Résumé
Objective To discuss the feasibility and safety of simultaneous bilateral adrenal vein sampling(AVS)using two 4F-MPA1 catheters via right elbow vein access.Methods A total of 51 consecutive patients with primary aldosteronism,who received simultaneous bilateral AVS using two 4F-MPA1 catheters(one of the two catheters was shaped into pig tail figure)via right elbow vein access at Xiangyang Municipal Central Hospital between October 2021 and October 2022,were enrolled in this study.The used catheter,the success rate of simultaneous bilateral AVS,and the incidence of complications rate were calculated.Results The 4F-MPA1 catheter was used for all of the right AVS,while a specially shaped 4F-MPA1 catheter was used for the main trunk vein AVS of the left adrenal gland and the central vein AVS of the left adrenal gland.The success rate of simultaneous bilateral AVS was 92.2%(47/51).Adrenal hematoma occurred in one patient(1.96%).Conclusion The technique of simultaneous bilateral AVS using two 4F-MPA1 catheters via right elbow vein access is simple to operate,less traumatic,and clinically safe and feasible.However,due to the small sample used in this study,the clinical value of this technique still needs further investigation and verification.
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Objective:To explore the prevalence and risk factors of thyroid nodules in physical examination population.Method:A total of 5934 Han people who underwent physical examination in the physical examination center of the Affiliated Hospital of Hubei University of Arts and Sciences from August 2016 to August 2019 were selected as the research objects. Retrospective research methods were used to divide them into thyroid nodule group and thyroid non nodule group according to the results of thyroid ultrasound examination, and statistical analysis was carried out in combination with relevant data. T-test was used for the comparison between measurement data groups that conform to the normal distribution and χ 2 test was used for the comparison between counting data groups. Binary Logistic regression was used to analyze the relationship between different factors and thyroid nodules, and the odds ratio ( OR) and 95% confidence interval (95% CI) were calculated. Results:(1) The prevalence of thyroid nodules in all population is 28.1% (1 668/5 934), the prevalence of thyroid nodule is 23.1% (977/4 230) in men and 40.6% (691/1 704) in women separately, and the distribution is obviously higher in women than that in male (χ 2=183.13, P=0.008). The prevalence increased with aging in both sexes ( P=0.001). (2) The correlation between the clinical data of physical examination population and thyroid nodules was analyzed according to gender. Among male patients, the rates of BMI≥23.0 kg/m 2 (82.2% (803/977)), diabetes (14.7% (144/977)), hypertension (44.4% (434/977)) and smoking history (63.1% (616/977)) in thyriod nodule group were higher than those in the non thyroid nodule group (78.9% (2 565/3 253), 8% (260/3 253), 29.3% (952/3 253), 56.9% (1 851/3 253)) (χ 2 were 5.17, 39.59, 78.35 and 11.80, respectively; P values were 0.023, 0.009, 0.005 and 0.007, respectively). Among female patients, the rates of BMI ≥23.0 kg/m 2 (55% (380/691)), obesity (31.1% (215/691)), diabetes (6.2% (43/691)), hypertension (28.9% (200/691)), high total cholesterol (43.6% (301/691)), low high-density lipoprotein cholesterol (7.1% (49/691)), high triglycerides (28.4% (196/691)), and high low-density lipoprotein cholesterol (29.1% (201/691)) in thyroid nodule group were higher than those in the non thyroid nodule group (43.6% (442/1 013), 22.5% (228/1 013), 1.9% (19/1 013), 19.2% (195/1 013), 34.7% (352/1 013), 17.9% (181/1 013), 21.5% (218/1 013), 4.5% (46/1 013)), and the differences were statistically significant (χ 2 were 21.23, 15.82, 22.14, 21.68, 13.51, 26.27, 12.69 and 5.08, respectively; P values were 0.007, 0.006, 0.009, 0.007, 0.008, 0.005, 0.005 and 0.024, respectively). (3) Multiple logistic regression analysis reveal that age ( OR=1.530, 95% CI:1.463-1.621, P=0.009), sex ( OR=3.580, 95% CI:2.931-4.381, P=0.005), smoking ( OR=1.360, 95% CI:1.161-1.592, P=0.007) and high blood pressure ( OR=1.290, 95% CI:1.121-1.482, P=0.006) were the risk factors of thyroid nodule. Conclusion:The prevalence of thyroid nodules is 28.1% in XiangYang and surrounding areas, and the elders, women, smoking and high blood pressure were the risk factors of thyroid nodule.
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The hospital observed the principles of ensuring medical safety,shared risks and responsibilities in its attempt to build the risk mortgage mechanism in the hospital.The mechanism is characteristic of setting up the scope and standards for the risk mortgage,defining the use and refund cycle of the risk mortgage,along with a series of rewards and penalties.This design aims at minimizing cases of medical disputes (malpractice) for better medical safety.