Objective:To explore the clinical significance detecting adrenomedullin (ADM)and high sensitive C reac-tive protein (hsCRP)in patients with acute coronary syndrome (ACS).Methods:A total of 51 inpatients,which were eliminated for coronary heart disease (CHD)by coronary angiography (CAG),were enrolled as non CHD group,and 124 ACS patients diagnosed by CAG were regarded as ACS group.ADM and hsCRP concentrations were measured before and after CAG in non CHD group and before and after percutaneous coronary intervention (PCI) in ACS group,and they were compared between two groups.Results:Before CAG/PCI,compared with non CHD group,ADM [(28.7±1.6)pg/ml vs.(36.7±2.5)pg/ml]and hsCRP [(4.74±3.21)mg/L vs.(27.65±11.76) mg/L]levels significantly rose in ACS group,P<0.05 or <0.01.Compared with before PCI,there were signifi-cant increase in levels of ADM [(36.7±2.5)pg/ml vs.(47.1±5.3)pg/ml]and hsCRP [(27.65±11.76)mg/L vs.(39.53±4.83)mg/L]in ACS group after PCI,P<0.01 both,and significantly higher than those of non CHD group (P<0.05~<0.01).There were no significant difference in ADM and hsCRP levels in non CHD group be-tween before and after CAG (P>0.05 all).Conclusion:Detecting arenomedullin combined high sensitive C-reac-tive protein is gelpful to early diagnosis and evaluating lesion severity for acute coronary syndrome.

BACKGROUND: There are some cytokines like interleukin-6, tumor necrosis factor-alpha as well as neurohormones such as norepinerphrine in serum of patients with congestive heart failure. However, whether they influence the occurrence and development of congestive heart failure is uncertain.OBJECTIVE: To explore the changes and significance of interleukin-6,tumor necrosis factor-alpha and norepinerphrine in order to provide basis for assessing the severity of heart failure and its prognosis.DESIGN: A case control study.SETTING: Department of Cardiology, Shidong Hospital of Shanghai City.INTERVENTIONS: A total of 58 patients with congestive heart failure admitted to Department of Cardiology, Shidong Hospital of Shanghai City from January 2000 to October 2001 were chosen as patient group with 33 males and 25 females. According to NYHA heart function classification,there were 12 cases of level Ⅱ, 32 cases with level Ⅲ and 14 cases of level Ⅳ. Thirty healthy volunteers who took physical examination during the same time were chosen as control group with 18 males and 12 females.ELISA was used to assay the levels of interleukin-6, tumor necrosis factoralpha and norepinerphrine in serum while two-dimension echocardiography was used to test the left ventricular ejection fraction in order to observe the relationship between cytokines and heart function.RESULTS: ① The levels of interleukin-6 [(367.6±78.6), (569.7±117.3)ng/L], tumor necrosis factor-alpha [(395.3±82.4), (583.1±124.8) ng/L] and norepinerphrine [(396.5±85.3),(675.9±136.2) ng/L] in patients with level Ⅰ-Ⅱ, Ⅳ heart function was remarkably higher than those of patients with level Ⅱ heart function and people in control group[(221.5±58.4), (170.2±42.7)ng/L; (205.4±59.2), (180.3±43.8) ng/L; (227.4±65.6),(163.8±41.5) ng/L] (P ＜ 0.05). Compared patients of level Ⅱ heart function with people in the control group, there was no difference on the above indicators (P ＞ 0.05).②There was highly negative correlation between interleukin-6, tumor necrosis factor-alpha, norepinerphrine and left ventricular ejection fraction (r=-0.63, P＜ 0.01; r=-0.54, P＜ 0.05;r=-0.58,P ＜ 0.01). The more severe the heart failure, the higher the levels of interleukin-6, tumor necrosis factor-alpha and norepinerphrine. There was obviously positive correlation between tumor necrosis factor-alpha and norepinerphrine as well as between interleukin-6 and norepinerphrine (r=0.57,P ＜ 0.01;r=0.51,P ＜ 0.05). The more severe the heart failure, the higher the level of interleukin-6 and tumor necrosis factor-alpha and that there was positive correlation between them (r=0.39, P ＜ 0.05).CONCLUSION: The tumor necrosis factor-alpha and interleukin-6 levels in patients with congestive heart failure all increased, especially in patients with moderate or severe congestive heart failure, and represented negative correlation with left ventricular ejection fraction. It suggests that the levels of interleukin-6, tumor necrosis factor-alpha in serum can be used as indicators to assess the severity and prognosis of congestive heart failure and provide assessment basis for quantitative evaluation of rehabilitation interventions.

H type hypertension is essential hypertension complicated elevated plasma homocysteine level ,which ac-counts for about 75% in Chinese adults with hypertension and is closely related to cerebral stroke and other cardio-vascular diseases .Lowering homocysteine level in patients with hypertension possesses important significance for preventing stroke .

Coronary microcirculation regulates coronary blood flow volume via systolic and diastolic function and af—fects myocardial perfusion ,which possesses deep influence on prognosis of patients with coronary heart disease and cardiomyopathy .Along with developments of recent noninvasive and invasive techniques , continuous updates of medication area ,understanding of coronary microvascular dysfunction keeps going deeper .The present article made following review on new research progress of coronary microvascular dysfunction .