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吸入性肺炎 (AP) 是一种常见病, 好发于老年人群, 临床表现不典型, 具有高发病率、高病死率、预后不佳 等特点。AP 发生有多种危险因素, 包括年龄、吞咽困难、意识障碍、管饲喂养、体位不当、气管插管、不良的口腔环 境、上消化道疾病等, 这些危险因素通过损害宿主防御机制及改变下呼吸道微生物菌群, 增加发生 AP 的风险。早期 识别和干预潜在的危险因素可减少 AP 的发生。近年来, AP 的病原体发生了变化, 厌氧菌的检出率降低, 需氧菌的 分离率升高, 其中革兰阴性杆菌占多数。 [ABSTRACT FROM AUTHOR]

Objective To investigate the correlation between subclinical peripheral neuropathy (sDPN) and time in range (TIR) in type 2 diabetes mellitus (T2DM), and to explore the risk factors of sDPN. Methods A total of 485 T2DM patients without DPN symptoms and underwent EMG examination during hospitalization were divided into the sDPN group (n=209) and the non-sDPN group (n=276) according to nerve function conduction examination. The differences of age, course of the disease, blood pressure, complications, biochemical index and continuous glucose monitoring index were compared between the two groups of patients. The correlation between sDPN and TIR was analyzed. Logistic regression analysis was used to analyze influence factors of sDPN. Results Compared with the non-sDPN group, patients in the sDPN group were older and had longer diabetes course, higher systolic blood pressure (SBP), urinary albumin/urinary creatinine (UACR), blood glucose 1 h postprandial (1 h-PG), 2 h-PG, TBR, mean blood glucose fluctuation range (MAGE), standard deviation of blood glucose level (SD) and glycemic coefficient of variation (CV) levels, higher proportion of hypertension (HT), diabetic nephropathy (DN), diabetic retinopathy (DR) and diabetic peripheral vascular disease (PAD), and lower levels of total cholesterol (TC), right limb ankle brachial index (R-ABI), L-ABI, hemoglobin A1c (HbA1c) and TIR. The differences in the above indexes were statistically significant (P＜0.05). The occurrence of sDPN was positively correlated with TBR (rs = 0.104, P＜0.05), and negatively correlated with TIR (rs =-0.093, P＜0.05). Logistic regression analysis showed that increased TBR (OR=1.093,95%CI: 1.009-1.183), combined with DN (OR=3.004, 95%CI: 1.020-8.849) and DR (OR=9.736, 95%CI: 3.499-27.087) were independent risk factors for sDPN, and increased R-ABI (OR=0.005, 95%CI: 0.000-0.424) was protective factor for sDPN. Conclusion sDPN was negatively correlated with TIR. For patients with T2DM complicated with DN, DR and decreased ABI, it is necessary to timely improve neuroelectrophysiological examination to identify sDPN as soon as possible and give early intervention. [ABSTRACT FROM AUTHOR]

Objective: To describe disability rates of dementia in community residents aged 65 years and over in China, and explore related risk factors of disability. Methods: This study conducted an in-depth data analysis of the China Mental Health Survey. World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to assess dementia disability, Community Screening Interview for Dementia (CSID) and Geriatric Mental Status Examination (GMS) were used for dementia screening and diagnosing. Univariate analysis was used to calculate the weighted disability rates of dementia in population and in patients, and their population distribution. Multiple linear regression and logistic regression were used to analyze the risk factors of the occurrence of dementia disability and its severity. Results: The weighted disability rate of dementia was 2.1% in population, and 38.6% in patients. The disability rates of comorbid dementia in population and in patients were higher than those of patients with only dementia. Female, older age, lower education level, lower economic status, and lower cognitive test scores in CSID had higher disability rates of dementia in population. Female and urban resident had higher disability rates of dementia in patients. Multiple linear regression showed economic status (β=0.11), gender (β = 0. 11), age (β = 0. 10), and treatment in the last 12 months (β = 0.20) were statistically associated with WHODAS 2.0 scores. Multiple logistic regression showed female (OR=2.81) and treatment in the last 12 months (OR = 2.38) were statistically associated with disability. Conclusions: Persons with low economic status, female and elderly people are the high-risk groups for dementia disability. It should be paid attention to prevent dementia and its consequential disabilities. [ABSTRACT FROM AUTHOR]

Objective: To describe functional disability rate of anxiety disorders in Chinese community adults and explore related risk factors of functional disability. Methods: To conduct in-depth data analysis on China Mental Health Survey (CMHS). The diagnostic tool for anxiety disorders was the Composite International Diagnostic Interview-3. 0, according to the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition (DSM-IV). The World Health Organization Disability Assessment Schedule, 2nd edition, was the functional disability assessment standard for anxiety disorders. Weighted 12-month functional disability rate of DSM-IV anxiety disorder with comorbidities and only anxiety disorder in population and those in patients, as well as days of partial disability were calculated. The effects of anxiety disorders comorbid other mental disorders and physical diseases and demographic factors on the severity and occurrence of functional disability were analyzed by multiple linear regression and logistic regression. Results: The functional disability rate of anxiety disorder with comorbidities in population was 1.7%, and 42.2% in patients, in which constituent rate of grade-four disability was the highest as 84.1%. The functional disability rate of only anxiety disorder in population was 0.3%, and 17.8% in patients. The medians of days of partial disability days in the past 30 days were from 0 to 14. 42. Multiple linear regression showed a positive association between comorbid anxiety disorder with other mental disorders and physical diseases (β= 0.24), comorbid other mental disorders and physical diseases (β=0.21), physical diseases (β=0.18), comorbid anxiety disorder and physical diseases (β = 0. 15), comorbid anxiety disorder with other mental disorders (β=0.08), other mental disorders (β = 0.07), only anxiety disorder (β = 0.06), lower education level (β=0.12), lower economic status (β=0.08), older age (β=0.06), non-marital status (β=0.06), male (p=0.02) and the severity of functional disability. Logistic regression showed that comorbid anxiety with other mental disorders and physical diseases (OR = 64.07), comorbid anxiety disorders with other mental disorders (OR = 36.75), comorbid other mental disorders with physical diseases (OR = 20. 60), comorbid anxiety with physical diseases (OR = 18. 88), anxiety disorder (OR = 9. 20), other mental disorders (OR = 6.65), physical diseases (OR =4.00), 65 years old and over (OR = 4. 40), 50 to 64 years old (OR = 2.33), low economic status (OR = 2. 10), illiterate and below primary school educational level (OR = 1.89), middle economic status (OR = 1.70), elementary school educational level (OR = 1.59), nonmarital status (OR = 1.47), male (OR = 1.16) were the risk factors of the occurrence of functional disability. Conclusion: Comorbidity of anxiety disorders and other mental disorders, and physical diseases increases severity and occurrence of functional disability. Comorbidity, male, gender, older age, lower economic and educational level and non-marital are risk factors of anxiety disorder functional disability. [ABSTRACT FROM AUTHOR]

BACKGROUND: The high rate of postoperative hypoproteinemia in patients undergoing hip revision is associated with severe trauma, which affects the rapid recovery of patients. OBJECTIVE: To investigate the risk factors of perioperative hypoproteinemia in patients with hip revision, and to provide guidance for early screening of highrisk patients with postoperative hypoproteinemia. METHODS: According to the inclusion and exclusion criteria, 161 patients who underwent hip revision were divided into hypoproteinemia group (76 cases) and normal group (85 cases). The rate of hypoproteinemia was 47.2%. Data such as age, gender, body mass index, osteoporosis, operation time, preoperative erythrocytes, preoperative hemoglobin, preoperative leukocytes, preoperative platelets, preoperative fibrinogen, preoperative C-reaction protein, preoperative sedimentation rate, preoperative blood calcium, preoperative albumin, postoperative drainage tube placement, American Society of Anesthesiologists score, and postoperative hypoproteinemia were collected. SPSS software was used to analyze the independent risk factors of hypoproteinemia after hip revision using multivariate binary logistic regression analysis. R software was used to construct the nomogram prediction model. Receiver operating characteristic curve and calibration curve and decision curve were drawn to evaluate the model. RESULTS AND CONCLUSION: (1) Univariate analysis results showed that body mass index, preoperative erythrocytes, preoperative hemoglobin, preoperative platelets, preoperative fibrinogen, preoperative C-reaction protein, and operation time were significantly different between the two groups (P < 0.05). (2) Multivariate binary Logistic regression analysis results showed that body mass index (OR=0.859, P=0.021), operation time (OR=1.010, P=0.002), preoperative erythrocytes (OR=0.424, P=0.036), and preoperative C-reaction protein (OR=1.043, P=0.032) levels were independent risk factors for postoperative hypoproteinemia in patients with hip revision. (3) Based on four independent risk factors: body mass index, operation time, preoperative erythrocytes and preoperative C-reaction protein, the nomogram can effectively predict the risk of hypoproteinemia after hip revision. This nomogram prediction model has good differentiation and accuracy, and may lead to better clinical net benefits for patients. [ABSTRACT FROM AUTHOR]

