Objective To analyze death causes and relevant factors in victims of Wenchuan earthquake．Methods Medical records of 27 dead patients admitted to W est China Hospital during the first 30 days after Wenchuan earthquake were analyzed retrospectively．Patient census data，diagnoses，dispositions，and prognoses were collected． Results A total of 2702 patients with earthquake related injuries were admitted to West China Hospital．The overall mortality rate was 1％(27／2702 patients)．The death were associated with age≥70．severe cerebral injuries and severe underlying illness．Mortality rate was highest in aged patients with comorbidities．Conclusions Insufficient pre-hospital treatment and inappropriate transfer procedure may contribute to the early death．Complicated with comorbidities is the leading cause of late death．Earlier involvement of intensivist in medical intervention in such a disaster is demanded．
Objective To analyze the clinical characteristics of the Guang’an Omicron epidemic and summarize the management experiences and practices in pandemic prevention and control of major infectious diseases.Methods Retrospective analysis was performed on patients infected with coronavirus disease (COVID-19), afterwards treated and observed in the isolation ward of Guang’an People’s Hospital and the shelter of Guang’an City from May 9 to June 26, 2022. The characteristics of patients at different age stages and the related factors affecting the severity, re-positive and negative conversion was analyzed. Results Finally 1 278 patients were collected, including 508 males and 770 females, with an average age of 41.3±22.6 years. Among them, 1 054 patients were asymptomatic carriers. The overall severe rate was 0.86%, the severe rate of the high-risk group was 3.06%. The median negative conversion time was 10.0 days and re-positive rate was 7.36%. Patients aged＞60 years were 2.589 times more likely to have a longer negative conversion time than those aged≤60 years (95%CI 1.921-3.489, P＜0.001). Conclusion The clinical characteristics of Guang’an COVID-19 epidemic are mainly that the elderly with high risk factors are more likely to develop severe cases, have longer clearance time, and re-positve is more likely to occur.
ObjectiveTo analyze the relation between age and postoperative pathological features of patients with colorectal cancer from Database from Colorectal Cancerr （DACCA）. MethodsThe data in DACCA were updated on January 5, 2022. The patients were selected from DACCA according to the established screening conditions, then were divided into ≤35, 35–59, and ≥60 years old groups. The differences of postoperative pathological （p） TNM （pTNM）, pT, pN, pM stages, perineural invasion （PNI）, high-risk factors grade, and tumor regression grade （TRG） among the three age groups were analyzed, and the correlation between them was analyzed. ResultsAfter screening, 5 628 data rows were enrolled, of whom 196 patients were <35 years old, 2 382 patients were 35–59 years old, and 3 050 patients were >59 years old. Statistical analysis showed that: ① There were statistical differences in the proportions of pN stage, PNI, and high-risk factors grade in the patients of different age groups （H=27.867, P<0.001; H=6.248, P=0.044; H=19.712, P<0.001, respectively）; However, it was not found that there were statistical differences in the proportions of pTNM, pT, pM stages, and TRG after neoadjuvant therapy among different age patients （H=0.920, P=0.631; H=4.923, P=0.085; H=2.272, P=0.321; H=2.337, P=0.311, respectively）. The Spearman correlation analysis results showed that there was a weakly negative correlation between the age and pN stage or grade of high-risk factors （rs=–0.070, P<0.001; rs=–0.067, P<0.001, respectively） and a weakly positive correlation between age and TRG after neoadjuvant therapy （rs=0.100, P=0.009）. ConclusionDACCA data analysis finds that patients of different age groups shows a negative correlation trend with pN stage or grade of high-risk factors and a positive correlation trend with TRG, which needs to be further verified.
