Objective To investigate the risk factors for acute respiratory failure in immunocompromised patients with Pneumocystis jirovecii pneumonia(PJP).Methods Clinical data of 123 immunocompromised patients complicated with PJP hospitalized at Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2021 to December 2023 were retrospectively collected and analyzed.SPSS 22.0 statistical software package was used to perform multivariate binary logistic regression analysis to identify risk factors for acute respiratory failure in PJP patients.Results Among the 123 PJP patients,77 were HIV-positive,and 46 were HIV-negative.HIV-negative PJP patients were more likely to have comorbidities such as hypertension(P＜0.001),diabetes mellitus(P＜0.001),coronary heart disease(P=0.034),chronic kidney disease(P＜0.001),chronic liver disease(P=0.019),chronic lung disease(P=0.011),and malignant tumor(P＜0.001).They were also more prone to respiratory failure(P＜0.001)and ICU admission(P＜0.001).The HIV-positive patients had significantly lower CD4+T lymphocyte counts and albumin levels(P＜0.001).Forty patients developed acute respiratory failure,and six patients died.Multivariate analysis showed that high neutrophil-to-lymphocyte ratio(NLR)(P=0.031),non-HIV infection(P=0.002),and concomitant infections with other pathogens(P＜0.001)were independent risk factors for incidence of respiratory failure.ROC curve analysis revealed that the area under the curve(AUC)was 0.686(0.584,0.789)for non-HIV infection,0.731(0.637,0.826)for concomitant infections with other pathogens,0.648(0.546,0.750)for NLR.The predicted probability was 0.845(0.778,0.912).Conclusions Non-HIV infection,high NLR,and concomitant infections with other pathogens are independent risk factors for incidence of respiratory failure in PJP patients.The panel combining these factors provides a higher predictive value for respiratory failure.Timely assessment of patient condition and early treatment are vital for better outcomes.

Objective To investigate the risk factors for acute respiratory failure in immunocompromised patients with Pneumocystis jirovecii pneumonia(PJP).Methods Clinical data of 123 immunocompromised patients complicated with PJP hospitalized at Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2021 to December 2023 were retrospectively collected and analyzed.SPSS 22.0 statistical software package was used to perform multivariate binary logistic regression analysis to identify risk factors for acute respiratory failure in PJP patients.Results Among the 123 PJP patients,77 were HIV-positive,and 46 were HIV-negative.HIV-negative PJP patients were more likely to have comorbidities such as hypertension(P＜0.001),diabetes mellitus(P＜0.001),coronary heart disease(P=0.034),chronic kidney disease(P＜0.001),chronic liver disease(P=0.019),chronic lung disease(P=0.011),and malignant tumor(P＜0.001).They were also more prone to respiratory failure(P＜0.001)and ICU admission(P＜0.001).The HIV-positive patients had significantly lower CD4+T lymphocyte counts and albumin levels(P＜0.001).Forty patients developed acute respiratory failure,and six patients died.Multivariate analysis showed that high neutrophil-to-lymphocyte ratio(NLR)(P=0.031),non-HIV infection(P=0.002),and concomitant infections with other pathogens(P＜0.001)were independent risk factors for incidence of respiratory failure.ROC curve analysis revealed that the area under the curve(AUC)was 0.686(0.584,0.789)for non-HIV infection,0.731(0.637,0.826)for concomitant infections with other pathogens,0.648(0.546,0.750)for NLR.The predicted probability was 0.845(0.778,0.912).Conclusions Non-HIV infection,high NLR,and concomitant infections with other pathogens are independent risk factors for incidence of respiratory failure in PJP patients.The panel combining these factors provides a higher predictive value for respiratory failure.Timely assessment of patient condition and early treatment are vital for better outcomes.

