OBJECTIVE: To construct and validate a prognostic prediction model for children with sepsis using the Phoenix sepsis score (PSS). METHODS: A retrospective case series study was conducted to collect clinical data of children with sepsis admitted to the pediatric intensive care unit (PICU) of the Affiliated Hospital of Guizhou Medical University from January 2022 to April 2024. The data included general information, the worst values of laboratory indicators within the first 24 hours of PICU admission, PSS score, pediatric critical illness score (PCIS), and the survival status of the children within 30 days of admission. The statistically significant indicators in univariate Logistic regression analysis were included in multivariate Logistic regression analysis to screen the risk factors affecting the prognosis of children with sepsis and construct a nomogram model. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive performance of the model. The Bootstrap method was used to perform 1 000 repeated sampling internal verification and draw the calibration curve of the model. RESULTS: A total of 199 children with sepsis were included, of which 32 died and 167 survived 30 days after admission. In the univariate Logistic regression analysis, shock, white blood cell count (WBC), international normalized ratio (INR), lactic acid (Lac), PSS score, and PCIS score were identified as statistically significant predictors. These variables were then included in the multivariate Logistic regression analysis, which demonstrated that shock [odds ratio (OR) = 4.258, 95% confidence interval (95%CI) was 1.049-17.288], WBC (OR = 1.124, 95%CI was 1.052-1.210), and PSS score (OR = 1.977, 95%CI was 1.298-3.012) were independent risk factors for mortality in pediatric patients with sepsis (all P < 0.05). A nomogram model was constructed based on these three risk factors, with the model equation as follows: -4.809+1.449×shock+0.682×PSS score+0.117×WBC. The calibration curve results showed that the model's predictions were highly consistent with the actual observations. The ROC curve showed that when the Youden index of the prediction model was 0.792, the sensitivity and specificity were 90.6% and 88.6%, respectively, and the area under the curve (AUC) was 0.957 (95%CI was 0.930-0.984), which was higher than the AUC of shock, WBC, and PSS score alone (0.808, 0.667, 0.908, respectively). CONCLUSIONS Shock, WBC, and PSS score have demonstrated certain predictive value for mortality in children with sepsis. The nomogram model based on the above indicators has important clinical significance for evaluating the prognosis and guiding treatment of children with sepsis.
Humans ; Sepsis/diagnosis* ; Prognosis ; Retrospective Studies ; Logistic Models ; Intensive Care Units, Pediatric ; Nomograms ; Child ; ROC Curve ; Risk Factors ; Male ; Female ; Child, Preschool ; Infant

Objective To compare the surgical effects between minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider and open anterior ondontoid screw fixation in the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ.Methods From July 2011 to July 2016,28 adults with odontoid fracture of Anderson-D'Alonzo type Ⅱ were treated at Department Ⅱ of Spinal Surgery,Hospital of 89 Army Group of Chinese PLA.Of them,15 were treated by minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider (guider group) while the other 13 by open anterior ondontoid screw fixation (open group).All the patients were male,aged from 31 to 59 years (average,42.7 years).The 2 groups were compared in terms of incision length,operation time,intraoperative bleeding,intraoperative fluoroscopic frequency and hospital stay.Results There were no significant differences between the 2 groups of patients in their preoperative general data,indicating they were compatible (P ＞ 0.05).All the patients were followed up for 12 to 45 months (average,22.1 months).The internal fixation was in good place and clinical union achieved in all the 28 patients.The incision length (2.2 ± 0.1 cm),operation time (45.0 ± 3.1 min),intraoperative bleeding (29.0 ± 2.3 mL) and intraoperative fluoroscopic frequency (15.5 ± 1.9 times) for the guider group were all significantly less than those (2.9 ±0.7 cm,61.6±3.8 min,51.6±3.9 mL and 21.7±3.2 times,respectively) for the open group (P ＜0.05),but there was no significant difference between the 2 groups in hospital stay (6.5 ± 0.5 d versus 6.5 ± 0.6 d) (P ＞ 0.05).Conclusion In the treatment of odontoid fractures of Anderson-D'Alonzo type Ⅱ,compared with open anterior ondontoid screw fixation,the minimally invasive anterior ondontoid screw fixation assisted by our self-designed odontoid guider may lead to a smaller incision,shorter operation time,less blood loss and a lower fluoroscopic frequency.

Objective To explore a simple classification of the axial mastoid process and its clinical significance in improving the traditional screw insertion in the treatment of odontoid fracture with percutaneous anterior odontoid screwing. Methods The median sagittal CT images of 120 patients with cervical dis-ease were measured. They were 63 males and 57 females, aged from 31 to 59 years (average, 41.6 years). On their median sagittal CT images, line A was the connection of the lowest point of the anterior inferior boarder of the axis body to the vertex of the odontoid process and line B a parallel line to line A through the mastoid process. The distance between lines A and B was measured (the height of the axial mastoid process) and a complete statistical record was made to analyze the distribution and regularity of distances AB. The improved insertion points were indentified based on the above measurements (X25%and X75%) and clinical ex-perience. We reviewed 32 patients with odontoid fracture of Anderson&D' Alonzo typeⅡA, ⅡB or superficialⅢ. Of them 15 underwent percutaneous anterior screwing by the improved insertion points and 17 underwent percutaneous anterior screwing by the conventional insertion points. The 2 groups were compared in terms of incision length, operation time, bleeding, fluoroscopy frequency and hospital stay. Results Distance AB was 3.42 ± 0.68 mm. The distance AB <3 mm was classified as low-level mastoid process, the distance AB between 3 to 4 mm as slightly convex mastoid process, and the distance AB > 4 mm as convex mastoid process. Of the 120 patients, 32 (26.7% ) were classified as having a low-level mastoid process, 57 (47.5%) as having a slightly convex mastoid process, and 31 (25.8%) as having a convex mastoid process. Compared with the conventional insertion group, the improved insertion group had significantly shorter oper-ation time (31.32 ± 2.12 min versus 46.18 ± 3.63 min), significantly lower fluoroscopy frequency (18.20 ±1.57 times versus 21.27 ± 2.50 times) but significantly greater bleeding (43.22 ± 3.17 mL versus 31.22 ± 3.52 mL) (P <0.05). There were no significant differences between the 2 groups in incision length or hospital stay (P > 0.05). Conclusions In the treatment of odontoid fracture with percutaneous anterior odontoid screwing, the screw insertion can be improved according to our classification of the axial mastoid process. Our simple classification of the axial mastoid process may lead to more efficient operation and less radiation hazard.

