A survey of high risk factors affecting retinopathy in full-term infants in China

AIM: To investigate the possible relationship between the influencing factors occurring before and during birth in full-term infants and the outcome of retinopathy. METHODS: Totally 816 full-term infants admitted in the neonate intensive unit of Boai Hospital of Zhongshan between 1 May, 2008 and 30 June, 2011 were included in the study. Fundus examination was performed and evaluated individually on them at the age of 48 hours after delivery, 2 weeks and 1 month. Some possible risk factors happening prenatally or during delivery such as pregnant related hypertension, placenta previa, placental abruption etc, as well as some neonatal risk factors such as neonatal asphyxia, hypoxic-ischemic encephalopathy (HIE), low birth weight etc, were recorded and evacuated. Then the effect of the risk factors of full-term infants on retinopathy was studied. RESULTS: The incidence of retinal hemorrhage of full-term infants with prenatal pregnant related hypertension (PRH) of the mother (43.6%) was significantly higher than that of full-term infants without (8.0%). (P<0.001). The incidence of retinal hemorrhage of full-term infants with neonatal asphyxia and /or hypoxic-ischemic encephalopathy (HIE)(29.3%) was significantly higher than that of those without (15.7%), but correlation was not found between the severity of retina hemorrhage and the degree of hypoxic disease. A pale color of optic disc was associated with a low birth weight of full-term infant. Full-term infants with birth weigh-less than 2500g had a significant higher incidence of retinopathy than those with birth weight equal or more than 2500g( P<0.001). CONCLUSION: The main influencing factors which lead to retinopathy of high risk full-term infants are prenatal factors such as PRH, and some neonatal risk factors such as asphyxia, hypoxic-ischemic encephalopathy, and low birth weight.

High Risk Factors of Pancreatic Carcinoma

Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer（PC） is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists.

Risk Factors of Precancerous Gastric Lesions in A Population at High Risk of Gastric Cancer

Objective： In cancer prevention, the targeting of precancerous lesions has been recognized as the most promising method. However, little attention has been paid to the risk factors of precancerous gastric lesions, especially in rural China where there is high prevalence of precancerous gastric lesions. We therefore conducted a cross-sectional study in Liaoning province, China, to investigate the potential risk and protective factors of these precancerous gastric lesions. Methods： A total of 1,179 subjects with high risk of gastric cancer from Zhuanghe County were included in this study. Standard questionnaires were used in collecting epidemiological factors and the data were then analyzed by the unconditional logistic regression model. Results： Smoking and drinking were the risk factors for the precancerous gastric lesions among rural subjects, and the association of smoking or drinking and the precancerous gastric lesions increased in strength with the daily consumption and duration. As the factors such as age, gender, smoking, alcohol were controlled, a multivariable analysis revealed that there was a significant correlation between the deep-fry food intake and the gastric epithelial dysplasia with the odds ratio （OR） of 1.78 [95% confidence interval （CI）： 1.01-3.12]. Garlic eating was shown to confer protection against the development of gastric ulcer （OR=0.55, 95% CI： 0.33-0.92）. Conclusion： Smoking and drinking were the risk factors for the precancerous gastric lesions among rural subjects. Deep-fry food intake might be one of the risk factors for the precancerous gastric lesions and garlic eating was shown to confer protection against the development of gastric ulcer among rural Chinese population.

Seroprevalence of <i>Brucella</i>Antibodies and Risk Factors Associated with Human Brucellosis in High-Risk Occupational Groups of the Noun Division in the West Region of Cameroon

