The pathogenesis of diabetic retinopathy (DR) is complex and there are many related risk factors. It is related to the course of diabetes, blood glucose, blood pressure, and blood lipids, among which the course of disease and hyperglycemia are recognized main risk factors. In addition, other factors which include heredity, gender, age, obesity, pregnancy, insulin use, can also affect the occurrence and development of DR, but there is no unified conclusion about its correlation. A comprehensive understanding of the risk factors that affect DR can provide new ideas for the prevention, diagnosis, treatment, and intervention of DR.
Objective
To observe the rate of iris vessels exposure and analyze its relevant factors in normal full-term neonates.
Methods
A retrospective study. 1855 normal full term neonates, including 947 boys and 908 girls, were enrolled. The mean gestational age (GA) was (38.84±1.10) weeks and mean birth weight (BW) was (3 396.52±402.08) g. There were 1235 neonates from normal term vaginal delivery, 402 cases of cesarean delivery and 218 cases of forceps delivery. All neonates were examined with hand-held portable slit lamp biomicroscopy within 1 to 3 days after birth by two trained ophthalmologist respectively. Iris vessels exposure was defined as radial red blood vessels along iris fibers. Infants were divided into iris vessels exposure group and iris vessels unexposed group according to the findings of slit lamp biomicroscopy. 78 infants with iris vessels exposure were followed up for 42 days after birth till the iris vessels can’t be seen under microscope. The differences between the two groups were compared for gender, mode of delivery (MOD), GA, BW and body length (BL). Multiple logistic regressions were used to determine the factors related to iris vessels exposure.
Results
There were 298 neonates with iris vessels exposure among 1855 neonates and the rate was 16.1%. 1557 neonates (83.9%) had unexposed iris vessels. There were no different in gender (χ2=0.551) and MOD (χ2=3.036) between iris vessels exposure group and unexposed group (P>0.05), while the differences in GA (χ2=47.216), BW (t=4.603) and BL (t=3.936) between the two groups were statistically significant (P=0.000). Multiple logistic regression analysis revealed that only GA (β=?0.291, odds ratio=0.747, 95% confidence interval: 0.656 - 0.851, P=0.000) was correlated to iris vessels exposure significantly. The iris vessels couldn’t be seen in 77 of 78 infants with iris vessels exposure when followed up to 42 days.
Conclusions
The iris vessels exposure in normal full-term neonates is frequently observed. There is a significant inverse correlation between GA and iris vessels exposure.
Objective
To establish a model for prognosis analysis of severe community-acquired pneumonia in order to find the independent risk factors for mortality.
Methods
The data of 88 patients with severe community-acquired pneumonia enrolled from 533 community-acquired pneumonia patients in Fujian Provincial Hospital from April 2012 to December 2015 were analyzed, they were divided into a survival group and a death group according to prognosis. The clinical materials of basic data of the population, clinical manifestation, treatment and prognosis and pulmonary severity indexes were collected. Then univariate analysis was used to screen risk factors of death before logistic multivaritae regression was applied to explore independent risk factors.
Results
The different pathogen groups including viral, bacterial, mixed infection, negative and other groups were compared and no differences were found in mortality (all P>0.05). Univariate analysis revealed antibiotics treatment before admission, higher APACHEⅡ score, higher Chalison's score, septicopyemia, and higher level of procalcitonin, blood urea nitrogen (BUN), blood glucose, lactate could increase death risk for the patients. While antiviral treatment and no invasive mechanical ventilation were determined as protective factors. Logistic multivaritae regression showed three factors including higher lactate and higher serum BUN and higher heart rates were independent death risk factors [OR values were 4.704 (95%CI 0.966-22.907), 1.264 (95%CI 0.994-1.606), and 1.081 (95%CI 1.003-1.165), respectively]. Whereas no invasive mechanical ventilation was protective factor (OR=0.033, 95%CI 0.001-0.764).
Conclusion
The patients with higher lactate and BUN, higher heart rate and accepting invasive mechanical ventilation have poor prognosis.
ObjectivesTo explore the clinical characteristics and risk factors for 30-day mortality of community-acquired pneumonia (CAP) patients with chronic obstructive pulmonary disease (COPD).MethodsThis was a multicentre, retrospective study. Data of patients hospitalized with CAP from four tertiary hospitals in Beijing, Shandong and Yunnan from January 1, 2013 to December 31, 2015 were reviewed. Patients with (COPD-CAP) and without (non COPD-CAP) COPD were compared, including demographic and clinical features, treatment and outcomes. Univariate analysis and multivariate Logistic regression analysis were performed to identify risk factors for 30-day mortality in COPD-CAP patients.ResultsThree thousand three hundred and sixty-six CAP patients were entered into final analysis, COPD-CAP accounted for 12.9% (435/3 366). Compared to non COPD-CAP patients, COPD-CAP patients were more male and more frequent with CURB-65 score 2 and pneumonia severity index (PSI) risk class Ⅲ to Ⅴ. Pseudomonas aeruginosa was the most common etiology and more common in COPD-CAP patients than non COPD-CAP patients. Though the proportion of respiratory failure and heart failure were higher in COPD-CAP patients, there was no significant difference in the 30-day mortality. The 30-day mortality of COPD-CAP patients was 5.7% (25/435). Logistic regression analysis confirmed aspiration (OR 9.505, 95%CI 1.483 - 60.983, P=0.018), blood procalcitonin ≥2.0 ng/mL (OR 5.934, 95%CI 1.162 - 30.304, P=0.032) and PSI risk class (OR 2.533, 95%CI 1.156 - 5.547, P=0.020) were independent risk factors for 30-day mortality in COPD-CAP patients.ConclusionsCOPD-CAP patients present specific characteristics. Besides PSI risk class, clinicians should pay high attention to the aspiration and blood procalcitonin, which could increase the 30-day mortality in COPD-CAP patients.
