简介:BackgroundThepresenceofachronictotalocclusion(CTO)inanon-infarct-relatedarterymightbeassociatedwithaworseprognosisinlongtermbenefitforST-segmentelevationmyocardialinfarction(STEIMI)patients.Butitstillremaincontroversial.MethodsAll383STEMIpatientsunderwentpercutaneousintervention(PCI)fromJan2015toJan2017inourcenterwereenrolledinthisprospectivestudy.Baselinecharacteristics,medicalhistory,biochemicalfindings,echocardiographicandangiographicparameters,proceduresperformedandcomplicationswererecorded.FactorsrelatedtoworseoutcomeCTOinSTEMIpatientswereanalyzedbythecoxlogisticregressionanalysisforthehazardrate(HR).ResultsInatotalof383patientsenrolledinthisstudy,85caseshadCTOinatleast1coronaryartery.Themeanfollow-upwas352days.1-yearmortalityandMACEratesinpatientswithCTOwere18.8%and11.8%,respectively.Majoradversecardiacevents(MACE)duringfollow-upweresignificantlyhigherinpatientswithCTO(HR=2.88;95%CI,1.82-4.77;P<0.001).ThemultivariateanalysisshowedasignificantassociationbetweenCTOandMACE(HR=2.1195%CI,1.27-3.88;P=0.014).ConclusionChronictotalocclusionisassociatedwithhigherriskofcomorbiditiesandhighermortality,andservesasanindependentpredictorofMACE.
简介:Introduction,Chronicpericarditisisinflammationthatbeginsgradually,islonglastingandresultsinfluidaccumulationinthepericardialspaceorthickeningofthepericardium.Therearetwomaintypesofchronicpericarditisa)chroniceffusivepericarditis,fluidslowlyaccumulatesinthepericardialspacebetweenthetwolayersofthepericardium.
简介:Liverinjuryisacharacteristicfeatureofhumanimmunodeficiencyvirus(HIV)infection,whichisthesecondmostcommoncauseofmortalityinHIV-infectedpatients.NowitisrecognizedthatliverplaysakeyroleinHIVinfectionpathogenesis.Antiretroviraltherapy(ART),whichsuppressesHIVinfectioninpermissiveimmunecells,islesseffectiveinhepatocytes,therebymakingthesecellsasilentreservoirofHIVinfection.InadditiontodirecthepatotoxiceffectsofHIV,certainARTtreatmentmodalitiesprovidehepatotoxiceffects.TheexactmechanismsofHIV-triggeredchronichepatitisprogressionarenotelucidated,buttheliverisadverselyaffectedbyHIV-infectionandlivercellsareprominentlyinvolvedinHIV-elicitedinjury.Theseeffectsarepotentiatedbysecondhitslikealcohol.Here,wewillfocusontheincidenceofHIV,clinicalevidenceofHIVrelatedliverdamage,interactionsbetweenHIVandlivercellsandtheroleofalcoholandco-infectionwithhepatotropicvirusesinliverinflammationandfibrosisprogression.
简介:Objective:LivercancerisoneofthemostcommoncancersandmajorcauseofcancerdeathsinChina,whichaccountsforover50%ofnewcasesanddeathsworldwide.Thesystematiclivercancerstatisticsincludingofprojectionthrough2030couldprovidevaluableinformationforpreventionandcontrolstrategiesinChina,andexperienceforothercountries.Methods:TheburdenoflivercancerinChinain2014wasestimatedusing339cancerregistries’dataselectedfromChineseNationalCancerCenter(NCC).Incidentcasesof22cancerregistrieswereappliedfortemporaltrendsfrom2000to2014.Theburdenoflivercancerthrough2030wasprojectedusingage-period-cohortmodel.Results:About364,800newcasesoflivercancer(268,900malesand95,900females)occurredinChina,andabout318,800livercancerdeaths(233,500malesand85,300females)in2014.WesternregionsofChinahadthehighestincidenceandmortalityrates.Incidenceandmortalityratesdecreasedbyabout2.3%and2.6%peryearduringtheperiodof2000-2014,respectively,andwoulddecreasebymorethan44%between2014and2030inChina.Theyounggeneration,particularlyforthoseagedunder40years,showedafasterdowntrend.Conclusions:Basedontheanalysis,incidenceandmortalityratesoflivercancerareexpectedtodecreasethrough2030,buttheburdenoflivercancerisstillseriousinChina,especiallyinruralandwesternareas.MostcasesoflivercancerinChinacanbepreventedthroughvaccinationandmorepreventioneffortsshouldbefocusedonhighriskgroups.
