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Objective:To investigate the relationship between serum interleukin-6 and interleukin-10 levels and clinical prognosis in patients with severe acute pancreatitis.Methods:Ninety-two patients with severe acute pancreatitis who received treatment in The Second People's Hospital of Liaocheng from August 2018 to July 2021 were included in this study. Serum interleukin (IL)-6 and IL-10 levels were detected. The Bedside Index of Severity in Acute Pancreatitis (BISAP) score was evaluated. Clinical interventions were performed. The relationship between serum IL-6 and IL-10 levels and the clinical prognosis of severe acute pancreatitis was investigated.Results:Serum IL-6 level [(103.75 ± 15.53) ng/L] was highest in patients who died. Serum IL-10 level [(97.33 ± 13.06) ng/L] was highest in patients with local complications. The highest number of patients with a prognostic outcome of death [26 (37.14%)] was found in patients with a BISAP score ≥ 3. Serum IL-6 level in patients with severe acute pancreatitis was positively correlated with the BISAP score ( r = 0.62, P < 0.05), and serum IL-6 level and BISAP score were negatively correlated with serum IL-10 level ( r = -0.57, -0.61, both P < 0.05). Conclusion:Increased or decreased serum IL-6 and IL-10 levels in patients with severe acute pancreatitis indicate that the patient's condition tends to worsen, and timely intervention according to serum IL-6 and IL-10 levels can improve the clinical prognosis of severe acute pancreatitis.
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Background: Heart rate variability (HRV) is a used to assess autonomic nervous system input to the heart. Studies on the impact of HRV on underweight are limited. Aims/Objectives: To evaluate HRV in age matched young adults of different BMI category. Methodology: This cross-sectional study was done among healthy young adult volunteers between 18 and 25 years of age. Anthropometric variables were measured. ECG was recorded in lead II configuration for 5 minutes. Heart rate variability was analysed with Kubios HRV analyzer. Results: HRV indices were reduced in underweight (UW), overweight (OW) and obese group compared to normal weight (NW) BMI group. Second order polynomial regression between BMI and HF log power in both genders shows an inverted U-shaped relationship with BMI. The association between BMI, waist circumference and body fat (percentage) with HRV indices shows a significant relation to heart rate var-iability among which waist circumference (WC) shows a greater association with HRV indices than BMI. Comparison of HRV parameters among men and women of different BMI group shows female had great-er heart rate variability compared to males across BMI Conclusions: underweight individual also have increased cardiovascular risk like obese group and ab-dominal obesity is better indicator of cardiovascular risk than BMI.
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Objective:To compare the incidence of carotid artery and lower extremity arterial disease between patients with type 2 diabetes mellitus complicated by cerebrovascular disease and those with no cerebrovascular disease and investigate the risk relationship between diabetic peripheral vascular disease and cerebrovascular disease.Methods:A total of 133 patients with type 2 diabetes mellitus complicated by cerebrovascular disease who received treatment in the Department of Endocrinology, The First People's Hospital of Kunming, China between June 2015 and June 2016 were included in the observation group. Sixty-six type 2 diabetes mellitus patients with no cerebrovascular disease were included in the control group. The incidence and severity of carotid artery and lower extremity arterial disease were compared between the observation and control groups. Stepwise logistic regression was performed taking whether cerebrovascular disease exists as a dependent variable. The risk factors for developing cerebrovascular disease in patients with type 2 diabetes mellitus were investigated.Results:The number of patients who had carotid plague in the observation group was significantly higher than that in the control group [66.17% (88/133) vs. 42.42% (28/66)]. Cervical vascular disease in the observation group was severer than that in the control group. In the observation group, 24.81% (33/133) of patients had rough carotid intima, and 9.02% (12/133) of patients had no rough carotid intima. In the control group, 33.33% (22/66) of patients had rough carotid intima, and 24.24% (16/66) of patients had no rough carotid intima. There was significant difference in the incidence of rough carotid intima between observation and control groups ( χ2 = 14.140, P = 0.030). The proportion of patients who had lower extremity carotid plaque in the observation group was higher than that in the control group [72.93% (97/133) vs. 42.42% (28/66)]. Lower extremity arterial disease in the observation group was severer than that in the control group. In the observation group, 22.56% (30/133) of patients had rough intima of lower extremity arteries and 4.51% (6/133) of patients had no rough intima of lower extremity arteries. In the control group, 33.33% (22/66) of patients had rough intima of lower extremity arteries and 24.24% (16/66) of patients had no rough intima of lower extremity arteries. There was significant difference in the proportion of rough intima of lower extremity arteries between observation and control groups ( χ2 = 24.030, P < 0.001). Logistic regression analysis showed that age, glycosylated hemoglobin, and the presence of lower extremity vascular disease were the risk factors for cerebrovascular disease [95% CI = 1.098 (1.051 -1.146), 1.240 (1.015-1.515), 3.802 (1.094-13.212)]. Conclusion:Peripheral vascular disease in patients with type 2 diabetes mellitus complicated by cerebrovascular disease is severer than that in patients with type 2 diabetes mellitus but without cerebrovascular disease. Aging, poor blood glucose control and lower extremity vascular disease are the risk factors for developing cerebrovascular disease in patients with type 2 diabetes mellitus. Lower extremity vascular disease has a certain value for predicting the occurrence of cerebrovascular disease in patients with type 2 diabetes mellitus.
