ObjectiveTo observe and analyze the influencing factors for the prognosis of anti-vascular endothelial growth factor (VEGF) drug treatment in patients with macular neovascularization (MNV) under 45 years old. MethodsA retrospective clinical case study. A total of 89 MNV patients with 96 eyes who were diagnosed and treated with anti-VEGF drugs in Department of Ophthalmology of The Second Hospital of Lanzhou University from January 2020 to January 2024 were included in the study. The ages of all patients were ＜45 years old. All patients underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations; 49 eyes underwent OCT angiography (OCTA) examination. The BCVA examination was carried out using the international standard visual acuity chart and was converted into the logarithm of the minimum angle of resolution (logMAR) visual acuity for statistics. The macular foveal thickness (CMT) was measured using an OCT instrument. The size of the MNV lesion was measured using the software of the OCTA self-contained device. The affected eyes were given intravitreal injection of anti-VEGF drugs once, and then the drugs were administered as needed after evaluation. The follow-up time after treatment was ≥6 months. During the follow-up, relevant examinations were performed using the same equipment and methods as before treatment. The last follow-up was taken as the time point for efficacy evaluation. According to the OCT image characteristics of the MNV lesions, the affected eyes were divided into the fibrous scar group and the non-fibrous scar group, with 52 (54.16%, 52/96) and 44 (45.83%, 44/96) eyes respectively. Comparing the CMT and BCVA at the last follow-up with those at the baseline, the affected eyes were divided into the CMT reduction group, the CMT increase group, the BCVA improvement group and the BCVA reduction group, with 66 (68.75%, 66/96), 30 (31.25%, 30/96) eyes and 74 (77.08%, 74/96), 22 (22.92%, 22/96) eyes respectively. The Mann-Whitney U test was used for the comparison of non-normally distributed measurement data between groups. Logistic regression analysis was used to analyze the independent factors affecting the prognosis of MNV patients. ResultsThere were no statistically significant differences in the age (Z=?0.928) and gender composition ratio (χ2= 0.123) between the fibrous scar group and the non-fibrous scar group (P＞0.05); there were statistically significant differences in the number of eyes with a follow-up time of ≥36 months and ＜36 months (χ2= 3.906, P=0.048); there were statistically significant differences in the size of the MNV lesions (Z=?2.385, P=0.017); there were statistically significant differences in the number of eyes with different vascular network morphologies (χ2=12.936, P=0.001). Before treatment and at the last follow-up, the CMT of the affected eyes was 267.50 (237.25, 311.75) μm and 242.00 (217.25, 275.75) μm respectively; logMAR BCVA was 0.20 (0.10, 0.50) and 0.35 (0.16, 0.60) logMAR respectively. There were statistically significant differences in the CMT and logMAR BCVA before treatment and at the last follow-up (Z=?3.311,?1.984; P=0.001, 0.047). There were statistically significant differences in different ages (Z=?2.284), myopic diopter (χ2=7.437), etiology (χ2=6.956), and disease course (Z=?1.687) between the CMT reduction group and the CMT increase group (P＜0.05). There were statistically significant differences in the number of eyes with different subjective feelings between the BCVA improvement group and the BCVA reduction group (χ2=10.133, P＜0.05). The results of logistic regression analysis showed that the etiology was an independent risk factor for CMT thickening. ConclusionsAge, etiology, myopic diopter, disease course, follow-up time, lesion size and the morphology of the neovascular network are the influencing factors for the prognosis of anti-VEGF drug treatment in MNV patients under 45 years old. The etiology is an independent risk factor for CMT increase.
Objective To identify the chief factors influencing the hospitalization expenses in fracture patients with health insurance so as to provide information for the control of irrational increase in medical expenses and reform in the mode of medical insurance payment. Methods A total of 113 fracture patients with medical insurance in a hospital of a certain city from September 2006 to April 2007 were included and statistical analysis was performed by using multinomial linear regression analysis. Results The major factors influencing the hospitalization expenses in fracture patients with health insurance included the proportion of material fees and drug fees, length of stay, performance of operations and blood transfusion and etc. Conclusion Lowering the proportion of material fees and drug fees reasonably, reducing the length of hospital stay and avoiding operations and blood transfusion were the key to the control of hospitalization expenses for fracture. It is imperative to speed up and deepen the reform in medical insurance system, formulate scientific diagnostic and treatment routines and clinical pathways as well as expense standards, and try out the payment on certain single disease such as fracture.
