1.Current situation investigation and analysis of influencing factors on the long-term quality of life of cured and discharged patients with severe acute pancreatitis.
Wenjun ZHOU ; Pinjie ZHANG ; Weili YU ; Zhonghua LU ; Mingjuan LI ; Lijun CAO ; Lu FU ; Shaokang WANG ; Yun SUN
Chinese Critical Care Medicine 2025;37(2):146-152
OBJECTIVE:
To investigate the current status of long-term quality of life in patients with severe acute pancreatitis (SAP) who have been cured and discharged, and to analyze the influencing factors affecting long-term quality of life in SAP cured patients after discharge.
METHODS:
A retrospective collection was conducted. Patients who were received standardized treatment before being cured and discharged from the hospital admitted to the first department of critical care medcine of the Second Affiliated Hospital of Anhui Medical University from January 2017 to December 2023 were enrolled. According to the 36-item short form health survey scale (SF-36) score, patients were divided into high score group (high quality of life, the top 50% of patients with total SF-36 score) and low score group (low quality of life, the bottom 50% of patients with total SF-36 score). The gender, age, history of hypertension and diabetes, etiology of pancreatitis, acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA), CT severity index (CTSI), laboratory indicators such as C-reactive protein (CRP), procalcitonin (PCT), blood glucose, and triglycerides upon admission, use of vasoactive drugs, non-invasive/high-flow ventilation, invasive ventilation, retroperitoneal puncture and drainage, open pancreatic surgery treatment and secondary infection during hospitalization were collected, as well as the retention of abdominal drainage tubes at discharge from hospital. Distribute follow-up questionnaires or telephone follow-up surveys through WeChat and Question Star programs to investigate the pancreatic secretion function, chronic abdominal pain, and recurrence of pancreatitis of patients after discharge. Multivariable Logistic regression was used to analyze the relevant factors affecting the long-term quality of life of cured patients with SAP.
RESULTS:
A total of 86 patients were ultimately enrolled. There were 43 patients in both the high and low score groups. Among 86 patients, 20 experienced acute pancreatitis recurrence, with a recurrence rate of 23.26%. Twenty-two (25.58%) experienced chronic abdominal pain after discharge, and 5 patients (5.81%) needed medication to relieve pain. Thirty-three patients (38.37%) had pancreatic exocrine dysfunction after discharge, characterized by abdominal distension, constipation or diarrhea. Twenty-two patients (25.58%) suffered from pancreatic endocrine dysfunction, and were diagnosed with diabetes. Univariate analysis showed that compared with the high score group, the low score group had more patients with hypertension, initial renal dysfunction, initial severe metabolic acidosis, initial serum calcium < 2.0 mmol/L, blood glucose > 11.1 mmol/L and cultured Gram positive bacteria (from blood/body fluid/pancreatic necrotic tissue) during treatment (48.84% vs. 16.28%, 60.47% vs. 32.56%, 18.60% vs. 4.65%, 88.37% vs. 62.79%, 55.81% vs. 30.23%, 34.88% vs. 13.95%), had higher CTSI score (6.60±1.61 vs. 5.77±1.32), lower hemoglobin level at discharge (g/L: 102.30±18.78 vs. 110.72±16.68), and a lower proportion of etiological interventions after discharge (34.88% vs. 67.44%), the differences were statistically significant (all P < 0.05). Multivariate Logistic regression analysis showed that hypertension [odds ratio (OR) = 4.814, 95% confidence interval (95%CI) was 1.196-19.378], initial serum calcium < 2.0 mmol/L (OR = 6.688, 95%CI was 1.321-33.873) and initial blood glucose > 11.1 mmol/L (OR = 6.473, 95%CI was 1.399-29.950) were risk factors for long-term quality of life in cured SAP patients (all P < 0.05), while post discharge prophylactic intervention was a protective factor for long-term quality of life (OR = 0.092, 95%CI was 0.020-0.425, P < 0.01).
CONCLUSIONS
Cured SAP patients have varying degrees of impaired secretion function and the possibility of recurrence of acute pancreatitis. Hypertension, initial serum calcium < 2.0 mmol/L and blood glucose > 11.1 mmol/L are independent influencing factors for low long-term quality of life in cured SAP patients. Prevention and intervention targeting the etiology of pancreatitis after discharge can improve the long-term quality of life of cured SAP patients.
