【摘要】 目的 探討內江市企事業及機關單位從業人員20~60歲人群中超重、肥胖者及其相關因素。 方法 2009年6月－2010年9月采用整體隨機分層方法，對內江市企事業及機關單位從業人員共5 832例進行調查。用問卷了解吸煙、飲酒、運動、家族史、文化程度，并測定身高、體重、空腹血糖、甘油三酯、膽固醇等。采用SPSS 17.0軟件進行統計學分析，以雙側Plt;0.05為有統計學的意義。與肥胖有關的危險因素采用多因素logistic回歸分析。 結果 超重及肥胖者比例為27.16%，其中超重者1 377例，占23.6%，肥胖者207例，占3.55%；肥胖較超重者空腹血糖、甘油三酯、血壓更高；多因素logistic回歸分析提示:超重及肥胖與年齡、吸煙、性別、運動、家族史、文化程度有關，與飲酒無關。 結論 內江市企事業及機關單位從業人員20~60歲人群中超重、肥胖者比例為27.16%；肥胖較超重者更易發生高血糖、高血壓、高血脂、高尿酸血癥；超重及肥胖與年齡、吸煙、性別、運動、家族史、文化程度均有關。【Abstract】 Objective To investigate the prevalence and the risk factors of overweight and obesity among employees aged 20 to 60 years old in enterprises and government institutions in Neijiang city. Methods From June 2009 to September 2010, 5 832 employees in government departments, enterprises and institutions in Neijiang were surveyed using stratified random sampling method. Items like physical exercise, smoking, drinking, educational level, and family history were collected through face-to-face questionnaire, and their height, weight, fasting plasma glucose, triglyceride, cholesterol were measured. SPSS 17.0 was used for statistical analysis, and the relationship of each index was analyzed by Pearson correlative analysis. Bilateral Plt;0.05 was considered to be statistically significant. Risk factors associated with obesity were analyzed by Logistic regression analysis. Results The overweight and obesity morbidity rate was 27.16%, including 1377 cases of overweight (23.6%) and 207 cases of obesity (3.55%). Fasting plasma glucose, triglyceride, and blood pressure of obesity patients were higher than those of the overweight patients. Correlation analysis showed that overweight and obesity were positively correlated with fasting plasma glucose (r=0.116,Plt;0.01), triglyceride(r=0.319,Plt;0.01), uric acid (r=0.373,Plt;0.01), diastolic blood pressure (r=0.198,Plt;0.01), and systolic blood pressure (r=0.212,Plt;0.01), but not correlated with cholesterol. Logistic regression multivariate analysis showed that overweight and obesity were related with age, smoking, sex, sports, the educational level and family history, but not related with drinking. Conclusions The prevalence of overweight and obesity among employees aged 20 to 60 years old in enterprises and government institutions in Neijiang city is 27.16%. People with overweight and obesity are more susceptible to hyperglycemia, hypertension, hyperlipemia, and hyperuricemia. Overweight and obesity were closely related with age, smoking, gender, sports activities, family history, and educational level.
ObjectiveTo retrospectively evaluate the risk factors of mortality in postoperative acute kidney injury (AKI) patients undergoing continuous renal replacement therapy (CRRT) after cardiopulmonary bypass (CPB). MethodsWe retrospectively analyzed the clinical data of 66 patients (38 males and 28 females with mean age of 59.11±12.62 years) underwent CRRT after cardiovascular surgery in our hospital between May 2009 and June 2014. The patients were divided into a survival group (18 patients) and a death group (48 patients) according to treatment outcome at discharge. Univariate analysis for risk factors of death was carried out for preoperative characteristics and lab results among study population. Significant univariate factors were then further analyzed by multivariable logistic regression models. ResultsSignificant predictors of death included blood transfusion volume during operation, peak level of blood sugar and lactate during operation, the total bilirubin level and platelet count on the first day after operation, hypotension on the first day after operation, pulmonary infection, multiple organ dysfunction syndrome (MODS) and the interval time of oliguria and CRRT (P<0.05). Logistic regression showed that there were statistical differencs in hypotension on the first day after operation, postoperative platelet count, and interval time of oliguria and CRRT respectively (P<0.05). ConclusionImproving intraoperative management, reducing bleeding and blood transfusion, controlling blood sugar level, dealing with complications such as hypotension, pulmonary infection and MODS more aggressively, starting CRRT when needed may be helpful to reduce mortality. Monitoring of the blood pressure and platelet count on the first day after operation is useful for prognosis estimation.
ObjectiveTo summarize the surgical treatment and explore factors which influencing prognosis of hilar cholangiocarcinoma. MethodsClinical data of 189 cases of hilar cholangiocarcinoma who treated in our hospital from Jan. 2000 to Dec. 2010 and clinicopathological factors that might influence survival were analyzed retrospectively. A multivariate factor analysis was performed through Cox proportional hazard model. ResultsOf 189 cases, 62 cases received radical resection, 54 cases received palliative surgery, and 73 cases received non-resection surgery. Operative procedure (RR=0.165), differentiated degree (RR=2.692), lymph node metastasis (RR=3.014), neural infiltration (RR=2.857), and vascular infiltration (RR=2.365) were found to be the statistically significant factors that influenced survival by multivariate factor analysis through the Cox proportional hazard model. ConclusionsRadical resection is the best treatment for hilar cholangiocarcinoma. Skeletonized hepatoduodenal ligament, complete excision of infiltrated nerve and blood vessel are important influence factors to improve the prognosis of hilar cholangiocarcinoma.