Brucellosis is an anthropozoonotic disease with an important public health impact. Although the transmission of Brucella from animals to humans can occur in different epidemiological settings of sub-Saharan African countries, little data has been published on human brucellosis. This study aimed to detect Brucella antibodies and the risk factors associated to brucellosis among high-risk occupational groups of people in the Noun Division of Cameroon. For this study, a structured questionnaire was used to assess risk factors associated with human brucellosis. Thereafter, blood samples were collected from high-risk occupational groups of people in four villages. Plasma was extracted from each sample and Brucella antibodies were detected using Rose Bengal Plate Test (RBPT) and indirect Enzyme-Linked Immunosorbent Assay (i-ELISA). Of the 273 participants enrolled, the overall seroprevalence of Brucella antibodies was 12.45% with RBPT and 10.26% with i-ELISA test. This seroprevalence was significantly (P = 0.04;X2 = 9.73) higher among livestock herdsmen (15.8%), slaughterhouse workers (9.8%), butchers (4.8%), participants having no educational level (14.3%) and those experiencing above 5 years of risky activity (15%). Raw milk consumption (OR: 4.8;P = 0.001), no formal education (OR: 6.4;P = 0.03) and assistance of animal during parturition (OR: 7.2;P < 0.0001) appeared as factors that may increase the risk of Brucella infections. The detection of Brucella antibodies indicates the risk of human brucellosis in some groups of people of the Noun division. Consuming unpasteurized milk, participating in parturition and lacking knowledge on brucellosis appeared as risk factors associated with human brucellosis in western Cameroon. It raises the need of developing and implementing control measures for human and animal brucellosis.

High myopia as a risk factor in primary open angle glaucoma

Glaucoma, one of the leading causes of irreversible blindness in the adult population worldwide, is a progressive optic neuropathy. Primary open angle glaucoma (POAG) is the most commonly reported type of glaucoma in population based prevalence studies worldwide. Elevated intraocular pressure is a well-known major risk factor for POAG. In addition, there is growing evidence that other risk factors like age, gender, race, refractive error, heredity and systemic factors may play a role in glaucoma pathogenesis. Many studies found that high myopia has been associated with POAG, however, direct and convincing evidences are still lacking. The aim of this review is to summarize the evidences implicating high myopia as a risk factor in the pathogenesis of POAG.

Prevalence of High Non-high-density Lipoprotein Cholesterol and Associated Risk Factors in Patients with Diabetes Mellitus in Jilin Province,China:A Cross-sectional Study

Dyslipidemia is a risk factor for cardiovascular diseases（CVDs）in patients with diabetes,and non-high-density lipoprotein cholesterol（non-HDL-C）is a better predictor of CVDs than low-density lipoprotein cholesterol（LDL-C）in patients with diabetes.Therefore,we aimed to investigate the distribution of non-HDL-C and the prevalence of high non-HDL-C level in Chinese patients with diabetes mellitus and identify the

AIDS-Related High-Risk Behaviors and Affecting Factors of Men Who Have Sex with Men (MSM) in China's Mainland

Objectives: To describe and analyze HIV/AIDS/STD-related high risk behaviors and affecting factors of men who have sex with men (MSM) in China's Mainland~ Methods: 426 self-administered or interview-based questionnaires collected from MSM were analyzed with SPSS or SAS Systems. Results: Of the MSM, four-fifths had engaged in oral-genital intercourse, about half had engaged in anal intercourse, and in the past year more than two-fifths had casual sexual partner(s).Very few maintained monogamous sexual relationships, and nearly half also had intercourse with women. One fourth had previously been diagnosed with a venereal diseases. One HIV+individual was found among the 40 who reported having been tested for HIV. Only two men consistently used condoms among the one-third who had ever used condoms, despite almost universal knowledge of HIV and its transmission. Conclusions: MSM in China's Mainland are very sexually active, highlighting the possibility of a serious HIV epidemic that may be directly spread to the female population. However,AIDS interventions targeting MSM face severe obstructions resulting from cultural bias and other factors.

