Objective:This study aimed to evaluate the effectiveness of an integrative educational intervention-combining hospital-based schooling programs,child-centered communication,and therapeutic play-on clinical,psychosocia...Objective:This study aimed to evaluate the effectiveness of an integrative educational intervention-combining hospital-based schooling programs,child-centered communication,and therapeutic play-on clinical,psychosocial,and educational outcomes among school-aged children with cancer.Materials and Methods:A quasi-experimental pre-and post-test control group design was conducted at the pediatric oncology unit of Rumah Sakit Islam Jemursari,Surabaya,Indonesia.Fifty-two hospitalized children aged 6-18 years were randomly assigned to an intervention group(n=26)or a control group(n=26).The intervention lasted 1 month and integrated hospital-based lessons aligned with the national curriculum,therapeutic play,and developmentally appropriate communication by trained staff.Outcomes included pain intensity(Wong-Baker FACES Scale),treatment adherence,quality of life(Pediatric Cancer Quality of Life-32[PCQL-32]),anxiety(Revised Children’s Manifest Anxiety Scale),and literacy-numeracy performance.Data were analyzed using paired t-tests,ANCOVA,and Cohen’s d,with significance set at P<0.05.Results:Compared with controls,the intervention group showed significant improvements in pain reduction(P<0.001),treatment adherence(P<0.001),and quality of life across all PCQL-32 domains(P<0.001).Anxiety levels decreased significantly(P<0.001),and academic performance in literacy and numeracy improved markedly(P<0.001).Conclusion:The integrative educational intervention effectively enhanced clinical recovery,psychosocial well-being,and academic continuity among hospitalized children with cancer,emphasizing the need to integrate hospital-based education and play-based communication into pediatric oncology care.展开更多
Dengue virus(DENV)is a positive-sense single-stranded RNA virus belonging to the genus Flavivirus within the Flaviviridae family.Four serotypes,DENV 1-4,are distributed globally[1].Hanoi metropolitan city is an endemi...Dengue virus(DENV)is a positive-sense single-stranded RNA virus belonging to the genus Flavivirus within the Flaviviridae family.Four serotypes,DENV 1-4,are distributed globally[1].Hanoi metropolitan city is an endemic hotspot for DENV transmission in Vietnam[2,3].The largest outbreak occurred in 2017,with more than 36000 cases and 7 deaths reported,causing by all four serotypes with the predominance of DENV1,following by DENV2[4,5].During the following dengue season,we collected 390 blood and serum samples from 197 hospitalized patients in a national hospital in Hanoi city,Northern Vietnam to identify the circulating DENV serotypes responsible for the 2018-2019 outbreak.展开更多
Background1 Currently,there is a scarcity of risk prediction models for frailty in hospitalized patients with chronic heart failure(CHF).This study aimed to investigate the frailty status of hospitalized CHF patients,...Background1 Currently,there is a scarcity of risk prediction models for frailty in hospitalized patients with chronic heart failure(CHF).This study aimed to investigate the frailty status of hospitalized CHF patients,identify independent risk factors significantly associated with frailty,and construct an effective risk prediction model.The goal was to provide a reference for clinical strategies in preventing and managing frailty among CHF patients.Methodss Using convenience sampling,we enrolled 184 hospitalized CHF patients from a tertiary hospital between February 2022 and December 2024.General demographic data were collected via questionnaires,alongside frailty screening using the FRAIL scale and assessment of daily functioning with the Activities of Daily Living(ADL)scale.Clinical data were obtained by reviewing medical records.Participants were categorized into a frail group(n=65)and a non-frail group(n=119)based on frailty status.Clinical risk factors were compared between groups.Multivariate logistic regression was used to identify independent risk factors.A prediction model was constructed,and a receiver operating characteristic(ROC)curve was plotted to evaluate its predictive value.Results A total of 184 hospitalized CHF patients were included,with 65(35.33%)exhibiting frailty.Multivariate logistic regression analysis showed that independent risk factors for frailty included:age,ADL score,N-terminal pro-brain natriuretic peptide(NT-pro-BNP),left ventricular ejection fraction(LVEF),New York Heart Association(NYHA)class II/IV,≥3 comorbidities,comorbid diabetes mellitus(DM),comorbid valvular heart disease(VHD),smoking history,hemoglobin(Hb),albumin,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),creatinine(Cr),and blood urea nitrogen(BUN).The aforementioned factors were incorporated into logistic regression analysis and the prediction model was built.The prediction model showed quite strong predictive performance.Its area under the ROC curve was 0.904(95%CI:0.857-0.951),with a sensitivity of98.5%and a specificity of 85.7%.ConclusionssThe frailty risk prediction model for hospitalized CHF patients demonstrated robust discriminative ability and calibration.It provided substantial reference value for clinical management of CHF,offering a basis for early assessment,risk stratification,and targeted interventions to prevent frailty by identifying high-risk patients.展开更多
Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chines...Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chinese and English databases was conducted to identify relevant studies.Two researchers independently assessed the quality of included literature using the Newcastle-Ottawa Scale(NOS).Data were extracted and analyzed via Stata 14.A random-effects model was applied due to significant heterogeneity(I²>50%).Sensitivity analysis and Egger’s test were performed to assess bias.Results:12 eligible studies(2014-2024)were included.Meta-analysis demonstrated that integrated nursing interventions significantly reduced cancer pain scores compared to routine care(SMD=-1.51,95%CI:-1.90 to-1.12;I²=84.8%),with superior efficacy.Subgroup-analyses revealed enhanced effects for“Nursing modes”(SMD=-2.11)and“cancer pain education”(SMD=-2.30).Conclusion:Research-oriented integrated nursing interventions significantly improve cancer pain management in Chinese hospitalized oncology patients,particularly through synergistic effects of“Nursing modes”and“can-cer pain education.”However,implementation bias from“additive interventions”in teaching hospitals and high heterogeneity warrant attention.Future studies should optimize designs to enhance clinical applicability.展开更多
Objective:To analyze the clinical characteristics of bone loss in hospitalized patients with Graves’disease.Methods:The clinical data of hospitalized patients with Graves’disease were collected.According to the resu...Objective:To analyze the clinical characteristics of bone loss in hospitalized patients with Graves’disease.Methods:The clinical data of hospitalized patients with Graves’disease were collected.According to the results of bone density examinations,they were divided into a normal bone density group,a low bone mass group,and an osteoporosis group.The normal bone density group was used as the control group to analyze the clinical characteristics of bone loss.Results:The incidence of bone loss in patients with Graves’disease was 80.72%,with osteoporosis accounting for 39.16%and low bone mass accounting for 41.57%.The incidences of hyperthyroid heart disease,Graves’ophthalmopathy,and leukopenia in the osteoporosis group and the low bone mass group were significantly higher than those in the normal bone density group,reaching 84.62%,60.87%,and 34.38%,respectively(P<0.05).The age of the osteoporosis group with Graves’disease was 50.88±12.03 years old,which was higher than that of the normal bone density group(40.03±12.58 years old).The disease course was 55.66±14.21 days,longer than that of the normal bone density group(43.38±8.55 days).FT4 was 61.69±8.42 pmol/L,higher than that of the normal bone density group(51.01±6.77 pmol/L),while TSH was 0.08±0.51μIU/ml,lower than that of the normal bone density group(0.22±0.55μIU/ml).The blood phosphorus was 1.25±0.29 mmol/L,lower than that of the normal bone density group(1.34±0.27 mmol/L),with statistical significance(P<0.05).In the low bone mass group,FT3(13.08±9.05 pmol/L)and FT4(46.14±3.46 pmol/L)were lower than those in the normal bone density group,with statistical significance(P<0.05).Logistic regression analysis revealed that age,disease course,and TSH were contributing factors to bone loss.Conclusion:Patients with Graves’disease are prone to bone loss,and age,disease course,and TSH are contributing factors to bone loss.展开更多
