1.A multi-dimensional analysis of pollen broadcasting concerns in Chinese population: a large-scale multi-center cross-sectional survey
Chiyu XU ; Yanshu ZHANG ; Ning LUAN ; Xiangyi LIU ; Dayang QIN ; Hongmin WANG ; Xuping XIAO ; Shuihong ZHOU ; Jie ZHANG ; Ping ZHANG ; Yuqing BAI ; Pengpeng WANG ; Yan QI ; Zhongwu SUN ; Zhuang LIU ; Luo BA ; Wenchao WANG ; Xing LU ; Min WANG ; Rui GUO ; Deyi SUN ; Liyuan TAO ; Li ZHU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2024;59(1):2-11
Objective:To investigate the concern about pollen broadcasting in Chinese population from multiple dimensions and to understand the information about allergic rhinitis (AR) in China by analyzing related factors.Methods:From March 1 to September 30, 2022, a large-scale multi-center cross-sectional survey was conducted based on the Questionnaire Star platform in 21 Chinese hospitals. A total of 7 056 subjects from 7 regions in China: Northeast, North, East, Central, South, Southwest, and Northwest China were included. Basic characteristics (including social demographic characteristics and disease characteristics of AR patients), concern about pollen broadcasting, the willingness of pollen-induced AR (PiAR) patients to receive pollen broadcasting, and the treatment satisfaction rate of AR patients were collected. The chi-square test, multivariate linear regression model, and Logistic regression analysis were used to analyze the concern about pollen broadcasting in the Chinese population and related factors from multiple dimensions.Results:Among 7 056 subjects, 23.02% were concerned about pollen broadcasting. Among 3 176 self-reported AR and 1 019 PiAR patients, 25.60% and 39.16% were concerned about pollen broadcasting, respectively, which was higher than that of non-AR or non-PiAR subjects ( χ2 value was 21.74 and 175.11, respectively, both P<0.001). Among AR patients, the proportion of spring and autumn allergen-positive patients concerned about pollen broadcasting was higher than that in perennial allergen-positive patients ( χ2 value was 20.90 and 19.51, respectively, both P<0.001). The proportion of AR patients with asthma, sinusitis, allergic conjunctivitis, and cardiovascular and cerebrovascular diseases was higher than those without complications ( χ2 value was 50.83, 21.97, 56.78, 7.62, respectively, all P<0.05). The proportion of AR patients in North China who could find pollen broadcasting locally was 31.01%, significantly higher than those in other regions (all P<0.05). Multivariate linear regression model analysis showed that among PiAR patients, those with higher per capita household income and higher AR disease cognition levels had been concerned about pollen broadcasting in the past, and those complicated with allergic conjunctivitis had stronger intention to receive pollen broadcasting (B value was 0.24, 0.13, 0.66, 0.47, respectively, all P<0.05). The higher the disease cognition level of PiAR patients, the stronger their willingness to actively participate in treatment ( R2=0.72, P<0.001). Only 18.89% of AR patients felt satisfied with the treatment effect. Logistic regression analysis showed that in AR patients, the treatment satisfaction rate was significantly higher among those concerned about pollen broadcasting compared to those who were not ( OR=1.83, P<0.001). Conclusions:Currently, the dissemination of pollen broadcasting in China is hindered by various factors such as disease cognition level. The treatment satisfaction among AR patients remains unsatisfactory.
