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Introducción: Los pacientes pediátricos con leucemia linfoide aguda se estratifican en tres grupos de riesgo: bajo, intermedio y alto. Hay condiciones predictivas de muerte en este grupo de pacientes que incluyen indicadores clínicos y de laboratorio, que en relación con estos factores desarrollan durante la enfermedad insuficiencias orgánicas. Objetivo: Analizar los factores asociados con la mortalidad en pacientes pediátricos diagnosticados de leucemia linfoide aguda con insuficiencias orgánicas. Métodos: Se realizó una investigación bibliográfico-documental acerca del tema. Se consultó fundamentalmente artículos de los últimos 10 años de las bases de datos de SciELO y PubMed. Análisis y síntesis de la información: Se describe los factores de alto riesgo en pacientes pediátricos graves con insuficiencias orgánicas, desde aquellos ya establecidos en protocolos nacionales e internacionales; así como los propios que se desencadenan en los pacientes con disfunción orgánica y su relación en la evolución desfavorable del paciente. Conclusiones: Se encontró una relación entre los factores de alto riesgo en pacientes pediátricos diagnosticados de leucemia linfoide aguda con el desarrollo de insuficiencias orgánicas como complicaciones y muerte en estos grupos de enfermos.
Introduction: Pediatric patients with acute lymphoid leukemia are stratified into three risk groups: low, intermediate and high. There are conditions predictive of death in this group of patients that include clinical and laboratory indicators, which in relation to these factors develop organ insufficiencies during the disease. Objective: To relate the factors associated with mortality in pediatric patients diagnosed with acute lymphoid leukemia with organ failure. Methods: A bibliographic-documentary research on the subject was carried out. The Scielo and PubMed databases of the last ten years were fundamentally consulted. Analysis and synthesis of information: High-risk factors in severe pediatric patients with organ failure are described, from those already established in national and international protocols; as well as those that are triggered in patients with organic dysfunction and their relationship in the unfavorable evolution of the patient. Conclusions: A relationship was found between high risk factors in pediatric patients diagnosed with acute lymphoid leukemia with the development of organ failure as complications and death in these groups of patients.
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Objective:To analyze the prognosis and risk factors for brain metastases (BM) in patients with limited-stage small cell lung cancer (LS-SCLC) after complete resection, aiming to identify those most likely to benefit from prophylactic cranial irradiation (PCI).Methods:Clinical data of 94 patients with LS-SCLC treated in Cangzhou Integrated Traditional Chinese and Western Medicine Hospital from January 2005 to December 2018 who underwent complete resection were retrospectively analyzed, including 31 cases treated with PCI and 63 without PCI. Prognostic factors and risk factors of BM were analyzed by Kaplan-Meier method. The differences between two groups were analyzed by log-rank test. Independent risk factors of overall survival (OS) and BM were assessed by multivariate Cox regression model.Results:The 2-year and 5-year OS rates were 80.6% and 61.3% in the PCI group, and 61.9% and 46.0% in the non-PCI group, respectively ( P=0.001). The 2-year and 5-year brain metastasis-free survival (BMFS) rates were 80.6% and 54.8% in the PCI group, and 57.1% and 42.9% in the non-PCI group, respectively ( P=0.045). The 2-year and 5-year progression-free survival (PFS) rates were 71.0% and 48.4% in the PCI group, and 49.2% and 34.9% in the non-PCI group, respectively ( P=0.016). PCI could improve OS in patients with pII/III stage LS-SCLC ( P=0.039, P=0.013), but the OS benefit in patients with pI stage LS-SCLC was not significant ( P=0.167). BM occurred in 3 patients (9.7%) in the PCI group, which was significantly lower than that in the non-PCI group ( n=17, 27.0%; P=0.044); there was no significant difference in the BM rate of patients with pI and pII stage LS-SCLC between PCI and non-PCI groups ( P=0.285, P=0.468); and the BM rate of patients with pIII stage LS-SCLC in the PCI group was significantly lower than that in the non-PCI group ( P=0.041). Multivariate analysis showed age ≥60 ( HR=2.803, P=0.001), BM ( HR=2.239, P=0.022), no PCI ( HR=0.341, P=0.004) and pathological stage pII/III ( HR=4.963, P=0.002) were the independent high-risk factors affecting OS; and pathological stage pII/III ( HR=11.665, P=0.007) was an independent high-risk factor affecting BM. Conclusions:LS-SCLC patients with pII-III stage have a higher risk of developing BM and poor prognosis after complete resection, and should receive PCI treatment. However, LS-SCLC patients with pI stage may not benefit significantly.
