ObjectiveTo explore the morbidity rate and risk factors of proliferative diabetic retinopathy (PDR) in type 2 diabetes.MethodsThe clinical data of patients, with PDR in 2739 consecutive cases of type 2 diabetes diagnosed in this hospital from 1994 to 2001 were analyed retospectively. The diagnosis of diabetic retinopathy (DR) was confirmed by ophthalmoscopy and fundus fluorescein angiography (FFA). Blood pressure, fasting and postprandial blood sugar, glycosylated haemoglobin（HbA1c）, total serum cholesterol, triglyceride, creatinine, and albumin excretion rate were measured.ResultsThe morbidity rate of type 2 DR was 27.8%（761/2739）, and the morbidity rate of PDR was 4.2%（114/2 739） occupying 15% of the patients with DR. The duration, fasting blood sugar, glycosylated haemoglobin, blood pressure and albumin excretion rate were much higher than those in the control（P＜0.01, glycosylated haemoglobin P＜0.05）. The independent risk factors of PDR were duration of the disease （r=0.15, P＜0.01） and albumin excretion rate （r=0.08, P＜0.05）. The risk factors of PDR were albumin excretion rate and fasting blood sugar (r=0.13, P＜0.05) in patients with longer duration(≥5 years). The morbidity rate of PDR was 2.3%, 5.9% and 12.4% in patients with duration less than 5 years, 5 to 10 years and over 10 years groups, respectively. The morbidity of PDR of the patients in normal albuminuria, microalbuminuria and overt albuminuria group was 2.1%、5.3% and 18.8% respectively.ConclusionsType 2 diabetes accompanied with PDR is relative to the duration of the diabetes, albumin excretion rate, fasting blood sugar, blood pressure, and glycosylated haemoglobin, in which the duration of the disease, albuminuria and fasting blood sugar are the risk factors of occurance of PDR. (Chin J Ocul Fundus Dis, 2003,19:338-340)
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.
ObjectiveTo explore the risk factors of nosocomial infection in children with acute lymphoblastic leukemia during induction remission chemotherapy.MethodsThe children with acute lymphoblastic leukemia who were admitted to the Department of Pediatrics, Huai’an First Hospital Affiliated to Nanjing Medical University between December 2012 and December 2018 were divided into the infection group (including the severe infection subgroup and the non-severe infection subgroup) and the non-infection group according to whether nosocomial infection occurred during induction and remission chemotherapy. The clinical data of patients were collected. Univariate analysis and multivariate logistic regression were used to analyze the risk factors of nosocomial infection during induction remission chemotherapy in children with acute lymphoblastic leukemia.ResultsA total of 96 patients were included. There were 67 cases in the infection group (26 in the severe infection subgroup and 41 in the non-severe infection subgroup) and 29 cases in the non-infection group. Univariate analysis showed that the granulocyte deficiency time and the prevalence of skin and mucosal damage in the infection group were significantly higher than those in the non-infection group, and the infection group had significantly lower laminar bed use and serum albumin level than the non-infection group did (P< 0.05). Multivariate logistic regression analysis showed that prolonged agranulocytosis [odds ratio (OR)=23.075, 95% confidence interval (CI) (3.682, 144.617), P=0.001], skin and mucosal lesions [OR=12.376, 95%CI (1.211, 126.507), P=0.034], hypoalbuminemia [OR=5.249, 95%CI (1.246, 22.113), P=0.024] were independent risk factors for nosocomial infection during induction and remission of childhood acute lymphoblastic leukemia, while laminar bed [OR=0.268, 95%CI (0.084, 0.854), P=0.026] was the protective factor.ConclusionsLong-term agranulocytosis, skin and mucosal lesions, and hypoalbuminemia are independent risk factors for nosocomial infection in children with acute lymphoblastic leukemia during induction remission chemotherapy. Laminar flow bed is its protective factor.
