Objectives To evaluate the risk factors of nonarteritic a nterior ischemic optic neuropathy（NAION）in a population of China and to provide theory basis for clinical decision. Methods Demographic features and clinical data of NAION were recorded. Cerebral infarction (CI) patients were also collected as control group. Systemic evaluations including whole blood chemical test, brain MRI, carotid artery ultrasound and fundus photography were perfor med in NAION and CI patients. The fundus photography and cup/disk ratio were als o acquired in a healthy controlgroup with matched age and gender. Statistical a nalysis was done by SPSS11.5 software. Results Thirtyeight N AION patients and 40 CI patients with intact data were included. Fundus photography and cup/disk ratio were acquired in 41 healthy individuals. No statistically significant difference regard to incidences of diabetes, male gender and lipid metabolic abnormalities was found between NAION and CI patients (Pgt;0.05). H ypertension, clinical and subclinical cerebral vascular disease and carotid ar tery stenosis were statistically more commonin CI patients than in NAION patien ts (Plt;0.01, 0.05). Cup/disk ratio was statistically significant smaller in NAION than in CI patients while no statistical difference (Pgt;0.05) was fo und between the CI group and healthy individuals. Conclusions NAION shared similar risk factors with cerebral infarction, but exposure of these risk factors was different between NAION and cerebral infarction. Hypertension , cerebral vascular disease and carotid artery stenosis were more common in cere bral infarction while diabetes, male gender and lipid metabolic abnormalities were similar. Small cup/disk ratio was an independent and the most important risk factor for NAION. (Chin J Ocul Fundus Dis,2008,24:86-89)
Epilepsy is one of the most common neurological diseases in children, about 2/3 can be seizure-free after anti-seizure medications (ASMs) treatment, but there are still some drug-resistant epilepsy (DRE) need surgical treatment, epilepsy surgery including excision surgery, dissociation surgery and palliative surgery, surgery can make 30%~40% DRE fully controlled. Clinicians usually choose to discontinue ASMs after seizure-free for 1 to 2 years after epilepsy surgery, but there has been controversy about whether to discontinue ASMs after surgery in children with epilepsy, how long to discontinue ASMs, the timing of ASMs withdrawal, and there is still a lack of unified guidelines. This article will comprehensively analyze and summarize the risk of recurrence after ASMs withdrawal in children with epilepsy.
目的 分析幽门螺杆菌(Helicobacter pylori, HP)根除治疗失败相关因素，为有效根除Hp提供建议和决策。 方法 对2005年5月-2008年12月经胃镜检查确诊的慢性胃炎或消化性溃疡，且Hp检测阳性并行含质子泵抑制剂三联或四联治疗的患者103例进行研究。治疗结束至少4周后，用14C呼气试验评估Hp是否成功根除，根据测试结果分为治疗失败组33例及治疗成功组70例。运用统一标准的调查表对每位患者进行相关因素调查，就调查表所涉及的因素在根除失败组与成功组间采用单因素及多因素Logistic回归进行分析。 结果 通过单因素分析依从性和饮酒在两组之间有统计学意义(P＜0.05)。Logistic多因素分析发现，依从性差是根除失败的独立危险因素。 结论 依从性差是治疗失败十分重要的影响因素。
【Abstract】 Objective To multifactorially analyze the risk factors related to the post-pancreaticoduodenectomy (PD) complications and death. Methods Two hundred and thirty-three PD cases were analyzed, average age 56, of those cases, 210 malignant with 72 pancreatic head and 138 periampullary involvement, 23 benign. Fifty-nine cases suffered coexisting vital organ disorders. Results Sixty-three cases (27.0%) experienced postoperative complications, among those 58 cases (24.9%) early complications, 28(12.0%) infection, 15(6.4%) organ systemic disorder, 14(6.0%) bleeding, 12(5.2%) pancreatic fistula, 15(6.4%) reoperations, 16 postoperative death during hospitalization. The independent risk factors related to the postoperative complications included coexisting vital organ disorders, operation methods, main pancreatic duct (MPD) diameter and surgeon’s experiences, those related to the death during hospitalization included preoperative serum creatinine, coexisting vital organ disorders, surgeon’s experiences; those related to the reoperation included preoperative CA19-9, surgeon’s experiences, tumor diameters, lymph nodes metastasis; and those related to the pancreatic fistula included operation methods, MPD diameters and surgeon’s experiences. Conclusion Coexisting vital organ disorders and surgeon’s experiences are the independent risk factors related to postoperative complications and death during hospitalization, operation methods, MPD diameter and surgeon’s experiences are the independent risk factors related to the pancreatic fistula. Thus, it is very important to choose the appropriate PD candidates, select the right operation method and to familiarize the operation.
