Objective To analyze and summarize the clinical characteristics of foreign body incarceration in upper digestive tract, and to explore the risk factors of its complications. Methods The clinical data of patients with foreign bodies in the upper digestive tract treated in the Affiliated Hospital of Zunyi Medical University between January 1, 2012 and December 31, 2021 were retrospectively analyzed, including demographic data, foreign body type, incarceration site, incarceration time, causes, symptoms, treatment methods and complications of foreign body incarceration. Logistic regression analysis was used to explore the risk factors of complications. Results A total of 721 patients were finally included, ranging in age from 3 months to 90 years old, with an average age of 26.76 years. The proportion of foreign bodies in the upper digestive tract in patients ≤14 years old was the highest (51.18%), and the duration of foreign body incarceration<12 hours was the highest (55.34%). The most common sharp foreign bodies in the upper digestive tract were animal bones (228 cases), and the most common round shaped foreign bodies were coins (223 cases). The most common impaction site was the upper esophageal segment (85.02%). 105 patients (14.56%) had complications, and perforation was the most common (5.55%). Logistic regression analysis showed that age [odds ratio (OR)=0.523, 95% confidence interval (CI) (0.312, 0.875), P=0.014], foreign body type [OR=0.520, 95%CI (0.330, 0.820), P=0.005], incarceration site [OR=2.347, 95%CI (1.396, 3.947), P=0.001], incarceration time [OR=0.464, 95%CI (0.293, 0.736), P=0.001] were the influencing factors of complications. Conclusions The majority of foreign bodies in the upper digestive tract are animal bones. The incidence of complications increase in patients with age ≥ 60 years, sharp foreign body edges, incarceration in the upper segment of the esophagus, and long incarceration time. It is recommended to remove the sharp foreign bodies incarcerated in the upper segment of the esophagus from the elderly as soon as possible.
摘要:目的: 总结2型糖尿病患者阴茎勃起功能障碍(ED)的相关危险因素及临床治疗评价。 方法 :分析收集两家医院120例住院及门诊2型糖尿病男性患者的性功能状况、年龄、糖尿病病程、血压、糖化血红蛋白、血脂、吸烟与否等指标,以及接受真空负压吸引联合万艾可治疗的79名患者追踪3个月的疗效评分。 结果 :男性2型糖尿患者中ED的患病率为658%,多因素回归分析显示患者年龄、糖尿病病程、糖化血红蛋白与ED的发生独立相关,而血压、血脂等因素〖WTBX〗P ＞005,无显著性差异。接受真空负压吸引联合万艾可治疗的79例ED患者其有效率达到759%。 结论 :男性2型糖尿病患者中ED是常见的合并症,患病率随年龄、糖尿病病程、糖化血红蛋白的增加而增加。真空负压吸引联合万艾可治疗糖尿病合并ED疗效可靠。Abstract: Objective: Make a conclusion on related ED risk factors and clinic therapy evaluation in 120 Type 2 male diabetic mellitus. Methods : Analyze and collect 120 cases in two hospitals regarding sexual function,age,diabetes course,blood pressure,HbA1c,bolldfat, smokingcondition,etc;follow up 79 cases for 3months and evaluate therapy as a result of vacuum subpressure absorption associated with viagra (sildenafil) therapy. Results : The ED rate in Type 2 male diabetic is 658%;the multifactorial regression analysis shows that occurrence of ED is respectively related with age,diabetes course,HbA1c;there isn’t obvious discrdpancy in blood pressure,blood fat,etc(P ＞005); the effective rate of vacuum subpressure absorption associated with Viagra (sildenafil) therapy in 79 cases is759%. Conclusion : It’s common complications to get ED among the Type 2 male Diabetics and the case rate goes up with the increase of age,diabetes course, HbA1c;it’s reliable to take therapy of vacuum subpressure absorption associated with Viagra.
