Objective:To explore the correlation among cardiac troponin I (cTnI),cardiac troponin T (cTnT),crea-tine kinase isoenzyme (CK-MB)levels and range of myocardial infarction in aged patients with acute myocardial in-farction (AMI).Methods:Clinical data of 80 aged AMI patients hospitalized in our internal medicine department from Sep 2012 to Sep 2013 were retrospectively analyzed.Correlation among levels of cTnI,cTnT,CK-MB and range of myocardial infarction were analyzed before and one week after treatment.Results:Compared with before treatment,there were significant reductions in levels of cTnI [(4.63±0.21)μg/L vs.(0.15±0.03)μg/L],cTnT [(0.71±0.05)μg/L vs.(0.17±0.01)μg/L],CK-MB [(40.21±2.13)U/L vs.(23.32±2.11)U/L]and myo-cardial infarction area [(35.25±4.65)mm2 vs.(23.17±3.76)mm2 ]after treatment,P <0.01 all;Pearson cor-relation analysis indicated that cTnI,cTnT and CK-MB were all positively correlated with myocardial infarction area (r =0.99,0.98,0.95,P <0.01 all).Conclusion:Cardiac troponin I,T and creatine kinase isoenzyme are closely related to myocardial infarction range.Combination of these three indexes can be used as important basis for judging myocardial infarction range in patients with myocardial infarction.

OBJECTIVE:To observe the clinical efficacy and safety of different doses of atorvastatin in the treatment of chron-ic subdural hematoma(CSDH). METHODS:One hundred and tweaty-eighie CSDH patients selected from our hospital during Jun. 2013-May 2015 were divided into observation group(n=62)and control group(n=66)in accordance with random number table. Both groups were given conventional treatment of brain cell nutrition. Control group received Atorvastatin tablet 20 mg,po,qd;observation group received Atorvastatin tablet 40 mg,po,qd. Both groups were treated for 6 months. Clinical efficacy,CSS and ADL score,hematoma volume,the levels of serum inflammatory factors (hs-CRP,MMP-9,IL-6,TNF-α) were observed in 2 groups. ADR was recorded during treatment and recurrence rate was also recorded. RESULTS:2 patients withdrew from observa-tion group and 6 from control group. Finally,120 patients met the criteria were included,with 60 cases in each group. Total re-sponse rate of observation group(88.3%)was significantly better than that of control group(73.3%),with statistical significance (P<0.05). After 1,3,6 months of treatment,CSS score,hematoma volume,the serum levels of hs-CRP,MMP-9,IL-6 and TNF-α in 2 groups were significantly decreased,while ADL score was increased significantly;the improvement of above indexes in observation group was significantly better than in control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). The recurrence rate of control group(13.3%)was significantly higher than that of observation group(3.3%),with statistical significance(P<0.05). CONCLUSIONS:Daily dose of shows ator-vastatin 40 mg better therapeutic efficacy and lower recurrence rate in the treatment of CSDH with good safety.

Objective: To explore the correlation among cardiac troponin I (cTnI), cardiac troponin T (cTnT), creatine kinase isoenzyme (CK-MB) levels and range of myocardial infarction in aged patients with acute myocardial infarction (AMI). Methods: Clinical data of 80 aged AMI patients hospitalized in our internal medicine department from Sep 2012 to Sep 2013 were retrospectively analyzed. Correlation among levels of cTnI, cTnT, CK-MB and range of myocardial infarction were analyzed before and one week after treatment. Results: Compared with before treatment, there were significant reductions in levels of cTnI [(4.63±0.21) μg/L vs. (0.15±0.03) μg/L], cTnT[(0.71±0.05) μg/L vs. (0.17±0.01) μg/L], CK-MB [(40.21±2.13) U/L vs. (23.32±2.11) U/L] and myocardial infarction area [(35.25±4.65) mm2 vs. (23.17±3.76)mm2] after treatment, P<0.01 all; Pearson correlation analysis indicated that cTnI, cTnT and CK-MB were all positively correlated with myocardial infarction area (r=0.99, 0.98, 0.95, P<0.01 all). Conclusions: Cardiac troponin I, T and creatine kinase isoenzyme are closely related to myocardial infarction range. Combination of these three indexes can be used as important basis for judging myocardial infarction range in patients with myocardial infarction.

Objective To quantitatively assess the left ventricular systolic dyssynchrony in patients with varied degrees of chronic congestive heart failure after old myocardial infarction(OMI) by real-time three-dimensional echocardiography(RT-3DE) and investigate the clinical value of the systolic dyssynchrony index(SDI). Methods Forty patients with congestive heart failure after OMI (infarction group) were divided into the severe dysfunction group (LVEF ≤35 %) and the mild dysfunction group (35 % ＜ LVEF＜50%) ,and 30 normal subjects served as the control. RT-3DE was performed on all subjects to obtain the 17-segmental time-volumetric curves and global systolic function. SDI changes in above groups and the correlation between SDI and LVEF were analyzed. Results The SDI of the infarction group was significantly higher than that of the normal control group ( P ＜0. 01 ). The SDI of the severe dysfunction group was significantly higher than that of the mild group (P＜0.01). SDI and LVEF were negatively correlated ( r = -0.84, P ＜0. 01 ). The dyssynchrony rate in the infarction group was 85 %,in the severe dysfunction group was 100%, in the mild group was 75%. Conclusions Left ventricular systolic dyssynchrony is prevalent in patients with OMI, and it is negatively correlated with the LVEF. SDI is a sensitive indicator in assessing left ventricular systolic dyssynchrony. RT-3DE has a unique advantage in the evaluation of the left ventricular systolic dyssynchrony,especially in the patients with myocardial infarction.

