ObjectiveTo investigate the related factors of the retina1 hemorrhage in newborns. Methods9558 newborns included in this observation between March of 2012 and July of 2013 in our hospital. The fundus was examined by the fully-integrated wide-field digital imaging system RetCamⅢat 0-4 days after born. According to the literature, retinal hemorrhage was classified into degreeⅠ, ⅡandⅢ. The condition for baby and the mother during pregnancy were correlatively analyzed. The other factors were analyzed including twins, premature delivery, big baby, mode of delivery, fetal birth, forceps delivery, suction delivery, asphyxia, jaundice, ABO hemolytic, cranial hematoma, intracranial hemorrhage, maternal age, first-time mom, the maternal previous mode of production, emergency delivery, the first stage of labor prolonged, the second stage of labor prolonged, the third stage of labor prolonged, pregnancy-induced hypertension, gestational diabetes, oxytocin, prenatal body mass index (BMI). Multivariate logistic regression analysis was used. ResultsIn 9558 cases of newborns, retinal hemorrhages were found in 2753 infants (28.8%), including 1137 degreeⅠ(41.3%), 895 degreeⅡ(32.5%) and 721 degreeⅢ(26.2%). Multivariate logistic regression analysis showed that the mode of delivery, asphyxia, jaundice, advanced maternal age, maternal previous birth, prenatal BMI is a risk factor for neonatal values retinal hemorrhage (r=0.146, 5.841, 1.847, 0.071, 0.246, 0.965;P < 0.05). The degree of fundus hemorrhage was not related to birth weight and BMI (P > 0.05). ConclusionsThe neonatal retinal hemorrhage rate was 28.8%. Mode of delivery, asphyxia, neonatal jaundice, maternal age, the previous mode of delivery of mothers with more than one previous birth, prenatal BMI values may be risk factors lead to retinal hemorrhage.
目的 对烧伤层流病房多重耐药菌感染的相关因素进行分析，通过护理干预来预防和减少烧伤病房多重耐药菌感染的发生。 方法 回顾性分析2011年1月－12月收治的629例烧伤患者，其中发生多重耐药菌感染74例，感染率为11.8%。 结果 感染部位：创面分泌物培养感染占70.2%，痰液标本培养感染占9.4%，血液标本培养感染占16.2%，其他占4.2%。感染病原菌：以金黄色葡萄球菌为主，占77.0%；鲍曼不动杆菌占4.2%，铜绿假单胞菌占10.8%，肺炎克雷伯菌占6.7%，真菌感染占1.3%。 结论 对发生医院内多重耐药菌感染的原因进行分析并及时采取相应的护理干预措施，及可行的医院感染管理控制措施，对烧伤患者预后有重要的意义，可有效降低院内感染率的发生。
Objective To investigate the prevalence and related factors of diabetic retinopathy (DR) among residents with type 2 diabetes mellitus (T2DM) in Culai Town of Tai'an City in Shandong Province. Methods According to the DM management file database for community, 785 patients with T2DM were randomly selected by cluster sampling method. The questionnaires, routine general examinations, visual and fundus-free fluoroscopy were performed on all the patients. DR diagnosis and classification was according to the guidelines for clinical diagnosis and treatment of DR in China (2014). Both monocular and binocular DR were selected as DR patients, and the worse eye for binocular DR were treated as the DR classification of the patient. The patients were grouped by presence or absence of DR. GraphPad Prism 6, SigmaPlot 12.5, SPSS 20.0 and Excel were used to achieve data analysis. Also, SPSS 20.0 was used for multi-factor logistic regression analysis. Results A total of 699 patients (89.04%) were actually recorded. There were 122 eyes of 63 patients (9.01%) with DR (DR group), 1272 eyes of 636 patients (90.99%) without DR (NDR group). Among the 122 eyes of DR, there were 19 (15.57%), 17 (13.93%), 70 (57.38%), 10 (8.20%), 6 (4.92%) eyes in stage Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ, respectively. The differences of mean age (t=15 290, P=0.002), DM duration (t=9075, P＜0.000) and diastolic blood pressure (t=15 810, P=0.006) between the two groups were statistically significant. There were 23 (36.51%) and 394 (61.95%) patients with hypertension history in the DR group and the NDR group, with the significant difference ( χ2=15.42, OR=0.35, 95%CI 0.21-0.60). There were 57 (90.48%) and 500 (78.62%) patients with fasting blood glucose larger than 6.11 mmol/L in the DR group and the NDR group, with the significant difference (OR=2.51, 95%CI 1.06-5.95, P=0.031). Logistic regression analysis showed that the age, fasting blood glucose and DM duration were influencing factors for DR (OR=1.039, 0.864, 0.898; P=0.021, ＜0.000, ＜0.000). Conclusion The prevalence of DR in patients with T2DM in Culai Town of Tai'an City is 9.01%. Age, DM duration, fasting blood glucose are associated to DR. Those with a history of hypertension may have a lower risk of DR than those without a history of hypertension.
