1.Association between congenital hypothyroidism and in-hospital adverse outcomes in very low birth weight infants
Sha ZHU ; Jing XU ; Ranran SHI ; Xiaokang WANG ; Maomao SUN ; Shina LI ; Lingling GAO ; Yuanyuan LI ; Huimin WEN ; Changliang ZHAO ; Shuai LI ; Juan JI ; Cuihong YANG ; Yonghui YU
Chinese Journal of Pediatrics 2024;62(1):29-35
Objective:To investigate the association between congenital hypothyroidism (CH) and the adverse outcomes during hospitalization in very low birth weight infants (VLBWI).Methods:This prospective, multicenter observational cohort study was conducted based on the data from the Sino-northern Neonatal Network (SNN). Data of 5 818 VLBWI with birth weight <1 500 g and gestational age between 24-<37 weeks that were admitted to the 37 neonatal intensive care units from January 1 st, 2019 to December 31 st, 2022 were collected and analyzed. Thyroid function was first screened at 7 to 10 days after birth, followed by weekly tests within the first 4 weeks, and retested at 36 weeks of corrected gestational age or before discharge. The VLBWI were assigned to the CH group or non-CH group. Chi-square test, Fisher exact probability method, Wilcoxon rank sum test, univariate and multivariate Logistic regression were used to analyze the relationship between CH and poor prognosis during hospitalization in VLBWI. Results:A total of 5 818 eligible VLBWI were enrolled, with 2 982 (51.3%) males and the gestational age of 30 (29, 31) weeks. The incidence of CH was 5.5% (319 VLBWI). Among the CH group, only 121 VLBWI (37.9%) were diagnosed at the first screening. Univariate Logistic regression analysis showed that CH was associated with increased incidence of extrauterine growth retardation (EUGR) ( OR=1.31(1.04-1.64), P<0.05) and retinopathy of prematurity (ROP) of stage Ⅲ and above ( OR=1.74(1.11-2.75), P<0.05). However, multivariate Logistic regression analysis showed no significant correlation between CH and EUGR, moderate to severe bronchopulmonary dysplasia, grade Ⅲ to Ⅳ intraventricular hemorrhage, neonatal necrotizing enterocolitis in stage Ⅱ or above, and ROP in stage Ⅲ or above ( OR=1.04 (0.81-1.33), 0.79 (0.54-1.15), 1.15 (0.58-2.26), 1.43 (0.81-2.53), 1.12 (0.70-1.80), all P>0.05). Conclusion:There is no significant correlation between CH and in-hospital adverse outcomes, possibly due to timely diagnosis and active replacement therapy.
2.Preoperative Adjacent Facet Joint Osteoarthritis Is Associated with the Incidence of Adjacent Segment Degeneration and Low Back Pain after Lumbar Interbody Fusion
Lixian TAN ; Xiaokang DU ; Runmin TANG ; Limin RONG ; Liangming ZHANG
Asian Spine Journal 2024;18(1):21-31
Methods:
The study included patients who underwent LIF. The demographic characteristics and radiographic and surgical data were collected and evaluated. The included patients were divided into control group and FJOA group based on the preoperative adjacent facet joint Pathria grade. Preoperative and last follow-up LBP Visual Analog Scale (VAS) score, leg pain (LP) VAS, Oswestry Disability Index (ODI) and RASD were evaluated and compared. The improvement rates in VAS and ODI were calculated and compared between the two groups. Logistic regression was used to analyze the risk factors of LBP relief and incidence of RASD.
Results:
In total, 197 patients (control group, 86; FJOA group, 111) were included, and the median follow-up was 46 months. The VAS and ODI in both groups significantly improved after surgery. At the last follow-up, the FJOA group had higher VAS and lower VAS improvement rates of LBP than the control group (p<0.05). However, no significant difference in the LP VAS and ODI was found between the two groups. The incidence of RASD in the FJOA group was significantly higher than that in the control group (48.6% vs. 30.2%, p=0.034). Multivariate logistic regression analysis showed that preoperative adjacent FJOA was significantly associated with LBP relief (odds ratio [OR], 0.691; 95% confidence interval [CI], 0.498–0.958) and the postoperative incidence of RASD (OR, 1.406; 95% CI, 1.020–1.939).
