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91.
目的 探讨心率减速力与冠状动脉病变范围和严重程度的相关性。 方法 纳入本院同时接受320排动态容积CT冠状动脉造影检查和24 h动态心电图(24 h DCG)监测的住院患者共270例,同时收集患者吸烟史、血脂、血糖、血压等临床指标。根据冠状动脉CT结果分为冠心病组、对照组。分析两组患者的临床指标和心率减速力(DC值)、心率加速力(AC值)和猝死危险分层的差异,判断DC值、AC值和猝死风险分层与冠脉病变严重程度、病变范围的相关性。 结果 冠心病组的总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(ApoA)水平均较对照组增高,载脂蛋白B(ApoB)则较对照组下降(P<0.05)。相比对照组,冠心病组的DC值明显下降,AC值明显升高,猝死危险分层则明显升高,差异具有统计学意义。DC值与猝死危险分层、冠脉病变支数、Gensini评分均呈负相关,AC值与猝死危险分层、病变支数、Gensini评分均呈正相关,猝死危险分层与病变支数、Gensini评分均呈正相关,差异具有统计学意义。 结论 心率减速力能够定量评估自主神经,与冠状动脉病变程度、病变范围密切相关,是冠状动脉粥样硬化性心脏病的一项重要预测指标。 相似文献
92.
Hu L Lytras A Bock ME Yuen CK Dodd JG Cattini PA 《Molecular and cellular endocrinology》1999,157(1-2):131-142
Diabetes is a common complication encountered during pregnancy. Earlier studies indicated that diabetic placentas bear morphological alterations consistent with modified placental differentiation, including alterations in the villous cellular content, structure, and total surface. Limited data associating the diabetic status with the expression of terminal placental differentiation markers are available. The human growth hormone/chorionic somatomammotropin (hGH/CS) family consists of five genes, one of which (GH-N) is expressed efficiently in pituitary while the other four (CS-A, B, L, and hGH-V) are expressed in placenta and represent ultimate placental differentiation markers. We developed and applied a sensitive RT-PCR method coupled with diagnostic restriction digestion to determine the relative levels of the hGH/CS family in normal pregnancies and examine whether their mRNA expression pattern is altered in pregnancies complicated by diabetes. We show that relative hCS-L content changes during placental development. Specifically, normal term placentas express higher relative levels of hCS-L, lower relative hGH-V levels and a 70-fold lower hGH-V/CS-L mRNA ratio compared to early placentas. Also, many term placentas from diabetic pregnancies express lower relative levels of hCS-L mRNA and a much higher hGH-V/CS-L mRNA ratio compared to normal term placenta, resembling more an early placenta pattern of expression. Thus, our study suggests that the expression of terminal placental differentiation markers, such as the hGH/CS genes, is altered in term placentas from these diabetics reflecting either impaired placental differentiation or post-differentiation impairment of normal placental function. 相似文献
93.
Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration 总被引:15,自引:0,他引:15
Yu SC Ho SS Lau WY Yeung DT Yuen EH Lee PS Metreweli C 《Hepatology (Baltimore, Md.)》2004,39(4):932-938
This study aims to compare the therapeutic effectiveness of continuous catheter drainage versus intermittent needle aspiration in the percutaneous treatment of pyogenic liver abscesses. Over a 5-year period, 64 consecutive patients with pyogenic liver abscess were treated with intravenous antibiotics (ampicillin, cefuroxime, and metronidazole) and randomized into two percutaneous treatment groups: continuous catheter drainage (with an 8F multi-sidehole pigtail catheter); and intermittent needle aspiration (18G disposable trocar needle). There was no statistically significant difference between the two groups regarding patient demographics, underlying coexisting disease, abscess size, abscess number, number of loculation of abscess, the presenting clinical symptoms such as fever, abdominal pain, and pretreatment liver function test. Although not statistically significant, the duration of intravenous antibiotics treatment before percutaneous treatment was longer with the catheter group, and the change of antibiotics after the sensitivity test was more frequent with the needle group. The needle group was associated with a higher treatment success rate, a shorter duration of hospital stay, and a lower mortality rate, although this did not reach statistical significance. In conclusion, this study suggests that intermittent needle aspiration is probably as effective as continuous catheter drainage for the treatment of pyogenic liver abscess, although further proof with a large-scale study is necessary. Due to the additional advantages of procedure simplicity, patient comfort, and reduced price, needle aspiration deserves to be considered as a first-line drainage approach. 相似文献
94.
95.
96.
