Objective To explore the clinical features, treatment measures, disease outcomes, and differences in patients with asthma admitted to hospitals in Qinghai and Tibetan Plateau, and further analyze the risk factors. Methods A retrospective analysis was conducted on the clinical data of 297 patients with asthma admitted to Qinghai Provincial People’s Hospital and Tibet Autonomous Region People’s Hospital from 2015 to 2021. A standardized case report form (CRF) was designed and used to collect patients’ general information, International Classification of Diseases (ICD-10), clinical symptoms, treatment, laboratory examination, and pulmonary function test data. The clinical features of the patients were described, and the risk factors of the clinical features of asthma patients admitted to hospitals in Qinghai and Tibetan Plateau were analyzed by using a stepwise Logistic regression model. Results A total of 297 patients with asthma admitted to hospitals in Qinghai and Tibetan Plateau were included in this study. The overall pulmonary function of asthma patients admitted to hospitals in Qinghai was worse than that in Tibetan Plateau (FEV1/FVC%: 73.22±13.59 vs. 80.70±18.36, P<0.001; TLC: 101.50 vs. 163.00, P=0.001). The incidence of related clinical symptoms in asthma patients admitted to hospitals in Qinghai were higher than those in Tibetan Plateau (dyspnea: 98.0% vs. 66.0%, P<0.001; cyanosis: 82.0% vs. 34.0%, P<0.001; pulmonary rales: 80.7% vs. 70.7%, P=0.046). There was no significant difference in treatment measures between patients in Qinghai and Tibetan Plateau (P>0.05). The main factors contributing to the differences in clinical characteristics between the two regions were the altitude of residence (OR=0.94, 95%CI: 0.91-0.98, P=0.004) and the co-existence of allergic diseases (OR=9.47, 95%CI: 2.68-3347.07, P=0.012).ConclusionsCompared with Tibet, the incidence of asthma symptoms and poorer lung function were higher among inpatients with asthma in Qinghai; there was no significant difference in treatment measures between the two regions, but there was a significant difference in prognosis; the main factors contributing to the differences in clinical characteristics between the two regions were the altitude of residence and the co-existence of allergic diseases.
ObjectiveTo conduct an umbrella review and meta-analysis of the effectiveness of melatonin in preventing delirium in hospitalized patients. MethodsSystematic reviews evaluating the effectiveness of melatonin for delirium prevention in hospitalized patients were retrieved from CNKI, VIP, WanFang Data, CBM, PubMed, Embase, CINAHL, Cochrane Library, and Web of Science. The search time frame spanned from database inception to March 20, 2025. Methodological quality was assessed using AMSTAR 2, and evidence quality was evaluated via the GRADE system. Data analysis was performed using RevMan 5.4. ResultsA total of 30 systematic reviews were included, and 98 evidence items were extracted. Methodological quality assessment identified 13 high-quality, 2 moderate-quality, 8 low-quality, and 7 very low-quality studies. Evidence quality evaluation revealed 19 high-quality, 34 moderate-quality, 31 low-quality, and 14 very low-quality evidence items. A meta-analysis of re-extracted raw data demonstrated that melatonin significantly reduces the incidence of delirium in hospitalized patients (OR=0.51, 95%CI 0.41 to 0.63, P<0.001). ConclusionMelatonin demonstrates beneficial effects in preventing delirium in hospitalized patients. However, due to limitations in the number and quality of included literature, some findings warrant further validation and clarification through high-quality research.