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Objective: To assess the utility of urinary misfolded proteins (MP) in predicting preeclampsia (PE) in high–risk twin pregnancies. Methods: A prospective study was conducted on 600 high–risk twin pregnancies at Shanghai First Maternity and Infant Hospital from March to August 2021. Clinical data were collected, and urinary MP levels were measured. Subsequently, fetal outcomes were monitored. The patients were categorized into three groups based on the presence of PE: unaffected PE group, early–onset PE (ePE) group (gestational age < 34 weeks), and late–onset PE (lPE) group (gestational age ≥ 34 weeks). The predictive value of MP in PE was evaluated using analysis of variance, Chi–square test, and ROC curve analysis. Results: A total of 464 twin pregnancies were included in the study, among which 66 cases (14.2%) developed PE, including 19 cases of ePE (4.1%) and 47 cases (10.1%) of lPE. Significant differences were found in maternal age, pre–pregnancy body mass index (BMI), BMI ≥ 28 km/m2, mean systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), MAP ≥ 85 mmHg, history of PE, history of chronic hypertension, and positive urine protein. The maternal and fetal complications of twin pregnancies with PE were higher than those without PE (P < 0.05). When maternal factors (MF), MAP, and MP were used to predict ePE and lPE alone, the area under the ROC curve of MF was the largest, at 0.739 (95% CI 0.619–0.860) and 0.692 (95% CI 0.603–0.782), respectively. The area under the ROC curve of the combination of the three factors was 0.770 (95% CI 0.703–0.837), higher than that of a single index. In addition, MP predicted the positive predictive value (PPV) and negative predictive value (NPV) of PE from 12 to 15+6 gestational weeks as 57.9% and 89.2%, respectively; from 16 to 27+6 gestational weeks as 36.2% and 89.9%, respectively; and during the 12–27+6 gestational weeks as 42.4% and 92.2%, respectively. Conclusion: The detection of MP in the urine of women with twin pregnancies is a non–invasive and convenient method for predicting PE. If the test result is positive, enhanced monitoring and timely transfer to a superior hospital are necessary. If the test result is negative, it indicates a low risk of developing PE, reducing the need for excessive clinical examination and intervention. [ABSTRACT FROM AUTHOR]

Objective: To explore the high-risk factors for neonatal pulmonary hemorrhage and analyze the therapeutic effect of high-frequency oscillatory ventilation on neonatal pulmonary hemorrhage. Method: 100 newborns with pulmonary hemorrhage admitted from January 2021 to December 2023 were selected as the observation group, and 100 healthy newborns were selected as the control group. The independent influencing factors of the high risk of neonatal pulmonary hemorrhage were analyzed. Subsequently, 100 newborns with pulmonary hemorrhage were randomly divided into two groups: the conventional group received conventional mechanical ventilation, and the high-frequency group received high-frequency oscillatory ventilation. Compare the relevant indicators between two groups of pediatric patients. Results: Premature infants, intrauterine distress, meconium aspiration, concurrent infectious pneumonia, neonatal asphyxia, and respiratory distress syndrome are independent factors for the onset of neonatal pulmonary hemorrhage (P<0.05); At T2, T3, and T4, both groups of children showed a decrease in Ol and PaCO2, with the high-frequency group lower than the conventional group and an increase in PaO2, with the high-frequency group higher than the conventional group (P<0.05); The incidence of complications in the high-frequency group was significantly lower than that in the conventional group (P<0.05). Conclusion: Premature infants, intrauterine distress, meconium aspiration, concurrent infectious pneumonia, neonatal asphyxia, and respiratory distress syndrome are independent risk factors for neonatal pulmonary hemorrhage. Key monitoring measures should be taken to prevent the occurrence of pulmonary hemorrhage. For newborns with pulmonary hemorrhage, high-frequency oscillatory ventilation treatment can be adopted to improve their blood gas indicators and prognosis, and reduce the incidence of complications. [ABSTRACT FROM AUTHOR]

