Clinical Analysis of Myocardial Injury in Highlanders with Pulmonary Hypertension.

Background: Pulmonary hypertension (PH) is a prevalent adverse cardiovascular event at high-altitude environments. Prolonged exposure to high altitudes may result in myocardial injury, which is associated with poor clinical outcomes. This study aims to investigate the clinical characteristics of myocardial injury in patients with PH at high altitude. Methods: Consecutive patients admitted to a general tertiary hospital at the altitude of 3,650 m were selected into this retrospective study. Clinical and biochemical data were collected, as well as based on cardiac troponin I (cTnI) and echocardiography, patients were divided into myocardial injury group and non-myocardial injury group. Results: A total of 231 patients were enrolled, among whom 29 (12.6%) had myocardial injury. We found that body mass index, left ventricular end-diastolic dimension, and serum level of creatine kinase-MB (CK-MB) in myocardial injury group were significantly higher than non-myocardial injury group. Spearman correlation analysis revealed that cTnI has a significant positive correlation with CK-MB and lactic dehydrogenase instead of aspartate aminotransferase. A receiver operating characteristic curve was drawn to demonstrate that CK-MB could significantly predict the occurrence of myocardial injury with an area under the curve of 0.749, and a level of 3.035 (sensitivity = 59.3%, specificity = 90.5%) was optimal cutoff value. Conclusion: The incidence of myocardial injury in highlanders with PH is significant. CK-MB, as a convenient and efficient marker, has been found to be closely associated with cTnI and plays a predictive role in the occurrence of myocardial injury with PH in individuals exposed to high altitude.

Risk assessment of severe adult tetanus using the NLR and AST level and construction of a nomogram prediction model.

We sought to examine high-risk factors for severe tetanus, construct a nomogram model, and predict the risk probability of severe tetanus in adult patients to provide a theoretical basis for clinical intervention. Methods: A retrospective analysis was employed in this study, which enrolled 65 adult patients with tetanus diagnosed at the Second Affiliated Hospital of Hainan Medical University from January 2017 to September 2022. Study participants were divided into severe and mild groups based on the Ablett classification. The general data and laboratory markers of both groups were compared, and logistic regression analysis was used to screen for independent risk factors for severe tetanus. A nomogram prediction model was constructed, and receiver operating characteristic (ROC), calibration curve, and decision curve analysis (DCA) were constructed and used to assess discrimination, calibration, and net benefit. Results: Of the 65 adults patients with tetanus, 28 were placed in the severe group and 37 were placed in the mild group. Univariate logistic regression analysis showed that there were statistically significant differences in the incubation period, time from disease onset to treatment, white blood cell count (WBC), neutrophil count (NEU), lymphocyte count (LYM), platelet count (PLT), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lactate dehydrogenase level (LDH), myoglobin level (Mb), and aspartate aminotransferase (AST) level between the two groups (P < 0.05). while the differences in age; sex; and creatine kinase, creatine kinase isoenzyme, and alanine aminotransferase levels were not statistically significant (P > 0.05). Multivariate analysis showed that NLR (odds ratio [OR] = 4.998, 95 % confidence interval [CI] = 1.154-21.649, P = 0.031), AST (OR = 1.074, 95 % CI = 1.007-1.146, P = 0.031), PLT (OR = 1.055, 95 % CI = 1.006-1.106, P = 0.027), and incubation period (OR = 0.597, 95 % CI = 0.423-0.843, P = 0.003) are independent risk factor for severe tetanus. A Nomogram for predicting Severe Tetanus (N-ST) prediction model was constructed based on variables in the multivariate analysis with P < 0.05. The ROC curve showed that the optimal cutoff point was 108.044 points. At this point, the sensitivity was 86.5 %, the specificity was 89.3 %, the area under the ROC curve was 0.936, and model discrimination was good. The calibration curve overlapped with the ideal curve, and the DCA curve showed that the model can provide clinical benefits. Conclusion: NLR, AST, PLT, and incubation period are predictors of severe tetanus. The constructed N-ST model can provide a new, convenient, and rapid method to predict the risk probability of severe tetanus in adults and guide early clinical intervention.

Associations of systemic inflammation markers with myocardial enzymes in pediatric adenotonsillar hypertrophy: A cross-sectional study.

