ObjectiveTo summarize the research progress of correlation between pancreatic cancer and diabetes mellitus.MethodsRecent studies on the association between pancreatic cancer and diabetes mellitus were extensively reviewed, and relevant research results on the association between pancreatic cancer and diabetes mellitus were reviewed.ResultsPancreatic cancer had a particular association with diabetes. Patients with pancreatic cancer may develop new diabetes or worsen existing diabetes mellitus. About 50% of patients with pancreatic cancer had diabetes mellitus before diagnosis, suggesting a “dual causal relationship” between pancreatic cancer and diabetes mellitus. Long-term type 2 diabetes mellitus (T2DM) was one of the high risk factors for the occurrence and development of pancreatic cancer. T2DM may also increase the risk of pancreatic cancer due to hyperinsulinemia, adipokine, and other factors. Pancreatic cancer was one of the cause of diabetes mellitus at the same time, but its mechanism was not yet known, also needed to get a lot of information to understand the impact of long-term diabetes mellitus on the development of pancreatic cancer, as well as the reason of pancreatic cancer related to diabetes mellitus mechanism.ConclusionThe clear relationship between pancreatic cancer and diabetes mellitus has not been proved, and further research is needed to clarify the relationship between them.
【摘要】 目的 比較薤白聯合阿司匹林或單用阿司匹林防治心腦血管事件的療效。 方法 2007年1月〖CD3/5〗2009年9月就診的188例高危患者納入研究,隨機分為實驗組(89例)和對照組(99例)。兩組均予口服阿司匹林0.1 g,1次/d。實驗組同時給予口服薤白0.9 g,3次/d。觀察兩組患者血管事件的發生率和不良反應的發生情況。 結果 實驗組血管總事件發生率為6.7%,對照組為19.2%,兩組間差異有統計學意義(Plt;0.05);實驗組腦梗死發生率為1.1%,對照組為9.1%,兩組間差異有統計學意義(Plt;0.05)。兩組短暫性腦缺血、心絞痛、心肌梗死的發生率比較,差異無統計學意義(Pgt;0.05)。兩組皮下出血、血尿、黑便、惡心、腹痛等不良反應的發生率比較,差異無統計學意義(Pgt;0.05)。 結論 服用阿司匹林加薤白可顯著降低高危患者心腦血管總事件發生率和腦梗死發生率,增加療效,而不良反應沒有顯著增加。【Abstract】 Objective Compare the curative effect of cerebrovascular diseases event prevented with llium macrostemon and aspirin or only with aspirin. Methods Divide the outpatient patients into experimental group (89 patients) and control group (99 patients). Use 0.1 g aspirin for two groups with oral administration once per day. The experimental group is used with 0.9 g allium macrostemon with oral administration three times per day. Observe the generation rate and adverse reaction of vascular events in two groups of patients. Results The Total generation rate of vascular events in the experimental group is 6.7% and the control group is 19.2%,the differences were statistically significant (Plt;0.05); the cerebral infarction generation rate in the experimental group is 1.1% and in the control group is 9.1%,the differences were statistically significant (Plt;0.05). There is no significant difference (Pgt;0.05) in TIA, angina pectoris, myocardial infarction generation rate in two groups. There is no significant difference (Pgt;005) in adverse reaction generation rate of subcutaneous hemorrhage, hematuria, melena, nausea, bellyache. Conclusion Taking aspirin with llium macrostemon can significantly decrease total cardiovascular and cerebrovascular events generation rate and cerebral infarction generation rate in high risk patients, improve the curative effect and the adverse reaction has not been significantly increased.
