[Association between serum homocysteine and in-hospital death in patients with acute pulmonary embolism].

OBJECTIVE: To explore the association between serum homocysteine (Hcy) level and in-hospital death in patients with acute pulmonary embolism. METHODS: A total of 186 acute pulmonary embolism patients [ (66.8 ± 12.7) years, 89 male] hospitalized in our department between June 2008 and June 2011 were included in this prospective study. Patients were divided into high Hcy group (Hcy ≥ 15.2 µmol/L, n = 95) and low Hcy group (Hcy < 15.2 µmol/L, n = 91). Patients were followed-up for 1 year for the incidence rate of early death associated with acute pulmonary embolism. The Cox proportional hazard model was used to analyze the relationship between serum Hcy level and early death in acute pulmonary embolism patients. RESULTS: Patients were hospitalized for 1-37 days [(10 ± 6) days]. In-hospital death rate was 14.5% (27/186) and was significantly higher in high Hcy group than in low Hcy group [25.3% (24/95) vs. 3.3% (3/91) , P = 0.001]. Univariate Cox regression analysis indicated that admission heart rate, oxygen saturation, enlargement of right ventricle, Hcy ≥ 15.2 µmol/L, serum creatinine level, peak TnT level and deep venous thrombosis (P < 0.05) were independent risk factors for in-hospital death. Multivariate Cox regression analysis showed that Hcy ≥ 15.2 µmol/L (HR = 4.10, 95%CI:3.00-4.98, P = 0.017), admission heart rate (HR = 1.10, 95%CI:1.01-1.20, P = 0.031) , deep venous thrombosis (HR = 1.65, 95%CI:1.45-1.76, P = 0.034) and age (HR = 1.10, 95%CI:1.02-1.19, P = 0.010) were independent predictors of in-hospital death for acute pulmonary embolism patients. One-year follow up was finished in 142 patients (89.3%). There were 19 deaths ( 5 due to repeat pulmonary embolism, 4 due to decompensated respiratory and /or cardiac diseases, 6 due to malignant tumors, 2 due to fatal bleeding and 2 due to pneumonia) . Death rate was similar between the two groups during follow up. CONCLUSION: Higher serum homocysteine is an independent for in-hospital death for patients with acute pulmonary embolism.

[Vicissitude of antibiotic sensitivity of Gram negative bacilli in patients with infection in emergency departments in Beijing during 2005 to 2007].

OBJECTIVE: To investigate changes in antibiotic sensitivity of Gram negative bacilli infections among emergency patients in large hospitals in Beijing during 2005 to 2007. METHODS: Retrospective analysis of all the identified strains of Gram negative bacilli, and their sensitivity to antibiotic obtained in the emergency departments of 5 top first-class hospitals in Beijing for recent 3 years. RESULTS: Two thousand two hundred and eighty-five strains of Gram negative bacilli had taken 64.62% of all, the priority 5 of which were Pseudomonas aeruginosa (23.89%), Escherichia coli (19.91%), Acinetobacter baumanii (17.59%), Klebsiella pneumoniae (8.05%) and Staphylococcus maltophilia (3.94%). The sensitivity of commonly used antibiotics plummeted greatly in recent 3 years, especially carbapenems, cephalosporins and quinolones. The resistance of imipenem-resistant Pseudomonas aeruginosa was 17.30%, 22.53%, 31.92% respectively. The resistance of imipenem-resistant Acinetobacter baumanii was 13.87%, 12.09%, 23.56% respectively. CONCLUSION: Infectious bacteria in emergency departments in Beijing top first-class hospitals tend to show the characteristics of hospital infection. In recent years, the sensitivity of bacilli to antibiotic has dropped greatly. The situation of antibiotics resistance might be depressed.

[Experimental study of the effects of mild hypothermia on the acute myocardial infarction size in the rabbits with coronary artery reperfusion].

OBJECTIVE: To study the effect of mild hypothermia on the acute myocardial infarction size in the rabbits with coronary artery reperfusion. METHODS: fourteen rabbits were randomly divided into two groups: mild hypothermia group and control group. Each group underwent 45 minutes of left anterior descending coronary artery occlusion and 2 hours of reperfusion. Core temperatures were measured with thermistor. The mild hypothermia group received ice cooling around the body and the core temperature was dropped to 32-35 centigrade after occluded for 30 minutes, while the control group's body temperature were kept above 38 centigrade. The myocardial area at risk and the infarct area were determined with Evan's blue dye and triphenyl tetrazolium chloride (TTC). RESULTS: The total elevated amplitude of ST segment in chest leads V1, V3 and V5 in the mild hypothermia group was (25.8+/-8.5) mV, it was lower than that in the control group (37.7+/-6.5) Mv (P=0.021). The changes of serum MB isoenzyme of creatine kinase (CK-MB) activities in mild hypothermia group was (2646.9+/-1227.3) U/L, it was significantly lower than that in the control group (4787.8+/-1934.2) U/L(P=0.045). The weight of infarct myocardium of the mild hypothermia group was (0.23+/-0.05)g, it was lower than that in the control group (0.42+/-0.16)g (P=0.020). Myocardial infarct size as a percentage of the risk zone (0.214+/-0.044 vs. 0.357+/-0.066, P=0.001) and of the left ventricle weight (0.041+/-0.010 vs. 0.071+/-0.027, P=0.029) were smaller than those in the control group. The ratio of the survived myocardial area over the risk zone in the mild hypothermia group was significantly higher than that in the control group (0.786+/-0.044 vs. 0.643+/-0.066, P<0.001). CONCLUSION: Mild hypothermia may reduce infarct size in the rabbits with transient acute myocardial infarction, and increase survived myocardium in the risk zone.

Novel ratiometric fluorescent sensor for silver ions.

Incorporating azacrown[N,S,O] into furoquinoline fluorophore yields a novel ratiometric fluorescent sensor FQ-crown for silver ions. UV-vis absorption and fluorescence emission investigations indicate that FQ-crown bears the features of a large Stokes shift, about 173 nm, and red-shift up to 50 nm in the emission spectra and high affinity for silver ions (log K = 7.21) in ethanol in comparison with other competitive d(10) metal ions.