Objective To assess the correlation between obstructive sleep apnea-hypopnea syndrome (OSAHS) and hypertension. Methods Such databases as MEDLINE (1950 to April 2011), EMbase (1989 to April 2011), VIP (1989 to April 2011), WANFANG (1977 to April 2011), CBM (1978 to April 2011) and CNKI (1979 to April 2011) were searched to collect literatures about the correlation between OSAHS and hypertension. The literatures in conference proceedings and some unpublicized articles were also retrieved. All cohort studies and case control studies were included. Two reviewers independently collected the data, assessed the quality, and conducted the Meta-analysis by using RevMan5.1 software. Results Among the total 11 studies involving 4 019 participants were included, 1 was prospective cohort study and the other 10 were case control studies. The results of Meta-analyses showed that: a) the OSAHS was correlated with hypertension (P=0.16, RR=2.52, 95%CI 2.21 to 2.87); and b) the correlation between OSAHS and hypertension was related with the different grades of OSHAS (P=0.83, RR=1.84, 95%CI 1.53 to 2.22). The more severe grade the OSAHS, the greater possibility the hypertension. Conclusion OSAHS is significantly related with hypertension, and they may be the mutual risk factor for each other. The correlation between OSAHS and hypertension may be related with different grades of OSAHS.
ObjectiveTo measure and evaluate the economic burden of hospital infection in Sichuan, and provide a basis for targeted economic evaluation of healthcare-associated infection (HAI).MethodsIn hospitals participating in the 2016 Sichuan provincial prevalence survey of HAI, matched cases were used to extract cases and controls, and then a multi-center nested case-control study was conducted.ResultsA total of 225 pairs/450 patients were selected in 51 hospitals, and 175 pairs/350 patients were successfully matched. The median of the difference of hospitalization costs between matched-pairs were RMB 3 362.0, and the difference was statistically significant (Z=3.275, P<0.001).ConclusionsThe hospitalization costs caused by HAI should be given special attention in the current medical insurance reform. Efforts need to be taken to reduce the hospitalization costs caused by HAI.
ObjectiveTo explore the clinical value of Goddard CT grade for comprehensive evaluation of emphysema-type COPD.
MethodsA total of 150 patients with emphysema-type COPD were recruited in the study. Chest CT scan was performed with German Siemens Difinition 64-slice spiral CT machine. The Goddard scoring of lung CT manifestations was used to grade lung emphysema. Lung function indexes were measured including FEV1, FVC, FEV1/FVC, RV, TLC, RV/TLC, DLCO, FEV1% pred, FVC% pred and DLCO% pred, etc. The correlation between Goddard scores and pulmonary function indexes were analyzed. The incidence of hospitalizations, length of hospital stay, severity of illness and complications in the previous year were compared between the patients with different Goddard CT grade.
ResultsThere were 57 cases of mild emphysema, 53 cases of moderate emphysema, and 40 cases of severe emphysema judged by Goddard scoring. The pulmonary Goddard scores were positive correlated with RV, TLC, and RV/TLC which reflecting pulmonary function (r value was 0.385, 0.349, 0.455, respectively, all P < 0.05), and negatively correlated with DLCO and DLCO% pred which reflecting pulmonary diffusing capacity (r value was-0.771, -0.787, respectively, P < 0.05). Compared with the mild and moderate emphysema-type patients, the incidence of hospitalization more than one time due to acute exacerbation was significantly higher (χ2 value was 44.69, 25.66, respectively, P < 0.05), the average length of hospital stay was significantly longer [(13.5±4.2) d vs. (6.4±3.1) d and (9.0±3.8) d, P < 0.05] in the severe emphysema-type COPD patients. The severe emphysema-type COPD patients suffered from more severe acute exacerbation, and higher incidence of heart failure, ischemic heart disease and respiratory failure than the mild and moderate emphysema-type patients (P < 0.05).
ConclusionsGoddard CT grade in complement with pulmonary function evaluation can provide more comprehensive evaluation of emphysema-type COPD. The higher Goddard score is, the more frequently and severe the acute exacerbation occurs, more easily the COPD patients complicated with respiratory failure, heart failure and other complications.
