Myocardial infarction (MI) is a major cause of death and disability worldwide.The definition of myocardial infarction has been updated.Released in 2012,Third Universal Definition of Myocardial Infarction of ESC/ACCF/AHA/WHF Expert Consensus,made the clinical application value of troponin clear and suggested to monitor the dynamic changes of cTn in patients with suspected,emphasized the importance of clinical differential diagnosis.In consensus,it also noted that the application of high sensitive troponin can lead to false positives results,and pointeds out that in the assessment of cardiac injury associated with percutaneous or surgical coronary procedures,the rational cut-off value of cTn remains controversival.In addition to acute coronary syndrome,cTn elevations are common in many disease states,and with the improvement of detection sensitivity,low level increase of cTn,will be more.In acute and chronic heart failure,the cTn is elevated,and ACS may be the cause of worsening heart failure,So we should identify whether the cTn elevation is pure from the myocardial injury of heart failure or myocardial necrosis caused by ACS.Nowadays,the increased incidence of myocardial infarction has much to do with the wide application of cTn.Clinical applications of cardiac biomarkers and imaging techniques are flexible as the differences in the diagnostic techniques of myocardial infarction among countries and regions result.

Objective To study the significance of serum uric acid in predicting coronary heart disease(CHD) risk.Methods Uric acid and its relationship with coronary heart disease(CHD) was analyzed in 215 cases who underwent coronary angiogaphy(CHD was present in 164 patients and absent in 51 as normal control group).Results Uric acid was significantly higher in patients with CHD than that in the normal control group [(316.67?97.35)?mol/L vs.(286.16?98.33)?mol/L,P

Objective To study the correlation between the degree of anxious state in patients with hypertension and the serum homocysteine level.Methods This is a case-control study in Beijing Anzhen Hospital from January to May in 2013.164 cases of essential hypertension with continuing unstable blood pressure after being treated for nearly a week were include.They have been analysed with GAD-7 and PHQ-9 evaluation scale for anxiety and depression state.According to the anxiety status,patients were devided into three groups:Group Ⅰ (28 cases without anxiety),Group Ⅱ (81 cases with mild anxiety),group Ⅲ (55 cases with moderate-to-severe anxiety).Results (1) Correlation analysis showed,the GAD-7 anxiety scale score related with age,PHQ-9 Depression Scale and Hcy level (P ＜ 0.05),PHQ-9 Depression Scale score and Hcy levels were correlated (P ＜ 0.05).(2) Multiple stepwise regression showed that PHQ-9 Depression Scale entered the regression equation,while GAD-7 anxiety scale,age and the level of hcy were risk factors.Conclusion Hcy level is a risk factor for hypertension patients with depression,there is correlation with the severity of anxiety.Mental health should be paid attention to patients with essential hypertension.

Objective To evaluate the effect of ginsenoside pre-treatment on serotonin (5-hydroxytryptamine,5-HT),5-HT2A receptor (5-HT2A R),and 5-HT transporter (serotonin transporter,SERT) in serum,platelet lysate and brain tissue homogenates in SD rats with myocardial infarction (MI) or depression.Methods Eighty SD rats were randomized treated with ginsenoside or normal saline (NS).After 4 weeks,the rats were,then,randomized to four subgroups:the MI,the depression,the MI in combination with depression and sham subgroups.5-HT,5-HT2A R and SERT levels were detected in serum,platelet or brain.Results In the NS pre-treatment groups,serum 5-HT levels in sham rats (237.1 ± 32.0)pg/ml were higher than in MI (58.0 ± 11.6) pg/ml,depression (72.8 ± 2.3) pg/ml,and MI with depression rats (62.5 ± 10.2) pg/ml (all P =0.000).Pre-treatment of ginsenoside increased serum and platelet 5-HT in MI,depression and MI with depression rats compared with each corresponding NS treated subgroups (all P ＜ 0.005).However,treatment of ginsenoside lowered the 5-HT2A R expression in MI,depression,and MI with depression subgroups both in platelet and brain tissue homogenates compared with each corresponding NS treated subgroups (all P ＜ 0.05).As to SERT in platelet,treatment of ginsenoside increased its levels in depression rats (P =0.019),but lowered the levels in MI rats (P =0.001) compared with NS treated rats.There were no differences in brain 5-HT and SERT between ginsenoside and NS treated groups.Conclusions The 5-HT system responses differently to ginsenoside treatment under different cardiac and mental stress conditions.Ginsenoside plays an important role in regulation of 5-HT system.

