Obstructive sleep apnea hypopnea syndrome (OSAHS) can affect the growth and development of minors. Although the gold standard for OSAHS diagnosis is an overnight polysomnography, its clinical application is limited due to the high requirements for equipment and environmental conditions. Body shape indicators can reflect the accumulation of fat in specific parts of the body. In recent years, body shape indicators (body mass index, neck circumference, waist circumference, waist to hip ratio, waist to height ratio, neck circumference to height ratio) have been increasingly used in the evaluation of minor OSAHS. This article will review the application of the above body shape indicators in the evaluation of minor OSAHS, aiming to provide a basis for better use of these indicators in the diagnosis and treatment of minor OSAHS.
Objective To analyze different characteristics of extra-vascular lung water ( EVLW) in the patients with acute respiratory distress syndrome( ARDS) , and examine its prognostic value. Methods 23 patients with ARDS admitted between November 2010 and December 2011 were divided into a survival group( n=13) and a dead group( n =10) according to the outcome. The hemodynamic status including extravascular lung water index( EVLWI) was measured in 3 consecutive days, and the relationship between EVLWI and the prognosis of patients was analyzed. Results On the first day of diagnosis, the EVLWI was higher in both groups in comparison with normal value. It was ( 13. 9 ±3. 45) mL/kg in the survival group and ( 14. 87 ±5. 75) mL/kg in the dead group( P gt;0. 05) . However, on the second day, the EVLWI in the survival group dropped significantly after intensive intervention, but the patients in the dead group did not respond well to the treatment and the EVLWI declined slightly. The EVLWI of both groups began to diverge significantly fromeach other, showing average value of ( 11. 07 ±2. 51) mL/kg and ( 15.63 ±5. 05) mL/kg, respectively( P lt; 0. 05) . On the third day, this difference between two groups was still more remarkable, resulting in ( 10.32 ±1.57) mL/kg vs. ( 16. 6 ±4. 33) mL/kg( P lt; 0. 01) . Conclusions The changes of EVLWI can be used to evaluate the effectiveness of treatment and predict the prognosis of patients with ARDS. EVLWI would likely be an indicator to evaluate the pulmonary capillary leakage.
ObjectiveTo investigate the clinical characteristics and risk factors of patients with coronavirus disease 2019 (COVID-19), to provide a basis for clinical classification, diagnosis, and treatment.MethodsThe clinical data of COVID-19 patients comfirmed between January 17th and February 13th, 2020 were collected, single-factor test and multivariate logistic regression were used to compare the relevant indicators between the mild or common cases and the severe or critically severe cases.ResultsA total of 202 patients with COVID-19 were included, with an average age of 45.2 years and a male-to-female ratio of 1∶1.02. There were 146 patients (72.3%) without underlying diseases. The average time from onset to diagnosis was 5.4 d, and 31 were clustering epidemic cases. There were 13 (6.4%) mild cases, 151 (74.8%) common cases, 32 (15.8%) severe cases, and 6 (3.0%) critically severe cases. The main clinical symptoms were fever, cough, gasp, and diarrhea. Of the 202 patients, 135 (66.8%) had normal white blood cell count, 22 (10.9%) had lymphocyte ratio >40%, 18 (8.9%) had elevated aspartate aminotransferase (AST), 11 (5.4%) had elevated creatine kinase MB isoenzyme (CKMB), and 143 (70.8%) had elevated C-reactive protein (CRP). Single factor analyses showed that there were statistically significant differences between the mild or common cases and the severe or critically severe cases in the days of diagnosis, age, underlying disease, percentage of neutrophil, percentage of lymphocyte, arterial oxygen partial pressure, CRP, procalcitonin, lactate dehydrogenase, creatine kinase, CKMB, and AST (all P<0.05); multiple logistic regression analysis showed that CRP [odds ratio (OR)=1.035, 95% confidence interval (CI) (1.015, 1.055), P=0.001], CKMB [OR=1.078, 95%CI (1.023, 1.135), P=0.005], and AST [OR=1.042, 95%CI (1.016, 1.069), P=0.002] were correlated with clinical classification.ConclusionsCOVID-19 patients are mild or common cases mostly. CRP, CKMB, and AST are elevated in some cases, which may be related to early inflammation and certain myocardial damages and are independent risk factors for predicting classification.