Objective To investigate the medication adherence to antihypertensives, antidiabetics, and lipid-lowering agents and its influence on the prognosis of individuals at high risk of stroke. Methods A total of 16892 residents aged 40 years or above in eight communities in Sichuan participated in a face-to-face study from May to September 2015. A database of a high-risk population of stroke in Sichuan province was established, and data were collected via using a standardized structured questionnaire by experienced investigators, including the treatment status and medication compliance of participants with hypertension, diabetes, or dyslipidemia during the follow-up period. Multiple logistic regression analyses were performed to explore the influencing factors of medication adherence and its influence on the prognosis of individuals at high risk of stroke. Results A total of 2893 participants at high risk of stroke were enrolled. The treatment rates of hypertension, diabetes, and dyslipidemia were 50.1%, 49.2%, and 5.1%, respectively, when the high-risk individuals were identified. At the end of follow-up (with a median follow-up period of 4.8 years), the treatment rates of hypertension, diabetes, and dyslipidemia were 24.8%, 25.0%, and 7.9%, respectively. Medication adherence to antihypertensives, antidiabetics, and lipid-lowering agents were 27.8%, 25.5%, and 18.1%, respectively. Multiple logistic regression analyses showed that the education level of high school or above [odds ratio (OR)=2.134, 95% confidence interval (CI) (1.098, 4.147), P=0.025], medical insurance for urban residents [OR=1.556, 95%CI (1.086, 2.230), P=0.016] and urban employees [OR=2.325, 95%CI (1.362, 3.967), P=0.002], having fewer children [OR=0.819, 95%CI (0.719, 0.933), P=0.003], and family history of stroke [OR=1.559, 95%CI (1.066, 2.282), P=0.022] were associated with greater adherence to antihypertensives; medical insurance for urban employees was associated with greater adherence to antidiabetics [OR=2.494, 95%CI (1.173, 5.300), P=0.018]. After adjusting for confounding factors, failure to regular use of antihypertensives [OR=2.617, 95%CI (1.414, 4.842), P=0.002], antidiabetics [OR=3.909, 95%CI (2.394, 6.380), P<0.001], and lipid-lowering agents [OR=4.828, 95%CI (2.581, 9.033), P<0.001] in patients with hypertension, diabetes, and dyslipidemia, respectively were associated with increased risk of ischemic stroke during the follow-up period. Regular use of lipid-lowering agents in patients with dyslipidemia was associated with an increased risk of intracerebral hemorrhage during the follow-up [OR=4.371, 95%CI (1.156, 16.530), P=0.030]. Conclusions The prevalences of hypertension, diabetes, and dyslipidemia are high in high-risk individuals of stroke in Sichuan province. However, the treatment rates are unsatisfactory, and the medication adherence is poor. The medication adherence is affected by a variety of demographic and socioeconomic factors. Regular treatments of hypertension, diabetes, and dyslipidemia reduce the risk of ischemic stroke in individuals at high risk of stroke, but regular use of lipid-lowering agents in patients with dyslipidemia is associated with an increased risk of intracerebral hemorrhage during the follow-up.
Clinical scientists have paid more and more attention to the acute respiratory distress syndrome(ARDS), a severe complication after thoracotomy, for its high mortality rate. Compared with other surgical patients, patients who received thoracotomy often have a worse cardiopulmonary function and are prone to suffering from ARDS. Surgical treatment or injury, massive blood transfusion, respiratory tract infection, improper fluid replacement and ventilation are probable reasons to cause ARDS. Mechanical ventilation is an important treatment for ARDS，but ventilation with lungprotective strategies was proved to be the only therapy which can improve the prognosis of patients with ARDS. At present, thinking highly of and promoting the perioperative management, lessening surgical injury and active prevention are still very important measures to reduce the mortality after thoracotomy. This article is aimed to review the high risk factors of ARDS after thoracotomy as well as its treatment.
We reported a case of a 61-year-old female patient, six years status post her last cardiac surgery, who was admitted with a chief complaint of bilateral lower extremity edema for over a year, which had acutely worsened with associated chest pain for two days. The patient had a complex cardiac surgical history: 12 years prior, she underwent double valve replacement (aortic and mitral) plus tricuspid valvuloplasty for mitral valve prolapse with severe regurgitation and moderate-to-severe aortic regurgitation. Nine years ago, she underwent bioprosthetic mitral valve replacement and vegetation removal for prosthetic valve vegetation with severe regurgitation. Six years ago, she underwent a transapical transcatheter mitral valve replacement and mitral balloon valvuloplasty due to prosthetic mitral valve prolapse with severe regurgitation. Following evaluation during this admission, she successfully underwent a valve-in-valve transcatheter aortic valve replacement (ViV-TAVR). The patient had an uneventful postoperative recovery. This case report aims to explore the clinical strategy and application of the ViV-TAVR technique for managing bioprosthetic valve failure in patients with a history of complex valvular surgeries.
