After Wenchuan earthquake on May 12, West China Medical School/ West China Hospital of Sichuan University organized a youth volunteer team for earthquake rescue and relief. A volunteer network was formed and relevant service regulations were formulated immediately. Volunteers have played an important role in post-earthquake evacuation of patients, emergency reception, ward care, on-call service, a service to help people find family members, telecommunications and some other major tasks.
Objective To investigate the correlation between glycosylated hemoglobin A1c (HbA1c) and severity of coronary artery lesions in young men with acute myocardial infarction (AMI). Methods Total 278 young men with AMI less than 45 years old were retrospectively studied, and all of them were admitted to hospital from January 2009 to December 2011, and had undergone coronary angiography. According to the results of coronary angiography, the patients were divided into three groups based on the number of artery lesions: the single group (156 cases), the double group (64 cases) and the triple group (58 cases). The relationship between the severity of coronary artery lesions and the following factors were observed: HbA1c, systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum uric acid (UA), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), body mass index (BMI), smoking history, drinking history and family history of early coronary artery disease. Results a) HbA1c levels were gradually raised in all the three groups, but the single group (6.39±1.67%) was significantly lower than the double group (6.91±1.63%) and the triple group (7.41±2.12%), with significant differences (Plt;0.05); the HbA1c level of the single group was significantly lower than the triple group in both the ST-segment elevation AMI (6.42±1.68% vs. 7.17±1.86%, Plt;0.05) and the non-ST-segment AMI (5.57±0.37% vs. 8.56±2.83%, Plt;0.05); the HbA1c level of the single group was significantly lower than the triple group in patients with diabetes millitus (8.31±1.83% vs. 8.59±2.02%, Plt;0.05) and in patients without diabetes millitus (5.56±0.33% vs. 5.74±0.37%, Plt;0.05); b) There were significant differences in SBP, TC, HDL-C, LDL-C and drinking history between the single group and the other two groups (all Plt;0.05), and there were significant differences in DBP and TG between the single group and the double group (all Plt;0.05); and c) The results of logistic regression analysis showed that, LDL-C (OR=1.790), HbA1c (OR=1.287) and SBP (OR=1.042) were the independent risk factors (all Plt;0.05) for multiple lesions in coronary arteries of young men with AMI. Conclusion Glycosylated hemoglobin A1c is an independent risk factor for multiple lesions in coronary arteries of young men with AMI.
【摘要】 目的 評價青年人頸動脈彩色多普勒超聲檢查的臨床意義，并探討青年人腦梗死與頸動脈粥樣硬化的關系。 方法 2008年2月-2011年3月，對256例青年腦梗死患者進行頸動脈彩色多普勒超聲檢測，選擇性別和年齡匹配的健康青年143例作對照組，比較兩組人群頸動脈彩色多普勒超聲特點的差異。 結果 腦梗死組頸動脈粥樣硬化斑以中等、強回聲斑塊為主，斑塊積分、血管壁內-中膜厚度（ITM值）及斑塊檢出率（34.77%，89例）均明顯高于對照組（Plt;0.01）；腦梗死組頸動脈硬化狹窄率及血栓發生率明顯高于對照組（Plt;0.05，lt;0.01）。 結論 青年腦梗死患者頸動脈粥樣硬化及血栓形成發生率均高，提示青年腦梗死患者的發病主要原因與動脈粥樣硬化有關。IMT值的增加、斑塊的檢出率及形態學特征等是頸動脈病變與腦梗死發生的有意義的檢測指標，在青年人腦梗死的防治中是有參考意義較大的超聲學指標。【Abstract】 Objective To assess the clinical significance of color Doppler ultrasonography in examining carotid arteries of young patients, and explore the relationship between cerebral infarction and carotid arteriosclerosis in young patients. Methods A total of 256 patients with cerebral infarction and 143 people without cerebral infarction diagnosed between February 2008 and March 2011 were assessed by color doppler ultrasonography. The ultrasonic characteristics of the two groups were compared and analyzed. Results Plaques incidence in cerebral infarction group was 81.43% which was higher than that in the control group. The most common sites of plaque formation were common carotid artery (CCA) bifurcate and the initial segment of internal carotid artery (ICA) in young people with cerebral infarction. In the cerebral infarction group, the rate of middle-echoic plaques was higher than that in the control group (Plt;0.05). The rate of low-grade carotid stenosis was higher in the cerebral infarction group than that in the control group (Plt;0.05). Conclusions Cerebral infarction occurrence in young people is closely correlated to carotid artery atherosclerosis. Ultrasonography can provide objective evidences for preventing and treating cerebral infarction.