Objective: The present study aimed to investigate the relationship between systemic inflammation markers and myocardial enzymes in children with adenotonsillar hypertrophy (ATH). Methods: The levels of myocardial enzymes were detected and the systemic inflammatory biomarkers including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) were calculated. Regression analyses were performed and a prediction model for screening myocardial injury was established by receiver operating characteristic (ROC) curve. Results: Finally, a total of 804 children with ATH were included. After adjusting for age, BMI, fasting blood glucose and lipid profiles, both NLR and SII were significantly associated with CK-MB (p = 0.041 and 0.034, respectively) and LDH (p = 0.002 and 0.001, respectively), and PLR was associated with CK-MB (p = 0.008). In addition, NLR, SII were independently associated with hyper-LDH [OR = 1.447, 95%CI (1.063, 1.968); OR = 1.001, 95%CI (1.000, 1.002), respectively] and the associations were more significant in girls. A prediction model for hyper-LDH based on SII was developed with the area under the ROC curve of 0.715 (0.682, 0.746). Conclusion: Systemic inflammation markers were only independently associated with serum hyper-LDH in children with ATH, especially in girls. Further investigation was needed to determine the relationship between systemic inflammation with myocardial enzymes in ATH children.

Effects of different simulated submarine escape depths by free ascent in animal models.

Objective: If a damaged submarine cannot be rescued in time, it is necessary to carry out a submarine escape by free ascent. Decompression illness is the greatest threat to the safety of submariners. The maximum depth at which a safe escape can be carried out is unknown. This study intends to explore the maximum safe escape depth by observing the effects of simulated submarine escape at different depths on animal models. Methods: We evaluated pulmonary function indexes, blood gas values, blood cell counts, the myocardial enzyme spectrum, coagulation parameters, and proinflammatory cytokine levels in rats, electrocardiographic activity in rabbits after simulated 150-m, 200-m, 220-m, and 250-m submarine escape by free ascent. Results: An escape depth of 150 m did not cause significant changes in the indicators. An escape depth of >200 m led to pulmonary ventilation and gas diffusion dysfunction, hypoxemia, myocardial ischemia, and activation of the fibrinolytic and inflammatory systems. The magnitudes of the changes in the indicators were proportional to escape depth. Conclusion: An escape depth of 150 m in animal models is safe, whereas escape at > 200 m can be harmful.

Curative effect of zinc-selenium tea on rat's cardiotoxicity induced by long-term exposure to nonylphenol.

This study aimed to explore whether zinc-selenium tea has an curative effect on the cardiotoxicity induced by nonylphenol (NP), and to compare the effect of zinc-selenium tea and green tea. After drinking of zinc-selenium tea or green tea, compared with the control group, the left ventricular anterior wall became thinner, and the left ventricular end-diastolic diameter increased, the anterior wall of the left ventricle became thin at the end of diastole in the NP group. The serum myocardial enzymes aspartate aminotransferase, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, and α-hydroxybutyrate dehydrogenase in the NP group were significantly increased, and the serum myocardial enzymes were significantly decreased after the intervention of zinc-selenium tea. Proteins and mRNA expressions of Collagen I and Collagen III in the tea groups were lower than those in the NP group. In the green tea and zinc-selenium tea intervention groups, the disorder and degree of myocardial fiber were alleviated to varying degrees. The disturbance, breakage, and inflammatory cell infiltration of myocardial fibers in zinc-selenium tea and green tea groups were less than that of NP group. After tea intervention, collagen I and collagen III in the myocardium decreased. The intervention effect of zinc-selenium tea was better than that of green tea. Zinc-selenium tea and green tea could interfere with the cardiotoxicity indued by NP, which would alleviate the myocardial fibrosis by reducing expressions of collagen I and collagen III. Moreover, the curative effect of zinc-selenium tea was better than that of green tea.

Correlation Between Neutrophil to Lymphocyte Ratio and Myocardial Injury in Population Exposed to High Altitude.

