Volume15 August2003 Number8
Chinese Critical Care Medicine, August 2003,Vol.15,No.8
PAGE：452
Patients of severe acute respiratory syndrome with hypoxemia treated by anisodamine
YANG Guo dong
Ningbo Instityte of Microcirculation and Henballe, Ningbo 334010, Zhejiang, China.
PAGE：453-454
Increasing the speed of construction of the public health incident command system in our country
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DUAN Yun you
Naval General Hospital, Beijing 100037, China.
PAGE: 455-458
Effect of vitamin E on myosin light chain kinase activity and endothelial permeability of the artery in atherosclerotic rabbit
ZHU Hua qing, REN Bin, XIONG Jiang xia, HU Ruo lei, LIU Xiao ying, WANG Xue, ZHANG Su mei, LIU Hui lan, JIANG Zhi kui, ZHOU Qing, GUI Shu lan, WANG Yuan
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Laboratory of Molecular Biology and Department of Biochemistry, Anhui Medical University, Hefei 230032, Anhui, China
Abstract：OBJECTIVE: To study the effect of vitamin E (Vit E) on the myosin light chain kinase (MLCK) activity and the endothelial permeability of the artery in atherosclerotic rabbits. Methods: The MLCK activity of rabbit artery was measured by incorporation of γ-32 P. The endothelial permeability was accessed by immunofluorescence. Results: The model of atherosclerosis was established after rabbits were fed with cholesterol for four weeks. The activity of MLCK increased markedly, and there was significantly statistical difference compared with the normal control (P<0.05). When the rabbits were fed with cholesterol for twelve weeks or with cholesterol and Vit E for twelve weeks, the activity of MLCK did not change markedly, and there was no statistical difference compared with the normal control, respectively (P>0.05). The permeability of arterial wall was increased after the rabbits were fed with cholesterol for four weeks, and the permeability increased even more obviously after the rabbits were fed with cholesterol for twelve weeks. The permeability appeared to be decreased when Vit E was added into the cholesterol feeding. Conclusion: The change in integrity of arterial wall may be associated with the increase of the activity of MLCK. Vit E may decrease the MLCK activity. Vit E may decrease the endothelial permeability of atherosclerotic rabbits.
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PAGE: 459-461
Role of kaliuretic peptide and molar ratio of kaliuretic peptide/ atrial natriuretic peptide in atrial fibrillation
JI Da, ZENG Qiang, SHEN Hong, FAN Ying xian, CHEN Wei, SONG Yang li
Department of Emergency, General Hospital of People's Liberation Army, Beijing 100853, China
Abstract：OBJECTIVE: To investigate the role of kaliuretic peptide (KP) and molar ratio of KP/ atrial natriuretic peptide (ANP) in atrial fibrillation. Methods: The levels of plasma KP and ANP in 23 patients with paroxysmal atrial fibrillation (group I), 24 patients with persistent atrial fibrillation (>1 year, group II) and 20 healthy humans (group III) were determined with radioimmunoassay. Results: Compared with group III, the levels of plasma KP and ANP of the group I and group II were both higher (both P<0.01). Compared with group III, the level of KP/ANP of the group I was lower (P<0.01), while that of group II was no substantial change (P>0.05). Conclusion: The change of levels in ANP, KP and ANP/KP may play important role in atrial fibrillation.
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PAGE: 461
Clinical analysis of 32 cases of patients with severe asthma combined with acute left-sided heart failure
PAN Yun dong
The First People’s Hospital, Nanning 530022, Guangxi, China.
PAGE: 462-464
Study on defibrinogenasing enhancing the thrombolytic effect of urokinase on acute myocardial infarction
, 百拇医药
WU Xu hui, HONG Shao cai, LIU Ying ming, LI Tan shi, XIAN Ding cheng, LU Guang sen
Department of Cardiology, Naval General Hospital, Beijing 100037, China
Abstract：OBJECTIVE: To investigate the thrombolytic effects and the security of combined therapy of defibrinogenase (DEF) and lower dose urokinase (UK) on patients with acute myocardial infarction (AMI). Methods: Forty-five patients with AMI within 6 hours from the onset were divided into two groups, the combined therapy group (UK+DEF group, n=23) and the full dose UK group (UK group, n =22). The dosage of the UK in UK+DEF group was only the half of the full dos e UK group. In UK+DEF group, intravenous injection of 5 U DEF was preceded with intravenous infusion of UK, and after that, 5 U of DEF was infused intravenously in three separate times. Aspirin was prescribed for all patients. Coronary reperfusion was evaluated according to clinical criteria. The complication of bleeding was noted. Plasma fibrinogen (Fg) and D-dimer levels were determined before and after thrombolytic therapy. Results: The age, body weight, time from onset, reperfusion rate, reinfarction rate, bleeding complications and the mortality during hospitalization were similar in both groups (P>0.05), and no severe bleeding was found. The reperfusion rate of UK+DEF group (69.56 percent) was comparable with that of UK group(68.18 percent), P>0.05. While the time to reperfusion of UK+DEF group was markedly shorten than that of UK group, it was(62.08±32.40) minutes vs. (80.00±39.14) minutes respectively (P<0.01). The plasma levels of D-dimer were similar and were elevated at the 6 hours after the beginning of thrombolytic therapy both in two groups (P<0.05). The plasma Fg level was declined obviously in UK+DEF group with a decrease in 58.46 percent, while it was slightly declined in U K group with a 1678 percent decrease in percentage compared to those levels of pre-thrombolysis. Conclusion: The combination of DEF can enhance the thrombo lytic efficacy of UK, and can accelerate the lysis of coronary thrombus. The effect and the security of combination therapy are comparable to the full do se UK therapy.
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PAGE: 465-468
Analysis of factors correlated to death and reinfarction in patients with acute myocardial infarction
YIN Li, LI Guang ping, LI Jian, LI Li feng, ZHANG Cheng zong, HUANG Ti gang
The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
Abstract：OBJECTIVE: To identify the predictors of death and reinfarction in patients with acute myocardial infarction (AMI) treated with urokinase (UK) thrombolysis or percutaneous transluminal coronary angioplasty (PTCA). Methods: In ambispective cohort study, 97 cases of AMI were treated with UK thrombolytic therapy, while 93 cases of AMI were treated with PTCA. The patients' data about clinical outcome during hospital and follow-up periods were collected. Death and reinfarction were defined as adverse event. To analyze the correlative factors and independent predictors of death and reinfarction, the spearman rank correlation and multivariate logistic regression modeling were performed. Results: During hospital，incidences of adverse event were 15.46 percent and 6.45 percent in UK and PTCA groups respectively. In follow-up period, they were 30.93 percent and 9.68 percent respectively. Age, Q wave leads, Kill ip class, heart failure in hospital, the history of hypertension and myocardial infarction were positive correlation with adverse event, whereas history of smoking, systolic blood pressure and ejection fraction (EF) showed negative correlation with the adverse event. The interventional therapy, associated with lower mortality and reinfarction rate, was the independent predictor for adverse event in UK and PTC A groups during hospital and follow-up periods. Furthermore, it was the only independent predictor for PTCA group. In UK group, the adverse event also was independently predicted by age, heart failure and Q wave leads in hospital and by age, heart failure during follow-up period. There was negative correlation between preinfarction angina and adverse event, and positive correlation between thrombolysis and adverse event inpatients undergone rescue PTCA. Conclusion: Interventional therapy is crucial independent predictor for adverse event of patients suffering from AMI. The adverse event is also predicted by age, Q wave leads and heart failure. The history of preinfarction angina is negative correlation with the adverse event in hospital, due to, maybe, myocardium ischemia preconditioning.
