Objective To determine the incidence of thrombogenic events during the prostate operation period in patients discontinuing aspirin.Methods Among a retrospective cohort of 342 patients admitted in our institution for benign prostatic hyperplasia (or prostate cancer),combined with acute coronary syndrome (or stroke),we studied 4 patients who had not been taking aspirin before thrombogenic vascular event.Data on age,sex,vascular disease risk factors,and clinical outcome were collected.Results The 4 patients' mean age was 78.8±5.9 years.Each patient had at least two following risk factors:atrial fibrillation,old cerebral infarction and type 2 diabetes.80％ patients had a clinical history of hypertension.2 of the 4 patients stopped aspirin before a surgical procedure and developed acute ischemic stroke and acute myocardial infarction,separately.The other two patients developed acute ischemic stroke without aspirin prescription.The median time between admission and thrombogenic events was 15.5± 10.5 days.All patients were not given finasteride on admission.Conclusions This study should alert clinicians to know the risk of aspirin withdrawl perioperatively in patients at high risk of cardiovascular and cerebrovascular diseases.

Objective To investigate the risk factors of reversible posterior leukoencephalopathy syndrome (RPLS) in pre-eclampsia or eclampsia gravida. Methods This study was conducted in the Third Affiliated Hospital of Guangzhou Medical University between January 2013 and March 2016. A total of 100 patients who had no severe neurological diseases and were diagnosed pre-eclampsia or eclampsia, and underwent brain MRI were collected retrospectively. They were divided into 2 groups according to the MRI results, the RPLS group (n=49) and the non-RPLS group (n=51). The medical history, clinical symptoms and the results of laboratory examination were analyzed by the logistic regression, in order to explore the risk factors.Results In single factor analysis, HELLP syndrome, pregnancy associated with other diseases, poor prenatal care, grade 3 hypertension, elevated systolic blood pressure or diastolic blood pressure, elevated WBC, aspartate transaminase (AST), alanine aminotransferase (ALT), uric acid (UA) and lactate dehydrogenase (LDH), decreased platelet (PLT), headache, visual changes, seizures and conscious disturbance were more frequent in the RPLS group than those in the non-RPLS group (all P<0.05). According to the multivariate logistic regression analysis, the elevated WBC (OR=1.291, 95%CI:1.058-1.575, P=0.012), UA (OR=1.008,95%CI:1.001-1.016,P=0.032) and headache (OR=18.260, 95%CI:3.562- 93.607, P=0.000) were the independent risk factors.Conclusions Maternal history, clinical symptoms and some laboratory examinations might help in the early diagnosis of RPLS in pre-eclampsia or eclampsia gravida. Headache, the elevation of WBC and UA were the most significant factors.

Risk factors of hyperamylasemia in 152 diabetic ketoacidosis(DKA)patients who had no acute pancreatitis were examined.Serum levels of hemodiastase,natrium,kalium,chlorine,calcium,phosphonium,creatinine,carbon dioxide combining power,osmotic pressure,blood glucose,blood lipids and uric acid were measured.With hemodiastase and other 14 factors as independent variables,the multiple linear regression analysis was performed and the partial regression coefficient was estimated.Blood glucose,serum natrium,osmotic pressure and triglyceride entered the regression equation,and their partial coefficients were 10.26,10.35,2.21 and 8.00,respectively.The constant quantitv was -2162.06.Compared with amylase-normal group,hyperamylasemia group showed statistically significant difference in blood glucose,serum natrium,osmotic pressure and triglyceride levels.Higher blood glucose and triglyceride might be the primary causes of hyperamylasemia.