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【Objective】 To analyze the clinical data of prostate cancer patients with normal PSA level confirmed with transperineal prostate biopsy or transurethral prostate surgery, in order to improve the diagnostic level of this disease. 【Methods】 The clinical data of 6 patients were retrospectively analyzed. The age,clinical manifestations, body mass index (BMI),prostate specific antigen density (PSAD),blood triglycerides,blood cholesterol,color ultrasound imaging,magnetic resonance imaging (MRI),pathological types and Gleason scores were analyzed. The clinical characteristics and high-risk factors were summarized. 【Results】 Two cases were confirmed with prostate biopsy and four after prostate resection. Three patients had high blood triglycerides, three were negative for bone imaging, and the other three were not examined. PSAD was 0.017 to 1.215. Color ultrasound indicated that two cases had irregular morphology, two uneven echo, and one both irregular morphology and uneven echo; all six cases had calcification. In the three cases who received MRI, two had PIRADS4 nodules, one had PIRADS5 nodules, invasion of seminal vesicle, rectum, posterior wall of urinary bladder,bilateral thickening of NVB, and lymph nodes enlargement. Pathology suggested prostatic acinar adenocarcinoma in five cases, four of which had a Gleason score of 3+3=6 and one had 5+5=10; one case suggested a high-grade neuroendocrine carcinoma. 【Conclusion】 The clinical detection rate is low for prostate cancer with normal PSA. The biopsy indications should be determined by combining the characteristics and high-risk factors to improve the detection rate.
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@#Objective To analyze the clinical characteristics of the Guang’an Omicron epidemic and summarize the management experiences and practices in pandemic prevention and control of major infectious diseases. Methods Retrospective analysis was performed on patients infected with coronavirus disease (COVID-19), afterwards treated and observed in the isolation ward of Guang’an People’s Hospital and the shelter of Guang’an City from May 9 to June 26, 2022. The characteristics of patients at different age stages and the related factors affecting the severity, re-positive and negative conversion was analyzed. Results Finally 1 278 patients were collected, including 508 males and 770 females, with an average age of 41.3±22.6 years. Among them, 1 054 patients were asymptomatic carriers. The overall severe rate was 0.86%, the severe rate of the high-risk group was 3.06%. The median negative conversion time was 10.0 days and re-positive rate was 7.36%. Patients aged>60 years were 2.589 times more likely to have a longer negative conversion time than those aged≤60 years (95%CI 1.921-3.489, P<0.001). Conclusion The clinical characteristics of Guang’an COVID-19 epidemic are mainly that the elderly with high risk factors are more likely to develop severe cases, have longer clearance time, and re-positve is more likely to occur.
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Objective:To study the high risk factors of hypothermia in premature infants with gestational age ≤34 weeks, and to analyze the incidence of hypothermia before and after the implementation of the quality improvement program of hypothermia in hospital and its influence on various systemic complications, aiming to improve the early identification of hypothermia and to reveal the important clinical significance of temperature management in time.Methods:Clinical data of preterm infants born in Maternal and Child Health Hospital of Hubei Province from May 2017 to December 2018, with gestational age ≤34 weeks, and admitted within 1 hour after birth were collected.According to the admission temperature, the infants were divided into normal temperature group (36.5-37.5 ℃), mild hypothermia group (36.0-36.4 ℃), moderate hypothermia gsroup (32.0-35.9 ℃), and severe hypothermia group (<32.0 ℃). The high risk factors of hypothermia in premature infants were analyzed.The incidence and degree of hypothermia and the effects on the systemic complications before and after the implementation of the hypothermia quality improvement program were compared.Results:A total of 306 premature infants were enrolled in the study, including 63(20.6%)cases in the normal temperature group, 115(37.6%) cases in the mild hypothermia group, and 128(41.8%) cases in the moderate hypothermia group, without severe hypothermia.Infants with birth asphyxia were at higher risk for hypothermia( OR=0.195, 95% CI 0.046-0.833, P=0.027); the lower the Apgar score at 1 min( r=0.123, P=0.032)and 5 min after birth( r=0.136, P=0.017), the higher the risk of admission hypothermia.After the quality improvement project, the incidence of admission hypothermia decreased from 82.3% to 73.8%( χ2=32.67, P<0.001), and the use of pulmonary surfactant in infants with respiratory distress syndrome was significantly reduced(70.0% vs. 32.0%, χ2=40.11, P<0.001), and the incidence of hypotension within 72 hours after birth decreased(11.8% vs. 4.9%, χ2=3.87, P<0.049). Conclusion:Birth asphyxia is a risk factor for admission hypothermia in premature infants, and Apgar score is associated with admission hypothermia in premature infants.Temperature management of preterm infants can significantly reduce the incidence of hypothermia and hypotension, and reduce the use of pulmonary surfactant in respiratory distress syndrome infants.
