Study on the Grouping of Patients with Chronic Infectious Diseases Based on Data Mining

Objective: According to RFM model theory of customer relationship management, data mining technology was used to group the chronic infectious disease patients to explore the effect of customer segmentation on the management of patients with different characteristics. Methods: 170,246 outpatient data was extracted from the hospital management information system (HIS) during January 2016 to July 2016, 43,448 data was formed after the data cleaning. K-Means clustering algorithm was used to classify patients with chronic infectious diseases, and then C5.0 decision tree algorithm was used to predict the situation of patients with chronic infectious diseases. Results: Male patients accounted for 58.7%, patients living in Shanghai accounted for 85.6%. The average age of patients is 45.88 years old, the high incidence age is 25 to 65 years old. Patients was gathered into three categories: 1) Clusters 1—Important patients (4786 people, 11.72%, R = 2.89, F = 11.72, M = 84,302.95);2) Clustering 2—Major patients (23,103, 53.2%, R = 5.22, F = 3.45, M = 9146.39);3) Cluster 3—Potential patients (15,559 people, 35.8%, R = 19.77, F = 1.55, M = 1739.09). C5.0 decision tree algorithm was used to predict the treatment situation of patients with chronic infectious diseases, the final treatment time (weeks) is an important predictor, the accuracy rate is 99.94% verified by the confusion model. Conclusion: Medical institutions should strengthen the adherence education for patients with chronic infectious diseases, establish the chronic infectious diseases and customer relationship management database, take the initiative to help them improve treatment adherence. Chinese governments at all levels should speed up the construction of hospital information, establish the chronic infectious disease database, strengthen the blocking of mother-to-child transmission, to effectively curb chronic infectious diseases, reduce disease burden and mortality.

Infectious, atopic and inflammatory diseases, childhood adversities and familial aggregation are independently associated with the risk for mental disorders: Results from a large Swiss epidemiological study

AIM To examine the associations between mental disorders and infectious, atopic, inflammatory diseases while adjusting for other risk factors.METHODS We used data from PsyC oL aus, a large Swiss Population Cohort Study(n = 3720; age range 35-66). Lifetime diagnoses of mental disorders were grouped into the following categories: Neurodevelopmental, anxiety(early and late onset), mood and substance disorders. They were regressed on infectious, atopic and other inflammatory diseases adjusting for sex, educational level, familial aggregation, childhood adversities and traumatic experiences in childhood. A multivariate logistic regression was applied to each group of disorders. In a complementary analysis interactions with sex were introduced via nested effects. RESULTS Associations with infectious, atopic and other chronic inflammatory diseases were observable together with consistent effects of childhood adversities and familial aggregation, and less consistent effects of trauma in each group of mental disorders. Streptococcal infections were associated with neurodevelopmental disorders(men), and measles/mumps/rubella-infections with early and late anxiety disorders(women). Gastric inflammatory diseases took effect in mood disorders(both sexes) and in early disorders(men). Similarly, irritable bowel syndrome was prominent in a sex-specific way in mood disorders in women, and, moreover, was associated with early and late anxiety disorders. Atopic diseases were associated with late anxiety disorders. Acne(associations with mood disorders in men) and psoriasis(associations with early anxiety disorders in men and mood disorders in women) contributed sex-specific results. Urinary tract infections were associated with mood disorders and, in addition, in a sex-specific way with late anxiety disorders(men), and neurodevelopmental and early anxiety disorders(women).CONCLUSION Infectious, atopic and inflammatory diseases areimportant risk factors for all groups of mental disorders. The sexual dimorphism of the associations is pronounced.

Epstein-Barr virus:Silent companion or causative agent of chronic liver disease?