2.Clinical implications of Naples prognostic scores in patients with resectable Siewert type II-III adenocarcinoma of the esophagogastric junction
Peng JIN ; Gang MA ; Yong LIU ; Bin KE ; Hongmin LIU ; Han LIANG ; Rupeng ZHANG
Chinese Journal of Gastrointestinal Surgery 2024;27(1):54-62
Objective:To evaluate the clinical value of preoperative Naples prognostic scores (NPS) in patients with resectable Siewert type II-III esophagogastric junction adenocarcinoma (AEG).Methods:In this retrospective observational study we collected and analyzed relevant data of patients with Siewert Type II-III AEG treated in the Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital from January 2014 to December 2018. NPS were calculated using preoperative albumin concentration, total cholesterol concentration, neutrophil/lymphocyte ratio, and lymphocyte/monocyte ratio and used to allocate patients into three groups: NTS-0 (0 points), NTS-1 (1-2 points) and NTS-2 (3-4 points). Kaplan–Meier was used to calculate disease-free survival (DFS) and overall survival (OS) in each NPS group and the log-rank test to compare these groups. Univariate and multivariate survival analyes were performed using the Cox regression model. Time-dependent receiver operating characteristic curves were constructed to compare the relationships between four commonly used tools for evaluating inflammatory responses and nutritional status:NPS, systemic inflammatory response scores, nutrient control status (CONUT), and prognostic nutrition index (PNI).Results:The study cohort comprised 221 patients with AEG of median age 63.0 (36.0–87.0) years. There were 190 men (86.0%) and 31 women (14.0%). As to pTNM stage, 47 patients (21.3%) had Stage I disease, 68 (30.8%) Stage II, and 106 (48.0%) Stage III. One hundred and forty-seven patients (66.5%) had Siewert Type II disease and 74 (33.5%) Siewert type III. There were 45 patients (20.4%) in the NPS-0, 142 (64.2%) in the NPS-1 and 34 (15.4%) in the NPS-2 groups. Higher NPS scores were significantly associated with older patients (χ2=5.056, P=0.027) and higher TNM stages ( H=5.204, P<0.001). The median follow-up was 39 (6-105) months; 16 patients (7.2%) were lost to follow-up. The median OS in the NPS-0, NPS-1, and NPS-2 groups were 78.4, 63.1, and 37.0 months, respectively; these differences are statistically significant ( P=0.021). Univariate and multivariate Cox regression analysis identified the following as independently and significantly associated with OS in patients with Siewert Type II-III: TNM stage (Stage II: HR=2.182, 95%CI: 1.227-3.878, P=0.008; Stage III: HR=3.534, 95%CI: 1.380-6.654, P<0.001), tumor differentiation (G3: HR=1.995, 95%CI: 1.141-3.488, P=0.015), vascular invasion (HR=2.172, 95%CI: 1.403-3.363, P<0.001), adjuvant chemotherapy (HR=0.326, 95%CI: 0.200-0.531, P<0.001), NPS (NPS-1: HR=2.331, 95%CI: 1.371-3.964, P=0.002; NPS-2: HR=2.494, 95%CI: 1.165-5.341, P=0.019), SIS group (NPS-1: HR=2.170, 95%CI: 1.244-3.784, P=0.006; NPS-2: HR=2.291, 95%CI: 1.052–4.986, P=0.037), and CONUT (HR=1.597, 95% CI: 1.187-2.149, P=0.038). The median DFS in the NPS-0, NPS-1, and NPS-2 groups was 68.6, 52.5, and 28.3 months, respectively; these differences are statistically significant ( P=0.009). Univariate and multivariate Cox regression analysis identified the following as independently and significantly associated with DFS in patients with Siewert Type II-III AEG: TNM stage (StageⅡ: HR=2.789, 95%CI:1.210-6.428, P=0.016; Stage III: HR=10.721, 95%CI:4.709-24.411, P<0.001), adjuvant chemotherapy (HR=0.640, 95% CI: 0.432-0.946, P=0.025), and NPS (NPS-1: HR=1.703, 95%CI: 1.043-2.782, P=0.033; NPS-2: HR=3.124, 95%CI:1.722-5.666, P<0.001). Time-dependent receiver operating characteristic curves showed that NPS was more accurate in predicting OS and DFS in patients with Siewert Type II-III AEG than were systemic inflammatory response scores, CONUT, or PNI scores. Conclusion:NPS is associated with age and TNM stage, is an independent prognostic factor in patients who have undergone resection of Siewert type II-III AEG, and is better than SIS, CONUT, or PNI in predicting survival.
