration The present trial was registered at ClinicalTrials.gov, number NCT04451928.

Resumo Objetivo Medir os níveis séricos de albumina modificada por isquemia (IMA), biglicano e decorina de gestantes hospitalizadas por ameaça de parto prematuro. Métodos Cinquenta e uma mulheres grávidas consecutivas com uma única gravidez entre a 24ᵃ e a 36ᵃ semanas com diagnóstico de ameaça de trabalho de parto prematuro foram incluídas no presente estudo de corte prospectivo. Resultados Como resultado da análise de regressão logística multivariada para prever parto prematuro dentro de 24 horas, 48 horas, 7 dias, 14 dias, ≤ 35 semanas gestacionais e ≤ 37 semanas gestacionais após a admissão, área sob a curva (AUC) (95% de confiança os valores de intervalo [CI[) foram 0,95 (0,89-1,00), 0,93 (0,86-0,99), 0,91 (0,83-0,98), 0,92 (0,85-0,99), 0,82 (0,69-0,96) e 0,89 (0,80-0,98), respectivamente. No presente estudo, os níveis de IMA e biglican foram maiores e os níveis de decorin menores em mulheres admitidas no hospital com ameaça de trabalho de parto prematuro e que tiveram parto prematuro em 48 horas em comparação com aquelas que deram à luz após 48 horas. Conclusão Em gestantes admitidas no hospital com ameaça de trabalho de parto prematuro, a predição de parto prematuro do modelo combinado criado pela adição de IMA, decorin e biglican, além da medição do TVS CL, foi maior do que a medição do TVS CL isoladamente. Registro do ensaio clínico O presente ensaio foi registrado em ClinicalTrials.gov, número NCT04451928.

The relationship between serum ischemia-modified albumin levels and uterine artery doppler parameters in patients with primary dysmenorrhea

Abstract Objective Primary dysmenorrhea occurs due to abnormal levels of prostanoids, uterine contractions, and uterine blood flow. However, the reasons for pain in primary dysmenorrhea have not yet been clarified. We examined the blood flow alterations in patients with primary dysmenorrhea and determined the relationship between ischemia-modified albumin (IMA) levels, as an ischemia indicator, and primary dysmenorrhea. Methods In the present study, 37 patients who had primary dysmenorrhea and were in their luteal and menstrual phase of their menstrual cycles were included. Thirty individuals who had similar demographic characteristics, who were between 18 and 30 years old and did not have gynecologic disease were included as control individuals. Their uterine artery Doppler indices and serum IMA levels were measured. Results Menstrual phase plasma IMA levels were significantly higher than luteal phase IMA levels, both in the patient and in the control groups (p < 0.001). Although the menstrual phase IMA levels of patients were significantly higher than those of controls, luteal phase IMA levels were not significantly different between the two groups. Menstrual uterine artery pulsatility index (PI) and resistance index (RI) of primary dysmenorrhea patients were significantly different when compared with luteal uterine artery PI and RI levels. There was a positive correlation between menstrual phase IMA and uterine artery PI and RI in the primary dysmenorrhea. Conclusion Ischemia plays an important role in the etiology of the pain, which is frequently observed in patients with primary dysmenorrhea. Ischemia-modified albumin levels are considered as an efficient marker to determine the severity of pain and to indicate ischemia in primary dysmenorrhea.

The effect of low dose ionizing radiation exposure on dynamic thiol-disulfide homeostasis and ischemia modified albumin levels: an observational study / Efeito da exposição à radiação ionizante de baixa dose na homeostase dinâmica de tiol-dissulfeto e níveis de albumina modificada por isquemia: estudo observacional

Abstract Background: The primary objective of this study was to investigate the effect of low dose ionizing radiation exposure on thiol/disulfide homeostasis and ischemia modified albumin levels. The secondary objective is to compare thiol/disulfide homeostasis and ischemia modified albumin levels among the personnel exposed to low dose ionizing radiation in anesthesia application areas, in and out of the operation room. Methods: The study included a total of 90 volunteers aged between 18 and 65 years old, with 45 personnel working in a setting with potential for radiation exposure (Exposed Group) and 45 personnel in a setting without radiation exposure (Control Group). Their native thiol, total thiol, disulphide, albumine and IMA levels were measured. Exposed group included personnel who were exposed to radiation outside the operating room - Operation room (−) Group and inside the operating room - Operation room (+) Group. Results: Albumin, native and total thiol levels were significantly lower in the participants exposed to radiation in the anesthesia application area; no statistically significant difference was found in terms of disulfide and ischemia modified albumin levels. In the Operation room (−) Group exposed to radiation, native thiol and total thiol values were significantly lower compared to the Operation room (+) Group. Conclusion: Awareness of being in danger of oxidative stress should be established in personnel exposed to radiation in the anesthesia application area following low dose ionizing radiation exposure, and the necessary measures should be taken.

