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Comparative Study of Acute Coronary Syndrome with Persistent ST-Segment Elevation (STEMI) between Diabetics and Non-Diabetics in Dakar, Senegal
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作者 Ngoné Diaba Gaye Aliou Alassane Ngaïdé +4 位作者 Joseph Salvador Mingou Massar Wague Momar Dioum Alassane Mbaye Abdoul Kane 《World Journal of Cardiovascular Diseases》 CAS 2024年第10期631-643,共13页
Introduction: This study aimed to compare the frequency of diabetic and non-diabetic patients admitted for ST-elevation myocardial infarction (STEMI), assess their epidemiological, clinical, and paraclinical profiles,... Introduction: This study aimed to compare the frequency of diabetic and non-diabetic patients admitted for ST-elevation myocardial infarction (STEMI), assess their epidemiological, clinical, and paraclinical profiles, and evaluate their therapeutic strategies and outcomes. Methodology: A descriptive, analytical, comparative study with prospective and retrospective data collection was conducted from April 1, 2020, to March 31, 2021. Diabetic and non-diabetic patients with STEMI admitted to a cardiology department were included. STEMI diagnosis was based on clinical and electrocardiographic criteria showing persistent ST-segment elevation in at least two leads. All patients included in the study signed a written, informed consent form. Data analysis was performed using SPSS, with a p-value ≤ 0.05 considered statistically significant. Results: STEMI prevalence was 15.27%, with 37.11% of patients being diabetic and 62.89% non-diabetic. Diabetic patients had a mean age of 59.2 ± 10.9 years, while non-diabetics averaged 58 ± 13.4 years. Diabetics were predominantly female (72.2%), whereas non-diabetics were mainly male (83.6%). Smoking was less frequent among diabetics (25% vs. 47.54%), but hypertension, obesity, and sedentary lifestyle were more common. Diabetics had an average of 3.5 ± 1.1 risk factors compared to 2.6 ± 1.2 in non-diabetics. Admission delay was longer for diabetics (34.8 ± 51.6 hours vs. 23.3 ± 52.3 hours). Chest pain was the main symptom in both groups. Electrocardiograms showed that anterior and inferior infarctions were most frequent. Triple vessel disease and severe complications, such as cardiogenic shock, were more common in diabetics, who also had higher mortality (5.56% vs. 3.28%). Conclusion: Diabetic STEMI patients represent a high-risk group with distinct clinical features, longer admission delays, and a greater accumulation of cardiovascular risk factors, emphasizing the need for targeted interventions. 展开更多
关键词 Acute Coronary syndrome with persistent ST-Segment Elevation DIABETES Senegal
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Persistent Muellerian duct syndrome with transverse testicular ectopia 被引量:1
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作者 Yue-You Liang Fu-Fu Zheng Yu-Ping Dai Ke-Li Zheng Jie-Xue Zhou 《Asian Journal of Andrology》 SCIE CAS CSCD 2006年第6期745-747,共3页
Persistent Muellerian duct syndrome (PMDS) is a rare form of male pseudohermaphrodism without the feature of ambiguous genitalia.We present a case of PMDS with transverse testicular ectopia(TTE).
关键词 pseudohermaphrodism persistent Muellerian duct syndrome transverse testicular ectopia
