This study aims to explore the correlation between plasma homocysteine (Hcy) levels and the clinical grading of varicocele (VC) when analyzing the potential pathogenesis of endothelial cells injury by Hcy. A total of ...This study aims to explore the correlation between plasma homocysteine (Hcy) levels and the clinical grading of varicocele (VC) when analyzing the potential pathogenesis of endothelial cells injury by Hcy. A total of 184 VC patients, aged 18–46 years, were included in this study. These patients visited The Second Hospital of Dalian Medical University (Dalian, China), between January 2022 and September 2024. Patients were divided into three groups based on clinical grading: Group A (59 cases, Grade I), Group B (28 cases, Grade II), and Group C (97 cases, Grade III). Additionally, 120 individuals with normal fertility test results during the same period were selected as the control group. Routine blood and biochemical indices were collected from the patients. Differences in clinical indices between groups were compared, and univariate and multivariate linear regression analyses were performed to identify factors associated with clinical grading. The results showed that the median Hcy levels in the control group and in patients with Grade I, II, and III VC were 9.56 (interquartile range [IQR]: 8.66, 14.02) µmol l−1, 11.28 (IQR: 9.71, 14.55) µmol l−1, 11.84 (IQR: 10.14, 15.60) µmol l−1, and 12.27 (IQR: 9.52, 15.40) µmol l−1, respectively. The differences between the four groups were statistically significant (χ2 = 12.41, P = 0.006). Multivariate regression analysis indicated that Hcy is a factor associated with the clinical grading of VC (t = 2.53, P = 0.013). Hcy is associated with the clinical grading and may have clinical value in assessing severity of VC.展开更多
BACKGROUND The optimal approach for managing hepatic hemangioma is controversial.AIM To evaluate a clinical grading system for management of hepatic hemangioma based on our 17-year of single institution experience.MET...BACKGROUND The optimal approach for managing hepatic hemangioma is controversial.AIM To evaluate a clinical grading system for management of hepatic hemangioma based on our 17-year of single institution experience.METHODS A clinical grading system was retrospectively applied to 1171 patients with hepatic hemangioma from January 2002 to December 2018.Patients were classified into four groups based on the clinical grading system and treatment:(1)Observation group with score<4(Obs score<4);(2)Surgical group with score<4(Sur score<4);(3)Observation group with score≥4(Obs score≥4);and(4)Surgical group with score≥4(Sur score≥4).The clinico-pathological index and outcomes were evaluated.RESULTS There were significantly fewer symptomatic patients in surgical groups(Sur score≥4 vs Obs score≥4,P<0.001;Sur score<4 vs Obs score<4,χ^(2)=8.60,P=0.004;Sur score≥4 vs Obs score<4,P<0.001).The patients in Sur score≥4 had a lower rate of in need for intervention and total patients with adverse event than in Obs score≥4(P<0.001;P<0.001).Nevertheless,there was no significant difference in need for intervention and total patients with adverse event between the Sur score<4 and Obs score<4(P>0.05;χ^(2)=1.68,P>0.05).CONCLUSION This clinical grading system appeared as a practical tool for hepatic hemangioma.Surgery can be suggested for patients with a score≥4.For those with<4,follow-up should be proposed.展开更多
Background Hypertension is widely acknowledged as a significant contributory factor to the heightened risk of intracranial aneurysm rupture.Nevertheless,the impact of hypertension management on the outcomes subsequent...Background Hypertension is widely acknowledged as a significant contributory factor to the heightened risk of intracranial aneurysm rupture.Nevertheless,the impact of hypertension management on the outcomes subsequent to aneurysmal subarachnoid haemorrhage(aSAH),particularly concerning the severity of aSAH,remains an underexplored area.Methods We conducted a retrospective analysis using data from a prospectively multicentre cohort of 4545 patients with aSAH in China.Premorbid hypertension status and the utilisation of antihypertensive medications prior to admission were set as key exposure factors.The primary outcomes encompassed unfavourable clinical grading scales observed on admission.Employing multivariable logistic regression,we explored the association between premorbid hypertension status,preadmission use of renin-angiotensin aldosterone system(RAAS)inhibitors and unfavourable clinical grading scales.Results In comparison to patients with normal blood pressure,only uncontrolled hypertension demonstrated a significant and independent association with an elevated risk of poor outcomes on the Hunt-Hess scale(OR=1.799,95%CI 1.413 to 2.291,p<0.001)and the World Federation of Neurological Surgeons(WFNS)scale(OR=1.721,95%CI 1.425 to 2.079,p<0.001).Furthermore,the antecedent use of RAAS inhibitors before admission was markedly and independently linked to a diminished risk of adverse outcomes on the Hunt-Hess scale(OR=0.653,95%CI 0.430 to 0.992,p=0.046)and the WFNS scale(OR=0.656,95%CI 0.469 to 0.918,p=0.014).Conclusions Uncontrolled hypertension markedly elevates the risk of adverse clinical outcomes following an aSAH.Conversely,the preadmission utilisation of RAAS inhibitors demonstrates a noteworthy association with a favourable clinical outcome after aSAH.展开更多
文摘This study aims to explore the correlation between plasma homocysteine (Hcy) levels and the clinical grading of varicocele (VC) when analyzing the potential pathogenesis of endothelial cells injury by Hcy. A total of 184 VC patients, aged 18–46 years, were included in this study. These patients visited The Second Hospital of Dalian Medical University (Dalian, China), between January 2022 and September 2024. Patients were divided into three groups based on clinical grading: Group A (59 cases, Grade I), Group B (28 cases, Grade II), and Group C (97 cases, Grade III). Additionally, 120 individuals with normal fertility test results during the same period were selected as the control group. Routine blood and biochemical indices were collected from the patients. Differences in clinical indices between groups were compared, and univariate and multivariate linear regression analyses were performed to identify factors associated with clinical grading. The results showed that the median Hcy levels in the control group and in patients with Grade I, II, and III VC were 9.56 (interquartile range [IQR]: 8.66, 14.02) µmol l−1, 11.28 (IQR: 9.71, 14.55) µmol l−1, 11.84 (IQR: 10.14, 15.60) µmol l−1, and 12.27 (IQR: 9.52, 15.40) µmol l−1, respectively. The differences between the four groups were statistically significant (χ2 = 12.41, P = 0.006). Multivariate regression analysis indicated that Hcy is a factor associated with the clinical grading of VC (t = 2.53, P = 0.013). Hcy is associated with the clinical grading and may have clinical value in assessing severity of VC.
