Objective To explore the prevalence of prehypertension and the risk factors of prehypertension in young and middle aged population of Pinghu area in Shenzhen .so as to provide the scientific basis for prevention and control of hypertension .Methods 1 498 residents who were young and middle aged in Pinghu Area in Shenzhen were recruited .The prevalence was calculated and the risk factors were analyzed with logistic regression .Results The incidence of prehypertension was 42 .90% in the population . The incidence of prehypertension in male(51 .82% ) was significantly higher than that in female(28 .27% ) .The mean levels of fast-ing plasma glucose ,total cholesterol ,triglycerides ,LDL-C ,body mass index were higher in prehypertension group than that in nor-mal blood pressure group ,HDL-C was lower than that in the normal blood pressure group .Logistic regression analysis showed that that abdominal obesity ,overweight ,triglycerides and HDL-C were the risk factors of prehypertension in men ,while abdominal obe-sity ,overweight and triglycerides were the risk factors of prehypertension in women .Conclusion Prevalence of prehypertension is higher in young and middle aged individuals of Pinghu area in Shenzhen .The abdominal obesity ,overweight and triglycerides are the most important risk factors of prehypertension .

OBJECTIVE:To explore the effect of different plasmapheresis supplement timing on therapeutic efficacy of toxic liver injury. METHODS:96 patients with toxic liver injury and divided into group A,B ,C and D with 32 cases in each group ac-cording to different plasmapheresis supplement timing. All patients received plasmapheresis supplement based on routine treatment. In group A,synchronized fluid replacement was 100% fresh plasma;in group B,synchronized fluid replacement was 40% normal saline firstly,and then 60%fresh plasma;in group C,substitute liquid was given till the in vitro blood reached 12%of circulation amount,supplement order as 40% normal saline for the first supplement,and then add 60% fresh plasma. The clinical symptoms and signs,liver function,prothrombin activity and blood biochemical indicators were observed in each group before and after treat-ment. RESULTS:Plasmapheresis supplement had good therapeutic efficacy on toxic liver injury;but the time of clinical symptoms and signs disappearance in group C was significantly shorter than that in group A and B,and the group B was significantly shorter the group A,with statistical significance (P<0.05). The plasma bilirubin,prothrombin activity,albumin levels of 3 groups after treatment were significantly better than before,with statistical significance(P<0.05);the group C was better than the group A and B,and the group B was better than the group A,with statistical significance(P<0.05). Compared with before treatment,the lev-els of AST and ALT in 3 groups decreased significantly after treatment,with statistical significance(P<0.05);the group B and C were better than the group A,with statistical significance(P<0.05);the group B and C was similar to each other,without statisti-cal significance(P>0.05). CONCLUSIONS:Different plasmapheresis supplement timing have different effect on toxic liver injury. The supplement method that giving 40% normal saline for the first supplement,and then add 60% fresh plasma when in vitro blood reach 12%of circulation amount has more significant effect.

Objective To compare the chnical curative effect between pendant laparoscopic and traditional laparoscopic apphed in uterine fibroids divest,and analyze the risk factors of recurrence after resection of uterine fibrnids.Methods According to the different methods,130 patients with uterine fibroids were divided into suspension group (pendant laparoscopic uterine fibroids divest) and control group (traditional laparoscopic uterine fibroids divest),and 65 cases in each group.The intraoperative blood loss,operative time,exhaust time,heating duration,laparoscopic drainage were recorded,and the complications and the factors of recurrence were evaluated.Results The operative time,intraoperative blood loss,laparoscopic drainage in suspension group was less than that in control group [(53.5 ±20.9) min vs.(100.8 ± 26.7) min,(92.7 ± 18.9) ml vs.(168.4 ± 19.6) ml,(94.3 ± 13.8) ml vs.(186.5 ± 24.7) ml],the complications rate in suspension group was lower than that in control group [3.08％ (2/65) vs.33.85％ (22/65)],and there was significant difference (P ＜ 0.05).Followed up for 1-3 years,the recurrence rate was 29.23％ (38/130),3 cases were recurred within 3-6 months in control group,no recent recurrence in suspension group.Among them,the menarche age ≤13 years old,multiple myoma,operation age ＜ 35 years old were correlated with recurrence (P＜ 0.01 or ＜ 0.05).Conclusions Pendant laparoscopic uterine fibroids divest is fast and safe in operation and the prognosis effect significantly,faint pain degrees,myoma resection completely,short hospitalization period,less postoperative recurrence and other advantages,is worthy of reference for clinical promotion.The menarehe age ≤ 13 years old,multiple myoma,operation age ＜ 35 years old are correlated with recurrence.

