ObjectiveTo figure out the factors affecting the prognosis of liver transplantation and the research progress on methods for predicting the prognosis of liver transplantation so as to provide guidance and reference for the distribution of liver sources and the perioperative treatment of liver transplantation.MethodThe literatures related to the factors influencing the prognosis of liver transplantation and the methods in predicting the prognosis were searched in the PubMed, CNKI, Wanfang, and other databases and the results were analyzed and summarized.ResultsThe liver transplantation was an effective method in the treatment of end-stage liver diseases. The main factors affecting the prognosis of liver transplantation included the change of internal environment, systemic inflammatory response, and general systemic conditions. On the basis of Model for End-stage Liver Disease (MELD), the new prediction model built in combination with the blood sodium ion, lactate, muscle mass, or reticulocyte count and hemoglobin concentration had improved the prognostic prediction ability of liver transplantation.ConclusionsIt is possible to predict the prognosis of patients with liver transplantation more accurately by selecting a more targeted prediction model combined with the factors affecting the prognosis of liver transplantation. It might provide a reference for perioperative management and treatment and make the limited liver source play the most role and save more lives.
Objective To broaden the current understanding of the usage willingness about artificial intelligence (AI) robots and relevant influence factors for elderly patients. Methods The elderly patients in the inpatient ward, outpatient department and physical examination of the Department of Geriatrics, West China Hospital of Sichuan University were selected by convenient sampling for investigation between February and April 2020, to explore the willingness of elderly patients to use AI robots and related influencing factors. Results A total of 446 elderly patients were included. There were 244 males and 202 females. The willingness to use AI robots was (14.40±3.62) points. There were statistically significant differences among the elderly patients with different ages, marital status, living conditions, educational level, current health status, current vision status, current hearing status, self-care ability and family support in their willingness to use AI robots (P<0.05). Multiple linear regression analysis showed that age, education level and family support were the influencing factors of use intention (P<0.05). Among the elderly patients, 60.76% had heard of AI robots, but only 28.03% knew the medical application of AI robots, and only 13.90% had used AI robot services. Most elderly patients (>60%) thought that some adverse factors may reduce their usage willingness, like “the price is too expensive” and “the use is complex, or I don’t know how to use”. Conclusions Elderly patients’ cognition of AI robots is still at a low level, and their willingness to use AI robots is mainly affected by age, education level and family support. It is suggested to consider the personalized needs of the elderly in terms of different ages, education levels and family support, and promote the cheap and user-friendly AI robots, so as to improve the use of AI robots by elderly patients.
Objective Influence factors of the stable warfarin dose in the early period after mechanical prosthetic valve replacement were analyzed to guide the anticoagulation therapy for these patients. Methods A total of 288 patients within 6 months after mechanical prosthetic valve replacement in West China Hospital were followed up and registered at outpatient department from July 2012 to April 2014, including basic information (name, sex, age, height, weight, etc.), general clinical data (cardiac function, heart rate, surgery pattern, etc.) and related data about anticoagulation therapy. The target international standardized ratio (INR) range was 1.60 to 2.20 and the acceptable INR was 1.50 to 2.30. The sex, age, height, body weight, body mass index (BMI), body surface area (BSA) and related clinical factors were analyzed to find the relationship with the dose of warfarin. Results Sex was found to have a significant effect on the stable warfarin dose (P<0.05). Women needed a lower stable warfarin dose than men during the early anticoagulation therapy. There was no significant difference in the stable warfarin dose of patients with different ages, rhythms, NYHA classification, surgery pattern and diseases before operation; but the stable warfarin dose was lower in the patients with radiofrequency ablation during valve replacement procedures than the patients with single valve replacement (P<0.05). There was an association between age, height, weight, BMI, BSA and the stable warfarin dose withR2 of 1.2%, 3.2%, 3.5%, 1.1%, 4.2%, respectively and they could explain 6.1% of variability in warfarin dose. Conclusion During early anticoagulation therapy in patients with mechanical prosthetic valve replacement, it is necessary to consider the effects of various preoperative factors, drug factors and demographic factors on warfarin dose. Even though there is an association between age, height, weight, BMI, BSA and the stable warfarin dose, which can only explain 6.1% of variability in warfarin dose, thus cannot guide the postoperative anticoagulation of these patients.