Objective Through the analysis of hospital costs of 16 866 cases of patients with lung cancer in Sichuan Province, in oder to find the main influencing factors of hospital costs of patients with lung cancer, and to provide references for reducing the hospital costs of patients with lung cancer. Methods We selected information of in-patients with lung cancer in 6 hospitals in Sichuan province from January 2008 to December 2011 based on full consideration into the local economic levels geographics distribution of different regions in Sichuan province. Then we extracted baseline data, hospitalization data and costs, and then analysis on relevant influencing factors was performed using single factor analysis of variance and multiple stepwise regression analysis. Results A total of 16 918 cases are chosen, of which, 16 866 were effective for further analysis. The results of statistical analysis showed that, the cost of western medicine accounted for the most of the average of the total hospital costs (50.79%) , followed by the cost of diagnosis and treatment (40.79%). The reuslts of multiple stepwise regression analysis showed that, the top three factors influencing hospital costs most included hospital stay, operation, and regions. Conclusion Facing daily increasing costs of hospital costs of lung cancer, effectively reducing drug expenses of patients could be a breakthrough. We could ultimately reduce the hospital costs of patients with lung cancer as well as the the economic burden of patients and society, by strengthening hospital management, shortening hospital stay, and rationally regulating drug use.
ObjectivesTo investigate the status quo of follow-up services for patients with cervical spondylosis, to explore its influencing factors, and to provide reference for the follow-up management model after postoperative discharge of patients with cervical spondylosis.MethodsA total of 220 patients with cervical spondylosis were selected by using convenient sampling from October 2018 to May 2019, and the general information questionnaire and the follow-up service needs questionnaire were used for the investigation.ResultsThe score of follow-up service content requirement for patients with cervical spondylosis was 54.87±7.56, and the rehabilitation training instruction was the highest. Multiple linear regression analysis showed that the follow-up service content score was influenced by education level [non-standardized partial regression coefficient (b)=3.186, 95% confidence interval (CI) (2.490, 3.882), P<0.001], length of hospital stay [b=5.140, 95%CI (3.914, 6.365), P<0.001], Neck Disability Index [b=1.326, 95%CI (0.189, 2.463), P=0.022], and age [≥75 years as the reference, 45-59 years: b=3.766, 95%CI (0.671, 6.860), P=0.017; 60-74 years: b=4.081, 95%CI(0.849, 7.314), P=0.014]. The method of obtaining follow-up services was mainly based on outpatient follow-up (85.5%), telephone follow-up (50.5%), and established a follow-up service center (40.5%) for discharged patients. The executives were multidisciplinary teams (60.5%) and hospital-community integration teams (48.2%). There were 19.1% of discharged patients who were willing to pay for relevant follow-up services.ConclusionsPatients with postoperative cervical spondylosis have strong demand for post-discharge follow-up services, which are affected by many factors. Medical staff should pay attention to this and develop a personalized follow-up service plan according to patient characteristics to meet different discharged patients and improve the quality of medical services.
ObjectiveTo analyze research status of influencing factors related to sun-protection problems in children and adolescents, and systematically review the influencing factors.
MethodsWe electronically searched the following databases including The Cochrane Library, PubMed, Web of Knowledge, Ovid, EBSCO, EMbase, CBM, CNKI, VIP and WanFang Data to collect cross-sectional studies on sun-protection problems in children and adolescents up to December 2012. The criteria for cross-sectional studies recommended by AHQR was applied in the assessment of included studies. Then, qualitative analysis methods were used to systematically summarize information and results of the included studies.
ResultsA total of 10 studies were included. The results showed that, the influencing factors of sun-protection behaviour in children and adolescents included gender, age, skin colour, eye colour, the mass media information, school health education, etc., of which, researches on gender, grade, light skin, eye colour were relatively more.
ConclusionAt present, there are many studies about influencing factors related to sun-protection problems in children and adolescents while the target influencing factors differ in regions.
ObjectivesTo establish statistical analysis and result reporting model for evaluation of the applicability of the clinical guidelines. We conducted an empirical study for clinical guidelines for the prevention and treatment of type 2 diabetes in China.MethodsA cross-sectional survey was conducted to select 6 to 8 doctors in geriatric, endocrinology, nephrology or related departments from medical institutions. The questionnaire was filled by doctors at a conference and electronic questionnaires were sent to those who did not attend the conference. Descriptive analysis was carried out for characteristics of evaluators, scores of each dimension, access to guidelines and factors affecting implementation. The Kruskal-Wallis rank-sum test and Nemenyi test were used for multi-group comparison and pairwise comparison. Multiple linear regressions with the stepwise strategy were used to screen out the association factors.ResultsA total of 725 questionnaires were collected in this survey. There were 722 valid questionnaires with an active recovery rate of 99.6%. The results showed the accessibility score was lowest and the acceptability score was highest. The results of multi-group comparison and multiple linear regression analysis showed that familiarity with the guidelines was the influencing factor of each score (P<0.05). The guidelines were primarily obtained from academic conferences (52.1%), WeChat (45.4%), and biomedical literature databases (43.5%). Among the evaluators, 44 (41.9%) believed that there were implementation obstacles in the guidelines, among which 136 (18.8%), 134 (18.5%) and 133 (18.4%) believed that implementation obstacles were medical personnel factor, patient factor and environmental factor.ConclusionsIn this study, a data analysis and result report model for the assessment of the applicability of the guidelines is established to provide evidence for the development/revision of the guidelines.