Objective To analyze the causes of infection after cesarean section.Methods 80 patients having infection after cesarean section from Jan.2008 to Jan.2013 in our hospital were studied.The clinical data were retrospectively analyzed.The nosocomial infection-related factors were observed and related factors were ana-lyzed by Logistic regression analysis.Results 80 cases of maternal infection occurs after cesarean section.The highest rate of infection was urinary tract infection and respiratory infection, accounting for 43.75%and 31.25%respectively.We found the possible factors related to infection after cesarean section induding operative time, the number of invasive procedures, premature rupture of membranes, and the use of antibiotics.Conclusions Knowing the factors related to infection and improving the operative skills of gynecologists can help to reduce the rate of infection after cesarean section.

Objective To evaluate the role of cabon nanoparticles for dissecting lymph nodes and preserving parathyroid glans in patients with differentiated thyroid carcinoma undergoing total thyroidectomy plus bilateral central neck dissection.Metheds From Sep.2015 to Feb.2016,100 patients in Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine with thyroid carcinoma undergoing primarily total thyroidectomy plus bilateral central neck dissection were randomly divided into carbon nonoparticle group and the contol group.The numbers of total dissected lymph nodes,the lymph node posterior to fight recurrent laryngeal nerve,metastasized lymph nodes,inadvertent parathyroidectomy,the parathyroid hormone and serum total calcium were measured.Results The average counts of lymph nodes in carbon nonoparticle group (10.96±5.43)were more than those in the control group at (8.22±4.40)lymph nodes,(t＝2.78,P＝0.01).The average counts of lymph node posterior to fight recurrent laryngeal nerve in carbon nonoparticle group (1.62±1.95)were more than those in the control group at (0.76±1.21)lymph nodes,(t＝2.66,P＝0.01).The numbers of metastasized lymph nodes was 2.02±2.40 in carbon nonoparticle group and 1.84±2.61 in the control group.The difference had no statistical significance(t＝0.36,P＞0.05).The amount of PTH and the decrease of PTH discrepancy one day after surgery between the two groups had no statistical difference (t＝0.23,P＞0.05),(t＝l.04,P＞0.05).The carbon nonoparticle group had 2％(1/50)mistakenly parathyroid gland removed incidence,on contrary,the control group had 6％(3/50)mistakenly removed incidence.The difference had no statistical significance(x2＝0.26,P＞0.05).Conclusion Carbon nonoparticle can improve the central lymph node detection rate,but the protection of the parathyroid glands is more likey to depend on the experience of the operator and the vascular protection.

