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Objective:To study the clinical effect of different application times of antibiotics in patients with hypertriglyceridemic severe acute pancreatitis(HTG-SAP).Methods:The clinical data of 92 patients with HTG-SAP who were treated at the Department of Critical Care Medicine of the Second Affiliated Hospital of Anhui Medical University from January 2016 to February 2022 were analyzed retrospectively. There were 65 males and 27 females, aged (40.82±10.55) years old. These patients were divided into three groups based on the time of prophylactic use of antibiotics: the early prevention group (used within 72 h after admission, n=39), the delayed prevention group (used after 72 h after admission, n=30) and the nonprevention group ( n=23). The clinical data such as the general data, length of stay and all cause mortality rate of the three groups of patients were analyzed. Results:Compared with patients in the nonprevention group, the incidence rate of pancreatic/peripancreatic infection [10.0%(3/30) vs. 39.1%(9/23)] and the incidence rate of bloodstream infection [6.7%(2/30) vs. 34.8%(8/23)] in the delayed prevention group were significantly decreased (pancreas/peripancreatic infection: χ 2=6.31, P=0.012; bloodstream infection: χ 2=6.72, P=0.010). The infection rate of multiple/pan resistant bacteria in the early prevention group [23.1%(9/39)] was significantly higher than the nonprevention group [4.3%(1/23)] (χ 2=4.49, P=0.034). There were no significant differences in the all cause mortality rate, length of stay, duration of intensive care, hospitalization cost, incidence of intestinal fistula and retroperitoneal hemorrhage, and the proportion of patients requiring surgery among the 3 groups (all P>0.05). Conclusions:Pophylactic use of antibiotics within 72 h of hospital admission significantly reduced the incidence of pancreatic/peripancreatic infection and bloodstream infection in patients with HTG-SAP. There were no significant differences in the final prognosis among these patients with HTG-SAP treated with antibiotics at different times.
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ObjectiveTo investigate risk factors for colorectal adenoma.Methods1260 subjects who received health check-ups were included.A questionnaire on life style was answered and anthropometric measurements including height, weight, waist circumference and blood pressure were taken.Fasting venous blood was obtained and fasting plasma glucose, total cholesterol, triglycerides(TG), highdensity lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured.Fatty liver was diagnosed by ultrasonography. Colonoscopy was performed on each subject. Categorical data were compared using Pearson's chi-squared test, and multivariate logistic regression analysis was used to estimate the strength of association between the colorectal adenoma and various factors. ResultsThe frequency of colorectal adenoma was significantly higher among males, older patients( ≥55 years), current smokers and subjects with less physical activity, abdominal obesity, fasting hyperglycemia or fatty liver (x2 =4.355, 11.549, 4.440, 4.608, 6.211, 4.510, 4.156, P＜0. 05). Male sex (OR: 1.61,CI:1.13 -2. 57), old age (OR: 4.41,CI:3.32- 10.27)and abdominal obesity (OR: 1.75,CI:1.21 -2.86)were independent risk factors for colorectal adenoma. However, the frequency of colorectal adenoma was not different in subjects above 55 years old according to gender and abdominal obesity( x2 = 1. 139, 3. 413 ,P ＞0. 05 ). ConclusionsAbdominal obesity, old age and male sex were significantly associated with colorectal adenoma. However, the effect of abdominal obesity and male sex on the development of colorectal adenoma is less significant in subjects above 55 years of age. It is especially important for people under 55 years old to prevent colorectal adenoma by avoiding abdominal obesity.
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Objective To clarify the expression of Tbx3 gene in breast cancer tissues and its clinical significance, and the expression of Tbx3 gene in different clinical pathological characteristic breast cancer. Methods Expression of Tbx3 gene in 53 specimens of breast cancer and 28 specimens of normal breast tissues were investigated by immunohistochemistry, analysing the clinical significance. Meanwhile the correlation of expression of Tbx3 gene in breast cancer classified was investigated by estrogen receptor ( ER),lymph node metastasis, Her-2 status. Results Positive rate of Tbx3 gene in breast cancer tissues was significantly higher than that in normal breast tissues [73.58% (39/53) vs 14.29% (4/28)] (P ＜ 0.05).Positive rate of Tbx3 gene in ER positive breast cancer tissues was higher than that in ER negative breast cancer tissues [ 84.38% (27/32) vs 57.14% ( 12/21 ) ] (P ＜ 0.05 ). Positive rate of Tbx3 gene in breast cancer tissues with lymph node metastasis was higher than that in breast cancer tissues without lymph node metastasis [86.21%(25/29) vs 58.33% (14/24) ] (P ＜ 0.05). Positive rate of Tbx3 gene in Her-2 positive breast cancer tissues was higher than that in Her-2 negative breast cancer tissues[ 93.75%(15/16) vs 64.86% (24/37) ] (P ＜ 0.05). Conclusions Tbx3 gene is over expressed in breast cancer tissues. It is related to ER, lymph node metastasis, Her-2 status.
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Objective To explore surgical management of bilateral thyroid papillary carcinoma. Methods The clinical data of 55 patients with bilateral thyroid papillary carcinoma were analyzed retrospectively. Among the 55 patients, total thyroidectomy was performed in 52 cases, total affected lobectomy plus isthmus and opposite near total lobectomy thyroidectomy was performed in 3 cases. Results Among the cases of bilateral functional neck lymph node dissection ,5 cases were all of bilateral neck lymph node metastasis, the positive rate was 100.0%(5/5);, among the cases of unilateral functional neck lymph node dissection,9 cases were found neck lymph node metastasis,the positive rate was 81.8%(9/11); among the cases of bilateral central region lymph node dissection, 1 case was of central region lymph node metastasis, the positive rate was 25.0% (1/4); among the cases of unilateral central region lymph node dissection, 14 cases were of central region lymph node metastasis, the positive rate was 66.7%(14/21). Fifty-three cases were tumor free survival, 2 cases accompanied distant metastasis also gained good effect Conclusions Total thyroidectomy should be performed for bilateral thyroid papillary carcinoma because of its characteristics of multiple tumors. It is considered that whether the neck lymph node dissection should be done depends on the stage of the tumor.