Objective: Myocardial injury is a severe complication in population exposed to high altitude. As a new biomarker for inflammatory response, neutrophil to lymphocyte ratio (NLR) has been widely used to predict the prognosis of various diseases. In this study, we intend to explore the risk factors for myocardial injury at high altitude and examine the relationship between NLR level and development of myocardial injury. Methods: Consecutive patients admitted to a secondary general hospital at high altitude from June 2019 to May 2020 were selected into this retrospective study. Clinical and biochemical data were collected. According to the results of lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzymes (CK-MB), and aspartate amino transferase (AST), patients were divided into myocardial injury group and normal group. Results: A total of 476 patients were enrolled in this study. Myocardial injury occurred in 158 patients (33.2%). We found that altitude, NLR, hemoglobin, total bilirubin, total cholesterol, and lipoprotein A in myocardial injury group were significantly higher than that in normal group (P < 0.05), while platelet count in myocardial injury group was significantly lower than that in normal group (P < 0.05). Logistic multivariate regression analysis revealed that there was an independent relationship between myocardial injury and smoke, NLR, hemoglobin (P < 0.05). By using Spearman correlation analysis, NLR was proved to have a significant positive correlation with LDH, CK, and CK-MB (P < 0.05) instead of AST. A receiver operating characteristic (ROC) curve was drawn to demonstrate that NLR could significantly predict the occurrence of myocardial injury with an area under the curve (AUC) of 0.594 (95% CI: 0.537-0.650, P < 0.05), and the level of 2.967 (sensitivity = 38.0%, specificity = 83.6%) was optimal cutoff value. Conclusion: The incidence of myocardial injury is high in population at high altitude. Smoke, hemoglobin, and NLR are independent factors related to myocardial injury. As a convenient and efficient marker, NLR is found to be closely associated with myocardial enzymes and have a predict role in the occurrence of myocardial injury. This study will provide a theoretical basis on NLR for the early diagnosis of myocardial injury at high altitude.

What the Cardiologist Needs to Consider in the Management of Oncologic Patients with STEMI-Like Syndrome: A Case Report and Literature Review.

In pre-hospital care, an accurate and quick diagnosis of ST-segment elevation myocardial infarction (STEMI) is imperative to promptly kick-off the STEMI network with a direct transfer to the cardiac catheterization laboratory (cath lab) in order to reduce myocardial infarction size and mortality. Aa atherosclerotic plaque rupture is the main mechanism responsible for STEMI. However, in a small percentage of patients, emergency coronarography does not reveal any significant coronary stenosis. The fluoropyrimidine agents such as 5-Fluorouracil (5-FU) and capecitabine, widely used to treat gastrointestinal, breast, head and neck cancers, either as a single agent or in combination with other chemotherapies, can cause potentially lethal cardiac side effects. Here, we present the case of a patient with 5-FU cardiotoxicity resulting in an acute coronary syndrome (ACS) with recurrent episodes of chest pain and ST-segment elevation.. Our case report highlights the importance of widening the knowledge among cardiologists of the side effects of chemotherapeutic drugs, especially considering the rising number of cancer patients around the world and that fluoropyrimidines are the main treatment for many types of cancer, both in adjuvant and advanced settings.

The Causes of Chest Pain in Children and the Criteria for Targeted Myocardial Enzyme Testing in Identifying the Causes of Chest Pain in Children.

Aims: Chest pain is a common complaint at pediatric cardiology clinics and often leads to an extensive cardiac evaluation. In this study, we analyzed the causes of chest pain in Chinese children and developed diagnostic procedures and criteria for targeted myocardial enzyme testing. Methods and Results: We retrospectively analyzed the clinical data of patients aged below 18 years visiting our hospital for chest pain between 2005 and 2019. Based on auxiliary exams and clinical diagnosis, we developed diagnostic procedures and criteria for targeted myocardial enzyme testing in children with chest pain. A total of 7,251 children were included in this study. The chest pain was of cardiac origin in 581 patients (8.0%). The incidence of non-cardiac chest pain was significantly higher in the preschool group and the school-age group than in the adolescent group (93.5 vs. 93.8 vs. 90.3%, P < 0.05). Among children with cardiac chest pain, the most common concomitant symptom was chest tightness (67.0%). Myocardial enzyme testing was performed in 5,408 patients and was abnormal in 453 patients. We developed a diagnostic procedure and criteria for targeted myocardial enzyme testing using pertinent history, physical examination, and ECG findings or UCG finding. Applying the diagnostic procedure and criteria could lead to the reduction in myocardial enzyme testing while still capturing all cardiac diagnoses. Conclusion: In children, chest pain is mostly benign and rarely cardiac. During diagnosis, targeted myocardial enzyme testing based on medical history and physical examination can effectively reduce resource use.

Significance changes in the levels of myocardial enzyme in the child patients with Mycoplasma Pneumoniae Pneumonia.

