Objectives To investigate the prevalence and characteristics of pulmonary embolism （PE） at autopsy in a Chinese general hospital over a period of 10 years, and to evaluate the antemortem achievement of the prophylax...Objectives To investigate the prevalence and characteristics of pulmonary embolism （PE） at autopsy in a Chinese general hospital over a period of 10 years, and to evaluate the antemortem achievement of the prophylaxis, diagnosis, and treatment of PE. Methods All medical records of deaths from the West Branch of the Chinese People＇s Liberation Army （PLA） General Hospital were retrospectively re- viewed, for the period of January 1, 2006 to December 31, 2015. Cases in which autopsies had been performed were identified and further analyzed. The numbers and detailed characteristics of patients who had PEs were noted. Prophylactic measures, along with diagnosis and treatment of PE, were recorded, if performed. Results During the 10-year period, 1057 patients died in the study hospital and 278 necrop- sies were performed （autopsy rate： 26.3%）. Nine patients were found to have PE （3.2%）, and in seven of these patients （2.5%）, the PE was considered to be fatal. Embolisms were found in the trunk and bilateral main branches of the pulmonary artery tree in all seven of the fatal PE cases. Right intracardiac thrombosis was detected in five of the nine PE patients （55.6%）. All patients with PE had been hospitalized in medical departments, and only one had undergone surgery during hospitalization. Antemortem prophylaxis was performed in two of the nine PE cases （22.2%）. None of the 9 patients had received a clinical diagnosis of PE before death. Conclusions The incidence of and death rate associated with PE may vary among different races and regions. Continuous monitoring of PE by means of necropsy in certain representative medical institutions is necessary.展开更多
BACKGROUND Observational studies suggest inverse associations between serum vitamin levels and the risk of heart failure(HF). However, the causal effects of vitamins on HF have not been fully elucidated. Here, we cond...BACKGROUND Observational studies suggest inverse associations between serum vitamin levels and the risk of heart failure(HF). However, the causal effects of vitamins on HF have not been fully elucidated. Here, we conducted a Mendelian randomization(MR) study to investigate the causal associations between genetically determined vitamin levels and HF.METHODS Genetic instrumental variables for circulating vitamin levels, including vitamins A, B, C, D, and E, which were assessed as either absolute or metabolite levels were obtained from public genome-wide association studies. Summary statistics for single-nucleotide-polymorphisms and HF associations were retrieved from the HERMES Consortium(47,309 cases and 930,014controls) and FinnGen Study(30,098 cases and 229,612 controls). Two-sample MR analyses were implemented to assess the causality between vitamin levels and HF per outcome database, and the results were subsequently combined by meta-analysis.RESULTS Our MR study did not find significant associations between genetically determined circulating vitamin levels and HF risk. For absolute vitamin levels, the odds ratio for HF ranged from 0.97(95% confidence interval [CI]: 0.85–1.09, P = 0.41) for vitamin C to 1.05(95% CI: 0.61–1.82, P = 0.85) for vitamin A. For vitamin metabolites, the odds ratio ranged between 0.94(95% CI:0.75–1.19, P = 0.62) for α-tocopherol and 1.11(95% CI: 0.98–1.26, P = 0.09) for γ-tocopherol.CONCLUSION Evidence from our study does not support the causal effects of circulating vitamin levels on HF. Therefore,there may be no direct beneficial effects of vitamin intake on the prevention of primary HF.展开更多
