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Objective To observe the change of results of lipoprotein-associated phospholipase A2 (Lp-PLA2) ,homocysteine (Hcy ) ,high-sensitivity C-reactive protein (hs-CRP ) ,lipids and other indicators in the patients with normal group ,primary hypertension group ,type H hypertension group and type H hypertension ischemic stroke group ,and search the relationship between LP-PLA2 and type H-hypertension ischemic stroke .Methods From January 2015 to June 2017 ,continuous selected 103 patients with type H hypertension ischemic stroke group ,124 patients with type H hypertension group ,80 patients with primary hypertension group and 50 patients with healthy controls as normal group .Analyzed level of Lp-PLA2 ,Hcy ,hs-CRP and lipids in serum ,compared the difference with each group .A binary Logistic regression analysis was used to an-alyze its correlation with ischemic stroke .Results The serum concentration of total cholesterol(TC) ,low-den-sity lipoproteincholesterol(LDL-C) ,LP-PLA2 in type H hypertension group and type H hypertension ischemic stroke group was higher than primary hypertension group and normal group ,the difference was statistically significant(P＜0 .05) .The serum concentration of triglyceride (TG) in type H hypertension ischemic stroke group was higher than primary hypertension group and normal group ,the difference was statistically signifi- cant(P＜0 .05) .The serum concentration of Hcy in primary hypertension group ,type H hypertension group and type H hypertension ischemic stroke group was higher than normal group ,the difference was statistically significant(P＜0 .05) ;The serum concentration of Hcy in type H hypertension group and type H hypertension ischemic stroke group was higher than primary hypertension group ,the difference was statistically significant (P＜ 0 .05) ;The serum concentration of Hcy ,LP-PLA2 in type H hypertension ischemic stroke group was higher than type H hypertension group ,the difference was statistically significant (P＜0 .05) .The serum con-centration of hs-CRP in type H hypertension group was higher than primary hypertension group and normal group ,the difference was statistically significant (P＜0 .05) ;The serum concentration of hs-CRP in type H hy-pertension ischemic stroke group was higher than type H hypertension group ,primary hypertension group and normal group ,the difference was statistically significant (P＜0 .05) .Two element Logistic regression analysis , Lp-PLA2 were significantly related to type H hypertension ischemic stroke ( SE ＝ 0 .013 ,P ＜ 0 .05 ) . Conclusion LP-PLA2 is an inflammatory biomarker and it is closely related to the occurrence and develop-ment of type H hypertension ischemic stroke .
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Objective To evaluate the effectiveness ,safety and prospect of ultrasound-guided radiofrequency ablation (RFA) in treatment of thyroid benign nodules .Methods We analyzed 153 patients with thyroid benign nodules from September 2015 to August 2016 treated by RFA at Department of Thyroid Surgery ,the First Affiliated Hospital of Zhengzhou University . One month later , we reviewed the thyroid functions after the operation , observed the changes of the nodules after 1 ,3 ,and 6 months ,calculated the volume reduction rate of the nodules , and analyzed the effectiveness of the treatment .Results After treatment ,the maximum diameter and volume of the nodules were significantly reduced in all the patients ( P<0 .05) .The patients' symptoms improved significantly without serious complications . Conclusion Ultrasound-guided RFA has obvious advantages such as fewer complications , less invasiveness , good safety , and definite effectiveness in treating thyroid benign nodules . Therefore ,it has promising prospects in clinical application .
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Objective To observe the curative effects of treatment with Octreotide for chylous leakage after neck dissection .Methods We enrolled 14 patients with intractable chylous fistula treated at the First Affiliated Hospital of Zhengzhou University for the study .The curative effects of Octreotide treatment were retrospectively reviewed .Results Out of 14 patients with intractable chylous fistula ,12 (12/14 ,86% ) were finally cured and had the drainage tube removed .The drainage volume of 7 patients (7/14 ,50% ) decreased significantly by over 50%the next day of Octreotide medication ,but decreased insignificantly in 4 patients (4/14 ,29% ) .Conclusion Octreotid is an alternative method in treatment for intactable chylous fistula because of a satisfactory curative effect in some of the patients .
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Objective To explore the characteristics and components of recurrent papillary thyroid cancer in patients with metabolic syndrome .Methods We retrospectively reviewed the information of the patients with recurrent papillary thyroid cancer after initial surgery during January 1st ,2010 and December 31st ,2015 in the First Affiliated Hospital of Zhengzhou University .We compared tumor size ,lymph node metastasis ,recurrence time and postoperative invasion rate in metabolic syndrome and non-metabolic syndrome groups . Results Totally 82 patients were included with 34 men and 48 women .There was no significant difference between patients with and those without metabolic syndrome grouped by the classic diagnosis approach .However ,the lymph node metastasis grade of recurrent papillary thyroid cancer patients who also suffered from at least two metabolic disorders ,was lower ,especially in women (P=0 .002) .Moreover ,patients with metabolic disorders had shorter recurrence time (Pdiabetes=0 .034 , Pdyslipidemia =0 .037 , PBMI =0 .004 , PMetS2 =0 .036) .Conclusion Papillary thyroid cancer patients with metabolic disorder ,especially with two or more components of metabolic syndrome and overweight and/or obesity ,may have an increasing risk of recurrence .