Mycoplasma is a gram-negative with thin wall bacterium that in humans, Mycoplasma pneumoniae causes pneumonia. This experiment was designed to explore the changes of myocardial enzymes in the mycoplasma pneumoniae pneumonia (MPP) child patients, and analyze the clinical value of these changes, in combination with the relevant indicators, symptoms and signs, in the evaluation of the pneumonia mycoplasma infection. For this aim, a total of 120 child patients with MPP in the acute phase,120 child patients with MPP in the recovery phase and 120 healthy children were simultaneously enrolled into this study to detect the levels of aspartate aminotransferase (AST), creatine kinase (CK), Creatine Kinase Isoenzyme (CK-MB) and lactic dehydrogenase (LDH) in blood. Results showed that MPP patients in the acute phase had higher levels of LDH, CK, CK-MB, AST, PCt, CRP, MPV, PDW, PCt, percentage of neutrophils, WBC count in the peripheral blood and ESR than those of the patients in the recovery patients and healthy children, while the level of PLT was lower (all P<0.05). In the acute phase, the level of CK-MB correlated to the fever, fever duration, extrapulmonary organ damage (except for the myocardial damage) and the antibody titer of MP (all P<0.05). It was concluded that in the acute phase of MMP, the level of CK-MB could not only reflect the myocardial damage readily but also the infection of MP as well as the resultant inflammation and disease progression, which could effectively guide the diagnosis and treatment of MPP.

microRNA-193b protects against myocardial ischemia-reperfusion injury in mouse by targeting mastermind-like 1.

The current study aimed to explore the functions and roles of microRNA-193b (miR-193b) in the myocardium with ischemia-reperfusion (I/R) injury and a potential therapeutic method for myocardial I/R injury. The mice were subjected to myocardial I/R with or without miR-193b pretreatment. The infarct size and myocardial enzymes were detected. The terminal deoxynucleotidyl transferase dUTP nick-end labeling assay was conducted to investigate the effect of miR-193b on cardiomyocyte apoptosis. The expression levels of miR-193b and mastermind-like 1 (MAML1) were validated by quantitative real-time polymerase chain reaction and Western blot analysis. The results suggested that the miR-193b expression level was significantly downregulated in the myocardium with I/R injury compared with control group. miR-193b overexpression is able to reduce infarct size and myocardial enzymes after myocardial I/R injury. Furthermore, overexpression of miR-193b could alleviate the apoptosis level after myocardial I/R injury. Taken together, the present study demonstrated that upregulated miRNA-193b alleviated myocardial I/R injury via targeting MAML1.

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.

[Effect of long-term crotonaldehyde exposure on heart damage in male rats].

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, 1ß, 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-1ß、IL-6、IL-8 in 4.5 mg/kg group and IL-1ß、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.

Detection of myocardial enzymes, cardiac troponin T and hepatic and renal function in the diagnosis and treatment of severe pneumonia in children.

OBJECTIVE: To analyze the significance of myocardial enzymes, cardiac troponin T (cTnT) and hepatic and renal function in the treatment of severe pneumonia in children. METHODS: One hundred and twenty children with severe pneumonia who were admitted to the hospital between April 2015 and February 2017 were selected and included as a severe pneumonia group; 120 children with common pneumonia were included as a common pneumonia group; 100 healthy children were included as controls. The myocardial enzymes, cTnT and hepatic and renal function of patients in the three groups were detected and compared. The children with severe pneumonia were divided into a mild hypoxia group, a moderate hypoxia group and a severe hypoxia group according to arterial partial pressure of oxygen; the myocardial enzymes, hepatic and renal function and cTnT of the children in the three groups were compared. The correlations of partial pressure of blood oxygen with myocardial enzymes, hepatic and renal function and cTnT were analyzed. RESULTS: The levels of myocardial enzymes, hepatic and renal function and cTnT of the severe pneumonia group, common pneumonia group and control group declined, and the differences had statistical significance (P<0.05). The levels of myocardial enzymes, hepatic and renal function and cTnT were higher in the children with severe hypoxia. The partial pressure of blood oxygen was in a negative correlation with myocardial enzymes, hepatic and renal function and cTnT in the severe pneumonia group. CONCLUSION: Timely monitoring of myocardial enzymes, hepatic and renal function and cTnT has an extremely important role in the evaluation of children with severe pneumonia.

