RESUMO
Objective:To investigate the clinical situation of 201 emergency adult sudden death patients, and analyze the influence of white blood cell count and arterial blood lactate level on prognosis.Methods:The clinical data of 201 patients diagnosed with sudden death in the emergency department of Medical College of Cangzhou people's Hospital from January 2017 to January 2021 were retrospectively analyzed. The gender, age, disease composition and etiology of the patients were statistically analyzed. The independent sample t-test was used to compare the measurement data with normal distribution, the χ 2 test or Fisher exact probability method was used to compare the counting data between groups, and the logistic regression model was used to screen the risk factors of emergency death, and the impact of white blood cell count and arterial blood lactate level on the prognosis was analyzed. Results:After active rescue, 11.44% (23/201) of the patients were successfully rescued, and 88.56% (178/201) of the patients were ineffective; ≥46-≤65 years old was the age group with high incidence of sudden death (55.22%(111/201)). The proportion of male (43.28% (87/201), 23.38% (42/201)) in the age group of ≥46-≤65 years old and the age group over 65 years old were higher than that of female (11.94% (24/201), 14.43% (29/201)), with a statistically significant difference (χ 2=4.801, 9.209; P=0.028, 0.002). In the past history of sudden death patients, the proportion of cardiovascular disease (53.23% (107/201)) was the highest; the proportion of patients may have inducements before sudden death was 74.13% (149/201), the proportion of patients have premonitory symptoms before sudden death was 67.66% (136/201), and sudden cardiac death was the first cause. Logistic regression analysis showed that white blood cell count ( OR=4.442,95% CI: 1.898-10.395), arterial blood lactic acid concentration ( OR=4.272,95% CI: 2.024-9.016), and albumin concentration ( OR=2.657,95% CI: 1.302-5.422) were independent risk factors affecting emergency sudden death patients ( P values were 0.001, <0.001, 0.007, respectively). Conclusions:There are some differences in gender, age and past history of adult sudden death patients. Most of them have premonitory symptoms and inducements. Sudden cardiac death is the primary cause. The increases of white blood cell count and lactic acid level, the decrease of albumin level are the risk factors of sudden death.
RESUMO
Objective To explore the relationship between iodine and fluoride content in drinking water and the incidence of adult thyroid nodules in Cangzhou,Hebei.Methods According to the previous reports on iodine and fluoride levels in drinking water in Cangzhou,from November 2016 to January 2017,Cangzhou was divided into high iodine,low iodine,normal iodine and fluorine,low iodine and high fluorine,high iodine and high fluorine areas,and according to the different contents of iodine and fluorine in drinking water,high iodine and high fluorine area was further divided into high iodine and high fluorine 1 (iodine:743.30 μg/L,fluorine:4.27 mg/L),2 (iodine:119.31μg/L,fluorine:4.67 mg/L) and 3 (iodine:105.30 μg/L,fluorine:1.64 mg/L) subareas.Subjects who lived for 20 or more years and aged 30 or older,without serious disease and not taken iodized salt were selected.Palpation was used to examine the size,texture,mass,tenderness and mobility of the thyroid gland.The boundary,internal echo,blood flow and quantity of nodules were observed and recorded by color Doppler.Results The prevalence difference of thyroid nodules [36.8％ (629/1 710),32.8％ (636/1 938),25.1％ (427/1 700)] in high iodine,low iodine and normal iodine and fluorine areas was statistically significant (x2 =55.597,P ＜ 0.05).The prevalences of thyroid nodules in both high iodine and low iodine areas were higher than that of normal iodine and fluorine area (P＜ 0.016 7).The prevalence difference of thyroid nodules [43.3％ (749/1 730),39.8％ (712/1 790),34.9％ (623/1 785)] in high iodine and high fluorine 1,2 and 3 subareas was statistically significant(x2 =26.220,P ＜ 0.05).Compared with low iodine area,the prevalence of thyroid nodules [41.2％ (735/1 785)] in low iodine and high fluorine area was increased (x2 =6.288,P ＜ 0.05).Conclusions Both high iodine and low iodine can induce thyroid nodules.In water source areas with high iodine content,both high iodine and high fluorine are the factors inducing thyroid nodules.The prevalence of thyroid nodules in low iodine and high fluorine area is significantly higher than that of low iodine area.
RESUMO
Iodine and fluoride are indispensable elements of human life activities,excessive or insufficient intakes can cause diseases,especially thyroid diseases,the relationship between iodine,fluoride and thyroid diseases has been paid more and more attention.The water iodine and fluoride are an important source of human intakes,so researching the influence of water iodine and fluoride on thyroid diseases is of great significance for guiding the population to maintain normal thyroid morphology and function.
