Cardioprotective effects of sinomenine in myocardial ischemia/reperfusion injury in a rat model

BackgroundIschemia reperfusion (I/R) play an imperative role in the expansion of cardiovascular disease. Sinomenine (SM) has been exhibited to possess antioxidant, anticancer, anti-inflammatory, antiviral and anticarcinogenic properties. The aim of the study was scrutinized the cardioprotective effect of SM against I/R injury in rat.MethodsRat were randomly divided into normal control (NC), I/R control and I/R + SM (5, 10 and 20 mg/kg), respectively. Ventricular arrhythmias, body weight and heart weight were estimated. Antioxidant, inflammatory cytokines, inflammatory mediators and plasmin system indicator were accessed.ResultsPre-treated SM group rats exhibited the reduction in the duration and incidence of ventricular fibrillation, ventricular ectopic beat (VEB) and ventricular tachycardia along with suppression of arrhythmia score during the ischemia (30 and 120 min). SM treated rats significantly (P < 0.001) altered the level of antioxidant parameters. SM treatment significantly (P < 0.001) repressed the level of creatine kinase MB (CK-MB), creatine kinase (CK) and troponin I (Tnl). SM treated rats significantly (P < 0.001) repressed the tissue factor (TF), thromboxane B2 (TXB2), plasminogen activator inhibitor 1 (PAI-1) and plasma fibrinogen (Fbg) and inflammatory cytokines and inflammatory mediators.ConclusionOur result clearly indicated that SM plays anti-arrhythmia effect in I/R injury in the rats via alteration of oxidative stress and inflammatory reaction.     

冠心病不稳定型心绞痛患者C-反应蛋白临床意义

目的探讨冠心病不稳定型心绞痛患者血清C一反应蛋白（CRP）、血清肌钙蛋白（Tn—T）、血清肌酸激酶同工酶（CK—MB）升高程度及升高程度与冠状动脉狭窄程度、病变支数的关系。方法测定115例冠心病不稳定型心绞痛患者血清CRP、Tn—T、CK—MB,冠状动脉造影了解冠状动脉狭窄程度及病变支数,并与110例非冠心病患者作对比研究。结果冠心病不稳定型心绞痛患者C一反应蛋白越高,冠状动脉狭窄程度越重、病变支数越多,非冠心病患者未见升高,两组比较差异具有统计学意义（P〈0．01）;Tn—T、CK—MB比较差异无统计学意义（P〉0．05）。结论C-反应蛋白是不稳定型心绞痛的独立危险因子,并与病变程度呈正相关。     

Influenza vaccine effectiveness to prevent influenza-related hospitalizations and serious outcomes in Canadian adults over the 2011/12 through 2013/14 influenza seasons: A pooled analysis from the Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS Network)

BackgroundOngoing assessment of influenza vaccine effectiveness (VE) is critical to inform public health policy. This study aimed to determine the VE of trivalent influenza vaccine (TIV) for preventing influenza-related hospitalizations and other serious outcomes over three consecutive influenza seasons.MethodsThe Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN) conducted active surveillance for influenza in adults ≥16 years (y) of age during the 2011/2012, 2012/2013 and 2013/2014 seasons in hospitals across Canada. A test-negative design was employed: cases were polymerase chain reaction (PCR)-positive for influenza; controls were PCR-negative for influenza and were matched to cases by date, admission site, and age (≥65 y or <65 y). All cases and controls had demographic and clinical characteristics (including influenza immunization status) obtained from the medical record. VE was estimated as 1-OR (odds ratio) in vaccinated vs. unvaccinated patients × 100%. The primary outcome was VE of TIV for preventing laboratory-confirmed influenza-related hospitalization; secondary outcomes included VE of TIV for preventing influenza-related intensive care unit (ICU) admission/mechanical ventilation, and influenza-related death.ResultsOverall, 3394 cases and 4560 controls were enrolled; 2078 (61.2%) cases and 2939 (64.5%) controls were ≥65 y. Overall matched, adjusted VE was 41.7% (95% Confidence Interval (CI): 34.4–48.3%); corresponding VE in adults ≥65 y was 39.3% (95% CI: 29.4–47.8%) and 48.0% (95% CI: 37.5–56.7%) in adults <65 y, respectively. VE for preventing influenza-related ICU admission/mechanical ventilation in all ages was 54.1% (95% CI: 39.8–65.0%); in adults ≥65 y, VE for preventing influenza-related death was 74.5% (95% CI: 44.0–88.4%).ConclusionsWhile effectiveness of TIV to prevent serious outcomes varies year to year, we demonstrate a statistically significant and clinically important TIV VE for preventing hospitalization and other serious outcomes over three seasons. Public health messaging should highlight the overall benefit of influenza vaccines over time while acknowledging year to year variability.ClinicalTrials.gov Identifier: NCT01517191.     

