Objective:To explore the influencing factors of evacuation associated pulmonary edema (WIPE) in patients with mechanical ventilation of cardiogenic respiratory failure, and to build a risk warning model based on independent influencing factors.Methods:A total of 220 patients with cardiogenic respiratory failure who were treated and received mechanical ventilation in Chengbei Campus of Hangzhou First People′s Hospital from April 2021 to December 2023 were retrospectively selected by cross-sectional investigation method, and were divided into WIPE group (34 cases) and non WIPE group (186 cases) according to whether the patients had WIPE or not. Clinical data of the patients were analyzed using the hospital electronic medical record system. The influencing factors of WIPE were determined by univariate analysis and multivariate Logistic regression analysis, and the risk early warning model was constructed based on regression analysis. The corresponding nomogram was drawn by R language software, and the predictive efficiency of the model was tested by receiver operating characteristic curve and calibration curve.Results:WIPE group included 18 males and 16 females, aged (65.12±9.28) years. Non WIPE group included 107 males and 79 females, aged (60.25±8.40) years. Multivariate Logistic regression analysis showed that age ( OR=1.072), smoking history ( OR=3.412), acute physiology and chronic health evaluationⅡ( OR=1.184), cardiac function classification ( OR=4.043), shallow rapid breathing index ( OR=1.100), mechanical ventilation time ( OR=1.540), hypertension ( OR=4.903), left ventricular diastolic dysfunction ( OR=5.151) and chronic obstructive pulmonary disease ( OR= 5.536) were independent influencing factors (all P < 0.05). The area under the curve of the risk early warning model constructed based on the above 9 independent influencing factors was 0.938, and the sensitivity and specificity corresponding to the optimal cutoff value of 0.620 were 0.971 and 0.801, respectively, indicating good differentiation ability. The calibration curve results show that the average absolute error was 0.020, the calibration curve fits the ideal curve, and the model calibration performance was good. Conclusions:WIPE in patients with cardiogenic respiratory failure induced by mechanical ventilation is affected by cardiac function status, mechanical ventilation parameters and other factors. The risk early warning model based on the above 9 independent influencing factors has good predictive efficacy, and can provide reference for clinical prevention of WIPE.

Objective:To investigate the correlation between oral cleanliness and secondary Pulmonary infection in patients with severe chronic obstructive pulmonary disease (COPD) in mechanical ventilation, and to investigate the predictive effect of oral cleanliness on the risk of secondary pulmonary infection.Methods:Using the cross-sectional survey method, the purposeful sampling method was adopted to select 216 patients with severe COPD who were hospitalized in Hangzhou First People′s Hospital from June 2020 to December 2023 and received mechanical ventilation. The oral cleanliness index and general clinical data of patients at admission were collected using the hospital electronic medical record system. The independent influencing factors of secondary lung infection were analyzed by univariate analysis and multivariate Logisitic regression. The predictive value of oral cleanliness index on secondary lung infection was analyzed by patient operating characteristic (ROC) curve.Results:216 patients with severe COPD who underwent mechanical ventilation were included.Patients aged 37-84 (66.81 ± 8.98) years were included, including 125 males and 91 females.Among them, 89 cases developed secondary pulmonary infection, with an infection rate of 41.20%.Univariate analysis and multivariate Logistic regression analysis showed that, Beck Oral Rating Scale (BOAS) score ( OR = 1.371), visual simulation score of oral odor ( OR = 1.405), gum index ( OR = 3.508), plaque index ( OR = 14.357), smoking history ( OR = 6.772), duration of disease ( OR = 1.391), COPD assessment test score ( OR = 1.269) and mechanical ventilation time ( OR = 1.302) were independent factors for secondary pulmonary infection (all P<0.05). ROC curve analysis showed that oral cleanliness index combined with infection prediction was effective (the area under the ROC curve was 0.833) . Conclusions:Oral cleanliness was closely related to secondary pulmonary infection in patients with severe COPD with mechanical ventilation. BOAS score, visual simulation score of oral odor, gingival index and plaque index could predict secondary pulmonary infection independently, and combined test could predict secondary pulmonary infection.

