Serum carbohydrate antigen-125 is elevated in patients with chronic atrial fibrillation

ObjectiveTo determine whether CA-125 is elevated in medically stable patients with chronic atrial fibrillation (AF) compared with patients without AF and to examine whether levels of CA-125 are associated with demographic and clinical variables in a sample of patients under study.Methods55 patients with chronic AF and 58 control patients in sinus rhythm were included into the study. Patients with acute heart failure (HF), chronic inflammatory or neoplastic disease were excluded from the study. Circulating levels of CA-125 were assessed; all patients underwent clinical examination, assessment and medical records including demographic data, history of comorbid conditions, current use of cardiac medications, and the results of cardiac tests including electrocardiograms.ResultsThe mean age of the study sample was 53.2±6.5 years and 48% were men. Patients with sinus rhythm were significantly more likely to have lower heart rates, smaller dimensions of left atrium, and to be treated with aspirin. Coumadin, coumadin and digoxin were more often prescribed in patients with chronic AF. The CA-125 levels were significantly higher in patients with chronic AF than in patients in sinus rhythm (48.5±7.65 U/ml and 28.43±5.48 U/ml, P<0.005). An inverse relation was found between CA-125 levels and left ventricular ejection fraction (LVEF) (r=-0.48, P<0.001). CA-125 was significantly related to the left atrium (LA) diameter, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and brain natriuretic peptide (BNP). There was no significant correlation between CA-125 and age.ConclusionIn subjects with chronic AF, CA-125 levels are increased; CA-125 was significantly related to the LA diameter, LVEDD, LVESD and BNP.     

Single nucleotide polymorphisms in the D-loop region of mitochondrial DNA and age-at-onset of patients with chronic kidney disease

Background The mitochondrial displacement loop （D-loop） accumulates mutations and single nucleotide polymorphisms （SNPs） at a higher frequency than other regions of mitochondrial DNA （mtDNA）.We previously identified disease riskassociated SNPs in the D-loop of chronic kidney disease （CKD） patients; in this study,we investigated the association of age-at-onset and D-loop SNPs in CKD patients.Methods The D-loop region of mtDNA was sequenced in 119 CKD patients attending the Fourth Hospital of Hebei Medical University between 2002 and 2008.The age-at-onset curve of the CKD patients was calculated using the KaplanMeier method at each SNP site,and compared using the log-rank test.Results The mean age of 119 CKD patients was （55.6±14.2） years,and 56.3% were males.The mean estimated glomerular filtration rate （eGFR） was （81.2±12.4） ml·min^-1·1.73 m^-2,with 79.8% （n=95） of patients having an eGFR 〈60 ml·min^-1·1.73 m^-2.All participants had an eGFR 〉30 ml·min^-1·1.73 m^-2.The age-at-onset for CKD patients who smoked was significantly lower than that of non-smoking CKD patients.The SNP sites of nucleotides 150C/T were identified for their association with age-at-onset using the log-rank test.The age-at-onset of patients with the minor allele T genotype was significantly lower than that of patients with the C genotype at the 150 SNP site （P=0.010）.Conclusions Genetic polymorphisms in the D-loop appear to be predictive markers for age-at-onset in CKD patients.Accordingly,the analysis of genetic polymorphisms in the mitochondrial D-loop may help identify CKD patient subgroups at high risk of early onset disease.     

功能性鼻内镜鼻窦手术围手术期护理

微创鼻内窥镜手术在鼻科的应用,使鼻窦炎鼻息肉的治愈率高达80%-90%。患慢性鼻窦炎、鼻息肉行鼻内窥镜术的病人,消除病灶、保留鼻腔和鼻窦结构、改善和重建鼻腔、鼻窦通气引流、恢复黏膜形态和生理功能。通过术前准备、术后护理、鼻窦冲洗和出院指导多个环节进行观察和护理研究,形成了一套系统的护理方法,从而进一步提高了治疗效果。1临床资料2003年3月至2009年1月收集193例患者,男150例,女43例,年龄26-64岁,平均年龄38岁。     

B超诊断肝内钙化灶132例分析

肝内钙化灶国内报道不多，本文通过B超对肝内钙化灶的诊断，谈点看法。 1 临床资料 本组132例均属住院及门诊患者，其中男72例，女60例，年龄最小20岁，最大71岁，平均年龄43岁，主诉上腹及右上腹部疼痛，均未伴发热及黄疽，使用心QSSD-256待阵仪，频率3．5MHZ，空腹时行常规肝、胆、胰、脾检查，132例肝大小均正常，内部可见大小不等，形态不规则或圆形的强回声，边界清晰，后方伴有声形，局部胆管均匀扩张，（未行PTC、ERCP）诊断为肝内钙化灶，另3例胆结石，11例慢性胆囊炎，132例肝内钙化灶个体特征见附表。     