Objective To identify clinical risk factors for early major adverse cardiovascular events (MACEs) following surgical correction of supravalvar aortic stenosis (SVAS). Methods Patients who underwent SVAS surgical correction between 2002 and 2019 in Beijing and Yunnan Fuwai Cardiovascular Hospitals were included. The patients were divided into a MACEs group and a non-MACEs group based on whether MACEs concurring during postoperative hospitalization or within 30 days following surgical correction for SVAS. Their preoperative, intraoperative, and postoperative clinical data were collected for multivariate logistic regression. Results This study included 302 patients. There were 199 males and 103 females, with a median age of 63.0 (29.2, 131.2) months. The incidence of early postoperative MACEs was 7.0% (21/302). The multivariate logistic regression model identified independent risk factors for early postoperative MACEs, including ICU duration (OR=1.01, 95%CI 1.00-1.01, P=0.032), intraoperative cardiopulmonary bypass (CPB) time (OR=1.02, 95%CI 1.01-1.04, P=0.014), aortic annulus diameter (OR=0.65, 95%CI 0.43-0.97, P=0.035), aortic sinus inner diameter (OR=0.75, 95%CI 0.57-0.98, P=0.037), and diameter of the stenosis (OR=0.56, 95%CI 0.35-0.90, P=0.016). Conclusion The independent risk factors for early postoperative MACEs include ICU duration, intraoperative CPB time, aortic annulus diameter, aortic sinus inner diameter, and diameter of the stenosis. Early identification of high-risk populations for MACEs is beneficial for the development of clinical treatment strategies.
Objective To analyze the trends in the burden of intracerebral hemorrhage (ICH) and its related risk factors in China from 1990 to 2021, providing evidence for targeted prevention and control. Methods Based on public data from the Global Burden of Disease Study 2021, four epidemiological indicators, including incidence, prevalence, deaths, and disability-adjusted life-years (DALYs) were selected to describe the burden of ICH in China in 2021. Change rates and estimated annual percentage changes (EAPC) were calculated to evaluate the trends in disease burden from 1990 to 2021. The Das Gupta method was used to decompose the effects of population growth, population aging and epidemiological changes on the burden during this period. Finally, the attributable burden of risk factors related to ICH was analyzed. Results In 2021, the age-standardized incidence, prevalence, mortality, and DALY rates of ICH in China were 61.2/100000, 222.1/100000, 68.8/100000, and 1351.6/100000, respectively, all higher than global estimates. From 1990 to 2021, although these rates showed a declining trend (EAPC: −2.24, −1.26, −2.38, and −2.47, respectively), the absolute disease burden, including the absolute number of incidence cases, prevalence cases, deaths, and DALYs, continued to rise, with an increase ranging from 20.57% to 51.59%. In addition, the burden of ICH in China varied by age and sex, with older adults and males experiencing a higher burden. Decomposition analysis indicated that population aging and growth were the primary drivers of the increasing ICH burden in China, while epidemiological changes mitigated this trend. Metabolic factors were the predominant attributable risk factors for ICH. High systolic blood pressure, ambient particulate matter pollution, and diet high in sodium were important risk factors common to both genders. The DALY burden attributable to smoking and alcohol use was higher in men, whereas impaired kidney function and secondhand smoke had a greater impact on women. Conclusions The burden of ICH in China has continued to increase from 1990 to 2021, and it may further escalate in the context of population aging. Risk factor control remains a key priority for prevention. Future strategies should incorporate age- and sex-specific interventions to reduce the ICH burden in China.
