Recent researches revealed that intestinal flora contribute to the development of metabolic syndrome, espe?cially to the disorder of their targeted cardiovascular system. Blood cholesterol level is affected by the metabolism of intesti?nal flora in cholesterol and bile acid. At the same time, the blood cholesterol level is the key player in development of athero?sclerosis. This review mainly discussed the relationship between the intestinal flora dependent metabolite trimethylamine ox?ide (Trimetlylamine oxide, TMAO) and atherosclerosis.

Objective To investigate the clinical value of heart-type fatty acid-binding protein ( H-FABP) and N terminal probrain natriuretic peptide (NT-proBNP) in sepsis patients with myocardium injury. Methods 118 sepsis patients were included as survivor group (68 cases) and death group (50 cases) according to their prognosis outcome. 50 healthy people were selected as control group. Creatase, H-FABP, NT-proBNP, APACHEⅡscore and 28 day morbidity of control group and sepsis patients were assessed at 1 h, 6 h after admission by physical examination . Results At 1 h after admission , APACHEⅡscore , H-FABP and NT-proBNP level in sepsis patients were significantly higher than control group (P < 0.05); APACHEⅡscore, H-FABP, NT-proBNP and cTnI level at 6 h after admission were higher than that at 1 h (P < 0.05); APACHEⅡscore, H-FABP and NT-proBNP level in death group were higher than survivor group at 1, 6 h after admission (P < 0.05), cTnI level at 6 h after admission was higher in death group (P < 0.05). Futhermore, H-FABP, NT-proBNP and cTnI at 6 h after admission were positively correlated with each other (both P < 0.05). At 6 h after admission , H-FABP showed a better predictive value of 28-day mortality than NT-proBNP and APACHEⅡscore (P < 0.05). Conclusion H-FABP and NT-proBNP may suggest important significance in early diagnosis and prognosis prediction of sepsis patients with myocardium injury.

Objective To investigate the changes and significance of cerebral oxygen utilization coefficients (O2UCc) in patients with acute carbon monoxide poisoning (ACOP) after treatment with Danshen Chuanxiongqin injection combined with ganglioside.Methods A prospective study was conducted.Two hundreds and six patients with ACOP admitted to the Department of Emergency in Harrison International Peace Hospital Affiliated to Hebei Medical University from January 2011 to January 2016 were enrolled,and they were divided into Danshen Chuanxiongqin group,ganglioside group and Danshen Chuanxiongqin injection combined with ganglioside group (combined treatment group) by random number table.The changes in oxygen saturation of internal carotid artery blood (SaO2) and oxygen saturation of internal jugular vein blood (SjO2) were detected by blood gas analysis for all the patients before and 6 hours,1 day,3 days after treatment,and then according to the rate of oxygen utilization formula [O2UCc=S(a-j)O2/SaO2],O2UCc wascalculated.Before and after treatment,the changes of O2UCc in three groups were compared;after treatment for 14 days,the improvement of clinical symptoms,the incidence of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) and the 28-day mortality were observed.Results The total therapeutic effective rate of combined treatment group was significantly higher than that in either Danshen Chuanxiongqin injection group or ganglioside group [91.67％ (66/72) vs.77.27％ (51/66),77.94％ (53/68),both P ＜ 0.05].Before treatment,there were no differences in levels of O2UCc among three groups (P ＞ 0.05);after treatment for 6 hours and 1 day,the level of O2UCc in combined treatment group was obviously lower than either that of Danshen Chuanxiongqin injection group or of ganglioside group [6 hours:(38.13±7.95)％ vs.(42.96±7.58)％,(42.30±9.87)％,1 day:(28.42±5.41)％ vs.(33.27±7.53)％,(32.64 ± 6.76)％,all P ＜ 0.05],and the levels of O2UCc at 6 hours and 1 day after treatment had no statistical significant differences between those in Danshen Chuanxiongqin injection group and ganglioside group (P ＞ 0.05);after treatment for 3 days,the percentages of O2UCc levels were very close in Danshen Chuanxiongqin injection group,ganglioside group and combined treatment group [(23.87 ± 6.06)％,(22.38±6.09)％,(23.68 ±4.34)％,respectively,all P ＞ 0.05];The incidence of DEACMP and the 28-day mortality after treatment in combined treatment group were lower than those in Danshen Chuanxiongqin injection group or ganglioside group [the incidence of DEACMP:2.78％ (2/72) vs.12.12％ (8/66),14.71％ (10/68),the 28-day mortality:2.78％ (2/72) vs.13.64％ (9/66),16.18％ (11/68),both P ＜ 0.05];while the incidence of DEACMP and the 28-day mortality after treatment had no statistical significant differences between Danshen Chuanxiongqin injection group and ganglioside group (all P ＞ 0.05).No adverse reactions occurred in the three groups.Conclusion The treatment of Danshen Chuanxiongqin injection combined with ganglioside in treatment of ACOP patients can effectively reduce the O2UCc,decrease the occurrence of DEACMP and 28-day mortality,thus it may improve the prognosis,and the clinical curative effect is distinct.