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TRANSCRANIAL DOPPLER CHARACTERISTICS IN PERSISTENT VEGETATIVE STATUS,LOCKED-IN SYNDROME AND BRAIN DEATH 被引量:1
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作者 高山 黄一宁 +3 位作者 洪霞 朱以诚 汪波 李舜伟 《Chinese Medical Sciences Journal》 CAS CSCD 1999年第4期211-214,共4页
Aim. Comparison of the trascranial Doppler (TCD) characteristics of cerebral circulation in persistent vegetative status (PVS), locked in syndrome and brain death patients. Methods. Using ... Aim. Comparison of the trascranial Doppler (TCD) characteristics of cerebral circulation in persistent vegetative status (PVS), locked in syndrome and brain death patients. Methods. Using TCD ultrasound to detect the flow velocity and waveform patterns of middle cerebral artery (MCA) and basilar artery (BA) in patients with PVS, locked in syndrome and brain death. Results. The mean velocities of middle cerebral artery (Vmca) and basilar artery (Vba) were 30.0cm/s and 24.3cm/s in PVS patients respectively, which decreased 45.0% and 14.4% in comparing with normal value. For patients with locked in syndrome, Vmca and Vba were 49.7cm/s and 9.8cm/s, which decreased 5.0% and 61.7% than the normal value respectively. These results showed that the decrease of anterior circulation was predominant in PVS, and the decrease of posterior circulation was predominant in locked in syndrome. A unique diastolic reverse flow, short peak systolic wave or undetectable flow signal in middle cerebral artery were predominant in brain death patients, which was completely different from that of either PVS or locked in syndrome. Conclusion. TCD was a valuable tool in distinguishing PVS, locked in syndrome and brain death patients according to the differences in velocities and patterns of anterior and posterior cerebral arteries. 展开更多
关键词 persistent vegetative status locked in syndrome brain death transcranial Doppler
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In situ hybridization detection of persistent infection and viral RNA distribution in laboratory rats with hemorrhagic fever with renal syndrome virus
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作者 林中清 杨守京 刘颜仿 《Journal of Medical Colleges of PLA(China)》 CAS 1995年第1期30-33,38,共5页
Digoxigenin-labelled Hantaan specific cDNA probes were used in the present study for in situ hybridization detection of hemorrhagic fever with renal syndrome virus(HFRSV) persistent infection and viral RNA distributio... Digoxigenin-labelled Hantaan specific cDNA probes were used in the present study for in situ hybridization detection of hemorrhagic fever with renal syndrome virus(HFRSV) persistent infection and viral RNA distribution in naturally infected laboratory rat 展开更多
关键词 HEMORRHAGIC FEVER with RENAL syndrome virus RNA persistent infection HYBRIDIZATION in SITU Rats
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Multifactor dimensionality reduction analysis of syndrome characteristics of chronic persistent asthma
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作者 Yanyan Meng Aiping Chen +4 位作者 Qi Shi Yue Yan Chaolumen Han Huiyuan Sun Youlin Li 《Journal of Traditional Chinese Medical Sciences》 2015年第3期159-165,共7页
