Objective: Our object is to study risk factors of tumor patients’ PICC catheter-related blood stream infection. Method: a retrospective analysis of data of 586 PICC catheterized patients was implemented, a univariate...Objective: Our object is to study risk factors of tumor patients’ PICC catheter-related blood stream infection. Method: a retrospective analysis of data of 586 PICC catheterized patients was implemented, a univariate analysis of general data and catheterizing data of tumor patients was then carried out, and data of single factors with statistical significance were incorporated into multi-factor Logistic regression model for analysis. Results: PICC catheter-related blood stream infection occurred to 16 patients, and occurrence rate was 2.73%. Multi-factor Logistic regression analysis results showed that number of puncturing times, positioning method and maintenance frequency were risk factors for tumor patients’ peripherally inserted central catheter catheter-related blood stream infection, and odds risk values were respectively 8.762, 9.253 and 10.324. Conclusion: for tumor patients implanted with peripherally inserted central catheters, using ECG positioning during strict sterile operation and catheterizing process to avoid repeated puncturing and increasing maintenance frequency could effectively reduce occurrence of PICC catheter-related blood stream infection.展开更多
Objectives:To explore the risk factors and nursing measures of early surgical site infection(SSI)after posterior lumbar interbody fusion(PLIF).Methods:A total of 468 patients who received PLIF in our hospital from Jan...Objectives:To explore the risk factors and nursing measures of early surgical site infection(SSI)after posterior lumbar interbody fusion(PLIF).Methods:A total of 468 patients who received PLIF in our hospital from January 2017 to June 2020 were enrolled into this study.According to the occurrence of early SSI,the patients were divided into two groups,and the general data were analyzed by univariate analysis.Multivariate logistic regression analysis was conducted with the dichotomous variable of whether early SSI occurred and other factors as independent variables to identify the risk factors of early SSI and put forward targeted prevention and nursing measures.Results:Among 468 patients with PLIF,18 patients developed early SSI(3.85%).The proportion of female,age,diabetes mellitus and urinary tract infection(UTI),operation segment,operation time,post-operative drainage volume,and drainage time were significantly higher than those in the uninfected group,with statistical significance(P<0.05),whereas the preoperative albumin and hemoglobin in the infected group were significantly lower than those in the uninfected group,with statistical significance(P<0.05).There was no significant difference between the two groups in the American Society of Anesthesiologists(ASA)grading,body mass index(BMI),complications including cardiovascular and cerebrovascular diseases or hypertension(P>0.05).Logistic regression analysis showed that preoperative diabetes mellitus(OR=2.109,P=0.012)/UTI(OR=1.526,P=0.035),prolonged drainage time(OR=1.639,P=0.029)were risk factors for early SSI.Men(OR=0.736,P=0.027)and albumin level(OR=0.526,P=0.004)were protective factors in reducing early SSI.Conclusions:Women,preoperative diabetes/UTI,hypoproteinemia,and prolonged drainage time are risk factors for early SSI after PLIF.Clinical effective preventive measures should be taken in combination with targeted nursing intervention to reduce the risk of early SSI.展开更多
AIM: To analyze the risk factors for central port failure in cancer patients administered chemotherapy, using univariate and multivariate analyses. METHODS: A total of 1348 totally implantable venous access devices (T...AIM: To analyze the risk factors for central port failure in cancer patients administered chemotherapy, using univariate and multivariate analyses. METHODS: A total of 1348 totally implantable venous access devices (TIVADs) were implanted into 1280 cancer patients in this cohort study. A Cox proportional hazard model was applied to analyze risk factors for failure of TIVADs. Log-rank test was used to compare actuarial survival rates. Infection, thrombosis, and surgical complication rates (χ2 test or Fisher's exact test) were compared in relation to the risk factors. RESULTS: Increasing age, male gender and openended catheter use were signifi cant risk factors reducing survival of TIVADs as determined by univariate