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PAGE: 469-471
Expression of mitogen-activated protein kinas e in vascular tissues after coronary artery balloon injury in rat
GE Hua, ZENG Ding yin, ZHAO Wei ping, QI Guo guang
Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China.
Abstract：OBJECTIVE: To observe the changes in mitogen-activated protein kinase (MAPK) activity and gene expression after coronary artery balloon injury in rat. Methods: Forty Wistar rats were randomly divided into control group (without coronary artery balloon injury), and 3, 7 and 14 days after coronary artery balloon injury groups (n=10, respectively). The activity of MAPK was measured by biochemical method and the gene expression was examined by reverse transcription-polymerase chain reaction (RT-PCR). Results: MAPK activity and gene expression of MAPK in the coronary artery balloon injury in rat after 3, 7 and 14 days were significantly higher than that of normal control, especially 3 days after injury [MAPK activity: (17.32±2.17) pmol·mg-1·min -1；MAPK protein: ERK1 was 194.7±8.6, ERK2 was 175.8±7.9 ; MAPK gene expression: ERK1 was 1.15±0.21, ERK2 was 1.13±0.14 ]. Conclusion: The increase activity and mRNA of MAPK may be involved in the restenosis process after coronary balloon injury.
, 百拇医药
PAGE: 472-475
Evolution of fibrinolysis status with D-dimer level and the rate of plasminogen activator inhibitor type-1/D-dimer in acute coronary syndrome patients complicated with impaired glucose tolerance
WU Wo dong, XU Yun hong, TAN Pei yi
Department of Cardiology, Guangzhou Second Municipal People's Hospital, Guangzhou 510150, Guangdong, China.
Abstract：OBJECTIVE：To study the status of fibrinolytic inhibition in patients with acute coronary syndrome (ACS) complicated with impaired glucose tolerance (IGT) and to evaluate the effect of fibrinolytic inhibition on treatment and prognosis. Methods：The subjects were divided into three groups included 39 patients with ACS without diabetes mellitus, 37 patients with IGT+ACS and 36 patients with ACS+noninsulin-dependent diabetes mellitus (NIDDM). Twenty healthy people were randomized to be control group. The plasma levels of tissue type plasminogen activator (t-PA), plasminogen activator inhibitor type-1 (PAI-1) and plasma D-dimer were detected by enzyme linked immunoadsorbent assay (ELISA) technique. The index of status of fibrinolysis was detected with the plasma levels of PAI-1, D-dimer and the ratio of PAI-1/D-dimer. This index was used to evaluate the status of fibrinolytic inhibition and the clinical out come in patients with AMI. Results：Plasma level of PAI-1 was significantly higher in IGT+ACS patients and NIDDM +ACS patients than that in ACS(P<0.05), but the plasma level of D-dimer raised from basic level was significantly lower in IGT+ ACS patients and NIDDM+ACS patients than that in ACS (P<0.05). The ratio of PAI-1/D-dimer was significantly higher in IGT+ACS patients and NIDDM +A CS patients than that in ACS or in control group (P<0.01). For AMI patients in treatment groups, the rate of reperfusion after the thrombolytic was significantly lower and the rate of incidences in pump failure was significantly higher in IGT+ACS patients and NIDDM+ACS patients than that in ACS, too (P<0.01 and P<0.05). The incidences of serious arrhythmia, re-infarction and death were also higher in IGT+ACS patients and NIDDM +ACS patients. Conclusion：The fibrinolytic inhibition is existed in IGT+ACS group patients. The plasma level of D-dimer combined with the ratio of PAI-1/D-dimer could be used to be the evidence and to be the index to evaluate the status of fibrinolytic inhibition and prognosis.
, 百拇医药
PAGE: 475
Treatment of early-period atrial ventricular fibrillation after cardiac operation
QIN Qing tong,ZHANG Hua ping
Taizhou Central Hospital, Taizhou 318000, Zhejiang, China.
PAGE: 476-478
Effects of irbesartan on remodeling of the left ventricular following acute myocardial infarction
, 百拇医药 HUANG Yan sheng,SUN Jun hua, LI Xue ji
Henan Provincial People's Hospital, Zhengzhou 450003, Henan, China.
Abstract：OBJECTIVE: To compare the inhibitory effects of irbesartan on left ventricular remodeling (LVRM) after acute myocardial infarction (AMI). Methods: A total of 72 patients with AMI were entered into the study, 36 patients were randomized to conventional treatment group, and 36 patients to irbesartan treatment group. At 2nd week and 24th week after AMI, the left ventricular myocardium weight was measured by echocardiogram, and the parameters of left ventricular systolic and diastolic function were measured by equilibrium radionuclide angiography. Results: At 24th week, interventricular septal thickness (IVST), left ventricular posterior wall thick(LVPWT), left ventricular diastolic diameter (LVDd) and left ventricular mass index(LVMI) in irbesartan treatment group were significantly decreased(P<0.05 or P<0.01) compared with conventional treatment group At 24th week, left ventricular ejection fraction(LVEF), left ventricular peak ejecting rate (LPER) and left ventricular peak filling rate (LPFR) in irbesartan treatment group were significantly increased (P<0.05 or P<0.01) compared with those in conventional treatment group, respectively. Left ventricular time of peak ejecting rate (LTPER) and left ventricular time of peak filling rate (LTPFR) in irbesartan group were decreased(P<0.05 or P<0.01) compared with the conventional treatment group, respectively. Conclusion: Irbesartan might significantly reduce myocardial hypertrophy and LVRM after AMI. Irbesartan improves the left ventricular systolic function.
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PAGE: 479-481
Observation on the effects of urapidil on hemodynamics in heart dysfunction dogs by thoracic electrical bioimpedance
CHEN Wei, SHEN Hong
Department of Emergency, General Hospital of People's Liberation Army, Beijing 100853, China.
