ObjectiveTo analyze the factors affecting the prognosis of patients with primary tracheal malignancy, and establish a nomogram model for prediction its prognosis.MethodsA total of 557 patients diagnosed with primary tracheal malignancy from 1975 to 2016 in the Surveillance, Epidemiology, and End Results Data were collected. The factors affecting the overall survival rate of primary tracheal malignancy were screened and modeled by univariate and multivariate Cox regression analysis. The nomogram prediction model was performed by R 3.6.2 software. Using the C-index, calibration curves and receiver operating characteristic (ROC) curve to evaluate the consistency and predictive ability of the nomogram prediction model.ResultsThe median survival time of 557 patients with primary tracheal malignancy was 21 months, and overall survival rates of the 1-year, 3-year and 5-year were 59.1%±2.1%, 42.5%±2.1%, and 35.4%±2.2%. Univariate and multivariate Cox regression analysis showed that age, histology, surgery, radiotherapy, tumor size, tumor extension and the range of lymph node involvement were independent risk factors affecting the prognosis of patients with primary tracheal malignancy (P<0.05). Based on the above 7 risk factors to establish the nomogram prediction model, the C-index was 0.775 (95%CI 0.751-0.799). The calibration curve showed that the prediction model established in this study had a good agreement with the actual survival rate of the 1 year, 3 year and 5 years. The area under curve of 1-year, 3-year and 5-year predicting overall survival rates was 0.837, 0.827 and 0.836, which showed that the model had a high predictive power.ConclusionThe nomogram prediction model established in this study has a good predictive ability, high discrimination and accuracy, and high clinical value. It is useful for the screening of high-risk groups and the formulation of personalized diagnosis and treatment plans, and can be used as an evaluation tool for prognostic monitoring of patients with primary tracheal malignancy.
Cardiac implantable electronic device (CIED) is commonly used to treat arrhythmias. The amount of CIED implantation has increased year by year since its first application in 1958. At the same time, the CIED infection rate also increases significantly. Although the infection rate is very low for the primary implantation, the consequences of CIED infection are serious, and it is often necessary to remove the equipment for treatment. The mortality rate in patients with CIED infections is high, and the economic burden is huge. In this paper, the epidemiology, pathogenesis and pathogen, manifestations and diagnosis, risk factors, treatment and preventive measures of CIED infection were systematically described based on the recently published guidelines and international consensus literature, so as to provide theoretical guidance for the prevention of CIED infections.
ObjectivesTo compare the survival outcomes between hepatocellular carcinoma and hepatic angiosarcoma, and to develop and validate a nomogram predicting the outcome of hepatic angiosarcoma.MethodsThe Surveillance, Epidemiology and End Results (SEER) database was electronically searched to collect the data of hepatic angiosarcoma patients and hepatocellular carcinoma patients from 2004 to 2016. Propensity score matching (PSM) was used to match the two groups by the ratio of 1:3. Cox regression analysis was used to compare the survival outcomes between hepatic angiosarcoma and HCC. In the angiosarcoma group, population was divided into training set and validation set by 6:4. Nomograms were built for the prediction of half- and one- year survival, and validated by concordance index (C-index) and calibration plots.ResultsA total of 210 histologically confirmed hepatic angiosarcoma patients and 630 hepatocellular carcinoma patients were included. The overall survival of HCC was significantly longer than angiosarcoma (3-year survival: 18.4% vs. 6.7%, median survival: 5 months vs. 1 month, P<0.001), and the nomogram achieved good accuracy with an internal C-index of 0.751 and an external C-index of 0.737.ConclusionsThe overall survival of HCC is significantly longer than angiosarcoma. The proposed nomograms can assist to predict survival probability in patients with hepatic angiosarcoma. Due to limitation of the data of included patients, more high-quality studies are required to verify above conclusions.
