Objective To evaluate the value of systemic inflammatory response index(SIRI),lactate dehydrogenase(LDH)and aspertate aminotransferase(AST)which is used to identify the high-risk population of adult fulminant myocarditis(FM).Methods A total of 131 adult myocarditis patients admitted to Affiliated Jinhua Hospital,Zhejiang University School of Medicine from January 2018 to December 2023 were selected as the study objects and divided into FM group(n=54)and non-FM group(n=77)according to their conditions.Differences of leukocyte count,neutrophil count,monocyte count,lymphocyte count,SIRI,C reactive protein,creatine kinase,creatine kinase,LDH,AST,and cardiac troponin I were compared.Influencing factors were analyzed by Logistic regression,and receiver operating characteristic(ROC)curve was used to analyze the predictive value.Results Upon admission,patients in non-FM group exhibited significantly lower levels of SIRI,creatine kinase,creatine kinase isoenzyme,LDH,AST,and cardiac troponin Ⅰ compared to those in FM group with statistical significance(P＜0.05).Through ROC curve analysis,it was determined that the predicted effect of LDH and AST was superior.The sensitivity of LDH and AST were found to be 75.5％and 84.9％,respectively,with corresponding specificity levels of 97.3％and 90.4％.The results of the multivariate Logistic regression analysis indicated that elevated levels of LDH＞633.00U/L,AST＞80.45U/L,and SIRI＞2.595×109/L were identified as significant risk factors associated with the development of FM in patients with myocarditis.Conclusion In the early stage of myocarditis,SIRI,LDH and AST have certain reference value for identifying the high-risk group of adult FM.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective To evaluate the value of systemic inflammatory response index(SIRI),lactate dehydrogenase(LDH)and aspertate aminotransferase(AST)which is used to identify the high-risk population of adult fulminant myocarditis(FM).Methods A total of 131 adult myocarditis patients admitted to Affiliated Jinhua Hospital,Zhejiang University School of Medicine from January 2018 to December 2023 were selected as the study objects and divided into FM group(n=54)and non-FM group(n=77)according to their conditions.Differences of leukocyte count,neutrophil count,monocyte count,lymphocyte count,SIRI,C reactive protein,creatine kinase,creatine kinase,LDH,AST,and cardiac troponin I were compared.Influencing factors were analyzed by Logistic regression,and receiver operating characteristic(ROC)curve was used to analyze the predictive value.Results Upon admission,patients in non-FM group exhibited significantly lower levels of SIRI,creatine kinase,creatine kinase isoenzyme,LDH,AST,and cardiac troponin Ⅰ compared to those in FM group with statistical significance(P＜0.05).Through ROC curve analysis,it was determined that the predicted effect of LDH and AST was superior.The sensitivity of LDH and AST were found to be 75.5％and 84.9％,respectively,with corresponding specificity levels of 97.3％and 90.4％.The results of the multivariate Logistic regression analysis indicated that elevated levels of LDH＞633.00U/L,AST＞80.45U/L,and SIRI＞2.595×109/L were identified as significant risk factors associated with the development of FM in patients with myocarditis.Conclusion In the early stage of myocarditis,SIRI,LDH and AST have certain reference value for identifying the high-risk group of adult FM.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective To analyze the value of plane QRS-T angle on prediction of malignant ventricular arrhythmia (MVA) occurred after emergency percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods The clinical data of 418 patients with STEMI who underwent PCI within 12 h of symptom onset were retrospectively analyzed, and the patients were divided into plane QRS-T angle ≤ 90° group (324 cases) and plane QRS-T angle>90° group (94 cases) according to the plane QRS-T angle after PCI. The clinical data were compared between 2 groups. Results Compared with patients in plane QRS-T angle ≤ 90° group, patients in plane QRS-T angle > 90° group was older: (67.4 ± 11.8) years vs. (63.6 ± 12.0) years, QTc interval was longer: (438.60 ± 34.97) ms vs. (425.24 ± 25.49) ms, rate of left ventricular ejection fraction (LVEF) <45% was higher: 57.4% (54/94) vs. 35.8% (116/324), rate of using of beta-blockers was less: 74.5% (70/94) vs. 84.9% (275/324), but the incidences of hypertension and MVA were higher:79.8%(75/94) vs. 64.5%(209/324) and 10.6%(10/94) vs. 1.2%(4/324), and there were statistical differences (P<0.01 or<0.05). Logistic regression analysis showed that plane QRS-T angle >90° was an independent risk factor of MVA after PCI in STEMI patients (OR = 9.640, P =0.001), and using of beta-blockers was a protective factor (OR = 0.266, P = 0.028). Conclusions Plane QRS-T angle>90° is an independent risk factor of MVA after PCI in STEMI patients, while the use of beta-blockers is a protective factor. Paients with STEMI after PCI should be alert to the occurrence of MVA in the condition of plane QRS-T angle>90° and not taking beta-blockers.