Resumo Justificativa: O objetivo principal do estudo foi investigar o efeito de exposição à radiação ionizante de baixa dose nos níveis de homeostase tiol/dissulfeto e de albumina modificada por isquemia. O objetivo secundário foi comparar os níveis de homeostase tiol/dissulfeto e albumina modificada por isquemia entre indivíduos expostos à radiação ionizante de baixa dose nas áreas de procedimentos anestésicos, dentro e fora da sala de cirurgia. Método: O estudo incluiu um total de 90 voluntários com idades entre 18 e 65 anos, 45 profissionais que trabalhavam em ambiente de exposição potencial a radiação (Grupo Exposto) e 45 profissionais que trabalhavam em ambiente sem exposição à radiação (Grupo Controle). Foram medidos os níveis de tiol nativo, tiol total, dissulfeto, albumina e albumina modificada por isquemia. O Grupo Exposto era constituído por profissionais expostos a radiação fora da sala de cirurgia - Grupo sala de cirurgia (-) e na sala de cirurgia - Grupo sala de cirurgia (+). Resultados: Os níveis de albumina, tiol nativo e total foram significantemente mais baixos nos participantes expostos à radiação em área de realização de anestesia, e nenhuma diferença estatisticamente significante foi encontrada para os níveis de dissulfeto e albumina modificada por isquemia. No Grupo exposto sala de cirurgia (-), os valores de tiol nativo e tiol total foram significantemente mais baixos quando comparados ao Grupo sala de cirurgia (+). Conclusões: Os profissionais expostos à radiação em área de realização de anestesia devem ser conscientizados quanto ao perigo do estresse oxidativo após exposição à radiação ionizante de baixa dose e medidas cabíveis devem ser instituídas.

The role of ischemia-modified albumin as a biomarker in preeclampsia

Abstract Objective Ischemia-modified albumin (IMA)is a modified type of albumin protein that is formed under oxidative stress. This study aims to compare the levels of serum IMA between normotensive and preeclamptic pregnancies and to evaluate the relationship between the severity of the disease. Methods A total of 90 pregnant women aged between 18 and 45 years participated in this cross-sectional study. The levels of serum IMA were measured by enzyme-linked immunosorbent assay in 30 preeclamptic pregnant women with the severe signs of the disease, 30 preeclamptic pregnant women, and 30 normotensive pregnant women.. The study was designed as a cross-sectional clinical study. Results When the demographic characteristics were examined, statistically significant differences were found between the groups in terms of age, gestational week at birth and blood pressure. Age was higher in the preeclampsia with signs of severity group than in the normotensive group (p = 0.033). Pregnancy week was significantly the lowest in the preeclampsia with the severity signs group (p = 0.004). In normotensive patients, IMA levels were lower than in the preeclampsia groups (p = 0.001) but there was no significant difference in terms of severity of disease (p = 0.191). According to laboratory data; only the creatinine level was significantly different between the groups. Conclusion The levels of serum IMA were higher in patients with preeclampsia than in healthy pregnancies. However, there was no significant correlation in terms of preeclampsia severity; more extensive, prospective and long-term studies are needed.

The effect of continuous ventilation on thiol-disulphide homeostasis and albumin-adjusted ischemia-modified albumin during cardiopulmonary bypass

Abstract Objective: To investigate the effect of continuous lung ventilation with low tidal volume on oxidation parameters, such as thiol/disulphide homeostasis and albumin-adjusted ischemia-modified albumin (AAIMA), during cardiopulmonary bypass (CBP) in coronary artery bypass grafting (CABG). Methods: Seventy-four patients who underwent elective CABG with CPB were included in the study. Blood samples were taken in the preoperative period, 10 minutes after CPB, and six and 24 hours postoperatively. Patients were assigned to the continuous ventilation group (Group 1, n=37) and the non-ventilated group (Group 2, n=37). The clinical characteristics, thiol/disulphide homeostasis, ischemia-modified albumin (IMA), and AAIMA levels of the patients were compared. Results: A significant difference was found between the groups regarding native thiol, total thiol, and IMA levels at the postoperative 24th hour (P=0.030, P=0.031, and P=0.004, respectively). There was no difference between the groups in terms of AAIMA. AAIMA levels returned to preoperative levels in Groups 1 and 2, at the 6th and 24th postoperative hours, respectively. Length of hospital stay was significantly shorter in Group 1 (P<0.001) than in Group 2. Conclusion: Continuous ventilation during CPB caused an increase in native and total thiol levels, an earlier return of AAIMA levels, and shorter hospital stay. Continuous ventilation may reduce the negative effects of CPB on myocardium (Table 2, Figure 1, and Reference 31).