Objective:The objective of this longitudinal study is to longitudinally monitor the lexical development and language proficiency of Mandarin-speaking children with cochlear implants (CI) over a three-year post-implantation period while also investigating whether early receptive and expressive vocabulary skills can serve as predictors for later language abilities in CI recipients.Methods:In this study, 42 children with CIs were selected as participants, including 19 males and 23 females, and with a mean age at CI activation of 16.6±4.9 months. Receptive and expressive vocabulary skills were assessed using the Infant Checklist of the Early Vocabulary Inventory for Mandarin Chinese (EVI) at one-year post-activation (T1). Additionally, expressive vocabulary sizes were evaluated using the EVI-Toddler Checklist, while syntactic ability was measured by the Grammatical Complexity test of the Mandarin-Chinese Communicative Developmental Inventory for Infants and Toddlers at two years post-activation (T2). The comprehensive language development level of preschool children, including language comprehension, expression, and grammar ability, was examined during the third year post-activation (T3) using the Revised Scale for Assessment of Language Disorders in Preschool Children. Data analysis was conducted using SPSS 22.0.Results:One year after CI activation, children exhibited a mean receptive vocabulary size of 155.7±52.8 and an expressive vocabulary size of 85.1±63.9. T2′s expressive vocabulary size was 455.7±167.7, while the Grammatical Complexity score was 36.5±13.0. The original language development score was determined to be 53.6±14.2 at T3. Correlation analysis revealed significant positive associations between T1′s receptive and expressive vocabulary with tests conducted at T2 and subsequent language development measured at T3 ( P<0.01). Furthermore, there was a significant correlation between expressive vocabulary at T1 and both tests conducted at T2 ( P<0.01), but no significant correlation with subsequent language development measured at T3. Regression analysis showed that T1 receptive vocabulary significantly predicted T2 expressive vocabulary and Grammatical Complexity scores and T3 language development scores. Moreover, the syntactic ability assessed during T2 independently predicted subsequent language proficiency measured at T3. Conclusions:Early receptive vocabulary and grammar ability two years post CI activation significantly predict later language proficiency in children with cochlear implants. Thus, during rehabilitation, emphasis should be placed on enhancing vocabulary and grammar comprehension.

Objective:The objective of this longitudinal study is to longitudinally monitor the lexical development and language proficiency of Mandarin-speaking children with cochlear implants (CI) over a three-year post-implantation period while also investigating whether early receptive and expressive vocabulary skills can serve as predictors for later language abilities in CI recipients.Methods:In this study, 42 children with CIs were selected as participants, including 19 males and 23 females, and with a mean age at CI activation of 16.6±4.9 months. Receptive and expressive vocabulary skills were assessed using the Infant Checklist of the Early Vocabulary Inventory for Mandarin Chinese (EVI) at one-year post-activation (T1). Additionally, expressive vocabulary sizes were evaluated using the EVI-Toddler Checklist, while syntactic ability was measured by the Grammatical Complexity test of the Mandarin-Chinese Communicative Developmental Inventory for Infants and Toddlers at two years post-activation (T2). The comprehensive language development level of preschool children, including language comprehension, expression, and grammar ability, was examined during the third year post-activation (T3) using the Revised Scale for Assessment of Language Disorders in Preschool Children. Data analysis was conducted using SPSS 22.0.Results:One year after CI activation, children exhibited a mean receptive vocabulary size of 155.7±52.8 and an expressive vocabulary size of 85.1±63.9. T2′s expressive vocabulary size was 455.7±167.7, while the Grammatical Complexity score was 36.5±13.0. The original language development score was determined to be 53.6±14.2 at T3. Correlation analysis revealed significant positive associations between T1′s receptive and expressive vocabulary with tests conducted at T2 and subsequent language development measured at T3 ( P<0.01). Furthermore, there was a significant correlation between expressive vocabulary at T1 and both tests conducted at T2 ( P<0.01), but no significant correlation with subsequent language development measured at T3. Regression analysis showed that T1 receptive vocabulary significantly predicted T2 expressive vocabulary and Grammatical Complexity scores and T3 language development scores. Moreover, the syntactic ability assessed during T2 independently predicted subsequent language proficiency measured at T3. Conclusions:Early receptive vocabulary and grammar ability two years post CI activation significantly predict later language proficiency in children with cochlear implants. Thus, during rehabilitation, emphasis should be placed on enhancing vocabulary and grammar comprehension.

