Objective To explore the clinical epidemiological characteristics of the lung infection after orthotopical liver transplantation. Methods The clinical data included infection morbidity, mortality, infectious times and relative factors, clinical manifestations, the bacterial strains and distributions of the pathogens, the bacterial resistances of the 53 liver transplantation recipients from 2003.3～2006.12 were summarized and analyzed retrospectively. Results Among 53 recipients, 33 developed lung infectious and 6 died .The mobidity was 62.3% and mortality was 18.2%, with a OR of 1.0. Lung infection predominantly occurred in the first month, especially in the first week after transplantation.There were many factors related to lung infections.Various pathogens, especially Klebsialla, Escherichia Coli and Staphylococus Hominis were isolated from sputum, airway suction drainages and throat swabs. Most of the G- bacteria were sensitive to aminoglycosides,β lactam and lactamase compounds and carbapenems while G+ bacteria were sensitive only to glycopeptides. All the bacteria were resistant to quinolones, β lactams of third and forth generation. Conclusions After liver transplantation, the morbidity and mortality of the lung infections are high.The infections develope at earlier stage, manifest nontypical clinical features.Many factors are revealed to be relevant to the lung infections,meanwhile, various drug-resistant pathogen strains are isolated.
ObjectiveTo study related factors for urinary and fecal incontinence in post-stroke patients, in order to present targeted treatment and effective care. MethodsWith continuous sampling methods, we prospectively evaluated 257 stroke patients admitted to our hospital from August 2010 to October 2012, and had the clinical features form completely filled. All statistical analysis was performed using SPSS 19.0. ResultsUrinary and fecal incontinence rate was 16.7%. Univariate analysis showed that the related factors for the incidence of urinary and fecal incontinence in post-stroke patients included the onset of disturbance of consciousness, disability to sit up or stand two hours after the onset, being complicated with pulmonary infection or ventricular dysfunction, complications, and constipation. A multivariate analysis identified three factors to be independently associated with urinary and fecal incontinence in post-stroke patients, including disturbance of consciousness[OR=4.186, 95%CI (2.010, 8.715), P<0.001], being complicated with pulmonary infection[OR=3.490, 95%CI (1.616, 7.539), P=0.001] and age[OR=1.036, 95%CI (1.004, 1.069), P=0.029]. ConclusionPost-stroke patients are most likely to develop urinary and fecal incontinence, and disturbance of consciousness, being complicated with pulmonary infection and age are three independent factors.
目的 探讨急性阑尾炎手术后切口感染的相关因素。方法 观察我院2002年5月至2007年5月期间收治的665例急性阑尾炎患者采用术前预防使用抗生素、术中保护切口、术后加强切口管理等处理后切口感染情况，并分析切口感染与阑尾炎的病程、手术时间、切口选择、留置引流和病理类型之间的关系。结果 本组患者中32例发生切口感染，感染率为4.81% (32/665)，急性阑尾炎术后切口感染与性别无关（ P ＞ 0.05），与病程长短、切口选择、手术时间、腹腔留置引流与否以及病理类型均有关（ P ＜ 0.01）。结论 病程长、手术时间久、炎症较重的急性阑尾炎病例切口感染率较高； 做好围手术期的处理，术中尽量保护切口可以降低切口感染率。
Objective To systematically analyze the factors influencing the left-behind children’s mental health. Methods After the search term and strategy were confirmed by researchers, four Chinese databases including Chinese Biological Medical Literature Database (CBM), Chinese Science and Technology Periodical Database (VIP), China National Knowledge Infrastructure (CNKI) and WanFang Database (WF) were searched to collect papers, published before March 2011, on relevant factors influencing mental health of left-behind children in China. Then two reviewers independently screened, extracted and cross-checked the data, and the disagreements were resolved by discussion or by consulting a third reviewer. Qualitative synthesis method was used to analyze the study results. Results Of the total 3 252 records, 49 studies were included. The results of qualitative analysis showed that factors influencing left-behind children’s mental health could be classified into four categories including social factors, family factors, school factors and personal factors. Of the nearly 30 kinds of specific factors, the main ones were gender, age, parent-child relationship, social support, personality and characteristics, and outgoing condition of parents, etc. Conclusion Current research results indicate that many factors have influences on mental health of left-behind children, but the research quality is not high with low argument efficiency. There are still controversies on several factors’ impact. Longitudinal studies with rigorous design are needed to analyze the impact of different factors on the left-behind children’s mental health and to summarize the interaction between various factors, so as to provide scientific evidence for developing practical and effective intervention measures.
Objective To provide references to control the cost of stroke inpatients by analysing pertinent factors of stroke inpatients. Methods According to the models of Anderson and Newnan, univariable analysis and multivariable statistical analysis were applied to a number of factors including predisposing factors, enabling factors, and needs factors in 1 969 stroke inpatients of two third level first-class hospitals in Chongqing. Results Among the 1 969 stroke inpatients, 64% had a history of hypertension, and 50% exhibited hypertension during their stay in hospital. Expenditure on medication consumed the highest costs (51%). Length of stay was the most important factor affecting inpatient expense, additional factors were number of surgical operation, nurse type, Rankin score, number of complications etc. Conclusions Complex measures focusing on hypertension to prevent and control of stroke are recommended. Reducing unnecessary stay in hospital and appropriate prescribing are important methods to reduce cost of stroke inpatients.
