Computed tomography coronary angiography after excluding myocardial infarction:high-sensitivity troponin versus risk score-guided approach

BACKGROUND:Patients with suspected acute coronary syndrome (ACS) in whom myocardial infarction has been ruled out are still at risk of having obstructive coronary artery disease (CAD).This rate is higher among patients with intermediate high-sensitivity troponin I (hsTnI) concentrations (5 ng/L to 99th percentile) than low concentrations (<5 ng/L).Therefore,an intermediate concentration has been suggested as a candidate for downstream investigation with computed tomography coronary angiography(CTCA).We tried to compare the HEART score-guided vs.hsTnI-guided approach for identifying obstructive CAD.METHODS:From a prospective cohort study of patients presenting to the emergency department with suspected ACS,433 patients without elevated hsTnI who also underwent CTCA were selected and analyzed.The performances of hsTnI concentration and HEART score were compared using sensitivity,specificity,positive predictive value (PPV),and negative predictive value (NPV).RESULTS:Overall,120 (27.7%) patients had obstructive CAD.Patients with intermediate hsTnI concentrations were more likely to have obstructive CAD than those with low hsTnI concentrations(40.0%vs.18.1%);patients with non-low-risk HEART scores (≥4 points) were also more likely to have obstructive CAD than those with low-risk scores (0 to 3 points)(41.0%vs.7.6%).The HEART score had higher sensitivity and NPV for detecting obstructive CAD in each classification than hsTnI concentration (sensitivity:89.2%vs.63.3%;NPV:92.4%vs.81.9%,respectively).CONCLUSION:After excluding myocardial infarction in patients with suspected ACS,adding the HEART score for selecting candidates for CTCA could improve patient risk stratification more accurately than relying on hsTnI concentration.

Prognostic role of high-sensitivity troponin T in elderly patients with sepsis in intensive care unit

Background Paucity of data is available on the in-hospital and 28-day prognostic value of at-admission highsensitivity troponin T(hs-TnT)level in elderly patients with sepsis admitted to intensive care units.Methods Patients aged 65 or older with sepsis or septic shock admitted to geriatric ICU in Guangdong Provincial People’s Hospital between January 2010 and December 2017 were enrolled in the study.Receiver operator characteristic(ROC)curve analysis was performed to evaluate the predictive value of hs-TnT for in-hospital mortality.Multivariate Cox survival regression was used to determine independent risk factor of hs-TnT for 28-day death.Results The in-hospital mortality was 64.4%.According to the receiver operator characteristic(ROC)curve analysis,the cut-off for predicting in-hospital death was 65.2 pg/mL.Patients with elevated hs-TnT had a higher rate of in-hospital mortality(75%vs.53.4%,P<0.001)and 28-day mortality(47.7%vs.27.6%,P<0.001).Multivariate regression showed that lg(hs-TnT)was an independent risk factor for in-hospital death(adjusted HR:1.53,95%CI:1.16-2.01,P=0.03).Kaplan-Meier survival curves showed that elderly patients with at-admission hs-TnT>65.2 pg/mL had a worse outcome than those with hs-TnT<65.2 pg/mL(Log-rank test:17.46,P=0.000).Conclusions In elderly patients with sepsis admitted to intensive care units,elevated hs-TnT level measured upon admission was associated with increased mortality rate.hs-TnT independently contributed to the prediction of 28-day mortality.

High-sensitivity cardiac troponins in everyday clinical practice

High-sensitivity cardiac troponin(hs-cTn) assays are increasingly being used in many countries worldwide,however,a generally accepted definition of high-sen-sitivity is still pending.These assays enable cTn mea-surement with a high degree of analytical sensitivity with a low analytical imprecision at the low measuring range of cTn assays(coefficient of variation of < 10% at the 99th percentile upper reference limit).One of the most important advantages of these new assays is that they allow novel,more rapid approaches to rule in or rule out acute coronary syndromes(ACSs) than with previous cTn assay generations which are still more commonly used in practice worldwide.hs-cTn is also more sensitive for the detection of myocardial damage unrelated to acute myocardial ischemia.Therefore,the increase in early diagnostic sensitivity of hs-cTn assays for ACS comes at the cost of a reduced ACS specificity,because more patients with other causes of acute or chronic myocardial injury without overt myocardial isch-emia are detected than with previous cTn assays.As hs-cTn assays are increasingly being adopted in clinical practice and more hs-cTn assays are being developed,this review attempts to synthesize the available clinical data to make recommendations for their everyday clini-cal routine use.

