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1.
目的探讨高荧光细胞(HFC)和血清腹水白蛋白梯度(SAAG)诊断恶性腹水的价值。方法选取202例出现腹水的患者,依据脱落细胞学检查结果分为恶性腹水组(36例)和良性腹水组(166例),分析HFC和SAAG在良、恶性腹水组中的分布差异。采用受试者工作特征(ROC)曲线评价各项指标单项及联合检测诊断恶性腹水的效能。结果恶性腹水组高荧光细胞绝对值(HF#)和高荧光细胞百分比(HF%)均显著高于良性腹水组(P=0.0000、P=0.0001),SAAG水平显著低于良性腹水组(P=0.0000)。HF#、HF%和SAAG诊断恶性腹水的曲线下面积分别为0.797、0.704、0.770。单项指标分析时,HF#和SAAG的敏感性、特异性、准确性分别为83.3%、66.9%、69.8%和88.9%、62.0%、66.8%,HF#和SAAG串联检测的敏感性、特异性、准确性分别为77.8%、80.1%、79.7%,HF#和SAAG并联检测的敏感性、特异性、准确性分别为94.4%、48.8%、56.9%。结论HF和SAAG联合检测诊断恶性腹水的敏感性有所下降,但特异性和准确性均明显升高,更有利于恶性腹水的诊断。  相似文献   
2.
目的分析经过保守治疗的Mason Ⅰ型及Ⅱ型桡骨头骨折病例失败的主要因素,同时探讨手术对保守治疗失败病例的疗效。 方法回顾性研究2010年2月至2015年6月在本中心行保守治疗的16~65岁急性Mason Ⅰ型及Ⅱ型的桡骨头骨折病例,排除合并同侧上肢其他损伤、颅脑外伤等影响桡骨头骨折预后的患者。收录信息包括患者一般情况、诊断、制动方式及时间,随访内容包括转为手术率、视觉模拟评分(visual analogue scale, VAS)、肘关节活动度、Mayo肘关节功能评分系统(Mayo elbow performance score, MEPS)等。 结果共612例患者符合纳入标准,其中成功随访患者345例,包括男205例、女140例,平均年龄37.5岁(17~65岁),平均随访时间13.4个月(5~23个月)。345例患者中有27例(7.8%)患者因疼痛、活动障碍等原因转为手术治疗,转为手术治疗的患者平均制动时间要显著高于保守治疗成功组的患者,其中Mason Ⅱ型19例(70.4%),3例(11.1%)术中证实存在骨软骨游离体,1例(3.7%)存在环状韧带关节囊嵌顿,4例(14.8%)存在外侧韧带复合体损伤,25例(92.6%)有明确的关节僵硬而行松解术,另有5例(18.5%)因康复过程中出现尺神经损伤而行神经探查松解术。27例转为手术的患者,平均VAS评分从术前(5.6±1.4)分降到术后(1.2±0.8)分,MEPS评分从(55.6±8.6)分提高到(89.6±4.9)分,平均上肢功能评分表(disability of arm shoulder and hand, DASH)从术前(44.4±9.8)分降至术后(15.4±5.9)分。 结论骨折类型、制动时间过长以及遗漏合并损伤是Mason Ⅰ型及部分Mason Ⅱ型桡骨头骨折保守治疗失败的主要原因,手术治疗可以满意解决相应的关节僵硬、疼痛、韧带和游离体嵌顿等并发症。  相似文献   
3.
目的探讨中国福建畲族人静息心率与动脉硬化的关系及其影响因素。 方法于2009年采用整体抽样法抽取中国福建省福安市畲族聚集地6个自然村511人为调查对象,最终样本量325例,进行颈-股动脉脉搏波传导速度(CF-PWV)、颈-桡动脉脉搏波传导速度(CR-PWV)、心踝血管指数(CAVI)、踝臂指数(ABI)检查,超声检测颈动脉内-中膜厚度(CIMT),静息心率(RHR)为动脉硬化设备VS-1000和超声设备三次测量的平均值,并检测血液血脂、血糖、尿酸、超敏C反应蛋白,调查人群一般资料(如年龄、性别、家族史和既往史等)。 结果不同四分位数RHR水平,RHR1≤61次/分,RHR2为62~69次/分,RHR3为70~77次/分,RHR4≥78次/分,其收缩压(SBP)、舒张压(DBP)、总胆固醇/高密度脂蛋白胆固醇(TC/HDL-C)、HDL-C、CF-PWV、CR-PWV显著不同(P<0.05),RHR4组甘油三酯(TG)、TC/HDL-C、DBP、CF-PWV、CR-PWV显著高于RHR1组,而HDL-C显著低于RHR1组(P<0.05);而CAVI、ABI、CIMT水平差异无统计学意义(P>0.05)。非条件Logistic回归分析提示在未调整其他危险因素的模型中,与RHR1组相比,RHR4组的动脉硬化OR值为3.074(95%置信区间为1.555~6.075,P=0.001);而进一步调整了年龄和性别之后,RHR4组的OR值增加为4.542(95%置信区间为2.078~9.928,P<0.001);再一次调整了年龄、性别、血压、血脂、血糖及超敏C反应蛋白等传统危险因素之后,RHR4组的OR值更进一步增加为5.336(95%置信区间为1.512~18.831,P=0.009)。 结论在中国福建畲族自然人群中,较高的静息心率水平伴随有较高的血压、血脂和动脉硬化水平。此外,较高的静息心率与动脉硬化密切相关,且独立于传统的血管疾病危险因素。  相似文献   
4.
5.
Background and aimsThe association between dietary sugars and vascular damage has been scarcely examined out of the context of established cardiovascular disease. We aimed to investigate the association between different types of sugars with subclinical atheromatosis and arteriosclerosis, in individuals free of cardiovascular disease being, however, at moderate-to-high cardiovascular risk.Methods and resultsTwo 24-h dietary recalls were conducted to estimate sugars intake. Subclinical atheromatosis was assessed by B-mode ultrasonography and arteriosclerosis (arterial stiffness) via tonometry (carotid-to-femoral pulse wave velocity). Multiple logistic regression analysis was performed to determine the relationship of quartiles of total sugars, monosaccharides and disaccharides with atheromatosis and arteriosclerosis, adjusting for potential confounders [Odds Ratio (95%Confidence Interval)]. In 901 participants (52.4 ± 13.8 years, 45.2% males), total sugars intake was not associated with any type of subclinical vascular damage. Subjects at 4th quartile of lactose intake (15.3 ± 5.5 g/day) had lower probability to present atheromatosis compared to those at 1st quartile (0.00 ± 0.01 g/day) even in the fully adjusted model [0.586 (0.353–0.974)]. Subjects at 3rd quartile of total disaccharides intake and particularly sucrose (15.1 ± 2.2 g/day) had higher probability to present arteriosclerosis compared to those at 1st quartile (3.0 ± 1.9 g/day) even after adjustment for all potential confounders [2.213 (1.110–4.409)].ConclusionsOverall, the present data suggest a distinct role of each type of sugars on vascular damage. These observations highlight the need for further studies investigating not only foods rich in sugars, but sugars as separate components of food as they probably contribute via different ways on the development of arterial pathologies.  相似文献   
