Logistic Regression Analysis of Influencing Factors on Serum ALT and HCV RNA Changes in Patients with Chronic Hepatitis C

Objective This study was undertaken to investigate the influencing factors on serum ALT level and hepatitis C virus(HCV)RNA titer in chronic hepatitis C(CHC)patients.Methods All patients enrolled into this study were anti-HCV positive.Retrospective tracing method was applied to detect serum ALT level and HCV RNA titer and to collect general information of the patients such as genders,age groups,interferon medication history,infection pathways,height and weight.Then the multi-factor analysis was adopted with the application of binominal logistic regression mode.Results The abnormal rate of ALT level was positively correlated to HCV RNA and gender while negatively correlated to interferon medication history and age group,with Wald value of the 4 factors as 39.604,11.823,18.991 and 7.389,respectively.The positive rate of HCV RNA was negatively correlated to interferon medication history and gender while positively correlated to ALT level,with corresponding Wald value of the 3 factors as81.394,7.618 and 27.562,respectively.Conclusions The normal ALT level in HCV infected patients was associated with viral load,age,gender and interferon medication history,while the normal rate of HCV RNA titer was closely associated with gender,interferon medication history and ALT level.

Virtual Determination of Sex:Estimating Cut off Value of Digital Metric Traits of Foramen Magnum on Three-dimensional Computed Tomography with Receiver Operating Characteristic and Logistic Regression Analysis

Background:Radiological imaging plays a pivotal role in forensic anthropology.As have the imaging techniques advances,so have the digital skeletal measurements inched towards precision.Secular trends of the population keep on changing in modem times.Hence,finding the precise technique of bone measurement,with greater reproducibility,in modem population is always needed in making population specific biological profile.Aim and Objective:The aim of this study was to estimate the accuracy of the foramen magnum measurement,obtained by three dimensional multi-detector computed tomography using volume rendering technique with the cut off value of each variable,in sex determination of an individual.Materials and Methods:Two metric traits,an antero-posterior diameter(APD)and transverse diameter(TD),were measured digitally in an analysis of 130 radiological images having equal proportion of male and female samples.Foramen magnum index and area of foramen magnum(Area by Radinsky's[AR],Area by Teixeira5s[AT])were derived from APD and TD.Results:Descriptive statistical analysis,using unpaired t-test,showed significant higher value in males in all the variables.Using Pearson correlation analysis,maximum correlation was observed between area(AT and AR r=0.999)and between area and TD(AR r=0.955 and AT r=0.945 respectively).When used individually,TD had the highest predictive value(67.7%)for sex detennination among all the parameters followed by AT(65.4%)and AR(64.6%).Cutoff value of variables TD,AR and AT were 29.9 mm,841.80 mm2 and 849.70 mm2 respectively.Receiver operating characteristic curve predicted male and female sex with 96.2%and 89.2%accuracy respectively.The overall accuracy of the model was 92.7%.Conclusion:Measurements from 3D CT using volume rendering technique were precise,and the application of logistic regression analysis predicted the sex with more accuracy.

Logistics Regression Analysis between TCM Constitution Types of Patients with Hypertension,Insomnia and ABPM,PSQI

[Objectives]The research aimed to explore the distribution characteristics of TCM constitution types of patients with hypertension and insomnia,and study the clinical characteristics of patients with different constitutions,in order to provide new ideas for the treatment of patients with hypertension and insomnia.[Methods]Cross sectional observation method was used,and 420 patients with hypertension and insomnia were selected.Required information was collected,and the constitution type of traditional Chinese medicine was determined,and relevant data were recorded.SPSS and Logistic regression analysis method were used to explore the correlation between the distribution of TCM constitution types and gender,age,24 h-SBP,24 h-DBP,24 h-BPV,PSQI score,etc.[Results]Among 420 patients,the proportion of gentleness constitution was the most,and others in turn were Qi deficiency constitution>Yang deficiency constitution>phlegm dampness constitution>Qi stagnation constitution>Yin deficiency constitution>blood stasis constitution>damp heat constitution>special constitution.Among male patients,the proportion of gentleness constitution was the most.Among female patients,the proportion of Qi deficiency constitution was the most.In each constitution,the proportion of men and women was different,and the difference in gentleness constitution,Qi deficiency constitution and Yin deficiency constitution had statistical significance(P<0.05).The proportion of gentleness constitution for young and middle-aged patients was the most,while elderly patients with Qi deficiency constitution was the most.There was difference in the distribution of TCM constitution in different age groups,and the difference had statistical significance(P<0.05).Compared with the patients with gentleness constitution,the patients with Qi deficiency constitution,Yang deficiency constitution,Yin deficiency constitution,damp heat constitution,blood stasis constitution and Qi stagnation constitution had different differences in terms of age,24 h-SBP,24 h-DBP,24 h-BPV and PSQI score,and there was statistical significance(P<0.05).Except damp heat constitution,blood stasis constitution and special constitution,other constitutions had certain correlation with age,24 h-SBP,24 h-DBP,24 h-BPV and PSQI score.[Conclusions]TCM constitution types of patients with hypertension and insomnia were dominant by gentleness constitution,Qi deficiency constitution and Yang deficiency constitution.The distribution of TCM constitution in different gender and age groups was different,and different TCM constitution was related to ABPM and PSQI.

