【摘要】 目的 分析颅咽管瘤术前泌乳素（PRL）、促甲状腺激素（TSH）和促肾上腺皮质激素（ACTH）的变化，探讨术前激素变化与术后尿崩症的关系，为术后并发症的防治及预后的评估提供参考依据。 方法 对2003年3月-2007年6月收治的96例颅咽管瘤患者进行回顾性分析。对患者术前的激素（PRL、TSH及ACTH）检测结果与术后尿崩症的关系进行分析；按照术前有异常的激素种类将患者分为Ⅰ组（术前无激素的改变）、Ⅱ组（术前有任意1种激素发生改变）、Ⅲ组（术前有任意2种激素发生改变）及Ⅳ组（术前3种激素都发生改变）组。分析不同组别与术后尿崩症的关系。 结果 术前PRL、TSH及ACTH有改变的患者术后尿崩症发生率高于术前上述激素无改变的患者，PRL、TSH及ACTH发生改变的种类越多，术后尿崩症发生率越高。 结论 术前PRL、TSH及ACTH的改变和改变的种类多少可以作为判定术后并发症和评估预后的参考指标之一。【Abstract】 Objective To observe the changes of prolactin (PRL), thyroid stimulating hormone (TSH), and adrenocorticotropic hormone (ACTH) in patients with craniopharyngiomas before surgery; and to analyze the relationship between their changes and incipidus after the surgery to get the basis for postoperative complications and prognosis. Methods Ninety-six patients with craniopharyngiomas from March 2003 to July 2007 were seleted. The relationship between endocrine changes before surgery and diabetes insipidus after surgery was analyzed. The patients were divided into four groups:no endocrine changed in group Ⅰ, one hormone changed in group Ⅱ, two hormones changed in group Ⅲ, and all the three hormones changed in group Ⅳ. The relationship between different groups and diabetes insipidus was analyzed. Results The pre-operative endocrine abnormalities was the sign of hypothalamus injury. There were significantly higher incidences of diabetes insipidus after the surgery in patients with endocrine abnormalities than that in the patients without any endocrine changes. There were significantly different incidence of diabetes insipidus after the surgery in different groups. Conclusion The pre-operative endocrine changes can be the guideline to predict the postoperative diabetes insipidus and to evaluate the prognosis.
Abstract: Objective To investigate the relationship between graft flow and incidence of perioperative myocardial infarction (MI) in coronary artery bypass grafting (CABG). Methods Between January 2010 and June 2010, 58 consecutive patients with coronary artery disease who underwent offpump CABG in the First Hospital of Peking University were enrolled in this study. An anastomosis between left internal mammary arteries (LIMA) and left ant erior descending coronary artery (LAD) were performed. And saphenous vein (SV) graft s were used as bypass grafts. Graft flow was measured intraoperatively using a transi t time flowmeter, and the total graft flow of each patient was calculated as a parameter of myocardial revascularization. The 58 patients were divided into a MI group and a nonMI group retrospectively. There were 11 patients in the MI group, including 7 males and 4 females, with an average age of 67.4±10.3 years.There were 47 patients in the nonMI group, 38 males and 9 females, with a mean age of 633±99 years. The graft flow of the two groups was tested and compared, and the preoperative variables were compared. Results There was no statistically significant difference in operation time (205.4±59.6min versus 1834±32.4 min, t=1.691, P=0.096) between the two groups. Therewere also no statistical differences in the average number of grafts (3.00±1.00 branches versus 2.96±0.78 branches, t=0.154, P=0878) or LIMALAD flow (1540±11.37 ml/min versus 16.50±10.83 ml/min, t=0.301, P=0.764) between the two groups. However, a significant difference was found in the total graft flow between the two groups (41.03±19.50 ml/min versus 64.09±32.44 ml/min, t=2.254, P=0.028), with lower total graft flow in the MI group. Further analysis showed [CM(159mm]that a total graft flow lt;48.5ml/min was a risk factor for MI (odds ratio 4.706, 95% confidence interval 1.099 to 20.147). Conclusion Total graft flow could be used to predict the occurrence of perioperative myocardial ischemia, as there is a high probability of MI for patients with a total graft flow of less than 48.5 ml/min.