Objective To statistically analyze clinical research literature on acupuncture treatment of gouty arthritis, explore regularities in its point selection and provide a basis for clinical point selection and reasonable point combination.Method Gouty arthritis, acupuncture, warm needling moxibustion, electroacupuncrue and fire needling were used as key words. January 1990 to May 2014 China HowNet (CNKI) full-text database and Wanfang academic periodical full-text database were searched to retrieve, sort out and analyze clinical literature on acupuncture treatment of gouty arthritis at home and abroad. Acupoints included in the literature were sorted out. Statistical analysis was made of the categories, meridians, use frequencies and positions of selected acupoints.Result One hundred and thirty-five articles with a total of 120 acupoints were included. From the analysis of point selection, the acupoints most frequently used to treat gouty arthritis were, arranged in order, Taichong (91), Sanyinjiao (87), Zusanli (80), Yinlingquan (58), Quchi (52), Taixi (51), Yanglingquan (45), Xuehai (44), Taibai (44) and Hegu (44). From the analysis of pertaining meridians, the meridians of more frequently used acupoints were the spleen meridian of foot-taiyin (323), the stomach meridian of foot-yangming (209), the large intestine of hand-yangming (143), the liver meridian of foot-jueyin (140), the gallbladder meridian of foot-shaoyang (134), the kidney meridian of foot-shaoyin (84) and the bladder meridian of foot-taiyang (80). From the analysis of point selection from different places, the part where acupoints were most distributed was the lower limb.Conclusion For acupuncture treatment of gouty arthritis, local and along-meridian point selections are main ones, selected points are relatively scattered and often located in the lower limb, and point selection is partly combined with syndrome differentiation, which provide a clinical reference.

Objective To investigate the relationship of plasma brain natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels with the severity of heart dysfunction in elderly patients with heart failure. Methods BNP levels were measured by immunofluorescence in 106 hospitalized patients with heart failure, while NT-proBNP levels were measured by electrochemiluminescence immunoassay in 48 patients. The severity of heart dysfunction was determined by NYHA classification. The left ventricular ejection fraction (LVEF) measured by Color Doppler Ultrasound was used to show the left ventricular systolic function. Results In patients with BNP≤400 ng/L versus BNP>400 ng/L, the rates of LVEF≤45% were 16.4% versus 46.8% (χ~2= 13. 93, P=0. 001), the rates of E/A<1 were 62.3% versus 40. 4% (χ~2 =22. 19,P = 0.024) and the rates of Cr>107 μmol/L were 13.1% versus 38.3% (χ~2 = 11. 31, P = 0. 002) . In patients with NT-proBNP≤400 ng/L versus NT-proBNP>400 ng/L, the rates of LVEF≤45% were 25. 0% versus 58. 3% (χ~2 = 10. 00,P = 0. 019) and the rates of Cr>107 μmol/L were 20. 8% versus 50.0% (χ~2=8. 50,P = 0. 035). Conclusions BNP or NT-proBNP levels increase significantly along the deterioration of the heart failure severity, and it may be important to use BNP or NT-proBNP to predict left ventricular function.

OBJECTIVE:To determine the content of Peiminine in Wenglitong tablets by TLC.METHODS:The content of Peiminine was determined by dual wavelength TLC with gel silica G as thin layer plate.The developing solvent was chloroform-ethyl acetate-methanol-ammonia water(2∶6.5∶1∶0.5)and the developer was modified potassium heptaiodobismuthate.RESULTS:The liner range of Peimine was 0.4～2.4 ?g with an average recovery rate of 99.28%(RSD=1.17%,n=6).CONCLUSION:This method is simple,reliable,reproducible and suitable for the quality control of Wenglitong tabl-ets.