Abstract：OBJECTIVE: To observe the effects of urapidil on hemodynamics in heart dysfunction dogs by thoracic electrical bioimpedance. Methods: Sixteen health anesthesia dogs were taken pentobarbital till their hearts dysfunction. Then 10 dogs were taken urapidil injection (4 μg·kg-1·min-1) and 6 dogs were taken the same doses of normal saline, and heart rate (HR), stroke volume (SV), cardiac output (CO), pre-ejection period (PEP), left ventricular ejection time (LVET), systole time ratio (STR), isovolumic relaxation time (IRT), pulmonary capillary wedge pressure (PCWP), left ventricular end-diastolic pressure (LVEDP), total peripheral resistance (TPR), stroke work (SW) and cardiac work (CW) were continuously monitored by non-invasive hemodynamic monitoring system. Data were recorded at 15 minutes, 30 minutes, 60 minutes, 90 minutes and 120 minutes after dysfunction. Results: Compared to the group of normal saline, urapidil could increase CO and SV, shorten PEP and STR, decrease PCWP, LVEDP and TPR, increase SW and CW. Conclusion: The change of hemodynamics in heart dysfunction dogs can be observed, non-invasively and accurately, by thoracic electrical bioimpedance. Urapidil can obviously decrease preload and postload of heart, increase CO and myocardial contract potentiality, and improve heart function.
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PAGE: 482-484
Effects of overdriving pacing preconditioning on the activity of antioxidase in the coronary sinus during the ischemia-reperfusion
LIN Xiao hong, WU Li ming
Department of Emergency, The Affiliated Union Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China.
Abstract：OBJECTIVE: To evaluate the effects of early and delayed overdriving pacing preconditioning on the concentration of nitric oxide (NO), superoxide dismutase (SOD) and malondialdehyde (MDA) in blood. Methods: Forty-eight rabbits were divided into control (C) group, ischemia-reperfusion (IR) group, overdriving pacing preconditioning (PP) group and delayed protection (DP) group. The concentrations of NO, SOD, MDA in the coronary sinus were detected during the ischemia-reperfusion. Results: The levels of NO in the coronary sinus of PP and DP group were higher than that of IR group, the levels of MDA of PP and DP group were lower than that of IR group. Conclusion: PP and DP could alleviate the injury by the oxygen free radicals during the myocardial ischemia-reperfusion.
, 百拇医药
PAGE: 485-488
Effects of captopril on myocardial energy metabolism in mice with viral myocarditis
CHEN Jian bin, RAO Bang fu, CHANG Jing, LIAO Xiao gang, CAO You de
Department of Internal Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Abstract：OBJECTIVE: To explore the changes of myocardial energy production in mice with viral myocar ditis, and to observe the interventional effects of captopril. Methods: The male Balb/c mice were randomly divided into three groups: coxsackie B3 virus (CVB3) infection group (infection group), CVB3 infection group with captopril treatment (treatment group) and control group. The morphology, membrane phospholipid, as well as activities of cytochrome oxidase (CCO) and succinate dehydrogenase (SDH) of myocardial mitochondria were studied by using transmission electron microscope, morphometry and enzyme cytochemical method respectively. Reversed phase high-performance liquid chromatography (RP-HPLC) was used to analyze contents of myocardial ATP, ADP and AMP. Results: A large number of mitochondria were damaged in infection group, the apparent mitochondrial membrane phospholipid deletion and localization change were observed, the activities of CCO and SDH in mitochondria declined obviously, and the contents of ATP, ADP as well as AMP declined notably. All of these were improved significantly in treatment group. Conclusion: The myocardial mitochondrial structure destroys and its functions decline apparently in viral myocarditis. Captopril has effects against myocardial mitochondrial structure damage and function decline, ameliorate myocardial energy metabolism.
, 百拇医药
PAGE: 488
The clinical experience of medchanical ventilation in the emergency treatment of severe acute left heart failure
WANG Xi ling, ZHA Wei, DONG Li min, ZHANG Hong wei, WANG Xiao dong
Tianjin Native Hospital, Tianjin 300122, China.
PAGE: 489-492
Clinical significance of the function of adrenal cortex in refractory congestive heart failure
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LU Liang, LI Wei min
Cardiovascular Department, Dongyang People's Hospital, Dongyang 322100, Zhejiang, China.
Abstract：OBJECTIVE: To investigate the function of adrenal cortex in refractory congestive heart failure and to testify the hypothesis that glucocorticosteroid can improve the effectiveness of medicine on this disease. Methods: Thirty-eight patients with refractory congestive heart failure (men 23 and women 15) were enrolled in this study and randomly divided into two groups, control group and treatment group. The cardiac index and ejection fraction were applied to evaluate the cardiac function and the level of blood cortisol was used to estimate the adrenal cortex function. Results: The level of blood cortisol was low at the time of hospitalization in all studied patients. Moreover, the digoxin, diuretic and vasodilating had little effective ness in those patients. However, the glucocorticosteroid at a low dosage was able to improve the effectiveness of those medicines on congestive heart failure. The cardiac index, left ventricular ejection fraction and urine output dramatically increased after glucocorticosteroid treatment. There was a significant difference between the treatment group and control group (23.8 percent vs. 70.6 percent, P<0.01). In addition, the mortality in treatmentgroup was also lower than that in control group (38.1 percent vs. 58.8 percent, P>0.05). Conclusion: Glucocorticosteroid at a low dosage obviously improved the effectiveness of medicines on congestive heart failure, and increased the survival rate in the patients.
, 百拇医药
PAGE: 492-494
Preliminary analysis of treatment in 32 patients with critical severe acute respiratory syndrome
LU Wei, ZHANG Hong sheng, WANG Feng mei, WANG Shao jun, WU Xiao di, ZHANG Na xin, Kan zhi chao, QIN Ying zhi, XIAO Lang
Tianjin Third Central Hospital, Tianjin 300162, China.
Abstract：OBJECTIVE: To summarize the experience of treatment in 32 critical severe acute respiratory syndrome (SARS) patients. Methods: The age of 32 patients ranged from 19 to 72 years, the average was 43.06 years. Among them, 13 patients were having serious primary diseases, i.e. cardio-cerebral-vascular disease in 9 patients, diabetes in 2 patients, renal dysfunction in 1 patient, and chronic obstructive pulmonary disease (COPD) in 1 patient. The treatment included antiviral agents, glucocorticoid, mechanical ventilation, antibiotics and immunologic enhancement, etc. Cure rate, mortality and complications were analyzed. Results: Among 32 patients, 24 were cured, 2 died of respiratory failure, 6 died of their primary diseases, and the overall mortality was 25.00 percent. Superimposed infection occured in 12 patients, and among 17 patients who required noninvasive ventilation, 3 patients were complicated by lung injury (mediastinal emphysema, pneumothorax). In addition, hyperglycemia was found in 4 patients, upper intestinal hemorrhage occurred in another 4 patients and cardiac failure occurred in 6 patients. Conclusion: The treatment of the pre-existing diseases should be emphasized in the treatment of critical SARS. Glucocorticoid should not be used for a long-term. Vigilance should be paid to avoid lung injury during mechanical ventilation.