Objective To evaluate the effects of metabolic factors on the quality of 18F-fluorode oxyglucose (18F-FDG) myocardial metabolic imaging in coronary artery disease (CAD) patients with type 2 diabetes mellitus (T2DM). Methods Seventy CAD patients aged 60 years or over with T2DM were studied with myocardial 18 F-FDG dual isotope simultaneous acquisition (DISA) single photon emission computed tomography (SPECT). Fasting plasma glucose, total triglyceride (TG),total cholesterol (TC), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-eholesterol(LDL-C), insulin, C peptide and glyeosylated hemoglobia (HbAlc) were detected. Insulin resistance and islet β cell function were calculated by using the Homeostasis Model Assessment (HOMA) equation. Results Compared with the bad image quality group (36 cases), patients in the excellent image quality group (34 cases) were younger [with average age of (62.2±8.5) years vs. (67.6±8.3) years, P<0.01] and slimmer [with BMI of (24.7±2.6)kg/m2 vs. (26.1±2.5)kg/m2, P<0.05]. The levels of fasting insulin and C peptide were lower in the excellent image quality group than those in the bad image quality group [with fasting insulin level of 8.3 (5.1～12.4) mIu/L vs. 12.7,(6.1～17.9)mIu/L and C-peptide level of 0.6(0.5～0.9)nmol/L vs. 0.9(0.6～1.2)nmol/L, respectively,both P<0.05]. The HOMA insulin resistant index was reduced in the excellent image group [2.7(1.6～4.0) vs. 4.1(1.7～6.5), P<0.05]. Logistic regression analysis showed that obesity and age≥65 years were independent risk factors for image quality, with OR value of 3.73 (95% CI: 1.12～12.45,P=0.022)and 3.75 (95%CI:0.96～14.6,P=0.058)after adjustment of other metabolic factors. Conclusions Insulin resistance is the main factor that influences the quality of 18F-FDG myocardial metabolic imaging in patients with T2DM. In addition, age≥65 years and obesity are also risk factors for image quality.

Objective To study the clinical characteristicsand perioperative managementof complicated placenta increta, effectively reduce the maternal adverse perinatal outcomes. Methods Retrospective analysis 25 cases of complicated placenta increta between January 2013 and December 2015 in the Third Affiliated Hospital Of Guangzhou Medical University. Grouped into preoperative line 9 cases of ureteral catheter group and without catheter group 16 cases; Conventional hysterectomy group of 17 cases and the posterior hysterectomy group of 8 cases , compare the operation time , postpartum hemorrhage , blood transfusion amount , bladder injury or ureteral injury rate , rate of transferred to the ICU and hospital stay. Results 76% appear repeatedly painless vaginal bleeding during pregnancy , 56% appear bleeding before delivery. Prenatal diagnosis of 17 cases (68%). The preoperative line cystoscopy + bilateral retrograde ureteral catheter or after the posterior hysterectomy , shorter operation time , less postpartum hemorrhage , reduce blood transfusion volume , no urinary tract injury rate, transferred to the ICU rate is low, the difference was statistically significant (P < 0.05). Conclusions We should attach importance to repeated painless vaginal bleeding , improve prenatal diagnostic rate of complicated placenta increta. The perioperative managementis more comprehensive , effective and standard participation , preoperative ureteral catheter and the posterior hysterectomy can effectively reduce the maternal adverse perinatal outcomes.

Objective: To study the serum interleukin-37 (IL-37) level changes in patients with acute coronary syndrome (ACS) and to explore the relationship between IL-37 and coronary atherosclerotic plaque.
Methods: Our research included 3 groups. ACS group, n=60, SAP (stable angina pectoris) group, n=30 and Control group, the subjects with normal coronary artery, n=15. The peripheral serum levels of IL-37 were examined by ELISA and the differences were compared among different groups.
Results: ① The serum levels of IL-37 at admission were as ACS group < SAP group < Control group, P<0.05.②Intervention could transitionally decrease IL-37 level in SAP group. With 4 weeks treatment, IL-37 levels were signiifcantly increased in both ACS group and SAP group than admission time, while they were still lower than Control group, P<0.05.③The serum level of IL-37 at admission was negatively related to IL-18 (r=-0.79, P<0.05), the ratio of IL-18/IL-37 were as ACS group>SAP group>Control group, P<0.05.④In ACS group, IL-37 level was negatively related to GRACE score (r=-0.71, P<0.05), the ratio of IL-18/IL-37 was positively related to GRACE score (r=0.73, P<0.05).⑤The diagnosis of ACS could be basically excluded if the patients with IL-37>77ug/L.
Conclusion: The serum IL-37 might be involved in the inlfammatory process in ACS patients, it could be expected as an index for ACS monitor and evaluation in clinical practice.