Conclusions
The preoperative FJOA in the adjacent segments was significantly associated with LBP following LIF. Patients with preoperative FJOA were more likely to have RASD following lumbar fusion surgery.
3.A diabetic foot classification model based on radiomics features of fundus photographs
Ying LI ; Yijuan HUANG ; Xiaokang LIANG ; Zhentai LU ; Dan SUN ; Fang GAO ; Yaoming XUE ; Ying CAO
Chinese Journal of Endocrinology and Metabolism 2023;39(2):103-111
Objective:To construct a diabetic foot classification prediction model based on radiomics features of fundus photographs.Methods:A total of 2 035 fundus photographs of patients with type 2 diabetes diagnosed at Nanfang Hospital between December 2011 and December 2018 were retrospectively collected [282 photographs from patients with diabetic foot(DF), and 1 753 from patients with diabetes mellitus(DM)]. All fundus photographs were randomly divided into a training set(1 424 photos) and a test set(611 photos) using a computer generated random number at 7∶3. After pre-processing the fundus photographs, a total of 4 128 texture features based on the gray matrix were extracted by the Radiomic toolkit, and 11 339 other features were extracted using the ToolboxDESC toolkit. The LASSO algorithm was used to select the 30 features most relevant to DF, and then the Bootstrap + 0.632 self-sampling method was used to further select the 7 best combinations. Logistic regression analysis was used to obtain the regression coefficients and establish the final diabetic foot classification prediction model. ROC curve was drawn, and AUC, sensitivity, specificity, and accuracy of the training and test sets were calculated to verify its prediction performance. Results:We screened 7 fundus radiomics markers for diabetic foot patients, and based on this established a DF/DM classification prediction model. The AUC, sensitivity, specificity, and accuracy of the model were 0.958 6, 0.984 0, 0.920 0, and 0.928 0 in the training set, and 0.927 1, 0.988 9, 0.881 0, and 0.896 9 in the test set, respectively.Conclusion:In this study, seven DF fundus markers were screened using radiomics technology. Based on this, a highly accurate and easy-to-use DF/DM classification model was constructed. This technology has the potential to increase the efficiency of DF screening programs.
4.Clinical analysis of single mediastinal chest drains in perioperative period after thoracoscopic resection of esophageal carcinoma: A randomized controlled study
TAN Cheng ; WEN Zhi ; SUN Xiaokang
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2019;26(12):1228-1232
Objective To compare the clinical effect of single mediastinal drainage tube and both mediastinal drainage tube and closed thoracic drainage tube for the patients who received thoracoscopic radical resection of esophageal carcinoma. Methods We enrolled 96 esophageal carcinoma patients who received thoracoscopic radical resection from June 2016 to October 2018. Of them, 49 patients were indwelt with both mediastinal drainage tube and closed thoracic drainage tube (a chest & mediastinal drainage group, a CMD group) while the other 47 patients were indwelt with single mediastinal drainage tube (a single mediastinal drainage group, a SMD group). The total drainage volume, intubation time and incidence of postoperative complications (postoperative atelectasis, pulmonary infection, pleural effusion and anastomotic leakage) between the two groups were compared. The pain score and comfort score were also compared between the two groups. Results The total drainage volume and intubation time in the SMD group were not significantly different from those in the CMD group (1 321±421 mL vs. 1 204±545 mL, P=0.541; 6.1±3.7 d vs. 6.4 ±5.1 d, P=0.321). The incidence of postoperative complications (postoperative atelectasis, pulmonary infection, pleural effusion and anastomotic leakage) in the SMD group was not significantly different from that in the CMD group (10.6% vs. 6.1%, P=0.712; 4.3% vs. 10.2%, P=0.656; 6.4% vs. 12.2%, P=0.121; 2.1% vs. 4.1%, P=0.526). The numerical rating scale (NRS) pain scores on the first to the fifth day after surgery and during extubation in the SMD group were significantly lower than those in the CMD group (3.2±2.1 vs. 5.1±2.4, P=0.041; 2.8±0.6 vs. 4.8±1.4, P=0.015; 2.1±0.4 vs. 4.5±0.4, P=0.019; 1.7±0.7 vs. 4.0±0.8, P=0.004; 1.8±0.7 vs. 3.2±1.2, P=0.006; 1.4±0.2 vs. 2.5±3.4, P=0.012). The VAS comfort scores in the SMD group were significantly lower than those in the CMD group (3.6±1.7 vs. 6.6±3.7, P=0.018; 2.9±2.0 vs. 5.1±3.4, P=0.007; 2.1±1.4 vs. 5.5±2.4, P=0.004; 3.0±0.9 vs. 4.6±3.8, P=0.012; 1.8±1.1 vs. 4.2±2.7, P=0.003; 2.4±3.2 vs. 5.3±1.7, P=0.020). Conclusion The clinical effect of single mediastinal drainage tube in thoracoscopic resection of esophageal carcinoma is similar to that of both mediastinal drainage tube and closed thoracic drainage tube, but it can significantly improve the comfort of the patients.