, 百拇医药
PAGE: 494
The treatment of 2500 fever patients in the outpatient and emergency department
CHEN Xiao yuan, CHEN Xin
Affiliated 3rd Hospital, Zhongshan University, Guangzhou 210009, Guangdong, China.
PAGE: 495-498
Comparison of severe acute respiratory syndrome with community-acquired pneumonia
, 百拇医药 XUE Xiao yan, ZHU Ji hong, CHENG Hui, PEI Li ying, GAO Zhan cheng
Peking University People's Hospital，Department of Emergency, Beijing 100044, China.
Abstract：OBJECTIVE: To study the features of severe acute respiratory syndrome (SARS) and community acquired pneumonia (CAP). Methods: The clinical presentation, chest radiographs, white blood cell count and outcome of 45 SARS patients from April 5 to 20 2003 were compared, with those of 80 CAP patients from October 1 2002 to April 1 2003 in our hospital, and the clinical features of SARS were summarized. Results: (1) Fever above 38.5 centigrade, dry cough, short of breath, headache, myalgia, diarrhea in SARS were more common in SARS patients than those in CAP (P<0.01). (2) Leucopenia was more common and leukocytosis was less common in SARS than those in CAP (P<0.01). (3) 22.2 percent of SARS patients were found abnormal chest radiographs within 24 hours after onset, 71.1 percent of SARS patients were showed progressive pulmonary infiltration via serial chest radiographs, while all CAP patients had abnormal chest radiographs when they were seen first time, and no patient showed progressive pulmonary infiltration, the difference was significant between the two groups (P<0.01). (4) Patients with SARS were lack of a response to the initial ant imicrobial therapy, all patients with CAP had an adequate clinical response within three days, the difference was significant between the two groups(P<0.01 ). (5) The ratio of severe pneumonia and mortality in SARS was much higher than in CAP (both P<0.01). Conclusion: The clinical presentation, chest radiographs, white blood cell count, response to initial antimicrobial therapy, and outcome in SARS is much different from CAP, differentiate them will be helpful to early recognition, prompt isolation, and prevention of its spread.
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PAGE: 498
Clinical significance of reversing the early stage reduction of renal function
inpatients with diabetes mellitus with insulin intensity treatment
JIANG Xia, HAN Jing, YU Guo ning, WU Jiang
Tianjin first Central Hospital, Tianjin 300192, China.
PAGE: 499-501
Retrospective analysis on clinical features of 35 patients with severe acute respiratory syndrome
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LUO Xian rong, LI Zhuo liang, CHENG Tao, WU Wei ling, LIU Shu ren, XIE Qing
Department of Infectious Disease, The 458 th Hospital of People′s Liberation Army, Guangzhou 510602, Guangdong, China.
Abstract：OBJECTIVE: To analyze the clinical features of severe acute respiratory syndrome (SARS). Methods: The clinical features of 35 patients with SARS in the past five months were retrospectively studied, and compared with 35 patients with community-acquired pneumonia. Consecutive blood samples from 13 patients with SARS and 10 healthy volunteers were collected. The CD+4 and CD+8 in T cell in peripheral blood were detected by flow cytometry. Results: The most common symptoms included fever (in 100.0 percent of the patients), cough (74.3 percent), headache (45.7 percent), myalgia (45.7 percent) and lymphopenia (20/33). Serial chest radiographs showed progressive multi-infiltration in the lung fields. The CD+4 and CD+8 in T cell in 13 patients with SARS significantly decreased [CD+4: (16.10±4.31) percent vs. (38.30±8.52) percent, t=8.174，P<0.01; CD+8: (19.90±5.40) percent vs. (28.38±4.33) percent, t=4.055, P<0.01]. The time of bringing down the fever and the time of absorption of pathological changes in SARS patients were prolonged than those of the pneumonia patients [the time of bringing down the fever (13.92±8.35) days vs. (3.86±1.42)days, t=16.490，P=0.000；the time of absorption of pathological changes: (11.97±4.41) days vs. (9.21±4.42) days, t=3.082，P=0.003]. Conclusion: SARS is a serious respiratory illness, the most common symptoms are fever, cough, headache and myalgia, other common findings are lymphopenia, the CD+4 and CD+8 in T cell in peripheral blood decrease and multi-infiltrate through out the lung fields.
, 百拇医药
PAGE: 502
Diagnostic testing evaluation of QTd, QTcd and QTdr in patients with myocardial infarction
WANG Cheng, XIE Zhen wu, LIN Ping, CAO Min jing, LI Ming xiang, LI Xiao ming
Second Xiangya Hospital Zhongnan University, Hunan changsha 410011, China.
PAGE: 503
Clinical significance of serum troponin I in patients with acute left heart failure
, 百拇医药
LU Zhi hua, ZHANG Bing, YAO Liang, LU Ping
People’s Hospital, Haiyan 314300, Zhejiang, China.
PAGE: 504
Effect of organization and cooperation of rescuing personnel on resuscitative successful ratio
CHAI Xiang ping, WU Zu lin
Second Xiangya Hospital Zhongnan University, Hunan changsha 410011, China.
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PAGE: 505-506
Tracing analysis of 30 patients with critical severe acute respiratory syndrome
ZHAN Chun, QIN Ying zhi, XU Lei, ZHANG Na xin
Tianjin Third Central Hospital, Intensive Care Unit, Tianjin Ventilator Therapy Research Center, Tianjin 300170, China.
PAGE: 508-510
Relationship of high homotype semicystine with coronary atherosclerosis disease
, 百拇医药
CHEN Ze, LI Chun sheng, ZHANG Jian
Beijing Chaoyang Hospital, Capital University of Medical Science, Beijing 100020, China.
PAGE: 510
A report of 3 patients with atypical severe acute respiratory syndrome
ZHANG Xiao he, ZHANG Wen hui, ZHOU Rong bin, LI Ai min, YI Gui yan, CAO Dan yang
Department of General Internal Medicine, Chaoyang hospital, Capital University of
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Medical Science, Beijing 100020, China.
PAGE: 511-512
European Society of cardiology guideline (III): percutaneous coronary interventions Emergency department.