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Abstract The purpose of this work was to analyze the high-risk factors of complications in the trial of vaginal delivery of a subsequent pregnancy for scar uterus after a previous cesarean. 136 pregnant women with scar uterus with a history of cesarean who were admitted to our obstetrics department from February 2016 to March 2019 were selected and were divided into a successful group and a failed group according to the results of pregnancy and trial of labor vaginal delivery. General data of before, during, and after delivery were collected and the high-risk factors for failed vaginal delivery of scar uterine were analyzed by the logistic regression analysis. Among the 136 patients, 108 cases (79.41%) of vaginal trials were successful, and 28 cases (20.59%) of vaginal trials faired. The univariate analysis showed that the differences in gravidity, parity and the previous cesarean interval, vaginal birth history, prenatal BMI, uterine contraction, gestational age, infant weight, dilatation of the cervix, cervical Bishop score, the height of the fetal head, the thickness of the lower uterus, and whether the membranes were prematurely ruptured were statistically significant (P<0.05). Logistic regression analysis showed vaginal birth history, prenatal BMI ≥ 30 kg/m2, parity ≥ 2 times, cesarean interval <2 times, dilatation of cervix ≥ 1 cm, the height of the fetal head ≥ -3, premature rupture of the membrane and the thickness of the lower uterus of 3.0 to 3.9 cm were the high-risk factors of complications in the vaginal trial delivery of pregnancy again for scar uterus (P<0.05). It is feasible for pregnant women with scar uterus to undergo vaginal delivery, but many related factors can affect the failure of trial of labor. It is necessary to pay attention to all aspects of clinical examination and choose applications strictly according to the indications.
Resumen El propósito del presente trabajo fue analizar los factores de alto riesgo de complicaciones por cicatriz uterina en la prueba de parto vaginal del siguiente embarazo después de una cesárea previa. 136 gestantes con cicatriz uterina fueron seleccionadas con antecedente de cesárea anterior que ingresaron a nuestro servicio de obstetricia de febrero 2016 a marzo 2019, y se dividieron en un grupo exitoso y un grupo fallido según los resultados de las pruebas de embarazo y parto vaginal. Los datos generales anteriores fueron recolectados, durante y después del parto y se analizaron los factores de alto riesgo para el parto vaginal fallido de la cicatriz uterina mediante el análisis de regresión logística. Entre las 136 pacientes, 108 casos (79,41%) de las pruebas vaginales fueron exitosas y 28 casos (20,59%) de las pruebas vaginales fracasaron. El análisis univariado mostró que las diferencias en la gravidez, la paridad y el intervalo de cesárea previa, la historia de parto vaginal, el IMC prenatal, la contracción uterina, la edad gestacional, el peso del lactante, la dilatación del cuello uterino, la puntuación cervical de Bishop, la altura de la cabeza fetal, el grosor del segmento uterino inferior, y si las membranas se habían roto prematuramente fueron estadísticamente significativas (P<0,05). El análisis de regresión logística mostró antecedente del parto vaginal, el IMC prenatal ≥ 30 kg/m2, la paridad ≥ 2 veces, el intervalo entre cesáreas < 2 veces, la dilatación del cuello uterino ≥ 1 cm, la altura de la cabeza fetal ≥ -3, la ruptura prematura de la membrana y el grosor del segmento uterino inferior de 3,0 a 3,9 cm fueron los factores de alto riesgo de complicaciones por cicatriz uterina en la prueba de parto vaginal de un siguiente embarazo (P<0,05). Sería posible que las gestantes con cicatriz uterina vuelvan a someterse a parto vaginal, pero existen muchos factores relacionados que inciden en el fracaso del trabajo de parto. Es necesario prestar atención a todos los aspectos de la exploración física y elegir las aplicaciones estrictamente de acuerdo con las indicaciones.
