简介:摘要目的探讨遵义医学院附属医院甲状腺乳腺外科2015—2017年甲状腺癌的发病情况及临床病理学特征。方法回顾性分析遵义医学院附属医院2015年1月—2017年12月初次行甲状腺手术,术后病理明确诊断的512例甲状腺癌患者的临床病理资料。结果男女发病比例约为13,临床上多无症状,无症状者占95.3%,有症状者占4.7%;男性患者发病年龄为40.15±11.95岁,女性患者发病年龄41.31±12.68岁,但二者间差异无统计学意义(P=0.397);512例甲状腺癌患者中乳头状癌495例(96.7%),滤泡状癌7例(1.4%),髓样9例(1.7%),未分化癌1例(0.2%);确诊甲状腺乳头状癌495例中,颈部淋巴结状态与性别、肿瘤直径及肿瘤病灶差异具有统计学意义(P<0.05);行BRAFV600E基因检测的326例甲状腺乳头状癌中,BRAFV600E突变状态与患者年龄、肿瘤分期及颈部淋巴状态差异具有统计学意义(P<0.05)。结论女性甲状腺癌发病高于男性,男女发病年龄高峰均为30~59岁,临床上多无症状;颈部淋巴结状态与性别、肿瘤直径、肿瘤病灶存在相关性;BRAFV600E突变状态与年龄、肿瘤分期及淋巴结状态存在相关性。
简介:摘要目的总结胸腔镜下心脏手术体会,分析手术要点,探讨手术方法及临床疗效。方法于2010年1月至2013年05月,开展胸腔镜下心脏手术512例,其中完全胸腔镜心脏手术224例,包括房间隔缺损修补手术137例,室间隔缺损修补手术34例,二尖瓣置换手术41例,二尖瓣成形手术9例,部分性心内膜垫缺损矫治手术3例。胸腔镜辅助下心脏手术288例,包括房间隔缺损修补+三尖瓣成形手术54例,室间隔缺损修补手术91例,室间隔缺损+右室流出道疏通术6例,二尖瓣置换+三尖瓣成形手术91例,二尖瓣成形手术42例,主动脉右冠窦瘤破裂4例。两组均采用右股动脉插供血管,右股静脉和(或)上腔静脉插引血管建立体外循环。顺行灌注保护心肌,胸壁打3孔或经右侧胸壁小切口(4-5cm)+两孔法在胸腔镜下完成心脏手术。结果全组无死亡病例,完全胸腔镜组体外循环时间、升主动脉阻断时间略长于传统开胸手术,但胸腔镜辅助组和传统开胸组无差别,且两组患者与传统开胸组相比较,术后呼吸机辅助时间短,术后胸腔引流量少,术后住院时间短,输血少。结论胸腔镜下行心脏手术创伤小,美容效果好,是可行的,安全的。
简介:AbstractBackground:Joint dislocations significantly impact public health. However, a comprehensive study on the incidence, distribution, and risk factors for joint dislocations in China is lacking. We conducted the China National Joint Dislocation Study, which is a part of the China National Fracture Study conducted to obtain the national incidence and risk factors for traumatic fractures, and to investigate the incidence and risk factors for joint dislocations.Methods:For this national retrospective epidemiological study, 512,187 participants were recruited using stratified random sampling and probability-proportional-to-size method from January 19 to May 16, 2015. Participants who sustained joint dislocations of the trunk, arms, or legs (skull, sternum, and ribs being excluded) in 2014 were personally interviewed to obtain data on age, educational background, ethnic origin, occupation, geographic region, and urbanization degree. The joint-dislocation incidence was calculated based on age, sex, body site, and demographic factors. The risk factors for different groups were examined using multiple logistic regression.Results:One hundred and nineteen participants sustained 121 joint dislocations in 2014. The population-weighted incidence rate of joint dislocations of the trunk, arms, or legs was 0.22 (95% confidence interval [CI]: 0.16, 0.27) per 1000 population in 2014 (men, 0.27 [0.20, 0.34]; women, 0.16 [0.10, 0.23]). For all ages, previous dislocation history (male: OR 42.33, 95% confidence interval [CI]: 12.03–148.90; female: OR 54.43, 95% CI: 17.37–170.50) and alcohol consumption (male: OR 3.50, 95% CI: 1.49–8.22; female: OR 2.65, 95% CI: 1.08–6.50) were risk factors for joint dislocation. Sleeping less than 7 h/day was a risk factor for men. Compared with children, women aged ≥15 years (female 15–64 years: OR 0.16, 95% CI: 0.04–0.61; female ≥65 years: OR 0.06, 95% CI: 0.01–0.41) were less likely to sustain joint dislocations. Women with more than three children were at higher dislocation risk than women without children (OR 6.92, 95% CI: 1.18–40.78).Conclusions:The up-to-date data on joint dislocation incidence, distribution, and risk factors can be used as a reference for national healthcare, prevention, and management in China. Specific strategies for decreasing alcohol consumption and encouraging adequate sleeping hours should be developed to prevent or reduce dislocation incidents.Trial Registration:Chinese Clinical Trial Registry, ChiCTR-EPR-15005878.
简介:摘要:本文对linux系统shadow文件SHA512模式下密码的生成方式进行了详细的讨论,同时对密码学安全进行了简要介绍。