Abstract: Objective To explore the inhospital mortalityrelated risk factors in the patients undergoing offpump coronary artery bypass grafting (OPCAB). Methods We retrospectively analyzed the clinical data of 215 patients undergoing OPCAB in our hospital from November 2007 to November 2008. There were 171 males and 44 females aged between 40 and 85 years old. Among them, there were 47 patients older than 70 years old. All of them were coronary artery disease (CAD) patients with triple vessel disease. We adopted univarialble analysis and logistic multivariable regression analysis to screen the risk factors for the mortality of OPCAB. Results Six patients died in hospital after OPCAB with a mortality rate of 2.79% (6/215). No renal dysfunction or respiratory failure occurred. The rate of reoperation for bleeding was 4.65% (10/215) and all the 10 patients having undergone reoperation were alive. A total of 209 patients were all alive after 1year follow-up. The results of logistic multivariable regression analysis showed that New York Heart Association (NYHA) Ⅲ and Ⅳ heart function (OR=42.116，95% CI 3.319 to 534.465，P=0.004) and mechanical ventilation duration (OR=1.007，95%CI 1.001 to 1.013，P=0.028) were independent risk factors for inhospital mortality of OPCAB. Conclusion OPCAB is an effective and safe treatment for CAD with triple vessel disease. NYHA Ⅲ and Ⅳ heart function and mechanical ventilation time after OPCAB are the risk factors for OPCAB inhospital mortality, yet, needs further study with large sample.
ObjectiveTo explore risk factors associated with mortality and restenosis after the surgery for congenital pulmonary venous stenosis (CPVS) combined with congenital heart disease.MethodsFrom May 2007 to August 2019, 58 patients received surgical relief of CPVS combined with congenital heart disease, including 24 males and 34 females, aged 17.2±26.3 months, weighing 8.8±8.2 kg. Endpoints were death and restenosis, and the risk factors were analyzed. A univariate and multivariate risk analyses were performed.ResultsPreoperative pulmonary venous stenosis severity score (PVSSS) was 4.5±2.7. Average pulmonary vein counts with CPVS was 1.9±1.0. There were 2 (3.4%) early deaths. The mean follow-up time was 2-145 (49.8±40.0) months. The 1-, 2-, 3- and 5-year overall survival rates were 86.7%, 81.3%, 78.5% and 73.6%, respectively, and the pulmonary venous restenosis-free rates were 79.6%, 68.5%, 68.5% and 68.5%, respectively. Preterm birth was an independent risk factor for mortality. The pulmonary venous peak flow rate ≥1.2 m/s at discharge was an independent risk factor for mortality and restenosis.ConclusionThe prognosis of CPVS is still poor. Postoperative residual stenosis at discharge is an independent risk factor for death and restenosis.
【摘要】 目的 调查分析有家庭成员在汶川地震中伤亡的再生育夫妇自然流产的相关危险因素。 方法 通过回顾性问卷调查方式，2008年9月-2011年3月收集整理44对震后有自然流产的再生育夫妇基本资料和自然流产相关危险因素，分析该类人群震后自然流产危险因素特点。 结果 自然流产发生率占总妊娠比例的22.9%，11.1%的女性出现了震后月经改变，有人流史妇女与无人流史妇女震后月经改变率比较，差异无统计学意义（χ2=0.58，Pgt;0.05）。 结论 震后女性易发生月经改变，地震后再生育夫妇的自然流产发生率显著高于正常人群中的自然流产发生率，环境、高龄等因素可能是该人群自然流产高发的主要危险因素。【Abstract】 Objective To explore the risk factors of spontaneous abortion related in reproduction-needed couples after the earthquake. Methods Between September 2008 and March 2011, 44 pairs of reproduction-needed couples were investigated by retrospective questionnaire. The risk factors of spontaneous abortion were analyzed. Results The spontaneous abortion rate was 22.9%; 11.1% females had the menstruation changes. The difference in the rate of the menstruation changes between the females had spontaneous abortion history and the ones didn′t had the history was not significant (χ2=0.58，Pgt;0.05). Conclusions The females after the earthquake may have menstruation changes; the spontaneous abortion rate in reproduction-needed couples after the earthquake is obviously higher than that in the normal couples. The risk factors may include the environment and the age.