ZHANG Wei, SHEN hong
General Hospital of People’s Liberation Army, Beijing 100853, China., http://www.100md.com
PAGE：452
Patients of severe acute respiratory syndrome with hypoxemia treated by anisodamine
YANG Guo dong
Ningbo Instityte of Microcirculation and Henballe, Ningbo 334010, Zhejiang, China.
PAGE：453-454
Increasing the speed of construction of the public health incident command system in our country
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DUAN Yun you
Naval General Hospital, Beijing 100037, China.
PAGE: 455-458
Effect of vitamin E on myosin light chain kinase activity and endothelial permeability of the artery in atherosclerotic rabbit
ZHU Hua qing, REN Bin, XIONG Jiang xia, HU Ruo lei, LIU Xiao ying, WANG Xue, ZHANG Su mei, LIU Hui lan, JIANG Zhi kui, ZHOU Qing, GUI Shu lan, WANG Yuan
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Laboratory of Molecular Biology and Department of Biochemistry, Anhui Medical University, Hefei 230032, Anhui, China
Abstract：OBJECTIVE: To study the effect of vitamin E (Vit E) on the myosin light chain kinase (MLCK) activity and the endothelial permeability of the artery in atherosclerotic rabbits. Methods: The MLCK activity of rabbit artery was measured by incorporation of γ-32 P. The endothelial permeability was accessed by immunofluorescence. Results: The model of atherosclerosis was established after rabbits were fed with cholesterol for four weeks. The activity of MLCK increased markedly, and there was significantly statistical difference compared with the normal control (P<0.05). When the rabbits were fed with cholesterol for twelve weeks or with cholesterol and Vit E for twelve weeks, the activity of MLCK did not change markedly, and there was no statistical difference compared with the normal control, respectively (P>0.05). The permeability of arterial wall was increased after the rabbits were fed with cholesterol for four weeks, and the permeability increased even more obviously after the rabbits were fed with cholesterol for twelve weeks. The permeability appeared to be decreased when Vit E was added into the cholesterol feeding. Conclusion: The change in integrity of arterial wall may be associated with the increase of the activity of MLCK. Vit E may decrease the MLCK activity. Vit E may decrease the endothelial permeability of atherosclerotic rabbits.
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PAGE: 459-461
Role of kaliuretic peptide and molar ratio of kaliuretic peptide/ atrial natriuretic peptide in atrial fibrillation
JI Da, ZENG Qiang, SHEN Hong, FAN Ying xian, CHEN Wei, SONG Yang li
Department of Emergency, General Hospital of People's Liberation Army, Beijing 100853, China
Abstract：OBJECTIVE: To investigate the role of kaliuretic peptide (KP) and molar ratio of KP/ atrial natriuretic peptide (ANP) in atrial fibrillation. Methods: The levels of plasma KP and ANP in 23 patients with paroxysmal atrial fibrillation (group I), 24 patients with persistent atrial fibrillation (>1 year, group II) and 20 healthy humans (group III) were determined with radioimmunoassay. Results: Compared with group III, the levels of plasma KP and ANP of the group I and group II were both higher (both P<0.01). Compared with group III, the level of KP/ANP of the group I was lower (P<0.01), while that of group II was no substantial change (P>0.05). Conclusion: The change of levels in ANP, KP and ANP/KP may play important role in atrial fibrillation.
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PAGE: 461
Clinical analysis of 32 cases of patients with severe asthma combined with acute left-sided heart failure
PAN Yun dong
The First People’s Hospital, Nanning 530022, Guangxi, China.
PAGE: 462-464
Study on defibrinogenasing enhancing the thrombolytic effect of urokinase on acute myocardial infarction
, 百拇医药
WU Xu hui, HONG Shao cai, LIU Ying ming, LI Tan shi, XIAN Ding cheng, LU Guang sen
Department of Cardiology, Naval General Hospital, Beijing 100037, China
Abstract：OBJECTIVE: To investigate the thrombolytic effects and the security of combined therapy of defibrinogenase (DEF) and lower dose urokinase (UK) on patients with acute myocardial infarction (AMI). Methods: Forty-five patients with AMI within 6 hours from the onset were divided into two groups, the combined therapy group (UK+DEF group, n=23) and the full dose UK group (UK group, n =22). The dosage of the UK in UK+DEF group was only the half of the full dos e UK group. In UK+DEF group, intravenous injection of 5 U DEF was preceded with intravenous infusion of UK, and after that, 5 U of DEF was infused intravenously in three separate times. Aspirin was prescribed for all patients. Coronary reperfusion was evaluated according to clinical criteria. The complication of bleeding was noted. Plasma fibrinogen (Fg) and D-dimer levels were determined before and after thrombolytic therapy. Results: The age, body weight, time from onset, reperfusion rate, reinfarction rate, bleeding complications and the mortality during hospitalization were similar in both groups (P>0.05), and no severe bleeding was found. The reperfusion rate of UK+DEF group (69.56 percent) was comparable with that of UK group(68.18 percent), P>0.05. While the time to reperfusion of UK+DEF group was markedly shorten than that of UK group, it was(62.08±32.40) minutes vs. (80.00±39.14) minutes respectively (P<0.01). The plasma levels of D-dimer were similar and were elevated at the 6 hours after the beginning of thrombolytic therapy both in two groups (P<0.05). The plasma Fg level was declined obviously in UK+DEF group with a decrease in 58.46 percent, while it was slightly declined in U K group with a 1678 percent decrease in percentage compared to those levels of pre-thrombolysis. Conclusion: The combination of DEF can enhance the thrombo lytic efficacy of UK, and can accelerate the lysis of coronary thrombus. The effect and the security of combination therapy are comparable to the full do se UK therapy.
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PAGE: 465-468
Analysis of factors correlated to death and reinfarction in patients with acute myocardial infarction
YIN Li, LI Guang ping, LI Jian, LI Li feng, ZHANG Cheng zong, HUANG Ti gang
The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
Abstract：OBJECTIVE: To identify the predictors of death and reinfarction in patients with acute myocardial infarction (AMI) treated with urokinase (UK) thrombolysis or percutaneous transluminal coronary angioplasty (PTCA). Methods: In ambispective cohort study, 97 cases of AMI were treated with UK thrombolytic therapy, while 93 cases of AMI were treated with PTCA. The patients' data about clinical outcome during hospital and follow-up periods were collected. Death and reinfarction were defined as adverse event. To analyze the correlative factors and independent predictors of death and reinfarction, the spearman rank correlation and multivariate logistic regression modeling were performed. Results: During hospital，incidences of adverse event were 15.46 percent and 6.45 percent in UK and PTCA groups respectively. In follow-up period, they were 30.93 percent and 9.68 percent respectively. Age, Q wave leads, Kill ip class, heart failure in hospital, the history of hypertension and myocardial infarction were positive correlation with adverse event, whereas history of smoking, systolic blood pressure and ejection fraction (EF) showed negative correlation with the adverse event. The interventional therapy, associated with lower mortality and reinfarction rate, was the independent predictor for adverse event in UK and PTC A groups during hospital and follow-up periods. Furthermore, it was the only independent predictor for PTCA group. In UK group, the adverse event also was independently predicted by age, heart failure and Q wave leads in hospital and by age, heart failure during follow-up period. There was negative correlation between preinfarction angina and adverse event, and positive correlation between thrombolysis and adverse event inpatients undergone rescue PTCA. Conclusion: Interventional therapy is crucial independent predictor for adverse event of patients suffering from AMI. The adverse event is also predicted by age, Q wave leads and heart failure. The history of preinfarction angina is negative correlation with the adverse event in hospital, due to, maybe, myocardium ischemia preconditioning.