3.Endoplasmic reticulum stress-induced NLRP3 inflammasome activation as a novel mechanism of polystyrene microplastics(PS-MPs)-induced pulmonary inflammation in chickens
LU HONGMIN ; GUO TIANTIAN ; ZHANG YUE ; LIU DEWANG ; HOU LULU ; MA CHENGXUE ; XING MINGWEI
Journal of Zhejiang University. Science. B 2024;25(3):233-243,中插7-中插10
Microplastics(MPs)have attracted growing attention worldwide as an increasingly prevalent environmental pollutant.In addition,chicken meat is currently the most widely consumed kind of poultry in the global market.Consumer demand for chicken is on the rise both at home and abroad.As a result,the safety of chicken raising has also received significant attention.The lungs play an essential role in the physiological activities of chickens,and they are also the most vulnerable organs.Lung injury is difficult to repair after the accumulation of contaminants,and the mortality rate is high,which brings huge economic losses to farmers.The research on the toxicity of MPs has mainly focused on the marine ecosystem,while the mechanisms of toxicity and lung damage in chickens have been poorly studied.Thus,this study explored the effects of exposure to polystyrene microplastics(PS-MPs)at various concentrations for 42 d on chicken lungs.PS-MPs could cause lung pathologies and ultrastructural abnormalities,such as endoplasmic reticulum(ER)swelling,inflammatory cell infiltration,chromatin agglutination,and plasma membrane rupture.Simultaneously,PS-MPs increased the expression of genes related to the heat shock protein family(Hsp60,Hsp70,and Hsp90),ER stress signaling(activating transcription factor 6(ATF6),ATF4,protein kinase RNA-like ER kinase(PERK),and eukaryotic translation initiation factor 2 subunit α(eIF2α)),pyroptosis-related genes(NOD-,LRR-and pyrin domain-containing protein 3(NLRP3),apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),interleukin-1β(IL-1β),cysteinyl aspartate-specific proteinase 1(Caspase1),and gasdermin-D(GSDMD)),and the inflammatory signaling pathway(nuclear factor-κB(NF-κB),inducible nitric oxide synthase(iNOS),and cyclooxygenase-2(COX-2)).The above results showed that PS-MP exposure could result in lung stress,ER stress,pyroptosis,and inflammation in broilers.Our findings provide new scientific clues for further research on the mechanisms of physical health and toxicology regarding MPs.
4.Association of Trajectories of Atherogenic Index of Plasma With Atherosclerotic Cardiovascular Disease
Shihe LIU ; Qian LIU ; Xu HAN ; Hongmin LIU ; Haiyan ZHAO ; Shuohua CHEN ; Shouling WU ; Yuntao WU
Chinese Circulation Journal 2024;39(7):676-681
Objectives:To investigate the association of trajectories of atherogenic index of plasma(AIP)with the risk of atherosclerotic cardiovascular disease(ASCVD). Methods:A total of 51 831 employees and retirees who participated in Kailuan Group health examination for three consecutive times from 2006 to 2010 were included in this study.AIP was calculated using the log(triglycerides[TG]/high-density lipoprotein-cholesterol[HDL-C])formula.AIP trajectory models were fitted by the SAS Proc Traj program,and according to AIP trajectory,the subjects were divided into low stability group(n=11 114),low to moderate stability group(n=21 647),medium to high stability group(n=13 659),and high stability group(n=5 411).Kaplan-Meier method was used to calculate the cumulative incidence of ASCVD in different groups and compared by log-rank test.Cox proportional risk regression model was used to analyze the effects of different AIP trajectories on ASCVD risk. Results:Finally,51 831 patients were included in the analysis.During a mean follow-up of(10.19±2.22)years,5 142(9.92%)subjects developed ASCVD,4 013(7.74%)subjects died.Cox regression analysis after adjusting for confounding factors showed:compared with the low stability group,the risk of ASCVD increased by 13%(HR=1.13,95%CI:1.04-1.23,P=0.003)and 20%(HR=1.20,95%CI:1.10-1.31,P<0.001)and 41%(HR=1.41,95%CI:1.27-1.57,P<0.001)in the low to moderate stability group,moderate to high stability group and high stability group,respectively,and the risk increased gradually(Ptrend<0.001).Stratified analysis showed that the risk of ASCVD in people aged<65 years and low-density lipoprotein cholesterol(LDL-C)<3.4 mmol/L with long-term high levels of AIP was higher than that in people aged≥65 years and LDL-C≥3.4 mmol/L(both Pinteraction<0.01). Conclusions:In Kailuan Study cohort,those with long-term high levels of AIP had a higher risk of ASCVD,and the risk gradually increased.In addition,we found that the risk of ASCVD in people with long-term high levels of AIP was higher in<65 years old than in≥65 years old,and the risk of ASCVD in people with LDL-C<3.4 mmol/L was higher than that in people with LDL-C≥3.4 mmol/L.