and multivariate analyses. Hematogenous malignancy decreased the survival time of TIVADs; this reduction was not statistically signifi cant by univariate analysis [hazard ratio (HR) = 1.336, 95% CI: 0.966-1.849, P = 0.080)]. However, it became a signifi cant risk factor by multivariate analysis (HR = 1.499, 95% CI: 1.079-2.083, P = 0.016) when correlated with variables of age, sex and catheter type. Close-ended (Groshong) catheters had a lower thrombosis rate than open-ended catheters (2.5% vs 5%, P = 0.015). Hematogenous malignancy had higher infection rates than solid malignancy (10.5% vs 2.5%, P < 0.001). CONCLUSION: Increasing age, male gender, openended catheters and hematogenous malignancy were risk factors for TIVAD failure. Close-ended catheters had lower thrombosis rates and hematogenous malignancy had higher infection rates.展开更多
Objective To explore the risk factors for epilepsy induced by stroke. Methods There were 179 patients with epilepsy caused by stroke,and 1 447 patients with cerebrovascular disorders without epilepsy after stroke. Mul...Objective To explore the risk factors for epilepsy induced by stroke. Methods There were 179 patients with epilepsy caused by stroke,and 1 447 patients with cerebrovascular disorders without epilepsy after stroke. Multivariate noncondition stepwise logistic model analysis was made after single variable analysis.Results The following four factors were associated with epilepsy, i.e., large size of cerebral hemorrhage or cerebral infarction,subarachnoid hemorrhage, electrolyte disturbances and cortical lesions.Conclusion Epilepsy induced by stroke is mainly associated with the size of brain tissue necrosis.展开更多
Background: Endoscopic retrograde cholangiopancreatography(ERCP) may have complications. Our study aimed to investigate the risk factors and prevention of post-ERCP cholangitis.Methods: We retrospectively analyzed 423...Background: Endoscopic retrograde cholangiopancreatography(ERCP) may have complications. Our study aimed to investigate the risk factors and prevention of post-ERCP cholangitis.Methods: We retrospectively analyzed 4234 cases undergone ERCP in the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2008 to December 2013. Patient-related factors and procedure-related factors were analyzed to find the risk factors of post-ERCP cholangitis. The time point of post-ERCP cholangitis was also analyzed. Univariate and multivariate analyses were performed to define the independent risk factors of post-ERCP cholangitis.Results: The success rate of ERCP was 96.8%(4099/4234). The overall complication rate was 9.4%(399/4234). Post-ERCP cholangitis occurred in 102 cases(2.4%, 102/4234). The most dangerous time of post-ERCP cholangitis was from 24 h–48 h after ERCP(45.1%, 46/102). Univariate analysis revealed that age, hypertension, diabetes, previous ERCP history, biliary stent insertion, pancreatography, endoscopic sphincterotomy, balloon dilation and hilar obstruction were risk factors of post-ERCP cholangitis(P < 0.05). Multivariate analysis indicated that age, previous ERCP history and hilar obstruction were independent risk factors(P < 0.05). While endoscopic stone extraction was the potential protective factor.Conclusions: Many risk factors are involved in post-ERCP cholangitis. Among them, old age, previous ERCP history and hilar obstruction were independently related to this post-ERCP complication.展开更多
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...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.展开更多
AIM To assess risk factors of hospital admission for acute colonic diverticulitis.METHODS The study was conducted as part of the second wave of the population-based North Trondelag Health Study(HUNT2), performed in No...AIM To assess risk factors of hospital admission for acute colonic diverticulitis.METHODS The study was conducted as part of the second wave of the population-based North Trondelag Health Study(HUNT2), performed in North Trondelag County, Norway, 1995 to 1997. The study consisted of 42570 participants(65.1% from HUNT2) who were followed up from 1998 to 2012. Of these, 22436(52.7%) were females. The cases were defined as those 358 participants admitted with acute colonic diverticulitis during follow-up. The remaining participants were used as controls. Univariable and multivariable Cox regression analyses was used for each sex separately after multiple imputation to calculate HR.RESULTS Multivariable Cox regression analyses showed that increasing age