Objective:To analyze the syndrome characteristics in patients with chronic persistent asthma.Methods:365 patients(121 males,244 females,60.829.1 years old)with chronic persistent asthma were enrolled in this cross-sec... Objective:To analyze the syndrome characteristics in patients with chronic persistent asthma.Methods:365 patients(121 males,244 females,60.829.1 years old)with chronic persistent asthma were enrolled in this cross-sectional study.The information of syndrome,symptoms,signs,tongue coating and pulse were collected from all patients.The syndrome characteristics of chronic persistent asthma were examined through the multifactor dimensionality reduction(MDR)analysis and the results were verified by the Chi-square test.Results:The results of the MDR analysis and the Chi-square test showed the following positive correlation of the interaction among:the deficiency syndrome of the lung and spleen and deep pulse,disinclination to talk due to lack of qi,fatigue,lassitude and thick tongue coating;the deficiency syndrome of the lung and kidney and dizziness and disinclination to talk due to lack of qi,fatigue,lassitude and pallid complexion;the syndrome of phlegm-heat obstructing the lung and rapid pulse,abdominal distension,disinclination to talk due to lack of qi,frequent urination and lassitude;the syndrome of phlegm-dampness obstructing the lung and disinclination to talk due to lack of qi,greasy coating,fatigue and lassitude.(P<.05 for all).Conclusion:The syndrome of chronic persistent asthma is characterized by fatigue and lassitude due to dysfunction of the lung,spleen and kidney. 展开更多
关键词 Bronchial asthma Chronic persistent period Traditional Chinese medicine syndrome characteristics Multifactor dimensionality reduction
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Prevalence of pulmonary hypertension among children with Down syndrome:A systematic review and meta-analysis 被引量:1
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作者 Amar Taksande Divya Pujari +2 位作者 Patel Zeeshan Jameel Bharati Taksande Revat Meshram 《World Journal of Clinical Pediatrics》 2021年第6期177-191,共15页
BACKGROUND Pulmonary hypertension(PH)has serious short-and long-term consequences.PH is gaining increasing importance in high risk groups such as Down syndrome(DS)as it influences their overall survival and prognosis.... BACKGROUND Pulmonary hypertension(PH)has serious short-and long-term consequences.PH is gaining increasing importance in high risk groups such as Down syndrome(DS)as it influences their overall survival and prognosis.Hence,there is a dire need to collate the prevalence rates of PH in order to undertake definitive measures for early diagnosis and management.AIM To determine the prevalence of PH in children with DS.METHODS The authors individually conducted a search of electronic databases manually(Cochrane library,PubMed,EMBASE,Scopus,Web of Science).Data extraction and quality control were independently performed by two reviewers and a third reviewer resolved any conflicts of opinion.The words used in the literature search were“pulmonary hypertension”and“pulmonary arterial hypertension”;“Down syndrome”and“trisomy 21”and“prevalence”.The data were analyzed by Comprehensive Meta-Analysis Software Version 2.Risk of bias assessment and STROBE checklist were used for quality assessment.RESULTS Of 1578 articles identified,17 were selected for final analysis.The pooled prevalence of PH in these studies was 25.5%.Subgroup analysis was carried out for age,gender,region,year of publication,risk of bias and etiology of PH.CONCLUSION This review highlights the increasing prevalence of PH in children with DS.It is crucial for pediatricians to be aware of this morbid disease and channel their efforts towards earlier diagnosis and successful management.Community-based studies with a larger sample size of children with DS should be carried out to better characterize the epidemiology and underlying etiology of PH in DS. 展开更多
