Objective To study the neural mechanism of hypotension or shock state in acute cholangitis in severe type (ACST) and its value of clinical application. Methods A technique of blocking abdominal splanchnic nervi via right adipose capsule of kidney was carried out on 28 patients by injecting 1% lidocaine before urgent operation. Results After blocking the relevant nervi, hypotension or shock state in 23 patients were improved significantly (Ｐ＜0.05). The death rate was lower (14.3%) after having performed biliary decompressions with laparotomy. Conclusion Patients′ hypotension or shock state at the early phase of ACST is the result of neural reflex in which the splanchnic nervi is its afferent pathway. Blocking the relevant nervi before urgent operation, the valuable opportunity of emergency treatment can be obtainded and the complication and death rate are reduced significantly.
Objective To analyze the death cause of residents in Zigong from 1985 to 2009, so as to provide the government with scientific information of health strategies, and disease prevention and control. Methods The death surveillance data in Zigong residents from 1985 to 2009 were collected, and the indexes such as all death mortality rate, infant mortality rate, maternal mortality rate, disease-specific mortality rate, age-specific mortality rate, and life expectancy were analyzed. Results The all death mortality rate had fluctuation of plus or minus 6‰, and the male mortality rate was higher than the female (χ2=8 059.769, P=0.000). The six main influencing factors of the death of Zigong residents were as follows: respiratory system diseases, circulatory system diseases, tumour, injury and poisoning regarded as external cause diseases, digestive system diseases, and infectious diseases and parasitic diseases. The mortality rates of different districts were statistically different (χ2=1 643.926, P=0.000), and Fushun County was the highest among them after standardization. The curve of mortality rate in different sex and age groups was changed alike letter “U”. The mortality rate was ascending with the age in the group of over 15 years old, the ascending trend was more evident especially after 50 years old. The infant mortality declined steadily and was well controlled. The maternal mortality declined obviously. The average life expectancy for the whole city was 74.72, which showed an ascending trend. Conclusion The chronic diseases are the main death cause of residents in Zigong. The prevention and controlling of acute infectious diseases and parasitic diseases should be persistently performed for declining both incidence rate and mortality rate. The Zigong city is gradually stepping into aging society, which requires the great development of senior work.
Objective To access and identify risk factors related to death and injuries in earthquakes. Method We searched The Cochrane Library, SCI, PubMed, CBM and CNKI from establishment to June 2008 to identify cohort, case-control and cross-sectional studies involving risk factors related to death and injuries in earthquakes. The methodological quality of included cohort and case-controlled studies were assessed, and the potential risk factors of earthquake related death and injuries were systematically enumerated. Results Two cohort, 2 case-control and 4 cross-sectional studies were included. Some included studies might be associated with selection bias. Risk factors for earthquake death and injuries included age, gender, mental disease, physical disabled, socioeconomics status, type/ age/ height/ collapse of building, motor vehicle driver and geographical location when the earthquake occurred. Conclusions Death and injuries in earthquakes may be attributed to 3 categories: demographic characteristics, building features, and seismic/ geographical/ location factors. However, the conclusion of this review and its implications may be limited by the potential selection bias of included studies and the regional characteristics of the included populations. Original studies from Chinese seismic areas are especially needed.
ObjectiveTo study the survival rate and death cause of patients with polymyositis (PM) and dermatomyositis (DM). MethodsBased on the Bohan and Peter diagnosis standard, DM (n=52) and PM (n=98) hospitalized patients between January 1, 2008 and January 1, 2013 were chosen to be followed up to January 2013, or to their death. Sex, age, disease entities, course of the disease, muscle creatine enzyme, interstitial lung disease, connective tissue diseases, lung infection, cardiac involvement, respiratory muscle paralysis, JO-1 antibody, hypoalbuminemia, tumor, and long-term hormone and immune inhibitor treatment were the influencing factors of death. ResultsThirty-eight patients died during the follow-up period, and the 1-, 3- and 5-year survival rate were 87.7%, 74.5% and 55.9% respectively. Cox regression analysis showed that interstitial pneumonia (RR=12.119, P=0.001), heart disease (RR=2.935, P=0.020) and tumor (RR=3.735, P=0.048) were the unfavorable factors of death, while long-term hormones (RR=0.329, P=0.024) and persistent immunosuppressant therapy (RR=0.148, P=0.022) were protective factors. ConclusionThe five-year survival rate of patients with PM/DM is still low, and pulmonary interstitial disease, tumor, cardiac involvement, and pulmonary infection are the major dead causes, while long-team immunosuppression and hormone therapy can decrease the PM/DM mortality.
