Analysis of hypertension in the Chinese elderly population with hypertension / 中华老年医学杂志

Objective:To assess the prevalences of hypertension, rates of medication recommendations and failure rates of blood pressure(BP)control in Chinese elderly patients(≥65 years old).Methods:We used data from the 2011 China Health and Nutrition Survey(CHNS). A total of 2, 391 Chinese adults aged≥65 years with complete information comprising BP measurements repeated three times and antihypertensive medication use were included for analysis.Results:The mean age of subjects was 72.6±6.2 years, and females accounted for 53.1%.The numbers of patients with hypertension were 1784(74.6%)and 1221(51.1%)according to the definitions from 2017 ACC/AHA guideline and the 2010 Chinese guideline, respectively.There was a significant difference in the prevalence of hypertension in the subgroup with a cardiovascular disease(CVD)history according to the definitions from the two guidelines( χ2=23.70, P<0.01). The BP thresholds for drug therapy recommendations were the same as those set in the diagnostic criteria of hypertension based on the two guidelines.Therefore, the rates for medication recommendations were 74.6% and 51.1%, respectively.The numbers of patients with BP above the target levels were 622(88.2%)and 346(49.1%), respectively, according to the definitions from the two guidelines.There was no significant difference in failure rate of BP control due to age( χ2=5.36, P>0.05), gender( χ2=0.12, P>0.05)or a CVD history( χ2=0.07, P>0.05)according to analyses using the definitions from the two guidelines. Conclusions:Compared with the 2010 Chinese hypertension guideline, the prevalence of hypertension and rate of medication recommendations are higher in the Chinese elderly population when the 2017 ACC/AHA hypertension guideline is used.Hypertension management and antihypertensive drug treatment should be reinforced to improve the control rate of hypertension.

Correlation analysis of ultrasound features and BRAF V600E gene mutation in thyroid cancer / 肿瘤研究与临床

Objective:To investigate the relationship between BRAF V600E gene mutation and ultrasonography manifestations as well as the lesion invasiveness in thyroid cancer.Methods:A total of 153 patients pathologically diagnosed as thyroid cancer after surgery who underwent thyroidectomy in Shanxi Provincial Cancer Hospital from January 2018 to October 2019 were selected, including 146 cases of papillary thyroid carcinoma. Ultrasonography was performed before operation. Paraffin embedded tissue after operation was used to detect BRAF V600E gene mutation. According to the results of BRAF V600E gene detection, patients were divided into mutation group and non-mutation group. The ultrasonic characteristics of the two groups were compared. The relationship of BRAF V600E gene mutation with ultrasonic characteristics, clinicopathological characteristics as well as cervical lymph node metastasis was analyzed by using logistic regression.Results:There were 130 cases (85.0%) of BRAF V600E gene mutation and 23 cases of BRAF V600E gene non-mutation in 153 patients with thyroid cancer. Among 146 cases with papillary thyroid carcinoma, there were 128 cases (87.7%) of BRAF V600E gene mutation. The percentage of patients with the unclear boundary between thyroid lesions and capsule in BRAF V600E gene mutation group was higher than that of patients in non-mutation group, and the difference was statistically significant [46.9% (60/128) vs. 11.1% (2/18), χ 2 = 8.261, P = 0.004]. There were no significant differences in age, gender, nodule long diameter, aspect ratio, nodal location, internal calcification, internal echo, echo uniformity, cystic solid, nodal shape, boundary clarity, blood flow signal, the number of tumor site, lymph node metastasis and nodular goiter between BRAF gene mutation group and non-mutation group (all P > 0.05). The results of logistic regression analysis showed that only the boundary clarity between thyroid lesions and capsule was an independent influencing factor of BRAF V600E gene mutation ( OR = 14.400, 95% CI 1.847-112.246, P = 0.011), tumor lesion size was an independent influencing factor of cervical lymph node metastasis in papillary thyroid carcinoma ( OR = 2.714, 95% CI 1.335-5.517, P = 0.006). Conclusions:In papillary thyroid carcinoma, BRAF V600E gene mutation is related with lesion and the unclear boundary between the tumor and capsule, but not related with lymph node metastasis. The size of the tumor lesion is associated with lymph node metastasis.

Application of integrated collaborative service mode in obstetrics and gynecology clinical service / 中国基层医药

Objective To explore and assess the reasonable application of integrated collaborative service mode in obstetrics and gynecology clinical service.Methods 152 pregnant women admitted in obstetric outpatient from March 2016 to May 2016 were randomly assigned into observation group and control group,76 cases in each group.The control group received obstetric traditional outpatient treatment and hospitalization mode,while the observation group implemented the integrated collaborative service mode.It was a integrated mode based on the traditional mode and multidisciplinary professionals integrated into groups for synergistic services,from the beginning of pregnancy to discharge.Results The number of cases who were knowledged maternal diseases,intraoperative coordination,reasonable diet and breastfeeding of the observation group (69,70,69,66) were superior to those of the control group (51,40,54,50) (x2=17.56,52.58,12.44,11.11,all P<0.001).The incidence rate of maternal and neonatal complications of the observation group were significantly lower than those of the control group(t=12.04,6.49,2.87,9.26,-7.14,all P<0.005).And patients satisfaction survey was improved,the number of satisfaction and complaint in the observation group was 70 persons,1 person,which of the control group was 70 persons,6 persons (x2=7.65,P<0.01).Conclusion Integrated collaborative service mode can improve the quality of medical service and patients' satisfaction,while reduce cesarean section rate,postpartum hemorrhage and maternal complications.Integrated collaborative service mode is an effective method to promote the development of perinatal medicine.