6.
ObjectiveTo evaluate whether the serum C-reactive protein to albumin ratio (CAR) could be used for risk stratification of patients undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS).Patients and MethodsFrailty is a predictor of poor outcomes in patients undergoing AS interventions. The CAR reflects key components of frailty (systemic inflammation and nutrition) and could potentially be implemented into assessment and management strategies for patients with AS. From March 1, 2010, through February 29, 2020, 1836 patients were prospectively enrolled in an observational TAVR database. Patients (prospective development cohort, n=763) were grouped into CAR quartiles to compare the upper quartile (CAR Q4) with the lower quartiles (CAR Q1-3). Primary end point was all-cause mortality. Results were verified in an independent retrospective cohort (n=1403).ResultsThe CAR Q4 had a higher prevalence of impaired left ventricular function, atrial fibrillation, diabetes, and cerebrovascular disease and a higher median logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) vs CAR Q1-3. After median follow-up of 15.0 months, all-cause mortality was significantly higher in CAR Q4 vs CAR Q1-3 (P<.001). In multivariable analyses, risk factors for all-cause mortality were CAR Q4 (>0.1632; hazard ratio, 1.45; 95% confidence interval, 1.05 to 2.00; P=.03), N-terminal pro–B-type natriuretic peptide Q4 (>3230 pg/mL [to convert to ng/L, multiply by 1), high-sensitivity troponin T Q4 (>0.0395 ng/mL [to convert to μg/L, multiply by 1]), above-median logistic EuroSCORE (16.1%), myocardial infarction, Acute Kidney Injury Network stage 3, and life-threatening bleeding.ConclusionElevated CAR was associated with increased risk of all-cause mortality in patients undergoing transfemoral TAVR. The CAR, a simple, objective tool to assess frailty, could be incorporated into assessing patients with AS being considered for TAVR.  相似文献   
7.
8.
The aim of this study was to investigate the acute repeated bouts of aerobic exercise decrease leg arterial stiffness. However, the influence of repeated bouts of aerobic exercise on arterial stiffness after glucose ingestion is unknown. The present study investigates the acute effects of repeated bouts of aerobic exercise on arterial stiffness after the 75-g oral glucose tolerance test (OGTT). Ten healthy young men (age, 23.2 ± 0.9 years) performed repeated bouts of aerobic exercise trial (RE, 65% peak oxygen uptake; two 15 min bouts of cycling performed 20 min apart) and control trial (CON, seated and resting in a quiet room) at 80 min before the 75-g OGTT on separate days in a randomized, controlled crossover fashion. Carotid-femoral (aortic) and femoral-ankle (leg) pulse wave velocity, carotid augmentation index, brachial and ankle blood pressure, heart rate and blood glucose and insulin levels were measured before (baseline) and 30, 60 and 120 min after the 75-g OGTT. Leg pulse wave velocity, ankle systolic blood pressure and blood glucose levels increased from baseline after the 75-g OGTT in the CON trial, but not in the RE trial. The present findings indicate that acute repeated bouts of aerobic exercise before glucose ingestion suppress increases in leg arterial stiffness following glucose ingestion.