关键词 Down syndrome Pulmonary hypertension PREVALENCE Trisomy 21 persistent pulmonary hypertension Congenital heart disease
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Combined Double Sleeve Lobectomy and Superior Vena Cava Resection for Non-small Cell Lung Cancer with Persistent Left Superior Vena Cava 被引量:1
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作者 Daxing ZHU Xiaoming QIU Qinghua ZHOU 《中国肺癌杂志》 CAS CSCD 北大核心 2015年第11期718-720,共3页
A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department.Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius... A 65-year-old man with right central type of lung squamous carcinoma was admitted to our department.Bronchoscopy displayed complete obstruction of right upper lobe bronchus and infiltration of the bronchus intermedius with tumor.Chest contrast computed tomography revealed the tumor invaded right pulmonary artery,superior vena cava,and the persistant left superior vena cava flowed into the coronary sinus.The tumor was successfully removed by means of bronchial and pulmonary artery sleeve resection of the right upper and middle lobes combined with resection and reconstruction of superior vena cava(SVC)utilizing ringed polytetrafluoroethylene graft.To the best of our knowledge,this was the first report of complete resection of locally advanced lung cancer involving superior vena cava,right pulmonary artery trunk and main bronchus with persistant left superior vena cava. 展开更多
关键词 摘要 编辑部 编辑工作 读者
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Acute respiratory distress syndrome following multiple wasp stings treated with extracorporeal membrane oxygenation:A case report
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作者 Zheng-Yin Cai Bao-Ping Xu +5 位作者 Wei-Hao Zhang Huai-Wen Peng Qing Xu Huai-Bin Yu Quan-Gen Chu Shu-Sheng Zhou 《World Journal of Clinical Cases》 SCIE 2022年第30期11122-11127,共6页
BACKGROUND It is necessary for clinicians to be aware of a rare but possible acute respiratory distress syndrome(ARDS)complication caused by multiple wasp stings.Severe ARDS has a high mortality rate but no specific p... BACKGROUND It is necessary for clinicians to be aware of a rare but possible acute respiratory distress syndrome(ARDS)complication caused by multiple wasp stings.Severe ARDS has a high mortality rate but no specific pharmacotherapies have been identified to date.This case study presents the first case of severe ARDS caused by multiple wasp stings,treated successfully with extracorporeal membrane oxygenation(ECMO).It also emphasizes the effectiveness of early ECMO treatment for severe ARDS with persistent hypoxemia.CASE SUMMARY A 24-year-old woman was admitted to the emergency department after being stung by more than 10 wasps within a 30-min period,with clinical symptoms of multiple rashes,dizziness,chest tightness,nausea,and vomiting.On the 2nd day of admission,the patient developed progressive dyspnea.The patient was diagnosed with ARDS based on clinical manifestations and lung computed