ObjectiveTo assess whether hyperlipoidemia affects the occurrence and progression of prostate cancer (PCA). MethodsA hospital based retrospective study was carried out in Zhangzhou Affiliated Hospital of Fujian Medical University using data from a total of 112 cases of PCA, which underwent radical prostatectomy due to suspected PCA and confirmed by prostate biopsy pathology. ResultsOf the 112 PCA patients, 64 (57.14%) were PCA with hyperlipoidemia (PCA-H). Compared with PCA patients, the patients of PCA-H patients had younger onset age (65.0±5.0 vs. 67.8±3.7, P=0.001), increased prostate volume (75.0±11.7 mL vs. 54.5±8.5 mL, P < 0.001), increased level of TPSA (61.4±23.3 ng/mL vs. 33.4±14.9 ng/mL, P < 0.001), and Gleason grade (6.9±1.8 vs. 5.0±1.9, P < 0.001), later clinical stage (P < 0.001), shorter survival time (49.8±12.7 months vs. 57.3±6.2 months, P < 0.001) and decreased 5 years of survival rate (51.6% vs. 77.1%, P=0.006). The level of cholesterol, triglyceride and high density lipoprotein was significantly associated with the rejuvenation of onset age, the enlargement of prostate volume, increasing of serum TPSA, the progression of TNM clinical stage, increasing of Gleason grade, shorten of survival time and dropping of 5 years of survival rate (P < 0.05). In multiplefactor regression analysis, only hyperlipoidemia (OR=3.204, P=0.022) and Gleason grade (OR=8.611, P < 0.001) were the independent risk factors of prognosis. ConclusionThe situation of PCA with hyperlipoidemia is frequently noted in clinics, and hyperlipoidemia may be one of the risk factors in the processes of PCA growth and progression.
Objective To explore the impact of hospital staff’s risk perception on their emergency responses, and provide reference for future responses to public health emergencies. Methods Based on participatory observation and in-depth interviews, the staff of the First Affiliated Hospital of Guangzhou Medical University who participated in the prevention and control of the coronavirus disease 2019 from April to September 2020 were selected. The information on risk perception and emergency responses of hospital staff was collected. Results A total of 61 hospital staff were included. The positions of hospital staff were involved including hospital leading group, hospital office, medical department, logistics support department and outpatient isolation area. The interview results showed that both individual and organizational factors of hospital staff would affect the risk perception of hospital staff, thus affecting the emergency responses of hospital staff, mainly reflected in the psychological and behavioral aspects. Among them, their psychological reactions were manifested as more confidence, sensitivity, and sense of responsibility and mission; The behavior aspects was mainly reflected in the initiation time, execution ability, and standardization level of emergency responses actions. Conclusion Therefore, relevant departments should pay attention to the risk perception of hospital staff, improve the risk perception and emergency responses of hospital staff by influencing the individual and organizational factors of hospital staff, so as to respond more effectively to future public health emergencies and reduce the adverse impact of public health emergencies on the work of hospital staff.
