Objective To evaluate the value of ultrasonograph for predicting axillary status in patients with breast cancer.Methods Our study enrolled 336 patients with breast cancer, accepted the clinical examination and axillary ultransonograpy before operation and pathological examination after operation. Results The sensitivity and specificity of diagnosis by clinical examination and ultrasonograpy were 76.2% and 47.6%, 86.1% and 74.3% respectively. The sensitivity and specificity of experienced ultrasonologist and un experienced ultrasonologist were 95.6% and 82.7%, 84.7% and 59.0% respectively.Conclusion Our study indicates that ultrasonograpy is better than clinical examination for predicting axillary node status,moreover the experiences of ultrasonologist affect the predicting results.
Background Currently, the clinical evidence regarding the prognostic significance of the TyG index in acute myocardial infarction (AMI) patients remains unclear. Our research analyzed the correlation between the TyG index and the risk of mortality in patients with AMI, in order to evaluate the influence of the TyG index on the prognosis of this population. Methods 1205 ICU patients with AMI were analyzed in this retrospective cohort analysis, and the necessary data were obtained from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The study conducted Kaplan-Meier analysis to compare all-cause mortality rates across four groups of patients. The study included logistic regression and Cox regression analysis to examine the correlation among the TyG index and the risk of in-hospital, 28-day, and 90-day mortality. Results In our study, 176 (14.61%) patients experienced in-hospital deaths, 198 (16.43%) patients died within 28 days of follow-up, and 189 (23.98%) patients died within 90 days of follow-up. Logistic regression and Cox proportional hazard analyses revealed that the TyG index was an independent predictor of in-hospital, 28-day, and 90-day mortality (OR: 1.406, 95% CI 1.141-1.731, p = 0.001; HR: 1.364, 95% CI 1.118-1.665, p = 0.002; HR: 1.221, 95% CI 1.024-1.445, p = 0.026, respectively). The restricted cubic spline regression model showed that the risk of in-hospital, 28-day, and 90-day mortality increased linearly with increasing TyG index. Conclusions The TyG index was significantly associated with an increased risk of mortality in AMI patients. Our findings suggested that the TyG index may be instrumental in identifying patients at high risk for adverse outcomes following AMI.
Abstract Background It is uncertain whether measurement of circulating total atherogenic lipoprotein particle cholesterol mass (non-high-density lipoprotein cholesterol [non-HDL-C]) or particle concentration (apolipoprotein B [Apo B]) more accurately reflects risk of incident cardiovascular disease (CVD). We evaluated CVD risk among China population in whom these markers where discordant. Methods In total, 7,117 initially healthy participants from the China Health and Nutrition Survey were included. Logistic regressions among Apo B, non-HDL-C, and LDL-C, respectively, were used to examined CVD risk by categories of concordant and discordant values defined by residual differences. Mediation analysis was performed to explore the intermediary effect of Apo B between the obesity and the risk of CVD. Results Although all 3 biomarkers were correlated (r ≥ 0.81), discordance occurred in approximately 16% of China participants. Participants with discordant high Apo B were more likely to have higher proportion of traditional risk factors and dyslipidemia. During a follow-up of 6 years, 207 CVD cases were identified. High LDL-C, non-HDL-C and Apo B were associated with increased risk of CVD. Participants with discordant high Apo B relative to LDL-C or non-HDL-C had increased CVD risk compared with concordant levels, odds ratios were 1.38 (95% CI: 1.01 to 1.87), 1.40 (95% CI: 1.01 to 1.94), respectively. Furthermore, mediation analyses revealed 16.67% of association between obesity with CVD was mediated by Apo B. Conclusions Discordance analysis demonstrates that Apo B is a more accurate marker of CVD risk in China healthy participants than LDL-C and non-HDL-C. Direct measurement of lipoprotein particle concentration might help better inform clinical risk assessment and guide clinical decision making.
In this article we reported a female patient with type 2 gastric neuroendocrine tumor (NET). The patient developed upper abdominal pain, acid reflux, heartburn, nausea, and vomiting without obvious cause 16 years ago. Later, a tumor was found in her stomach. Two years ago, a solid mass was found at the pancreatic head. Somatostatin receptor scintigraphy showed positive result. Puncture biopsy showed the presence of a NET. The serum gastrin level was significantly increased (3,527pg/mL) at presentation. A second gastroscopy showed polypoid uplifts in gastric body. Puncture biopsy confirmed the presence of a G2 NET in gastric body. The patient previously had received a pituitary tumor surgery and thyroid gland resection. The diagnosis was multiple endocrine neoplasia type 1 (MEN-1). The treatments included sutent, lanreotide, and traditional Chinese herbs. In this article we described the diagnosis and treatment of a patient with MEN-1 accompanied with type 2 gastric NET, which may be clinically informative.