Background:To date,there is still a lack of standardized management strategies for gastric low-grade dysplasia(LGD),which is a direct neoplastic precancerous lesion and requires specifically superficial destruction.Ra...Background:To date,there is still a lack of standardized management strategies for gastric low-grade dysplasia(LGD),which is a direct neoplastic precancerous lesion and requires specifically superficial destruction.Radiofrequency ablation(RFA)is expected to be an effective method for gastric LGD,but post-RFA pain may affect patients’satisfaction and compliance.The current study aimed to evaluate the value of a submucosal injection prior to RFA(SI-RFA)for postoperative pain and treatment outcomes.Methods:Between October 2014 and July 2021,gastric LGDs without risk factors(size>2 cm,unclear boundary,and abnormal microsurface and microvascularity)undergoing regular RFA and SI-RFA were retrospectively analyzed.Postoperative pain scores,wound healing,and clinical efficacy were compared.Propensity score matching,stratified analysis,and multivariable logistic regression were performed to control the confounding variables.Results:One hundred and ninety-seven gastric LGDs in 151 patients received regular RFA.Forty-nine gastric LGDs in 36 patients received SI-RFA.Thirty-six pairs of patients were selected for the assessment of postoperative pain by propensity score matching.Compared to regular RFA,SI-RFA significantly decreased the degree and duration of postoperative pain(OR,0.32;95%CI,0.13-0.84;P=0.020),improved wound healing rate(80.0%[36/45]vs.58.9%[89/151],P=0.012),increased the complete ablation rate(91.8%[45/49]vs.86.3%[170/197],χ^(2)=1.094,P=0.295),but correlated with higher rates of local recurrence and progression(25.6%[10/39]vs.13.2%[18/136],χ^(2)=3.471,P=0.062;8.3%[3/36]vs.0.9%[1/116],P=0.042).The multivariable logistic regression model confirmed that submucosal injection was associated with local recurrence(OR,2.93;95%CI,1.13-7.58;P=0.027).Conclusions:Submucosal injections prior to RFA may reduce postoperative pain and scar formation while ensuring complete ablation of gastric LGD.However,local recurrence and progression should be considered seriously.展开更多
Managing Editor:Peng Lyu Mantle cell lymphoma(MCL),a relatively uncommon subtype of non-Hodgkin's lymphoma(NHL),constitutes approximately 2%-10%of NHL cases.Characterized by its inertness,aggressiveness,and incura...Managing Editor:Peng Lyu Mantle cell lymphoma(MCL),a relatively uncommon subtype of non-Hodgkin's lymphoma(NHL),constitutes approximately 2%-10%of NHL cases.Characterized by its inertness,aggressiveness,and incurability,MCL has a median overall survival(OS)of approximately 3-5 years.展开更多
文摘Objectives To investigate the prevalence and characteristics of pulmonary embolism （PE） at autopsy in a Chinese general hospital over a period of 10 years, and to evaluate the antemortem achievement of the prophylaxis, diagnosis, and treatment of PE. Methods All medical records of deaths from the West Branch of the Chinese People＇s Liberation Army （PLA） General Hospital were retrospectively re- viewed, for the period of January 1, 2006 to December 31, 2015. Cases in which autopsies had been performed were identified and further analyzed. The numbers and detailed characteristics of patients who had PEs were noted. Prophylactic measures, along with diagnosis and treatment of PE, were recorded, if performed. Results During the 10-year period, 1057 patients died in the study hospital and 278 necrop- sies were performed （autopsy rate： 26.3%）. Nine patients were found to have PE （3.2%）, and in seven of these patients （2.5%）, the PE was considered to be fatal. Embolisms were found in the trunk and bilateral main branches of the pulmonary artery tree in all seven of the fatal PE cases. Right intracardiac thrombosis was detected in five of the nine PE patients （55.6%）. All patients with PE had been hospitalized in medical departments, and only one had undergone surgery during hospitalization. Antemortem prophylaxis was performed in two of the nine PE cases （22.2%）. None of the 9 patients had received a clinical diagnosis of PE before death. Conclusions The incidence of and death rate associated with PE may vary among different races and regions. Continuous monitoring of PE by means of necropsy in certain representative medical institutions is necessary.
基金supported by the National Natural Science Foundation of China(Grant No.81970341)Beijing Natural Science Foundation(Grant No.7232157).
