Objective To review the cadaveric kidney transplantations at our center in the past 22 years and to analyze the causes and the influencing factors on death in 176 patients who died after renal transplantation. Methods...Objective To review the cadaveric kidney transplantations at our center in the past 22 years and to analyze the causes and the influencing factors on death in 176 patients who died after renal transplantation. Methods A total of 1 039 patients received cadaveric kidney graftings between October 1977 and June 1999. Patient’ s mortality was calculated by the Kaplan-Meier method. The factors which might lead to patients’ death,including age and sex of the donors and recipients, frequency of transplantation, dialysis time and transfusion volume before transplantation, cold ischemic time(CIT),delayed graft function(DGF),rejection, immunosuppressive regimen, and post-transplant complications, were analyzed by log-rank and Cox model. Results Total mortalities of the patient at 1 - ,5 - , 10 - , and 15-year were 6.9%, 19.7%, 32.1% and 34.7%, respectively. The leading causes of patients’ death were infection, cardiocerebral vascular diseases, and hepatic failure. The factors of transplant times, dialysis time展开更多
Dear editor, We report a case of a 47-year-old female who presented with a toxic bupropion ingestion leading to cardiac arrest. She initially exhibited a loss of brainstem reflexes in conjunction with burst-suppressio...Dear editor, We report a case of a 47-year-old female who presented with a toxic bupropion ingestion leading to cardiac arrest. She initially exhibited a loss of brainstem reflexes in conjunction with burst-suppression pattern on EEG. Burst suppression is an EEG waveform pattern of alternating isoelectric suppressions and high voltage bursts, Our patient ultimately made a full neurologic recovery a few days later. While there are two other cases in the literature of bupropion overdose resulting in EEG burst-suppression and loss of brainstem reflexes, we believe this is the only reported adult case complicated by cardiac arrest.展开更多
目的定量评估高温热浪与居民猝死之间的暴露—反应关系,量化其超额死亡,并探究潜在的脆弱人群。方法以江苏省2015—2021年间猝死居民为研究对象开展时间分层病例交叉研究,利用中国气象局陆面数据同化系统(China Meteorological Administ...目的定量评估高温热浪与居民猝死之间的暴露—反应关系,量化其超额死亡,并探究潜在的脆弱人群。方法以江苏省2015—2021年间猝死居民为研究对象开展时间分层病例交叉研究,利用中国气象局陆面数据同化系统(China Meteorological Administration Land Data Assimilation System,CLDAS V2.0)温度数据识别江苏省不同定义下的高温热浪事件(结合相对温度阈值和持续时间进行定义),根据死亡日期和生前家庭住址评估研究对象的高温热浪暴露情况,采用条件logistic回归模型和分布滞后非线性模型(Distributed Lag Nonlinear Model,DLNM)评估高温热浪与猝死之间的暴露—反应关系,估算可归因于高温热浪暴露的超额死亡,根据性别和年龄进行分层分析并探讨其效应修饰作用。结果所有不同定义下的高温热浪暴露均与猝死风险增加有关,且随高温热浪强度增加,其猝死风险也随之增加。以P95_3d定义(温度超过第95百分位数且持续至少3 d)为例,高温热浪的人群猝死风险升高56%(95%CI:31%~86%),可归因于高温热浪暴露的猝死占总猝死人群的1.19%(95%CI:0.77%~1.58%)。分层分析结果提示,高温热浪暴露与猝死之间的关联在不同年龄和性别组中无显著差异。结论高温热浪暴露与猝死风险增加有关,在夏季减少热浪暴露可能有助于降低猝死的发生风险。展开更多
Objective To assess the relationship between diurnal temperature range （DTR） and sudden infant death （SID） between 2001 and 2004 in Shanghai,China.Methods We conducted a time‐stratified case‐crossover analysis t...Objective To assess the relationship between diurnal temperature range （DTR） and sudden infant death （SID） between 2001 and 2004 in Shanghai,China.Methods We conducted a time‐stratified case‐crossover analysis to estimate the percent increase of SID associated with changes in DTR after adjustment for daily weather conditions （temperature and relative humidity） and outdoor air pollution.Results DTR was significantly associated with daily SID.An increase of 1 °C in the current‐day （L0） and in the 2‐day moving average （L01） DTR corresponds to a 1.56% （95% CI：0.97%,2.15%） and a 1.89% （95% CI：1.17%,2.60%） increase in SID,respectively.Conclusion An increased DTR was associated with an increased risk of SID in Shanghai.More studies are needed to understand the effect of DTR on infant deaths.展开更多
文摘Objective To review the cadaveric kidney transplantations at our center in the past 22 years and to analyze the causes and the influencing factors on death in 176 patients who died after renal transplantation. Methods A total of 1 039 patients received cadaveric kidney graftings between October 1977 and June 1999. Patient’ s mortality was calculated by the Kaplan-Meier method. The factors which might lead to patients’ death,including age and sex of the donors and recipients, frequency of transplantation, dialysis time and transfusion volume before transplantation, cold ischemic time(CIT),delayed graft function(DGF),rejection, immunosuppressive regimen, and post-transplant complications, were analyzed by log-rank and Cox model. Results Total mortalities of the patient at 1 - ,5 - , 10 - , and 15-year were 6.9%, 19.7%, 32.1% and 34.7%, respectively. The leading causes of patients’ death were infection, cardiocerebral vascular diseases, and hepatic failure. The factors of transplant times, dialysis time
文摘Dear editor, We report a case of a 47-year-old female who presented with a toxic bupropion ingestion leading to cardiac arrest. She initially exhibited a loss of brainstem reflexes in conjunction with burst-suppression pattern on EEG. Burst suppression is an EEG waveform pattern of alternating isoelectric suppressions and high voltage bursts, Our patient ultimately made a full neurologic recovery a few days later. While there are two other cases in the literature of bupropion overdose resulting in EEG burst-suppression and loss of brainstem reflexes, we believe this is the only reported adult case complicated by cardiac arrest.
