AIM: To investigate the association between dyslipidemia and macular hard exudates(HEs)in non-proliferative diabetic retinopathy(NPDR)secondary to type 2 diabetes mellitus(T2DM).METHODS: NPDR patients attending the outpatient ophthalmology clinic from January 2021 to December 2023 were selected and divided into three groups according to the severity of macular HEs. Group A: None or minimal HEs; Group B: Definite HEs; Group C: Prominent HEs. Total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), lipoprotein(a)[Lp(a)] levels and other lipid-related indicators were routinely measured. The correlation between these indicators and HEs was analyzed.RESULTS:Group A(24 eyes)consisted of 9 males and 15 females with the mean age of 54.71±6.15 y, group B(52 eyes)consisted of 20 males and 32 females with the mean age of 55.08±6.27 y, group C(14 eyes)consisted of 9 males and 5 females with the mean age of 53.93±6.08 y. The concentration of TC, TG, LDL-C and Lp(a)was highest in group C, followed by group B and lowest in group A with statistically significant differences(P<0.001). There were no statistically significant differences between the three groups for fasting plasma glucose(FPG), glycated hemoglobin A1c(HbA1c), creatinine(Cr), and HDL-C(P>0.05). The results of multivariate Logistic regression analysis showed that elevated levels of TC, TG, LDL-C, and Lp(a)were associated with the presence of macular HEs. Receiver operating characteristiccurve analysis showed that the area under the curve(AUC)for TC, TG, LDL-C, Lp(a), and their combination in predicting macular HEs in NPDR were 0.785, 0.718, 0.784, 0.742, and 0.911, respectively, with the combined model demonstrating the highest predictive performance.CONCLUSION: Dyslipidemia is closely associated with the development and progression of macular HEs in patients with NPDR and T2DM. The levels of TC, TG, LDL-C, and Lp(a)were correlated with the severity of macular HEs, suggesting that dyslipidemia may be involved in the pathological process of macular HEs formation.

Objective:To investigate the application value of risk level prevention intervention based on delirium prediction models in ICU patients undergoing mechanical ventilation.Methods:A randomized controlled study was conducted on 124 patients with acute respiratory distress syndrome who underwent mechanical ventilation in the ICU at the Marine Police Corps Hospital of Chinese People's Armed Police Force from January 2020 to December 2022. They were divided into an observation group and a control group, with 62 patients in each group, using a random number table method. The control group received routine intervention, while the observation group received risk level prevention intervention based on delirium prediction models. The intervention lasted for 4 weeks. The intervention effects were observed in both groups.Results:In the observation group, the duration of mechanical ventilation was (149.97 ± 29.86) hours, the duration of delirium was (2.79 ± 1.03) days, the incidence of delirium was 3.23% (2/62), the length of ICU stay was (7.57 ± 2.14) days, and the mortality rate was 1.61% (1/62). All of these values were significantly shorter or lower than those in the control group [(170.78 ± 34.28) hours, (4.12 ± 0.98) days, 33.87% (21/62), (10.21 ± 2.85) days, 19.35% (12/62), t = 3.60, 7.37, χ2 = 19.29, t = 5.83, χ2 = 10.40, all P < 0.001]. The observation group scored significantly higher than the control group in terms of difficulty in falling asleep, sleep depth, difficulty in returning to sleep, nighttime awakenings, and overall sleep quality ( t = -8.48, -4.57, -4.50, -5.26, -5.86, all P < 0.001). After the intervention, the observation group also had significantly higher scores for treatment confidence [(28.75 ± 4.87) points], family care [(7.62 ± 1.13) points], and intervention satisfaction [91.94% (57/62) points] compared with the control group [(28.75 ± 4.87) points, (7.62 ± 1.13) points, 77.42% (48/62), t = -7.79, -12.74, χ2 = 5.03, all P < 0.05]. Conclusion:The risk level prevention intervention based on delirium prediction models helps to reduce the duration of mechanical ventilation, the duration of delirium, and the length of ICU stay. It also controls delirium and mortality rates, improves patients' sleep quality, and enhances treatment confidence, family support, and overall satisfaction with the intervention.

