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《中国医学前沿杂志(电子版)》2016,(1)
目的探讨急性心肌梗死(AMI)并发初诊心力衰竭住院患者的生存状况。方法将本院收治的160例AMI患者按住院期间是否并发心力衰竭分为心力衰竭组和非心力衰竭组。采用自制表格统计患者一般资料和相关指标。结果 160例AMI患者中58例(36.25%)确诊为首发心力衰竭。两组患者在年龄、心率、发病至就诊时间、住院时间、左心室射血分数(LVEF)、合并慢性阻塞性肺疾病比例、肌酸激酶同工酶(CK-MB)、血肌酐(SCr)和血清尿素氮(BUN)方面比较差异均具有显著性(P<0.05或P<0.01)。心力衰竭组患者总死亡率、心房颤动、心源性休克和室性心律失常发病率均显著高于非心力衰竭组(P<0.01)。Logistic回归分析显示,影响AMI患者住院死亡率的因素由高至低依次为Killip分级、并发心源性休克、并发心力衰竭、并发慢性阻塞性肺疾病、LVEF、年龄和CKMB。结论 AMI首发心力衰竭患者死亡率较高,预后较差,应及时检测相关指标,积极预防AMI患者发生心力衰竭,有助于改善患者预后。 相似文献
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BACKGROUND: Relaxin can significantly improve cardiac and renal dysfuction caused by pathological factors, inhibit myocardial hypertrophy, have an anti-fibrosis effect, and improve ischemia-reperfusion injury. However, its protective mechanism against hypoxia-reoxygenation injury of endothelial cells remains unclear. OBJECTIVE: To investigate the protective mechanism of relaxin against hypoxia-reoxygenation injury of myocardial microvascular endothelial cells. METHODS: Mouse myocardial microvascular endothelial cell line (H5V cells) was used for the experiment. Cells were treated by three different interventions: in control group, cells were normally cultured for 33 hours; in model group, cells were treated by 6-hour hypoxia followed by 3-hour reoxygenation); and in relaxin group, 24 hours of routine culture (180 ng/mL relaxin), 6 hours of hypoxia and 3 hours of reoxygenation (180 ng/mL relaxin) were given to simulate myocardial hypoxia-reperfusion injury. Cell permeability and Caspase-3 activity were then detected. Levels of tumor necrosis factor-α, interleukin-1β and interleukin-6 in cell supernatants were detected by ELISA. Expressions of VE-cadherin, Akt, and GSK-3β at mRNA and protein levels were detected by RT-PCR and western blot, respectively. RESULTS AND CONCLUSION: Compared with the control group, the cell permeability and expression of caspase-3 increased significantly in the model group (P < 0.05). Compared with the model group, the cell permeability and expression of caspase-3 decreased in the relaxin group (P < 0.05). Moreover, the levels of tumor necrosis factor-α, interleukin-1β and interleukin-6 were elevated in the model group, while the levels were significantly decreased after relaxin treatment (all P < 0.05). There were no significantly changes in the mRNA and protein expressions of VE-cadherin, Akt1, and GSK-3β mRNA among three groups (all P > 0.05). Compared with the control group, the expression of phosphorylated VE-cadherin, Akt1 and GSK-3β were decreased in the model group (P < 0.05), and relaxin treatment reversed these changes to the control levels (P < 0.05). To conclude, relaxin treatment could enhance VE-cadherin expression, reduce hypoxiareoxygenation-induced microvascular endothelial cell damage, inhibit inflammatory cytokine release, and reduce cell apoptosis, which may be related to the activation of the Akt/GSK-3β signaling pathway. © 2023, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved. 相似文献
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BACKGROUND: Tumor segment resection is one of the standard methods for the treatment of bone tumors. However, the reconstruction of bone defects atumor resection faces many challenges. A growing number of researchers are focusing on 3D-printed prostheses for bone defect repair and reconstruction following bone tumor surgery. OBJECTIVE: To explore the feasibility of 3D-printed prostheses in the reconstruction of large bone defect following bone tumor surgery and to evaluate the postoperative outcomes. METHODS: Retrospective analysis of clinical data of 24 patients [19 males and 5 females, age 23.8 (6-61) years] who underwent bone tumor resection and 3D-printed prosthesis implantation in the Department of Bone Oncology, the First Affiliated Hospital of Xinjiang Medical University from December 2020 to September 2021 was conducted. There were 7 cases with distal femur tumor, 5 with pelvis tumor, 4 with proximal tibia tumor, 3 with middle femur tumor, 1 with distal tibia tumor, 1 with