Objective To investigate the incidence of full-term prelabor rupture of membranes (FPROM) and risk factors for FPROM. Methods A prospective nested case-control study was performed on pregnant women in early pregnancy and their spouses, who underwent prenatal examination for the first time in Zhuhai Center for Maternal and Child Health Care from May 2021 to December 2022. Pregnant women with a clear diagnosis of FPROM were included in the case group, and pregnant women without FPROM were randomly selected at a 1∶3 ratio for inclusion in the control group. A questionnaire survey was performed to collect exposure information possibly related to FPROM. The hospital's medical record system was used for information verification and to record the pregnancy outcomes. A multivariate logistic regression analysis was used to investigate the risk factors for FPROM. Results The incidence of FPROM in this study was 24.27%. The multivariate logistic regression analysis showed that obesity pregnant women, smoking, drinking, unbalanced diet, high-intensity physical activity during pregnancy, eating areca nut before pregnancy, using glucocorticoids during pregnancy, older at the time of first pregnancy, a history of adverse pregnancy outcomes, a history of pregnancy complications, a history of diabetes, a history of scar uterus, no folate supplementation during pregnancy, repeated intrauterine operations, polyembryony, polyhydramnios, transverse fetus and fetal cephalopelvic disproportion as the way of conception were risk factors for FPROM (P<0.05). Additionally, the pregnant women whose spouses were obese or smoked or drinking had an increased risk of FPROM (P<0.05). Lower gravidity and lower parity were protective factors against FPROM (P<0.05). Conclusion There are many risk factors for FPROM. Special attention should be given to the life behaviors of pregnant women during pregnancy, and health education should be strengthened for pregnant women and their spouses to help them develop good living habits and reduce the incidence of FPROM.
Objective To analyze the risk factors of hospitalized children with acute asthma exacerbation in Chongqing region. Methods A total of 193 cases were randomly selected from the hospitalized children with acute asthma exacerbation in Chongqing Children’s hospital and Jiangjin District People’s Hospital from January 2009 to December 2009. A self-designed questionnaire was used to collect data. A control group of children were randomly selected from the out-patients who received regular maintain therapy without asthma attacks for more than 3 months. Results The first independent risk factor of asthma hospitalization was respiratory infection ( 85. 5%, 165 /193) . Irregular use of control medications was the second important factor for the acute exacerbation. There were 75% ( 138 /193) patients didn’t take controlmedications regularly, includes 102 undiagnosed and 36 pre-diagnosed cases which was more common than that in regular maintain therapy group ( 21/110, 19. 1% ) . A variety of allergen-induced acute exacerbation of asthma was also common, which accountted for 9. 3 % ( 18/193) . There were more boys than girls ( M/F:124 /69) and no significant difference in the family history of allergic diseases ( P gt; 0. 05) . Conclusion Respiratory infection, under-diagnosis of asthma, and irregular use of the control medications are risk factors of acute exacerbation in children with asthma in Chongqing region. Meanwhile allergen exposure warrantsmore attention.
Objective To analyze the risk factors for duration of mechanical ventilation in critically ill patients. Methods Ninety-six patients who received mechanical ventilation from January 2011 to December 2011 in intensive care unit were recruited in the study. The clinical data were collected retrospectively including the general condition, underlying diseases, vital signs before ventilation, laboratory examination, and APACHEⅡ score of the patients, etc. According to ventilation time, the patients were divided into a long-term group ( n = 41) and a short-term group ( n = 55) . Risk factors were screened by univariate analysis, then analyzed by logistic regression method.Results Univariate analysis revealed that the differences of temperature, respiratory index, PaCO2 , white blood cell count ( WBC) , plasma albumin ( ALB) , blood urea nitrogen ( BUN) , pulmonary artery wedge pressure ( PAWP) , APACHEⅡ, sex, lung infection in X-ray, abdominal distention, and complications between two groups were significant.With logistic multiple regression analysis, the lower level of ALB, higher level of PAWP, lung infection in X-ray, APACHE Ⅱ score, abdominal distention, and complications were independent predictors of long-term mechanical ventilation ( P lt;0. 05) . Conclusion Early improving the nutritional status and cardiac function, control infection effectively, keep stool patency, and avoid complications may shorten the duration of mechanical ventilation in critically ill patients.