The Establishment of Mathematical Models for the Composition Analysis and Identification of Ancient Glass Products

Glass is the precious material evidence of the trade of the early Silk Road. The ancient glass was easily affected by the environmental impact and weathering, and the change of composition ratios affected the correct judgment of its category. In this paper, mathematical models and methods such as Chi-square test, weighted average method, principal component analysis, cluster analysis, binary classification model and grey correlation analysis were used comprehensively to analyze the data of sample glass products combined with their categories. The results showed that the weathered high-potassium glass could be divided into 12, 9, 10 and 27, 7, 22 and so on.

Analysis of the incidence and influencing factors of hyponatremia before ^(131)I treatment of differentiated thyroid carcinoma

BACKGROUND Hyponatremia is a common clinical electrolyte disorder.However,the association between hyponatremia and acute hypothyroidism is unclear.Acute hypothyroidism is usually seen in patients who undergo preparation for radioactive iodine therapy.AIM To analyze the incidence and influencing factors of hyponatremia in a condition of iatrogenic acute hypothyroidism in patients with differentiated thyroid cancer(DTC)before ^(131)I treatment.METHODS The study group consisted of 903 DTC patients who received ^(131)I treatment.The clinical data before and after surgery,as well as on the day of ^(131)I treatment were analyzed.According to the blood sodium level before ^(131)I treatment,patients were divided into the non-hyponatremia group and hyponatremia group.Correlations between serum sodium levels before ^(131)I treatment and baseline data were analyzed.Univariate analysis and binary logistic regression were performed to identify the influencing factors of hyponatremia.RESULTS A total of 903 patients with DTC,including 283(31.3%)males and 620(68.7%)females,with an average age of 43.8±12.7 years,were included in this study.The serum sodium levels before surgery and ^(131)I treatment were 141.3±2.3 and 140.5±2.1 mmol/L,respectively(P=0.001).However,the serum sodium levels in males and females before ^(131)I treatment were lower than those before surgery.Patients aged more than 60 years and less than 60 years also showed decreased serum sodium levels before ^(131)I treatment.In addition,the estimated glomerular filtration rate(eGFR)in males and females decreased before ^(131)I treatment compared with those before surgery(P=0.001).Moreover,eGFR in patients over 60 years and under 60 years decreased before ^(131)I treatment,when compared with that before surgery.There were no significant differences in serum potassium,calcium,albumin,hemoglobin,and blood glucose in patients before surgery and ^(131)I treatment(P>0.05).Among the 903 patients,23(2.5%)were diagnosed with hyponatremia before ^(131)I treatment,including 21 cases(91.3%)of mild hyponatremia and 2 cases(8.7%)of moderate hyponatremia.Clinical data showed that patients with mild hyponatremia had no specific clinical manifestations,while moderate hyponatremia cases were mainly characterized by fatigue and dizziness,which were similar to neurological symptoms caused by hypothyroidism and were difficult to distinguish.Correlation analysis showed a correlation between serum sodium before ^(131)I treatment and the preoperative level(r=0.395,P=0.001).There was no significant correlation between blood sodium and thyroid-stimulating hormone(TSH)levels and urine iodine before ^(131)I treatment(r=0.045,P=0.174;r=0.013,P=0.697).Univariate analysis showed that there were significant differences in age,sex,history of diuretic use,distant metastasis,preoperative blood sodium,blood urea nitrogen(BUN),eGFR,TSH and urinary iodine between the two groups(all P<0.05).Logistic regression analysis showed that factors such as history of diuretic use,distant metastases,preoperative sodium and BUN were all influencing factors of hyponatremia.The Hosmer and Lemeshow test(c2=2.841,P=0.944)suggested a high fit of the model.Omnibus tests of model coefficients indicated the overall significance of the model in this fitted model(P<0.05).Preoperative serum sodium was a significant factor associated with pre-^(131)I therapy hyponatremia(OR=0.763;95%CI:0.627-0.928;P=0.007).CONCLUSION The incidence of hyponatremia induced by ^(131)I treatment preparation was not high.Preparation for radioactive iodine therapy was not a risk factor for the development of hyponatremia in thyroid cancer patients.