类似结节硬化型Hodgkin淋巴瘤的ALK阳性的间变性大细胞性淋巴瘤

间变性大细胞性淋巴瘤(ALCL)和Hodgkin淋巴瘤(HL)虽然是两种具有不同生物学行为的独立的疾病实体,但有时这两种疾病的形态学特征比较相似,该诊断带来了困难。作者从其收集的380例ALCL中发现有10例具有Hodgkin样特点,其中男性7例,女性3例,年龄3~92岁,平均年龄11岁。病变位于颈部     

高龄病人三叉神经痛的微血管减压术治疗

目的目前对于药物难以控制的三叉神经痛,应用微血管减压术进行治疗已经得到普遍的认同,但是对于高龄病人,由于考虑到是否能耐受手术的原因,也经常选用其他的一些方法。本文拟对75岁以上的高龄三叉神经痛病人施行微血管减压术的安全性和有效性进行评价。方法作者对从2000年6月～2003年12月期间25例患有三叉神经痛的高龄病人进行了回顾性的分析并且对这些病人进行了电话随访。本组病人平均年龄为79.4岁（75～88岁）,所有病人都接受了三叉神经微血管减压术。对照组为平均年龄为42.3岁（17～50岁）的病人。结果在两组中初始疼痛有96%的病人得到缓解。没有手术死亡率。平均随访时间为44～52个月。老年组和对照组分别的疼痛缓解率为78%和72%,不再需要药物治疗（P=0.74）。结论微血管减压术对于老年三叉神经痛的患者是一种有效的治疗方法。作者的经验表明微血管减压术的死亡率和并发症发生率与年轻组无明显差异。     

医源性胆管损伤17例诊治体会

现将我们近年来收治的医源性胆管损伤17例病例的诊治报告如下。临床资料1.一般资料:男4例,女13例,平均年龄45.5岁,17例胆管损伤均因胆囊结石、胆囊炎行胆囊切除所致。损伤类型:本组病例的损伤分别为胆总管横断伤(Ⅰ类)5例,胆总管被丝线结扎(Ⅱ类)5例,胆管及肝总管被电凝钩灼伤(Ⅲ类)7例。2.方法:(1)Ⅰ类损伤5例,4例行胆总管空肠Roux-Y吻合术,另1例行丝线松解,胆总管内置支撑管3个月。(2)Ⅱ类损伤7例,2例仅引流腹腔得到治愈,3例除引流腹腔外另加ERCP下放置支撑管半年。2例再次手术探查,放置T管引流、腹腔引流。(3)Ⅲ类损伤5例,均为术中发…     

针刺补法治疗陈旧性面瘫36例

笔者观察浅刺透穴治疗气虚血瘀型陈旧性面瘫36例，效果满意，现介绍如下。 1 临床资料 36例患者，男21例，女15例，年龄最小35岁，最大73岁，平均年龄57岁。病程6个月～1年18例，l～2年12例，2～3年4例，3年以上2例。     

文摘

该文系回顾性病例对照研究。选择1985年至2000年间339例在东京大学医院行椎板成形术治疗的患者。所患疾病包括颈椎间盘突出、后纵韧带骨化、风湿性关节炎、脑瘫及其他可影响脊柱序列的疾病。在排除因C7椎体在X线平片上显示不清而无法测量Cobb角的病例后，最后入选72例脊髓型颈椎病患者，其中手术范围为C2～731例，C3～729例，C1～75例，C3～63例，C3～T12例，C2～61例，C2～T11例；平均年龄60．0岁（26～83岁），平均症状出现时间3．0年（2个月～17年），平均随访4．0年（2～11年）。依据G椎板情况将患者分为3组，S组18例，C2椎板被完全劈开；D组20例，行C2椎板下弧形切除减压；I组34例，保留C1、2椎板的完整。     

医源性胆管损伤16例治疗体会

病例资料2007年1月至2011年12月期间笔者所在医院共收治医源性胆管损伤16例,男10例,女6例;年龄31～72岁,平均年龄53．6岁。I型7例,Ⅱ型5例,Ⅲ型3例,Ⅳ型1例。16例中5例系术中发现胆管损伤者,I型2例,行胆囊床损伤小胆管缝扎、腹腔引流管引流治疗;Ⅱ型2例,行损伤胆管修补、T管引流术;