Prognostic value of high-sensitivity cardiac troponin T in patients with en-domyocardial-biopsy proven cardiac amyloidosis

Objective To investigate prognostic predictors of long-term survival of patients with cardiac amyloidosis （CA）, and to determine predictive value of high-sensitivity cardiac troponin T （hs-cTnT） in CA patients. Methods We recruited 102 consecutive CA cases and followed these patients for 5 years. We described their clinical characteristics at presentation and used a new, high-sensitivity assay to determine the concentration of cTnT in plasma samples from these patients. Results The patients with poor prognosis showed older age （56 ±12 years vs. 50 ±15 years, P=0.022）, higher incidences of heart failure （36.92%vs. 16.22%, P=0.041）, pericardial effusion （60.00%vs. 35.14%, P=0.023）, greater thickness of interventricular septum （IVS） （15 ±4 mm vs. 13 ±4 mm, P=0.034）, higher level of hs-cTnT （0.186 ±0.249 ng/mL vs. 0.044 ±0.055 ng/mL, P=0.001） and higher NT-proBNP （N-terminal pro-B-type natriuretic pep-tide） levels （11,742 ± 10,464 pg/mL vs. 6,031 ± 7,458 pg/mL, P=0.006）. At multivariate Cox regression analysis, heart failure （HR：1.78, 95%CI：1.09-2.92, P=0.021）, greater wall thickness of IVS （HR：1.44, 95%CI：1.04-3.01, P=0.0375） and higher hs-cTnT level （HR：6.16, 95%CI：2.20-17.24, P=0.001） at enrollment emerged as independent predictors of all-cause mortality. Conclusions We showed that hs-cTnT is associated with a very ominous prognosis, and it is also the strongest predictor of all-cause mortality in multivariate analysis. Examination of hs-cTnT concentrations provides valuable prognostic information concerning long-term outcomes.

Design and Implementation of a High-Sensitivity Magnetic Sensing System Based on GMI Effect

A high-sensitivity magnetic sensing system based on giant magneto-impedance(GMI)effect is designed and fabricated.The system comprises a GMI sensor equipped with a gradient probe and an signal acquisition and processing module.A segmented superposition algorithm is used to increase target signal and reduce the random noise.The results show that under unshielded,room temperature conditions,the system achieves successful detection of weak magnetic fields down to 2 pT with a notable sensitivity of 1.84×10^(8)V/T(G=1000).By applying 17 overlays,the segmented superposition algorithm increases the power proportion of the target signal at 31 Hz from6.89%to 45.91%,surpassing the power proportion of the 2 Hz low-frequency interference signal.Simultaneously,it reduces the power proportion of the 20 Hz random noise.The segmented superposition process effectively cancels out certain random noise elements,leading to a reduction in their respective power proportions.This high-sensitivity magnetic sensing system features a simple structure,and is easy to operate,making it highly valuable for both practical applications and broader dissemination.

Concept and Design of a Novel High-Bandwidth,High-Sensitivity Differential Receiver for Optical Interconnections

A novel high-bandwidth, high-sensitivity differential optical receiver without any additional cost compared to general optical receivers, is proposed for high-speed optical communications and interconnections. High bandwidth and high sensitivity are achieved through a fully differential transimpedance amplifier with balanced input loads and two photodetectors to convert the incident light into a pair of differential photogenerated currents,respectively. In addition,a corresponding 0.35μm standard CMOS optoelectronic integrated receiver with two 60μm × 30μm, 1. 483pF fingered p^＋/n- well/p-substrate photodiodes is also presented. The simulation results demonstrate that it achieves a 1.37GHz bandwidth and a 81.9dBΩ transimpedance gain,supporting data rates up to at least 2Gbit/s. The device consumes a core area of 0. 198mm^2 and the optical sensitivity is at least - 13dBm for a 10^-12 bit error rate under a 2^15 - 1 PRBS input signal.