ObjectiveTo establish a systematic, scientific, and sensitive index system to provide a scientific basis for quality evaluation and comprehensive quality management of day surgery nursing.MethodsThe databases of Wanfang, China National Knowledge Infrastructure, CQVIP, PubMed, and Web of Science were searched. The retrieval time was from the establishment of the databases to 15th July, 2019. Based on the “structure-process-outcome” management model, Delphi method was used to conduct two rounds of expert consultation for nursing experts related to day surgery in five tertiary hospitals. The results of the consultation were sorted out and the consensus of experts was obtained, so as to determine the quality-sensitive indicators of day surgery nursing.ResultsA total of 20 nursing experts participated in the questionnaire survey. The final evaluation indicators determined by expert correspondence included 1 structural indicator, 9 process indicators, and 4 outcome indicators.ConclusionsThe construction of quality evaluation standard of day surgery nursing not only embodies the connotation of nursing management of day surgery, but also puts forward clear requirements and quality standards for specialized nursing management. It has high reliability, scientificity, and strong operability, which can effectively improve the quality of nursing management and service level of day surgery.
ObjectiveTo overview of systematic reviews of the efficacy and safety of antimicrobials in the prevention of postpartum infection after vaginal delivery, and to provide evidence for the rational use of antimicrobials. MethodsThe CNKI, WanFang Data, VIP, PubMed, Embase, and Cochrane Library databases were searched to collect systematic reviews/meta-analyses on antibiotic prophylaxis for transvaginal delivery from inception to June 25, 2023. The data of the included systematic reviews were extracted by 2 investigators independently, and the methodological quality, risk of bias, and report quality were evaluated by AMSTAR 2.0 scale, ROBIS tool, and PRISMA, respectively. And a pool of outcomes for assessing the effectiveness of antimicrobials in prevention of postpartum infection after transvaginal delivery was developed. ResultsA total of 7 systematic reviews were included. And the AMSTAR 2.0 indicated that most studies (5/7) were from very low quality to low quality. The ROBIS tool showed 3 studies with low risk of bias, 3 with high risk of bias, and 1 with unclear risk of bias. The results of the PRISMA statement showed that the included system evaluation reports were relatively complete. The present evidence showed that prophylactic use of antimicrobials may be beneficial and recommended in women with Ⅲ-Ⅳ perineal fissures, with no significant benefit in women with manual placenta removal, but prophylactic use of antimicrobials was recommended considering their invasive nature, but it was controversial whether antimicrobials should be used in the categories of vaginal assisted delivery, perineal lateralization, and spontaneous delivery (without complications). ConclusionAntimicrobial prophylaxis may not be recommended for all the pregnant women undergoing vaginal delivery to prevent the postpartum infection, but considering the low methodological quality of the included systematic review and the inconsistent outcomes in this field, the conclusion should be further verified by future research with high-quality.
ObjectiveNew Rural Cooperative Medical Systems (NCMS) has been constructed as a financial protection for rural population commencing 2003. With the development of NCMS, there were quite a few management models existing across the nation. In order to assess the management alternatives, we try to explore how to set up a set of indicators to analysis management effect of different management models. MethodsBy literature review, we sorted all qualitative indicators into 8 types. Delphi and Multi-Attribute utility theories were applied to construct the appraisal indicators, including shaping first and second level indicators and assigning the weights for each type of indicators. ResultsWe managed to identify the indicator system which was comprised of 4 types of first level indicators, aiming at claim, manament process, transparency and supervision on accredited hospitals. Besides, there were 9 sub-indicators. ConclusionThe evaluation indicators are constructed for future assessment on management effect of rural health insurance.
Objective To clarify the specific clinical predictive efficacy of CT and serological indicators for the progression of connective tissue disease-associated interstitial lung disease (CTD-ILD) to progressive pulmonary fibrosis (PPF). Methods Patients who were diagnosed with CTD-ILD in Chest Hospital of Zhengzhou University Between January 2020 and December 2021 were recruited in the study. Clinical data and high-resolution CT results of the patients were collected. The patients were divided into a stable group and a progressive group (PPF group) based on whether PPF occurred during follow-up. COX proportional hazards regression was used to identify risk factors affecting the progression of CTD-ILD to PPF, and a risk prediction model was established based on the results of the COX regression model. The predictive efficacy of the model was evaluated through internal cross-validation. Results A total of 194 patients diagnosed with CTD-ILD were enrolled based on the inclusion and exclusion criteria. Among them, 34 patients progressed to PPF during treatment, and 160 patients did not progress. The variables obtained at lambda$1se in LASSO regression were ANCA associated vasculitis, lymphocytes, albumin, erythrocyte sedimentation rate, and serum ferritin. Multivariate COX regression analysis showed that the extent of fibrosis, serum ferritin, albumin, and age were independent risk factors for the progression of CTD-ILD to PPF (all P<0.05). A prediction model was established based on the results of the multivariate COX regression analysis. The area under the receiver operator characteristic curve at 6 months, 9 months, and 12 months was 0.989, 0.931, and 0.797, respectively, indicating that the model has good discrimination and sensitivity, and good predictive efficacy. The calibration curve showed a good overlap between predicted and actual values. Conclusions The extent of fibrosis, serum ferritin, albumin, and age are independent risk factors for the progression of CTD-ILD to PPF. The model established based on this and externally validated shows good predictive efficacy.
