The prognosis of stroke patients with hypertension and its related factors based on a one-year follow-up / 中华老年医学杂志

Objective:To investigate the prognosis and related factors of stroke patients with hypertension after a one-year follow-up, in order to provide evidence for early clinical identification and intervention of high-risk groups.Methods:A total of 719 stroke patients with hypertension who were hospitalized in our hospital from April 2017 to August 2018 were enrolled as the research subjects.General information, history of underlying diseases, family history, drug treatments and laboratory test results were collected.Patients were followed up for 1 year.Patients were divided into the death group and the survival group according to prognosis.Logistic regression analysis was used to identify risk factors for death in stroke patients with hypertension.Results:A total of 77 patients died during the follow-up period, and the mortality rate was 10.7%(77/719). Univariate analysis showed significant differences in marital status( χ2=35.455, P<0.001), education level( χ2=35.238, P<0.001), exercise habits( χ2=10.172, P=0.001), BMI( t=2.161, P=0.031), age( t=-5.976, P<0.001), history of heart disease( χ2=5.064, P=0.024), antiplatelet use( χ2=14.275, P=0.003), antihypertensive drug treatment( χ2=14.597, P<0.001), lipid-lowering drug treatment( χ2=11.311, P=0.001), and creatinine( t=-4.63, P<0.001)between the death group and the survival group.Logistic regression analysis showed that age( OR=1.042, 95% CI: 1.011-1.073), loss of a spouse( OR=3.674, 95% CI: 1.558-8.665), education level( OR=0.418, 95% CI: 0.225-0.779), use of aspirin( OR=0.376, 95% CI: 0.165-0.855), use of clopidogrel( OR=0.451, 95% CI: 0.219-0.928), antihypertensive drug treatment( OR=0.505, 95% CI: 0.282-0.901)and creatinine( OR=1.009, 95% CI: 1.004-1.014)were independent influencing factors for prognosis( P<0.05). Conclusions:The mortality rate is high in stroke patients with hypertension.Advanced age, loss of a spouse and high creatinine level are risk factors for prognosis, whereas high education level, antihypertensive drug treatment and antiplatelet use are protective factors for prognosis.

Risk factors for early miscarriage among intrauterine singleton pregnancies after treatment with in vitro fertilization/intracytoplasmic sperm injection / 中南大学学报(医学版)

OBJECTIVE@#To investigate the risk factors associated with early miscarriage among intrauterine singleton pregnancies after treatment with in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).
@*METHODS@#A retrospective case-control study was performed on all singleton pregnancies underwent IVF/ICSI from January, 2013 to May, 2014, in Xiangya Hospital. Ninety-six early miscarriage patients served as a case group and 593 pregnancies with live birth served as a control group. We analyzed factors for early miscarriage after IVF/ICSI in two groups.
@*RESULTS@#Multivariate logistic regression analysis demonstrated that the women age, miscarriage history, and sperm DAN fragmentation index (DFI) were the risk factors for early miscarriage (P30 years old), women with a history of miscarriage or men with higher sperm DFI (≥15%) are the risk.

Relationship between perioperative blood transfusion and post-operative hospital infection in patients with closed traumatic brain injury / 中南大学学报(医学版)

OBJECTIVE@#To explore the relationship between allogeneic transfusion and hospital infections in patients with closed traumatic brain injury in the perioperative period.
@*METHODS@#The clinical data of 181 patients with open brain surgery suffering closed brain injury in Changsha Central Hospital from February, 2012 to December, 2013 were retrospectively collected. The patients were divided into a mild and moderate brain injury group (n=83) and a severe brain injury group (n=98) according to evaluation system of Glasgow coma scale (GCS). They were also divided into a autologous transfusion plus mild and moderate brain injury group (n=14), a autologous transfusion plus severe brain injury group (n=10); an allogeneic transfusion plus mild and moderate brain injury group (n=31), an allogeneic transfustion plus severe brain injury group (n=70); a non-transfusion plus mild and moderate brain injury group (n=38) and a non-transfusion plus severe brain injury group (n=18) according to the transfusion styles. The hospital infection of all the patients was examined.
@*RESULTS@#The rate of hospital infection was significantly higher in the severe brain injury group than that in the mild and moderate brain injury group (P<0.05). The rate of post-operative hospital infection in the allogeneic transfusion plus severe brain injury group was also significantly higher than that in the autologous transfusion plus severe brain injury group (P<0.05). Similarly, the rate of post-operative hospital infection in the allogeneic transfusion plus mild and moderate brain injury group is higher than that in the non-transfusion plus mild and moderate brain injury group (P<0.05).
@*CONCLUSION@#The allogeneic transfusion at perioperative period may be one of the risk factors for post-operative hospital infection in the closed brain injury patients. The more severe the injury is, the higher risk the hospital infection will be.

Prevalence rate of healthcare-associated infection in a hospital in 2014 / 中国感染控制杂志

Objective To investigate the basic status of healthcare-associated infection(HAI)in a hospital,and provide evidence for strengthening HAI management.Methods A cross-sectional study was conducted to investi-gate the prevalence rates of HAI in all hospitalized patients at 0 ∶00 -24∶00 of May 7,2014.Results A total of 2 262 patients were supposed to be investigated,while 2 253 (99.60%)patients were actually investigated,586 of whom (26.01%)came from pulmonary hospital(specialized in tuberculosis)affiliated to the general hospital.53 patients devel-oped 58 times of HAI,prevalence rate and case prevalence rate was 2.35% and 2.57% respectively;1 073 patients devel-oped 1 265 times of community-acquired infection (CAI),prevalence rate and case prevalence rate was 47.63% and 56.15% respectively.Rates of HAI and CAI were high in intensive care unit(ICU,21.28%)and pulmonary hospital (99.49%)respectively;the main infection site was lower respiratory tract,which accounting for 46.55%(n =27)and 69.72%(n=882)respectively.The major pathogens causing HAI were gram-negative bacteria(n = 19),and the major pathogens causing CAI were Mycobacteria(n=141)and fungi (n=89).The rate of antimicrobial usage and etiological ex-amination was 34.80%(n=784 )and 81.48%(n=550 )respectively.Conclusion In order to prevent cross infection of tuberculosis and reduce the incidence of HAI,lower respiratory tract and ICU should be one of the key infection sites and departments of HAI surveillance,treatment and management of patients with tuberculosis should be stand-ardized,professional precaution of health care workers should be enhanced.