The Epstein-Barr virus(EBV)has an important and multifaceted role in liver pathology.As a member of the herpes virus family,EBV establishes a persistent infection in more than 90%of adults.Besides acute hepatitis during primary infection,many clinical syndromes of interest for the hepatologist are associated with EBV infection.The role of EBV in the evolution of chronic hepatitis from hepatotropic viruses is considered.Chronic EBVassociated hepatitis is suspected in immunocompetent adults with compatible serology,suggestive histology and detection of the viral genome in the liver and/or increase of specific circulating cytotoxic T-lymphocytes.EBV is the main cause of post-transplant lymphoproliferative disorders which occur in up to 30%of cases.EBV-driven lymphoproliferative diseases are also recognized in non-immunocompromised patients and liver is involved in up to a third of the cases.Directly implicated in the pathogenesis of different tumors,EBV has a disputable role in hepatocellular carcinoma carcinogenesis.Further research is required in order to establish or reject the role of EBV in human liver cancer.This paper attempts to discuss the range of EBV-associated chronic liver diseases in immunocompetent patients,from mild,self-limiting mononuclear hepatitis to liver cancer.

Chronic fatigue syndrome with history of severe infection combined altered blood oxidant status, and reduced potassium efflux and muscle excitability at exercise

It is documented that chronic fatigue syndrome (CFS) combines enhanced oxidative stress with altered muscle excitability. We hypothesized that these disorders may be accentuated when severe infection preceded the CFS symptoms. This case-control study compared 55 CFS patients to a matched control group of 40 healthy subjects. In twenty-five CFS patients, severe infection was reported within the three to seven?month period preceding the CFS symptoms. The others had practiced sport at high level. Plasma concentrations of potassium, a marker of lipid peroxidation (thiobarbituric acid reactive substances, TBARS), and an endogenous antioxidant (reduced ascorbic acid, RAA) were measured. Action potential (M-wave) was evoked in the vastus lateralis muscle to explore the muscle membrane excitability. All subjects performed a maximal incremental cycling exercise. Compared to control subjects, all CFS patients presented an elevated resting TBARS level and, during and after exercise, an altered M-wave configuration. History of infection was associated with marked significant increase in resting TBARS level, enhanced M-wave alterations, and also reduced exercise-induced potassium efflux. The magnitude of exercise-induced M-wave alterations was proportional to the baseline TBARS level. Severe infection preceding CFS seems to constitute a stressor inducing altered blood oxidant status and a reduced muscle excitability at work.

Associations of socioeconomic status with infectious diseases mediated by lifestyle, environmental pollution and chronic comorbidities: a comprehensive evaluation based on UK Biobank

Background Socioeconomic status(SES)inequity was recognized as a driver of some certain infectious diseases.However,few studies evaluated the association between SES and the burden of overall infections,and even fewer identified preventable mediators.This study aimed to assess the association between SES and overall infectious diseases burden,and the potential roles of factors including lifestyle,environmental pollution,chronic disease history.Methods We included 401,009 participants from the UK Biobank(UKB)and defined the infection status for each participant according to their diagnosis records.Latent class analysis(LCA)was used to define SES for each participant.We further defined healthy lifestyle score,environment pollution score(EPS)and four types of chronic comorbidities.We used multivariate logistic regression to test the associations between the four above covariates and infectious diseases.Then,we performed the mediation and interaction analysis to explain the relationships between SES and other variables on infectious diseases.Finally,we employed seven types of sensitivity analyses,including considering the Townsend deprivation index as an area level SES variable,repeating our main analysis for some individual or composite factors and in some subgroups,as well as in an external data from the US National Health and Nutrition Examination Survey,to verify the main results.Results In UKB,60,771(15.2%)participants were diagnosed with infectious diseases during follow-up.Lower SES[odds ratio(OR)=1.5570]were associated with higher risk of overall infections.Lifestyle score mediated 2.9%of effects from SES,which ranged from 2.9 to 4.0%in different infection subtypes,while cardiovascular disease(CVD)mediated a proportion of 6.2%with a range from 2.1 to 6.8%.In addition,SES showed significant negative interaction with lifestyle score(OR=0.8650)and a history of cancer(OR=0.9096),while a significant synergy interaction was observed between SES and EPS(OR=1.0024).In subgroup analysis,we found that males and African(AFR)with lower SES showed much higher infection risk.Results from sensitivity and validation analyses showed relative consistent with the main analysis.Conclusions Low SES is shown to be an important risk factor for infectious disease,part of which may be mediated by poor lifestyle and chronic comorbidities.Efforts to enhance health education and improve the quality of living environment may help reduce burden of infectious disease,especially for people with low SES.