Objective Analyzing risk factors for prolonged ICU stay after cardiac surgery of Infective Endocarditis （IE） provides a basis for preventing extended ICU durations in postoperative IE cases. Methods From January 1, 2019, to March 31, 2021, a total of 223 patients with infective endocarditis who underwent cardiac surgery in the cardiac surgery department of Guangdong Provincial People's Hospital were included. Patients were divided into non-prolonged group （< 3 days） and prolonged group （≥ 3 days） based on postoperative ICU stay duration. There were 156 cases in the non-prolonged group and 67 cases in the prolonged group. Single-factor analysis of risk factors for prolonged ICU stay was conducted using t-tests or rank-sum tests. Variables with P < 0.05 in the single-factor analysis were further subjected to binary logistic regression for multivariate analysis. The accuracy of the model was evaluated using the ROC curve. Results Among the 223 patients, 67 experienced prolonged ICU stay, with an incidence rate of 30%. Single-factor analysis results included gender, age, history of coronary heart disease, history of stroke, preoperative heart failure, aortic valve regurgitation area, left ventricular end-diastolic diameter, left ventricular ejection fraction （LVEF） <60%, extracorporeal circulation time, aortic cross-clamp time, use of Intra-Aortic Balloon Pump （IABP）, endotracheal tube reintubation, pulmonary infection, use of Continuous Renal Replacement Therapy （CRRT）, and prolonged mechanical ventilation time （> 24 hours）, among others. Multivariate analysis results revealed that preoperative LVEF < 60% （OR = 3.004, P = 0.041）, postoperative use of IABP （OR = 31.686, P = 0.008）, and mechanical ventilation time > 24 hours （OR = 8.135, P < 0.001） were independent risk factors for prolonged ICU stay after cardiac surgery. The model's AUC value for predicting risk factors for prolonged ICU stay was 0.858 （95% CI: 0.806 ~ 0.901, P < 0.001）. Conclusion Preoperative left ventricular ejection fraction （LVEF） < 60%, the use of IABP, and mechanical ventilation time > 24 hours were identified as independent risk factors for prolonged ICU stay after infective endocarditis （IE） surgery. In clinical practice, it is important to comprehensively address and manage various risk factors with the aim of reducing ICU stay duration and improving the overall success rate of the surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND: Studies have shown that good bone cement distribution during percutaneous vertebroplasty reduces postoperative secondary vertebral fractures and helps improve prognosis. However, how to get a good distribution of bone cement is a problem for spine surgeons. OBJECTIVE: To analyze the correlation of bone cement distribution with surgical and adjacent vertebral refractures after percutaneous vertebroplasty. METHODS: A total of 193 patients with thoracolumbar compression fracture (≤ 2 fractured vertebrae) admitted to Xinjiang Uygur Autonomous Region Orthopedic Hospital from January 2018 to December 2022 were selected. They underwent percutaneous vertebroplasty via unilateral approach and were followed up after surgery. They were divided into fracture group (n=30) and non-fracture group (n=163) based on whether the surgical and adjacent vertebral fractures were observed during the follow-up period (more than 6 months). The basic data of the two groups were analyzed by univariate analysis. Statistically significant factors were replaced with binary logistic regression model to explore the correlation with recompression fracture of surgical and adjacent vertebrae after percutaneous vertebroplasty. RESULTS AND CONCLUSION: (1) Univariate analysis showed that there was no significant difference between the two groups in gender, body mass index, menopause age of female patients, bone cement dose, previous history, smoking history, drinking history, operation segment, operation time, and hospital stay (P > 0.05). There were significant differences in age, bone mineral density T value, bone cement leakage, and bone cement distribution between the two groups (P < 0.05). (2) Binary logistic regression analysis showed that age (95%CI: 1.016-1.167, P=0.016), bone cement leakage (95%CI: 0.080-0.582, P=0.002), bone mineral density T value (95%CI: 1.214-22.602, P=0.026), and bone cement distribution (P=0.007) were risk factors for recurrent fractures after percutaneous vertebroplasty and adjacent vertebroplasty. Patients with type I bone cement distribution (which did not touch the upper and lower endplates of the vertebral body) had a higher risk of recurrent fractures of surgical and adjacent vertebrae after percutaneous vertebroplasty. (3) The results of this study show that refracture of surgical and adjacent vertebrae is caused by the interaction of various risk factors. Age, bone cement leakage, T value of bone mineral density and bone cement distribution are independent risk factors for surgical and adjacent vertebral refracture. Refracture of surgical and adjacent vertebrae can easily occur when bone cement is distributed type I. [ABSTRACT FROM AUTHOR]

脓毒症是一种由宿主对感染反应失调引起的全身炎症反应综合征, 具有高发病率、高病死率的特点。脓 毒症的发病机制复杂, 至今仍尚未明确。孟德尔随机化 (MR) 分析使用与暴露因素相关的遗传变异作为工具变量, 将基因组数据纳入流行病学研究设计中, 能够更为准确地推断暴露因素与健康结局之间的因果关系。近年来, 随着 全基因组关联研究大样本数据的发布, MR分析在脓毒症相关危险因素与发病风险及预后的关系方面取得一定进 展。MR分析作为一种强有力的流行病学研究方法, 在脓毒症领域可明确相关危险因素对脓毒症发病风险或预后 是否起到诱导作用, 有助于识别高危人群、及时制定干预措施并进一步探索针对脓毒症的潜在防治策略, 以避免或 延缓疾病发生发展及改善患者预后。 [ABSTRACT FROM AUTHOR]

目的 分析全膝关节置换术 (TKA) 患者全身麻醉苏醒期躁动 (EA) 的危险因素, 据此构建与验证其风险 预测列线图模型。方法 选择 136 例 TKA 患者, 均于全身麻醉下行 TKA 治疗。麻醉恢复室 (PACU) 观察期间通过 Ricker 镇静-躁动评分评估 EA。收集 TKA 患者入院时一般资料、术前实验室检查资料、麻醉相关资料以及围手术期相关 资料。采用多因素 Logistic 回归模型分析 TKA 患者全身麻醉 EA 的危险因素。根据其危险因素, 采用R语言构建风险预 测列线图模型。采用受试者工作特征 (ROC) 曲线评估风险预测列线图模型的预测效能, 并通过Hosmer-Lemeshow 拟合 优度检验评估其校准度。结果 136 例 TKA 患者中, 全身麻醉发生 EA 20 例 (14. 7%), 均于入 PACU 后 2 h 内发生。单因素分析发现, TKA 患者全身麻醉EA发生可能与年龄、2 型糖尿病、术前焦虑、ASA 分级、全身麻醉方式、手术时 间、导尿管留置、术后镇痛、术后疼痛视觉模拟评分 (VAS) 有关 (P 均<0. 05), 而与性别、BMI、高血压、脑卒中、冠心 病、吸烟史、饮酒史、损伤至手术时间、白细胞计数、白蛋白、血红蛋白、术中失血量、麻醉时间等无关 (P均>0. 05)。多因素 Logistic 回归分析显示, 年龄、手术时间、术后 VAS 为 TKA 患者全身麻醉 EA 的独立危险因素 (P均<0. 05)。以 年龄、手术时间、术后 VAS 构建其风险预测列线图模型: Logit (P) =－29. 948 + 0. 182 × 年龄 + 0. 081 × 手术时间 + 1. 942 × 术后 VAS。ROC 曲线分析发现, 该风险预测列线图模型预测 TKA 患者全身麻醉 EA 的曲线下面积为 0. 954 (95% CI：0. 923～0. 999), 其预测灵敏度、特异度分别为 85. 0%、94. 0%。经 Hosmer-Lemeshow 拟合优度检验, 该风 险预测列线图模型对TKA患者全身麻醉EA的预测发生概率与实际发生概率比较差异无统计学意义 (χ² =4. 657, P> 0. 05), 校准度较好。结论 年龄大、手术时间长、术后 VAS 增加是 TKA 患者全身麻醉 EA 的独立危险因素, 据此构 建的风险预测列线图模型对 TKA 患者全身麻醉 EA 的预测效能较高, 校准度较好。 [ABSTRACT FROM AUTHOR]

With the gradual increase of the incidence of cardiovascular diseases, cardiac implantable electronic device (CIED) as an important means of treatment has been applied more and more widely in clinical practice, and the incidence of CIED infection has also increased. At present, international guidelines and consensus all recommend that the entire device system (including pulse generator and electrode) should be completely removed as soon as possible after infection. However, the technical difficulty and risk of electrode removal are relatively high, and some patients cannot complete relevant surgical treatment due to physiological or psychological factors. Therefore, a correct understanding of the pathogenesis, risk factors, and treatment and prevention of CIED infection is of great significance for clinicians to correctly deal with CIED infection. This article reviews the recent progress in the diagnosis and treatment of CIED infection. [ABSTRACT FROM AUTHOR]

Objective: Explore the incidence characteristics, risk factors, T lymphocyte subsets, inflammatory factors, and their correlation in children with mumps of different age groups. Methods: 80 children with mumps who came to our hospital for diagnosis and treatment from January 2021 to December 2023 were selected as the observation group, and 160 children who underwent routine physical examinations during the same period were selected as the control group. According to age, the observation group and control group were divided into 2-6 year old group, 7-12 year old group, and>12 year old group. Analyze the incidence characteristics, risk factors, and correlation between T lymphocytes and inflammatory factors in children with mumps at different age groups. Results: School children, those who have received less than 2 doses of the vaccine, those who have not received the mumps vaccine, and migrant children are risk factors for mumps (P<0.05) The levels of CD3+, CD3 CD4+, and CD3 CD8+ in 7-year-old children were higher than those in 2-6 year old children (P<0.05); The CD3 CD4+ and CD3+CD4/CD3+CD8+ levels in the observation group were lower than those in the control group, while CD3 CD8 levels were higher than those in the control group (both P<0.05). CD3+, CD3 CD4+, CD3 CD8 in the observation group were positively correlated with CRP and TNF-a (all P<0.05). Conclusion: School children, those who have received less than 2 doses of the vaccine, those who have not received the mumps vaccine, and migrant children are risk factors for mumps. Changes in T lymphocyte subsets and inflammatory factors can impair immune function and increase the risk of infection, which requires close attention. [ABSTRACT FROM AUTHOR]