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Objective To investigate the etiology of chronic renal failure (CRF) in middle-aged and elderly people, and to analyze related factors influencing the prognosis. Methods The clinical data of 456 middle-aged and elderly CRF patients treated in our hospital from January 2018 to January 2021 were collected. The etiology and related factors affecting prognosis were analyzed. Results The etiology of 456 middle-aged and elderly patients with CRF was as follows: 220 cases of primary glomerulonephritis (48.24%), 78 cases of diabetic nephropathy (17.14%), 65 cases of hypertensive nephropathy (14.25%), and 37 cases of pyelonephritis (8.11%), 19 cases of drug-induced renal injury (4.16%), 18 cases of obstructive nephropathy (3.95%), 12 cases of lupus nephritis (2.63%), and 7 cases of polycystic kidney disease (1.54%). The age of onset in patients with primary glomerulonephritis and lupus nephritis was lower than that in patients with other causes (P<0.05). The results showed that 94 of the 456 patients died in the hospital, and the mortality rate was 20.6%. Multivariate logistic regression analysis showed that age, severe infection, cerebrovascular disease, arrhythmia, hypertension stage III, left ventricular hypertrophy, and myocardial infarction were high-risk factors leading to poor prognosis (P<0.05). Conclusion The main causes of CRF in middle-aged and elderly patients are primary glomerulonephritis, diabetic nephropathy, and hypertensive nephropathy. Heart disease is the main factor leading to the poor prognosis of such patients. Efforts shall be put into disease prevention and control work for high-risk groups, so as to reduce the incidence and mortality of CRF.
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Objective:To explore the carrier status of group B streptococci (GBS) in pregnant women of Mongolian and Han nationality and the neonatal GBS infection in order to identify the high risk factors of GBS infection in Mongolian and Han newborns in this area.Methods:Totally 7289 pregnant women and their newborns born alive were tested for GBS in the Affiliated Hospital of Inner Mongolia Medical University from June 2017 to June 2020, and their newborns were cultured for GBS, and the venous blood of newborns delivered by GBS positive women were detected for anti-GBS capsular polysaccharide antibody level, in order to determine the high risk factors of neonatal GBS infection.Results:Among the 7289 pregnant women, 3136 were Mongolian pregnant women (2599 full-term delivery and 537 premature delivery) and 4153 were Han pregnant women (3541 full-term delivery and 612 premature delivery). The results of GBS test showed that the GBS carrier rate was 8.19% in the Mongolian preterm delivery group, 4.35% in the Mongolian term group, 11.93% in the Han preterm group, and 5.76% in the Han term group, indicating that the carrier rate of GBS in the preterm group was significantly higher than that in the term group, regardless of Mongolian and Han nationality ( P < 0.05). Further comparing the GBS carrier rate of Mongolian and Han pregnant women, the GBS carrier rate of Mongolian pregnant women was significantly lower than that of Han pregnant women regardless of the premature delivery group and term group ( P < 0.05). (2) A total of 434 newborns were born by GBS positive parturients. The positive rates of GBS in Mongolian premature infants, Mongolian full-term infants, Han premature infants and Han full-term infants were 29.55%, 14.16%, 31.51% and 17.65%, respectively, suggesting that the positive rate of GBS in premature infants was significantly higher than that in full-term infants, regardless of Mongolian and Han nationality ( P<0.05). Further comparing the positive rate of GBS in Mongolian and Han newborns, there was no significant difference in the positive rate of GBS between Mongolian newborns and Han newborns, no matter the premature delivery group and the full-term group. (3) This study compared the incidence of early-onset GBS septicemia in Mongolian and Han newborns. The results showed that the incidence of early-onset GBS septicemia in Mongolian premature infants was 23.08%, and none in full-term infants. The incidence of early-onset GBS septicemia in Han premature infants was 26.09%. The incidence of early-onset GBS septicemia in term infants was 5.56%. The incidence of neonatal GBS septicemia in the preterm group was significantly higher than that in the term group, regardless of Mongolian and Han nationality. By further comparing the incidence of GBS septicemia in Mongolian and Han newborns, there was no significant difference in the positive rate of GBS between Mongolian newborns and Han newborns regardless of the premature delivery group and the term group. (4) In both Mongolian