Evaluation of the Association between Ischemia Modified Albumin (IMA), Glycemic and Lipid Status in Diabetic Nephropathy

Introduction:Hyperglycemia induced oxidative stress in Type 2 Diabetes Mellitus modifyvarious biomolecules to cause Diabetic Nephropathy (DN). IMA (Ischemia-Modified Albumin) is one such oxidative stress marker already examined in various clinical events but have not yet been evaluated in different stages of DN. Aim:To estimate and assess the relationship of IMA with glycemic status and lipid parameters in all stages of DN. Study Design: Cross-sectional study.Place and Duration of Study: Study was conducted at Department of Biochemistry,Kasturba Medical College Hospitals, Mangaluru conducted between 2014 and 2015 Materials andMethods:There were 60 type 2 diabeticcases and 30 healthy controls. Diabetic cases were further categorized into three equal groups on the basis of UACR (urine albumin-creatinine ratio), DN stage I having UACR less than 30 mg/g, DN stage II having UACR 30 to 300 mg/g, and DN stage III havingUACR ≥ 300 mg/g of creatinine. Using enzyme-linked immunosorbent assay serum IMA level was estimated whereas automated analyzers was used for serum creatinine, HbA1c, urine albumin and urine creatinine analysis.Results:Lowest level of IMA (109 ng/mL) measured in DN stage I, which was significantly different from those in DN stage II (154 ng/mL) and DN stage III (178 ng/mL). The significant positive correlation between IMA and fasting blood glucose, glycated hemoglobin were present in stage II and stage III DN. In this study significant positive correlation of serum IMA to serum total cholesterol, low density lipoprotein cholesterol and negative correlation with high density lipoprotein were revealed in all stage of DN. Conclusion:Current study postulates that early evaluation of serum IMA in diabetic patients with deranged lipid profile will provide an index of nephropathy development. This will help in prognosis and controlling complication in diabetes mellitus.

Protective effect of ulinastatin on myocardial injury after cardiopulmonary resuscitation in pigs / 中华急诊医学杂志

Objective@#To evaluate the protective effect of ulinastatin (UTI) on myocardial injury after post-cardiac arrest syndrome (PCAS) of cardiopulmonary resuscitation in pigs.@*Methods@#Twelve male 3-4 months pigs were randomly divided into two groups, UTI group and control group. The ventricular fibrillation (VF) animal model was replicated by programmed stimulation method. Among the 12 pigs, 11 pigs were successfully resuscitated by CPR after 5 min VF, of which, 6 pigs were in the UTI group and 5 pigs in the control group. Immediately after resuscitation, pigs in the UTI group was given 100 kU dissolved in 5 mL normal saline with slowly injection every 3 h until 24 h after recovery (no drug was given at 24 h). In the control group, 5 mL normal saline was given with same delivery time and frequency as that in the UTI group. The venous blood of the pigs was collected at VF, 2, 4, 6, 12, and 24 h after ROCS, and tumor necrosis factor -α (TNF-α), interleukin-6 (IL-6), superoxide dismutase (SOD), malondialdehyde (MDA), and ischemia modified albumin (IMA) were measured by enzyme-linked immunosorbent assay (ELISA) method. Because IMA was sensitive and increased rapidly, venous blood was detected at 1 h after ROSC, and the rest test time were same with the rest of the blood factors. Statistical analysis was performed using LSD-t test and variance analysis. The pigs were sacrificed 24 h after ROSC, and specimens from heart tissue were taken for HE staining.@*Results@#Before ventricular fibrillation in three groups, there was no significant difference in serum levels of inflammatory cytokines, oxidative stress indexes, and myocardial ischemia markers between the two groups (P>0.05). At 2 h after ventricular fibrillation, the levels of TNF-α and IL-6 level in the UTI group was significantly lower than those in the control group. At 4 h, MDA level in the UTI group was significantly lower than that in the control group (P<0.05); IMA was significantly increased at 1 h after ROSC, and the level of 1 h in the UTI group was significantly lower than that in the control group (P<0.05), but was not statistically significant at 12 h between the two groups (P>0.05). HE staining results showed that the damage degree of myocardial tissue in the UTI group was significantly lower than that in the control group at 24 h after ROSC.@*Conclusions@#UTI can significantly antagonize inflammatory response, reduce oxidative stress, and improve the myocardial tissue injury after resuscitation. It can protect myocardial injury after cardiopulmonary resuscitation.

