Objectives
To analyze the risk factors for cardiovascular disease (CVD) in patients with chronic obstructive pulmonary disease (COPD) of different severities.
Methods
The study included 50 patients with mild-to-moderate COPD and 50 with severe-to-very severe COPD admitted between January 2014 and January 2016. Comorbidities were recorded on the basis of data obtained from medical charts and clinical evaluations. The Charlson comorbidity index was calculated, and the Hospital Anxiety and Depression Scale (HADS) score was determined in each subject.
Results
There were more prevalences of smoking, depression and dyslipidemia in the patients with mild-to-moderate COPD than those with severe-to-very severe COPD (all P<0.001). The prevalences of high blood pressure, diabetes mellitus, alcoholism, and chronic heart failure were not different significantly between the two groups. The Charlson comorbidity index and HADS scores were not different between the two groups.
Conclusions
Comorbidities are fairly common in COPD regardless of its severity. Certain risk factors for CVD, as smoking, dyslipidemia, and depression, appear to be more prevalent in patients with mild-to-moderate COPD.
Purpose To analyze the clinical characteristicsand prognostic factors of Status epilepticus (SE) in children. Methods The clinical data of 33 children with SE treated in Jinan Central Hospital Affiliated of Shandong University from January 2014 to June 2021 were collected, and their clinical characteristics were analyzed. Then, according to Glasgow prognosis scale, the children were divided into good prognosis group (n=20) and poor prognosis group (n=13). The age of first attack, duration of attack, type of attack and SE classification, EEG, cranial imaging and etiology were used to analyze the influencing factors of SE prognosis. Results 75.7% were 0 ~ 6 years old in the age of first attack, and 29 cases of convulsive status epilepticus accounted for 87.9% in the classification of seizure types. There were significant differences in age of first attack, duration of attack, EEG, history of mental retardation and etiology between the two groups (P<0.05); Logistic regression analysis showed that the age of first attack, duration of attack, history of mental retardation and EEG were independent factors affecting the prognosis. Conclusion Low age, especially ≤ 6 years old, is the high incidence of SE in children at first attack. Most children are symptomatic and have obvious incentives. Convulsive SE is the main type of SE in children. The age of first onset, duration of epilepsy, history of mental retardation, and EEG can affect the prognosis of SE.
ObjectiveThe risk factors of relapse in 133 epileptic children after withdrawal were analyzed retrospectively and provide reference for clinical withdrawal.MethodsFrom January 2017 to March 2019, 133 children with withdrawal epilepsy were selected as the study object. According to whether there was recurrence during the follow-up period, the children with epilepsy were divided into recurrence group (42 cases) and non recurrence group (91 cases). The gender, age of onset, history of trauma, frequency of seizure before treatment, EEG before drug reduction, imaging, type of medication, family history, time of reaching control, course of disease before treatment, comorbidity, multiple attack types, withdrawal speed and EEG before treatment were observed and compared between the two groups. ResultsThere were significant differences in EEG (χ2 =7.621), medication type (χ2=8.760), time to control (χ2=6.618), course before treatment (χ2=6.435), multiple seizure types (χ2=5.443) and epilepsy comorbidity (χ2=42.795) between the two groups (P < 0.05). The results of Logistic multiple regression analysis showed that the recurrence of epileptic children after drug reduction / withdrawal was correlated with abnormal EEG before drug reduction [OR=9.268, 95%CI (2.255, 38.092)], combined drug treatment [OR=3.205, 95%CI (1.159, 8.866)] and course of disease > 1 year before treatment [OR=5.363, 95%CI (1.781, 16.150)] (P < 0.05).ConclusionsIn order to reduce the possibility of recurrence of epileptic children, the treatment time of epileptic children with abnormal EEG, combined medication and long course before treatment should be prolonged properly.
Objective The purpose of the current research was to analyze the relevant risk factors for short-term death in patients with chronic obstructive pulmonary disease (COPD) and heart failure (HF), and to build a predictive nomogram. Methods We conducted a retrospective analysis of clinical data from 1 323 COPD and HF comorbidity patients who were admitted to the Affiliated Hospital of Southwest Medical University from January 2018 to January 2022. Samples were divided into survival and death groups based on whether they died during the follow-up. General data and tested index of both groups were analyzed, and the discrepant index was analyzed by single factor and multiple factor Logistic regression analysis. R software was applied to create the nomogram by visualizing the results of the regression analysis. The accuracy of the results was verified by C index, calibration curve, and ROC curve. Results The results from the multiple factor Logistic regression analysis indicated that age (OR=1.085, 95%CI 1.048 to 1.125), duration of smoking (OR=1.247, 95%CI 1.114 to 1.400), duration of COPD (OR=1.078, 95%CI 1.042 to 1.116), comorbidity with respiratory failure (OR=5.564, 95%CI 3.372 to 9.329), level of NT-proBNP (OR=1.000, 95%CI 1.000 to 1.000), level of PCT (OR=1.153, 95%CI 1.083 to 1.237), and level of D-dimer (OR=1.205, 95%CI 1.099 to 1.336) were risk factors for short-term death of COPD and HF comorbidity patients. The level of ALB (OR=0.892, 95%CI 0.843 to 0.942) was a protective factor that was used to build the predictive nomogram with the C index of 0.874, the square under the working characteristics curve of the samples of 0.874, the specify of 82.5%, and the sensitivity of 75.0%. The calibration curve indicated good predictive ability of the model. Conclusion The nomogram diagram built by the current research indicated good predictability of short-term death in COPD and HF comorbidity patients.