Objective To investigate the risk factors associated with neovascular glaucoma (NVG) after pars plana vitrectomy (PPV) in eyes with proliferative diabetic retinopathy (PDR). Methods Retrospective study. One hundred and thirty-seven patients (137 eyes) with PDR who underwent PPV were recruited. There were 85 males and 52 females. The average age was (60.1±8.8) years old. The duration of diabetes was (10.2±3.6) years. There were 49 patients with ipsilateral carotid artery stenosis. Fifty-three eyes underwent intravitreal ranibizumab or conbercept injection before PPV. All eyes were treated with 23G standard three-port PPV. The average follow-up time after PPV was 11.5 months. Fundus fluorescein angiography (FFA) was conducted in postoperative 4-6 weeks to observe non-perfused retinal areas. Risk factors, such as ipsilateral carotid artery stenosis, the presence of non-perfusion in retina after PPV and the application of anti-vascular endothelial growth factor (VEGF) drugs before PPV, were identified by logistic regression. Results Twenty of 137 patients (14.6%) developed postoperative NVG after PPV. Ipsilateral carotid artery stenosis [odds ratio (OR) =5.048, 95% confidence interval (CI) 2.057-12.389,P=0.000] and the presence of non-perfusion in retina after PPV (OR=4.274, 95%CI 1.426-12.809,P=0.009) were significant risk factors for postoperative NVG, while the application of anti-VEGF drugs was not (OR=1.426, 95%CI 0.463-4.395,P=0.536). But the time from PPV to the onset of NVG varies significantly between the two groups of injection of anti-VEGF drugs or not (t=−4.370,P=0.000). Conclusions Risk factors associated with NVG after PPV in eyes with PDR included ipsilateral carotid artery stenosis and the presence of non-perfusion in retina after PPV. The application of anti-VEGF drugs before PPV can delay the onset of NVG in PDR eyes after vitrectomy.
To explore related factors of cubital tunnel syndrome caused by cubitus valgus deformity so as to provide theoretical basis for the cl inical treatment. Methods Between June 2002 and September 2008, 40 patients with cubital tunnel syndrome caused by cubitus valgus deformity underwent anterior subcutaneous ulnar transposition. Related factors wasanalysed through logistic regression analysis using scoring standard recommended by Yokohama City University. Results All 40 patients were followed up 27.5 months on average (range, 12-75 months). The duration of cubitus valgus deformity, cubitus valgus deformity angle, and the duration of paraesthesia and muscular atrophy were identified as related factors for ulnar neuropathy and the odds ratios were 1.005 (P=0.045), 9.374 (P=0.000), and 4.358 (P=0.010), respectively. The related prognosis factors were duration of paraesthesia and muscular atrophy, deformity angle, and age at surgery, with odds ratios of 8.489 (P=0.000), 2.802 (P=0.030), and 4.611 (P=0.031), respectively. Conclusion Related factors for ulnar neuropathy are durations of cubitus valgus deformity, cubitus valgus deformity angle, and duration of paraesthesia and muscular atrophy. Related factors for prognosis include age at surgery, cubitus valgus deformity angle, and duration of muscular atrophy. Early anterior subcutaneous ulnar transposition should be performed in patients with cubital tunnel syndrome caused by cubitus valgus deformity
ObjectiveTo understand the situation of off-label use of aspirin among outpatients in Sun Yatsen Memorial Hospital, so as to provide baseline data for developing off-label drug use policy. MethodsA stratified random sampling method was used to collected prescription data of aspirin among outpatients in 2013. The incidence rates between different types of off-label use of aspirin were determined by chi-square test, and the influence factors of off-label drug use were analyzed by logistic regression model. ResultsA total of 5 023 prescriptions with aspirin were collected and analyzed, with incidence rate of off-label use up to 17.7%. The major category of off-label use was no indication (94.38%). The top 3 no indications were recurrent abortion, infertility and systemic lupus erythematosus. Drug specification, gender, age and prescribed department were the risk factors of off-label use. ConclusionAspirin off-label use is common among outpatients in Sun Yat-sen Memorial Hospital in 2013, especially in obstetrics and gynecology department and assisted reproductive center. The results suggest that more clinical studies about aspirin for reproduction are needed to provide more evidence of drug use, so as to ensure the safety of drug use in special populations and avoid potential medical risk.