Convergence of COVID-19 and recurrent stroke:In-hospital mortality risks explored

This editorial comments on the article by Desai et al,which investigates the impact of coronavirus disease 2019(COVID-19)on in-hospital mortality among patients with recurrent stroke using data from the 2020 National Inpatient Sample.The findings reveal significantly higher mortality rates in COVID-19-positive patients compared to non-COVID-19 patients,particularly among middle-aged individuals,males,and ethnic minorities.This editorial explores the underlying mechanisms contributing to these outcomes and discusses the clinical implications for targeted management strategies in high-risk groups.The results emphasize the need for comprehensive approaches to mitigate the heightened risks faced by recurrent stroke patients during the COVID-19 pandemic.

Intravenous Hydrogen Peroxide for Chronic Pain: An Alternative Etiology and Treatment Plan for the Long-Standing Painful States

Background: Anecdotal reports of improvement in chronic pain patients given oxidative therapy (OXT) in the form of Intravenous Hydrogen Peroxide (IVHP) led the author to try this therapy on intractable pain cases. Method: 54 intractable non-malignant pain cases selected at random (16 had spinal problems, 14 had Interstitial Cystitis, 8 had headaches and 16 with miscellaneous problems) each received an average of 9 weekly IVHP infusions of 250 ml 0.03% Hydrogen Peroxide. After 4 months of this therapy all patients were given a questionnaire to evaluate and study any improvements in their condition. The questions covered three areas: 1) Subjective improvements: pain, function, mental and emotional status, general health, and sexual health, 2) Analgesic medication usage: dosage and efficacy changes, 3) Satisfaction with the therapy and desire to continue. Results: 52%-70% mean 66% of the patients responded positively (more than slightly improved) to questions in the subjective areas, 85% of the patients were using less medication and/ or getting more effect from the analgesics they were taking, 96% of the patients wished to continue the therapy. These improvements were constant over the range of the four diagnostic groups. The improved patients all demonstrated some signs and lab results including fever, chills, abscess formation, purulent discharges, elevated WBCs and ESRs consistent with resolving systemic and/ or regional infections. Conclusions: IVPH can significantly improve patients in a majority of chronic painful conditions. Chronic Infection is associated with or absolutely the cause of Chronic Pain in the patients studied.

科技创新应对健康挑战

随着全球化、人口老龄化趋势的加剧和全球气候变化,人类面临的健康挑战日益复杂。全球化带来了全球性健康问题的出现,传染病的传播速度和范围明显增加,影响更加深远;气候变化不仅直接影响着人类健康,还通过改变生态系统和病媒生物分布等方式间接增加传染病暴发风险;与此同时,人口老龄化使得慢性非传染性疾病负担持续攀升,共病等复杂健康问题日益凸显,给医疗卫生健康系统和社会服务保障系统均带来了巨大挑战。而科技创新为应对这些挑战提供了前所未有的机遇,从精准医学到人工智能(AI),科技的进步正重塑健康管理范式。科技创新不仅是现代医学发展的引擎,更是应对未来健康问题的关键。未来应加强卫生健康体系建设、创新医防协同及医防融合机制、加强科技攻关与创新、AI赋能基层能力提升,以更好地应对健康挑战,增进人类福祉。