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PAGE: 469-471
Expression of mitogen-activated protein kinas e in vascular tissues after coronary artery balloon injury in rat
GE Hua, ZENG Ding yin, ZHAO Wei ping, QI Guo guang
Department of Cardiology, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China.
Abstract：OBJECTIVE: To observe the changes in mitogen-activated protein kinase (MAPK) activity and gene expression after coronary artery balloon injury in rat. Methods: Forty Wistar rats were randomly divided into control group (without coronary artery balloon injury), and 3, 7 and 14 days after coronary artery balloon injury groups (n=10, respectively). The activity of MAPK was measured by biochemical method and the gene expression was examined by reverse transcription-polymerase chain reaction (RT-PCR). Results: MAPK activity and gene expression of MAPK in the coronary artery balloon injury in rat after 3, 7 and 14 days were significantly higher than that of normal control, especially 3 days after injury [MAPK activity: (17.32±2.17) pmol·mg-1·min -1；MAPK protein: ERK1 was 194.7±8.6, ERK2 was 175.8±7.9 ; MAPK gene expression: ERK1 was 1.15±0.21, ERK2 was 1.13±0.14 ]. Conclusion: The increase activity and mRNA of MAPK may be involved in the restenosis process after coronary balloon injury.
, 百拇医药
PAGE: 472-475
Evolution of fibrinolysis status with D-dimer level and the rate of plasminogen activator inhibitor type-1/D-dimer in acute coronary syndrome patients complicated with impaired glucose tolerance
WU Wo dong, XU Yun hong, TAN Pei yi
Department of Cardiology, Guangzhou Second Municipal People's Hospital, Guangzhou 510150, Guangdong, China.
Abstract：OBJECTIVE：To study the status of fibrinolytic inhibition in patients with acute coronary syndrome (ACS) complicated with impaired glucose tolerance (IGT) and to evaluate the effect of fibrinolytic inhibition on treatment and prognosis. Methods：The subjects were divided into three groups included 39 patients with ACS without diabetes mellitus, 37 patients with IGT+ACS and 36 patients with ACS+noninsulin-dependent diabetes mellitus (NIDDM). Twenty healthy people were randomized to be control group. The plasma levels of tissue type plasminogen activator (t-PA), plasminogen activator inhibitor type-1 (PAI-1) and plasma D-dimer were detected by enzyme linked immunoadsorbent assay (ELISA) technique. The index of status of fibrinolysis was detected with the plasma levels of PAI-1, D-dimer and the ratio of PAI-1/D-dimer. This index was used to evaluate the status of fibrinolytic inhibition and the clinical out come in patients with AMI. Results：Plasma level of PAI-1 was significantly higher in IGT+ACS patients and NIDDM +ACS patients than that in ACS(P<0.05), but the plasma level of D-dimer raised from basic level was significantly lower in IGT+ ACS patients and NIDDM+ACS patients than that in ACS (P<0.05). The ratio of PAI-1/D-dimer was significantly higher in IGT+ACS patients and NIDDM +A CS patients than that in ACS or in control group (P<0.01). For AMI patients in treatment groups, the rate of reperfusion after the thrombolytic was significantly lower and the rate of incidences in pump failure was significantly higher in IGT+ACS patients and NIDDM+ACS patients than that in ACS, too (P<0.01 and P<0.05). The incidences of serious arrhythmia, re-infarction and death were also higher in IGT+ACS patients and NIDDM +ACS patients. Conclusion：The fibrinolytic inhibition is existed in IGT+ACS group patients. The plasma level of D-dimer combined with the ratio of PAI-1/D-dimer could be used to be the evidence and to be the index to evaluate the status of fibrinolytic inhibition and prognosis.
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PAGE: 475
Treatment of early-period atrial ventricular fibrillation after cardiac operation
QIN Qing tong,ZHANG Hua ping
Taizhou Central Hospital, Taizhou 318000, Zhejiang, China.
PAGE: 476-478
Effects of irbesartan on remodeling of the left ventricular following acute myocardial infarction
, 百拇医药 HUANG Yan sheng,SUN Jun hua, LI Xue ji
Henan Provincial People's Hospital, Zhengzhou 450003, Henan, China.
Abstract：OBJECTIVE: To compare the inhibitory effects of irbesartan on left ventricular remodeling (LVRM) after acute myocardial infarction (AMI). Methods: A total of 72 patients with AMI were entered into the study, 36 patients were randomized to conventional treatment group, and 36 patients to irbesartan treatment group. At 2nd week and 24th week after AMI, the left ventricular myocardium weight was measured by echocardiogram, and the parameters of left ventricular systolic and diastolic function were measured by equilibrium radionuclide angiography. Results: At 24th week, interventricular septal thickness (IVST), left ventricular posterior wall thick(LVPWT), left ventricular diastolic diameter (LVDd) and left ventricular mass index(LVMI) in irbesartan treatment group were significantly decreased(P<0.05 or P<0.01) compared with conventional treatment group At 24th week, left ventricular ejection fraction(LVEF), left ventricular peak ejecting rate (LPER) and left ventricular peak filling rate (LPFR) in irbesartan treatment group were significantly increased (P<0.05 or P<0.01) compared with those in conventional treatment group, respectively. Left ventricular time of peak ejecting rate (LTPER) and left ventricular time of peak filling rate (LTPFR) in irbesartan group were decreased(P<0.05 or P<0.01) compared with the conventional treatment group, respectively. Conclusion: Irbesartan might significantly reduce myocardial hypertrophy and LVRM after AMI. Irbesartan improves the left ventricular systolic function.
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PAGE: 479-481
Observation on the effects of urapidil on hemodynamics in heart dysfunction dogs by thoracic electrical bioimpedance
CHEN Wei, SHEN Hong
Department of Emergency, General Hospital of People's Liberation Army, Beijing 100853, China.