A Case-control Study on High-risk Factors for Newborn Hearing Loss in Seven Cities of Shandong Province

To investigate the high-risk factors for newborn hearing loss and to provide information for preventing the development of hearing loss and delaying its progression, from May 2003 to June 2006, neonates who failed to pass the universal newborn hearing screening （UNHS） were referred to Jinan Newborn Hearing Screening and Rehabilitation Center from 7 newborn hearing screening centers in seven cities of Shandong province. One-to-one pair-matched case-control method was employed for statistical analysis of the basic features of definitely identified cases. High-risk factors relating to the bilateral hearing loss were evaluated by univariate and multivariate Logistic regression analysis. Our results revealed that 721 transferred newborns who didn＇t pass the heating screening received audiological and medical evaluation and 367 were confirmed to have hearing loss. Of them, 177 neonates with hearing loss who met the matching requirements were included in the study as subjects. Univariate analysis showed that high-risk factors related to hearing loss incuded age of father, education backgrounds of parents, parity, birth weight, gestational weeks, craniofacial deformity, history of receiving treatment in neonatal intensive care unit （NICU）, neonatal disease, family history of otopathy and family history of congenital hearing loss. Multivariate Logistic regression analysis revealed that 4 independent risk factors were related to bilateral hearing loss, including parity （OR=16.285, 95% CI 3.379--78,481）, neonatal disease （OR=34;968, 95% CI 2.720 449.534）, family history of congenital hearing loss （OR=69.488, 95% CI 4.417--1093.300） and birth weight （OR=0.241, 95% CI 0.090--0.648）. It is concluded that parity, neonatal disease and family history of heating loss are the promoting factors of bilateral hearing loss in neonates and appropriate intervention measures should be taken to deal with the risk factors.

Relationship between cardiovascular risk factors and traditional Chinese constitution in subjects with high-normal blood pressure

Objective: We explored the relationship between traditional Chinese constitution and risk factors for cardiovascular disease in subjects with high-normal blood pressure (BP). Methods: The traditional Chinese constitution of 80 subjects with high-normal BP was judged by questionnaires and interviews. Measurements of cardiovascular and metabolic health in- cluded BP, body weight, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), 2-hour oral glucose tolerance test (OGTT2h), and waist cir- cumference. Statistical relationships between cardiovascular disease risk factors and specific Chinese constitution were evaluated by univariate and multivariate analyses. Results: Ping He, Tan Shi, and Yin Xu were the dominant constitutions in subjects with high-normal blood pressure. There were significant differences in weight, LDL-C, BMI, OGTT2h, and waist circumference between Tan Shi and Ping He (P P < 0.05), and weight, BMI, waist circumference, SBP, and LDL-C between Tan Shi and Yin Xu constitutions (P < 0.01). Logistic regression found a strong association between the Tan Shi constitution and LDL-C in subjects with high-normal blood pressure. Conclusion: Ping He, Tan Shi, and Yin Xu are the principle traditional Chinese constitutions in subject with high-normal blood pressure. The Tan Shi constitution is associated with multiple risk factors for cardiovascular disease (LDL-C, BMI, body weight, and waist circumference), while OGTT2h is closely related to the Yin Xu constitution.

MODIFIED CLASSIC RISK FACTORS FOR CORONARY ARTERY DISEASE IN CHINESE HAN POPULATION

Objective To investigate the levels of cardiovascular disease risk factors and their relations to clinical phenotype associated with coronary artery disease(CAD).Methods The subjects were recruited from five independent cardiovascular centers.Coronary angiography was employed to define the CAD with stenosis in each major vessel ≥70% and control with stenosis <10% in every lesion.The classic risk factors including family history,body mass index,smoking habits,hypertension,diabetes mellitus,and serum lipid levels were surveyed according to established criteria.Associations between risk levels and clinical phenotypes were assessed by case control and correlation analysis.Results A total of 762 individuals were collected,including 481 men and 281 women,aged from 17 to 81(mean 60±10) years.The patients with CAD accounted for 55.5% of all participants,and controls 44.5%,respectively.Compared with the pattern in published data,our study showed that mean serum high density lipoprotein cholesterol(HDL-C) level was significantly lower(P<0.001) and triglycerides was significantly higher(P<0.001),while total cholesterol(TC) and low density lipoprotein cholesterol levels were comparative(both P>0.05).The prevalence of low HDL-C(<40 g/L) and hypertriglyceridemia(>150 g/L) were 27.2% and 41.4%,respectively.Mean serum levels of HDL-C and apolipoprotein A1 were significantly higher in female subjects than in male(P<0.001).Lower HDL-C functioned as an independent risk factor for CAD only in men(RR=2.8,95%CI:1.5-4.2,P<0.001),yet increased non-HDL cholesterol combined with diabetes mellitus and obesity seemed to play a key role in the development ofCAD in women.Similarity in risk association with CAD was found for hypertension and TC/HDL ratio in male and female subjects,while family history had no relationship with the presence of CAD.Conclusion It is remarkable that emphasis of intervention in future should be given on the prevalent low serum HDL-C and its strong risk correlation with the presence of CAD in male subjects of Chinese Han population.