Objective To investigate the effect of machine-enzyme digestion method on the residual quantity of small intestinal submucosa (SIS) cell and the content of growth factors. Methods Fresh jejunum of pig within 4 hours after harvesting was prepared into SIS after machine digestion (removing placenta percreta, mucosa, and muscular layer), degrease,trypsinization, abstergent processing, and freeze drying. Samples were kept after every preparation step serving as groups A, B, C, D, and E, respectively (n=4 per group). And the fresh jejunum served as control group (group F, n=4). The histological alteration in each preparation process was reviewed with HE staining and scanning electron microscope (SEM). Nest-polymerase chain reaction (PCR) was used to determine the content of death associated protein 12 (DAP12), and enzyme-linked immunosorbent assay (ELISA) was appl ied to detect the content of vascular endothel ial growth factor (VEGF), basic fibroblast growth factor (bFGF), transforming growth factor β (TGF-β), tumor necrosis factor α (TNF-α). Results HE staining and SEM observation showed that there were residual cells in groups A and B, and there were no residual cells in groups C, D, and E. Nest-PCR test revealed the occurrence of DAP12 in each group. The contents of DAP12 in groups A, B, C, D, E, and F were (18.01 ± 9.53), (11.87 ± 2.35), (0.59 ± 0.27), (0.29 ± 0.05), (0.19 ± 0.04), and (183.50 ± 120.13) copy × 106/cm2. The content of DAP12 in group F was significant higher than that of other groups (P lt; 0.05), groups A and B was higher than groups C, D, and E (P lt; 0.05), there were significantdifferences among groups C, D, and E (P lt; 0.05), and there was no significant difference between groups A and B (P gt; 0.05). The ELISA test showed the content of VEGF, bFGF, TGF-β, and TNF-α in group A was significantly higher than that of groups B, C, D, and E (P lt; 0.05), and there was no significant difference among groups B, C, D, and E (P gt; 0.05). Conclusion SIS prepared by simple mechanical method has more residual cells, while the machine-enzyme digestion method can effectively remove the cells and significantly reduce the DAP12 content. This approach can not obviously reduce the growth factor content in SIS.
ObjectiveTo investigate the high-risk factors for death in infants with severe pneumonia. MethodsWe analyzed hospitalized infants and young children diagnosed with severe pneumonia from January 2011 to December 2013, and investigated the risk factors for death. ResultsA total of 1 411 infants with severe pneumonia were included in the analysis. The mortality rate was 3.12%. In single factor analysis, the following factors were significant:age, severe infection, artificial feeding, congenital heart diseases, bad habitation, repeated infection history, surgical history, multi-organ dysfunction, internal environment disorder, multiple drug-resistant strains infection. The results of Logistic multiple regression analysis showed that there were statistical significance in severe infection, repeated infection history, Multiple drug-resistant strains infection, multi-organ dysfunction, and internal environment disorder. ConclusionInfants with severe pneumonia should be intensively monitored and actively treated for reducing the mortality rate if they have one of the following high-risk factors:age, congenital heart diseases, repeated infection history, multiple drug-resistant strains infection, surgical history, multi-organ dysfunction, and internal environment disorder.