BACKGROUND Atrial fibrillation(AF)remains the most common cardiac arrhythmia.The safety of endoscopic retrograde cholangiopancreatography(ERCP)in patients with AF remains largely unknown.AIM To analyze the effect of A...BACKGROUND Atrial fibrillation(AF)remains the most common cardiac arrhythmia.The safety of endoscopic retrograde cholangiopancreatography(ERCP)in patients with AF remains largely unknown.AIM To analyze the effect of AF on hospital outcomes in patients undergoing ERCP.METHODS We performed a retrospective cohort study using the Nationwide Inpatient Sample database.Adult patients with AF who underwent an inpatient ERCP were identified,then stratified by timing of ERCP,via international classification of diseases-10 codes.The primary outcome was all-cause in-hospital mortality.Secondary outcomes,including resource utilization,were assessed.Statistical analysis was performed using STATA software.RESULTS Of the 433245 patients that underwent an ERCP,49615 had a diagnosis of AF.Patients with AF had a significantly higher in-hospital mortality compared to those without AF[3.82%vs 1.13%,odds ratio(OR)=1.93,P<0.01].AF was significantly associated with increased hospital stay(+1.71 days),hospital charges($21210),shock(OR=2.17),sepsis(OR=1.34),intensive care unit admission(OR=2.41),acute kidney injury(OR=1.51),as well as a decreased likelihood of discharge to home(OR=0.59),(all with P<0.01).These results were consistent after propensity score matching.Upon subgroup analysis,patients with AF,whom underwent ERCP>72 hours,had worse outcomes including higher inhospital mortality(adjusted OR=1.47,P<0.01).CONCLUSION By way of this large,national analysis it appears AF is associated with significantly worse hospitalization outcomes,inducing increased mortality,in those undergoing ERCP.Further prospective investigation is warranted to potentially guide clinical recommendations for patients with AF undergoing ERCP in this setting.展开更多
Objective:To record surveillance,antibiotic resistance of uropathogens of hospitalized patients over a period of 18 months.Methods:Urine samples from wards and cabins were used for isolating urinary tract infection(UT...Objective:To record surveillance,antibiotic resistance of uropathogens of hospitalized patients over a period of 18 months.Methods:Urine samples from wards and cabins were used for isolating urinary tract infection(UTI)-causing bacteria that were cultured on suitable selective media and identified by biochemical tests;and their antibiograms were ascertained by Kirby-Bauer's disc diffusion method,in each 6-month interval of the study period,using 18 antibiotics of five different classes.Results:From wards and cabins,1 245 samples were collected,from which 996 strains of bacteria belonging to 11 species were isolated,during April 2011 to September2012.Two Gram-positive,Staphylococcus aureus(S.aureus)and Enterococcus faecalis(E.faecalis),and nine Gram-negative bacteria,Acinetobacter baumannii,Citrobactcr sp.,Escherichia coli,Enterobacter aerogenes,Klebsiella pneumoniae.Klebsiella oxytoca,Proteus mirabilis,Proteus vulgaris and Pseudomonas aeruginosa were isolated.Both S.aureus and E.faecalis were vancomycin resistant,and resistant-strains of all pathogens increased in each 6-month period of study.Particularly,all Gram-negatives were resistant to nitrofurantoin and co-trimoxazole,the most preferred antibiotics of empiric therapy for UTI.Conclusions:Antibiograms of 11 UTI-causing bacteria recorded in this study indicated moderately higher numbers of strains resistant to each antibiotic studied,generating the fear of precipitating fervent episodes in public health particularly with bacteria,Acinetobacter baumannii,Escherichia coli,Klebsiella pneumoniae and S.aureus.Moreover,vancomycin resistance in strains of S.aureus and E.faecalis is a matter of concern.展开更多
AIM: To compare thromboembolism rates between hospitalized patients with a diagnosis of ulcerative colitis and other hospitalized patients at high risk for thromboembolism. To compare thromboembolism rates between pat...AIM: To compare thromboembolism rates between hospitalized patients with a diagnosis of ulcerative colitis and other hospitalized patients at high risk for thromboembolism. To compare thromboembolism rates between patients with ulcerative colitis undergoing a colorectal operation and other patients undergoing colorectal operations. METHODS: Data from the National Hospital Discharge Survey was used to compare thromboembolism rates between (1) hospitalized patients with a discharge diagnosis of ulcerative colitis and those with diverticulitis or acute respiratory failure, and (2) hospitalized patients with a discharge diagnosis of ulcerative colitis who underwent colectomy and those with diverticulitis or colorectal cancer who underwent colorectal operations. RESULTS: Patients diagnosed with ulcerative colitis had similar or higher rates of combined venous thromboembolism (2.03%) than their counterparts with diverticulitis (0.76%) or respiratory failure (1.99%), despite the overall greater prevalence of thromboembolic risk factors in the latter groups. Discharged patients with colitis that were treated surgically did not have signifi cantly different rates of venous or arterial thromboembolism than those with surgery for diverticulitis or colorectal cancer.CONCLUSION: Patients with ulcerative colitis who do not undergo an operation during their hospitalization have similar or higher rates of thromboembolism than other medical patients who are considered to be high risk for thromboembolism.展开更多
BACKGROUND Acute severe ulcerative colitis unresponsive to systemic steroid treatment is a lifethreatening medical condition requiring hospitalization and often colectomy.Despite the increasing choice of medical thera...BACKGROUND Acute severe ulcerative colitis unresponsive to systemic steroid treatment is a lifethreatening medical condition requiring hospitalization and often colectomy.Despite the increasing choice of medical therapy options for ulcerative colitis, the condition remains a great challenge in the field of inflammatory bowel diseases(IBD). The performance of the calcineurin inhibitor tacrolimus in this clinical setting is insufficiently elucidated.AIM To evaluate the short and long-term outcomes of tacrolimus therapy in adult inpatients with steroid-refractory acute severe ulcerative colitis.METHODS We conducted a retrospective monocentric study enrolling 22 patients at a tertiary care center for the treatment of IBD. All patients who were admitted to one of the wards of the Department of Gastroenterology and Hepatology of the Heidelberg University Hospital with acute severe ulcerative colitis between 2007 and 2018, and who received oral or intravenous tacrolimus for steroid-refractory disease were included. Baseline characteristics and data on the disease courses were retrieved from entirely computerized patient charts. The primary study endpoint was clinical response to tacrolimus therapy, resulting in discharge from the hospital. Secondary study endpoints were colectomy rate and time to colectomy, achievement of clinical remission under tacrolimus therapy, and the occurrence of side effects.RESULTSIn the majority of the 22 included patients(68.2%), tacrolimus therapy was initiated intravenously and subsequently converted to oral administration. The treatment duration was 128 ± 28.5 d(mean ± SEM), and the patients were followed up for 705 ± 110 d after treatment initiation. Among all patients, 86.4%were discharged from the hospital under continued oral tacrolimus therapy. In36.4% of the patients, the administration of tacrolimus resulted in clinical remission at some point during the treatment. Thirty-two percent of the patients underwent colectomy between 5 and 194 d after the initiation of tacrolimus treatment(mean: 97.4 ± 20.8 d). Colectomy-free survival rates at 1, 3, 6 and 12 mo after the initiation of tacrolimus therapy were 90.9%, 86.4%, 77.3% and 68.2%,respectively. The safety profile of tacrolimus was overall favorable. Only two patients discontinued the treatment due to side effects.CONCLUSION The short-term outcome of tacrolimus in steroid-refractory acute severe ulcerative colitis was beneficial, and side effects were rare. In all, tacrolimus therapy appears to be a viable option for short-term treatment of steroidrefractory acute severe ulcerative colitis besides ciclosporin and anti-tumor necrosis factor α treatment.展开更多
Norovirus （NOV） is a pathogen that commonly causes viral diarrhea in children. Studies indicate that NoV recognizes human histo-blood group antigens （HBGAs） as cell attachment factors. In order to explore the corr...Norovirus （NOV） is a pathogen that commonly causes viral diarrhea in children. Studies indicate that NoV recognizes human histo-blood group antigens （HBGAs） as cell attachment factors. In order to explore the correlation between of NoV infection and HBGAs, a cross-sectional study was conducted in children less than five years old who were hospitalized with diarrhea in two areas of China between November 2014 and February 2015. Of the paired stool and saliva samples taken from 424 children,展开更多