Analysis of influencing factors of clinical effect of TCM treatment for degenerative lumbar spondylolisthesis

Objective:To explore the related factors that may affect the efficacy of traditional Chinese medicine in treating degenerative lumbar spondylolisthesis.Methods:A total of 535 patients with DLS who were treated in Wangjing Hospital of China Academy of Chinese Medical Sciences and other hospitals from June 2011 to October 2014 were selected.The central random system was used to randomly divide the treatment group and control group.This study included 267 patients in the treatment group using the traditional Chinese medicine program((lumbar spine reduction and lumbar spine rehabilitation),36 cases of severely missing data were excluded,and a total of 231 DLS patients were included.Observation indicators were selected using the Visual Analog Scale(VAS)and the Japanese Orthopaedic Association(JOA)for the evaluation of lumbar vertebral disorders.The clinical efficacy was evaluated using the JOA lumbar pain curative effect evaluation standard[7].[(Joa score after treatment-JOA score before treatment]/(out of 29 points-JOA score before treatment)]×100%.The JOA score and the change of the efficacy index of the patients were observed.According to the JOA efficacy index after the treatment,it was divided into significant effect(≥50%)and poor effect(<50%).Single-factor screening and multi-factor Logistic regression analysis were used.Gender,age,course of disease,BMI index,slip-off segment,slip-off direction,back pain VAS score,total JOA score,back pain-score,lower limb pain and numbness-score,walking ability-score,straight leg elevation test-score,Feeling-scoring,muscle strength-scoring,supine turn-scoring,standing action-scoring,washing action-scoring,standing posture and continuous standing-scoring,long sedentary-scoring,weight lifting and holding-scoring,walking-scoring 2.Bladder function-scores were assigned to logistic regression models for univariate analysis,and meaningful independent variables were screened for multivariate logistic regression.Results:No serious adverse reactions occurred in the patients included in this study.According to the comparison of JOA scores before and after treatment,the results of the index of efficacy index showed that the effective rate of DLS in this project was 96.6%,and a significant effect of 77.6%was achieved.Univariate Logistic regression analysis showed that the duration of disease,supine turn-scoring,washing action-scoring,prolonged sedentary-scoring,weight lifting and keeping-scoring had statistically significant effects on the inclusion of patients with significant efficacy(P<0.05);single factor logistic regression analysis of total score of JOA score before treatment was not statistically significant(P=0.215),but because it is important for evaluating the patient's condition,it was included in multifactor logistic regression analysis at the same time.Course of onset,supine turn-scoring,washing action-scoring,prolonged sedentary-scoring,weight lifting and holding-scoring,JOA score before treatment.Six independent variables were substituted into the two-class logistic regression model for multivariate analysis..Multivariate logistic regression analysis showed that the effects of total JOA score and supine turn-scoring before treatment on the efficacy of patients were statistically significant(P<0.05).There are many factors influencing the efficacy of traditional Chinese medicine treatment of DLS,and the probability of obtaining a significant effect for each additional point of JOA score and supine turn-score before treatment increases by 1.167 and 0.410 times,respectively.Conclusion:The clinical application of lumbar spine reduction combined with lumbar rehabilitation exercises in patients with degenerative lumbar spondylolisthesis with a higher total JOA score or a lower limit of supine turning can achieve better clinical results.This finding has certain guiding significance for the clinical application of this therapy in the treatment of DLS,and is beneficial to improving patient satisfaction and clinical effectiveness.

