Risk Prediction Model for Pulmonary Fungal Infections in Patients with Lung Cancer / 中山大学学报(医学科学版)

ObjectiveTo investigate the risk factors for pulmonary fungal infection in lung cancer patients， construct and validate a risk prediction model using available clinical data to predict the risk of pulmonary fungal infections in patients with lung cancer. MethodsWe conducted a retrospective study and collected information of 390 lung cancer patients treated at Zhongshan People's Hospital from January 2021 to March 2023. Demographic and clinical characteristics of the patients with and without pulmonary fungal infections were used to construct column line graphs to predict the occurrence of pulmonary fungal infections. All enrolled patients were randomly assigned to training set and internal validation set in the ratio of 7：3. For the modelling group， LASSO regression was applied to screen variables and select predictors， and multivariate logistic regression with a training set was used to construct the Noe column line graph model. The judgment ability of the model was determined by calculating the area under the curve （AUC）， and in addition， calibration analysis and decision curve analysis （DCA） were performed on the model. ResultsLASSO regression identified 14 potential predictive factors， and further logistic regression analysis showed that hepatic injury， surgery， anemia， hypoalbuminemia， illness course， invasive operation， hospital stay at least 2 weeks and glucocorticoid used for at least 2 weeks were independent predictors for the occurrence of pulmonary fungal infection in lung cancer patients. A predictive model was established based on these variables， with an AUC95%CI of 0.980 （0.973， 0.896） for the training set and an AUC95%CI of 0.956 （0.795， 1.000） for internal validation， indicating high discriminative ability. The calibration curves for both the training set and validation set were distributed along the 45°line， and the decision curve analysis （DCA） showed net benefit for threshold probabilities greater than 0.03. ConclusionsThe construction and validation of a predictive model for the risk of lung fungal infections in lung cancer patients will help clinical practitioners to identify high-risk groups and give timely intervention or adjust treatment decisions.

Value of five-repetition sit-to-stand test in clinical evaluation of chronic obstructive pulmonary disease / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the value of five-repetition sit-to-stand test (5STS) in clinical evaluation of elderly patients with chronic obstructive pulmonary disease (COPD).</p><p><b>METHODS</b>Fifty-one patients with COPD and 20 healthy individuals were enrolled in this study. All the participants underwent 5STS, pulmonary function examination, and 6 min walking test (6MWT) and were evaluated for severity of dyspnea (by mMRC) and BODE index during the tests.</p><p><b>RESULTS</b>All the participants completed 5STS test with a good reproducibility of the time used for 3 sessions of the test (P<0.001). The mean time used by COPD patients for 5STS was significantly longer than that by healthy individuals (12.93±3.11s vs 0.72±0.71 s, P=0.002). The results of 5STS showed a significant negative correlation with those of 6MWT in the case group and control group with correlation coefficients of -0.611 and -0.682, respectively. The results of 5STS were negatively correlated with FEV1%Pre and body mass index (P<0.05) but positively with mMRC and BODE index in COPD patients (P<0.05).</p><p><b>CONCLUSION</b>5STS is a simple and reproducible test to evaluate the patients' exercise capacity and the severity of COPD, and is well correlated with the current methods for clinical evaluation of COPD.</p>

Analysis of the clinical indications of asthma control test / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the clinical indications of asthma control test (ACT).</p><p><b>METHODS</b>A total of 120 asthmatic patients with a diagnosis in line with the American Thoracic Society criteria and treated for over a month were enrolled in this study. The patients were asked to complete a survey to assess their symptoms and asthma attacks, and ACT evaluation was conducted by physicians familiar with ACT evaluation. The patients were classified into two groups based on the pulmonary function test (positive for bronchodilator test and provocation test) or based on disease severity (mild and moderate-to-severe asthma groups). The effect of ACT evaluation was graded as good (no less than 4 item available for evaluation), fair (2-3 items available) and poor (no more than 1 item). To further analyze the ACT sensitivity in relation to different disease severity, 29 asthmatic patients with an initial diagnosis and BDT positivity were included, and the ACT score of the patients with mild, moderate and severe asthma based on FEV1% were compared.</p><p><b>RESULTS</b>In patients positive for bronchodilator test, good, fair and poor evaluation effects were found in 48, 15, and 5 cases, as compared to 10, 15, and 27 in those positive for provocation test, respectively, showing significant differences between the two groups (P < 0.001). In mild asthma group, good, fair and poor evaluation effects were found in 12, 15, and 18 cases, respectively, significantly different from those in moderate-to- severe asthma group (50, 21, and 4 cases, P < 0.001). ACT scores showed a positive correlation to FEV1% in 29 patients with positive BDT (r = 0.55, P = 0.003). ACT scores had no significant difference between mild and moderate asthma groups (P > 0.05), but showed significant differences between mild and severe groups (P = 0.009) and between moderate and severe groups (P = 0.008).</p><p><b>CONCLUSION</b>ACT is more suitable for evaluating patients positive for bronchodilator test or with moderate to severe asthma.</p>

Antibacterials in Patients Accepted Operation in Grass-roots Hospitals:Their Application and Cost Analysis / 中华医院感染学杂志

OBJECTIVE To investigate the application of antibacterials in patients accepted operation in grass-roots(hospitals),so to standardize the application of antibacterials and cut down the medical cost.METHODS Full-time administrators for nosocomial infection investigated the application of antibacterials in patients who accepted(operation) in Sep 2004,and filled in the questionnaires.RESULTS In 1 383 cases of 11 hospitals the application rate of antibacterials was 98.63%;in which 86.50% were for prophylactic usage and 13.50% for therapeutic usage;(29.90%) for single antibiotics treatment and 50.15% for bigeminy,18.70% were for trigeminy.Time of(application) differentiated(6.90,7.00,6.60d) fromⅠto Ⅲ kinds of operation.Per capita cost of antibacterials was $956.50(47.60%).CONCLUSIONS High cost of antibacterials results from such factors as multiple kinds,long time and(combined) application.