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Objective:To explore risk factors for clinical onset in children with uncontrolled self-limited epilepsy with centrotemporal spikes (SeLECTS) managed by 2 anti-seizure medications (ASMs).Methods:A total of 112 children with SeLECTS who were diagnosed at the Department of Pediatric Neurology of the Third Affiliated Hospital of Zhengzhou University from January 2018 to May 2021 were retrospectively reviewed.All of them were treated with conventional ASMs, and regularly followed up for 1-2 years.Types of therapeutic drugs, clinical seizure control status, presence of new seizure forms, electroencephalogram (EEG) were reviewed at follow-up visits.According to whether the seizures were controlled after the use of no more than 2 ASMs, patients were divided into poor response group (43 cases) and good response group (69 cases), and their clinical data and EEG characteristics were compared.Multivariate Logistic regression analysis was used to explore the risk factors for seizures that were uncontrolled by 2 ASMs. Results:There were significant differences in the age of onset ( χ2=8.919, P=0.003), seizure form ( χ2=4.218, P=0.040), seizure frequency ( Z=-7.664, P<0.001), EEG background slowing ( χ2=10.284, P=0.001), emergence of electrical status epilepticus during slow-wave sleep (ESES)( χ2=11.921, P=0.001), discharge generalization ( χ2=25.377, P<0.001), and presence of epileptic encephalopathy with spike-and-wave activation in sleep (EE-SWAS)( χ2=54.334, P<0.001) between groups.Multivariate Logistic regression analysis showed that seizure frequency ( P<0.001, OR=0.086, 95% CI: 0.022-0.329), discharge generalization ( P=0.006, OR=9.942, 95% CI: 1.918-51.527) and EEG background slowing ( P=0.041, OR=6.648, 95% CI: 1.077-41.038) were the 3 main risk factors associated with poor response to short-term medications of ASMs. Conclusions:Seizures are easily controlled in most SeLECTS patients medicated with ASMs with a favorable prognosis.Seizure frequency, discharge generalization and EEG background slowing are risk factors for the poor response to short-term pharmacotherapy in children with SeLECTS.
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Objective To evaluate the risk factors for benign childhood epilepsy with centrotemporal spikes (BECT) complicated by electrical status epilepticus in sleep(ESES).Methods From January 2013 to January 2017,a total of 80 children diagnosed as BECT in pediatric neurology outpatient department of Provincial Clinical Medical College Affiliated to Fujian Medical University were enrolled.According to whether there was an attack of ESES or not,patients were divided into ESES group(38 cases) and non-ESES group(42 cases).In order to elucidate risk factors for BECT complicated by ESES,clinical data including age,gender,first seizure age,seizure frequency before treatment,types of seizure,therapeutic drug,recurrence of seizure after treatment,febrile seizure,status at birth,family history,brain MRI,discharge quantity,discharge location,and intelligence score were investigated by multivariate Logistic regression analysis.Results Compared with non-ESES patients,ESES patients were more likely to have recurrence of epilepsy after treatment (68.4％ vs 26.2％,P ＜ 0.001),and had worse intellectual development (＜ 90 scores;73.7％ vs 38.1％,P =0.001);while electroencephalogram showed more discharge in anterior location (47.4％ vs 21.4％,P =0.014) and bilateral distribution of brain (52.6％ vs 26.2％,P =0.015).However,the multivariate Logistic regression analysis showed that only recurrence of seizure after treatment was the risk factor for ESES in BECT patients(P=0.008,OR=4.039,95％CI:1.429-11.418).Conclusion Recurrence of seizure after treatment of BECT was a high risk factor for ESES.Controlling seizure and reducing ESES phenomenon could be beneficial to alleviate the intellectual impairment of patients with BECT.