James Siu Ki Lau Chi Kit Yuen Ka Leung Mok Wing Wa Yan Pui Gay Kan 《The American journal of emergency medicine》2018,36(7):1134-1138
Objectives
This study is to present the diagnostic values of the novel sonographic visualization of the inferoposterior thoracic wall (VIP) and boomerang signs in detecting right pleural effusion by sonologists with little to no experience in ultrasound.Methods
A prospective analysis of a convenience sample of patients who were assessed by junior intensive care physicians was performed. The patients all underwent computed tomography (CT) of the chest or abdomen with lung bases as part of their care regardless of indication; the results were interpreted by radiologists and were considered the gold standard. Sonography was performed to assess for the presence of the VIP and boomerang signs. Sonographic and chest radiographic findings were compared against CT results.Results
73 patients were enrolled. The sensitivity and specificity for the VIP sign were 0.85 (95% confidence interval [CI], 0.67–0.94) and 0.86 (95% CI, 0.70–0.95). The sensitivity and specificity for the boomerang sign were 0.78 (95% CI, 0.60–0.90) and 0.87 (95% CI, 0.71–0.95). However, the sensitivity and specificity for the traditional approach of detecting an anechoic collection above the diaphragm to indicate pleural effusion were only 0.54 (95% CI, 0.37–0.71) and 0.86 (95% CI, 0.80–0.99).Conclusions
Despite inexperience in sonography, the novel VIP and boomerang signs show high diagnostic values in detecting right pleural effusion compared to the traditional methods. 相似文献97.
Purpose:
There have been 3 published reports (4 cases) of symptomatic sinus bradycardia occurring after intravenous (IV) administration of the selective 5-hydroxytryptamine 3 (5-HT3) receptor antagonist ondansetron. We report a fifth case in which the patient developed asystole after rechallenge with ondansetron.Summary:
A 36-year-old pregnant patient with no cardiac history, status post cerclage for cervical insufficiency, experienced nausea in the post ambulatory care unit after administration of morphine and indomethacin for pain. After IV administration of ondansetron, the patient’s heart rate decreased to the 40s and improved spontaneously. The patient experienced a second episode of nausea, another dose of ondansetron was administered, and the patient went into asystole. Advanced cardiac life support measures were initiated and chest compressions were conducted for 3 minutes with return of spontaneous circulation. The patient was monitored overnight with no development of new cardiac arrhythmias and was discharged from the hospital in stable condition.Conclusions:
Sinus bradycardia after IV administration of ondansetron was observed in a 36-year-old pregnant patient status post cerclage. On rechallenge, the patient went into asystole. This case report adds to the available literature regarding ondansetron-induced cardiac arrhythmias and the possibility of asystole upon rechallenge. 相似文献98.
99.
Susanna K.P. Lau Alan K.L. Wu Jade L.L. Teng Herman Tse Shirly O.T. Curreem Stephen K.W. Tsui Yi Huang Jonathan H.K. Chen Rodney A. Lee Kwok-Yung Yuen Patrick C.Y. Woo 《Emerging infectious diseases》2015,21(2):232-241
Elizabethkingia anophelis, recently discovered from mosquito gut, is an emerging bacterium associated with neonatal meningitis and nosocomial outbreaks. However, its transmission route remains unknown. We use rapid genome sequencing to investigate 3 cases of E. anophelis sepsis involving 2 neonates who had meningitis and 1 neonate’s mother who had chorioamnionitis. Comparative genomics revealed evidence for perinatal vertical transmission from a mother to her neonate; the 2 isolates from these patients, HKU37 and HKU38, shared essentially identical genome sequences. In contrast, the strain from another neonate (HKU36) was genetically divergent, showing only 78.6% genome sequence identity to HKU37 and HKU38, thus excluding a clonal outbreak. Comparison to genomes from mosquito strains revealed potential metabolic adaptations in E. anophelis under different environments. Maternal infection, not mosquitoes, is most likely the source of neonatal E. anophelis infections. Our findings highlight the power of genome sequencing in gaining rapid insights on transmission and pathogenesis of emerging pathogens. 相似文献
100.
Mak Lung-Yi Huang Qi Wong Danny Ka-Ho Stamm Luisa Cheung Ka-Shing Ko Kwan-Lung Yan Ran Ouyang Lea Fung James Seto Wai-Kay Yuen Man-Fung 《Journal of gastroenterology》2021,56(5):479-488
Journal of Gastroenterology - We aimed to assess whether residual hepatitis B virus (HBV) viraemia is associated with HCC development. This is a case–control study of 104 patients [52 HCC and... 相似文献