ObjectiveTo investigate the association between colorectal adenoma (CRA) and colorectal cancer (CRC), and to analyze the main pathogenesis of CRA, in order to identify and control the key factors of CRA and reduce the incidence of CRC. MethodThe studies on the mechanism of CRA in recent years were searched and summarized, focusing on the interaction of inflammation, genetic and epigenetic changes, gut microbiota and lipid metabolism, and their effects on the development of CRA. ResultsInflammation, genetic and epigenetic changes, intestinal flora and lipid metabolism play an important roles in the occurrence and development of CRA. These factors had a significant impact on the formation and progress of CRA at different stages through complex interaction, and had potential application value in preventing CRC. ConclusionsMany factors participate in the occurrence and development of CRA and plays an important role, which provide reference for future research and clinical intervention.
目的 探讨影响岩斜区脑膜瘤（PCM）预后的相关因素。 方法 回顾分析解放军452医院2005年9月－2009年6月及四川大学华西医院1999年9月－2009年2月110例患者的临床资料及随访结果，通过单因素生存分析及Cox比例风险模型分析探讨影响PCM预后的相关因素。 结果 单因素生存分析发现8种相关因素影响PCM患者的预后，但Cox多因素分析仅发现脑干T2像高信号（OR=5.54，P=0.012）、肿瘤侵入脑干（OR=5.10，P=0.034）、病理高级别（OR=4.03，P=0.011）这3种因素有统计学意义。 结论 脑干T2像高信号、肿瘤侵入脑干、病理高级别可影响岩斜区脑膜瘤患者的预后。
摘要:目的:探讨儿童分泌性中耳炎的临床特点及不同治疗方案的效果.方法:回顾性分析84例分泌性中耳炎患儿的临床资料及其相关因素,并收集资料完整的22例做治疗前后的对比。结果:84例患儿中有73.8%存在鼻咽或口咽部病变,另有继发于感冒占8.33%,伴有先天性听力障碍占3.65%,例原因不明占总14.29%,鼓膜穿刺并置管同时切除增殖体病变后,听力显著提高(Plt;0.05)。结论:对反复发作的SOM患儿应行鼓膜置管,保留6个月以上,同时鼻咽和口咽部伴发病变应引起临床医生的重视,积极处理相关疾病。
Objective To explore the relative prognostic factors of Tile C pelvic injury after iliolumbar fixation. Methods Between March 2007 and March 2010, 60 patients with Tile C pelvic injuries were surgically treated with iliolumbar fixation, including 39 males and 21 females with an average age of 37 years (range, 17-66 years). Of them, 27 cases were classified as Tile C1, 20 as Tile C2, and 13 as Tile C3. The preoperative injury severity score (ISS) was 12-66 (mean, 29.4). The time from injury to surgery was 2-25 days (mean, 8.1 days). Iliolumbar fixation was performed in all patients. Unconditional logistic analysis was used to analyze the relationship between the age, sex, body mass index (BMI), operation opportunity, the preoperative combined injury, classification of fracture, the postoperative complication, reduction outcome, sacral nerve injury, and the time of physical exercise and the prognosis. Results All 60 patients were followed up 12-56 months (mean, 27.3 months). Infection of incisions occurred in 12 cases and were cured after dressing change; healing of incision by first intention was obtained in the other patients. Delay sacral nerve injury was found in 15 patients, 6 patients underwent nerve decompression, and 9 underwent conservative treatment. Ten patients had nail protrusion of Schanz screws at the posterior superior illac spine, and 3 patients had pain, which was relieved after removal of the internal fixator. One patient had bone-grafting nonunion of sacroiliac joint, which was improved by pressured bone graft. Five patients had the beam breakage without significant effect. Six patients had deep vein thrombosis, among them 4 underwent filter and 2 underwent nonsurgical treatment. The healing time of fracture was 3-6 months (mean, 3.9 months). According to the Matta function score, the results were excellent in 31 cases, good in 24 cases, fair in 3 cases, and poor in 2 cases with an excellent and good rate of 91.7% at last follow-up. Majeed score was 58-100 (mean, 86), 28 were rated as excellent, 12 as good, 16 as fair, and 4 as poor with an excellent and good rate of 66.7%. The logistic analysis showed that the age, sex, BMI, and postoperative complications were not prognostic factors; early operation (within 10 days), early function exercises (within 7 days), the better reduction quality, and the less sacral nerve injury were in favor of prognosis; and the worse preoperative combined injury and pelvic injury were, the worse the prognosis was. Conclusion Operation opportunity, the preoperative combined injury, reduction outcome, sacral nerve injury, and the time of physical exercise are all significantly prognostic factors of Tile C pelvic injuries