Abstract：OBJECTIVE: To observe the effects of urapidil on hemodynamics in heart dysfunction dogs by thoracic electrical bioimpedance. Methods: Sixteen health anesthesia dogs were taken pentobarbital till their hearts dysfunction. Then 10 dogs were taken urapidil injection (4 μg·kg-1·min-1) and 6 dogs were taken the same doses of normal saline, and heart rate (HR), stroke volume (SV), cardiac output (CO), pre-ejection period (PEP), left ventricular ejection time (LVET), systole time ratio (STR), isovolumic relaxation time (IRT), pulmonary capillary wedge pressure (PCWP), left ventricular end-diastolic pressure (LVEDP), total peripheral resistance (TPR), stroke work (SW) and cardiac work (CW) were continuously monitored by non-invasive hemodynamic monitoring system. Data were recorded at 15 minutes, 30 minutes, 60 minutes, 90 minutes and 120 minutes after dysfunction. Results: Compared to the group of normal saline, urapidil could increase CO and SV, shorten PEP and STR, decrease PCWP, LVEDP and TPR, increase SW and CW. Conclusion: The change of hemodynamics in heart dysfunction dogs can be observed, non-invasively and accurately, by thoracic electrical bioimpedance. Urapidil can obviously decrease preload and postload of heart, increase CO and myocardial contract potentiality, and improve heart function.
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PAGE: 482-484
Effects of overdriving pacing preconditioning on the activity of antioxidase in the coronary sinus during the ischemia-reperfusion
LIN Xiao hong, WU Li ming
Department of Emergency, The Affiliated Union Hospital, Fujian Medical University, Fuzhou 350001, Fujian, China.
Abstract：OBJECTIVE: To evaluate the effects of early and delayed overdriving pacing preconditioning on the concentration of nitric oxide (NO), superoxide dismutase (SOD) and malondialdehyde (MDA) in blood. Methods: Forty-eight rabbits were divided into control (C) group, ischemia-reperfusion (IR) group, overdriving pacing preconditioning (PP) group and delayed protection (DP) group. The concentrations of NO, SOD, MDA in the coronary sinus were detected during the ischemia-reperfusion. Results: The levels of NO in the coronary sinus of PP and DP group were higher than that of IR group, the levels of MDA of PP and DP group were lower than that of IR group. Conclusion: PP and DP could alleviate the injury by the oxygen free radicals during the myocardial ischemia-reperfusion.
, 百拇医药
PAGE: 485-488
Effects of captopril on myocardial energy metabolism in mice with viral myocarditis
CHEN Jian bin, RAO Bang fu, CHANG Jing, LIAO Xiao gang, CAO You de
Department of Internal Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Abstract：OBJECTIVE: To explore the changes of myocardial energy production in mice with viral myocar ditis, and to observe the interventional effects of captopril. Methods: The male Balb/c mice were randomly divided into three groups: coxsackie B3 virus (CVB3) infection group (infection group), CVB3 infection group with captopril treatment (treatment group) and control group. The morphology, membrane phospholipid, as well as activities of cytochrome oxidase (CCO) and succinate dehydrogenase (SDH) of myocardial mitochondria were studied by using transmission electron microscope, morphometry and enzyme cytochemical method respectively. Reversed phase high-performance liquid chromatography (RP-HPLC) was used to analyze contents of myocardial ATP, ADP and AMP. Results: A large number of mitochondria were damaged in infection group, the apparent mitochondrial membrane phospholipid deletion and localization change were observed, the activities of CCO and SDH in mitochondria declined obviously, and the contents of ATP, ADP as well as AMP declined notably. All of these were improved significantly in treatment group. Conclusion: The myocardial mitochondrial structure destroys and its functions decline apparently in viral myocarditis. Captopril has effects against myocardial mitochondrial structure damage and function decline, ameliorate myocardial energy metabolism.
, 百拇医药
PAGE: 488
The clinical experience of medchanical ventilation in the emergency treatment of severe acute left heart failure
WANG Xi ling, ZHA Wei, DONG Li min, ZHANG Hong wei, WANG Xiao dong
Tianjin Native Hospital, Tianjin 300122, China.
PAGE: 489-492
Clinical significance of the function of adrenal cortex in refractory congestive heart failure
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LU Liang, LI Wei min
Cardiovascular Department, Dongyang People's Hospital, Dongyang 322100, Zhejiang, China.
Abstract：OBJECTIVE: To investigate the function of adrenal cortex in refractory congestive heart failure and to testify the hypothesis that glucocorticosteroid can improve the effectiveness of medicine on this disease. Methods: Thirty-eight patients with refractory congestive heart failure (men 23 and women 15) were enrolled in this study and randomly divided into two groups, control group and treatment group. The cardiac index and ejection fraction were applied to evaluate the cardiac function and the level of blood cortisol was used to estimate the adrenal cortex function. Results: The level of blood cortisol was low at the time of hospitalization in all studied patients. Moreover, the digoxin, diuretic and vasodilating had little effective ness in those patients. However, the glucocorticosteroid at a low dosage was able to improve the effectiveness of those medicines on congestive heart failure. The cardiac index, left ventricular ejection fraction and urine output dramatically increased after glucocorticosteroid treatment. There was a significant difference between the treatment group and control group (23.8 percent vs. 70.6 percent, P<0.01). In addition, the mortality in treatmentgroup was also lower than that in control group (38.1 percent vs. 58.8 percent, P>0.05). Conclusion: Glucocorticosteroid at a low dosage obviously improved the effectiveness of medicines on congestive heart failure, and increased the survival rate in the patients.
, 百拇医药
PAGE: 492-494
Preliminary analysis of treatment in 32 patients with critical severe acute respiratory syndrome
LU Wei, ZHANG Hong sheng, WANG Feng mei, WANG Shao jun, WU Xiao di, ZHANG Na xin, Kan zhi chao, QIN Ying zhi, XIAO Lang
Tianjin Third Central Hospital, Tianjin 300162, China.
Abstract：OBJECTIVE: To summarize the experience of treatment in 32 critical severe acute respiratory syndrome (SARS) patients. Methods: The age of 32 patients ranged from 19 to 72 years, the average was 43.06 years. Among them, 13 patients were having serious primary diseases, i.e. cardio-cerebral-vascular disease in 9 patients, diabetes in 2 patients, renal dysfunction in 1 patient, and chronic obstructive pulmonary disease (COPD) in 1 patient. The treatment included antiviral agents, glucocorticoid, mechanical ventilation, antibiotics and immunologic enhancement, etc. Cure rate, mortality and complications were analyzed. Results: Among 32 patients, 24 were cured, 2 died of respiratory failure, 6 died of their primary diseases, and the overall mortality was 25.00 percent. Superimposed infection occured in 12 patients, and among 17 patients who required noninvasive ventilation, 3 patients were complicated by lung injury (mediastinal emphysema, pneumothorax). In addition, hyperglycemia was found in 4 patients, upper intestinal hemorrhage occurred in another 4 patients and cardiac failure occurred in 6 patients. Conclusion: The treatment of the pre-existing diseases should be emphasized in the treatment of critical SARS. Glucocorticoid should not be used for a long-term. Vigilance should be paid to avoid lung injury during mechanical ventilation.