Protective effect of ulinastatin on myocardial injury after cardiopulmonary resuscitation in pigs / 中华急诊医学杂志

Objective To evaluate the protective effect of ulinastatin (UTI) on myocardial injury after post-cardiac arrest syndrome (PCAS) of cardiopulmonary resuscitation in pigs.Methods Twelve male 3-4 months pigs were randomly divided into two groups,UTI group and control group.The ventricular fibrillation (VF) animal model was replicated by programmed stimulation method.Among the 12 pigs,11 pigs were successfully resuscitated by CPR after 5 min VF,of which,6 pigs were in the UTI group and 5 pigs in the control group.Immediately after resuscitation,pigs in the UTI group was given 100 kU dissolved in 5 mL normal saline with slowly injection every 3 h until 24 h after recovery (no drug was given at 24 h).In the control group,5 mL normal saline was given with same delivery time and frequency as that in the UTI group.The venous blood of the pigs was collected at VF,2,4,6,12,and 24 h after ROCS,and tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6),superoxide dismutase (SOD),malondialdehyde (MDA),and ischemia modified albumin (IMA) were measured by enzymelinked immunosorbent assay (ELISA) method.Because IMA was sensitive and increased rapidly,venous blood was detected at 1 h after ROSC,and the rest test time were same with the rest of the blood factors.Statistical analysis was performed using LSD-t test and variance analysis.The pigs were sacrificed 24 h after ROSC,and specimens from heart tissue were taken for HE staining.Results Before ventricular fibrillation in three groups,there was no significant difference in serum levels of inflammatory cytokines,oxidative stress indexes,and myocardial ischemia markers between the two groups (P＞0.05).At 2 h after ventricular fibrillation,the levels of TNF-α and IL-6 level in the UTI group was significantly lower than those in the control group.At 4 h,MDA level in the UTI group was significantly lower than that in the control group (P＜0.05);IMA was significantly increased at 1 h after ROSC,and the level of 1 h in the UTI group was significantly lower than that in the control group (P＜0.05),but was not statistically significant at 12 h between the two groups (P＞0.05).HE staining results showed that the damage degree of myocardial tissue in the UTI group was significantly lower than that in the control group at 24 h after ROSC.Conclusions UTI can significantly antagonize inflammatory response,reduce oxidative stress,and improve the myocardial tissue injury after resuscitation.It can protect myocardial injury after cardiopulmonary resuscitation.

Concentraciones de albúmina modificada por la isquemia en niños con asma: estudio piloto / Ischemia-modified albumin levels in children with asthma: a pilot study

Introducción. La albúmina modificada por la isquemia puede aumentar en el asma (IMA), estrés oxidativo y la inflamación. El objetivo fue evaluar las concentraciones de IMA en niños asmáticos durante períodos asintomáticos y de exacerbación. Población y métodos. Niños asmáticos y sanos en seguimiento (grupo de referencia). La gravedad de la exacerbación se evaluó mediante la Iniciativa global para el asma (GINA) y la puntuación del índice pulmonar modificado (MPIS). Se usaron pruebas intraepidérmicas y de proteína C reactiva para medir las concentraciones séricas de IMA durante la exacerbación y 4 semanas después del tratamiento. Resultados. Participaron 26 pacientes y 26 controles. Las concentraciones medias de IMA durante la exacerbación (0,45 ± 0,12 ABSU) y durante el período de estabilidad (0,41 ± 0,14 ABSU) fueron mayores que en los niños sanos (0,32 ± 0,08 ABSU): p= 0,001 y p= 0,005, respectivamente. No hubo diferencias en IMA al agrupar a los pacientes por tratamiento antiinflamatorio, infección de las vías respiratorias altas previa a la exacerbación, concentraciones de PCR o sensibilidad a las pruebas intraepidérmicas. Las concentraciones fueron más elevadas en los pacientes con exacerbación grave que leve/moderada (p= 0,009). La correlación entre IMA y la gravedad de la exacerbación (r: 0,498; p= 0,010) fue positiva. Conclusiones. Los niños asmáticos presentaron concentraciones de IMA más elevadas que el grupo de referencia, tanto en el período de estabilidad como durante la exacerbación. Hubo una relación positiva entre las concentraciones de IMA y la gravedad de la exacerbación.