ABSTRACT Purpose Sleep deprivation and elevated blood pressure (BP) increase the risk of cardiovascular diseases. However, the effects of sleep deprivation on BP response, especially at exercise onset remain unclear. We aimed to elucidate the effects of experimental sleep deprivation (ESD) on resting and exercise BPs, including that at exercise onset, and investigate whether a night-time nap during ESD changes the ESD-altered BP. Methods Twelve healthy young men underwent 2-min submaximal isometric elbow flexion (IEF) exercise to measure BP after 7 days of normal sleep (control trial), 24-h ESD (ESD trial), and ESD with a 2-h night-time nap (ESD + NAP trial), which were randomly performed. Results ESD significantly elevated the mean arterial pressure (MAP) at rest (85.8 ± 8.0 to 93.3 ± 5.1 mmHg, P = 0.003) and at the last minute of IEF (116.9 ± 13.0 to 126.2 ± 11.8 mmHg, P = 0.003) compared with that observed in the control trial. At IEF onset (the initial 15 s), ESD significantly elevated the MAP (88.7 ± 12.6 to 103.1 ± 8.8 mmHg, P < 0.001) and augmented the MAP responsiveness from baseline, compared with that observed in the control trial (Δ2.9 ± 11.4 to Δ9.8 ± 6.6 mmHg, P = 0.017). The MAP responsiveness in the ESD + NAP trial (Δ7.3 ± 5.2 mmHg) was not significantly different from that in the control trial ( P = 0.165) and the ESD trial ( P = 0.129). Conclusions ESD significantly elevated both resting BP and the BP during submaximal isometric exercise and significantly augmented the initial pressor response to the exercise. A 2-h night-time nap during ESD appears to be insufficient to completely attenuate ESD-induced augmented pressor responses.
Background Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease and its prevalence has risen sharply. However, whether nutrition, dietary strategies, exercise, lifestyle and environment have preventive value for NAFLD remains unclear.
Abstract Background Previous studies, in which the data were collected about half a century ago, suggested that elevated low density lipoprotein cholesterol (LDL-C) is not associated with increased risk of cardiovascular disease (CVD) in patients over 70 years old. However, what is the relationship between LDL-C and CVD risk in a contemporary population aged over 70 years has not been well examined in China. Methods The China Health and Retirement Longitudinal Study (CHARLS) is an ongoing nationally representative study. In this analysis, participants of CHARLS who did not taking statins and did not have heart disease and stroke at 2011 were include and were followed up to 2018. The outcome of this analysis was occurrence of CVD at follow up, which include heart disease and stroke. Cox regression was used to assess the harmful effect of LDL-C on CVD occurrence. We calculated e-values to quantify the effect of unmeasured confounding on our results. Results Of the 9,631 participants, 15.2% (N=1,463) were aged over 70 years and 52.5% (N=5,060) were female. During the 7 years follow-up, 1,437 participants had a first CVD attack. Risk of CVD occurrence increased 8% with each 10 mg/mL elevation in LDL-C in whole participants (adjusted HR, 1.08; 95% CI, 1.06-1.10) and age groups of ≥70 years, 60-69years and <60 years. Similar results were observed in subgroup analyses, in which participants were stratified by sex, hypertension, diabetes and chronic kidney disease. According to the restricted cubic spline, we noted a U-shaped relationship between LDL-C and risk of CVD occurrence in group over 70 years old, however, we further found that in the left side of U-shape curve, LDL-C was not associated with occurrence of CVD and its attribution to CVD occurrence was only 2.1%, which indicated that lower level of LDL-C could not increase the risk of CVD occurrence as it was demonstrated by a U-shape association. E-value analysis suggested robustness to unmeasured confounding. Conclusions In contemporary society of China, elevated the level of LDL-C also increased the risk of CVD in participants over 70 years old as in the relatively younger participants. These results should strengthen guideline recommendations for the use of lipid lowering therapies in those elderly.
Objective: To observe the effect of HANS in relifing labour pain compared with PCEA. Method:80 pregnant women were randomly divided into 4 groups. Group I with HANS, group Ⅱ with HANS Placebo+PCEA, group Ⅲ with HANS+PCEA and group Ⅳ for control. Result:Pain threshold in group I increased 40% deducing through VAS Scoring,which was significantly effective than that in group Ⅳ( P 0.05), but less efficacious than that in group Ⅱand group Ⅲ( P 0.05). The VAS Scores in group Ⅱ and grorp Ⅲ showed no difference, but the dosage of local anaesthetic used and the frequency of attempts for PCEA showed marked difference( P 0.05). Thus HANS used in labour pain can decrease the dosage of lidocaine by 39%. Conclusion: HANS combined with local anacsthetic for labour pain is an efficent method which can not only relif pain but ensure the safety both for mother and her newborn infant.
Objective To study the effect of captopril tablets on plasma endothelin(ET)and nitric oxide (NO) of the patients of hypertension. Methods The 35 selected patients of hypertension were adhibited with 12.5～25mg captopril tablets one time everyday in four weeks. ET of plasma and NO of hypertension patients were compared before treatment with those after treatment.They were also compared with 30 healthy persons too. Results ET of patients of hypertension is much higher significantly(P0.01).NO of them is significantly lower(P0.01).After the treatment of captopril tablets,systolic pressure and diastolic pressure lowered significantly(P0.01),ET decreased significantly(P0.01)and NO rose significantly(P0.01). Conclusion Captopril tablets can not only lower blood pressure,but also ameliorate vascular endothelium function.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)