and Han nationality, the level of anti-GBS capsular polysaccharide antibody in premature infants was significantly lower than that in term infants ( P < 0.05). (5) Regardless of the Mongolian and Han nationality, compared with GBS negative group, GBS positive rate was higher in pregnant women aged≥35 years old, with history of menstruation, miscarriage, vaginitis, floating population, and those who had not undergone pre-pregnancy examination,,which were the high risk factors for GBS-positive pregnant women during pregnancy. (6) In both Mongolian and Han nationality, the incidence of chorioamnionitis, puerperal infection, premature delivery and premature rupture of membranes in the GBS positive group was higher than that in the GBS negative group, and the incidence of fetal distress and neonatal asphyxia in the GBS positive group was also higher than that in the GBS negative group. Conclusions:The carrier rate of GBS in Mongolian pregnant women is lower than that in Han pregnant women, and positive GBS during pregnancy will increase the incidence of adverse maternal and fetal outcomes such as chorioamnionitis, puerperal infection, premature delivery, premature rupture of membranes, fetal distress, neonatal asphyxia and neonatal early-onset GBS septicemia. The high risk factors are maternal age ≥ 35 years old, history of menstruation, abortion, vaginitis, floating population, and infection without pre-pregnancy examination. We should attach great importance to the perinatal high risk factors and formulate corresponding intervention measures accordingly, and make rational use of antibiotics for prenatal prevention, so as to further reduce the incidence of early-onset GBS septicemia in newborns.
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Objective To analyze the relationship between hepatitis B virus genotyping and primary liver cancer (PHC) in Wuhan, and to provide a theoretical basis for the early prevention and diagnosis of PHC. Methods Patients with chronic hepatitis B (CHB) from Wuhan Sub-heart General Hospital for treatment from February 2020 to February 2021 were selected and divided into PHC group (182 cases) and control group (189 cases) according to whether they were complicated with primary liver cancer. 5ml of fasting elbow venous blood was taken from all subjects at admission. HBV genotyping was determined by real-time fluorescence quantitative PCR. The DNA of CHB virus was determined by fluorescence probe hybridization and PCR amplification, and genotyping and drug-resistant mutation points were detected according to the product sequencing analysis. Spearman linear correlation analysis was used to analyze the correlation between genotyping and mutation rate of PHC patients. Results The proportion of C genotype in PHC group was significantly higher than that in non-PHC group (P0.05). The proportion of HEPATITIS B virus mutation in PHC group (114/182) was significantly higher than that in control group (84/189) (χ2=12.331, P0.05). The proportion of HBV C mutant in PHC group was significantly higher than that in control group (P1=0.349, r2=0.305, P<0.05). Conclusion The HBV genotype of PHC patients is mainly TYPE C, and has a high mutation rate of C genotype. It can be used for diagnosis of PHC by detecting the genotyping of CHB and mutation rate of C genotype in clinic.
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Objectiv e To investigate the risk of coronary heart disease in urban residents of Handan City from 2017 to 2018, and to provide a scientific basis for the prevention and treatment of coronary heart disease. Methods A total of 1 546 residents in an urban area of Handan were selected as the research subjects. According to coronary artery stenosis, they were divided into the coronary heart disease group and the non-coronary heart disease group. The physical indexes and laboratory test results of the two groups were collected. Univariate and multivariate logistic regression models were used to analyze the risk factors of coronary heart disease. Results The correlation analysis of the results reveled that the increase of LDL-C level, smoking history, diabetes, hypertension and body mass index were significantly correlated with the incidence of coronary heart disease (P<0.05), which were the risk factors for the onset of coronary heart disease. Conclusion The incidence of coronary heart disease in urban residents of Handan from 2017 to 2018 was related to a variety of factors, among which the increase of LDL-C level, smoking history, diabetes, hypertension and body mass index were high risk factors for coronary heart disease. Quitting smoking, reducing the intake of high salt and sugar, and controlling the LDL-C level and body weight are important to reduce the incidence of coronary heart disease.
