ABSTRACT
Objective To establish a prediction model for tuberculosis incidence in Nantong area by multivariate regression analysis, and to provide theoretical support for the implementation of combined prevention work in this area. Methods A total of 37 338 registered patients with pulmonary tuberculosis in Nantong City from 2010 to 2021 were enrolled in the observation group. A total of 28,721 healthy people who underwent physical examination during the same period were selected as the control group. Results From 2010 to 2021, there were a total of 37 338 cases of pulmonary tuberculosis in central Nantong. From 2010 to 2015, more than 3,000 cases were reported annually, with the largest number (4 142 cases) in 2011, accounting for 11.09% of the total. The number of cases reported from 2016 to 2021 was all less than 3 000, and the number of cases reported from 2021 was the least , 1 803 cases, accounting for 4.83% of the total. The number of cases decreased each year in the past 12 years. The incidence of pulmonary tuberculosis in males was 70.97% (26 497 cases) and that in females was 29.03% (10 841 cases). In terms of age, the lowest incidence rate was 0.06% (23 cases) in the age group of 0-9 years old, and the highest incidence rate was 19.56% (7 304 cases) in the age group of 60-69 years old. Logistics regression analysis showed that male, age ≥60 years old, occupation as a farmer and smoking history were the risk factors for pulmonary tuberculosis (P < 0.05). ROC curve results showed that the AUC value of the risk prediction model for pulmonary tuberculosis in the Nantong area was 0.872, with a predictive sensitivity of 86.32% and a specificity of 89.21%. Conclusion There are many risk factors for pulmonary tuberculosis in Nantong area, and different factors interact and influence each other. The construction of a risk prediction model for pulmonary tuberculosis can better predict the clinical incidence, which is helpful to guide clinical diagnosis and treatment.
ABSTRACT
Objective To retrospectively analyze the clinical and pathological data of 48 patients with adenoid cystic carcinoma of the head and neck and screen out related factors that affect the patient's prognosis. Methods The overall survival rate of patients is used as the main indicator for observing prognosis. We selected 11 clinical and pathological factors as observation indicators that may have an impact on the survival and prognosis of patients. The relation between observation factors and the overall survival rate of patients was analyzed by Cox multivariate regression. Results The median follow-up time was 33.5(1-98) months. The 1-, 2- and 5-years overall survival rates were 95%, 91% and 87%. Local recurrence occurred in 14(29.2%) patients. Distant metastasis occurred in 22(45.8%) patients. Cox regression analysis showed that recurrence, distant metastasis and primary site were correlated with the overall survival rate of patients with head and neck adenoid cystic carcinoma (P < 0.05). Conclusion Adenoid cystic carcinoma is a relatively rare tumor of the head and neck with a low degree of malignancy. However, recurrence, distant metastasis and primary site have relatively great impact on the prognosis of patients.
ABSTRACT
Objective:To investigate early neonatal deaths born to pregnant women with syphilis and the risk factors.Methods:Data were obtained from the maternal syphilis surveillance system in Zhejiang Province. Pregnant women with syphilis who delivered ≥28 weeks during January 2014 to December 2020 were included. Demographic characteristics (age, education level, occupation, gravidity, parity, adverse pregnancy history, etc.), maternal and perinatal health records, syphilis laboratory test results, syphilis treatment regimen, delivery information, and infant information were collected. Trend chi-square analysis was conducted to track the early neonatal mortality over years. Pearson correlation coefficient was used to estimate the relationship between maternal syphilis treatment and early neonatal mortality. Logistic analysis was conducted to investigate the risk factors for early neonatal death.Results:Among the 71 cases with early neonatal death, 49 cases (69.01%) were aged from 21 to 34 years old, 52 cases (73.24%) had middle school education, 39 cases (54.93%) had no fixed occupation, 39 cases (54.93%) had more than three gravidities, 48 cases (67.61%) were multiparas. There were eight cases (11.27%) of stillbirth abortion. Forty-nine cases (69.01%) with rapid plasma reagin circle card test (RPR) or tolulized red unheated serum test (TRUST) titer ≥1∶4. Among the 72 early neonatal deaths, 40 were males and 32 were females. The leading cause of death was preterm birth/low birth weight (56 cases, 77.78%). From 2014 to 2020, the early neonatal mortality rate of pregnant women with syphilis in Zhejiang Province decreased from 10.37‰ (24/2 314) to 1.49‰(3/2 007) (trend χ2=20.05, P<0.001). The rate of maternal antisyphilitic treatment was negatively correlated with early neonatal mortality ( r=-0.895, P=0.006). Multivariate analysis showed that standard treatment reduced the risk of early neonatal death (Wald=24.845, P<0.001, odds ratio ( OR)=0.181). However, RPR or TRUST titer ≥1∶4 in the last trimester (Wald=72.026, P<0.001, OR=10.112) increased the risk of early neonatal death. Conclusions:Preterm birth and low birth weight are the leading causes of early neonatal death in pregnant women with syphilis. Strengthening the treatment of syphilis in pregnancy women, especially the standard treatment, is beneficial to reduce the risk of early neonatal death.