Objective: To investigate the risk factors of early withdrawal of pump in patient-controlled analgesia (PCA) after surgery and to construct a nomogram prediction model. Methods: A total of 2517 surgical patients who received PCA between July 2019 and May 2021 were enrolled, and then randomized the eligible patients into training group (n=1773) and validation group (n=744) with a ratio of 7:3. The Least Absolute Shrinkage and Selection Operator (LASSO) method was used to screen the characteristic variables in the training set, and multifactorial logistic model was used to select independent risk factors that were associated with outcomes. Akaike Information Criterion (AIC) was used to evaluate the model fit, and the nomogram of PCA early withdrawal was further constructed. In the training and validation sets, Receiver Operation Characteristic curve (ROC curve), calibration curve and Brier score were used to evaluate the prediction efficiency of the nomogram. Results: Nine independent risk factors and one related factor related to early pump withdrawal were used to construct a nomogram for predicting early withdrawal of pump after PCA. The area under the curve (AUC) of the training set was 0.880 (95% CI: 85.87% -90.16%), and the AUC of the validation set was 0.888 (95% CI: 85.55% -92%). The calibration curves of the training set and the validation set were tested by Hosmer-Lemeshow good of fit test. The P values were 0.004 and 0.228, and the Brier scores were 0.018 and 0.016, respectively. Conclusion: The nomogram we established has an ideal discrimination and calibration, which can provide a certain reference value for predicting the high-risk population of early withdrawal of pump in PCA after surgery. [ABSTRACT FROM AUTHOR]

Objective To summarize the characteristics of chemotherapy-induced peripheral neuropathy (CIPN) in children with acute B-lymphoblast leukemia (B-ALL) and to identify the influencing factors and prognosis of CIPN. Methods The clinical data of 60 children with B-ALL admitted to the 29th Ward of the Department of Hematology and Oncology, Children's Hospital Affiliated to Soochow University from June 2020 to December 2023 who received chemotherapy and had finished chemotherapy for 6 months were retrospectively reviewed. Results There were 37 cases of B-ALL combined with CIPN; the incidence of CIPN was 61.7%. Increasing age of onset was a risk factor for CIPN in children [OR= 1.209, 95% CI (1.023-1.428), P=0.026] with the highest incidence of sensory nerve dysfunction (78.4%). Electromyography indicated that B-ALL combined with CIPN was multiple peripheral neurogenic lesions with certain reversibility. In the induction stage of chemotherapy, 13 cases (35.1%) showed CIPN, accounting for the highest proportion. The CIPN improvement rate 6 months after chemotherapy was 67.6%, the age of onset [OR=2.418, 95% CI (0.212-2.106), P=0.018] and the severity of CIPN [OR=203.394, 95% CI (2.29-18 065.04). P=0.02] were risk factors for poor prognosis of children with CIPN. The older the age of onset was, the higher the severity of CIPN and worse prognosis were found. Conclusions Children with B-ALL complicated with CIPN are reversible multiple peripheral nerve lesions, and the occurrence and outcome of CIPN is potentially related to individual differences of children. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by hyperglycemia and insulin resistance, often leading to complications in multiple systems, including neuropathy, nephropathy, retinopathy, and bone diseases. Osteoporotic fractures are particularly concerning public health issues due to their high incidence, significant fatality rate, and substantial consumption of medical resources. Compared to non ⁃ diabetic individuals, patients with T2DM have an elevated risk of fragility fractures. Despite often having normal or increased bone density, the primary cause of this increased fracture risk is impaired bone mass. The mechanisms underlying increased bone fragility in T2DM patients are complex and multifactorial, involving obesity, hyperglycemia, insulin resistance, oxidative stress, microvascular complications, and the accumulation of advanced glycation end products. These factors can lead to alterations in bone metabolism, structure, and strength. Additionally, other factors, such as hypoglycemia and the associated increased risk of falls, as well as the direct effects of certain antidiabetic medications on bone and mineral metabolism, may further contribute to the heightened fracture risk in this population. This review provides a concise overview of the mechanisms by which these factors influence bone fragility in patients with T2DM. [ABSTRACT FROM AUTHOR]

The incidence rate of hyperlipidemic acute pancreatitis (HLAP) is gradually increasing, with the features of young age, severe conditions, frequent recurrence, and poor prognosis, and recurrent HLAP has become a difficult issue that needs to be solved urgently in clinical practice. This article summarizes the risk factors for HLAP recurrence and corresponding prevention and treatment strategies. The risk factors for HLAP recurrence include dyslipidemia, abnormal glucose metabolism, obesity, smoking, and drinking. In addition to the early treatment in the acute stage, HLAP requires long-term management, including effective control of blood glucose and lipids, diet regulation, and cigarette and alcohol withdrawal. As for patients with unexplained recurrent HLAP, genetic testing and gene therapy may provide novel diagnosis and treatment strategies. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is a malignant tumor with high incidence and mortality rates, and although surgical resection is a possible method for cure, the prognosis of HCC is still affected by its high recurrence rate. Early recurrence (within 2 years after surgery) is defined as true recurrence and is usually caused by the intrahepatic spread of primary tumor. Early recurrence of HCC tends to have a poorer prognosis than late recurrence. Therefore, it is of great importance to fully understand the high-risk factors and prediction methods for early recurrence, which is essential to the selection of preoperative treatment regimens, postoperative follow-up, and prognosis. This article reviews the high-risk factors and prediction methods for early recurrence of HCC after surgery. [ABSTRACT FROM AUTHOR]

Objective To investigate clinical features and risk factors of childhood diabetes mellitus (DM) complicated with urinary tract infection (UTI). Methods The data of 160 children with DM in our hospital in the past 2 years were collected as the research object, and they were divided into the UTI group and the non-UTI group UTI, with 80 cases in each group. The clinical data of children with DM and UTI were collected and analyzed, including DM type, sex, age, body mass index (BMI), living environment, duration of disease, length of hospital stay, indwelling catheter, ketoacidosis, antibiotic and insulin use, the types of bacteria isolated from urine samples and various laboratory indicators on admission. Results Pathogen bacteria mainly included Escherichia coli (n=37, 46.2%), Enterococci (n=21, 26.2%) and Klebsiella pneumoniae (n= 9, 11.2%) in the UTI group. Univariate analysis showed that there were significant differences in obesity, duration of disease, length of hospital stay, indwelling catheter, ketoacidosis, antibiotic use, glycosylated hemoglobin (HbA1c), albumin (ALB) and serum creatinine (Cr) between the two groups (P＜0.05). Multivariate regression analysis showed that risk factors for DM complicating UTI included prolonged hospitalization (OR=2.087, 95%CI: 1.562-2.789), indwelling urinary catheter (OR= 15.886, 95%CI: 2.336-108.007), ketoacidosis (OR=9.300, 95%CI: 1.169-73.992), duration of disease ≥36 months (OR= 20.548, 95%CI: 2.425-174.119), increased HbA1c (OR=16.686, 95%CI: 3.666-75.955) and serum Cr (OR=1.010, 95%CI: 1.002-1.019), while the increased serum ALB (OR=0.799, 95%CI: 0.702-0.910) was its protective factor. Conclusion Pathogenic bacteria in the UTI group are mainly Escherichia coli. Children with DM and UTI are closely related to the length of hospitalization, indwelling catheter, ketoacidosis, duration of disease, HbA1c, serum Cr and ALB levels. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To construct a risk prediction model for pulmonary infection in stroke patients and verify its clinical predictive performance. Methods Using convenience sampling, 750 stroke patients hospitalized in a tertiary hospital in Guizhou Province from January 2021 to January 2023 were selected as study subjects. They were divided into a pulmonary infection group (n=267) and a non-pulmonary infection group (n=483) based on whether pulmonary infection occurred. Comparative analysis of relevant data between the two groups was conducted. Logistic regression analysis was applied to establish a risk prediction model. The goodness-of-fit of the model was tested using the Hosmer-Lemeshow (H-L) test, and the predictive performance of the model was evaluated by the area under the receiver operating characteristic curve (ROC curve). Another 145 eligible patients from February to August 2023 were selected to validate the predictive performance of the model. Results Univariate and multivariate analyses revealed that dysphagia [odds ratio (OR) =10.462], coexisting pulmonary diseases (OR=6.046), hypokalemia (OR=2.266), hyponatremia (OR=3.807), low hemoglobin (OR=4.036), National Institutes of Health Stroke Scale (NIHSS) score at admission (OR=38.135), Activities of Daily Living (ADL) score at admission (OR=12. 942), and length of hospital stay (OR=8.992) were independent risk factors for pulmonary infection in stroke patients (P＜0.05). The risk prediction model formula was: Logit (P) =-4.761+2. 348× (dysphagia score) +1.799× (coexisting pulmonary diseases score) +0.818× (hypokalemia score) +1. 337× (hyponatremia score) +1.395× (low hemoglobin score) +3. 641× (NIHSS score) +2.560× (ADL score) +2.196× (length of hospital stay score). The area under the ROC curve of the modeling group was 0.953 [95% confidence interval (95%CI) 0.940-0. 967, P＜0.001], with a Youden index of 0.762, a sensitivity of 0.880, a specificity of 0. 882, and a P value of 0. 553 in the H-L test. The validation results showed that the area under the ROC curve of the validation group was 0. 946 (95%CI: 0. 927-0. 987, P＜0.001), with a sensitivity of 0. 898, a specificity of 0. 875, an accuracy of 88. 3%, and a P value of 0. 510 in the H-L test. Conclusion The established risk prediction model for pulmonary infection in stroke patients has good predictive performance, providing a reference for clinical healthcare professionals to early identify high-risk groups for stroke induced pulmonary infection and facilitating the timely adoption of preventive management measures. [ABSTRACT FROM AUTHOR]