【摘要】 目的 探討腹部非胃、十二指腸手術后胃癱綜合征（postoperative gastroparesis syndrome，PGS）發生的高危因素。 方法 回顧分析2004年9月-2010年3月2 559例腹部非胃、十二指腸術后患者的臨床資料，將患者分為PGS組和非PGS組，其中PGS組23例，非PGS組2 536例。 結果 比較PGS組和非PGS組間年齡、性別、術后開始進食時間、手術持續時間、是否為腫瘤晚期、有無貧血低蛋白血癥、既往有無腹部手術史、術后早期有無營養支持等因素，χ2值分別為:19.687、0.018、0.346、48.243、21.801、16.803、24.679、0.870，P值分別是:lt;0.01、gt;0.05、gt;0.05、lt;0.01、lt;0.01、lt;0.01、lt;0.01、gt;0.05。 結論 年齡gt;65歲、手術持續時間gt;4 h、腫瘤晚期、既往有腹部手術史及貧血低蛋白血癥是腹部非胃、十二指腸手術后PGS發生的高危因素。【Abstract】 Objective To analyze the risk factors of postoperative gastroparesis syndrome (PGS) after non-gastroduodenal abdominal surgery. Methods We retrospectively analyzed the clinical data of 2 559 patients who underwent non-gastroduodenal abdominal surgeries in our hospital between September 2004 and March 2010. We divided them into the PGS group with 23 patients and the non-PGS group with 2 536 patients. Results By comparing the age, the gender, the starting time of eating after surgery, the duration of surgery, whether the patients had advanced cancer, whether anemia or hypoproteinemia existed, whether the patients had a history of previous abdominal surgery, and whether nutritional support was provided early after operation between the PGS group and the non-PGS group, we found that the chi-square value was 19.687, 0.018, 0.346, 48.243, 21.801, 16.803, 24.679, 0.870 and the P value waslt;0.01, gt;0.05, gt;0.05, lt;0.01, lt;0.01, lt;0.01, lt;0.01, gt;0.05 respectively. Conclusion Over 65 years of age, the duration of surgery over four hours, advanced cancer, the history of previous abdominal surgery and anemia or hypoproteinemia are the risk factors of PGS after non-gastroduodenal abdominal surgery.
ObjectiveTo analyze the relation between ABO blood type and postoperative pathological features of patients with colorectal cancer served by West China Hospital of Sichuan University as a regional center in the current version of Database from Colorectal Cancer (DACCA). MethodsThe data of DACCA was updated on January 5, 2022. According to the screening conditions, the enrolled patients with colorectal cancer were divided into blood type A, B, AB, and O. The differences in the postoperative pathological characteristics of patients with different blood types, such as pathological TNM, T, N, M (pTNM, pT, pN, pM) staging, peripheral nerve involvement, high risk factors, tumor regression grade (TRG), and cancer nodules, were analyzed. ResultsAfter screening, 6 089 data rows were analyzed. The patients involved 2 058 blood type A, 1 469 blood type B, 494 blood type AB, and 2 068 blood type O. The results of statistical analysis showed that: ① There were statistical differences in the overall distribution of pTNM and pM stages among the patients with different blood types (H=11.564, P=0.009; H=7.947, P=0.047), which was reflected in: from the overall distribution trend, the proportion of patients with the four blood types in the same stage was similar, but it could still be seen that patients with blood type AB accounted for the highest proportion in the patients with stage Ⅲ, Ⅳ, M1a, M1b as compared with other blood types. ② There were no statistical differences in the overall distribution of peripheral nerve involvement and TRG in the patients with different blood types (H=3.414, P=0.332; H=1.143, P=0.767). ③ There was statistical difference in the proportion of different grades of high risk factors in the patients with different blood types (H=14.540, P=0.002). Specifically, the proportions of patients with grade 3–5 of high risk factors in the patients with AB blood type were the highest. ④ There was no statistical difference in the proportion of the grade of cancer nodules number in patients with different blood types (H=4.460, P=0.216). ConclusionsFrom results of this study, it is found that there are some differences in pTNM stage, pM stage, and high risk factors of colorectal cancer patients with different blood types, but no differences in pT stage, pN stage, peripheral nerve involvement, TRG, and cancer nodules among different blood types of patients. The influence of blood type on postoperative pathological characteristics of colorectal cancer patients needs to be further explored.
