Assessment of ischemia-modified albumin levels for emergency room diagnosis of acute coronary syndrome.

BACKGROUND: The aim of this study was to retrospectively evaluate the utility of assessing ischemia-modified albumin (IMA) levels for diagnosing acute coronary syndrome (ACS) in patients presenting to the emergency room (ER) with chest pain. METHODS: The records of patients admitted to the ER with chest pain between August 2006 and December 2008 were examined. Those subsequently diagnosed with ACS were included in the study. Serum IMA and cardiac troponin I (cTnI) concentrations were determined in blood samples obtained from patients within 3h of ER admission and on days 1, 3, 7 and 14. IMA and cTnI cut-off values for diagnosis of ACS were employed and the successful diagnosis rates were compared. RESULTS: Of the patients diagnosed with ACS following ER presentation with acute chest pain, the correct diagnosis rate was significantly higher as determined by assessment of IMA vs. cTnI concentrations within 3h of ER presentation (81.02% vs. 42.34%, P<0.01). Thereafter there were no between marker differences in rates of successful diagnosis. CONCLUSIONS: These findings support the notion that IMA may be a useful biochemical marker for the early diagnosis of ACS, particularly in patients presenting to the ER with acute chest pain.

[Effect of the ratio of height to diameter on the performance of the simultaneous reactor for nitrogen removal from swine wastewater and sulfide removal from biogas].

The effect of the ratio of height to diameter (H/D) on the process of simultaneous nitrogen removal from swine wastewater and hydrogen sulfide removal from biogas was investigated, using the bubble column reactors with packing material. The performance of the reactor with H/D of 8 : 1, 3 :1 and 2 : 1 was compared. Under temperature of 30-32 degrees C, gas retention time of 6.70 min, hydraulic retention time of 3.35 d, hydrogen sulfide concentration of 1 414-1 838 mg x m(-3) in biogas, and NO(x)(-) -N concentration of 114-243 mg x L(-1) in influent. The reactor with H/D of 2 : 1 achieved a stable and good treatment result, with the average removal rates of 96.7% for hydrogen sulfide, and 88.7% for N(x)(-) -N. While the reactors with H/D of 3 : 1 and 8 : 1 obtained unstable and inferior results, with the average removal rates of 68.0%, 80.4% for hydrogen sulfide respectively, and 89.7%, 90.2% for NO(x)(-) -N respectively. The reason could be attributed to the following facts. The reactor with H/D of 2:1 has a slower optimum gas velocity (3.12 x 10(-2) m x s(-1))- than the reactor with H/D of 3 : 1 and 8 : 1 (3.62 x 10(-2) m x s(-1) and 6.64 x 10(-2) m x s(-1) respectively), and has a higher gas-liquid mass transfer coefficient (1.79 x 10(-5) s(-1)) than the other two reactors (1.64 x 10(-5) s(-1) and 1.55 x 10(-5) s(-1) respectively). Results of the performance and the hydrodynamics parameters of the reactors all indicated that the reactor with H/D of 2 : 1 was more suitable for the process of simultaneous nitrogen and hydrogen sulfide removal.

[Time course of ubiquitin and rat component 3 of proteasome expressions and association with common carotid artery intimal proliferation after balloon injury in rats.].

OBJECTIVE: To investigate the dynamic ubiquitin and rat component 3 of proteasome (RC3) change and association with intimal proliferation in the common carotid artery of rats after balloon injury. METHODS: Male SD rats were randomly divided into two groups: sham operation group (n = 8), ballon injury group at various time points (1, 4, 7, 14, 21, 28-days post injury, n = 8 each). The balloon injury model was established by deendothelializing the rat common carotid aortic artery by inflated 2F balloon catheter. HE staining was used to observe the ratio of intima-media (I/M) thickness of the injured arteries under optical microscopy. The expression levels of ubiquitin and RC3 mRNA were detected with RT-PCR. The expression level of ubiquitin protein was measured by immunohistochemistry method. RESULTS: The maximal intimal proliferation and peak intima-media ratio (2.31 +/- 0.43 vs. control 0.02 +/- 0.005, P < 0.01) were seen at 28th day post injury. The peak expression of ubiquitin was observed at the 7th day post injury (1.33 +/- 0.26 vs. control 0.21 +/- 0.04, P < 0.01) and peak RC3 expression was found at the 14th day post injury (1.35 +/- 0.26 vs. control 0.31 +/- 0.06, P < 0.01). The protein expression of ubiquitin was also seen at the 14th day post injury (21.53 +/- 4.09 vs. control 4.21 +/- 0.78, P < 0.01). The expression of ubiquitin protein was positively correlated with intimal proliferation(r = 0.827, P < 0.05). CONCLUSION: The upregulated ubiquitin and RC3 expressions after balloon injury might play an important role in intimal proliferation in this model.

[Diagnostic value of ischemia-modified albumin in patients with acute coronary syndrome].

OBJECTIVE: To investigate the diagnostic value of ischemia-modified albumin (IMA) for patients with acute coronary syndrome (ACS). METHODS: We detected the IMA levels by albumin cobalt-binding (ACB) test and observed its dynamic changes in 492 patients with ACS, 74 patients with high blood pressure, 78 patients with viral myocarditis (VMC), 395 patients with acute chest pain (133 patients with acute ACS and 262 follow-up patients due to chest pain), 68 patients underwent percutaneous coronary intervention (PCI) and 830 healthy controls. Cardiac troponin I (cTnI) levels were assayed and electrocardiogram (ECG) recorded in patients with ACS. RESULTS: The optimal diagnostic cutoff point for IMA in this study population was found to be 0.45 ABSU by ROC analysis. The IMA level (ABSU) in ACS group (0.55 +/- 0.11) was significantly higher than that in VMC group (0.38 +/- 0.11) and IMA levels in ACS and VMC groups were both higher than that in control and high blood pressure groups (0.34 +/- 0.08 and 0.35 +/- 0.08, all P < 0.05). IMA levels and the positive rates in patients with ACS were significantly higher (0.54 +/- 0.12 vs 0.44 +/- 0.12, 77.4% vs 39.3%, all P < 0.01) than those in chest pain follow-up group. In 133 patients with ACS, positive rate for IMA was significantly higher than that for cTnI within 1 h of admission (82.0% vs 40.6%, P < 0.01), and was similar at 6 - 24 h after admission (96.2% vs. 95.5%, P > 0.05). In 72 patients presenting to the emergency center within 3 h of acute chest pain and with negative cTnI, positive rate for IMA was 86.1% and for ECG 72.2%, the sensitivity for ACS diagnosis rised to 93.1% with both methods. The IMA leve was higher immediately after PCI than that before PCI (P < 0.05). IMA levels peaked 1d after hospitalization, then decreased gradually and returned to normal 14 days later. CONCLUSIONS: IMA was a useful biochemical marker for the early diagnosis of ACS.