Objective To investigate the risk factors, treatment strategies and related survival time of meningeal metastasis in patients with non-small cell lung cancer with brain metastasis. Methods A total of 170 patients with brain metastasis of non-small cell lung cancer in Fujian Cancer Hospital were analyzed retro- spectively. They were divided into the combined meningeal metastasis group and the non-combined meningeal metastasis group. The basic clinical characteristics, molecular pathological characteristics, survival time and treatment options were compared between the two groups. At the same time, the clinical survival information of 63 patients with brain metastasis and meningeal metastasis of non-small cell lung cancer was tracked and analyzed, and the progression time and survival time of meningeal metastasis in patients with brain metastasis of non-small cell lung cancer were analyzed. Results Among the 121 patients with epidermal growth factor (EGFR) mutation-positive non-small cell lung cancer and brain metastasis. 51 patients (42.15%) had meningeal metastasis. While only 24.49% (12/49) of patients with brain metastases from non-small cell lung cancer without EGFR mutation had meningeal metastasis (X²=4.663,P=0.031).49.20% (31/63) of patients with meningeal metastasis received intrathecal chemotherapy, compared with no meningeal metastasis, the difference was statistically significant (X²=64.393,P<0.001). There was no significant difference in other treatment methods, such as surgery, radiotherapy, chemotherapy, targeting, anti-tumor angiogenesis and immuno- therapy (P>0.05). The median time from the discovery of lung cancer to the occurrence of meningeal metastasis in 63 patients with non-small cell lung cancer with meningeal metastasis was 35 months, with a 95% confidence interval of 27.230-42.770. The median time from the discovery of brain metastases to the occurrence of meningeal metastases in 63 patients with brain metastases from non-small cell lung cancer with meningeal metastases was 12 months, with a 95% confidence interval of 7.139-16.861. Conclusion EGFR mutation is a high risk factor for meningeal metastasis in patients with non-small cell lung cancer brain metastasis. For patients with brain and meningeal metastasis of non-small cell lung cancer, intrathecal chemotherapy on the basis of comprehensive treatment is a promising treatment. [ABSTRACT FROM AUTHOR]

Objective To analyze the high risk factors and nursing intervention measures of acquired weakness in intensive care unit (ICU-AW). Methods The clinical data of 261 patients with critically ill admitted to the ICU of our hospital from January 2023 to December 2023 were collected retrospectively. They were divided into the ICU-AW group (115 cases) and the non-ICU-AW group (146 cases) according to whether the patients were complicated with ICU-AW. The statistically significant factors were included in multivariate Logistic regression analysis to further analyze the risk factors of ICU-AW in patients with critically ill according to the clinical data of patients. Results Among 261 patients with critically ill, 115 patients had ICU-AW, and the incidence of ICU-AW was 44. 06%. The results of multivariate Logistic regression analysis showed that high score of acute physiological and chronic health status (score of APACHE II) and level of blood lactic acid , long time of ICU stay , and time of mechanical ventilation, diagnosis of multiple organ dysfunction, continuous renal replacement therapy and application of hormone drugs were independent risk factors for ICU-AW in patients with critically ill (OR= 3. 086, 4. 297, 1. 958, 3. 180, 3. 736, 3. 658, 4. 031, P

This research was aimed to analyse the application value of magnetic resonance imaging based on Fuzzy C‐means (FCM) algorithm in neonatal hypoglycemia brain injury (HBI), and explore the risk factors related to the occurrence of brain injury in children, to provide guidance for clinical diagnosis and treatment. 114 children with hypoglycemia were divided into brain injury group (58 cases) and no brain injury group (56 cases) according to whether they had brain injury or not. The MRI image signal performance, general data, average minimum blood glucose value, duration of hypoglycemia, first feeding time, age of onset of hypoglycemia, and algorithm segmentation performance of the two groups of patients were observed and compared. Furthermore, the Logistic factor analysis was carried out to summarize the MRI characteristics and related risk factors of neonatal hypoglycemic brain injury. The results showed that the average minimum blood glucose (1.09 ± 0.53 mmoL/L) in the brain injury group was lower than that in the non‐brain injury group (1.75 ± 0.49 mmoL/L), and the duration of hypoglycemia (43.1 ± 21.07 h) was higher than that in the non‐brain injury group (13.79 ± 6.81 h), p < 0.05. The first feeding time and age of hypoglycemia in the brain injury group were higher than those in the non‐brain injury group, showing a difference with p < 0.05. In the brain injury group, all 58 cases showed high DWI (diffusion weighted imaging) signal at the damaged site at the early stage of MRI (magnetic resonance imaging), and 23 cases (39.66%) were involved in parieto‐occipital lobe. Image segmentation coefficient of Vpc increased significantly under FCM clustering algorithm (p < 0.05). Late first feeding time, low blood sugar level, and long duration were high risk factors for hypoglycemic brain injury. In conclusion, MRI images based on FCM clustering algorithm had higher image quality. Late first feeding time, low blood sugar level, and long duration of hypoglycemia were high risk factors for hypoglycemic brain injury. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy of keloid surgery combined with radiation therapy (radiotherapy) and the effects of surgical approach, the start time of radiotherapy, the dose of radiotherapy, the site of keloid growth, and whether or not to apply a medical silicone gel dressing (Barnes ＆ Noble) on keloid recurrence. Methods A total of 45 patients with keloid who admitted to the hospital from January 2020 to July 2021 were retrospectively analyzed and divided into the group A (surgery combined with conventional radiotherapy, 10 cases),the group B (surgery combined with macrodissected radiotherapy, 12 cases),group C (surgery alone, eight cases),and group D (surgery combined with Barnes ＆ Noble treatment, 15 cases) according to the different treatment modalities. The treatment modalities, clinical efficacy and recurrence factors of the four groups were retrospectively analyzed. Results There were two cases of recurrence in patients in group A (20. 00%),one case of recurrence in patients in group B (8. 33%),seven cases of recurrence in patients in group C (87. 50%),and 13 cases of recurrence in patients in group D (86. 67%) . The efficacy of surgery combined with radiotherapy was significantly better than that of the group without postoperative radiotherapy, and the difference was statistically significant (P＜0. 05) . Whether or not postoperative combined radiotherapy was the main influencing factor of keloid recurrence. Conclusion Compared with the non-radiotherapy group, surgery combined with radiotherapy can significantly increase the cure rate and decrease the recurrence rate of patients; whether or not to combine radiotherapy after surgery, and whether or not the scar is in the joint mobility area are the high-risk factors for keloid recurrence. [ABSTRACT FROM AUTHOR]

