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Objective To evaluate factors associated with mechanical ventilation in infants and young children undergoing cardiac surgery with pulmonary hypertension.Methods 161 Children who were ≤36 months of age, had congenital heart disease with pulmonary hypertension, and had been treated at our hospital between October 2011 and April 2013 were included in this retrospective study.Stepwise linear regression analysis was used to analyse the independent risk factors associated with mechanical ventilation (MV).Results The average of MV time was 40.9 h, the independent risk factors for MV were cardiopulmonary bypass(CPB) time (P =0.020), risk adjustment for surgery for congenital heart disease (RACHS-1) (P =0.014) ,low cardiac output syndrome(LCOS) (P ＜0.001), ventilator-associated pneumonia(VAP) (P =0.001) and postoperative pulmonary artery systolic pressure (sPAP) (P ＜ 0.001).Conclusion The present results suggest that CPB time,RACHS-1 score, LCOS, VAP and postoperative sPAP can significantly affect the MV time in infants and young children with pulmonary hypertension after cardiac surgery.
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Objective To understand the vital signs on admission time and traumatic classification of the inpatients injured in Lushan Earthquake ,and provide a basis evidence for handling major disasters and treating masses of injured patients .Methods The information of patients injured in Lushan Earthquake who were admitted in Chengdu Military General Hospital was collected by“No .1 Military Medical Project” hospital information system and self-edited “Questionnaire for Hospitalized Patients Injured in 4 .20 Lushan Earthquake” .The data of the vital signs on admission time and traumatic classification of these patients were analyzed by SPSS 16 .0 .Results A total of 65 civilian patients were admitted in this hospital .Among these patients ,there were 30 men (46 .15% )and 35 women(53 .85% );with mean age of(45 .74 ± 20 .96)years old .On admission time ,the abnormal rates of tempera-ture ,pulse ,respiratory rate ,systolic pressure ,diastolic pressure of these patients were 18 .46% ,6 .15% ,21 .54% ,12 .31% and 23 .08% ,respectively .48(73 .85% )patients had closed injury .Traumatic condition:8(12 .31% )patients in mild degree ,17(26 .15% ) patients in moderate degree ,32 patients(49 .23% )patients in severe degree and 8(12 .31% )patients in critical degree .The top 4 traumatic parts were as follows :33(50 .77% )patients got waist(abdomen)division and pelvis(perineum);31(47 .69% )patients got lower limb injuries;18(27 .69% )patients got chest and back injuries and 10(15 .38% )patients got facial injuries .There were 39 skin and soft tissue injuries ,counting for 60 .00% ,and 38 fractures ,counting for 58 .46% .Conclusion The epidemiological characteris-tics of earthquake injuries are founded by analyzing the vital signs on admission time and traumatic classification of the inpatients in-jured in Lushan earthquake ,which suggests attention of the relevant scholars and departments .
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Objective To develop an overall health risk model and to evaluate its convergent validity and reliability.Methods Health examination results of 230 adults from a public institution were collected by using Chinese Health Risk Appraisal Questionnaire V1.0 (CHRAQ V1.0).An CHRAQ V1.0-based overall health risk model was then developed,which included 34 items.Kolmogorov-Smirnov was used to test normal distribution of the data.Pearson correlation coefficient and Spearman correlation coefficient were used to evaluate parallel validity of the model.Crane Bach coefficient,Spearman-Brown coefficient and test-retest reliability were calculated to evaluated the reliability of the model.Results In this study,212 valid questionnaires (92.17％) were received.The average score of the newly developed overall health risk model was 41.96 ± 9.69,and its kurtosis coefficient and coefficient of skewness were 2.105 and 0.862,respectively.In Kolmogorov-Smirnov,the data were normally distributed (Z =1.073,P =0.199).The correlation coefficient of positive rate of all objective examinations with model scores was 0.774 (P ＜ 0.05).The Cronbach's alpha coefficient,Spearman-Brown coefficient and test-retest reliability of the model were 0.652,0.784 and 0.841,respectively (P ＜ 0.05).Conclusion In this investigation,our newly developed overall health risk model shows good validity and reliability and application prospect in the field of health management.
