EFFECT OF REPERFUSION THERAPY ON SOLUBLE CELL ADHESION MOLECULES IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Objective To observe the changes of serum soluble intercellular adhesion moiecuie type-1(ICAM-1) and E-selectin in patients with acute myocardial inlarction (AMI) receiving reperfusiontherapy. Methods Peripheral venous blood samples were taken from 21 patients with AMI before and4,8,12,24,48,72h after thrombolytic treatment or direct percutaneous transluminal coronary angioplasty (PTCA).Blood samples from 16 control subjects were drawn for one time. Serum concentration of ICAM-1 and E-selectinwas determined by double antibodies sandwich enzyme-linked immunosorbent assay. Results Serum levels ofICAM-1 and E-selectin were higher in patients with AMI than those in controls. Sixteen patients with AMIand successful roperfusion therapy had signifcantly reduction in serum concentration of ICAM-1 and E-selectinat 24 and 48h, but had a peak at 4h. The remaining live patients who failed in mperfusion theropy didn’t show anysignificant changes in these values. Conclusion The serum concentration of ICAM-1 and E-selectin waselevated significantly in patients with AMI Successful reperfusion therapy can reduce the increased serumconcentration.

Does endothelium agree with the concept of idiopathic hepatic vessel thrombosis?

AIM： To investigate the major steps of thrombogenesis and to identify the differences in these steps between idiopathic patient group and control group. METHODS： Fibrinogenesis was studied by measuring the activated factor Ⅶ, total and free levels of tissue factor pathway inhibitor （TFPI）. The fibrinolysis step was investigated by determining the global fibrinolytic capacity. The endothelial function was assessed by measuring the levels of soluble adhesion molecules, namely soluble intercellular adhesion molecule 1 （sICAM-1）, soluble vascular cell adhesion molecule 1 （sVCAM-1） and soluble E-selectin molecule. The exclusion criteria from ＂idiopat- hic＂ patient group were abdominal surgery, pregnancy, use of oral contraceptives, anti-phospholipid syndrome, Behet＇s disease, cancer, myeloproliferative diseases. The congenital factors like mutations of factor-Ⅴ Leiden and prothrombin, deficiencies of proteins C and S, antithrombin, hyperhomocysteinemia and hyperfibrinogenemia were ruled out. The total number of patients was reduced from 96 to 9 （7 with portal vein thrombosis, 2 Budd Chiari syndrome） by exclusion criteria. RESULTS： The levels of adhesion molecules sICAM-1, sVCAM-1, free TFPI levels and global fibrinolytic capacity were significantly different （P〈 0.05） in the patient group indicating an endothelial dysfunction and a lower fibrinolytic activity. CONCLUSION： These results show that this patient group should be tested by means of endothelial dysfunction and managed differently.

Effects of cardiopulmonary bypass on endothelial cell injury

Objective: To observe the changes of plasma concentrations of endotoxin, soluble intercellular adhesion molecule 1, tumor necrosis factor α, and urinary microalbumin in children undergoing cardiac procedure and to study the effects of cardiopulmonary bypass (CPB) on the injury or activation of endothelial cells and vascular permeability. Methods: Twenty children undergoing cardiac operation with CPB were selected in the study. Plasma concentrations of endotoxin, soluble intercellular adhesion molecule 1, tumor necrosis factor α, and urinary microalbumin were measured after anesthetic induction (baseline), bypass for 20 minutes, at the end of CPB, and at 2, 4, and 18 h after the end of CPB. Results: The plasma concentrations of endotoxin, soluble intercellular adhesion molecule 1, and urinary microalbumin began to increase at 2 h after the end of CPB, and remained higher than that of the baseline, while the concentration of tumor necrosis factor α increased only at the end CPB and at 2 h after the end of CPB. Conclusion: Cardiopulmonary bypass can induce inflammatory response, resulting in the activation or injury of vascular endothelial cells, and can increase the vascular permeability.

A preliminary clinical application of sICAM-1 RIA in three kinds of thyroid disease

To examine serum levels of sICAM 1 from normal controls and patients with thyroid diseases (simple goitre, Graves’ disease or Hashimoto’s thyroiditis) with 125 Ⅰ sICAM 1 RIA established in our lab Methods Using 125 Ⅰ sICAM 1 RIA, serum sICAM 1 levels of 400 healthy individuals as the normal group and 1020 patients with simple goitre (SG), Graves’ disease (GD) or Hashimoto’s thyroiditis (HT) were examined for a comporative chinical study Results The serum level of sICAM 1 ( ±s ) in the normal group was 168 43±36 23 μg/L There was no significant difference between the normal and SG groups ( P 】0 05), whereas the serum levels of sICAM 1 in autoimmune thyroid diseases (GD or HT) were higher than those in the normal or SG groups ( P 【0 05, respectively) After GD patients received one of three medical treatments, their serum sICAM 1 levels decreased ( P 【0 05) After GD patients were treated and their thyroid function decreased to normal, their serum sICAM 1 levels were lower than those in relapsed GD patients ( P 【0 05) Conclusions sICAM 1 RIA can be used to examine autoimmune thyroid diseases Serum levels of sICAM 1 can be used as a parameter in diagnosing autoimmune thyroid disease and in evaluating the effects of therapy, drug administration or relapse in GD

Influence of Scalp Point-to-Point Acupuncture on Serum sICAM1 in Patients with Acute Cerebral Infarction

Objective： To study the influence of different methods on serum soluble intercellular adhesion molecule1 （sICAM1） in patients with acute cerebral infarction. Methods： Double antibody enzyme-linked immunoadsorbent assay was used. Results and Conclusion： Scalp point-to-point acupuncture has a significant reducing effect on abnormally elevated serum sICAM1 in patients with acute cerebral infarction. Its curative effect is superior to that of simple Western medicine. There is a significant difference between them （P〈 0,05）.

Biomarkers in differentiating clinical dengue cases:A prospective cohort study

Objective:To evaluate five biomarkers(neopterin,vascular endothelial growth factor-A,thrombomodulin,soluble vascular cell adhesion molecule 1 and pentraxin 3)in differentiating clinical dengue cases.Methods:A prospective cohort study was conducted whereby the blood samples were obtained at day of presentation and the final diagnosis were obtained at the end of patients’follow-up.All patients included in the study were 15 years old or older,not pregnant,not infected by dengue previously and did not have cancer,autoimmune or haematological disorder.Median test was performed to compare the biomarker levels.A subgroup Mann-Whitney U test was analysed between severe dengue and non-severe dengue cases.Monte Carlo method was used to estimate the 2-tailed probability(P)value for independent variables with unequal number of patients.Results:All biomarkers except thrombomodulin has P value<0.001 in differentiating among the healthy subjects,non-dengue fever,dengue without warning signs and dengue with warning signs/severe dengue.Subgroup analysis for all the biomarkers between severe dengue and non-severe dengue cases was not statistically significant except vascular endothelial growth factor-A(P<0.05).Conclusions:Certain biomarkers were able to differentiate the clinical dengue cases.This could be potentially useful in classifying and determining the severity of dengue infected patients in the hospital.