increased the risk of admission for acute colonic diverticulitis: Comparing with ages < 50 years, females with age 50-70 years had HR = 3.42, P < 0.001 and age > 70 years, HR = 6.19, P < 0.001. In males the corresponding values were HR = 1.85, P = 0.004 and 2.56, P < 0.001. In patients with obesity(body mass index ≥ 30) the HR = 2.06, P < 0.001 in females and HR = 2.58, P < 0.001 in males. In females, present(HR = 2.11, P < 0.001) or previous(HR = 1.65, P = 0.007) cigarette smoking increased the risk of admission. In males, breathlessness(HR = 2.57, P < 0.001) and living in rural areas(HR = 1.74, P = 0.007) increased the risk. Level of education, physical activity, constipation and type of bread eaten showed no association with admission for acute colonic diverticulitis.CONCLUSION The risk of hospital admission for acute colonic diverticulitis increased with increasing age, in obese individuals, in ever cigarette smoking females and in males living in rural areas.展开更多
Objective: To evaluate the morbidity due to diabetes mellitus type 2 within the State of San Luis Potosí, México, through a strong methodology, through which the multivariate relations were identified of the...Objective: To evaluate the morbidity due to diabetes mellitus type 2 within the State of San Luis Potosí, México, through a strong methodology, through which the multivariate relations were identified of the main social and environmental determiners in the disease, thus managing to quantify their respective levels of responsibility. Material and Methods: This evaluation began as a hypothesis of a multicasual theoretical model on diabetes mellitus and its main determining factors, which was analyzed through the application of multivariate exploratory statistical methodologies and confirmed as it is the case of the principal components analysis and the structural equation models. Results: Three components were extracted that explain the 96% of the total variance of the indicators;the main risk factors which were identified in the first component were, the use of the car, age, homes with TV use, urban life and feminine population;the indicators from the second and third component have little influence in the impact of the disease. Conclusions: the study shows the usefulness of the model for the analysis and prioritization of the environmental and social determiners of the disease, information that could sustain the design of public guidelines for the prevention and control of the analyzed disease.展开更多
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 s...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.展开更多
Objective:This study is to investigate the nisk factors of femoral head contracture after total hip arthroplasty(THA)in patients with avascular necrosis of femoral head.Methods:Retrospective analysis was perfomed in 3...Objective:This study is to investigate the nisk factors of femoral head contracture after total hip arthroplasty(THA)in patients with avascular necrosis of femoral head.Methods:Retrospective analysis was perfomed in 361 cases of femoral head necrosis patients taking THA fom September 2016 to December 2017.A total of 179 patents with no significant preoperative adductor muscle contraction were finally enrolled in this study.These 179 patients were further divided into two groups:contracture group(64 cases)and noncompaction group(115 cases).The chi-square test was used to compare the differences between the two groups.Risk factors were identifed by logistic regession analysis.Results:of the patients included,64 patients (35.75%)developed into end adductor muscle contracture.There were signuificant differences in limb shortening.surgical history,whether taction,surgical approach,surgical methods,and fumctional training between the two goups(P<0.05).Logistic regression analysis showed that shortness of extremity,sugical approach,effective taction,surgical history,and etiology were the factors affecting femoral head contracture after THA in patients with avascular necrosis of femoral head.Conclusions:Preoperative traction therapy,surgical methods,and postoperative functional training are the factors that affect the adductor muscle contraction after THA.展开更多
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.METH...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.展开更多
