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肥胖与新发房颤危险之间的关系

世界核心医学期刊文摘（心脏病学分册） 2005年第4期1卷 20-21页

作者： parise H. Levy D. E. j. Benjamin 王亭忠 fra.ingham Heart Study 73 Mount Wayte Ave Framingham MA 01702-5827 United States Dr.

Context: Obesity is associated with atrial enlargement and ventricular diastol ic dysfunction, both known predictors of atrial fibrillation(AF). However, it is unclear whether obesity is a risk factor for AF. Objective: To examine the asso ciation between body mass index(BMI) and the risk of developing AF. Design, Sett ing, and participants: prospective, communitybased observational cohort in fra.mingham, Mass. We studied 5282 participants(mean age, 57[SD, 13] years; 2898 wom en[55%]) without baseline AF(electrocardiographic AF or arterial flutter). Body mass index(calculated as weight in kilograms divided by square of height in met ers) was evaluated as both a continuous and a categorical variable(normal define d as ju sting for clinical confounders by multivariable techniques, we also examined mod els including echocardiographic left atrial diameter to examine whether the infl uence of obesity was mediated by changes in left atrial dimensions. Main Outcome Measure: Association between BMI or BMI category and risk of developing newon set AF. Results: During a mean followup of 13.7 years, 526 participants(234 wo men) developed AF. Age adjusted incidence rates for AF increased across the 3 BM I categories in men(9.7, 10.7, and 14.3 per 1000 personyears) and women(5.1, 8 .6, and 9.9 per 1000 personyears). In multivariable models adjusted for cardio vascular risk factors and interim myocardial infarction or heart failure, a 4%i ncrease in AF risk per 1-unit increase in BMI was observed in men(95%confidenc e interval[CI], 1%-7%; p=.02) and in women(95%CI, 1%-7%; p=.009). Adjuste d hazard ratios for AF associated with obesity were 1.52(95%CI, 1.09-2.13; p=. 02) and 1.46(95%CI, 1.03-2.07; p=.03) for men and women, respectively, compare d with individuals with normal BMI. After adjustment for echocardiographic left atrial diameter in addition to clinical risk factors, BMI was no longer associat ed

关键词：舒张功能不全房扑左房扩大临床危险因素连续变量队列研究马萨诸塞州血管危险因素多变量模型混杂因素

一组孤立性房颤患者行导管射频消融术1年后左侧心腔重构发生逆转

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世界核心医学期刊文摘(心脏病学分册) 2006年第4期 51-51页

作者： Reant p. Lafitte S. jas p. 尹涛 Hopital Cardiologique du Haut-Leveque Service pr Roudaut Avenue de Magellan 33604 Bordeaux-pessac fra.ce Dr.

Background -Isolated atrial fibrillation(AF)is associated with mild enlargement of the left atrium(LA)and left ventricular(LV)diastolic dysfunction. The impact of ablation of isolated AF on left chamber size and function is unclear, and whether diastolic dysfunction is the cause or the consequence of AF remains unknown. The objective of this prospective study was to evaluate the impact of sinus rhythm restoration by catheter ablation on LV diastolic dysfunction, LA morphology, and mechanical function. Methods and Results -Forty-eight patients with isolated AF were studied by serial echocardiographic studies at baseline and at 1-, 3-, 6-, 9-, and 12-month intervals after radiofrequency ablation. LA dimensions and mechanical function and LV systolic and diastolic functions were evaluated at each time interval. Diastolic function was assessed with conventional Doppler parameters and new indexes such as tissue Doppler imaging, mitral flow propagation velocity, and combined criteria. LV diastolic dysfunction was present in paroxysmal and chronic AF patients with a reduction of tissue Doppler imagin g lateral early diastolic peak velocity in 37%(ppp ectively, compared with healthy control subjects. At the end of the follow-up, LA area decreased significantly by 18%(pparoxysmal and 23%(ppatients. Diastolic function improved significantly with an increa se in lateral early diastolic peak velocity of 29%(pparoxysmal AF an d 46%(ppatients. A significant increase in LV ejection fra.ction was also noted for both groups: 7.7%and 18.8%, respectively. Conclusions -This study demonstrates reverse morphological remodeling of the LA and improv ement of LV diastolic and systolic functions after restoration of sinus rhythm b y ablation for isolated AF. Because patients with isolated AF have none of the t raditional causes of LV diastolic dysfunction, our findings suggest that AF may be partly t