ABSTRACT Importance Hospitalizations for heart failure （HHF） represent a major health burden, with high rates of early postdischarge rehospitalization and mortality. Objective To investigate whether aliskiren, a d...ABSTRACT Importance Hospitalizations for heart failure （HHF） represent a major health burden, with high rates of early postdischarge rehospitalization and mortality. Objective To investigate whether aliskiren, a direct renin inhibitor, when added to standard therapy, would reduce the rate of cardiovascular （CV） death or HF rehospitalization among HHF patients. Design, Setting, and Participants International, double-blind, placebo-controlled study that randomized hemodynamically stable HHF patients a median 5 days after admission. Eligible patients were 18 years or older with left ventricular ejection fraction （LVEF） 40% or less,展开更多
Diabetes Mellitus is a significant health care challenge in the United States.The Center for Disease Control and Prevention estimates approximately 9.4%of patients in the United States are afflicted by diabetes.The In...Diabetes Mellitus is a significant health care challenge in the United States.The Center for Disease Control and Prevention estimates approximately 9.4%of patients in the United States are afflicted by diabetes.The Infectious Disease Society of America asymptomatic bacteriuria in women as two consecutive cleancatch voided urine specimens with isolation of the same bacterial strain in counts≥105 cfu/mL It is understood that diabetic patients tend to be at higher risk for infections than non-diabetics.Urinary tract infections(UTIs)tend to be the most common infection contracted by this population.UTIs are not only a significant cause of morbidity and mortality,they are also a significant financial burden.The data are conflicting,in regard to treating asymptomatic bacteriuria in diabetic patients to avoid hospital complications and ultimately decrease healthcare costs associated with these complications.However,clinicians continue to prescribe antibiotics empirically.Further randomized controlled study looking into the specific population as immunocompromised diabetic patients,patient with diabetic ketoacidosis and patient in intensive care unit needs to be undertaken.展开更多
OBJECTIVE To assess the association between beta-blockers and 1-year clinical outcomes in heart failure(HF)patients with atrial fibrillation(AF),and further explore this association that differs by left ventricular ej...OBJECTIVE To assess the association between beta-blockers and 1-year clinical outcomes in heart failure(HF)patients with atrial fibrillation(AF),and further explore this association that differs by left ventricular ejection fraction(LVEF)level.METHODS We enrolled hospitalized HF patients with AF from China Patient-centered Evaluative Assessment of Cardiac Events Prospective Heart Failure Study.COX proportional hazard regression models were employed to calculate hazard ratio of betablockers.The primary outcome was all-cause death.RESULTS Among 1762 HF patients with AF(756 women[41.4%]),1041(56%)received beta-blockers at discharge and 1272(72.2%)had an LVEF>40%.During one year follow up,all-cause death occurred in 305(17.3%),cardiovascular death occurred in203 patients(11.5%),and rehospitalizations for HF occurred in 622 patients(35.2%).After adjusting for demographic characteristics,social economic status,smoking status,medical history,anthropometric characteristics,and medications used at discharge,the use of beta-blockers at discharge was not associated with all-cause death[hazard ratio(HR):0.86;95%Confidence Interval(CI):0.65-1.12;P=0.256],cardiovascular death(HR:0.76,95%CI:0.52-1.11;P=0.160),or the composite outcome of all-cause death and HF rehospitalization(HR:0.97,95%CI:0.82-1.14;P=0.687)in the entire cohort.There were no significant interactions between use of beta-blockers at discharge and LVEF with respect to all-cause death,cardiovascular death,or composite outcome.In the adjusted models,the use of beta-blockers at discharge was not associated with all-cause death,cardiovascular death,or composite outcome across the different levels of LVEF:reduced(<40%),mid-range(40%-49%),or preserved LVEF(≥50%).CONCLUSION Among HF patients with AF,the use of beta-blockers at discharge was not associated with 1-year clinical outcomes,regardless of LVEF.展开更多
A retrospective analysis was performed in two major HIV/AIDS referral hospitals in Beijing to evaluate the prevalence of Mycobacterium tuberculosis（MTB） and non-tuberculous mycobacterial（NTM） infections in HIV-inf...A retrospective analysis was performed in two major HIV/AIDS referral hospitals in Beijing to evaluate the prevalence of Mycobacterium tuberculosis（MTB） and non-tuberculous mycobacterial（NTM） infections in HIV-infected patients. A total of 627 patients＇ data were reviewed, and 102（16.3%） patients were diagnosed with culture-confirmed mycobacterial infection, including 84 with MTB, 16 with NTM, and 2 with both MTB and NTM. The most frequent clinical complication by mycobacterial infection was pulmonary infection（48/102, 47.1%）. The overall rates of multidrug-resistant TB（MDR-TB） and extensively drug-resistant TB（XDR-TB） were 11.9% and 3.4%, respectively. This study underlines the urgent need to intensify screening for mycobacteria coinfection with HIV and to prevent the spread of drug-resistant TB among HIV-infected patients.展开更多
Insomnia is among the most common sleep disorders worldwide.Insomnia in older adults is a social and public health problem.Insomnia affects the physical and mental health of elderly hospitalized patients and can aggra...Insomnia is among the most common sleep disorders worldwide.Insomnia in older adults is a social and public health problem.Insomnia affects the physical and mental health of elderly hospitalized patients and can aggravate or induce physical illnesses.Understanding subjective feelings and providing reasonable and standardized care for elderly hospitalized patients with insomnia are urgent issues.AIM To explore the differences in self-reported outcomes associated with insomnia among elderly hospitalized patients.METHODS One hundred patients admitted to the geriatric unit of our hospital between June 2021 and December 2021 were included in this study.Self-reported symptoms were assessed using the Athens Insomnia Scale(AIS),Generalized Anxiety Disorder Scale-7(GAD-7),Geriatric Depression Scale-15(GDS-15),Memorial University of Newfoundland Scale of Happiness(MUNSH),Barthel Index Evaluation(BI),Morse Fall Scale(MFS),Mini-Mental State Examination,and the Short Form 36 Health Survey Questionnaire(SF-36).Correlation coefficients were used to analyze the correlation between sleep quality and self-reported symptoms.Effects of insomnia was analyzed using Logistic regression analysis.RESULTS Nineteen patients with AIS≥6 were included in the insomnia group,and the incidence of insomnia was 19%(19/100).The remaining 81 patients were assigned to the non-insomnia group.There were significant differences between the two groups in the GDA-7,GDS-15,MUNSH,BI,MFS,and SF-36 items(P<0.05).Patients in the insomnia group were more likely to experience anxiety,depression,and other mental illnesses,as well as difficulties with everyday tasks and a greater risk of falling(P<0.05).Subjective well-being and quality of life were poorer in the insomnia group than in the control group.The AIS scores positively correlated with the GAD-7,GDS-15,and MFS scores in elderly hospitalized patients with insomnia(P<0.05).Logistic regression analysis showed that GDS-15≥5 was an independent risk factor for insomnia in elderly hospitalized patients(P<0.05).CONCLUSION The number of self-reported symptoms was higher among elderly hospitalized patients with insomnia.Therefore,we should focus on the main complaints of patients to meet their care needs.展开更多
Background:The risk of lower extremity arterial disease (LEAD) is increased in diabetic patients.LEAD in diabetic patients occurs earlier and is often more severe and diffuse;however,it is largely underdiagnosed and u...Background:The risk of lower extremity arterial disease (LEAD) is increased in diabetic patients.LEAD in diabetic patients occurs earlier and is often more severe and diffuse;however,it is largely underdiagnosed and untreated.The purposes of this study were to investigate and analyze LEAD situation of hospitalized elderly type 2 diabetic patients.Methods:The ankle-brachial index (ABI) was used to screen LEAD in hospitalized elderly type 2 diabetic patients.The patients were divided into 5 groups based on the screening results:non-LEAD group and LEAD group;the LEAD group was divided into mild stenosis group,moderate stenosis group,and severe stenosis group.Results:The percentage of patients who had LEAD was 43%.Significant difference in age,diabetes duration,peak velocity,microalbuminuria,and vibratory sensory neuropathy was observed between patients with and without LEAD;regression analysis showed that urinary albumin and vibratory sensory neuropathy were independent risk factors for LEAD.Significant difference in age,body mass index (BMI),peak velocity,urinary albumin,and high-density lipoprotein cholesterol (HDL-C) was observed between mild stenosis group,moderate stenosis group,and severe stenosis group;regression analysis showed that urinary albumin,BMI,and HDL-C were independent risk factors for accelerating vascular stenosis.Conclusions:The incidence of LEAD in hospitalized elderly type 2 diabetic patients is high;age,diabetes duration,peak velocity,BMI,urinary microalbumin,vibratory sensory neuropathy,and HDL-C are the maior risk factors for LEAD.Active control of risk factors is helpful to reduce or delay LEAD.展开更多
