ObjectiveTo explain surgical and medical comorbidities and preoperative physical status of colorectal cancer in detail as well as their tags and structures of Database from Colorectal Cancer (DACCA) in West China Hospital.MethodThe article was described in words.ResultsThe definition to the surgical comorbidities with its related content module, the medical comorbidity with its related content modules, and the preoperative physical status and characteristics of the DACCA in West China Hospital were given. The data label corresponding to each item in the database and the structured way needed for the big data application stage in detail were explained. And the error correction notes for all classification items were described.ConclusionsThrough the detailed description of the medical and surgical comorbidities and the preoperative physical status of DACCA in West China Hospital, it provides the standard and basis for the clinical application of DACCA in the future, and provides reference for other peers who wish to build a colorectal cancer database.
Recently, World Health Organization/International Agency for Research on Cancer (WHO/IARC) published the World Cancer Report 2020. This report described the cancer burden of the world, the risk factors of cancer, biological process in cancer development and the prevention strategies of cancer. Based on current status of China’s cancer burden and prevention strategies, this paper briefly interpreted the key points of cancer prevention and control in the report.
ObjectiveTo investigate the associations of preoperative red cell distribution width (RDW) with mortality and morbidity in patients underwent liver transplantation. MethodsThis investigation was a retrospective study, the patients underwent liver transplantation met the inclusion criteria from June 2017 to May 2020 in the West China Hospital of Sichuan University were enrolled. The patients were divided into RDW≤14.5% group and RDW>14.5% group according to the normal RDW critical value (14.5%). The propensity score matching (PSM) was used to adjust the baseline characteristics. The primary outcome was 1-year mortality. The secondary outcomes included 1-year survival, 30-day mortality, incidence of early allograft dysfunction, acute kidney injury, renal replacement therapy, and pulmonary complications, as well as ICU stay and postoperative hospital stay. ResultsA total of 303 patients who met the analysis conditions were included. After PSM, 57 patients in each group were matched. There were no significant differences between the two groups in the baseline data such as the gender, age, body mass index (BMI), initial diagnosis, MELD score, Child-Pugh grade of the recipients, and the gender, age, and BMI of the donors (P>0.05). The 1-year [22.8% (13/57) versus 5.3% (3/57), χ2=7.27, P=0.007] and 30-day [15.8% (9/57) versus 3.5% (2/57), χ2=4.93, P=0.026] mortality of the patients with RDW >14.5% were higher than that of the patients with RDW ≤14.5% . The Kaplan-Meier survival curve showed that the 1-year survival of the patients with RDW ≤14.5% after liver transplantation was better than that of the patients with RDW >14.5% [hazard ratio=4.75, 95%CI (1.78, 12.67), P=0.007], but there were no significant differences between the two groups in the incidence of early graft dysfunction, acute renal injury, renal replacement therapy, and pulmonary complications, as well as postoperative hospital stay and ICU stay (P>0.05). ConclusionPreliminary results of this study indicate that preoperative RDW of patients underwent allogeneic liver transplantation is associated with1-year mortality, 30-day mortality, and 1-year survival.
Objective To explore impact of climate change on aortic dissection and to put forward a new way about prediction and prevention of aortic dissection. Methods We retrospectively analyzed the characteristics of acute aortic dissection patients came from Hebei province in Fuwai Hospital between 2010 and 2016 year. Meanwhile, we collected monthly maximum temperature, minimum temperature, average temperature, average pressure, amount of rainfall, sunshine, humidity and other meteorological data. Generalized model was implied to explore climate change and the incidence of aortic dissection. Results A total of 1 121 acute aortic dissection patients from Hebei province were admitted in Fuwai Hospital during the period of 6 years. There were 774 patients were type A aortic dissection, and 347 patients were type B aortic dissection. The average age was 51.4±12.0 years. There were 873 males and 248 females. There were 889 (79.3%) patients with hypertension, 99 (8.83%) with Marfan syndrome. It was found that temperature, humidity and air pressure were all statistically significant for indication aortic dissection through single variable analysis (P<0.01). The temperature was only variable by one-way analysis of variance (P<0.01). The lowest temperature has the best predictive effect on the occurrence of aortic dissection. The relative risk was 1.02 with 95% confidence interval 1.02 to 1.03. Conclusion The change of climatic conditions can affect the occurrence of aortic dissection, and the lowest temperature is an important trigger factor for aortic dissection onset.
