Chin Crit Care Med, March 2004,Vol.16,No.3
129-132
Experimental study of the effects of mild hypothermia on the acute myocardial infarction size in the rabbits with coronary artery reperfusion
Qian Yuan-yu, Meng Qing-yi, Wang Zhi-zhong, Ma Yong, Wang Yun-zhong, Dong Zhen-nan Emergency Department of the Chinese PLA General Hospital, Beijing 100853, China.
OBJECTIVE: To study the effect of mild hypothermia on the acute myocardial infarction size in the rabbits with coronary artery reperfusion. METHODS: fourteen rabbits were randomly divided into two groups: mild hypothermia group and control group. Each group underwent 45 minutes of left anterior descending coronary artery occlusion and 2 hours of reperfusion. Core temperatures were measured with thermistor. The mild hypothermia group received ice cooling around the body and the core temperature was dropped to 32-35 ℃ after occluded for 30 minutes, while the control group's body temperature were kept above 38 ℃. The myocardial area at risk and the infarct area were determined with Evan's blue dye and triphenyl tetrazolium chloride(TTC). RESULTS: The total elevated amplitude of ST segment in chest leads V1, V3 and V5 in the mild hypothermia group was (25.8±8.5)mV, it was lower than that in the control group (37.7±6.5)Mv (P=0.021). The changes of serum MB isoenzyme of creatine kinase (CK-MB) activities in mild hypothermia group was (2646.9±1227.3)U/L, it was significantly lower than that in the control group (4787.8±1934.2)U/L(P=0.045). The weight of infarct myocardium of the mild hypothermia group was (0.23±0.05)g, it was lower than that in the control group (0.42±0.16)g (P=0.020). Myocardial infarct size as a percentage of the risk zone (0.214±0.044 vs. 0.357±0.066， P=0.001) and of the left ventricle weight(0.041±0.010 vs. 0.071±0.027, P=0.029) were smaller than those in the control group. The ratio of the survived myocardial area over the risk zone in the mild hypothermia group was significantly higher than that in the control group (0.786±0.044 vs. 0.643±0.066， P<0.001). CONCLUSION: Mild hypothermia may reduce infarct size in the rabbits with transient acute myocardial infarction, and increase survived myocardium in the risk zone.
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133-136
Effects of Ca2+ antagonist on cardiomyocytic apoptosis after experimental myocardial infarction
Feng Quan-zhou, Li Tian-de, Wang Zhao-xia, Yi Jun, Wang Li, Yang Ting-shu
Department of Cardiology, General Hospital of Chinese PLA, Beijing 100853, China.
OBJECTIVE: To explore the effects of Ca2+ antagonist on apoptosis of cardiomyocytes after myocardial ischemia. METHODS: The model of myocardial infarction was made by ligating left coronary artery in SD rats. In experimental group, the rats were administrated with Adalat through oral cavity (1 mg/kg) before operation and through peritoneal cavity (0.4 mg/kg 3 hours after operation. In ischemic control group the rats were injected with placebo and in normal control group the rats were treated with sham operation (no ligating left coronary artery) and placebo. The rats were killed 6 hours after operation, with their left ventricular function had been measured. Apoptotic myocardial cells were detected by terminal deoxynucleotidyl transferase mediated dUTP nick end-labeling (TUNEL) method, Fas and Bcl-2 proteins by the ABC immunohistochemistry method. Apoptosis indexes were calculated under high magnification field of microscopy. RESULTS: The systolic pressure, end-diastolic pressure and dp/dt of left ventricle in experiment group were not significant different from those in the ischemic control group, they were 76.7±7.5/8.0±6.1 mm Hg vs. 74.9±11.1/11.6±8.3 mm Hg(P>0.05) and (777.3±128.6)mm Hg/s vs. (761.8±136.4)mm Hg/s (P>0.05) respectively; but those in both the experimental group and the ischemic control group were lower than those in the normal control group, they were 94.9±7.5/2.8±3.2 mm Hg (P<0.001) and (1131.5±112.8)mm Hg/s(P<0.001). There were a lot of positive myocytes with TUNEL stain in the ischemic region of left ventricle in both the experimental and the ischemic control group, apoptosis index in the experimental group was lower than that in the ischemic control group (0.201±0.053 vs. 0.261±0.045， P<0.05). The positive myocytes of Fas and Bcl-2 protein appeared in the region surrounding ischemic myocytes. There were no positive myocytes with the three types of stain in normal control group. CONCLUSION: Ischemia could induce apoptosis of myocytes and expression of Fas and Bcl-2 gene; Ca2+ antagonist could protect myocytes from apoptosis.
, 百拇医药
137-141
Clinical significance of soluble selectins and matrix metalloproteinases-9 in patients after successful cardiopulmonary resuscitation
Li Pei-jie, Yang Xiao-hua, Zhang Li-ping, Cao Wen, Qin Jing, Yao Wei
Second Affiliated Hospital of Lanzhou Medical College, Lanzhou Emergency Center of Gansu Province, Lanzhou 730030, Gansu, China.
OBJECTIVE: To investigate whether patients after successful cardiopulmonary resuscitation (CPR) exist elevated levels of soluble P-and E-selectin (sP-selectin, sE-selectin), matrix metalloproteinases-9 (MMP-9) and to evaluate the clinical significance of changes in these cytokine levels. METHODS: Plasma levels of sP-and sE-selectin, MMP-9 of 82 patients who survived ≥48 hours after CPR were determined on the second day after successful CPR. They were classified into different groups according to whether causing systemic inflammatory response syndrome (SIRS) and developing sepsis. Sixty-five non-critically ill patients were served as control group. RESULTS: Incidence of SIRS was 68.3% (56/82 cases) after successful CPR. Plasma levels of sP-selectin were higher in patients with SIRS compared with those in patients without SIRS or control group (all P<0.01). Plasma levels of sE-selectin and MMP-9 were not significantly different between patients with SIRS and without SIRS (all P>0.05), but were higher in both patient groups than those in the control group (all P<0.01) 43.9% of the patients developed sepsis within 1 week after CPR. Plasma levels of sP-selectin were higher in patients developing sepsis than those in patients without sepsis (P<0.05), but plasma levels of sE-selectin and MMP-9 were not significantly different between two groups (all P>0.05). Plasma levels of sE-selectin and MMP-9 were higher in nonsurvivors than those in survivors (both P<0.01), but plasma levels of sP-selectin were not significantly different between two groups (all P>0.05). CONCLUSION: SIRS is a frequent but unspecific finding after CPR with only minor impact on outcome. Determination of sP-and sE-selectin, MMP-9 early after CPR might help to identify patients at a high risk for sepsis or an adverse, respectively.
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142-147
Effect of β3-adrenoreceptors agonist on β3-adrenoreceptors expression and myocyte apoptosis in a rat model of heart failure
Kong Yi-hui, Li Wei-min, Tian Ying
Department of Cardiology, the First Clinical College of Harbin Medical University, Harbin 150001, Heilongjiang, China.