Establishment of a prediction model for prehospital return of spontaneous circulation in out-of-hospital patients with cardiac arrest

BACKGROUND Out-of-hospital cardiac arrest(OHCA)is a leading cause of death worldwide.AIM To explore factors influencing prehospital return of spontaneous circulation(P-ROSC)in patients with OHCA and develop a nomogram prediction model.METHODS Clinical data of patients with OHCA in Shenzhen,China,from January 2012 to December 2019 were retrospectively analyzed.Least absolute shrinkage and selection operator(LASSO)regression and multivariate logistic regression were applied to select the optimal factors predicting P-ROSC in patients with OHCA.A nomogram prediction model was established based on these influencing factors.Discrimination and calibration were assessed using receiver operating charac-teristic(ROC)and calibration curves.Decision curve analysis(DCA)was used to evaluate the model’s clinical utility.RESULTS Among the included 2685 patients with OHCA,the P-ROSC incidence was 5.8%.LASSO and multivariate logistic regression analyses showed that age,bystander cardiopulmonary resuscitation(CPR),initial rhythm,CPR duration,ventilation mode,and pathogenesis were independent factors influencing P-ROSC in these patients.The area under the ROC was 0.963.The calibration plot demonstrated that the predicted P-ROSC model was concordant with the actual P-ROSC.The good clinical usability of the prediction model was confirmed using DCA.CONCLUSION The nomogram prediction model could effectively predict the probability of P-ROSC in patients with OHCA.

Investigation of contemporary college students’mental health status and construction of a risk prediction model

BACKGROUND Due to academic pressure,social relations,and the change of adapting to independent life,college students are under high levels of pressure.Therefore,it is very important to study the mental health problems of college students.Developing a predictive model that can detect early warning signals of college students’mental health risks can help support early intervention and improve overall well-being.AIM To investigate college students’present psychological well-being,identify the contributing factors to its decline,and construct a predictive nomogram model.METHODS We analyzed the psychological health status of 40874 university students in selected universities in Hubei Province,China from March 1 to 15,2022,using online questionnaires and random sampling.Factors influencing their mental health were also analyzed using the logistic regression approach,and R4.2.3 software was employed to develop a nomogram model for risk prediction.RESULTS We randomly selected 918 valid data and found that 11.3%of college students had psychological problems.The results of the general data survey showed that the mental health problems of doctoral students were more prominent than those of junior college students,and the mental health of students from rural areas was more likely to be abnormal than that of urban students.In addition,students who had experienced significant life events and divorced parents were more likely to have an abnormal status.The abnormal group exhibited significantly higher Patient Health Questionnaire-9(PHQ-9)and Generalized Anxiety Disorder-7 scores than the healthy group,with these differences being statistically significant(P<0.05).The nomogram prediction model drawn by multivariate analysis includ-ed six predictors:The place of origin,whether they were single children,whether there were significant life events,parents’marital status,regular exercise,intimate friends,and the PHQ-9 score.The training set demonstrated an area under the receiver operating characteristic(ROC)curve(AUC)of 0.972[95%confidence interval(CI):0.947-0.997],a specificity of 0.888 and a sensitivity of 0.972.Similarly,the validation set had a ROC AUC of 0.979(95%CI:0.955-1.000),with a specificity of 0.942 and a sensitivity of 0.939.The H-L deviation test result was χ^(2)=32.476,P=0.000007,suggesting that the model calibration was good.CONCLUSION In this study,nearly 11.3%of contemporary college students had psychological problems,the risk factors include students from rural areas,divorced parents,non-single children,infrequent exercise,and significant life events.

D-dimer may predict poor outcomes in patients with aneurysmal subarachnoid hemorrhage: a retrospective study

Serum biomarkers may play a reliable role in predicting the outcomes of patients with aneurysmal subarachnoid hemorrhage. This study retrospectively analyzed the relationship between serum biomarkers on admission and outcomes in patients with aneurysmal subarachnoid hemorrhage. We recruited 146 patients with aneurysmal subarachnoid hemorrhage who were treated in Renmin Hospital of Wuhan University of China between 1 May 2014 and 30 March 2016. There were 57 males and 89 females included and average age of included patients was 57.03 years old. Serum samples were taken immediately on admission(within 48 hours after initial hemorrhage) and the levels of serum biomarkers were detected. Baseline information, complications, and outcomes at 6 months were recorded. Univariate and multivariate logistic regression analyses were used to explore the relationship between biomarkers and clinical outcomes. Receiver operating characteristic curves were obtained to investigate the possibility of the biomarkers predicting prognosis. Of the 146 patients, 102 patients achieved good outcomes and 44 patients had poor outcomes. Univariate and multivariate analyses showed that high World Federation of Neurosurgical Societies grade, high serum D-dimer levels, and high neurological complications were significantly associated with poor outcomes. Receiver operating characteristic curves verified that D-dimer levels were associated with poor outcomes. D-dimer levels strongly correlated with neurological complications. In conclusion, we suggest that D-dimer levels are a good independent prognostic factor for poor outcomes in patients with aneurysmal subarachnoid hemorrhage.