5.Analysis on epidemiology and clinical characteristics of 3431 pediatric patients with measles
Binghu SUN ; Xiaokang WANG ; Zhiliang HU ; Cong CHENG ; Yun CHI ; Hongxia WEI
Journal of Clinical Pediatrics 2017;35(8):589-591
Objective To analyze the epidemiology and clinical characteristics of the children with measles. Methods Retro-spectively analyzed methods were applied to analyze the timing, and season of the break, age distribution, clinical manifestations and major complications of 3431 children with measles (<12 years) in the Second Hospital of Nanjing from 2008 to 2015. Results It found that there was a peak incidence of measles in children each in 2009, 2013, and 2015 , peaking in March to May. Onset age of measles mainly within the first year of life, and incidence increased with age within the first 8 months. Typical clinical manifestations are mainly fever, rash, cough, and catarrhal symptoms. The main complications of measles were pneumonia, laryngitis and heart failure. Conclusions Early diagnosis and effective treatment of the children with measles needs to be strengthened.
6.A New Era of Mobile Health: Mode and Application of Connected Health
Xiaolei XIU ; Sizhu WU ; Xiaokang SUN ; Qing QIAN
Journal of Medical Informatics 2017;38(6):1-6
Based on the social background of increasingly serious aging of the population and the growth of chronic diseases,the paper introduces the mode of Connected Health (cHealth),analyzes the differences between cHealth and Mobile Health (mHealth) as well as the advantages of cHealth,introduces the application of cHealth in contemporary society,and discusses the challenges of cHealth,including the optimization of sensing strategy,creation of data integration,analysis on the new mode,optimization of feedback strategy and development of new health insurance modes.
7.Effect of low-frequency electroacupuncture on pancreatic endocrine system in patients with simple obesity
Fei GAO ; Xiaokang XU ; Yulei LIANG ; Zhongqiu WU ; Xiaoxue SUN ; Xiaofeng LI ; Xiaoyi DU ; Jie ZHU ; Xiaohong ZHOU ; Lihong SUN ; Lili WANG
Journal of Acupuncture and Tuina Science 2017;15(3):209-213
Objective:To observe different efficacies of low-frequency electroacupuncture (EA) on pancreatic endocrine system in male and female patients with simple obesity due to spleen deficiency-related dampness.Methods:A total of 80 simple obesity patients were assigned to a male group (n=37) and a female group (n=43). Both groups received a 30-minute low-frequency EA at Yinlingquan (SP 9), Sanyinjiao (SP 6), Zusanli (ST 36), Fenglong (ST 40), Quchi (LI 11), Tianshu (ST 25), Zhongwan (CV 12), Shuifen (CV 9), Qihai (CV 6) and Guanyuan (CV 4). The treatment was done once a day, and 10 times made up a course of treatment. Patients in both groups were treated for 2 courses. Then the changes in body mass index (BMI), serum insulin, insulin antibodies and leptin level in the two groups were observed and analyzed.Results:After treatment, the BMI, serum insulin, insulin antibodies and leptin levels were significantly reduced in both groups (P<0.01 orP<0.05); the BMI and serum insulin concentration were more significantly reduced in the male group than those in the female group (bothP<0.01); and the leptin level was more significantly reduced in the female group than that in the male group (P<0.01).Conclusion: EA can significantly regulate BMI and pancreatic endocrine system in both men and women with simple obesity; however, there is a gender difference: better effect for men in reducing BMI and serum insulin and better effect for women in reducing serum leptin level.