Objective To analyze the risk factors for postoperative infection in patients with oral and maxillofacial malignancies treated in stomatological hospitals, providing a reference for preventing postoperative infections. Methods The medical records of patients with oral and maxillofacial malignancies admitted to the Stomatological Hospital of Chongqing Medical University from January 2020 to January 2023 were collected. Univariate analysis and binary logistic regression analysis were performed on relevant factors using SPSS 22.0 statistical software. Results Univariate analysis showed statistically significant differences in hospital stay, gender, operative time, postoperative drainage duration, and intraoperative blood loss between infected and uninfected patients (P＜0.05). Binary logistic regression analysis revealed that postoperative drainage duration of 10 days or more and operative time of 6 hours or more were independent risk factors for postoperative infection (P＜0.05). Conclusion Postoperative drainage duration of 10 days or more and operative time of 6 hours or more are independent risk factors for postoperative infection in patients with oral and maxillofacial malignancies. Preventive measures such as early bacterial culture and drug sensitivity tests, and monitoring of albumin levels in the first 3 days after surgery, should be implemented. [ABSTRACT FROM AUTHOR]

Objective: To explore the influencing factors of poor intestinal function recovery after operation in children with congenital intestinal atresia, and to construct a predictive model. Methods: 126 children with congenital intestinal atresia who were admitted to Hebei Children's Hospital from March 2020 to March 2023 were selected, intestinal function recovery after operation was counted, children were divided into poor recovery group and good recovery group according to intestinal function recovery after operation. The influencing factors of poor intestinal function recovery after operation in children with congenital intestinal atresia were analyzed by multivariate Logistic regression, and the predictive model was constructed based on Logistic regression. The value of predictive model in distinguishing postoperative poor intestinal function recovery after operation in children with congenital intestinal atresia were analyzed by receiver operating characteristic (ROC) curve. Results: 37 cases had poor intestinal function recovery after operation among 126 children with congenital intestinal atresia, and 89 cases had good recovery. The birth weight and the proportion of enteral nutrition support after operation in poor recovery group were lower than those in good recovery group (P < 0.05) the proportion of Grosfeld pathological type IV, jejunal atresia and premature infants in poor recovery group were higher than those in good recovery group (P < 0.05), the anastomotic diameter in poor recovery group was larger than that in good recovery group (P < 0.05) Multivariate Logistic regression analysis showed that premature infants, jejunal atresia and Grosfeld pathological type IV were risk factors for poor intestinal function recovery after operation (P < 0.05) and enteral nutrition support after operation was a protective factor (P < 0.05) The area under the curve of the predictive model based on Logistic regression to predict poor intestinal function recovery after operation in children with congenital intestinal atresia was 0.852, and the sensitivity and specificity were 83.78% and 85.39% respectively. Hosmer-Lemeshow test P > 0.05 the model fitting effect was good. Conclusion: Premature infants, jejunal atresia and Grosfeld pathological type IV are risk factors for poor intestinal function recovery after operation, and enteral nutrition support after operation is a protective factor. The predictive model base on Logistic regression has a good predictive value for poor intestinal function recovery after operation in children with congenital intestinal atresia. [ABSTRACT FROM AUTHOR]

Regular premenopausal endometrial withdrawal bleeding can avoid the occurrence of endometrial cancer. However, when the endometrium cannot be completely withdrawn, the risk of endometrial lesions begins to appear. However, due to the physiological characteristics of menstruation, it is allowed to change within a certain range. This range will be the most important basis for clinical differentiation and prevention of endometrial cancer. In this paper, the menstrual correlation characteristics of endometrial cancer are summarized into three categories: menstrual pattern, female sex hormone and endocrine metabolism. The research progress is reviewed, and the viewpoints and conclusions of different literatures on this topic are discussed. [ABSTRACT FROM AUTHOR]

Objective To explore the risk factors and pregnancy outcomes of placenta previa combined with penetrating placenta implantation (PP). Methods A total of 369 pregnant women with placenta previa combined with PP admitted to the hospital for delivery via cesarean section from June 2019 to December 2022 were selected and divided into the unperforated group (297 cases) and the perforated group (72 cases) according to the clinical grading of placenta implantation. The pregnancy outcomes of pregnant women in the two groups were compared, and the risk factors for the occurrence of placenta previa combined with PP were analyzed using logistic regression models. Results The percentage of pregnant women in the penetrated group with placement of abdominal aortic balloon, uterine tamponade (balloon/gauze), and hysterectomy, as well as the rates of intraoperative hemorrhage, post-partum complications, and adverse neonatal outcomes were significantly higher than those in the non-penetrated group, and the differences were all statistically significant (P＜0. 05). Induced abortion clearance was a risk factor for PP combined with placenta previa (OR=2. 421, 95%CI 1. 107-5. 296, P=0. 027). The number of previous cesarean sections ≥1 was an independent risk factor for PP combined with placenta previa (OR=3. 314, 95%CI 1. 525-7. 203, P=0. 002). Conclusion The rate of adverse outcomes in pregnant women with placenta previa combined with PP was high despite more aggressive perioperative measures to prevent bleeding. The number of previous cesarean sections ≥1 is an independent risk factor for PP with placenta previa. [ABSTRACT FROM AUTHOR]

Objective To analyze the prevalence of hypertension and its relationship with the clustering of risk factors of cardiovascular diseases ( CVD) in the elderly of Han majority and Ha Ni ethnic minority in rural districts of Yunnan Province. Methods The multi-stage stratified random sampling method was used to select 1 413 Han majority participants and 1 402 Ha Ni ethnic minority participants aged ≥60 years from Mo Jiang Hani Autonomous County, respectively, and each participant received a questionnaire survey and physical examination. Results The prevalence of hypertension was 64.5% for Han majority and 63.4%for Ha Ni ethnic minority. Female Han older adults, Han older adults with higher annual income and good medical service accessibility had a higher prevalence of hypertension than Ha Ni ethnic minority counterparts (all P < 0.05), while Han older adults with poor medical service accessibility had a lower prevalence of hypertension than Ha Ni ethnic minority counterparts (P < 0.05). Prevalence of hypertension increased with age for both ethnicities (all P < 0.05). The prevalence of clustering of CVD risk factors was 90.4% and 86.9%among Han majority and Ha Ni ethnic minority, respectively, which was higher in the Han majority than in the Ha Ni ethnic minority (P < 0.05). Compared with the Ha Ni ethnic minority elderly. Female Han older adults, Han older adults with higher annual income and good medical service accessibility had a higher prevalence of clustering of CVD risk factors ( all P < 0.01) . The result of multivariate logistic regression analysis showed that the clustering of CVD risk factors was a risk factor for hypertension in the elderly of Han majority (OR = 1.590, 95%CI: 1.101～2.296, P = 0.013); In addition, for both Han majority and Ha Ni ethnic minority older adults, the individuals with 4 (Han: P = 0.016, Ha Ni: P = 0.029) or ≥5 (Han: P < 0.001, Ha Ni: P < 0.001) CVD risk factors had higher prevalence of hypertension than those without clusters of cardiovascular disease risk factors. Conclusion The prevalence of hypertension and clustering of CVD risk factors are both at a high level in Han majority and Ha Ni ethnic minority elderly in rural Yunnan Province, the individuals with multiple risk factors should be targeted as a priority population for intervention reducing the number of clusters of CVD risk factors is helpful to decrease the risk of hypertension. [ABSTRACT FROM AUTHOR]

Objective: To analyze the association between the peripheral blood lymphocyte subsets and the occurrence of carotid atherosclerosis (CAS) and discuss the risk factors of CAS, and to provide the basis for risk prediction and early intervention of CAS. Methods: A total of 419 subjects were selected according to the inclusion and exclusion criteria. All the subjects underwent carotid ultrasonography, and the detection of T lymphocyte, B lymphocyte, and natural killer (NK) cell subsets were performed. According to the carotid artery intima-media thickness (IMT), the subjects were divided into normal carotid artery group (n=166) and CAS group (n=253). The basic data and laboratory inspection indexes of the subjects n two groups were collected, including age, gender, blood pressure, medical history, smoking history, medication history, blood lipids, and percentages of T lymphocyte, B lymphocyte, and NK cell subsets. The risk factors for the occurrence of CAS of the subjects were analyzed using Logistic regression analysis. Results: The univariate analysis results showed that compared with normal carotid artery group, the age, morbidity rate of hypertension, morbidity rate of diabetes, and smoking rate of the subjects in CAS group were increased (P<0. 05), and the percentages of CD4+ T lymphocytes, CD4+ T lymphocyte count, CD4+/CD8+ ratio, CD16+CD56+NK cell count, and low-density lipoprotein cholesterol (LDL-c) level in peripheral blood were increased (P<0. 05), while the percentage of CD8+T lymphocyte was decreased (P<0. 05). The multivariable Logistic regression analysis results showed that age (OR= 1. 112, 95%CI: 1. 083-1. 142, P<0. 001), smoking (OR=1. 997, 95%CI: 1. 192-3. 346, P=0. 009), LDL-c (OR=1. 427, 95%CI: 1. 017-2. 001, P=0. 039), and percentage of CD4+T lymphocyte (OR=1. 044, 95%CI: 1. 002-1. 087, P=0. 039) were the independent risk factors for the occurrence of CAS. Conclusion: The percentage of CD4+ T lymphocyte is associated with the occurrence of CAS and it is a predictive risk factor for CAS. [ABSTRACT FROM AUTHOR]

Aim To explore the association between insomnia and myocardial infarction (MI) using bidirectional two-sample Mendelian randomization (MR). Methods The summary statistics of MI were obtained from genome-wide association studies (GWAS), and single nucleotide polymorphisms (SNP) associated with insomnia phenotype were selected as instrumental variables. Inverse variance weighting (IVW) was used to evaluate the causal relationship between insomnia and MI. Results MR analysis showed that there was positive relationship between insomnia and MI (IVW: OR=1. 015, 95%CI 1. 004 ~1. 027, P =0. 007). There was no horizontal pleiotropy and heterogeneity in instrumental variables. Sensitivity analysis suggested that MR analysis results were stable. Reverse MR analysis showed no causal relationship between MI and increased risk of insomnia (IVW: OR=0. 725,95% CI 0. 466 ~ 1. 126, P = 0. 152), and the statistical results were stable after the removal of outliers. Conclusion Insomnia is a risk factor for MI and there was positive relationship between insomnia and MI. However, there was no causal relationship between MI and an increased risk of insomnia. [ABSTRACT FROM AUTHOR]

