Association of lipoprotein-associated phospholipase A2 with characteristics of vulnerable coronary atherosclerotic plaques.

PURPOSE: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an inflammatory enzyme expressed in atherosclerotic plaques. We investigated the association of circulating Lp-PLA2 with characteristics of vulnerable coronary atherosclerotic plaques. MATERIALS AND METHODS: We recruited 113 patients with either unstable angina (UA, n=59) and stable angina (SA, n=54) by coronary angiography. Thirty-six healthy subjects served as controls. Intravascular ultrasound (IVUS) was used to evaluate the characteristics of coronary atherosclerotic plaque, and serum Lp-PLA2 concentration was measured as well. RESULTS: Lp-PLA2 concentration was significantly higher in both UA and SA patients [(396±36) µg/L and (321±39) µg/L, respectively] compared with the controls [(127 ± 49) µg/L, p<0.01], and higher in UA than SA group. IVUS findings showed that remodeling index (RI) (0.91 ± 0.15 vs. 0.85 ± 0.11, p=0.005) and eccentricity index (EI) (0.73 ± 0.16 vs. 0.65 ± 0.22, p=0.039) were larger in UA than in SA group, and fibrous caps were thicker in SA than UA group [(0.91 ± 0.23) mm vs. (0.63 ± 0.21) mm, p=0.032]. Moreover, Lp-PLA2 correlated positively with EI (r=0.439, p<0.01) and RI (r=0.592, p<0.05) in UA group. There was an inverse relationship between Lp-PLA2 and fibrous cap thickness in both UA (r=-0.587, p<0.001) and SA (r=-0.318, p<0.05) groups. The independent risk factors in UA group were Lp-PLA2 (OR=1.055, 95% CI: 1.03-1.08, p=0.013), LDL-cholesterol (OR=0.032, 95% CI: 0.00-0.05, p=0.041) and fibrous cap thickness (OR=0.008, 95% CI: 0.00-0.45, p=0.019). Lp-PLA2 was strongly associated with both EI and fibrous cap thickness in both groups. CONCLUSION: Serum level of Lp-PLA2 is associated with both eccentricity index and fibrous cap thickness in both UA and SA groups. Elevated levels of circulating Lp-PLA2 might to be a strong risk factor and more serious for unstable angina than stable angina.

[Clinical comparison between micro-endoscopic discectomy (MED) and open discectomy for treatment of lumbar disc herniation].

OBJECTIVE: To compare between micro-endoscopic discectom) (MED) and open decompression discectomy, and assess the clinical value of MED. METHODS: Two hundreds and sixty-one cases who suffered from lumbar disc herniation had a retrospective study. One hundred and twenty-one of 261 patients were treated with MED including 72 male and 52 female with an average age of 37.6 years ranging 26 to 63, the segment of herniated discs were at L4.5 in 66 and at L5S1 in 58. The other 137 patients were treated with decompression by fenestration and discectomy including 66 male and 71 female with an average age of 44.5 years ranging 25 to 71, the segment of herniated discs were at L4.5 in 64 and at L5S1 in 73. MED was performed via a scopes. Open decompression discectomy was performed decompression by fenestration and discectomy. RESULTS: MED group were followed up for 14.5 months on average, the operative time was (85 +/- 15) minutes and blood loss was (50 +/- 10) ml, time of laying in bed after operation was (50 +/- 8) hours. Open decompression group were followed up for 15.5 months on average, operative time was (60 +/- 15) minutes and blood loss was (80 +/- 20) ml, time of laying bed after operation was (150 +/- 24) hours. MED group needed significantly less narcotic medication after operation than open decompression group. According to modified Macnab criteria, the results were excellent in 94, good in 25, fair in 5 in MED group and excellent in 101, good in 28, fair in 8 in open decompression group. CONCLUSION: As compared with open decompression group, MED offers a similar short-term clinical outcome, but with smaller incision, less tissue trauma and quicker recovery.

[Investigations and analysis of traumatic condition of Longnan area in Wenchuan earthquake].

OBJECTIVE: To investigate and analyze the traumatic conditions of Longnan area of Gansu in Wenchuan earthquake, and to explore the measures coping with unexpected disasters. METHODS: A sample survey including questionnaire survey, interviews and other methods was adopted to investigate the conditions of affected population of Longnan area in earthquake, especially on the traumatic conditions, the injured causes, treatment methods. RESULTS: In the sample survey of a total of 1652 earthquake casualties, the dead were 16 and the patients with extremities fractures were 750 (45.4%). Organized and timely rescue of the wounded could reduce the complications and the mortality . CONCLUSION: Strengthening the prevention and treatment of earthquake trauma can effectively decrease the death rate and disabled rate.