ABSTRACT
BACKGROUND: During the orthodontic treatment, the results of related reports on potential risk factors affecting the clinical success rate of miniscrew implants are inconsistent. The influential factors that clinicians concern are not all included in this study, and the conclusions from animal experiments are difficult to apply to clinical practice directly. Therefore, what factors affect the clinical success rate of miniscrew implants need further thorough and systematic research. OBJECTIVE: To investigate the factors that influence the clinical success rate of miniscrew implants used as orthodontic anchorage. METHODS: A total of 114 patients with oral implants, including 42 males and 72 females, aged (19. 26±9. 19) years were included in this study. A total of 253 miniscrew implants were implanted as orthodontic anchorage. The following influential factors were included: Gender, age, vertical skeletal facial pattern, implant site, implant arch, soft tissue type at the implant site, oral hygiene status, diameter and length of the miniscrew implants, implantation method, implantation angle, stress loading timing and intensity, and clinical use. Logistic regression analysis was used to study the correlation between success rate and all variables. Analysis of variance was used to test the effect of each variable on clinical success rate. This trial protocol was approved by the Medical Ethics Committee of Sichuan University. RESULTS AND CONCLUSION: Among 253 successful miniscrew implants, the overall success rate was 88. 54% with an average loading period of 9. 5 months. The average loading period of the 29 failed miniscrew implants was 2. 3 months. The chi-square test, Fisher exact test and Logistic regression revealed that age, oral hygiene, vertical skeletal facial pattern, and implant site were significantly correlated with clinical success rate (P 0. 05). These results suggest that to minimize the failure of miniscrew implants, proper oral hygiene instruction and effective supervision should be given to patients, in particular to those young (< 12 years) high mandibular plane patients.
ABSTRACT
Abstract The variability in parasite abundance has an ecological basis; however, from an epidemiological point of view, the contribution of factors inherent to the host to the variability in parasite abundance remains an open question. A database consisting of 3,746 specimens of 73 fish species was used to verify the relation between the distribution of parasite abundance in fishes and a set of biotic factors inherent to the hosts. Classical and mixed Poisson regression models were constructed. Prevalence ratios (PR) and their respective 95% confidence intervals were estimated. The parasite abundance was significantly higher in female hosts, nonschooling species, species from benthopelagic and pelagic habitats, and fishes with greater body length. Overall, these results suggest that the variability in the abundance of infection is an attribute of the parasite species. Although the results are biologically plausible, important gaps may still exist and should be explored to better understand the variations in parasite abundance, which has great relevance in epidemiological studies. We reinforce the importance of choosing the statistical model most appropriate for the nature of the data to avoid spurious results, especially when the autocorrelation in the data is not taken into account.
Resumo A variabilidade na abundância parasitária tem embasamento na perspectiva ecológica, entretanto, do ponto de vista epidemiológico, permanece em aberto a possibilidade da contribuição de fatores inerentes aos hospedeiros para essa variabilidade. Foram analisados 3.746 espécimes, pertencentes a 73 espécies de peixes, para verificar a relação entre a distribuição da abundância parasitária em peixes e um conjunto de fatores bióticos inerentes aos hospedeiros. Modelos de Regressão de Poisson clássico e misto foram ajustados. As razões de prevalência (RP) e seus respectivos intervalos, com 95% de confiança, foram estimados. A abundância parasitária foi significativamente maior em hospedeiros fêmeas, não formadoras de cardumes, de hábitats bentopelágico e pelágico e com maior comprimento do corporal. De um modo geral, esses resultados sugerem que a abundância de infecção é um atributo da espécie de parasitos que pode ser variável. Apesar dos resultados apresentarem plausibilidade biológica, ainda pode haver lacunas importantes a serem exploradas para o melhor entendimento das variações da abundância parasitária que, por sua vez, tem grande relevância nos estudos epidemiológicos. Reforça-se a importância da escolha de um modelo estatístico mais adequado à natureza dos dados, evitando-se resultados espúrios, principalmente quando não se leva em conta a autocorrelação entre os dados.
Subject(s)
Animals , Parasites/isolation & purification , Fishes/parasitology , Brazil , Databases, Factual , EcosystemABSTRACT
BACKGROUND: This study aimed to determine whether modified shock index (MSI) is associated with mortality that is superior to heart rate, blood pressure, or the shock index (SI) in emergency patients.METHODS: A retrospective database review was performed on 22161 patients who presented to Peking Union Medical College Hospital Emergency Department and received intravenous fluids from January 1 to December 31, 2009. We gathered data of the patients on age, gender, vital signs, levels of consciousness, presenting complaints, and SI and MSI were calculated for all patients.RESULTS: Multivariate regression analysis was performed to determine the correlation between risk factors and outcome. There is a significant correlation between emergency patient mortality rate and patient's vital signs obtained at the triage desk (HR>120 beats/min, systolic BP<90 mmHg, diastolic BP<60 mmHg). MSI is a stronger predictor of emergency patient mortality compared to heart rate and blood pressure alone, whereas SI does not have a significant correlation with emergency patient mortality rate.CONCLUSION: MSI is a clinically significant predictor of mortality in emergency patients. It may be better than using heart rate and blood pressure alone. SI is not significantly correlated with the mortality rate of the emergency patient.
ABSTRACT
Objective: To discuss the influence factors of the prognosis of intraventricular hemorrhage.Methods: 96 consecutive cases were studied.General information,onset symptoms,PE on admission,features on CT scan,treatment strategies and complications such as pneumonia and stress ulcer were used as independent valuables.Prognosis was judged with Scandinavian Stroke Scale after 3 months.The valuable influence factors were filtrated and formulated with multivariate regression analysis model.Results: The data were processed with statistic software,found that Glasgow Coma Score(GCS),consciousness grade on admission,pupil size,treatment strategies,complications and the ventricles which were involved,especially the third ventricle and the contralateral ventricle,were found to affect the prognosis.Conclusion: GCS,consciousness grade,pupil size,pneumonia,stress ulcer,treatment strategies,in special,the position and volume of intraventricular hemorrhage affect the prognosis of intraventricular hemorrhage.