Humans
;
Quality of Life
;
Retrospective Studies
;
Pancreatitis/therapy*
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Patient Discharge
;
Male
;
Female
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Middle Aged
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APACHE
;
Adult
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Acute Disease
;
Aged
2.Analysis of Depression and Influencing Factors in HIV/AIDS Patients Receiving Antiviral Therapy
Xin YUAN ; Yuanyuan XU ; Zhengping ZHU ; Min ZHANG ; Sushu WU ; Jingwen WANG ; Shaokang WANG
Journal of Sun Yat-sen University(Medical Sciences) 2024;45(3):438-445
[Objective]To investigate the depression status and its influencing factors in HIV/AIDS patients receiving antiviral therapy.[Methods]From July 2022 to September 2022,successive sampling method was used to recruit HIV/AIDS patients receiving antiviral therapy from antiviral treatment institutions in Nanjing,and they were instructed to fill out anonymous questionnaires.The questionnaire collected the basic information of patients,and depression,HIV stigma score and social support level were investigated by Patient Health Questionnaire-9(PHQ-9),Berger HIV stigma scale(BHSS)and Multidimensional Scale of Perceived Social Support(MSPSS).Multivariate Logistic regression was used to an-alyze the influencing factors of depression.[Results]A total of 1879 valid questionnaires were collected in this study,and the detection rate of depression was 50.1%.The results of multivariate logistic analysis showed that compared with patients with middle school or below,the risk of depression was lower for those with postgraduate or above[OR=0.534,95%CI(0.341,0.835),P=0.006].Compared with antiviral therapy duration<1 year,antiviral therapy duration for 1 to 5 years[OR=0.729,95%CI(0.536,0.991)],>5 to 10 years[OR=0.516,95%CI(0.379,0.702)],>10 years[OR=0.603,95%CI(0.375,0.969)]was associated with a lower risk of depression.High level of social support was a protective factor for depression in HIV/AIDS patients compared with middle and low level of social support[OR=0.430,95%CI(0.349,0.530),P<0.001].There was a higher risk of depression with side effects than without side effects[OR=2.260,95%CI(1.833,2.786),P<0.001].The higher the score on the HIV stigma scale,the higher the possibility of depression was.[Conclusion]The detection rate of depression of patients receiving antiviral therapy in Nanjing is high.After starting antivi-ral therapy,we should strengthen the monitoring of side effects and psychological status of patients,carry out psychologi-cal intervention,alleviate psychological problems,and improve the quality of life of patients receiving antiviral therapy.
3.Design and preliminary application of outdoor flying pigeon-robot.
Hao WANG ; Shaokang WANG ; Zhaocheng QIU ; Qi ZHANG ; Shuai XU
Journal of Biomedical Engineering 2022;39(6):1209-1217
Control at beyond-visual ranges is of great significance to animal-robots with wide range motion capability. For pigeon-robots, such control can be done by the way of onboard preprogram, but not constitute a closed-loop yet. This study designed a new control system for pigeon-robots, which integrated the function of trajectory monitoring to that of brain stimulation. It achieved the closed-loop control in turning or circling by estimating pigeons' flight state instantaneously and the corresponding logical regulation. The stimulation targets located at the formation reticularis medialis mesencephali (FRM) in the left and right brain, for the purposes of left- and right-turn control, respectively. The stimulus was characterized by the waveform mimicking the nerve cell membrane potential, and was activated intermittently. The wearable control unit weighted 11.8 g totally. The results showed a 90% success rate by the closed-loop control in pigeon-robots. It was convenient to obtain the wing shape during flight maneuver, by equipping a pigeon-robot with a vivo camera. It was also feasible to regulate the evolution of pigeon flocks by the pigeon-robots at different hierarchical level. All of these lay the groundwork for the application of pigeon-robots in scientific researches.
Animals
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Columbidae/physiology*
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Robotics/methods*
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Cerebral Cortex
4.Early CT Findings of Coronavirus Disease 2019 (COVID-19) in Asymptomatic Children: A Single-Center Experience
Lan LAN ; Dan XU ; Chen XIA ; Shaokang WANG ; Minhua YU ; Haibo XU
Korean Journal of Radiology 2020;21(7):919-924
Objective:
The current study reported a case series to illustrate the early computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) in pediatric patients.