OBJECTIVE: To evaluate the effects of β3-adrenoreceptor (AR) agonist (BRL-37344) on the expression of β3-AR in a isoproterenol(ISO)-induced heart failure (HF) rat model and to investigate the influence on the levels of β3-AR in failing heart. METHODS: The rats were randomly divided into four groups: I group (control group, n=10); II group (normal with BRL group, n=10); III group (HF group, n=30); IV group (HF with BRL group, n=35).II and IV groups received BRL 0.4 nmol·kg-1·min-1 through caudal vein for 10 minutes twice a week. Iand III groups received saline at the same time. The measure included hemodynamics, the expression of β3-AR in left ventricular myocytes by the techniques of immunohistochemistry, β3-AR proteins by western blot, expression levels of β3-AR mRNA in myocardium by reverse transcription- polymerase chain reaction (RT-PCR) and the levels of apoptotic cells with a terminal deoxynucleotidyl transferase mediated dUTP-biotin nick end labeling(TUNEL) kit. RESULTS: (1)Hemodynamic： The tendency of left ventricular end systolic pressure (PES)， maximal rates of rise of ventricular pressure(dp/dtmax)， maximal rates of decline of ventricular pressure(dp/dtmin) in II, III and IV groups were lower (P<0.01)， time constant of left ventricular relaxation(Tc) and left ventricular end diastolic pressure (PED) were higher than those of the I group (all P<0.01). There was no difference between I and II group except PED (P<0.05). Compared with III group, PES， dp/dtmax, dp/dtmin in IV group were dramatically decline (P<0.05)； Tc, PED were markedly increased (Tc P<0.05，PED P<0.01). (2)The levels of β3-AR mRNA and β3-AR proteins were higher in III and IV groups when compared with I and II groups. There was no difference between I and II group. IV group’s levels were higher than III group’s. (3)The apoptotic rates in III group and IV group were significantly higher than those in I and II group (all P<0.01). When compared with III group’s apoptotic cell rate, IV group’s was higher(P<0.01). CONCLUSION: The levels of β3-AR mRNA and proteins show an increase in failing heart compared with nonfailing heart. The effect of β3-AR agonist aggravate markedly cardiac function and stimulate cardiac myocytes apoptosis in failing heart. If the levels of β3-AR were too high, they might contribute to the loss of cardiac function and be the foundation of the functional degradation of HF.
, 百拇医药
148-150
Clinical features and treatment of cardiogenic shock complicated with acute myocardial infarction
Zhao Yu-sheng, Wang Shi-wen， Lu Cai-yi, Wu Xing-li, Li Yu-feng, Liu Ling-ling, Yan Mu-yang, Cheng Rui
Institute of Geriatric Cardiology, General Hospital of Chinese PLA, Beijing 100853, China.
OBJECTIVE: To identify the clinical features and the outcome of patients with cardiogenic shock complicating acute myocardial infarction (AMI). METHODS: One hundred and eight consecutive patients with AMI were included in this retrospective analysis. The characteristics, management, and outcome of patients with AMI were compared between patients with cardiogenic shock (group A, n=11) and without cardiogenic shock (group B, n=9). RESULTS: There was no difference in the age and other characteristics including proportion of women, diabetics, prior myocardial infarction and the position of myocardial infarction. The levels of peak creatine kinase and troponin I were (31979.7±22271.1)nmol·s-1·L-1 and (90.7±61.1)μg/L respectively in group A, they were higher than those in group B (17795.2±14979.7)nmol·s-1·L-1 and (39.9±52.1)μg/L, respectively (both P<0.05). The left ventricular ejection fraction was significantly lower in group A than that in group B (0.46±0.12 vs. 0.55±0.12, P<0.05). Patients in group A had a higher proportion of pump failure, arrhythmia and pneumonia (64% vs. 14%, P<0.001; 55% vs. 21 %, P<0.05; and 46% vs. 12%, P<0.01, respectively) than those in group B. In addition, in group A patients often underwent thrombolysis of urokinase, coronary angiography and intra-aortic balloon counterpulsation (46% vs. 18%, 73% vs. 26% and 36% vs. 4%, all P<0.05, respectively). There was no difference in in-hospital mortality between group A and group B (0 vs. 4%, P>0.05). CONCLUSION: Shock patients more likely have pump failure, arrhythmia, and pneumonia and more often underwent intra-aortic balloon counterpulsation. If cardiogenic shock complicating AMI is managed with rapid evaluation and prompt initiation of supportive measures and definitive therapy, outcomes can be improved.
, 百拇医药
151-154
Study on changes of neuron apoptosis after focal cerebral ischemia/reperfusion in the aged rats
Li Jian-sheng, Ren Xiao-qiao, Liu Ke, Liu Zheng-guo, Kong Ling-fei
Geriatrics Department of Henan College of Traditional Chinese Medicine, Zhengzhou 450003, Henan, China.
OBJECTIVE: To study ultrastructured change and neuron apoptosis after focal cerebral ischemia/reperfusion (I/R) in the aged rats. METHODS: The aged SD rats (20-21 months) and the young (4-5 months) were subjected to 3 hours of middle cerebral artery occulsion with the intraluminal filament technique, followed by reperfusion for 3 hours, 6 hours, 12 hours, 24 hours, 72 hours. The ultrastructure of brain, infarct zone and neuron apoptosis were observed. RESULTS: The cerebral infarct zone increased in the aged rats with ischemia for 3 hours and I/R for 12 hours compared with those in the young. The brain injury was obviously deteriorated with I/R time longer, which was serious in the aged than that in the young. The neuron apoptosis increase with I/R time longer, and showed earlier and lasted longer in the aged. CONCLUSION: The cerebral injury is serious and neuron apoptosis increase shows early and lasts longer.
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155-157
Therapeutic assessment between the thrombolysis in 6 hours and delayed thrombolysis after onset of acute myocardial infarction
Ren Hai-bin, Zhong Yong-gen
Heyuan People's Hospital, Heyuan 517000, Guangdong, China.
OBJECTIVE: To explore the effect of different starting time of thrombolysis on acute myocardial infarction (AMI). METHODS: Ninety-five patients of AMI were divided into prompt thrombolysis group (less then 6 h, 46 patients) and delayed thrombolysis group (6-12 hours, 49 patients), according to the different starting time of treating AMI. The incidences of reopening and side-effect, as well as mortality were compared between two groups. RESULTS: The reopening rate and mortality in prompt thrombolysis group were 76% and 4%, respectively. The reopening rate and mortality in delayed thrombolysis group were 49% and 12%, respectively. Compared the prompt thrombolysis group with the delayed thrombolysis group, there was a significance discrepancy (both P<0.01). The side-effect rate had not significant discrepancy (15% vs. 16%, P>0.05). CONCLUSION: The clinical reopening rate of the thrombolysis is higher in patients with thrombolysis less than 6 hours, the mortality is lower. The thrombolytic treatment should be prompt for patients adapting thrombolysis.
, 百拇医药
157
The investigation of the effect of prostaglandin E1 on indications of in flammation reaction in patients with coronary artery syndrome
Cai Jin-ying, Zhai Gui-lan, Gao Wei, Wang Qing-ru, Zhao Li-yan, Chen Ying, Sun Yang-ling, Sun Yu
The first affiliated Hospital, Jinzhou medical College, Jinzhou 121000, China.