Objective To explore the association between plasma IgG and acute exacerbation (AE) or death risk in patients with chronic obstructive pulmonary disease (COPD). Methods A total of 262 COPD patients treated in our hospital from February 2018 to February 2020 were recruited in our study. All patients were divided into AE≥2 group and AE≤1 group according to AE frequency during follow-up of 1 year. Basic data and laboratory data such as IgG, IgA and IgM of two groups were comparatively analyzed. Univariate analysis and COX regression were performed to analyze the related factors of frequency of AE≥2 times in 1 year. Depicting restricted cubic spline was performed to analyze the relation between IgG and AE by R software. All patients were also divided into high IgG group, low IgG group, high IgA group and low IgA group based on median of patients’ baseline plasma IgG and IgA level, depicting survival curve by Kaplan-Meier to analyse differences between the groups with different IgG or IgA level in the risk of AE and death respectively. ResultsFinally, there were 14 patients lost to follow-up and 248 cases were included (AE≤1 group contained 154 cases, AE≥2 group contained 94 cases) until February 28, 2021. Age and COPD Assessment Test (CAT) scores in the AE≥2 group were higher than those in the AE≤1 group; Albumin, IgG and IgA level in the AE≥2 group were lower than those in the AE≤1 group; Neutrophil to lymphocyte ratio (NLR) in the AE≥2 group was higher than that in the AE≤1 group (all P<0.05). There were 99 and 114 cases of AE in the high IgG and low IgG groups respectively within 1 year. Kaplan Meier survival analysis showed that risk of AE in the high IgG group and high IgA group were lower than that in the low IgG group and the low IgA group (log rank χ2=23.791, 67.153, both P=0.000). Risk of death in the high IgG group was lower than that in the low IgG group (log rank χ2=6.214, P=0.013), there was no statistically difference in the risk of death in the high IgA group compared to the low IgA group (log rank χ2=2.400, P=0.121). Multivariate Cox regression analysis showed that CAT score (HR=1.096, P=0.001) and NLR (HR=2.061, P=0.000) were independent risk factors of frequency of AE≥2 times in 1 year for COPD patients, albumin (HR=0.921, P=0.006) and IgG (HR=0.572, P=0.000）were the independent protective factors. Restricted cubic spline analysis showed that combining the COX regression model, after adjusting for IgA, albumin, NLR and other variables, there was non-linear relationship between IgG level and AE (P=0.000).Conclusion Plasma IgG level is related to AE in COPD patients, and may become a reliable predictor of acute exacerbation risk in the future.
Objective To investigate the causes of death and evaluation of injury severity in patients with thoracic trauma so as to enhance the diagnosis and treatment of thoracic trauma. Methods A retrospective study was carried out in 687 patients with thoracic trauma, which were divided into different groups according to their condition of injury (chest injury group and multiple injuries group) and outcome (survival group and death group) and penetrating into pleural cavity (penetrating injury group and blunt trauma group), then trauma scores(revised trauma score,abbreviated injury scale,injury severity score,probability of survival)were compared respectively. In addition, the highrisk causes of trauma death were analyzed. Results Among 687 cases, there are 488 cases with blunt trauma and 199 cases with penetrating injury. The causes of trauma death in blunt trauma group were brain injury (10 cases) and acute respiratory failure (6 cases) and multiple organ dysfunction syndrome (4 cases) and hypovolemic shock (1 case). The causes of trauma death in penetrating trauma group were hypovolemic shock (9 cases). There were statistically difference of trauma score in the death group and the survival group（GCS：t=4.648,P=0.000; RTS:t=4.382,P=0.000;thoracic AIS：t=2.296,P=0.027;ISS：t=4.871，P=0.000; Ps：t=4.254,P=0.000）. There was no statistically difference of thoracic AIS in the chest injury group and the multiple injuries group (t=0.723, P=34.567), and there were statistical significances in RTS（t=2.553,P=0.032）, ISS（t=10.776,P=0.000）, Ps（t=3.868,P=0.007）. There were statistically difference of RTS（t=3.161,P=0.007）and ISS （t=4.118,P=0.005） in the blunt trauma survival group and penetrating injury survival group, and there was no statistical significance in Ps（t=0.857,P=97.453）. The blunt trauma death group had statistical difference compared with penetrating injury death group in trauma score（GCS：t=4.016,P=0.001，RTS:t=3.168,P=0.006;thoracic AIS：t=2.303, P=0.043;ISS：t=4.218,P=0.002;Ps：t=4.624,P=0.001）. The mortality of trauma was gradually increased with the trauma scores. The mortality was 10.7% when whole ISS was 20.25. The mortality in penetrating injury group was higher than that in blunt trauma group with the same ISS between two groups. Conclusion Applying trauma score is conducive to the judgement of trauma severity and optimizing clinical treatment. The death causes in blunt trauma group were more complex than in penetrating injury group. Severe trauma and multiple injuries are the main death causes of thoracic trauma.