tomography(CT)scan.Because of the progressive dyspnea,the intensive care unit physician performed endotracheal intubation and continued to provide ventilator support,but the patient’s respiratory distress worsened,as indicated by the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen.Veno-venous ECMO was initiated for 6 d.On day 7 of admission,ECMO was stopped.On the 11th day of admission,CT scan of the lungs revealed significant reduction of ground-glass opacities and consolidations.After about 2 wk,the patient recovered completely from ARDS and was discharged to home.At the 2-mo follow-up,the patient was in good health with no recurrence of dyspnea nor chest tightness.CONCLUSION ARDS complication caused by multiple wasp stings may be fatal when mechanical ventilation becomes dangerous due to persistent hypoxemia and despite optimization of ARDS management.We propose that the early implementation of ECMO is a relatively effective treatment,although the evidence is relatively limited. 展开更多
关键词 WASP Bites and stings Respiratory distress syndrome persistent hypoxemia Extracorporeal membrane oxygenation Case report
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通窍鼻炎颗粒治疗中重度持续性变应性鼻炎的临床观察
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作者 周立 孙永东 +4 位作者 孟娟 王中亮 鲜小龙 王巧灵 田理 《中国中西医结合耳鼻咽喉科杂志》 2024年第4期255-260,共6页
目的观察通窍鼻炎颗粒治疗中重度持续性变应性鼻炎的有效性和安全性。方法在5家医院招募251例中重度持续性变应性鼻炎患者,随机平行分配至西药组、中成药组及联合治疗组。西药组为氯雷他定联合糠酸莫米松,中成药组为通窍鼻炎颗粒,联合... 目的观察通窍鼻炎颗粒治疗中重度持续性变应性鼻炎的有效性和安全性。方法在5家医院招募251例中重度持续性变应性鼻炎患者,随机平行分配至西药组、中成药组及联合治疗组。西药组为氯雷他定联合糠酸莫米松,中成药组为通窍鼻炎颗粒,联合治疗组为西药方案联合中成药方案。观察治疗前后鼻部症状评分(Total Nasal Symptoms Scores,TNSS),眼部症状评分(Total Ocular Symptom Score,TOSS),鼻结膜炎生活质量(Rhinoconjunctivitis Quality of Life Questionnaire,RQLQ),肝肾功能,血清免疫学,前鼻镜评分变化情况,并访视不良反应发生率及24周后变应性鼻炎复发情况。结果各组患者在治疗后TNSS、前鼻镜评分、TOSS、RQLQ以及IL-4、IL-5、IL-13、TGF-β均下降,且有统计学差异(P<0.05)。治疗后总体有效率为80.9%,且3组间无统计学差异(P=0.5552)。治疗后24周复发率,西药组为61.9%,中成药组为45.8%,西药联合中成药组为21.4%,3组间有统计学差异(P<0.01)。总体不良反应发生率6.0%,各组间无统计学差异(P=0.8267)。结论通窍鼻炎颗粒治疗中重度持续性变应性鼻炎疗效显著,安全性高,可改善患者免疫状况并防止复发,值得推广应用。 展开更多
关键词 通窍鼻炎颗粒 肺脾气虚证 中重度持续性 变应性鼻炎
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重症急性胰腺炎并发持续炎症-免疫抑制-分解代谢综合征的列线图预测模型构建与验证
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作者 郑云 涂倩倩 +1 位作者 张阿芳 张泓 《中国急救医学》 CAS CSCD 2024年第10期890-896,共7页
目的在重症急性胰腺炎(severe acute pancreatitis,SAP)是否并发持续炎症-免疫抑制-分解代谢综合征(PICS)中探讨中性粒细胞与淋巴细胞计数比值(NLR)联合纤维蛋白降解产物(FDP)与D-二聚体比值等指标的临床预测效能,并构建预测模型。方法... 目的在重症急性胰腺炎(severe acute pancreatitis,SAP)是否并发持续炎症-免疫抑制-分解代谢综合征(PICS)中探讨中性粒细胞与淋巴细胞计数比值(NLR)联合纤维蛋白降解产物(FDP)与D-二聚体比值等指标的临床预测效能,并构建预测模型。方法回顾性收集2018年5月至2023年5月安徽医科大学第一附属医院重症医学科、急诊医学科、消化内科入住的133例SAP患者的临床资料。根据PICS诊断标准将其分为SAP并发PICS组(60例)和SAP非并发PICS组(73例),对两组间NLR、FDP与D-二聚体比值及常见临床指标进行回顾性分析;比较两组患者临床特征、重症监护病房(ICU)病死率及随访1年后生存率。采用Lasso回归及多因素Logistic回归筛选出独立危险因素,构建列线图预测模型。采用受试者工作特征(ROC)曲线、校准曲线对模型进行内部验证;采用临床决策曲线分析(DCA)评估模型的临床实用性。结果与SAP非并发PICS组比较,SAP并发PICS组的改良Marshall评分、NLR、血小板计数与淋巴细胞计数比值(PLR)及FDP与D-二聚体比值均明显升高(P<0.05);SAP并发PICS组合并血流感染及腹腔感染比例明显高于SAP非并发PICS组(P<0.05);通过多因素Logistic回归分析发现,NLR、FDP与D-二聚体比值是SAP并发PICS的独立危险因素(OR分别为0.790、0.131,P均<0.05)。Lasso回归筛选的预测变量得到三因素逻辑回归模型,预测变量包括FDP/D-二聚体、NLR、C反应蛋白(CRP)/前白蛋白(OR分别为1.981、1.048、4.726,P均<0.05)。将上述因素进行模型拟合,经bootstrap内部验证列线图模型曲线下面积(AUC)为0.948(95%CI 0.909~0.980)。校准曲线接近参考曲线,且DCA显示预测模型具有良好临床实用性。结论基于NLR、FDP与D-二聚体比值、CRP/前白蛋白构建SAP患者并发PICS风险列线图预测模型具备良好区分度、校准度和实用性。在SAP早期对是否并发PICS进行评估,若并发PICS,可能提示患者预后不良。 展开更多