158-160
Effects of adenosine preconditioning on cardiac myocyte apoptosis and expression of nuclear factor-κB in ischemia/reperfusion rats
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Zhang Liang-qing, Xu Jun-fa, Cai Kang-rong, Li Li-zhi
Department of Anesthesiology, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524001, Guangdong, China.
OBJECTIVE: To investigate the effect of adenosine preconditioning on cardiac myocyte apoptosis and the expression of nuclear factor-κB (NF-κB)during myocardial ischemia/reperfusion (I/R) in rats. METHODS: A model of I/R injury (I/R group) and pretreatment with adenosine (AP group) was reproduced in rats. The morphologic features of apoptosis were identified histochemically by TdT-mediated dUTP nick end (TUNEL) staining. Expression of NF-κB in apoptosis myocardiac cells was observed by immunohistochemical stain and image analysis. RESULTS: The percentage of cardiac myocyte apptosis and the expression of NF-κB in AP group were (2635.0±316.0)% and (33.21±16.91)%, they were significantly lower than those in I/R group (5013.0±503.7)% and (59.30±10.36)% respectively(P<0.05 or P<0.01), but higher than those in control group (68.7±50.3)% and (10.98±4.65)% respectively (both P<0.01). CONCLUSION: Adenosine preconditioning can pretect from myocardial I/R injury and relieve cardiac myocyte apoptosis and expression of NF-κB.
, 百拇医药
161-164
Relationship between polymorphisms of cystathionine beta-synthase gene and stroke
Fang Le, Wu Wei, Wu Ying-quan
Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun 130031, Jilin, China.
OBJECTIVE: To determine whether the T27796C mutation in cystathionine beta-synthase (CBS) gene is associated with stroke in Chinese. METHODS: The T27796C mutation in CBS gene of 59 cases with stroke and 65 health controls were detected by polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP). RESULTS: As this investigation shown, the frequencies of two alleles of T27796C mutation were followed: C was 56.8%, T was 43.2% in cases and C was 51.5%, T was 48.5% in controls. T27796C mutation had no obvious relativity to the stroke (P>0.05). There was no significant difference in frequency of alleles of this mutation between cases and controls (CC: 35.6% vs. 24.6%; CT: 42.4% vs. 53.8%; TT: 22.0% vs. 21.5%; all P>0.05). There was not obvious difference in frequency of alleles of this mutation between hemorrhagic patients and ischemic stroke patients (all P>0.05). CONCLUSION: T27796C mutation in CBS is not obviously correlated with stroke and this mutation is not associated with categories of stroke.
, 百拇医药
164
Comparison analysis between two kinds of sublingual capoten and intrarensous urapidil on treatment for hypertension emergency
Yang Ze-min, Li Ning-rong, Zhu Xiao-ling
Meilin Hospital, Shenzhen 518049, Guangdong, China.
165-168
Clinical significance of plasma free 15-F2t-isoprostane concentration during coronary artery bypasses graft surgery
, 百拇医药
Huang Zhi-yong, Xia Zheng-yuan, David M.Ansley， Baljinder S.Dhaliwal
Department of Anesthesia, Shenzhen Sun Yat-Sen Cardiovascular Hospital, Shenzhen 518000, Guangdong, China.
OBJECTIVE: To analyse retrospectively the variation of plasma 15-F2t-isoprostane concentration during cardiac surgery and the relation with early myocardial dysfunction following normothemic cardiac surgery. METHODS: Thirty patients scheduled for coronary artery bypass graft surgery using normothermic cardiopulmonary bypass (CPB) and warm intermittent blood, crystalloid cardioplegia were enrolled. Patients were divided into two groups treated with (group II) or without (group I) positive inotropic drugs. Central venous blood was sampled at baseline, 30 minutes after global myocardial ischemia, 10, 30 and 120 minutes after aortic declamping (reperfusion). Plasma free 15-F2t-isoprostane was measured with enzyme immunoassay (EIA) using a highly specific rabbit 15-F2t-isoprostane antibody. Cardiac index (CI) was monitored intraoperatively and up to 6 hours following surgery. RESULTS: Plasma free 15-F2t-isoprostane increased significantly during ischemia, remained elevating at 10 minutes after reperfusion (P<0.05 vs. baseline) and began to decline at 30 minutes after reperfusion in the whole population. 15-F2t-isoprostane underwent exponential decay and returned to baseline at 30 minutes after reperfusion in groupⅠ that did not need any postoperative inotropic support. In contrast, 15-F2t-isoprostane further increased upon reperfusion and remained significantly higher than baseline at 30 minutes after reperfusion (P<0.05) in group II that needed two or more inotropes to maintain CI greater than 2.2 L·min-1·m-2. Postoperative CI was significantly inversely correlated with the percentage change in plasma free 15-F2t-isoprostane concentration from 10 to 30 minutes after reperfusion (r=-0.95, P<0.01). CONCLUSION: It shows a close relationship between free plasma concentrations of 15-F2t-isoprostane and early postoperative cardiac function following coronary artery bypass graft surgery.
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169-171
Study on the reperfusion rate of acute myocardial infarction affected by inspiring nitric oxide and resolving thrombus intravenously before admission
Sun Li-dong, Tang You-lin, Xi Wei-bin, Zhang Nan, Zhang Yin-zhu
Emergency Department, the 155th Hospital of PLA, Kaifeng 475003, Henan, China.
OBJECTIVE: To observe the reperfusion rate of acute myocardial infarction (AMI) affected by inspiring nitric oxide (NO) and resolving thrombus through veins. METHODS: Sixty cases with AMI were randomly divided into test group (n=30) and control groups (n=30). Patients in test group were cured with NO (20±1)mg/L inspiration for 30 minutes at once before admission and urokinase (150×104 U) adding 0.9% sodium chloride intravenously injected within 30 minutes, while patients in control were treated with urokinase as the same method of the test group. RESULTS: The reperfusion and non-reperfusion patients were 25 and 5 cases in test group, and they were 19 and 11 cases in control group. The reperfusion rate of AMI in test group was significantly higher than that in control group 83.3% vs. 63.3% (P<0.05). No peak periods of lactate dehydrogenase (LDH) and creatine phosphokinase (CPK) appeared in test group, and the difference was significant compared to the control group (P<0.05). CONCLUSION: NO inspiration before urokinase is an effective method to treat AMI and advance the reperfusion rate.
, 百拇医药
171
Relationship of tracheal cannula occasion with cardio-pulmonary resuscitation
Zhu Ren-chun, Yang Jian-ping
Xinchang People’s Hospital, Zhejiang 312500, Zhejiang, China.
172-174
Evaluation of operation and anesthesia on hemodynamic variables in patients undergoing elective abdominal surgery by noninvasive thoracic bioimpedance technique
, 百拇医药
Chen Hong, Li Fei, Yang Lei, Yang Peng, Li Jia, Jia Jian-guo, Sun Jia-bangDepartment of General Surgery, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053, China.
