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Left atrial enlargement and non-paroxysmal atrial fibrillation as risk factors for left atrial thrombus/spontaneous Echo contrast in patients with atrial fibrillation and low CHA2DS2-VASc score

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Journal of Geriatric Cardiology 2020年第3期17卷 155-159页

作者： Wei-Dong LIN Yu-Mei XUE fang-Zhou LIU Xian-Hong FANG xian-Zhang ZHAN hong-Tao LIAO Gary Tse Shu-Lin WU Guangdong Cardiovascular Institute Guangdong General HospitalGuangzhouChina Department of Medicine and Therapeutics Faculty of MedicineChinese University of Hong KongHong KongChina Li Ka Shing Institute of Health Sciences Faculty of MedicineChinese University of Hong KongHong KongChina

Objective To determine the risk factors for thromboembolism in lower risk patients with non-valvular atrial fibrillation(AF)and low CHA2DS2-VASc scores,which remain undefined.Methods We retrospectively analyzed the baseline clinical characteristics,routine laboratory parameters,and echocardiographic measurements of 705 patients(71.1%male;mean age:52.10±9.64 years)with low CHA2DS2-VASc score(0 or 1;1 point for female sex)out of 1346 consecutive patients with non-valvular AF who underwent transesophageal echocardiography(TEE)at Guangdong Cardiovascular Institute between January 2013 and December 2015.Results Patients with left atrial thrombus(LAT)or spontaneous echo contrast(SEC)on TEE(24/705,4%)showed a higher incidence rate of vascular disease(54.2%vs.32.9%,P=0.045)and non-paroxysmal AF(79.2%vs.29.4%,P<0.001),larger left atrial diameter(43.08±4.59 vs.36.02±5.53 mm,P<0.001),and lower left ventricular ejection fraction(58.23±8.82%vs.64.15±7.14%,P<0.001)than those without.Multivariate logistic regression analysis identified left atrial diameter[odds ratio(OR)=1.171,95%confidence interval(CI):1.084–1.265,P<0.001]and non-paroxysmal AF(OR=3.766,95%CI:1.282–11.061,P=0.016)as independent risk factors for LAT/SEC.In ROC curve analysis,a left atrial dimeter cutoff of 37.5 mm yielded 95.0%sensitivity and 62.7%specificity(AUC:0.847,P<0.0001,95%CI:0.793–0.914).Conclusion In patients with non-valvular AF with low CHA2DS2-VASc score,the presence of LAT or SEC was associated with left atrial enlargement,which had moderate predictive value,and non-paroxysmal AF.

关键词： Atrial fibrillation Left atrial diameter Left atrial spontaneous echo contrast Left atrial thrombus

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Predictive value of serum uric acid on left atrial spontaneous echo contrast in non-valvular atrial fibrillation patients

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Journal of Geriatric Cardiology 2015年第6期12卷 641-646页

作者： hong-Tao LIAO fang-Zhou LIU Yu-Mei XUE xian-Zhang ZHAN Xian-Hong FANG Jun HUANG Wei WEI fang RAO Hai DENG Yang LIU Wei-Dong LIN Shu-Lin WU Department of Cardiovascular Guangdong Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Science GuangzhouGuangdong China Research Center of Medical Science Guangdong General Hospital Guangdong Academy of Medical Science Guangzhou Guangdong China

ObjectivesTo 调查在浆液之间的关系尿酸( SUA )和左 atrial 在纤维性颤动( AF ) patients.MethodsWe 回顾地屏蔽了的非瓣膜的 atrial 的自发的回响对比(LA秒)在 radiofrequency 以前经历了 transesophageal echocardiography 的有 AF 的 1,476 个连续就医的病人导管脱离，在广东医院将军的左 atrial 附器闭合和电的 cardioversion 。所有病人的临床的基线特征上的数据与左 atrial 血栓从电子医药记录和病人的 analyzed.ResultsAfter 排除被收集， 1,354 个病人进入了现在的学习， 57 是 LA 秒。吝啬的女 SUA 水平(380.88 ±；94.35 µ； mol/L 对 323.37 ±；72.19 µ； mol/L， P <；0.001 ) 并且男 SUA 水平(416.97 ±；98.87 µ； mol/L 对 367.88 ±；68.50 µ； mol/L， P = 0.008 ) 比在控制在有 LA 秒的病人更高显著地是两个。吝啬的左 atrial 尺寸(41.32 ±；5.12 公里对 36.12 ±；5.66 公里， P <；0.001 ) 在有 LA 秒的病人是显著地更大的。在 multivariate 回归分析， SUA 水平是为 LA 秒的一个独立风险因素(或：1.008， P <；0.001 ) 。在操作典型曲线分析的接收装置，在为在女性和男性预言 LA 秒的 SUA 的曲线下面的相应区域分别地是 0.670 和 0.657。SUA 水平在有 LA-SEC.ConclusionSUA 的非瓣膜的 AF 病人是显著地更高的水平是一个独立风险因素并且在南部的中国在非瓣膜的 AF 病人之中为 LA 秒有中等预兆的价值。

