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Objective:To investigate the clinical characteristics as well as short-term and long-term prognostic factors of patients with Stanford type B aortic dissection (TBAD) with hypertension.Methods:Patients with TBAD who received thoracic endovascular aortic repair (TEVAR) admitted to Xiangyang Central Hospital from January 2014 to December 2018 were enrolled. The baseline data of patients admitted to the hospital were collected through the case management system, including gender, age, underlying diseases (hypertension, diabetes, coronary heart disease), smoking history, drinking history, duration of pain, vital signs at admission [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP)], laboratory results [white blood cell count (WBC), platelet count (PLT), neutrophil/lymphocyte ratio (NLR), serum creatinine (SCr), C-reactive protein (CRP), D-dimer, ascending aorta diameter], etc. The clinical characteristics of TBAD patients with hypertension were analyzed. Logistic regression model and Cox proportional risk model were used to analyze the impact of hypertension on the short-term and long-term all-cause deaths after TEVAR in TBAD patients.Results:Among 227 TBAD patients, 160 cases (70.5%) were complicated with hypertension, while 67 cases (29.5%) were not. The average age, the proportion of diabetes and coronary heart disease, and the level of SBP, DBP and SCr at admission of TBAD patients with hypertension were higher than those of TBAD without hypertension [age (years old): 53.1±11.9 vs. 42.8±14.1, combined with diabetes: 8.8% vs. 1.5%, combined with coronary heart disease: 6.3% vs. 0%, SBP (mmHg, 1 mmHg = 0.133 kPa): 147.9±18.1 vs. 136.9±15.2, DBP (mmHg): 93.9±11.9 vs. 89.1±13.8, SCr (μmol/L): 97.8±25.4 vs. 89.8±23.6, all P < 0.05]. The short-term mortality of TBAD with hypertension group was significantly higher than that of TBAD without hypertension group [6.3% (10/160) vs. 0% (0/67), χ2 = 4.386, P = 0.036]. 227 patients with TBAD were followed up for 3-66 months, with a median follow-up time of 25 months. There was no significant difference in long-term mortality between TBAD patients with and without hypertensive during discharge follow-up [13.1% (21/160) vs. 9.0% (6/67), χ2 = 0.784, P = 0.376]. Further multivariate Logistic regression analysis and Cox regression analysis did not indicate that hypertension was an independent risk factor for short-term and long-term death in TBAD patients [odds ratio ( OR) and 95% confidence interval (95% CI) were 13.477 (0.541-330.215), 1.012 (0.990-1.035), both P > 0.05]. Age and HR were independent risk factors for the short-term mortality of TBAD patients [ OR and 95% CI were 15.287 (1.051-226.415), 0.026 (0.002-0.840), both P < 0.05]. Age, PLT and D-dimer were independent risk factors for the long-term mortality of TBAD patients [ OR and 95% CI were 1.808 (1.205-2.711), 0.555 (0.333-0.924), 1.482 (1.035-2.122), respectively, all P < 0.05]. Conclusions:The TBAD patients with hypertension have older age, high rates of diabetes or coronary heart disease. However, hypertension is not an independent risk factor for short-term and long-term mortality in TBAD patients.
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Objective@#To investigate the clinical significance of antegrade lower limb venography in varicose veins of lower limbs.@*Methods@#The data of 230 cases of varicose veins of lower limb in Department of Vascular Surgery, Xiangyang Central Hospital from June 2018 to August 2019 were examined by antegrade lower limb venography. All patients were divided into simple varicose veins group (group A, 67 cases) and secondary varicose veins group (group B, 63 cases) according to the patency of deep veins. The data of sex, limb side, swelling and ulcer were analyzed respectively.@*Results@#There was no significant difference in the results of sex between the two groups (57.5% vs 63.5%, P>0.05). The incidence of left side in group A was lower than that in group B (59.3% vs 76.2%, P<0.05). And the incidence of swelling of lower extremities and ulcer in boot area in group A was lower than that in group B (31.1% vs 49.2%, P<0.05; 18.6% vs 31.7%, P<0.05 respectively).@*Conclusions@#Combined with swelling of lower extremities, ulcer in boot area or the varicose veins in left side had a higher incidence of secondary varicose veins. Anterograde venography of lower extremities can accurately distinguish the classification of varicose veins of lower extremities and improve the diagnostic coincidence rate, which has significant clinical significance.
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Objective To investigate the clinical significance of antegrade lower limb venography in varicose veins of lower limbs.Methods The data of 230 cases of varicose veins of lower limb in Department of Vascular Surgery,Xiangyang Central Hospital from June 2018 to August 2019 were examined by antegrade lower limb venography.All patients were divided into simple varicose veins group (group A,67 cases) and secondary varicose veins group (group B,63 cases) according to the patency of deep veins.The data of sex,limb side,swelling and ulcer were analyzed respectively.Results There was no significant difference in the results of sex between the two groups (57.5％ vs 63.5％,P ＞ 0.05).The incidence of left side in group A was lower than that in group B (59.3％ vs 76.2％,P ＜ 0.05).And the incidence of swelling of lower extremities and ulcer in boot area in group A was lower than that in group B (31.1％ vs 49.2％,P＜0.05;18.6％ vs31.7％,P＜0.05 respectively).Conclusions Combined with swelling of lower extremities,ulcer in boot area or the varicose veins in left side had a higher incidence of secondary varicose veins.Anterogrede venography of lower extremities can accurately distinguish the classification of varicose veins of lower extremities and improve the diagnostic coincidence rate,which has significant clinical significance.
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Objective To investigate the clinical efficacy and safety of total thyroidectomy combined with 131Ⅰradioiodine therapy for patients with hurthle cell thyroid cancer(HCT). Methods From January 2001 to January 2013,20 HCT patients in our hospital,who under-went total thyroidectomy combined with 131Ⅰradioiodine therapy. The complications, the thyroid dysfunction and tumor recurrence were ob-served. Results The total efficiency of patients received total thyroidectomy combined with 131Ⅰradioiodine therapy was 100%, with no hoarseness,infection and other complications. And there was no tumor recurrence or death during follow-up. Total thyroidectomy combined with central lymphadenectomy had increased the chance of injury of parathyroid. There was no significant differences of PTH levels between simple thyroidectomy and total thyroidectomy combined with central lymphadenectomy in patients with different stages of treatment in 131Ⅰtreatment (P>0. 05). Conclusion Simple thyroidectomy combined with 131Ⅰradioiodine therapy causes less chance of injury of parathy-roid that restored within a month, which is high safety.