Risk factors for intussusception in children with Henoch-Schönlein purpura:A case-control study

BACKGROUND The etiology of Henoch-Schönlein purpura(HSP)with intussusception remains undefined.AIM To investigate the risk factors for intussusception in children with HSP and gastrointestinal(GI)involvement.METHODS Sixty children with HSP and concomitant intussusception admitted to the Beijing Children’s Hospital of Capital Medical University between January 2006 and December 2018 were enrolled in this study.One hundred pediatric patients with HSP and GI involvement but without intussusception,admitted to the same hospital during the same period,were randomly selected as a control group.The baseline clinical characteristics of all patients,including sex,age of onset,duration of disease,clinical manifestations,laboratory test results,and treatments provided,were assessed.Univariate and multiple logistic regression analyses were performed to identify possible risk factors.RESULTS The 60 children in the intussusception group comprised 27 girls(45%)and 33 boys(55%)and the 100 children in the non-intussusception group comprised 62 girls(62%)and 38 boys(38%).The median age of all patients were 6 years and 5 mo.Univariate and multiple regression analyses revealed age at onset,not receiving glucocorticoid therapy within 72 h of emergence of GI symptoms,hematochezia,and D-dimer levels as independent risk factors for intussusception in children with HSP(P<0.05).CONCLUSION The four independent risk factors for intussusception in pediatric HSP with GI involvement would be a reference for early prevention and treatment of this potentially fatal disease.

Clinical effectiveness of a pneumatic compression device combined with low-molecular-weight heparin for the prevention of deep vein thrombosis in trauma patients:A single-center retrospective cohort study

BACKGROUND:To investigate the clinical effectiveness of a pneumatic compression device(PCD)combined with low-molecular-weight heparin(LMWH)for the prevention and treatment of deep vein thrombosis(DVT)in trauma patients.METHODS:This study retrospectively analyzed 286 patients with mild craniocerebral injury and clavicular fractures admitted to our department from January 2016 to February 2020.Patients treated with only LMWH served as the control group,and patients treated with a PCD combined with LMWH as the observation group.The incidence of DVT,postoperative changes in the visual analogue scale(VAS)score,and coagulation function were observed and compared between the two groups.Excluding the influence of other single factors,binary logistic regression analysis was used to evaluate the use of a PCD in the patient’s postoperative coagulation function.RESULTS:After excluding 34 patients who did not meet the inclusion criteria,252 patients were were included.The incidence of DVT in the observation group was significantly lower than that in the control group(5.6%vs.15.1%,χ^(2)=4.605,P<0.05).The postoperative VAS scores of the two groups were lower than those before surgery(P<0.05).The coagulation function of the observation group was significantly higher than that of the control group,with a better combined anticoagulant effect(P<0.05).There were no significant differences between the two groups in preoperative or postoperative Glasgow Coma Scale scores,intraoperative blood loss,postoperative infection rate,or length of hospital stay(P>0.05).According to logistic regression analysis,the postoperative risk of DVT in patients who received LMWH alone was 1.764 times that of patients who received LMWH+PCD(P<0.05).The area under the receiver operating characteristic(AUROC)curve of partial thromboplastin time(APTT)and platelet(PLT)were greater than 0.5,indicating that they were the influence indicators of adding PCD to prevent DVT.Excluding the influence of other variables,LMWH+PCD effectively improved the coagulation function of patients.CONCLUSIONS:Compared with LMWH alone,LMWH+PCD could improve blood rheology and coagulation function in patients with traumatic brain injury and clavicular fracture,reduce the incidence of DVT,shorten the length of hospital stay,and improve the clinical effectiveness of treatment.