关键词：患者心房预测价值颤动尿酸超声心动图膜

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Efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer

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World Journal of Clinical Cases 2024年第9期12卷 1569-1577页

作者： xian Qin Chen Chen Yang Liu xian-hong Hua Jia-Yi Li Meng-Jie Liang fang Wu Department of Anesthesiology The First People's Hospital of Jiangxia DistrictWuhan 430200Hubei ProvinceChina Department of Obstetrics and Gynecology The First People's Hospital of Jiangxia DistrictWuhan 430200Hubei ProvinceChina

BACKGROUND Ovarian cancer is one of the most common malignant tumors in female reproductive system in the world,and the choice of its treatment is very important for the survival rate and prognosis of patients.Traditional open surgery is the main treatment for ovarian cancer,but it has the disadvantages of big trauma and slow recovery.With the continuous development of minimally invasive technology,minimally invasive laparoscopic surgery under general anesthesia has been gradually applied to the treatment of ovarian cancer because of its advantages of less trauma and quick recovery.However,the efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia in the treatment of ovarian cancer are still controversial.AIM To explore the efficacy and safety of general anesthesia minimally invasive surgery in the treatment of ovarian cancer.METHODS The clinical data of 90 patients with early ovarian cancer in our hospital were analyzed retrospectively.According to the different surgical treatment methods,patients were divided into study group and control group(45 cases in each group).The study group received minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer,while the control group received traditional open surgery for ovarian cancer.The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),clinical efficacy and safety of the two groups were compared.RESULTS The intraoperative blood loss,length of hospital stay,postoperative gas evacuation time,and postoperative EORTC QLQ-C30 score of the study group were significantly better than those of the control group(P<0.05).The incidence of postoperative complications in the study group was significantly lower than in the control group(P<0.05).The two groups had no significant differences in the preoperative adrenocorticotropic hormone(ACTH),androstenedione(AD),cortisol(Cor),cluster of differentiation 3 positive(CD3+),and cluster of differentiation 4 positive(CD4+)indexes(

关键词： Early-stage ovarian cancer Efficacy Minimally invasive Laparoscopy Safety Surgery

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Endoscopic-ultrasound-guided biliary drainage with placement of electrocautery-enhanced lumen-apposing metal stent for palliation of malignant biliary obstruction:Updated meta-analysis

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 907-920页

作者： Zu-xiang Peng fang-fang Chen Wen Tang Xu Zeng hong-Juan Du Ru-xian Pi hong-Ming Liu Xiao-Xiao Lu Department of Hepatobiliary Surgery Daping HospitalArmy Medical UniversityChongqing 400042China Department of Oncology Chongqing General HospitalChongqing UniversityChongqing 401147China Department of Gastroenterology and Hepatobiliary Surgery People’s Hospital of Fenggang CountyGuizhou 564200Guizhou ProvinceChina Hepatobiliary and Pancreatic Tumor Center Chongqing University Cancer HospitalChongqing 400030China