Respiratory syncytial virus(RSV)is the main pathogen that causes hospitalization for acute lower respiratory tract infections(ALRIs)in children.With the reopening of communities and schools,the resurgence of RSV in th...Respiratory syncytial virus(RSV)is the main pathogen that causes hospitalization for acute lower respiratory tract infections(ALRIs)in children.With the reopening of communities and schools,the resurgence of RSV in the COVID-19 post-pandemic era has become a major concern.To understand the circulation patterns and genotype variability of RSV in Tianjin before and during the COVID-19 pandemic,a total of 19,531 nasopharyngeal aspirate samples from hospitalized children in Tianjin from July 2017 to June 2022 were evaluated.Direct immunofluorescence and polymerase chain reaction(PCR)were used for screening RSV-positive samples and subtyping,respectively.Further analysis of mutations in the second hypervariable region(HVR2)of the G gene was performed through Sanger sequencing.Our results showed that 16.46%(3215/19,531)samples were RSV positive and a delayed increase in the RSV infection rates occurred in the winter season from December 2020 to February 2021,with the average RSV-positive rate of 35.77%(519/1451).The ON1,with H258Q and H266L substitutions,and the BA9,with T290I and T312I substitutions,are dominant strains that alternately circulate every 1–2 years in Tianjin,China,from July 2017 to June 2022.In addition,novel substitutions,such as N296Y,K221T,N230K,V251A in the BA9 genotype,and L226I in the ON1 genotype,emerged during the COVID-19 pandemic.Analysis of clinical characteristics indicated no significant differences between RSV-A and RSV-B groups.This study provides a theoretical basis for clinical prevention and treatment.However,further studies are needed to explore the regulatory mechanism of host immune responses to different lineages of ON1 and BA9 in the future.展开更多
Rational nutritional support shall be based on nutritional screening and nutritional assessment. This study is aimed to explore nutritional risk screening and its influencing factors of hospitalized patients in centra...Rational nutritional support shall be based on nutritional screening and nutritional assessment. This study is aimed to explore nutritional risk screening and its influencing factors of hospitalized patients in central urban area. It is helpful for the early detection of problems in nutritional supports, nutrition management and the implementation of intervention measures, which will contribute a lot to improving the patient＇s poor clinical outcome. A total of three tertiary medical institutions were enrolled in this study. From October 2015 to June 2016, 1202 hospitalized patients aged ≥18 years were enrolled in Nutrition Risk Screening 2002（NRS2002） for nutritional risk screening, including 8 cases who refused to participate, 5 cases of same-day surgery and 5 cases of coma. A single-factor chi-square test was performed on 312 patients with nutritional risk and 872 hospitalized patients without nutritional risk. Logistic regression analysis was performed with univariate analysis（P〈0.05）, to investigate the incidence of nutritional risk and influencing factors. The incidence of nutritional risk was 26.35% in the inpatients, 25.90% in male and 26.84% in female, respectively. The single-factor analysis showed that the age ≥60, sleeping disorder, fasting, intraoperative bleeding, the surgery in recent month, digestive diseases, metabolic diseases and endocrine system diseases had significant effects on nutritional risk（P〈0.05）. Having considered the above-mentioned factors as independent variables and nutritional risk（Y=1, N=0） as dependent variable, logistic regression analysis revealed that the age ≥60, fasting, sleeping disorders, the surgery in recent month and digestive diseases are hazardous factors for nutritional risk. Nutritional risk exists in hospitalized patients in central urban areas. Nutritional risk screening should be conducted for inpatients. Nutritional intervention programs should be formulated in consideration of those influencing factors, which enable to reduce the nutritional risk and to promote the rehabilitation of inpatients.展开更多
Hypoglycemia occurred on hospitalized patients would result in severe complications.So we monitored the blood glucose of hospitalized patients with diabetes in 14 clinical departments from January to December 2013.Tot...Hypoglycemia occurred on hospitalized patients would result in severe complications.So we monitored the blood glucose of hospitalized patients with diabetes in 14 clinical departments from January to December 2013.Totally 105728 cases of blood glucose were monitored and 1374 cases of hypoglycemia were detected.The incidence of hypoglycemia was 1.29%.Among which,317 cases of severe hypoglycemia were detected and the incidence of severe hypoglycemia was 0.29%.The peak periods of hypoglycemia were 0:00~2:00,22:00~24:00,2:00~4:00,8:00~10:00 and 10:00~12:00.The symptomatic hypoglycemia accounted for 47.01%,The asymptomatic hypoglycemia accounted for 52.98%.The incidence of hypoglycemia was 1.49%in medical departments and 0.87%in surgical departments.It is suggested to be vigilant of high risk periods of hypoglycemia,detect and treat asymptomatic hypoglycemia timely and rationally administer antidiabetics to prevent hypoglycemia.展开更多
OBJECTIVE: To explore the effects of acupoint massage combined with psychological nursing on depression and hope level and coping style in hospitalized patients with hepatocirrhosis, and to provide scientific basis fo...OBJECTIVE: To explore the effects of acupoint massage combined with psychological nursing on depression and hope level and coping style in hospitalized patients with hepatocirrhosis, and to provide scientific basis for clinical treatment. METHODS: A total of 86 patients with hepatocirrhosis hospitalized in The Sixth Hospital of Handan from June 2015 to June 2018 were selected and divided into 2 groups according to the nursing method. The control group, with a total of 42 patients, were given psychological nursing intervention. The observation group, with a total of 44 patients, were given acupoint massage and psychological nursing intervention. Changes in depression levels, hope levels, and coping style scores were compared between the 2 groups. RESULTS: There was no significant difference in depression, hope level and coping style before the intervention between the 2 groups(P > 0.05). In the observation group, the self-rating depression scale(SDS) score of depression before intervention was 55.16 ± 4.17; and the positive attitude score was 8.40 ± 2.02; the positive action score was 8.33 ± 3.05; and the intimate score was 8.13 ± 2.44. The negative response score was 30.14 ± 3.31, and the positive response score was 30.49 ± 3.26. Before the intervention, the SDS score in the control group was 56.81 ± 4.39, and the positive attitude score was 8.29 ± 1.98. The positive action score was 8.04 ± 2.57, and the intimate score was 8.06 ± 2.31. The total level of hope score was 24.07 ± 3.11. The negative coping score was 30.55 ± 3.06, and the positive coping score was 30.93 ± 3.17. After intervention the SDS scores of the observation group were lower than those of the control group(P < 0.05). The SDS score of the observation group was 36.19 ± 4.19, and the SDS score of the control group was 42.95 ± 3.71. The total level of hope in the observation group was higher than that in the control group after intervention(P < 0.05). The positive attitude score of the observation group was 16.10 ± 2.15, and the score of positive action was 14.74 ± 3.11; the score of intimate relationship was 15.08 ± 5.45; and the total score of hope was 45.71 ± 5.63. The positive attitude score of the control group was 10.92 ± 2.07; the score of positive action was 11.38 ± 3.14; the score of intimate relationship was 10.92 ± 2.33; and the total score of hope was 34.09 ± 5.77. The patients in the observation group had lower response scores after intervention than the control group, and the positive response scores were higher than those in the control group(P < 0.05). The negative response score of the observation group was 20.14 ± 2.19; the positive response score was 38.92 ± 4.33; the negative response score of the control group was 26.61 ± 2.34; and the positive response score was 34.08 ± 2.69. CONCLUSION: Acupoint massage combined with psychological nursing can effectively improve depression in hospitalized patients with hepatocirrhosis, improve the patient's hope level, help patients cope with lifestyle changes from negative to positive, which is worthy of clinical promotion.展开更多