5.Construction of risk prediction model for intraoperative stress injury in children with posterior scoliosis
Xiaoyan LIU ; Sisi TENG ; Si CHEN ; Hongmin XU ; Hui PENG
Journal of Clinical Surgery 2024;32(8):878-881
Objective The aim of this study was to investigate the high risk factors of intraoperative stress injury in children with posterior spinal scoliosis and to construct a corresponding risk prediction model.Methods A total of 237 cases of orthopaedic surgery for posterior scoliosis performed in three first-class hospitals in Changsha City from October 2021 to February 2023.The patients were divided into injury group(31 cases)and uninjured group(206 cases)according to whether stress injury occurred.The risk factors were screened by single factor analysis and multiple Logistic regression analysis,and the corresponding risk prediction model was constructed.Results The results of single factor analysis showed that constitutional index,preoperative skin condition,preoperative hypoproteinemia,preoperative anemia,operative time,intraoperative body temperature and intraoperative bleeding were related to the occurrence of vascular crisis.BMI,preoperative skin condition,preoperative hypoproteinemia,operative time and intraoperative bleeding are high risk factors for the occurrence of intraoperative stress injury in children with posterior scoliosis.The area under ROC curve is 0.612,the sensitivity is 89.7%,and the specificity is 91.0%,indicating that this model has good risk prediction ability.Conclusion BMI,preoperative skin condition,preoperative hypoproteinemia,operative time and intraoperative bleeding are high risk factors for the occurrence of intraoperative stress injury in children with posterior scoliosis.
6.Observation on the effect of postpartum application of extended care in patients with heart disease during pregnancy under the mode of multi-disciplinary team collaboration
Hui QI ; Huijie LIU ; Hongmin WANG ; Pingfan WANG ; Zhimin WANG
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2024;31(1):77-81
Objective To analyze the effect of extended care in patients with gestational heart disease under the mode of multi-disciplinary team(MDT).Methods A total of 116 patients with gestational heart disease admitted to Liaocheng Second People's Hospital from June 2020 to June 2022 were selected as the study objects,and the patients were divided into observation group and control group according to nursing method,with 58 patients in each group.All the patients delivered in our hospital,and the control group received routine clinical intervention after delivery.The observation group was given continuous nursing intervention under MDT mode,including team building,intervention implementation and psychological nursing.First,a management team was established and a WeChat group was formed.The team members include 1 deputy chief physician of obstetrics,1 deputy chief physician of cardiology,1 dietitian,1 psychotherapist,1 head nurse of obstetrics,1 head nurse of cardiology,3 responsible nurses of obstetrics and 3 responsible nurses of cardiology.Then the nursing intervention was divided into 3 stages:prenatal,postpartum,and postpartum.Finally,in the hospital and during the follow-up,we communicated with the patients to understand their basic situation,provided targeted guidance,and directed them to shift their attention from negative emotions.Both groups were treated for 6 months.The self-rated abilities for health practices scale(SRAHP)was used to evaluate the patient's health behavior ability(including nutrition status,exercise,health responsibility,and psychological well-being),and atrial fibrillation-quality of life-18(AF-QoL-18)was used to evaluate the patient's quality of life(including physiological,psychological,and sexual function).Cervical local microcirculation(including blood perfusion,capillary tube diameter,microvascular tube diameter),postpartum blood loss at 2 hours and 24 hours,postpartum hospital stay,maternal and infant adverse outcomes(including postpartum hemorrhage,heart failure,maternal death,neonatal death)of the two groups were observed.Results After intervention,all SRAHP scores,AF-QoL-18 scores and cervical local microcirculation levels in both groups were significantly improved compared to before intervention,and the above indexes in the observation group were significantly higher than those in the control group after intervention[nutrition score:25.06±2.31 vs.19.72±2.68,exercise score:25.54±1.45 vs.19.14±3.65,health responsibility score:24.17±2.33 vs.20.54±2.52,psychological well-being score:25.03±1.62 vs.21.34±3.35,blood perfusion(mL/min):1.10±0.18 vs.0.44±0.15,capillary tube diameter(μm):5.94±0.45 vs.3.41±0.67,microvascular tube diameter(μm):56.59±2.13 vs.44.12±3.78,physiological score:3.86±1.13 vs.3.41±1.04,psychological score:4.13±0.64 vs.3.67±1.42,sexual function score:4.02±0.67 vs.3.78±0.75,all P<0.05].The amount of postpartum blood loss at 2 hours and 24 hours in the observation group was reduced compared to the control group[2 hours postnatal(mL):95.26±10.53 vs.142.74±18.45,24 hours postnatal(mL):183.61±17.54 vs.262.19±38.56,both P<0.05],and the postpartum hospital stay was shorter than the control group(days:5.07±1.48 vs.8.12±2.45,P<0.05),the total incidence of adverse outcomes was lower than that of the control group[1.72%(1/58)vs.12.07%(7/58),P<0.05].Conclusion The continuous nursing intervention under the mode of MDT cooperation can enhance the ability of healthy behavior,improve cervical local microcirculation,promote postpartum recovery,reduce adverse outcomes of maternal and infant,and improve the quality of life of pregnant heart disease patients to a certain extent.