Objective To explore the correlation between multimorbidity and hip fractures in middle-aged and elderly populations. Methods The population without hip fractures in 2011 was selected in the China Health and Retirement Longitudinal Study database. According to whether the research subjects experienced hip fractures between 2015 and 2020, they were divided into the hip fracture group and the non-hip fracture group. Multiple logistic regression analysis was used to explore the correlation between multimorbidity and hip fracture occurrence. Results A total of 9644 subjects were included. Among them, there were 4406 males and 5238 females. There were 419 cases in the hip fracture group and 9225 cases in the non-hip fracture group. Multivariate logistic regression analysis showed that diabetes, heart disease, arthritis and hearing impairment were independent risk factors for hip fracture. Compared to those without chronic diseases, individuals with ≥3 types of comorbidities among the 4 chronic diseases had a higher risk of hip fracture. Conclusions In the middle-aged and elderly population, diabetes, heart disease, arthritis and hearing impairment are chronic diseases associated with hip fracture. The higher the number of comorbidities of chronic diseases, the higher the risk of new hip fractures.
Epilepsy and sleep disorders are common health problems in the world, and sleep disorders as a common comorbidity of epilepsy patients, there are high prevalence, low attention rate, low treatment rate phenomenon. In addition, epilepsy and sleep disorders can affect each other, exacerbating the onset of their own symptoms. Therefore, timely identification and treatment of these comorbidities are crucial to improve patients' quality of life, increase daytime alertness and reduce the occurrence of seizures. This article reviews the effects of different anti-seizure programs on patients with epilepsy comorbidities sleep disorders, in order to provide references for how to better choose epilepsy treatment measures for these patients.
Abstract： Objective To explore the impact of obesity on postoperative morbidity and mortality after pneumonectomy. Methods Clinical data of 3 494 patients with pulmonary diseases who underwent pneumonectomy in Shanghai Pulmonary Hospital from September 2003 to December 2007 were retrospectively analyzed. All the 3 494 patients were divided into two groups according to the patients’ preoperative body mass index （BMI）. There were 3 340 patients in the non-obesity group （BMI＜28 kg/m2） including 2 502 males and 838 females with their average age of 61.9±10.7 years， and 154 patients in the obesity group （BMI≥28 kg/m2） including 87 males and 67 females with their average age of 59.7±9.6 years. Univariate analysis and logistic regression were used to analyze the impact of obesity （BMI≥28 kg/m2） on postoperative morbidity after pneumonectomy. Results There were a total of 26 cases of perioperative death， including 23 patients in the non-obesity group and 3 patients in the obesity group. There was no statistical difference in mortality between the two groups ［0.7% （23/3 340） vs. 1.9% （3/154）， P=0.118］. There was no statistical difference in any particular postoperative morbidity or incidence of pulmonary complications between the two groups （P＞0.05）. Other than pulmonary complications， the incidence of postoperative complication in other body systems of the obesity group was significant higher than that of the non-obesity group （P＜0.05）. The incidence of cerebrovascular accidents， myocardial infarction and acute renal failure of the obesity group was significant higher than those of the non-obesity group （P＜0.05）. Logistic regression showed that obesity （BMI≥28 kg/m2） was not an independent risk factor for postoperative morbidity after pneumonectomy ［B=0.648， OR=1.911， 95% CI（0.711， 5.138），P=0.199］. Conclusion Obesity is not a significant risk factor of postoperative mortality or morbidity after pneumonectomy.