OBJECTIVE: To analyse and discuss the effects of elective abdominal operation and anaesthesia on patients' cardiac output via noninvasive thoracic bioimpedance technique. METHODS: Noninvasive monitoring system HeMo-601 was applied to detect the hemodynamic variables of 32 elective abdominal surgery patients.The clinical data of cardiac output(CO), cardiac index(CI), cardiac working per minute(CW), left ventricular end-diastolic pressure(LVEDP), stroke volume(SV), cardiac stroke working(SW)and heart rate (HR) were analysed at 1 hour before operation, 4-6 hours after operation and 24 hours after operation, respectively. RESULTS: No significant differences were found in CO, CI, CW and LVEDP between various time points and preoperation(all P>0.05). SV and SW at 4-6 hours after operation were significant lower than those before operation(all P<0.05). Whereas, SV and SW at 24 hours after operation were no significant differences compared with those before operation(all P>0.05). As compared with preoperation, HR at 4-6 hours after operation was significantly faster(P<0.05). However, there was no significant difference in HR between 24 hours after operation and preoperation (P>0.05). CONCLUSION: The reductions in SV and SW at 4-6 hours after operation might be a result of anaesthesia that could weaken the contraction of heart. The presence of rapidness of HR at 4-6 hours after operation might be a compensatory mechanism for the decreases in SV and SW. Therefore, optimizing adequate infusion by the greatest extent during and after operation is very crucial for the maintenance of CO, CI and tissue perfusion.
, 百拇医药
175-178
Changes of blood-cerebrospinal fluid barrier in rabbits with diabetic ketoacidosis
Zhu Xiao-yun, Gu Xiao-jun, Chang Jia-bao, Zhang Yan, Feng Yan-hong, Yin Guo-qing
The Second Hospital of Nanjing, Medical College of Southeast University, Nanjing 210003, Jiangsu, China.
OBJECTIVE: To explore the mechanism of the changes of blood-cerebrospinal fluid barrier in rabbits with diabetic ketoacidosis (DKA). METHODS: The New Zealand rabbits were injected with 150 mg/kg streptozotion and alloxan monohydrate each (model group, n=6) intravenously, or equal volume of normal saline (control group, n=6). After 72 hours, blood sugar and uric ketone were detected. All of animals were injected with Evans blue (EB). After 6 hours, arterial blood gases were measured and animals were killed. Absorbency of EB of brain tissue was detected. All brains of animals were examined with light and electron microscopy. Marker of blood-cerebrospinal fluid barrier, cytochemical stains of alkaline phosphatase (ALPase) was operated by ultrastructure. The inducible nitric oxide synthase (iNOS) in brain tissue was detected by immunohistochemical method. RESULTS: The models of DKA were established after 72 hours of injecting streptozotion and alloxan monohydrate. Absorbency of EB of model group rabbits was slightly increased, but had no significant difference compared with controls (P>0.05). The brain edema, damages of vessel endothelium and necrosis of neuron were observed through histological and ultrastructure examination in model group. ALPase activity of model group was evidently decreased in brain blood vessel endothelium in comparison with controls. Compared to controls, the iNOS activity of model group was increased and its positive cells were aggregated on blood vessel of brain membrane. CONCLUSION: By streptozotion and alloxan monohydrate inducing DKA models, NO could induce blood-cerebrospinal fluid barrier damages and result in brain edema.
, 百拇医药
179-181
Study on the clinical value of serum cardiac troponin T in early diagnosing of acute non-Q-wave myocardial infarction and prognostic evaluation
Zheng Qun, Wang Wei-zhan, Zhang Ying-xuan, Wang Lan, Zhao Ling-jun
Department of Cardiology, Harrison International Peace Hospital, Hengshui 053000, Hebei, China.
OBJECTIVE: To investigate the value of serum cardiac troponin T (cTnT) in diagnosing earlier acute non-Q-wave myocardial infarction (NQMI) and judging the prognosis. METHODS: Seventy-four NQMI patients and 118 Q-wave myocardial infarction (QMI) patients were studied. Serum cTnT and MB isoenzyme of creatine kinase (CK-MB) levels were monitored on fixed time. On the 15th day of hospitalization, 99 mTc-MIBI myocardial single photon emission computed tomography (SPECT) was performed to assess the infarct size index. Clinical informations of the two groups such as cardiac dysfunction, re-infarction, fatal cadiac arrhythmia, sudden death were collected. RESULTS: The time for serum cTnT beginning to rise was earlier than CK-MB. Its peak time value was paralled to that of CK-MB, and cTnT elevation lasted longer than CK-MB. Serum cTnT and CK-MB peak value showed positive correlation with the infarct size index (both P<0.01). The peak values of cTnT and CK-MB in NQMI group were lower than those in QMI group, and the infarct size was smaller than QMI group (all P<0.05). The frequencies of cardiac events were significantly raised in both groups when there was a high level of serum cTnT. But the proportion in NQMI group was less than those in QMI group (P<0.05). The cardiac events in NQMI group were less than that in QMI group (P<0.05). CONCLUSION: Serum cTnT is an effective marker for diagnosing earlier NQMI, detecting myocardial damage, estimating infarct size and prognosis in the nearly future.
, 百拇医药
182-183
Clinical values of von willebrand factor and C-reactive protein in patients with coronary heart disease
Bai Xiao-yi, Zheng Jin-shi, Liu Mei-xia, Mi Xia
Department of Geriutrics, The people’s Hospital of Hebei Province, Shijiazhuang 050051, Hebei, China.
184-185
ST segment changes of simultaneous 12-lead electrocardiogram in mucocutaneous lymphnode syndrome
, 百拇医药
Wang Cheng, Gao Shou-quan, Li Shu-fen, Xie Zhen-wu, Cao Min-jing, Li Ming-xiang, Qin Yun
Department of Cardiovascular Pediatric, the Second Xiangya Hospital, Central South University, Changsha 410011, China.
185
A report of rescue of multiple organ dysfunetion syndrome after prolonged cardion-pulmonary resuscitation in aged patients with pneumonia
Wang Chang-ming, Zhang Chu-ming, Chen Jie
, 百拇医药
Taizhou’s Municipal Hospital Zhejiang, Zhejiang 318000, Zhejiang, China.
186-187
Serum levels and their clinic significances of neuron-specific enolase and myelin basic protein in palierts with pulmonary encephalopathy
Chen Shao-ping, Chen Xiao-bing, Zhang Guo-yuan, Liu Li-xing
Department of Respiratory disease, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan, China.
, 百拇医药
188-189
Relation of higher blood homocyoteine levels with ischemic cerebrovascular diseases
Han Hui, Jin Yi-min, Fu Jun, Qiao Fang-fang
The second in patient department, the first clinical medical college, Haerbing Medical University, Haerbin 150001, China.
190-191
A report on 10 cases of the prolonged cardiopulmonary resuscitation
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He Guang-hui, Fu Jian-min, Tang Guang-ning, Song Xin-ke
Shihezi People’s Hospital, Xinjiang 832000, China.