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Objective To investigate the high-risk factors of stroke in Anqing area, and to analyze the value of standard treatment for the intervention of high-risk population for stroke. Methods A total of 3 062 permanent residents over 40 years of age in Anqing were surveyed by a questionnaire for the high-risk population of stroke. Physical examination was carried out for people at a high risk of stroke. The physical examination included general physical examination, laboratory tests, and carotid artery color Doppler ultrasound examination. People at a high risk of stroke were investigated on whether or not they received standardized symptomatic treatment and prevention interventions. Results Hypertension or taking antihypertensive drugs accounted for the highest risk factors of stroke in Anqing area, followed by smoking and seldom physical exercise. The abnormal rates of body mass index, blood pressure, contents of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL) , homocysteine (HYC), and blood glucose (GLU), as well as intimal thickening, plaque and carotid artery stenosis in people at high risk of stroke receiving standardized treatment were significantly lower than those in people receiving no standardized treatment, and the difference was statistically significant (P<0.05). The standard treatment was an independent factor influencing the body mass index, blood pressure, TC, TG, LDL, HDL, HYC, GLU, intimal thickening, plaque and carotid artery stenosis (P<0.05). Conclusion Hypertension accounted for the highest proportion of high-risk factors for stroke in Anqing area. Standardized symptomatic treatment can effectively control the physical indicators, laboratory test indicators and carotid artery state of stroke high-risk populations, which can play a positive role in the prevention of stroke.
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Background: Respiratory distress syndrome (RDS) is one of the most common causes of neonatal respiratory failure and neonatal death. It is more common in preterm neonates but also been found in term and late preterm neonates. This study aims at studying the risk' factors for developing RDS in term neonates. Objectives was to study the maternal and perinatal risk factors for RDS in term neonates.Methods: This is a retrospective case control study conducted in neonatal intensive care unit of tertiary care centre. A total of 100 term neonates with RDS were taken as cases and 150 normal term neonates were taken as control. Data were collected from the hospital NICU records, maternal and neonatal history was taken. The ?2 tests or Fisher's exact text were used for one-way risk factor analysis. The effects of multiple factors on term neonatal RDS were analyzed using logistic regression analysis.Results: In our study RDS in term neonates' was significantly associated with following risk factors like selective cesarean section, male sex, SGA, oligohydramnios, MSAF, severe fetal distress, birth asphyxia, PROM, and maternal-fetal infection. Among the significant risk factors severe birth asphyxia, maternal-fetal infection, PROM, MSAF were showing positive association with RDS in full-term neonates.Conclusions: Several high-risk factors such as severe birth asphyxia, maternal-fetal infection, PROM, and MSAF were closely correlated with full-term neonatal RDS. Hence these could provide a significant reference for the diagnosis and treatment of term neonatal RDS.
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@#AIM:To investigate the incidence and risk factors of retinopathy of prematurity(ROP)in Sichuan Province.<p>METHODS: From July 2017 to Augest. 2018, 238 premature infants(476 eyes)with gestational age of 34wk or less, or birth weight of 2500g or less, were examined by RetCamⅢ for ROP screening. The infants were divided into ROP group and non-ROP group according to the results of screening. Meanwhile, the general condition of the premature infants and maternal health during pregnancy were assessed and recorded to determine the risk factors of ROP.<p>RESULTS: In 238 infants(476 eyes), ROP developed in 35 infants and the incidence of ROP was 14.7%, which including 14 cases(28 eyes)suffering from stage 1, 11 cases(22 eyes)from stage 2, 8 cases(16 eyes)from stage 3, 2 cases(4 eyes)from stage 4, 0 cases from stage 5. 12 cases(24 eyes)received laser therapy. The gestation age and birth weight in non-ROP group were higher than ROP group, significant difference was found between the two groups(<i>P</i><0.01). The incidence of ROP was statistically significant between different gestational age groups and different birth weight groups(<i>P</i><0.01). The ratios of oxygen inhalation>72h, hypoxic-ischemic encephalopathy and mechanical ventilation in non-ROP group and ROP group were statistically significant(<i>P</i>=0.034; <i>P</i>=0.001; <i>P</i>=0.004). However, the significant difference had not been found with other systemic diseases of the premature infants sand maternal health during pregnancy between the two groups(<i>P</i>>0.05).<p>CONCLUSION: The incidence of ROP in Sichuan Province is 14.7% from July 2017 to Augest 2018. The gestation age, birth weight, oxygen inhalation>72h, hypoxic-ischemic encephalopathy and mechanical ventilation are high risk factors for the occurrence of ROP.
