糖尿病足患者并发肌少症的危险因素分析

目的 探讨分析糖尿病足患者并发肌少症的相关危险因素。方法 选取2019年1月至2020年12月焦作市人民医院收治的80例糖尿病足患者作为研究对象,收集患者性别、体重指数、糖尿病病程、蛋白质摄取量、是否合并维生素D缺乏症、运动锻炼时间、有无吸烟史、有无饮酒史、是否合并高血压以及糖化血红蛋白、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇水平等资料,并根据患者是否并发肌少症将患者分为发生组和未发生组,多因素Logistic回归分析糖尿病足患者并发肌少症的相关危险因素。结果 80例糖尿病足患者中13例(16.25%)患者发生肌少症,设为发生组;67例(83.75%)患者未发生肌少症,设为未发生组。单因素分析结果显示,发生组糖尿病病程≥10年、蛋白质摄取量不足、合并有维生素D缺乏症、运动锻炼时间<30 min/d的患者比例均明显高于未发生组(χ²=5.996、6.701、3.990、10.533,P=0.015、0.010、0.046、0.001),糖化血红蛋白水平亦明显高于未发生组(t=3.189,P=0.002);多因素Logistic回归分析结果显...     

老年胃溃疡出血患者再发出血的危险因素分析

【摘要】 目的 探讨分析老年胃溃疡出血患者再发出血的相关危险因素。方法 选取 2020 年3月至2022年3月许昌市中心医院收治的 140 例老年胃溃疡出血患者作为研究对象, 收集患者性别、年龄、发病部位、胃溃疡长径、出血活动度、是否为胃溃疡 A1 期、是否合并幽门螺杆菌 (Hp) 感染、有无吸烟史、有无饮酒史、合并其他慢性疾病种类 (≤2 种、>2 种)、是否进行消化内镜治疗、是否长期使用非甾体抗炎药 (NSAIDs) 等资料,并根据患者止血成功后 1 个月内是否再发出血将患者分为发生组与未发生组? 多因素 Logistic 回归分析老年胃溃疡出血患者再发出血的危险因素。结果 140 例老年胃溃疡出血患者均于止血成功后随访 1 个月, 随访过程中 21例 (15.0%) 患者再发出血, 设为发生组; 119 例 (85.0%) 患者未再发出血, 设为未发生组。单因素分析结果显示, 发生组胃溃疡 A1 期、Hp 感染、未进行消化内镜治疗、长期使用 NSAIDs 的患者比例均明显高于未发生组(χ2 = 4.269、7.381、7.580、11.836, P= 0.039、0.007、0.006、0.001); 多因素 Logistic 回归分析结果显示, 胃溃疡 A1 期、Hp 感染、未进行消化内镜治疗、长期使用 NSAIDs 是老年胃溃疡出血患者再发出血的独立危险因素(95%CI 为 1.039~ 9.660、1.909~ 58.707、0.059~ 0.585、1.880~ 18.559, P= 0.043、0.007、0.004、0.002)。 结论 胃溃疡 A1 期、Hp 感染、未进行消化内镜治疗、长期使用 NSAIDs 是老年胃溃疡出血患者再发出血的独立危险因素, 临床应根据患者具体情况制定针对性干预措施, 以降低再出血发生风险。     

糖尿病肾病患者并发高尿酸血症的相关因素

目的 分析糖尿病肾病患者并发高尿酸血症的影响因素。方法 收集2018年02月-2022年02月期间治疗的糖尿病肾病并发高尿酸血症患者38例临床资料,将其纳入发生组;另收集同期医院治疗的糖尿病肾病未并发高尿酸血症的患者38例临床资料,将其纳入未发生组。统计所有患者基线资料,将可能的影响因素纳入,找出糖尿病肾病患者并发高尿酸血症的影响因素。结果 两组肥胖、吸烟史、饮酒史、甘油三酯与N-末端脑钠肽前体水平比较,差异有统计学意义(P<0.05);经Logistic回归分析结果显示肥胖、吸烟史、饮酒史、甘油三酯、N-末端脑钠肽前体是糖尿病肾病患者并发高尿酸血症的影响因素(OR>1,P<0.05)。结论 糖尿病肾病患者并发高尿酸血症受肥胖、吸烟史、饮酒史、甘油三酯水平高、N-末端脑钠肽前体水平高等因素影响。     