Objective To explore the current status of nutritional literacy in maintenance hemodialysis (MHD) patients and analyze its influencing factors. Methods MHD patients in Wenjiang Hemodialysis Center of West China Hospital, Sichuan University between January and April 2022 were selected by convenient sampling method. A questionnaire survey was conducted using the Nutrition Literacy Evaluation Scale for end-stage renal disease dialysis patients, and the current status and influencing factors of nutritional literacy in MHD patients were analyzed. Results A total of 214 patients were included, with an average nutritional literacy score of 19.14±5.78 for MHD patients. Among them, there were 60 cases (28.04%) of highly likely low nutritional literacy, 124 cases (57.94%) of moderate nutritional literacy, and 30 cases (14.02%) of highly likely high nutritional literacy. The correlation test results showed that hemoglobin, albumin, cholesterol, triglyceride, calcium, phosphorus, potassium, creatinine, estimated glomerular filtration rate, and nutritional literacy scores were not correlated. The results of multiple linear stepwise regression analysis showed that education level [non-standardized partial regression coefficient (b)=1.821, 95% confidence interval (CI) (1.143, 2.498), P<0.001], age [b=?2.460, 95%CI (?4.247, ?0.672), P=0.007], hypertensive kidney damage [b=2.233, 95%CI (0.428, 4.039), P=0.016] were all factors affecting the nutritional literacy of MHD patients. Conclusions In clinical work, more attention should be paid to MHD patients with low educational level, older age, and more primary diseases. And targeted interventions should be adopted to improve the level of nutritional literacy in order to improve the quality of life of MHD patients.
Objective To identify the factors which influence the effectiveness of clinical evaluation of undergraduate nursing students. Methods A self-made questionnaire was used in face-to-face interviews with 158 clinical teachers of undergraduate nursing students in four teaching hospitals in Sichuan. Results The main factors that influence the effectiveness of clinical evaluation of undergraduate nursing students included: clinical environment, duration of evaluation, degree of familiarity with the evaluation criteria of clinical teachers, and evaluation methods used by clinical teachers. The less important factors included: “halo-effect” of teachers to students, relationship between teachers and students, attitude towards evaluation and emotional status of clinical teachers. Conclusion It is of great importance to improve the clinical environment, provide enough time for clinical teachers to evaluate, cultivate and improve clinical teachers’ evaluation and competence, and establish a good relationship between teachers and students.This should improve the accuracy, objectivity and fairness of undergraduate nursing students’ clinical evaluation.
ObjectiveTo explore the prevalence and risk factors of hypertension in Anyue County from June 2011 to June 2013. MethodsUsing stratfied random cluster sampling method, 5 391 people over 15 years of age were selected from 3 residential areas and 3 natural villages to finish a questionnaire and blood pressure measurement. ResultsThe total prevalence rate of hypertension in Anyue County was 18.77%. The prevalence rates of hypertension in urban areas and rural areas were 21.75% and 16.20%, and the difference was significant (χ2=27.120, P<0.001). In both urban and rural areas, the prevalence rate of hypertension increased with age (χ2=475.634, P<0.001; χ2=394.026, P<0.001). The percentages of awareness, treatment and control in Anyue County were 31.30%, 24.41%, and 9.09%. The percentages of awareness, treatment and control in urban areas were 40.15%, 33.70%, and 11.23% and were 20.68%, 13.65%, and 6.61% in rural areas. There were significant differences in the percentages of awareness, treatment and control between urban and rural areas (χ2=44.475, P<0.001; χ2=54.861, P<0.001; χ2=8.202, P=0.004). The logistic regression analysis showed that age (OR=1.061, P<0.001), diabetes (OR=1.550, P<0.001), hyperlipemia (OR=2.372, P<0.001) and smoking (OR=1.335, P<0.001) were the risk factors for hypertension; and it showed that high level of education was a protective factor for hypertension (OR=0.755, P<0.001). ConclusionBecause of high prevalence and low percentages of awareness, treatment and control in Anyue County, the prevention and control situation of hypertension are grim. We should focus on the control of smoking, blood lipid and blood glucose.
The pathogenesis of diabetic retinopathy (DR) is complex and there are many related risk factors. It is related to the course of diabetes, blood glucose, blood pressure, and blood lipids, among which the course of disease and hyperglycemia are recognized main risk factors. In addition, other factors which include heredity, gender, age, obesity, pregnancy, insulin use, can also affect the occurrence and development of DR, but there is no unified conclusion about its correlation. A comprehensive understanding of the risk factors that affect DR can provide new ideas for the prevention, diagnosis, treatment, and intervention of DR.
