1.Comparison of clinical characteristics between first-episode and recurrent acute hypertrigly-ceridemic pancreatitis: a national multicenter clinical research
Shuai LI ; Jing ZHOU ; Guixian LUO ; Hongwei ZHANG ; Siyao LIU ; Weijie YAO ; Donghuang HONG ; Kaixiu QIN ; Lanting WANG ; Rong WEI ; Yizhen XU ; Longxiang CAO ; Zhihui TONG ; Yuxiu LIU ; Weiqin LI ; Lu KE
Chinese Journal of Digestive Surgery 2024;23(5):703-711
Objective:To investigate the clinical characteristics of first-episode and recurrent acute hypertriglyceridemic pancreatitis (HTGP).Methods:The retrospective cohort study was con-ducted. The clinical data of 313 patients with HTGP admitted to 26 medical centers in China in the Chinese Acute Pancreatitis Clinical Research Group (CAPCTG)-PERFORM database from November 2020 to December 2021 were collected. There were 219 males and 94 females, aged 38(32,44)years. Of the 313 patients, 193 patients with first-episode HTGP were allocated into the first-episode group and 120 patients with recurrent HTGP were allocated into the recurrent group. Observation indica-tors: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) comparison of severity and prognosis in the course of disease within 14 days between the two groups; (3) the association between recurrent HTGP and the risk of persistent organ failure (POF); (4) follow-up. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Wilcoxon rank sum test. Count data were expressed as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the Wilcoxon rank sum test. The Kaplan-Meier method was used to plot the cumulative recurrence rate curve and Log-Rank test was used for survival analysis. The Logistic regression model was used for multivariate analysis, and continuous variables were converted into categorical variables according to the mean value or common criteria. Propensity score matching was performed by 1∶1 nearest neighbor matching method, with caliper value of 0.02. Paired t test or Wilcoxon rank sum test and McNemar′s test were used for comparison between matched groups. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 313 patients,208 cases were successfully matched, including 104 cases in the first-episode group and 104 cases in the recurrent group. After propensity score matching, there was no significant difference in demographic characteristics, severity of illness scores and laboratory test between the two groups ( P>0.05). The elimination of gender, acute physiology and chornic health evaluation (APACHE) Ⅱ score, computed tomography severity index score, systemic inflammatory response syndrome score, sequential organ failure assessment score, apolipoprotein E, C-reactive protein, creatinine, lactic acid dehydrogenase, procal-citonin confounding bias ensured comparability between the two groups. (2) Comparison of severity and prognosis in the course of disease within 14 days between the two groups. There were signifi-cant differences in POF and local complications between the first-episode group and the recurrent group ( P<0.05). (3) The association between recurrent HTGP and the risk of POF. Results of uncor-rected univariate analysis showed that there was no association between recurrent HTGP and the risk of POF ( odds ratio=0.78, 95% confidence interval as 0.46-1.30, P>0.05). Results of multivariate analysis after adjusting for covariates such as gender, age, APACHE Ⅱ score, C-reactive protein, triglyceride and total cholesterol showed that compared with first-episode HTGP, recurrent HTGP was associated with a higher risk of POF ( odds ratio=2.22, 95% confidence interval as 1.05-4.71, P<0.05). Results of subgroup analysis showed that age<40 years was associated with an increased risk of POF ( odds ratio=3.31, 95% confidence interval as 1.09-10.08, P<0.05). (4) Follow-up. Twelve of the 313 patients died during hospitalization, including 9 cases in the first-episode group and 3 cases in the recurrent group. The rest of 301 surviving patients, including 184 cases in the first-episode group and 117 cases in the recurrent group, were followed up for 19.2(15.5, 21.9)months. Results of follow-up showed that for 184 survived patients of the first-episode group, 164 cases were followed up and 24 cases experienced recurrence, for 117 survived patients of the recurrent group,29 cases experienced recurrence, showing a significant difference between the two groups ( χ2=4.67, P<0.05). Conclusion:Compared with first-episode HTGP, patients with recurrent HTGP are more prone to POF and local complications, and are more prone to recurrence after discharge. The risk of POF in recurrent HTGP patients is 2.22 times that of those with first-episode, and the risk is higher in patients with age <40 years.
2.Effect of Whole-Course Empowerment Health Intervention on Psychological Resilience and Self-care Ability in Older Patients With Severe Pneumonia
Chun FENG ; Ai ZHANG ; Huaicong LONG ; Zhengping TANG ; Kaixiu LI ; Jing GUAN
Journal of Sichuan University (Medical Sciences) 2024;55(6):1587-1592
Objective To investigate the effect of whole-course empowerment health intervention on the psychological resilience and self-care ability of older patients with severe pneumonia.Methods A total of 210 older patients with severe pneumonia admitted to Sichuan Provincial People's Hospital between January 2020 and December 2023 were enrolled.The patients were sequentially numbered according to the order of admission.Then,they were assigned to a conventional care group(105 cases)and a whole-course empowerment group(105 cases)by a 1∶1 ratio using a random number table.The conventional care group received conventional clinical intervention,while the whole-course empowerment group received the whole-course empowerment health intervention regimen in addition to the intervention administered in the conventional care group.Psychological resilience was assessed with the Connor-Davidson Resilience Scale(CD-RISC),self-care ability with Exercise of Self-Care Agency Scale(ESCA),and quality of life with the World Health Organization Quality of Life Brief Version(WHOQOL-BREF).The evaluation results obtained before and after the interventions were compared.Results After intervention,the scores for all dimensions of CD-RISC in the whole-course empowerment group were higher than those in the conventional care group(t=10.326,P<0.001;t=6.386,P<0.001;t=9.581,P<0.001).The scores for all dimensions of ESCA after intervention were higher in whole-course empowerment group than those in the conventional care group(t=1 1.599,P<0.001;t=9.072,P<0.001;t=4.353,P<0.001;t=16.646,P<0.001).After intervention,the scores for all dimensions of WHOQOL-BREF in the whole-course empowerment group were higher than those in the conventional care group(t=9.164,P<0.001;t=13.809,P<0.001;t=5.001,P<0.001;t=6.695,P<0.001).Conclusion Whole-course empowerment health intervention significantly enhances psychological resilience,self-care capacity,and quality of life in older patients with severe pneumonia.