192
Clinical application of mechanical ventilation on Neurogenic pulmonary edema following intracranial injury
Tu Chuan-jian, Ma Wei-xing, Liu Jian-sheng, Zhang Yue-jiang, Song Da-jiang, Ma Jun
Department of Neurosurgery, zhejiang shaoxing Fourth Hospital, Zhejiang 312030, China., http://www.100md.com
Experimental study of the effects of mild hypothermia on the acute myocardial infarction size in the rabbits with coronary artery reperfusion
Qian Yuan-yu, Meng Qing-yi, Wang Zhi-zhong, Ma Yong, Wang Yun-zhong, Dong Zhen-nan Emergency Department of the Chinese PLA General Hospital, Beijing 100853, China.
OBJECTIVE: To study the effect of mild hypothermia on the acute myocardial infarction size in the rabbits with coronary artery reperfusion. METHODS: fourteen rabbits were randomly divided into two groups: mild hypothermia group and control group. Each group underwent 45 minutes of left anterior descending coronary artery occlusion and 2 hours of reperfusion. Core temperatures were measured with thermistor. The mild hypothermia group received ice cooling around the body and the core temperature was dropped to 32-35 ℃ after occluded for 30 minutes, while the control group's body temperature were kept above 38 ℃. The myocardial area at risk and the infarct area were determined with Evan's blue dye and triphenyl tetrazolium chloride(TTC). RESULTS: The total elevated amplitude of ST segment in chest leads V1, V3 and V5 in the mild hypothermia group was (25.8±8.5)mV, it was lower than that in the control group (37.7±6.5)Mv (P=0.021). The changes of serum MB isoenzyme of creatine kinase (CK-MB) activities in mild hypothermia group was (2646.9±1227.3)U/L, it was significantly lower than that in the control group (4787.8±1934.2)U/L(P=0.045). The weight of infarct myocardium of the mild hypothermia group was (0.23±0.05)g, it was lower than that in the control group (0.42±0.16)g (P=0.020). Myocardial infarct size as a percentage of the risk zone (0.214±0.044 vs. 0.357±0.066， P=0.001) and of the left ventricle weight(0.041±0.010 vs. 0.071±0.027, P=0.029) were smaller than those in the control group. The ratio of the survived myocardial area over the risk zone in the mild hypothermia group was significantly higher than that in the control group (0.786±0.044 vs. 0.643±0.066， P<0.001). CONCLUSION: Mild hypothermia may reduce infarct size in the rabbits with transient acute myocardial infarction, and increase survived myocardium in the risk zone.
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133-136
Effects of Ca2+ antagonist on cardiomyocytic apoptosis after experimental myocardial infarction
Feng Quan-zhou, Li Tian-de, Wang Zhao-xia, Yi Jun, Wang Li, Yang Ting-shu
Department of Cardiology, General Hospital of Chinese PLA, Beijing 100853, China.
OBJECTIVE: To explore the effects of Ca2+ antagonist on apoptosis of cardiomyocytes after myocardial ischemia. METHODS: The model of myocardial infarction was made by ligating left coronary artery in SD rats. In experimental group, the rats were administrated with Adalat through oral cavity (1 mg/kg) before operation and through peritoneal cavity (0.4 mg/kg 3 hours after operation. In ischemic control group the rats were injected with placebo and in normal control group the rats were treated with sham operation (no ligating left coronary artery) and placebo. The rats were killed 6 hours after operation, with their left ventricular function had been measured. Apoptotic myocardial cells were detected by terminal deoxynucleotidyl transferase mediated dUTP nick end-labeling (TUNEL) method, Fas and Bcl-2 proteins by the ABC immunohistochemistry method. Apoptosis indexes were calculated under high magnification field of microscopy. RESULTS: The systolic pressure, end-diastolic pressure and dp/dt of left ventricle in experiment group were not significant different from those in the ischemic control group, they were 76.7±7.5/8.0±6.1 mm Hg vs. 74.9±11.1/11.6±8.3 mm Hg(P>0.05) and (777.3±128.6)mm Hg/s vs. (761.8±136.4)mm Hg/s (P>0.05) respectively; but those in both the experimental group and the ischemic control group were lower than those in the normal control group, they were 94.9±7.5/2.8±3.2 mm Hg (P<0.001) and (1131.5±112.8)mm Hg/s(P<0.001). There were a lot of positive myocytes with TUNEL stain in the ischemic region of left ventricle in both the experimental and the ischemic control group, apoptosis index in the experimental group was lower than that in the ischemic control group (0.201±0.053 vs. 0.261±0.045， P<0.05). The positive myocytes of Fas and Bcl-2 protein appeared in the region surrounding ischemic myocytes. There were no positive myocytes with the three types of stain in normal control group. CONCLUSION: Ischemia could induce apoptosis of myocytes and expression of Fas and Bcl-2 gene; Ca2+ antagonist could protect myocytes from apoptosis.
, 百拇医药
137-141
Clinical significance of soluble selectins and matrix metalloproteinases-9 in patients after successful cardiopulmonary resuscitation
Li Pei-jie, Yang Xiao-hua, Zhang Li-ping, Cao Wen, Qin Jing, Yao Wei
Second Affiliated Hospital of Lanzhou Medical College, Lanzhou Emergency Center of Gansu Province, Lanzhou 730030, Gansu, China.
OBJECTIVE: To investigate whether patients after successful cardiopulmonary resuscitation (CPR) exist elevated levels of soluble P-and E-selectin (sP-selectin, sE-selectin), matrix metalloproteinases-9 (MMP-9) and to evaluate the clinical significance of changes in these cytokine levels. METHODS: Plasma levels of sP-and sE-selectin, MMP-9 of 82 patients who survived ≥48 hours after CPR were determined on the second day after successful CPR. They were classified into different groups according to whether causing systemic inflammatory response syndrome (SIRS) and developing sepsis. Sixty-five non-critically ill patients were served as control group. RESULTS: Incidence of SIRS was 68.3% (56/82 cases) after successful CPR. Plasma levels of sP-selectin were higher in patients with SIRS compared with those in patients without SIRS or control group (all P<0.01). Plasma levels of sE-selectin and MMP-9 were not significantly different between patients with SIRS and without SIRS (all P>0.05), but were higher in both patient groups than those in the control group (all P<0.01) 43.9% of the patients developed sepsis within 1 week after CPR. Plasma levels of sP-selectin were higher in patients developing sepsis than those in patients without sepsis (P<0.05), but plasma levels of sE-selectin and MMP-9 were not significantly different between two groups (all P>0.05). Plasma levels of sE-selectin and MMP-9 were higher in nonsurvivors than those in survivors (both P<0.01), but plasma levels of sP-selectin were not significantly different between two groups (all P>0.05). CONCLUSION: SIRS is a frequent but unspecific finding after CPR with only minor impact on outcome. Determination of sP-and sE-selectin, MMP-9 early after CPR might help to identify patients at a high risk for sepsis or an adverse, respectively.
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142-147
Effect of β3-adrenoreceptors agonist on β3-adrenoreceptors expression and myocyte apoptosis in a rat model of heart failure
Kong Yi-hui, Li Wei-min, Tian Ying
Department of Cardiology, the First Clinical College of Harbin Medical University, Harbin 150001, Heilongjiang, China.