Objective To develop an evaluation tool for the screening of high risk population for oral complications in critically ill patients, which can be performed accurately and scientifically. Methods Basing on the related foreign oral assessment scale, combined with the method of brainstorming, expert consultation, method of clinical status and so on, the item pool of the assessment scale was determined. Five nursing experts and two oral experts assessed the content validity and 50 ICU nurses were tested. Then, the screening accuracy of the assessment scale was proved by application in 100 critically ill patients selected randomly. Results The Cronbach’s a coefficient of final version of the High Risk Assessment Scale for Oral Complications in Critically Ill Patients (including seven parts contents of oral health assessment and oral pH value test) was 0.815, the content validity index (Sr-CVI/Ave) was 0.932. The results of 50 nurses to the 91.2% assessment items of the assessment scale were very important and important. For screening related indicators of oral complications in high-risk patients, the sensitivity of the assessment scale was 97.53%, the specificity was 94.11%, the positive predictive value was 98.75%, the negative predictive value was 88.89%, and the crude agreement was 95%. Conclusion There are good reliability, validity and a high accuracy of screening test in the High Risk Assessment Scale for Oral Complications in Critically Ill Patients. It can be used for screening patients at high risk for oral complications in critically ill patients, and help clinical nurses to complete the oral health status of the critically ill patients quickly.
Objective To investigate the information of label use of high-alert drugs for children of high risk population, in the Military General Hospital of Beijing PLA. Methods We selected high-alert drugs used in this hospital as objectives. The package inserts of these drugs were investigated and medication parts for children were analyzed. Results 201 drugs regarded as high-alert drugs were included, of which only 78 drugs have accurate detailed description of medication for children, accounting for 38.8% of the total of investigated high-alert drugs. Conclusion Children, as high-risk population, needs more attention concerning the use of high-alert drugs. However, risks in the use of high-alert drugs increased due to the lack of the information of label use of high-alert drugs. To ensure the safety of drug use in children, the information of drug use for children in the package inserts should be urgently supplemented.
ObjectiveTo analyze the relation between ABO blood type and postoperative pathological features of patients with colorectal cancer served by West China Hospital of Sichuan University as a regional center in the current version of Database from Colorectal Cancer (DACCA). MethodsThe data of DACCA was updated on January 5, 2022. According to the screening conditions, the enrolled patients with colorectal cancer were divided into blood type A, B, AB, and O. The differences in the postoperative pathological characteristics of patients with different blood types, such as pathological TNM, T, N, M (pTNM, pT, pN, pM) staging, peripheral nerve involvement, high risk factors, tumor regression grade (TRG), and cancer nodules, were analyzed. ResultsAfter screening, 6 089 data rows were analyzed. The patients involved 2 058 blood type A, 1 469 blood type B, 494 blood type AB, and 2 068 blood type O. The results of statistical analysis showed that: ① There were statistical differences in the overall distribution of pTNM and pM stages among the patients with different blood types (H=11.564, P=0.009; H=7.947, P=0.047), which was reflected in: from the overall distribution trend, the proportion of patients with the four blood types in the same stage was similar, but it could still be seen that patients with blood type AB accounted for the highest proportion in the patients with stage Ⅲ, Ⅳ, M1a, M1b as compared with other blood types. ② There were no statistical differences in the overall distribution of peripheral nerve involvement and TRG in the patients with different blood types (H=3.414, P=0.332; H=1.143, P=0.767). ③ There was statistical difference in the proportion of different grades of high risk factors in the patients with different blood types (H=14.540, P=0.002). Specifically, the proportions of patients with grade 3–5 of high risk factors in the patients with AB blood type were the highest. ④ There was no statistical difference in the proportion of the grade of cancer nodules number in patients with different blood types (H=4.460, P=0.216). ConclusionsFrom results of this study, it is found that there are some differences in pTNM stage, pM stage, and high risk factors of colorectal cancer patients with different blood types, but no differences in pT stage, pN stage, peripheral nerve involvement, TRG, and cancer nodules among different blood types of patients. The influence of blood type on postoperative pathological characteristics of colorectal cancer patients needs to be further explored.
目的 分析死胎死亡原因及可能的相關因素，為降低死胎發生的措施提供依據。 方法 對2007年1月－2011年12月住院分娩的609例死胎（≥28周） 的病例資料進行回顧性分析,包括對產檢次數差異、死胎性別、死胎孕周分布、母親年齡差別、母親文化程度等進行統計分析。 結果 ① 死胎的原因依次為：胎兒因素（41.2%），母體因素（24.1%），胎盤因素（21.7%）及不明原因（13.0%）；其中胎兒畸形、重度子癇前期及胎盤早剝為主要原因；② 母親的文化程度低、未建卡或未正規產檢者死胎發生的幾率高于正規產檢者，差異有統計學意義（P＜0.05）。 結論 加強圍產保健，早期篩查胎兒畸形、防治妊娠期并發癥及合并癥等都有助于降低死胎的發生率。