Abbreviations: RE trial repeated bouts of aerobic exercise trial; CON trial control trial; BG blood glucose; VO2peak peak oxygen uptake; PWV Pulse wave velocity; AIx carotid augmentation index; BP blood pressure; HR heart rate; CVs coefficients of variation; RPE Ratings of perceived exertion; SE standard error  相似文献   

9.
Our knowledge of the radiological spectrum of myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD) is growing rapidly. An update on the radiological features of the disease, and its evolution is thus necessary. Magnetic resonance imaging (MRI) has an increasingly important role in the differential diagnosis of MOGAD particularly from aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-NMOSD), and multiple sclerosis (MS). Differentiating these conditions is of prime importance because the management is different between the three inflammatory diseases, and thus could prevent further attack-related disability. Therefore, identifying the MRI features suggestive of MOGAD has diagnostic and prognostic implications. We herein review optic nerve, spinal cord and the brain MRI findings from MOGAD adult patients, and compare them to AQP4-NMOSD and MS.  相似文献   
10.
Backgrounds and aims: Increased arterial stiffness may increase cardiovascular morbidity and mortality. Angiotensin II type 1 receptor blockers (ARBs) are potentially useful in controlling the central blood pressure and arterial stiffness in mild to moderate essential hypertension, while the effects of ARBs in aged patients with essential hypertension are not entirely investigated.

Methods: The carotid-femoral arterial pulse wave velocity (PWV) was measured in aged patients with essential hypertension.

Results: In a cross-sectional study, PWV value was significantly higher in these old patients with essential hypertension, compared to patients without essential hypertension. In correlation analysis, PWV was associated positively with age, hypertension duration, and carotid atherosclerosis. However, there was no relationship between PWV and gender in aged patients with essential hypertension. In a perspective study, 6–12 months administration of ARBs (losartan, 50 mg/day; telmisartan, 40 mg/day; valsartan 80 mg/day; irbesartan, 150 mg/day) remarkably reduced PWV in aged patients with essential hypertension. Regression analyses of multiple factors indicated that the effects of ARBs on arterial stiffness were not associated with the reduction of blood pressure.

Conclusion: ARB treatment is a negative risk factor of arterial stiffness in aged patients with essential hypertension.  相似文献   

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