OBJECTIVE: To evaluate the effects of β3-adrenoreceptor (AR) agonist (BRL-37344) on the expression of β3-AR in a isoproterenol(ISO)-induced heart failure (HF) rat model and to investigate the influence on the levels of β3-AR in failing heart. METHODS: The rats were randomly divided into four groups: I group (control group, n=10); II group (normal with BRL group, n=10); III group (HF group, n=30); IV group (HF with BRL group, n=35).II and IV groups received BRL 0.4 nmol·kg-1·min-1 through caudal vein for 10 minutes twice a week. Iand III groups received saline at the same time. The measure included hemodynamics, the expression of β3-AR in left ventricular myocytes by the techniques of immunohistochemistry, β3-AR proteins by western blot, expression levels of β3-AR mRNA in myocardium by reverse transcription- polymerase chain reaction (RT-PCR) and the levels of apoptotic cells with a terminal deoxynucleotidyl transferase mediated dUTP-biotin nick end labeling(TUNEL) kit. RESULTS: (1)Hemodynamic： The tendency of left ventricular end systolic pressure (PES)， maximal rates of rise of ventricular pressure(dp/dtmax)， maximal rates of decline of ventricular pressure(dp/dtmin) in II, III and IV groups were lower (P<0.01)， time constant of left ventricular relaxation(Tc) and left ventricular end diastolic pressure (PED) were higher than those of the I group (all P<0.01). There was no difference between I and II group except PED (P<0.05). Compared with III group, PES， dp/dtmax, dp/dtmin in IV group were dramatically decline (P<0.05)； Tc, PED were markedly increased (Tc P<0.05，PED P<0.01). (2)The levels of β3-AR mRNA and β3-AR proteins were higher in III and IV groups when compared with I and II groups. There was no difference between I and II group. IV group’s levels were higher than III group’s. (3)The apoptotic rates in III group and IV group were significantly higher than those in I and II group (all P<0.01). When compared with III group’s apoptotic cell rate, IV group’s was higher(P<0.01). CONCLUSION: The levels of β3-AR mRNA and proteins show an increase in failing heart compared with nonfailing heart. The effect of β3-AR agonist aggravate markedly cardiac function and stimulate cardiac myocytes apoptosis in failing heart. If the levels of β3-AR were too high, they might contribute to the loss of cardiac function and be the foundation of the functional degradation of HF.
, 百拇医药
148-150
Clinical features and treatment of cardiogenic shock complicated with acute myocardial infarction
Zhao Yu-sheng, Wang Shi-wen， Lu Cai-yi, Wu Xing-li, Li Yu-feng, Liu Ling-ling, Yan Mu-yang, Cheng Rui
Institute of Geriatric Cardiology, General Hospital of Chinese PLA, Beijing 100853, China.
OBJECTIVE: To identify the clinical features and the outcome of patients with cardiogenic shock complicating acute myocardial infarction (AMI). METHODS: One hundred and eight consecutive patients with AMI were included in this retrospective analysis. The characteristics, management, and outcome of patients with AMI were compared between patients with cardiogenic shock (group A, n=11) and without cardiogenic shock (group B, n=9). RESULTS: There was no difference in the age and other characteristics including proportion of women, diabetics, prior myocardial infarction and the position of myocardial infarction. The levels of peak creatine kinase and troponin I were (31979.7±22271.1)nmol·s-1·L-1 and (90.7±61.1)μg/L respectively in group A, they were higher than those in group B (17795.2±14979.7)nmol·s-1·L-1 and (39.9±52.1)μg/L, respectively (both P<0.05). The left ventricular ejection fraction was significantly lower in group A than that in group B (0.46±0.12 vs. 0.55±0.12, P<0.05). Patients in group A had a higher proportion of pump failure, arrhythmia and pneumonia (64% vs. 14%, P<0.001; 55% vs. 21 %, P<0.05; and 46% vs. 12%, P<0.01, respectively) than those in group B. In addition, in group A patients often underwent thrombolysis of urokinase, coronary angiography and intra-aortic balloon counterpulsation (46% vs. 18%, 73% vs. 26% and 36% vs. 4%, all P<0.05, respectively). There was no difference in in-hospital mortality between group A and group B (0 vs. 4%, P>0.05). CONCLUSION: Shock patients more likely have pump failure, arrhythmia, and pneumonia and more often underwent intra-aortic balloon counterpulsation. If cardiogenic shock complicating AMI is managed with rapid evaluation and prompt initiation of supportive measures and definitive therapy, outcomes can be improved.
, 百拇医药
151-154
Study on changes of neuron apoptosis after focal cerebral ischemia/reperfusion in the aged rats
Li Jian-sheng, Ren Xiao-qiao, Liu Ke, Liu Zheng-guo, Kong Ling-fei
Geriatrics Department of Henan College of Traditional Chinese Medicine, Zhengzhou 450003, Henan, China.
OBJECTIVE: To study ultrastructured change and neuron apoptosis after focal cerebral ischemia/reperfusion (I/R) in the aged rats. METHODS: The aged SD rats (20-21 months) and the young (4-5 months) were subjected to 3 hours of middle cerebral artery occulsion with the intraluminal filament technique, followed by reperfusion for 3 hours, 6 hours, 12 hours, 24 hours, 72 hours. The ultrastructure of brain, infarct zone and neuron apoptosis were observed. RESULTS: The cerebral infarct zone increased in the aged rats with ischemia for 3 hours and I/R for 12 hours compared with those in the young. The brain injury was obviously deteriorated with I/R time longer, which was serious in the aged than that in the young. The neuron apoptosis increase with I/R time longer, and showed earlier and lasted longer in the aged. CONCLUSION: The cerebral injury is serious and neuron apoptosis increase shows early and lasts longer.
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155-157
Therapeutic assessment between the thrombolysis in 6 hours and delayed thrombolysis after onset of acute myocardial infarction
Ren Hai-bin, Zhong Yong-gen
Heyuan People's Hospital, Heyuan 517000, Guangdong, China.
OBJECTIVE: To explore the effect of different starting time of thrombolysis on acute myocardial infarction (AMI). METHODS: Ninety-five patients of AMI were divided into prompt thrombolysis group (less then 6 h, 46 patients) and delayed thrombolysis group (6-12 hours, 49 patients), according to the different starting time of treating AMI. The incidences of reopening and side-effect, as well as mortality were compared between two groups. RESULTS: The reopening rate and mortality in prompt thrombolysis group were 76% and 4%, respectively. The reopening rate and mortality in delayed thrombolysis group were 49% and 12%, respectively. Compared the prompt thrombolysis group with the delayed thrombolysis group, there was a significance discrepancy (both P<0.01). The side-effect rate had not significant discrepancy (15% vs. 16%, P>0.05). CONCLUSION: The clinical reopening rate of the thrombolysis is higher in patients with thrombolysis less than 6 hours, the mortality is lower. The thrombolytic treatment should be prompt for patients adapting thrombolysis.
, 百拇医药
157
The investigation of the effect of prostaglandin E1 on indications of in flammation reaction in patients with coronary artery syndrome
Cai Jin-ying, Zhai Gui-lan, Gao Wei, Wang Qing-ru, Zhao Li-yan, Chen Ying, Sun Yang-ling, Sun Yu
The first affiliated Hospital, Jinzhou medical College, Jinzhou 121000, China.
