1.Effect analysis of endolymphatic sac surgery on Meniere’s disease based on propensity score matching
Yu SI ; Shipei ZHUO ; Yan HUANG ; Wuhui HE ; Jingman DENG ; Jintao LOU ; Zhigang ZHANG
Chinese Journal of Clinical Medicine 2025;32(2):165-170
Objective To analyse the clinical efficiency of endolymphatic sac surgery (ESS) in the management of Meniere’s disease (MD). Methods A retrospective analysis was conducted on 274 patients with MD who were hospitalized for treatment in Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University from January 2009 to August 2023. All patients received lifestyle management and drug treatment such as diuretics. For those whose conditions were not well controlled 3 to 6 months after the initial treatment, intratympanic glucocorticoid (ITG) or ESS treatment was carried out. Six months after the treatment, the classes of vertigo relief and hearing changes in the patients were evaluated. After adjusting the confounding factors through propensity score matching (PSM), the impact of ESS on the prognosis of MD patients was evaluated. Results Among 274 patients, 194 and 80 patients underwent ITG and ESS, respectively. Eighty patients were enrolled into each group after PSM. Before and after PSM, the rate of patients reaching vertigo relief class A in ESS group was higher than that in the ITG group (P=0.004); there was no significant difference in hearing preservation between the two groups. Kaplan-Meier curve analysis showed that vertigo relief in the ESS group was better than that in the ITG group (P=0.029); there was no statistically significant difference in hearing preservation between the two groups. Conclusion When the initial treatment for patients with MD is ineffective, choosing ESS is more beneficial than ITG for controlling vertigo.
2.Construction and validation of a predictive model for supportive care needs within 24 hours after surgical anesthesia recovery in breast cancer patients
Wuhui ZHANG ; Yaya XU ; Xiumei LYU ; Qian ZHANG
Journal of Clinical Medicine in Practice 2025;29(15):52-57
Objective To construct and validate a precise predictive model for supportive care needs within 24 hours after surgical anesthesia recovery in breast cancer patients.Methods A retro-spective analysis was conducted on data of 156 breast cancer patients who underwent surgical treat-ment in the hospital from June 2022 to June 2024.Based on their supportive care needs within 24 hours after surgical anesthesia recovery,the patients were divided into no and low demand group(n=41)and moderate and high demand group(n=115).Clinical data of the two groups were compared using one-way analysis of variance.Binary Logistic regression analysis was employed to identify fac-tors influencing supportive care needs within 24 hours after surgical anesthesia recovery in breast cancer patients,and a predictive model was constructed accordingly.Results Binary Logistic re-gression analysis revealed that sources of medical expenses(non-urban medical insurance),occupa-tion(worker),primary caregiver(spouse),the M.D.Anderson Symptom Inventory(MDASI)score,and Quality of Recovery(QoR)score were all influencing factors for supportive care needs within 24 hours after surgical anesthesia recovery in breast cancer patients(P<0.05).Receiver op-erating characteristic(ROC)curve analysis showed that the area under the curve(AUC)for predic-ting supportive care needs within 24 hours after surgical anesthesia recovery in breast cancer patients was 0.635 for sources of medical expenses,0.723 for occupation,0.618 for primary caregiver,0.742 for MDASI score,and 0.749 for QoR score,respectively.The AUC of the predictive model for sup-portive care needs within 24 hours after surgical anesthesia recovery in breast cancer patients was 0.965,with a sensitivity of 93.0%and a specificity of 90.2%.Internal validation of the model using the Bootstrap method with B=1,000 self-sampling times demonstrated an overall predictive accuracy of 88.5%,indicating good predictive performance.Conclusion Sources of medical ex-penses(non-urban medical insurance),occupation(worker),primary caregiver(spouse),MDASI score,and QoR score are all influencing factors for supportive care needs within 24 hours after surgi-cal anesthesia recovery in breast cancer patients.The predictive model constructed based on these factors exhibits good predictive value and can serve as a quantitative decision-making tool for optimi-zing postoperative nursing pathways.
3.Analysis of drug resistance and virulence genes of clinical isolates of Staphylococcus aureus in Northwest Hubei Province
Yating ZHANG ; Wuhui JIANG ; Kang YANG ; Lanfang LIU ; Yan YANG
International Journal of Laboratory Medicine 2024;45(19):2311-2315,2322
Objective To investigate the drug resistance and virulence genes of Staphylococcus aureus iso-lated from clinical specimens of hospitals in northwest Hubei province.Methods A total of 142 clinical iso-lates of Staphylococcus aureus were collected from 5 hospitals in Shiyan City from 2019 to 2021.Broth mi-crodilution method was used to detect drug resistance,and PCR method was used to detect 9 enterotoxin genes such as sea,mecA and Panton-Valentine leukocidein(PVL)virulence genes.Results A total of 44 methicillin-resistant Staphylococcus aureus(MRSA)strains were detected in 142 strains of Staphylococcus aureus,and the detection rate was 30.99%(44/142).The resistance rates of MRSA to erythromycin,clindamycin,levo-floxacin,tetracycline and gentamicin were higher than those of methicillin-sensitive Staphylococcus aureus(MSSA),and the differences were statistically significant(P<0.05).The detection rate of enterotoxin genes was 70.42%(100/142),among which the detection rates of classic enterotoxin genes(sea-see)and new ente-rotoxin genes(seg-sej)were 47.18%(67/142)and 42.25%(60/142),respectively.The detection rate of PVL virulence genes was 13.38%(19/142),among which the detection rates of MSSA and MRSA were 9.18%(9/98)and 22.73%(10/44),respectively,and the difference was statistically significant(P<0.05).Conclusion The detection rate of enterotoxin and PVL gene of Staphylococcus aureus isolated from clinical isolates is high.In clinical di-agnosis and treatment,it is necessary to control hospital infection,take effective isolation measures in time and strengthen the monitoring of PVL gene.

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