The Cardioprotective Effects of 4-O-(2″-O-acetyl-6″-O- P-coumaroyl-ß-D-glucopyranosyl)-P-coumaric Acid (4-ACGC) on Chronic Heart Failure.

The 4-ACGC isolated from BP was prepared to investigate the cardioprotective effects on attenuating chronic heart failure in-vivo and in-vitro. A chronic heart failure (CHF) rat model was established to investigate the cardioprotective effects of 4-ACGC. From this, several cardiac function indexes were recorded. The inflammatory markers including tumor necrosis factor-α (TNF-α), Interleukin-6 (IL-6), and Interleukin-1ß (IL-1ß) were evaluated by enzyme-linked immunosorbent assay (ELISA). Subsequently, serum levels of myocardial enzymes lactate dehydrogenase (LDH) and creatine kinase (CK) were also assessed by ELISA kits. Ultimately, the cardioprotective and anti-inflammatory effects of 4-ACGC were further verified on CMECs. The results showed that the treatment of 4-ACGC significantly reduced cardiac hypertrophy and reversed the Ejection Fraction (EF), Heart Rate (HR), Fractional Shortening (FS), and Cardiac Output (CO) changes in CHF rats. The treatment of 4-ACGC could effectively inhibit the inflammatory cytokines induced by CHF. It's also showed that a reverse effect of 4-ACGC on serum increased levels of LDH and CK in CHF rats. The increased levels of IL-1ß and IL-6 stimulated by TNF-α on CMECs were also decreased after treating with 4-ACGC. The present study provided experimental evidence that 4-ACGC possessed obvious cardioprotective effects on attenuating CHF. 4-ACGC could suppress the expression of inflammatory mediators and myocardial enzymes, which might be one of the mechanisms.

The potential effect of garlic extract and curcumin nanoparticles against complication accompanied with experimentally induced diabetes in rats.

BACKGROUND: Modified herbal medicines implicate the combination of several therapeutic practices of native systems of medicine that may extend many earlier generations, which frequently afford valuable therapeutic benefits. PURPOSE: In this study, the role of nano-curcumin and aged garlic extract (AGE) as two modified phytomedicines on alleviating both of advanced glycation end products (AGEPs) and oxidative stress (OS) in streptozotocin (STZ) induced diabetic rats were investigated during this study. METHOD: Nano-curcumin and AGE suspension were orally administrated at a dose of 300, 500 mg/kg body weight respectively. Serum glucose, insulin, total cholesterol, triglycerides and myocardial enzyme activities including creatine kinase-isoenzyme (CK-MB), lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) were determined biochemically, while quantitative real-time polymerase chain reaction (qRT-PCR)-test had been used to determine relative of manganese-superoxide dismutase (Mn-SOD) and receptor for advanced glycation end products (RAGE) gene expressions in the heart tissue of rats. Structure of rat's heart tissue was examined by histopathological analysis (H&E). RESULTS: AGE increased the body weight and insulin concentration, while, it decreased serum glucose concentration, CK-MB, and LDH enzyme activities in comparing with the diabetic group. In addition, total cholesterol, triglycerides, and AST didn't show any significant changes in serum values of AGE compared to diabetic rats. Nano-curcumin suspension decreased the serum levels of triglycerides, CK- MB, LDH, and AST. While, there were non-significant changes in the body weight, glucose, insulin, and total cholesterol level of the same group compared with the STZ- untreated induced diabetic rats. The transcript quantity of manganese-superoxide dismutase gene (Mn-SOD) was highly accumulated (3.25 and 3.87-fold) in the heart tissue sample of the induced diabetic rats in response to both nano-Curcumin and AGE suspension respectively. While AGE was the most potent treatment where it caused down regulation of the receptor for advanced glycation end products gene (RAGE) expression (1.79-fold). Results of histopathological analyses under the light microscope showed restoring the structural integrity of the myocytes towards normalization in diabetic hearts treated with each of nano-curcumin and AGE suspension compared with the untreated diabetic heart samples. CONCLUSION: Nano-curcumin and AGE suspension have a great therapeutic potential in the treatment of DCM, Diabetic cardiomyopathy, by attenuating cardiac inflammation, myocardial fibrosis, and programmed myocardial cell deaths through inhibiting OS and AGEPs accumulation in diabetic heart tissue. Furthermore, the hypoglycemic antioxidant properties of AGE resulted in more potent therapeutic effect than nano-curcumin in the treatment of diabetic hearts.

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 (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.