BACKGROUND Endoscopic ultrasound-guided biliary drainage using electrocautery-enhanced(ECE)delivery of lumen-apposing metal stent(LAMS)is gradually being re-cognized as a viable palliative technique for malignant biliary obstruction after endoscopic retrograde cholangiopancreatography(ERCP)failure.However,most of the studies that have assessed its efficacy and safety were small and hetero-geneous.Prior meta-analyses of six or fewer studies that were published 2 years ago were therefore underpowered to yield convincing evidence.AIM To update the efficacy and safety of ECE-LAMS for treatment of biliary ob-struction after ERCP failure.METHODS We searched PubMed,EMBASE,and Scopus databases from the inception of the ECE technique to May 13,2022.Primary outcome measure was pooled technical success rate,and secondary outcomes were pooled rates of clinical success,re-intervention,and adverse events.Meta-analysis was performed using a random-effects model following Freeman-Tukey double-arcsine transformation in R soft-ware(version 4.1.3).RESULTS Fourteen eligible studies involving 620 participants were ultimately included.The pooled rate of technical success was 96.7%,and clinical success was 91.0%.Adverse events were reported in 17.5%of patients.Overall reinter-vention rate was 7.3%.Subgroup analyses showed results were generally consistent.CONCLUSION ECE-LAMS has favorable success with acceptable adverse events in relieving biliary obstruction when ERCP is impossible.The consistency of results across most subgroups suggested that this is a generalizable approach.

关键词： Biliary obstruction Biliary drainage Electrocautery-enhanced lumen-apposing metal stents Endoscopic ultrasound Endoscopic retrograde cholangiopancreatography failure

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MiR-106b-5p Inhibits Tumor Necrosis Factor-α-induced Apoptosis by Targeting Phosphatase and Tensin Homolog Deleted on Chromosome 10 in Vascular Endothelial Cells

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Chinese Medical Journal 2016年第12期129卷 1406-1412页

作者： Jing Zhang Su-fang Li hong Chen Jun-xian Song Department of Cardiology Peking University People's Hospital Beijing 100044 China Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction Peking University People's Hospital Beijing 100044 China Center for Cardiovascular Translational Research Peking University People's Hospital Beijing 100044 China

Background： Apoptosis of endothelial cells （ECs） plays a key role in the development of atherosclerosis and there are also evidence indicated that phosphatase and tensin homolog deleted on chromosome 10 （PTEN） is a viable target in therapeutic approaches to prevent vascular ECs apoptosis. Aberrant miR-106b-5p expression has been reported in the plasma of patients with unstable atherosclerotic plaques. However, the role and underlying mechanism of miR-106-5p in the genesis of atherosclerosis have not been addressed. In this study, we explored the anti-apoptotic role of miR-106-5p by regulating PTEN expression in vascular ECs. Methods： Real-time reverse transcription polymerase chain reaction （RT-PCR） was performed to detect the expression levels of miR-106b-5p in human atherosclerotic plaques and normal vascular tissues. Human umbilical vein endothelial cells （HUVEC） were transfected with miR-106b-5p mimic or negative control mimic, and apoptosis was induced by serum starvation and tumor necrosis factor-α （TN F-α） treat. Western blotting and real-time RT-PCR experiments were used to detect PTEN expression levels and TN F-α-induced apoptosis was evaluated by the activation of caspase-3 and cell DNA fragmentation levels in HUVEC. Results： The expression ofmiR-106b-5p was significantly downregulated in plaques than in normal vascular tissues. TNF-α significantly downregulated miR-106b-5p expression levels and upregulated activation of caspase-3 and cell DNA fragmentation levels in HUVEC. Overexpression ofmiR-106b-5p with miR-106b-5p mimic inhibited PTEN expression and TNF-α-induced apoptosis in HUVEC. Luciferase reporter assays confirmed that miR-106b-5p binds to PTEN mRNA 3＇ untranslated region site, Conclusion： MiR-106b-5p could inhibit the expression of PTEN in vascular ECs, which could block TNF-α-induced activation of caspase-3, thus prevent ECs apoptosis in atherosclerosis diseases.