Materials and Methods:
All pediatric patients who were diagnosed with COVID-19 and who underwent CT scan in Zhongnan Hospital of Wuhan University from January 20, 2020 to February 28, 2020 were included in the current study. Data on clinical and CT features were collected and analyzed.
Results:
Four children were included in the current study. All of them were asymptomatic throughout the disease course (ranging from 7 days to 15 days), and none of them showed abnormalities in blood cell counts. Familial cluster was the main transmission pattern. Thin-section CT revealed abnormalities in three patients, and one patient did not present with any abnormal CT findings. Unilateral lung involvement was observed in two patients, and one patient showed bilateral lung involvement. In total, five small lesions were identified, including ground-glass opacity (n = 4) and consolidation (n = 1). All lesions had ill-defined margins with peripheral distribution and predilection of lower lobe.
Conclusion
Small patches of ground-glass opacity with subpleural distribution and unilateral lung involvement were common findings on CT scans of pediatric patients in the early stage of the disease.
5.A correlation study of CT and clinical features of different clinical types of COVID-19
Lu HUANG ; Rui HAN ; Pengxin YU ; Shaokang WANG ; Liming XIA
Chinese Journal of Radiology 2020;54(4):300-304
Objective:To investigate the CT and clinical features of COVID-19.Methods:Chest CT and clinical data of 103 patients who were confirmed as COVID-19 in January 2020 were collected retrospectively. According to diagnosis and treatment of COVID-19 (trial version 5), all the patients were classified into common( n=58), severe ( n=36) and critical ( n=9) types, and their clinical findings, laboratory examination and CT finding were analyzed. CT features included distribution, location, size, shape, edge, number and density of the lesion, percentage of pneumonia lesions of the whole lung and extra-pulmonary manifestations. The CT features among different clinical types were compared using χ 2 test or Fisher's exact probability. Comparisons of age, duration from onset to CT examination, and percentage of pneumonic lesions to total lung volume among different types were performed by using analysis of variance (normal distribution) or Kruskal-Wallis rank sum test (non-normal distribution). Results:In terms of clinical manifestations, the patients with critical COVID-19 were more common in elderly men, with a median age of 65 years. Fever was the first symptom in 49 (84%) of 58 common patients, and also the first symptom in both severe and critical COVID-19 patients. The incidence of coughing in severe (25/36, 69%) and critical (6/9, 67%) COVID-19 patients was higher than that in common patients (20/58, 34%). All critical patients had dyspnea. CT showed the common COVID-19 was located in bilateral lung (40/58, 71%)with multiple (40/58, 69%), ground glass (31/58, 52%) or mixed (25/58, 43%)opacities (56/58, 97%), while all the severe and critical COVID-19 were located in bilateral lung(100%) with multiple (34/36, 96%), patchy (33 /36, 92%), or mixed opacities (26/36, 72%) in severe patients, and with mixed opacities more than 3 cm in critical patients. As for the percentage of pneumonia focus in the whole lung volume, the common type (12.5%±6.1%) was significantly lower than the severe type (25.9%± 10.7%) and the critical type (47.2%±19.2%), with statistically significant differences( P< 0.001 and 0.002 respectively), and the severe type COVID-19 was also significantly lower than the critical type ( P= 0.032). Conclusions:CT and clinical features of different clinical types of COVID-19 pneumonia are different. Chest CT findings are characteristic, which can not only help the early diagnosis but also evaluate the clinical course and severity.
6. A correlation study ofCT and clinical features of different clinical types of 2019 novel coronavirus pneumonia
Lu HUANG ; Rui HAN ; Pengxin YU ; Shaokang WANG ; Liming XIA
Chinese Journal of Radiology 2020;54(0):E003-E003
Objective:
To investigate the CT and clinical features of 2019 novel coronavirus (NCP) pneumonia.