ObjectiveTo investigate the clinicopathological characteristics and prognosis of elderly patients with colon cancer. MethodsThe clinicopathological and followup data of patients with colon cancer were compared retrospectively between those older than 60 years (405 patients) and those younger than 40 years (146 patients). ResultsFamily history, comorbidities, preoperative intestinal obstruction, and differentiation grade were significantly different between two groups (P＜0.05). The 5-year survival rate of patients in elder group and younger group was 64.9% and 56.8% respectively, and there was significant difference （P＜0.05）. The multivariate analysis indicated that the independent predictors of survival were comorbidities, perioperative CEA level, preoperative intestinal obstruction, tumor gross type, lymph node metastasis, hepatic metastasis, and TNM stage. ConclusionPatients older than 60 years with colon cancer have unique clinicopathological characteristics and better prognosis. The independent predictors of survival are comorbidities, perioperative CEA level, preoperative intestinal obstruction, tumor gross type, lymph node metastasis, hepatic metastasis, and TNM stage.
ObjectiveIn order to provide guidance for early interference of diabetic retinopathy (DR) in patients with diabetes mellitus (DM), we surveyed the prevalence and analysis the related factors of DR in Shanghai Songnan community. MethodsBased on an established resident health database, an epidemiology study was performed on the residents with DM in Shanghai Songnan community.1177 patients completed questionnaire survey, and received physical examination and laboratory tests. The diagnosis and grading of DR were established based on the ocular fundus images acquired by digital non-mydriasis fundus camera. Patients with incomplete questionnaires were excluded. ResultsThere were 1120 DM patients with valid questionnaires. DR was found in 264 (23.57%) patients. The prevalence of mild, moderate, severe non-proliferative DR and proliferative DR was 17.05%, 5.09%, 1.16% and 0.27% respectively. There was significant differences in age, disease course, systolic blood pressure, insulin usage between the DR group and NDR group(t=-2.647, 2.688, 2.204, 2.291;χ2=12.527;P=0.008, 0.007, 0.028, 0.022, 0.000). There was significant differences in fasting blood-glucose and insulin usage between the mild, the moderate and the severe DR group(t=21.964, χ2=14.996;P=0.000, 0.001). Stepwise logistic analysis identified that age, DM course, and insulin usage were the related factors of DR (OR=0.769, 1.239, 1.100, 1.071, 1.682;P=0.001, 0.043, 0.176, 0.097, 0.005). ConclusionThe age, DM course, and insulin usage were the related factors of DR. The high prevalence of DR indicated the importance of the management of diabetic patients.
Objective To explore the correlative factors affecting the compl ications resulting from cement leakage after percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral body compression fractures (OVCF). Methods From February 2005 to October 2008, 71 patients with OVCF were treated by PKP and were retrospectively analyzed. There were 16 males and 55 females, and the average age was 71.5 years (range, 52-91 years). The average duration of disease was 5.7 months (range, 1-11 months). A total of 171 vertebra were involved in fracture including 19 cases of single vertebral fractures, 21 cases of double vertebral fractures, 20 cases of three vertebral fractures, and 11 cases of more than three vertebral fractures. All the treated vertebra were divided into acute (86 vertebra) or subacute (85 vertebra) state based on changes in MRI signal intensity. There was no radiculopathy or myelopathy. The average injected cement volumewas 4.6 mL (range, 1.5-6.5 mL). The treatment efficacy was assessed by observing the change in anterior and middle vertebral column height, Cobb angle, visual analogue scale (VAS) and Oswestry functional score at preoperation, 3 days after operation and last follow-up. The patients were divided into cement leakage group and no cement leakage group. All the compl ications were recorded, and then the correlative factors affecting the compl ications were analyzed. Results All the cases had rapid and significant improvement in back pain following PKP. All patients were followed up for 14 months (range, 7-18 months). There was no cement extravasation resulting in radiculopathy or myelopathy. Four patients (5.63%) had lung-related compl ications. During the follow-up, 9 recurrence vertebral fractures were observed in 6 patients (8.45%). The anterior and middle vertebral column height, Cobb angle, VAS and Oswestry score were significantly improved when compared with preoperation (P lt; 0.05). Cement leakage occurred in 17 (9.94%) vertebral bodies; of 17 cases, the cement leaked into the paravertebral space in 7 cases, intervertebral space in 6 cases, channel of needl ing insertion in 3 cases, and spinal canal in 1 case. Univariate analysis showed statistically significant differences (P lt; 0.05) in preoperative anterior and middle vertebral column height, injected cement volume and vertebral body wall incompetence between the cement leakage group and no cement leakage group. There were no significant differences (P gt; 0.05) in preoperative Cobb angle, freshness of vertebral fracture, location of operative vertebrae and operative approach between the two groups. Multiple logistic regression analysis showed that the injected cement volume [odds ratio (OR)=3.105, 95% confidence interval (CI)=1.674-5.759, P lt; 0.01] and vertebral body wall incompetence (OR=11.960, 95%CI=3.512-40.729, P lt; 0.01) were the predominant variable associated with the compl ications resulted fromcement leakage. Conclusion The injected cement volume and vertebral body wall incompetence were the factors affecting the compl ications. The improvement of surgical technique is the capital factor that may reduce the compl ications in the PKP.