关键词 重症急性胰腺炎(SAP) 持续炎症-免疫抑制-分解代谢综合征(PICS) 中性粒细胞与淋巴细胞计数比值(NLR) 纤维蛋白降解产物与D-二聚体比值 C反应蛋白/前白蛋白
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急性前庭综合征患者脑梗死的临床特征及相关因素分析 被引量:2
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作者 张春悦 方力群 《中国全科医学》 CAS 北大核心 2024年第14期1678-1684,共7页
背景急性脑梗死是急性前庭综合征中较为危重的疾病。急性前庭综合征患者起病急,症状重,CT诊断急性脑梗死的灵敏度低,而核磁共振检查又不易立即实施,这使得表现为急性前庭综合征的急性脑梗死诊断具有一定挑战性,因此有必要探究适用于急... 背景急性脑梗死是急性前庭综合征中较为危重的疾病。急性前庭综合征患者起病急,症状重,CT诊断急性脑梗死的灵敏度低,而核磁共振检查又不易立即实施,这使得表现为急性前庭综合征的急性脑梗死诊断具有一定挑战性,因此有必要探究适用于急性前庭综合征患者的检查和评价方法。目的分析急性前庭综合征患者中急性脑梗死发生的相关危险因素,为急性前庭综合征中急性脑梗死的诊断提供借鉴,争取急性脑梗死患者的黄金治疗时间。方法收集2021年4月—2022年7月就诊于哈尔滨医科大学附属第四医院神经内科急性前庭综合征患者102例,录入相关临床体征,以核磁共振检查结果作为脑梗死诊断的金标准,分为脑梗死组(16例)与非脑梗死组(86例),对比两组患者临床特点,采用单因素和多因素Logistic回归分析探究急性前庭综合征中脑梗死发生的相关影响因素,并绘制受试者工作特征(ROC)曲线评价相关影响因素对脑梗死的预测价值。结果脑梗死组患者吸烟史、饮酒史、头脉冲试验-眼震-眼位偏斜试验(HINTS)阳性比例、ABCD2评分均高于非脑梗死组(P<0.05)。单因素Logistic回归分析显示HINTS阳性、ABCD2评分、吸烟史、饮酒史、听力下降是脑梗死发生的影响因素(P<0.05),多因素Logistic回归分析显示HINTS阳性(OR=99.043,95%CI=8.120~1208.090)和ABCD2评分(OR=2.820,95%CI=1.188~6.696)是脑梗死发生的影响因素(P<0.05)。多指标联合、HINTS阳性、ABCD2评分、吸烟史、饮酒史、听力下降预测脑梗死的ROC曲线下面积(AUC)为0.949、0.874、0.734、0.643、0.649和0.604。结论急性前庭综合征患者中非脑梗死比例较大,其中以前庭神经炎最常见,HINTS阳性和ABCD2评分与急性前庭综合征中脑梗死的发生密切相关。 展开更多
关键词 急性持续性头晕 急性前庭综合征 脑梗死 头脉冲试验-眼震-眼位偏斜试验 危险因素
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儿童迁延性泄泻脾阳虚证的粪便代谢组学研究
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作者 张厦 袁斌 陈晓斌 《南京中医药大学学报》 CAS CSCD 北大核心 2024年第6期633-639,共7页
目的从粪便代谢角度探寻儿童迁延性泄泻脾阳虚证的证候物质基础。方法选取20例脾阳虚证的迁延性泄泻患儿作为观察组,20例健康儿童作为对照组,采集各组的粪便样本后,采用气相色谱质谱联用仪器对样本进行代谢组学分析,比较2组代谢物的差... 目的从粪便代谢角度探寻儿童迁延性泄泻脾阳虚证的证候物质基础。方法选取20例脾阳虚证的迁延性泄泻患儿作为观察组,20例健康儿童作为对照组,采集各组的粪便样本后,采用气相色谱质谱联用仪器对样本进行代谢组学分析,比较2组代谢物的差异。结果与儿童迁延性泄泻脾阳虚证相关的潜在生物标志物有25种,在迁延性泄泻脾阳虚证患儿的粪便中下调的有9种代谢物,分别为L-谷氨酰胺、L-谷氨酸、4-羟基苯甲醛、L-半胱氨酸、鸟氨酸、L-异亮氨酸、丁二酸、β-丙氨酸、富马酸,在泄泻脾阳虚证患儿的粪便中上调的有16种代谢物,包括丝氨酸、核糖酸、α-亚麻酸、苯甲酸、果糖、L-丙氨酸、焦谷氨酸、丙酮酸、次黄嘌呤、癸酸、L-天门冬氨酸等代谢物,涉及相关通路有7条,包括丙氨酸、天冬氨酸和谷氨酸代谢、D-谷氨酰胺和D-谷氨酸代谢、丙酮酸代谢、精氨酸和脯氨酸代谢、精氨酸生物合成、糖酵解/糖异生、柠檬酸循环(TCA循环)。结论迁延性泄泻脾阳虚证患儿与健康儿童相比,神经调节代谢发生紊乱,能量代谢发生异常,机体无氧酵解有所增强,相关差异代谢物的发现可能对儿童迁延性泄泻脾阳虚证的发病机制、诊断和治疗均奠定了一定的物质基础。 展开更多
关键词 粪便代谢组学 迁延性泄泻 儿童 脾阳虚证 中医证候学
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严重多发伤急救患者并发持续炎症-免疫抑制-分解代谢综合征风险的相关预测模型构建与验证
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作者 杨晓晴 朱昱凝 +1 位作者 门茂颖 王颖 《河北医科大学学报》 CAS 2024年第7期810-815,共6页
目的探究严重多发伤急救患者并发持续炎症-免疫抑制-分解代谢综合征(persistent inflammation immuo-suppression catabolism syndrome,PICS)的影响因素,并构建PICS预测模型。方法选取严重多发伤急救患者200例,统计伤后15~20 d内PICS发... 目的探究严重多发伤急救患者并发持续炎症-免疫抑制-分解代谢综合征(persistent inflammation immuo-suppression catabolism syndrome,PICS)的影响因素,并构建PICS预测模型。方法选取严重多发伤急救患者200例,统计伤后15~20 d内PICS发生情况。根据是否发生PICS分为PICS组31例和非PICS组169例,比较2组临床资料,采用Logistic多因素模型分析严重多发伤急救患者发生PICS的影响因素,根据影响因素构建PICS发生风险的Nomogram预测模型,并验证Nomogram预测模型的预测价值和临床效用。结果严重多发伤急救患者伤后15~20 d内PICS发生率为15.50%(31/200)。PICS组年龄≥60岁比例、急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)发生率、入院时血清白细胞介素6(interleukin-6,IL-6)、白细胞介素10(interleukin-10,IL-10)水平均高于非PICS组,入院时格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)评分及血清CD4^(+)/CD8^(+)水平均低于非PICS组(P<0.05)。Logistic回归分析结果显示,年龄、入院时ARDS、IL-6、IL-10均为严重多发伤急救患者发生PICS的危险因素,入院时GCS评分及血清CD4^(+)/CD8^(+)水平为严重多发伤急救患者发生PICS的保护因素(P<0.05)。绘制森林图显示,年龄≥60岁、并发ARDS、入院时血清IL-6、IL-10水平均为严重多发伤急救患者发生PICS的正相关影响因素,入院时GCS评分及血清CD4^(+)/CD8^(+)水平为负相关影响因素(P<0.05);根据影响因素构建严重多发伤急救患者PICS发生风险的Nomogram预测模型,该模型的一致性指数(concordance index,C-index)为0.856,具有良好的区分度,校准曲线显示该预测模型与实际观测结果有较好的一致性,决策曲线(decision curve analysis,DCA)显示该预测模型具有良好的临床效用。结论严重多发伤急救患者发生PICS的影响因素包括年龄、入院时GCS评分、ARDS、血清IL-6、IL-10、CD4^(+)/CD8^(+)水平,根据影响因素构建PICS发生风险的Nomogram预测模型可为临床筛查并发PICS高危患者提供可靠参考依据。 展开更多