Analysis of ultrasonic characteristics of primary breast lymphoma / 白血病·淋巴瘤

Objective To analyze the ultrasonic imaging characteristics of primary breast lymphoma and their significance for diagnosis.Methods Data of ultrasonograph from 21 cases of primary breast lymphoma were reviewed, and all cases had been certificated by pathology.Results All of 21 cases with primary breast lymphoma were solid mass.The contours of 16 cases were regular, and the boundaries of 9 cases were clear.20 cases were hypoechoic masses, besides 3 cases with lower echo like liquefactive degeneration.The internal echoes of 19 cases were disorderly, part of them with hyperechoic trabs.The rear echoes of 17 cases were neither enhanced nor fading.The surrounding tissues of 19 cases were not changed.13 cases had more than 3 blood vessels on color Doppler imaging.Conclusion There are some ultrasound characteristics in primary breast lymphoma, which would be helpful in the diagnosis of primary breast lymphoma.

Impact factors investigation in oral ultrasonic contrast agent on diagnosis of ulcerative type gastric neoplasms on T staging / 肿瘤研究与临床

Objective To explore the factors affecting diagnosis accuracy on T stage of oral ultrasonic contrast agent examination on ulcerative gastric neoplasms.Methods Data from 82 patients were analyzed who were pathologically diagnosed as ulcerative gastric neoplasms ultrasounds data of oral ultrasonic contrast agent before surgery were compared to postoperative pathology,analysis had been done on influence of the lesion site,size of the T staging on ulcerative gastric neoplasms.Results The diagnosis accuracy rate of T stage on lesser curvature of stomach and gastric antrum were 91.3 ％ (21/23) and 85.7 ％ (24/28),compared with the pathological results were in good concordancy (Kappa =0.763,0.68,P ＜ 0.05).The accuracy rate of T stage on cardiac lesions was 68.0 ％ (17/25),compared with the pathological results consistency in general (Kappa =0.446,P ＜ 0.05).Further research on the effects of T stage accuracy would be necessary.The accuracy rate ofT staging on tumor size ≤ 5.0 cm group and ＞ 5.0 cm were 92.3 ％ (36/39) and 72.1％ (31/43),the difference was significant in two groups (x2 =5.591,P ＜ 0.05).Conclusion Oral ultrasonic contrast agent application is more accurate on lesser curvature of stomach,gastric antrum and lesions size ≤ 5.0 cm.

Contrast-enhanced ultrasonography diagnostic value of the liver low-density focus on contrast-enhanced CT / 肿瘤研究与临床

Objective To discuss the contrast-enhanced ultrasonography diagnostic value of the liver low-density focus on contrast-enhanced CT. Methods The contrast-enhanced ultrasonography results of 47 cases of the liver low-density focus on contrast-enhanced CT. were retrospectively analyzed. Results The pathological diagnosis in 47 focuses was metastatic carcinoma 20 cases, inflammatory pseudotumour 9 cases,hepatic hemangioma 6 cases, primary liver carcinoma 4 cases, cyst 2 cases, abscess 2 cases, tuberculosis 2 cases, FNH (focal liver nodular hyperplasia) 1 case, local adipose tissue infiltration of liver 1 case. 45 cases of contrast-enhanced ultrasonography diagnosis was consistent with pathological or clinical diagnosis. Cysts and inflammatory pseudotumour had not ultrasound contrast enhancement in the entire phase, but the crossed blood vessels was observed in inflammatory pseudotumour. The local adipose infiltration of liver had synchronous ultrasound contrast enhancement accompanied with liver tissue enhancement. 80% (12/15) of liver metastases of lack of blood supply showed fast contrast enhancement around the tumour edge and homogeneous and light contrast enhancement in the tumour center. 80 % (4/5) of liver metastases of rich of blood supply showed heavy and rapid contrast enhancement in the whole tumour. The enhancement degree in bscess and tuberculosis in the ultrasound contrast enhancement was correlated with necrosis degree, which showed fast and uneven contrast enhancement, hepatic hemangioma showed gradually contrast enhancement from its edge to center, whose enhancement time lasted for longer time than that of metastatic tumour with a statistically difference. FNH showed a typical contrast enhancement pattern, fast enhancement and fast weakening from center to edge. Hepatic cell carcinoma showed fast enhancement and fast weakening in the whole tumour. Conclusion Contrast-enhanced ultrasonography have diagnostic value of CT liver focus of low-density, which is helpful for the differential diagnosis of such focus.