Along with the development of society and the rapid economic growth in the past decades,hypertension and other chronic diseases have become important reasons for people's poverty caused by illness in China.This study collected a total of 5857 people from 2010 to 2013 randomly from the database of the Medical Insurance Department (MID),including 3229 people in Hubei province and 2628 people in Guangdong province.One-way ANOVA was used to compare the total medical expense,out-of-pocket (OOP)expense and hospital stay between variables.A multiple linear regression analysis was done to identify possible risk factors of total medical expense.The results showed that the average total medical expense per capita was 5709.89 yuan,and the medical expense per capita was 7053.58 and 4555.97 yuan in Guangdong province and Hubei province,respectively.The medical expense of hypertensive inpatients decreased from 7222.32 yuan in 2012 to 4894.66 yuanin 2013.There were no significant differences in medical expenses between different genders of hypertensive patients (P＞0.05).People of different ages,provinces,medical insurances and medical institution levels showed significant differences in medical expenses.The government should increase the investment in chronic disease management and treatment in the central and western regions to narrow the gap with the eastern region.Medical insurance fund payment should be improved to ensure the fairness of the use of medical services in different medical insurances.And measures should be taken to encourage chronic patients to visit primary medical institutions to effectively reduce medical expenses.

Objective To explore the better time for representing the true body temperature when measuring the axillary temperatures of the elderly patients with clinical thermometer. Methods The objects were divided into the test group(78 cases)with an average age of 79 years and the control group(52 cases)with an average age of 33.5 years. Three thermometers meeting the measurement requirement were selected and were placed in the armpit of the two groups. The thermometers were taken out when measuring for 5,10 and l5 minutes, respectively. The body temperatures were recorded and analyzed statistically. Results The temperatures at 5,10 and 15 minutes were(36.01±0.54),(36.30±0.41)and(36.45±0.37)℃ in the elderly patient group, and(36.11±0.37),(36.64±0.34)and(36.87±0.29)℃ in the control group(P

Objective The purpose of this study was to investigate the value of serum galactomannan (GM) in the diagnosis of invasive pulmonary aspergillosis (IPA) in patients with chronic obstructive pulmonary disease (COPD).Methods We enrolled 60 COPD patients in the study, including 19 IPA and 41 non-IPA cases.We examined serum GM of the patients by ELISA, evaluate the value of serum GM test for the diagnosis of IPA in patients with COPD, and compared the GM values before and after treatment.Results With 0.5 as the positive cutoff value, the sensitivity, specificity, positive predictive value, and negative predictive value of serum GM were 57.9%, 95.3%, 84.6%, and 83.0%, respectively, with a high specificity and a low sensitivity.The 7 IPA cases showed a significantly decreased GM value after treatment as compared with the baseline (0.30±0.21 vs 1.48±1.37, P=0.004).Conclusion The serum GM test has a limited value in the diagnosis of IPA in patients with COPD, but dynamic monitoring of the changes of the serum GM value may help evaluate the patient's condition.

Objective To explore the nursing intervention Oil the rehabilitation of patients with coronary heart disease,help the patients build healthy daily habits.make their life better.Methods 118 patients who have the heart illness and were admitted to our hospital between July 2004 and December 2006 were selected and tlleir knowledge about the heart attack.their dailv life style and how they take the medicine were evaluated.Depend oil the result of the evaluatioil,the speeches about healthy life.scientific life style and how to take the medicine scientifically were given,and then the second evaluation Was conducted after having the speeches 6 months.1 year and 2years later.Results The patient'S knowledge about the decease was obviously increasing (average P