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<p><b>BACKGROUND</b>The purpose of this study was to conduct thyroid ultrasound examinations on a large sample of subjects and explore the occurrence, distribution, and characteristics of thyroid nodules and thyroid cancer to provide some information on the epidemic trend of thyroid nodules and cancer.</p><p><b>METHODS</b>The thyroid ultrasonic examination results of 19 895 healthy physical examinees who visited the Department of Health Management, Peking Union Medical College Hospital from January 2009 to December 2011 were analyzed retrospectively to determine the detection rate and characteristics of thyroid nodules. Fine needle aspiration or surgical resection was suggested to subjects suspected of having thyroid cancer.</p><p><b>RESULTS</b>The detection rate of thyroid nodules was 42.6% (8 480/19 895), 40.0% (4 661/11 678) in men and 46.5% (3 819/8 217) in women. The detection rate noticeably increased with increasing age. The detection rate of thyroid nodules by palpation was obviously lower than by ultrasonic examination in various age groups. Among those with thyroid nodules, 61.3% were multiple and 38.7% were solitary; multiple nodule was the major type both in men and women. Twenty-nine cases of malignant nodules were solitary, and 30 cases of malignant nodules were multiple. There was no significant difference. The detection rate of thyroid cancer was 0.30% for the entire group of examinees, and 0.15% in men and 0.50% in women. Among all sex and age groups, 30- to 40-year-old women had the highest detection rate (0.76%). The detection rate of thyroid nodules correlated with age, systolic blood pressure, height, and weight. Increasing age and/or higher systolic blood pressure correlated with a higher detection rate, while smaller height and weight also correlated with a higher detection rate with significant differences. However, there were no significant correlations between the detection rate and diastolic blood pressure or body mass index.</p><p><b>CONCLUSIONS</b>The detection of thyroid cancer increased significantly, especially in women. Thus, precautions needed to be taken. Regular physical examination and timely intervention after detection of malignant nodules are critical to improve the prognosis in thyroid cancer patients.</p>
الموضوعات
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Biopsy, Fine-Needle , Retrospective Studies , Thyroid Neoplasms , Diagnosis , Epidemiology , Thyroid Nodule , Diagnosis , Epidemiologyالملخص
Objective Emergency department overcrowding (EDO) is an increasingly international occurrence which affects the quality and access of health care across the globe.We assessed perceptions of EDO by a detailed and comprehensive surveying of current international research literatures.Methods Through PubMed and BMC electronic literatures search engines from 1974 to 2012,1587 papers of original articles,reviews and comments with key wordsemergency departmentANDcrowding OR overcrowding are selected.Results 52.6％ (835/1587) all selected literatures is original research articles.21.2％ (n =337) of these papers involved the disciplinary construction of emergency medicine,and editorial comment (included viewpoints) holds almost one fifth (302,19.0％).Most common types of study methods in all original researches is single-center cohort study (722/835,86.5％),and none of them was multi-center,randomized control clinical trial.The number of papers on EDO is 8 during 1974 and 1988,and gradually elevated to 325 during 1989 and 2002.Yet the number has climbed up to 1254 dramatically (account for 79％) during 2003 and 2012.Together,USA,Canada and Austria,these three countries generated more than three-quarters of all published literatures (81.0％).So far,the authors in 48 countries and areas gave forth initial contributions in the field of EDO.Conclusions The studies and papers about EDO are steadily increasing in recent years.But the investigation shows the research quality still remain need to improve.This systemic review on EDO studies showed that the standardized measurement of EDO has become the bottleneck of EDO study.It is very important and urgent for ED staff to establish an objective and effective EDO evaluation system.
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Objective To investigate the relationship between carotid artery atherosclerosis and risk factor in a young and middle-aged population in China who received health checkup.Methods A total of 762 cases of young and middle-aged adult were recruited between April and October in 2013.These subjects had no hypertension,diabetes,coronary heart disease,cerebrovascular disease,and connective tissue disease,etc.Their Blood pressure,serum glucose (Glu),total cholesterol (TC),triglyceride (TG),and low density lipoprotein cholesterol (LDL-C) were measured and carotid artery ultrasonography was performed.Of the 762 cases,589 were male,173 were female,mean age was (46 ± 9) years.For blood pressure,blood lipids,the t test was performed to detect the difference between arteriosclerosis group and non arteriosclerosis group in different age groups.Logistic regression was performed to reveal the risk factors with carotid arteriosclerosis.Results Of the 762 subjects,205 had carotid artery atherosclerosis; 30.2％ (178/589) of them were men and 15.6％(27/173) of them were women,with a significant difference between two groups,(x2=14.522,P=0.000).In the younger than 40 years old group,the diastolic blood pressure has statistical significance between carotid arteriosclerosis and non carotid arteriosclerosis group (t=-2.789,P＜ 0.05); blood sugar had statistically significant difference between the two groups (t value was-2.256,-2.930,-2.174,respectivly,P＜0.05).Multiple regression analysis revealed that the independent risk factors for carotid artery arteriosclerosis were age,sex,DBP,and Glu.The regression coefficients were 0.993,0.711,0.047,0.334 seperately.The ROC curve of age was analyzed,the area under the ROC curve was 0.731,cut-off was 51 years old.Conclusions Routine carotid artery ultrasound should be performed for older than 50 healthy middle-aged men,to determine whether arteriosclerosis exists,especially for people with abnormal blood glucose or elevated DBP.
