BACKGROUND Systemic amyloidosis in which multiple systems can be involved has become a common clinical disease.When the liver is affected,symptoms such as abdominal distension,fatigue,edema,liver,and jaundice could ap...BACKGROUND Systemic amyloidosis in which multiple systems can be involved has become a common clinical disease.When the liver is affected,symptoms such as abdominal distension,fatigue,edema,liver,and jaundice could appear.To date,hepatic amyloidosis combined with hepatic venular occlusive disease and Budd-Chiari syndrome has not been reported.CASE SUMMARY A 54-year-old female patient was admitted to the Beijing Shijitan Hospital with hepatic amyloidosis leading to hepatic venular occlusion and Budd-Chiari syndrome in 2018.The patient underwent surgery 1 mo previously for liver rupture and hemorrhage after Budd-Chiari syndrome was diagnosed.She was diagnosed with hepatic venular occlusion,liver amyloidosis,and Budd-Chiari syndrome(i.e.extensive hepatic vein occlusion).Transjugular intrahepatic portosystem shunt was performed.After the treatment,the clinical symptoms improved markedly with increase in urine volume.CONCLUSION Hepatic amyloidosis with hepatic venous occlusion and Budd-Chiari syndrome is relatively rare clinically,and transjugular intrahepatic portosystem shunt is an effective treatment for this disease.展开更多
Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,t...Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.展开更多
目的探讨糖尿病视网膜病变(DR)患者餐后2 h血糖(2 h PG)升高对眼底图像中动静脉宽度比(AVR)的影响。方法选取DR患者316例,均行标准75 g口服葡萄糖耐量试验(OGTT)检测空腹血糖(FPG)和餐后2 h PG,根据餐后血糖变化幅度(2 h PG-FPG)将所有...目的探讨糖尿病视网膜病变(DR)患者餐后2 h血糖(2 h PG)升高对眼底图像中动静脉宽度比(AVR)的影响。方法选取DR患者316例,均行标准75 g口服葡萄糖耐量试验(OGTT)检测空腹血糖(FPG)和餐后2 h PG,根据餐后血糖变化幅度(2 h PG-FPG)将所有研究对象按三分位分为3组,低分位组(G1)104例、中分位组(G2)108例及高分位组(G3)104例。测量各组眼底图像中AVR水平,采用Pearson相关性分析和多元线性回归分析DR患者AVR的影响因素。结果 (1)G3组和G2组餐后2 h PG、空腹胰岛素(FIns)、糖化血红蛋白(Hb A1c)及稳态模型评估-胰岛素抵抗指数(HOMA-IR)均高于G1组,且G3组餐后2 h PG和Hb A1c高于G2组;G3组和G2组2 h AVR较G1组降低,G3组较G2组降低(P<0.05),而各组间空腹AVR比较,差异无统计学意义(P>0.05);(2)Pearson相关分析显示,AVR与FPG、餐后2 h PG、Hb A1c、收缩压(SBP)及舒张压(DBP)均呈负相关(P<0.05);(3)多元线性回归分析显示,餐后2 h PG为DR患者AVR的影响因素(P<0.05)。结论餐后2 h PG升高可能会导致AVR降低,对DR患者应动态观察AVR的变化,对判断DR的严重程度具有意义。展开更多
目的在疑似高血压并至高血压门诊就诊的未接受降压治疗者中,研究血浆晚期糖基化终末产物(AGEs)浓度与眼底视网膜中央小血管直径的关系。方法选择2011-2012年至瑞金医院高血压门诊就诊且未接受降压治疗者,作为研究对象。采用免散瞳法进...目的在疑似高血压并至高血压门诊就诊的未接受降压治疗者中,研究血浆晚期糖基化终末产物(AGEs)浓度与眼底视网膜中央小血管直径的关系。方法选择2011-2012年至瑞金医院高血压门诊就诊且未接受降压治疗者,作为研究对象。采用免散瞳法进行眼底视网膜照相(德国蔡司VISUCAM PRO NM),并使用相机自带眼底血管分析软件进行眼底图像分析,测算视网膜中央小动脉直径等效值(CRAE)、视网膜中央小静脉直径等效值(CRVE)和动静脉直径比值(AVR)。使用酶联免疫吸附法,检测血浆AGEs浓度。采用逐步回归分析血浆AGEs浓度的影响因素。结果共纳入398例患者,平均年龄为50.3岁,其中女性占47.2%,糖尿病患者占7.5%,糖尿病前期者占6.1%,高血压患者占29.9%。随着血浆AGEs浓度增加,体质量指数(BMI,P<0.001)、空腹血糖(P=0.001)、血清三酰甘油(P<0.001)、血清总胆固醇与高密度脂蛋白胆固醇(HDL-C)的比值(总胆固醇/HDL-C,P<0.001)及CRVE(P=0.012)增加。相关分析显示,血浆AGEs浓度与CRVE呈正相关(r=0.14,P=0.006)。调整混杂因素后,多元线性回归分析结果显示,血浆AGEs浓度每增加1个单位,CRVE增加5.49μm(P=0.041),而CRAE(P=0.110)及AVR(P=0.690)的变化则无统计学意义。分层分析结果显示,血浆AGEs浓度与CRVE的关系仅见于糖尿病及糖尿病前期者(血浆AGEs浓度每增加1个单位,CRVE增加23.30μm,P=0.038),而非正常血糖者(P=0.130)。结论血浆AGEs浓度与CRVE呈正相关,尤其糖尿病及糖尿病前期患者。展开更多
