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 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.

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 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.

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

Objective To explore the clinical efficacy of knee osteoarthritis treated by abdominal acupuncture combined with sodium hyaluronate injected in intraarticular.Methods 120 patients with knee osteoarthritis were randomly divided into observation group and control group,60 patients in each group.The observation group was treated by abdominal acupuncture combined with sodium hyaluronate injected in intraarticular.The control group was treated with intraarticular injection of sodium hyaluronate alone.Results After a follow up of 6 months, the total effective rate of the treatment group was 95.00%,which was higher than 78.33% of the control group, the difference was statistically significant (x2=7.21,P<0.01).Conclusion Abdominal acupuncture combined with intraarticular injection of sodium hyaluronate is a good way to treat middle and old age patients with knee osteoarthritis.

Objective To evaluate the usefulness of speckle tracking imaging(STI) for assessment of left ventricular(LV) and right ventricular (RV) functions in patients with isolated disease of right coronary artery.Methods 45 cases were diagnosed as single right coronary lesions given echocardiography,30 cases had chest pain but coronary angiography had not seen the obvious narrow as a comparison.The twodimensional loop-cinec were obtained in apical 4-chamber view,apical 2-chamber view and long axis of LV view.Eighteen segments of LV longitudinal peak systolic strain,global peak systolic strain of each view and three segments of RV free wall were measured by two-dimensional strain software.Results In the patients who had right coronary lesions but did not happen myocardial infarction,the strain(S) values in the base,mid and apex segmental of LV post wall,the base and mid segmental of LV inferior wall and the base and mid segmental of LV septum were significantly lower( P ＜0.05).The S values in the mid segment of RV free wall was lower( P ＜0.05).In the patients who had right coronary lesions and myocardial infarction,the S values in the base,mid segmental of LV antsept,the apex segmental of LV anterior wall,the base,mid and apex segmental of LV post wall,the base and mid segmental of LV inferior wall and the base and mid segmental of LV septum were significantly lower( P ＜0.05).The S values in the mid and apex segments of RV free wall were lower ( P ＜0.05).And the LV global longitudinal strains were lower in the two groups (P ＜0.05).Conclusions STI is a new and useful technology for assessment ventricular functions in patients with isolated disease of right coronary artery,and there are multiple segments impaired.

Objective To assess left ventricular function early and late improvement of patients with acute myocardial infarction (AMI) treated by percutaneous coronary intervention (PCI) by speckle tracking imaging (STI).The clinical values of the assessment of STI for the prognosis and heart function improvement of AMI patients treated by PCI were discussed.Methods 73 AMI patients who had AMI for the first time and had been treated by primary PCI from September 2010 to July 2011 and were examined in the follow-ups from December 2010 to February 2012 in our hospital were enrolled.Dynamic images were acquired before PCI,at 3 months and 6 months after PCI and analyzed by STI.Dynamic images were analyzed for longitudinal peak systolic strain (LPSS),radial peak systolic strain (RPSS) and circumferential peak systolic strain (CPSS) values by STI.According to the comparison of left ventricular ejection fraction (LVEF) before PCI and 6 months after PCI,patients were divided into left ventricular function improved group (ΔLVEF6＞5％) and not-improved group.According to the comparison of LVEF before PCI and 3 months after PCI,improved group were divided into left ventricular function early-improved group (ΔLVEF3 ＞5％) and late-improved group.Results The values of all STI parameters before PCI,3 months and 6 months after PCI in improved group were higher than those in not-improved group (P ＜0.001,all).LPSS before PCI and at the follow-ups and RPSS at 3 months after PCI in early-improved group were higher than those in late-improved group (LPSS at 3 months after PCI:P＜0.001;Other parameters:P ＜0.05).There were significant correlations between all STI parameters and both ΔLVEF3 and ΔLVEF6.LPSS before PCI was more closely related to ΔLVEF3 (r =-0.781,P ＜0.001).CPSS at 6 months after PCI was more closely related to ΔLVEF6 (r =-0.834,P ＜ 0.001).Conclusions Early and late function improvement of left ventricle in AMI patients who is treated by PCI are accurately assessed by STI.The precise analyses of longitudinal and circumferential movements in STI are important for clinical diagnosis.

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 assess the left ventricular dyssynchrony in coronary artery disease(CAD) without visual segmental wall motion abnormalities using strain delay index (SDI).Methods A total of 135 patients under suspicion of CAD were recruited in this study.Two-dimensional cchocardiography was performed to collect dynamic images of left ventricular apical long axis views,tow-chamber views,four chamber views and parasternal short axis mitral views,papillary views and apical views.The time to minimal systolic longitudinal,radial,circumferential strain (Tssl,Tssr and Tssc) were measured from the start point of QRS wave in electrocardiogram.The left ventricular segmental standard deviation (Tssl-SD,Tssr-SD,Tssc-SD),maximal difference (Tssl-Dif,Tssr-Dif,Tssc-Dif) and longitudinal,radial,circumferential SDI (LSDI,RSDI,CSDI) of 18 left ventricular segments were calculated.Results According to coronary angiography results,patients were divided into three groups:severe stenosis group,mild stenosis group and control group.Compared with the other two groups,SDI and Tssl-SD,Tssl-Dif were decreased in severe stenosis group (P ＜0.001 or P ＜0.05).However,there were not significant differences between the mild stenosis group and the control group except Tssr-SD.The receiver operating characteristic (ROC) curves analysis demonstrated that LSDI had the highest accuracy and Tssl-SD had the lowest accuracy for detecting severe CAD (areas under the curve were 0.891,0.797,0.666,0.580 and 0.556 respectively).High sensitivity and specificity (80.6％ and 86.7％,respectively) were shown when using-12.67％ as a cutoff point of LSDI to diagnose severe CAD.Conclusions SDI can be helpful for assessing the left ventricular dyssynchrony in patients without visual segmental wall motion abnormalities,and LSDI is the most effective parameter to detecting severe CAD.