Introduction: Hypoxia may occur in the severe exacerbations of asthma. Ischemia-modified albumin (IMA) may increase in ischemia, in addition to oxidative stress and inflammation. The aim was to evaluate IMA levels in children during the asthma exacerbation and the asymptomatic period. Populations and methods: Children with asthma who were followed up in our clinic were included and healthy children were selected as the control group. The severity of exacerbation was evaluated with Global Initiative for Asthma and Modified Pulmonary Index Score. Serum IMA levels were measured at the time of exacerbation and 4 weeks after treatment during asymptomatic period. Skin prick test and C reactive protein (CRP) levels were measured. Results: A total of 26 patients and 26 controls were included. Mean IMA level was 0.45+0.12 absorbance units -ABSU- during asthma exacerbation and 0.32+0.08 ABSU in the control group (p=0.001). Mean IMA levels (0.41+0.14 ABSU) during the stable period were higher than the control group (p=0.005). There was no difference in terms of IMA levels when patients were grouped according to anti-inflammatory treatment, upper respiratory tract infection before exacerbation, CRP levels or sensitivity of skin prick tests. However, IMA levels were higher in patients with severe asthma exacerbation (p=0.009) in comparison with mild/moderate exacerbation. Positive correlation was observed between IMA levels and severity of exacerbation (r: 0.498, p=0.010). Conclusions: Asthmatic children had higher IMA levels than the control group, both in stable and exacerbated asthma. There was a positive relationship between IMA levels and severity of asthma exacerbation.

Therapeutic Efficacy of Ezetimibe Combined with Tirofiban in the Treatment of Acute Coronary Syndrome Patients and Its Influence on the Content of Ischemia Modified Albumin / 中国药房

OBJECTIVE:To investigate therapeutic efficacy of ezetimibe combined with tirofiban in the treatment of acute coronary syndrome patients and its influence on the content of ischemia modified albumin (IMA) in peripheral blood.METHODS:A total of 82 patients with acute coronary syndrome in our hospital from Jan.2016 to Jan.2017 were divided into observe group and control group according to random number table,with 41 cases in each groups.All patients were given general treatment containing statins,glyceryl trinitrate and so on.Control group was additionally given Ezetimibe tablet 10 mg orally once a day.Observation group was additionally given Tirofiban hydrochloride sodium chloride injection 5 mg intravenously once a day,on the basis of control group,for consecutive 15 d.Clinical efficacies of 2 groups were evaluated.The dose of glyceryl trinitrate,duration and frequency of angina pectoris attack,left ventricular function indexes (SV,LVDD,CO,LVEF) were compared before treatment and after last medication.The contents of IMA in peripheral blood were detected before treatment and 3,6,9,12,15 h after the first day medication.ADR of the 2 groups were observed closely during the treatment.RESULTS:The total response rate of observation group was 92.7％,which was significantly higher than 72.3％ of control group (P＜0.05).Compared with before treatment,dose of glyceryl trinitrate and the content of IMA in 2 groups were decreased significantly after last medication,duration and frequency of angina pectoris attack were shortened significantly;the levels of SV,CO and LVEF were increased significantly while the level of LVDD was decrease significantly;the effect of observation group was significantly better than that of control group,with statistical significance (P＜0.05).No severe ADR was found in all patients during the treatment.CONCLUSIONS:Based on general treatment of glyceryl trinitrate therapeutic efficacy of ezetimibe combined with tirofiban is better than that of ezetimibe alone in the treatment acute coronary syndrome patients,and can decrease the content of IMA in peripheral blood more quickly.

Relationship between ischemia-modified albumin and coronary stenosis / 西安交通大学学报(医学版)

Objective To investigate the relationship between ischemia-modified albumin (IMA) and coronary artery stenosis in patients without myocardial infarction.Methods For this study we consecutively enrolled 345 patients who received coronary angiography (CAG).According to the results,the subjects were divided into coronary stenosis group (232 cases)and control group (113 cases)to investigate the the relationship of IMA and IMA/albumin (IMAr)with coronary stenosis.Results ① The levels of IMA and IMAr in coronary stenosis group were higher than those in control group (P＜0.001).② The IMA and IMAr were higher in single-branch and multi-branch lesion groups than in control group (P＜0.05),whereas there was no significant difference between single-branch lesion group and multi-branch lesion group (P＞0.05).③ In receiver operating characteristics curve analysis,the sensitivity of IMA and IMAr was 64.4% and 78.0%,respectively (AUC:0.653,0.705,P＜0.001)in predicting coronary stenosis.④ Multivariate logistic regression analysis showed that IMAr was an independent risk factor for coronary stenosis in patients without myocardial infarction (OR=73.05,P＜0.001).Conclusion IMA and IMAr are closely correlated with coronary stenosis and have a value in predicting coronary artery stenosis in patients without myocardial infarction.