美罗培南联合莫西沙星治疗慢性阻塞性肺疾病合并感染性肺炎的临床疗效及安全性

目的探讨美罗培南联合莫西沙星治疗慢性阻塞性肺疾病(COPD)合并感染性肺炎的临床疗效及安全性。方法选取2020年1月至2021年12月内蒙古林业总医院收治的88例COPD合并感染性肺炎患者作为研究对象,按照随机数字表法分为观察组与对照组,每组44例。两组均接受COPD基础治疗,对照组静脉滴注莫西沙星治疗,观察组在对照组基础上给予美罗培南治疗,比较两组临床疗效、症状及体征改善时间、肺功能指标[最大呼气中期流速(MMEF)、第1秒用力呼气容积占预计值百分比(FEV_(1)%)、最大自主通气量占预计值百分比(MVV%)]、炎症因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及降钙素原(PCT)]及不良反应发生情况。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。观察组肺湿啰音、咳嗽、呼吸困难、体温及白细胞改善时间均短于对照组,差异有统计学意义(P<0.05)。治疗后,两组MMEF均快于治疗前,FEV_(1)%、MVV%均高于治疗前,且观察组MMEF快于对照组,FEV_(1)%、MVV%均高于对照组,差异有统计学意义(P<0.05)。治疗后,两组hs-CRP、TNF-α、IL-6及PCT水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论美罗培南联合莫西沙星治疗COPD合并感染性肺炎效果显著,可减轻肺部炎症损伤,加快症状及体征消失,增强肺功能,安全性高,值得临床推广应用。

HPV感染的慢病管理

目前HPV的感染在全球人群中普遍存在,并且HPV感染人体后很难被彻底清除,因此由HPV感染所诱发的多种慢性疾病如病毒疣、宫颈上皮内瘤变、呼吸道乳头状瘤等往往存在着很高的复发率,给患者乃至社会均带来了沉重负担。因此,需要对HPV感染所诱发的慢性疾病进行科学规范的管理,进而降低HPV感染率与疾病复发率、缩短病程,从而有效促进HPV的防治工作。本文就HPV感染的慢病管理的必要性、具体方法及其意义进行综述。

河北口岸出入境人员疾病监测异常结果分析

目的 分析河北出入境人员疾病监测异常结果患病情况及流行特点,为口岸疾病监测及制定防控措施提供科学依据。方法 对2021.1.1-2022.12.31河北国际旅行卫生保健中心(石家庄海关口岸门诊部)体检的出入境人员传染病和非传染病体检结果进行统计和分析。结果 共体检24 151人,监测传染病患病率最高的为乙肝0.14%,其次为梅毒0.06%、丙肝0.05%;主要非传染病患病率排前3位的是超重或肥胖59.72%、脂肪肝28.83%、高血压12.90%,不同人群、性别、年龄组差异有统计学意义(P<0.05)。结论 加强出入境人员疾病监测并根据不同疾病流行特点制定针对性的预防措施,对出入境人员传染病、慢性病等防控具有重要意义。

传染病针对性护理对慢性乙肝患者应对方式的影响分析

目的探究传染病针对性护理在慢性乙肝患者中的应用效果。方法便利选取2023年1—7月新沂市人民医院收治的108例慢性乙肝患者为研究对象,根据不同护理方法将其分为两组,各54例。对照组实施常规护理,研究组在常规护理基础上实施传染病针对性护理。比较两组护理干预前及患者出院前1 d的不良情绪、应对方式、生活质量评分。结果出院前1 d,研究组不良情绪评分低于对照组,差异有统计学意义(P<0.05)。出院前1 d,研究组应对方式中面对评分高于对照组,回避及屈服评分均低于对照组,差异有统计学意义(P均<0.05)。出院前1 d,研究组生活质量评分为(96.71±1.38)分,高于对照组的(91.47±2.69)分,差异有统计学意义(t=12.736,P<0.05)。结论通过在慢性乙肝患者护理中采用传染病针对性护理策略,不仅可以提高患者治疗信心,还能够降低患者的负性情绪,改善其生活质量。