proximal humerus tumor, 1 with middle humerus tumor, 1 with scapula tumor, 1 with ulna tumor, and 22 cases with primary tumors (13 osteosarcoma, 4 Ewing sarcoma, 2 giant cell tumor of bone, 1 chondroblastoma, 1 chondrosarcoma, and 1 osteoblastoma), 2 metastatic carcinoma. Preoperative and postoperative imaging data were recorded and neoadjuvant chemotherapy was administered in 17 cases before surgery. The Musculoskeletal Tumour Society score was used to assess limb function before surgery and 6 months after surgery, and pain was assessed by the Visual Analog Scale, as well as the complications were recorded. RESULTS AND CONCLUSION: (1) All patients undergoing resection of the tumor segment and 3D-printed prosthesis implantation for the reconstruction of the bone defect were followed for 6-49 months, and the results showed that the length of osteotomy was (18.2 ± 7.3) cm and an average intraoperative bleeding volume was 740 (100-3 000) mL. (2) Two patients died of systemic metastasis, the remaining 22 had no pulmonary metastasis or recurrence during the follow-up period, and 1 patient developed aseptic loosening of the prosthesis at 25 months postoperatively. (3) The Musculoskeletal Tumour Society scores were significantly increased, while Visual Analog Scale scores were significantly decreased (P < 0.05) at 6 months postoperatively. (4) The Musculoskeletal Tumor Society score was rated excellent in all 22 patients at the final follow-up. (5) These results suggest that 3D-printed prosthesis is suitable for the reconstruction of large bone defects caused by bone tumor resection. Patients have good postoperative function and few complications. However, further investigations are needed to explore long-term follow-up results. © 2023, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved. 相似文献
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目的探讨肝包虫合并乙型肝炎病毒(HBV)感染患者辅助性T细胞17(Th17)、CD4+细胞表面程序性死亡分子-1/程序性死亡分子1配体(PD-1/PD-L1)的表达水平及其临床意义。方法选取2014年9月一2019年9月新疆医科大学第一附属医院收治的肝包虫病患者作为研究对象﹐其中100例肝包虫病合并HBV感染患者为合并HBV感染组,肝包虫病无HBV感染患者88例为非HBV感染组﹐采用流式细胞仪检测外周血Th17,CD4+细胞表面PD-1,PD-L1表达水平。结果合并HBV感染组患者乙型肝炎家族史,B~C Child分级占比均高于非HBV感染组(P<0.05);肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST),γ-谷氨酰转肽酶(γ-GT)]水平以及Th17 PD-1、Th17 PD-L1,CD,PD-1,CD4+PD-L1表达水平均高于非HBV感染组(P<0.05);Child分级A级肝包虫病患者的Th17 PD-1,Th17 PD-L1,CD4+PD-1,CD4+PD-L1表达水平均低于Child分级B~C级患者(P<0.05)。结论HBV感染会影响肝包虫病患者的肝功能及外周血Th17,CD4+细胞表面PD-1,PD-L1表达水平,肝功能严重程度可能与外周血Th17,CD4+细胞PD-1,PD-L1表达存在关系。 相似文献
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目的 对急性肾损伤(AKI)患者的病例特征和短期预后影响因素进行分析,以期为AKI治疗提供临床参考依据。方法 以2020年1月1日至2021年12月31日新疆地区3家医院收治的AKI患者为研究对象,根据AKI发生后90 d内的肾功能是否恢复分为恢复组和未恢复组,对2组患者的基础疾病、临床特征和血清学指标进行比较分析,并利用多因素回归模型对患者的短期预后影响因素进行分析。结果 纳入研究的1 355例AKI患者中男性848例,女性507例,平均年龄(51.37±9.64)岁;合并基础疾病情况为高血压711例(52.47%)、糖尿病208例(15.35%)、冠心病220例(16.24%)、慢性肾脏病189例(13.95%)。AKI病因分布分别为肾前性591例(43.62%),肾性400例(29.52%),肾后性272例(20.07%)。疾病诱因以肾脏缺血(615例)最常见,占45.39%。分级为危险共865例(63.84%),损伤361例(26.64%),衰竭129例(9.52%)。肾功能恢复组784例(57.86%),未恢复组571例(42.14%)。多因素Logistic回归分析结果显示年龄(OR=1.132)、机械通气(OR=2.214)、肾脏替代治疗(OR=3.040)、APACHE II评分(OR=2.179)、SOFA评分(OR=1.468)和血尿素氮水平(OR=1.179)均是AKI患者短期预后(未恢复)的独立影响因素。结论 在AKI患者的病发诱因以肾脏缺血和感染/脓毒症较为常见,高龄、行机械通气、肾脏替代治疗以及APACHE II评分、SOFA评分和血尿素氮水平较高与短期预后密切相关,早期针对该重点人群采取干预措施能有效改善预后。 相似文献
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随着人口老龄化 ,高血压脑出血在我国呈上升趋势 ,该病的高死亡率、高残废率 ,高复发率 ,长期困挠着临床医生 ,特别是手术治疗问题值得探讨 ,结合我科 1 995年以来手术治疗 33例讨论分析如下 :1 资料与方法高血压脑出血 33例均经CT及手术证实诊断。血肿量大脑半球 40~ 1 2 0mL ,小脑 2 0~ 30mL。其中 ,男 2 2例 ,女 1 1例 ,年龄 33~ 78岁。意识障碍33例 ,呕吐 2 8例 ,抽搐 1 3例 ,一侧瞳孔散大 1 1例 ,双侧瞳孔散大 5例 ,偏瘫 2 0例 ,去大脑强直 9例 ,颈抵抗 1 7例 ,双侧锥体束征阳性 1 6例 ,单侧锥体束征阳性 1 7例。血肿位于大… 相似文献
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目的:研究新疆苯丙酮尿症(PKU)家系苯丙氨酸羧化酶(PAH)基因突变位点及其遗传标记,探索适合新疆各民族PKU基因诊断和产前基因诊断途径。方法:联合采用PCR-STR、APSCR和PCR-SSCP3种基因诊断方法进行分析。结果:(1)PCR-STR连锁分析表明:除家系4母亲为STR纯合型外,其余家系双亲皆为杂合子,对家系1(维吾尔族)1例风险胎儿(妊娠6周,流产)进行产前基因诊断和1例新生儿(出生1d)进行症前基因诊断,均为携带者,并经出生后证实。(2)采用ASPCR法在家系1、2和3均未检出R243Q和R413P两种常见突变。(3)应用PCR-SSCP分析发现,家系2(回族)患儿为外显子7突变纯合子,家系4(汉族)患儿为外显子7和外显子11突变复合体,其外显子11突变位于第399位点(GTA→GTT),可能为一致病突变。结论:上述3种基因诊断方法联合使用简便、快捷,适合新疆地区的基因诊断和产前基因诊断。 相似文献