Value of ultrasound in diagnosing ductal carcinoma in situ / 肿瘤研究与临床

Objective To evaluate the value of ultrasound in diagnosing ductal carcinoma in situ (DCIS). Methods The sonographic characteristics of 12 DCIS which were confirmed by pathology were analyzed retrospectively. Results The ultrasound image of DCIS could be divided into four types;the solid mass nodule, mammary dysplasia, mix mass nodule, the dilated duct type. Micro calcification had high incidence rate. Ultrasonic diagnosis accordance rate was 50.0 %. On molybdenum target mammograms, the tumor appeared as a cluster of calcified spots in 8 cases, and the accuracy rate of diagnosis of was 66.7 %.Conclusion There are no typical characters of DCIS in ultrasound image. However, some characteristics are suggestive and can help to differentiate them from the benign tumors, such as small nodule, irregular shape,obscure boundary, and microcalcification. When sonography combine with molybdenum target mammography,the accuracy rate of diagnosis will be improved.

Comparison of intrarectal filling with water and idling in rubber sheath with water in endoluminal ultrasonography for preoperative staging of rectal tumors / 肿瘤研究与临床

Objective To compare the value of intrarectal filling with water and filling in rubber sheath with water in endoluminal uhrasonography for preoperative staging of rectal tumors. Methods 215 cases of rectal tumors were divided into two groups. 120 cases using the method of filling in rubber sheath with water and 95 cases using intrarectal filling with water were diagnosed with uhrasonography. The results were compared with corresponding pathologic results for the judgment of their accuracy. Results The accuracy for the diagnosis of infiltration depth was 60.0 % in the first group and was 73.7 % in the second. The difference was statistically significant (P <0.05). The accuracy for diagnosis of metastases of perirectal lymph nodes was 82.5 % in the first group and was 80.0 % in the second. The difference has no statistical significance (P >0.50). Conclusion Intrarectai filling with water is better than filling in rubber sheath with water in the diagnosis of infiltration depth of rectal tumors, while there is no difference in the diagnosis of metastasis of perirectal lymph nodes.

Transrectal ultrasound-guided 10 cores plus fixed-point prostate biopsy for diagnosing prostate cancer / 肿瘤研究与临床

Objective To evaluate the clinical value of transrectal ultrasound-guided 10 cores plus fixed-point prostate biopsy for diagnosing prostate cancer.Methods The serum PSA level of 181 patients were determined with ELISA.AU the patients underwent 10 cores plus fixed-point prostate biopsy under the guidance of transrectal ultrasound.Resuits 80 cases with prostate cancer(44.2%),63 cases with benign prostatic hypertrophy (34.8%),36 cases with prostatitis(19.9%),1 cage with tuberculosis(0.6%),and 1 cage with prostate leiomyoma(0.6%).When PSA WaS more than 20 μg/L,the incidence rate of prostate cancer was significantly higher than other PSA levels.Meanwhile,Gleason scores were increased with the advance of PSA levels (P＜0.001).Conclusion Transrectal ultrasound-guided systematic 10 cores plus fixed-point prostate biopsy could significantly enhance the prostate cancer detection rate, and it was important in diagnosing prostate cancer for patients,especially when PsA was more than 20 μg/L.

Value of color Doppler ultrasound-guided percutaneous transhepatic cholangiol drainage / 肿瘤研究与临床

Objective To evaluate the clinical value of color Doppler ultrasound-guided percutaneous transhepatic cholangiol drainage(PTCD) for treating obstructive jaundice. Methods 248 cases of PTCD were performed in 224 patients under the guidance of color Doppler ultrasound. 118 PTCD cases were carried out passing through the inferior segmental biliary duet of Left laterallobe (Left drainage mode). Right lobe drainage mode (right drainage mode)was conducted in 130 patients. Left plus right lobe drainage mode in 16 patients. Results The total success rate was 99.59 %(247/248), and the success rate of the firs time PTCD was 92.33 %(229/248). The success rate of left drainage mode was significantly higher than righl lobe drainage (96.61% vs 88.46 %, P ＜0.05). Conclusion The technique of color Doppler ultrasound-guided PTCD is an efficient method in obstructive jaundice therapy, with the advantages of safety, convenience, minimal invasion, and higher success rate.

Role of ultrasound in the diagnosis of poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma / 肿瘤研究与临床

Objective To investigate the sonographic diagnostic value of poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma. Methods Ultrasonography of 22 cases with differentiated thyroid carcinoma and anaplastic thyroid carcinoma were observed with color doppler sonography.The shape,size,echo,boundary,microcalcifieation foci and blood stream distribution were studied,and contrasted with pathological diagnosis after operation.Lymphnode in cervical part and sulcus esophagus were examined.The characters of thyropathy according to the above sonographie features were judged. Results 16uhrasonography or before operation and biopsy,in which 9 were left,7 were right.6 cases were in both leaves.Ultrasound showed that 2 cases were poody differentiated thyroid carcinoma, 1 case was parathyroid carcinoma. 1 case was Hashimoto's thyroditis, and remainders were thyroid carcinoma. Conclusion Ultrasonography could enhance the detection rates and diagnose accordance rates of poorly differentiated thyroid carcinoma and anaplastic thyroid carcinoma.