文摘BACKGROUND Observational studies suggest inverse associations between serum vitamin levels and the risk of heart failure(HF). However, the causal effects of vitamins on HF have not been fully elucidated. Here, we conducted a Mendelian randomization(MR) study to investigate the causal associations between genetically determined vitamin levels and HF.METHODS Genetic instrumental variables for circulating vitamin levels, including vitamins A, B, C, D, and E, which were assessed as either absolute or metabolite levels were obtained from public genome-wide association studies. Summary statistics for single-nucleotide-polymorphisms and HF associations were retrieved from the HERMES Consortium(47,309 cases and 930,014controls) and FinnGen Study(30,098 cases and 229,612 controls). Two-sample MR analyses were implemented to assess the causality between vitamin levels and HF per outcome database, and the results were subsequently combined by meta-analysis.RESULTS Our MR study did not find significant associations between genetically determined circulating vitamin levels and HF risk. For absolute vitamin levels, the odds ratio for HF ranged from 0.97(95% confidence interval [CI]: 0.85–1.09, P = 0.41) for vitamin C to 1.05(95% CI: 0.61–1.82, P = 0.85) for vitamin A. For vitamin metabolites, the odds ratio ranged between 0.94(95% CI:0.75–1.19, P = 0.62) for α-tocopherol and 1.11(95% CI: 0.98–1.26, P = 0.09) for γ-tocopherol.CONCLUSION Evidence from our study does not support the causal effects of circulating vitamin levels on HF. Therefore,there may be no direct beneficial effects of vitamin intake on the prevention of primary HF.
基金supported by the National Natural Science Foundation of China(No.82070682)the Chinese PLA General Hospital Young Independent Innovation Science Fund(No.22QNFC028).
文摘Background:To date,there is still a lack of standardized management strategies for gastric low-grade dysplasia(LGD),which is a direct neoplastic precancerous lesion and requires specifically superficial destruction.Radiofrequency ablation(RFA)is expected to be an effective method for gastric LGD,but post-RFA pain may affect patients’satisfaction and compliance.The current study aimed to evaluate the value of a submucosal injection prior to RFA(SI-RFA)for postoperative pain and treatment outcomes.Methods:Between October 2014 and July 2021,gastric LGDs without risk factors(size>2 cm,unclear boundary,and abnormal microsurface and microvascularity)undergoing regular RFA and SI-RFA were retrospectively analyzed.Postoperative pain scores,wound healing,and clinical efficacy were compared.Propensity score matching,stratified analysis,and multivariable logistic regression were performed to control the confounding variables.Results:One hundred and ninety-seven gastric LGDs in 151 patients received regular RFA.Forty-nine gastric LGDs in 36 patients received SI-RFA.Thirty-six pairs of patients were selected for the assessment of postoperative pain by propensity score matching.Compared to regular RFA,SI-RFA significantly decreased the degree and duration of postoperative pain(OR,0.32;95%CI,0.13-0.84;P=0.020),improved wound healing rate(80.0%[36/45]vs.58.9%[89/151],P=0.012),increased the complete ablation rate(91.8%[45/49]vs.86.3%[170/197],χ^(2)=1.094,P=0.295),but correlated with higher rates of local recurrence and progression(25.6%[10/39]vs.13.2%[18/136],χ^(2)=3.471,P=0.062;8.3%[3/36]vs.0.9%[1/116],P=0.042).The multivariable logistic regression model confirmed that submucosal injection was associated with local recurrence(OR,2.93;95%CI,1.13-7.58;P=0.027).Conclusions:Submucosal injections prior to RFA may reduce postoperative pain and scar formation while ensuring complete ablation of gastric LGD.However,local recurrence and progression should be considered seriously.
基金This work was supported by the National Natural Science Foundation of China(No.82200169).
文摘Managing Editor:Peng Lyu Mantle cell lymphoma(MCL),a relatively uncommon subtype of non-Hodgkin's lymphoma(NHL),constitutes approximately 2%-10%of NHL cases.Characterized by its inertness,aggressiveness,and incurability,MCL has a median overall survival(OS)of approximately 3-5 years.