Most current studies focus on statistics of the incidence, etiology, and rehabilitative treatment of cerebral palsy. However, very few studies focus on the environmental risk factors for this syndrome In the present s...Most current studies focus on statistics of the incidence, etiology, and rehabilitative treatment of cerebral palsy. However, very few studies focus on the environmental risk factors for this syndrome In the present study, a total of 202 children with cerebral palsy in the Jiamusi district of China were selected as the case group, and 404 children were randomly selected for the control group. The survey focused on environmental factors during pregnancy, which included indoor pollution as the most dangerous factor (odds ratio = 2.432, 95% confidence interval = 1.172-5.047; P = 0.017), followed by use of high-radiation mobile phones, more than 5 hours of watching television per day, and cooking with a marble kitchen platform during pregnancy. Results demonstrated that environmental risk factors play a role in the development of cerebral palsy in children.展开更多
Landslide is a serious natural disaster next only to earthquake and flood,which will cause a great threat to people’s lives and property safety.The traditional research of landslide disaster based on experience-drive...Landslide is a serious natural disaster next only to earthquake and flood,which will cause a great threat to people’s lives and property safety.The traditional research of landslide disaster based on experience-driven or statistical model and its assessment results are subjective,difficult to quantify,and no pertinence.As a new research method for landslide susceptibility assessment,machine learning can greatly improve the landslide susceptibility model’s accuracy by constructing statistical models.Taking Western Henan for example,the study selected 16 landslide influencing factors such as topography,geological environment,hydrological conditions,and human activities,and 11 landslide factors with the most significant influence on the landslide were selected by the recursive feature elimination(RFE)method.Five machine learning methods[Support Vector Machines(SVM),Logistic Regression(LR),Random Forest(RF),Extreme Gradient Boosting(XGBoost),and Linear Discriminant Analysis(LDA)]were used to construct the spatial distribution model of landslide susceptibility.The models were evaluated by the receiver operating characteristic curve and statistical index.After analysis and comparison,the XGBoost model(AUC 0.8759)performed the best and was suitable for dealing with regression problems.The model had a high adaptability to landslide data.According to the landslide susceptibility map of the five models,the overall distribution can be observed.The extremely high and high susceptibility areas are distributed in the Funiu Mountain range in the southwest,the Xiaoshan Mountain range in the west,and the Yellow River Basin in the north.These areas have large terrain fluctuations,complicated geological structural environments and frequent human engineering activities.The extremely high and highly prone areas were 12043.3 km^(2)and 3087.45 km^(2),accounting for 47.61%and 12.20%of the total area of the study area,respectively.Our study reflects the distribution of landslide susceptibility in western Henan Province,which provides a scientific basis for regional disaster warning,prediction,and resource protection.The study has important practical significance for subsequent landslide disaster management.展开更多
文摘Objective: Our object is to study risk factors of tumor patients’ PICC catheter-related blood stream infection. Method: a retrospective analysis of data of 586 PICC catheterized patients was implemented, a univariate analysis of general data and catheterizing data of tumor patients was then carried out, and data of single factors with statistical significance were incorporated into multi-factor Logistic regression model for analysis. Results: PICC catheter-related blood stream infection occurred to 16 patients, and occurrence rate was 2.73%. Multi-factor Logistic regression analysis results showed that number of puncturing times, positioning method and maintenance frequency were risk factors for tumor patients’ peripherally inserted central catheter catheter-related blood stream infection, and odds risk values were respectively 8.762, 9.253 and 10.324. Conclusion: for tumor patients implanted with peripherally inserted central catheters, using ECG positioning during strict sterile operation and catheterizing process to avoid repeated puncturing and increasing maintenance frequency could effectively reduce occurrence of PICC catheter-related blood stream infection.