文摘BACKGROUND The optimal approach for managing hepatic hemangioma is controversial.AIM To evaluate a clinical grading system for management of hepatic hemangioma based on our 17-year of single institution experience.METHODS A clinical grading system was retrospectively applied to 1171 patients with hepatic hemangioma from January 2002 to December 2018.Patients were classified into four groups based on the clinical grading system and treatment:(1)Observation group with score<4(Obs score<4);(2)Surgical group with score<4(Sur score<4);(3)Observation group with score≥4(Obs score≥4);and(4)Surgical group with score≥4(Sur score≥4).The clinico-pathological index and outcomes were evaluated.RESULTS There were significantly fewer symptomatic patients in surgical groups(Sur score≥4 vs Obs score≥4,P<0.001;Sur score<4 vs Obs score<4,χ^(2)=8.60,P=0.004;Sur score≥4 vs Obs score<4,P<0.001).The patients in Sur score≥4 had a lower rate of in need for intervention and total patients with adverse event than in Obs score≥4(P<0.001;P<0.001).Nevertheless,there was no significant difference in need for intervention and total patients with adverse event between the Sur score<4 and Obs score<4(P>0.05;χ^(2)=1.68,P>0.05).CONCLUSION This clinical grading system appeared as a practical tool for hepatic hemangioma.Surgery can be suggested for patients with a score≥4.For those with<4,follow-up should be proposed.
基金funded by the National Research and Development Project of Key Chronic Diseases(Grant No.2016YFC1300703)the Fujian Provincial Natural Science Foundation of China(Grant No.2021J011367 and No.2021J011353)+3 种基金the Medical Project of Xiamen Municipal Bureau of Science and Technology(Grant No.3502Z20214ZD1013)Xiamen Municipal Health Commission,Xiamen Municipal Bureau of Science and Technology(Grant No.3502Z20209005)Fujian Provincial Clinical Research Center for Brain Diseases(Grant No.2021FJSLCYX01)Xiamen Clinical Research Center for Neurological Diseases(Grant No.2021XMSLCYX01).
文摘Background Hypertension is widely acknowledged as a significant contributory factor to the heightened risk of intracranial aneurysm rupture.Nevertheless,the impact of hypertension management on the outcomes subsequent to aneurysmal subarachnoid haemorrhage(aSAH),particularly concerning the severity of aSAH,remains an underexplored area.Methods We conducted a retrospective analysis using data from a prospectively multicentre cohort of 4545 patients with aSAH in China.Premorbid hypertension status and the utilisation of antihypertensive medications prior to admission were set as key exposure factors.The primary outcomes encompassed unfavourable clinical grading scales observed on admission.Employing multivariable logistic regression,we explored the association between premorbid hypertension status,preadmission use of renin-angiotensin aldosterone system(RAAS)inhibitors and unfavourable clinical grading scales.Results In comparison to patients with normal blood pressure,only uncontrolled hypertension demonstrated a significant and independent association with an elevated risk of poor outcomes on the Hunt-Hess scale(OR=1.799,95%CI 1.413 to 2.291,p<0.001)and the World Federation of Neurological Surgeons(WFNS)scale(OR=1.721,95%CI 1.425 to 2.079,p<0.001).Furthermore,the antecedent use of RAAS inhibitors before admission was markedly and independently linked to a diminished risk of adverse outcomes on the Hunt-Hess scale(OR=0.653,95%CI 0.430 to 0.992,p=0.046)and the WFNS scale(OR=0.656,95%CI 0.469 to 0.918,p=0.014).Conclusions Uncontrolled hypertension markedly elevates the risk of adverse clinical outcomes following an aSAH.Conversely,the preadmission utilisation of RAAS inhibitors demonstrates a noteworthy association with a favourable clinical outcome after aSAH.