Brown-Sequard Syndrome ; etiology ; Cervical Vertebrae ; Humans ; Intervertebral Disc Displacement ; complications ; surgery ; Male ; Middle Aged

Objective To create a three-dimensional speckle tracking imaging (3DSTI) multiparameter analysis model to improve the diagnostic efficiency of obstructive coronary artery stenosis.Methods One hundred and four patients with chest pain were divided into two groups:coronary heart disease(CHD) group (61 patients) and control group (43 patients) according to the result of selective coronary angiography (SCA).The two groups' clinical data and echocardiographic parameters were aquired,including mitral flow E and A velocities,E peak deceleration time,isovolumic relaxation time (IVRT),mitral annulus velocity e' and a' peak in diastolic and s' peak in systolic by tissue Doppler imaging (TDI),and left ventricular ejection fraction (LVEF).The global longitudinal peak strain (2D-GLPS) by two dimensional speckle tracking,global longitudinal peak strain (3D-GLPS),circumferential peak strain(3D-GCPS),radial peak strain (3D-GRPS) and area peak strain (3D-GAPS) were acquired.Results For conventional parameters,there were no significant difference between the two groups.Compared with control group,TDI e' peak,3D-GRPS decreased,significantly E/e',2D-GLPS,3D-GLPS,3D-GAPS,3D-GCPS increased significantly (P ＜0.01).For single parameter,area under the ROC curve (AUC) were successively 3D-GAPS(0.766) ＞ 3D-GLPS(0.746) ＞ 2D-GLPS(0.746) ＞3D-GRPS(0.727) ＞ s' (0.703) ＞E/e' (0.688)＞3D-GCPS(0.686).AUC for single and multi technology were successively p-Union(0.856)＞p-3DSTI(0.772) ＞ p-TDI (0.757) ＞ p-2DSTI (0.746).Conclusions 3DSTI together with multi-parameter analysis model can significantly improve the diagnostic efficiency of obstructive coronary artery stenosis.Area strain is an independent predictor of obstructive coronary artery stenosis.

Objective To evaluate the changes of left atrial (LA)functions in patients with constrictive pericarditis (CP)after pericardiectomy by two-dimensional speckle tracking echocardiography (STE).Methods A total of 41 patients with CP underwent echocardiography before and after pericardiectomy.The procedure was performed to obtain global LA longitudinal strain,the septal and lateral walls'longitudinal strain,including peak negative strain (NS),peak positive strain (PS),and total strain (TS),using speckle tracking echocardiography.Thirty-five healthy volunteers were recruited as controls. Results After pericardiectomy,global LA peak negative strain and total strain of CP increased significantly (P <0.005).There were no obvious changes in global LA peak positive strain (P >0.05).And three components of LA longitudinal strain were still lower than normal (P <0.005).LA lateral wall's total strain,peak positive strain and peak negative strain improved apparently after pericardiectomy (P <0.005),only peak negative strain increased in LA septum (P < 0.01 ).Conclusions In the early postoperative period,LA reservoir and contractile function presented significant improvements,even notable in the lateral area when compared with septum.However,all three parts of LA function were still lower than normal.STE can regionally estimate LA functions in patients with CP after pericardiectomy.

Objective To assess the clinical value of three-dimensional speckle tracking imaging (3D-STI) in detecting left ventricular systolic function in patients with paroxysmal atrial fibrillation (PAF).Methods 34 patients with PAF and 34 matched subjects were included.The strains of the left ventricular 17 segments (longitudinal and radial strain) were acquired using 3D-STI.Results Compared with the controls,the strains were decreased in the posterior wall,the inferior wall and the posterior septum below the left ventricular papillary muscle level in the PAF group,the differences were statistically significant (P ＜ 0.05),while there were no significant differences in other segments (P ＞ 0.05).Conclusions Left ventricular systolic function in patients with PAF was decreased,but the decreased degree of the segments was not all the same.3D-STI can evaluate left ventricular systolic function in patients with PAF and provide valuable clinical information.

Objective To evaluate the performance of ELISA by detecting low quantitative HBsAg in serums.Methods 305 serum samples that the quantitation range was from 0.05 IU/ml to 9.99 IU/ml were collected,and then detected by ELISA. Results The rate of patients with low quantitation of HBsAg was 18.12% in patients with positive HBsAg.The total de-tected rate of ELISA was 87.87%,and the rate of 0.05~0.11,0.12~0.20,0.21 ~0.50,0.51 ~ 1.00,1.01~5.00 IU/ml and 5.01~9.99IU/ml were 36.00%,61.11%,78.38%,84.62%,99.11% and 100.00%,respectively.The differences were statistically significant between the detected rates of each group(χ2 =99.84,P =0.000).There was high correlation coeffi-cient between the results detected by ELISA and by CMIA(r = 0.874,P = 0.000).Conclusion The clinical laboratory should be careful to apply the method of ELISA to detect HBsAg for its missing detection in samples with low quantitation of HBsAg.

Educational reform of pathophysiology oriented to clinical application is to pass the physician qualifica -tion examination .One of essential approach is to implement pathophysiology teaching with the translational medical philosophy and promote the harmonious development of physician -patient relationship with the utilization of the de-velopment and changes of disease in the teaching process .In that way, the pathophysiology in basic and clinical medicine is worthy of the name of “bridge”, and ultimately achieves the goal of “the transformation and develop-ment of the cultivation of clinical application talents”.