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Objective To evaluate the curative effects of endoscopic and open thyroidectomy for papillary thyroid microcarcinoma so as to explore the feasibility of endoscopic operation for papillary thyroid microcarcinoma . Methods We made a retrospective analysis of data of 98 cases of papillary thyroid microcarcinoma diagnosed pathologically between June 2016 and January 2017 in the First Affiliated Hospital of Zhengzhou University .All the patients were divided into two groups :52 in traditional operation group and 46 in endoscopic operation group . We analyzed the complications and the number of lymph nodes in the two groups . Results There was no significant difference in complications like voice hoarseness , hydroposia bucking and hypocalcemia between the two groups (P= 0 .6993 ,0 .9141 ,0 .5819 ,respectively) .Each patient had (5 .06 ± 3 .20) and (4 .80 ± 3 .19) lymph nodes in endoscopic operation group and traditional operation group ,respectively . No significant difference was found between the two groups (P=0 .6967) .Conclusion The traditional operation and endoscopic operation have similar curative effects for papillary thyroid microcarcinoma ,and the latter has better cosmetic effects .
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Objective To understand the drug resistance of Escherichiacoli in the bloodstream infections from community infec-tion and hospital infection,in order to provide the basis for clinical rational drug use.Methods According to the CLSI 2013 stran-dard,VITEK-2GN and AST-GN13 cards from France Bio-merieux company were used to identify the bacteria and analyze the drug susceptibility.The data was analyzed by SPSS 13.0.Results A total of 181 strains of Escherichiacoli were isolated from communi-ty-acquired and hospital-acquired bloodstream infections from January to December in 2014.There were 88 strains of community in-fection and 93 strains of hospital infection.The rates of ESBLs (+)strains isolated from community infection and hospital infection were 53.4% and 73.1% respectively.The ESBLs (+)rate of Escherichiacoli isolated from community infection was significantly lower than that from hospital infection (P =0.006).Antibiotics of resistance less than 10% in 181 strains of Escherichiacoli were Cefoperazone/Sulbactam,Piperacillin/Tazobactam,Ertapenem,Imipenem,Amikacin.The resistant rate of Hospital infection strains was generally higher than that of community infection strains.The ESBLs (+)rate of Escherichiacoli isolated from bloodstream in-fections of Urology Surgery wsa higher than that of other departments.Conclusion The drug resistance of Escherichiacoli in the bloodstream infections from hospital infection is higher than that from community infection.Using antibiotics rationally and strengthening the nosocomial infection surveillance of ICU and Surgery Ward are effective measures to control the bacterial drug re-sistance.
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Objective To investigate the distribution and drug resistance of clinical bacteria infection in the Second Affiliated Hospital of Kunming Medical University,so as to provide reference for the treatment of bacterial infections.Methods 4 802 strains of bacteria isolated from this hospital,from January 2013 to December 2013,were retrospectively analysed.The isolates were identi-fied by using VITEK-2 Compact bacterial identification system.Drug resistance was measured by using disc diffusion test,and its results were interpreted according to the breakpoints of Clinical and Laboratory Standards Institute(CLSI)2013.WHONET 5.6 was applied for analysis.Results These pathogens were mainly isolated from urine,sputum,blood,secretions and pus,accounted for 31.7%,21.4%,1 9.7%,1 1.7% and 7.0%,respectively.In the clinical isolates,gram negative bacilli accounted for 55.8%, which was mainly Escherichia coli(26.3%).Gram positive cocci accounted for 31.7%,,which was mainly coagulase negative staph-ylococcus(1 5.0%).Fungi accounted for 3.1%,which was mainly Candida albicans.Escherichia coli and Klebsiella pneumonia were most sensitive to carbapenem,resistance rate was less than 10.0%.The detection rates of Escherichia coli and Klebsiella pneumoni-ae producing extended-spectrumβ-lactamases(ESBLs)was 61.1% and 49.1%,respectively.Among non-fermentative gram nega-tive bacilli,excepting Pseudomonas aeruginosa had good sensitivity to Amikacin,Pseudomonas aeruginosa and Acinetobacter bau-mannii showed high resistance to most antibiotics(resistance rate was more than 50.0%).Among gram positive bacteria,the detec-tion rates of meticillin-resistant Staphylococcus aureus and methicillin-resistant coagulase negative Staphylococcus were 42.3% and 65.6%,respectively.The resistance rates of Enterococcus faecium to most of antibacterials were higher.Except for linezolid and teicoplanin,the resistances of Enterococcus faecium to other antibacterials were higher than those of Enterococcus faecalis.Only a strain of Enterococcus faecium resistant to vancomycin was isolated.Conclusion Resistance monitoring might have significance in guiding the clinical rational use of antimicrobial agents,and reducing the spread of antibiotic resistance in bacteria.