简介:Objective:EvaluatingtheauditoryfunctioninpatientswithchronichepatitisCtreatedwithsofosbuvirandribavirin.Methods:Thisstudyinvolved80patientswithchronichepatitisCwhoagreedtoreceivesofosbuvirandribavirin.Allparticipantsweresubjectedtobaselineotologicalandaudiologicalassessmentjustbeforetreatment.Theaudiologicalassessmentincludedstandardpuretoneaudiometry,extendedhighfrequencyaudiometry,immitancemetryandotoacousticemissions(OAEs)(transientanddistortionproduct).Accordingtobaselinehearingthresholdmeasurements,thestudypopulationwasdividedinto2groups.Group1included42patientswithnormalhearingsensitivity(250e8000Hz),andGroup2included38patientswithsensorineuralhearingloss.After24weeksoftherapy,otologicalandaudiologicalassessmentswererepeatedandcomparedbetweenthetwogroupsandbeforeandaftertherapy.Results:Post-treatmenthearingthresholdevaluationshowednosignificantdifferencefrompretreatmentevaluationatalltestedfrequencies.Therewasnostatisticallysignificantdifferencebetweenpreandpost-treatmentotoacousticemissionsresults.Conclusion:TherapywithsofosbuvirandribavirininchronichepatitisChasnonoticeableeffectsoncochlearfunctions.
简介:Chronicinflammatorydemyelinatingpolyneuropathy(CIDP)isaprogressiveautoimmunedisorderthattargetsperipheralnerves.Itcommonlypresentswithmotor-predominantdysfunctionandenlargementofcranialnerves.Withregardstohearingloss,afewcasesofsensorineurallosshavebeendescribed.WepresentanovelcaseofconductivehearinglosscausedbyamassonthetympanicsegmentofthefacialnerveinthesettingofCIDP.
简介:Objective:Livermetastasis,whichcontributessubstantiallytohighmortality,isthemostcommonrecurrentmodeofcoloncarcinoma.Thus,itisnecessarytoidentifygenesimplicatedinmetastaticcolonizationoftheliverincoloncarcinoma.Methods:WecomparedmRNAprofilingin18normalcolonmucosa(N),20primarytumors(T)and19livermetastases(M)samplesfromthedatasetGSE49355andGSE62321ofGeneExpressionOmnibus(GEO)database.Geneontology(GO)andpathwaysoftheidentifiedgeneswereanalyzed.Co-expressionnetworkandproteinproteininteraction(PPI)networkwereemployedtoidentifytheinteractionrelationship.SurvivalanalysesbasedonTheCancerGenomeAtlas(TCGA)databasewereusedtofurtherscreening.Then,thecandidategeneswerevalidatedbyourdata.Results:Weidentified22specificgenesrelatedtolivermetastasisandtheywerestronglyassociatedwithcellmigration,adhesion,proliferationandimmuneresponse.Simultaneously,theresultsshowedthatC-X-Cmotifchemokineligand14(CXCL14)mightbeafavorablepredictionfactorforsurvivalofpatientswithcoloncarcinoma.Importantly,ourvalidateddatafurthersuggestedthatlowerCXCL14representedpooreroutcomeandcontributedtometastasis.Genesetenrichmentanalysis(GSEA)showedthatCXCL14wasnegativelyrelatedtotheregulationofstemcellproliferationandepithelialtomesenchymaltransition(EMT).Conclusions:CXCL14wasidentifiedasacrucialanti-metastasisregulatorofcoloncarcinomaforthefirsttime,andmightprovidenoveltherapeuticstrategiesforcoloncarcinomapatientstoimproveprognosisandpreventmetastasis.