目的 探讨乳腺癌改良根治术后影响局部复发与远处转移的相关因素。方法 对陕西省汉中市铁路中心医院略阳医院2000年3月至2007年3月期间行乳腺癌改良根治术且资料完整的637例原发性乳腺癌患者的临床资料进行回顾性分析。结果 66例（10.36%）患者术后发生局部复发和远处转移，其中局部复发50例（7.85%），远处转移16例（2.51%）；术后3～4年内发生复发与远处转移者47例（71.21%）。术后复发和远处转移与患者年龄、肿瘤大小、腋窝淋巴结转移情况、TNM分期、激素受体（ER/PR）表达情况及术后是否接受正规的辅助治疗有关，与患者有无家族史无关。结论 肿瘤大小、腋窝淋巴结转移情况、TNM分期、ER/PR表达情况及术后是否接受正规的辅助治疗是影响乳腺癌改良根治术后复发与远处转移的危险因素，重视乳腺癌术后随访，规范乳腺癌的手术方式，强化乳腺癌的综合治疗是降低乳腺癌改良根治术后复发与远处转移率的主要措施。
Objective To study the prevalence of snoring in adults aged over 35 yrs in Kelamayi city of Xinjiang province, and screen the snoring associated factors.Methods 2600 subjects( age≥35 yrs) were enrolled from a random sample of the population living in 5 streets, two districts in Kelamayi city. All subjects were required to answer questions about their snoring by himself or bed partner at home. The questionnaire included items concerning snoring, daytime sleepness ( Epworth sleep scale, ESS) , smoking and drinking habits, while height, weight, neck circumference, abdominal circumference, waistline, and hip circumference were meatured. The subjects were assigned to a high risk group and a low risk group according to the questionaire of scoring. Results 2590 subjects had completed the questionnaire and 2513 ( 97. 0% )were eligble for evaluation. The cases of ever snoring was 1312 ( 52. 2% ) , among which moderate to severe snoring accounted for 38. 9% . Before the age of 60 yrs, the risk of snoring increased with age, and higher in males than females( 61. 7% vs. 45. 1% ) . The prevalence of snoring increased with neck circumference( P lt;0. 05) . The body mass index ( BMI) [ ( 28. 2 ±3. 6) kg/m2 vs. ( 25. 1 ±3. 9) kg/m2 ] , neck circumference [ ( 37. 7 ±3. 6) cmvs. ( 35. 6 ±3. 6) cm] , abdominal circumference [ ( 96. 9 ±13. 6) cm vs. ( 88. 7 ±11. 1) cm] , waistline [ ( 92. 2 ±9. 8) cm vs. ( 84. 7 ±10. 2) cm] , hip circumference [ ( 102. 9 ±9. 6) cm vs.( 96. 4 ±9. 3) cm] , proportionlity of waistline to hip circumference ( 0. 90 ±0. 07 vs. 0. 88 ±0. 08) , systolic blood pressure [ ( 132. 0 ±17. 5) mm Hg vs. ( 125. 6 ±16. 8) mm Hg] , and diastolic blood pressure [ ( 83. 3 ±12. 8) mm Hg vs. ( 78. 3 ±12. 6) mm Hg] were significantly different bettween the high and the low risk groups ( P lt; 0. 01) . Logistic regression analysis revealed that age ( OR = 1. 519) , BMI ( OR =2. 549) , neck circumference (OR = 2. 473) , smoking (OR = 2. 765) , ESS(OR = 2. 575) , and postmenopause( OR=1. 806) were main risk factors for snoring( P lt; 0. 05) . Conclusions The prevalence of snoring in adults over 35 yrs is high in Kelamayi city. The high risk factors for snoring are age, BMI, neck circumference, smoking, ESS, and post-menopause.