Objective
To investigate the relationship among central retinal vein occlusion (CRVO), major systemic diseases, ocular local diseases and related risk factors in Chinese population.
Methods
Seventeen-six patients with CRVO diagnosed by fundus fluorescein angiography (FFA) without any medical treatment were in CRVO group. Another 76 patients without CRVO or any vascular diseases of ocular fundus were in the control group who were matched with the ones in CRVO group to a one-to-one partnership according to the age and gender. The 2 groups were subdivided into le;45 years old (25 patients, 32.9%) and gt;45 years old (51 patients, 67.1%) subgroups according to the age, and 2 ischemia and non-ischema subgroups according to the results of FFA, respectively. The blood lipid, blood pressure, and fasting blood glucose were measured. The systematic diseases, ocular local diseases and the related risk factors were statistically analyzed and compared.
Results
The incidence of hypertension and hyperlipemia in CRVO group were significantly higher than that in the control group (Plt;0.001,P=0.001). There was no significant difference of cardiovascular diseases, cerebrovascular diseases, open-angle glaucoma, and smoking and drinking between the two groups(Pgt;0.05). In le;45 years old subgroups, there was no significant difference of each examination target between CRVO and control group(Pgt;0.05). In ischemia subgroups, except for the hypertension and hyperlipemia, the incidence of diabetes mellitus was obviously higher in CRVO group than that in the control group (hyperlipidemia:P=0.031; diabetes mellitus:P=0.024; diabetes mellitus: Plt;0.001).
Conclusion
Hypertension and hyperlipidemia are the systematic factors in Chinese population with occurrence of CRVO. In addition, diabetes mellitus is associated with ischemic CRVO. Timely diagnosis and treatment of the systematic diseases is important to the prevention and treatment for CRVO.
(Chin J Ocul Fundus Dis, 2007, 23:159-162)
Objective To systematically review risk prediction models of in-hospital cardiac arrest in patients with cardiovascular disease, and to provide references for related clinical practice and scientific research for medical professionals in China. Methods Databases including CBM, CNKI, WanFang Data, PubMed, ScienceDirect, Web of Science, The Cochrane Library, Wiley Online Journals and Scopus were searched to collect studies on risk prediction models for in-hospital cardiac arrest in patients with cardiovascular disease from January 2010 to July 2022. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias of the included studies. Results A total of 5 studies (4 of which were retrospective studies) were included. Study populations encompassed mainly patients with acute coronary syndrome. Two models were modeled using decision trees. The area under the receiver operating characteristic curve or C statistic of the five models ranged from 0.720 to 0.896, and only one model was verified externally and for time. The most common risk factors and immediate onset factors of in-hospital cardiac arrest in patients with cardiovascular disease included in the prediction model were age, diabetes, Killip class, and cardiac troponin. There were many problems in analysis fields, such as insufficient sample size (n=4), improper handling of variables (n=4), no methodology for dealing with missing data (n=3), and incomplete evaluation of model performance (n=5). Conclusion The prediction efficiency of risk prediction models for in-hospital cardiac arrest in patients with cardiovascular disease was good; however, the model quality could be improved. Additionally, the methodology needs to be improved in terms of data sources, selection and measurement of predictors, handling of missing data, and model evaluations. External validation of existing models is required to better guide clinical practice.
Objective To systematically review the accuracy and consistency of large language models (LLM) in assessing risk of bias in analytical studies. Methods The cohort and case-control studies related to COVID-19 based on the team's published systematic review of clinical characteristics of COVID-19 were included. Two researchers independently screened the studies, extracted data, and assessed risk of bias of the included studies with the LLM-based BiasBee model (version Non-RCT) used for automated evaluation. Kappa statistics and score differences were used to analyze the agreement between LLM and human evaluations, with subgroup analysis for Chinese and English studies. Results A total of 210 studies were included. Meta-analysis showed that LLM scores were generally higher than those of human evaluators, particularly in representativeness of exposed cohorts (△=0.764) and selection of external controls (△=0.109). Kappa analysis indicated slight agreement in items such as exposure assessment (κ=0.059) and adequacy of follow-up (κ=0.093), while showing significant discrepancies in more subjective items, such as control selection (κ=?0.112) and non-response rate (κ=?0.115). Subgroup analysis revealed higher scoring consistency for LLM in English-language studies compared to that of Chinese-language studies. Conclusion LLM demonstrate potential in risk of bias assessment; however, notable differences remain in more subjective tasks. Future research should focus on optimizing prompt engineering and model fine-tuning to enhance LLM accuracy and consistency in complex tasks.