Perioperative Changes of Serum Biochemical Markers in Patients with PCI / 现代检验医学杂志

Objective To evaluate the perioperative changes of h-FABP,IMA,IL-2R,IL-6,IL-8,TNF-α and MPO in patients with PCI.Methods The serial serum samples from 34 patients were collected from November of 2011 to February of 2012 in coronary care unit of Peking Union Hospital on separately 2,4,8 and 24 hours after PCI,then IL2R,IL6,IL8,TNF-α,h-FABP,IMA and MPO were measured.Results MPO,h-FABP and CKMB increased dramatically at 2 hours after PCI(Z value were separately-3.621,-5.123 and-2.789 compared with the level at 2 h and 24 h,all P＜ 0.05),and h-FABP within 24 hours fell into the normal range.MPO dropped quickly after 4 hours of surgery and CKMB peaked at 4 hours,then decreased.The concentration of CK and cTnⅠ rose up at 4h (Z value were separately-2.803 and-2.31 compared with the level at 2h and 24 h,all P＜0.05) and declined with a climax at 8h after PCI.The correlation coefficient of CKMB and CK with cTnⅠ were higher than 0.6.Conclusion This study provided an overview of the change of multi-biomarkers following PCI,which gave a valuable information for clinical treatment.

The effect of single incision laparoscopic cholecystectomy on systemic oxidative stress: a prospective clinical trial

PURPOSE: Single incision laparoscopic cholecystectomy (SILC) has become a more frequently performed method for benign gallbladder diseases all over the world. The effects of SILC technique on oxidative stress have not been well documented. The aim of this study was to evaluate the effect of laparoscopic cholecystectomy techniques on systemic oxidative stress by using ischemia modified albumin (IMA). METHODS: In total, 70 patients who had been diagnosed with benign gallbladder pathology were enrolled for this prospective study. Twenty-one patients underwent SILC and 49 patients underwent laparoscopic cholecystectomy (LC). All operations were performed under a standard anesthesia protocol. Serum IMA levels were analysed before operation, 45 minutes and 24 hours after operation. RESULTS: Demographics and preoperative characteristics of the patients were similiar in each group. The mean duration of operation was 37.5 ± 12.5 and 44.6 ± 14.3 minutes in LC and SILC group, respectively. In both groups, there was no statistically significant difference in hospital stay, operative time, or conversion to open surgery. Operative technique did not effect the 45th minute and 24th hour IMA levels. However, prolonged operative time (>30 minutes) caused an early increase in the level of IMA. Twenty-fourth hour IMA levels were not different. CONCLUSION: SILC is an effective and safe surgical prosedure for benign gallbladder diseases. Independent of the surgical technique for cholecystectomy, the prolonged operative time could increase the tissue ischemia.

Clinical Study of Fructose Sodium Diphosphate in the Treatment of Acute Myocardial Infarction / 中国药房

OBJECTIVE:To investigate the effects and safety of fructose sodium diphosphate on cardiac function,myocardial injury markers,ischemia modified albumin (IMA) and copeptin in patients with acute myocardial infarction (AMI).METHODS:In retrospective study,102 AMI patients were collected from Nanyang Second People's Hospital during Feb.2014-Apr.2015,and then divided into observation group and control group according to therapy plan,with 51 cases in each group.Both groups received routine therapy and symptomatic therapy as intravenous dripping of urokinase+ intravenous pump of heparin+oral admin istration of aspirin.Observation group was additionally given fructose sodium diphosphate 10 g intravenously,bid.Treatment courses of 2 groups lasted for 7-10 d.The changes of cardiac function indexes (LVDd,LVSd,LVEF),myocardial injury mark ers (cTn Ⅰ,CK-MB),IMA and copeptin were recorded in 2 groups before and after treatment.The cardiac function grading,the occurrence of ADR and adverse events were also recorded in 2 groups.RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups (P＞0.05).12,24 h after treatment,LVDd and LVSd of 2 groups were shortened significantly,while LVEF and IMA levels were increased significantly,and CK-MB and copeptin levels were decreased significantly,compared to before treatment;the improvement of observation group was significantly better than control group,with statistical significance (P＜0.05).cTn Ⅰ levels of 2 groups were increased gradually compared to before treatment [there was no statistical significance in observation group between 12 h after treatment and before treatment (P＞0.05)];the increase of obser vation group was significantly smaller than that of control group,with statistical significance (P＜0.05).24 h after treatment,the proportion of cardiac function Killip grade Ⅰ-Ⅱ was 96.1％ in observation group,which significantly higher than 78.4％ in control group,with statistical significance (P＜0.05).No severe ADR was found in 2 groups,and there was no statistical significance in the incidence of ADR (P＞0.05).In respect of adverse events,the number of adverse events as severe arrhythmia,re current myocardial infarction,postinfarction angina pectoris and total incidence of ADE in observation group was significantly less or under than control group,with statistical significance (P＜0.05),besides there was no statistical significance in mortality between 2 groups (P＞0.05).CONCLUSIONS:Routine symptomatic treatment combined with sodium fructose diphosphate in the treatment of AMI can effectively increase myocardial injury markers,copeptin and IMA levels,improve cardiac function and reduce the risk of adverse events so as to improve the quality of prognosis.

