1.Assessment application of the modified CURB-65 score for emergency community-acquired pneumonia
Hua SHEN ; Lei BAO ; Honglang ZHANG ; Ying XU ; Zheng ZHANG ; Haidong QIN
Chinese Journal of Emergency Medicine 2014;23(8):911-914
Objective To evaluate the clinical application value of modified CURB-65 score for assessing severity of community-acquired pneumonia (CAP) in emergency patients.Methods During the period from May 2011 to May 2012,198 emergency patients with CAP enrolled in this study were evaluated by CURB-65 score and modified CURB-65 score,respectively.Based on the severity of CAP,patients were divided into mild pneumonia group (Group A,n =107) and severe pneumonia group (Group B,n =91).The clinical status and biomarkers (the white blood cell count,procalcitonin,pneumonia severity index,hospitalization days,and hospitalization expenses) were recorded and compared with t test.Group B was divided into survived-subgroup (n =62) and death-subgroup (n =29).The differences in CURB-65 score and modified CURB-65 scere between the two groups were compared with t test.The correlation of CURB-65 score and modified CURB-65 score with procalcitonin,pneumonia severity index,hospitalization days,and hospitalization expenses were determined with Pearson rank correlation method.Results The procalcitonin,pneumonia severity index,hospitalization days,hospitalization expenses,modified CURB-65 score and CURB-65 score in Group B were significantly higher than those in Group A [(3.70 ± 0.83) vs.(1.27±0.24),t=28.91,P<0.01; (121.33±16.74) vs.(73.79±9.21),t=25.23,P<0.01;(25.79±10.13) vs.(14.85 ±6.83),t=9.02,P<0.01; (22.71 ±3.84) vs.(9.83 ±1.24),t=32.76,P<0.01; (3.69±1.03) vs.(3.32±1.06),t=2.48,P<0.05; (4.21±1.13) vs.(3.41±0.96),t =5.39,P<0.01],while no significant difference was observed in the white blood cell count between GroupA and B (17.58 ±5.99 vs.16.86±4.41,t =0.97,P>0.05).For Group B,the modified CURB-65 score of death-subgroup was significantly higher than that of survived-subgroup [(4.75± ± 1.17) vs.(4.01 ± 1.09),t =2.95,P < 0.01],whilc no significant difference was observed in the CURB-65 score between the death-subgroup and survived-subgroup (4.01 ± 1.15 vs.3.58 ±0.97,t =1.86,P > 0.05).The CURB-65 score positive correlated with the procalcitonin (r =-0.803,P =0.025),and had no obvious correlation with the pneumonia severity index,hospitalization days,and hospitalization expenses (r=0.621,P=0.320; r=0.701,P=0.231; r=0.675,P=0.256); The modified CURB-65 score significantly positively correlated with the procalcitonin,pneumonia severity index,hospitalization days,and hospitalization expenses (r =0.951,P =0.003 ; r =0.965,P =0.002 ; r =0.947,P =0.004 ; r =0.961,P =0.002).Conclusions Compared with the CURB-65 score,the modified CURB-65 score is more efficient in evaluating the severity and prognoses of CAP for emergency patients.
2.Prevalence and related factors of HIV/HBV coinfection among HIV/AIDS patients
Dan FENG ; Tian YAO ; Yanpeng CHENG ; Minghu PAN ; Chunxia LI ; Jun WANG ; Yongliang FENG ; Jing SHI ; Honglang HUANG ; Hongyan LU ; Guanghua LAN ; Suping WANG ; Yawei ZHANG
Chinese Journal of Epidemiology 2017;38(12):1624-1628
Objective To reveal the prevalence and the related factors of hepatitis B (HepB) virus infection among HIV/AIDS patients.Methods We conducted a cross-sectional study in two HIV clinics,affiliated to local Centers of Disease Control and Prevention in Guangxi Zhuang Autonomous Regional.A face-to-face interview,with questionnaire was conducted to collect information on socio-demographic characteristics,drug use,and sexual behavior.Blood samples were used to test HBsAg.x2 test or Fisher's exact test and unconditional logistic regression models were used to identify the influencing factors.Results The prevalence of HBV and HIV co-infection was 13.85% (113/816).Results from multivariate logistic regression analyses showed that age (25-45),family history of HBV and history of HepB vaccination were independent influencing factors for HBV and HIV coinfection,with OR (95% CI) as 1.738 (1.031-2.931),2.898 (1.678-5.005) and 1.744 (1.052-2.892),respectively.Conclusion The prevalence of HBV among HIV/AIDS patients was significantly higher than that in general population.HIV/AIDS patients aged between 25 and 45 and with family history of HBV were more likely to be infected with HBV,while HepB vaccination was associated with the reduction of HIV/HBV coinfection.Specific comprehensive prevention and treatment programs on HIV/AIDS patients need to be set up.