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 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.

Humans ; Asthma/drug therapy* ; Biological Therapy

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.

【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 teaching effect of 12-lead electrocardiogram (ECG) interpretation based on self-drawing method.Methods:This study recruited 489 students from 10 classes of clinical medicine major of Shandong Medical College as research objects. They were divided into control group and experimental group. Theoretical teaching and traditional practical training were adopted to the control group while theoretical teaching and self-drawing method were adopted to the experimental group. The ECG test scores, the number of students with excellent performance and the ECG scores of the final exam were compared between the two groups. Questionnaires were issued to assess the effect of different teaching methods on students. SPSS 25.0 was used for t test and chi-square test. Results:Compared with the experimental group, the results of the ECG special test, the number of excellent students and the ECG scores of the final exam in the control group all decreased, and the difference was statistically significant ( P<0.01). The results of the questionnaire showed that the experimental group had higher mastery of ECG abnormal patterns, learning initiative, self-confidence and better satisfaction with the overall teaching of ECG ( P<0.01). Conclusion:The practical training based on self-drawing method can improve ECG interpretation skills, learning initiative and self-confidence of students, which has achieved good teaching effect.

Objective:To explore the effect of remote blood glucose management led by specialist nurses on blood glucose, self-management ability and quality of life of type 2 diabetic patients during home rehabilitation.Methods:From January to December 2019, convenience sampling was used to select 218 patients with type 2 diabetes in the First Affiliated Hospital of Xinjiang Medical University. According to the random number table method, the patients were divided into the observation group and the control group, each with 109 cases. The control group conducted conventional blood glucose management, and the observation group implemented remote blood glucose management led by specialist nurses for a total of three months of observation. Both were observed for 3 months. The self-management behavior and quality of life of the two groups of patients before and after the intervention were evaluated with the Diabetes Self-Management Behavior Scale (SDSCA) and the Diabetes Quality of Life Specific Scale (DSQL), and the blood glucose indicators of the two groups before and after the intervention were compared.Results:All 218 cases cooperated to complete all the research contents, and there was no dropout case. After the intervention, the fasting blood glucose, two hours postprandial blood glucose, glycosylated hemoglobin and DSQL score of the observation group were lower than those of the control group, and the SDSCA score was higher than that of the control group. The differences were all statistically significant ( P<0.05) . Conclusions:Compared with conventional blood glucose management, the remote blood glucose management led by specialist nurses can more effectively control the blood glucose of patients with type 2 diabetes, improve the patients' self-management ability and quality of life, and overall increase the management efficiency of patients during home rehabilitation.

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.