Large Population Screening Identified the Main Risk Factors of Stroke in Shashi District of Jingzhou City

Objective: This paper aims to screen and analyze the current status of high-risk stroke patients in Shashi District of Jingzhou City and the exposure levels of related risk factors, and provides suggestions as the references for prevention and treatment of stroke. Methods: Using cluster sampling, on-site investigations were conducted on 1060 permanent residents aged 40 years and over at 3 townships and 2 communities in Shashi District of Jingzhou City from January 2018 to December 2018. Risk assessment of stroke is based on the stroke risk screening form. Statistical analysis was performed by using SPSS 22.0 software. Results: After making a stroke risk assessment, a total of 313 high-risk stroke patients were screened, and the detection rate was 29.53%. The exposure rate of risk factors from high to low was hypertension (70.93%), dyslipidemia (46.33%), less physical exercise (46.01%), diabetes (36.10%), overweight (33.55%), smoking (33.23%), family history of stroke (24.92%), atrial fibrillation or valvular heart disease (7.35%). There are statistically significant differences among all risk factors between the high-risk group and middle and low-risk groups (P Conclusion: The detection rate of high-risk stroke patients in Shashi District of Jingzhou City is high. Hypertension, dyslipidemia and less physical exercise are the main risk factors of stroke occurrence and recurrence in the region. The prevention and treatment of risk factors for stroke should be strengthened to control the incidence and recurrence rate of stroke.

青少年抑郁症非自杀性自伤行为的影响因素

目的分析青少年抑郁症与非自杀性自伤(non-suicidal self-injury,NSSI)行为的关系及预防对策。方法114例2021年1月-2023年1月南通市第一人民医院收治的青少年抑郁症患者,依据是否伴有NSSI分为伴有NSSI组(59例)和不伴有NSSI组(55例)。统计青少年抑郁症患者NSSI的单因素,并分析其高危因素。结果伴有NSSI组与不伴有NSSI组有无焦虑、抑郁程度、有无童年家庭功能不全、有无童年虐待、是否受过校园欺凌比较,差异有统计学意义(P<0.05);有焦虑、重度抑郁、有童年家庭功能不全、有童年虐待、受过校园欺凌是青少年抑郁症患者NSSI的独立高危因素(P<0.05)。结论青少年抑郁症患者NSSI的高危因素包括有焦虑、重度抑郁、有童年家庭功能不全、有童年虐待、受过校园欺凌等,临床可据此给予青少年抑郁症患者针对性预防对策,以减少青少年抑郁症患者NSSI的发生。

成都地区汉族男性腹主动脉瘤的筛查及高危因素分析

目的探讨成都地区汉族男性腹主动脉瘤(AAA)患病率并分析危险因素。方法2014—2022年对成都市双流区24个敬老院和四川大学华西医院体检中心≥65岁的男性居民进行普查。筛查项目包括一般情况、合并症、生活习惯和超声指标。计算患病率。通过单因素及logistic逐步回归分析探索AAA发病的危险因素。结果共7132人纳入筛查,体检中心应答率为2518/3638(69.2%);敬老院应答率为3092/3494(88.5%)。参加筛查的人群均为男性,汉族,患病率为5.17%(290/5610)。290人患AAA为患病组,未患病者为未患病组。患病组腹痛、高血压、心血管疾病、脑血管疾病、吸烟,及饮酒高于未患病组(P<0.05)。高血压、脑血管疾病、心血管疾病、吸烟是AAA的影响因素(P<0.05)。结论超声在AAA筛查中可行;高血压、心脑血管疾病、吸烟是成都地区65岁以上男性人群AAA患病的危险因素。

