ObjectiveTo explore risk factors associated with mortality and restenosis after the surgery for congenital pulmonary venous stenosis (CPVS) combined with congenital heart disease.MethodsFrom May 2007 to August 2019, 58 patients received surgical relief of CPVS combined with congenital heart disease, including 24 males and 34 females, aged 17.2±26.3 months, weighing 8.8±8.2 kg. Endpoints were death and restenosis, and the risk factors were analyzed. A univariate and multivariate risk analyses were performed.ResultsPreoperative pulmonary venous stenosis severity score (PVSSS) was 4.5±2.7. Average pulmonary vein counts with CPVS was 1.9±1.0. There were 2 (3.4%) early deaths. The mean follow-up time was 2-145 (49.8±40.0) months. The 1-, 2-, 3- and 5-year overall survival rates were 86.7%, 81.3%, 78.5% and 73.6%, respectively, and the pulmonary venous restenosis-free rates were 79.6%, 68.5%, 68.5% and 68.5%, respectively. Preterm birth was an independent risk factor for mortality. The pulmonary venous peak flow rate ≥1.2 m/s at discharge was an independent risk factor for mortality and restenosis.ConclusionThe prognosis of CPVS is still poor. Postoperative residual stenosis at discharge is an independent risk factor for death and restenosis.
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)
Objectives To evaluate the risk factors of nonarteritic a nterior ischemic optic neuropathy（NAION）in a population of China and to provide theory basis for clinical decision. Methods Demographic features and clinical data of NAION were recorded. Cerebral infarction (CI) patients were also collected as control group. Systemic evaluations including whole blood chemical test, brain MRI, carotid artery ultrasound and fundus photography were perfor med in NAION and CI patients. The fundus photography and cup/disk ratio were als o acquired in a healthy controlgroup with matched age and gender. Statistical a nalysis was done by SPSS11.5 software. Results Thirtyeight N AION patients and 40 CI patients with intact data were included. Fundus photography and cup/disk ratio were acquired in 41 healthy individuals. No statistically significant difference regard to incidences of diabetes, male gender and lipid metabolic abnormalities was found between NAION and CI patients (Pgt;0.05). H ypertension, clinical and subclinical cerebral vascular disease and carotid ar tery stenosis were statistically more commonin CI patients than in NAION patien ts (Plt;0.01, 0.05). Cup/disk ratio was statistically significant smaller in NAION than in CI patients while no statistical difference (Pgt;0.05) was fo und between the CI group and healthy individuals. Conclusions NAION shared similar risk factors with cerebral infarction, but exposure of these risk factors was different between NAION and cerebral infarction. Hypertension , cerebral vascular disease and carotid artery stenosis were more common in cere bral infarction while diabetes, male gender and lipid metabolic abnormalities were similar. Small cup/disk ratio was an independent and the most important risk factor for NAION. (Chin J Ocul Fundus Dis,2008,24:86-89)
Purpose Researching the relared risk factors of diabetic retinopathy (DR) through the epidemiological investigation. Methods Basing on a population random sampling survey and screening in 6 areas and cities of Anhui,216 diabetics were screened and they were then investigated in detail by filling in forms,measuring blood pressure,ocular examination including ophthalmoscopy,and lab examination including fasting blood glucose (FBG),blood glucose 2 hours after meal,urine albumin excretion (UAE),serum triglyceride,and cholesterol. Results The resultant date revealed that the duration of diabetes,blood pressure FBG and UAE were associated significantly with DR (Plt;0.05),and serum triglyceride and cholesterol were associated not significantly with DR(Pgt;0.05). Conclusion Long duration of diabetes,hight FBG and hight blood pressure are the important risk factors of DR,and urine albumin might forebode the occurrence of DR. (中华眼底病杂志,1998,14:119-121)
Epilepsy is one of the most common neurological diseases in children, about 2/3 can be seizure-free after anti-seizure medications (ASMs) treatment, but there are still some drug-resistant epilepsy (DRE) need surgical treatment, epilepsy surgery including excision surgery, dissociation surgery and palliative surgery, surgery can make 30%~40% DRE fully controlled. Clinicians usually choose to discontinue ASMs after seizure-free for 1 to 2 years after epilepsy surgery, but there has been controversy about whether to discontinue ASMs after surgery in children with epilepsy, how long to discontinue ASMs, the timing of ASMs withdrawal, and there is still a lack of unified guidelines. This article will comprehensively analyze and summarize the risk of recurrence after ASMs withdrawal in children with epilepsy.