文摘Objectives:To explore the risk factors and nursing measures of early surgical site infection(SSI)after posterior lumbar interbody fusion(PLIF).Methods:A total of 468 patients who received PLIF in our hospital from January 2017 to June 2020 were enrolled into this study.According to the occurrence of early SSI,the patients were divided into two groups,and the general data were analyzed by univariate analysis.Multivariate logistic regression analysis was conducted with the dichotomous variable of whether early SSI occurred and other factors as independent variables to identify the risk factors of early SSI and put forward targeted prevention and nursing measures.Results:Among 468 patients with PLIF,18 patients developed early SSI(3.85%).The proportion of female,age,diabetes mellitus and urinary tract infection(UTI),operation segment,operation time,post-operative drainage volume,and drainage time were significantly higher than those in the uninfected group,with statistical significance(P<0.05),whereas the preoperative albumin and hemoglobin in the infected group were significantly lower than those in the uninfected group,with statistical significance(P<0.05).There was no significant difference between the two groups in the American Society of Anesthesiologists(ASA)grading,body mass index(BMI),complications including cardiovascular and cerebrovascular diseases or hypertension(P>0.05).Logistic regression analysis showed that preoperative diabetes mellitus(OR=2.109,P=0.012)/UTI(OR=1.526,P=0.035),prolonged drainage time(OR=1.639,P=0.029)were risk factors for early SSI.Men(OR=0.736,P=0.027)and albumin level(OR=0.526,P=0.004)were protective factors in reducing early SSI.Conclusions:Women,preoperative diabetes/UTI,hypoproteinemia,and prolonged drainage time are risk factors for early SSI after PLIF.Clinical effective preventive measures should be taken in combination with targeted nursing intervention to reduce the risk of early SSI.
文摘AIM: To analyze the risk factors for central port failure in cancer patients administered chemotherapy, using univariate and multivariate analyses. METHODS: A total of 1348 totally implantable venous access devices (TIVADs) were implanted into 1280 cancer patients in this cohort study. A Cox proportional hazard model was applied to analyze risk factors for failure of TIVADs. Log-rank test was used to compare actuarial survival rates. Infection, thrombosis, and surgical complication rates (χ2 test or Fisher's exact test) were compared in relation to the risk factors. RESULTS: Increasing age, male gender and openended catheter use were signifi cant risk factors reducing survival of TIVADs as determined by univariate and multivariate analyses. Hematogenous malignancy decreased the survival time of TIVADs; this reduction was not statistically signifi cant by univariate analysis [hazard ratio (HR) = 1.336, 95% CI: 0.966-1.849, P = 0.080)]. However, it became a signifi cant risk factor by multivariate analysis (HR = 1.499, 95% CI: 1.079-2.083, P = 0.016) when correlated with variables of age, sex and catheter type. Close-ended (Groshong) catheters had a lower thrombosis rate than open-ended catheters (2.5% vs 5%, P = 0.015). Hematogenous malignancy had higher infection rates than solid malignancy (10.5% vs 2.5%, P < 0.001). CONCLUSION: Increasing age, male gender, openended catheters and hematogenous malignancy were risk factors for TIVAD failure. Close-ended catheters had lower thrombosis rates and hematogenous malignancy had higher infection rates.
文摘Objective To explore the risk factors for epilepsy induced by stroke. Methods There were 179 patients with epilepsy caused by stroke,and 1 447 patients with cerebrovascular disorders without epilepsy after stroke. Multivariate noncondition stepwise logistic model analysis was made after single variable analysis.Results The following four factors were associated with epilepsy, i.e., large size of cerebral hemorrhage or cerebral infarction,subarachnoid hemorrhage, electrolyte disturbances and cortical lesions.Conclusion Epilepsy induced by stroke is mainly associated with the size of brain tissue necrosis.
基金supported by grants from the outstanding Youth Project of Nanjing Medical Scientific and Technological Development Project of Nanjing City(JQX14005)
文摘Background: Endoscopic retrograde cholangiopancreatography(ERCP) may have complications. Our study aimed to investigate the risk factors and prevention of post-ERCP cholangitis.Methods: We retrospectively analyzed 4234 cases undergone ERCP in the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2008 to December 2013. Patient-related factors and procedure-related factors were analyzed to find the risk factors of post-ERCP cholangitis. The time point of post-ERCP cholangitis was also analyzed. Univariate and multivariate analyses were performed to define the independent risk factors of post-ERCP cholangitis.Results: The success rate of ERCP was 96.8%(4099/4234). The overall complication rate was 9.4%(399/4234). Post-ERCP cholangitis occurred in 102 cases(2.4%, 102/4234). The most dangerous time of post-ERCP cholangitis was from 24 h–48 h after ERCP(45.1%, 46/102). Univariate analysis revealed that age, hypertension, diabetes, previous ERCP history, biliary stent insertion, pancreatography, endoscopic sphincterotomy, balloon dilation and hilar obstruction were risk factors of post-ERCP cholangitis(P < 0.05). Multivariate analysis indicated that age, previous ERCP history and hilar obstruction were independent risk factors(P < 0.05). While endoscopic stone extraction was the potential protective factor.Conclusions: Many risk factors are involved in post-ERCP cholangitis. Among them, old age, previous ERCP history and hilar obstruction were independently related to this post-ERCP complication.