Objective To compare the clinical efficacy of laparoscope and open operation in treatment of adrenal pheochromocytoma.Methods 52 cases with adrenal pheochromocytoma were randomly divided into two groups,they were treated with laparoscope or open operation.Intraoperative blood loss,intraoperative blood pressure and heart rate fluctuations,operation time,drainage,hospitalization and postoperative complications were compared between two groups.Results Intraoperative comparison:In laparoscope group,operative blood loss was (65.7 ± 50.2) ml,blood pressure fluctuations in 1 case (3.8％),heart rate variability was (18.7 ± 6.1)/min and the operation time was (93.7 ± 21.7) min; in the open operation group,amount of bleeding during the operation was (240.4 ± 150.5) ml,blood pressure fluctuations in 7 cases(26.9％),heart rate variability was (25.6 ± 6.3)/min and the operation time was (137.7 ± 30.5) min,the differences between the two groups was significant (t =3.15,x2 =5.32,t =3.65,t =4.16,all P＜0.05).The maximum tumor diameter of open operation group was (7.3 ± 1.4) cm,which was bigger than that of the laparoscope group (6.6 ± 1.2) cm,but no significant difference between two groups (P ＞ 0.05).Postoperative comparison:in the laparoscope group,postoperative drainage was (174.3 ± 121.3)ml,drainage time was (4.3 ± 1.3) d and time of hospitalization was (8.4 ± 1.2) d,which were significantly less than those in open operation group(318.5 ± 132.6)ml,(8.7 ±2.3)d and (11.4 ±3.2)d(t =2.54 3.13,2.12,all P ＜0.05).No serious complications were observed in two groups,laparoscope group 1 case,open operation group 5 cases had postoperative pain,after the corresponding symptomatic treatment was improved.After 3 months of follow-up,clinical symptoms were significantly improved or disappeared,ultrasound or CT reexamination found no recurrence.Conclusion Laparoscope in treatment of adrenal pheochromocytoma not only has definite curative effect,but also has small trauma,shorter operation time and less complications,it is worth clinical application.

Objective:To analyze the relationship between corrected Tp-e interval(Tp-ec), Tp-e/QT ratio and the degree of vein bridge vessel stenosis after coronary artery bypass grafting(CABG) in patients with left main coronary artery stenosis, and its predictive value for malignant electrophysiological events.Methods:Patients admitted to Beijing Anzhen Hospital affiliated to Capital Medical University from January 2018 to August 2019 were selected, coronary angiography was performed 5-7 years after coronary artery bypass grafting(CABG) due to recurrence of symptoms. 169 patients with >50% restenosis in SVG were selected. According to the degree of bridge angiography stenosis, the patients were divided into group A(50%-70% SVG restenosis, 105 cases) and group B(SVG restenosis >70%, 64 cases), routine electrocardiogram examination, measurement and correction of QT interval(QTc), Tp-ec and Tp-e/QT ratio were made. Patients were followed up 6 months, the occurrence of malignant ECG events is observed, and the area under the receiver operating characteristic( ROC) curve( AUC) was used to quantitatively evaluate the predictive power of Tp-ec and Tp-e/QT ratios for malignant ECG events. Results:The QTc, Tp-ec and Tp-e/QT ratios in group B were significantly greater than those in group A, and the differences were statistically significant( P<0.05). After multivariate logistic regression analysis, both the Tp-ec and Tp-e/QT ratios were independent influencing factors for the degree of vein bridge vessel stenosis>70%( P<0.05). After Pearson correlation analysis, both the Tp-ec and Tp-e/QT ratios were positively correlated with the degree of vein bridge vessel stenosis( r= 0.384 and 0.457, both P=0.000). A total of 162 cases(95.86%) were followed up, 25 cases of malignant electrophysiological events occurred. After ROC curve analysis, Tp-ec combined with Tp-e/QT ratio predicted coronary malignant electrophysiological events in patients with left main artery stenosis after GABG with AUC=0.924, which was significantly greater than 0.698 of the single index Tp-ec and 0.712 of the Tp-e/QT ratio, the differences were both statistically significant( P<0.05). Conclusion:Tp-ec and Tp-e/QT ratios are both positively correlated with the degree of vein bridge vessel stenosis after CABG in patients with left main coronary artery stenosis, the combined effect of them in predicting the occurrence of malignant electrocardiological events is good, and it is worth further research and application.