7.Effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix in the treatment of children with deep burns
Yan LIANG ; Wen SHI ; Yang SHAO ; Xinzhuang LIU ; Hongmin GONG ; Guohui CAO ; Cong GAO ; Naijun XIN ; Guodong SONG
Chinese Journal of Burns 2024;40(4):348-357
Objective:To explore the effects of early debridement and conservative eschar removal followed by wound coverage with acellular dermal matrix (ADM), i.e., early surgery, in the treatment of children with deep burns.Methods:This study was a retrospective cohort study. From January 2017 to December 2022, 278 deep burned hospitalized children aged 1-7 years who met the inclusion criteria were admitted to Central Hospital Affiliated to Shandong First Medical University. According to the differences in treatment processes, 134 children who underwent early surgery+routine dressing change were enrolled in eschar removal+dressing change group (77 males and 57 females, aged 1 (1, 2) years), and 144 children who underwent only routine dressing change were enrolled in dressing change alone group (90 males and 54 females, aged 1 (1, 2) years). Fifty-one children without full-thickness burns in eschar removal+dressing change group were enrolled in eschar removal+dressing change group 1 (26 males and 25 females, aged 1 (1, 2) years), and 57 cases of the 83 children with full-thickness burns who did not undergo autologous skin grafting at the same time of early surgery (namely early skin grafting) in eschar removal+dressing change group were included in eschar removal+dressing change group 2 (37 males and 20 females, aged 1 (1, 2) years). Seventy-six children without full-thickness burns in dressing change alone group were included in dressing change alone group 1 (51 males and 25 females, aged 1 (1, 3) years), and 68 children with full-thickness burns in dressing change alone group were included in dressing change alone group 2 (39 males and 29 females, aged 1 (1, 2) years). For deep partial-thickness burn wounds and small full-thickness burn wounds in eschar removal+dressing change group, the eschar removal was performed on the basis of retaining a thin layer of denatured dermis so as to preserve the healthy tissue of the wound base, and ADM was applied to all wounds externally after eschar removal. For larger full-thickness burn wounds in this group, especially those located in the functional part of joints, eschar removal to the plane layer of viable tissue and early autologous skin grafting was needed. When the superficial wounds of children healed or tended to heal, the residual wounds were evaluated, and elective autologous skin grafting was performed if it was difficult to heal within 14 days. The healing time, intervention healing time, times of operation/dressing change, and times of intervention operation/dressing change in children with deep partial-thickness burn wounds of children in eschar removal+dressing change group, dressing change alone group, eschar removal+dressing change group 1, and dressing change alone group 1 were recorded. At the last follow-up (follow-up period was set to 7-12 months), the modified Vancouver scar scale (mVSS) scores of the most severe area of scar hyperplasia of healed deep partial-thickness burn wounds of 54 children in eschar removal+dressing change group and 48 children in dressing change alone group were recorded. The healing time and times of operation/dressing change of all burn wounds of children in eschar removal+dressing change group and dressing change alone group, and the healing time and times of operation/dressing change of full-thickness burn wounds of children in eschar removal+dressing change group 2 and dressing change alone group 2 were recorded. The incidences of wound infection, sepsis, fever, and fever after 5 days of burns in children of eschar removal+dressing change group and dressing change alone group during wound healing.Results:Compared with those in dressing change alone group, the healing time and intervention healing time were significantly shortened, and the times of operation/dressing change and times of intervention operation/dressing change were significantly reduced in children with deep partial-thickness burn wounds in eschar removal+dressing change group (with Z values of -11.00, -11.33, -12.64, and -11.65, respectively, P<0.05). Compared with those in dressing change alone group 1, the healing time and intervention healing time were significantly shortened, and the times of operation/dressing change and times of intervention operation/dressing change were significantly reduced in children with deep partial-thickness burn wounds in eschar removal+dressing change group 1 (with Z values of 6.57, 6.46, 8.04, and 6.57, respectively, P<0.05). At the last follow-up, the mVSS score of the most severe scar hyperplasia area of healed deep partial-thickness burn wounds of 54 children in eschar removal+dressing change group was 4.00 (3.00,5.00), which was significantly lower than 6.50 (5.00,7.00) of 48 children in dressing change