Objective To investigate the clinical features,diagnosis and treatment of medullary thyroid microcarcinoma (MTMC).Methods The clinical data of 14 patients with MTMC from Mar.2012 to Sep.2016 were retrospectively reviewed.All cases were treated with surgery and pathologically proved to be MTMC.Results All patients were sporadic MTMC.Calcitonin and CEA levels were measured before surgery in 11 patients.The median values were 81.61 (3.36-1187) pg/ml and 7.42 (0.81-90.75) ug/ml,respectively.All patients were followed up postoperatively.During a median follow-up of 24 months (8-63 months),no death happened.Regional lymph node metastasis occurred in 8 patients (57.14％),and lateral lymph node metastasis in 5 cases (35.71％).The rate of postoperative calcitonin abnormal was significantly higher in patients with lateral lymph node metastasis (P＜0.01).6 cases (42.86％) had abnormal postoperative calcitonin,among whom 5 cases had preoperative baseline calcitonin level higher than 100 pg/ml.Patients having abnormal postoperative calcitonin suffered from higher calcitonin and CEA baseline (P＜0.05).The tumor size was similar in two groups (P＞0.05).Conclusions For patients with thyroid nodules,preoperative screen of calcitonin can effectively detect MTC.Patients with elevated CEA also need to exclude the possibility of MTC.Compared with tumor size,calcitonin baseline is more important to surgical options and postoperative outcomes.Lateral lymph node metastasis,baseline calcitonin ＞100 pg/ml indicates abnormal postoperative calcitonin.

The tumor hospital has its unique resources superiority.To collect and utilize the information from tumor patients,information from their diagnosis and treatment,and biological specimens,through clinical epidemiology methods and design,would facilitate the deep development in the management and research at tumor hospitals in the new circumstances.Nantong Tumor Hospital,a first rate 3A hospital,and also one of the earliest-run specialized tumor hospitals in prefecture-level cities,possesses own basis for clinical epidemiological research,medical follow-up,and application of biobanking.In this paper we report the specific work plan and work contents,including:to establish a hospital-based cancer registry system for serving clinical epidemiology; to set up a follow-up system for clinical cases with tumor,in order to assess the effect of factors on tumor treatment and to analyse their survival rates; to build a biobank of tumor cases with perfect epidemiological information and background,fitting in with the needs of the development of translational medicine.The bottleneck problems in the work are also discussed.

ObjectiveTo observe and evaluate the role of cervical cytological examination in 1946 cases in gestation, and at 2 months and 6 months after delivery, and treatment for abnormal cases.MethodsThe thinprep cytologic test samples of 1946 cases from external cervical orifice and cervical cavity were collected. The cytological diagnosis was performed according to TBS-diagnosis and classification system.ResultsIn 1946 samples, there were 160 inflammatory samples (8.2%), including bacterial vaginitis 51 cases (2.6%), trichomonal vaginitis 49 cases (25.%), candidal vaginitis 58 cases (3.0%); typical epithelial cells 105 cases (5.4%), including atypical squamous cells (ASUCS) 70 cases (3.6%), low-grade squamous intraepithelial lesions (LSIL) 29 cases (1.5%), high-grade squamous intraepithelial lesions (HSIL) 5cases (0.2%), the carcinoma in situ 1 case (0.05%); human papilloma virus (HPV) 32 cases (1.6%), including HPV combined with atypical squamous cells 21 cases (1.1%), HPV combined with LSIL 10 cases (0.5%). Large mass of cases with a abnormally result of cervical cytological examination had a normal childbearing, the cases that re-examination after birth showed carcinoma in situ and HSIL treated by conization, and others treated with physical treatment.ConclusionCervical cytology examination has positive effect on prevention and treatment of precancerous changes and carcinoma in gestational women. Cervical lesions less likely get worse during pregnancy. Conservative management is possible if regular cytology, copolscopy and bioposy performed when necessary. Re-examination at two and six months after birth is necessary for determining treatment method.