Contributing Factors for Delays during the Morning Commute Hours and the Impact of the Spread of COVID-19 for Metropolitan Train Lines in Japan

The present study aims to conduct 2 types of statistical analysis to reveal the impact of the spread of COVID-19 on train delays by comparing the potential contributing factors before, during and after the outbreak of the virus in the metropolitan train lines in Japan. First of all, the result of the present study clearly revealed the changes in contributing factors for train delays caused by the spread of COVID-19. Specifically, the contributing factors for train delays changed due to the decrease of passengers by the effect of the outbreak of the virus. Additionally, though large terminal stations were considered to be a major contributing factor in causing and increasing train delays in the past, this was not the case after the spread of COVID-19. Therefore, under such conditions, it is more effective to make improvements in small to medium stations and tracks rather than terminal stations. Furthermore, as the decrease in passengers also decreased train delays in commuter lines going to the suburbs due to the spread of COVID-19, the contributing factor for such lines is the excessive number of passengers. Therefore, as for countermeasures for train delays after the effects of COVID-19, it is necessary to disperse passengers in order to avoid passengers concentrating in the same time zones and train lines.

On-treatment predictions of success in peg-interferon/ribavirin treatment using a novel formula

AIM:To predict treatment success using only simple clinical data from peg-interferon plus ribavirin therapy for chronic hepatitis C. METHODS:We analyzed the clinical data of 176 patients with chronic hepatitis and hepatitis C virus genotype 1 who received 48 wk standard therapy, derived a predictive formula to assess a sustained virological response of the individual patient using a logistic regression model and confirmed the validity of this formula.The formula was constructed using data from the first 100 patients enrolled and validated using data from the remaining 76 patients. RESULTS:Sustained virological response was obtained in 83(47.2%)of the patients and we derived formulae to predict sustained virological response at pretreatment and weeks 4,12 and 24.The likelihood of sustained virological response could be predicted effectively bythe formulae at weeks 4,12 and 24(the area under the curve of the receiver operating characteristic:0.821, 0.802,and 0.891,respectively),but not at baseline (0.570).The formula at week 48 was also constructed and validation by test data achieved good prediction with 0.871 of the area under the curve of the receiver operating characteristic.Prediction by this formula was always superior to that by viral kinetics. CONCLUSION:These results suggested that our formula combined with viral kinetics provides a clear direction of therapy for each patient and enables the best tailored treatment.

Nomogram model for predicting oculomotor nerve palsy in patients with intracranial aneurysm

AIM:To explore the risk factors of oculomotor nerve palsy(ONP)in patients with intracranial aneurysm(IA)and develop a nomogram model for predicting ONP of IA patients.METHODS:A total of 329 IA patients were included.Logistic regression analysis was applied to identify independent factors,which were then integrated into the nomogram model.The performance of the nomogram model was evaluated by calibration cur ve,receiver operating curve(ROC),and decision curve analysis.RESULTS:Univariate and multivariate logistic regression analysis indicated posterior communicating artery(PCo A)aneur ysm[hazard ratio(HR)=17.13,P<0.001]and aneurysm diameter(HR=1.31,P<0.001)were independent risk factors of ONP in IA patients.Based on the results of logistic regression analysis,a nomogram model for predicting the ONP in IA patients was constructed.The calibration curve indicated the nomogram had a good agreement between the predictions and observations.The nomogram showed a high predictive accuracy and discriminative ability with an area under the curve(AUC)of 0.863.The decision curve analysis showed that the nomogram was powerful in the clinical decision.PCo A aneurysm(HR=3.38,P=0.015)was identified to be the only independent risk factor for ONP severity.CONCLUSION:PCo A aneurysm and aneurysm diameter are independent risk factors of ONP in IA patients.The nomogram established is performed reliably and accurately for predicting ONP.PCo A aneurysm is the only independent risk factor for ONP severity.

Does Hospital Ownership Influence Hand Hygiene Compliance?

The issue as to whether hospital ownership has an impact on the quality of care has long been a serious concern. Hand hygiene(HH) compliance is regarded as an important indicator of the quality of care in the control of hospital-acquired infections. However, little information is available on whether hospital ownership influences HH compliance. In this study, of 229 hospitals selected from Hubei province in China, 152 were public and 77 were private hospitals. A total of 23 652 healthcare workers(HCWs) were surveyed, using a convenience sampling. HH compliance, the WHO's "My Five Moments for hand hygiene"(5 MHH), among HCWs, together with the factors of hospital ownership, training frequency, bed occupancy rates, etc. were collected. Univariate analysis and ordinal logistic regression analysis were used to analyze factors affecting HH compliance. Overall, HH compliance rates were 67% and 79% for public and private hospitals, respectively. The HH compliance rates of HCWs and 5 MHH were between 55% and 95%, and influenced by hospital ownership(P<0.05), excluding compliance rate at the moment after body fluid exposure, and other influence factors included training frequency and bed occupancy rate(P<0.05). HH compliance is better in private than in public hospitals. Hospital ownership is a significant factor affecting HH compliance, in addition to training frequency and bed occupancy rate.

