目的:探讨早产儿呼吸暂停相关高危因素,指导临床防治工作。方法:对90例早产儿呼吸暂停进行回顾性分析。结果:胎龄越小,体重越低的早产儿,原发性呼吸暂停发生率越高,随着胎龄增加继发性呼吸暂停发生率亦增加,继发性呼吸暂停与缺氧、低体温、酸中毒、脑损伤、感染等因素有关,生后2～5d为发病高峰期。结论:呼吸暂停与胎龄、体重、缺氧、低体温、低血糖、酸中毒、感染、颅脑损伤等多因素有关。对有相关高危因素早产儿应足够重视,减少呼吸暂停发生。
Objective To investigate the correlated risk factors of deep venous thrombosis (DVT) after the laparoscopic surgery. Methods Clinical records of 16 patients with DVT and 148 patients without DVT after laparoscopic surgery in Huashan hospital from Mar.2007 to Jan.2008 were analyzed retrospectively. Results There were several factors which could induce DVT after the laparoscopic surgery, including operation time ＞1 h 〔OR=4.15 （95% CI： 1.36-12.68）〕, operative site located in hypogastrium 〔OR=2.94 （95% CI： 1.07-8.08）〕 and the number of high risk factors ≥3 〔OR=3.94 （95% CI： 1.38-11.23）〕. Conclusions The long time of operation， hypogastric operation of laparoscopic surgery and high risk factors could induce DVT. Prevention measures should be made in preoperative period.
Objective To analyze the clinical characteristics of the Guang’an Omicron epidemic and summarize the management experiences and practices in pandemic prevention and control of major infectious diseases.Methods Retrospective analysis was performed on patients infected with coronavirus disease (COVID-19), afterwards treated and observed in the isolation ward of Guang’an People’s Hospital and the shelter of Guang’an City from May 9 to June 26, 2022. The characteristics of patients at different age stages and the related factors affecting the severity, re-positive and negative conversion was analyzed. Results Finally 1 278 patients were collected, including 508 males and 770 females, with an average age of 41.3±22.6 years. Among them, 1 054 patients were asymptomatic carriers. The overall severe rate was 0.86%, the severe rate of the high-risk group was 3.06%. The median negative conversion time was 10.0 days and re-positive rate was 7.36%. Patients aged＞60 years were 2.589 times more likely to have a longer negative conversion time than those aged≤60 years (95%CI 1.921-3.489, P＜0.001). Conclusion The clinical characteristics of Guang’an COVID-19 epidemic are mainly that the elderly with high risk factors are more likely to develop severe cases, have longer clearance time, and re-positve is more likely to occur.
Objective To identify the high risk factors related to postpartum suicide. Methods A total of 40 women with postpartum depression who had suicidal act or ideation were included in the study. They were evaluated by the Edinburgh Postpartum Depression Scale (EPDS), the Life Events Scale (LES) and the Social Support Rate Scale (SSRS), and compared with healthy postpartum women. The multi-element gradual regression analysis was performed to identify the high risk factors. Results Such factors as prior history of depression, negative life events within the previous half year, absence of social support, disease of mothers or infants, and conjugal relationship were significantly correlated with postpartum suicide. Conclusion It might be helpful to reduce the incidence of postpartum suicide by prenatal mental intervention and postpartum crisis intervention.
ObjectiveTo analyze the relation between ABO blood type and postoperative pathological features of patients with colorectal cancer served by West China Hospital of Sichuan University as a regional center in the current version of Database from Colorectal Cancer (DACCA). MethodsThe data of DACCA was updated on January 5, 2022. According to the screening conditions, the enrolled patients with colorectal cancer were divided into blood type A, B, AB, and O. The differences in the postoperative pathological characteristics of patients with different blood types, such as pathological TNM, T, N, M (pTNM, pT, pN, pM) staging, peripheral nerve involvement, high risk factors, tumor regression grade (TRG), and cancer nodules, were analyzed. ResultsAfter screening, 6 089 data rows were analyzed. The patients involved 2 058 blood type A, 1 469 blood type B, 494 blood type AB, and 2 068 blood type O. The results of statistical analysis showed that: ① There were statistical differences in the overall distribution of pTNM and pM stages among the patients with different blood types (H=11.564, P=0.009; H=7.947, P=0.047), which was reflected in: from the overall distribution trend, the proportion of patients with the four blood types in the same stage was similar, but it could still be seen that patients with blood type AB accounted for the highest proportion in the patients with stage Ⅲ, Ⅳ, M1a, M1b as compared with other blood types. ② There were no statistical differences in the overall distribution of peripheral nerve involvement and TRG in the patients with different blood types (H=3.414, P=0.332; H=1.143, P=0.767). ③ There was statistical difference in the proportion of different grades of high risk factors in the patients with different blood types (H=14.540, P=0.002). Specifically, the proportions of patients with grade 3–5 of high risk factors in the patients with AB blood type were the highest. ④ There was no statistical difference in the proportion of the grade of cancer nodules number in patients with different blood types (H=4.460, P=0.216). ConclusionsFrom results of this study, it is found that there are some differences in pTNM stage, pM stage, and high risk factors of colorectal cancer patients with different blood types, but no differences in pT stage, pN stage, peripheral nerve involvement, TRG, and cancer nodules among different blood types of patients. The influence of blood type on postoperative pathological characteristics of colorectal cancer patients needs to be further explored.