Objective To explore the clinicopathological characteristics which were associated with lymph node metastases in early gastric cancer patients. Methods Clinical data of 187 early gastric cancer patients who received surgical treatment in The Second People’s Hospital of Jiaozuo between January 2009 and January 2016, were retrospectively analyzed, and then exploring the clinicopathological characteristics which were associated with lymph node metastases in early gastric cancer, including age, gender, tumor location, diameter of tumor, number of tumor, depth of invasion, macroscopic type, histological type, venous invasion, and local ulcer. Results In this study, 187 patients with early gastric cancer were included, and lymph node metastasis was detected in 32 patients (17.1%). Results of multivariate logistic regression analysis showed that, lymph node metastasis was significantly closely related with diameter of tumor (OR=2.080,P=0.022), depth of invasion (OR=21.048,P=0.001), histological type (OR=3.507,P=0.018), venous invasion (OR=2.406,P=0.009), and local ulcer (OR=2.738,P=0.001), patients with diameter of tumor larger than 2 cm, infiltration depth of submucosa, histological types of undifferentiated type, vascular infiltration, and local ulcer had higher lymph node metastasis rate. Conclusion The clinicopathological characteristics, including diameter of tumor, depth of invasion, histological type, venous invasion, and local ulcer are risk factors for lymph node metastasis of early gastric cancer patients, which should be paid high attention.
ObjectiveTo construct an evaluation index system for the dissemination influence of new media health science popularization, providing a quantitative evaluation tool for comprehensively assessing the dissemination influence of health science communication works. MethodsMeta integration, Delphi method and analytic hierarchy process (AHP) were used to build a preliminary evaluation index system, form a framework of the evaluation index system, and calculate the weight values of the evaluation indexes, respectively. ResultsA total of 18 studies were included through retrieval. On the basis of preliminary evaluation index system, ten experts in related professional fields were invited to participate in two rounds of expert consultation, resulting in an evaluation index system framework that includes 2 first-level indicators, 4 second-level indicators, and 9 third-level indicators. ConclusionA preliminary evaluation index system for the dissemination and influence of new media health science communication works, which is reliable, universally applicable, and has a reasonable structure, is constructed.
Fatigue is an exhaustion state caused by prolonged physical work and mental work, which can reduce working efficiency and even cause industrial accidents. Fatigue is a complex concept involving both physiological and psychological factors. Fatigue can cause a decline of concentration and work performance and induce chronic diseases. Prolonged fatigue may endanger life safety. In most of the scenarios, physical and mental workloads co-lead operator into fatigue state. Thus, it is very important to study the interaction influence and its neural mechanisms between physical and mental fatigues. This paper introduces recent progresses on the interaction effects and discusses some research challenges and future development directions. It is believed that mutual influence between physical fatigue and mental fatigue may occur in the central nervous system. Revealing the basal ganglia function and dopamine release may be important to explore the neural mechanisms between physical fatigue and mental fatigue. Future effort is to optimize fatigue models, to evaluate parameters and to explore the neural mechanisms so as to provide scientific basis and theoretical guidance for complex task designs and fatigue monitoring.
ObjectiveTo investigate the influence of gender, age, activity level, and diameter of graft on the anterior cruciate ligament (ACL) reconstruction.MethodsBetween February 2012 and June 2017, 179 cases (111 males and 68 females) with an average age of 30.0 years (range, 11-63 years) were included in study. The patients underwent internal fixator removal at 2 years or more after single bundle ACL reconstruction with hamstring tendon autografts. All patients were sports injuries. The time from injury to operation ranged from 3 days to 26 years (median, 120 days). Lachman test and pivot shift test were positive. Univariate analysis was conducted on gender, age, post-operative activity level (Tegner score at the time of internal fixator removal), diameter of graft, and number of graft strands, and logistic regression was used to conduct multivariate analysis to screen the independent risk factors.ResultsAll patients were followed up 24-90 months (mean, 29.1 months). At last follow-up, Lachman test was positive in 25 cases and pivot shift test was positive in 28 cases. The KT-2000 side-to-side difference was –1-7 mm (mean, 1.89 mm). Eleven patients (6.15%) failed after ACL reconstruction. Univariate and multivariate analyses showed that the age, gender, post-operative activity level, diameter of graft, and number of graft strands were not risk factors for the failure of ACL reconstruction (P>0.05).ConclusionThere was no significant difference in the risk for ACL reconstruction failure among age, gender, and activity level. ACL reconstruction failure rate cannot be reduced by increasing the number of graft strands to increase the diameter of grafts.