ObjectiveTo investigate the value of neutrophil/lymphocyte ratio (NLR) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) by detecting the relationship between NLR and other well-known inflammatory biomarkers.MethodsRetrospective study of 610 AECOPD cases was performed. In order to analyze the influence of NLR level on disease condition, treatment plan and prognosis, the clinical data with acute exacerbation were collected and the value of NLR in AECOPD were analyzed.ResultsThe level of NLR was higher in the group with pneumonia than that in the non-pneumonia group (P<0.05), and the more severe the pulmonary inflammation, the higher the NLR level (P<0.05). The level of NLR was higher in the group with heart failure and the group treated with ventilator and glucocorticoid (P<0.05). The NLR level was higher in the group of hospital stay over 14 days than the group of hospital stay less than 14 days (P<0.05). The NLR value of the death group was higher than that of the survival group (P<0.05). With the increase of NLR value, the mortality rate in hospital increased gradually. Compared with C-reactive protein and interleukin-6, NLR had the highest odds ratio by binary regression analysis. Cutoff value of NLR was 5.92 by analysis of receiver-operating characteristic curve with a sensitivity of 88% and a specificity of 51%, and the area under the curve in predicting in-hospital death was 0.727 (OR=4.112, 95% confidence interval 0.609 - 0.849, P=0.02).ConclusionsNLR can be used as an inflammatory marker to evaluate the severity of AECOPD and to predict the prognosis.
Lung cancer ranks among the most prevalent and lethal malignancies globally. Its prognostic outcomes are not only contingent upon tumor characteristics and therapeutic interventions but also intricately linked to the nutritional and immune profiles of patients. This article conducts a thorough review of both domestic and international research, providing a comprehensive synthesis of the prognostic value of widely investigated nutritional and immune indicators in the context of lung cancer. The primary objective is to identify optimal prognostic markers in clinical practice, offering guidance for precise post-treatment assessment and early intervention for lung cancer patients.
Objective To construct a multi-dimensional risk assessment system and scale for the prevention and control risk of respiratory infectious diseases in general hospitals, and make evaluation and early warning. Methods Through the collection of relevant literature on the prevention and control of respiratory infectious diseases during the period from January 1st, 2020 to December 31st, 2022, the articles related to the risk assessment of respiratory infectious diseases such as severe acute respiratory syndrome, COVID-19 and influenza A (H1N1) were screened, and the Delphi method was used to evaluate the articles and establish an indicator system. The normalized weight and combined weight of each item were calculated by analytic hierarchy process. The technique for order preference by similarity to the ideal solution method was used to calculate the risk composite index of 38 clinical departments in a tertiary general hospital in Jiangxi Province in December 2022. Results A total of 16 experts were included, including 4 with senior titles, 8 with associate senior titles, and 4 with intermediate titles. After two rounds of Delphi consult, a total of 4 first-level indicators, 11 second-level indicators, and 38 third-level indicators of risk assessment for the prevention and control of respiratory infectious diseases were determined. The reliability and validity of the scale were good. The top three items with the largest combined weights in the scale were spread by aerosol, spread by respiratory droplet, and commonly used instruments (inspection instruments and monitoring equipment). After a comprehensive analysis on the 38 departments, the top 10 departments in the risk index were the departments of medical imaging, pediatrics, ultrasound, cardiac and vascular surgery, infection, emergency, respiratory and critical care, general medicine, otolaryngology and neck surgery, stomatology, and obstetrics. Conclusions This study constructed the risk assessment scale of respiratory infectious diseases in general hospitals, and the scale has good reliability and validity. The use of this scale for risk assessment of general hospitals can provide a theoretical basis for the risk characteristics of prevention and control of respiratory infectious diseases in general hospitals.