Objective To study effects of mitral valve replacement(MVR) on the old with mitral valve diseases(MVD). Methods The documents of 265 cases undergoing MVR were reviewed, who aged 60 years old or over between June 1991 and June 2003. Demographices, clinical preoperative conditions, indications to surgery, early postoperative course and long-term outcome were collected via hospital documents and outpatient follow-up. Many risk factors were analysed. Results Follow-up rate amounted to 93.7%(236/252). The mortality was 4.9% (13/265) within 30 days. Heart failure and renal failure were the main cause of death. Compared with younger patients(lt;60 years old), long-term survival rate was lower in the old, 5-year 87.52% vs 96.84%, 10-year 81.23% vs 94.87%. There were 15 late deaths(0.17% case/M), most of whom died of heart failure, cancers and lung infections. Risk factors for MVR in the old included New York Heart Association class Ⅳ, diabetes, and lung incompetence. Conclusions The patients with MVD over 60 years old tended to present high postoperatively mortality and morbidity.
ObjectiveTo summarize the research progress of correlation between pancreatic cancer and diabetes mellitus.MethodsRecent studies on the association between pancreatic cancer and diabetes mellitus were extensively reviewed, and relevant research results on the association between pancreatic cancer and diabetes mellitus were reviewed.ResultsPancreatic cancer had a particular association with diabetes. Patients with pancreatic cancer may develop new diabetes or worsen existing diabetes mellitus. About 50% of patients with pancreatic cancer had diabetes mellitus before diagnosis, suggesting a “dual causal relationship” between pancreatic cancer and diabetes mellitus. Long-term type 2 diabetes mellitus (T2DM) was one of the high risk factors for the occurrence and development of pancreatic cancer. T2DM may also increase the risk of pancreatic cancer due to hyperinsulinemia, adipokine, and other factors. Pancreatic cancer was one of the cause of diabetes mellitus at the same time, but its mechanism was not yet known, also needed to get a lot of information to understand the impact of long-term diabetes mellitus on the development of pancreatic cancer, as well as the reason of pancreatic cancer related to diabetes mellitus mechanism.ConclusionThe clear relationship between pancreatic cancer and diabetes mellitus has not been proved, and further research is needed to clarify the relationship between them.
ObjectiveTo explore risk factors of pneumonia of patients after esophagectomy and its preventive measures. MethodsClinical data of 258 patients undergoing esophagectomy in Guangyuan Central Hospital between 2009 and 2012 were retrospectively analyzed. According to whether they had pneumonia after esophagectomy, all the 258 patients were divided into 2 groups. In the pneumonia group, there were 86 patients including 62 males and 24 females with their age of 65.1 (45-84)years, who all had pneumonia after esophagectomy. In the control group, there were 172 patients including 124 males and 48 females with their age of 60.2 (43-78)years, who didn't have pneumonia after esophagectomy. Preoperative pulmonary function, age, smoking history, anastomotic location, intraoperative blood loss, pneumonia and other perioperative complications were compared between the 2 groups. Multivariate logistic regression was performed to analyze risk factors of pneumonia after esophagectomy. ResultsUnivariate analysis showed that incidences of moderate or severe pulmonary dysfunction, smoking history (≥400 cigarettes per year), old age (≥65 years), laryngeal recurrent nerve injury, perioperative blood loss (≥1 000 ml), operation time longer than 4 hours, and preoperative diabetes mellitus of the pneumonia group were significantly higher than those of the control group (P < 0.05). Multivariate logistic regression analysis showed that moderate or severe pulmonary dysfunction (P=0.022), smoking history (≥400 cigarettes per year, P=0.000), old age (≥65 years, P=0.026), laryngeal recurrent nerve injury (P=0.002), and perioperative blood loss (≥1000 ml, P=0.020)were main risk factors of pneumonia after esophagectomy. ConclusionsModerate or severe pulmonary dysfunction, smoking history (≥400 cigarettes per year), old age (≥65 years), laryngeal recurrent nerve injury and perioperative blood loss (≥1 000 ml)are main risk factors of pneumonia after esophagectomy. Preoperative smoking cessation, pulmonary function exercise, airway preparation, careful hemostasis, and avoidance of laryngeal recurrent nerve injury are helpful to prevent pneumonia after esophagectomy.