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Objective To identify the risk factors for postoperative fatigue syndrome(POFS)in outpatients with painless gastroscopy.Methods The outpatients received painless gastroscopy from October 2016 to February 2017 in our hospital were included in this study.The possible factors related to POFS were summarized by reviewing the relevant literature.The questionnaires were completed by the methods such as preoperative interview,intraoperative recording,and telephone follow-up.POFS occurrence,score and outcomes were evaluated.The patients were divided into POFS group(groupⅠ)and non-POFS group(groupⅡ)according to whether POFS occurred.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors.Results Two hundred and forty-six patients completed this study.Sixty-nine cases developed POFS,and the incidence was 28.0％,the initial fatigue score was(5.2±2.4),and the duration of POFS was 3(9)h.The mean con-sumption of propofol(according to anesthesia time,mg/min)was an independent risk factor for POFS.Conclusion The mean consumption of propofol is an independent risk factor for POFS in outpatients with painless gastroscopy.
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Objective To analyze the risk factors of implant?related complications in adult patients with adult degenera?tive scoliosis (ADS) who underwent long?level internal fixation. Methods This was a retrospective study that analyzed 99 cases of adult degeneration scoliosis patients who underwent long level posterior pedicle screw fixation in our hospital between June 2013 and January 2016. The internal fixation and related complications were evaluated by measuring and analyzing the radiograph?ic data of the postoperative X?ray films. The timepoints of measurement were pre?operation, before discharge, half a year, 1 year, when complications occur and the final follow?up after operation. Implant?related complications included proximal junctional ky?phosis (PJK), proximal junctional failure (PJF), distal junctional kyphosis/failure (DJK/DJF), rod breakage in addition to other ra?diographic implant?related complications (that were not related to PJF) such as screw loosening, breakage or pullout, or interbody graft and hook or set screw dislodgements seen on follow?up radiographs. The incidence of postoperative implant?related complica?tions was counted. All the cases included in the study were divided into the complication group and the non?complication group. Statistical difference between groups at different follow?up time point was analyzed. Potential risk factors were identified using uni?variate testing. Multivariate Logistics regression was used to analyze the independent risk factors for implant?related complica?tions. The postoperative functional scores were assessed using the Oswestry Disability Index (ODI), Japanese Orthopaedic Associa? tion Scores (JOA), Visual Analogue Scale (VAS), and Lumbar Stiffness Disability Index (LSDI). Functional scores were tested us?ing group t tests. Patients were divided into groups according to PI-LL<10°, 10°-20°and>20°. The preoperative and postoper?ative radiographical parameters and clinical function score among each groupwere compared.The best PI-LL matching value was verified by analyzing the effect of long?segment fusion orthopedics on ADS. Results Ninety?nine ADS patients who underwent long level posterior fixation were included. The incidence of patients with mechanical complications was 30.3%. Univariate analy?sis showed that chronic risk factors of postoperative implant?related complications after surgery of ASD included diabetes ( OR=3.52, P=0.001) and blood transfusion ( OR=2.61, P=0.030); surgical risk factor isosteotomy ( OR=4.33, P=0.000); preoperative im?aging risk factor was preoperative SVA ( OR=1.03, P=0.000); the risk factors for increased risk of the implant?related complications included anemia ( OR=1.17, P=0.810), cardiac complications ( OR=1.80, P=0.290) and hospital stay ( OR=1.11, P=0.110). Indepen?dent predictors identified on multivariate Logistics regression modeling included osteotomy ( OR=3.05,P=0.032), and preoperative SVA ( OR=1.03,P=0.007). The radiographical parameters and clinical function scores of the PI-LL 10°-20° group were better than or partially superior to those of the PI-LL<10°group and the PI-LL>20°group. The postoperative SVA of the PI-LL 10°-20°group was significantly lower than that of the PI-LL<10°group (t=2.399, P=0.020) and the PI-LL>20°group (t=-3.074, P=0.005). The incidence of implant?related complications in the PI-LL 10°-20°group was significantly lower than that in the PI-LL<10°group (t=1.584, P=0.003). Survival analysis showed that the PI-LL 10°-20°group was significantly better than the PI-LL<10°group (χ2=7.782, P=0.005), while the PI-LL 10°-20°group had better survival than PI-LL>20°group, althoughthatwas not statistically significant (χ2=2.542, P=0.111). Conclusion Risk factors of postoperative implant?related complications after sur?gery of ASD included osteotomy and preoperative SVA. Patients with one or more of these risk factors should be informed of the risk increase with informed consent. Patients with PI-LL between 10°and 20°had better postoperative radiographical parame?ters and clinical functional scores. They should be optimized preoperatively and followed up closely during the postoperative period.