无肝硬化乙肝患者肝癌发病影响因素分析

 目的 探讨无肝硬化乙肝相关肝癌患者的发病因素。方法 收集2004-01至2015-12月我院就诊的原发性肝癌共1000例。根据是否有肝硬化分为肝硬化组(n=934例)及无肝硬化组(n=66例),回顾性分析2组患者的一般情况及实验室检查指标等资料,对无肝硬化乙肝相关肝癌患者的发病因素进行χ²检验及Logistic回归分析。结果 单因素分析表明2组患者在年龄、是否饮酒、是否重叠丙型肝炎病毒感染、是否合并高血压、基线血清e抗原状态及血清HBV DNA水平、是否行抗病毒治疗与是否有肝癌家族史方面差异有统计学意义(P<0.05);将其纳入多因素非条件Logistic回归分析,结果提示饮酒(OR=0.176,P=0.002)、有高血压病史(OR=0.505,P=0.039)、基线血清HBV DNA水平偏低(OR=0.031,P＜0.001)、既往未行抗病毒治疗(OR=7.268,P＜0.001)、有肝癌家族史(OR=0.487,P=0.010)是无肝硬化慢性乙型肝炎患者直接进展为原发性肝癌的独立危险因素。结论 对于有饮酒史、有高血压病史、基线血清HBV DNA水平偏低、既往未行抗病毒治疗及有肝癌家族史的无肝硬化慢性乙型肝炎患者,应密切监测肝癌的发生。     

南方某部队官兵消化性溃疡患者合并出血的相关因素分析

目的探讨部队消化性溃疡(PU)患者合并出血(PUB)的相关因素。方法回顾性分析南方战区近5年收治的192例军人PUB患者的临床资料。结果在南方部队军人中,PU患者合并出血的发生率为34.1%。在相关因素中,有军事专业、军事因素、心理因素、吸烟饮酒、感染幽门螺杆菌的PU患者的PUB发生率明显高于无上述因素PU患者发生率(均P<0.01),1、4季度PUB的发生率明显高于2、3季度的发生率(P<0.01)。结论军人PUB发生危险因素与军事专业、军事因素、心理因素、吸烟饮酒、季节、幽门螺杆菌感染有关。     

药物性胃炎流行病学调查研究

目的调查用药患者的药物性胃炎流行病学特征,为揭示药物性胃炎发病特点提供依据。方法按照一定标准纳入1 684例用药患者为研究对象,收集其病历资料,分析药物性胃炎发病与临床特征参数的关系及用药种类的关系。结果本组1 684例用药患者中,共发生药物性胃炎132例,发病率7.8%。其中,男性患者群体的发病率显著高于女性患者(P=0.006);有吸烟史或者饮酒史的患者发病率显著高于没有吸烟史(P=0.006)或饮酒史(P=0.034)的患者;在45~59岁年龄段、满族、蒙古族、劳动强度高的人群药物性胃炎发病率有增高的趋势。非甾体抗炎药导致的患者数最多,占28.0%;其次为抗菌药,占19.7%;抗肿瘤药物是最易于引发药物性胃炎的药物种类,发病率达19.7%;其次是非甾体抗炎药,发病率达到12.4%。结论药物性胃炎好发于有吸烟史、饮酒史、男性用药人群,且劳动强度高、45~59岁年龄段、满蒙等尚酒民族人群发病率有增高趋势,其病因以非甾体抗炎药和抗菌药最为常见,而最易诱发药物性胃炎者为抗肿瘤药物。     

新兵消化性溃疡发病特点及相关因素研究进展

消化性溃疡(PU)的发生是因一种或多种有害因素对黏膜破坏超过黏膜抵御损伤和自身修复的能力。集训期新兵是一个特殊人群,除季节、吸烟、饮酒、服用非甾体抗炎药等常见危险因素外,还存在生活模式突变、军事训练、心理压力、高幽门螺杆菌(HP)感染率等特有的PU危险因素。现就新兵消化性溃疡发病特点及相关因素的研究进展综述如下。     