Background: Targeted new-born hearing screening, based on high risk factors is recommended in the absence of universal new-born hearing screening in resource-constrained settings. The relevance of risk factors listed in the guidelines of high-income countries and used by low-middle income countries remains relatively unknown. Risk factors consistent with the epidemiological profile, evolution of risks and disease burden in these countries need to be considered. Objectives: This study aimed to profile the frequency of risk factors and their manifestation in hearing outcomes of young children in the KwaZulu-Natal province of South Africa. Method: A chart review of N = 1433 patients’ archival audiology records was conducted, conveniently sampled from a single tertiary hospital (n = 351), a provincial assessment and therapy centre (n = 649), a university clinic (n = 291), and two schools for the deaf (n = 142). Results: Overall, 56% of the participants presented with either a conductive, sensorineural or a mixed hearing loss; 62% of the children had between 1 and 2 risk factors present (Mean [M] = 1.1; standard deviation [s.d.] = 0.98). Admission to neonatal intensive care unit, maternal infections, bacterial and viral infections and chemotherapy, from the Joint Committee on Infant Hearing list of high risk factors were significantly associated with hearing loss (p 0.05). Known non-JCIH risks, emerging risks and other statistically significant contextually relevant risk factors were also noted. Conclusion: Understanding the profile of high risk factors in a given context has implications for prevention, early hearing identification and intervention services. Contribution: Targeted new-born hearing screening needs to be based on risk factors that are contextually relevant. This study is one of the first profiling high risk factors for hearing loss in children in KZN, the province with the second highest population in South Africa.

Abstract Aim To analyse the risk factors for falls in vascular patients and methods to mitigate fall risk in hospitalised patients receiving vascular surgery. Design This study is a multicentre, retrospective study. Methods A total of 112 inpatients that underwent vascular surgery in five hospitals in Shanxi Province from April 2018 to April 2022 were selected. They were divided into two groups according to whether they had fallen or not; 56 patients who fell were taken as the observation group and 56 patients who did not fall were taken as the control group. The risk factors of falls were analysed by univariate and logistic regression. Results There was no significant difference between the observation and the control groups in male patients and the incidence of falls without family members. In the observation group, the percentage of patients aged ≥65 years old, with a history of falls and/or fractures, long‐term medications and a history of osteoporosis was higher than in the control group and showed a statistically significant difference. Multivariate logistic regression analysis showed that advanced age, a history of falls and fractures, long‐term medications and a history of osteoporosis were independent risk factors for falls, and the differences were statistically significant. Conclusion Older age, a history of falls and/or fractures, continuous medication for more than 3 months and a history of osteoporosis are the risk factors for falls in hospitalised patients undergoing vascular surgery.

