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Objective@#To investigate the correlation between low serum albumin level and major adverse cardiovascular events in patients with stable coronary heart disease.@*Methods@#A total of 367 consecutive patients with stable coronary heart disease from April 2013 to April 2015 in the Central Hospital of Nanchong City Sichuan Province were selected, and 328 cases completed follow-up. The follow-up time was (15.3 ± 8.1) months. The patients were divided into normal albumin group (serum albumin ≥ 35 g/L, 244 cases) and low serum albumin group (serum albumin < 35 g/L, 84 cases); then according to the happening of the major adverse cardiovascular events (MACE), the patients were divided into MACE group (53 cases) and non-MACE group (275 cases). The general clinical data were collected, including the gender, age, basic diseases (diabetes, hypertension), smoking history, body mass index (BMI), number of blood vessel lesion, drug treatment history. The serum albumin, hemoglobin, creatine, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triacylglycerol (TG), high sensitivity C reactive protein (hs-CRP) were detected. The estimated glomerular filtration rate (eGFR) was calculated by modification of diet in renal disease (MDRD) formula; the left ventricular ejection fraction (LVEF) was detected by color Doppler echocardiography. The Kaplan-Meier curve and receiver operating characteristics (ROC) curve were analyzed respectively, and the prognosis was analyzed by Cox regression.@*Results@#The age, diabetes rate, TG and hs-CRP in low serum albumin group were significantly higher than those in normal albumin group: (66.99 ± 9.40) years vs. (61.65 ± 9.36) years, 46.43% (39/84) vs. 34.02% (83/244), (2.36 ± 0.10) mmol/L vs. (2.15 ± 0.05) mmol/L and (4.10 ± 0.35) g/L vs. (3.83 ± 0.39) g/L, the albumin, hemoglobin, LVEF and eGFR were significantly lower than those in normal albumin group: (30.36 ± 3.09) g/L vs. (42.95 ± 4.86) g/L, (126.42 ± 18.45) g/L vs. (142.35 ± 16.53) g/L, (50.71 ± 5.60)% vs. (56.66 ± 8.01)% and (68.25 ± 12.47) ml/(min·1.73 m2) vs. (84.42 ± 14.48) ml/(min·1.73 m2), and there were statistical differences (P < 0.01 or <0.05); there were no statistical differences in gender composition, hypertension rate, smoking history, drug treatment history, BMI, number of blood vessel lesion, creatine, TC, LDL-C and HDL-C between 2 groups (P>0.05). The albumin in MACE group was significantly lower than that in non-MACE group: (34.09 ± 6.87) g/L vs. (40.81 ± 6.90) g/L, the TG was significantly higher than that in non-MACE group: (2.24 ± 0.11) mmol/L vs. (2.20 ± 0.11) mmol/L, and there were statistical differences (P<0.01); there were no statistical difference in gender composition, age, basic diseases, smoking history, drug treatment history, BMI, number of blood vessel lesion, hemoglobin, LVEF, eGFR, creatine, TC, LDL-C, HDL-C and hs-CRP between 2 groups (P>0.05). Cox regression analysis result showed that the hemoglobin, eGFR and albumin were the independent risk factors of MACE in patients with stable coronary heart disease (RR = 1.020, 1.040 and 0.787; 95% CI 1.001 to 1.040, 1.016 to 1.064 and 0.733 to 0.846; P < 0.05 or <0.01). Kaplan-Meier curve result showed that the lower the level of serum albumin, the higher the incidence of MACE in patients with stable coronary heart disease (log-rank χ2 = 6.244, P = 0.012). ROC curve analysis result showed that the cut-off value of serum albumin was 39.8 g/L, the area under curve was 0.769 (95% CI 0.719 to 0.813), with a sensitivity of 90.6%, a specificity of 60.4%.@*Conclusions@#There is close correlation between low serum albumin and recent MACE in patients with stable coronary heart disease, and it can be used as a index for the poor prognosis of patients.
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Objective To explore the diagnostic value of 18F-FDG PET/CT in biliary obstruction.Methods Totally,28 biliary obstruction patients were divided into benign obstruction group (n =11) and malignant obstruction group (n =17)according to the cause of obstruction.Imaging characteristics of 18F-FDG PET/CT and maximal standard uptake value (SUVmax) were compared between the two groups.Efficacy of PET/CT and MRI in the diagnosis of obstructive jaundice were compared.Results In 28 cases,no or mild dilatation of biliary tract accounted for 53.57％ (15/28),moderate to severe dilatation of biliary tract accounted for 46.42％ (13/28).Among the malignant obstruction group,2 cases of hilar cholangiocarcinoma,5 cases of bile duct carcinoma,6 cases of carcinoma of the head of pancreas,and 4 cases of ampullary carcinoma were included,18F-FDG PET/CT showed proximal high metabolic nodules of the obstruction site in 14 cases.Among the benign obstruction group,7 cases were bile duct inflammatory stricture,of which 4 cases with bile duct stones.18F-FDG PET/CT showed a slight increase with patchy or nodular mild metabolism in 6 cases.There were 4 cases of autoimmune pancreatitis.The imaging 18 F-FDG PET/CT demonstrated multi-segmental or multiple nodular enlargement of the pancreas,with generally increased metabolism.SUVmax of malignant obstruction group (6.88± 2.81) was significantly higher than that of benign obstruction group (4.20± 1.70;t=3.143,P＜0.05).The sensitivity,specificity and accuracy of 18F-FDG PET/CT and MRI in the diagnosis of malignant obstructive jaundice were 94.12％ (16/17) and 58.82％ (10/17;x2=4.086 5,P=0.043),81.82％ (9/11) and 63.64％ (7/11;x2=0.229 2,P=0.632),89.29％ (25/28) and 60.71％ (17/28;x2 =4.666 7,P=0.031),respectively.Conclusion 18F-FDG PET / CT has a great value in the diagnosis of obstructive jaundice,which is of great significance for clinical decision-making.
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Objective To study the multi-slice spiral CT (MSCT) manifestations of septic pulmonary embolism(SPE) in order to get a better understanding of the disease,Methods The MSCT manifestations of 12 patients with septic pulmonary embolism were retrospectively analyzed and compared with chest radiograph.Results Of the 12 patients,Chest radiograph and CT scanning showed multiple peripheral pulmonary nodules in 8 and 12 cases,a feeding vessel sigu(0,9 cases),cavitations(6,10 cases) and wedge-shaped opacities(4,7 cases),focal infiltrates(2,4 cases),air cyst(2,5 cases),pleural lesions (3,6 cases),hilar or mediastinal lymphadenopathy(0,3 cases).Peripheral or subpleural zones were most commonly affected (8,12 cases).CT was more useful in revealing nodules and a feeding vessel sign.Multiplanar reconstructions (MPR),maximum intensity projection (MIP) showed that most of these vessels passed around nodules and wedge-shaped lesions.MPR showed regular nodular margin.Conclusion SPE presents with variable and often nonspecific clinical and radiographic features.MPR and MIP showed the features of nodules and feeding vessels better.The diagnosis is usually suggested by the presence of a predisposing factor,febrile illness,and CT findings of multiple,periphery pulmonary nodules,with orwithout cavitation and a feeding vessel sign.