A total of 11 200 subjects from urban and rural areas of Taocheng of Hebei Province were surveyed for cardiopulmonary resuscitation (CPR) knowledge with self-made questionnaire. Our results showed that of the 11200 participants, there were 3708 subjects (33.11%) knew CPR; 6105 subjects (54.51%) knew but couldnt put it into practice; and 1387 subjects (12.38%) didn't know CPR. There was a significant difference in CPR awareness rate among people with different education level and profession (P <0.01). Awareness of emergency treatment and therapeutic technique was proved to be low among urban and rural residents, especially those living at poor-educated small towns. We suggest that more attention should be paid to increased awareness of CPR and its technique to improve to outcome of the treatment.

Objective To study the relationship between copeptin,ischemia modified albumin (IMA) and the degree of myocardial injury in patients with acute carbon monoxide poisoning (ACOP).Methods A total of 110 ACOP patients with different degree of poisoning were selected as poisoning group and included mild poisoning 22 cases (mild group),moderate poisoning 50 cases (moderate group),severe poisoning 38 cases (severe group),and 30 healthy subjects were selected as control group.The cardiac troponin Ⅰ (cTnⅠ),IMA,copeptin level was detected at 2 h,7 d after admission in poisoning group and at admission in control group.According to with or without complications,poisoning group was divided into complications group (26 cases) and non-complications group (84 cases).cTnⅠ,IMA,copeptin level was compared among groups.Results At 2 h after admission,IMA was decreased and copeptin was increased in mild,moderate,severe group[(62.50 ± 2.17),(59.04 ± 3.10),(56.01 ± 8.85) kU/L and (2.82 ± 0.73),(7.31 ±0.95),(13.08 ± 1.96) μg/L],there was statistical difference compared with control group [(67.23 ± 1.40) kU/L and (0.87 ±0.19) μg/L](P＜0.05),and there was significant difference between moderate group and mild group,severe group and mild group,moderate group (P ＜ 0.05);there was no statistical difference in cTnⅠ among groups.At 7 d after admission,there was no significant difference in IMA,copeptin among groups (P ＞ 0.05) ; cTnⅠ was increased in mild,moderate,severe group [(1.80 ± 0.17),(2.34 ±0.46),(2.60 ±0.54) μg/L],and there was statistical difference compared with control group [(1.27 ±0.28) μg/L] (P ＜0.05),and there was significant difference between moderate group and mild group,severe group and mild group,moderate group (P＜ 0.05).IMA,copeptin at 2 h,7 d after admission in complications group was higher than that in non-complications group [(54.62 ± 1.53) kU/L vs.(57.89 ± 4.02) kU/L,(60.65 ± 3.61) kU/L vs.(66.84 ± 1.78) kU/L and (13.88 ± 1.45) μ g/L vs.(6.99 ± 3.39) μ g/L,(6.65 ± 1.82) μ g/L vs.(2.47 ± 0.61) μ g/L](P＜ 0.05).cTnⅠ at 7 d after admission in complications group was higher than that in non-complications group [(3.10 ± 0.22) μ g/L vs.(1.87 ± 0.27) μ g/L] (P ＜ 0.05).Correlation analysis showed that copeptin was negatively correlated with IMA in patients with different degree of poisoning (r =-0.560,P ＜ 0.01).Conclusions The combined detection of IMA and copeptin has important clinical value to the early diagnosis and prognosis in evaluating the prognosis of ACOP myocardial injury.There is important guidance for early clinical drug application.