Aim: To analyse the risk factors for falls in vascular patients and methods to mitigate fall risk in hospitalised patients receiving vascular surgery. Design: This study is a multicentre, retrospective study. Methods: A total of 112 inpatients that underwent vascular surgery in five hospitals in Shanxi Province from April 2018 to April 2022 were selected. They were divided into two groups according to whether they had fallen or not; 56 patients who fell were taken as the observation group and 56 patients who did not fall were taken as the control group. The risk factors of falls were analysed by univariate and logistic regression. Results: There was no significant difference between the observation and the control groups in male patients and the incidence of falls without family members. In the observation group, the percentage of patients aged ≥65 years old, with a history of falls and/or fractures, long‐term medications and a history of osteoporosis was higher than in the control group and showed a statistically significant difference. Multivariate logistic regression analysis showed that advanced age, a history of falls and fractures, long‐term medications and a history of osteoporosis were independent risk factors for falls, and the differences were statistically significant. Conclusion: Older age, a history of falls and/or fractures, continuous medication for more than 3 months and a history of osteoporosis are the risk factors for falls in hospitalised patients undergoing vascular surgery. [ABSTRACT FROM AUTHOR]

The incidence rate of invasive mucormycosis (IM) in patients with hematological malignancies (HMs) is increasing year by year, ranging from 0.07% to 4.29%, and the mortality rate is mostly higher than 50%. With the ongoing pandemic of COVID-19, COVID-19-associated mucormycosis (CAM) also became a global health threat. Patients with high risk factors such as active HMs, relapsed/refractory leukemia, prolonged neutropenia may still develop breakthrough mucormycosis (BT-MCR) even under the prophylaxis of Mucorales-active antifungals, and such patients often have higher mortality. Rhizopus spp. is the most common genus associated with IM, followed by Mucor spp. and Lichtheimia spp. Pulmonary mucormycosis (PM) is the most common form of IM in patients with HMs, followed by rhino-orbital-cerebral mucormycosis (ROCM) and disseminated mucormycosis. The prognosis of IM patients with neutrophil recovery, localized IM and receiving early combined medical–surgical therapy is usually better. As for management of the disease, risk factors should be eliminated firstly. Liposome amphotericin B (L-AmB) combined with surgery is the initial treatment scheme of IM. Those who are intolerant to L-AmB can choose intravenous formulations or tablets of isavuconazole or posaconazole. Patients who are refractory to monotherapy can turn to combined antifungals therapy. [ABSTRACT FROM AUTHOR]

Objective: For exploring the clinical efficacy of laparoscopic radical hepatectomy and laparotomy for hepatocellular carcinoma and analysing related factors of postoperative recurrence. Methods: Totally 212 patients with hepatocellular carcinoma admitted to our hospital between April 2017 and December 2020 were enrolled, and all of them were followed up after the operation. According to the treatment modes, the patients were assigned to a laparotomy group (n=106) and a laparoscopic group (n=106). Perioperative indicators, haematological examination results, complications and recurrence were compared between the two groups. The recurrence time of hepatocellular carcinoma after the operation was confirmed by imaging examination with definite mass, and logistic multivariate analysis was used for analyzing the risk factors associated with postoperative recurrence. Results: Patients in both groups were comparable in terms of general baseline data. The laparoscopic group experienced longer operation time and shorter incision length, less intraoperative blood loss, early time to have the first off-bed activity and time to eat liquid and shorter hospital stay than the laparotomy group (all P<0.05). Seven days after the operation, the laparoscopic group showed notably lower levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), tumour necrosis factor-a (TNF-a), interleukin-8 (IL-8), and C-reactive protein (CRP) than the laparotomy group (all P<0.05), and also showed notably higher levels of immunoglobulin A (IgA), IgG and IgM than the laparotomy group (all P<0.05). Additionally, the laparotomy group showed a higher total incidence rate of complications than the laparoscopic group (19.81% vs. 9.43%, P<0.05). During the one-year follow-up, the laparotomy group was not greatly different from the laparoscopic group in recurrence rate (22.64% (24/106) vs. 16.98% (18/106), P>0.05). Multivariate analysis showed that average tumour diameter and microvascular invasion were risk factors for postoperative recurrence (P<0.05). Conclusion: Laparoscopic radical hepatectomy for hepatocellular carcinoma can reduce the influence on liver function and immune function, with less damage to tissues, and can ameliorate postoperative inflammatory reaction, and promote postoperative recovery of patients as soon as possible. There are many factors influencing the postoperative recurrence of hepatocellular carcinoma, and average tumour diameter and microvascular invasion are the risk factors. [ABSTRACT FROM AUTHOR]