Clinical Study on Acupuncture plus Early-stage Rehabilitation Training for Acute Cerebral Infarction / 上海针灸杂志

Objective To observe the effect of acupuncture plus early-stage rehabilitation training on the neurological function and levels of serum ischemia-modified albumin (IMA) and neuron-specific enolase (NSE) in patients with acute cerebral infarction.Method Sixty-eight patients with acute cerebral infarction were randomized into a treatment group and a control group, 34 cases each. The control group was intervened by conventional medications, while the treatment group was intervened by acupuncture plus early-stage rehabilitation training in addition to the medications given to the control group. The two groups were both treated once a day, 10 d as a treatment course. Three treatment courses later, the changes of serum IMA and NSE levels were observed; the Modified Edinburgh-Scandinavian Stroke Scale (MESSS), Barthel Index (BI) and Fugl-Meyer Assessment (FMA) scores were compared before and after the treatment.Result The MESSS, BI and FMA scores were significantly changed in both groups after the intervention (P<0.01). After the intervention, the MESSS, BI and FMA scores in the treatment group were significantly different from those in the control group (P<0.05). The serum IMA and NSE levels were significantly changed in both groups after the intervention (P<0.01). After the treatment, the serum IMA and NSE levels in the treatment group were markedly lower than those in the control group (P<0.01).Conclusion Acupuncture medication combined plus early-stage rehabilitation training can promote the recovery of neurological function of acute cerebral infarction patients, which is related to the down-regulation of serum NSE and IMA levels.

The study on the total oxidative and antioxidant status and lipid levels in patients with COPD / 实用医学杂志

Objective To explore and evaluate the total oxidative and antioxidant status and lipid levels in patients with COPD. Methods Measurement and comparative analysis were preformed between 51 cases of COPD patients and 45 healthy people in serum TOS,TAS,IMA concentration,blood lipid,and the concentration of ox-LDL. Results In the COPD group,serum IMA concentration was significantly higher than those in the control group(0.94 ± 0.31 vs. 0.62 ± 0.25,P<0.001). The serum TOS was higher than that in the control group(6.51 ± 4.85 vs. 4.53 ± 3.81,P<0.05). The serum ox-LDL concentration in COPD group increased significantly compared with the control group(5.91 ± 3.61 vs. 4.51 ± 2.05,P<0.05). The serum HDL concentration in the COPD group was significantly lower than that in the control group(36.49 ± 9.60 vs. 44.19 ± 10.14,P<0.001). There was no sig-nificant difference in TAS,triglyceride and low LDL between the two groups. Conclusions The serum levels of TOS,ox-LDL and IMA are significantly increased in COPD patients compared with the control group,while HDL-C concentration is significantly decreased. Increase of IMA and ox-LDL in serum of patients with COPD may be relat-ed to imbalance of TOS and TAS due to chronic inflammation and oxidative stress.