Objective:To explore the influencing factors of evacuation associated pulmonary edema (WIPE) in patients with mechanical ventilation of cardiogenic respiratory failure, and to build a risk warning model based on independent influencing factors.Methods:A total of 220 patients with cardiogenic respiratory failure who were treated and received mechanical ventilation in Chengbei Campus of Hangzhou First People′s Hospital from April 2021 to December 2023 were retrospectively selected by cross-sectional investigation method, and were divided into WIPE group (34 cases) and non WIPE group (186 cases) according to whether the patients had WIPE or not. Clinical data of the patients were analyzed using the hospital electronic medical record system. The influencing factors of WIPE were determined by univariate analysis and multivariate Logistic regression analysis, and the risk early warning model was constructed based on regression analysis. The corresponding nomogram was drawn by R language software, and the predictive efficiency of the model was tested by receiver operating characteristic curve and calibration curve.Results:WIPE group included 18 males and 16 females, aged (65.12±9.28) years. Non WIPE group included 107 males and 79 females, aged (60.25±8.40) years. Multivariate Logistic regression analysis showed that age ( OR=1.072), smoking history ( OR=3.412), acute physiology and chronic health evaluationⅡ( OR=1.184), cardiac function classification ( OR=4.043), shallow rapid breathing index ( OR=1.100), mechanical ventilation time ( OR=1.540), hypertension ( OR=4.903), left ventricular diastolic dysfunction ( OR=5.151) and chronic obstructive pulmonary disease ( OR= 5.536) were independent influencing factors (all P < 0.05). The area under the curve of the risk early warning model constructed based on the above 9 independent influencing factors was 0.938, and the sensitivity and specificity corresponding to the optimal cutoff value of 0.620 were 0.971 and 0.801, respectively, indicating good differentiation ability. The calibration curve results show that the average absolute error was 0.020, the calibration curve fits the ideal curve, and the model calibration performance was good. Conclusions:WIPE in patients with cardiogenic respiratory failure induced by mechanical ventilation is affected by cardiac function status, mechanical ventilation parameters and other factors. The risk early warning model based on the above 9 independent influencing factors has good predictive efficacy, and can provide reference for clinical prevention of WIPE.

Objective:To investigate the correlation between oral cleanliness and secondary Pulmonary infection in patients with severe chronic obstructive pulmonary disease (COPD) in mechanical ventilation, and to investigate the predictive effect of oral cleanliness on the risk of secondary pulmonary infection.Methods:Using the cross-sectional survey method, the purposeful sampling method was adopted to select 216 patients with severe COPD who were hospitalized in Hangzhou First People′s Hospital from June 2020 to December 2023 and received mechanical ventilation. The oral cleanliness index and general clinical data of patients at admission were collected using the hospital electronic medical record system. The independent influencing factors of secondary lung infection were analyzed by univariate analysis and multivariate Logisitic regression. The predictive value of oral cleanliness index on secondary lung infection was analyzed by patient operating characteristic (ROC) curve.Results:216 patients with severe COPD who underwent mechanical ventilation were included.Patients aged 37-84 (66.81 ± 8.98) years were included, including 125 males and 91 females.Among them, 89 cases developed secondary pulmonary infection, with an infection rate of 41.20%.Univariate analysis and multivariate Logistic regression analysis showed that, Beck Oral Rating Scale (BOAS) score ( OR = 1.371), visual simulation score of oral odor ( OR = 1.405), gum index ( OR = 3.508), plaque index ( OR = 14.357), smoking history ( OR = 6.772), duration of disease ( OR = 1.391), COPD assessment test score ( OR = 1.269) and mechanical ventilation time ( OR = 1.302) were independent factors for secondary pulmonary infection (all P<0.05). ROC curve analysis showed that oral cleanliness index combined with infection prediction was effective (the area under the ROC curve was 0.833) . Conclusions:Oral cleanliness was closely related to secondary pulmonary infection in patients with severe COPD with mechanical ventilation. BOAS score, visual simulation score of oral odor, gingival index and plaque index could predict secondary pulmonary infection independently, and combined test could predict secondary pulmonary infection.