Objective To analyze the clinical risk factors of the occurrence of severe proliferative vitreoretinopathy (PVR) after scleral reattachment surgery. Methods A total of 4031 eyes of 4031 consecutive patients with reghmatogenous retinal detachment (RRD) and PVR (grade C1 or less), on whom the scleral buckling was performed, were retrospectively studied. Twenty-two clinical charac teristics of the patients (including the ocular tension, condition of lens and vitreous, characte ristics of retinal detachment, whether or not with choroidal detachment, et al) were recorded.In 4031 patients, 2660 were followed up for more than 3 months, and 72 (in PVR group) of the 2660 patients underwent the second surgery (vitre oretinal surgery) because of the occurrence of postoperative seve re PVR; in the other 2588 patients, 72 (72 eyes) with retinal reattachment for more than 3 months were selected randomly as the control. The data were analyzed in SPSS (10.0) software. Results Logistic regression analysis revealed that the significant risk factors for PVR were incomplete posterior vitreous detachment ( P＜0.001), intraocular pressure lt;7 mm Hg（1 mm Hg=0.133 kPa, P＜0.002）, and large retinal tear (gt;2 DD,P＜0.005). Conclusion Incomplete posterior vitreous detachment, intraocular pressure lt;7 mm Hg and large retinal tear of the patient with RRD may be the major risk factors for PVR. (Chin J Ocul Fundus Dis，2003，19：141-143)
Objective To analyze the risk factors for duration of mechanical ventilation in critically ill patients. Methods Ninety-six patients who received mechanical ventilation from January 2011 to December 2011 in intensive care unit were recruited in the study. The clinical data were collected retrospectively including the general condition, underlying diseases, vital signs before ventilation, laboratory examination, and APACHEⅡ score of the patients, etc. According to ventilation time, the patients were divided into a long-term group ( n = 41) and a short-term group ( n = 55) . Risk factors were screened by univariate analysis, then analyzed by logistic regression method.Results Univariate analysis revealed that the differences of temperature, respiratory index, PaCO2 , white blood cell count ( WBC) , plasma albumin ( ALB) , blood urea nitrogen ( BUN) , pulmonary artery wedge pressure ( PAWP) , APACHEⅡ, sex, lung infection in X-ray, abdominal distention, and complications between two groups were significant.With logistic multiple regression analysis, the lower level of ALB, higher level of PAWP, lung infection in X-ray, APACHE Ⅱ score, abdominal distention, and complications were independent predictors of long-term mechanical ventilation ( P lt;0. 05) . Conclusion Early improving the nutritional status and cardiac function, control infection effectively, keep stool patency, and avoid complications may shorten the duration of mechanical ventilation in critically ill patients.
This study introduced the construction of individualized risk assessment model based on Bayesian networks, comparing with traditional regression-based logistic models using practical examples. It evaluates the model's performance and demonstrates its implementation in the R software, serving as a valuable reference for researchers seeking to understand and utilize Bayesian network models.
【Abstract】ObjectiveTo determine the risk factors associated with development of pancreatic fistula after pancreatoduodenectomy (PD). Methods The clinical data of 123 consecutive patients who underwent PD from Dec. 1994 to Dec. 2003 were analysed retrospectively. Results The incidence of pancreatic fistula was 11.4% (14/123). Univariate analysis showed history of upper abdominal operation, texture of pancreas, postoperative serum hemoglobin level, type of pancreatojejunostomy and diameter of pancreatic duct were significantly associated with pancreatic fistula after PD. Multivariate analysis using Logistic regression identified four variables as independent factors associated with the occurrence of pancreatic fistula: history of upper abdominal operation, texture of pancreas, postoperative serum hemoglobin level and type of pancreatojejunostomy. Conclusion History of upper abdominal operation, soft texture of pancreas, postoperative serum hemoglobin level less than 90 g/L and routine invaginated pancreaticojejunostomy are main risk factors associated with development of pancreatic fistula after PD.
Objective To Analyze the high risk factors correlated to the perioperative complications of patients with lung cancer, aiming to study their predictive value on surgical safety and guide the perioperative treatment. Methods The clinical experience of 452 lung cancer patients undergone operation from June 2000 to May 2006 were retrospectively study. The risk factors which closely related to the occurrence of postoperative complications were analyze by multivariate statistical analysis with logistic regression. Results The operative mortality was 0.66%（3/452）, and the incidence rate of postoperative complications was 8.85%(40/452), including pulmonary infection, pulmonary atelectasis, arrhythmia, respiratory function failure, empyema, bronchopleural fistula, thoracic bleeding, etc. Multivariate statistical analysis with logistic regression demonstrated that the risk factors which closely related to the occurrence of postoperative complications were age over 70 year (OR=17.823), smoking index over 400 piece year(OR=5.666), concomitance with diseases of vital organs(OR=8.290), modus operandi of pneumonectomy(OR=7.991), forced expiratory volume in one second (FEV1.0%)≤60% (OR=0.922). Conclusion To evaluate above factors of lung cancer patients before operation, the probability of postoperative complications occurrence can be roughly forecasted. This can provide actively clinical guide to help the patients overcome the perioperation successfully and to increase the safety of surgery.