关键词： Apoptosis Atherosclerosis MicroRNAs Phosphatase and Tensin Homolog Deleted on Chromosome 10

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Predictive value of red cell distribution width on left atrial thrombus or left atrial spontaneous echo contrast in patients with non-valvular atrial fibrillation

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Journal of Geriatric Cardiology 2018年第6期15卷 408-412页

作者： xian-Zhang ZHAN Wei-Dong LIN fang-Zhou LIU Yu-Mei XUE hong-Tao LIAO Xin LI Xian-Hong FANG Hai DENG Jun HUANG Yang-Qiu LI Jo-Jo HAI Hung-Fat Tse Shu-Lin WU Department of Hematology the First Affiliated Hospital Jinan University Guangzhou China Department of Cardiology Atrial Fibrillation Center Guangdong Cardiovascular Institute Guangdong General Hospital Guangdong Academy of Medical Sciences Guangzhou China Cardiology Division Department of Medicine Queen Mary Hospital the University of Hong Kong Hong Kong China Division of Cardiology Department of Medicine the University of Hong Kong Shenzhen Hospital Shenzhen China

ObjectiveTo 在左 atrial 血栓( LAT )或左 atrial 上评估红房间分发宽度( RDW )的预兆的价值在有纤维性颤动( AF ) .MethodsWe 考察了的非瓣膜的 atrial 的病人的自发的回响对比( LASEC )作为非瓣膜的 AF 被诊断并且经历了 transesopha... 详细信息

ObjectiveTo 在左 atrial 血栓( LAT )或左 atrial 上评估红房间分发宽度( RDW )的预兆的价值在有纤维性颤动( AF ) .MethodsWe 考察了的非瓣膜的 atrial 的病人的自发的回响对比( LASEC )作为非瓣膜的 AF 被诊断并且经历了 transesophageal echocardiography ( T )在里面的 692 个病人从2014年4月的广东心血管的研究所到2015年12月。基线临床的特征，血常规的实验室测试，心动电流描记器大小是 analyzed.ResultsEighty -- 四个病人在 T 下面与 LAT/LASEC 被检查。吝啬的 RDW 水平与 non-LAT/LASEC 病人相比在 LAT/LASEC 病人是显著地更高的(13.59%

关键词：纤维性价值预兆血栓宽度分发房间颤动

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Optical quality of toric intraocular lens implantation in cataract surgery

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International Journal of Ophthalmology(English edition) 2015年第1期8卷 66-71页

作者： xian-Wen Xiao Jing Hao hong Zhang fang Tian Tianjin Medical University Eye Hospital Xiamen Eye Center of Xiamen University

AIM: To analyze the optical quality after implantation of toric intraocular lens with optical quality analysis system.METHODS: Fifty-two eyes of forty-four patients with regular corneal astigmatism of at least 1.00 D underwent implantation of Acry Sof toric intraocular lens, including T3 group 19 eyes, T4 group 18 eyes, T5 group 10 eyes,T6 group 5 eyes. Main outcomes evaluated at 3mo of follow-up, included uncorrected distance visual acuity(UDVA), corrected distance visual acuity(CDVA), residual refractive cylinder and intraocular lens(IOL) axis rotation.Objective optical quality were measured using optical quality analysis system(OQAS Ⅱ, Visiometrics, Spain),included the cutoff frequency of modulation transfer function(MTFcutoff), objective scattering index(OSI),Strehl ratio, optical quality analysis system value(OV)100%, OV 20% and OV 9% [the optical quality analysis system(OQAS) values at contrasts of 100%, 20%, and 9%].RESULTS: At 3mo postoperative, the mean UDVA and CDVA was 0.18 ±0.11 and 0.07 ±0.08 log MAR; the mean residual refractive cylinder was 0.50 ±0.29 D; the mean toric IOL axis rotation was 3.62 ±1.76 degrees, the mean MTFcutoff, OSI, Strehl ratio, OV 100%, OV 20% and OV9% were 22.862 ±5.584, 1.80 ±0.84, 0.155 ±0.038, 0.76 ±0.18,0.77±0.19 and 0.78±0.21. The values of UDVA, CDVA, IOL axis rotation, MTFcutoff, OSI, Strehl ratio, OV100%,OV20% and OV9% depending on the power of the cylinder of the implantation were not significantly different(P >0.05), except the residual refractive cylinder(P <0.05).CONCLUSION: The optical quality analysis system was useful for characterizing the optical quality of Acry Sof toric IOL implantation. Implantation of an Acry Sof toric IOL is an effective and safe method to correct corneal astigmatism during cataract surgery.