文摘BACKGROUND Systemic amyloidosis in which multiple systems can be involved has become a common clinical disease.When the liver is affected,symptoms such as abdominal distension,fatigue,edema,liver,and jaundice could appear.To date,hepatic amyloidosis combined with hepatic venular occlusive disease and Budd-Chiari syndrome has not been reported.CASE SUMMARY A 54-year-old female patient was admitted to the Beijing Shijitan Hospital with hepatic amyloidosis leading to hepatic venular occlusion and Budd-Chiari syndrome in 2018.The patient underwent surgery 1 mo previously for liver rupture and hemorrhage after Budd-Chiari syndrome was diagnosed.She was diagnosed with hepatic venular occlusion,liver amyloidosis,and Budd-Chiari syndrome(i.e.extensive hepatic vein occlusion).Transjugular intrahepatic portosystem shunt was performed.After the treatment,the clinical symptoms improved markedly with increase in urine volume.CONCLUSION Hepatic amyloidosis with hepatic venous occlusion and Budd-Chiari syndrome is relatively rare clinically,and transjugular intrahepatic portosystem shunt is an effective treatment for this disease.
基金supported by the Youth Fund of Fundamental Research Fund for the Central Universities of Jinan University,No.11622303(to YZ).
文摘Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.
文摘目的探讨糖尿病视网膜病变(DR)患者餐后2 h血糖(2 h PG)升高对眼底图像中动静脉宽度比(AVR)的影响。方法选取DR患者316例,均行标准75 g口服葡萄糖耐量试验(OGTT)检测空腹血糖(FPG)和餐后2 h PG,根据餐后血糖变化幅度(2 h PG-FPG)将所有研究对象按三分位分为3组,低分位组(G1)104例、中分位组(G2)108例及高分位组(G3)104例。测量各组眼底图像中AVR水平,采用Pearson相关性分析和多元线性回归分析DR患者AVR的影响因素。结果 (1)G3组和G2组餐后2 h PG、空腹胰岛素(FIns)、糖化血红蛋白(Hb A1c)及稳态模型评估-胰岛素抵抗指数(HOMA-IR)均高于G1组,且G3组餐后2 h PG和Hb A1c高于G2组;G3组和G2组2 h AVR较G1组降低,G3组较G2组降低(P<0.05),而各组间空腹AVR比较,差异无统计学意义(P>0.05);(2)Pearson相关分析显示,AVR与FPG、餐后2 h PG、Hb A1c、收缩压(SBP)及舒张压(DBP)均呈负相关(P<0.05);(3)多元线性回归分析显示,餐后2 h PG为DR患者AVR的影响因素(P<0.05)。结论餐后2 h PG升高可能会导致AVR降低,对DR患者应动态观察AVR的变化,对判断DR的严重程度具有意义。
文摘目的在疑似高血压并至高血压门诊就诊的未接受降压治疗者中,研究血浆晚期糖基化终末产物(AGEs)浓度与眼底视网膜中央小血管直径的关系。方法选择2011-2012年至瑞金医院高血压门诊就诊且未接受降压治疗者,作为研究对象。采用免散瞳法进行眼底视网膜照相(德国蔡司VISUCAM PRO NM),并使用相机自带眼底血管分析软件进行眼底图像分析,测算视网膜中央小动脉直径等效值(CRAE)、视网膜中央小静脉直径等效值(CRVE)和动静脉直径比值(AVR)。使用酶联免疫吸附法,检测血浆AGEs浓度。采用逐步回归分析血浆AGEs浓度的影响因素。结果共纳入398例患者,平均年龄为50.3岁,其中女性占47.2%,糖尿病患者占7.5%,糖尿病前期者占6.1%,高血压患者占29.9%。随着血浆AGEs浓度增加,体质量指数(BMI,P<0.001)、空腹血糖(P=0.001)、血清三酰甘油(P<0.001)、血清总胆固醇与高密度脂蛋白胆固醇(HDL-C)的比值(总胆固醇/HDL-C,P<0.001)及CRVE(P=0.012)增加。相关分析显示,血浆AGEs浓度与CRVE呈正相关(r=0.14,P=0.006)。调整混杂因素后,多元线性回归分析结果显示,血浆AGEs浓度每增加1个单位,CRVE增加5.49μm(P=0.041),而CRAE(P=0.110)及AVR(P=0.690)的变化则无统计学意义。分层分析结果显示,血浆AGEs浓度与CRVE的关系仅见于糖尿病及糖尿病前期者(血浆AGEs浓度每增加1个单位,CRVE增加23.30μm,P=0.038),而非正常血糖者(P=0.130)。结论血浆AGEs浓度与CRVE呈正相关,尤其糖尿病及糖尿病前期患者。