Assessment of disease severity by serum IMA levels in patients with COPD / 重庆医学

Objective To explore the value of serum ischemia modified albumin (IMA) level in assessment of disease severity for patients with chronic obstructive pulmonary disease (COPD).Methods A total of 81 cases of patients with COPD treated in our hospital from September 2015 to March 2016 were selected (COPD group),including 51 cases of patients with acute exacerbation of COPD and 30 cases of patients with stable of COPD.Meanwhile,30 volunteers without COPD were collected as control group.Serum levels of IMA were detected and compared among different groups.Correlations between serum level of IMA and serum level of myoglobin (MYO),troponin T (TNT) and C reactive protein (CRP),and white blood cell (WBC) count were analyzed respectively.A receiver operating characteristic (ROC) curve was also plotted to investigate the diagnostic value of serum IMA level for diagnosing COPD.Results Serum level of IMA in the COPD group was higher than that in the control group [84.1 (79.1,88.5) U/L vs.73.1 (70.2,75.1)U/L],serum level of IMA in patients with acute exacerbation of COPD was higher than that of patients with stable of COPD [85.5 (82.3,89.4)U/L vs.78.1 (75.9,83.0)U/L],serum levels of IMA in patients with acute exacerbation and stable of COPD both were higher than that in the control group,there were statistically significant differences (P＜0.05).The serum level of IMA was positively related with serum level of MYO in patients with COPD (r=0.554,P =0.00).ROC curve indicated when the cutoff value was set as 76.55 U/L,the sensitivity and specificity of serum level of IMA for diagnosing COPD was 88.5％ and 80.0％ respectively,and area under the ROC curve was 0.88.Conclusion Serum level of IMA could be a valuable indicator for clinically assessing disease severity of patients with COPD,which deserves further study through expanding samples size.

Correlation between Ischemia-modified Albumin Levels and Coronary Artery Lesions in Patients with Acute Coronary Syndrome / 中国医科大学学报

Objective To evaluate the correlation between ischemia-modified albumin (IMA) levels and severity of coronary artery lesions in patients with acute coronary syndrome (ACS).Methods This study included 51 in-hospital patients diagnosed as having ACS.All patients had undergone coronary angiography and received the standard treatment for coronary heart disease.Meanwhile,we included 10 healthy volunteers as the control group.Coronary angiography reports were collected,Gensini scores were calculated,and serum IMA levels were measured.Results The IMA levels of patients with ACS were higher than those of the controls (P ＜ 0.05).However,when divided by the degree of coronary artery stenosis,number of vessel lesions,and Gensini scores,the IMA levels showed no significant difference between the groups.The IMA levels were not related with the Gensini scores.The moderate group had a low ratio of TIMI flow grade 3.Conclusion Patients with ACS had higher IMA levels.We found no correlation between IMA level and coronary artery lesions.IMA level may not accurately reflect the severity of coronary artery lesions.Increased IMA level may indicate the unstable status of ischemia.

Application of IMA and H-FABP in Forensic Diagnosis of Sudden Cardiac Death / 法医学杂志

Acute myocardial ischemia is the most common cause of sudden cardiac death.The diagnosis of early myocardial ischemia is a hot point in forensic medicine,which is also an early and important part for a prevention against myocardial infarction.This paper conducts a comprehensive discussion of the structure,function,clinical value and forensic medicine application prospect of ischemia modified albumin (IMA) and heart-type fatty acid binding protein (H-FABP),aiming to determine whether the two proteins can be used as biochemical detection indicators of early myocardial ischemia for the diagnosis of sudden cardiac death in forensic medicine.

The value of the combined detection of IMA, NT-proBNP and dynamic electrocardiogram in the diagnosis of silent myocardial ischemia / 中国医学装备

Objective:To evaluate the clinical value of combined detection of ischemia modified albumin(IMA), N-terminal pro brain natriuretic peptide(NT-proBNP) and dynamicelectrocardiogram(DEG) in the diagnosis of silent myocardial ischemia.Methods: IMA, NT-proBNP and DEG of 114 patients with silent myocardial ischemia who were suspected coronary heart disease were detected, and then these results were compared and analyzed with the results of coronary angiography(CAG).Results: In 114 patients with suspected coronary heart disease, 68 cases(59.65％)were positive as the results of CAG. And there were 60 cases were positive as the results of IMA detection, and the specificity and sensitivity of IMA compared with CAG were 82.61％ and 88.24％, respectively. There were 63 cases were positive as the results of NT-proBNP, and the specificity and sensitivity of NT-proBNP compared with CAG were 80.43％ and 92.64％, respectively. There were 57 cases were positive as the results of DEG, and the specificity and sensitivity of DEG compared with CAG were 86.96％ and 83.82％, respectively. While there were 66 cases were positive as the combined detection of the three methods, and specificity and sensitivity of the combined detection compared with CAG were 95.65％ and 97.06％, respectively. Therefore, the specificity and sensitivity of combined detection were significantly higher than that of alone detection of IMA, NT-proBNP and DEG (F=140.637,F=255.467,P<0.05).Conclusion: The comprehensive analysis for the combined detections of IMA, NT-proBNP and DEG can increase both of the specificity and sensitivity of diagnosis, and it can be used as a important screening method for earlier finding silent myocardial.