Objective To investigate the value of creatine kinase and computed tomography(CT)angiography to evaluate short-term prognosis of patients with superior mesenteric artery embolism(SMAE).Methods The retrospective cross-sectional study was adopted.The clinical data of 26 patients with SMAE who were admitted to the first Affiliated Hospital of Wenzhou Medical University between January 2008 and October 2015 were collected.The patients received serologic examination and CT angiography firstly,and then medicinal conservative method and surgical method were respectively conducted according to the results of above examinations.Observation indices:(1)clinical features,(2)serum indicators results,(3)CT angiography results:①location(main stem and non-main stem)of SMAE and development of distal branches of superior mesenteric artery(SMA),②indirect signs,such as bowel wall thickening,bowel dilatation combined with effusion and air accumulation and pneumatosis intestinalis,(4)therapy and prognosis.Measurement data with normal distribution were presented as-x±s,comparisons among groups were analyzed by one-way ANOVA.Measurement data with skewed distribution were presented as M(range)and analyzed by the Kruskal-Wallis rank sum test,and pairwise comparison was done using the Nemenyi test.Results(1)Clinical features:of 26 patients with SMAE,6 patients had intestinal ischemia,8 patients had partial intestinal necrosis and 12 patients had long segmental intestinal necrosis(postoperative short bowel syndrome in 5 patients and total small intestinal necrosis and partial colonic necrosis in 7 patients).Duration of symptoms before diagnosis was(1.7±0.8)days in 6 patients with intestinal ischemia and(2.1±1.1)days in 8 patients with partial intestinal necrosis and(1.5±0.7)days in 12 patients with long segmental intestinal necrosis,with no statistically significant difference(F=1.27,P＞0.05).(2)Serum indicators results:levels of serum creatine kinase in patients with intestinal ischemia,partial intestinal necrosis and long segmental intestinal necrosis were 68 U/L(range,50-86 U/L),98 U/L(range,54-244 U/L)and 300 U/L(range,40-873 U/L),respectively,with a statistically significant difference among patients(H=7.32,P＜0.05)and between patients with intestinal ischemia and with long segmental intestinal necrosis(H=7.21,P＜0.05),and with no statistically significant difference between patients with partial intestinal necrosis and with intestinal ischemia or long segmental intestinal necrosis(H=1.53,2.07,P＞0.05).(3)CT angiography results:①developments of SMAE(main stem and non-main stem)and distal branches of SMA:main stem embolism of SMA in 13 patients demonstrated hypodense shadow,with non-contrast of distal branches of artery,including 1 with intestinal ischemia,1 with partial intestinal necrosis and 11 with long segmental intestinal necrosis.Main stem embolism of SMA in 8 patients demonstrated hypodense shadow,with contrast of distal branches of SMA,including 3 with intestinal ischemia,4 with partial intestinal necrosis and 1 with long segmental intestinal necrosis.Main stem embolism of SMA in 2 patients demonstrated hypodense shadow,with non-contrast of distal branches of SMA,showing partial intestinal necrosis.Non-main stem embolism of SMA in 3 patients demonstrated hypodense shadow,with contrast of distal branches of SMA,including 2 with intestinal ischemia and 1 with partial intestinal necrosis.②Indirect signs:5 patients had bowel wall thickening,including 3 with intestinal ischemia and 2 with long segmental intestinal necrosis.Seventeen patients had bowel dilatation combined with effusion and air accumulation,with gas fluid level in local intestinal canal,including 2 with intestinal ischemia,5 with partial intestinal necrosis and 10 with long segmental intestinal necrosis.Two patients had pneumatosis intestinalis,with bubble shadow of bowel wall,showing long segmental intestinal necrosis.(4)Therapy and prognosis:of 6 patients with intestinal ischemia,1 underwent embolectomy of SMA and 5 underwent low-molecular-weight heparin anticoagulation and vasodilator alprostadil therapy.Eight patients with partial intestinal necrosis received resection of necrotic intestine.Of 12 patients with long segmental intestinal necrosis,5 with postoperative short bowel syndrome received resection of necrotic intestine combined with postoperative parenteral hyperalimentation.The above-mentioned patients were improved and discharged from hospital after symptomatic treatment and surgery.Twelve patients with long segmental intestinal necrosis,7 with total small bowel necrosis and partial colonic necrosis underwent only exploratory laparotomy and then were dead in a short time.Conclusion Elevated creatine kinase and main stem embolism of SMA combined with non-contrast of distal branches using CT angiography maybe predict poor short-term prognosis of patients with SMAE.

Carcinoma ; Humans ; Parathyroid Neoplasms