Partial frequency band match filtering based on high-sensitivity data: method and applications

During seismic data acquisition, a high-sensitivity geophone with a high inherent frequency can increase high frequency energy by suppressing low frequency signals. This could cause a worse response at low frequencies. If the advantages of high-sensitivity data and conventional data are combined, the effective bandwidth will be broadened. Considering this, we propose a partial frequency band match filtering method which can combine the advantages of both high frequency and conventional frequency ranges. By introducing Ricker wavelets with different dominant frequencies and amplitudes, we established a theoretical model which possesses characteristics of both types of seismic data and demonstrates the feasibility of the partial frequency band match filtering method. A test using single shot records shows the effectiveness of this method for widening the effective frequency band.

Distribution of High-sensitivity C-reactive Protein Status in an Urban Population in China

Objectives To evaluate the distribution by age and sex of serum high-sensitivity C-reactive protein(hsCRP)in an urban Chinese population and to provide a profile prediction for the risk of bacterial infection,inflammatory diseases,or tissue damages in the body.Methods Serum hsCRP was determined using the Roche Tina-quant immuno-turbidimetric assay on a Hitachi 7600–010 automatic biochemical analyzer(Roche Diagnostics)in 1,572 males and 1,800 females,including 78 pregnant women,who were derived from the National Health and Nutrition Survey in2010–2012.Results The average hsCRP concentration in urban China was 0.68 mg/L for males and 0.65 mg/L for females.Significant differences in hsCRP were found among different age groups(P<0.05).Monitoring results showed no significant differences among the 6–11,45–59,and≥60-year-old groups in the comparison of hsCRP between males and females in large cities.However,hsCRP concentration was significantly higher in men aged 12–17 and 18–44 years than in women.Conclusion The distribution of the hsCRP status of residents in large cities in China was influenced by age and gender,and the hsCRP levels of both sexes increased gradually with age.In addition,hsCRP concentration was higher in healthy pregnant women than in non-pregnant women.Basing on our results,we recommend that this parameter be included in future national and international screening for early detection of various illnesses.

Elevated levels of inflammatory cytokines and high-sensitivity C-reactive protein in periodontitis patients in Kosovo: A pilot study

The following article has been retracted due to the investigation of complaints received against it. The Editorial Board found that the same contents have been published in another journal at the same time. The scientific community takes a very strong view on this matter, and the Open Journal of Stomatology treats all unethical behavior such as plagiarism seriously. This paper published in Vol.3 No.1 32-38, 2013 has been removed from this site. Title: Elevated levels of inflammatory cytokines and high-sensitivity C-reactive protein in periodontitis patients in Kosovo: A pilot study Authors: Zana Sllamniku-Dalipi, Hasan Mehmeti, Fatmir Dragidella, Ferit Kocani, Metush Disha, Kastriot Meqa, Luljeta Begolli, Gramos

Responses of serum inflammatory factor high-sensitivity C-reactive protein, interleukin-6, and tumor necrosis factor-alpha in elderly males with cerebral infarction Non-randomized concurrent control

BACKGROUND： Cerebral infarction is poorly treated due to neuronal necrosis and secondary pathophysiological changes; for example, free radical production and inflammatory reactions. OBJECTIVE： To detect the levels of high-sensitivity C-reactive protein （hs-CRP）, interleukin-6 （IL-6）, and tumor necrosis factor- a （TNF- α ） in elderly males with cerebral infarction. DESIGN： Non-randomized current control study. SETTING： Cadre Medical Department, Guizhou Provincial People＇s Hospital. PARTICIPANTS： Forty elderly males （65-89 years old） with cerebral infarction were selected from Cadre Medical Department, Guizhou Provincial People＇s Hospital from February 2004 to December 2006. All patients met the diagnostic criteria of cerebral infarction modified at the 4th National Cerebrovascular Disease Academic Meeting, and were diagnosed on the basis of CT or MRI tests. Furthermore, 35 elderly male inpatients （65-87 years old） without cerebral infarction were selected as the control group. Included subjects provided confirmed consent and did not have heart disease, diabetes mellitus, lipid disorder, acute trauma, infection, rheumatism, or other inflammatory diseases. The study was approved by the local ethics committee. There were no significant differences in age, blood pressure, and lipid levels between the cerebral infarction group and the control group （P 〉 0.05）, and this suggested that the baseline data of both groups were comparable. METHODS： Fasting venous blood was drawn from cerebral infarction patients 24 hours after cerebral infarction attack and from control subjects 24 hours after hospitalization. A latex-enhanced immunoturbidimetric assay and an enzyme-linked immunosorbent assay were used to detect the levels of hs-CRP, IL-6, and TNF- α in the serum. MAIN OUTCOME MEASURES： The levels of hs-CRP, 1L-6, and TNF- α in the serum in both groups. RESULTS： Forty cerebral infarction patients and thirty-five control subjects were included in the final analysis without any loss. Levels of hs-CRP, IL-6, and TNF-α in the cerebral infarction group were significantly higher than those in the control group （P 〈 0.01 ）. CONCLUSION： Levels of serum inflammatory reactive factors are increased in elderly males with cerebral infarction.