ObjectiveTo explore the relation between preoperative serum gamma-glutamyl transpeptidase to platelet ratio (GPR) and overall survival (OS) of patients with hepatitis B virus-associated hepatocellular carcinoma (Abbreviated as “patients with HCC”), and to establish a nomogram for predicting OS. MethodsAccording to the inclusion and exclusion criteria, the clinicopathologic data of patients with HCC who underwent radical resection in the Department of Hepatobiliary Surgery of Xianyang Central Hospital, from January 15, 2012 to December 15, 2018, were retrospectively analyzed. The optimal critical value of GPR was determined by receiver operating characteristic curve, then the patients were divided into a low GPR group (GPR was optimal critical value or less ) and high GPR group (GPR was more optimal critical value). The Kaplan-Meier method was used to draw the survival curve and analyze the OS of patients. The univariate and multivariate Cox proportional hazards regression model were used to analyze the factors influencing prognosis in the patients with HCC. According to the risk factors of OS for patients with HCC, a nomogram was established. The consistency index and calibration curve in predicting the 3-year and 5-year accumulative OS rates of patients with HCC were evaluated. ResultsA total of 213 patients were gathered. The optimal critical value of GPR was 0.906. There were 114 patients in the low GPR group and 99 patients in the high GPR group. The Kaplan-Meier survival curve analysis showed that the 1-, 3- and 5-year accumulative OS rates were 99.1%, 81.8%, 60.6% in the low GPR group, respectively, which were 74.2%, 49.1%, 35.7% in the low GPR group, respectively. The OS curve of the low GPR group was better than that of the high GPR group (χ2=25.893, P<0.001). The multivariate analysis results showed that the microvascular invasion, incomplete capsule, intraoperative bleeding ＞1 000 mL, postoperative complications, GPR >0.906, low tumor differentiation, and late TNM stage did not contribute to accumulative OS in the patients with HCC (P<0.05). The consistency index (95%CI) of the nomogram in predicting accumulative OS rates at 3- and 5-year for patients with HCC were 0.761 (0.739, 0.783) and 0.735 (0.702, 0.838), respectively. The calibration curves of 3- and 5-year accumulative OS rates of the nomogram were in good agreement with the actual results. ConclusionsPreoperative GPR is associated with OS, and patients with higher GPR have worse prognosis. The nomogram based on GPR has a good accuracy and differentiation.
ObjectiveTo investigate the risk factors for lymph node metastasis (LNM) and prognosis of T1-stage esophageal squamous carcinoma (ESC).MethodsClinical data of 387 patients with T1-stage ESC who underwent surgical treatment in our hospital from March 2013 to March 2018 were collected. There were 281 males and 106 females aged 60 (41-80) years. The patients were divided into a lymph node metastasis group (n=77) and a non-metastasis group (n=310). The risk factors for LNM and prognosis were analyzed.ResultsAmong 387 patients with T1-stage ESC, 77 (19.9%) patients had LNM. The incidence of LNM was 8.4% (8/95) in T1a-stage patients and 23.6% (69/292) in T1b-stage patients. Univariate analysis showed that tumor size, differentiation degree, depth of invasion and vascular tumor thrombus were associated with LNM (P<0.05). Multivariate logistic regression analysis showed that invasion depth of tumor [OR=2.456, 95%CI (1.104, 5.463), P<0.05] and vascular tumor thrombus [OR=15.766, 95%CI (4.880, 50.938), P<0.05] were independent risk factors for LNM. The follow-up time was 41 (12, 66) months. The 1-year, 3-year and 5-year survival rates were 98.71%, 89.67% and 86.82%, respectively. Univariate analysis showed statistically significant differences in tumor invasion depth, vascular tumor thrombus and LNM between the survival group and the death group. Cox analysis showed that LNM [OR=3.794, 95%CI (2.109, 6.824), P<0.05] was an independent risk factor for prognosis.ConclusionT1-stage ESC patients with deeper invasion or vascular tumor thrombus have a higher risk of LNM. The prognosis of T1-stage ESC with LNM is relatively poor.