文摘Objective:This study aimed to evaluate the effectiveness of an integrative educational intervention-combining hospital-based schooling programs,child-centered communication,and therapeutic play-on clinical,psychosocial,and educational outcomes among school-aged children with cancer.Materials and Methods:A quasi-experimental pre-and post-test control group design was conducted at the pediatric oncology unit of Rumah Sakit Islam Jemursari,Surabaya,Indonesia.Fifty-two hospitalized children aged 6-18 years were randomly assigned to an intervention group(n=26)or a control group(n=26).The intervention lasted 1 month and integrated hospital-based lessons aligned with the national curriculum,therapeutic play,and developmentally appropriate communication by trained staff.Outcomes included pain intensity(Wong-Baker FACES Scale),treatment adherence,quality of life(Pediatric Cancer Quality of Life-32[PCQL-32]),anxiety(Revised Children’s Manifest Anxiety Scale),and literacy-numeracy performance.Data were analyzed using paired t-tests,ANCOVA,and Cohen’s d,with significance set at P<0.05.Results:Compared with controls,the intervention group showed significant improvements in pain reduction(P<0.001),treatment adherence(P<0.001),and quality of life across all PCQL-32 domains(P<0.001).Anxiety levels decreased significantly(P<0.001),and academic performance in literacy and numeracy improved markedly(P<0.001).Conclusion:The integrative educational intervention effectively enhanced clinical recovery,psychosocial well-being,and academic continuity among hospitalized children with cancer,emphasizing the need to integrate hospital-based education and play-based communication into pediatric oncology care.
基金the“Metropolitan Mosquitoes Project”funded by the Swedish Research Council for Environment,Agricultural Sciences and Spatial Planning(Formas,grant number 2016-00364).
文摘Dengue virus(DENV)is a positive-sense single-stranded RNA virus belonging to the genus Flavivirus within the Flaviviridae family.Four serotypes,DENV 1-4,are distributed globally[1].Hanoi metropolitan city is an endemic hotspot for DENV transmission in Vietnam[2,3].The largest outbreak occurred in 2017,with more than 36000 cases and 7 deaths reported,causing by all four serotypes with the predominance of DENV1,following by DENV2[4,5].During the following dengue season,we collected 390 blood and serum samples from 197 hospitalized patients in a national hospital in Hanoi city,Northern Vietnam to identify the circulating DENV serotypes responsible for the 2018-2019 outbreak.
基金supported by Guangdong Medical Science and Technology Research Fund Project(No.A2022458)Guangdong Provincial People's Medical Climbing Plan(Nursing Research Project)(No.DFJH2020011)。
文摘Background1 Currently,there is a scarcity of risk prediction models for frailty in hospitalized patients with chronic heart failure(CHF).This study aimed to investigate the frailty status of hospitalized CHF patients,identify independent risk factors significantly associated with frailty,and construct an effective risk prediction model.The goal was to provide a reference for clinical strategies in preventing and managing frailty among CHF patients.Methodss Using convenience sampling,we enrolled 184 hospitalized CHF patients from a tertiary hospital between February 2022 and December 2024.General demographic data were collected via questionnaires,alongside frailty screening using the FRAIL scale and assessment of daily functioning with the Activities of Daily Living(ADL)scale.Clinical data were obtained by reviewing medical records.Participants were categorized into a frail group(n=65)and a non-frail group(n=119)based on frailty status.Clinical risk factors were compared between groups.Multivariate logistic regression was used to identify independent risk factors.A prediction model was constructed,and a receiver operating characteristic(ROC)curve was plotted to evaluate its predictive value.Results A total of 184 hospitalized CHF patients were included,with 65(35.33%)exhibiting frailty.Multivariate logistic regression analysis showed that independent risk factors for frailty included:age,ADL score,N-terminal pro-brain natriuretic peptide(NT-pro-BNP),left ventricular ejection fraction(LVEF),New York Heart Association(NYHA)class II/IV,≥3 comorbidities,comorbid diabetes mellitus(DM),comorbid valvular heart disease(VHD),smoking history,hemoglobin(Hb),albumin,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),creatinine(Cr),and blood urea nitrogen(BUN).The aforementioned factors were incorporated into logistic regression analysis and the prediction model was built.The prediction model showed quite strong predictive performance.Its area under the ROC curve was 0.904(95%CI:0.857-0.951),with a sensitivity of98.5%and a specificity of 85.7%.ConclusionssThe frailty risk prediction model for hospitalized CHF patients demonstrated robust discriminative ability and calibration.It provided substantial reference value for clinical management of CHF,offering a basis for early assessment,risk stratification,and targeted interventions to prevent frailty by identifying high-risk patients.
文摘Objective:To systematically evaluate the effectiveness of research-oriented integrated nursing interventions on cancer pain management in hospitalized oncology patients in China.Methods:A computerized search of Chinese and English databases was conducted to identify relevant studies.Two researchers independently assessed the quality of included literature using the Newcastle-Ottawa Scale(NOS).Data were extracted and analyzed via Stata 14.A random-effects model was applied due to significant heterogeneity(I²>50%).Sensitivity analysis and Egger’s test were performed to assess bias.Results:12 eligible studies(2014-2024)were included.Meta-analysis demonstrated that integrated nursing interventions significantly reduced cancer pain scores compared to routine care(SMD=-1.51,95%CI:-1.90 to-1.12;I²=84.8%),with superior efficacy.Subgroup-analyses revealed enhanced effects for“Nursing modes”(SMD=-2.11)and“cancer pain education”(SMD=-2.30).Conclusion:Research-oriented integrated nursing interventions significantly improve cancer pain management in Chinese hospitalized oncology patients,particularly through synergistic effects of“Nursing modes”and“can-cer pain education.”However,implementation bias from“additive interventions”in teaching hospitals and high heterogeneity warrant attention.Future studies should optimize designs to enhance clinical applicability.
文摘Objective:To analyze the clinical characteristics of bone loss in hospitalized patients with Graves’disease.Methods:The clinical data of hospitalized patients with Graves’disease were collected.According to the results of bone density examinations,they were divided into a normal bone density group,a low bone mass group,and an osteoporosis group.The normal bone density group was used as the control group to analyze the clinical characteristics of bone loss.Results:The incidence of bone loss in patients with Graves’disease was 80.72%,with osteoporosis accounting for 39.16%and low bone mass accounting for 41.57%.The incidences of hyperthyroid heart disease,Graves’ophthalmopathy,and leukopenia in the osteoporosis group and the low bone mass group were significantly higher than those in the normal bone density group,reaching 84.62%,60.87%,and 34.38%,respectively(P<0.05).The age of the osteoporosis group with Graves’disease was 50.88±12.03 years old,which was higher than that of the normal bone density group(40.03±12.58 years old).The disease course was 55.66±14.21 days,longer than that of the normal bone density group(43.38±8.55 days).FT4 was 61.69±8.42 pmol/L,higher than that of the normal bone density group(51.01±6.77 pmol/L),while TSH was 0.08±0.51μIU/ml,lower than that of the normal bone density group(0.22±0.55μIU/ml).The blood phosphorus was 1.25±0.29 mmol/L,lower than that of the normal bone density group(1.34±0.27 mmol/L),with statistical significance(P<0.05).In the low bone mass group,FT3(13.08±9.05 pmol/L)and FT4(46.14±3.46 pmol/L)were lower than those in the normal bone density group,with statistical significance(P<0.05).Logistic regression analysis revealed that age,disease course,and TSH were contributing factors to bone loss.Conclusion:Patients with Graves’disease are prone to bone loss,and age,disease course,and TSH are contributing factors to bone loss.
