Objective To explore the diagnostic value of serum myoglobin (Mb) and cardiac troponin (cTn) in patients with acute myocardial infarction (AMI) by reviewing and evaluating the corresponding references with evidence-based medicine (EBM) theory.Methods All references (including papers,reviews and abstracts) of CNKI-CHKD,CMCC(1994-2005)and EMCC(1995-2005) were collected and retrospectively analyzed according to evidence based medicine (EBM) standard,with Mb cTn as the detected indices for diagnosing AMI.Results In the searched period of 1994-2005,123 papers were published (93 pieces were written in Chinese,and 30 were written in English). In most references,the authors set clinical control trial (CCT) (Chinese: 92.5%;English: 53.3%),blind control trial (Chinese: 19.4%;English: 10.0%) and/or random control trial (RCT) (Chinese: 9.7%;English: 16.7%). The respective reference ranges weren′t provided in 42 pieces of articles.Conclusion The analytic result of the references in home and aborad indicates combined detection of Mb and cTnI posseses favourite sensitivity and specificity,which contributes to the early diagnosis of acute myocardial infarction.

Objective To explore the clinical manifestation of systemic lupus erythematosus (SLE) complicated with Pneumocystis carinii pneumonia (PCP).Methods Retrospective analysis of the clinical data of two cases of SLE complicated with PCP.Results The two patients were both aged 31 years and have had SLE disease for 4 and 7 years respectively.Both had lupus nephritis and were previously treated with high dose corticosteroid and cyclophosphadmide.Both patients had ceased immunosuppressive drug treatment for 6 and 12 months respectively at the time of diagnosis of PCP infection.Both patients presented with acute fever with dry cough,shortness of breath at rest,progressive hypoxia and diffuse reticular shadows on chest X ray. Pneumocystis carinii were identified in the bronchoalveolar lavage fluid (BAF) in both cases.SMZ was used to treat the PCP infection.The first patient recovered with improvement in her clinical well being and chest X ray appearance,while the second failed to respond and eventually succumbed.Conclusion One should be alert to the occurrence of PCP when patients with SLE present with rapidly progressive hypoxemia and type I respiratory failure.The mortality rate is high in SLE patients complicated with PCP and early diagnosis and treatment are the key to improving survial in these patients.Recurrence of PCP is common and adequate duration of treatment is essential.