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Objective To study the heart function,risk factors and associated complications caused by patent ductus arteriosus( PDA)in preterm infants. Methods A retrospective analysis Was conducted at Neonatal Intensive Care Unit of Shenzhen People＇s Hospital from October 2016 to August 2017 to study the cardiac functions of infants less than 3 days after birth betWeen PDA group and non－PDA group(1: 1 paired study according to gestational age and Weight). MeanWhile their clinical data Were collected by case－control analysis method,to explore the risk factors and complications caused by PDA in preterm infants. Results There Were 50 cases in PDA group,and 50 cases in non－PDA group. The physical data betWeen 2 groups had no statistically significant difference(all P＞0. 05). The heart rate (HR),cardiac output(CO)and cardiac output index(CI)in 2 groups Were(148. 36 ± 12. 98)times／min,(0. 52 ± 0. 21)L／min,(0. 44 ± 0. 19)L／( min·m2 )and(142. 52 ± 18. 07)times／min,(3. 48 ± 0. 92)L／min,(2. 99 ± 0. 80)L／(min·m2 ),respectively;the levels of PDA group Were higher than those of the non－PDA group,and the differences Were significant(P﹦0. 021,0. 020,0. 027). Single factor analysis shoWed that PDA in the preterm infants Was significantly associated With asphyxia,premature rupture of membranes and the use of prenatal hormone( P﹦0. 001,0. 009,0. 004). Ventilation time,pneumonia,feeding intolerance,and bronchial pulmonary dysplasia Were asso﹣ciated With PDA in preterm infants(P﹦0. 010,0. 010,0. 000,0. 026). The Logistic regression analysis shoWed that asphyxia Was independent risk factor for PDA in preterm infants(OR﹦7. 280),and prenatal antenatal corticosteroids Was independent protective factor( OR ﹦0. 008). Conclusions In preterm infants With PDA,the HR,CO and CI increase and electronic heart monitoring could identify the hemodynamic changes in preterm infants With PDA. Asphyxia is major high risk factor in PDA in preterm infants,While the use of prenatal antenatal corticosteroids is seen as the pro﹣tective factor. PDA in preterm infants can prolong the ventilation times and increase the pneumonia,feeding intolerance and BPD.
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Community acquired pneumonia ( CAP) is the most common respiratory infectious disease in hospitalized children. With the development of etiology detection technology, the detection rate of CAP pathogens has rose significantly, and meanwhile the co-infections of multiple pathogens have been paid more at-tention gradually. The combinations of co-infection agents are in a diverse way. There is not a unified under-standing about the impact on the severity of disease. The mechanism of co-infection and risk factors remain un-clear. These have brought great difficulties for clinical diagnosis and treatment. This review provides an over-view of the current situation, pathogen combination, age and seasonal characteristics, clinical features, the impact on the severity of disease, risk factors, treatment and so on in CAP hospitalized children with co-infec-tion.
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Objective To analyze the efficiency of perinatal group B streptococcal(GBS)infection preven-tion in the local area.Methods From June 2015 to June 2016,3 667 pregnant women were included.Both pre-natal examinations and deliveries were done in our hospital.The analysis of GBS colonization,risk factors and prevention of early-onset disease were done.Results Among preterm and term pregnant women,the rates of GBS screening were 23.4% and 35.6%,respectively.The positive results of GBS were 10.9% and 8.4%,re-spectively.The percentage of women with 2 risk factors were 22.9% and 0.3%,respectively.GBS screening has a better prediction effect for GBS colonization status of women at labor.There were significant differences in the intrapartum antibiotic prophylaxis(IAP)implementation between preterm and term pregnant women. In the IAP efficiency analysis of preterm,GBS colonization and risk factors,preterm had a high sensitivity (96.1%),while the specialties of GBS carry and risk factors were high(93.2% and 90.3% respectively).Con-clusion preterm pregnant women should be highlighted as an important population in the implementation of IAP.GBS screening strategy is better than the risk factors strategy.