OBJECTIVES: The aim of this study was to evaluate the disease burden of prostate cancer (PC) and assess key influencing factors associated with the disease expenditures of PC in the United States. METHODS: The total deaths, incidence, prevalence, and disability-adjusted life-years of PC were obtained from the Global Burden of Disease Study 2019. The Medical Expenditure Panel Survey was used to estimate healthcare expenditures and productivity loss and to investigate patterns of payment and use of healthcare resources in the United States. A multivariable logistic regression model was conducted to identify key factors influencing expenditures. RESULTS: For patients aged 50 and older, the burden for all age groups showed a modest increase over the 6-year period. Annual medical expenditures were estimated to range from US$24.8 billion to US$39.2 billion from 2014 to 2019. The annual loss in productivity for patients was approximately US$1,200. The top 3 major components of medical costs were hospital inpatient stays, prescription medicines, and office-based visits. Medicare was the largest source of payments for survivors. In terms of drug consumption, genitourinary tract agents (57.0%) and antineoplastics (18.6%) were the main therapeutic drugs. High medical expenditures were positively associated with age (p=0.005), having private health insurance (p=0.016), more comorbidities, not currently smoking (p=0.001), and patient self-perception of fair/poor health status (p<0.001). CONCLUSIONS From 2014 to 2019, the national real-world data of PC revealed that the disease burden in the United States continued to increase, which was partly related to patient characteristics.

Humans ; Asthma/drug therapy* ; Biological Therapy

【Objective】 To explore the role and value of applied muscle tension (AMT) in preventing vasovagal nerve reaction (VVR) in blood donors. 【Methods】 A total of 2 992 people, susceptible to suffer VVR from May 2020 to may 2022, were randomly divided into control group (1406 cases) and observation group (1 586 cases). The control group was not given AMT intervention, while the observation group received AMT intervention at different periods during blood donation. The changes of systolic blood pressure, diastolic blood pressure, heart rate and psychological state of anxiety (self-rating anxiety scale, SAS) of blood donors were monitored in the two groups at each period to compare the occurrence of VVR. 【Results】 There were no statistically significant differences in blood pressure and heart rate between the two groups before blood donation (P>0.05). The parameters were relatively stable in observation group during and after donation, but significantly different from that of the controls(P>0.05). SAS score was similar in two groups before blood donation(P>0.05), while decreased in observation group during and after donation in comparison with the controls(P<0.05). The incidence of VVR in the observation group was 3.09%, which was significantly lower than that in the control group (7.97%)(P<0.05). The incidence of VVR was 2.18% after AMT exercise during blood donation. 【Conclusion】 AMT intervention in different periods of blood donation can significantly reduce the occurrence of VVR.