ObjectiveTo explore the epidemiological characteristics and analyze the related diagnosis and treatment information of wound outpatient cases in a tertiay hospital in Leshan City.MethodsThe data of cases admitted to the wound clinic in a tertiary hospital of Leshan City between January 1st, 2017 and December 31st, 2019 were retrospectively collected. The SPSS software was used for statistical analyses in terms of basic patient information, wound type and dressing use, number of visits and expenses.ResultsA total of 10 880 cases were enrolled. The average age of the patients treated was (45.23±13.45) years old. Patients from the Central District, where the hospital was located in, accounted for the highest proportion (38.63%). The proportion of acute skin and soft tissue injuries was higher than that of chronic skin and soft tissue injuries (62.51% vs. 37.49%). According to the proportions from high to low, the top three chronic skin and soft tissue injuries were postoperative refractory wounds (19.63%), skin and soft tissue infections (3.90%), and stoma complications (3.04%), respectively. A total of 22 937 functional wound dressings were used, of which non-woven outer dressings accounted for 47.52%. Patients with acute skin and soft tissue injuries had a higher healing rate compared with those with chronic skin and soft tissue injuries (96.65% vs. 43.03%, P<0.05). The type of skin and soft tissue injuries with the most visits was cancerous wound [the median (lower quartile, upper quartile) was 68 (35, 121) visits], and the one with the least visits was acute skin and soft tissue injuries [the median (lower quartile, upper quartile) was 2 (1, 7) visits].ConclusionsAs the distance between residence and hospital grows, the number of patients decreases, suggesting that the specialized nursing assistance has achieved initial results in remote areas, but the task of assistance in surrounding areas is still heavy. The type of skin and soft tissue injuries is changing under the concept of enhanced recovery after surgery, and wound care plays an important role in the recovery of patients after surgery. The concept of wet healing and new dressings to promote wound healing are widely used, but still need to be further popularized among patients and medical staff. For chronic wounds that are more expensive to treat, it is necessary to formulate comprehensive treatment plans such as wound treatment, psychological support, and systemic nutrition to promote healing.
Objective To survey the prevalence of coexisting chronic obstructive pulmonary disease ( COPD) and chronic heart failure in Chengdu communities. Methods A cross-sectional study was performed in the population aged over 40 years in eight communities of Chengdu city. The subjects were selected by stratified cluster random sampling. Using the same protocol and questionnaire, all participants underwent medical history taking, physical examination and spirometry. Results Of 354 participating patients with a diagnosis of COPD, 74 ( 20. 90% ) cases were complicated with chronic heart failure. The prevalence of chronic heart failure in COPD in male was significantly higher than that in female ( 22. 69%vs. 18. 12% , P lt; 0. 05) . The major causes of chronic heart failure were hypertension ( 31. 64% ) , ischaemic heart disease ( 18. 93% ) , chronic pulonary heart disease ( 17. 51% ) and diabetes ( 11. 86% ) .Conclusions The prevalence of coexisting COPD and chronic heart failure in Chengdu city is significantly higher than the average level of the whole country, which warrant more attention in prevention and treatment of COPD in communities.
ObjectiveTo understand variations in clinical epidemiology of lung cancer and to help with early accurate diagnosis and treatment of lung cancer.MethodsThis research was based on the Lung Cancer Database of West China Hospital of Sichuan University. Clinicopathological data of inpatients with primary lung cancer from 2011 to 2018 was collected for analysis. Information regarding sex, age, smoking history, surgical resection modalities, TNM stage of tumor, and pathological subtypes was included.ResultsA total of 23 228 inpatients with primary lung cancer were included in this research. There were 1 932, 2 029, 2 162, 2 773, 2 975, 3 318, 3 993, and 4 046 patients in every single year from 2011 to 2018, respectively. The male-to-female ratio of patients had changed significantly from 2.00∶1 in 2011 to 1.34∶1 in 2018 (P<0.001). Statistically significant difference was found in age distribution of patients in different years, while elderly always accounted for the majority of all patients. More nonsmokers were among the group of lung cancer patients, the proportion of whom rose from 41.61% in 2011 to 52.47% in 2018 (P<0.001). The proportion of adenocarcinoma in all subtypes rose from 54.04% in 2011 to 71.73% in 2018, while the proportion of squamous carcinoma dropped from 29.04% to 17.67% simultaneously. From 2011 to 2018, the proportion of stage Ⅰ lung cancer rose from 15.68% to 40.79%. Patients with stage ⅠA1 accounted for 11.82% in 2018. In 2018, 60.78% of stage ⅠA patients had gone through surgical resection modalities, forming a stark contrast with the fact that only 26.48% of stage ⅠA patients adopted surgeries in 2011.ConclusionsFrom 2011 to 2018, the total number of lung cancer patients increased year by year. The proportions of female patients and nonsmokers rose significantly. Adenocarcinoma accounted for the highest proportion of all subtypes, followed by squamous cell carcinoma. There were more patients with early lung cancer and less with advanced lung cancer diagnosed, implying a gradual accumulation of weight on the early stages according to the TNM classification of lung cancer.
