目的探讨合并单纯性肾囊肿(simple renal cyst,SRC)的急性A型主动脉夹层(acute type A aortic dissection,ATAAD)患者的临床预后特点。方法回顾性分析广东省人民医院2017年6月至2023年6月因ATAAD入院手术患者的病历资料,根据术前主动脉...目的探讨合并单纯性肾囊肿(simple renal cyst,SRC)的急性A型主动脉夹层(acute type A aortic dissection,ATAAD)患者的临床预后特点。方法回顾性分析广东省人民医院2017年6月至2023年6月因ATAAD入院手术患者的病历资料,根据术前主动脉计算机断层扫描血管造影(computed tomography angiography,CTA)检查是否合并有SRC,将患者分为SRC组和无SRC组,将基线资料进行1∶1倾向性评分匹配校准后,比较两组患者围术期相关指标及随访的差异。结果共533例患者纳入研究,两组各有165例进入匹配队列,两组患者在神经系统、循环系统、呼吸系统、泌尿系统、消化系统及其他并发症方面比较,均差异无统计学意义(P>0.05)。术后随访发现,SRC组患者较无SRC组更易发生主动脉事件(P<0.001)。多因素COX回归分析SRC组患者较无SRC组发生主动脉终点事件的风险比为2.545(95%CI:1.668~3.883,P<0.001)。结论SRC的存在不影响多个系统并发症的发生,但是SRC的存在能提高ATAAD患者术后残存主动脉发生主动脉事件的风险。展开更多
Background Patients with decreased cardiac and renal function,as well as old age suffer from poor outcomes when undergoing cardiac surgery.The aim of this study was to evaluate the association of age,creatinine and ej...Background Patients with decreased cardiac and renal function,as well as old age suffer from poor outcomes when undergoing cardiac surgery.The aim of this study was to evaluate the association of age,creatinine and ejection fraction(ACEF)score with in-hospital prognosis of patients with the acute type A aortic dissection(ATAAD).Methods From September 2017 to June 2021,a total of 435 ATAAD patients undergoing open surgery repair were enrolled,and classified into low ACEF(ACEF score<0.91,n=286)and high ACEF group(ACEF score≥0.91,n=149)according to the optimal cutoff value of 0.91.Logistic regression analysis was performed to investigate the association between ACEF score with adverse events.Results Thirty-five(8.0%)patients were excluded and 94(21.6%)developed in-hospital major adverse clinical events(MACEs)during hospitalization.The in-hospital mortality in high ACEF group was significantly higher than in low ACEF group(13.4%vs.5.2%,P=0.003).The in-hospital MACE rate was also significantly higher in patients with high ACEF score(high ACEF group:27.5%vs.low ACEF group:18.5%,P=0.031).Multivariable logistic analysis revealed that ACEF score was an independent indicator for in-hospital mortality[odds ratio(OR):5.66,95%confidence interval(CI):1.43-22.48,P=0.014]and in-hospital MACEs(OR:3.44,95%CI:1.30-9.15,P=0.013).Conclusions Elevated ACEF score was an independent predictor for in-hospital mortality and MACEs in patients with ATAAD undergoing open surgery repair,which might provide additional risk stratification.展开更多
试验旨在研究核蛋白1(nuclear protein 1,Nupr1)mRNA在小鼠早期妊娠子宫中的表达,探讨Nupr1与小鼠胚胎着床的相关性。通过建立小鼠早期妊娠模型、假孕妊娠模型、延迟着床及激活模型、人工蜕膜化模型和激素处理模型,采用原位杂交的方法检...试验旨在研究核蛋白1(nuclear protein 1,Nupr1)mRNA在小鼠早期妊娠子宫中的表达,探讨Nupr1与小鼠胚胎着床的相关性。通过建立小鼠早期妊娠模型、假孕妊娠模型、延迟着床及激活模型、人工蜕膜化模型和激素处理模型,采用原位杂交的方法检测Nupr1mRNA在小鼠各种模型子宫组织中的定位表达情况,并应用实时荧光定量PCR法检测早期妊娠模型和假孕妊娠模型中Nupr1mRNA的相对表达量。结果显示,Nupr1mRNA在小鼠早期妊娠第1~4天子宫的腔上皮和腺上皮表达,第5~8天表达于蜕膜区域;假孕妊娠第1~5天,Nupr1mRNA主要表达于小鼠子宫腔上皮和腺上皮;延迟着床模型中信号表达于在小鼠子宫的腔上皮和腺上皮,与正常妊娠第4天结果相似;延迟激活模型中信号表达于蜕膜区,与早期妊娠第5天表达结果相似;人工蜕膜化模型中信号表达于蜕膜区,而蜕膜对照组中信号表达于腔上皮和腺上皮;17β-雌二醇(oestrogen,E2)处理组信号表达于腔上皮和腺上皮,信号增强,孕酮(progesterone,P4)和E2共同处理表达无明显变化;实时荧光定量PCR结果显示,正常妊娠第2天Nupr1mRNA相对表达量较高,假孕妊娠第2天Nupr1mRNA相对表达量也较高。本研究结果表明,Nupr1mRNA在小鼠子宫中的表达与小鼠早期妊娠过程相关,Nupr1mRNA在腔上皮和腺上皮的表达可能受激素调节,在子宫基质中的表达与蜕膜化及活化胚泡相关。展开更多
