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1.
BackgroundSeveral recent genome-wide association studies tried to explore associations between LOC643714 polymorphisms and breast cancer (BC). However, the results of these studies were inconsistent. The purpose of this meta-analysis was to better analyze the effects of LOC643714 polymorphisms on individual susceptibility to BC in a larger pooled population.Materials and MethodsPubMed, Web of Science, and Embase were searched for eligible studies. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to estimate the strength of associations.ResultsIn total, 42 studies with 231,191 subjects were analyzed. Significant associations with BC were observed for rs3803662 (dominant comparison: OR, 0.89; 95% CI, 0.84-0.95; P = .0008; recessive comparison: OR, 1.17; 95% CI, 1.07-1.28; P = .0004; over-dominant comparison: OR, 1.07; 95% CI, 1.02-1.11; P = .002; allele comparison: OR, 0.90; 95% CI, 0.86-0.95; P = .0002), rs8051542 (dominant comparison: OR, 0.87; 95% CI, 0.83-0.91; P < .0001; recessive comparison: OR, 1.19; 95% CI, 1.11-1.28; P < .0001; over-dominant comparison: OR, 1.07; 95% CI, 1.02-1.11; P = .004; allele comparison: OR, 0.89; 95% CI, 0.86-0.91; P < .0001), and rs12922061 (dominant comparison: OR, 0.83; 95% CI, 0.73-0.93; P = .002; over-dominant comparison: OR, 1.43; 95% CI, 1.27-1.61; P < .0001) polymorphisms in the overall population. Further subgroup analyses yielded similar positive results for rs3803662 and rs8051542 polymorphisms in Asians, Caucasians, and Africans, for rs12443621 polymorphism in Caucasians, and for rs12922061 polymorphism in Asians.ConclusionsOur findings suggested that LOC643714 rs3803662, rs8051542, rs12443621, and rs12922061 polymorphisms were all significantly associated with BC in certain populations.  相似文献   
2.

Background

Persistent iatrogenic atrial septal defect (iASD) is a common but poorly characterized complication after cryoballoon (CB) pulmonary vein isolation (PVI) procedures. We therefore investigate its prevalence, evolution, risk factors, and clinical outcomes in a prospective longitudinal study.

Methods

A total of 108 patients (41 women, mean age 57 ± 11.3) underwent CB PVI for AF. Serial transesophageal echocardiography (TEE) was performed 9 months and then annually until 6 years after the procedure to study the characteristics of persistent iASD.

Results

Persistent iASD occurred in 33 (30.6%) patients 9 months after CB PVI. Spontaneous closure of iASD was found in 6 (22.2%) and 3 (15.8%) patients 2 and 3 years after the procedures, respectively. No spontaneous closure was observed on 4, 5, and 6-year TEE follow-up. The projected long-term persistence rate of iASD after CB PVI was therefore 20% (30.6% × 0.778 × 0.842). Using multivariate logistic regression, a higher number of cryoapplications (≥ 2 minutes) was the only independent predictor of persistent iASD 9 months after CB PVI (odds ratio [OR] 1.207; 95% confidence interval [CI], 1.033-1.411, P = 0.018). Two (1.9%) patients with significantly larger iASD size than the others (long diameter 12.6 ± 0.8 vs 3.7 ± 1.5 mm, P < 0.001; short diameter 10.9 ± 0.2 vs 3 ± 1.1 mm, P < 0.001) required percutaneous closure because of exertional dyspnea and right ventricular enlargement. Over 129.7 patient-years follow-up, during which iASD persisted, there was no occurrence of neurologic events.

