Objective:To examine the association between baseline serum albumin level and short-term, long-term outcomes in patients with systemic sclerosis associated interstitial lung disease (SSc-ILD).Methods:A total of 259 patients with SSc-ILD who were hospitalized in West China Hospital of Sichuan University from January 2008 to December 2018 were enrolled. The data of serum albumin, demographic characteristics, peripheral blood hemoglobin at admission, and treatment plan were obtained from the hospital information management system, and the survival of the patients were followed up to June 1, 2019. The mean baseline serum albumin of 259 patients was 37.67 g/L, there were 118 patients with serum albumin ≤37.67 g/L (low protein group) and 141 patients with serum albumin>37.67 g/L (high protein group).Results:There were 64 males and 195 females with a mean age of 50.0(41.0, 61.0) years. The follow-up time was 627(61, 1 426) days. Compared to high protein group, the low protein group had higher proportion of male patients [30.5%(36/118) and 19.9%(28/141),χ 2=3.92, P=0.048], and higher levels of the erythrocyte sedimentation rate [45.0(27.0,69.0) vs. 29.0 (19.0,46.0)mm/1 h,χ 2=4.07, P<0.001], neutrophil percentage [71.50(63.35,77.13) vs. 65.60(59.50,72.50)%,χ 2=3.65, P<0.001], platelet [196(140,273) vs. 172(126,240)×10 9/L,χ 2=1.99, P=0.046], nutrophil/lymphocyte ratio [33.85(2.53,5.28) vs. 2.61(1.97,3.83),χ 2=4.57, P<0.001], platelet/lymphocyte ratio [149.0(112.0,216.8) vs. 113.5(72.76,158.8),χ 2=4.98, P<0.001], aspartate aminotransferase [27.0(21.0,39.0) vs. 23.0 (19.5,30.0) IU/L,χ 2=2.93, P=0.003], globulin [31.20(26.90,36.83) vs. 29.50(25.65,32.80) g/L,χ 2=2.28, P=0.023], serum cystatin C[1.14(0.98,1.33) vs. 1.02(0.88,1.16) mg/L,χ 2=3.80, P<0.001], IgA[2 710 (1 965,3 505) vs. 2 460 (1 862,3 105) mg/L,χ 2=2.13, P=0.033], IgG[15.05(12.83,21.08) vs. 13.60(11.53,17.23)g/L,χ 2=3.24, P=0.001], IgE[60.44(24.92,197.99) vs. 34.82(14.72,85.04) kIU/L,χ 2=3.33, P=0.001] and circulating immune complex [0.13(0.08,0.19) vs. 0.10(0.08,0.13)O.D,χ 2=2.60, P=0.009]; and lower levels of hemoglobin [121.5(101.8,132.0) vs. 129.0(119.0,142.0) g/L,χ 2=5.05, P<0.001], albumin [(33.28±3.49) vs.(41.34±2.95) g/L,χ 2=20.17, P<0.001] and IgM[1 320 (932,1 745) vs.1 560(1 170,2 030) mg/L, χ 2=2.63, P=0.009]. The utilization rate of antibiotics was higher in the low protein group (60 vs. 43 cases, χ 2=11.10, P=0.001). The number of patients followed up to 1, 5, and 10 years were 248, 245, and 244, respectively. The 1-year, 5-year, and 10-year cumulative survival rates of patients in low protein group and high protein group were(91.0% vs. 98.4%, χ 2=6.23, P=0.013;87.0% vs. 97.1%, χ 2=6.15, P=0.013; 81.6% vs. 97.1%, χ 2=7.00, P=0.008) respectively. Conclusions:Patients with scleroderma-associated interstitial lung disease have an increased risk of poorer prognosis when serum albumin ≤37.67 g/L.

BACKGROUND: Nasal insertion is the preferred method for non-intubated patients in flexible bronchoscopy; however, the relatively narrow nasal cavity results in difficulties related to bronchoscope insertion. This study aimed to investigate whether pre-operative nasal probe tests could reduce the time to pass the glottis, improve the first-pass success rate and patients' tolerance, and reduce postoperative bleeding. METHODS: This three-arm prospective randomized controlled trial was conducted in a tertiary hospital between May and October 2020. Three hundred patients requiring diagnosis and treatment using flexible bronchoscopy were randomly allocated to three groups: control group, simple cotton bud detection group (CD group), and adrenaline + lidocaine detection group (AD group). The primary outcome was the time to pass the glottis. Secondary outcomes included the first-pass success rate, the patients' tolerance scores, and post-operative bleeding. One-way analysis of variance, Kruskal-Wallis H test, Chi-squared test, Fisher's exact test, and Bonferroni's multiple comparison tests were used in this study. RESULTS: In total, 189 men and 111 women were enrolled in this study, with a mean age of 55.72 ± 12.86 years. The insertion time was significantly shorter in the AD group than in the control group (18.00 s [12.00-26.50 s] vs . 24.00 s [14.50-45.50 s], P = 0.005). Both the AD (99% vs . 83%, χ2 = 15.62, P < 0.001) and CD groups (94% vs . 83%, χ2 = 5.94, P = 0.015) had a significantly higher first-pass success rate than the control group. Compared with the control group, post-operative bleeding (1% vs . 13%, χ2 = 11.06, P < 0.001) was significantly lower in the AD group. However, no significant difference was found in the patients' tolerance scores. CONCLUSIONS: Pre-operative nasal cavity probe tests especially with adrenaline and lidocaine during flexible bronchoscopy can significantly reduce the time to pass the glottis, improve the first-pass success rate, and reduce post-operative nasal bleeding. Pre-operative nasal probe tests are recommended as a time-saving procedure for patients undergoing flexible bronchoscopy. TRIAL REGISTRATION Chinese Clinical Trial Registry (ChiCTR), ChiCTR2000032668; http://www.chictr.org.cn/showprojen.aspx?proj=53321 .
Adult ; Aged ; Bronchoscopes ; Bronchoscopy/methods* ; Epinephrine/therapeutic use* ; Female ; Humans ; Lidocaine/therapeutic use* ; Male ; Middle Aged ; Postoperative Hemorrhage/prevention & control* ; Prospective Studies

Objective: Through research on the geriatric nursing related literature in Chinese journals and medical care and elderly care combination related keywords from 1979 to 2017, this study provides the development trend of geriatric nursing research. Methods: Searching articles in Wanfang, CNKI, VIP database, selecting the keywords and published time of the paper. Employing descriptive statistics to describe literatures information such as publication time, quantity of keywords, word frequency of keywords, heat degree of keywords, character of keywords and so on. Results: Totally 134 791 articles were got and 58 031 articles were included in the analysis. The amount of literature growth was slow before 2005, The cumulative amount of literature in 1979-2005 was only 12.75% of the total amount of literature. After 2005, the amount of literature increased rapidly year by year. The number of literature published in 2017 has exceeded 12%. The amount of the geriatric nursing related literature was proportional to the number of people aged 65 and over in China. In the research of geriatric nursing, the content related to medical care and elderly care combination was quite dispersed, and it did not involve research at the level of Medical Association. The medical care and elderly care combination and Medical Association were new areas in the research of geriatric nursing. Conclusion The amount of the geriatric nursing related literature from 1979 to 2017 was proportional to the number of people aged 65 and over in China. There are few researches on how to carry out geriatric nursing under the policy of medical care and elderly care combination and Medical Association, which should be the focus of future research and exploration to actively respond to the challenge of aging population.