Objective To investigate the clinical value of copeptin and ischemia modified albumin combined determination in the early diagnosis and clinical significance in myocardial damage of acute organic phosphorus pesticide poisoning .Methods Eighty‐six cases of AOPP patients were divided into two groups :the myocardial injury group (50 cases) and non myocardial injury group (36 cases) ;30 healthy people were selected as the control group .3 mL of venous blood were collected for all subjects involved within one hour in admission ,and their cTnI ,IMA and copeptin levels were detected .Results Compared with the control group ,the copep‐tin levels of non myocardial injury group and myocardial injury group were elevated and there was significant difference (P< 0 .05) ;the difference between myocardial injury group and non myocardial injury groups was also significantly different (P< 0 .05) .Among them ,the comparison between severe and mild to moderate group revealed that the IMA and copeptin levels reduced obviously ,there was significant difference (P< 0 .05) ;in myocardial injury group ,the IMA and copeptin levels of patients in different poisoning de‐gree were negatively correlated .Conclusion Early determination of IMA and copeptin level has important significance in the early diagnosis of myocardial injury in patients with poisoning in AOPP ,and could provide guidance for clinical medication .

Objective To investigate the application value of early lactate clearance rate and acute physiology and chronic health evaluation (APACHE) Ⅱ score in patients with acute carbon monoxide poisoning encephalopathy.Methods One hundred and forty-six patients with acute severe carbon monoxide poisoning were divided into control group (60 cases) and case group (86 cases) according to the occurrence of toxic encephalopathy.All the patients were extracting 1 ml arterial blood under the condition of air before treatment and 6,24,72 h after treatment,arterial blood lactic acid level was detected,and the lactate clearance rate was calculated.The initial level of blood lactic acid,lactic acid clearance rate and APACHE Ⅱ score 6,24,72 h after treatment,complication rate and mortality rate were compared between the two groups.Results Compared with control group,the initial level of blood lactic acid in case group was higher [(3.30 ± 0.55) mmol/L vs.(2.64 ± 0.24) mmol/L],the lactate clearance rate 6,24 h after treatment was lower [(8.22 ± 1.20)％ vs.(12.83 ± 5.31)％,(12.00 ± 2.40)％ vs.(15.17 ± 2.99)％],the APACHE Ⅱ score 6,24,72 h after treatment was higher [(16.78 ±2.82) scores vs.(12.33 ±2.16) scores,(14.11 ± 1.54) scores vs.(10.17 ±0.98) scores,(10.56 ± 1.51) scores vs.(7.83 ± 1.17) scores],the complication rate and mortality rate were higher,and there were statistical differences (P ＜ 0.05).There was no statistical difference in lactate clearance rate 72 h after treatment between the two groups (P ＞ 0.05).In acute carbon monoxide poisoning encephalopathy patients,the lactate clearance rate 6 h after treatment was negatively correlated with APACHE Ⅱ score and mortality rate (r =-0.616,P =0.015;r =-0.606,P =0.017).Conclusion Early lactate clearance rate and APACHE Ⅱ score can help to assessment the severity,guide treatment and judging prognosis in patients with acute carbon monoxide poisoning encephalopathy.

AIM To investigate the effects of safflower yellow on myocardial injury in patients with severe sepsis.METHODS Using prospective research methods,ninety-two patients with severe sepsis treated in our hospital from Jan.2013 to Mar.2016 were divided equally into two groups:control group (routine treatment) and observation group (routine treatment + safflower yellow).In addition,6 and 72 hours after the treatment,heart-type fatty acid binding protein (H-FABP),creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) of patients were detected,and the changes of left ventricular ejection fraction (LVEF) and sequential organ failure assessment (SOFA) scores were observed;length of ICU stay,cumulative incidence of major adverse cardiac events (MACE) and 28-day survival also were recorded at the same time.RESULTS In admission,there were no differences in the levels of H-FABP,CK,CK-MB and LVEF,SOFA scores between the two groups.After 6 hours treatment,the levels of H-FABP,CK,CK-MB and SOFA score in the observation group were lower than those in the control group;the two groups had higher levels of H-FABP,CK and CK-MB than those before the treatment,SOFA score was lower than that before the treatment;After 72 hours treatment,H-FABP,CK,CK-MB and SOFA score were lower than those after 6 hours treatment;SOFA score in the observation group was lower than that in the control group;there were no differences in H-FABP,CK and CK-MB between the two groups.The observation group had a lower cumulative incidence of MACE than the control group.There was no statistical difference in LVEF and length of ICU stay after the treatment between the two groups.The observation group had a higher 28-day survival than the control group,the difference was statistically significant (76.08％,35/46 vs 54.35％,25/46;x2 =4.529,P =0.033).The level of serum H-FABP in severe sepsis patients was negatively correlated with LVEF (r =-0.270,P =0.009).CONCLUSION Therapeutic effects of safflower yellow on myocardial injury in patients with severe sepsis is superior to routine treatment with the improvement of the prognosis of patients to a certain extent.

