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Objective:To analyze the related factors of neurotoxicity induced by oxaliplatin chemotherapy in patients with colorectal cancer and its prevention and treatment strategies.Methods:A total of 300 patients with colorectal cancer treated with oxaliplatin in Zhejiang Cancer Hospital from January 2018 to December 2020 were randomly selected for baseline collection using the convenience sampling method. The occurrence of oxaliplatin-induced peripheral neurotoxicity (OIPN) was statistically analyzed. The factors that affect the occurrence of OIPN were analyzed using univariate analysis.Results:There was a significant difference in OIPN score between patients of different genders, between patients who had different education levels, between patients who had different occupations, and between patients who lived in different long-term residence places ( t = 7.29, 3.39, 2.53, 18.11, all P < 0.05). There was no significant difference in OIPN score between patients adhering to different religion's beliefs, between patients married and not, between patients who lived with and without members, between patients who paid medical costs and not, and between patients who had a previous history of smoking and not ( t = 3.25, 0.37, 0.69, 2.39, 0.15, all P > 0.05). There was a significant difference in OIPN score between patients with different tumor-node-metastasis stages, between patients who received medication via different administration routes, and between patients who received different times of oxaliplatin administration ( t = 8.40, 3.34, 3.49, all P < 0.05). Conclusion:Medical staff should pay attention to the occurrence of OIPN in patients with colorectal cancer treated with oxaliplatin, focus on the patient's factors related to the disease, and take correct and effective coping strategies promptly to reduce the adverse reactions, improve the quality of life, and ensure the therapeutic effect.
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Objective:To analyze the factors influencing the poor effect of short-term electrical spinal cord stimulation in the treatment of postherpetic neuralgia (PHN).Methods:The medical records of PHN patients of either sex, aged 40-85 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who received short-term electrical spinal cord stimulation from July 2017 to July 2022, were retrospectively collected. The therapeutic effect was evaluated using the modified MacNab criteria at 3 months after operation, and the patients were divided into good efficacy group (excellent and good efficacy) and poor efficacy group (fair and poor efficacy). General information, disease course, lesion site, complicated diseases, ossification of the yellow ligament in the diseased spinal segment, severity of pain in the herpetic stage, standard antiviral therapy in the herpetic stage (for more than 7 days) and use of neurotrophic drugs in the herpetic stage (for more than 7 days) were collected. Multivariate logistic regression analysis was used to screen the influencing factors for the poor effect of electrical spinal cord stimulation in the treatment of PHN.Results:A total of 168 patients were eventually enrolled, among which 69 had poor curative effect, and the rate of poor curative effect was 41.1%. The results of multivariate logistic regression analysis showed that the patient′s age ( OR=2.230, P=0.015), course of disease ( OR=2.191, P=0.027), complication with diabetes mellitus( OR=8.859, P=0.010), ossification of ligamentum flavum at the same segment ( OR=6.602, P=0.019), severity of pain in the herpetic stage ( OR=5.788, P=0.038) and non-standard antiviral therapy in the herpetic stage ( OR=6.765, P=0.021) were the influencing factors for the poor effect of electrical spinal cord stimulation in the treatment of PHN. Conclusions:Age, course of disease, complication with diabetes mellitus, ossification of ligamentum flandum at the same segment, severity of pain in the herpetic stage and non-standard antiviral therapy in the herpetic stage are the factors influencing the poor effect of short-term electrical spinal cord stimulation in the treatment of PHN.
