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Objective: To explore early diagnostic and resent prognostic assessment value of serum levels of ischemia-modified albumin (IMA) and cardiac troponin I (cTnI) for acute coronary syndrome (ACS).Methods: A total of 175 ACS patients were selected, including 73 cases with unstable angina pectoris (UAP), 61 cases with non-ST elevation myocardial infarction (NSTEMI) and 41 cases with ST elevation myocardial infarction (STEMI).According to chest pain-to-visit time, ACS patients were divided into <3h group (n=112) and 3~6h group (n=63);another 40 healthy subjects were selected simultaneously as healthy control group.Serum IMA and cTnI levels were compared among above groups and between patients suffering from major adverse cardiovascular events (MACE) within 30d or not in <3h group.Risk factors for MACE in <3h patients within 30d were screened.Results: Compared with healthy control group and UAP group, there were significant rise in serum levels of IMA[(16.78±4.25) μg/L, (35.16±8.32) μg/L vs.(49.76±9.29) μg/L, (52.07±11.34) μg/L], cTnI[(0.17±0.06) ng/ml, (0.15±0.06) ng/ml vs.(7.65±1.29) ng/ml, (8.83±1.40) ng/ml]in NSTEMI group and STEMI group, and IMA level in STEMI group was significantly higher than that of NSTEMI group, that of UAP group was significantly higher than that of healthy control group (P<0.05 or <0.01);serum IMA level of <3h group was significantly higher than those of 3~6h group and healthy control group, and cTnI level of <3h group was significantly lower than that of 3~6h group (P<0.01 all);serum levels of cTnI and IMA in patients suffering from MACE in <3h group were significantly higher than those of patients without MACE (P<0.01 both);multi-factor Logistic regression analysis indicated that elevated serum IMA level was an independent risk factor for MACE within 30d in ACS patients[OR=2.757,95%CI(2.084~4.705), P=0.001].Conclusion: The levels of cTnI and IMA significantly rise in ACS patients.IMA level possesses early diagnosis and recent prognosis evaluation value.
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Objective To explore the application value of D-dimmer(DD),hs-CRP and homocysteine(Hcy) in postoperative condition monitoring in the patients with femoral neck fracture.Methods Forty cases of femoral neck fracture treated in our hospital were selected as the observation group and 40 patients with other fractures were selected as the control group.The observation group were given the surgical treatment,while the control group adopted the corresponding measures for conducting intervention according to the fracture situation.The DD,hs-CRP and Hcy levels were detected in the two groups.Then the detection results were compared between the two groups.Results The various indexes before treatment in the observation group were slightly higher than those in the control group without statistical difference(P>0.05).The levels of various indicators at postoperative 24,48 h in the observation group were significantly elevated,moreover the increase range at postoperative 24 h in the observation group was maximal,which was significantly higher than that in the control group(P<0.05).The positive rates of hs CRP,Hcy and DD in the observation group were 75.00%,77.50% and 60.00% respectively,while which in the control group were 0.00%,2.50% and 0.00%,the observation group was significantly higher than the control group (P<0.05).Conclusion Hs CRP,Hcy and DD can be used as the important indicators of condition monitoring for femoral neck fracture.
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Objective To evaluate the clinical significance of radiofrequency ablation (RFA) with clustered electrodes in the treatment of unresectable large primary liver cancer. Methods Under the guidance of ultrasonography, Percutaneous and intraoperative RFA was performed in 38 patients and 5 patients,respectively. Additional ablation could be conducted if residual tumor or recurrence was found after the primary treatment. Results A total of 62 times of RFA, with a mean of 6 foci every treatment, were completed in the 43 patients, in whom the mean diameter of tumor was 7 3 cm. AFP levels had decreased to normal in 18/32 patients (56 3%) whose preoperative AFP levels were above 400 ?g/L. Postoperative CT examinations indicated that the tumor was completely ablated in 33/43 patients (76 7%). Frequent complications included fever, local pain, and liver impairment. No severe complications or treatment-related deaths were seen. The 1-year survival rate was 79 3% (23/29). Conclusions RFA with clustered electrodes in the treatment of unresectable large liver cancer can produce extensive coagulation necrosis of tumor, being a safe and effective therapeutic method. It is breaking fresh ground in the management of unresectable large
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To study the value of the treatment of hepatocellular carcinoma with B ultrasonographic located radiofrequency ablation(RFA).Methods: The radiofrequency multielectrodes were inserted into the hepatic carcinoma with B ultrasonographic locating.RFA was applied with the power from 50W up to 90W. RFA scope was 1cm out of the margin of the tumor mass in three dimension. After RFA treatment, the AFP level changes and the B ultrasonography, computed tomography (CT), biopsy of the liver and hepato arterioangiography were observed.Results: One month after RFA treatment ,in those with abnormal AFP level AFP falled to normal in 18/20 patients, the volume of the tumor mass were enlarged in 9 patients, not changed in 8 patients and decreased in the others at CT and/or ultrasonography. The alive cancer cells in the margin of the tumor mass were found in 1/6 patients at biopsy. The scattering bloodstream in the carcinoma was showed in 1/8 patients on hepato arteriography. After three months, the volume of the tumor was remarkably decreased in 25 patients.Conclusion: The results suggests that RFA appears to ablate hepatic carcinoma effectively as suitable method mastered.
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Objective The reseach of hepatic vein (HV) and inferior vein cavity(IVC) obstruction recanalized with catheter needle were evaluated. Methods 16 cases of BCS diagnosed with angiography in recent 5 years were all undergone interventional treatment. Five with HV web occlusion principally and 9 with IVC complete occlusion were treated with introducing a catheter needle to penetrate the block through jugular vein or femoral vein. Stenosis or needle track was dilated with balloon. Stent was planted to IVC in 10 cases. Results All cases were successful in technic including a segmental obstrution of IVC and with a lower IVC atresia. Venography demonstrated the patency of blood flow. HV pressure of 5 cases was reduced 1.85kPa, and IVC pressure of 11 cases was reduced 1.21kPa on an average.Conclusions The use of catheter needle technique increases the successful rate in BCS treatment.