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? AIM: To investigate the influence of phacoemulsification on corneal endothelial cells and its injury risk factors in diabetic cataract patients.?METHODS: From January 2013 to October 2015, 186 diabetic cataract patients ( 224 eyes ) as diabetes group and 190 patients with simple cataract ( 227 eyes ) as control group in our hospital were enrolled. All patients received phacoemulsification combined with intraocular lens implantation. Observation of corneal endothelial cell density, coefficient of variation and percentage of hexagonal cells preoperatively, 1d, 1wk, 1 and 3mo postoperatively were carried out, and multiple Logistic regression analysis for risk factors of corneal endothelial cell injury was taken.?RESULTS: There were no significant difference in the density of corneal endothelial cells, the coefficient of variation and the percentage of hexagonal cells between the two groups before surgery (P>0. 05). Each time point after operation corneal endothelial cell density and the percentage of hexagonal endothelial cells of diabetes group were significantly lower than the preoperative and those of control group ( P < 0. 05 ). Each time after operation endothelial cell coefficient of variation of diabetes group were significantly higher than the preoperative(P<0. 05). The endothelial cell coefficient of variation in diabetes group of the 1wk, 1 and 3mo after operation were significantly higher than those of the control group ( P<0. 05 ) . Corneal endothelial cell density and percentage of hexagonal cells of the control group at 1wk, 1 and 3mo after operation were significantly lower than the preoperative ( P<0. 05 ). The endothelial cell coefficient of variation of control group at 1wk, 1 and 3mo after operation were significantly higher than the preoperative(P<0. 05). Single factor analysis showed that age, shallow anterior chamber, long ultrasonic time, short eye axis, high energy ultrasonic, high cumulative released energy, a lot of perfusate and nuclear hardness ≥ grade Ⅲ associated with corneal endothelial cell injury ( P< 0. 05 ) . Multivariate Logistic regression analysis showed that age, long ultrasonic time, high ultrasonic energy, high cumulative released energy and nuclear hardness ≥ grade Ⅲ were the risk factors of corneal endothelial cell injury, the OR value and 95%CI were 1. 742 (1. 056-2. 682), 1. 958 (1. 227-3. 135), 2. 064(1. 274-3. 256), 2. 585(1. 493-3. 682), 2. 193 (1. 348-3. 316).?CONCLUSION: The injury of corneal endothelial cells after phacoemulsification in diabetic cataract patients is more serious than in patients with simple cataract. Age, long ultrasonic time, high ultrasonic energy, high cumulative released energy and nuclear hardness ≥grade Ⅲ are the risk factors of corneal endothelial cell injury.
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Objective To investigate the complications related factors in infants with mycoplasma pneumonia pulmonary(MPP). Methods According to the condition of pulmonary complications, 105 cases of infants MPP were divided into pulmonary complication group and no pulmonary complication group with 72 cases and 33 cases respectively,and the general related factors and disease related factors of two groups were analyzed. Results The incidence rate of pulmonary complication was 68.6% (72/105) in infants MPP, and the main involved extra-pulmonary systems were digestive system (54.2%), cardiovascular system (44.4%) and blood system(33.3%). Among 20 factors associated with pulmonary complications of MPP, age, feeding method (including artificial, mixing and milk three classification), season of onset, fever days, the titer of mycoplasma pneumonia (MP)-IgM, C-reaction protein, erythrocyte sedimentation rate and the initial time of using macrolides had significant differences between two groups (P<0.05). Multivariate Logistic regression analysis showed that age≥2 years, fever days≥7 d, titer of MP-IgM≥1∶160, increased C-reaction protein levels and accelerated erythrocyte sedimentation rate were the risk factors for pulmonary complications of infants MPP, while breastfeeding and using macrolides within 7 d were the protective factors. Conclusions The incidence rate of pulmonary complications in infants MPP is high, which can affect multiple systems. For children with older age, longer thermal process, higher titer of MP-IgM, and increased C-reaction protein , accelerated erythrocyte sedimentation rate and more past medical history, more attention should be paid for their higher pulmonary complications incidence.
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OBJECTIVE:To explore the risk factors of adverse reaction of cefazolin drugs by Logistic model. METHODS:Re-lated information was collected from the information system of our hospital,and SPSS 19.0 software was conducted for statistical analysis. RESULTS:Totally 855 patients were enrolled,30 of which had adverse reactions(3.51%). According to the results of Logistic analysis,intravenous administration with the concentration of ≥20 mg/ml (OR=7.857,95% CI:1.566-39.431,P=0.003) was the risk factor of adverse reaction of cefazolin drugs when single dose was above 2 g (OR=13.75,95% CI:2.423-78.028,P1.75 g with ad-ministration time of 0:00-9:05 and concentration of above 7 mg/ml. According to the predictive thresholds,the risk of patients with adverse reaction can be predicted to promote safe and effective use of cefazolin.