Objective To explore the high risk factors of skin basal cell carcinoma, the differences in pathological characteristics and differential diagnosis between skin basal cell carcinoma and trichoblastoma. Methods A total of 35 patients with trichoblastoma and 118 patients with skin basal cell carcinoma from January 2018 to January 2021 were selected. At the same period, 60 healthy volunteers were randomly selected and questionnaire survey was performed in all volunteers. The content of questionnaire survey includes general conditions (such as gender and age), family history of disease, history of drug use, living habits, occupation and skin photosensitivity classification. The samples of tumor were collected from all patients after surgical resection for HE staining, and immunohistochemistry was used to examine the expression of B-lymphoma-2 gene (Bcl-2), androgen receptor (AR) and CD10. The logistic regression was used to analyze high-risk factors. Results Univariate analysis showed that there was statistical significance in family history, long-term sun exposure, radiation, immunosuppressive therapy, skin photosensitivity classification, occupation and outdoor exposure between patients with trichoblastoma and healthy volunteers (P<0.05). Multiple logistic regression analysis showed that the family history, long-term exposure without protection, radiation, immunosuppressive therapy, skin photosensitivity type Ⅲ and Ⅳ, outdoor work and outdoor exposure more than 4 hours were high risk factors of skin basal cell carcinoma (P<0.05). There were significant differences in the expression of Bcl-2, AR and CD10 between skin basal cell carcinoma and trichoblastoma (P<0.05). Conclusion There are many high risk factors for skin basal cell carcinoma, including family history, radiation, immunosuppressive therapy, skin photosensitivity type Ⅲ and Ⅳ, outdoor work and outdoor exposure more than 4 hours. The difference in pathological characteristics between skin basal cell carcinoma and trichoblastoma was low. It is easy to be confused in diagnosis. It is recommended to combine clinical high-risk factors, histopathological examination and immunohisto-chemical examination for comprehensive diagnosis to improve the accuracy of differential diagnosis. [ABSTRACT FROM AUTHOR]

Primary enucleation is a life-saving treatment for advanced intraocular retinoblastoma, particularly in patients with poor visual potential and functional contralateral eyes. This single-center study presents the treatment outcomes of patients with unilateral retinoblastoma who received primary enucleation and adjuvant chemotherapy with cyclophosphamide, vincristine, doxorubicin, and intrathecal methotrexate (CVDM) between 2000 and 2020. Twenty patients were enrolled in the study. The median age at diagnosis was 26 months (range, 1–45). Eighteen patients (90%) were in group E and two (10%) were in group D, according to the intraocular classification of retinoblastoma guidelines. Excluding one patient with an inadequate specimen, 19 patients (95%) had optic nerve involvement (ONI) at least up to the lamina cribrosa. Eight patients (40%) had choroidal invasion in addition to ONI. Two patients (10%) were surgical resection margin positive. The overall and event-free survival rates were 100% and 95%, respectively, for a median follow-up duration of 102.24 months (range 24.2–202.9). There were no relapses or deaths due to any cause, but one patient developed secondary rhabdomyosarcoma 99.6 months after chemotherapy. Treatment was well tolerated, with minimal hematotoxicity and hepatotoxicity. CVDM as a post-enucleation chemotherapy for advanced intraocular retinoblastoma has excellent outcomes with tolerable toxicity. However, in line with updated treatment trends, further risk stratification and lowering the treatment intensity should be considered. Continued long-term follow-up is required to further determine late effects. [ABSTRACT FROM AUTHOR]

The incidence rate of invasive mucormycosis (IM) in patients with hematological malignancies (HMs) is increasing year by year, ranging from 0.07% to 4.29%, and the mortality rate is mostly higher than 50%. With the ongoing pandemic of COVID-19, COVID-19-associated mucormycosis (CAM) also became a global health threat. Patients with high risk factors such as active HMs, relapsed/refractory leukemia, prolonged neutropenia may still develop breakthrough mucormycosis (BT-MCR) even under the prophylaxis of Mucorales-active antifungals, and such patients often have higher mortality. Rhizopus spp. is the most common genus associated with IM, followed by Mucor spp. and Lichtheimia spp. Pulmonary mucormycosis (PM) is the most common form of IM in patients with HMs, followed by rhino-orbital-cerebral mucormycosis (ROCM) and disseminated mucormycosis. The prognosis of IM patients with neutrophil recovery, localized IM and receiving early combined medical–surgical therapy is usually better. As for management of the disease, risk factors should be eliminated firstly. Liposome amphotericin B (L-AmB) combined with surgery is the initial treatment scheme of IM. Those who are intolerant to L-AmB can choose intravenous formulations or tablets of isavuconazole or posaconazole. Patients who are refractory to monotherapy can turn to combined antifungals therapy.