ObjectiveTo explore risk factors of pneumonia of patients after esophagectomy and its preventive measures. MethodsClinical data of 258 patients undergoing esophagectomy in Guangyuan Central Hospital between 2009 and 2012 were retrospectively analyzed. According to whether they had pneumonia after esophagectomy, all the 258 patients were divided into 2 groups. In the pneumonia group, there were 86 patients including 62 males and 24 females with their age of 65.1 (45-84)years, who all had pneumonia after esophagectomy. In the control group, there were 172 patients including 124 males and 48 females with their age of 60.2 (43-78)years, who didn't have pneumonia after esophagectomy. Preoperative pulmonary function, age, smoking history, anastomotic location, intraoperative blood loss, pneumonia and other perioperative complications were compared between the 2 groups. Multivariate logistic regression was performed to analyze risk factors of pneumonia after esophagectomy. ResultsUnivariate analysis showed that incidences of moderate or severe pulmonary dysfunction, smoking history (≥400 cigarettes per year), old age (≥65 years), laryngeal recurrent nerve injury, perioperative blood loss (≥1 000 ml), operation time longer than 4 hours, and preoperative diabetes mellitus of the pneumonia group were significantly higher than those of the control group (P < 0.05). Multivariate logistic regression analysis showed that moderate or severe pulmonary dysfunction (P=0.022), smoking history (≥400 cigarettes per year, P=0.000), old age (≥65 years, P=0.026), laryngeal recurrent nerve injury (P=0.002), and perioperative blood loss (≥1000 ml, P=0.020)were main risk factors of pneumonia after esophagectomy. ConclusionsModerate or severe pulmonary dysfunction, smoking history (≥400 cigarettes per year), old age (≥65 years), laryngeal recurrent nerve injury and perioperative blood loss (≥1 000 ml)are main risk factors of pneumonia after esophagectomy. Preoperative smoking cessation, pulmonary function exercise, airway preparation, careful hemostasis, and avoidance of laryngeal recurrent nerve injury are helpful to prevent pneumonia after esophagectomy.
Objective To observe the high-risk histopathological feature (HRF) and their correlation with prognosis in children with intraocular retinoblastoma (RB) in the intraocular stage after failed eye-preserving treatment and enucleation surgery. MethodsA single-center retrospective case study. From August 2018 to January 2023, 64 children (64 eyes) with advanced intraocular RB who were diagnosed in Department of Ophthalmology of Beijing Children's Hospital and underwent enucleation surgery after failed eye-preserving treatment were included in the study. The median follow-up time was 51 months. The gender of the children patients, the age of visit and enucleation, International Intraocular Retinoblastoma Classification (IIRC), the initial chemotherapy regimen (hereinafter referred to as "chemotherapy"), the time of enucleation surgery, pathological results, post-enucleation treatment methods and prognosis were collected. The Mann-Whitney U test was used for comparison between groups. Survival analysis was performed using the Kaplan-Meier method, and the log-rank test was used for comparison between groups. ResultsAmong 64 cases and 64 eyes, 37 were male and 27 were female. The age of seeking medical treatment was 20 (11-31) months. The age at which the surgery was performed was 29 (16-40) months. The number of eyes in IIRC stage D and E was 16 and 48 respectively. The initial chemotherapy regimens simply applied (hereinafter referred to as "alone") intravenous systemic chemotherapy (IVC) and ophthalmic artery infusion chemotherapy (IAC) in 40 cases and 11 cases, 13 cases of IVC+IAC. All patients with positive HRF received systemic adjuvant chemotherapy after surgery. There were 37 eyes (57.8%, 37/64) positive for HRF. There was no statistically significant difference in the positive rate of HRF between children in IIRC stage D and stage E (χ2=0.021, P=0.884). Among the 37 eyes with HRF, the numbers of eyes with extensive choroidal invasion, posterior lamina cribrosa optic nerve invasion, scleral invasion and optic nerve stump involvement were 17 (45.9%, 17/37), 16 (43.2%, 16/37), 3 (8.1%, 3/37) and 3 (8.1%, 3/37), respectively. During the follow-up period, there