Objective To identify the key influencing factors of death anxiety in rural elderly and their mechanisms of action. Methods A total of 701 rural elderly individuals from 6 prefecture-level cities (prefectures) in Sichuan Province were selected for a questionnaire survey on death anxiety, health-related physical fitness, and subjective well-being. A structural equation model was constructed to thoroughly analyze the influencing factors of death anxiety and their mechanisms of action. Results Higher levels of health-related physical fitness, higher levels of subjective well-being, and having more children were the top three protective factors against death anxiety among elderly people in rural Sichuan, with effect values of ?0.392, ?0.287, and ?0.154, respectively. In contrast, suffering from chronic diseases was the leading risk factor for death anxiety, with an effect value of 0.127. Suffering from chronic diseases was the leading risk factor for death anxiety, with an effect value of 0.127. The structural equation model fitting results showed that the medical insurance type of rural elderly in Sichuan (β=?0.062, P=0.002), suffering from chronic diseases (β=0.127, P=0.001), hospitalization due to health reasons in the past year (β=0.086, P=0.002), and educational level (β=?0.067, P=0.001) had indirect effects on death anxiety through health-related physical fitness. Not seeking medical treatment due to financial difficulties in the past year had an indirect effect on death anxiety through subjective well-being (β=0.060, P=0.002). The number of children had both a direct effect on death anxiety (β=?0.119, P=0.004) and an indirect effect through subjective well-being (β=?0.034, P=0.001). Health-related physical fitness had both a direct effect on death anxiety (β=?0.278, P=0.001) and an indirect effect through subjective well-being (β=?0.114, P=0.002). Conclusion Multiple factors directly or indirectly affect the level of death anxiety in the rural elderly population. Health-related physical fitness, subjective well-being, and the number of children are important protective factors. Moreover, health-related physical fitness and subjective well-being act as mediating variables in the chain of effects of multiple factors on death anxiety.
Objective To analyze the death constitution of inpatients in The Tibet Autonomous Region People's Hospital from 2014 to 2015 and to provide baseline data for further rational drug use. Methods The medical records of death inpatients between 2014 and 2015 were collected. We classified all diseases according to the international classification of diseases coding (ICD-10) and analyzed the general situation, main death discharge diagnosis and single death diseases. Distribution of inpatients frequency, constituent ratio, cumulative frequency of death diseases were calculated by EXCEL 2007 software. Results (1) A total of 40 147 patients were discharged and 339 (8.44‰) inpatients died between 2014 and 2015. The sex ratio of male to female was 2.08 to 1 for death inpatients. (2) Death constitution of four diseases' categories were over 10%, including circulatory system diseases, exogenous injury or poisoning system diseases, respiratory system diseases, and digestive system diseases. (3) Death constitution of 3 diseases' categories were between 5% to 10%, including tumor, abnormal signs and symptoms, urogenital system diseases. (4) The main death cause single diseases were cerebral hemorrhage diseases, myocardial infarction, respiratory failure, damage, pneumonia, cancer, neonatal hypoxic-ischemic encephalopathy. Conclusion The main death inpatients of the Tibet Autonomous Region People's Hospital are of the age 25 to 59, and the main death cause diseases are circulatory system diseases.