【摘要】 目的 探讨早产儿视网膜病变（retinopathy of prematurity，ROP）的发生率及危险因素。 方法 收集2007年12月-2008年12月在四川省人民医院、成都市妇幼保健院、成都市妇产科医院住院的85例体重≤2 000 g或有严重疾病的早产儿,自出生后4~6周或矫正胎龄32周开始筛查，至周边视网膜血管化。 结果 85例早产儿中，有9例发生ROP，发病率10.58%。其中出生体重lt;1 500 g的早产儿ROP发病率为17.07%，孕周lt;30周的早产儿ROP发病率为40%。 结论 低体重、胎龄小、吸氧为早产儿发生ROP的重要危险因素；尽早进行眼底筛查是早期发现、诊断及治疗ROP的关键。【Abstract】 Objective To investigate the occurrence and risk factors of retinopathy of prematurity (ROP). Methods A total of 85 premature infants were enrolled from Sichuan provincial people′s hospital, Chengdu maternal and child health hospital, and Chengdu obstetric and gynecology hospital. The infants were born between December 2007 and December 2008, with a birth weight less than 2 000 g. The ocular funds examination was carried out four to six weeks after the birth or at the 32nd week of the corrected gestational age;the infants were followed up until the retina was entirely vascularized. Results ROP was found in 9 of the 85 premature infants, with a percentage of 10.58%. About 17.07% premature infants with a birth weight less than 1500 g and 40% infants with a gestational age shorter than 30 weeks had ROP. Conclusions A lower birth weight, a shorter gestational age and oxygen usage are the risk factors of ROP. It′s important to examine the ocular fundus in premature infants as early as possible so as to identify, diagnose and treat ROP at an early stage.
Chronic obstructive pulmonary disease is often accompanied by anxiety or depression. The exacerbation of anxiety and depression can lead to the deterioration of chronic obstructive pulmonary disease, reduce patients’ quality of life, worsen poor prognosis, and increase the risk of death. Anxiety and depression are one of the important causes of death in patients with chronic obstructive pulmonary disease, but the complexity of their risk factors and pathogenesis often lead to clinicians being unable to make accurate diagnosis and treatment in a timely manner. Based on existing research, this article elaborates on the risk factors and pathogenesis of chronic obstructive pulmonary disease complicated with anxiety or depression, aiming to improve the diagnosis and treatment ability of clinical physicians for chronic obstructive pulmonary disease complicated with anxiety or depression, achieve timely diagnosis and treatment, improve patients’ prognosis, and improve quality of life.
ObjectiveTo analyze the prevalence and risk factors of metabolic syndrome (MS) after adult liver transplantation (LT) recipients. MethodsThe clinicopathologic data of patients with survival time ≥1 year underwent LT in the People’s Hospital of Zhongshan City from January 1, 2015 to August 31, 2020 were analyzed retrospectively. The logistic regression model was used to analyze the risk factors affecting MS occurrence after LT, and the receiver operating characteristic (ROC) curve was used to evaluate the optimal cutoff value of the index of predicting MS occurrence and its corresponding evaluation effect. ResultsA total of 107 patients who met the inclusion criteria were collected in this study. Based on the diagnostic criteria of MS of Chinese Medical Association Diabetes Association, the occurrence rate of MS after LT was 32.7% (35/107). Multivariate logistic regression analysis showed that the increased age of the recipient [OR (95%CI)=1.106 (1.020, 1.199), P=0.014], preoperative increased body mass index [OR (95%CI)=1.439 (1.106, 1.872), P=0.007] and blood glucose level [OR (95%CI)=1.708 (1.317, 2.213), P<0.001], and with preoperative smoking history [OR (95%CI)=5.814 (1.640, 20.610), P=0.006] and drinking history [OR (95%CI)=5.390 (1.454, 19.984), P=0.012] increased the probability of MS after LT. The areas under the ROC curve (AUC) corresponding to these five indexes were 0.666, 0.669, 0.769, 0.682, and 0.612, respectively. The corresponding optimal cutoff values of three continuous variables (recipient’s age, preoperative body mass index, and blood glucose level) were 53 years old, 23.1 kg/m2, and 6.8 mmol/L, respectively. The AUC of combination of the above five indexes in predicting occurrence of MS was 0.903 [95%CI (0.831, 0.952)], and the sensitivity and specificity were 80.0% and 90.3%, respectively. ConclusionsIncidence of MS after adult LT recipient is not low. For recipients with preoperative hyperglycemia, obese, elderly, histories of drinking and smoking before LT need to pay attention to the early detection and early intervention of MS.