In recent years, clinical research in traditional Chinese medicine (TCM) has witnessed vigorous development, with increasingly close integration with clinical epidemiological methodologies. However, certain controversies persist, such as the difficulty in aligning epidemiology’s population-based perspective with TCM’s principle of syndrome differentiation and treatment and the characteristics of individualized diagnosis and treatment. This paper reviews the development and current status of TCM clinical research, integrating the practice rules of TCM, and analyzes the manifestations and applicability of the basic characteristics of epidemiology in TCM clinical research. The study shows that epidemiological concepts and characteristics are fully compatible with the practical features of TCM clinical practice and its research needs. Moreover, epidemiological techniques can effectively uncover and elucidate the scientific basis of TCM clinical practice. Building on these analyses, we propose future directions for TCM clinical research, aiming to promote the integration of epidemiology and TCM clinical research and advance TCM clinical research to a higher level.
Objective To explore the characteristics of diagnosis and treatment for the rectal cancer in the young patients （≤40 years）．Methods The domestic and abroad literatures about the research on the progress of rectal cancer in the young patients were reviewed, the clinical data of patients with rectal cancer were compared between the young patients and the other age patients, the characteristics of diagnosis and treatment for the rectal cancer in the young patients were summarized．Results The onsets of the young patients with rectal cancer were related to the diet，lifestyle, and genetic factors．Compared with the older patients, more later stage, higher percentage of poor differentiation, earlier lymph node metastasis were found in the young patients with rectal cancer．Rectal cancer of the young patients was often misdiagnosed and with a poor prognosis．Currently，surgery assisted with neoadjuvant therapy was generally acknowledged as a better method．Conclusions It has specificity in epidemiology, pathology, treatment, prognosis, and so on for rectal cancer in the young patients, but surgery needs further research．
Objective To review the research progress of alcohol-induced osteonecrosis of the femoral head (ONFH). Methods Recent literature concerning alcohol-induced ONFH was reviewed and summarized. Results Alcohol-induced ONFH accounte for approximately 1/3 of total ONFH. Alcohol intake and the incidence of ONFH has a significant dose-effect relationship. There are some correlations between alcohol-induced ONFH and lipid metabolism, secretion of corticosteroid, and some gene of alcohol or lipid metabolism. Conclusion The relationships between alcohol and lipid metabolism, and between alcohol and steroid are still the main direction of the research of ONFH. Gene level researches can not demonstrate the pathogenesis, therefore further research should be carried on.
Objective To investigate the etiological and clinical characteristics of 1298 cases with spontaneous intracerebral hemorrhage. Methods A retrospective analysis was conducted to investigate the epidemiology and clinical characteristics of 1298 patients who suffered from spontaneous intracerebral hemorrhage and were hospitalized in Neurology Dept. of Anhui Provincial Hospital from 2005 to 2009. Results Among 1 298 patients, 822 (63.33%) were male while 476 (36.67%) were female. The constituent ratio of male and female patients was significantly different; the patients mainly suffered from spontaneous intracerebral hemorrhage in winter and spring which was commonly caused by hypertension accounting for 65.87% and was mostly happened on basal ganglia site (n=895, 68.95%). Conclusions The incidence of spontaneous cerebral hemorrhage is related with age, season and hypertension, it is very important to be prevented effectively and to well control the blood pressure.