158-160
Effects of adenosine preconditioning on cardiac myocyte apoptosis and expression of nuclear factor-κB in ischemia/reperfusion rats
, http://www.100md.com
Zhang Liang-qing, Xu Jun-fa, Cai Kang-rong, Li Li-zhi
Department of Anesthesiology, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524001, Guangdong, China.
OBJECTIVE: To investigate the effect of adenosine preconditioning on cardiac myocyte apoptosis and the expression of nuclear factor-κB (NF-κB)during myocardial ischemia/reperfusion (I/R) in rats. METHODS: A model of I/R injury (I/R group) and pretreatment with adenosine (AP group) was reproduced in rats. The morphologic features of apoptosis were identified histochemically by TdT-mediated dUTP nick end (TUNEL) staining. Expression of NF-κB in apoptosis myocardiac cells was observed by immunohistochemical stain and image analysis. RESULTS: The percentage of cardiac myocyte apptosis and the expression of NF-κB in AP group were (2635.0±316.0)% and (33.21±16.91)%, they were significantly lower than those in I/R group (5013.0±503.7)% and (59.30±10.36)% respectively(P<0.05 or P<0.01), but higher than those in control group (68.7±50.3)% and (10.98±4.65)% respectively (both P<0.01). CONCLUSION: Adenosine preconditioning can pretect from myocardial I/R injury and relieve cardiac myocyte apoptosis and expression of NF-κB.
, 百拇医药
161-164
Relationship between polymorphisms of cystathionine beta-synthase gene and stroke
Fang Le, Wu Wei, Wu Ying-quan
Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun 130031, Jilin, China.
OBJECTIVE: To determine whether the T27796C mutation in cystathionine beta-synthase (CBS) gene is associated with stroke in Chinese. METHODS: The T27796C mutation in CBS gene of 59 cases with stroke and 65 health controls were detected by polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP). RESULTS: As this investigation shown, the frequencies of two alleles of T27796C mutation were followed: C was 56.8%, T was 43.2% in cases and C was 51.5%, T was 48.5% in controls. T27796C mutation had no obvious relativity to the stroke (P>0.05). There was no significant difference in frequency of alleles of this mutation between cases and controls (CC: 35.6% vs. 24.6%; CT: 42.4% vs. 53.8%; TT: 22.0% vs. 21.5%; all P>0.05). There was not obvious difference in frequency of alleles of this mutation between hemorrhagic patients and ischemic stroke patients (all P>0.05). CONCLUSION: T27796C mutation in CBS is not obviously correlated with stroke and this mutation is not associated with categories of stroke.
, 百拇医药
164
Comparison analysis between two kinds of sublingual capoten and intrarensous urapidil on treatment for hypertension emergency
Yang Ze-min, Li Ning-rong, Zhu Xiao-ling
Meilin Hospital, Shenzhen 518049, Guangdong, China.
165-168
Clinical significance of plasma free 15-F2t-isoprostane concentration during coronary artery bypasses graft surgery
, 百拇医药
Huang Zhi-yong, Xia Zheng-yuan, David M.Ansley， Baljinder S.Dhaliwal
Department of Anesthesia, Shenzhen Sun Yat-Sen Cardiovascular Hospital, Shenzhen 518000, Guangdong, China.
OBJECTIVE: To analyse retrospectively the variation of plasma 15-F2t-isoprostane concentration during cardiac surgery and the relation with early myocardial dysfunction following normothemic cardiac surgery. METHODS: Thirty patients scheduled for coronary artery bypass graft surgery using normothermic cardiopulmonary bypass (CPB) and warm intermittent blood, crystalloid cardioplegia were enrolled. Patients were divided into two groups treated with (group II) or without (group I) positive inotropic drugs. Central venous blood was sampled at baseline, 30 minutes after global myocardial ischemia, 10, 30 and 120 minutes after aortic declamping (reperfusion). Plasma free 15-F2t-isoprostane was measured with enzyme immunoassay (EIA) using a highly specific rabbit 15-F2t-isoprostane antibody. Cardiac index (CI) was monitored intraoperatively and up to 6 hours following surgery. RESULTS: Plasma free 15-F2t-isoprostane increased significantly during ischemia, remained elevating at 10 minutes after reperfusion (P<0.05 vs. baseline) and began to decline at 30 minutes after reperfusion in the whole population. 15-F2t-isoprostane underwent exponential decay and returned to baseline at 30 minutes after reperfusion in groupⅠ that did not need any postoperative inotropic support. In contrast, 15-F2t-isoprostane further increased upon reperfusion and remained significantly higher than baseline at 30 minutes after reperfusion (P<0.05) in group II that needed two or more inotropes to maintain CI greater than 2.2 L·min-1·m-2. Postoperative CI was significantly inversely correlated with the percentage change in plasma free 15-F2t-isoprostane concentration from 10 to 30 minutes after reperfusion (r=-0.95, P<0.01). CONCLUSION: It shows a close relationship between free plasma concentrations of 15-F2t-isoprostane and early postoperative cardiac function following coronary artery bypass graft surgery.
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169-171
Study on the reperfusion rate of acute myocardial infarction affected by inspiring nitric oxide and resolving thrombus intravenously before admission
Sun Li-dong, Tang You-lin, Xi Wei-bin, Zhang Nan, Zhang Yin-zhu
Emergency Department, the 155th Hospital of PLA, Kaifeng 475003, Henan, China.
OBJECTIVE: To observe the reperfusion rate of acute myocardial infarction (AMI) affected by inspiring nitric oxide (NO) and resolving thrombus through veins. METHODS: Sixty cases with AMI were randomly divided into test group (n=30) and control groups (n=30). Patients in test group were cured with NO (20±1)mg/L inspiration for 30 minutes at once before admission and urokinase (150×104 U) adding 0.9% sodium chloride intravenously injected within 30 minutes, while patients in control were treated with urokinase as the same method of the test group. RESULTS: The reperfusion and non-reperfusion patients were 25 and 5 cases in test group, and they were 19 and 11 cases in control group. The reperfusion rate of AMI in test group was significantly higher than that in control group 83.3% vs. 63.3% (P<0.05). No peak periods of lactate dehydrogenase (LDH) and creatine phosphokinase (CPK) appeared in test group, and the difference was significant compared to the control group (P<0.05). CONCLUSION: NO inspiration before urokinase is an effective method to treat AMI and advance the reperfusion rate.
, 百拇医药
171
Relationship of tracheal cannula occasion with cardio-pulmonary resuscitation
Zhu Ren-chun, Yang Jian-ping
Xinchang People’s Hospital, Zhejiang 312500, Zhejiang, China.
172-174
Evaluation of operation and anesthesia on hemodynamic variables in patients undergoing elective abdominal surgery by noninvasive thoracic bioimpedance technique
, 百拇医药
Chen Hong, Li Fei, Yang Lei, Yang Peng, Li Jia, Jia Jian-guo, Sun Jia-bangDepartment of General Surgery, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053, China.