were 5 cases (7.8%, 5/64) of extraocular metastasis of the tumor and death, all of which were stage E and had HRF. Among them, the initial treatment plan was IAC for 4 cases, one case of IVC. The survival rates of children among the IVC, IAC or IVC+IAC regimens were 97.5% (39/40), 63.6% (7/11), and 100.0% (13/13), respectively. The comparison of survival rates among different chemotherapy regimens showed statistically significant differences (χ2=14.233, P＜0.001). The results of survival analysis showed that the cumulative survival rate of those with extensive choroidal invasion, posterior lamina cribrosa optic nerve infiltration, and those who received IAC was significantly lower than that of those without extensive choroidal invasion, posterior lamina cribrosa optic nerve infiltration, and those who received IVC+IAC and IVC (P＜0.05). ConclusionsEye-preserving treatment for children with advanced intraocular RB may increase the positive rate of HRF and the risk of extraocular metastasis. The IVC+IAC eye-protecting treatment plan can improve the survival rate of children.
ObjectiveTo analyze the relation between age and postoperative pathological features of patients with colorectal cancer from Database from Colorectal Cancerr （DACCA）. MethodsThe data in DACCA were updated on January 5, 2022. The patients were selected from DACCA according to the established screening conditions, then were divided into ≤35, 35–59, and ≥60 years old groups. The differences of postoperative pathological （p） TNM （pTNM）, pT, pN, pM stages, perineural invasion （PNI）, high-risk factors grade, and tumor regression grade （TRG） among the three age groups were analyzed, and the correlation between them was analyzed. ResultsAfter screening, 5 628 data rows were enrolled, of whom 196 patients were <35 years old, 2 382 patients were 35–59 years old, and 3 050 patients were >59 years old. Statistical analysis showed that: ① There were statistical differences in the proportions of pN stage, PNI, and high-risk factors grade in the patients of different age groups （H=27.867, P<0.001; H=6.248, P=0.044; H=19.712, P<0.001, respectively）; However, it was not found that there were statistical differences in the proportions of pTNM, pT, pM stages, and TRG after neoadjuvant therapy among different age patients （H=0.920, P=0.631; H=4.923, P=0.085; H=2.272, P=0.321; H=2.337, P=0.311, respectively）. The Spearman correlation analysis results showed that there was a weakly negative correlation between the age and pN stage or grade of high-risk factors （rs=–0.070, P<0.001; rs=–0.067, P<0.001, respectively） and a weakly positive correlation between age and TRG after neoadjuvant therapy （rs=0.100, P=0.009）. ConclusionDACCA data analysis finds that patients of different age groups shows a negative correlation trend with pN stage or grade of high-risk factors and a positive correlation trend with TRG, which needs to be further verified.
ObjectiveTo summarize the research progress of correlation between pancreatic cancer and diabetes mellitus.MethodsRecent studies on the association between pancreatic cancer and diabetes mellitus were extensively reviewed, and relevant research results on the association between pancreatic cancer and diabetes mellitus were reviewed.ResultsPancreatic cancer had a particular association with diabetes. Patients with pancreatic cancer may develop new diabetes or worsen existing diabetes mellitus. About 50% of patients with pancreatic cancer had diabetes mellitus before diagnosis, suggesting a “dual causal relationship” between pancreatic cancer and diabetes mellitus. Long-term type 2 diabetes mellitus (T2DM) was one of the high risk factors for the occurrence and development of pancreatic cancer. T2DM may also increase the risk of pancreatic cancer due to hyperinsulinemia, adipokine, and other factors. Pancreatic cancer was one of the cause of diabetes mellitus at the same time, but its mechanism was not yet known, also needed to get a lot of information to understand the impact of long-term diabetes mellitus on the development of pancreatic cancer, as well as the reason of pancreatic cancer related to diabetes mellitus mechanism.ConclusionThe clear relationship between pancreatic cancer and diabetes mellitus has not been proved, and further research is needed to clarify the relationship between them.