, 百拇医药
PAGE: 494
The treatment of 2500 fever patients in the outpatient and emergency department
CHEN Xiao yuan, CHEN Xin
Affiliated 3rd Hospital, Zhongshan University, Guangzhou 210009, Guangdong, China.
PAGE: 495-498
Comparison of severe acute respiratory syndrome with community-acquired pneumonia
, 百拇医药 XUE Xiao yan, ZHU Ji hong, CHENG Hui, PEI Li ying, GAO Zhan cheng
Peking University People's Hospital，Department of Emergency, Beijing 100044, China.
Abstract：OBJECTIVE: To study the features of severe acute respiratory syndrome (SARS) and community acquired pneumonia (CAP). Methods: The clinical presentation, chest radiographs, white blood cell count and outcome of 45 SARS patients from April 5 to 20 2003 were compared, with those of 80 CAP patients from October 1 2002 to April 1 2003 in our hospital, and the clinical features of SARS were summarized. Results: (1) Fever above 38.5 centigrade, dry cough, short of breath, headache, myalgia, diarrhea in SARS were more common in SARS patients than those in CAP (P<0.01). (2) Leucopenia was more common and leukocytosis was less common in SARS than those in CAP (P<0.01). (3) 22.2 percent of SARS patients were found abnormal chest radiographs within 24 hours after onset, 71.1 percent of SARS patients were showed progressive pulmonary infiltration via serial chest radiographs, while all CAP patients had abnormal chest radiographs when they were seen first time, and no patient showed progressive pulmonary infiltration, the difference was significant between the two groups (P<0.01). (4) Patients with SARS were lack of a response to the initial ant imicrobial therapy, all patients with CAP had an adequate clinical response within three days, the difference was significant between the two groups(P<0.01 ). (5) The ratio of severe pneumonia and mortality in SARS was much higher than in CAP (both P<0.01). Conclusion: The clinical presentation, chest radiographs, white blood cell count, response to initial antimicrobial therapy, and outcome in SARS is much different from CAP, differentiate them will be helpful to early recognition, prompt isolation, and prevention of its spread.
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PAGE: 498
Clinical significance of reversing the early stage reduction of renal function
inpatients with diabetes mellitus with insulin intensity treatment
JIANG Xia, HAN Jing, YU Guo ning, WU Jiang
Tianjin first Central Hospital, Tianjin 300192, China.
PAGE: 499-501
Retrospective analysis on clinical features of 35 patients with severe acute respiratory syndrome
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LUO Xian rong, LI Zhuo liang, CHENG Tao, WU Wei ling, LIU Shu ren, XIE Qing
Department of Infectious Disease, The 458 th Hospital of People′s Liberation Army, Guangzhou 510602, Guangdong, China.
Abstract：OBJECTIVE: To analyze the clinical features of severe acute respiratory syndrome (SARS). Methods: The clinical features of 35 patients with SARS in the past five months were retrospectively studied, and compared with 35 patients with community-acquired pneumonia. Consecutive blood samples from 13 patients with SARS and 10 healthy volunteers were collected. The CD+4 and CD+8 in T cell in peripheral blood were detected by flow cytometry. Results: The most common symptoms included fever (in 100.0 percent of the patients), cough (74.3 percent), headache (45.7 percent), myalgia (45.7 percent) and lymphopenia (20/33). Serial chest radiographs showed progressive multi-infiltration in the lung fields. The CD+4 and CD+8 in T cell in 13 patients with SARS significantly decreased [CD+4: (16.10±4.31) percent vs. (38.30±8.52) percent, t=8.174，P<0.01; CD+8: (19.90±5.40) percent vs. (28.38±4.33) percent, t=4.055, P<0.01]. The time of bringing down the fever and the time of absorption of pathological changes in SARS patients were prolonged than those of the pneumonia patients [the time of bringing down the fever (13.92±8.35) days vs. (3.86±1.42)days, t=16.490，P=0.000；the time of absorption of pathological changes: (11.97±4.41) days vs. (9.21±4.42) days, t=3.082，P=0.003]. Conclusion: SARS is a serious respiratory illness, the most common symptoms are fever, cough, headache and myalgia, other common findings are lymphopenia, the CD+4 and CD+8 in T cell in peripheral blood decrease and multi-infiltrate through out the lung fields.
, 百拇医药
PAGE: 502
Diagnostic testing evaluation of QTd, QTcd and QTdr in patients with myocardial infarction
WANG Cheng, XIE Zhen wu, LIN Ping, CAO Min jing, LI Ming xiang, LI Xiao ming
Second Xiangya Hospital Zhongnan University, Hunan changsha 410011, China.
PAGE: 503
Clinical significance of serum troponin I in patients with acute left heart failure
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LU Zhi hua, ZHANG Bing, YAO Liang, LU Ping
People’s Hospital, Haiyan 314300, Zhejiang, China.
PAGE: 504
Effect of organization and cooperation of rescuing personnel on resuscitative successful ratio
CHAI Xiang ping, WU Zu lin
Second Xiangya Hospital Zhongnan University, Hunan changsha 410011, China.
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PAGE: 505-506
Tracing analysis of 30 patients with critical severe acute respiratory syndrome
ZHAN Chun, QIN Ying zhi, XU Lei, ZHANG Na xin
Tianjin Third Central Hospital, Intensive Care Unit, Tianjin Ventilator Therapy Research Center, Tianjin 300170, China.
PAGE: 508-510
Relationship of high homotype semicystine with coronary atherosclerosis disease
, 百拇医药
CHEN Ze, LI Chun sheng, ZHANG Jian
Beijing Chaoyang Hospital, Capital University of Medical Science, Beijing 100020, China.
PAGE: 510
A report of 3 patients with atypical severe acute respiratory syndrome
ZHANG Xiao he, ZHANG Wen hui, ZHOU Rong bin, LI Ai min, YI Gui yan, CAO Dan yang
Department of General Internal Medicine, Chaoyang hospital, Capital University of
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Medical Science, Beijing 100020, China.
PAGE: 511-512
European Society of cardiology guideline (III): percutaneous coronary interventions Emergency department.
ZHANG Wei, SHEN hong
General Hospital of People’s Liberation Army, Beijing 100853, China., http://www.100md.com