关键词： optical quality analysis system toric intraocular lens astigmatism

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Pomolidomide for relapsed/refractory light chain amyloidosis after resistance to both bortezomib and daratumumab:A case report

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World Journal of Clinical Cases 2022年第34期10卷 12703-12710页

作者： xian Li Xiao-hong Pan Qiu fang Yun Liang Department of Hematology The Second Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhou 310009Zhejiang ProvinceChina Department of Cardiology The Second Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhou 310009Zhejiang ProvinceChina Department of Hematology Huzhou Central HospitalAffiliated Huzhou HospitalZhejiang University School of MedicineHuzhou 313099Zhejiang ProvinceChina

BACKGROUND Immunoglobulin light chain(AL)amyloidosis is a rare disease characterized by deposition of ALs essentially in any organ or tissue,with cardiac involvement being very frequent(61%).Early diagnosis is of high importance because early initiation of treatment in AL amyloidosis may improve outcomes.Despite the administration of immunotherapeutic agents,in particular bortezomib and daratumumab,which have improved the outcomes of AL amyloidosis,antiplasma cell therapy remains suboptimal for some patients.CASE SUMMARY We report the case of a 55-year-old man presenting with heart failure who was diagnosed with cardiac AL amyloidosis by an endomyocardial biopsy.He experienced a short-term hematological remission with no organ response after being administered a bortezomib-daratumumab containing regimen.The treatment was switched to pomolidomide due to pulmonary involvement and progressive pleural effusion,in which flow cytometry analysis showed abnormal plasma cells.After two cycles of this regimen,the pleural effusion was controlled effectively with no recurrence.CONCLUSION This case emphasizes the crucial role of endomyocardial biopsy in early diagnosis of cardiac amyloidosis and suggests that pomolidomide may be an effective treatment for patients with AL amyloidosis that is relapsed/refractory to both bortezomib and daratumumab.

关键词： Immunoglobulin light chain amyloidosis Relapsed/refractory Pleural effusion Endomyocardial biopsy Immunomodulatory agent Case report

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Predictors and in-hospital prognosis of recurrent acute myocardial infarction

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Journal of Geriatric Cardiology 2016年第10期13卷 836-839页

作者： Cheng-Fu CAO Su-fang LI hong CHEN Jun-xian SONG Department of Cardiology Peking University People's Hospital Beijing China Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction Peking University People's Hospital Beijing China Center for Cardiovascular Translational Research Peking University People's Hospital Beijing China

为了调查作出贡献的因素和病人的在里面医院预后与或没有周期性的尖锐心肌的梗塞(AMI ) ， 1686 个连续 AMI 病人全部的 .MethodsA 承认到 2015 年 12 月的从 2010 年 1 月的医院被招募到北京大学民族。他们的临床的特征回顾地与或没有... 详细信息

为了调查作出贡献的因素和病人的在里面医院预后与或没有周期性的尖锐心肌的梗塞(AMI ) ， 1686 个连续 AMI 病人全部的 .MethodsA 承认到 2015 年 12 月的从 2010 年 1 月的医院被招募到北京大学民族。他们的临床的特征回顾地与或没有周期性的 AMI 在病人之间被作比较。然后 multivariable 逻辑回归被用来估计周期性的心肌的 infarction.ResultsRecurrent AMI 病人的预言者更旧(69.3 #

关键词：急性心肌梗死临床特点复发 logistic回归分析预测预后冠状动脉疾病危险因素

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Novel Mutations in the 3β-hydroxy-A5-C27-steroid Dehydrogenase Gene （HSD3B7）in a Patient with Neonatal Cholestasis

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Chinese Medical Journal 2016年第1期129卷 98-100页

作者： He-Yu Huang Hua Zhou hong Wang Ya-xian Chen Feng fang Department of Pediatrics Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei 430030 China Department of Internal Medicine Genetic Diagnostic Centre Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei 430030 China

Bile acid synthetic defect （BASD） is a rare category of genetic disorders that are responsible for approximately 2% of persistent cholestasis in infants. Until date, four enzynles responsible for congenital defects of bile acid synthesis （CBAS） have been identified. 313-hydroxy-A5-C27-steroid dehydrogenase （3β-HSD）, the deficiency of which can cause CBAS 1 （OMIM No. 607765）, is encoded by the gene HSD3B7 and works in the second step of transforming the steroid into primary bile acids.

关键词： HSD3B7 Mutation Neonatal Cholestasis

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