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Objective: This study aimed to identify predictive factors for percutaneous nephrolithotomy (PCNL) bleeding risks. With better risk stratification, bleeding in high-risk patient can be anticipated and facilitates early identification. Methods: A prospective observational study of PCNL performed at our institution was done. All adults with radio-opaque renal stones planned for PCNL were included except those with coagulopathy, planned for additional procedures. Factors including gender, co-morbidities, body mass index, stone burden, puncture site, tract dilatation size, operative position, surgeon's seniority, and operative duration were studied using stepwise multivariate regression analysis to identify the predictive factors associated with higher estimated hemoglobin (Hb) deficiency. Results: Overall, 4.86% patients (n=7) received packed cells transfusion. The mean estimated Hb deficiency was 1.3 (range 0-6.5) g/dL and the median was 1.0 g/dL. Stepwise multivariate regression analysis revealed that absence of hypertension (p=0.024), puncture site (p=0.027), and operative duration (p=0.023) were significantly associated with higher estimated Hb deficiency. However, the effect sizes are rather small with partial eta-squared of 0.037, 0.066, and 0.038, respectively. Observed power obtained was 0.621, 0.722, and 0.625, respectively. Other factors studied did not correlate with Hb difference. Conclusion: Hypertension, puncture site, and operative duration have significant impact on estimated Hb deficiency during PCNL. However, the effect size is rather small despite adequate study power obtained. Nonetheless, operative position (supine or prone), puncture number, or tract dilatation size did not correlate with Hb difference. The mainstay of reducing bleeding in PCNL is still meticulous operative technique. Our study findings also suggest that PCNL can be safely done by urology trainees under supervision in suitably selected patient, without increasing risk of bleeding.
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<p><b>OBJECTIVE</b>To investigate the influencing factors on tuberculosis (TB) in four provinces in the eastern and central parts of China.</p><p><b>METHODS</b>From Nov. 2009 to Feb. 2011, three population-based field surveys were conducted among the resident population in several townships/streets in Guangdong, Hunan and Jiangsu provinces and Shanghai municipality to collect TB-related information. 474 sputum smear positive TB patients and 1896 controls were randomly selected from the population under study and each case was matched by province, age and sex using a frequency matching method. Single-variable and multiple non-conditional logistic regression modeling were applied for data analysis, and odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were estimated.</p><p><b>RESULTS</b>Data from Single-variable analysis showed that TB history, history of exposure to TB, DM history, immigrant population and per-capita living space were risk factors for TB, and high level of education was protective factors.</p><p><b>RESULTS</b>from multiple logistic regression showed that the risk factors of TB would include the following items: history of having had TB (OR = 52.356, 95%CI: 18.956 - 144.607), living space over 50 m(2)per-capita (OR = 8.742, 95%CI: 1.107 - 69.064), history of exposure to TB (OR = 6.083, 95%CI: 2.336 - 15.839) and being immigrants (OR = 3.306, 95%CI: 1.907 - 5.734), while having had high degree of education as the protective factor of TB (OR = 0.284, 95%CI: 0.110 - 0.733).</p><p><b>CONCLUSION</b>Control programs targeting those ever having TB patients and contacts to TB patients as well as immigrants should be strengthened.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Case-Control Studies , China , Epidemiology , Cities , Logistic Models , Multivariate Analysis , Risk Factors , Tuberculosis , EpidemiologyABSTRACT
Objective To establish the surveillance and warning index system corresponnding with the epidemic characteristics of tuberculosis,in China.Methods Literature review and expert meeting were conducted to formulate the preliminary index system frame.Delphi method was used for screening the index and determining the weight of each index.Results Two-round Delphi consultations were performed.The activity coefficients were 87.0％,90.0％ respectively,with means of authority coefficient as 0.850 ± 0.055 and 0.917 ± 0.017,respectively.Mean scores of the index were 7.063 ± 1.435,8.156 ± 0.611 respectively,with the means of coefficient of variation as 0.352 ±0.161 and 0.170 ± 0.057 respectively.The harmony coefficients were 0.322 (x2=499.472,P＜0.05)and 0.393 (x2=241.126,P＜0.05) respectively.After the two-round consultation,the tuberculosis monitoring and warning index system was developed,including 4 first-class indicators,9 second-class indicators and 48 third- class indicators.Conclusion An index system was established for tuberculosis monitoring and early warning that could provide evidence for tuberculosis prevention and control as well as for the forecasting and warning model of the disease.
