Medicine
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Observational Study
Apelin: A novel prognostic predictor for atrial fibrillation recurrence after pulmonary vein isolation.
Apelin, the ligand for the APJ receptor, is involved in the pathogenesis of atrial fibrillation (AF). However, whether serum apelin can predict the recurrence of AF after pulmonary vein isolation (PVI) has not been determined. A prospective cohort study was performed in patients with AF (but without structural heart disease) who were undergoing first-time PVI. ⋯ Results of Cox stepwise multivariate analysis demonstrated that lower baseline apelin-12 (<2265 ng/L) was independently associated with increased AF recurrence within 6 months after PVI (P < .05). The specificity and positive predictive value of apelin-12 for AF recurrence were significantly higher than those of baseline N-terminal brain proBNP (60.4% vs 28.6%, P < .001; 58.8% vs 34.4%, P = .01), although the sensitivity and negative predictive value were similar. Reduced baseline serum apelin-12 may be an independent risk factor for the recurrence of AF after PVI in patients without structural heart disease.
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Severe cardiac dysfunction or severe pulmonary hypertension is a contraindication of liver transplantation (LT). Extracorporeal membrane oxygenation (ECMO) is an advanced therapy for severe lung and/or cardiocirculatory dysfunction or failure. The application of ECMO to patients during the LT perioperative period may help recipients with severe cardiac disease to maintain the heart function and alleviate the reperfusion syndrome. ⋯ It is feasible to utilize ECMO as a cardiocirculatory function support in the LT. ECMO does not increase the risk of hemorrhage. ECMO can play an important role in ensuring the security of the liver recipients in the surgery and in the postoperative period.
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Paragangliomas are neuro-endocrine tumors originating from the adrenal gland. They are usually benign and nonfunctioning, rarely seen in central nervous system. More than 90% of central nervous system paragangliomas are manifested as carotid and glomus jugulare tumors. ⋯ Recurrence was not observed in 7 patients, 1 patient is being followed up due to residual tumor. Treatment may be achieved through recognizing malignant transformation in patients who were not diagnosed histopathologically. We consider that quality of life of the patients may be improved through this way.
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Complete non-mosaic trisomy 22 is a fatal chromosomal disorder that only few fetuses can survive over 12 weeks as reported. Prenatal sonographic findings combined with postnatal or postmortem discoveries showed characteristic multi-systematic anomalies. ⋯ This was the first time a case of spinal cord defect was reported in trisomy 22 fetuses. More attention should be paid to the spinal cord during sonographic examinations in trisomy 22 fetuses.
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Case Reports
A rare case of deep cerebral venous thrombosis secondary to traumatic epidural hematoma: Case report.
Deep cerebral venous thrombosis (DCVT) is a rare disease, but always results in poor prognosis. ⋯ If the CT shows hypodense areas in bilateral thalami and basal ganglia, a diagnosis of DCVT should be suspected once the patients could not recover from the treatment of primary diseases.