Methods:
Chest CT and clinical data of confirmed 103 patients with 2019 novel coronavirus pneumonia in January 2020, retrospectively. According to diagnosis and treatment of NCP infected pneumonia (trial version 5), all the patients were classified into mild(
7.Efficacy and side effect analysis of paclitaxel liposome for neoadjuvant chemotherapy in locally advanced cervical cancer
Yating WANG ; Bin LI ; Xiaoguang LI ; Shaokang MA ; Rong ZHANG ; Lingying WU
Chinese Journal of Obstetrics and Gynecology 2019;54(9):588-594
Objective To investigate the efficacy and side effect of paclitaxel liposome for neoadjuvant chemotherapy (NACT) in locally advanced cervical cancer. Methods This study were included 265 cervical cancer patients staging Ⅰb2 and Ⅱa2 who underwent paclitaxel-platinum NACT followed by radical surgery from June 2008 to December 2016 in the Cancer Hospital , Peking Union Medical College, Chinese Academy of Medical Sciences. All patients were classified into two groups with 106 patients in paclitaxel liposome group and 159 patients in traditional paclitaxel group. The difference in clinicopathologic characteristics, efficacy and side effect were analyzed retrospectively between the two groups.Results (1)Clinicopathologic characteristics: there were no significant difference in clinicopathologic characteristics between the two groups, including age, body mass index, clinical stage, pathological histology, cycles of NACT, combined platinum regimen, lymph-vascular space invasion, lymph node metastasis, deep stromal invasion, and postoperative adjuvant therapy (all P>0.05). (2) Efficacy: after NACT, the overall response occurred in 90 (15 complete response plus 75 partial response) of 106 cases in the paclitaxel liposome group versus 131 (21 complete response plus 110 partial response) of 159 cases in the traditional paclitaxel group without statistical significance (84.9% vs 82.4%; χ2=0.291, P=0.590). A total of 248 patients received surgery after NACT and were evaluable in survival. The 5-year recurrence-free survival (RFS) rate and 5-year overall survival (OS) rate of these patients was 85.1% and 88.2%. The 5-year RFS rate in the paclitaxel liposome group was 85.9% compared with 85.2% in the traditional paclitaxel group, while the corresponding 5-year OS rate was 88.5% and 88.7%, respectively. There was no statistically significant difference in efficacy between the two groups (P=0.968, P=0.797). (3) Side effect: the incidence of allergic reaction between the paclitaxel liposome group and the traditional paclitaxel group was 0 versus 1.9% (3/159) without statistical significance (P=0.277). But the incidence of neurotoxicity in the paclitaxel liposome group significantly decreased compared with the traditional paclitaxel group (6.6% vs 15.7%, P<0.05), as well as the incidence of alopecia (67.9% vs 79.2%, P<0.05) and myalgia (17.9% vs 28.9%, P<0.05). However, significant differences were not found in terms of hematological toxicity, gastrointestinal reaction, and hepatic function damage (P>0.05). Conclusion In paclitaxel-platinum NACT of local advanced cervical cancer, paclitaxel liposome can achieve similar efficacy compared with traditional paclitaxel, but paclitaxel liposome is helpful in decreasing the toxicity of neurotoxicity, alopecia and myalgia.
8. Efficacy and side effect analysis of paclitaxel liposome for neoadjuvant chemotherapy in locally advanced cervical cancer
Yating WANG ; Bin LI ; Xiaoguang LI ; Shaokang MA ; Rong ZHANG ; Lingying WU
Chinese Journal of Obstetrics and Gynecology 2019;54(9):588-594
Objective:
To investigate the efficacy and side effect of paclitaxel liposome for neoadjuvant chemotherapy (NACT) in locally advanced cervical cancer.
Methods:
This study were included 265 cervical cancer patients staging Ⅰb2 and Ⅱa2 who underwent paclitaxel-platinum NACT followed by radical surgery from June 2008 to December 2016 in the Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences. All patients were classified into two groups with 106 patients in paclitaxel liposome group and 159 patients in traditional paclitaxel group. The difference in clinicopathologic characteristics, efficacy and side effect were analyzed retrospectively between the two groups.