alone group ( Z =-4.67, P<0.05).Compared with those in dressing change alone group, the healing time was significantly shortened, and times of operation/dressing change was significantly reduced in all burn wounds in eschar removal+dressing change group (with Z values of -5.20 and -6.34, respectively, P<0.05). Compared with those in dressing change alone group 2, the healing time was significantly shortened, and times of operation/dressing change was significantly reduced in full-thickness burn wounds in eschar removal+dressing change group 2 (with Z values of -5.22 and -5.73, respectively, P<0.05). During wound healing, the probabilities of fever and fever after 5 days of burns in children of eschar removal+dressing change group were significantly lower than those in dressing change alone group (with χ2 values of 4.13 and 3.91, respectively, P<0.05); only 1 child in dressing change alone group developed sepsis, and there was no statistically significant difference in the wound infection rate of children in the two groups ( P>0.05). Conclusions:For children with deep burns, early surgery, and early skin grafting or elective autologous skin grafting as needed, have better short-term and long-term effects than those without early surgery.
8.Effects of antibacterial absorbable suture closure in the repair of small range of bone defect wounds due to deep sternal wound infection after median thoracotomy
Hanhua LI ; Bing XIONG ; Zu'an LIU ; Zhifeng HUANG ; Chuanwei SUN ; Hongmin LUO ; Lianghua MA ; Huining BIAN ; Shaoyi ZHENG ; Wen LAI
Chinese Journal of Burns 2024;40(5):461-467
Objective:To investigate the effects of antibacterial absorbable suture closure in the repair of small range of bone defect wounds due to deep sternal wound infection after median thoracotomy.Methods:This study was a retrospective non-randomized clinical controlled study. A total of 32 patients (20 males and 12 females, aged (58±11) years) who met the inclusion criteria and underwent closure with antibacterial absorbable sutures (hereinafter referred to as direct closure surgery) admitted to Guangdong Provincial People's Hospital of Southern Medical University (hereinafter referred to as our hospital) from October 2017 to December 2021 were included in direct closure group. A total of 39 patients (27 males and 12 females, aged (59±11) years) who met the inclusion criteria and received bilateral pectoralis major muscle flap packing repair admitted to our hospital from January 2015 to January 2020, were included in muscle flap packing group. In the two groups, sternal infected wounds were thoroughly debrided during stage Ⅰ surgery, followed by wound repair during stage Ⅱ surgery. The width of sternal cross-section defects after debridement was less than 1 cm for patients in the two groups. For patients in direct closure group, stage Ⅱ wound repair involved intermittent sutures to the anterior sternal plate or full-thickness sternum with a total of 6 or 7 double sternal sutures. Relevant data including the duration of the stage Ⅱ wound repair surgery and the volume of blood loss during surgery, length of hospital stay, and bacterial wound infection of patients in the two groups were recorded. The postoperative complications and wound healing of patients in the two groups were recorded. During follow-up, the wound infection or recurrence of patients in the two groups and the sternal healing of patients in direct closure group were observed.Results:Compared with those in muscle flap packing group, the duration of stage Ⅱ wound repair surgery and length of hospital stay of patients in direct closure group were significantly shorter (with t values of 13.61 and 6.25, respectively, P<0.05), and there was no statistically significant difference in intraoperative blood loss volume of the stage Ⅱ wound repair surgery between the two groups ( P>0.05). The main bacterial infection in the two groups was Staphylococcus. In direct closure group, one patient had exudation in the wound two weeks post-operation, however the wound healed well after two weeks of conservative dressing changes; the wounds of the other patients healed well. In muscle flap packing group, 5 patients had postoperative complications, of which one patient died, and the wounds of 4 patients healed after dressing change or reoperation; the wounds of the other patients healed well. There was no statistically significant difference in complication incidence of patients between the two groups ( P>0.05). During the follow-up of 22-45 months, there was no re-infection or recurrence in the wound of patients in direct closure group and surviving patients in muscle flap packing group, the sternum of patients in the direct closure group achieved anatomical union. Conclusions:Direct closure surgery can not only effectively repair sternal cross-sectional defects with width below 1 cm due to deep sternal wound infections after median thoracotomy, but can also significantly shorten the operation time and duration of hospitalization.