慢性化脓性中耳炎患者耳鸣发生现况、高危因素及预测模型构建与评价

目的分析慢性化脓性中耳炎患者耳鸣发生现况,调查高危因素并构建预测模型。方法选取2020年10月至2022年10月南阳市中心医院耳鼻咽喉头颈外科就诊的103例慢性化脓性中耳炎患者,回顾性收集患者的临床资料,分析慢性化脓性中耳炎患者耳鸣发生现况。通过单因素及多因素分析慢性化脓性中耳炎患者耳鸣发生的高危因素,建立预测模型,并绘制受试者工作特征(ROC)曲线分析预测模型对慢性化脓性中耳炎患者耳鸣发生的预测价值。结果103例慢性化脓性中耳炎患者耳鸣发生45例(43.69%)纳入耳鸣组,非耳鸣组58例。多因素logistic分析结果显示,咽鼓管鼓口异常、睡眠障碍、血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和肿瘤坏死因子-α(TNF-α)水平升高为慢性化脓性中耳炎患者耳鸣发生的高危因素(P<0.05)。将上述因素纳入预测模型,将耳鸣患者纳入阳性,非耳鸣患者纳入阴性,按照预测模型绘制ROC曲线,结果显示,当logit(P)>14.60时,曲线下面积(AUC)为0.906,灵敏度为86.67%、特异度为87.93%。结论慢性化脓性中耳炎患者耳鸣发生率较高,咽鼓管鼓口异常、睡眠障碍、血清IL-6、IL-8、TNF-α水平升高与疾病发生密切相关,据此建立的预测模型预测价值较高,可为临床防治策略制定提供依据。

在自定义高危群体中M蛋白定量筛查多发性骨髓瘤及相关预后研究

目的探讨M蛋白定量检测在符合自定义高危群体中对多发性骨髓瘤的诊断及预后分层价值。方法纳入2020年6月至2022年12月就诊于本院所筛查出的200例符合自定义多发性骨髓瘤高危群体进行血清蛋白电泳M蛋白检测及血清游离轻链定量测定,记录入组患者血清蛋白电泳结果、血清游离轻链定量及κ/λ比值;阳性患者进一步完善检测确诊为多发性骨髓瘤,确诊患者再进一步行Fish检测评估预后危险分层,记录相关检测结果。结果200例高危群体中血清游离轻链比值异常共检出58例,血清蛋白电泳阳性检出39例,进一步确诊多发性骨髓瘤共34例;确诊患者血清游离轻链比值异常为34例,而血清蛋白电泳M蛋白阳性为27例,7例漏诊;免疫原位杂交(Fish)检测结果提示确诊患者血清游离轻链高比值13例中(>100或<0.01)有8例存在高危遗传学改变,其他21例有3例存在高危遗传学改变。而多发性骨髓瘤高危影响因素的多因素分析显示:女性、贫血、球蛋白异常、血肌酐升高是高危影响因素,符合本研究中自定义多发性骨髓瘤高危群体的诊断标准。结论血清游离轻链检测相较于血清蛋白电泳检测可以明显降低多发性骨髓瘤漏诊率,是高危人群检测筛查的有效手段,并且血清游离轻链高比值跟基因风险分层存在一定的正相关性,能在一定程度上反应其预后风险。