Results:
(1) Clinicopathologic characteristics: there were no significant difference in clinicopathologic characteristics between the two groups, including age, body mass index, clinical stage, pathological histology, cycles of NACT, combined platinum regimen, lymph-vascular space invasion, lymph node metastasis, deep stromal invasion, and postoperative adjuvant therapy (all
9.Clinical analysis of 32 cases with neuroendocrine carcinoma of the uterine cervix in early-stage disease
Ziyi WANG ; Lingying WU ; Hongwen YAO ; Yangchun SUN ; Xiaoguang LI ; Bin LI ; Rong ZHANG ; Shaokang MA ; Manni HUANG
Chinese Journal of Obstetrics and Gynecology 2015;(3):198-203
Objective To investigate the survival and recurrence data after treatment in neuroendocrine carcinoma of the uterine cervix(NECUC)with stageⅠb-Ⅱa, and to analyse its prognostic factors. Methods Thirty-two cases of primary NECUC in early-stage disease treated from Jan. 2005 to Dec. 2013 at Cancer Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences were reviewed, and their data of clinicopathologic characteristics were collected and analysed. The median age was 37 years (range, 23-57 years). The distribution by International Federation of Gynecology and Obstetrics (FIGO) clinical stage:19 cases stageⅠb1, 10 cases stageⅠb2, 1 case stageⅡa1, 2 cases stageⅡa2. Pathologic types: 22 cases of small cell carcinoma, 1 case of atypical carcinoid, 9 cases of mixed carcinoma. The diameter of cervical tumor:12 cases≥4 cm, 20 cases<4 cm. All patients underwent radical hysterectomy and pelvic ± para-aortic lymphadenectomy, and 15 cases of them were preserved unilateral or bilateral ovaries. Pathologic examination showed that 25 cases with cervical deep stromal invasion thickness ≥1/2, 21 cases with lymph-vascular space invasion (LVSI), and 18 cases with pelvic and (or) para-aortic lymph nodes involvement. Ten cases were performed neoadjuvant chemotherapy (range,1-3 cycles), all patients received postoperative chemotherapy (range,3-6 cycles), and 15 patients were treated with radiotherapy after surgery. The follow-up data were updated on Jul. 2014. The median follow-up time was 18 months (range, 7-71 months). A retrospective analysis was conducted to analyse the survival and recurrence data,and to explore the prognostic factors of NECUC. Results Thirteen patients died during the follow-up period. The cumulative progression-free survival (PFS) of 2 and 5 years were respectively 54.2%and 38.1%, and the estimated median PFS was 29 months. The cumulative overall survival (OS) of 2 and 5 years were respectively 56.1%and 44.9%, and the estimated median OS was 31 months. Fourteen cases had recurrence, and the median recurrence time was 9 months (range, 3-30 months). Recurrent or metastatic sites:2 cases in pelvis, 4 cases in liver, 3 cases in lung, 3 cases in adrenal glands, 3 cases in bones, 2 cases in brain, 1 case in pancreas, 1 case in lymph nodes of para-aorta and neck, and 3 cases had metastasis in two or more organs. Thirteen cases with recurrence died of disease, and another one is alive with disease. The univariate analysis showed that lesion size of the cervix and FIGO stage were significant prognostic factors (P<0.01), while age, tumor components, deep invasion in cervical stromal, LVSI, pelvic and (or) para-aortic lymph nodes involvement, neoadjuvant chemotherapy, adjuvant radiotherapy and preserving ovaries were not significantly associated with prognosis(all P>0.05). Conclusion The prognosis of NECUC in early-stage is poor and the lesion size of the cervix and FIGO stage are prognostic factors.
10.Dietary survey and nutritional evaluation of one meal among the four-star hotel customers in Nanjing city
Yang YANG ; Hui LV ; Haiteng ZHOU ; Xinhe LV ; Miao JIANG ; Shaokang WANG
Chongqing Medicine 2015;(3):362-365
Objective To investigate the food intake of one meal of the hotel customers and evaluate it rationality ,then provide dietary suggestions .Methods Six hundreds hotel customers were investigated in 2 four‐star hotel and 2 five‐star hotel of Nanjing , who were selected with a stratified sampling method .Their 5 days diet were investigated and then the dietary intake ,the percentage of energy from protein ,fat and carbohydrate and the percentage of protein resource were calculated based on the food composition table .Results It was shown that the daily energy intake of one meal was appropriate among the surveyed hotel customers ,and the energy proportion from 3 major nutrients were not reasonable ,and the energy proportion from fat were higher than other 2 major nutrients ;the proportion from the source of good proteins was reasonable ,but the intake of protein was too much;the customers fell short on their daily serving of grains ,eggs ,beans and milk products and the intake of cooking oil and salt was excessive in diets . Their intake of fat ,protein ,retinol equivalent ,niacin ,vitamin E ,sodium and iron were too much .Instead ,they ate less ascorbic acid;only the intake of energy ,riboflavin and thiamine were appropriate .Conclusion The one meal dietary structure of hotel customers is not appropriate ,while nutrition collocation is not reasonable .It is necessary to promote nutrition and health education and some intervention measures must be taken .

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