Aim To compare the cytotoxicity of geni-poside (GS)and its metabolite genipin (GP)on hu-man hepatocelluar HepG2 cells and explore the sub-stance and mechanism of hepatotoxicity induced by Fructus Gardeniae.Methods The cytotoxic effect of GS and GP was analyzed by MTT method;the antioxi-dant enzyme activities of manganese superoxide dis-mutase (Mn-SOD),catalase (CAT)and levels of glu-tathione (GSH)were detected by respective kits;the change of intracellular reactive oxygen species (ROS ) was measured by 2′,7′-dichlorofluorescin diacetate (DCFH-DA)staining method;multiparameter cytotox-icity analysis (cell loss,nuclear size and morphologi-cal changes,DNA content,cell membrane permeabili-ty,mitochondrial membrane potential changes,cyto-chrome C release ) were measured simultaneously by high content screening (HCS)assays.Results No cytotoxicity was found in GS (20~1 000 μmol·L-1 ) groups (P>0.05 ),but GP was found to exert obvi-ous cytotoxic effect,and 50μmol·L-1 GP could obvi-ously inhibit HepG2 cell proliferation (P<0.05 ),and the IC50 value was (450.00 ±26.15)μmol·L-1;GS showed no obvious effects on Mn-SOD, CAT, GSH ,ROS (P >0. 0 5 ),GP could significantly decrease the activity of Mn-SOD,CAT and the level of GSH,and obviously increase the content of ROS (P<0.05 or P <0.01 );treatment with 50,500,1 000μmol·L-1 GP resulted in loss of mitochondrial mem-brane potential,cytochrome C release and increased cell permeability (P<0.05 or P<0.01),500,1 000μmol· L-1 GP could also show abvious nuclear con-densation,increased total nuclear intensity and cell loss (P<0.0 1 ).Opposed with GP,GS had no signif-icant effect on the cytotoxic parameters (P>0.05 ). Conclusion GP is the direct substance of hepatotox-icity induced by Fructus Gardeniae,and the mecha-nism might be associated with oxidative stress,mito-chondria injury and apoptosis.

Objective:Selected virulence factors more than and high virulent Aeromonas hydrophia strain made into inactivated vaccine,to study the immunization effect of inactivated vaccine.Methods:Crucian were vaccinated with formalin-killed vaccine via in-traperitoneal injection.Controls were injected with the same volumes of saline.Then the antibody titres, histopathology and relative percent survival were analyzed from samples of both groups.Results: The antibody in the indirect agglutination reaction could be detected in vaccinated fish once a weeks after immunization and reached highest level 6 weeks after immunization.The histopathology analysis indicated that the vaccine had a good protective effect on crucian target organs.Vaccinated fish showed 100%relative percent survival and the immune period would be 6 month.Conclusion:The vaccine in this study has a significant protective effect on crucian and may be used as effective fish vaccines against bacterial septicemia.

Objective Exploring clinical prediction value of the ischemia modified albumin (IMA) for acute coronary syndrome (ACS) patients after the percutaneous coronary intervention (PCI).Methods A total of 109 cases of the PCI postoperative patients of ACS at the Panggang General Hospital from January 2010 to July 2012 were included.IMA was determined within 6 hours after admission,and standardized treatment after PCI.After a 6-month follow-up,they were divided into the event group and non-event group according to cardiovascular events occurrence.Results 101 cases were followed-up,including 26 cases of cardiovascular events (25.74％) and 75 cases of no cardiovascular events (74.26％).The left ventricular ejection fraction of the event group [(45 ± 7)％] was significantly lower than the non-event group [(52 ± 10) ％] (t =1.894,P ＜ 0.05).Serum IMA of the event group[(105.51 ± 13.26) U/ml]was significantly higher than the non-event group [(85.18 ± 11.36) U/ml] (t =7.3518,P ＜0.01).After controlling other cardiovascular risk factors,IMA was still independent risk factors for cardiovascular events (OR =1.69,95％ CI: 1.18 ～ 2.13,P =0.01).Conclusions IMA have very good clinical prediction value of cardiovascular events occurrence for ACS after PCI.

Traditional Chinese medicine injections have advantages on cardiovascular, respiratory critical treatment fields that cannot be irreplaceable by chemical medicines. In particular, they show good clinical efficacy in critical and severe cases caused by viral infection. However, in recent years, traditional Chinese medicine injections have frequently caused serious adverse effects and even fatalities, which made the safety of traditional Chinese medicine injections doubtful. This is mainly resulted from the quality of drugs themselves and rational clinical administration. Therefore, this essay summarizes literature materials starting from the development history of traditional Chinese medicine injections and suggests rationally using traditional Chinese medicine injections under the guidance with traditional Chinese medicine theories.
Animals ; Drug Therapy ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Humans ; Medicine, Chinese Traditional ; adverse effects