Objective To investigate the effects of enhanced recovery after surgery (ERAS) on postoperative function and pain in total hip arthroplasty (THA) patients with high comorbidity. Methods Patients with THA who were admitted between January 2020 and January 2022 were selected as the study objects, and a total of 223 patients with high comorbidity met the selection criteria. Patients were randomly divided into two groups using the random envelope method. During perioperative period, 112 cases in the ERAS group were treated according to the ERAS protocol and 111 cases in the control group with the traditional protocol. There was no significant difference in gender, age, body mass index, Charlson comorbidity index, preoperative diagnosis, the type and number of the comorbidities, preoperative visual analogue scale (VAS) score between the two groups (P>0.05). However, the Harris score of ERAS group was significantly lower than that of control group before operation (P<0.05). Preoperative and postoperative hospital stays were recorded. The VAS score was used to evaluate the pain before operation, at 1 day after operation, at the leaving bed time, at the day after discharge, and at 2 weeks after operation. Harris score was used to evaluate hip function before operation and at 2 weeks, 1 month, 3 months, 6 months, and 12 months after operation. The incidence of complications, 30-day readmission rate, mortality rate, and patient’s satisfaction were recorded. Results The length of preoperative hospital stay in ERAS group was significantly shorter than that in control group (P<0.05). But there was no significant difference in the length of postoperative hospital stay between groups (P>0.05). All patients in the two groups were followed up 12 months. The VAS score in the two groups after operation was lower than that before operation, and showed a gradually trend with the extension of time, with significant differences between different time points (P<0.05). VAS scores of ERAS group were significantly lower than those of control group at different time points after operation (P<0.05). The postoperative Harris scores in both groups were higher than those before operation, and showed a gradually increasing trend with the extension of time, with significant differences between different time points (P<0.05). Harris scores of ERAS group at 2 weeks, 1 month, and 3 months after operation were significantly higher than those of control group (P<0.05). Complications occurred in 2 cases (1.79%) of the ERAS group and 6 cases (5.41%) of the control group, with no significant difference in incidence (P>0.05). In the control group, 1 case was readmitted within 30 days after operation, and 1 case died of severe pneumonia within 1 year of follow-up. There was no readmission or death in ERAS group, and there was no significant difference in the above indexes between the two groups (P>0.05). At last follow-up, the satisfaction rate of patients in ERAS group was slightly higher than that in control group, but the difference was not significant (P>0.05). Conclusion For THA patients with high comorbidity, ERAS protocol can shorten preoperative waiting time, better reduce pain, and improve hip function.
Multimorbidity is becoming a major issue in global health due to the increased prevalence of chronic diseases and the accelerated aging of the population. Clinical practice guidelines, as key tools for guiding clinical practice, play an important role in the field of multimorbidity, but also face many challenges. In this paper, we will review the necessity of developing multimorbidity guidelines, the current situation, challenges and opportunities, and on this basis, we will put forward our thoughts and suggestions to promote the development of guidelines in the field of multimorbidity in China.
Adenoid hypertrophy in children with epilepsy is rarely reported. This paper analyzes the clinical characteristics and incidence of adenoid hypertrophy in children with epilepsy.Methods The clinical data in children with epilepsy from December 2014 to April 2020 in Shenzhen Children's hospital were analyzed retrospectively.Results There were 449 cases diagnosed with adenoid hypertrophy (2.74%) in 16387 children with epilepsy. Among 449 cases of adenoid hypertrophy, 276 males (61.47%) and 173 females (38.53%). The age distribution was: 28 days to 1 year old, 8 cases (2%); 1-3 years old, 78 cases (17%); 3-6 years old 167 cases (37%); 6-12 years old, 153 cases (34%); 12-18 years old, 43 cases (10%). In 40 patients the IgG antibody were positive for EB capsid antigen in 25 (62.5%). In 56 cases of EB virus DNA were detected by fluorescence quantitative PCR, 25 (44.64%) positive, and 21/44 cases (47.72%) were positive by general nucleic acid detection of enteroviruses. The neutrophil reduction rate in peripheral blood was 42.19% in 673 tests, lymphocyteincreased in 292 (43.38%), platelet count increased in 307 (45.61%), abnormal in platelet hematocrit in 311 (46.21%); the mean volume of RBC was decreased in319 (47.39%) tests. The content of \begin{document}${\rm{HCO}_3^-} $\end{document} was reduced in 20/55 cases (36.36%). 25-hydroxy vitamin D was 33 (44.5%) decreased in 74 cases. The blood glucose was measured in 146 cases, 60 (41.09%) increased, total cholesterol was 31 (40.78%) increased in 76 cases, serum C peptide was 12 (29.26%) increased in 41 cases.Conclusion Adenoid hypertrophy in children with epilepsy may be related to infection, inflammation or immune disorder, which may cause nutritional, metabolic or internal environment disorders. Therefore, there is need of nursing and health education, transferring to specialized centers for diagnosis and treatment.