基金Supported by Hubei Province Education Science Planning Project,No.2020GB132。
文摘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.
基金Supported by Institute of Cancer Research and Molecular Medicine,The Medical Faculty,Norwegian University of Science and Technology,Trondheim,Norwaythe Department of Research,Levanger Hospital,Levanger
文摘AIM To assess risk factors of hospital admission for acute colonic diverticulitis.METHODS The study was conducted as part of the second wave of the population-based North Trondelag Health Study(HUNT2), performed in North Trondelag County, Norway, 1995 to 1997. The study consisted of 42570 participants(65.1% from HUNT2) who were followed up from 1998 to 2012. Of these, 22436(52.7%) were females. The cases were defined as those 358 participants admitted with acute colonic diverticulitis during follow-up. The remaining participants were used as controls. Univariable and multivariable Cox regression analyses was used for each sex separately after multiple imputation to calculate HR.RESULTS Multivariable Cox regression analyses showed that increasing age increased the risk of admission for acute colonic diverticulitis: Comparing with ages < 50 years, females with age 50-70 years had HR = 3.42, P < 0.001 and age > 70 years, HR = 6.19, P < 0.001. In males the corresponding values were HR = 1.85, P = 0.004 and 2.56, P < 0.001. In patients with obesity(body mass index ≥ 30) the HR = 2.06, P < 0.001 in females and HR = 2.58, P < 0.001 in males. In females, present(HR = 2.11, P < 0.001) or previous(HR = 1.65, P = 0.007) cigarette smoking increased the risk of admission. In males, breathlessness(HR = 2.57, P < 0.001) and living in rural areas(HR = 1.74, P = 0.007) increased the risk. Level of education, physical activity, constipation and type of bread eaten showed no association with admission for acute colonic diverticulitis.CONCLUSION The risk of hospital admission for acute colonic diverticulitis increased with increasing age, in obese individuals, in ever cigarette smoking females and in males living in rural areas.
文摘Objective: To evaluate the morbidity due to diabetes mellitus type 2 within the State of San Luis Potosí, México, through a strong methodology, through which the multivariate relations were identified of the main social and environmental determiners in the disease, thus managing to quantify their respective levels of responsibility. Material and Methods: This evaluation began as a hypothesis of a multicasual theoretical model on diabetes mellitus and its main determining factors, which was analyzed through the application of multivariate exploratory statistical methodologies and confirmed as it is the case of the principal components analysis and the structural equation models. Results: Three components were extracted that explain the 96% of the total variance of the indicators;the main risk factors which were identified in the first component were, the use of the car, age, homes with TV use, urban life and feminine population;the indicators from the second and third component have little influence in the impact of the disease. Conclusions: the study shows the usefulness of the model for the analysis and prioritization of the environmental and social determiners of the disease, information that could sustain the design of public guidelines for the prevention and control of the analyzed disease.
基金Key Medical Speciality (Obstetrics) of Jiading District, Shanghai (JDYXZDZK-8)
文摘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.
基金This study is supported by Guangxi Zhuang Traditional Chinese Medicine Self-financing Research Projects.