文摘BACKGROUND Atrial fibrillation(AF)remains the most common cardiac arrhythmia.The safety of endoscopic retrograde cholangiopancreatography(ERCP)in patients with AF remains largely unknown.AIM To analyze the effect of AF on hospital outcomes in patients undergoing ERCP.METHODS We performed a retrospective cohort study using the Nationwide Inpatient Sample database.Adult patients with AF who underwent an inpatient ERCP were identified,then stratified by timing of ERCP,via international classification of diseases-10 codes.The primary outcome was all-cause in-hospital mortality.Secondary outcomes,including resource utilization,were assessed.Statistical analysis was performed using STATA software.RESULTS Of the 433245 patients that underwent an ERCP,49615 had a diagnosis of AF.Patients with AF had a significantly higher in-hospital mortality compared to those without AF[3.82%vs 1.13%,odds ratio(OR)=1.93,P<0.01].AF was significantly associated with increased hospital stay(+1.71 days),hospital charges($21210),shock(OR=2.17),sepsis(OR=1.34),intensive care unit admission(OR=2.41),acute kidney injury(OR=1.51),as well as a decreased likelihood of discharge to home(OR=0.59),(all with P<0.01).These results were consistent after propensity score matching.Upon subgroup analysis,patients with AF,whom underwent ERCP>72 hours,had worse outcomes including higher inhospital mortality(adjusted OR=1.47,P<0.01).CONCLUSION By way of this large,national analysis it appears AF is associated with significantly worse hospitalization outcomes,inducing increased mortality,in those undergoing ERCP.Further prospective investigation is warranted to potentially guide clinical recommendations for patients with AF undergoing ERCP in this setting.
基金Supported by the major research project on Botany(Grant No.39-388/2010/SR)from UGC+1 种基金New Delhiawarded RN Padhy
文摘Objective:To record surveillance,antibiotic resistance of uropathogens of hospitalized patients over a period of 18 months.Methods:Urine samples from wards and cabins were used for isolating urinary tract infection(UTI)-causing bacteria that were cultured on suitable selective media and identified by biochemical tests;and their antibiograms were ascertained by Kirby-Bauer's disc diffusion method,in each 6-month interval of the study period,using 18 antibiotics of five different classes.Results:From wards and cabins,1 245 samples were collected,from which 996 strains of bacteria belonging to 11 species were isolated,during April 2011 to September2012.Two Gram-positive,Staphylococcus aureus(S.aureus)and Enterococcus faecalis(E.faecalis),and nine Gram-negative bacteria,Acinetobacter baumannii,Citrobactcr sp.,Escherichia coli,Enterobacter aerogenes,Klebsiella pneumoniae.Klebsiella oxytoca,Proteus mirabilis,Proteus vulgaris and Pseudomonas aeruginosa were isolated.Both S.aureus and E.faecalis were vancomycin resistant,and resistant-strains of all pathogens increased in each 6-month period of study.Particularly,all Gram-negatives were resistant to nitrofurantoin and co-trimoxazole,the most preferred antibiotics of empiric therapy for UTI.Conclusions:Antibiograms of 11 UTI-causing bacteria recorded in this study indicated moderately higher numbers of strains resistant to each antibiotic studied,generating the fear of precipitating fervent episodes in public health particularly with bacteria,Acinetobacter baumannii,Escherichia coli,Klebsiella pneumoniae and S.aureus.Moreover,vancomycin resistance in strains of S.aureus and E.faecalis is a matter of concern.
文摘AIM: To compare thromboembolism rates between hospitalized patients with a diagnosis of ulcerative colitis and other hospitalized patients at high risk for thromboembolism. To compare thromboembolism rates between patients with ulcerative colitis undergoing a colorectal operation and other patients undergoing colorectal operations. METHODS: Data from the National Hospital Discharge Survey was used to compare thromboembolism rates between (1) hospitalized patients with a discharge diagnosis of ulcerative colitis and those with diverticulitis or acute respiratory failure, and (2) hospitalized patients with a discharge diagnosis of ulcerative colitis who underwent colectomy and those with diverticulitis or colorectal cancer who underwent colorectal operations. RESULTS: Patients diagnosed with ulcerative colitis had similar or higher rates of combined venous thromboembolism (2.03%) than their counterparts with diverticulitis (0.76%) or respiratory failure (1.99%), despite the overall greater prevalence of thromboembolic risk factors in the latter groups. Discharged patients with colitis that were treated surgically did not have signifi cantly different rates of venous or arterial thromboembolism than those with surgery for diverticulitis or colorectal cancer.CONCLUSION: Patients with ulcerative colitis who do not undergo an operation during their hospitalization have similar or higher rates of thromboembolism than other medical patients who are considered to be high risk for thromboembolism.
文摘BACKGROUND Acute severe ulcerative colitis unresponsive to systemic steroid treatment is a lifethreatening medical condition requiring hospitalization and often colectomy.Despite the increasing choice of medical therapy options for ulcerative colitis, the condition remains a great challenge in the field of inflammatory bowel diseases(IBD). The performance of the calcineurin inhibitor tacrolimus in this clinical setting is insufficiently elucidated.AIM To evaluate the short and long-term outcomes of tacrolimus therapy in adult inpatients with steroid-refractory acute severe ulcerative colitis.METHODS We conducted a retrospective monocentric study enrolling 22 patients at a tertiary care center for the treatment of IBD. All patients who were admitted to one of the wards of the Department of Gastroenterology and Hepatology of the Heidelberg University Hospital with acute severe ulcerative colitis between 2007 and 2018, and who received oral or intravenous tacrolimus for steroid-refractory disease were included. Baseline characteristics and data on the disease courses were retrieved from entirely computerized patient charts. The primary study endpoint was clinical response to tacrolimus therapy, resulting in discharge from the hospital. Secondary study endpoints were colectomy rate and time to colectomy, achievement of clinical remission under tacrolimus therapy, and the occurrence of side effects.RESULTSIn the majority of the 22 included patients(68.2%), tacrolimus therapy was initiated intravenously and subsequently converted to oral administration. The treatment duration was 128 ± 28.5 d(mean ± SEM), and the patients were followed up for 705 ± 110 d after treatment initiation. Among all patients, 86.4%were discharged from the hospital under continued oral tacrolimus therapy. In36.4% of the patients, the administration of tacrolimus resulted in clinical remission at some point during the treatment. Thirty-two percent of the patients underwent colectomy between 5 and 194 d after the initiation of tacrolimus treatment(mean: 97.4 ± 20.8 d). Colectomy-free survival rates at 1, 3, 6 and 12 mo after the initiation of tacrolimus therapy were 90.9%, 86.4%, 77.3% and 68.2%,respectively. The safety profile of tacrolimus was overall favorable. Only two patients discontinued the treatment due to side effects.CONCLUSION The short-term outcome of tacrolimus in steroid-refractory acute severe ulcerative colitis was beneficial, and side effects were rare. In all, tacrolimus therapy appears to be a viable option for short-term treatment of steroidrefractory acute severe ulcerative colitis besides ciclosporin and anti-tumor necrosis factor α treatment.