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Objective To investigate the relationship between the onset of cerebral infarction in anterior and posterior circulation and the "three high" risk factors in Guangzhou communities. Methods From Jan. 2014 to Jan.2016,367 patients from Guangzhou communities were diagnosed with new cerebral infarction by head diffu-sion weighted imaging(DWI).The data were divided into two groups of anterior and posterior circulation,and uni-variate and multivariate methods were used to analyze the relationship between the "three high" and other risk factors and the onset of cerebral infarction in anterior and posterior circulation.The data of anterior circulation cere-bral infarction were further divided into two subgroups of lacunar and non-lacunar infarction,and the same statisti-cal methods were employed to analyze differences of risk factors between the two subgroups. Results The frequen-cies of hypertension(P = 0.040)and large atherosclerotic infarction(P = 0.012)were significantly higher,and the serum high-density lipoprotein(HDL)level(P = 0.045)was significantly lower in posterior circulation than those in anterior circulation,respectively;and the onset of posterior circulation cerebral infarction was more associ-ated with the incidence of hypertension(OR = 1.767,P = 0.035)and the decrease of HDL(OR = 0.380,P =0.021). In anterior circulation,the levels of systolic blood pressure(SBP)(P = 0.011)and diastolic blood pres-sure(DBP)(P=0.000),as well as the frequency of large atherosclerotic infarction(P=0.000)in non-lacunar infarction subgroup were significantly higher than those in lacunar infarction subgroup respectively,and the onset of non-lacunar infarction was more closely related to increased SBP levels(OR=1.045,P=0.001). Conclusions Among the"three high"risk factors,the onset of posterior circulation cerebral infarction is more closely related to the incidence of hypertension and the decrease of HDL.In anterior circulation,and the onset of non-lacunar infarc-tion is more closely related to the increased levels of DBP and SBP,especially to the elevated levels of SBP.
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Ojective To determine the risk factors and the clinical distribution of multiple drug resistant bacteria in stroke- associated pneumonia (SAP) patients with multiple drug-resistant bacterial infections from in-tensive care unit, providing guidance for clinical treatment of SAP. Methods A retrospective study was de-signed to analyze the clinical data of the SAP patients from January 2012 to December 2015. Univariate analysis and multivariable regression analysis were taken for risk factors of MDR infections , and investigated the distribu-tion and drug resistance of MDR. Results There were 183 SAP patients, of which 131patients (71.6%) had MDR infection. There are 193 MDR strains in the 131 patients , the first 5 MDR strains were Acinetobacter bau-mannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus and Escherichia coli. MDR in-fection is highly associated with sever unconsciousness , time of stay in ICU longer than 7 days , ventilator time longer than 7 days and late-onset pneumonia and the difference was significant (P < 0.05). Conclusion SAP patients with MDR bacterial infections are in association with the following risk factors: sever unconsciousness , time of stay in ICU longer than 7 days, ventilator time longer than 7 days and late-onset pneumonia. The rate of MDR bacterial infections was high , and these MDR strains were widely different degrees of resistance to many antibiotics.
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Objective To evaluate the correlation between occupational exposure and work intensity of health care workers(HCWs)in an infectious diseases hospital for 5 consecutive years,and provide reference for occupational precaution.Methods Occupational exposures cases reported between January 2010 and December 2014 were ana-lyzed retrospectively,occupation types,exposure routes,and exposure sources were analyzed.Results A total of 228 cases of occupational exposure were reported,nurses and doctors were the major exposure population(75.44%and 19.30% respectively);occupational exposure mainly occurred during the infusion process(52.19%);hepatitis B was the main exposure source (71 .05%),followed by human immunodeficiency virus (10.09%).The Pearson correlation coefficient between the occupational exposure rate of doctors and the ratio of doctors to patients was-0.849 (P <0.05),and for nurses,the correlation coefficient was -0.823 (P <0.05 ).Conclusion Nurses are high risk population of occupational exposures,occupational exposure is most likely to occur during transfusion process,occupational exposure of doctors and nurses has a strong correlation with the work intensity.