Objective To analyze midterm effectiveness of percutaneous compression plate (PCCP) for femoral neck fractures in young and middle-aged patients. Methods The clinical data of 173 young and middle-aged patients with femoral neck fractures who met the selection criteria and were treated with PCCP internal fixation between January 2011 and March 2019 were retrospectively analyzed. Among them, there were 102 males and 71 females; the age ranged from 18 to 59 years, with an average age of 44.9 years. The injury causes included falling in 112 cases, traffic accident in 32 cases, falling from height in 21 cases, struck in 7 cases, and sprain in 1 case. According to Garden classification, there were 90 cases without displacement (51 cases of type Ⅰ and 39 cases of type Ⅱ) and 83 cases with displacement (51 cases of type Ⅲ and 39 cases of type Ⅳ). According to Pauwels classification, there were 10 cases of type Ⅰ, 88 cases of type Ⅱ, and 75 cases of type Ⅲ. The time from injury to operation was 1-14 days, with an average of 4.5 days. The operation time, intraoperative blood loss, perioperative blood transfusion, and hospitalization stay were recorded; the fracture reduction was evaluated by Garden alignment index at 1 day after operation; fracture healing and complications were observed, and Harris score was used to evaluate the effectiveness at last follow-up. Results The operation time was 34-130 minutes (mean, 78.6 minutes); the intraoperative blood loss was 10-250 mL (mean, 93.2 mL); 171 cases did not receive blood transfusion during perioperative period, 2 patients received blood transfusion of 400 mL and 800 mL respectively; the hospitalization stay was 3-19 days (mean, 11.3 days). All 173 cases were followed up 11-103 months, with an average of 42.6 months. Postoperative reduction quality was satisfactory in 170 cases and unsatisfactory in 3 cases. There were 13 cases of osteonecrosis of femoral head, 1 case of screw cutting out, 2 cases of screw withdrawal, 5 cases of femoral neck shortening, and no deep vein thrombosis in the lower extremity requiring surgical intervention. Fractures healed in 172 patients, and the healing time ranged from 3.0 to 7.5 months, with an average of 3.6 months; 1 case of nonunion occurred. Internal fixation was removed after fracture healing in 51 patients. At last follow-up, Harris score was excellent in 156 cases, good in 11 cases, fair in 3 cases, and poor in 3 cases, with an excellent and good rate of 96.5%. ConclusionThe treatment of femoral neck fractures with PCCP has advantages of rigid fixation, immediate weight-bearing, and sliding compression, reducing the incidences of osteonecrosis of femoral head and nonunion.
Objective To study the application and the curative effect of compressed screw and sartorius bone flap in treating femoral neck fractures in youth or middle age. Methods From February 1996 to December 2004, 86 patients with femoral neck fracture were treated by open reduction compressed screw and sartorius bone flap, aging from 21 to 49 years. Fracture was caused by traffic accident in 35 cases, fall from height in 27 cases and fall in 24 cases. Accoding to Garden classification, 23 cases were type Ⅱ, 25 cases were type Ⅲ, and 15 cases were type Ⅳ. We analyzed fracture healing and evaluate function by observation of the postoperative X-ray films. Results Of the 86 patients, 62 were followed up 6 months to 7 years (2 years and 5 months on average). According to Weijie’s criterion for nonunion and necrosis offemoral head, nonunion occurred in 4 cases; the healing rate of fracture was 93.5%. In healed patients, necrosis of femoral head occurred in 7 cases (11.3%) after 3 years. The results of hip joint function evaluation were excellent in 44 cases, good in 8 cases, fair in 6 cases and poor in 4 cases; and the excellent and good rate was 83.9%. Conclusion Compressed screw and sartorius bone flap was simple and effective for femoral neck fractures in youth or middle age.
Objective To explore the characteristics of diagnosis and treatment for the rectal cancer in the young patients （≤40 years）．Methods The domestic and abroad literatures about the research on the progress of rectal cancer in the young patients were reviewed, the clinical data of patients with rectal cancer were compared between the young patients and the other age patients, the characteristics of diagnosis and treatment for the rectal cancer in the young patients were summarized．Results The onsets of the young patients with rectal cancer were related to the diet，lifestyle, and genetic factors．Compared with the older patients, more later stage, higher percentage of poor differentiation, earlier lymph node metastasis were found in the young patients with rectal cancer．Rectal cancer of the young patients was often misdiagnosed and with a poor prognosis．Currently，surgery assisted with neoadjuvant therapy was generally acknowledged as a better method．Conclusions It has specificity in epidemiology, pathology, treatment, prognosis, and so on for rectal cancer in the young patients, but surgery needs further research．
ObjectiveTo investigate the predictive value of volatile organic compounds (VOCs) on pulmonary nodules in people aged less than 50 years.MethodsThe 147 patients with pulmonary nodules and aged less than 50 years who were treated in the Department of Thoracic Surgery of Sichuan Cancer Hospital from August 1, 2019 to January 15, 2020 were divided into a lung cancer group and a lung benign disease group. The lung cancer group included 36 males and 68 females, with the age of 27-49 (43.54±5.73) years. The benign lung disease group included 23 males and 20 females, with the age of 22-49 (42.49±6.83) years. Clinical data and exhaled breath samples were collected prospectively from the two groups. Exhaled breath VOCs were analyzed by gas chromatography mass spectrometry. Binary logistic regression analysis was used to select variables and establish a prediction model. The sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve of the prediction model were calculated.ResultsThere were statistically significant differences in sex (P=0.034), smoking history (P=0.047), cyclopentane (P=0.002), 3-methyl pentane (P=0.043) and ethylbenzene (P=0.009) between the two groups. The sensitivity, specificity and area under the ROC curve of the prediction model with gender, cyclopentane, 3-methyl pentane, ethylbenzene and N,N-dimethylformamide as variables were 80.8%, 60.5% and 0.781, respectively.ConclusionThe combination of VOCs and clinical characteristics has a certain predictive value for the benign and malignant pulmonary nodules in people aged less than 50 years.