文摘目的定量评估高温热浪与居民猝死之间的暴露—反应关系,量化其超额死亡,并探究潜在的脆弱人群。方法以江苏省2015—2021年间猝死居民为研究对象开展时间分层病例交叉研究,利用中国气象局陆面数据同化系统(China Meteorological Administration Land Data Assimilation System,CLDAS V2.0)温度数据识别江苏省不同定义下的高温热浪事件(结合相对温度阈值和持续时间进行定义),根据死亡日期和生前家庭住址评估研究对象的高温热浪暴露情况,采用条件logistic回归模型和分布滞后非线性模型(Distributed Lag Nonlinear Model,DLNM)评估高温热浪与猝死之间的暴露—反应关系,估算可归因于高温热浪暴露的超额死亡,根据性别和年龄进行分层分析并探讨其效应修饰作用。结果所有不同定义下的高温热浪暴露均与猝死风险增加有关,且随高温热浪强度增加,其猝死风险也随之增加。以P95_3d定义(温度超过第95百分位数且持续至少3 d)为例,高温热浪的人群猝死风险升高56%(95%CI:31%~86%),可归因于高温热浪暴露的猝死占总猝死人群的1.19%(95%CI:0.77%~1.58%)。分层分析结果提示,高温热浪暴露与猝死之间的关联在不同年龄和性别组中无显著差异。结论高温热浪暴露与猝死风险增加有关,在夏季减少热浪暴露可能有助于降低猝死的发生风险。
基金supported by the National Basic Research Program (973 program) of China (2011CB503802)the National Natural Science Foundation of China (81001228)+2 种基金the National High Technology Research and Development Program of China (863 Program) (2007AA02Z442)the Shanghai Pu Jiang Program (09PJ1401700)the Program for New Century Excellent Talents in University (NCET-09-0314)
文摘Objective To assess the relationship between diurnal temperature range （DTR） and sudden infant death （SID） between 2001 and 2004 in Shanghai,China.Methods We conducted a time‐stratified case‐crossover analysis to estimate the percent increase of SID associated with changes in DTR after adjustment for daily weather conditions （temperature and relative humidity） and outdoor air pollution.Results DTR was significantly associated with daily SID.An increase of 1 °C in the current‐day （L0） and in the 2‐day moving average （L01） DTR corresponds to a 1.56% （95% CI：0.97%,2.15%） and a 1.89% （95% CI：1.17%,2.60%） increase in SID,respectively.Conclusion An increased DTR was associated with an increased risk of SID in Shanghai.More studies are needed to understand the effect of DTR on infant deaths.
文摘目的基于疾病诊断相关分组(diagnosis-related groups,DRG)分析北京市某三级综合医院住院死亡病例情况,以期为医疗质量管理提供参考依据。方法回顾性收集北京市某三级综合医院2015年1月1日—2023年12月31日DRG入组住院患者数据,以死亡风险分级为标准进行住院死亡病例分析,重点探讨低/中低风险组死亡病例的时间分布趋势、科室来源、DRG构成等。结果该院DRG共入组住院患者927304例,住院死亡患者2346例(低、中低、中高、高死亡风险组分别为130例、209例、411例、1596例),住院总死亡率为0.25%。DRG入组病例中,低死亡风险组死亡率为0.02%(130/680939),中低死亡风险组死亡率为0.16%(209/130449),2015—2023年入组病例死亡率整体呈下降趋势(χ^(2)=104.77,P<0.001)。低/中低风险死亡病例主要来自内科重症监护病房(medical intensive care unit,MICU)和ICU(37.8%,128/339)。全部死亡病例最多的DRG组为RW29,低/中低风险死亡病例最多的DRG组为EC13(结核,手术室手术,伴并发症与合并症),居前3位的主要诊断依次为C34.101(肺上叶恶性肿瘤)、J18.903(重症肺炎)、J15.600x005(鲍曼不动杆菌性肺炎)。结论重症监护病房为该院死亡病例最多的科室,患者手术伴并发症与合并症可能是低/中低风险死亡的主要DRG相关因素。医院应予以高度重视,识别优化薄弱环节,推动死亡病例多学科讨论,以充分保障患者安全。
