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 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 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)
ObjectiveTo explore the risk factors for lymph node metastasis in patients with T2 stage non-small cell lung cancer.MethodsThe clinical data of 271 patients with non-small cell lung cancer who underwent surgical treatment in our hospital from 2014 to 2017 were collected, including 179 males and 92 females, with an average age of 62.73±0.58 years. The patients were divided into N0, N1, and N2 groups according to the lymph node metastasis status. The clinical data of the patients in different groups were compared.ResultsThe body mass index (BMI, P=0.043), preoperative lymph node enlargement (P<0.001), and tumor diameter (P<0.001) were significantly different among groups. The BMI (OR=1.131, 95%CI 1.001-1.277, P=0.048) and preoperative lymph node enlargement (OR=3.498, 95%CI 1.666-7.342, P=0.001) were independent risk factors for N2 lymph node metastasis, and tumor diameter was an independent risk factor for both N1 (OR=1.538, 95%CI 1.067-2.218, P=0.021) and N2 (OR=1.814, 95%CI 1.196-2.752, P=0.005) lymph node metastasis.ConclusionPatients with high BMI or enlarged lymph nodes before surgery have a high risk for N2 lymph node metastasis, and those with large tumor diameter have a high risk for both N1 and N2 lymph node metastasis.
Ａ ｒｅｖｉｅｗ ｏｆ ｐａｔｉｅｎｔｓ ｗｉｔｈ ａｃｕｔｅ ｐａｎｃｒｅａｔｉｔｉｓ ｔｒｅａｔｅｄ ｉｎ ｔｈｉｓ ｈｏｓｐｉｔａｌ ｉｎ ｒｅｃｅｎｔ １０ ｙｅａｒｓ ｗａｓ ｍａｄｅ．Ｔｏ ｄｅｔｅｒｍｉｎｅ ｔｈｅ ｒｉｓｋ ｆａｃｔｏｒｓ ｏｆ ｓｅｐｔｉｃ ｎｅｃｒｏｓｉｓ ｉｎ ａｎｄ ａｒｏｕｎｄ ｔｈｅ ｐａｎｃｒｅａｓ，３２ ｃａｓｅｓ ｗｉｔｈ ｓｅｐｔｉｃ ｎｅｃｒｏｓｉｓ ｗｈｉｃｈ ｗｅｒｅ ｐｒｏｖｅｄ ｉｎ ｓｕｒｇｉｃａｌ ｏｐｅｒａｔｉｏｎ ａｎｄ ４４ ｃａｓｅｓ ｗｉｔｈｏｕｔ ｓｅｐｔｉｃ ｎｅｃｒｏｓｉｓ（ａｓ ｃｏｎｔｒｏｌ）ｗｅｒｅ ｉｎｃｌｕｄｅｄ ｉｎ ｔｈｉｓ ｓｔｕｄｙ．Ｔｈｅ ｐｏｓｓｉｂｌｅ ｆａｃｔｏｒｓ ｗｅｒｅ ｃｏｍｐａｒａｔｉｖｅｌｙ ａｎａｌｙｓｅｄ．Ｔｈｅ ｒｅｓｕｌｔｓ ｓｈｏｗｅｄ ｔｈａｔ ｓｅｐｔｉｃ ｎｅｃｒｏｓｉｓ ｉｎ ａｎｄ ａｒｏｕｎｄ ｔｈｅ ｐａｎｃｒｅａｓ ｏｂｖｉｏｕｓｌｙ ｒｅｌａｔｅｄ ｔｏ ｔｈｅ ｄｉａｇｎｏｓｔｉｃ ｏｒ ｔｈｅｒａｐｅｕｔｉｃ ｐｕｎｃｔｕｒｅｓ，ｅａｒｌｙ ｓｕｒｇｉｃａｌ ｄｒａｉｎａｇｅ ａｎｄ ｐａｒａｌｙｔｉｃ ｉｌｅｕｓ（ＯＲ ３０２－５４８，Ｐ＜００５)，ｂｕｔ ｔｈｅｒｅ ｗｅｒｅ ｎｏ ａｓｓｏｃｉａｔｉｏｎｓ ｗｉｔｈ ａｇｅ，ｅｔｉｏｌｏｇｙ，ｓｈｏｃｋ，ｒｅｓｐｉｒａｔｏｒｙ ｆａｉｌｕｒｅ ａｎｄ ｔｏｔａｌ ｐａｒｅｎｔｅｒａｌ ｎｕｔｒｉｔｉｏｎ（ＯＲ ０７８－１２６，Ｐ＞００５）．Ｔｈｅ ａｕｔｈｅｒｓ ｓｕｇｇｅｓｔ ｔｈａｔ ｅｉｔｈｅｒ ｐａｎｃｒｅａｔｉｃ，ｐｅｒｉｐａｎｃｒｅａｔｉｃ ｐｕｎｃｔｕｒｅ ｏｒ ｅａｒｌｙ ｓｕｒｇｉｃａｌ ｄｒａｉｎａｇｅ ｓｈｏｕｌｄ ｂｅ ｌｉｍｉｔｅｄ ａｎｄ ａｎｙ ｍｅｄｉｃａｔｉｏｎ ｗｈｉｃｈ ｍａｋｅｓ ｐａｒａｌｙｔｉｃ ｉｌｅｕｓ ｄｅｔｅｒｉｏｒａｔｅｄ ｓｕｃｈ ａｓ ａｔｒｏｐｉｎｅ ｓｈｏｕｌｄ ｂｅ ａｖｏｉｄｅｄ ｉｎ ｔｈｅ ｔｒｅａｔｍｅｎｔ ｏｆ ａｃｕｔｅ ｐａｎｃｒｅａｔｉｔｉｓ．
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.