基金supported by the National Natural Science Foundation of China(81472003 and 31500139)
文摘Norovirus （NOV） is a pathogen that commonly causes viral diarrhea in children. Studies indicate that NoV recognizes human histo-blood group antigens （HBGAs） as cell attachment factors. In order to explore the correlation between of NoV infection and HBGAs, a cross-sectional study was conducted in children less than five years old who were hospitalized with diarrhea in two areas of China between November 2014 and February 2015. Of the paired stool and saliva samples taken from 424 children,
文摘ABSTRACT Importance Hospitalizations for heart failure （HHF） represent a major health burden, with high rates of early postdischarge rehospitalization and mortality. Objective To investigate whether aliskiren, a direct renin inhibitor, when added to standard therapy, would reduce the rate of cardiovascular （CV） death or HF rehospitalization among HHF patients. Design, Setting, and Participants International, double-blind, placebo-controlled study that randomized hemodynamically stable HHF patients a median 5 days after admission. Eligible patients were 18 years or older with left ventricular ejection fraction （LVEF） 40% or less,
文摘Diabetes Mellitus is a significant health care challenge in the United States.The Center for Disease Control and Prevention estimates approximately 9.4%of patients in the United States are afflicted by diabetes.The Infectious Disease Society of America asymptomatic bacteriuria in women as two consecutive cleancatch voided urine specimens with isolation of the same bacterial strain in counts≥105 cfu/mL It is understood that diabetic patients tend to be at higher risk for infections than non-diabetics.Urinary tract infections(UTIs)tend to be the most common infection contracted by this population.UTIs are not only a significant cause of morbidity and mortality,they are also a significant financial burden.The data are conflicting,in regard to treating asymptomatic bacteriuria in diabetic patients to avoid hospital complications and ultimately decrease healthcare costs associated with these complications.However,clinicians continue to prescribe antibiotics empirically.Further randomized controlled study looking into the specific population as immunocompromised diabetic patients,patient with diabetic ketoacidosis and patient in intensive care unit needs to be undertaken.
基金supported by the National Key Research and Development Program from the Ministry of Science and Technology of China(grant number:2018YFC1312400)the CAMS Innovation Fund for Medical Science(grant number:2016-I2M-2-004,2017-I2M-2-002)+1 种基金the National Key Technology R&D Program from the Ministry of Science and Technology of China(grant number:2015BAI12B02)the 111 Project from the Ministry of Education of China(grant number:B16005)。
文摘OBJECTIVE To assess the association between beta-blockers and 1-year clinical outcomes in heart failure(HF)patients with atrial fibrillation(AF),and further explore this association that differs by left ventricular ejection fraction(LVEF)level.METHODS We enrolled hospitalized HF patients with AF from China Patient-centered Evaluative Assessment of Cardiac Events Prospective Heart Failure Study.COX proportional hazard regression models were employed to calculate hazard ratio of betablockers.The primary outcome was all-cause death.RESULTS Among 1762 HF patients with AF(756 women[41.4%]),1041(56%)received beta-blockers at discharge and 1272(72.2%)had an LVEF>40%.During one year follow up,all-cause death occurred in 305(17.3%),cardiovascular death occurred in203 patients(11.5%),and rehospitalizations for HF occurred in 622 patients(35.2%).After adjusting for demographic characteristics,social economic status,smoking status,medical history,anthropometric characteristics,and medications used at discharge,the use of beta-blockers at discharge was not associated with all-cause death[hazard ratio(HR):0.86;95%Confidence Interval(CI):0.65-1.12;P=0.256],cardiovascular death(HR:0.76,95%CI:0.52-1.11;P=0.160),or the composite outcome of all-cause death and HF rehospitalization(HR:0.97,95%CI:0.82-1.14;P=0.687)in the entire cohort.There were no significant interactions between use of beta-blockers at discharge and LVEF with respect to all-cause death,cardiovascular death,or composite outcome.In the adjusted models,the use of beta-blockers at discharge was not associated with all-cause death,cardiovascular death,or composite outcome across the different levels of LVEF:reduced(<40%),mid-range(40%-49%),or preserved LVEF(≥50%).CONCLUSION Among HF patients with AF,the use of beta-blockers at discharge was not associated with 1-year clinical outcomes,regardless of LVEF.
基金supported by the Beijing Municipal Natural Science Foundation[No.5072021]Capital Medical Development Scientific Research Fund[No.2009-1057]the 11th Five Years Key Programs for Science and Technology Development of China[No.2013ZX10003006 and No.2013ZX10003002-001]
文摘A retrospective analysis was performed in two major HIV/AIDS referral hospitals in Beijing to evaluate the prevalence of Mycobacterium tuberculosis（MTB） and non-tuberculous mycobacterial（NTM） infections in HIV-infected patients. A total of 627 patients＇ data were reviewed, and 102（16.3%） patients were diagnosed with culture-confirmed mycobacterial infection, including 84 with MTB, 16 with NTM, and 2 with both MTB and NTM. The most frequent clinical complication by mycobacterial infection was pulmonary infection（48/102, 47.1%）. The overall rates of multidrug-resistant TB（MDR-TB） and extensively drug-resistant TB（XDR-TB） were 11.9% and 3.4%, respectively. This study underlines the urgent need to intensify screening for mycobacteria coinfection with HIV and to prevent the spread of drug-resistant TB among HIV-infected patients.
文摘Insomnia is among the most common sleep disorders worldwide.Insomnia in older adults is a social and public health problem.Insomnia affects the physical and mental health of elderly hospitalized patients and can aggravate or induce physical illnesses.Understanding subjective feelings and providing reasonable and standardized care for elderly hospitalized patients with insomnia are urgent issues.AIM To explore the differences in self-reported outcomes associated with insomnia among elderly hospitalized patients.METHODS One hundred patients admitted to the geriatric unit of our hospital between June 2021 and December 2021 were included in this study.Self-reported symptoms were assessed using the Athens Insomnia Scale(AIS),Generalized Anxiety Disorder Scale-7(GAD-7),Geriatric Depression Scale-15(GDS-15),Memorial University of Newfoundland Scale of Happiness(MUNSH),Barthel Index Evaluation(BI),Morse Fall Scale(MFS),Mini-Mental State Examination,and the Short Form 36 Health Survey Questionnaire(SF-36).Correlation coefficients were used to analyze the correlation between sleep quality and self-reported symptoms.Effects of insomnia was analyzed using Logistic regression analysis.RESULTS Nineteen patients with AIS≥6 were included in the insomnia group,and the incidence of insomnia was 19%(19/100).The remaining 81 patients were assigned to the non-insomnia group.There were significant differences between the two groups in the GDA-7,GDS-15,MUNSH,BI,MFS,and SF-36 items(P<0.05).Patients in the insomnia group were more likely to experience anxiety,depression,and other mental illnesses,as well as difficulties with everyday tasks and a greater risk of falling(P<0.05).Subjective well-being and quality of life were poorer in the insomnia group than in the control group.The AIS scores positively correlated with the GAD-7,GDS-15,and MFS scores in elderly hospitalized patients with insomnia(P<0.05).Logistic regression analysis showed that GDS-15≥5 was an independent risk factor for insomnia in elderly hospitalized patients(P<0.05).CONCLUSION The number of self-reported symptoms was higher among elderly hospitalized patients with insomnia.Therefore,we should focus on the main complaints of patients to meet their care needs.
基金funded by Shanghai Municipal Commission of Health and Family Planning,Key Developing Disciplines(2015ZB0501)Project of Shanghai Science and Technology Commission(16411971300).
文摘Background:The risk of lower extremity arterial disease (LEAD) is increased in diabetic patients.LEAD in diabetic patients occurs earlier and is often more severe and diffuse;however,it is largely underdiagnosed and untreated.The purposes of this study were to investigate and analyze LEAD situation of hospitalized elderly type 2 diabetic patients.Methods:The ankle-brachial index (ABI) was used to screen LEAD in hospitalized elderly type 2 diabetic patients.The patients were divided into 5 groups based on the screening results:non-LEAD group and LEAD group;the LEAD group was divided into mild stenosis group,moderate stenosis group,and severe stenosis group.Results:The percentage of patients who had LEAD was 43%.Significant difference in age,diabetes duration,peak velocity,microalbuminuria,and vibratory sensory neuropathy was observed between patients with and without LEAD;regression analysis showed that urinary albumin and vibratory sensory neuropathy were independent risk factors for LEAD.Significant difference in age,body mass index (BMI),peak velocity,urinary albumin,and high-density lipoprotein cholesterol (HDL-C) was observed between mild stenosis group,moderate stenosis group,and severe stenosis group;regression analysis showed that urinary albumin,BMI,and HDL-C were independent risk factors for accelerating vascular stenosis.Conclusions:The incidence of LEAD in hospitalized elderly type 2 diabetic patients is high;age,diabetes duration,peak velocity,BMI,urinary microalbumin,vibratory sensory neuropathy,and HDL-C are the maior risk factors for LEAD.Active control of risk factors is helpful to reduce or delay LEAD.