Objective To explore the mid-term patency of venous stent and high risk factors on deep venous post-thrombotic syndrome （PTS） of the legs. Methods From Aug 2015 to Mar 2019，124 patients with PTS treated in Qingpu Branch of Zhongshan Hospital，Fudan University were followed up for 2 years. All patients received balloon angioplasty and implantation of iliac-femoral venous stent therapy. Standard anticoagulant therapy was used after intervention operation. Finally，102 patients participated in the study，the patency of the stent was counted and high-risk factors were evaluated by Logistic regress analysis. Results The successful rate of stent implantation was 100%，and the clinical remission rate was 93.1% after the operation. The patency of the stent was 85.3% within 2 years. Obesity（OR=1.999， 95%CI：1.145-3.489），informal antiplatelet therapy（OR=0.050，95%CI：0.003-0.932），long stent（OR=41.033，95%CI：1.346-1250.940） and informal elastic support stocking therapy （OR=0.018，95%CI： 0.001-0.622） were the major risk factors for stent patency in PTS patients. Conclusion The venous stent implantation is an effective treatment for PTS of the legs. Short stent and treatment of antiplatelet， elastic support stocking therapy and weight loss within 2 years after operation in obese patients may help to increase the mid-term patency of venous stent. [ABSTRACT FROM AUTHOR]

Background:  Targeted new-born hearing screening, based on high risk factors is recommended in the absence of universal new-born hearing screening in resource-constrained settings. The relevance of risk factors listed in the guidelines of high-income countries and used by low-middle income countries remains relatively unknown. Risk factors consistent with the epidemiological profile, evolution of risks and disease burden in these countries need to be considered., Objectives:  This study aimed to profile the frequency of risk factors and their manifestation in hearing outcomes of young children in the KwaZulu-Natal province of South Africa., Method:  A chart review of N = 1433 patients' archival audiology records was conducted, conveniently sampled from a single tertiary hospital (n = 351), a provincial assessment and therapy centre (n = 649), a university clinic (n = 291), and two schools for the deaf (n = 142)., Results:  Overall, 56% of the participants presented with either a conductive, sensorineural or a mixed hearing loss; 62% of the children had between 1 and 2 risk factors present (Mean [M] = 1.1; standard deviation [s.d.] = 0.98). Admission to neonatal intensive care unit, maternal infections, bacterial and viral infections and chemotherapy, from the Joint Committee on Infant Hearing list of high risk factors were significantly associated with hearing loss (p  0.05). Known non-JCIH risks, emerging risks and other statistically significant contextually relevant risk factors were also noted., Conclusion:  Understanding the profile of high risk factors in a given context has implications for prevention, early hearing identification and intervention services.Contribution: Targeted new-born hearing screening needs to be based on risk factors that are contextually relevant. This study is one of the first profiling high risk factors for hearing loss in children in KZN, the province with the second highest population in South Africa.

Primary enucleation is a life-saving treatment for advanced intraocular retinoblastoma, particularly in patients with poor visual potential and functional contralateral eyes. This single-center study presents the treatment outcomes of patients with unilateral retinoblastoma who received primary enucleation and adjuvant chemotherapy with cyclophosphamide, vincristine, doxorubicin, and intrathecal methotrexate (CVDM) between 2000 and 2020. Twenty patients were enrolled in the study. The median age at diagnosis was 26 months (range, 1–45). Eighteen patients (90%) were in group E and two (10%) were in group D, according to the intraocular classification of retinoblastoma guidelines. Excluding one patient with an inadequate specimen, 19 patients (95%) had optic nerve involvement (ONI) at least up to the lamina cribrosa. Eight patients (40%) had choroidal invasion in addition to ONI. Two patients (10%) were surgical resection margin positive. The overall and event-free survival rates were 100% and 95%, respectively, for a median follow-up duration of 102.24 months (range 24.2–202.9). There were no relapses or deaths due to any cause, but one patient developed secondary rhabdomyosarcoma 99.6 months after chemotherapy. Treatment was well tolerated, with minimal hematotoxicity and hepatotoxicity. CVDM as a post-enucleation chemotherapy for advanced intraocular retinoblastoma has excellent outcomes with tolerable toxicity. However, in line with updated treatment trends, further risk stratification and lowering the treatment intensity should be considered. Continued long-term follow-up is required to further determine late effects.