3.Research progress on chronic obstructive pulmonary disease and mechanisms underlying its regulation of aging
Kaixiu CAO ; Zheng LI ; Xianmin WANG
Chinese Journal of Geriatrics 2020;39(2):241-244
Chronic obstructive pulmonary disease(COPD)is a common respiratory disease with a high disability and mortality rate, and it has become one of the major public health issues of concern worldwide.It includes small airway disease and emphysema caused by abnormal tissue repair, but its pathogenesis is still unclear.COPD is currently viewed as a disease of accelerated lung aging and is closely associated with aging mechanisms such as telomere/telomerase, epigenetic changes and mitochondrial dysfunction.This article reviews research progress on the mechanisms linking COPD and aging-related regulation.
4.Experimental study of calvarial critical size defect in rats with type 2 diabetes mellitus
Lifeng WANG ; Kaixiu FANG ; Xiaoru XU ; Shuai REN ; Naiwen TAN ; Zhen LI ; Lincong QIU ; Wei MA ; Dehua LI ; Yingliang SONG
Journal of Practical Stomatology 2015;(2):157-161
Objective:To explore the calvarial critical size defect (CSD)in rats with type 2 diabetes mellitus(T2DM).Methods:T2DM model of SD rats(weighted 300-320 g)was induced by high fat and high sugar diet and low dose intraperitoneal streptozotocin (STZ)injection.The rats with T2DMand the normal controls were divided into 4 groups(n=3)respectively.Defects with the diame-ter(mm)of 2,3,4 and 5 were made on the central calvaria of each rat.General observation,X-ray examination and histological study were performed 8 weeks postoperatively.Results:In the T2DM group,only the defects of 2 mm diameter were healed completely,X-ray resistance and new bone formation were observed;the defects of 3,4 and 5 mm diameter were unhealed,X-ray transmission was observed and newly formed bone was insufficient.In the control group,the defects of 2,3 and 4 mm diameter were healed completely, X-ray resistance and new bone formation were observed;the defects of 5 mm diameter were unhealed,X-ray transmission was ob-served,newly formed bone was insufficient.Conclusion:The calvarial CSD of T2DM rat model can be defined as the defect with the diameter of 3 mm.
5.Study of the peripheral nervous morphology in the diabetic peripheral neuropathy patient and to observe its clinical value *
Lihua WANG ; Yuanyi ZHENG ; Suqun HUANG ; Kaixiu QIN ; Ahe MOSE ; Zhiheng LI ; Huagang JIAN
Chongqing Medicine 2013;(27):3225-3226
Objective To investigate the size and diversification of peripheral nerve measured by high frequency ultrasound in di-abetic peripheral neuropathy patient .Methods The endings of the medial branch of deep peripheral nerves(DPN) were interrogated by high frequency ultrasound and nerve electrophysiology ,and the nerve conduction characters were studied in a cohort of 150 clini-cally diagnosed diabetic peripheral neuropathy patients and a control group of 100 healthy volunteers .At the sametime these cases underwent electrophysiological examination .Results Distinct echoic appearances were consistently detected between the DPN nerves of diabetic peripheral neuropathy patients and healthy volunteers .The sensitivity rate of high frequency ultrasound and nerve electrophysiological examination in diagnosis of diabetic peripheral neuropathy were 91 .33% and 74 .67% ,and the specificity rate were 91% and 82% .Conclusion High frequency ultrasound may play a role in the diagnosis of diabetic peripheral neuropathy .
6.Clinical study of application of insulin pump on diabetes mellitus patients with cataract during perioperative period
Chinese Journal of Practical Nursing 2011;27(2):4-5
Objective To discuss the application value of insulin pump in the perioperative nursing of cataract diabetic patients. Methods 25 diabetic patients used the insulin pump for continuous subcutaneous insulin injection (CSII) during perioperative period were taken as the CSII group, the other 25 patients used multiple subcutaneous insulin injection (MSII) at the same time were taken as the MSII group.The patients' blood sugar undulations, the time of reaching the goal blood sugar, hospital stay, incidence of hypoglycemia, patient satisfaction degree were compared between the two groups. Results Blood sugar at various time points of the two groups reduced effectively, and the time of controlling the blood sugar, the incidence of hypoglycemia, hospital stay, patient satisfaction degree in the CSII group were obviously lower than the MSII group. Conclusions The insulin pump could control the blood glucose effectively, safely,rapidly and smoothly, which guarantees the safety of operation with standard nursing.

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