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@#AIM:To investigate the characteristic changes of ocular surface and meibomian gland function after strabismus in adolescents and analyze the related influencing factors.<p>METHODS:Retrospective study. Totally 168 cases(224 eyes)with strabismus surgery in our hospital from January 2019 to December 2019 were selected as the study objects. According to the surgical incision, all patients were divided into the limbal incision group(group A, 54 cases, 78 eyes), trans-muscular terminal-incision group(group B, 48 cases, 62 eyes), and near-fornix incision group(group C, 66 cases, 84 eyes). Based on the number of muscles involved in the operation, patients were divided into single extraocular muscle group(68 eyes), the double extraocular muscle group(106 eyes)and three extraocular muscle group(50 eyes). The children's eye surface health were evaluated. Other eye index such as lipidlayer thickness(LLT), tear meniscus height(TMH), corneal fluorescence staining score(CFSS), tear film break up time(TBUT), tear secretion(SⅠt), and meibomial gland opening were analyzed by Lipiview eye surface interferometer.<p>RESULTS:The eye surface and meibomian gland function presented no significant difference in groups after surgery 1wk. Postoperative 1mo, ocular surface and muscle operating meibomian gland function were improved significantly(<i>P</i><0.05), which TBUT in group B was obviously higher than that of group A(<i>P</i><0.05), and OSDI, CFSS, TBUT in group C were significantly better than that of group A(<i>P</i><0.05). TMH of children in two groups was significantly higher than that of a single group(<i>P</i><0.05), three children OSDI is higher than a single extraocular muscle group(<i>P</i><0.05). Three month after surgery, the children with ocular surface and meibomian gland function were compared with postoperative 1wk and 1mo improved significantly(<i>P</i><0.05). Among them, the OSDI, LLT, TMH, CFSS, TBUT and SⅠt of children in C group were significantly better than that of group A(<i>P</i><0.05). And TMH, CFSS, SⅠt and meibomian gland orifices in other two groups were better than that of group A(<i>P</i><0.05), double extraocular muscle group and three extraocular muscle group of children with meibomian gland orifices were lower than single extraocular muscle group(<i>P</i><0.05). OSDI, CFSS and meibomian gland orifices score of children had significantly correlation with the surgery involving muscle number(<i>P</i><0.05).<p>CONCLUSION:Ocular surface and meibomian gland function recovery of children in the fornix incision group were better than that of corneal limbus incision group and across muscle check incision.The ocular surface and meibomian gland function recovery of children with single set were also better than that of children with two and three.Thus,taking nearly fornix incision and decreasing the number of the surgery involving the muscles was helpful to ocular surface and meibomian gland function recovery in the youth eye strabismus surgery.
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@#AIM:To investigate the clinical effect and influencing factors of phacoemulsification in cataract patients with high myopia.<p>METHODS:A retrospective analysis of 109 eyes of 90 patients with cataract combined with high myopia was performed on January 2016. According to the best corrected visual acuity, the curative effect was evaluated and divided into two groups: low vision group(best corrected visual acuity <0.3)and normal vision group(best corrected visual acuity ≥0.3). A Logistic regression analysis model was established to analyze the factors affecting the postoperative efficacy.<p>RESULTS:There were 22 cases(27 eyes)in the low vision group and 68 cases(82 eyes)in the normal vision group. During the follow-up period, 6 eyes of the posterior lens capsule became cloudy, all of which were mildly cloudy and improved after laser treatment. No complications such as secondary glaucoma, corneal decompensation, retinal detachment, and intraocular lens displacement were observed. Univariate analysis found that the axial length, corneal astigmatism, Emery classification, fundus lesion classification were the influential factors affecting the efficacy of the operation(<i>P</i><0.05). Logistic regression analysis results showed that the axial length(<i>OR</i>=2.121), corneal astigmatism(<i>OR</i>=1.698), Emery classification(<i>OR</i>=1.901), and fundus lesion classification(<i>OR</i>=1.964)were independent factors affecting the postoperative efficacy(<i>P</i><0.05).<p>CONCLUSION: Axial length, corneal astigmatism, Emery classification, and fundus lesion classification can affect cataract phacoemulsification surgery for cataract combined with high myopia, but patients have more influential factors for prognosis, and effective measures should be formulated according to influencing factors Intervention to improve the prognosis of patients.
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Rational nutritional support shall be based on nutritional screening and nutritional assessment.This study is aimed to explore nutritional risk screening and its influencing factors of hospitalized patients in central urban area.It is helpful for the early detection of problems in nutritional supports,nutrition management and the implementation of intervention measures,which will contribute a lot to improving the patient's poor clinical outcome.A total of three tertiary medical institutions were enrolled in this study.From October 2015 to June 2016,1202 hospitalized patients aged ≥18 years were enrolled in Nutrition Risk Screening 2002 (NRS2002) for nutritional risk screening,including 8 cases who refused to participate,5 cases of same-day surgery and 5 cases of coma.A single-factor chi-square test was performed on 312 patients with nutritional risk and 872 hospitalized patients without nutritional risk.Logistic regression analysis was performed with univariate analysis (P＜0.05),to investigate the incidence of nutritional risk and influencing factors.The incidence of nutritional risk was 26.35％ in the inpatients,25.90％ in male and 26.84％ in female,respectively.The single-factor analysis showed that the age ≥60,sleeping disorder,fasting,intraoperative bleeding,the surgery in recent month,digestive diseases,metabolic diseases and endocrine system diseases had significant effects on nutritional risk (P＜0.05).Having considered the above-mentioned factors as independent variables and nutritional risk (Y=1,N=0)as dependent variable,logistic regression analysis revealed that the age ≥60,fasting,sleeping disorders,the surgery in recent month and digestive diseases are hazardous factors for nutritional risk.Nutritional risk exists in hospitalized patients in central urban areas.Nutritional risk screening should be conducted for inpatients.Nutritional intervention programs should be formulated in consideration of those influencing factors,which enable to reduce the nutritional risk and to promote the rehabilitation of inpatients.