中国东北地区成人非传染性慢性疾病的流行病学调查及影响因素分析

目的:了解中国东北吉林省德惠市城乡居民高血压、糖尿病(DM)、血脂紊乱、酒精性肝病(ALD)、非酒精性脂肪性肝病(NAFLD)、代谢综合征(MS)及肥胖(Obesity)等9种非传染性慢性疾病的流行病学现状,并对这些慢性病危险因素进行分析。方法:采用分层抽样方法,对德惠市11个居委会和9个村共6 043人进行问卷调查和体格检查。采用多因素Logistic回归分析对各疾病的相关危险因素进行分析。结果:东北地区德惠城乡居民的高血压、DM、血脂紊乱、ALD、NAFLD、MS、超重和中心型肥胖的患病率分别为28.67%、4.82%、51.00%、3.74%、15.5%、21.54%、58.22%和36.67%;不同疾病患病率性别间比较有差异,高血压患病率男性多于女性(P<0.001),中心性肥胖、血脂紊乱、MS和NAFLD患病率女性大于男性(P<0.05)。高龄(OR=1.04,95%CI为1.03～1.05)、脂肪肝(OR=19.42,95%CI为11.62～32.4)、高血糖(OR=1.15,95%CI为1.06～1.26)、高胆固醇血症(OR=1.38,95%CI为1.19～1.59)、高甘油三酯血症(OR=1.32,95%CI为1.1～1.49)和高体重指数(OR=1.42,95%CI为1.3～1.47)是非传染性慢性病的主要危险因素。结论:中国东北部地区德惠市部分非传染性慢性病的发病率较高,且随着年龄的增长患病率逐渐增高;慢性病的发病和进展与本地区的生活、饮食习惯、经济水平、教育程度、地区差异有明显相关性。

复合式与单纯式营养干预效果的初步比较

目的 研究比较复合式与单纯式营养干预对社区三高人群的疾病控制效果差异 ,为社区慢病防治提供方法。方法 将基线调查筛查出的“三高”中老年居民 2 6 0人随机分配到复合式营养干预组、单纯式营养干预组和空白对照组。复合式营养干预组居民给予粗杂粮的膳食干预和营养教育 ,单纯式营养干预组居民给予营养教育。结果 三个月后 ,复合式和单纯式营养干预组的血脂、血压、血糖和IBM均比空白对照有不同程度的下降 ,复合式营养干预组下降幅度显著高于单纯式营养干预组。

2007年浙江省居民出生、死亡、传染病、慢性病漏报调查结果分析

目的对浙江省2007年居民漏报调查资料进行分析,得出出生、死亡、传染病和慢性病的漏报率。方法在全省30个公共卫生监测区内,采用多阶段整群随机抽样的方法抽取93599户常住居民,根据"捕捉-标记-再捕捉"的原理,调查过去1年传染病和3年出生及主要慢性病的漏报情况。结果本次漏报调查共调查30个县(区)居民93599户,280164人。其中城市监测区调查100658人,占总调查人数的35.93%;农村监测区调查179505人,占总调查人数的64.07%,性别比1.03∶1,与监测系统人口性别比一致。查出出生人数5179人,漏报460人,出生漏报率为8.88%,其中城市漏报率19.04%,农村漏报率4.31%。查出死亡人数3447人,漏报183人,居民死亡漏报率合计为5.31%,城市8.18%,农村4.43%。共查出传染病病例403例,漏报37例,漏报率为9.18%,漏诊率为9.44%,城市漏报率6.67%,漏诊率0.94%,农村漏报率10.07%,漏诊率12.09%。查出慢性病病例3077例,漏报1003例,4类主要慢性病的总漏报率为32.60%,其中恶性肿瘤为23.95%,糖尿病为45.97%,冠心病为39.01%,脑卒中为29.69%。结论经统计学检验,浙江省出生及死亡的漏报率城市均高于农村;传染病漏报率在城市和农村间无差异;4种主要慢性病的漏报率仍然较高,漏报主要以省级和地市级大医院为主。