文摘目的探讨合并单纯性肾囊肿(simple renal cyst,SRC)的急性A型主动脉夹层(acute type A aortic dissection,ATAAD)患者的临床预后特点。方法回顾性分析广东省人民医院2017年6月至2023年6月因ATAAD入院手术患者的病历资料,根据术前主动脉计算机断层扫描血管造影(computed tomography angiography,CTA)检查是否合并有SRC,将患者分为SRC组和无SRC组,将基线资料进行1∶1倾向性评分匹配校准后,比较两组患者围术期相关指标及随访的差异。结果共533例患者纳入研究,两组各有165例进入匹配队列,两组患者在神经系统、循环系统、呼吸系统、泌尿系统、消化系统及其他并发症方面比较,均差异无统计学意义(P>0.05)。术后随访发现,SRC组患者较无SRC组更易发生主动脉事件(P<0.001)。多因素COX回归分析SRC组患者较无SRC组发生主动脉终点事件的风险比为2.545(95%CI:1.668~3.883,P<0.001)。结论SRC的存在不影响多个系统并发症的发生,但是SRC的存在能提高ATAAD患者术后残存主动脉发生主动脉事件的风险。
基金supported by the Science and Technology Planning Project of Guangzhou(No.2014y2-00052)。
文摘Background Patients with decreased cardiac and renal function,as well as old age suffer from poor outcomes when undergoing cardiac surgery.The aim of this study was to evaluate the association of age,creatinine and ejection fraction(ACEF)score with in-hospital prognosis of patients with the acute type A aortic dissection(ATAAD).Methods From September 2017 to June 2021,a total of 435 ATAAD patients undergoing open surgery repair were enrolled,and classified into low ACEF(ACEF score<0.91,n=286)and high ACEF group(ACEF score≥0.91,n=149)according to the optimal cutoff value of 0.91.Logistic regression analysis was performed to investigate the association between ACEF score with adverse events.Results Thirty-five(8.0%)patients were excluded and 94(21.6%)developed in-hospital major adverse clinical events(MACEs)during hospitalization.The in-hospital mortality in high ACEF group was significantly higher than in low ACEF group(13.4%vs.5.2%,P=0.003).The in-hospital MACE rate was also significantly higher in patients with high ACEF score(high ACEF group:27.5%vs.low ACEF group:18.5%,P=0.031).Multivariable logistic analysis revealed that ACEF score was an independent indicator for in-hospital mortality[odds ratio(OR):5.66,95%confidence interval(CI):1.43-22.48,P=0.014]and in-hospital MACEs(OR:3.44,95%CI:1.30-9.15,P=0.013).Conclusions Elevated ACEF score was an independent predictor for in-hospital mortality and MACEs in patients with ATAAD undergoing open surgery repair,which might provide additional risk stratification.
文摘试验旨在研究核蛋白1(nuclear protein 1,Nupr1)mRNA在小鼠早期妊娠子宫中的表达,探讨Nupr1与小鼠胚胎着床的相关性。通过建立小鼠早期妊娠模型、假孕妊娠模型、延迟着床及激活模型、人工蜕膜化模型和激素处理模型,采用原位杂交的方法检测Nupr1mRNA在小鼠各种模型子宫组织中的定位表达情况,并应用实时荧光定量PCR法检测早期妊娠模型和假孕妊娠模型中Nupr1mRNA的相对表达量。结果显示,Nupr1mRNA在小鼠早期妊娠第1~4天子宫的腔上皮和腺上皮表达,第5~8天表达于蜕膜区域;假孕妊娠第1~5天,Nupr1mRNA主要表达于小鼠子宫腔上皮和腺上皮;延迟着床模型中信号表达于在小鼠子宫的腔上皮和腺上皮,与正常妊娠第4天结果相似;延迟激活模型中信号表达于蜕膜区,与早期妊娠第5天表达结果相似;人工蜕膜化模型中信号表达于蜕膜区,而蜕膜对照组中信号表达于腔上皮和腺上皮;17β-雌二醇(oestrogen,E2)处理组信号表达于腔上皮和腺上皮,信号增强,孕酮(progesterone,P4)和E2共同处理表达无明显变化;实时荧光定量PCR结果显示,正常妊娠第2天Nupr1mRNA相对表达量较高,假孕妊娠第2天Nupr1mRNA相对表达量也较高。本研究结果表明,Nupr1mRNA在小鼠子宫中的表达与小鼠早期妊娠过程相关,Nupr1mRNA在腔上皮和腺上皮的表达可能受激素调节,在子宫基质中的表达与蜕膜化及活化胚泡相关。