基金funded by the Tianjin Key Medical Discipline(Specialty)Construction Project(Grant number TJYXZDXK-040A)the Public Health and Technology Project of Tianjin(Grant number TJWJ2021QN050).
文摘Respiratory syncytial virus(RSV)is the main pathogen that causes hospitalization for acute lower respiratory tract infections(ALRIs)in children.With the reopening of communities and schools,the resurgence of RSV in the COVID-19 post-pandemic era has become a major concern.To understand the circulation patterns and genotype variability of RSV in Tianjin before and during the COVID-19 pandemic,a total of 19,531 nasopharyngeal aspirate samples from hospitalized children in Tianjin from July 2017 to June 2022 were evaluated.Direct immunofluorescence and polymerase chain reaction(PCR)were used for screening RSV-positive samples and subtyping,respectively.Further analysis of mutations in the second hypervariable region(HVR2)of the G gene was performed through Sanger sequencing.Our results showed that 16.46%(3215/19,531)samples were RSV positive and a delayed increase in the RSV infection rates occurred in the winter season from December 2020 to February 2021,with the average RSV-positive rate of 35.77%(519/1451).The ON1,with H258Q and H266L substitutions,and the BA9,with T290I and T312I substitutions,are dominant strains that alternately circulate every 1–2 years in Tianjin,China,from July 2017 to June 2022.In addition,novel substitutions,such as N296Y,K221T,N230K,V251A in the BA9 genotype,and L226I in the ON1 genotype,emerged during the COVID-19 pandemic.Analysis of clinical characteristics indicated no significant differences between RSV-A and RSV-B groups.This study provides a theoretical basis for clinical prevention and treatment.However,further studies are needed to explore the regulatory mechanism of host immune responses to different lineages of ON1 and BA9 in the future.
基金supported by Soft Science Application Program of Wuhan Scientific and Technological Bureau of China(No.2016040306010211)
文摘Rational nutritional support shall be based on nutritional screening and nutritional assessment. This study is aimed to explore nutritional risk screening and its influencing factors of hospitalized patients in central urban area. It is helpful for the early detection of problems in nutritional supports, nutrition management and the implementation of intervention measures, which will contribute a lot to improving the patient＇s poor clinical outcome. A total of three tertiary medical institutions were enrolled in this study. From October 2015 to June 2016, 1202 hospitalized patients aged ≥18 years were enrolled in Nutrition Risk Screening 2002（NRS2002） for nutritional risk screening, including 8 cases who refused to participate, 5 cases of same-day surgery and 5 cases of coma. A single-factor chi-square test was performed on 312 patients with nutritional risk and 872 hospitalized patients without nutritional risk. Logistic regression analysis was performed with univariate analysis（P〈0.05）, to investigate the incidence of nutritional risk and influencing factors. The incidence of nutritional risk was 26.35% in the inpatients, 25.90% in male and 26.84% in female, respectively. The single-factor analysis showed that the age ≥60, sleeping disorder, fasting, intraoperative bleeding, the surgery in recent month, digestive diseases, metabolic diseases and endocrine system diseases had significant effects on nutritional risk（P〈0.05）. Having considered the above-mentioned factors as independent variables and nutritional risk（Y=1, N=0） as dependent variable, logistic regression analysis revealed that the age ≥60, fasting, sleeping disorders, the surgery in recent month and digestive diseases are hazardous factors for nutritional risk. Nutritional risk exists in hospitalized patients in central urban areas. Nutritional risk screening should be conducted for inpatients. Nutritional intervention programs should be formulated in consideration of those influencing factors, which enable to reduce the nutritional risk and to promote the rehabilitation of inpatients.
文摘Hypoglycemia occurred on hospitalized patients would result in severe complications.So we monitored the blood glucose of hospitalized patients with diabetes in 14 clinical departments from January to December 2013.Totally 105728 cases of blood glucose were monitored and 1374 cases of hypoglycemia were detected.The incidence of hypoglycemia was 1.29%.Among which,317 cases of severe hypoglycemia were detected and the incidence of severe hypoglycemia was 0.29%.The peak periods of hypoglycemia were 0:00~2:00,22:00~24:00,2:00~4:00,8:00~10:00 and 10:00~12:00.The symptomatic hypoglycemia accounted for 47.01%,The asymptomatic hypoglycemia accounted for 52.98%.The incidence of hypoglycemia was 1.49%in medical departments and 0.87%in surgical departments.It is suggested to be vigilant of high risk periods of hypoglycemia,detect and treat asymptomatic hypoglycemia timely and rationally administer antidiabetics to prevent hypoglycemia.
文摘OBJECTIVE: To explore the effects of acupoint massage combined with psychological nursing on depression and hope level and coping style in hospitalized patients with hepatocirrhosis, and to provide scientific basis for clinical treatment. METHODS: A total of 86 patients with hepatocirrhosis hospitalized in The Sixth Hospital of Handan from June 2015 to June 2018 were selected and divided into 2 groups according to the nursing method. The control group, with a total of 42 patients, were given psychological nursing intervention. The observation group, with a total of 44 patients, were given acupoint massage and psychological nursing intervention. Changes in depression levels, hope levels, and coping style scores were compared between the 2 groups. RESULTS: There was no significant difference in depression, hope level and coping style before the intervention between the 2 groups(P > 0.05). In the observation group, the self-rating depression scale(SDS) score of depression before intervention was 55.16 ± 4.17; and the positive attitude score was 8.40 ± 2.02; the positive action score was 8.33 ± 3.05; and the intimate score was 8.13 ± 2.44. The negative response score was 30.14 ± 3.31, and the positive response score was 30.49 ± 3.26. Before the intervention, the SDS score in the control group was 56.81 ± 4.39, and the positive attitude score was 8.29 ± 1.98. The positive action score was 8.04 ± 2.57, and the intimate score was 8.06 ± 2.31. The total level of hope score was 24.07 ± 3.11. The negative coping score was 30.55 ± 3.06, and the positive coping score was 30.93 ± 3.17. After intervention the SDS scores of the observation group were lower than those of the control group(P < 0.05). The SDS score of the observation group was 36.19 ± 4.19, and the SDS score of the control group was 42.95 ± 3.71. The total level of hope in the observation group was higher than that in the control group after intervention(P < 0.05). The positive attitude score of the observation group was 16.10 ± 2.15, and the score of positive action was 14.74 ± 3.11; the score of intimate relationship was 15.08 ± 5.45; and the total score of hope was 45.71 ± 5.63. The positive attitude score of the control group was 10.92 ± 2.07; the score of positive action was 11.38 ± 3.14; the score of intimate relationship was 10.92 ± 2.33; and the total score of hope was 34.09 ± 5.77. The patients in the observation group had lower response scores after intervention than the control group, and the positive response scores were higher than those in the control group(P < 0.05). The negative response score of the observation group was 20.14 ± 2.19; the positive response score was 38.92 ± 4.33; the negative response score of the control group was 26.61 ± 2.34; and the positive response score was 34.08 ± 2.69. CONCLUSION: Acupoint massage combined with psychological nursing can effectively improve depression in hospitalized patients with hepatocirrhosis, improve the patient's hope level, help patients cope with lifestyle changes from negative to positive, which is worthy of clinical promotion.