Objective:To investigate the clinical significance of soluble growth stimulating expression gene 2 protein (sST2) combined with neutrophil/lymphocyte ratio (NLR) in the prediction of nosocomial cardiovascular adverse events in patients with acute carbon monoxide poisoning (ACOP) myocardial injury.Methods:Patients with ACOP myocardial injury from January 2017 to December 2019 in Emergency Ward and EICU of Harrson International Peace Hospital, Hebei Medical University were enrolled. NLR was calculated by routine blood examination on admission, and sST2 (T 0sST2, T 3dsST2) was detected by ELISA on admission and at 3 days after admission. According to the occurrence of cardiovascular adverse events, the patients were divided into the event group and the non-event group. Logistic regression was used to analyze the risk factors of in-hospital cardiovascular adverse events. ROC curve was used to analyze the value of sST2, NLR, sST2 and NLR combined in predicting the occurrence of in-hospital cardiovascular adverse events in patients with ACOP myocardial injury. Results:Totally 255 patients with ACOP myocardial injury were included in the final analysis. NLR was (13.38±4.33) in the event group and (9.57±4.22) in the non-event group, T 3dsST2 was (61.59±22.67) ng/mL in the event group and (40.52±13.14) ng/mL in the non-event group, with statistically significant differences (all P<0.01). T 0sST2 was (265.34±89.95) ng/mL in the event group and (242.43±93.09) ng/mL in the non-event group, with no statistically significant difference ( P=0.333). Logistic regression analysis showed that NLR ( OR=1.270, 95% CI: 1.125-1.434, P<0.01) and T 3dsST2 ( OR=1.082, 95% CI: 1.052-1.114, P<0.01) were independent risk factors for nosocomial cardiovascular adverse events in patients with ACOP myocardial injury. The optimal cutoff value of T 3dsST2 was 44.5 ng/mL, and of NLR was 12.08. The sensitivity and specificity of dual T 3dsST2 and NLR in predicting nosocomial cardiovascular adverse events was 79.3% and 82.7%, respectively (AUC 0.857, Youden index 0.620). Conclusions:T 3dsST2 and NLR are independent risk factors for the nosocomial cardiovascular adverse events in patients with ACOP myocardial injury. The predictive cutoff values are 44.5 ng/mL for T 3dsST2 and 12.08 for NLR. Combination of T 3dsST2 and NLR has a practical predictive value for nosocomial cardiovascular adverse events in patients with ACOP myocardial injury.

Objective To study the value of copeptin and APACHE Ⅱ used for assessing acute paraquat poisoning (APP). Methods One hundred and twenty six APP patients were divided into survival group (n = 58) and death group (n = 68), with clinical death as the endpoint of observation. 3 mL blood was obtained from each subject at 2 h , 24 h and 7 d after admission for detecting the levels of copeptin , and APACHE Ⅱ scores were recorded at the same time. Results There was significant difference in dosages of paraquat taken in the death group and the survival group , but the differences were significant in the rescue time , the first time for hemoperfusion and the times for hemoperfusion. 2 h after admission , the death group and survival group had significant difference in elevated copeptin but no significant difference in scores by APACHE Ⅱ. 24 h after admission copeptin decreased to normal level in the survival group but maintained at a higher level in the death group, while the scores by APACHE Ⅱ had insignificant difference between two groups. 7 d after admission, copeptin kept at a higher level and the scores by APACHE Ⅱwere significantly increased in the death group , with significant differences compared to the survival group. The oral doses of pesticides the patients took were positively correlated with copeptin level and scores by APACHE Ⅱ. Conclusion Repeated detection of copeptin and APACHE Ⅱ score are of clinical importance for the assessment of prognosis of APP patients and reasonable distribution of medical resources.