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Objectives To evaluate the association between serum cystatin C and carotid atherosclerosis.Methods Medical data,including physical examinations,serum levels of cystatin C,bilirubin,uric acid and other biochemical markers and duplex ultrasonographic scanning for the carotid artery,of 1741 healthy adults (1193 men and 548 women) who sought physical check-up at Peking Union Medical College Hospital during January 2010 and December 2011 were collected,and those with hypertension,diabetes and liver or renal function failure were excluded.Based on the results of carotid duplex uhrasonography,all the adults checked were assigned to two groups,one with thickened intima-media and atherosclerotic plaque (group A),the other with non-thickened intima-media and non-atherosclerotic plaque (group B).Difference in serum cystatin C,bilirubin,uric acid and other biochemical markers between the two groups was analyzed by using Student's t test.The correlation between the markers and carotid plaque was analyzed by using Spearman correlation analysis.The correlated factors of the carotid thickness and plaque appearance were analyzed by using unconditional Logistic regression analysis.Results Serum level of cystatin C was significantly increased in group A (t =-8.85,P ＜ 0.05).Thickness of carotid intima was positively correlated with serum cystatin C (r =0.21,P ＜ 0.05).In multivariate Logistic regression analysis,high level of serum cystatin C was not an independent risk factor of carotid atherosclerosis.Conclusion Relationship between serum cyatatin C and carotid atherosclerosis was not confirmed in our populations,which should be explored further in cohort studies.
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Objective To assess the value of SureTouch tactile breast imaging (SureTouch) in early breast disease detection.Methods From April 2009 to March 2011,16 010 adults received health checkup in our center,5000 of whom took breast screening and were randonly selected to accept SureTouch.The results of the SureTouch were reviewed.Results In SureTouch,799 participants were normal,resulting in an abnormal rate of 84.02％.Four thousands and nineteen adults were found with breast hyperplasias (80.38％) and 150 with breast nodulars (3.00％),and another 32 women were suspected with malignant condition (0.64％).Breast hyperplasia was the most commonly seen disease in all age groups,although breast nodular and malignant changes were mainly found in 35-50 age group.The incidence of malignant disease showed a trend of affecting younger females.Pathological follow-up results of two controversial cases supported the diagnosis of SureTouch.Conclusions SureTouch shows high sensitivity in this study.The application of SureTouch in breast screening may play an important role in the early detection,diagnosis and treatment of breast diseases.
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ObjectiveTo explore the significance of colonoscopy examination in healthy subjects.MethodsA total of 537 health examination cases who underwent colonoscopy from January 2010 to June 2011 in Peking Union Medical College Hospital (PUMCH) health examination center were enrolled,in which 529 cases underwent total colonoscopy.Detection of colorectal lesion,polyp types and pathology were recorded and the correlation between detection rate of polyps,lesion sites and ages as well as gender were analyzed.ResultsThere were 315 male and 214 female,with a mean age of 48.3 ± 9.3 years.A total of 158 colorectal polyps were detected in 104 cases ( 19.7％ ),including 84 ( 15.9％ ) adenomas,17 (3.2％ ) advanced polyps and 1 (0.2％ ) rectal cancer.Other abnormalities were hemorrhoids in 61 cases ( 11.5％ )and inflammation in 22 (4.2％ ).Colorectal polyps were more frequent in men (P ＜0.001 ).Adults older than 50 had higher rates of colorectal polyps (P ＜0.001 ) and advanced polyps ( P ＜0.05).The proportion of patients with proximal polyps increased with age,whereas that of patients with distal polyps decreased with age ( P ＜0.05).ConclusionColonoscopy is an effective screening modality for colorectal lesions and the importance of colonoscopy on health examination population to prevent colorectal cancer should be stressed.
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Objective To investigate the influential factors of brachial-ankle artery pulse wave velocity (baPWV) in healthy individuals.Methods Total 716 healthy subjects including 503 males and 213 females,who underwent health check up in 2010,were enrolled in the study Bilateral baPWV was examined in all subjects and multiple factor linear regression was applied to evaluate the correlations of baPWV with sex,age,body mass index,arterial blood pressure,ankle-brachial index and biochemical variables.Results The mean baPWV of 716 healthy subjecs was ( 1224 ± 162) cm/s,and there was significant difference between men and women [ ( 1257 ± 159) cm/s vs.( 1144 ± 143) cm/s].There was a significant linear correlation of baPWV with sex,age,mean arterial blood pressure and plasma homocysteine concentration ; and the linear regression equation was:mean PWV =6.635 × age + 7.285 × mean arterial blood pressure + 2.682 × homocysteine concentration - 64.334 × sex + 347.500 ( sex:man =0,woman =1 ).Conclusion Age,sex,mean arterial blood pressure and plasma homocysteine concentration are independent influential factors of baPWV.
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Objective To study the effectiveness of ultrasonography in thyroidnodule disease detection and malignant/benign lesion differentiation during health check-up.Method Thyroid examination data of Peking Union Medical College Hospital(PUMCH)staff over the last 6 years were retrospectively reviewed.The results of thyroidnodule scanning by using ultrasonography were compared with the findings of physical examinations.Results Among 6348 health check-up receivers from 2006 to 2010,450 were found to have thyroidnodule(detection rate 7.09％).Twenty malignant lesions were confirmed in histological examinations(mean detection rate per year 0.38％).In 2011,1706 thyroid glands were scanned by both physical examination and ultrasonography,and 525 thyroidnodules were identified(detection rate 30.77％).Surgical operations were performed for 22 suspected malignant tumors,and 18 malignant lesions were finally confirmed(detection rate 1.06％).Conclusion Ultrasonography can improve the detection of thyroidnodule.Irregular shape,microcalcification,and rich blood-flow may indicate malignant nodules.