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Objective To compare the differences of disease spectrum between patients with brain trauma injury (TBI) in the high altitude areas and those in the plain areas.Methods The front page information of medical records of local TBI patients admitted to military hospitals from 2001 to 2007 was extracted from the Chinese Trauma Database.Ten military hospitals from high altitude areas (high altitude group) and 10 military hospitals with the same hospital level from plain areas (plain group) were selected and the patients in the two groups were compared for their differences in general condition and disease spectrum.Results High altitude group displayed a larger proportion of male patients (P＜0.01),a lower age (P＜0.01),a smaller proportion of patients with Han nationality (P＜0.01),asmaller proportion of emergency patients (P＜0.01),a larger proportion of critically ill patients (P＜0.01),a lower median of hospital days (P＜0.01),a lower operation rate (P＜0.01),as compared with the plain group.The injury of the patients with TBI in turn were intracranial organ injury (excluding those with skull fracture),open wound of head,neck,and trunk,skull fracture,injury of nerves and spinal cord.The orders of TBI disease spectrum of the high altitude and plain groups were the same,but the disease compositions of the two groups had significant difference (P＜0.01).Conclusions Thereexist significant differences in demographics,admission status and disease spectrum of TBI patients inhigh altitude and plain areas.However,the current clinical treatments of TBI in high altitude areas are usually with reference to the experience in plain areas,which is worthy of paying attention by relevant departments.
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Objective To investigate the short term effect of gastric bypass surgery for the treatment of nonobese type 2 diabetes mellitus and possible mechanisms. Methods The clinical data of 58 patients with nonobese type 2 diabetes mellitus who received gastric bypass surgery from March to August, 2009 were retrospectively analyzed. The levels of fasting plasms glucose (FPG), 2-hour postprandial plasma glucose (2h PG) and glycosylated hemoglobin (HbA1c) were dynamically monitored, and the insulin resistance index (HOMA-IR) and body mass index ( BMI) were calculated. All data were analyzed using variance of analysis and LSD test. Results Of the 58 patients, 48 (83% ) met the requirement of complete response criteria and stopped administration of hypoglycemic agents; 7( 12% ) had to use hypoglycemic agents, but the dose of the agents was lowered by 50% compared to that before surgery. The surgery was ineffective in 3 patients (5% ). The levels of FPG, 2h PG, HbAlc and HOMA-IR of the 58 patients showed a significant decreasing trend after surgery when compared to those before surgery (F = 67. 867, 50. 885, 78. 278, 572. 757, P 0. 05 ). Conclusions Gastric bypass surgery has a good effect on nonobese patients with type 2 diabetes mellitus whose BMI was less than 25 kg/m2. The improvement of insulin resistance after the surgery might be the main reason.
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Objective To compare the efficiency of χ~2-Fisher's exact test which is one of the competitive null hypothesis approaches with SAM-GS which belongs toself-contained null hypothesis approaches. Methods The two methods were used to analyze a simulation experiment which contained five different scenarios. The results were compared with the simulated initialization,and assessing indexes were calculated to compare the efficiency. Results Under the same conditions,SAM-GS always have higher power than that of χ~2-fisher's exact test. However, the final inference is equivalent, namely if the difference between the two groups are smaller than 0.30,the two methods can not be better to identify differences between them. By contrary, when the differences between the two phenotypes are larger than 0.30, the two ways can both identify differences. Conclusion SAM-GS tends to have slightly higher power thanχ~2-Fisher' s exact test. The two methods can be used for screening enrichment gene sets of gene expression profile.χ~2-Fisher's exact test has the important advantage of being able to analyze multi-class phenotype.