喂养方式对高危新生儿生长发育的影响及相关因素分析

目的探究喂养方式对高危新生儿生长发育的影响,并分析影响新生儿高危的因素。方法回顾性选取2017年3月至2023年3月在秦皇岛市第一医院出生且采用人工喂养的60例高危新生儿作为人工喂养组,选取同期在本院出生的60例采用母乳喂养的高危新生儿作为母乳喂养组。分析两组新生儿出生时及3月龄时的身长、体重、身长别体重Z评分(WLZ)和年龄别体重指数Z评分(BAZ)情况,比较两组新生儿3月龄时的发育指数[智力发育指数(MDI)和运动发育指数(PDI)]、气质类型及免疫水平。另选50名正常新生儿作为正常组,收集其临床资料,探究影响高危新生儿发生的相关因素。结果与出生时比较,人工喂养组与母乳喂养组患儿在3月龄时身长、体重、WLZ评分、BAZ评分均升高,差异均有统计学意义(P<0.05),但两组出生时和3月龄时的身长、体重、WLZ评分、BAZ评分组间比较,差异均无统计学意义(P>0.05)。3月龄时,母乳喂养组患儿的MDI评分和PDI评分分别为(108.55±10.98)、(108.16±10.61)分,均高于人工喂养组[(99.12±8.79)、(98.01±9.21)分],差异均有统计学意义(P<0.05),但两组的气质类型比较,差异无统计学意义(P>0.05)。母乳喂养组患儿的免疫球蛋白(Ig)G、IgM、IgA和CD3^(+)、CD4^(+)、CD8^(+)水平分别为(7.11±0.67)×10^(-6)g/L、(0.77±0.11)×10^(-6)g/L、(0.46±0.08)×10^(-6)g/L、(49.06±6.15)%、(50.33±5.78)%、(36.33±5.16)%,均高于人工喂养组[(6.12±0.78)×10^(-6)g/L、(0.68±0.16)×10^(-6)g/L、(0.33±0.07)×10^(-6)g/L、(46.33±4.56)%、(47.55±6.12)%、(28.55±6.11)%],差异均有统计学意义(P<0.05)。单因素分析可知,高危组和正常组在有无生殖道感染、有无人工终止妊娠手术史、有无腹压增高、有无胎位异常方面差异存在统计学意义(P<0.05)。多因素Logistic回归分析结果显示存在生殖道感染、患儿出生体重低于2500 g为高危新生儿发生的影响因素(P<0.05)。结论母乳喂养对于高危新生儿的生长发育和免疫功能具有积极的影响。同时,生殖道感染和低出生体重因素与高危新生儿的发生密切相关。

2018—2022年某三级甲等医院分娩产妇特征变化分析

目的:分析2018—2022年某三级甲等医院分娩产妇数量、分娩方式、不良妊娠结局、妊娠高危因素等内在特征的变化,为提高孕产妇救治能力提供依据。方法:调阅患者病历信息,收集分娩产妇基本信息、分娩方式、不良妊娠结局等指标,探讨产妇内在特征的变化。结果:2018—2022年该院产妇数量呈波动下降趋势,从2018年的9216人下降致2022年的7218人,其中2019年产妇人数达到最高峰(10084人),之后产妇数量快速下降,2022年产妇数量下降幅度趋向平稳。2018—2022年该院高龄产妇比例呈逐年上升趋势,差异有统计学意义(χ^(2)=6.819,P<0.05),其中2018年高龄产妇比例最高,为24.61%,2019年快速下降,之后逐年上升,至2022年达到22.39%。分娩结局方面,剖宫产率及无痛分娩顺产率呈逐年波动上升趋势,不良妊娠结局中低出生体重儿占比呈上升趋势,巨大儿占比呈下降趋势。2018—2022年该院胎膜早破、高龄产妇、妊娠糖尿病为发生率排名前3位的高危因素,发生率分别为22.73%、21.16%、18.42%。各高危因素中,高龄产妇、妊娠糖尿病、低出生体重儿、甲状腺功能异常、高血压、子宫肌瘤发生率呈上升趋势,巨大儿、胎心/胎动异常、过期妊娠发生率呈下降趋势。结论:2018—2022年该院产妇数量逐年下降,高龄产妇占比增加,产妇中大部分不良妊娠结局及高危因素占比均呈上升趋势。建议加强高危妊娠管理,降低产科风险因素,保障产妇及新生儿生命健康。