Objective:To investigate the application value of risk level prevention intervention based on delirium prediction models in ICU patients undergoing mechanical ventilation.Methods:A randomized controlled study was conducted on 124 patients with acute respiratory distress syndrome who underwent mechanical ventilation in the ICU at the Marine Police Corps Hospital of Chinese People's Armed Police Force from January 2020 to December 2022. They were divided into an observation group and a control group, with 62 patients in each group, using a random number table method. The control group received routine intervention, while the observation group received risk level prevention intervention based on delirium prediction models. The intervention lasted for 4 weeks. The intervention effects were observed in both groups.Results:In the observation group, the duration of mechanical ventilation was (149.97 ± 29.86) hours, the duration of delirium was (2.79 ± 1.03) days, the incidence of delirium was 3.23% (2/62), the length of ICU stay was (7.57 ± 2.14) days, and the mortality rate was 1.61% (1/62). All of these values were significantly shorter or lower than those in the control group [(170.78 ± 34.28) hours, (4.12 ± 0.98) days, 33.87% (21/62), (10.21 ± 2.85) days, 19.35% (12/62), t = 3.60, 7.37, χ2 = 19.29, t = 5.83, χ2 = 10.40, all P < 0.001]. The observation group scored significantly higher than the control group in terms of difficulty in falling asleep, sleep depth, difficulty in returning to sleep, nighttime awakenings, and overall sleep quality ( t = -8.48, -4.57, -4.50, -5.26, -5.86, all P < 0.001). After the intervention, the observation group also had significantly higher scores for treatment confidence [(28.75 ± 4.87) points], family care [(7.62 ± 1.13) points], and intervention satisfaction [91.94% (57/62) points] compared with the control group [(28.75 ± 4.87) points, (7.62 ± 1.13) points, 77.42% (48/62), t = -7.79, -12.74, χ2 = 5.03, all P < 0.05]. Conclusion:The risk level prevention intervention based on delirium prediction models helps to reduce the duration of mechanical ventilation, the duration of delirium, and the length of ICU stay. It also controls delirium and mortality rates, improves patients' sleep quality, and enhances treatment confidence, family support, and overall satisfaction with the intervention.

BACKGROUND: Studies have shown that the incidence and severity of corona virus disease 2019 (COVID-19) in patients with lung cancer are higher than those in healthy people. At present, the main anti-tumor treatments for lung cancer include surgery, immunotherapy, chemotherapy, radiotherapy, targeted therapy and anti-angiogenesis therapy. While the effects of different anti-tumor treatments on the occurrence and severity of COVID-19 pneumonia are not uniform. Therefore, we aimed to describe clinical characteristics and antitumor therapy of patients with lung cancer and COVID-19 pneumonia, and examined risk factors for severity in this population. METHODS: From December 1, 2022 to February 15, 2023, a retrospective study was conducted in 217 patients diagnosed with COVID-19 and pathologically confirmed lung cancer in the Jinling Hospital. We collected data about patients' clinical features, antitumor treatment regimen within 6 months, and the diagnosis and treatment of COVID-19. Risk factors for occurrence and severity of COVID-19 pneumonia were identified by univariable and multivariable Logistic regression models. RESULTS: (1) Among the 217 patients included, 51 (23.5%) developed COVID-19 pneumonia, of which 42 (82.4%) were classified as medium and 9 (17.6%) were classified as severe; (2) Univariate and multivariate analysis revealed overweight (OR=2.405, 95%CI: 1.095-5.286) and intrapulmonary focal radiotherapy (OR=2.977, 95%CI: 1.071-8.274) are risk factors for increasing occurrence of COVID-19 pneumonia, while other therapies are not; (3) Chronic obstructive pulmonary disease (COPD) history (OR=7.600, 95%CI: 1.430-40.387) was more likely to develop severe pneumonia and anti-tumor therapies such as intrapulmonary focal radiotherapy, chemotherapy, targeted therapy and immunotherapy did not increase severity. CONCLUSIONS Intrapulmonary focal radiation therapy within 6 months increased the incidence of COVID-19 pneumonia, but did not increase the severity. However, there was no safety concern for chemotherapy, targeted therapy, surgery and immunotherapy.
Humans ; COVID-19 ; Retrospective Studies ; Lung Neoplasms/drug therapy* ; Incidence ; Pneumonia/etiology*