Objective To broaden the current understanding of the usage willingness about artificial intelligence (AI) robots and relevant influence factors for elderly patients. Methods The elderly patients in the inpatient ward, outpatient department and physical examination of the Department of Geriatrics, West China Hospital of Sichuan University were selected by convenient sampling for investigation between February and April 2020, to explore the willingness of elderly patients to use AI robots and related influencing factors. Results A total of 446 elderly patients were included. There were 244 males and 202 females. The willingness to use AI robots was (14.40±3.62) points. There were statistically significant differences among the elderly patients with different ages, marital status, living conditions, educational level, current health status, current vision status, current hearing status, self-care ability and family support in their willingness to use AI robots (P<0.05). Multiple linear regression analysis showed that age, education level and family support were the influencing factors of use intention (P<0.05). Among the elderly patients, 60.76% had heard of AI robots, but only 28.03% knew the medical application of AI robots, and only 13.90% had used AI robot services. Most elderly patients (>60%) thought that some adverse factors may reduce their usage willingness, like “the price is too expensive” and “the use is complex, or I don’t know how to use”. Conclusions Elderly patients’ cognition of AI robots is still at a low level, and their willingness to use AI robots is mainly affected by age, education level and family support. It is suggested to consider the personalized needs of the elderly in terms of different ages, education levels and family support, and promote the cheap and user-friendly AI robots, so as to improve the use of AI robots by elderly patients.
ObjectiveTo investigate the clinical feature, prognosis and prognostic factors of early post-traumatic seizures in children. MethodsRetrospective review was performed on 101 individuals with early post-traumatic seizures (EPTS) who were diagnosed in Department of Neurosurgery in Children's Hospital of Chongqing Medical University from January 2008 to June 2013. The record was collected, which included patient's demographics, clinical and radiological presentation, management, and follow-up results of 12 months. The individuals were divided into late post-traumatic seizures (LPTS) group and control group according to the occurrence of LPTS or not. The SAS 9.2 was used for statistical analysis. ResultsDuring 101 cases in our study, male accounted for 60.4%, female accounted for 39.6%, and the ratio was 1.5 to 1. The percentage of patients who were under 6 years old was 74.3%, and the number of cases decreased with age. The peak time of EPTS was within 24 hours after traumatic brain injury. 55.4% of EPTS was the generalized seizures, 34.7% was the partial seizures, and 9.9% was the partial seizures and evolved to secondarily generalized seizures. The incidence of LPTS observed in our study was 26.7% within 12 months follow-up. The electroencephalogram displayed epileptiform discharges in 3 individuals who were without epileptic seizures. There was statistically significant difference in group LPTS compared to control group on these factors which included GSC score≤8(P=0.0064), complicated necrencephalus and/or encephalatrophy(P < 0.0001), multiple brain injuries(P=0.0210), subdural hemorrhage(P=0.0151) and intracranial operation(P=0.0029). The age, history, epileptic seizure type of EPTS, brain contusion, skull fracture and the early use of antiepileptic drugs (AEDs) had no statistically significant difference between LPTS group and control group(P > 0.05). ConclusionsEPTS is prone to occur in children under 6 years old. Male is obviously more than female, and the ratio is 1.5:1. The peak time of EPTS is within 24 hours after traumatic brain injury and most of EPTS are generalized seizures. The incidence of LPTS in children with EPTS exceeds those previously reported. Periodical electroencephalogram examination is essential to decrease the missed diagnosis of LPTS. The GSC score≤8 and complicated necrencephalus and/or encephalatrophy will dramaticlly increase the risk of LPTS. Multiple brain injuries, subdural hemorrhage and intracranial operation are also risk factors for the prognosis of EPTS. Although the use of AEDs is unable to decrease the incidence of LPTS after 12 months follow-up, it is probably beneficial to improving the cognition and brain development. The controversial finding in our study is whether intracranial operation can influence the prognosis of EPTS or not.
Objective To analyze the risk factors of hypertension combined with cerebral hemorrhage. Methods From May 2015 to October 2016, 92 hypertension patients with cerebral hemorrhage (group A) were enrolled; simultaneously, 110 hypertension patients without cerebral hemorrhage (group B) were included. We analyzed retrospectively the clinical data of two groups and the risk factors of hypertension complicated with cerebral hemorrhage. Results The results of univariate analysis showed that the ratios of patients in group A with the following indexes, >65 years old, body mass index >30 kg/m2, >7-year smoking history, triglyceride level >1.7 mmol/L, cholesterol level >5.72 mmol/L, high density lipoprotein level >0.9 mmol/L, and bad medication compiance, were much more higher than those in group B (P<0.05). The rusults of multivariate analysis showed that smoking history, diabetes mellitus history, hypertension history, triglycerides level, cholesterol level, bad medication compliance were the risk factors of hypertension combined with cerebral hemorrhage (P<0.05). Conclusions The risk factors of hypertension combined with cerebral hemorrhage include smoking history, diabetes mellitus history, hypertension history, triglyceride level, cholesterol level, and medication compliance. We shoud pay more attention to these factors in clinical practice.