Risk factors and prediction of macrosomia in a cohort study

Objective: To investigate the risk factors of macrosomia and to predict the risk of macrosomia so as to reduce the incidence of macrosomia. Methods: A total of 2063 pregnant women who met the inclusion criteria were selected as the subjects from February 2016 to April 2017 in Jiading District Maternal and Child Health Hospital of Shanghai and Pudong New Area Maternal and Child Health Hospital. According to the birth weight of the neonates, the neonates were divided into the macrosomia group (neonatal weight > 4000 g, n=125) and the normal infant group (2500 g < neonatal weight < 4000 g, n=1938).The general data of age, number of pregnant women, BMI before pregnancy, gestational diabetes mellitus, glucose tolerance, weight gain during pregnancy, birth weight and gestational week were compared between the two groups. Multivariate logistic regression was used to analyze the risk factors of macrosomia. Results: ①There were significant differences in BMI, glucose tolerance, fasting blood sugar, weight gain in the second trimester, weight gain in the third trimester, birth weight and gestational week between the two groups (P<0.05). ②Single factor analysis showed that pre-pregnancy BMI, gestational week at first diagnosis, fasting blood glucose tolerance, weight gain in the second trimester, weight gain in the third trimester, gestational week and birth weight were the influencing factors of macrosomia (P<0.05). ③Multi-factor analysis showed that gestational weeks, gestational diabetes, fasting glucose tolerance and weight growth in the second trimester were the main factors affecting the production of macrosomia, among which gestational diabetes was the protective factor, while gestational weeks, fasting glucose tolerance and weight growth in the second trimester were the risk factors. Conclusion: The high risk factors for macrosomia are gestational weeks, glucose tolerance, fasting blood sugar and weight gain in the second trimester of pregnancy.We should strengthen regular obstetric examination, health care during pregnancy, reasonable diet and proper exercise, and strictly control the weight gain during the second trimester of pregnancy. At the same time, we should monitor blood sugar in time so as to reduce the incidence of macrosomia.

A Statistical Evaluation of Uncoupling Protein 1 in the Limited Area of Brown Adipose Tissue by Immunoelectron Microscopy

Uncoupling protein 1 (UCP1) expressed by the brown adipose tissue (BAT) in the mitochondrial crista acts as a homeostatic thermogenerator of eutherians. The evaluation of UCP1 expression in the BAT offers significant scientific insight, especially in studies targeting limited areas such as the periarterial and pericardial regions of small experimental mammals. However, the negligible amount of this adipose tissue would render the general quantitative evaluation of the protein unreliable because of lipid contamination and low protein concentration. To address this problem, we quantitatively evaluated UCP1 expression in the mitochondrion of the mouse interscapular BAT using immunoelectron microscopy and immunohistochemical studies using a combination of primary and secondary antibodies in scheme A (rabbit anti-UCP1 IgG/gold particle-conjugated goat anti-rabbit IgG), B (rabbit IgG/gold particle-conjugated goat anti-rabbit IgG), C (rabbit anti-UCP1 IgG/gold particle-unconjugated goat anti-rabbit IgG), and D (rabbit IgG/gold particle-unconjugated goat anti-rabbit IgG). Scheme A shows the immunopositive reaction of obvious gold particles in the mitochondrial area, whereas other procedures revealed less distinctive reactions. The distinctive gold particle immunoreaction comprised electrical high-density spots with a mean diameter of >5 nm. However, in scheme B, the electrical high-density spots were scattered outside the mitochondrion and were significantly smaller than 4 nm;schemes C and D demonstrated few immunoreactions. Logistic regression analysis between schemes A and B showed that the threshold diameter of the electrical high-density spots measuring >5 nm indicated a true positive immunoreaction to anti-UCP1 antibody specifically in the mitochondrial area. Minor statistical difference was observed in the primary anti-UCP1 antibody between polyclonal IgG and monoclonal antibodies. Therefore, immunoelectron microscopy might be useful for evaluating negligible protein expression in some limited areas, such as UCP1 expression in the BAT of small experimental animals.