A dual-axis, high-sensitivity atomic magnetometer

Atomic magnetometer （AM） operated in a spin-exchange relaxation-free （SERF） regime features superior sensitivity and non-cryogenic operation, and thus is competitive with the best superconducting quantum interference devices. Previously, SERF AM with fT/Hz1/2 level sensitivity commonly acted as a single-axis sensor. Here we demonstrate a dual-axis SERF AM capable of simultaneously and independently detecting x-and y-field components with a sensitivity of 20 fT/Hz1/2. As there is no necessity to worry about the cross-talk effects arising from field modulations, the dual-axis scheme proposed here is of particular interest to AM array and hence the biomagnetic applications.

N-terminal pro-brain natriuretic peptide but not high-sensitivity C-reactive protein is related to severity of coronary artery stenosis in patients with acute coronary syndrome

Objective Biochemical indicators such as N-terminal pro-brain type natriuretic peptide（NT pro-BNP）and high-sensitivity Creactive protein（hsCRP）predict mortality in acute coronary syndrome（ACS）.However,little is known about the relationship of these factors with severity of coronary artery stenosis in patients with.Methods Three hundred and thirty-one subjects including 246 unstable angina pectoris patients and 85 myocardial infarction patients were recruited and classified into two groups：single-vessel disease group（1-vessel disease,n=93）and multiple-vessel disease group（≥2-vessels disease,n=238）according to selective coronary angiography.Plasma levels of NT pro-BNP and hsCRP were measured and severity of coronary stenosis was determined by Gensini score.Results NT pro-BNP but not hsCRP level was higher in patients with myocardial infarction than in patients with unstable angina pectoris.The patients with multiple-vessel disease had significantly higher NT pro-BNP level but not hsCRP compared with those with single-vessel disease.NT pro-BNP levels increased significantly as left ventricle（LV）function decreased,and only NT proBNP but not hsCRP level was related to Gensini score of severity of coronary stenosis in ACS.Conclusion NT proBNP but not hsCRP level is related to severity of coronary artery stenosis in patients in ACS.

High-Sensitivity Magnetization Measurements

The three most common instruments for high-sensitivity magnetization measurements (the vibrating-sampie magnetometer, the alternating gradient magnetometer, and the SQUID magnetometer) are described and their limiting sensitivities are discussed. The advantages and disadvantages of each are described. Magnetometers using micro-machined force detectors are briefly mentioned.

A High-Sensitivity Refractive-Index Sensor Based on Plasmonic Waveguides Asymmetrically Coupled with a Nanodisk Resonator

A high-sensitivity plasmonic refractive-index sensor based on the asymmetrical coupling of two metal-insulator- metal waveguides with a nanodisk resonator is proposed and simulated in the finite-difference time domain. Both analytic and simulated results show that the resonance wavelengths of the sensor have an approximate linear relationship with the refractive index of the materials which are filled into the slit waveguides and the disk- shaped resonator. The working mechanism of this sensor is exactly due to the linear relationship, based on which tile refractive index of the materials unknown can be obtained from the detection of the resonance wavelength. The measurement sensitivity can reach as high as 6.45 × 10-7, which is nearly five times higher than the results reported in the recent literature [Opt. Commun. 300 （2013） 265]. With an optimum design, the sensing value can be further improved, and it can be widely applied into the biological sensing. Tile sensor working for temperature sensing is also analyzed.