Objective To investigate the risk factors of perioperative red blood cells transfusion for coronary artery bypass grafting (CABG) surgery.
Method We retrospectively analyzed the clinical data of 534 patients underwent CABG in our hospital from January to March 2014 year. Those patients were divided into two groups:an on-pump coronary artery bypass grafting group (on-pump group) and an off-pump coronary artery bypass grafting group (off-pump group). There were 185 males and 54 females with a mean age of 59.1±9.4 years in the on-pump group. There were 233 males and 62 females with a mean age of 60.3±8.5 years in the off-pump group. Preoperative data, the relative parameters of extracorporeal circulation, the quantity of red blood cells transfusion of those two groups were compared. risk factors associated with red blood cells transfusion were evaluated by multivariate logistic regression analysis.
Results The risk factors of perioperative red blood cells transfusion were age (OR=1.04, 95% CI 1.02-1.07, P=0.001) , weight (OR=0.95, 95% CI 0.93-0.97, P<0.001) , smoking (OR=0.61, 95% CI 0.39-0.94, P=0.027) , preoperative level of HCT (OR=0.90, 95% CI 0.85-0.96, P=0.001) and cardiopulmonary bypass (CPB) (OR=4.90, 95% CI 3.11-7.71, P<0.001) . During CPB, the nadir hemoglobin (nHb) (OR=0.63, 95% CI 0.47-0.84, P=0.002) was the only independent risk factor of red blood cell transfusion.
Conclusions Age, weight, non-smoking, preoperative level of HCT, CPB are the risk factors for patients underwent CABG perioperatively and the lowest level of Hb in CPB is an independent risk factor of perioperative red blood cells transfusion.
ObjectiveTo investigate the correlation between lipid accumulation product (LAP) and risk of ischemic cardiovascular disease (ICVD).
MethodsThis cross-sectional study was performed among community residents from an urban community in Chengdu area between September 2011 and June 2012. Questionnaire survey was carried out. Each individual underwent biochemistry analysis and physical examination. In addition, brachial-ankle pulse wave velocity (BaPWV) and augmentation index (AI) were detected. Pearson correlation analysis was performed to explore the relationship between LAP and each cardiovascular risk factor. Liner regression model was used to analyze the relationship between LAP and ICVD.
ResultsA total of 780 individuals with complete data were included in the analysis. LAP was correlated with blood pressure, total cholesterol, high density lipoprotein cholesterol, fasting blood glucose, and BaPWV (P＜0.05). LAP was associated with the risk of ICVD (r=0.253, P＜0.001). After being adjusted with sex, age and other cardiovascular risk factors, LAP was also correlated with the risk of ICVD (r=0.050, P＜0.001).
ConclusionsHigh LAP is associated with elevated cardiovascular risks and subclinical vascular damage. In addition, LAP is correlated with ICVD risk, thus it may be used to predict the incidence of ICVD to some extent. However, as the correlation is weak, our study does not support the direct use of this indicator to predict ICVD. Large-sample studies based on different races and ages are needed.
Objective To learn the prevalence and risk factors of diabetic retinopathy (DR) of provincial civil servants (more than 40 years old) in Guangdong, China. Methods Total of 3844 Guangdong provincial civil servants over 40 years old were enrolled in this study. All participants diagnosed with diabetes underwent a complete ophthalmologic examination, including stereoscopic fundus photography and optical coherence tomography. Photographs were graded in a masked manner to assess the presence and severity of DR and diabetic macular edema (DME). Results Of 3844 civil servants, DM was confirmed in 155 patients, the prevalence was 4.03%. Of 155 DM patients, DR was in 11 patients, the DR prevalence was 7.10%. There were statistically differences on the fasting blood glucose (FBG), total cholesterol, low density lipoprotein and whether or not to use insulin between DR group and non DR group (t=3.158, 2.200, 2.050;chi;2=5.128; P＜0.05). High-FBG values, high blood lipids, INS applications had accelerated the occurrence and development of DR. The high FBG and the insulin using were the independent risk factors of DR. Conclusions DR prevalence is 7.10% in Guangdong provincial civil servants more than 40 years old. The high FBG and the insulin using are the independent risk factors of DR.