OBJECTIVE: To analyse and discuss the effects of elective abdominal operation and anaesthesia on patients' cardiac output via noninvasive thoracic bioimpedance technique. METHODS: Noninvasive monitoring system HeMo-601 was applied to detect the hemodynamic variables of 32 elective abdominal surgery patients.The clinical data of cardiac output(CO), cardiac index(CI), cardiac working per minute(CW), left ventricular end-diastolic pressure(LVEDP), stroke volume(SV), cardiac stroke working(SW)and heart rate (HR) were analysed at 1 hour before operation, 4-6 hours after operation and 24 hours after operation, respectively. RESULTS: No significant differences were found in CO, CI, CW and LVEDP between various time points and preoperation(all P>0.05). SV and SW at 4-6 hours after operation were significant lower than those before operation(all P<0.05). Whereas, SV and SW at 24 hours after operation were no significant differences compared with those before operation(all P>0.05). As compared with preoperation, HR at 4-6 hours after operation was significantly faster(P<0.05). However, there was no significant difference in HR between 24 hours after operation and preoperation (P>0.05). CONCLUSION: The reductions in SV and SW at 4-6 hours after operation might be a result of anaesthesia that could weaken the contraction of heart. The presence of rapidness of HR at 4-6 hours after operation might be a compensatory mechanism for the decreases in SV and SW. Therefore, optimizing adequate infusion by the greatest extent during and after operation is very crucial for the maintenance of CO, CI and tissue perfusion.
, 百拇医药
175-178
Changes of blood-cerebrospinal fluid barrier in rabbits with diabetic ketoacidosis
Zhu Xiao-yun, Gu Xiao-jun, Chang Jia-bao, Zhang Yan, Feng Yan-hong, Yin Guo-qing
The Second Hospital of Nanjing, Medical College of Southeast University, Nanjing 210003, Jiangsu, China.
OBJECTIVE: To explore the mechanism of the changes of blood-cerebrospinal fluid barrier in rabbits with diabetic ketoacidosis (DKA). METHODS: The New Zealand rabbits were injected with 150 mg/kg streptozotion and alloxan monohydrate each (model group, n=6) intravenously, or equal volume of normal saline (control group, n=6). After 72 hours, blood sugar and uric ketone were detected. All of animals were injected with Evans blue (EB). After 6 hours, arterial blood gases were measured and animals were killed. Absorbency of EB of brain tissue was detected. All brains of animals were examined with light and electron microscopy. Marker of blood-cerebrospinal fluid barrier, cytochemical stains of alkaline phosphatase (ALPase) was operated by ultrastructure. The inducible nitric oxide synthase (iNOS) in brain tissue was detected by immunohistochemical method. RESULTS: The models of DKA were established after 72 hours of injecting streptozotion and alloxan monohydrate. Absorbency of EB of model group rabbits was slightly increased, but had no significant difference compared with controls (P>0.05). The brain edema, damages of vessel endothelium and necrosis of neuron were observed through histological and ultrastructure examination in model group. ALPase activity of model group was evidently decreased in brain blood vessel endothelium in comparison with controls. Compared to controls, the iNOS activity of model group was increased and its positive cells were aggregated on blood vessel of brain membrane. CONCLUSION: By streptozotion and alloxan monohydrate inducing DKA models, NO could induce blood-cerebrospinal fluid barrier damages and result in brain edema.
, 百拇医药
179-181
Study on the clinical value of serum cardiac troponin T in early diagnosing of acute non-Q-wave myocardial infarction and prognostic evaluation
Zheng Qun, Wang Wei-zhan, Zhang Ying-xuan, Wang Lan, Zhao Ling-jun
Department of Cardiology, Harrison International Peace Hospital, Hengshui 053000, Hebei, China.
OBJECTIVE: To investigate the value of serum cardiac troponin T (cTnT) in diagnosing earlier acute non-Q-wave myocardial infarction (NQMI) and judging the prognosis. METHODS: Seventy-four NQMI patients and 118 Q-wave myocardial infarction (QMI) patients were studied. Serum cTnT and MB isoenzyme of creatine kinase (CK-MB) levels were monitored on fixed time. On the 15th day of hospitalization, 99 mTc-MIBI myocardial single photon emission computed tomography (SPECT) was performed to assess the infarct size index. Clinical informations of the two groups such as cardiac dysfunction, re-infarction, fatal cadiac arrhythmia, sudden death were collected. RESULTS: The time for serum cTnT beginning to rise was earlier than CK-MB. Its peak time value was paralled to that of CK-MB, and cTnT elevation lasted longer than CK-MB. Serum cTnT and CK-MB peak value showed positive correlation with the infarct size index (both P<0.01). The peak values of cTnT and CK-MB in NQMI group were lower than those in QMI group, and the infarct size was smaller than QMI group (all P<0.05). The frequencies of cardiac events were significantly raised in both groups when there was a high level of serum cTnT. But the proportion in NQMI group was less than those in QMI group (P<0.05). The cardiac events in NQMI group were less than that in QMI group (P<0.05). CONCLUSION: Serum cTnT is an effective marker for diagnosing earlier NQMI, detecting myocardial damage, estimating infarct size and prognosis in the nearly future.
, 百拇医药
182-183
Clinical values of von willebrand factor and C-reactive protein in patients with coronary heart disease
Bai Xiao-yi, Zheng Jin-shi, Liu Mei-xia, Mi Xia
Department of Geriutrics, The people’s Hospital of Hebei Province, Shijiazhuang 050051, Hebei, China.
184-185
ST segment changes of simultaneous 12-lead electrocardiogram in mucocutaneous lymphnode syndrome
, 百拇医药
Wang Cheng, Gao Shou-quan, Li Shu-fen, Xie Zhen-wu, Cao Min-jing, Li Ming-xiang, Qin Yun
Department of Cardiovascular Pediatric, the Second Xiangya Hospital, Central South University, Changsha 410011, China.
185
A report of rescue of multiple organ dysfunetion syndrome after prolonged cardion-pulmonary resuscitation in aged patients with pneumonia
Wang Chang-ming, Zhang Chu-ming, Chen Jie
, 百拇医药
Taizhou’s Municipal Hospital Zhejiang, Zhejiang 318000, Zhejiang, China.
186-187
Serum levels and their clinic significances of neuron-specific enolase and myelin basic protein in palierts with pulmonary encephalopathy
Chen Shao-ping, Chen Xiao-bing, Zhang Guo-yuan, Liu Li-xing
Department of Respiratory disease, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan, China.
, 百拇医药
188-189
Relation of higher blood homocyoteine levels with ischemic cerebrovascular diseases
Han Hui, Jin Yi-min, Fu Jun, Qiao Fang-fang
The second in patient department, the first clinical medical college, Haerbing Medical University, Haerbin 150001, China.
190-191
A report on 10 cases of the prolonged cardiopulmonary resuscitation
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He Guang-hui, Fu Jian-min, Tang Guang-ning, Song Xin-ke
Shihezi People’s Hospital, Xinjiang 832000, China.
192
Clinical application of mechanical ventilation on Neurogenic pulmonary edema following intracranial injury
Tu Chuan-jian, Ma Wei-xing, Liu Jian-sheng, Zhang Yue-jiang, Song Da-jiang, Ma Jun
Department of Neurosurgery, zhejiang shaoxing Fourth Hospital, Zhejiang 312030, China., http://www.100md.com