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Cervical adenosarcoma is a very rare type of Mullerian adenosarcoma and it is easily confused with benign polyps, therefore, differential diagnosis is necessary. The primary clinical symptoms are vaginal abnormal bleeding and abdominal pain, which can be prevented through the study of high-risk factors. Surgery excision has been considered as the main treatment at present. Due to the low incidence of cervical adenosarcoma, its etiology, pathogenesis, diagnosis and treatment need to be discussed further. This paper reviews the diagnosis and treatment progress of cervical adenosarcoma.
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OBJECTIVE: To improve the understanding of the IFI,and to help the early diagnosis and treatment and positive improvement of prognosis. METHODS: A total of 21 children were chosen as the research subjects,who were diagnosed with the IFI bloodstream infection and were hospitalized in Shengjing Hospital affiliated to China Medical University from January2012 to January 2018,and the clinical characteristics,high risk factors and prognosis of them were retrospectively analyzed.RESULTS: Therewasnosignificantcorrelationbetweentheincidenceoffungalinfectionandageorsexin 21 children with IFI bloodstream infection. Candida albicans and Candida parapsilosis were the leading pathogen,and the mortality rate of Candida parapsilosis was high(80%).For the 21 children with IFI bloodstream infection,the mortality rate was as high as 61.9%(13 cases)with 28 days' following research. The protopathy was mainly respiratory system disease(14.29%)and digestive system disease(23.81%). Among them,there were 4 cases of severe pneumonia and 4 cases of gastrointestinal perforation. The high risk factors were mainly the combined use of broad-spectrumantibiotics,invasive operation(tracheal intubation,central venous catheterization,catheterization and indwelling stomach tube,etc.),long-term hospitalization in ICU and so on,all above 85%.Fungal infection was characterized by atypical fever(80.95%),abnormal increase or decrease of white blood cells(47.62%)andCRPincrease(80.95%);thepositiverateof Gtest couldreach 42.86%. Inthesurvival groupincluding 8 casesof children,75% were treated with antifungal treatment before diagnosed with fungal infection;the rate of preventive drug use was 53.85%for the death group. CONCLUSION: Long-termhospitalization in ICU,long-termand combined use of a large amount of broadspectrum antibiotics,invasive operation,autoimmune deficiency and other factors increase the risk of fungal infection. If there is atypical refractory infection after clinical primary diseases,fungal infection should be paid attention to and the related microbiological examination should be performed.
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The ureteral injury is one of the significant complication of cesarean section.High risk factors include emergency caesarean section,history of caesarean section,hysterectomy during cesarean section,history of hypogastric zone operation,pelvic infection,etc.The lower uterine segment,especially1.5-3cm from UVJ,is the most common injury level,and more injuries occur on the left side than on the right.It is difficult to recognize the ureteral injuries intraoperatively.Postoperative diagnosis can be made by ultrasound,CTU or retrograde pyelography.Early recognition and repair of the ureteral injury are essential to the patient outcome and preventing late complications and reducing the cost.If the injuries are diagnosed postoperatively,the delayed operation can be performed between 6 weeks and 3months after cesarean section if conditions permitted.The key to avoiding ureteral injury during cesarean section is prevention.This requires us to observe the course of labor closely and handle abnormal labor process in time to avoid emergency caesarean section after long trial.The incidence of ureteral injuries can be reduced by careful operation.