关键词 多处创伤 持续炎症-免疫抑制-分解代谢综合征 影响因素
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冠心病合并持续性房颤中医证候的外泌体转录组学特征
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作者 贾秋蕾 杨亦含 +4 位作者 胡元会 杜宜航 段成林 袁果真 陈婷 《世界中西医结合杂志》 2024年第4期779-788,共10页
目的 探索冠心病持续性房颤不同中医证候的外泌体RNA表达谱,揭示气阴两虚兼痰瘀互结和血瘀水停证患者的生物学基础,阐明证候的内在机制。方法 对冠心病持续性房颤气阴两虚兼痰瘀互结证、肝肾不足证、阴虚火旺证及血瘀水停证患者的血浆... 目的 探索冠心病持续性房颤不同中医证候的外泌体RNA表达谱,揭示气阴两虚兼痰瘀互结和血瘀水停证患者的生物学基础,阐明证候的内在机制。方法 对冠心病持续性房颤气阴两虚兼痰瘀互结证、肝肾不足证、阴虚火旺证及血瘀水停证患者的血浆进行外泌体全转录组测序,每组各5例,另外选取8例健康对照,运用生物信息学方法对气阴两虚兼痰瘀互结和血瘀水停证患者独有的差异基因的进行生物学过程和KEGG富集分析。结果 气阴两虚兼痰瘀互结证患者独有的差异表达的microRNA13个、mRNA6个、lncRNA3个,血瘀水停证患者独有的差异表达的microRNA25个、mRNA16个、lncRNA5个。气阴两虚兼痰瘀互结证患者的基因主要富集在激素应答、细胞粘附等生物学过程,以及脂质和动脉粥样硬化等信号通路上。血瘀水停证患者基因主要富集在自噬的调控、脂肪酸衍生物的代谢过程、脂肪酸代谢过程、脂质运输等生物学进程,以及PPAR信号通路上。结论 气阴两虚兼痰瘀互结证患者可能存在内分泌功能失常、免疫功能紊乱、动脉粥样硬化的病理状态,血瘀水停证患者可能存在自噬和脂代谢的异常,从外泌体转录组学的角度阐述了证候的内在机制,为临床治疗用药提供依据。 展开更多
关键词 冠心病 持续性房颤 外泌体 转录组测序 中医证候
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从“虚劳”论治脓毒症并发持续炎症-免疫抑制-高分解代谢综合征
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作者 徐建兴 杨志旭 《中国中医急症》 2024年第1期71-74,共4页
本文以“虚劳”理论为基础并结合临床研究,分析脓毒症并发持续炎症-免疫抑制-高分解代谢综合征(PICS)的病因、病机及辨治,认为“营卫失调,正虚邪恋,瘀毒阻络”为脓毒症并发PICS的病机,治疗上以“扶正解毒通络”为总体治则,以补益为主并... 本文以“虚劳”理论为基础并结合临床研究,分析脓毒症并发持续炎症-免疫抑制-高分解代谢综合征(PICS)的病因、病机及辨治,认为“营卫失调,正虚邪恋,瘀毒阻络”为脓毒症并发PICS的病机,治疗上以“扶正解毒通络”为总体治则,以补益为主并辅以清透,维持阴阳气血低水平平衡,同时开达通路清透余邪,消除体内痰瘀浊毒等积聚的病理产物,调节免疫代谢紊乱,以期预防反复感染,为中医辨治PICS拓展思路。 展开更多
关键词 脓毒症 持续炎症-免疫抑制-高分解代谢综合征 虚劳(重症迁延期) 瘀毒阻络 扶正祛邪
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改良版危重症营养风险评分对脓毒症病人发生持续炎症-免疫抑制-分解代谢综合征的预测价值
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作者 洪巧 李云婷 李芬 《安徽医药》 CAS 2024年第5期943-948,共6页
目的探讨改良版危重症营养风险(mNUTRIC)评分对脓毒症病人发生持续炎症-免疫抑制-分解代谢综合征(PICS)的预测价值。方法纳入2021年1月至2022年8月在海南医学院第二附属医院重症监护病房(ICU)接受治疗的285例脓毒症病人为研究对象。收... 目的探讨改良版危重症营养风险(mNUTRIC)评分对脓毒症病人发生持续炎症-免疫抑制-分解代谢综合征(PICS)的预测价值。方法纳入2021年1月至2022年8月在海南医学院第二附属医院重症监护病房(ICU)接受治疗的285例脓毒症病人为研究对象。收集病人入ICU时的年龄、查尔森合并症指数评分、急性生理学与慢性健康状况评价Ⅱ(APACHEⅡ)评分、序贯器官衰竭估计(SOFA)评分、mNUTRIC评分以及实验室指标和器官功能支持治疗情况。根据是否发生PICS将病人分为PICS组(n=102)与非PICS组(n=183),比较两组间各指标的差异。应用二分类logistic回归模型和受试者操作特征(ROC)曲线分析mNUTRIC评分与脓毒症病人发生PICS的关系。结果脓毒症病人PICS发生率为35.79%。PICS组年龄、查尔森合并症指数评分、APACHEⅡ评分、SOFA评分、mNUTRIC评分、应用血管活性药物时间≥72 h占比、机械通气时间≥72 h占比、连续肾脏替代治疗(CRRT)时间≥72 h占比以及血清C-反应蛋白、乳酸水平分别为(73.49±8.64)岁、[2.00(1.00,3.00)]分、(21.67±6.62)分、(8.69±2.63)分、[5.00(5.00,6.00)]分、53.92%、71.57%、48.04%、[32.85(20.83,74.98)]mg/L、[3.33(2.30,4.78)]mmol/L,均高于非PICS组的(67.72±8.63)岁、[1.00(0.00,2.00)]分、(17.83±6.05)分、(7.45±2.43)分、[3.00(2.00,4.00)]分、29.51%、41.53%、23.50%、[27.00(18.50,38.30)]mg/L、[2.60(2.02,4.00)]mmol/L,差异有统计学意义(P<0.05)。PICS组的血清白蛋白水平为(37.17±2.92)g/L,低于非PICS组的(38.22±2.88)g/L,差异有统计学意义(P<0.05)。mNUTRIC评分≥5分的脓毒症病人PICS发生率为73.64%,高于mNUTRIC评分<5分的12.00%(χ^(2)=111.66,P<0.001)。logistic回归分析结果显示,mNUTRIC评分值升高[OR=2.61,95%CI:(1.73,3.94),P<0.001],机械通气时间≥72 h[OR=3.24,95%CI:(1.60,6.56),P=0.001]、CRRT时间≥72 h[OR=3.45,95%CI:(1.68,7.08),P=0.001]是脓毒症病人发生PICS的独立危险因素。mNUTRIC评分预测脓毒症病人发生PICS的ROC曲线下面积为0.85,95%CI:(0.81,0.89),最佳截断值为4分时,预测脓毒症病人发生PICS的灵敏度为79.41%、特异度为84.15%和约登指数为0.64。结论发生PICS的脓毒症病人入ICU时mNUTRIC评分明显高于非PICS病人,同时mNUTRIC评分是脓毒症病人发生PICS的独立预测因子,并且mNUTRIC评分在预测脓毒症病人PICS方面具有更好的区分能力。 展开更多
关键词 脓毒症 改良版危重症营养风险评分 持续炎症-免疫抑制-分解代谢综合征 预测价值
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柴陈泽泻汤联合腕踝针治疗持续性姿势-感知性头晕临床研究