ObjectiveTo assess whether hyperlipoidemia affects the occurrence and progression of prostate cancer (PCA). MethodsA hospital based retrospective study was carried out in Zhangzhou Affiliated Hospital of Fujian Medical University using data from a total of 112 cases of PCA, which underwent radical prostatectomy due to suspected PCA and confirmed by prostate biopsy pathology. ResultsOf the 112 PCA patients, 64 (57.14%) were PCA with hyperlipoidemia (PCA-H). Compared with PCA patients, the patients of PCA-H patients had younger onset age (65.0±5.0 vs. 67.8±3.7, P=0.001), increased prostate volume (75.0±11.7 mL vs. 54.5±8.5 mL, P < 0.001), increased level of TPSA (61.4±23.3 ng/mL vs. 33.4±14.9 ng/mL, P < 0.001), and Gleason grade (6.9±1.8 vs. 5.0±1.9, P < 0.001), later clinical stage (P < 0.001), shorter survival time (49.8±12.7 months vs. 57.3±6.2 months, P < 0.001) and decreased 5 years of survival rate (51.6% vs. 77.1%, P=0.006). The level of cholesterol, triglyceride and high density lipoprotein was significantly associated with the rejuvenation of onset age, the enlargement of prostate volume, increasing of serum TPSA, the progression of TNM clinical stage, increasing of Gleason grade, shorten of survival time and dropping of 5 years of survival rate (P < 0.05). In multiplefactor regression analysis, only hyperlipoidemia (OR=3.204, P=0.022) and Gleason grade (OR=8.611, P < 0.001) were the independent risk factors of prognosis. ConclusionThe situation of PCA with hyperlipoidemia is frequently noted in clinics, and hyperlipoidemia may be one of the risk factors in the processes of PCA growth and progression.
ObjectiveTo observe the frequency and severity of carotid atherosclerotic stenosis in senior chronic obstructive pulmonary disease (COPD) patients and explore the related risk factors in order to provide a theoretical basis for the effective prevention of cardiovascular comorbidity in COPD. MethodsStable COPD out-patients followed up in Sichuan Provincial People's Hospital were prospectively enrolled between August 2012 and August 2015, who had carotid atherosclerosis confirmed by cervical vascular color ultrasonic inspection within 3 months. All the patients were divided into a carotid stenosis group and a non-carotid stenosis group. Demographic and laboratory data were extracted and compared between two groups. Pearson correlation and Logistic regression analysis were performed to analyze the risk factors related to carotid stenosis. ResultsOf 380 consecutive senior patients with COPD and carotid atherosclerosis, 199 (52.37%) had carotid stenosis. Compared with those without carotid stenosis, the patients in the carotid stenosis group had significantly higher levels of hypersensitive C reactive protein (hs-CRP), uric acid (UA), brain natriuretic peptide (BNP) and smoking index (P < 0.05). Lower levels of forced expiratory volume in one second (FEV1%) and body mass index (BMI) were also observed in the carotid stenosis group (P < 0.05). Pearson correlation and logistic regression analysis showed that hs-CRP (OR 1.040, 95%CI 1.011-3.070), UA (OR 1.003, 95%CI 1.000-2.006), FEV1 (OR 0.899, 95%CI 0.200-5.722), smoking index (OR 1.002, 95%CI 1.001-2.904) and BMI (OR 0.955, 95%CI 0.312-4.866) were associated with carotid stenosis. ConclusionsCarotid atherosclerotic stenosis is common in senior COPD patients. Higher levels of hs-CRP, UA and smoking index and lower levels of FEV1 and BMI may be independent risk factors for carotid stenosis in COPD.