关键词：房颤舒张功能心房纤颤孤立性心腔患者

免疫荧光联合电镜检测诊断不典型膜性肾病的价值

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国际免疫学杂志 2017年第1期40卷 37-41页

作者：姜传学李龙海王建胡冬梅董葆阜阳市第二人民医院肾脏内科 236015 阜阳市第二人民医院超声科北京大学人民医院肾内科 100044

目的探讨免疫荧光联合电镜检测诊断不典型膜性肾病（atypicalmembranousnephropathy，AMN））的价值。方法连续选择2010年1月至2015年1月入我院经肾穿刺活检诊断为AMN的92例和特发性膜性肾病（idiopathicmembranousnephropathy，IMN）165例。分析外周血的尿素氮、肌酐、胱抑素c和24h尿蛋白定量、免疫球蛋白（immunoglobulin，Ig）A、IgM、IgG和补体3（complement3，C3），肾组织中的IgA、IgM、IgG及IgG亚型、C1q）、纤维蛋白相关抗原（fibrinogen—relatedantigen，fra.、M型磷脂酶A2受体（***2receptor，pLA2R）和Nephrin，电镜和光镜下检查病理改变。结果AMN和IMN组患者血尿素氮、肌酐、胱抑素c和24h尿蛋白定量，血清IgA、IgG、IgM和C3的差异均无统计学意义（p〉0．05）。与IMN组比较，AMN患者的Igh[69（75．0％）比50（30．3％）,X2=47．461，p〈0．05]、IgM[68（73．9％）比55（59．8％），x2=38．977，p〈0．05]、Clq[72（78．3％）比33（20．0％），x2=112．423，p〈0．05]、fra.28（30．4％）比32（19．4％）,x2=4．023，p〈0．05]、IgG4[64（69．6％）比82（49．7％）,X2=9．503，p〈0．05]和pLA2R[75（81．5％）比99（60．0％）,X2=12．512，p〈0．05]的阳性沉积率均增高（p〈0．05），Nephrin[28（30．4％）比81（49．1％）,X2=8．417，p〈0．05]阳性沉积率低于IMN（p〈0．05），AMN与IMN组的IgG、IgG1、IgG2和IgG3和C3阳性沉积率比较差异无统计学意义（p〉0．05）。AMN组与IMN组相比，光镜下肾小球钉突形成比例增加[64（69．6％）比52（31．5％）,X2=34：533，p〈0．05]，其他病理改变无差异。电镜下AMN系膜细胞和系膜基质增生比例增加[78（84．8％）比33（20．O％）,X2=101．029，p〈0．05]，电子致密物多沉积在上皮下、基膜内、系膜区等部位，MN电子致密物多沉积在上皮下及基底膜区，很少沉积在系膜区[82（89．1％）比0（0．0％），x2=215．976，p〈0．05]在系膜区沉积差异有统计学意义。结论免疫荧光联合电镜检测对鉴别AMN有重要应用价值，推荐临床免疫荧光检测IgA、IgM、Clq、fra.IgG4、pLA2R和Nephfin，电镜检测系膜细胞和系膜基质增生及电子致密物沉积于系膜区等病理改变。

关键词：免疫荧光免疫球蛋白不典型膜性肾病

聚合酶链反应检查诊断迁延复发型带状疱疹病毒角膜炎

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世界核心医学期刊文摘（眼科学分册） 2005年第10期1卷 23-23页

作者： Magone M.T. Nasser R.E. Cevallos A.V. Margolis T.p. 杨秀梅 fra.cis I. proctor Foundation Box 0944 University of California San Francisco San Fra ncisco CA 94143-0944 United States Dr.

pURpOSE: To report a case of chronic recurrent varicella virus epithelial kera titis in a child. DESIGN: Case report. METHODS: Clinical examination and polymer ase chain reaction analysis of corneal epithelium. RESULTS: A 10-year-old heal thy child developed chronic recurrent varicella virus keratitis with pseudodendr ites after recovering from systemic varicella. Analysis of the debrided pseudode ndrites was repeatedly positive for VZV DNA and negative for HSV DNA. Treatment with oral acyclovir and topical corticosteroid drops was effective in eliminatin g the pseudodendrites; however, recurrences occurred once the medications were d iscontinued. CONCLUSIONS: Varicella virus epithelial keratitis in children can b e a recurrent chronic condition requiring prolonged treatment.

关键词：带状疱疹病毒聚合酶链反应复发型上皮型树突角膜上皮清创术单纯疱疹病毒