Drug craving has been defined as tendency or compulsion to abuse substances. Coping skills approach provides a systematic way assessing the full range of antecedents' and consequences of abusing drug that influence an individual's craving potential and devising interventions to deal with them that are likely to reduce the probability of future relapse. Aim to enhancing coping skills to reduce drug craving among addicts. Study design: a quasiexperimental design was utilized to conduct this study. Setting: this study was conducted in the Heliopolis psychiatric Hospital. Subject: convenient sample of thirty patients suffered from drug craving at the addiction outpatient clinic, Data collection tools: 1) Socio-demographic interview questionnaire to assess the socio demographic characteristics of study subjects and data related to the previous history of drug abuse and relapse. 2) Drug craving questionnaire that was used to assess variable contributing to craving among drug abuse. 3) Coping Behavior Inventory (CBI) that was used to assess coping skills among drug craving patients. Results: The present study revealed that youth aged between twenty-five to thirty-five years were the most prone to multiple craving factors, the intervention program was successful in improving coping skills with high risk factors of craving. Conclusion: improvement of behavioral and cognitive coping skills with high-risk situation after program implementation. Recommendations: designing continuous health education programs for family caregivers and their patients with craving to teach them how to avoid craving and how to enhance their coping skills. Psychiatric /mental health nurses should have active role in helping patients with drug craving to cope effectively with high risk factors of craving [ABSTRACT FROM AUTHOR]

AIM:To investigate the incidence and risk factors of retinopathy of prematurity(ROP)in Sichuan Province.METHODS: From July 2017 to Augest. 2018, 238 premature infants(476 eyes)with gestational age of 34wk or less, or birth weight of 2500g or less, were examined by RetCamⅢ for ROP screening. The infants were divided into ROP group and non-ROP group according to the results of screening. Meanwhile, the general condition of the premature infants and maternal health during pregnancy were assessed and recorded to determine the risk factors of ROP.RESULTS: In 238 infants(476 eyes), ROP developed in 35 infants and the incidence of ROP was 14.7%, which including 14 cases(28 eyes)suffering from stage 1, 11 cases(22 eyes)from stage 2, 8 cases(16 eyes)from stage 3, 2 cases(4 eyes)from stage 4, 0 cases from stage 5. 12 cases(24 eyes)received laser therapy. The gestation age and birth weight in non-ROP group were higher than ROP group, significant difference was found between the two groups(PP72h, hypoxic-ischemic encephalopathy and mechanical ventilation in non-ROP group and ROP group were statistically significant(P=0.034; P=0.001; P=0.004). However, the significant difference had not been found with other systemic diseases of the premature infants sand maternal health during pregnancy between the two groups(P>0.05).CONCLUSION: The incidence of ROP in Sichuan Province is 14.7% from July 2017 to Augest 2018. The gestation age, birth weight, oxygen inhalation>72h, hypoxic-ischemic encephalopathy and mechanical ventilation are high risk factors for the occurrence of ROP.

Objective: To examine the ultrasonic changes in postmenopausal endometrial polyps and analyze factors related to their malignant transformation., Methods: This retrospective study analyzed clinical data from 200 postmenopausal patients with endometrial polyps treated at Jinan Maternity and Child Care Hospital and Pingyin Hospital of Traditional Chinese Medicine from December 2020 to December 2023. All patients underwent pathological biopsies to diagnose the nature of the endometrial polyps. This study compared the clinical and ultrasonic imaging features of these patients and analyzed factors influencing the malignant transformation of postmenopausal endometrial polyps., Results: Pathological findings classified 160 patients (80.00%) into the benign group and 40 patients (20.00%) into the malignant group. Significant differences were noted in endometrial thickness, polyp diameter, heterogeneity of lesion echogenicity, and vascularization between the groups (all P<0.05). The malignant group exhibited notably higher blood flow (Grade II+III constituted 70.00% compared to 29.38% in the benign group, P<0.05). The time average velocity (TAV), pulse index (PI), and resistance index (RI) were significantly lower in the malignant group (all P<0.05). The area under curve (AUC) values for TAV, PI, and RI in diagnosing malignant endometrial polyps were 0.754, 0.713, and 0.771, respectively. Increased body mass index (BMI), irregular premenopausal menstruation, and ≥2 occurrences of postmenopausal bleeding were identified as risk factors for malignant transformation (all P<0.05). These six indicators were used to create a predictive model for malignant transformation, achieving an AUC of 0.942., Conclusion: Malignancy in postmenopausal endometrial polyps is uncommon, yet distinct differences exist in the transvaginal color Doppler ultrasound characteristics between benign and malignant cases. Factors such as increased BMI, irregular premenopausal menstruation, and ≥2 occurrences of postmenopausal bleeding significantly contribute to the risk of malignant transformation. These findings, combined with ultrasound features, provide a robust basis for screening and monitoring these patients., Competing Interests: None., (AJTR Copyright © 2024.)