ObjectiveTo explore the level of hope of patients with tumor recurrence and its affecting factors.
MethodsPatients with tumor recurrence admitted in West China Hospital from March 2014 to March 2015 were included in this study. Questionnaire survey was conducted to collect the general information of the patients and the information on their coping style, level of hope and social support. The structural equation model was used to analyze the factors that affect the level of hope in patients with tumor recurrence.
ResultsA total of 431 patients were included. The average score of hope in patients with tumor recurrence was 32.88±5.83. Among these patients, 27 (6.26%) had low level of hope, 277 (64.27%) had medium level of hope and 127 (29.47%) had high level of hope. The result of univariate analysis showed that, the level of hope in different genders, marital status, education levels, income levels and types of tumors had significant differences (all P values＜0.05). The result of structural equation model showed that gender (r=-0.322, P<0.001), marital status (r=-0.243, P<0.001), education level (r=-0.219, P<0.001), income (r=0.116, P=0.021) and coping style (r=0.182, P=0.029) had direct effect on the level of hope in patients with tumor recurrence. Social support (r=0.255, P=0.027) and income (r=0.224, P=0.019) could indirectly affect patients’ coping style and therefore the level of hope.
ConclusionMost patients with tumor recurrence have medium to high level of hope. Gender, marital status, education level, income and coping style have influence on the level of hope. More attention should be given to patients with low level of hope, and measures should be taken to improve the level of hope basing on the individual situations of patients with tumor recurrence.
ObjectiveTo systematically review the indoor influencing factors of asthma in Chinese children. MethodsThe CNKI, WanFang Data, VIP, PubMed, Cochrane Library, and ScienceDirect databases were electronically searched to collect cross-sectional studies on the indoor influencing factors of asthma in Chinese children from inception to November 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies; then, meta-analysis was performed using Stata 16.0 software. ResultsA total of 29 cross-sectional studies were included, and 11 influencing factors were analyzed by meta-analysis. The results of the meta-analysis showed that redecoration (OR=1.57, 95%CI 1.37 to 1.79, P<0.01), environmental tobacco smoke (OR=1.59, 95%CI 1.34 to 1.88, P<0.01), cooking oil fume (OR=1.98, 95%CI 1.20 to 3.25, P<0.01), mold and water damage (OR=1.49, 95%CI 1.09 to 2.02, P<0.01), mold (OR=2.01, 95%CI 1.40 to 2.90, P<0.01), water damage (OR=1.72, 95%CI 1.44 to 2.06, P<0.01), moldy odor (OR=1.38, 95%CI 1.22 to 1.56, P<0.01), indoor humidity (OR=1.50, 95%CI 1.18 to 1.91, P<0.01), furry pets (OR=1.55, 95%CI 1.39 to 1.72, P<0.01) and cockroach (OR=1.63, 95%CI 1.24 to 2.14, P<0.01) were risk factors for asthma in Chinese children, while burning incense had no association with the occurrence of asthma in children. ConclusionCurrent evidence indicates that redecoration, environmental tobacco smoke, cooking oil fume, mold and water damage, mold, water damage, moldy odor, indoor humidity, furry pets, and cockroaches are influencing factors of asthma in Chinese children. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectivesTo investigate the knowledge, attitude and practice (KAP) of hepatitis E among Anlu residents and to identify the influencing factors.MethodsA stratified random sampling method was used and 1 840 Anlu residents were recruited between March 2019 and September 2019. Chi-square test and multivariate logistic regression model were used to analyze the influencing factors by SPSS 22.0 software.ResultsThe overall awareness rate of residents was 36.32%. There were statistically significant differences in age, occupation category and education (P<0.05). Qualification rate of awareness increased with age until age 40, but not with age after 40. Individuals occupationally exposed to swines (swine breeders, sales staff, slaughterers) had the lowest rates. Education level was positively associated with the qualification rate of awareness. The overall positive attitude rate was 53.89%. The overall healthy behavior rate was 82.95%.ConclusionsThe overall knowledge and awareness of hepatitis E among Anlu residents is low, especially individuals who have been occupationally exposed to swines. Health education and promotion programs are necessary.
Objective To systematically review the influencing factors of mild cognitive impairment in type 2 diabetic patients. MethodsPubMed, Web of Science, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP, and CBM databases were electronically searched to collect studies on the influencing factors of mild cognitive impairment in patients with type 2 diabetes from inception to December 31, 2021. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of included studies; then, meta-analysis was performed by using RevMan 5.4 software and Stata 12.0 software. ResultsA total of 32 studies involving 7 519 subjects were included. The results of the meta-analysis showed that the main influencing factors of mild cognitive impairment in type 2 diabetic patients were age, duration of type 2 diabetes, educational level, cerebral infarction, hypertension, smoking, insulin resistance index, glycosylated hemoglobin, and homocysteine. ConclusionCurrent evidence shows that some factors such as age, duration, and educational level are the main influencing factors of mild cognitive impairment in type 2 diabetic patients. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusions.