Objective To investigate the risk factors for clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD), and to establish a predictive model for early identification of CR-POPF. Methods A total of 244 patients who underwent PD in General Hospital of Northern Theater Command from January 2019 to October 2023 were collected, and based on strict inclusion and exclusion criteria, 179 patients were finally enrolled in this study. According to the presence or absence of CR-POPF, these patients were divided into non-CR-POPF group with 120 patients and CR-POPF group with 59 patients. Univariate and multivariate logistic regression analyses were used to determine the independent risk factors for CR-POPF, and a nomogram model was established based on such factors. The receiver operating characteristic (ROC) curve was used to assess the predictive performance of the model, the calibration curve was used to evaluate the calibration degree of the model, and the clinical decision curve and the clinical impact curve were used to analyze and validate the clinical application value of the model. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups； the independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of continuous data with skewed distribution between two groups. Results Among the 179 patients, 59（33.0%) developed CR-POPF. The multivariate Logistic regression analysis showed that alanine aminotransferase/aspartate aminotransferase (odds ratio [OR] =2.221, P=0.004), main pancreatic duct diameter (OR=0.276, P=0.022), the distance between the peritoneum and the anterior pancreatic neck (OR=1.034, P=0.027), and extracellular volume fraction (OR=0.001, P= 0.005) were independent risk factors for CR-POPF. Based on the above four independent risk factors, a nomogram was established to predict CR-POPF after PD, with an area under the ROC curve of 0.837, a sensitivity of 0.932, and a specificity of 0.725. The decision curve and the clinical impact curve also showed that the nomogram had good clinical practicability. Conclusion Preoperative clinical indicators combined with multi-phase CT have a good performance in predicting CR-POPF after PD, which can be used to early identify patients at high risk of pancreatic fistula before surgery and provide further guidance for clinical work. [ABSTRACT FROM AUTHOR]

Objective To investigate the risk factors for portopulmonary hypertension (POPH) in liver cirrhosis, and to construct a noninvasive predictive model. Methods A retrospective analysis was performed for the clinical data of 310 cirrhotic patients with portal hypertension who were hospitalized in The Third Affiliated Hospital of Hebei Medical University from January 2013 to August 2022, and according to whether pulmonary artery systolic pressure was ≥40 mmHg on ultrasound, the patients were divided into POPH group with 31 patients and non-POPH group with 279 patients. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. A binary Logistic regression analysis was used to determine the independent risk factors for POPH, and a nomogram prediction model was constructed. The Bootstrap resampling method was used for internal validation, and C-index and calibration curve were used to assess the discriminatory ability and consistency of the model. The rms package was used to plot the nomogram. Results Compared with the nonPOPH group, the POPH group had a significantly younger age, a significantly higher proportion of women or patients with hepatic encephalopathy or Child-Pugh class C disease, and significantly higher levels of direct bilirubin, Model for End-Stage Liver Disease score, albumin-bilirubin (ALBI) score, international normalized ratio, prothrombin time, FIB-4 index, LOK score, and Forns index, as well as significantly lower levels of serum albumin, alanine aminotransferase, gamma-glutamyl transpeptidase, hemoglobin，total cholesterol, and triglycerides (all P<0.05）. The multivariate analysis showed that sex (odds ratio [OR] =0.172，95% confidence interval [CI] ：0.064—0.462，P<0.001）, age (OR=0.944，95%CI：0.901—0.989，P=0.016）, ALBI score (OR=3.091，95%CI： 1.100—8.687，P=0.032）, and hepatic encephalopathy (OR=3.466，95%CI：1.331—9.031，P=0.011) were independent risk factors for POPH. A predictive model for POPH in liver cirrhosis was established based on the above independent risk factors, with a C-index of 0.796（95%CI：0.701—0.890）, suggesting that the model had good discriminatory ability, and the calibration curve showed that the model had good calibration ability, suggesting that the model had certain predictive efficacy. Conclusion Young female individuals, elevated ALBI score, and comorbidity with hepatic encephalopathy are independent risk factors for POPH in patients with liver cirrhosis, and the predictive model established based on these factors has a certain clinical application value. [ABSTRACT FROM AUTHOR]

Objective To investigate the risk factors for unplanned readmission within 30 days after discharge in cirrhotic patients with esophagogastric variceal bleeding undergoing transjugular intrahepatic portosystemic shunt (TIPS), and to construct a nomogram predictive model. Methods A total of 241 cirrhotic patients who underwent TIPS due to esophagogastric variceal bleeding in Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2020 to June 2023 were enrolled as subjects, and unplanned readmission within 30 days was analyzed. According to the presence or absence of unplanned readmission, they were divided into readmission group with 36 patients and non-readmission group with 198 patients, and related clinical data were collected from all patients. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. A logistic regression analysis was used to identify independent risk factors for unplanned readmission. A nomogram prediction model was constructed, and the receiver operating characteristic (ROC) curve was plotted to assess its discriminatory ability for unplanned readmission; the calibration curve was plotted to evaluate the consistency of the nomogram model in predicting unplanned readmission; the ResourceSelection package of R language was used for the Hosmer-Lemeshow goodness-of-fit test to evaluate the degree of fitting of the mode; the decision curve analysis was used to investigate the practicality of the model. Results Age (odds ratio [OR] =2.664, 95% confidence interval [CI] : 1.139—6.233，P<0.05), CTP score (OR=1.655，95%CI: 1.098—2.495，P<0.05), and blood ammonia (OR=1.032，95%CI: 1.016—1.048，P<0.05) were independent risk factors for unplanned readmission within 30 days after discharge in the patients undergoing TIPS. The multivariate analysis showed that for the nomogram predictive model constructed in this study, repeated sampling for 1 000 times using the Bootstrap method was performed for internal validation, and the area under the ROC curve was 0.773, which was significantly higher than that of age (0.582), CTP score (0.675), and blood ammonia (0.641) . The calibration curve showed good consistency between the probability of unplanned readmission predicted by the nomogram model and the actual probability, and the Hosmer-Lemeshow goodness-of-fit test showed good degree of fitting (c 2 = 5.647 3，P=0.686 7) . Conclusion Age, CTP score, and blood ammonia are independent risk factors for unplanned readmission within 30 days after TIPS, and the nomogram prediction model constructed based on these factors can help to predict the risk of unplanned readmission in TIPS patients and provide an accurate decision-making basis for early prevention. [ABSTRACT FROM AUTHOR]

Liver cancer is a significant global disease burden with a major impact on population health, and it is one of the important concerns in terms of public health worldwide. Cancer risk prediction models can estimate an individual’s absolute risk of developing cancer. Individual risk assessment allows targeted screening of high-risk populations, which is essential for primary and secondary cancer prevention. In this review, we examine existing epidemiological studies to explore key issues in the design, predictive variables, and performance of risk prediction models for liver cancer in the general population. The aim is to provide an important reference for the future development of highly comprehensive liver cancer risk prediction models. [ABSTRACT FROM AUTHOR]

Objective To analyze the influencing factors of pulmonary infection in patients with primary liver cancer (PHC) before intervention, and establish a nomogram risk prediction model to verify it. Methods A total of 1 635 patients with PHC diagnosed and hospitalized for the first time were selected and divided into the infected group (197 cases) and the non-infected group (1 438 cases) according to whether they had pulmonary infection. General data such as body mass index (BMI), chronic hepatitis B (CHB), chronic hepatitis C (CHC), Barcelona stage (BCLC), white blood cells (WBC), neutrophils (NEU), hemoglobin (Hb) and other blood routine indicators were collected. Total protein (TP), prealbumin (PA), aspartate aminotransferase (AST), gamma glutamylaminotransferase (GGT), alkaline phospholipase (ALP), abnormal prothrombin (PIVKA- Ⅱ), alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), procalcitonin (PCT), hypersensitive C-reactive protein (hs-CRP), cholinesterase (ChE), total cholesterol (TC) and other blood biochemical indicators, CD3 cell count (CD3+ ), CD4 cell count (CD4+ ), CD4/CD8 ratio (CD4+ /CD8+ ), CD19 cell count (CD19+ ), interleukin (IL)-2, interferon (IFN)-α, tumor necrosis factor (TNF) - α and other cytokines were also collected. Univariate analysis and Lasso regression were used to screen variables, and binary Logistic regression analysis was used to determine risk factors for pulmonary infection in PHC patients before intervention. The risk prediction model was established and evaluated. Results Compared with the noninfected group, age, smoking rate, CHC, pleural effusion, gastrointestinal hemorrhage, Child-Pugh grade C, BCLC Phase A /C /D ratio, WBC, NEU, AST, GGT, ALP, PIVKA-Ⅱ, AFP, CEA, PCT, hs-CRP, IL-2, IL-5, IL-6, IL-8, IL-10, IL-12, IFN-γ and TNF-α levels were higher in the infected group, and levels of BMI, CHB ratio, Hb, TP, PA, ChE, TC, CD3+, CD4+, CD4+ /CD8+, CD19+ and IFN-α were lower (P < 0.05). Lasso regression and binary Logistic regression analysis showed that pleural effusion, gastrointestinal hemorrhage, higher level of age, WBC, Hb and lower level of TP were independent risk factors for pulmonary infection in patients with PHC before intervention. The area under receiver operating curve (ROC) of the established nomogram model was 0.700（95%CI: 0.659-0.740), and Hosmer-Lemeshow test results showed good goodness-fit of the model. Self-sampling was repeated 1 000 times for internal verification. The consistency of the model was good. Conclusion Pleural effusion, gastrointestinal hemorrhage, higher level of age, WBC, Hb and lower level of TP are independent risk factors for pulmonary infection in PHC patients before intervention. The established nomogram prediction model can effectively evaluate the risk of pulmonary infection in PHC patients before intervention. [ABSTRACT FROM AUTHOR]