Analysis of Clinical Features of Patients With Psoriasis and Metabolic Syndrome in Xinjiang,China:A Cross-Sectional Study

Objective:Psoriasis is often closely related to metabolic syndrome (MS),herein we conducted this study to investigate the clinical characteristics of a large sample of psoriasis patients with MS in Xinjiang,China.Methods:The prevalence of MS,age,height,weight,body mass index (BMI),red blood cell count,white blood cell count,platelet count,aspartate aminotransferase level,alanine aminotransferase level,and other clinical data were analyzed in 2,492 patients with psoriasis.The patients were divided into 2 groups based on the presence of MS and their clinical features were compared.Studentt test was used for independent samples,and the chi-square test was used for count data.Results:Among the 2,492 patients,349 had MS and 1,269 were considered overweight/obese.There were significant differences in sex,age,disease course,age at onset,BMI,systolic blood pressure (SBP),and diastolic blood pressure (DBP) between the patients with MS and those without (allP < 0.05).The red blood cell count (P < 0.001),white blood cell count (P = 0.013),erythrocyte sedimentation rate (P < 0.001),blood urea nitrogen level (P < 0.001),triglyceride level (P < 0.001),total cholesterol level (P < 0.001),and low-density lipoprotein cholesterol level (P = 0.002) were significantly higher in the MS group than in the psoriasis-only group.The high-density lipoprotein cholesterol level was significantly lower in the MS group than in the psoriasis-only group (P < 0.001).The alanine aminotransferase (P = 0.145) and albumin levels (P = 0.192) were not significantly different between the 2 groups (P > 0.05).Binary logistic regression analysis showed that sex,age,BMI,SBP,DBP,and fasting plasma glucose were independent risk factors for MS in patients with psoriasis,and high-density lipoprotein cholesterol was considered a protective factor for these patients.Conclusion:The prevalence of MS in patients with psoriasis is high.Female sex,age,BMI,SBP,DBP,and fasting plasma glucose may be risk factors for psoriasis complicated by MS.

Factors influencing outcomes after cardiopulmonary resuscitation in emergency department

BACKGROUND:The outcome of cardiopulmonary resuscitation(CPR) may depend on a variety of factors related to patient status or resuscitation management.To evaluate the factors influencing the outcome of CPR after cardiac arrest(CA) will be conducive to improve the effectiveness of resuscitation.Therefore,a study was designed to assess these factors in the emergency department(ED) of a city hospital.METHODS:A CPR registry conforming to the Utstein-style template was conducted in the ED of the First Affiliated Hospital of Wenzhou Medical College from January 2005 to December 2011.The outcomes of CPR were compared in various factors groups.The primary outcomes were rated to return of spontaneous circulation(ROSC),24-hour survival,survival to discharge and discharge with favorable neurological outcomes.Univariate analysis and multivariable logistic regression analysis were performed to evaluate factors associated with survival.RESULTS:A total of 725 patients were analyzed in the study.Of these patients,187(25.8%) had ROSC,100(13.8%) survived for 24 hours,48(6.6%) survived to discharge,and 23(3.2%) survived to discharge with favorable neurologic outcomes.A logistic regression analysis demonstrated that the independent predictors of ROSC included traumatic etiology,first monitored rhythms,CPR duration,and total adrenaline dose.The independent predictors of 24-hour survival included traumatic etiology,cardiac etiology,first monitored rhythm and CPR duration.Previous status,cardiac etiology,first monitored rhythms and CPR duration were included in independent predictors of survival to discharge and neurologically favorable survival to discharge.CONCLUSIONS:Shockable rhythms,CPR duration ≤15 minutes and total adrenaline dose≤5 mg were favorable predictors of ROSC,whereas traumatic etiology was unfavorable.Cardiac etiology,shockable rhythms and CPR duration ?15 minutes were favorable predictors of 24-hour survival,whereas traumatic etiology was unfavorable.Cardiac etiology,shockable rhythms,CPR duration ≤15 minutes were favorable predictors of survival to discharge and neurologically favorable survival to discharge,but previous terminal illness or multiple organ failure(MOF) was unfavorable.

Correction:Establishment of a prediction model for prehospital return of spontaneous circulation in out-of-hospital patients with cardiac arrest

This is an erratum to an already published paper named“Establishment of a prediction model for prehospital return of spontaneous circulation in out-ofhospital patients with cardiac arrest”.We found errors in the affiliated institution of the authors.We apologize for our unintentional mistake.Please note,these changes do not affect our results.