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Chinese Medical Journal ; (24): 1720-1725, 2021.
Article in English | WPRIM | ID: wpr-887614


BACKGROUND@#Geriatric hip fracture patients receiving clopidogrel are a surgical challenge. In China, most of these patients undergo delayed surgical treatment after clopidogrel withdrawal for at least 5 to 7 days. However, delayed surgery is associated with increased complications and mortality in the older adults. This retrospective paralleled comparison study investigated the safety of early surgery for geriatric hip fracture patients within 5 days of clopidogrel withdrawal.@*METHODS@#Acute hip fracture patients (≥65 years) who were hospitalized in the orthogeriatric co-management ward of Beijing Jishuitan Hospital between November 2016 and April 2018 were retrospectively reviewed. Sixty patients taking clopidogrel before injury and discontinued  0.050). The percentages of patients with coronary heart disease (61.7% vs. 18.3%; P  0.050). There was no significant difference in perioperative complications, and 30-day and 1-year mortality rates between the groups.@*CONCLUSIONS@#Early hip fracture surgery is safe for elderly patients within 5 days of clopidogrel withdrawal, without increased perioperative blood loss, transfusion requirement, complications, and mortality compared with patients not taking antiplatelet drugs.

Aged , Case-Control Studies , Clopidogrel/therapeutic use , Hip Fractures/surgery , Humans , Platelet Aggregation Inhibitors/adverse effects , Retrospective Studies , Ticlopidine/adverse effects
Article in Chinese | WPRIM | ID: wpr-816456


OBJECTIVE: To evaluate tumor location as a factor predicting lateral lymph node metastasis(LLNM) and to assess the accuracy of ultrasonography(US) in the diagnosis of LLNM.METHODS: The clinicopathological data of 134 patients with thyroid microcarcinoma admitted between January 2014 and December 2015 in Tianjin Medical University Cancer Hospital were collected,and the relationship between the location of cancer foci and lateral cervical lymph node metastasis was analyzed according to the ultrasonic localization and grouping.RESULTS: The incidence rates of lymph node metastasis in levels Ⅱ,Ⅲ,Ⅳ,Ⅴ were 30.6, 50.7, 57.5 and 11.3%, respectively. Tumors located in the superior/middle were prone to metastasize to the lateral lymph nodes than those located in the inferior portion(89.7% vs. 75.7%,P=0.038). Cases with exterior locations were more likely to have lateral cervical lymph node metastasis compared with those cases with interior, respectively(93.7% vs.81.4%,P=0.049). The sensitivity values for US for the prediction of LLNM in levels Ⅱ,Ⅲ,Ⅳ,Ⅴ were 43.9%, 85.3%, 85.7% and 14.3%, and the corresponding specificity values were 91.4%, 57.6%, 35.1% and 99.1%. The ultrasonographic prediction of lymph node metastasis in Ⅲ and Ⅳ was highly sensitive,and the specificity in Ⅱ and Ⅴ was high.CONCLUSION: The localization of primary carcinoma is correlated with lateral lymph node metastasis in papillary thyroid microcarcinoma,and ultrasound could provide a basis for clinical determination of the dissection range of lateral lymph node.

Article in Chinese | WPRIM | ID: wpr-317868


<p><b>OBJECTIVE</b>To summarize the clinical, pathological and prognosis character of malignant carotid body tumor and explore its methods of diagnosis and treatment.</p><p><b>METHODS</b>The data of clinic, pathology, treatment and follow-up of nine patients with malignant carotid body tumor in Tianjin Cancer Hospital from February 1982 to June 2006 were analyzed retrospectively.</p><p><b>RESULTS</b>Four Male and five female cases were included, their average history was 6.5 years. Shamblin classification: one case was type II, eight cases were type III. All the patients were underwent ultrasonic inspection, four digital subtraction arteriography (DSA) and three magnetic resonance angiography (MRA). Seven cases were diagnosed as carotid body tumor. Five cases underwent Matas test training course. All the patients were performed wide excision of tumor and surrounding tissue. Three carotids were occludes, one of them reconstructed with vascular prosthesis, two were resected. There were no perioperative hemiplegias or deaths. Before operation, one case had atrophy of left side of tongue and fixed left vocal card; two cases had Horner syndrome. After operation, eight cases had 13 cranial nerve deficits, they were: two cerchnus, four glossal deviation, three Horner syndrome and one drop of oral corner, one choking cough. Pathologic diagnosis included nine malignant carotid body tumors, two with capsule, seven without capsule, one cervical and one lung metastasis. Two of them underwent radiotherapy. The median follow-up was 6 years (range: 6 months-14 years). Six patients survived. Two cases died, one died of cervical recurrence, the other of lung cancer. One case was lost.</p><p><b>CONCLUSIONS</b>Malignant carotid body tumor is rare in clinic, and often invade the carotid and cranial nerve, the diagnosis of malignant tumor should base on occurring extensive invasion of adjacent organs and metastasis; Wide surgical excision should be selected early, radiotherapy is effective, the effect of chemotherapy is uncertainty.</p>

Adult , Carotid Body Tumor , Pathology , General Surgery , Cranial Nerves , Pathology , Female , Head and Neck Neoplasms , Pathology , General Surgery , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Treatment Outcome
Article in Chinese | WPRIM | ID: wpr-309565


Based on the wavelet transform, the ways and process of wavelet de-noising are presented in the paper. The detail experimental results show that wavelet de-noising is better than traditional filtering ways, and the soft-threshold denoising is obviously better than the hard- threshold denoising.

Algorithms , Artifacts , Electrocardiography , Methods , Humans , Signal Processing, Computer-Assisted , Wavelet Analysis