Objective To explore the relationship between macro-economic indicators and incidences of adverse events linked to intrauterine devices (IUDs). Methods Data on IUD-associated adverse events were collected from a cohort study conducted between September 2005 and December 2006. Regional economic data were from the 2006 National Economic and Social Development Statistical Bulletins and Statistical Yearbooks of various regions. A total of 20,220 IUD users in 236 towns in Jiangsu, Shanghai, Guangdong, Anhui, Sichuan, and Chongqing provinces in China were included in this study. Linear correlation and regression analyses were used to analyze the relationships between regional income and total incidences of adverse events, incidences of mild adverse events, and incidences of severe adverse events. Results Incidences of total adverse events and mild adverse events were positively correlated with regional economic level (rs=0.336, Plt;0.05; rs=0.272, Plt;0.05), while incidences of severe adverse events were not correlated with regional economic level. Conclusions The positive relationship between regional economic level and reported IUD-associated mild adverse events likely reflects income-related disparities in women seeking care and receiving treatment for mild adverse events. This points to a need to improve both public health education and the quality of health services, particularly in poorer areas.
ObjectiveTracheobronchial foreign bodies (TFBs) aspiration is rare in adults,although it can occur at any age. This study aimed to report our experience in airway foreign body removal by flexible bronchoscopy in adult patients of central south China.
MethodsA total of 244 patients with TFBs over the age of 14 years were reviewed retrospectively from January 1997 to February 2012. The incidence,risk factors,clinical manifestations,radiological findings,types and locations of TFBs were analyzed.
ResultsAmong the 27719 patients,TFBs were found only in 0.88%(244) cases. The prevalence of TFB aspiration increased steadily with age beginning in the fifth decade. The incidence of TFBs was 0.62% among people aged 70 to 80 years. Risk factors such as cerebrovascular diseases and neural degenerative disease were found among 32 (6.6%) patients. Among 153 patients with clear history of foreign body aspiration,135 patients (88.2%) were addicted to the hot pepper. Paroxysmal cough (81.1%) was the most common clinical manifestations of TFBs. Only 12 cases (4.9%) were found with non-opaque foreign bodies by chest X-ray but 106 cases (43.4%) were found with opaque foreign bodies by chest CT. The most common indirect chest imaging findings were recurrent infections and consolidation of the same area.Bone fragments of animals was the most common type in foreign bodies (47.2%). The most common position of foreign bodies was the right bronchial (65.6%). Total foreign bodies of 234 patients (95.9%) had been successfully removed by flexible bronchoscopy.
ConclusionAlthough TFBs is rare in adults in south China,but yield by flexible bronchoscopy (0.88%) is much higher than that is reported in western countries (0.32%-0.33%). Addiction to the hot pepper and speaking loudly when having dinner may be the major risk factor for high incidence in central south China.
Objective To establish a risk evaluation indicator system for intrauterine device (IUD), to determine the weight of indicators, to comprehensively evaluate the risk of IUDs by using a variety of comprehensive evaluation methods according to the data of IUDs, so as to provide references for the government purchasing decision-making. Methods The literature review, long-term monitoring of IUD adverse events, large sample randomized controlled trials (RCTs) and Delphi methods were applied to establish the risk evaluation indicator system for IUD. The weight of each indicator was determined by jointly using the subjective scoring method and CRITIC method. Based on the established indicator system, primary research (RCT) data and secondary research data (literature data), the analytic hierarchy process (AHP), technique for order preference by similarity to ideal solution (TOPSIS) and synthetical scored method were used to assess the risk of IUDs respectively, and then the assessment results of three methods were integrated to obtain a comprehensive rank of various IUDs. Results A two-level risk evaluation indicator system for IUD was established and the seven 1st level indicators included unwanted pregnancy, expulsion, menstruation problems, pain, IUD ectopia, position and shape changes as well as total health problems, which were divided into 26 2nd level indicators. Through the subjective and objective weighting method, the weights of each 1st level indicator were 0.147 5, 0.144 3, 0.140 7, 0.174 8, 0.163 2, 0.132 8, and 0.096 6, respectively. The risk evaluation of the above three methods showed that among the three kinds of IUD in a multicenter RCT, yuangong365 was with the lowest risk, followed by TCu380A and MLCu375. The risk evaluation showed that among the 14 kinds of IUD from literatures, medicated γ IUD was with the lowest risk, followed by HCu280, yuangong365, and Gyne IUD, while the medicated stainless steel ring 165 was with the highest risk. Conclusion The established indicator system has a good representation and credibility, and the ways to identify the weight of indicators are scientific, comprehensive and accurate. Meanwhile, the findings which were demonstrated by various assessing methods are consistent to a large extent. Now that medicated γ IUD and HCu280 have been already included in the National Coverage Plan, it is suggested that if the prices of yuangong365 and Gyne IUD are reasonable, the two IUDs could be considered to be listed in the National Coverage Plan and freely chosen by women of child-bearing age.