Mother‐infant bonding is influenced by several risk and protective factors, and the literature has investigated the relationships between these factors independently. This study aimed to verify the interrelationships of some of these factors and how they influence mother‐infant bonding in Brazil. In this study, 361 mothers participated, and the outcome variable of mother‐infant bonding was assessed using the Postpartum Bonding Questionnaire (PBQ). Multivariate regression analysis was performed using a hierarchical model with three blocks structured according to the influence exerted on mother‐infant bonding. The PBQ's factor scores were estimated and used in the subsequent analyses to decrease measurement error. The variable "violence experienced by mothers" was statistically significant for explaining the second block model but not significant for the third block. Network analysis was performed after multiple regression, showing that the violence experienced by mothers does not directly influence mother‐infant bonding but rather is mediated by postpartum depression. This explains why violence is not significant in the hierarchical multiple regression when maternal depression is added to the model. This study's strengths lie in its utilization of PBQ factor scores and network analysis, enabling the estimation of conditional relationships among variables. This approach provides deeper insights into factors affecting mother‐infant bonding. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Percutaneous vertebroplasty is the most widely used method for the treatment of osteoporotic vertebral compression fractures, and most studies have concluded that percutaneous vertebroplasty increases the probability of adjacent vertebral secondary compression fractures in patients with osteoporotic vertebral compression fractures. However, controversy remains regarding the risk factors associated with adjacent vertebral re-fracture caused after percutaneous vertebroplasty. OBJECTIVE: To summarize the influencing factors of adjacent vertebral compression fractures after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures, in order to provide a certain reference for reducing the risk of its occurrence as well as formulating the corresponding treatment plan. METHODS: Using “osteoporosis, fracture, percutaneous vertebroplasty, adjacent vertebral compression fractures, risk factors” as the Chinese search terms, “osteoporosis, osteoporotic vertebral compression fractures, percutaneous vertebroplasty, adjacent vertebral compression fractures, risk factors” as English search terms, computerized searches were conducted on CNKI, Wanfang Medical Network, VIP, PubMed, Springer, ScienceDirect, and Elsevier databases. The search timeframe focuses on January 2018 through September 2023, with the inclusion of a few classic forward literature. The literature was screened by reading the titles and abstracts, and 83 papers were finally included in the review. RESULTS AND CONCLUSION: (1) Osteoporotic vertebral compression fractures are one of the most common complications of osteoporosis, placing elderly patients at a significant risk of disability and death. Percutaneous vertebroplasty is a practical and effective treatment for osteoporotic vertebral compression fractures. (2) With the popularity of percutaneous vertebroplasty, its secondary vertebral compression fractures have gradually increased, with adjacent vertebral compression fractures being the most common. (3) Previous studies have only discussed the effects of factors such as bone mineral density, multiple vertebral fractures, body mass index, age, sex, amount of bone cement, cement leakage, and anti-osteoporosis treatment on secondary compression fractures of adjacent vertebrae after percutaneous vertebroplasty, and summarized the number of vertebral fractures, timing of the operation, surgical approach, cement material, diffuse distribution of bone cement, recovery height of the injured vertebrae, and wearing of a support after surgery, which is not yet comprehensive. The analysis of the specific mechanisms of risk factor-induced adjacent vertebral fractures is relatively rare. (4) The results of the article showed that low bone mineral density, advanced age, perimenopausal women, multiple vertebral fractures, excessive recovery of the height of the injured vertebrae, cement leakage, comorbid underlying diseases, and poor lifestyle habits were the risk factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty, and that maintaining a normal body mass index, early surgery, bilateral percutaneous vertebroplasty, use of a new type of cement material, an appropriate volume of bone cement injection and uniform cement dispersion, regular anti-osteoporosis treatment, and postoperative brace wearing are protective factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty. [ABSTRACT FROM AUTHOR]

BACKGROUND: Establishing a nomogram prediction model for postoperative pulmonary infection in hip fractures and taking early intervention measures is crucial for improving patients’ quality of life and reducing medical costs. OBJECTIVE: To construct a nomogram risk prediction model of postoperative pulmonary infection in elderly patients with hip fracture, and provide theoretical basis for feasible prevention and early intervention. METHODS: Case data of 305 elderly patients with hip fractures who underwent surgical treatment at Wuxi Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine between January and October 2020 (training set) were retrospectively analyzed. Using univariate and multivariate logistic regression analysis and Hosmer-Lemeshow goodness of fit test, receiver operating characteristic curve was utilized to analyze the diagnostic predictive efficacy of independent risk factors and joint models for postoperative pulmonary infections. Tools glmnet, pROC, and rms in R Studio software were applied to construct a nomogram model for predicting the risk of postoperative pulmonary infection in elderly patients with hip fractures, and calibration curves were further drawn to verify the predictive ability of the nomogram model. Receiver operating characteristic curves, calibration curves, and decision curves were analyzed for 133 elderly patients with hip fractures (validation set) receiving surgery at the same hospital from November 2022 to March 2023 to further predict the predictive ability of the nomogram model. RESULTS AND CONCLUSION: (1) The postoperative pulmonary infection rate in elderly patients with hip fractures in this group was 9.18% (28/305). (2) Single factor and multivariate analysis, as well as forest plots, showed that preoperative hospitalization days, leukocyte count, hypersensitive C-reactive protein, and serum sodium levels were independent risk factors (P < 0.05). The Hosmer-Leme show goodness of fit test showed good fit (χ² =4.57, P=0.803). Receiver operating characteristic curve analysis was conducted on the independent risk factors and their joint models mentioned above, and the differentiation of each independent risk factor and joint model was good, with statistical significance (P < 0.05). (3) The graphical calibration method, C-index, and decision curve were used to validate the nomogram prediction model. The predicted calibration curve was located between the standard curve and the acceptable line, and the predicted risk of the nomogram model was consistent with the actual risk. (4) The validation set used receiver operating characteristic curve, graphic calibration method, and decision curve to validate the prediction model. The results showed good consistency with clinical practice, indicating that the model had a good fit. The nomogram risk prediction model constructed for postoperative pulmonary infection in elderly patients with hip fractures has good predictive performance. The use of the nomogram risk prediction model can screen high-risk populations and provide a theoretical basis for early intervention. [ABSTRACT FROM AUTHOR]

BACKGROUND: Anterior cruciate ligament avulsion fracture at tibial insertion is a special type of intra-articular fracture, which is mostly seen in sports injuries. At present, there are relatively few anatomical studies on this disease, but a large number of studies focus on the injury of the anterior cruciate ligament. It is generally believed that the increase in the posterior slope of the tibial plateau, the decrease of the depth of the medial tibial plateau, and the decrease in the width index of the femoral intercondylar notch are the risk factors for the injury of the anterior cruciate ligament. It is unclear whether avulsion fractures of the anterior cruciate ligament at the tibial insertion point are also related to it. OBJECTIVE: To investigate the correlation between the avulsion fracture of the anterior cruciate ligament at the tibial insertion and the posterior tibial slope, the medial tibial depth, the notch width index of the femoral intercondylar fossa, and the coronal slope angle of the tibial plateau. METHODS: A retrospective analysis was made on 101 patients who were admitted to the Department of Orthopedics of Affiliated Hospital of Xuzhou Medical University due to anterior knee pain from January 2019 to December 2022. Totally 51 patients with tibial insertion avulsion fracture of anterior cruciate ligament who received arthroscopy treatment were taken as the observation group, and 50 patients with anterior knee pain but no knee joint injury confirmed by physical examination and imaging examination were taken as the control group in the same period. The posterior tibial slope, anatomical parameters such as the medial tibial depth, and the notch width index of the femoral intercondylar fossa, were statistically analyzed for the anatomical risk factors leading to the tibial insertion avulsion fracture of the anterior cruciate ligament. RESULTS AND CONCLUSION: (1) There was no significant difference between the two groups in the comparison of the lateral posterior tibial slope, the posterior slope ratio of the lateral/medial tibial plateau, the notch width index of the femoral intercondylar fossa, and the coronary slope angle of the tibial plateau (P > 0.05). The medial posterior tibial slope in the observation group was significantly higher than that in the control group (P < 0.05). The medial tibial depth in the observation group was significantly lower than that in the control group (P < 0.05). (2) Multifactor logistic regression analysis showed that the medial posterior tibial slope and the medial tibial depth were independent risk factors for tibial insertion avulsion fracture of anterior cruciate ligament (P < 0.05). (3) The receiver operating characteristic curve shows that the medial posterior tibial slope and the medial tibial depth had certain predictive values for the tibial insertion avulsion fracture of the anterior cruciate ligament. (4) It is indicated that the increased medial posterior tibial slope and the shallower medial tibial depth are the anatomical risk factors for the avulsion fracture of the tibial insertion of the anterior cruciate ligament. [ABSTRACT FROM AUTHOR]