【Abstract】 Objective To investigate the expression of connexin 40 (Cx40) and hyperpolarization-activated cycl icnucleotide-gated cation channel 4 (HCN4) in rat bone marrow mesenchymal stem cells (BMSCs) cocultured with the sinoatrialnode (SAN) tissues in vitro, so as to evaluate the possibil ity of BMSCs differentiation into SAN cells. Methods BMSCs wereisolated from Sprague Dawley rats (aged 4-6 weeks, male or female) by the adhesive method and cultured; BMSCs at the 3rdpassage were marked with carboxyfluorescein succinimidyl ester, and then were incubated on 6-well culture plate; cell climingsl ices were prepared at the same time. SAN tissue was taken and cut into 0.3 cm × 0.3 cm mass, and then placed into 4℃ PBSsolution. The SAN tissue mass was cocultured with marked BMSCs at the 3rd passage for 3 weeks as the experimental group, andBMSCs at 3rd passage were cultured alone for 1 week as the control group. At 1, 2, and 3 weeks after coculture, the mean integratedabsorbance (MIA) values of Cx40 and HCN4 were measured by Image pro plus 5.0 through the method of immunohistochemistry,and the mRNA expressions of Cx40 and HCN4 were identified by real-time fluorescent quantitative PCR. Results TheMIA values of Cx40 and HCN4 in the experimental group were higher than that in the control group, showing significantdifferences (P lt; 0.01). In the experimental group, the expressions of Cx40 and HCN4 increased gradually with time. The longerthe culture time was, the higher the expressions of Cx40 and HCN4 were, showing significant differences (P lt; 0.05). The mRNAexpressions of Cx40 and HCN4 in the experimental group were significantly higher than those in the control group (P lt; 0.01); inthe experimental group, the mRNA expressions of Cx40 and HCN4 increased gradually with time, showing significant differencesbetween different time points (P lt; 0.05). Conclusion The expressions of Cx40 and HCN4 increase obviously after coculturingBMSCs with SAN tissue, indicating that BMSCs could differentiate into SAN cells by coculturing with SAN tissue in vitro.
Cryptogenic stroke (CS) accounts for 25% of ischemic stroke. The etiology of undetermined stroke is unclear leading to untargeted secondary prevention, high recurrence rate, so the clinical burden of cryptogenic stroke is substantial. Cardiac magnetic resonance (CMR) imaging can identify more occult cardiac embolism that cannot be identified by standard cardiac assessment based on its excellent spatial resolution and contrast, three-dimensional imaging capacity and ability to depict soft tissues, to accelerate the initiation of optimal secondary prevention and improve the prognosis of patients. This review summarizes the application of CMR in the field of CS in recent years. Based on the latest evidence of diagnosis and management strategies, this paper proposes a cardiac diagnostic examination plan for CS patients, thereby improving the secondary prevention strategy of CS patients and improving their quality of life.
ObjectivesTo systematically review the association between pretreatment serum ferritin (SF) concentration and prognosis in lung cancer patients.MethodsDatabases including PubMed, EMbase, Web of Science, CNKI, VIP and WanFang Data were electronically searched to identify cohort studies on the relationship between the pretreatment SF concentration and prognosis of lung cancer patients from inception to January, 2020. Literature screening, data extraction and quality evaluation of included studies were independently performed by two reviewers. Then, meta-analysis was conducted by Stata 12.0 software.ResultsA total of 8 cohort studies involving 1 002 lung cancer patients were included. The results of meta-analysis indicated that patients with higher pretreatment SF concentration had poorer overall survival (HR=1.70, 95%CI 1.06 to 2.73, P=0.029) compared with patients with lower pretreatment SF concentration. Subgroup analysis based on the pathological type manifested showed that pretreatment SF concentration only had high prognostic value in small cell lung cancer patients (HR=4.78, 95%CI 2.83 to 8.05, P<0.001).ConclusionsLung cancer patients with high pretreatment SF level have worse overall survival. Pretreatment SF concentration may serve as an independent prognostic factor in lung cancer, especially in small cell lung cancer. Due to the limited quality and quantity of included studies, more prospective well-designed studies are required to verify above conclusions.