Conclusions

Approximately one fifth of patients undergoing CB PVI will have permanently persistent iASD. Patients with defect sizes of greater than 10 mm may need percutaneous closure due to significant left-to-right shunting.  相似文献   
3.
[目的]总结归纳霍介格教授辨治原发性肝癌的经验。[方法]通过跟随霍介格教授临证抄方及病案收集,同时结合对中医文献的研究,总结霍介格教授对肝癌病机证素的认识,归纳其对肝癌分期的认知及用药特色,辅以典型案例论述中医药在治疗患者并发症状,提高患者生存质量所具有的独特疗效。[结果]霍介格教授提出肝癌的病机总属本虚标实,指出湿瘀热毒是核心病机,癌毒是其发病关键;本虚应责之脾肝肾,标实应责之气滞、血瘀、水湿、癌毒;强调治疗应明虚实,辨分期,结合证候及临床表现,从而消补兼施,配伍用药,扶正祛邪,贯穿整个治疗过程;并提出了在药物治疗的同时,更应关注患者的身心健康,防止身心同病。[结论]霍介格教授擅于论治原发性肝癌,其临床经验值得学习推广。  相似文献   
4.
This study aims to evaluate endplate/cortex fracture (ECF)-based method for detecting osteoporotic vertebral fracture (VF) in elderly Chinese population (age ≥ 65 years). The radiographs of 1954 elderly Chinese men (mean: 72.3 years) and 1953 elderly Chinese women (mean: 72.5 years) were evaluated according to Genant's morphometrical vertebral deformity (VD) severity criteria, as well as identified VF according to ECF without necessary requirement of VD. According to ECF, grade-1, -2, and -3 VF prevalence was 1.89%, 1.74%, and 2.25% in men, and 3.33%, 3.07%, and 5.89% in women, respectively. In men and women, 15.7% (35 of 223) and 34.5% (48 of 139) of vertebrae with VD grade-1 deformity were ECF(+, with fracture), respectively. In men and women, 89.7% (35 of 39) and 66.7% (48 of 72) of vertebrae with ECF grade-1 fracture had VD grade-1 deformity. For grade-1 change, ECF(+) subjects tended to have a lower BMD than the VD(+) subjects. In subjects with VD grade-2 deformity, those who were also EC (+) tended to have a lower BMD than those were ECF(?). In all grades, VD(?) and ECF(?) subjects tended to have highest BMD, whereas VD(+) and ECF(+) subjects tended to have lowest BMD. ECF may be more specific for assessing mild VF than the criteria based on vertebral deformity.  相似文献   
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7.
BackgroundThe relationship between clinical outcomes and gene mutations in Chinese pediatric patients with idiopathic and heritable pulmonary arterial hypertension (PAH) is unclear.MethodsWe retrospectively studied the clinical characteristics and outcomes of pediatric patients who visited Beijing Anzhen Hospital from September 2008 to December 2018.ResultsEighty-two pediatric patients were included. Forty-two gene mutations were identified in 41 patients (50%), including 25 mutations in BMPR2, 5 mutations in ACVRL1, 3 mutations each in ABCA3 and NOTCH3, 2 mutations each in KCNK3 and HTR2B, 1 mutation in ENG, and 1 mutation in EIF2AK4. The mean age at diagnosis of PAH was 86.4 ± 55.1 months. Forty-eight patients (twenty-eight mutation carriers) underwent cardiac catheterization examinations, with acute vasodilator testing performed simultaneously. Results showed that mutation carriers demonstrated a higher pulmonary vascular resistance index (P = 0.037). Patients with gene mutations responded poorly to vasodilators (P = 0.001). The 1-, 2-, and 3-year survival rates of mutation noncarriers were 95.1%, 87.8%, and 82.5% respectively; while for mutation carriers, the proportions were 86.6% (P = 0.216), 63.8% (P = 0.021), and 52.2% (P = 0.010), respectively. Cardiac index was an independent predictor of death (P = 0.005; odds ratio [OR] 2.16, 95% confidence interval [CI] 1.258-3.704), as well as RAP (P = 0.01; OR 1.26, 95% CI 1.056-1.503).ConclusionsIn our cohort of Chinese pediatric patients, those with an identified gene mutation demonstrated worse clinical outcomes. Therefore, early gene screening for pediatric patients with idiopathic and heritable PAH is recommended, and more aggressive treatment for mutation carriers may be advisable.  相似文献   