Objective To investigate the efficacy of negative pressure combined ureteroscopy combined with flexible ureteroscopy holmium laser lithotripsy in the treatment of renal calculi or upper ureteral calculi with a maximum diameter of 2-4cm.Methods The data of patients with renal calculi or upper ureteral calculi with a maximum diameter of 2-4cm who were hospitalized inAffiliated Hospital of Youjiang Medical University for Nationalities from March 2023 to March 2024 were collected and divided into observation group(n=40)and control group(n=40).The observation group was treated with negative pressure combined ureteroscopy combined with flexible ureteroscopy for holmium laser lithotripsy,and control group was treated with nephroscope for percutaneous nephrolithotomy(PCNL).The operation time,postoperative hospital stay,changes of blood routine white blood cell(WBC)before and after operation,changes of urine routine WBC before and after operation,postoperative visual analogue score(VAS),one-stage stone clearance rate and postoperative complications were compared between two groups.Results The postoperative hospitalization time and VAS of observation group were significantly lower than those of control group(P＜0.05).There was no significant difference in operation time,stone clearance rate,postoperative blood routine WBC and postoperative urine routine WBC between two groups(P＞0.05).However,the blood routine WBC of two groups after operation was higher than that before operation(P＜0.05).The overall stone clearance rate of two surgical methods was 86.25％,of which the stone clearance rate of observation group was 82.5％,and control group was 90％.There was no significant difference between two groups(P＞0.05).Conclusion It is safe and effective to treat renal calculi;or upper ureteral calculi with a maximum diameter of 2-4cm by negative pressure combined ureteroscopy combined with flexible ureteroscopy holmium laser lithotripsy.It is expected to partially replace PCNL and become another safe and reliable operation for the treatment of renal calculi or upper ureteral calculi with a maximum diameter of 2-4cm.

Objective To investigate the efficacy and safety of long-term intermittent treatment with topical corticosteroids in localized chronic eczema.Methods A total of 129 patients with localized chronic eczema were treated with triamcinolone acetonide and econazole nitrate cream (Pevisone (R)).Those who achieved a clinical cure within 4-week treatment were recruited into the following long-term study and classifled into 2 groups to be intermittently treated with triamcinolone acetonide and econazole nitrate cream or a moisturizing cream for 8 weeks.The cream was applied topically twice a day for 2 days every week.Patients were followed up on week 4 and 8 after the beginning of treatment and on week 12 after the discontinuation of treatment.The severity of eczema in patients was rated according to SCORAD (SCORing atopic dermatitis) score.Results The SCORAD score was significantly lower in patients treated with triamcinolone acetonide and econazole nitrate cream than in those with moisturizing cream on week 8 in the treatment and week 12 after the discontinuation (t=3.076,2.367,both P<0.05).A statistical decrease was also observed in the recurrence rate of eczema in patients treated with triamcinolone acetonide and econazole nitrate cream compared with moisturizing cream.treated patients at the 3 follow-up time points (x2=4.426,7.683,8.199,all P<0.05).The incidence of adverse events was 3.1% during the treatment with triamcinolone acetonide and econazole nitrate cream.No severe adverse reactions were observed.Conclusion Long-term intermittent treatment with topical corticosteroids is effective for the prevention of exacerbation and postponement of recurrence,of eczema.

Objective To investigate the clinical efficac y of internal fixation with Titanium Alloy(TIA)reconstruction plate in treatment o f clavicular midpiece fracture.Methods 37cases of clavicular midpiece frac-ture underwent open reduction and in ternal fixation with TIA.All the 37c ases were followed up and their clini cal efficacy were analyzed.Results All the clavicle fractures achieved clinical union and satisfactory fun ctional re-covery.Conclusion Open reduction and internal fixatio n with TIA reconstruction plate is on e of the best choices for clavicular midpiece fractures,for it can free the patients from distress of reoperation.[