文摘Objective:This study is to investigate the nisk factors of femoral head contracture after total hip arthroplasty(THA)in patients with avascular necrosis of femoral head.Methods:Retrospective analysis was perfomed in 361 cases of femoral head necrosis patients taking THA fom September 2016 to December 2017.A total of 179 patents with no significant preoperative adductor muscle contraction were finally enrolled in this study.These 179 patients were further divided into two groups:contracture group(64 cases)and noncompaction group(115 cases).The chi-square test was used to compare the differences between the two groups.Risk factors were identifed by logistic regession analysis.Results:of the patients included,64 patients (35.75%)developed into end adductor muscle contracture.There were signuificant differences in limb shortening.surgical history,whether taction,surgical approach,surgical methods,and fumctional training between the two goups(P<0.05).Logistic regression analysis showed that shortness of extremity,sugical approach,effective taction,surgical history,and etiology were the factors affecting femoral head contracture after THA in patients with avascular necrosis of femoral head.Conclusions:Preoperative traction therapy,surgical methods,and postoperative functional training are the factors that affect the adductor muscle contraction after THA.
基金Supported by the Beijing Traditional Chinese Medicine Science and Technology Development Fund,No.JJ2018-45the Beijing Municipal Natural Science Foundation,No.7172076 and No.7212169.
文摘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.
基金the National Natural Science Foundation of China,No. 30671803,30771863
文摘Most current studies focus on statistics of the incidence, etiology, and rehabilitative treatment of cerebral palsy. However, very few studies focus on the environmental risk factors for this syndrome In the present study, a total of 202 children with cerebral palsy in the Jiamusi district of China were selected as the case group, and 404 children were randomly selected for the control group. The survey focused on environmental factors during pregnancy, which included indoor pollution as the most dangerous factor (odds ratio = 2.432, 95% confidence interval = 1.172-5.047; P = 0.017), followed by use of high-radiation mobile phones, more than 5 hours of watching television per day, and cooking with a marble kitchen platform during pregnancy. Results demonstrated that environmental risk factors play a role in the development of cerebral palsy in children.
基金This work was financially supported by National Natural Science Foundation of China(41972262)Hebei Natural Science Foundation for Excellent Young Scholars(D2020504032)+1 种基金Central Plains Science and technology innovation leader Project(214200510030)Key research and development Project of Henan province(221111321500).
文摘Landslide is a serious natural disaster next only to earthquake and flood,which will cause a great threat to people’s lives and property safety.The traditional research of landslide disaster based on experience-driven or statistical model and its assessment results are subjective,difficult to quantify,and no pertinence.As a new research method for landslide susceptibility assessment,machine learning can greatly improve the landslide susceptibility model’s accuracy by constructing statistical models.Taking Western Henan for example,the study selected 16 landslide influencing factors such as topography,geological environment,hydrological conditions,and human activities,and 11 landslide factors with the most significant influence on the landslide were selected by the recursive feature elimination(RFE)method.Five machine learning methods[Support Vector Machines(SVM),Logistic Regression(LR),Random Forest(RF),Extreme Gradient Boosting(XGBoost),and Linear Discriminant Analysis(LDA)]were used to construct the spatial distribution model of landslide susceptibility.The models were evaluated by the receiver operating characteristic curve and statistical index.After analysis and comparison,the XGBoost model(AUC 0.8759)performed the best and was suitable for dealing with regression problems.The model had a high adaptability to landslide data.According to the landslide susceptibility map of the five models,the overall distribution can be observed.The extremely high and high susceptibility areas are distributed in the Funiu Mountain range in the southwest,the Xiaoshan Mountain range in the west,and the Yellow River Basin in the north.These areas have large terrain fluctuations,complicated geological structural environments and frequent human engineering activities.The extremely high and highly prone areas were 12043.3 km^(2)and 3087.45 km^(2),accounting for 47.61%and 12.20%of the total area of the study area,respectively.Our study reflects the distribution of landslide susceptibility in western Henan Province,which provides a scientific basis for regional disaster warning,prediction,and resource protection.The study has important practical significance for subsequent landslide disaster management.