8.
 目的 比较接受巴塞罗那临床肝癌分期系统(BCLC)或香港的分期系统(HKLC)推荐治疗方案对肝细胞肝癌(HCC)患者生存率的影响。方法 回顾性分析436例初治肝癌患者的临床资料,根据HKLC和BCLC进行肿瘤分期,按是否最终接受两个分期系统推荐的治疗方案分组。比较患者是否接受BCLC或HKLC分期推荐方案治疗对生存率的影响,并评估拒绝BCLC或HKLC推荐方案对预后可能产生的影响。 结果 接受BCLC推荐治疗方案的患者5年生存率显著高于拒绝推荐治疗方案的患者(48% vs. 30%, P<0.001)。与拒绝推荐治疗方案的患者相比,接受HKLC推荐治疗方案的患者亦有较高的5年生存率(41% vs. 29%, P<0.001)。对BCLC和HKLC交叉亚组分析,BCLC-B/HKLC-Ⅰ+Ⅱa+Ⅱb、BCLC-B/HKLC-Ⅲa+Ⅲb和BCLC-C/HKLC-Ⅲa+Ⅲb亚组中,接受手术切除的HCC患者显著高于接受TACE、索拉非尼或最佳支持治疗的患者5年生存率均较高(均P<0.05)。 结论 接受BCLC和HKLC分期系统推荐治疗方案可以提高HCC患者的存活率,但对于中晚期肝癌患者指导作用减弱。部分BCLC-B/HKLC-Ⅰ+Ⅱa+Ⅱb、BCLC-B/HKLC-Ⅲa+Ⅲb和BCLC-C/HKLC-Ⅲa+Ⅲb的患者通过积极的根治性治疗可以获得更好的生存。  相似文献   
9.
目的:研究急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)前静脉注射丹红注射液对术中无复流血流的改善及C-反应蛋白(CRP)的影响。方法:对120例AMI患者术前均给予阿司匹林300 mg、氯吡格雷300 mg等治疗。随机分成A组与B组两组,各60例。A组PCI术前予以丹红注射液,术中出现无复流2例,再予以硝酸甘油冠脉内给药;B组直接行PCI术,术中出现无复流8例,再予以硝酸甘油冠脉内给药,对比两组患者冠脉血流恢复情况。同时两组患者均在术前及术后监测CRP。结果:A组全部冠脉血流恢复TIMI3级,B组有4例冠脉血流恢复TIMI3级,且用丹红注射液组术后CRP降低更明显。结论:PCI术前静脉注射丹红注射液可以降低AMI患者的CRP值,且联合硝酸甘油后较单一给予硝酸甘油可更有效恢复无复流血管的TIMI血流值。  相似文献   
10.
Objectives: This study applied a multidimensional model on a continuum to examine successful aging (SA) and investigated whether SA is associated with biomedical and psychosocial–demographic factors among Hong Kong Chinese near-centenarians and centenarians.

Method: A cross-sectional data analysis was performed on a geographically representative sample of 120 near-centenarians and centenarians with an age range of 95–108 years. We developed an integrated and cumulative Successful Aging Index (SAI) based on participants’ performance in four dimensions: (1) physical and functional health (PF), (2) psychological well-being and cognition (PC), (3) social engagement and family support (SF), (4) economic resources and financial security (EF). To examine the criterion validity of SAI, we conducted a multiple binary logistic regression with interviewer-rated health. A multiple regression model was ran to investigate the independent biomedical and psychosocial–demographic correlates of SAI.

Results: Results show that only 5.8% of participants attained SA in all four dimensions. PF had the least achievers, whereas the proportion was the highest in PC. SAI was significantly associated with interviewer-rated health and a high level of high-density lipoprotein cholesterol. Living with family or friends, high level of optimism, fewer diseases, and barriers to social activities were independent predictors of SAI score.

Conclusion: In the light of the lack of consensus on the constituents and assessment of SA especially among very old adults, our findings add to the extant literature by underscoring the importance of the multidimensional nature and the utility of an integrated and cumulative-based assessment of SA at the extreme of longevity.  相似文献   

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