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Objective To analyze the incidence rate of congenital malformations in Xintai City from January 2010 to December 2013,and to investigate the risk factors for neonatal malformations. Methods A total of 21 463 ca-ses of perinatal infants pregnant for 28 weeks later to postpartum 7 d in Xintai city from January 2010 to December 2013 were retrospectively analyzed. The congenital malformations detection data were analyzed. The risk factors were analyzed by univariate and Logistic analysis methods. Results There were 281 cases with congenital malformations were identi-fied out,and the congenital malformation rate was 1. 31%(281 / 21 463 cases). The incidence rates of multi - finger (toe)[0. 24%(52 / 21 463 cases)],cleft lip[0. 23%(49 / 21 463 cases)],and congenital heart disease[0. 22%(47 /21 463 cases)]were the main congenital malformations. Total malformation rates in the year of 2010,2011,2012,and 2013 were similar(1. 26% ,1. 25% ,1. 33% ,1. 26% ,Z = - 1. 826,P = 0. 068). Univariate and Logistic regression analysis results showed that birth weight,parity,births number,gestational age,educational level,residence,income,ill-ness history,exposure to pesticides,hepatitis,influenza,severe vomiting of pregnancy,threatened abortion,threatened premature,contraceptives,smoking history,drinking history,and father's chronic disease were the risk factors for neo-natal congenital malformations( χ2 = 10. 212,4. 299,5. 860,5. 278,10. 422,9. 327,15. 680,127. 395,245. 735, 74. 141,718. 876,96. 414,77. 770,11. 300,9. 126,74. 927,68. 283,5. 450,P = 0. 001,0. 038,0. 015,0. 022, 0. 001,0. 002,0. 000,0. 000,0. 000,0. 000,0. 000,0. 000,0. 001,0. 001,0. 003,0. 000,0. 000,0. 020 ). Conclusions Neonatal congenital malformation is mainly determined by genetic and environmental factors. For childbearing age and pregnant women,targeted health education should be strengthened to reduce the incidence rate of congenital malformations.
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Objective To investigate the incidence of surgical site infection(SSI)following clean incision breast surgery under non-local anesthesia,and evaluate risk factors for SSI.Methods Clinical data of 3 327 patients who underwent clean incision breast surgery under non-local anesthesia in 22 hospitals in Fujian Province were surveyed retrospectively,SSI and risk factors were analyzed.Results Among 3 327 patients,1 502(45.19%)were with malignant tumors,the average dura-tion of surgery were (101.18 ±8.04)minutes;a total of 24 cases of SSI occurred,incidence of SSI was 0.72%;253 (7.60%)patients received pre-operative antimicrobial prophylaxis,62.66% used antimicrobial agents within 0.5-2 hours before surgery.The main pathogenic bacteria was Staphylococcus aureus .Univariate and logistic regression analysis re-vealed that malignant tumor,diabetes mellitus,and use of immunosuppressants were all risk factors for SSI (all P <0.05). Conclusion SSI following clean incision breast surgery under non-local anesthesia is well controlled,risk factors for SSI should be evaluated before operation,comprehensive preventive measures should be taken to reduce the incidence of SSI.
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Objective To understand the dietary intake of selenium and its influencing factors among rural and urban residents in Zhejiang province. Methods From 2010 to 2012,a total of 2,659 residents were selected from large urban sites,small-medium urban sites and rural sites in Zhejiang. Using 24 -hour dietary recall method,a 3 -day household dietary survey to analysis the dietary intake of selenium. Results The average daily dietary intake of selenium for residents aged 1-,4-,7 -,11 -,14 -,18 -,45 - and 60 - was 21. 96,26. 39,31. 62,35. 26,29. 39,41. 78,39. 12 and 38. 40 μg,respectively. According to formulation of Chinese Nutrition Society,the dietary selenium intake of 42. 56%juveniles and 52. 09% of adults was below the estimated average requirement( EAR). Significant statistical differences were found between normal group and insufficient dietary selenium intake group in terms of age,sex,region,level of education, per capita annual income,physical exercise and smoking status(all P<0. 01). Influencing factors of insufficient selenium intake were female(OR =1. 86,95%CI:1. 59 -2. 63),rural area( OR =1. 46,95%CI:1. 23 -1. 73),lower level of education(OR=0. 70,95%CI:0. 57 -0. 86)and lower income( OR =0. 72,95% CI:0. 60 -0. 88). Conclusion Influencing factors of dietary selenium intake are sex,region,level of education and per capita income. Dietary selenium supplement should be strengthened through a variety of ways,especially in target population.
