1.Study on the prognostic factors in patients with acute exacerbation of chronic obstructive pulmonary disease combined with respiratory failure
Xiaowen PU ; Runyi FANG ; Jinqing ZHANG
Chinese Journal of Postgraduates of Medicine 2014;37(34):42-44
Objective To investigate the risk factors of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) combined with respiratory failure.Methods The clinical data of 120 patients with AECOPD combined with respiratory failure were retrospectively analyzed.The patients were divided into disease improved group (96 cases) and disease serious group (24 cases,including death) according to the treatment outcome.Risk factor and treatment strategies of the two groups were statistically analyzed.Results There was no significant difference in age,sex,disease course and arterial blood oxygen partial pressure(P > 0.05).The body mass index,albumin,pH,successful cough and expectoration rate,nutritional support rate,and noninvasive mechanical ventilation rate in disease improved group was higher than that in disease serious group[(28.5 ± 9.8) kg/m2 vs.(23.3 ± 7.4) kg/m2,(21.4 ± 7.9) g/L vs.(19.3 ± 6.8) g/L,7.23 ± 0.20 vs.7.11 ± 0.17,79.2% (76/96) vs.25.0% (6/24),58.3% (56/96) vs.33.3% (8/24),81.2% (78/96) vs.62.5% (15/24)],arterial blood carbon dioxide partial pressure,mild consciousness obstacle rate,multiple drug-resistant infections rate,fungal infection rate,nasal feeding rate,hormone use time and the incidence of heart failure,pulmonary encephalopathy,hepatorenal function damage and upper gastrointestinal bleeding in disease improved group was lower than that in disease serious group [(10.08 ±1.71) kPa vs.(11.98 ± 2.03) kPa,13.5% (13/96) vs.58.3% (14/24),22.9% (22/96) vs.41.7% (10/24),0 vs.29.2% (7/24),50.0%(48/96) vs.75.0%(18/24),(5.3 ± 1.3) d vs.(11.3 ± 3.8) d,8.3%(8/96) vs.25.0%(6/24),13.5%(13/96) vs.70.8%(17/24),28.1%(27/96) vs.41.7%(10/24),5.2%(5/96) vs.12.5%(3/24)],and there was significant difference (P < 0.05).Conclusion Complicating disease,nutritional status,consciousness,capability of sputum exclusion,the degree of respiratory infection,treatment with noninv asive positive pressure ventilation,arterial gas analysis index are the correlated factors of prognosis in AECOPD combined with respiratory failure.
2.Detection rate and influencing factors of suspected scoliosis among primary and middle school students in Dali Bai Autonomous Prefecture
Guanghong PU ; Xiaowen WANG ; Zhi ZHAO ; Jiang LU ; Caihong LI ; Zixiang YAN ; Yiwen WANG ; Li ZHANG ; Yingsong WANG
Chinese Journal of Orthopaedics 2022;42(21):1433-1440
Objective:To investigate the epidemiological characteristics and influencing factors of scoliosis among primary and middle school students in Dali Bai autonomous prefecture.Methods:A total of 176,729 students aged 6-18 years from 380 primary and secondary schools in eight counties of Dali Bai Autonomous Prefecture were screened for spinal health by visual method, Adams forward bend test and scoliometer measuring the angle of trunk rotation from September to November 2021. The angle of trunk rotation ≥5° or visual method retest positive was used as a positive standard to confirm suspected scoliosis population. Demographic data of the screening population including name, gender, age and ethnicity were collected. The average altitude of the community or village committee in the screening area was recorded. Binary logistic regression analysis was used to screen the influencing factors of scoliosis.Results:There were 176,729 people planned to complete the screening. A total of 140,026 people were actually completed screening with completion rate 79.23%. A total of 3,190 (2.28%) suspected scoliosis positive people were detected. The detection rate of female was 2.52%, which was higher than that of male 2.03% (χ 2=37.18, P<0.001). The detection rate of 10-18 years old group was 2.90%, which was higher than that of 6-9 years old group 0.70% (χ 2=620.79, P<0.001). There was a significant difference in the detection rate among different age groups from 6 to 18 years old (χ 2=1,451.00, P<0.001). The detection rate of Han population was 2.67%, which was higher than that of non-Han population 2.15% (χ 2=31.06, P<0.001). In non-Han population, the detection rate of Bai population was 2.07%, which was lower than that of non-Bai population 2.26% (χ 2=4.02, P=0.045). Trend chi-square test showed significant difference in the detection rate of scoliosis among the general population, 10-18 years old population and 6-9 years old population in the altitude <1,500 m, 1,500-1,599 m, 1,600-1,699 m, 1,700-1,799 m, 1,800-1,899 m, 1,900-1,999 m, 2,000-2,099 m, 2,100-2,199 m, 2,200-2,299 m and ≥2,300 m groups (χ 2=249.02, 195.64, 24.46, P<0.05). Binary logistic regression analysis showed that the risk of scoliosis was lower in males than that in females ( OR=0.82, P<0.001). The risk of scoliosis was increased in 10-18 years old compared with that in 6-9 years old ( OR=0.12, P<0.001). The risk of scoliosis was low in Bai population compared with that in Han populations ( OR=0.75, P<0.001). The altitude ≥2,000 m was a risk factor ( OR=1.52, P<0.001). Conclusion:The detection rate of suspected scoliosis in primary and middle school students in Dali Bai Autonomous Prefecture was 2.28%. Female, aged 10-18 years, Han populations, and residence in altitude ≥2,000 m might be the risk factors for scoliosis.