ObjectiveTo explore the curative effect of synchronous resection of hepatopancreas lesions in the treatment of hepatic oligometastatic pancreatic cancer. MethodsThe patients with hepatic oligometastatic pancreatic cancer who met the inclusion and exclusion criteria in the Neijiang Second People’s Hospital from January 2016 to December 2020 were retrospectively collected. The enrolled patients were divided into resection group and non-resection group according to the treatment method. The patients in the resection group were treated with synchronous resection of hepatopancreas lesions, the patients in the non-resection group were treated with conservative treatment including palliative bypass surgery, biliary drainage, systemic chemotherapy, and so on. The patients were followed up to December 2021. The overall survival of the patients in the two groups were compared, and the factors affecting the overall survival were analyzed. ResultsA total of 54 patients who met the inclusion and exclusion criteria were collected in this study, including 31 cases in the resection group and 23 cases in the non-resection group. There were no statistical differences between the two groups in the baseline data such as age, gender, preoperative liver function indexes, and so on (P>0.05). The pancreaticojejunostomy leakage occurred in 7 cases (22.6%) of the resection group. The median follow-up time of the resection group and the non-resection group were 14 and 11 months. The median overall survival time of patients in the resection group and non-resection group were 18.0 months [95%CI (13.8, 22.1)] and 12.0 months [95%CI (8.2, 15.8)] respectively. The survival of the resection group was better than that of the non-resection group by log-rank test (χ2=4.074, P=0.045). Cox multivariate regression analysis result showed that the preoperative low albumin level (≤35.0 g/L), no perioperative chemotherapy, and no synchronous resection of hepatopancreas lesions shortened the overall survival time of patients with hepatic oligometastatic pancreatic cancer (P<0.05). For the patients who underwent the synchronous resection of hepatopancreas lesions, R0 resection and perioperative chemotherapy could prolong the overall survival time (P<0.05). ConclusionsFrom the results of this study, synchronous resection of hepatopancreas lesions can benefit survival for patients with hepatic oligometastatic pancreatic cancer. The prognosis of patients without R0 resection and perioperative chemotherapy is even worse.
Objective To investigate the thirst status of patients in intensive care unit (ICU) who underwent oral tracheal intubation and ventilator assisted ventilation, and explore its influence factors. Methods A total of 172 patients with oral tracheal intubation admitted in ICU from June 2020 to September 2021 were investigated, and a numerical rating scale was employed for rating their thirst feelings. The patients were divided into a thirst group and a non-thirst group based on thirst status. The thirst status and influence factors of thirst distress were analyzed. Results The incidence of thirst in the ICU patients with oral tracheal intubation and ventilator assisted ventilation was 88.4%, and the thirst score in the thirst group was 7.70±1.17. Single factor analysis showed statistically significant difference between the two groups in sex, medical payment, smoking, drinking, duration of mechanical ventilation, humidification effect, sputum viscosity, gastrointestinal decompression, fasting, continuous renal replacement therapy, diuretics, 24-hour urine volume and liquid balance, heart function grading, sedatives, agitation, sweating, acute physiology and chronic health evaluation Ⅱ, endotracheal intubation depth, body mass index, PCO2, PO2, HCO3–, tidal volume, and sodium ion (all P<0.05). Multivariable regression analysis demonstrated that diuretics, sputum viscosity, sodium ion, alcohol consumption, smoking, intubation depth, and cardiac function were independent influence factors for the occurrence of thirst in the ICU patients who received tracheal intubation (P<0.01). Conclusions The incidence of thirst was high in ICU patients with airway intubation and ventilator assisted ventilation. Diuretics, sputum viscosity, sodium ion, alcohol consumption, smoking, 24-hour urine volume, and cardiac function grading were independent influence factors for the occurrence of thirst in ICU patients with tracheal intubation. It is necessary to implement targeted intervention to prevent and alleviate the thirst degree of patients, reduce the occurrence of related complications, and improve patient comfort.
ObjectiveTo investigate the protein intake of patients in the general surgery intensive care unit (ICU) and to analyze the factors, both hindering and facilitating, that affecting protein intake from the perspective of healthcare professionals. MethodsA mixed-methods approach was used in this study, including a quantitative study and a qualitative study. The quantitative study was use to assess the protein intake in the ICU patients. The qualitative study was used to analyze the perspectives of healthcare professionals via semi-structured interviews. In the quantitative study, 32 variables were analyzed, and the sample size was estimated to be 10 times the number of study variables. The qualitative study employed the maximum difference sampling strategy, with the sample size determined by data saturation. The multiple linear regression was used to identify the risk factors affecting protein intake achievement, with a significance level of α=0.05. ResultsThe quantitative study included 459 patients, with a protein intake of (0.739±0.552) g/(kg·d). Of the patients, 90 (19.6%) had a protein intake of 1.2–2.0 g/(kg·d), 11 (2.3%) had 2.0 g/(kg·d) or more, and 358 (78.0%) had less 1.2 g/(kg·d). The multiple linear regression analysis identified several risk factors influencing protein intake attainment, including male, higher body mass index, elevated blood glucose levels upon ICU admission, early initiation of enteral nutrition (≤48 h), nasoenteric tube placement, and the only use of enteral nutrition feedings. In the qualitative study, three key themes relevant protein intake attainment were identified from the interviews: inadequate infrastructure, healthcare workers’ factors, and patient-related factors. ConclusionsThe findings of this study suggest a substantial gap between the protein intake of general surgical ICU patients and the guideline-recommended intake. The study highlights patient groups at risk for inadequate protein intake based on identified risk factors. Future efforts should focus on improving the efficiency of protein supplementation, enhancing the nutritional status of patients, standardizing protein supplementation protocols, and increasing education for both healthcare workers and patients.