Objective To analyze cancer incidence and mortality in Fujian in 2012 and to provide sci-entific basis for tumor prevention .Methods In accordance with the methods and criteria of data quality control made by NCCR,7 regristries data qualified from 9 submitted regritries in Fujian after data assessment were mer-ged and analyzed.Results In 2012,the cancer incidence rate was 251.44/105 (308.44/105 in male and 193.03/105 in female),age standardized incidence by Chinese standard population (ASR China)and by world standard population(ASR world)were 205.15/105 and 201.11/105.The cumulative incidence(0~74 age)was 23.51%.The mortality rate was 161.85/105(220.87/105 in male and 101.37/105 in female).ASR China and ASR world were 128.54/105 and 127.70/105 the cumulative incidence(0~74 age)was 15.04%.The age-spe-cific incidence and mortality reached maximum value in 75 ages and 80 ages respectively .The top 5 cancer inci-dences were lung cancer ,stomach cancer ,liver cancer ,esophagus cancer and breast cancer .The top 5 cancer mor-tality were lung cancer ,liver cancer ,stomach cancer ,esophagus cancer and colorectum cancer .Conclusion Di-gestive malignancies ,lung cancer ,and breast cancer in female were the most frequent in Fujian province ,and the prevention and control for those cancers should be enhanced .

China ; epidemiology ; Humans ; Incidence ; Neoplasms ; epidemiology ; mortality ; Registries

OBJECTIVE: To explore the method of the controlled synechiae technique to maintain the stability of middle turbinate (MT), reduce the incidence of middle meatus synechia formation and improve the treatment effect of endoscopy surgery. METHOD: Eighty-six patients with chronic sinusitis were randomly divided into control group and treatment group in this study. In control group, the patients received extended nasal packing in middle meatus until 1 week after surgery. In treatment group, the patients received the controlled synechiae technique. RESULT: The MT position was described as stable, slight drifting laterally and synechia formation. And the incidence of synechia between MT and the nasal lateral wall was 29.4% and 14.9% in control group and treatment group,respectively. The differences were significant (P < 0.05). CONCLUSION For those patients with anatomic variation, destruction or weak supporting structures resulted from previous surgery, the controlled synechiae technique is very useful in preventing lateralization of the middle turbinate after endoscopy surgery.
Adult ; Aged ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Nasal Surgical Procedures ; methods ; Postoperative Complications ; prevention & control ; Suture Techniques ; Tissue Adhesions ; Turbinates ; surgery ; Young Adult

OBJECTIVE: To compare the value of video laryngoscope in localization diagnosis of upper airway stricture in obstructive sleep apnea-hypopnea syndrome (OSAHS) between awake and drug-induced sleep. METHOD: Ninety-eight patients of OSAHS were examined with video laryngoscope to locate the upper airway stricture under awake and Midazolam-induced sleep. RESULT: The several stricture levels under awake was 58.2% and it was 77.5% under drug induced sleep. CONCLUSION Several stricture levels of upper airway were founded in most of the patients of OSAHS. The upper airway stricture levels was more in the sleep than in the wake.
Adult ; Female ; Humans ; Laryngoscopes ; Male ; Middle Aged ; Sleep ; drug effects ; Sleep Apnea, Obstructive ; diagnosis ; Videotape Recording ; Wakefulness

OBJECTIVE: To investigate the value of video laryngoscope in localization diagnosis of upper airway stricture in obstructive sleep apnea-hypopnea syndrome (OSAHS) during drug-induced sleep. METHOD: One hundred and thirty two patients with OSAHS were randomly divided into group A and B in this study. In group A, the patients were examined with video laryngoscope to locate the upper airway stricture under midazolam-induced sleep. In group B, the patients had conventional physical examination and video laryngoscope when awake. And the operation plans of both groups were made based on the localization diagnosis results. RESULT: In group A, 72.1% patients have several stricture levels and in group B only 33.8%. The patients was followed up time more than 6 months, and the cure rate, the excellent effective rate, and the total effective rate of group A were significantly higher than those in group B respectively (P<0.05). CONCLUSION Most patients of OSAHS have several stricture levels of upper airway under Midazolam- induced sleep. Localization diagnosis of upper airway stricture in patients with OSAHS with video laryngoscope before operation can improve the cure efficiency significantly.
Adult ; Female ; Humans ; Laryngoscopes ; Male ; Midazolam ; Middle Aged ; Sleep Apnea, Obstructive ; diagnosis