Objective To investigate the risk factors for lymph node metastasis in cT1N0M0 stage squamous cell lung cancer and develop a logistic regression model to predict lymph node metastasis. Methods A retrospective study was conducted on patients with cT1N0M0 stage lung squamous cell carcinoma in our department from August 2017 to October 2022. The correlation between basic clinical data, imaging data, and pathological data and lymph node metastasis was analyzed. Univariate and multivariate logistic regression analyses were employed for risk factor analysis. Receiver operating characteristic curves and the Hosmer-Lemeshow test were utilized to evaluate the model’s discrimination and calibration. The Bootstrap method with 1 000 resamples was employed for internal validation of the model. Results Tumor location of central-type, tumor differentiation, cytokeratin 19 fragment (CYFRA21-1) levels, and tumor size were independent risk factors for lymph node metastasis in cT1N0M0 stage squamous cell lung cancer. The optimal cutoff values for tumor size and CYFRA21-1 levels were determined to be 2.05 cm and 4.20 ng/mL, respectively. The combination of tumor location, CYFRA21-1 levels, and tumor size demonstrates superior predictive capability compared to any individual factor. Conclusion Tumor location of central-type, poorly differentiated tumors, CYFRA21-1 levels, and tumor size are risk factors for lymph node metastasis in cT1N0M0 stage lung squamous cell carcinoma. The combined predictive model has certain guiding significance for intraoperative lymph node resection strategies in cT1N0M0 stage lung squamous cell carcinoma.
ObjectiveTo explore and analyze the risk factors for arrhythmia in patients after heart valve replacement.MethodsA retrospective analysis of 213 patients undergoing cardiac valve replacement surgery under cardiopulmonary bypass in our hospital from August 2017 to August 2019 was performed, including 97 males and 116 females, with an average age of 53.4±10.5 year and cardiac function classification (NYHA) grade of Ⅱ-Ⅳ. According to the occurrence of postoperative arrhythmia, the patients were divided into a non-postoperative arrhythmia group and a postoperative arrhythmia group. The clinical data of the two groups were compared, and the influencing factors for arrhythmia after heart valve replacement were analyzed by logistic regression analysis.ResultsThere were 96 (45%) patients with new arrhythmia after heart valve replacement surgery, and the most common type of arrhythmia was atrial fibrillation (45 patients, 18.44%). Preoperative arrhythmia rate, atrial fibrillation operation rate, postoperative minimum blood potassium value, blood magnesium value in the postoperative arrhythmia group were significantly lower than those in the non-postoperative arrhythmia group (P<0.05); hypoxemia incidence, hyperglycemia incidence, acidosis incidence, fever incidence probability were significantly higher than those in the non-postoperative arrhythmia group (P<0.05). The independent risk factors for postoperative arrhythmia were the lowest postoperative serum potassium value (OR=0.305, 95%CI 0.114-0.817), serum magnesium value (OR=0.021, 95%CI 0.002-0.218), and hypoxemia (OR=2.490, 95%CI 1.045-5.930).ConclusionTaking precautions before surgery, improving hypoxemia after surgery, maintaining electrolyte balance and acid-base balance, monitoring blood sugar, detecting arrhythmia as soon as possible and dealing with it in time can shorten the ICU stay time, reduce the occurrence of complications, and improve the prognosis of patients.
Dysphagia is a common non-motor symptom in Parkinson’s disease (PD), with a high incidence and insidious progression. It can lead to complications such as dehydration, malnutrition, aspiration pneumonia, and even death, seriously affecting the quality of life and prognosis of patients. Therefore, early screening, assessment, and intervention are crucial for improving the quality of life and prognosis of PD patients with dysphagia. This article mainly reviews the risk factors and management strategies of dysphagia in PD, with the aim of providing a reference for healthcare professionals to conduct subsequent evaluations and develop targeted interventions.
Cerebral hemorrhage is a common clinical critical disease, and venous thromboembolism is one of its common complications. How to diagnose and treat venous thromboembolism early is still the main problem in the management of patients with cerebral hemorrhage. This article reviews the concept, pathogenesis, risk factors, evaluation tools, prevention and treatment of venous thromboembolism in patients with cerebral hemorrhage. Suggestions are put forward on the development of evaluation tools and improvement of prevention and treatment, in order to provide reference for clinical management and related research of patients with cerebral hemorrhage complicated with venous thromboembolism.