Objective To investigate the predictive value of soluble growth-stimulated expressed gene 2 protein （sST2） in predicting sepsis-associated acute kidney injury （SA-AKI）. Methods From January 2020 to December 2023， a total of 395 sepsis patients with sepsis from the Emergency Department， Affiliated Hospital of Nantong University were enrolled in this retrospective observational study. These patients were further categorized into two groups: AKI group （114 cases） and non-AKI group （281 cases）. Clinical data and laboratory indicators were collected within 24 hours after admission. ROC curve analysis was used to evaluate the diagnostic ability of sST2 for SA-AKI. Logistic regression analysis was performed to assess independent risk factors for the development of SA-AKI. Concurrently， two predictive models for SA-AKI were constructed， and the predictive ability of sST2 for SA-AKI was assessed using the Area Under the Curve （AUC）， the Net Reclassification Index （NRI） and the Integrated Discrimination Improvement （IDI）. Results T The levels of sST2 were significantly higher in the AKI group compared to the non-AKI group （P < 0.001）. The AUC predicted by sST2 （0.839， 95% CI: 0.799 ~ 0.874） in sepsis patients with AKI was significantly superior to other laboratory indicators （P < 0.000 1）. An sST2 concen-tration greater than 85 ng/mL independently increased the risk for SA-AKI （OR: 14.315， 95% CI: 5.867 ~ 34.926， P < 0.001）. Incorporating sST2 into the prediction model substantially improved the AUC values （0.954 vs. 0.909， P < 0.000 1）， NRI（ 21.48%， 95% CI: 11.48% ~ 31.49%， P < 0.000 1） and IDI（ 8.62%， 95% CI: 5.75% ~ 11.49%， P < 0.000 1）. Conclusion sST2 has the potential to serve as a promising biomarker for prognosticating AKI in septic patients. [ABSTRACT FROM AUTHOR]

Objective: To analyse the changes of bone metabolic markers in type 2 diabetes patients with osteoporosis, and analyze the risk factors. Methods: Eighty patients with type 2 diabetes and osteoporosis admitted to our hospital from January 2022 to December 2022 were selected as the research objects, and they were divided into osteoporosis group. Eighty patients with type 2 diabetes and non osteoporosis admitted to our hospital in the same period were selected as the non osteoporosis group, and 80 healthy volunteers who came to our hospital for physical examination in the same period were selected as the control group. The expression level of bone metabolic markers in three groups of subjects was compared, and dual energy X-ray absorptiometry was used as the "gold standard" for the diagnosis of osteoporosis. The ROC curve of subjects was established, and the critical value of related bone metabolic markers for the diagnosis of type 2 diabetes with osteoporosis was analyzed. Finally, the disease risk factors were analyzed. Results: There was no significant difference in the levels of alkaline phosphatase (ALP), blood phosphorus (P), and calcium (Ca) among the three groups of subjects (P＞0.05). However, there were differences in the levels of urinary type 1 collagen C-terminal peptide (CTX-1), osteocalcin, and parathyroid hormone (PTH) among the three groups of subjects. There were also differences in the levels of CTX-1, osteocalcin, and parathyroid hormone (PTH) among the three groups of subjects PTH was higher than that of the non osteoporosis group and control group, while osteocalcin was lower than that of the non osteoporosis group and control group (P＜0.05); The critical value of CTX-1 for the diagnosis of type 2 diabetes with osteoporosis was 525.74 μg/mmoL Cr, the sensitivity was 83.35%, the specificity was 67.95%, the critical value of osteocalcin was 14.12ng/L, the sensitivity was 81.27%, the specificity was 79.46%, and the critical value of PTH was 45.75 pmol/L, the sensitivity was 74.84%, the specificity was 81.36%; There was no difference between the osteoporosis group and the non osteoporosis group in terms of gender, duration of diabetes, combined with other basic diseases, peripheral neuropathy, and fasting blood glucose (P＞0.05). There were differences between the osteoporosis group and the non osteoporosis group in terms of age, BMI, peripheral vascular disease, diabetes nephropathy, retinopathy, glycosylated hemoglobin, CTX-1, osteocalcin, and PTH levels (P＜0.05); Age, diabetes nephropathy, retinopathy, glycosylated hemoglobin, CTX-1, osteocalcin, PTH were independent risk factors for type 2 diabetes with osteoporosis (P＜0.05). Conclusion: The levels of CTX-1 and PTH in type 2 diabetes patients with osteoporosis increase and osteocalcin decreases. The three can provide important reference for the clinical diagnosis of type 2 diabetes patients with osteoporosis. Age, diabetes nephropathy, retinopathy, glycosylated hemoglobin, CTX-1, osteocalcin and PTH are independent risk factors for type 2 diabetes patients with osteoporosis. [ABSTRACT FROM AUTHOR]

Esophageal tumors are common digestive tract tumors worldwide, and surgical treatment is the main treatment for resectable esophageal cancer. However, the incidence of postoperative complications is high, with anastomotic fistula being the most common and serious complication, with a high mortality rate. In order to reduce the incidence of postoperative anastomotic fistula in esophageal cancer, it is necessary to identify high-risk populations for postoperative anastomotic fistula in esophageal cancer early on and intervene in risk factors. The article reviews the risk factors for postoperative anastomotic fistula in esophageal cancer from three aspects: preoperative, intraoperative, and postoperative. [ABSTRACT FROM AUTHOR]

目的　分析急诊中重度肝硬化食管胃底静脉曲张出血（EGVB）患者首次内镜治疗后再出血危险因素。 方法　选取 2018 年 1 月— 2021 年 1月急诊活动性出血，于新疆医科大学第一附属医院入院48 h内行首次内镜治疗 的中重度 EGVB 患者 144 例, 按首次内镜治疗后6个月是否发生再出血分为再出血组（n=32）和对照组（n=99），多因 素 Logistic 回归分析影响 EGVB 行内镜治疗后再出血的危险因素, 采用受试者工作特征（ROC）曲线分析各指标诊断 再出血的价值。结果　治疗前存在红色征、MELD 评分高、Child-pugh 评分高, 既往无出血病史是EGVB 行首次内镜 治疗后发生再出血的独立影响因素（P均<0. 05)。ROC 曲线结果显示，治疗前红色征、MELD 评分, Child-pugh 评分 和既往无出血病史评分指标联合诊断6个月再出血的灵敏度68. 80%, 特异度81. 80%, ROC 曲线下面积 0. 782, 均高 于单一指标诊断（P均<0. 05）。结论 对于 EGVB 行 首次内镜治疗的患者，术前红色征, MELD评分高, Child-pugh评 分高、既往无出血病史应高度重视再出血风险。 [ABSTRACT FROM AUTHOR]

Cerebral edema is easily complicated after aneurysmal subarachnoid hemorrhage (aSAH), which leads to the aggravation of the patient's condition. Therefore, to clarify the risk factors, pathogenesis, diagnostic methods and treatment progress of global cerebral edema (GCE) after aSAH is of great significance for reducing the incidence of GCE and improving the prognosis of patients. This article mainly reviews the risk factors, pathogenesis, and treatment progress of GCE after aSAH, in order to provide early preventive intervention and improve the prognosis of such patients. [ABSTRACT FROM AUTHOR]

Objective: To explore the risk factors of portal vein thrombosis and treatment of backdoor hypertension in patients with esophageal and gastric varices. Methods: In tively, 102 patients from January 2019, all patients underwent endoscopic treatment with oesophageal and gastric varices, with portal venous thrombosis group (n=48 cases) and non-portal vein thrombosis (54 cases),compared with the two groups of laboratory examination, general clinical data, imaging examination results, and multifactor Logistic regression analysis was used to determine the risk factors of esophageal and gastric venous thrombosis. According to whether the patient has portal hypertension gastric disease aggravation after treatment. 102 patients were divided into portal hypertension plus restructuring and no portal hypertension and aggravation, and the general data and laboratory examination results of the two groups were compared.Multivariate Logistic regression analysis identified the risk factors for endoscopic treatment of posterior artery hypertension gastric disease aggravation. Results: The proportion of endoscopic esophageal varicose portal vein thrombosis was 47.06% (48/102). Univariate analysis showed that splenectomy history of portal vein thrombosis, gastric sclerosis injection, PLT, FIB, D2, internal diameter of portal vein, spleen length, spleen thickness, and splenic vein diameter without portal vein thrombosis (P＜0.05); multifactor Logistic regression analysis showed that the history of splenectomy, D-dimer, PLT, splenic thickness, and enlarged splenic vein diameter were the risk factors for portal vein thrombosis in patients with cirrhosis (P＜0.05). The proportion of endoscopic treatment for backdoor hypertension gastric disease aggravation was 29.41% (30/102). The results of the univariate analysis showed that, Portal hypertensive gastric disease and esophageal gastric Pux grade, Child-Pugh grade, Hp infection, portal vein flow history, portal vein trunk diameter and splenic vein diameter (P＜0.05); The multivariate Logistic regression analysis showed that, Severe esophageal varicose veins, Child-Pugh grade C, Hp infection, and history of portal vein disconnection were the risk factors for endoscopic treatment of posterior artery hypertension in cirrhosis (P＜0.05). Conclusion: A history of splenectomy, D-dimer, PLT, splenic thickness, and elevated splenic vein diameter are the risk factors for portal vein thrombosis of esophageal and gastric varices, severe, Child-Pugh grade C, Hp infection, and a history of portal vein rupture are the risk factors for the aggravation of portal hypertensive gastric disease after endoscopic treatment of liver cirrhosis. [ABSTRACT FROM AUTHOR]