9.Construction of risk prediction model for fear of disease progression in stroke patients
Jingjing JIA ; Xinping WANG ; Jia LIU ; Yuanyuan GUI ; Hongmin LIU
Chinese Journal of Modern Nursing 2024;30(20):2737-2743
Objective:To explore influencing factors of the occurrence of fear of disease progression (FoP) in stroke patients and to construct a risk prediction nomogram model.Methods:A total of 201 stroke patients of the First Affiliated Hospital of Qiqihar Medical University and the Third Affiliated Hospital of Qiqihar Medical University from July to December 2023 were selected as the survey objects by the convenient sampling method. Baseline data questionnaire, Fear of Progression Questionnaire-Short Form (FoP-Q-SF), Chinese version of Perceived Stress Scale (CPSS), Social Support Rating Scale (SSRS) and Fatigue Severity Scale (FSS) were used to investigate of patients FoP occurrence, stress perception, social support level and fatigue level of stroke patients. The influencing factors of FoP occurrence in stroke patients were explored and R 4.3.2 was used to construct a risk prediction nomogram model for FoP occurrence in stroke patients. The performance of the model was evaluated using receiver operating characteristic curve, calibration curve, and clinical decision curve from the perspectives of discrimination, calibration and clinical practicality.Results:In this study, a total of 201 questionnaires were collected, 199 were valid, and the effective rate was 99%. The FOP-Q-SF score of 199 patients was (29.64±9.50), of which 71 patients (35.7%) developed FoP. Educational level, complications, self-care ability, social support, stress perception and fatigue were the influencing factors of FoP in stroke patients ( P<0.05). A risk prediction nomogram model for FoP in stroke patients was constructed based on the results of binary Logistic regression analysis. The Hosmer-Lemeshow results showed that the nomogram model fitted well (χ 2=10.466, P=0.234). The area under ROC curve was 0.912 (95% CI: 0.871-0.952). The clinical decision curve showed that when the threshold probability ranged from 4% to 99%, choosing this model to predict the risk of FoP could benefit stroke clinically. Conclusions:Educational level, complications, self-care ability, social support, stress perception and fatigue are the influencing factors for fear of disease progression in stroke patients. The risk nomogram model based on multiple evaluation indexes has certain clinical value.
10.Establishment of Autoregressive Integrated Moving Average Model of Tuberculosis Incidence in Heze City and Evaluation of its Prediction Effect
Fusheng SUN ; Hongmin LIU ; Jing WANG
Chinese Journal of Health Statistics 2024;41(2):185-189
Objective An autoregressive integrated moving average model(ARIMA)was established to predict the incidence of tuberculosis in Heze in 2022.Methods Based on the monthly registered incidence of tuberculosis patients in Heze city from 2010 to 2020,the optimal ARIMA model was established to predict the incidence in 2021 and compare with the actual value,so as to evaluate the prediction effect and predict the incidence trend in 2022.Results The incidence of tuberculosis in Heze city showed a decreasing trend year by year,with certain seasonal changes.The optimal model was ARIMA(0,1,1)(1,1,1)12,the fitting results showed that the overall prediction error rate was 2.59%and the mean absolute percentage error was 17.76%in 2021.The number of cases predicted in 2022 was 1644,which continued to show a downward trend and the epidemic situation was stable.Conclusion ARIMA(0,1,1)(1,1,1)12 model can better predict the short-term incidence trend of tuberculosis in Heze city,but it should be modified according to the changes of monitoring data to improve the prediction accuracy.

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