Objective To explore the clinical and inflammatory characteristics and risk factors of severe asthma to improve clinicians' awareness of the disease. Methods The general information of patients with asthma who visited the Department of Respiratory Medicine, the First Hospital of Shanxi Medical University from May 2018 to May 2021, as well as the diagnosis and treatment of asthma, personal history, comorbidities, auxiliary examination, asthma control test (ACT) score were collected. A total of 127 patients were included, including 40 in the severe asthma group and 87 in the mild-to-moderate asthma group. Chi-square test, independent sample t test and logistic regression were used to analyze the clinical characteristics, inflammatory markers and risk factors of severe asthma. Results Compared with the patients with mild to moderate asthma, the patients with severe asthma were more older (51.0±12.0 years vs 40.7±12.8 years, P<0.05), had more smokers (32.5% vs. 14.9%, P<0.05), and more males (67.5% vs. 40.2%, P<0.05). The patients with severe asthma got poor FEV1%pred [(56.1±23.8)% vs. (93.2±18.0)%, P<0.05] and FEV1/FVC [(56.7±13.2)% vs. (75.8±9.0)%, P<0.05)], and more exacerbations in the previous year (2.7±3.1 vs. 0.1±0.4, P<0.05), lower ACT score (14.4±3.7 vs. 18.0±5.0, P<0.05), and higher blood and induced sputum eosinophil counts [(0.54±0.44)×109/L vs. (0.27±0.32)×109/L, P<0.05; (25.9±24.2)% vs. (9.8±17.5)%, P<0.05]. There was no significant difference in the proportion of neutrophils in the induced sputum or FeNO between the two groups (P>0.05). Analysis of related risk factors showed that smoking (OR=2.740, 95%CI 1.053 - 7.130), combined with allergic rhinitis (OR=14.388, 95%CI 1.486 - 139.296) and gastroesophageal reflux (OR=2.514, 95%CI 1.105 - 5.724) were risk factors for severe asthma. Conclusions Compared with patients with mild to moderate asthma, patients with severe asthma are characterized by poor lung function, more exacerbations, and a dominant eosinophil inflammatory phenotype, which is still poorly controlled even with higher level of treatment. Risk factors include smoking, allergic rhinitis, and gastroesophageal reflux, etc.
Objective To assess the burden of hypertensive nephropathy in China and the world from 1990 to 2021 and predict future trends. Methods Based on the Global Burden of Disease Database 2021, standardized prevalence, standardized mortality and standardized disability adjusted life year (DALY) rates were used to describe the burden of hypertensive nephropathy in China and the world from 1990 to 2021. Estimated annual percentage change (EAPC) and autoregressive integrated moving average model were used to reveal the trend of disease burden. Results From 1990 to 2021, the EAPCs of standardized prevalence, standardized mortality and standardized DALY rates of hypertensive nephropathy in China were −0.61% (−0.73%, −0.50%), −0.77% (−0.85%, −0.69%), and −1.00% (−1.09%, −0.91%), respectively. The global EAPCs for standardized prevalence, standardized mortality, and standardized DALY rates of hypertensive nephropathy were −0.16% (−0.18%, −0.13%), 0.97% (0.91%, 1.03%), and 0.63% (0.58%, 0.67%), respectively. The standardized prevalence rate, standardized mortality rate and standardized DALY rate of hypertensive nephropathy in China all showed a downward trend, and the global standardized prevalence rate also showed a downward trend, while the global standardized mortality rate and standardized DALY rate showed an upward trend, and the indicators of disease burden in China were lower than the global level. The standardized mortality rate and the standardized DALY rate of hypertensive nephropathy were higher in males than in females. With the increase of age, the disease burden indicators of hypertensive nephropathy in China and the world were on the rise, and the age of disease and death were concentrated in the age group over 65 years old. Renal dysfunction and hypertension were important risk factors for death in hypertensive nephropathy patients. It was estimated that from 2022 to 2040, the standardized prevalence rate and mortality rate of hypertensive nephropathy would be on the rise in China and the world, and the standardized DALY rate would be on the rise in the world, while in China it would be on the decline. Conclusions The burden of hypertensive nephropathy is heavy in China and the world from 1990 to 2021, and the control of hypertension and prevention of renal dysfunction should be strengthened. It is estimated that the standardized prevalence and mortality of hypertensive nephropathy will increase in China and the world from 2022 to 2040, and the disease burden will remain heavy.