Objective: To explore the effectiveness of laparoscopic hook needle hernia ring closure in patients with inguinal incarcerated hernia, as well as the risk factors for postoperative recurrence and chronic pain. Methods: A total of 92 patients with inguinal incarcerated hernia admitted to our hospital from January 2018 to December 2021 were selected, they underwent laparoscopic crochet hernia ring closure surgery. The surgical conditions of all patients were analyzed, and postoperative recurrence and chronic pain were used as variables. Logistic regression models were used to analyze the risk factors for postoperative recurrence and pain in inguinal incarcerated hernia patients. Results: The incidence of postoperative complications was 7.61% (7/92), with 4 cases of subcutaneous hematoma, 1 case of incision infection, 1 case of postoperative bleeding, and 1 case of delayed intestinal perforation. After 2 years of follow-up for all patients, the incidence of postoperative chronic pain was 16.30% (15/92), including 5 cases of mild pain, 7 cases of moderate pain, and 3 cases of severe pain. The postoperative recurrence rate was 10.87% (10/92); There was no difference in gender, age,comorbidities, hernia anatomical classification, lesion location, postoperative drainage, patch type, and emergency surgery between the chronic pain group and the non chronic pain group (P＞0.05). However, there was a significant difference in BMI, number of surgeries,intraoperative neuroprotection, and preoperative pain in the operating area between the chronic pain group and the non chronic pain group (P＜0.05). There was no difference between the recurrent group and the non recurrent group in terms of age, coronary heart disease,number of operations, intraoperative nerve protection, lesion location, postoperative drainage, patch type, preoperative pain in the operating area (P＞0.05). There were significant differences between the recurrent group and the non recurrent group in terms of gender,BMI, diabetes, hypertension, hernia anatomy classification, and emergency surgery (P＜0.05); BMI, diabetes, hypertension and hernia anatomy were classified as independent risk factors for recurrence after inguinal pin hernioplasty for incarcerated hernia (P＜0.05); BMI,number of surgeries, and preoperative pain in the operating area are independent risk factors for postoperative chronic pain in inguinal incarcerated hernia treated with inguinal needle closure, while intraoperative neuroprotection is a protective factor (P＜0.05). Conclusion: Laparoscopic hook needle herniorrhaphy for inguinal incarcerated hernia is effective and safe. However, some patients still have postoperative recurrence and chronic pain. BMI, diabetes, hypertension and hernia anatomy are risk factors for postoperative recurrence. BMI, number of surgeries, and preoperative pain in the surgical area are risk factors for postoperative chronic pain, while intraoperative neuroprotection is a protective factor. [ABSTRACT FROM AUTHOR]

Objective To investigate the risk factors of type 2 diabetic peripheral neuropathy ( DPN) complicated with microangiopathy. Methods A total of 197 DPN patients hospitalized in the Department of Endocrinology of the First People's Hospital of Yunnan Province from November 1, 2021 to December 31, 2022 were retrospectively reviewed. Patients were divided into groups based on whether they had concurrent microvascular complications: 66 cases in the pure DPN group, 45 cases in the DPN combined with type 2 diabetic retinopathy (DR) group, 50 cases in the DPN combined with type 2 diabetic kidney disease (DKD) group, and 36 cases in the DPN combined with DR and DKD group. General conditions and relevant clinical indicators of the patients were collected to analyze the factors influencing the combination of DPN with microvascular complications. Results The prevalence of DPN alone was 33.50%, DPN combined with DR Was 22.84%, DPN combined with DKD was 25.38%, and DPN combined with DR and DKD was 18.27%. In the four groups, age, disease duration, history of hypertension, systolic blood pressure ( SBP), estimated glomerular filtration rate ( eGFR), creatinine ( Cr), blood urea nitrogen (BUN), albumin (ALB), albumin/globulin ratio (A/G), free triiodothyronine (FT3), fasting C-peptide (C-P), two hours of C-peptide (C-P2), fasting insulin (INS), insulin 2 hours after a meal (INS2h), time in range (TIR) for glucose, visceral fat area (VFA), and standard deviation of NN intervals (SDNN) for sinus rhythm all show statistically significant differences (P < 0.05) . The results of logistic regression analysis show that compared to DPN patients, age (OR = 0.882, 95%CI: 0.814～0.956, P = 0.002) and eGFR (OR=0.934, 95%CI: 0.886～0.985, P = 0.011) are protective factors for those with DPN and DR, while SBP (OR = 1.030, 95%CI: 1.003～1.058, P = 0.028) is an independent risk factor. When comparing DPN patients with those who have DPN and DKD, SBP (OR = 1.026, 95%CI: 1.001～1.052, P = 0.042) is an independent risk factor. Comparing DPN patients with those who have DPN and both DR and DKD, FT3 (OR = 0.468, 95%CI: 0.224～0.976, P = 0.43) is a protective factor, while SBP (OR = 1.029, 95%CI: 1.000～1.059, P = 0.047) and VFA (OR = 1.027, 95%CI: 1.006～1.049, P = 0.013) are independent risk factors. Conclusion Elevated systolic blood pressure and visceral fat are high-risk factors for the development of microvascular complications in diabetic peripheral neuropathy (DPN), contributing to the occurrence and progression of microvascular complications in DPN. [ABSTRACT FROM AUTHOR]

Objective To explore the main risk factors for cancer, cardiovascular and cerebrovascular diseases, diabetes and chronic respiratory disease (referred to as the four major chronic diseases), and to evaluate the disease burden associated with the exposure to risk factors. Methods The data of this study were collected from the 2019 Global Burden of Disease Study (GBD) database. By analyzing the number of deaths and disability-adjusted life years (DALYs) of four major chronic diseases among Chinese residents in 2019, the proportion of these four major chronic diseases attributable to the exposure to related risk factors was determined. Results The primary risk factor for disease burden was the tobacco exposure, which accounted for 31.4% of DALYs. High systolic blood pressure was the main risk factor for cardiovascular and cerebrovascular diseases, which accounted for 55.6% of DALYs. The common risk factors of four major chronic diseases were tobacco exposure, air pollution and high body mass index (BMI); among them, tobacco exposure had the highest proportion of attributable risk in the disease burden of cancer and chronic respiratory disease. Diet related risk factors, alcohol consumption, and physical inactivity were associated with cancer, cardiovascular and cerebrovascular diseases, and diabetes. The results of the attribution analysis of major cancers showed that lung cancer had the highest proportion of attributable risk due to tobacco exposure, followed by esophageal cancer, gastric cancer, liver cancer, and colorectal cancer. Conclusions Tobacco exposure, air pollution and high BMI are common risk factors for the four major chronic diseases in Chinese residents. This result provides important evidence for high⁃risk population screening. [ABSTRACT FROM AUTHOR]

Objective To analyze the influencing factors of postoperative facial paralysis in patients with parotid tumors by using machine learning technique. Methods The data of patients with parotid tumors in the medical record system of Guigang People's Hospital from January 2013 to December 2023 were collected retrospectively. LASSO regression was used to screen the potential risk factors of post-operative facial paralysis, followed by an disordered multi-classification Logistic regression analysis to determine the risk factors of postoperative facial paralysis. Results 54 of 395 patients with parotid tumors experienced facial paralysis, including 40 cases of transient facial paralysis and 14 cases of permanent facial paralysis. Disordered multi-classification LASSO regression identified 26 risk factors of postoperative facial paralysis in patients with parotid tumors under the optimal lambda value, which were included in the disordered multi-classification Logistic regression analysis. The results showed that tumor location, tumor nature, preoperative mass tenderness, smoking, glutamyl transferase, chloride concentration, magnesium concentration, and partial thromboplastin time were the influencing factors for transient facial paralysis (all P<0.05); tumor nature tumor volume, age, and body mass index were influencing factors for permanent facial paralysis (all P<0.05). Conclusions The key influencing factors of postoperative facial paralysis in patients with parotid tumors are identified by using the machine learning technique, helping the early identification of high-risk groups for postoperative facial paralysis and providing a scientific basis for the prevention and prediction of facial paralysis. [ABSTRACT FROM AUTHOR]

Objective To explore the suicidal tendencies and risk factors among parents of children and adolescents with psychiatric disorders and to develop a predictive model for suicidal tendencies.Methods A cross-sectional survey was conducted from August 2022 to July 2023, involving 299 parents of children and adolescents with psychiatric disorders from two hospitals in Anhui Province. Sociodemographic data were collected, and suicidal tendencies, depressive symptoms, and alexithymia were assessed using standardized suicide-related questions, the Patient Health Questionnaire-9 (PHQ-9), and the Toronto Alexithymia Scale-20 (TAS-20), respectively. Results The overall prevalence of suicidal tendencies was 15.4%, with the rates of suicidal ideation, planning, and attempts being 11.0%, 3.3%, and 8.0%, respectively. Logistic regression analysis revealed that a history of physical illness, depressive symptoms, alexithymia, and difficulty identifying feelings were associated with a higher risk of suicidal tendencies (all P＜0.05). Based on the regression analysis results, a predictive model for the risk of suicidal tendencies among parents was developed. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.80 (95% CI: 0.72-0.87, P＜0.05). Conclusion The high prevalence of suicidal tendencies among parents of children and adolescents with psychiatric disorders underscores the need for clinicians to pay attention to the mental health of both the patients and their parents. It is crucial to enhance care for both the children and their parents and to provide individualized comprehensive interventions when necessary. [ABSTRACT FROM AUTHOR]

Objective To explore the risk factors and clinical prognosis of patients with carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infection in hospital, and provide a scientific basis for the effective control of CRKP bloodstream infection. Methods Adopting a case-control study in a 1∶2 ratio, cases of CRKP bloodstream infection in Guangdong Provincial People′s Hospital from January 2012 to December 2022 were collected and analyzed through retrospective analysis. Based on the results of the blood culture for 28 days, the CRKP group was divided into a survival group and a death group. Meanwhile, univariate and multivariate logistics regression were applied to analyze the related risk factors of CRKP bloodstream infection and the important risk factors affecting the prognosis of CRKP bloodstream infection in 28 days. Kalan-Meier was employed to plot the survival curve.Results Central venous intubation (P=0.042), other site infections (P=0.028), and previous use of antibiotics (P＜0.001) may be important risk factors for CRKP bloodstream infection in the hospital. Cardiovascular and cerebrovascular diseases (P=0.029) were the main risk factors for patients infected with CRKP dead in 28 days, and the death rate of patients in the CRKP group was significantly higher than that in the carbapenem-sensitive Klebsiella pneumoniae (CSKP) group (P＜0.001）. Conclusion The high fatality rate of CRKP bloodstream infection seriously affects the prognosis of patients. Hence, the clinic should endeavor to protect patients from infection, reduce the occurrence of CRKP bloodstream infection, and curb the spread of CRKP in hospital. [ABSTRACT FROM AUTHOR]