Objective:To explore the impacts of smoking on the need for respiratory support and mortality in patients hospitalized with pneumonia.Methods:A total of 24 367 patients hospitalized with pneumonia from 2009 to 2017 in the China Kadoorie Biobank, were included. Smoking status was self-reported, and data regarding respiratory support during hospitalization and mortality during follow-up were obtained from medical claims and death registries, respectively. OR, HR, and 95% CI were calculated and adjusted for potential confounders using logistic regression models and Cox proportional hazards regression models, respectively. Results:Among males, current smokers or those who quit smoking due to illness had higher risks of requiring respiratory support ( OR=1.15, 95% CI: 1.03-1.29), 1-year mortality ( HR=1.66, 95% CI: 1.32-2.08), and 5-year mortality ( HR=1.32, 95% CI: 1.13-1.54) following pneumonia hospitalization compared to nonsmokers. Male smokers who started smoking at a younger age or with longer smoking duration had the highest mortality risks (trend test both P<0.05). Female current smokers or those who quit smoking due to illness had higher risks of 1-year mortality ( HR=1.62, 95% CI: 1.17-2.23) and 5-year mortality ( HR=1.33, 95% CI: 1.06-1.67). We found no statistically significant difference in 90-day mortality between current smokers/those who quit smoking due to illness and nonsmokers. Conclusions:Smoking was associated with higher risks of requiring respiratory support and mortality in patients hospitalized with pneumonia, especially among males and heavy smokers. These findings highlight the need for targeted strategies to promote smoking cessation in patients hospitalized with pneumonia.

Objective:To explore the impacts of smoking on the need for respiratory support and mortality in patients hospitalized with pneumonia.Methods:A total of 24 367 patients hospitalized with pneumonia from 2009 to 2017 in the China Kadoorie Biobank, were included. Smoking status was self-reported, and data regarding respiratory support during hospitalization and mortality during follow-up were obtained from medical claims and death registries, respectively. OR, HR, and 95% CI were calculated and adjusted for potential confounders using logistic regression models and Cox proportional hazards regression models, respectively. Results:Among males, current smokers or those who quit smoking due to illness had higher risks of requiring respiratory support ( OR=1.15, 95% CI: 1.03-1.29), 1-year mortality ( HR=1.66, 95% CI: 1.32-2.08), and 5-year mortality ( HR=1.32, 95% CI: 1.13-1.54) following pneumonia hospitalization compared to nonsmokers. Male smokers who started smoking at a younger age or with longer smoking duration had the highest mortality risks (trend test both P<0.05). Female current smokers or those who quit smoking due to illness had higher risks of 1-year mortality ( HR=1.62, 95% CI: 1.17-2.23) and 5-year mortality ( HR=1.33, 95% CI: 1.06-1.67). We found no statistically significant difference in 90-day mortality between current smokers/those who quit smoking due to illness and nonsmokers. Conclusions:Smoking was associated with higher risks of requiring respiratory support and mortality in patients hospitalized with pneumonia, especially among males and heavy smokers. These findings highlight the need for targeted strategies to promote smoking cessation in patients hospitalized with pneumonia.

OBJECTIVETo summarize the experience of heart-shaped anastomosis operation in patients with Hirschsprung's disease.

METHODSHirschsprung's disease treated by heart-shaped anastomosis, improvement of surgery procedure, and complications were reviewed retrospectively.

RESULTSOf 193 cases, 152 completed follow-up. Early complications included urine retention (2 cases), enteritis (10), anastomosis stricture (1), and intestinal obstruction (2). Late complications (22 cases) included adhesive intestinal obstruction (2), constipation (5), incision hernia (2), enteritis (6), and occasionally stool stains (7). Neither infection in celiac, pelvic cavity and wound nor incontinence or death occurred in all patients.

CONCLUSIONHeart-shaped anastomosis procedure can effectively reduce the complications ceased by Hirschsprung's disease operation and is superior to other procedures.

Child ; Child, Preschool ; Female ; Follow-Up Studies ; Gastroenterostomy ; adverse effects ; methods ; Hirschsprung Disease ; surgery ; Humans ; Infant ; Infant, Newborn ; Male ; Postoperative Complications ; etiology ; Retrospective Studies

Objective To evaluate the long-term results of partial internal sphincterectomy for the treatment of internal anal sphincter achalasia in childhood. Methods The clinical,radiographic,manometrical and histochemical data of 6 cases were reviewed retrospectively. All patients had received partial internal sphincterectomy and were followed-up for 2 to 8 years. Results All patients presented with severe constipation with or without soiling. No stenosis zone of intestine could be noted in 3 patients by barium enema examination. The rectoanal inhibition reflex on rectal balloon inflation was absent in all patients. The normal acetylcholinesterase activity on rectal biopsies was demonstrated by histochemical staining. Ganglion cells within internal anal sphincter was noted in all cases. On follow-up,all patients regained regular bowel habits and are not on any laxatives. Conclusion The long term results of partial internal sphincterectomy for the treatment of internal anal sphincter achalasia in childhood are satisfactory.