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作者 林书阳 陈妙 +2 位作者 黄祖秀 周荣 胡万华 《新中医》 CAS 2024年第18期60-65,共6页
目的:观察柴陈泽泻汤联合腕踝针治疗持续性姿势-感知性头晕(PPPD)痰湿中阻证的临床疗效,以及对血清同型半胱氨酸(Hcy)、尿酸(UA)的影响。方法:选取60例PPPD痰湿中阻证患者,以随机数字表法分对照组与试验组各30例。对照组给予腕踝针治疗... 目的:观察柴陈泽泻汤联合腕踝针治疗持续性姿势-感知性头晕(PPPD)痰湿中阻证的临床疗效,以及对血清同型半胱氨酸(Hcy)、尿酸(UA)的影响。方法:选取60例PPPD痰湿中阻证患者,以随机数字表法分对照组与试验组各30例。对照组给予腕踝针治疗,试验组在对照组基础上给予柴陈泽泻汤治疗。2组均治疗4周。比较2组临床疗效,眩晕残障量表(DHI)、汉密尔顿焦虑量表-14 (HAMA-14)、汉密尔顿抑郁量表(HAMD)评分,血清Hcy、UA水平,以及不良反应发生率。结果:治疗4周后,试验组总有效率96.67%,高于对照组80.00%,差异有统计学意义(P<0.05)。治疗2周、4周后,2组DHI评分均较治疗前降低,试验组DHI评分均低于同期对照组,差异均有统计学意义(P<0.05)。治疗2周、4周后,2组HAMA-14、HAMD评分均较治疗前降低,试验组HAMA-14、HAMD评分均低于同期对照组,差异均有统计学意义(P<0.05)。治疗4周后,2组血清Hcy、UA水平均较治疗前降低,试验组血清Hcy、UA水平均低于对照组,差异均有统计学意义(P<0.05)。治疗期间,试验组不良反应发生率23.33%,对照组不良反应发生率20.00%,2组比较,差异无统计学意义(P>0.05)。结论:柴陈泽泻汤联合腕踝针治疗PPPD痰湿中阻证,可缓解眩晕症状及焦虑、抑郁情绪,下调血清Hcy、UA水平,安全性高。 展开更多
关键词 持续性姿势-感知性头晕 痰湿中阻证 柴陈泽泻汤 腕踝针 焦虑 抑郁 同型半胱氨酸 尿酸
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晚期早产儿合并多种并发症1例报道
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作者 柳彩霞 张小婷 +1 位作者 盛敏 张芳芳 《妇儿健康导刊》 2024年第13期62-66,共5页
新生儿呼吸窘迫综合征(RDS)是新生儿科常见的急危重症,早产儿发病率为5%~10%,胎龄越小发病率越高,择期剖宫产率为0.9%~3.7%。本文报道1例晚期早产儿合并RDS、气胸、持续性肺动脉高压、肺出血的抢救经过。通过回顾该患儿的病程,分析并发... 新生儿呼吸窘迫综合征(RDS)是新生儿科常见的急危重症,早产儿发病率为5%~10%,胎龄越小发病率越高,择期剖宫产率为0.9%~3.7%。本文报道1例晚期早产儿合并RDS、气胸、持续性肺动脉高压、肺出血的抢救经过。通过回顾该患儿的病程,分析并发症发生机制及相互之间的关联,并通过复习相关文献及指南为临床针对性抢救提供理论依据。临床医师对有呼吸系统症状的剖宫产晚期早产儿应提高警惕,早期识别新生儿危重症,提高救治成功率。 展开更多
关键词 晚期早产儿 新生儿呼吸窘迫综合征 气胸 持续性肺动脉高压 肺出血
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经胸超声心动图可减少无顶冠状静脉窦综合征漏误诊率
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作者 刘红娇 杨冬妹 王玉婷 《分子影像学杂志》 2024年第9期951-956,共6页
目的分析经胸超声心动图诊断无顶冠状静脉窦综合征(UCSS)漏误诊原因,并提出相应的解决策略。方法回顾性分析2015年1月~2024年3月在中国科学技术大学附属第一医院接受手术治疗的12例UCSS患者,男性7例,女性5例,年龄3~74岁。将患者的超声... 目的分析经胸超声心动图诊断无顶冠状静脉窦综合征(UCSS)漏误诊原因,并提出相应的解决策略。方法回顾性分析2015年1月~2024年3月在中国科学技术大学附属第一医院接受手术治疗的12例UCSS患者,男性7例,女性5例,年龄3~74岁。将患者的超声心动图结果进行比较,将纳入患者分为超声确诊组和超声漏误诊组。分析患者术前超声心动图录像资料,记录并分析特异性征象,根据冠状静脉窦显示情况,分为显示清楚、可疑、模糊、未显示/显示不清4种,计算各切面的显示率,分析漏误诊原因,总结无顶冠状动脉窦的超声心动图特征。结果超声确诊组8例,诊断准确率为66.7%,超声漏诊1例,漏诊率为8%,误诊3例,误诊率为25%。在UCSS确诊患者中,显示CS的常用切面的显示率均高于漏误诊组,其中右室流入道非标准切面在所有TTE确诊的患者中均可显示,该切面在两组中差异有统计学意义(P<0.05)。结论超声医师对UCSS解剖、病理生理、血流动力学的理解以及对CS各切面的观察对于准确诊断该病至关重要。经胸超声心动图作为该病极佳的筛查和诊断方式,有助于减少该病的误诊和漏诊率。 展开更多
关键词 无顶冠状静脉窦综合征 房间隔缺损 永存左上腔静脉 超声医疗质量控制
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加味生脉散联合铺灸法治疗慢性持续期肥胖型哮喘临床研究
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作者 李斌武 马彦俏 冯卿 《新中医》 CAS 2024年第15期19-23,共5页
目的:观察加味生脉散联合铺灸法治疗慢性持续期肥胖型哮喘的临床疗效。方法:选取90例肥胖型哮喘患者,根据随机数字表法分为A、B、C 3组各30例。A组予加味生脉散治疗,B组予药物铺灸法治疗,C组予加味生脉散联合药物铺灸法联合治疗,连续治... 目的:观察加味生脉散联合铺灸法治疗慢性持续期肥胖型哮喘的临床疗效。方法:选取90例肥胖型哮喘患者,根据随机数字表法分为A、B、C 3组各30例。A组予加味生脉散治疗,B组予药物铺灸法治疗,C组予加味生脉散联合药物铺灸法联合治疗,连续治疗4周。比较3组治疗前后中医证候评分、哮喘控制测试(ACT)评分、肺功能指标[最大呼气流速(PEF)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1)/FVC]、血清学指标[白细胞介素-6 (IL-6)、白细胞介素-18 (IL-18)、干扰素-γ (INF-γ)、免疫球蛋白E (IgE)、脂联素、瘦素],并比较3组不良反应发生情况。结果:治疗后,3组中医证候评分均降低(P<0.05),且C组低于A组、B组(P<0.05);3组ACT评分均升高(P<0.05),C组高于A组、B组(P<0.05);A、B 2组中医证候评分、ACT评分比较,差异均无统计学意义(P>0.05)。治疗后,3组FVC、FEV1/FVC、PEF均升高(P<0.05),且C组均高于A组、B组(P<0.05);A、B 2组比较,差异均无统计学意义(P>0.05)。治疗后,3组血清IL-6、IL-18、IgE、瘦素均降低(P<0.05),且C组低于A组、B组(P<0.05);3组脂联素、INF-γ均升高(P<0.05),且C组高于A组、B组(P<0.05);A、B 2组上述血清指标比较,差异均无统计学意义(P>0.05)。3组均未发生严重不良反应。结论:加味生脉散联合铺灸法治疗慢性持续期肥胖型哮喘患者,可改善哮喘情况,减轻临床症状,改善肺功能,其作用机制可能与调控细胞因子和炎性因子水平、降低炎症反应、改善中医体质有关。 展开更多
关键词 肥胖型哮喘 慢性持续期 生脉散 铺灸法 作用机制 肺功能 中医证候评分
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