疾病预防控制对人群期望寿命提升贡献的测算结果

目的 :定量明确疾病预防控制工作对期望寿命提升的贡献,并对2011—2020年的贡献趋势作出预测。方法 :收集华东某省1950—2010年分年龄组的人口、发病和死亡数据资料,依据课题组形成的疾病预防控制对人群期望寿命提升贡献的测算思路、步骤进行测算。结果 :1950—2010年,华东某省期望寿命提升26.59岁,疾病预防控制的贡献高达77.92%,其中传染病防控贡献3.57%、意外伤害防控贡献5.87%、孕产妇保健贡献3.61%、慢性病防控贡献为-1.73%。2011—2020年自然趋势下,传染病防控和孕产妇保健对期望寿命的提升仍然保持"正贡献",但已相对较小,慢性病和意外伤害对期望寿命提升的"负贡献"加剧。结论 :疾病预防控制工作对人群期望寿命的提升贡献巨大,有力证明了"预防为主"卫生工作方针的重要性。

北京市城区中老年社区居民慢性病相关危险因素分析

目的了解北京市城区社区居民中老年高血压、冠心病、糖尿病3种慢性病的相关危险因素,为早期防病、治病提供临床依据。方法对北京城区4866名中老年居民进行常规检查,采用多因素logistic回归分析分别探讨3种慢性疾病的相关危险因素,并分析患慢性病组与正常人群组伴随疾病情况。结果年龄、三酰甘油、糖尿病、体质指数(BMI)与高血压呈正相关;年龄、高血压、糖尿病与冠心病呈正相关;性别、年龄、三酰甘油、高血压与糖尿病呈正相关;各种慢性病患者的伴随疾病患病率均较正常组高(P<0.05)。结论年龄增加、高三酰甘油、高BMI是中老年社区居民高血压、冠心病、糖尿病的相关危险因素,应在社区居民中倡导科学的生活方式和正确的饮食观,加强体育锻炼,保持身心健康。

健康管理在慢性非传染性疾病管理中的应用

对慢性非传染性疾病(慢病)进行健康管理,不仅可以提高病人的生活质量而且可以降低医疗费用。目前,国内外已经大规模地开展了对慢病的健康管理的相关研究。现将相关研究从以下几个方面进行综述:健康管理的起源、定义及其在慢病中的实践研究与效果的评价。

微型营养评价法评价慢病住院老人的营养状况

[目的]用MNA法调查老年慢性住院患者的营养状况,并比较不同营养状况患者的传统营养评价指标的差异。[方法]随机抽取141例住院的慢性疾病的老年患者,用MNA对其进行营养状况评价,并收集和比较其常用的营养评价参数进行分析。[结果]慢性疾病的老年患者营养不良、营养不良危险的发生率分别为36.88%和26.95%,而营养状况良好的患者只占36.17%;对3种不同营养状况的患者常用营养指标分析后发现:3组患者BMI、ALB、HB、Na+、Ca2+、TLC和K+差异有统计学意义(P﹤0.01或P﹤0.05),营养状况好的患者,其BMI、ALB、HB和TLC较高,而TG和TC无明显统计学意义。[结论]慢性疾病老年住院患者营养不良和营养不良危险的发生率较高,营养不良和营养不良危险患者的常用营养评价指标也会下降。

神经梅毒的MRI表现(2例报告并文献复习)

目的:探讨神经梅毒的MRI表现。方法:1例血清和脑脊液密螺旋体抗体检测阳性,经青霉素治疗后临床症状消退。另1例血清密螺旋体抗体阳性手术后病理证实为脊髓梅毒树胶样肿。2例均行MRI检查。结果:1例脑实质性梅毒表现为右侧颞叶内侧T1WI呈略低信号,T2WI呈均匀高信号,DWI及FLAIR呈高信号。1例脊髓树胶样肿表现为T1WI为低信号或等、低混杂信号灶,呈类圆形,T2WI为等高混杂信号灶;钆喷替酸葡甲胺(Gd-DTPA)增强T1WI示病灶呈不规则环形强化,并与背侧脊膜以钝角相交。结论:神经梅毒的MRI表现多种多样,对其的认识很重要以达到早期诊断和治疗的目的。