ICU 骨科术后患者并发感染的危险因素分析

【摘要】 目的 探讨分析重症监护病房(ICU)骨科术后患者并发感染的相关危险因素。方法 选取2020年6月至2022年6月南阳市中心医院综合ICU收治的 86 例骨科术后患者作为研究对象, 收集患者性别、年龄?体重指数、骨折类型、美国麻醉医师协会 (ASA) 分级、手术时间、切口类型、是否输血、是否进行机械通气、抗菌药物使用时间、ICU入住时间以及是否合并高血压、糖尿病及骨质疏松等资料，并根据术后30 d内是否发生感染将患者分为感染组与未感染组，多因素Logistic回归分析ICU骨科术后患者并发感染的相关危险因素。结果 86例患者中术后发生感染14例 (16.28% ), 设为感染组; 未发生感染 72 例 (83.72% ), 设为未感染组?单因素分析结果显示, 感染组年龄≥65 岁、手术时间≥2 h、切口类型为Ⅲ类、进行机械通气、抗菌药物使用时间≥7 d、ICU 入住时间≥7 d 以及合并糖尿病的患者比例明显高于未感染组(χ2= 9.260、11.427、9.108、5.917、16.124、9.101、15.849, P = 0.002、P = 0.001、P = 0.011、P = 0.015、P < 0.001、P = 0.003、P <0.001);多因素Logistic回归分析结果显示，手术时间≥2 h、进行机械通气、抗菌药物使用时间≥7 d、合并糖尿病是ICU骨科术后患者并发感染的独立危险因素(95% CI 为 1.190 ~ 9.430、1.550 ~ 17.957、1.328 ~ 17.859、2.244 ~ 16.702, P = 0.022、0.008、0.017、0.000)。结论 ICU 骨科术后患者的感染发生情况与手术时间、是否进行机械通气、抗菌药物使用时间以及是否合并糖尿病密切相关。     

HIV感染者并发肺结核发病特征及危险因素分析

目的 探讨HIV感染者并发肺结核的发病特征及危险因素,为其预防提供参考.方法 对196例HIV感染者进行为期3年的跟踪随访,统计并发肺结核发生率、首发症状、发病距确诊HIV感染时间、临床特征及危险因素,包括是否有结核家族史、结核接触史,是否抗HIV治疗,是否吸烟、饮酒,是否吸毒及方式,是否为同性恋,居住环境是否通风,有无卡介苗接种史,是否劳累、贫困,是否经常体育锻炼等.结果 196例中,188例成功随访,随访期间并发肺结核38例(20.2％),发病距初诊HIV感染时间为3～26个月;发生于HIV感染急性期4例,无症状期12例,艾滋病期22例.首发症状以发热(47.4％)、咳嗽(31.6％)、咯血(10.5％)为主.结核接触史、吸烟、饮酒、吸毒、劳累、贫困是并发肺结核的危险因素,而抗HIV治疗、居住环境通风、卡介苗接种史是并发肺结核的保护因素.结论 HIV感染并发肺结核的首发症状以发热为主,好发于艾滋病期,结核接触史、吸烟、饮酒、吸毒、劳累、贫困是HIV感染者并发肺结核的危险因素.     

腹腔镜手术对胆囊结石合并急性胆囊炎患者机体应激及免疫功能影响

目的探讨腹腔镜手术对胆囊结石合并急性胆囊炎患者机体应激及免疫功能的影响。方法选取辽阳市中心医院自2015年3月至2017年10月收治的206例胆囊结石合并急性胆囊炎患者为研究对象。根据术式不同将患者分为腹腔镜组(n=101)和开腹组(n=105)。比较两组患者手术前后白细胞(WBC)、中性粒细胞百分比、白细胞介素-6(IL-6)、C反应蛋白(CRP)、皮质醇、促肾上腺皮质激素(ACTH)、T淋巴细胞亚群(CD3~+、CD4~+、CD8~+和CD4~+/CD8~+)、自然杀伤(NK)细胞水平。结果两组患者术后WBC、中性粒细胞百分比、IL-6、CRP、皮质醇和ACTH水平均较术前显著上升(P<0.05);腹腔镜组患者WBC、中性粒细胞百分比、IL-6、CRP、皮质醇和ACTH水平显著低于开腹组,两组比较,差异有统计学意义(P<0.05)。术后腹腔镜组CD3~+、CD4~+、CD8~+、CD4~+/CD8~+、NK细胞水平高于开腹组,两组比较,差异有统计学意义(P<0.05)。腹腔镜组各指标术后、术前差值低于开腹组,组间比较,差异有统计学意义(P<0.05)。结论与传统开腹手术相比,腹腔镜手术对胆囊结石合并急性胆囊炎患者机体应激及免疫功能影响较小。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.