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Objective@#To evaluate the clinical value of high-risk factors in combination with stratification method in predicting the clinical prognosis of patients diagnosed with N2-3M0 nasopharyngeal carcinoma (NPC).@*Methods@#A total of 226 N2-3M0 NPC patients who underwent IMRT from November 2013 to May 2015 were enrolled in this study. The relationship between tumor volume, cervical metastatic lymph node characteristics (necrosis and fusion) and T and N staging was analyzed. The high-risk factors that affected the survival were identified. The value of high-risk factors combined with stratification method in predicting the clinical prognosis was assessed.@*Results@#N3 staging, Vn≥47.15cm3 and lymph node fusion (LNF) were the high-risk factors for distant metastasis in patients with stage N2-3M0 NPC. All patients were classified into the low-risk, medium-risk, high-risk and extremely high-risk groups according to high-risk factors. For patients in the low-risk, medium-risk, high-risk and extremely high-risk groups, the 3-year overall survival rates were 84.2%, 76.7%, 58.7% and 36.4%(all P<0.001), 87.3%, 85.2%, 54.5% and 12.1% for the distant metastasis-free survival (DMFS) rates (all P<0.001), 76.8%, 74.3%, 49.2% and 12.1%for the progression-free survival (PFS) rates (all P<0.001), and 89.2%, 88.5%, 91.5% and 88.3% for the loco-regional recurrence-free survival (LRRFS) rates (P=0.914), respectively. The risk stratification method showed the best curve separation for DMFS compared to the Vn, N staging and LNF classification groups (all P<0.05).@*Conclusion@#High-risk factors in combination with stratification method has the highest clinical value in predicting the clinical prognosis of N2-3M0 NPC patients.
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·Diabetic Retinopathy ( DR ) has gradually worsening and lingering, which is the leading cause of global young people blindness. With the progression of the disease, patients with diabetes mellitus ( DM) will have different degrees of DR. If you can not prevent and give acute early intervention, once the visual acuity decreased significantly, DR would be difficult to reverse. DR progressively has worsening, the treatment status has no optimistic. Therefore, DR in the early prevention and treatment will be indispensable. This article summarizes some of the early warning of the occurrence and development of biological markers and characteristic indicators in order to provide a basis for the early prevention of DR.
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· AIM:To investigate the incidence and risk factors of retinopathy of prematurity (ROP) in preterm infants.· METHODS:The wide-field digital pediatric Retinal imaging system was used to screen 2203 preterm infants with gestational age ＜ 37wk or birth weight ≤ 2000g in NICU and the Ophthalmology Department of Northwest Women and Children Hospital from January 15,2015 to October 15,2017.The screening results were used to calculate the incidence of ROP and to analyze the risk factors.· RESULTS:Totally 367 infants (621 eyes) were diagnosed as retinopathy among 2203 premature infants and the incidence of ROP was 16.66％;236 cases (399 eyes) of ROP (26.61％) were detected in 887 cases of premature infants in accord with screening standard of the Chinese Premature Retinopathy Screening Guidelines (2014),and 131 cases (222 eyes) of ROP (9.95％) was detected in 1316 cases of premature infants outside the screening standard.In our research,the incidence of ROP was related with gestational age,birth weight,oxygen duration and mechanical ventilation.However,the relationship had not been found with artificial insemination,caesarean birth,gender,polyembryony,acute respiratory distress syndrome (ARDS),hypertensive disorders in pregnancy,gestational diabetes mellitus,intrauterine infection,intrauterine distress,premature rupture of membrane.The incidence of ROP was statistically significant between different gestational age groups,different birth weight groups and different oxygen groups (P＜ 0.05).Logistic analysis showed that gestational age,birth weight,oxygen duration and mechanical ventilation were independent risk factors of ROP.· CONCLUSION:The incidence of ROP is 16.66％ in this study,and there is still a certain proportion outside the screening standard of the Chinese Premature Retinopathy Screening Guidelines (2014).Gestational age,birth weight,oxygen duration and mechanical ventilation are high risk factors for ROP.
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Objective:To investigate and analyze the clinical application and adverse reactions of scopolamine butylbromide injection to promote the rational use in clinics. Methods:Totally 3695 effective cases treated with scopolamine butylbromide injection were collected from January 2016 to July 2017, and the age, sex, cause of drug use, medication days, combined use, high risk factors, and names, types and clinical manifestations of adverse reactions induced by scopolamine butylbromide were classified and statistically analyzed. Results:The overall incidence of adverse reactions of scopolamine butylbromide was 0.22%. The drug use rate was 44.36% in high-risk patients. The incidence of adverse drug reactions in high-risk patients was 1.83%,and that in low-risk patients was 0.24%, and the difference was 7.63 times. Combined drug use was common, and 1.98% of the combined use had potential drug interactions. Conclusion:The requirements of drug instructions should be strictly followed,and high-risk patients and drug combination should be paid much attention in order to reduce the risk of adverse drug reactions and ensure the drug safety.