Prognostic value of N-terminal pro B-type natriuretic peptide and troponin Ⅰ in children with dengue shock syndrome

Objective:To investigate the contribution of N-terminal pro B-type natriuretic peptide(NT-pro BNP)and troponin Ⅰ to mortality in children with dengue shock syndrome.Methods:A longitudinal study was conducted on children with dengue shock syndrome in a hospital in southern Vietnam.Detailed clinical histories,physical examinations,and laboratory parameters,including NT-pro BNP and troponin Ⅰ,were recorded.A comparison between survival and non-survival was carried out to identify factors influencing mortality.Results:A total of 107 patients with a median age of 9 years were included in the study.Among them,63.6%(68/107)presented with compensated shock,36.4%(39/107)had hypotensive shock,23.4%(25/107)required mechanical ventilation,and 12.1%(13/107)died.The NT-pro BNP levels were 3.9 pmol/L(IQR:1.9,10.3)and 15.2 pmol/L(5.8,46.3),while the median high sensitivity troponin Ⅰ levels were 20 pg/L(6,95)and 62 pg/L(12,325)at the first and second measurements,respectively.The mortality group exhibited higher rates of hypotensive shock,prolonged shock,lactate levels,liver damage,NT-pro BNP,and troponin Ⅰ levels.Hypotensive shock(OR 12.96,95%CI 2.70-62.30,P=0.004),prolonged shock(OR 39.40,95%CI 6.68-232.70,P<0.001),AST>1000 IU/L(OR 9.50,95%CI 2.63-34.34,P=0.041),and NT-pro BNP>7 pmol/L(OR 44.40,95%CI 5.44-362.20,P=0.001)were identified as predictive factors for mortality in dengue shock syndrome.Conclusions:The NT-pro BNP level could serve as a potential biomarker for predicting mortality in children with dengue shock syndrome.

Value of N-Terminal Pro B-Type Natriuretic Peptide,High-Sensitivity C-Reactive Protein,and Homocysteine Levels in Predicting Cardiovascular Events in Chronic Heart Failure Patients After Discharge

Objective:To investigate the value of N-terminal pro B-type natriuretic peptide(NT-proBNP),high-sensitivity C-reactive protein(hs-CRP),and homocysteine(Hcy)levels in predicting cardiovascular events(CV)in patients with chronic heart failure(CHF).Methods:A total of 63 patients with CHF admitted to our hospital between June 2019 and July 2021 were selected.Their NT-proBNP,hs-CRP,and Hcy levels were detected at discharge,and a 12-month follow-up was done after their discharge to collect clinical data.The collected data were inclusive of data from 21 CHF patients with cardiovascular disease and 42 CHF patients without cardiovascular disease.The effect of NT-proBNP,hs-CRP,and Hcy levels on the occurrence of CV was analyzed.Results:The levels of NT-proBNP,hs-CRP,and Hcy in the group with cardiovascular disease were significantly higher than those in the group without cardiovascular disease(P<0.05);the levels of serum NT-proBNP,hs-CRP,and Hcy at discharge had certain value in predicting short-term CV in CHF patients(P<0.05).Conclusion:NT-proBNP,hs-CRP,and Hcy levels can be used to predict CV in CHF patients,thus having clinical application value.

电刺激和延迟冷却对宰后牛肉肌原纤维Troponin-T降解的影响

为了探讨牛肉嫩化的机理,选择24头24月龄,体重约500kg杂交牛(鲁西黄牛×西门塔尔)随机分成4组,在宰前或宰后分别进行以下4种处理:常规预冷组,延迟冷却组,电刺激处理组,电刺激和延迟冷却处理组。用SDS-PAGE和蛋白免疫印迹的方法比较分析了4种处理牛肉成熟1,3,7,10d其肌原纤维骨架蛋白Troponin-T的降解情况。结果表明:与常规冷却组相比,电刺激处理在1、3、7d时显著加快了Troponin-T的降解,而10d时差异不显著;延迟冷却处理在1、3d时显著加快了Troponin-T的降解,而7、10d时差异不显著;1、3d时延迟冷却对Troponin-T的降解影响比电刺激显著,而7、10d时则是电刺激比较显著;电刺激和延迟冷却处理的结合对Troponin-T降解的影响比电刺激处理组、延迟冷却处理组显著。综上可见,延迟冷却、电刺激无论在速度和数量上显著加快了Troponin-T的降解,加快了牛肉成熟,缩短了成熟时间,且二者有协同作用。