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Objective To study the risk factors for surgical site infections (SSIs)in patients with hepatobiliary and pancreatic surgery.Methods Sixty patients who received hepatobiliary and pancreatic surgery and suffered SSIs from January 2006 to January 2010 were selected as infections group,119 patients who also received hepatobiliary and pancreatic surgery but didn’t develop infection were as control group,retrospective investigation was per-formed.Results Univariate analysis revealed the associated factors for post-operative SSIs were age,history of car-diocerebrovascular disease,history of abdominal surgery,history of smoking,preoperative anemia,abnormal pre-operative coagulation and blood sugar,pre-operative infection,use of laparoscope,incision type,duration of opera-tion,ASA score,post-operative drainage and dressing chang within 24 hours of post-operation(all P<0.05).Mult-ivariate analysis revealed that abdominal surgery history (OR95%CI:3.09 [1.21 -7.91 ]),high NISS score (OR95%CI:6.18[2.41-15.85])were risk factors of SSIs in patients with hepatobiliary and pancreatic surgery, and dressing chang within 48 hours of post-surgery were protective factor (OR95%CI:3.81 [1.56-9.34]). Conclusion History of abdominal surgery and high score of NISS are major risk factors for SSIs in patients with hepatobiliary and pancreatic surgery.To reduce the risk of SSIs,blood glucose should be actively adj usted,anemia and coagulation abnormalities should be treated;duration of operation should be shortened as far as possible,wound should be kept clean and dressing should be changed timely after surgery.
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Objective To explore the risk factors for persistent pulmonary hypertension of the newborns (PPHN).Methods An 1 ∶ 1 matched case-control study was conducted in 41 cases of PPHN.Chi-square,t-test or ANOVA were used to perform univariate analysis.All factors for P values less than 0.05 were used as independent variables for multivariate analysis of Logistic regression,and a predictive model of Logistic regression for the genesis of PPHN was established,and the model was evaluated preliminarily.Results By multivariate analysis of Logistic regression,meconium aspiration syndrome (OR =52.391,95 ％ CI:3.899-703.959),matemal diabetes (OR =49.758,95 ％ CI:3.544-698.686),neonatal pneumonia (OR =49.637,95％ CI:6.143-401.100),intra-uterine growth restriction (OR =26.666,95％ CI:2.997-237.282),hyaline membrane disease (OR =15.200,95 ％ CI 2.862-80.726) were significantly related to genesis of PPHN.Goodness of fit for predictive model of Logistic regression was checked by Chisquare and x2 value was 23.681.It indicated model check was statistically significant (P ＜ 0.01).Conclusions Meconium aspiration syndrome,maternal diabetes,neonatal pneumonia,intra-uterine growth restriction,and hyaline membrane disease are major risk factors for genesis of PPHN.
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Objective:To analyze the infectious ODDS risks of anticancer plant alkaloids and other anticancer drugs in GI cancer patients with chemotherapy regiments.Method:2384 profiles of cancer patients agreeable with studying condition were collected.All the profiles were evaluated with different variants,and then these variants were analyzed with the logistic liner.Result:The line values of ages,days in hospital,insurances,alkylating agents,platinum antitumor com- pounds and other antitumor drugs were 0.010,0.147,-0.361,-0.930,-0.390,and-1.306.Conclusion:The infection OR of the ages and days in hospital increased OR factors and the medical insurances decreased OR factors.Antitumor antibiot- ics,antimetabolites,plant alkaloids had their higher infectious risks than platinum antiturnor compounds,alkylating agents and other antitumor drugs did in GI cancer patients with chemotherapy regiments.
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Purpose:To evaluate the significance of surgery for pulmonary metastases and investigate the adverse factors of prognosis.Methods:Forty six patients with pulmonary metastases were studied. Operation was performed through conventional thoracotomy ( in 30 patients) and video assisted thoracoscopic surgical techniques (in 16 patients). Patients were followed up. Survival rate was calculated with Kaplan Meier method. Logistic regressive analysis was done to identify adverse prognostic factors.Results:Three year and five year survival rates were 33.8% and 15.8% respectively. Logistic multivariate regressive analysis revealed that multiple lobes metastases and metastases with lymph nodal metastases were adverse factors for prognosis.Conclusions:Surgery might cure some selected patients with pulmonary metastases. Multiple lobes metastases and metastases with mediastinal lymph nodal metastases are indicators of poor prognosis.
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Objective:To study factors influencing drug abuse in f emale.Method:230 female drug abusers admitted into Institute of Dr ug Withdrawal were investigated by Drug Abuse Inventory made by Chinese Drug Depend ence Institute.Data was analyzed by Logistic analysis.Results:Risk f actors related to drug abuse included:poor education,unemployment,divorce or sep aration,stimulus seeking,destructive social relationship,meaningless life.Conclusion:Drug abuse in female is a problem occurring on poor psychosoci al background.