急性心肌梗死时血清心脏肌钙蛋白Ⅰ的测定及临床意义

目的：测定急性心肌梗死（AMI）病人血清肌钙蛋白I（cTnI)和肌酸激酶同功酶（CK－MB）水平,以探讨其诊断AMI价值。方法：采用微粒子化学发光法,对21例AMI患,30例陈旧性心肌梗死患（OMI）和21例健康（对照组）进行血清cTnI,CK-MB测定,并对AMI患胸痛发生3－6小时,2天,3－6天,7－10天,11－14天共五个时段了测定。结果：AMI患发病早期cTnI,CK-MB阳性率均为90．5％,特异性分别为100％,78．4％,二比较有显差异（P＜0．01）。AMI患中各项指标的动态测定显示：在AMI发生早期,cTnI和CK－MB都有显升高,AMI 2天内cTnI和CK－MB阳性率分别为95．2％,90．5％。随时间推移而逐渐下降,3－6天,cTnI阳性率仍达90．5％,而后已按近正常,11－14天时血清中仍有cTnI的持续存在。结论：cTnI对诊断AMI具有高度特异性和敏感性,且诊断窗口时间较长,血清cTnI检测优于CK－MB。     

中药穴位敷贴对小鼠实验性病毒性心肌炎的疗效观察

为研究中药穴位敷贴治疗病毒性心肌炎的疗效，将小鼠以CVB3病毒感染制成病毒性心肌炎模型后，随机分为对照组与治疗组。治疗组用中药（黄芪、沙参、党参、丹参、冰片）穴位敷贴，对照组不加以治疗，30d后分别观察小鼠心肌组织病理学改变和超微结构改变并检测血清中CK－MB含量。结果：治疗组小鼠心肌组织病理改变及超微结构改变均较对照组减轻，血清CK－MB含量明显低于对照组（P＜0．05）。提示中药穴位敷贴对病毒性心肌炎有一定疗效。     

The baby MB case: medical decision making in the context of uncertain infant suffering

The recent MB case involved a dispute between an infant's parents and his medical team about the appropriateness of continued life support. The dispute reflected uncertainty about two key factors that inform medical decision making for seriously ill infants: both the amount of pain MB experiences and the extent of his cognitive capacities are uncertain. Uncertainty of this order makes decision making in accordance with the best-interests principle very problematic. This article addresses two of the problems that cases such as that of MB pose for those charged with making medical decisions for infants. First, the question of the moral significance of the interest in avoiding pain is considered. It is claimed that this interest can be outweighed by higher-order interests such as those related to autonomy but that where such higher-order interests do not exist, the interest in avoiding pain should be prioritised. Second, the question of how to proceed in cases in which the level of pain or the extent of an infant's higher-order interests cannot be decisively established is considered. It is suggested that when genuine uncertainty over the interests of an infant exists, parental views about treatment should prevail.     

Clinical significance of incomplete tricuspid valve closure seen on two-dimensional echocardiography

Incomplete closure of the tricuspid valve without apparent cusp disease was noted on two-dimensional echocardiography in 31 patients. This abnormality was defined as a failure of the tricuspid valve leaflet tips to reach the plane of the tricuspid valve anulus by at least 1 cm in the standard apical four chamber view at the point of maximal systolic closure. This resulted in a final systolic leaflet position deeper within the right ventricular cavity than is normally seen. The finding was present in the following diagnostic subgroups: Group A, pulmonary hypertension (11 patients); Group B, rheumatic heart disease (4 patients); Group C, dilated cardiomyopathy (9 patients) and Group D, previous myocardial infarction (7 patients). Right atrial, right ventricular and tricuspid anulus measurements were made and compared with those from a group of 67 normal subjects. The results were as follows: right atrial endsystolic area = 27.2 +/- 8.6 cm2 (normal = 13.4 +/- 2.0); right ventricular end-systolic area = 25.6 +/- 8.7 cm2 (normal = 10.9 +/- 2.9); right ventricular end-diastolic area = 31.5 +/- 9.1 cm2 (normal = 20.1 +/- 4.9) and tricuspid valve anular end-systolic dimension = 4.0 +/- 0.6 cm (normal = 2.2 +/- 0.3). The differences from the normal data were all statistically significant (p less than 0.001). Incomplete closure of the tricuspid valve, although a nonspecific diagnostic finding, is primarily associated with right-sided chamber enlargement. Tricuspid regurgitation may be present. The mechanism could be related to geometric changes in valve apparatus dynamics secondary to right-sided cardiac enlargement and tricuspid valve anular dilation.(ABSTRACT TRUNCATED AT 250 WORDS)     

IMA、hs-CRP、MYO、CK-MB、hs-cTnT 联合检测在急性冠脉综合症诊断中的价值比较

目的：探讨血清中缺血个儿蛋白（IMA）、超敏 C 反应蛋白（hs-CRP）、肌红蛋白（MYO）、肌酸激酶同工酶（CK-MB）、超敏肌钙蛋白（hs-cTnT）在急性冠状动脉综合征（ACS）患者早期诊断的价值。方法测定99例健康对照组和94例 ACS 患者（其中不稳定性心绞痛40例,非 ST 段抬高的心肌梗死即非 Q 波心肌梗死20例,ST 段抬高的心肌梗死即 Q 波心肌梗死34例）中IMA、hs-CRP、MYO、CK-MB、hs-TNT 的含量。通过 ROC 曲线比较5种标志物在 ACS 早期诊断中的诊断效率、灵敏度、特异性、阴阳性预测值。结果血清中 IAM、hs-CRP、MYO、CK-MB、hs-cTnT 检测结果在病例组 UAP,NSTEMI,STEMI 3组和正常对照组间比较,差异均有统计学意义（P ＜0．05）。其中 IMA、hs-CRP、MYO、CK-MB、hs-cTnT 在 UAP 与 NSTEMI 组,UAP 与NSTEMI 组间比较,差异均有统计学意义（P ＜0．05）,NSTEMI 与 STEMI 组间比较,差异均无统计学意义（P ＞0．05）。结论在ACS 中,多个指标的联合检测能取得早期诊断的价值。