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The heart is the main organ of the circulatory system and requires fatty acids to maintain its activity. Stress is a contributor to aggravating cardiovascular diseases and even death, and exacerbates the abnormal lipid metabolism. The cardiac metabolism may be disturbed by stress. Cholecystokinin (CCK), which is a classical peptide hormone, and its receptor (CCKR) are expressed in myocardial cells and affect cardiovascular function. Nevertheless, under stress, the exact role of CCKR on cardiac function and cardiac metabolism is unknown and the mechanism is worth exploring. After unpredictable stress, a common stress-inducing model that induces the development of mood disorders such as anxiety and reduces motivated behavior, we found that the abnormal contraction and diastole of the heart, myocardial injury, oxidative stress and inflammation of mice were aggravated. Cholecystokinin A receptor and cholecystokinin B receptor knockout (CCK1R2R-/-) significantly reversed these changes. Mechanistically, fatty acid metabolism was found to be altered in CCK1R2R-/- mice. Differential metabolites, especially L-tryptophan, L-aspartic acid, cholesterol, taurocholic acid, ADP, oxoglutaric acid, arachidonic acid and 17-Hydroxyprogesterone, influenced cardiac function after CCK1R2R knockout and unpredictable stress. We conclude that CCK1R2R-/- ameliorated myocardial damage caused by unpredictable stress via altering fatty acid metabolism. [ABSTRACT FROM AUTHOR]

Background: The precise effect and the quality of different cases used in dermatology problem-based learning (PBL) curricula are yet unclear. Aim: To prospectively compare the impact of real patients, digital, paper PBL (PPBL) and traditional lecture-based learning (LBL) on academic results and student perceptions. Methods: A total of 120 students were randomly allocated into either real-patients PBL (RPBL) group studied via real-patient cases, digital PBL (DPBL) group studied via digital-form cases, PPBL group studied via paper-form cases, or conventional group who received didactic lectures. Academic results were assessed through review of written examination, objective structured clinical examination and student performance scores. A five-point Likert scale questionnaire was used to evaluate student perceptions. Results: Compared to those receiving lectures only, all PBL participants had better results for written examination, clinical examination and overall performance. Students in RPBL group exhibited better overall performance than those in the other two PBL groups. Real-patient cases were more effective in helping develop students' self-directed learning skills, improving their confidence in future patient encounters and encouraging them to learn more about the discussed condition, compared to digital and paper cases. Conclusion: Both real patient and digital triggers are helpful in improving students' clinical problem-handling skills. However, real patients provide greater benefits to students. [ABSTRACT FROM AUTHOR]

Using heart-type fatty acid-binding protein (H-FABP) as an early cardiac marker for diagnosis of acute myocardial infarction (AMI) soon after the onset of symptoms requires a rapid assay. A one-step test called, CardioDetect®, is used for detection of H-FABP in whole blood sample. Thirty patients suspected of AMI presenting to the emergency department within 12 hours after onset were enrolled in this study. The diagnostic performance of CardioDetect® was compared with different cardiac markers. There were 59.1% of patients with positive H-FABP within 6 hours after onset, while there were only 18.2% with positive cardiac troponin I (cTnI). Results indicated the diagnostic power of H-FABP for AMI was significantly higher than that of cTnI. The sensitivity of H-FABP was 81.8%, which was higher than those of the other cardiac markers, while the specificity was comparable. The area under the receiver operating characteristic curve for H-FABP was 0.909, which was significantly larger than the others. With this rapid and sensitive immunotest, H-FABP could be soon introduced in clinical practice in combination with well-established markers like troponins. [ABSTRACT FROM AUTHOR]