虾过敏原Troponin C(Pen m6)的克隆表达、免疫学鉴定及生物信息学分析

目的对斑节对虾(Penaeus monodon)第6组过敏原(Pen m6),肌钙蛋白C(Troponin C)进行克隆表达、免疫学鉴定并研究其生物学意义。方法提取斑节对虾总RNA;根据Gen Bank:HM034316.1设计引物及构建表达载体PET-24a-Pen m6;转化至大肠杆菌BL21(DE3)进行表达;纯化后的重组Pen m6用Western bolt来鉴定免疫学特性;用生物信息学相关工具对Pen m6进行同源性分析,并预测其蛋白质的结构和功能。结果克隆出斑节对虾Pen m6基因开放阅读框453 bp,编码150个氨基酸。重组Pen m6蛋白呈可溶性,分子量约35kDa,能够与斑节对虾过敏患者血清IgE结合。斑节对虾与凡纳滨对虾亲缘关系比较近,其中斑节对虾Pen m6蛋白与凡纳滨对虾Troponin C1(gb|AET36896.1|)同源性为98%。理化性质预测Pen m6蛋白质不稳定。蛋白质结构预测结果显示Pen m6的结构主要以α螺旋组成。T细胞抗原表位预测得到4个肽序列(15~23、35~43、91~99、112~120)。B细胞抗原表位预测得到4个肽序列(7~16、21~30、28~37、58~67)。结论克隆的重组斑节对虾Pen m6蛋白具有良好的免疫原性,为进一步研究斑节对虾过敏原的结构成分及其理化性质奠定理论基础。

血清Troponin I,CK-MBmass,Myoglobin在急性心肌梗塞诊断中的应用评价

为了解CTnI，CK－MBmass和Mb指标对急性心肌梗塞（AMI）早期诊断、后期监测及预后判断的临床意义，采用微粒子化学发光法，对20例AMI患者、24例不稳定心绞痛（UA）患者、17例骨骼肌损伤（SM）患者和19例健康者（对照组）进行血清CTnI，CK－MBmass和Mb的测定，并对AMI患者胸病发生3～5小时，8～14小时，20～24小时，72小时和7天共五个时段进行了测定。结果：AMI患者发病早期CTnI，CK－MBmass和Mb的阳性检出率分别为65％，70％，70％，CTnI在UA患者组和SM患者组中未检出。CTnI，CK－MBmass和Mb测定值含量在AMI组中明显高于UA组和SM组，AMI患者组CTnI分别是UA组和SM组的84倍和91.63倍，CK－Mbmass分别是该二组的8．82倍和4．67倍，Mb分别是该二组的11．57倍和2．25倍，AMI组与UA组和SM组比较，有显著性差异（P＜0．001）。AMI患者组中该三项指标的动态测定显示，在疾病发生早期（3～5小时）时，CTnI，CK－MBmass和Mb都有显著性升高，随时间延长而逐渐升高，高峰值期均在8～14小时段，72小时时Mb已基本回到正常。7天时血清中仍有CTnI的持续存在，但CK－MBmass已接近正常。以上显示，CTnI，CK－MBmass和Mb在早期诊断AMI时，都具有较高的敏感性，CTnI在AMI患者中的阳性检出率具有心肌特异性。

人Troponin I的表达载体构建诱导表达和纯化及活性测定

以人肝脏cDNA文库为模板,通过PCR方法扩增出Tropon in基因,将其克隆到pCR-TOPO质粒中,构建表达质粒pET-22 b(+)-TnI,转化大肠杆菌BL 21(DE 3)-RPX并进行诱导表达,表达的目的蛋白占菌体总蛋白的20%以上并主要以可溶形式存在。建立了Tropon in I的非亲和色谱纯化工艺,纯化后蛋白产量约为20 mg/L,纯度在90%以上。体外活性实验表明重组蛋白具有良好的抗血管生成。