老年急性脑卒中患者经鼻高流量氧疗后呼吸困难信念现状及相关影响因素分析

目的 探讨老年急性脑卒中(CVA)患者经鼻高流量氧疗后(HFNC)呼吸困难信念现状及影响因素。方法 回顾性选取2022年1月-2023年1月首都医科大学附属北京天坛医院收治的136例老年CVA经HFNC患者作为研究对象,采用呼吸困难信念问卷(BBQ)进行呼吸困难信念评分,得分率=分值/满分×100%,将得分率<满分的60%设为低呼吸困难信念组,得分率≥满分的60%设为高呼吸困难信念组。比较2组文化程度、性别、领悟社会支持量表(PSSS)、住院时间、日常生活活动能力(ADL)、 24项自我效能感量表(SEES)差异,并通过二元Logistic回归分析高呼吸困难信念的影响因素。结果 研究共纳入136例老年CVA经HFNC患者,其中低呼吸困难信念组87例,高呼吸困难信念组49例;低呼吸困难信念组年龄、肺部感染控制、昏迷、吞咽功能、咳嗽反射、 SEES评分、 PSSS评分、 ADL、是否规律体育锻炼、 HFNC设置温度、发病后救治时间评估值与高呼吸困难信念组差异均有统计学意义(P<0.05);二元Logistic分析结果显示,年龄>75岁(OR=1.719,P=0.004)、吞咽功能越差(OR=1.735,P=0.006)、咳嗽反射越差(OR=1.898,P=0.0004)、 SEES评分低(OR=1.785,P=0.002)、 PSSS评分低(OR=1.599,P=0.006)、不规律体育锻炼(OR=1.634,P=0.003)、 HFNC设置温度≥37℃(OR=1.621,P=0.006)均为影响老年CVA患者HFNC后呼吸困难信念的独立危险因素(P<0.05);构建老年CVA患者HFNC后高呼吸困难信念的风险预测模型,以模型新生成概率值为依据,绘制预测模型ROC曲线,得到AUC=0.769 0(95%CI为0.681~0.759)>0.75;Hosmer-Lemeshow检验评价模型校准能力(χ^(2)=3.543,P=0.896>0.05)。结论 老年CVA患者经HFNC后呼吸困难信念总体处于较低水平,临床工作者应早期识别患者经HFNC后呼吸困难的动机,纠正他们对呼吸困难的灾害性认识,制定针对性干预措施,促进患者心理调适和疾病康复。

战斗机飞行员腰椎退行性病变危险因素分析

目的探讨战斗机飞行员腰椎退行性病变的危险因素,提出针对性的预防及治疗方案。方法利用问卷调查方式结合脊柱影像学资料对相关飞行员进行评价,调查问卷内容包括一般资料、生活方式、飞行训练方式等暴露因素,脊柱影像学检查项目包括腰椎MRI和腰椎X线片。将存在腰椎退行性病变的飞行员纳入退变组,无腰椎退行性病变的飞行员纳入健康组,采用单因素分析和logistic回归模型进行腰椎退行性病变的危险因素筛选。结果纳入研究的战斗机飞行员腰椎退行性病变的整体患病率为45.8%(66/144)。战斗机飞行员发生腰椎退行性病变的危险因素分别为久坐(OR=2.714,95%CI 1.351~5.375,P=0.004)、缺乏腰背肌锻炼(OR=3.136,95%CI1.536~6.037,P=0.001)、飞行中静态姿势不适(OR=8.160,95%CI 3.152~21.120,P<0.001)、飞行中腰椎矢状位不正(OR=8.397,95%CI 3.367~20.942,P<0.001)、飞行中腰椎冠状位不正(OR=2.744,95%CI 1.102~6.831,P=0.030)。结论战斗机飞行员腰椎退行性病变患病率较高,飞行中持续的静态姿势不适和腰椎冠状位、矢状位失稳是腰椎退行性病变的重要诱因,减少久坐、加强腰背肌锻炼是避免腰椎退行性病变的重要方法。