ObjectiveTo acquire the flow law of outpatient and emergency visits in a large general hospital.
MethodsBy sampling monthly amount of outpatient and emergency from January 2005 to December 2013 of a large general hospital in Guangzhou, the trend of the time series was analyzed and calculated the seasonal index of the amount of hospital outpatient and emergency visits with the use of long-term trends method.
ResultThe flow law of patients in the hospital outpatient and emergency was significantly affected by seasonal factors, and different month had its own variation characters. The seasonal indexes were the highest in March, July, August, November and December (seasonal index >105%), while the lowest in January, February, October (seasonal index <95%).
ConclusionBased on analysis of the outpatient and emergency visits and causes with hospitals, decision makers and hospitals should make reasonable allocation of medical resources and provide evidence for the scientific decisions of hospital management. Thus, ensure the safety of patients.
ObjectiveTo investigate the prevalence of impaired glucose regulation (IGR) and IGR combined with cardiovascular risk factors in rural areas of Chengdu City.
MethodsFrom February to October 2010, we randomly sampled 1 016 patients in a rural community 100 kilometers away from the city center as the study subjects. The investigation was carried out by using questionnaire survey, physical examination and laboratory tests. The standard 75 g oral glucose tolerance test was used.
ResultsA total of 1 016 subjects were investigated, among whom there were 431 males and 585 females with an average age of 56 years old. Of these subjects, 333 were diagnosed to have IGR with a rate of 32.77% (333/1 016). The age-adjusted standardized prevalence of pre-diabetes in rural areas in Chengdu was 32.52% (336/1 016), and the male and female prevalence were respectively 30.63% (132/431) and 34.36% (201/585) without significant difference (χ2=1.569，P=0.210). Impaired glucose tolerance (IGT) was the most common type of glycometabolism abnormality. Women had a significantly higher prevalence of IGT than men. In IGR population, major cardiovascular risk factors were overweight and obesity (40.8%), high low density lipoprotein cholesterol (38.4%), high triglyceride (30.3%), hypertension (23.7%), smoking (24.3%), and drinking alcohol (23.7%). The stratified analysis showed that the prevalence of overweight, obesity and low high density lipoprotein cholesterol in female was significantly higher than that in males, while the prevalence of smoking and drinking alcohol was significantly higher in males.
ConclusionIn rural areas, the prevalence of pre-diabetes is high and complicated with multiple cardiovascular risk factors.
ObjectiveTo investigate risk factors of anastomotic fistula after total mesorectum excision (TME) in middle and low rectal cancer.
MethodsThe clinical data of 446 patients with middle and low rectal cancer received TME surgery from June 2004 to June 2014 were retrospectively analyzed.Single-factor analysis of risk factors was used by χ2 test,multiple-factor analysis was used by logistic regression analysis.
ResultsThere were 36 patients with anastomotic fistula in these 446 patients,which of 22 patients were recovered after conservative treatment,of 14 patients were recovered after colostomy.The results of single-factor analysis showed that the age>60 years,preoperative hemoglobin<110 g/L,preoperative albumin<35 g/L,accompanied with diabetes mellitus,neoadjuvant chemoradiation,distance from anasto-mosis to anus<5 cm,non-strengthen suture by hand were the risk factors of anastomotic fistula after TME in the middle and low rectal cancer (P<0.05).The results of multiple-factor analysis showed that the preoperative hemoglobin<110 g/L,preoperative albumin<35 g/L,accompanied with diabetes mellitus,neoadjuvant chemoradiation,and distance from anastomosis to anus<5 cm were the independent risk factors of anastomotic fistula after TME in the middle and low rectal cancer (P<0.05).
ConclusionsRisk of anastomotic fistula after TME in middle and low rectal cancer is higher.Basic complications of patient and local conditions of anastomosis,and intraoperative factors could affect incidence of anastomotic fistula,it should be paid enough attention.In general,most of anastomotic fistula could be cured with conservative treatment,in case of conservative treatment is invalid,colostomy is feasible.
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 investigate the prognostic factors related to long-term survival after gastrectomy. Methods A total of 351 patients with gastric cancer who underwent gastrectomy were successfully followed-up in our hospital had been selected from January 2004 to December 2009. The clinicopathological and follow-up data were studied by univariate and multivariate analysis. Results The age, location of tumors, T stage, N stage, TNM stage, and differentiation were related with postoperative survival of patients with gastric cancer by using univariate analysis（P＜0.05）. By using multivariate analysis, location of tumors, T stage, N stage, and chemotherapy were independent prognostic factors（P＜0.05）. Conclusions Location of tumors, depth of tumor invation, lymph node metastasis, and chem-otherapy were independent prognostic factors for gastric cancer patients who underwent gastrectomy. Chemotherapy after surgery could increase the survival rate of gastric cancer patients with lymph node metastasis or in TNM stage Ⅲ.
