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.
ObjectiveConstructing a prediction model for seizures after stroke, and exploring the risk factors that lead to seizures after stroke. MethodsA retrospective analysis was conducted on 1 741 patients with stroke admitted to People's Hospital of Zhongjiang from July 2020 to September 2022 who met the inclusion and exclusion criteria. These patients were followed up for one year after the occurrence of stroke to observe whether they experienced seizures. Patient data such as gender, age, diagnosis, National Institute of Health Stroke Scale (NIHSS) score, Activity of daily living (ADL) score, laboratory tests, and imaging examination data were recorded. Taking the occurrence of seizures as the outcome, an analysis was conducted on the above data. The Least absolute shrinkage and selection operator (LASSO) regression analysis was used to screen predictive variables, and multivariate Logistic regression analysis was performed. Subsequently, the data were randomly divided into a training set and a validation set in a 7:3 ratio. Construct prediction model, calculate the C-index, draw nomogram, calibration plot, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) to evaluate the model's performance and clinical application value. ResultsThrough LASSO regression, nine non-zero coefficient predictive variables were identified: NIHSS score, homocysteine (Hcy), aspartate aminotransferase (AST), platelet count, hyperuricemia, hyponatremia, frontal lobe lesions, temporal lobe lesions, and pons lesions. Multivariate logistic regression analysis revealed that NIHSS score, Hcy, hyperuricemia, hyponatremia, and pons lesions were positively correlated with seizures after stroke, while AST and platelet count were negatively correlated with seizures after stroke. A nomogram for predicting seizures after stroke was established. The C-index of the training set and validation set were 0.854 [95%CI (0.841, 0.947)] and 0.838 [95%CI (0.800, 0.988)], respectively. The areas under the ROC curves were 0.842 [95%CI (0.777, 0.899)] and 0.829 [95%CI (0.694, 0.936)] respectively. Conclusion These nine variables can be used to predict seizures after stroke, and they provide new insights into its risk factors.
ObjectiveTo explore the prevalence and risk factors of hypertension in Anyue County from June 2011 to June 2013.
MethodsUsing stratfied random cluster sampling method, 5 391 people over 15 years of age were selected from 3 residential areas and 3 natural villages to finish a questionnaire and blood pressure measurement.
ResultsThe total prevalence rate of hypertension in Anyue County was 18.77%. The prevalence rates of hypertension in urban areas and rural areas were 21.75% and 16.20%, and the difference was significant (χ2=27.120, P<0.001). In both urban and rural areas, the prevalence rate of hypertension increased with age (χ2=475.634, P<0.001; χ2=394.026, P<0.001). The percentages of awareness, treatment and control in Anyue County were 31.30%, 24.41%, and 9.09%. The percentages of awareness, treatment and control in urban areas were 40.15%, 33.70%, and 11.23% and were 20.68%, 13.65%, and 6.61% in rural areas. There were significant differences in the percentages of awareness, treatment and control between urban and rural areas (χ2=44.475, P<0.001; χ2=54.861, P<0.001; χ2=8.202, P=0.004). The logistic regression analysis showed that age (OR=1.061, P<0.001), diabetes (OR=1.550, P<0.001), hyperlipemia (OR=2.372, P<0.001) and smoking (OR=1.335, P<0.001) were the risk factors for hypertension; and it showed that high level of education was a protective factor for hypertension (OR=0.755, P<0.001).
ConclusionBecause of high prevalence and low percentages of awareness, treatment and control in Anyue County, the prevention and control situation of hypertension are grim. We should focus on the control of smoking, blood lipid and blood glucose.
ObjectiveTo understand basic characteristics and clinical features of tuberculosis in Mianyang, Sichuan, and to investigate the risk factors of two case-finding methods for tuberculosis:"passive finding" and "active screening".
MethodsOne-hundred and seventy-five active tuberculosis patients screened by physical examination in 21 villages of Fucheng and Jiangyou from June 2013 to March 2014 were included. Information about basic characteristics and clinical features of tuberculosis was collected using questionnaire, chest X-ray and laboratory examinations. We also applied binary logistic regression to explore the risk factors of finding for tuberculosis.