8.Control observation between mild moxibustion and TDP for obsolete collateral ligament injury of interphalangeal joints.
Yulei LIANG ; Weihua LI ; Xiaokang XU ; Chenguang DING ; Ling TIAN ; Jiaqiang DUAN ; Zhifang ZHANG ; Lihong SUN
Chinese Acupuncture & Moxibustion 2016;36(1):21-24
OBJECTIVETo compare the effects between mild moxibustion and specific electromagnetic spectrum therapy apparatus (TDP) for obsolete collateral ligament injury of interphalangeal joints.
METHODSSixty patients were randomly divided into a mild moxibustion group and a TDP group, 30 cases in each one. In the mild moxibustion group, pure moxa sticks were used at the affected digital joints locally for 20-30 min a time. In the TDP group, TDP was applied at the affected digital joints locally for 20-30 min a time. The treatment was given once a day for two courses, and 10-day treatment was made into a course. Visual analogue scale (VAS) for pain, swelling degree of the affected digital joints before and after treatment were observed and the clinical efficacy and safety were evaluated in the two groups.
RESULTSThe excellent rate was 56.7% (17/30) and the excellent and, good rate was 83.4% (25/30) in the mild moxibustion group,which were better than 36.7% (11/30) and 76.7% (23/30) in the TDP group respectively (both P < 0.01). After treatment the score of VAS and digital joints swelling degree were improved than those before treatment in the two groups (P < 0.01, P < 0.05), and the improvements of the mild moxibustion group were better than those of the TDP group (P < 0.01, P < 0.05).
CONCLUSIONMild moxibustion can apparently relieve the painful and swelling degree of obsolete collateral ligament injury of interphalangeal joints, which is superior to TDP.
Acupuncture Points ; Adolescent ; Adult ; Collateral Ligaments ; injuries ; Electromagnetic Radiation ; Female ; Humans ; Joint Diseases ; therapy ; Magnetic Field Therapy ; Male ; Moxibustion ; Pain Measurement ; Young Adult
9.Present situation and development direction of microacupuncture therapy.
Xiaofeng LI ; Yanhui SUN ; Xiaokang XU ; Xin ZHANG ; Xuanping ZHANG ; Du YUZHU ; Chunsheng JIA
Chinese Acupuncture & Moxibustion 2016;36(5):557-560
There have been many reports of clinical and experimental researches of microacupuncture therapy, the relevant systematic works, teaching materials and national standards in recent decades. It shows that microacupuncture system has been formed and its influence has been promoted. While the rapid development of microacupuncture therapy, there are the problems and contradictions on nomenclature, explanation of theoretical basis, optimal indications, and multiple systems and schools, etc. All the above have blocked the clinical application and development. It is considered that we need to unify the nomenclature, condense the theoretical basis, clear the optimal indications, promote the exchange and blend among different schools and sum up the outcomes by systematic review and data mining technique.
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10.Spatial distribution of integrated comparative advantages in domestic pharmaceutical manufacturing industry
Xiaokang SUN ; Qing QIAN ; Sizhu WU ; Ze ZHANG ; Xiaolin HE ; Wei WANG
Chinese Journal of Medical Library and Information Science 2016;25(8):42-47
The index system of comparative advantages was constructed for the pharmaceutical manufacturing in-dustry in different provinces , municipalities directly under the Central Government , and autonomous regions ac-cording to the integrated comparative advantage theory .The integrated comparative advantages in different provinces , municipalities directly under the Central Government , and autonomous regions were scored by principal component analysis and qualitatively analyzed by clustering analysis to reveal their spatial distribution , thus providing the deci-sion-making support for the policy makers, manufacturers, investors and staff of pharmaceutical manufacturing in-dustry.

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