Objective:To explore the effect of programmatic follow-up of joint nutrition team on the follow-up management of type 2 diabetes mellitus patients and to provide a basis for clinical practice.Methods:Using the convenient sampling method, a total of 144 patients with type 2 diabetes mellitus who were treated at the Diabetes Specialist Follow-up Clinic of the First Affiliated Hospital of Xinjiang Medical University from March 2016 to December 2017 were selected, and the programmatic follow-up of joint nutrition team was used for prospective observation. After the completion of 2-year follow-up, the changes in obesity, blood glucose, blood lipids and self-care activities of patients at baseline, 12th month and 24th month were compared using repeated measurements analysis of variance.Results:In the end, 141 patients completed the 2-year follow-up. Of the 141 patients, body mass index (BMI) was (21.73±1.89) kg/m 2, waistline was (77.57±1.68) cm, waist-to-hip ratio was (0.87±0.04) , fasting blood glucose was (5.14±0.92) mmol/L, glycosylated hemoglobin was (5.27±0.73) %, total cholesterol was (3.92±1.67) mmol/L, triglycerides was (1.94±0.68) mmol/L and low density lipoprotein was (1.04±0.31) mmol/L at the 24th month. The differences were statistically significant ( F=32.629, 5.556, 5.640, 89.734, 122.451, 43.373, 74.888, 35.887; P<0.05) among the 24th month, the 12th month and the baseline of the above indicators. At the 24 months, scores of diet, exercise, blood glucose monitoring and foot care in diabetic self-management behavior scale were respectively (20.33±3.09) , (11.13±1.54) , (11.78±1.99) and (10.42±1.91) . Compared with baseline and the 12th month, scores increased, and the differences were statistically significant ( F=25.276, 72.250, 74.503, 37.928; P<0.01) . Conclusions:The programmatic follow-up of joint nutrition team can improve indexes related to obesity, blood glucose and blood lipids in patients with type 2 diabetes mellitus and improve self-management ability of patients.

Objective:To explore the effect of precision nutrition therapy on the dietary pattern and appetite of patients with type 2 diabetes mellitus (T2DM) .Methods:From September 2018 to September 2019, convenience sampling method was used to select 155 patients with T2DM discharged from the Endocrinology Department of the First Affiliated Hospital of Xinjiang Medical University. All patients were randomly divided into control group (73 cases) and experimental group (82 cases) . Control group received routine nutritional intervention. Based on routine follow-up intervention, experimental group established a patient's personalized data model according to the medical artificial intelligence system for precise nutritional treatment, including the establishment of diabetes diet management prescriptions and intelligent diet intervention. The Dietary Pattern Questionnaire and the Simplified Nutritional Appetite Questionnaire (SNAQ) were used to compare the changes in dietary patterns and appetite before and after intervention between two groups.Results:After three months of intervention, the proportion of patients with reasonable protein, fat, and carbohydrate intake in two groups was higher than that before intervention, and that of experimental group was higher than that of control group, and the difference was statistically significant ( P<0.05) . After three months of intervention, the score of SNAQ of experimental group and control group was (13.20±1.54) and (10.32±1.25) respectively, and the difference was statistically significant ( t=-12.838, P<0.05) . Conclusions:The establishment of a big data model based on a medical artificial intelligence system for precise nutritional therapy can regulate the dietary behavior of patients with T2DM and increase their appetite.

Objective:To explore the effect of exercise prescription intervention with multidisciplinary support on elderly patients with diabetes mellitus accompanied by sarcopenia.Methods:Using the convenient sampling method, a total of 84 patients with diabetes mellitus accompanied by sarcopenia over 60 years old were selected from 6 community health service centers that had long-term cooperation with the First Affiliated Hospital of Xinjiang Medical University from January 2018 to September 2019. They were randomly divided into the observation group and the control group, with 41 cases in each group. The control group received routine nursing management, while the observation group implemented exercise prescription intervention with multidisciplinary support on the basis of the control group, and the intervention period was 12 weeks. The differences in laboratory indexes, limb motor function and Diabetes Specific Quality of Life Scale (DSQL) scores were compared between the two groups.Results:After intervention, glycosylated hemoglobin (5.38±0.67) % and DSQL score (76.35±5.48) of patients in the observation group were lower than those of the control group, and the differences were statistically significant ( t=-9.964, -5.113; P<0.05) . After intervention, serum albumin (35.81±1.86) g/L and limb motor function score (88.94±7.02) of patients in the observation group were higher than those in the control group, and the differences were statistically significant ( t=5.860, 2.501; P<0.05) . Conclusions:Exercise prescription intervention with multidisciplinary support can help elderly patients with diabetes mellitus accompanied by sarcopenia to improve their blood sugar control, quality of life and skeletal muscle quality and function.