ResultsIn all 175 tuberculosis patients, 41.71% were over 60 years old and 73.71% were farmers. Productive cough over two weeks was the most common symptom, accountting for 58.29%. 19.63% were sputum smear-positive while 70.87% were PPD-positive. Binary logistic regression analysis demonstrated that tuberculosis history significantly influenced the findings for tuberculosis (OR=15.809,95%CI: 6.708~37.258).
ConclusionsActive tuberculosis patients screened by physical examination in Mianyang, Sichuan were mainly elderly male over 60 years old and farmers, with single pulmonary symptom as the primary clinical feature. The patients with tuberculosis history may be found by "passive finding".
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.
Objective To compare the risk factors between multiple cerebral infarction (MCI) and single cerebral infarction (SCI). This would be beneficial for carrying out corresponding prevention and treatment. Methods We prospectively registered consecutive cases of ischemic stroke in the neurological wards and divided them into two groups: MCI group and SCI group according to their clinical and imaging data. Firstly, the single variable analyses of 24 factors that could be related to the onset of MCI were conducted, and then the multivariate non-condition stepwise logistic regression was performed. Results Significant differences were noted between MCI group and SCI group in terms of age, gender, hpertension, diabetes, heart valvular disease, smoking, cerebral infarction history and first systolic blood pressure after admission. The logistic regression analyses showed that factors of age (OR=1.014, 95%CI 1.003 to 1.026), hypertension (OR=1.566, 95%CI 1.185 to 2.068), smoking (OR=1.473, 95%CI 1.052 to 2.061), cerebral infarction history (OR=1.948, 95%CI 1.326 to 2.864) were independent risk factors for MCI. Conclusion Compared to SCI, age, hypertension, smoking and cerebral infarction history were independent risk factors for MCI patients.
ObjectiveIn order to improve the prevention and treatment of bronchial asthma, the prevalence and risk factors of asthma in Chengdu among residents over 14 years old were investigated.MethodsA cross-sectional survey was conducted in Chengdu. The inhabitants (age > 14 years) recruited in this household questionnaire survey were through multi-stage cluster random sampling. Univariate and multivariate logistic regression were used to analyze the risk factors of asthma.ResultsA total of 3 477 subjects were finally recruited in this study. Of them, 131 were asthmatic patients; and the prevalence rate was 3.8%. There were significant differences observed in the prevalence of asthma among people of different ages, residences, occupations and educational levels (χ2=191.084, P<0.05; χ2=9.114, P<0.05; χ2=114.268, P<0.05; χ2=62.123, P<0.05). Univariate regression analysis showed that the risk factors of asthma included five factors (measles, chickenpox, pneumonia, tracheobronchitis and intestinal parasitic diseases) related to childhood illness, and two factors (asthma and chronic bronchitis) related to the first-degree relatives (P<0.05). In addition, active smoking history was a risk factor for asthma in men (P<0.05). Multivariate logistic regression indicated that measles, pneumonia, tracheobronchitis, intestinal parasitic diseases in childhood and first-degree relatives suffering from asthma were independent risk factors for asthma.ConclusionsThis study describes the epidemiological characteristics of asthma in Chengdu among adolescents (age>14 years) and adults. The history of measles, pneumonia, tracheobronchitis, and intestinal parasitic diseases in childhood, and first-degree relatives suffering from asthma are the independent risk factors for asthma. In addition, active smoking history is a risk factor for asthma in men.
ObjectiveTo investigate the prevalence and risk factors for chronic obstructive pulmonary disease (COPD) in Dayi County of Chengdu.
MethodsRandomly cluster sampled residents between 40 and 70 years of age from two natural villages in the rural communities from February to December, 2010 were included in our study. We used questionnaire survey, physical examination and portable spirometry to collect data. Post-bronchodilator forced expiratory volume in 1 second/forced vital capacity of less than 70% was defined as the diagnostic criterion of COPD. Univariate analysis and logistic regression mode were used to define the risk factors.