RESUMO
Objective To investigate the association of single nucleotide polymorphisms in the rs2268458 locus of thyroid-stimulating hormone receptor (TSHR) gene with Graves disease (GD) and Hashimoto's thyroiditis (HT).Methods Part of the cases diagnosed through the epidemiological investigation project about thyroid diseases of Cangzhou City in 2016 was selected as the case group.The case group was subdivided into GD group and HT group according to the diagnosis.At the same time,healthy people with similar gender and age to the case group were selected as the control group.All subjects were from the Han nationality and were not related to each other.The genotypes and alleles of the TSHR gene rs2268458 (C/T) of all subjects were detected by restriction endonuclease (RFLP).And based on genotyping analysis of patient risk (odds ratio,OR) and 95％ confidence interval (95％CI).Results There were 87 cases in GD group [aged (43.17 ± 12.56) years old],including 64 females and 23 males.There were 31 cases in HT group [aged (44.41 ± 16.51) years old],including 26 females and 5 males.In the control group,there were 147 cases [age (40.26 ± 9.31) years old],including 80 females and 67 males.HardyWeinberg equilibrium test was performed on each group.The results showed that P ＞ 0.05,suggesting that the study samples were representative of the population.The results of genetic analysis showed that in females,the C allele frequency of GD patients was significantly higher than that of the control group [x2 =4.632,36.7％ (47/128) vs 25.0％ (40/160),P ＜ 0.05,OR =1.741,95％CI =1.048-2.891].The frequency distribution of each genotype (CC,CT,TT) at TSHR rs2268458 (T/C) was statistically different (x2 =6.104,P ＜ 0.05),and the frequency of TC ± CC combined genotype was significantly higher in GD patients than in controls (x2 =6.092,P ＜ 0.05,OR =2.333,95％ CI =1.184-4.598),however,there was no statistical difference between the HT group and the control group in genotype (CC,CT,TT) frequency distribution and alleles (P ＞ 0.05).In males,there was no statistically significant difference in genotype (CC,CT,TT) frequency distribution and allele between groups (P ＞ 0.05).Conclusion Among women in Cangzhou,the single nucleotide polymorphism of rs2268458 in TSHR gene is associated with the susceptibility to GD,but not to HT,and C genotype increases the risk of GD by dominant inheritance.
RESUMO
Objective@#To investigate the metastatic sequence of cervical lymph node in hypopharyngeal carcinoma aimed at guiding neck exploration.@*Methods@#Seventy-five serial sections of integrally dissected lateral neck specimens from 67 patients of hypophayryngeal carcinoma were histopathologically observed, and the metastatic sequence of cervical lymph node of hypophayryngeal carcinoma were analysed.@*Results@#In 75 integrally dissected lateral neck specimens, 63 laterals were found to occur cervical lymph node metastases, the metastatic ratio was 84.0%. The analytic result of 63 dissected lateral neck specimens with positive lymph nodes showed that the metastatic lymph node ratio in descending order was level Ⅱ (90.5%), level Ⅲ (76.2%), level Ⅳ (41.3%), level Ⅴ (15.9%), level Ⅰ (7.9%) and level Ⅵ (3.2%). The metastatic ratio of lymph node between level Ⅰ~Ⅵ were significantly different from each other (P<0.01). When the tumor metastasized to one cervical lymph node, this could be found in levels Ⅱ or Ⅲ, when metastasized to two cervical lymph nodes, these could be found in levels Ⅱ, Ⅲ, Ⅳ, and when metastasized to more than 5 of cervical lymph nodes, these could be found in levels Ⅱ, Ⅲ, Ⅳ, Ⅴ, Ⅰand Ⅵ. According to the occurring sequence, metastatic ratio and number of cervical lymph node metastasis (LNM), levels Ⅱ and Ⅲ were identified as the first station, level Ⅳ was the second station and levels Ⅴ, Ⅰ and Ⅵ were the third station of cervical LNM in hypopharyngeal carcinoma.@*Conclusion@#The confirmation of metastatic sequence of cervical lymph node in hypophayryngeal carcinoma provides a reliable evidence for neck lymph node dissection and reference value for clinic therapy.
RESUMO
<p><b>OBJECTIVE</b>To investigated the clinicopathologic features of familial papillary thyroid carcinoma (PTC) compared to sporadic PTC.</p><p><b>METHODS</b>Between January 2008 and August 2014, 20 patients who underwent surgery at Liaoning Cancer Hospital and Institute were diagnosed with familial PTC. We compared the clinicopathologic characteristics between familial PTC and sporadic PTC.</p><p><b>RESULTS</b>The prevalence of familial PTC was 1.3% (20/1 587). The median age of patients at diagnosis was 37 years and there were 12 females and 8 males. Thirty percent of the familial PTC cases exhibited a parent-offspring relationship, and 70% exhibited a sibling relationship. There were significant differences between familial PTC and sporadic PTC in terms of concomitant chronic thyroiditis (P < 0.01), nodular goiter (P = 0.04), tumor multicentricity (P < 0.01), bilaterality (P < 0.01), histological subtype (P < 0.01), and central lymph node metastasis (P = 0.02). When familial PTC patients were classified based on parent-child and sibling relationship, there were significant differences in preoperative TSH level (P = 0.02) and concomitant chronic thyroiditis (P = 0.01) between the two categories.</p><p><b>CONCLUSIONS</b>There are significant differences in clinicopathologic features between familial PTC and sporadic PTC and between familial PTC with parent-child and those with sibling relationship. Familial PTC appears more aggressive than sporadic carcinoma. Optimal treatment for familial PTC is not yet established, but improved awareness and screening will permit earlier detection, more timely intervention, and improved outcomes for patients and their families.</p>