ObjectivesTo investigate the status quo of follow-up services for patients with cervical spondylosis, to explore its influencing factors, and to provide reference for the follow-up management model after postoperative discharge of patients with cervical spondylosis.MethodsA total of 220 patients with cervical spondylosis were selected by using convenient sampling from October 2018 to May 2019, and the general information questionnaire and the follow-up service needs questionnaire were used for the investigation.ResultsThe score of follow-up service content requirement for patients with cervical spondylosis was 54.87±7.56, and the rehabilitation training instruction was the highest. Multiple linear regression analysis showed that the follow-up service content score was influenced by education level [non-standardized partial regression coefficient (b)=3.186, 95% confidence interval (CI) (2.490, 3.882), P<0.001], length of hospital stay [b=5.140, 95%CI (3.914, 6.365), P<0.001], Neck Disability Index [b=1.326, 95%CI (0.189, 2.463), P=0.022], and age [≥75 years as the reference, 45-59 years: b=3.766, 95%CI (0.671, 6.860), P=0.017; 60-74 years: b=4.081, 95%CI(0.849, 7.314), P=0.014]. The method of obtaining follow-up services was mainly based on outpatient follow-up (85.5%), telephone follow-up (50.5%), and established a follow-up service center (40.5%) for discharged patients. The executives were multidisciplinary teams (60.5%) and hospital-community integration teams (48.2%). There were 19.1% of discharged patients who were willing to pay for relevant follow-up services.ConclusionsPatients with postoperative cervical spondylosis have strong demand for post-discharge follow-up services, which are affected by many factors. Medical staff should pay attention to this and develop a personalized follow-up service plan according to patient characteristics to meet different discharged patients and improve the quality of medical services.
Abstract： Objective?To analyze the risk factors for early shunt dysfunction after systemic-pulmonary shunt in order to improve early postoperative outcomes. Methods We retrospectively analyzed the clinical records of 189 patients who underwent systemic-pulmonary shunt in General Hospital of Shenyang Military District between February 2002 and December 2010. There were 87 males and 102 females with their age ranging from 3 months to 50（5.3±6.2）years，and body weight ranging from 3 to 56（17.7±11.0）kg. There were 94 patients with tetralogy of Fallot （TOF） and pulmonary artery stenosis，51 patients with pulmonary atresia （PA） and ventricular septal defect，4 patients with PA and intact ventricular septum，10 patients with functional single ventricle （SV） and pulmonary stenosis（PS），6 patients with SV and PA，6 patients with double outlet right ventricle and PS，8 patients with transposition of the great arteries（TGA） and PS，and 10 patients with TGA and PA. The surgical procedures included central aorto-pulmonary shunt （Waterston） in 105 patients, modified Blalock-Taussig shunt in 61 patients and Melbourne shunt in 23 patients. Results Early postoperative death occurred in 13 patients （6.9%）. There were 12 patients （6.3%） with intra-operative severe hypotension or arrhythmia, 10 patients （5.3%） with postoperative severe low cardiac output, and 10 patients （5.3%） with early shunt dysfunction within the first 24 h postoperatively. Univariate analysis identified low body weight （P=0.027）, shunt size with diameter＜4 mm （P=0.025） and severe intra-operative adverse event （hypotension or arrhythmia with P=0.002） were risk factors for early shunt dysfunction. In multivariate analysis, intra-operative adverse event was an independent risk factor for early shunt dysfunction（P=0.017）. Conclusion Early outcomes after systemic-pulmonary shunt can be significantly improved by preventing intra-operative severe hypotension or arrhythmia and choosing shunt size larger than 4 mm，especially for patients with young age, low body weight, and poorly-developed pulmonary artery.
Objective To study the mortality and prognostic factors of post-operative acute respiratory failure in cancer patients. Methods There were 1632 postoperative cancer patients from2004 to 2006 in the ICU of Cancer Hospital, in which 447 patients were complicated with acute respiratory failure ( intubation or tracheotomy and mechanical ventilation) . The clinical data was retrospectively analyzed. Stepwise logistic regression analysis was used to identify variables associated with mortality for acute respiratory failure. Results In 447 patients with acute respiratory failure ( male 260, female 187) , 106 cases died with a mortality of 6. 5% . Single factor analysis showed that acute morbodities ( shock, infection, organ failure) , intervention ( continuous renal replacement therapy, vasopressor drugs) , the 28-day ICU free days and APACHE scores ( ≥ 20) had significant differences between the survivor and non-survivor. Multiple logistic regression analysis showed that duration of operation( P = 0. 008, OR 1. 032, 95% CI 1. 008-1. 057) , APACHEⅡ≥20 scores( P =0. 000, OR12. 200, 95% CI 2. 896-51. 406) , organ function failure( P =0. 000, OR 13. 344,95% CI 3. 791-7. 395) were associated with mortality of acute respiratory failure. Conclusion Duration of operation, organ function failure, and APACHE Ⅱ scores were risk prognostic factors for postoperative cancer patients with acute respiratory failure.