ResultsA total of 1 017 residents were enrolled in this survey, and 782 participants were valid for analysis, with a valid response rate of 76.89%. There were 330 males and 452 females, with an average age of (51.97±8.17) years old. The overall prevalence of COPD was 10.61%. After population standardization, the prevalence rate was 12.37%, and the overall prevalence increased with increment of age. The prevalence in male (13.33%) was higher than that in female (8.62%) with significant difference (P<0.01) and the prevalence increased with age. Univariate analysis showed that sex, age, education level, smoking and amount of smoking (pack-years) were the risk factors for COPD with significant difference. Logistic regression analysis showed that age, amount of smoking (pack-years) were the main risk factors for COPD.
ConclusionCOPD is highly prevalent in Dayi County of Chengdu and it is important to prevent COPD by controlling smoking and improving education level.
ObjectiveTo explore the risk factors of diabetic retinopathy.
MethodsWe retrospectively analyzed the clinical data of 137 patients with diabetes mellitus (DM) from July 2012 to July 2015. According to the situation of retinopathy, the patients were divided into three groups. Forty-three patients without retinopathy were regarded as the control group, 46 non-proliferative retinopathy patients as the observation group, and 48 patients with proliferative retinopathy as the trial group. DM blood pressure, blood glucose, glycosylated hemoglobin, blood lipid, albumin creatinine ratio and other indicators were collected and analyzed, and multiple-factor non-conditional logistic regression analysis was carried out.
ResultsGlycosylated hemoglobin, total cholesterol, triglyceride, low density lipoproteincholesterol, high density lipoprotein cholesterol, body mass index, postprandial 2-hour blood glucose and fasting blood glucose were not significantly different among the three groups (P ＞ 0.05) , but the duration of diabetes, vascular endothelial growth factor and urinary albumin creatinine ratio were significantly different (P ＜ 0.05) . The diabetic duration, glycosylated hemoglobin, systolic blood pressure, urinary albumin creatinine ratio and vascular endothelial growth factor were independently associated with diabetic retinopathy (P ＜ 0.05) .
ConclusionThe prolonged disease course of diabetic patients, unstable status of blood glucose and blood pressure, and the increase of blood vessel growth factor and vascular endothelial growth factor can cause the development of diabetic retinopathy.
Objective To investigate nosocomial non-fermented bacterial infection in lower respiratory tract and the risk factors for multi-drug resistant bacterial infection. Methods 229 patients with nosocomial nonfermented bacterial infection in lower respiratory tract from January to December in 2007 in Xiangya Hospital were analyzed retrospectively. The distribution and drug sensitivity of pathogens were recorded. Of those 229 patients,183 cases were infected by non-fermented multi-drug resistant bacteria( MDRB) . The risk factors for non-fermented MDRB infection in lower respiratory tract were analyzed by multi-factor logistic multiple regression analysis.Results The top four non-fermented bacteria isolated were Pseudomonas aeruginosa( 47.6%) , Acinetobacter baumannii( 36. 3% ) , Acinetobacter spp( 8. 6% ) , and Stenotrophomonas maltophilia( 5. 1%) . Higher isolatated rate was found in neurosurgery ( 25. 7% ) and central ICU( 22. 9% ) . The isolated non-fermented bacteria except Stenotrophomonas maltophilia were resistant to all antibiotics except cefoperazone-sulbactam and meropenem. ICU stay( P lt; 0. 001) , tracheotomy or tracheal intubation( P = 0. 001) , and previous use of carbapenemantibiotics( P =0. 032) were independent risk factors for non-fermented MDRB infection. Conclusion Non-fermented bacillus were important pathogens of nosocomial infection in lower respiratory tract with high rates of antibiotic resistance. It is important to prevent non-fermented MDRB infection by strict limitation on the indication of ICU stay,tracheotomy and use of carbapenem.
