1.Effects of glucocorticoid on APACHEⅡ,SOFA scores and prognosis of elderly patients with severe pneu-monia and respiratory failure
Kui YANG ; Xuran PAN ; Min SHAO
The Journal of Practical Medicine 2025;41(10):1569-1574
Objective To explore the application value of glucocorticoid in the treatment of elderly patients with severe pneumonia(SP)and respiratory failure(RF).Methods A retrospective analysis was performed on the clinical data of 208 elderly patients with SP and RF in the hospital between January 2022 and December 2023.According to use of glucocorticoid or not,patients were divided into non-hormone group(n=83)and hormone group(n=125).According to propensity score matching method,there were 71 patients in each group.The clinical indexes,disease improvement,blood gas indexes,laboratory biochemical indexes and prognosis were compared between the two groups.Results The ventilator use time and length of hospital stay in hormone group were shorter than those in non-hormone group(P<0.05).After 7 d of treatment,score of Glasgow coma scale(GCS),oxygen-ation index(P/F),blood oxygen saturation(SaO2)and lymphocyte count(TLC)in hormone group were higher than those in non-hormone group,while scores of acute physiological and chronic health evaluation Ⅱ(APACHE Ⅱ)and sequential organ failure assessment(SOFA),partial pressure of carbon dioxide(PaCO2),blood lactic acid (LAC)and procalcitonin(PCT)were lower than those in non-hormone group(P<0.05).The survival curves showed that 28 d survival rate in hormone group was higher than that in non-hormone group(P<0.05).Cox pro-portional hazard model showed that no use of glucocorticoids was an independent risk factor of 28d death in elderly patients with SP and RF(P<0.05).Conclusion Glucocorticoid can shorten ventilator use time and length of hospital stay,alleviate disease severity,promote the recovery of blood gas indexes,improve biochemical indexes and increase survival rate in elderly patients with SP and RF.
2.Effects of glucocorticoid on APACHEⅡ,SOFA scores and prognosis of elderly patients with severe pneu-monia and respiratory failure
Kui YANG ; Xuran PAN ; Min SHAO
The Journal of Practical Medicine 2025;41(10):1569-1574
Objective To explore the application value of glucocorticoid in the treatment of elderly patients with severe pneumonia(SP)and respiratory failure(RF).Methods A retrospective analysis was performed on the clinical data of 208 elderly patients with SP and RF in the hospital between January 2022 and December 2023.According to use of glucocorticoid or not,patients were divided into non-hormone group(n=83)and hormone group(n=125).According to propensity score matching method,there were 71 patients in each group.The clinical indexes,disease improvement,blood gas indexes,laboratory biochemical indexes and prognosis were compared between the two groups.Results The ventilator use time and length of hospital stay in hormone group were shorter than those in non-hormone group(P<0.05).After 7 d of treatment,score of Glasgow coma scale(GCS),oxygen-ation index(P/F),blood oxygen saturation(SaO2)and lymphocyte count(TLC)in hormone group were higher than those in non-hormone group,while scores of acute physiological and chronic health evaluation Ⅱ(APACHE Ⅱ)and sequential organ failure assessment(SOFA),partial pressure of carbon dioxide(PaCO2),blood lactic acid (LAC)and procalcitonin(PCT)were lower than those in non-hormone group(P<0.05).The survival curves showed that 28 d survival rate in hormone group was higher than that in non-hormone group(P<0.05).Cox pro-portional hazard model showed that no use of glucocorticoids was an independent risk factor of 28d death in elderly patients with SP and RF(P<0.05).Conclusion Glucocorticoid can shorten ventilator use time and length of hospital stay,alleviate disease severity,promote the recovery of blood gas indexes,improve biochemical indexes and increase survival rate in elderly patients with SP and RF.
3.Research progress of related factors affecting poor response to wet age-related macular degeneration
Haitao PAN ; Ruizhuang LI ; Qiuli ZHANG ; Xuran CHEN
International Eye Science 2024;24(4):567-571
Wet age-related macular degeneration(wARMD)emerges as a primary contributor to irreversible vision impairment in the aging demographic. In clinical practice, anti-vascular endothelial growth factor(VEGF)therapies exhibit pronounced success in managing wARMD. However, in the actual clinical application, there are significant individual differences in the prognosis of anti-VEGF drug therapy, and some patients show poor response to the treatment, which may be related to the morphological differences of retinal layers in macular area, genetics, systemic conditions and other factors. It will help develop a more rational and individualized treatment plan to judge the prognosis of patients according to their different clinical manifestations in advance, so as to reduce overtreatment and the risk of retinal damage. In recent years, most studies on treatment response mainly focus on fundus morphology, genetics and so on. In this study, the relevant factors affecting adverse response to wARMD were reviewed, aiming to provide with more accurate treatment and prognostic monitoring programs for clinicians.

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