Diagnostic value of combined detection of myocardial markers, white blood cell count and platelet distribution width in patients with positive myocardial injury markers

Objective:To explore the diagnostic value of combined detection of myocardial markers, white blood cell (WBC) counts and platelet distribution width (PDW) in patients with positive myocardial injury markers.Methods: From January 2017 to January 2018, 100 patients with positive markers of myocardial injury in our hospital were selected as observation group, and 100 healthy people were selected as control group. Serum myocardial markers troponin I (cTnI), creatine kinase isoenzyme (CK-MB), myoglobin (MYO), WBC count, and PDW levels were measured at admission, and analyzed for individual indicators. And individual and combined detections of these indicators in early diagnosis of acute myocardial infarction (AMI) were analysed.Results: Serum cTnI, CK-MB, MYO, WBC count and PDW level were higher in the observation group than those in the control group, and the difference between the groups was statistically significant. Of the 100 patients with positive myocardial injury markers, 48 (48.00%) were diagnosed with AMI by final clinical diagnosis. Compared with the control group, the positive rate of serum index and the combined detection of five indicators in the observation group were significantly increased. The sensitivity and specificity of the five indicators combined detection and diagnosis of AMI were 95.83% and 94.23%, respectively, which were higher than the individual detection of each index, and the difference was statistically significant.Conclusions: The combined detection of serum cTnI, CK-MB, MYO, WBC count and PDW is helpful for early diagnosis of AMI and can improve the sensitivity and specificity of diagnosis.

Burning Numbers of Barbells

Motivated by a discrete-time process intended to measure the speed of the spread of contagion in a graph,the burning number b(G)of a graph G,is defined as the smallest integer k for which there are vertices x1,…xk such that for every vertex u of G,there exists i∈{1,…k}with dG(u,xi)≤k−i,and dG(xi,xj)≥j−i for any 1≤i<j≤k.The graph burning problem has been shown to be NP-complete even for some acyclic graphs with maximum degree three.In this paper,we determine the burning numbers of all short barbells and long barbells,respectively.

Sources of Heterogeneity in Trials Reporting Hydroxyethyl Starch 130/0.4 or 0.42 Associated Excess Mortality in Septic Patients： A Systematic Review and Meta-regression

Background： This meta-analysis was to determine the association of the cumulative dose of 130/0.4 or 0.42 （hydroxyethyl starch [HES] 130/0.4＊） or delta daily fluid balance （i.e., daily fluid balance in HES group over or below control group） with the heterogeneity of risk ratio （RR） for mortality in randomized control trials （RCTs）. Methods： Three databases （PubMed, EMBASE, Cochrane） were searched to identify prospective RCTs reporting mortality in adult patients with sepsis to compare HES 130/0.4＊ with crystalloids or albumin. Meta-analysis was performed using random effects. Sensitivity and meta-regression analyses were used to examine the heterogeneity sources of RR for mortality, Results： A total number of 4408 patients from 11 RCTs were included. The pooled RR showed no significant difference for overall mortality in patients with administration of liES130/0.4＂ compared with treatment of control fluids （RR： 1.02, 95% confidence interval： 0.9-1.17; P = 0.73）. Heterogeneity was moderate across recruited trials （l^2 = 34%, P = 0.13）. But, a significant variation was demonstrated in subgroup with crystalloids as control fluids （l^2 = 42%, P 〈 0.1）. Sensitivity analysis revealed that trials with high risk of bias did not significantly impact the pooled estimates for mortality. Meta-regression analysis also did not determine a dose-effect relationship of HES 130/0.4＊ with mortality （P - 0.298）, but suggested daily delta fluid balance being likely associated with mortality in septic patients receiving HES130/130/0.4＊ （P = 0.079）.Conclusions： Inappropriate daily positive fluid balance was likely an important source of heterogeneity in these trials reporting HES 130/0.4＊ associated with excess mortality in septic patients.

Incomparable Subsequent Effects between Study and Control Fluids Might Cause Questionable Results in Randomized Controlled Trials

Dr. Wiedermann commented on our systematic review and meta-regression tbr the sources of heterogeneity in trials reporting H ES 130/0.4 or 0.42 associated excess mortality in septic patients that the pooled analysis of mortality, which showed neither benefit nor harm, might be influenced by trials of low-quality. Statistically, we agree with this conclusion if two of the recruited trials judged as the intermediate risk of bias are precluded.