简介:BackgroundThrombocytopeniaisacommoncomplicationofIABP.Untilnow,thereisnounifiedconclusionsabouttheincidence,characteristics,riskfactorsandtheprognosisofIABPrelatedthrombocytopenia.MethodsInthisstudy,thedataofpatientswithACSundergoingPCIandIABPwereretrospectivelyanalyzed.Allenrolledpatientsweredividedintothrombocytopeniagroupandnon-thrombocytopeniagroupaccordingtotheoccurrenceofthrombocytopeniaafterinsertionofIABP.Thebaselinedataofthetwogroupswerecompared,andthepossibleriskfactorsofthrombocytopeniaandtheirimpactonprognosiswereanalyzedbychi-squaretestandlogisticregressionanalysis.ResultsSixty-twopatientswereenrolledinthisstudy.TherateofIABPassociatedthrombocytopeniawas25.8%(16/62)ofallpatients.OlderagewasanindependentriskfactorofIABPassociatedthrombocytopenia(OR:3.625;95%confidenceinterval:1.016-12.935;P=0.047).TheincidenceofTIMIbleedingeventswashigherinthrombocytopeniagroup[75.0%(12/16)vs.43.5%(20/46),P=0.042].Therateofin-hospitaldeathwassimilarbetweenthetwogroups[18.8%(3/16)vs.17.4%(8/46),P=1.0].ConclusionIABPassociatedthrombocytopeniaoccursin25.8%ofpatientswithACSundergoingPCIandcorrelateswithincreasedTIMIbleedingevents.OlderagemaypredictIABPassociatedthrombocytopenia.
简介:Thewide-shallowcompositebucketfoundation(WSCBF)isanewtypeofoffshorewindpowerfoundationthatcanbebuiltonlandandrapidlyinstalledoffshore,therebyeffectivelyreducingtheconstructiontimeandcostsofoffshorewindpowerfoundation.Inthisstudy,thehorizontalbearingcapacityiscalculatedbyfiniteelementsimulationandcomparedwithtestresultstoverifythevalidityofresults.Inthisprocess,theverticalloadandbendingloadarerespectivelycalculatedbythefiniteelementsimulation.Undertheverticalloadeffect,thebucketfoundationandthesoilinsideareregardedasawhole,andthecorrespondingbucklingfailuremodeisobtained.Theultimateverticalbearingcapacityiscalculatedusingempiricalandtheoreticalformulas;thetheoreticalformulaisalsorevisedbyfiniteelementresults.Underbendingload,therotationalcenterofthecompositebucketfoundation(inaregionclosetothebucketbottom)graduallymovesfromtheleftofthecentralaxis(reversetoloadingdirection)tothenearbycompartmentboardsalongtheloadingdirection.TheH–Menvelopelineshowsalinearrelationship,anditisdeterminedthattheverticalandbendingultimatebearingcapacitiescanbeimprovedbyanappropriateverticalload.
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简介:Acuteaorticsyndromeincludesclassicaorticdissection,aorticintramuralhematoma,andpenetratingatheroscleroticulcer–agroupofconditionsthataredefinedbytheirdynamicevolutionandsimilarclinicalmanifestation.Accuratediagnosisandprompttreatmentareessentialasalltheaforementionedconditionsareasignificantthreattoapatient’slife.However,acuteaorticsyndromeandespeciallyaorticintramuralhematomamaybechallengingdiagnosticproblems.Intravascularultrasoundimagingisadiagnosticmethodthatcanbeusefulformorethoroughevaluationoftheaorticlesionandcanparticularlyaidindiscerningthedifferentformsofacuteaorticsyndrome.Wepresentacaseofapatientwithaorticintramuralhematomathatwasmissedbyconventionalimagingstudiesbutwassuccessfullyvisualizedwithintravascularultrasoundimaging.