Objective: To investigate the relationship among depression, anxiety, stress and addictive substance use behavior in secondary vocational students. Methods: Cluster sampling method and the Adolescent Health-related Behaviors Questionnaire were used to collect demographic characteristics, psychological symptoms, and addictive substance usage among 5 935 students in nine vocational schools in Chongqing, Zhaoqing, Ningbo, and Taiyuan. Multivariate logistic regression analysis was used to analyze the relationship between the addictive substance use behavior and psychological factors. Results: The detection rates of depression, anxiety and stress were 46.5% (n=2 762), 58.7% (n=3 483), and 29.8% (n= 1 770), respectively. The prevalence of addictive substances was 74.8% (n=4 440), traditional drugs was 0.8% (n=50), new drugs was 2.8% (n=166), other addictive drugs was 4.1% (n=241). Multivariate logistic regression analysis showed that compared with the normal psychological states of secondary vocational students, the OR value of mild depression tendency alcohol and tobacco use behavior of secondary vocational students was 1.45; the OR values of mild anxiety, moderate anxiety, severe anxiety and very serious anxiety were 1.46, 1.46, 1.71, and 1.83, respectively; the traditional drugs use behaviors were 5.51, and 2.61, respectively, for the severe anxiety and very serious anxiety. Compared with the normal psychological state of secondary vocational students, the OR values of the severe anxiety and very severe anxiety were 2.56, and 2.66, respectively, for severe anxiety and very serious anxiety. Compared with normal psychological status of secondary vocational students, the OR values of mild, moderate, severe, and very severe anxiety were 2.14, 2.47, 2.39, and 3.45, respectively; all P values <0.05. Conclusion Anxiety and mild depression were risk factors of tobacco and alcohol use in secondary vocational students; severe and above anxiety were the risk factors of drug use in secondary vocational students; anxiety was the risk factor for other addictive drug use in secondary vocational students.

Objective To determine the expression of interleukin-21 (IL-21) in patients infected with hepatitis B virus (HBV) and its association with HBV-DNA and ALT. Methods Clinical dates and blood specimen were collected from 25 unrelated healthy controls (HC) and 101 independent chronic HBV infected patients, including 25 patients in immune tolerant phase (IT), 25 in immune clearance phase (IC), 26 patients in inactive HBV carrier state (IA) and 25 patients in immune reactive phase (IR). Serum IL-21 levels were measured by Cytometric Bead Array (CBA). IL-21 mRNA and IL-21 receptor mRNA were measured by real-time PCR. Results Chronic HBV-infected patients had higher levels of serum IL-21 and IL-21 mRNA , with P <0.001 for both. In subgroup analysis, both serum IL-21 and IL-21 mRNA levels in IC, IR were higher than those in IT, IA and HC (all P < 0.001). Serum IL-21 level in IA was higher than that in HC and IT (P <0.001, P = 0.036). IL-21R mRNA levels were different between groups. Serum IL-21 level was associated with HBV-DNA (r = -0.472, P < 0.001), but not with ALT. Conclusion IL-21, up-regulated in chronic HBV infection, is associated with immune activity and may play a key role in HBV control.

Objective To evaluate the bedside index for severity in acute pancreatitis (BISAP) and harmless acute pancreatitis (HAP) scoring system in predicting prognosis of acute pancreatitis (AP).Methods A total of 442 AP patients,who were admitted to The First Affiliated Hospital of Sun Yat-sen University from January 2003 to December 2010,were retrospectively studied.BISAP and HAP scores were evaluated respectively.The value of BISAP and HAP scores in predicting severity,local complications,organ failure and mortality were measured by the area under the curve (AUC) of receiver operator characteristic curve (ROC),and it was compared with that of traditional Ranson's score.Results Among 442 patients,73 patients (16.5％) were diagnosed to have severe acute pancreatitis (SAP).AUC for BISAP score in predicting SAP,local complications,organ failure and mortality were 0.90 (95％ CI:0.86 ～ 0.93),0.82(95％ CI:0.76 ～ 0.89),0.93 (95％ CI:0.89 ～ 0.96),0.93 (95％ CI:0.87 ～ 0.98).There were no statistically significant differences in AUCs of the four prognostic parameters between BISAP and Ranson's score.The specificity,positive predictive value (PPV),and AUC of HAP score in predicting mild AP were 85％,95％ and 0.73 (95％ CI:0.67 ～ 0.79).The risk of dismal prognosis increased when both BISAP and HAP score were abnormal.Conclusions BISAP and Ranson's score have comparable ability in predicting prognosis of patients with AP.However,BISAP score is simpler.HAP score is a simple and accurate method for predicting prognosis of patients with mild AP.Combination of BISAP score with HAP score can better help predict the prognosis of AP patients.