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Pulmonary arterial hypertension(PAH)remains a severe clinical condition despite the increasing understanding of PAH, the publication of many randomized controlled studies, and the availability of multiple targeted drugs over the past 20 years. Risk stratification of PAH can predict prognosis and guide treatment. The new risk stratification criterion,which combines clinical, exercise, right ventricular function and hemodynamic parameters, has good consistency with the original criteria,and its clinical practicability has increased significantly. Appropriate initial treatment strategies are established based on the risk stratification of newly diagnosed PAH patients. The risk stratification of patients is continuously evaluated during follow-up, and possible deterioration is detected in time. Then the treatment plan can be adjusted to improve the prognosis of patients.
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OBJECTIVE: To analyze the clinical feature and prognosis during hospitalization of pulmonary thromboembolism(PTE) patients with hemoptysis. METHODS: Between January 2010 and January 2015, a total of 220 patients diagnosed with acute PTE were recruited in our study in Beijing Hospital. Baseline characteristics, clinical signs and symptoms, laboratory tests, imaging findings, therapy and hospitalization outcomes(including mortality, and incidences of bleeding events) were collected. All the patients were divided into two groups according to whether hemoptysis occurred. A variety of clinical parameters in clinical features and prognosis were compared between the two groups.RESULTS: Among 220 patients, 16(7.3%) had hemoptysis and 204(92.7%) did not. Hemoptysis group were significantly younger [(59.7±16.6)vs.(67.2±13.6) years, P=0.037] and there were more males(75.0% vs. 44.6%, P=0.034). Compared to patients without hemoptysis, those with hemoptysis had a higher incidence of fever(31.3% vs. 11.3%, P=0.037) and chest pain(50.0% vs. 26.0%; P=0.039). The average diagnosis time of hemoptysis group was(8.91 ± 6.09) days. Patients in the hemoptysis group had a higher proportion of inferior vena cava filter(IVCF)(18.8%vs. 3.4%, P=0.028). There was no significant difference in severity and in-hospital mortality between the two groups. CONCLUSION: The lack of specificity of hemoptysis caused by PTE often leads to misdiagnosis or delayed diagnosis. Early diagnosis is helpful to correct treatment and reduce the adverse consequences of improper measures.
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<p><b>OBJECTIVE</b>To investigate the potential correlation between the single nucleotide polymorphisms (SNPs) in the KLKB1 region and pulmonary thromboembolism(PTE) in a Chinese Han population.</p><p><b>METHODS</b>In this case-control study, 95 patients with confirmed PTE were enrolled as the PTE group and 90 healthy subjects as the control group. The genotypes, alleles, and haplotypes of the SNPs were analyzed with PLINK 1.07 and Haploview 4.2 software using chi-square test and Logistic regression analysis. SNPs were further analyzed under three genetic models (additive, dominant, and recessive).</p><p><b>RESULTS</b>The distribution of rs3733402 in KLKB1 gene showed significant difference between PTE group and control group (P=0.041). The distributions of GTG haplotypes consisted of rs2292423, rs4253325,and rs3733402 in KLKB1 gene were also significantly different between PTE group and control group(P=0.040).</p><p><b>CONCLUSION</b>The rs3733402 locus variation in KLKB1 gene is associated with PTE in Chinese Han people.</p>
Subject(s)
Humans , Alleles , Case-Control Studies , Chi-Square Distribution , Genotype , Haplotypes , Kallikreins , Polymorphism, Single Nucleotide , Pulmonary EmbolismABSTRACT
<p><b>OBJECTIVE</b>To analyze characteristic CT enhancement patterns of noncalcified pulmonary tuberculomas and their pathological basis.</p><p><b>METHOD</b>Fifty-six patients with noncalcified pulmonary tuberculomas underwent surgical resection of the tuberculomas. Enhanced CT images of these tuberculomas were reviewed and analyzed in relation to the histological findings.</p><p><b>RESULTS</b>Of the 56 patients, 45 showed no enhancement in the tuberculomas, which were histologically characterized by central caseous necrosis and a poorly vascularized peripheral fibrotic zone. Eleven patients showed ring-like or eggshell enhancement, and the central low density region was histologically confirmed to be caused by caseous or liquefied necrosis, while the ring enhancement resulted pathologically from moderately or well vascularized peripheral fibrotic or granulomatous tissues.</p><p><b>CONCLUSIONS</b>Pulmonary tuberculomas consists mainly of caseous necrotic tissues characterized by no enhancement and ring or eggshell enhancement on dynamic contrast-enhanced CT.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Calcinosis , Contrast Media , Tomography, X-Ray Computed , Tuberculoma , Diagnostic Imaging , Metabolism , Tuberculosis, Pulmonary , Diagnostic Imaging , MetabolismABSTRACT
Objective To investigate the morphological features of normal lumbar dorsal root ganglia using a three-dimensional(3D)coronal MR imaging.Methods One hundred and fifteen volunteers were included.Ages ranged from 15 to 75 years,with a mean of 40 years.Coronal 3D fast field echo(FFE) with water selective excitation(Proset)MR examination of 1150 dorsal root gangha were underwent at nerve root levels from L1 to L5.The source coronal images were further reconstructed into a series of rotational alignment coronal images with an interval angel of 12 degree using maximum intensity projection(MIP) technique.All DRGs of bilateral spinal nerve from L1 to L5 were morphologically analyzed on the original and MIP images including qualitative evaluation of the location,signal intensity,architecture and quantitative dimensional measurement.Results There were 225,225,219,210 and 160 foraminal ganglia from L1 to L5 level,respectively.The incidence of intraspinal ganglia from L3 to L5 gradually increased with a maximum at L5 level of 29.1%(X~2=188.371,P