Introduction: Cervical cancer is the fourth most common cancer in women across the globe. Women prisoners are a vulnerable population, so timely provision of screening programs is of utmost importance in this population. Aim: To screen female prisoners for cervical cancer using visual inspection with acetic acid method. Materials and Methods: This was a cross-sectional study conducted on women inmates in one of the largest prisons of North India. A total of 181 women prisoners aged 18 and older were interviewed using a questionnaire. After an informed consent, women were screened using Visual Inspection with Acetic acid (VIA). Results: Majority of the women (74.03%) were between 21 to 40 years. Ninety-one women (50.2%) were illiterate. Majority of the women (123) had between one and three pregnancies. Majority (43) used condoms as a birth control method. Thirtyeight women (20.9%) had multiple partners. Among 181 women who were screened for cervical cancer, 22.6% were VIA positive. Conclusion: Women prisoners are at a high risk of cervical cancer because of increased prevalence of risk factors in them. Screening and intervention programs must be in place to ensure organisation of health services within the prison environment so that screening, diagnosis and treatment for cervical carcinoma can be provided at early stages with improved prognosis.

Diabetic Retinopathy(DR)has gradually worsening and lingering, which is the leading cause of global young people blindness. With the progression of the disease, patients with diabetes mellitus(DM)will have different degrees of DR. If you can not prevent and give acute early intervention, once the visual acuity decreased significantly, DR would be difficult to reverse. DR progressively has worsening, the treatment status has no optimistic. Therefore, DR in the early prevention and treatment will be indispensable. This article summarizes some of the early warning of the occurrence and development of biological markers and characteristic indicators in order to provide a basis for the early prevention of DR.

AIM: To investigate the incidence and risk factors of retinopathy of prematurity(ROP)in preterm infants. METHODS: The wide-field digital pediatric Retinal imaging system was used to screen 2 203 preterm infants with gestational age RESULTS: Totally 367 infants(621 eyes)were diagnosed as retinopathy among 2 203 premature infants and the incidence of ROP was 16.66%; 236 cases(399 eyes)of ROP(26.61%)were detected in 887 cases of premature infants in accord with screening standard of the Chinese Premature Retinopathy Screening Guidelines(2014), and 131 cases(222 eyes)of ROP(9.95%)was detected in 1 316 cases of premature infants outside the screening standard. In our research, the incidence of ROP was related with gestational age, birth weight, oxygen duration and mechanical ventilation. However, the relationship had not been found with artificial insemination, caesarean birth, gender, polyembryony, acute respiratory distress syndrome(ARDS), hypertensive disorders in pregnancy, gestational diabetes mellitus, intrauterine infection, intrauterine distress, premature rupture of membrane. The incidence of ROP was statistically significant between different gestational age groups, different birth weight groups and different oxygen groups(PCONCLUSION: The incidence of ROP is 16.66% in this study, and there is still a certain proportion outside the screening standard of the Chinese Premature Retinopathy Screening Guidelines(2014). Gestational age, birth weight, oxygen duration and mechanical ventilation are high risk factors for ROP.

Purpose: The prognostic value of [18F]-fluorodeoxyglucose positron emission tomography (FDG PET) in early-stage high-risk cervical cancer patients was evaluated. Materials and Methods:A total of 86 Stage IB or IIA cervical cancer patients with high risk factors (positive resection margin (RM), parametrial invasion (PI) or pelvic lymph node (PLN) metastasis) were retrospectively investigated. Results: There was a statistically significant decrease in recurrence-free survival (RFS) in patients with bulky tumor (p = 0.011), positive RM (p = 0.001), and PLN positivity on FDG PET (p = 0.012) in multivariate analyses. Independent prognostic factors for overall survival (OS) included non-squamous cell type (p = 0.005), bulky tumor (p = 0.020), and PLN positivity on FDG PET (p = 0.007). Patients with positive PLN on FDG PET had worse five-year RFS (62.0% vs. 85.0%, p = 0.013) and OS (68.7% vs. 89.5%, p = 0.011) rates than those with negative PLN uptake. Conclusion: PLN metastasis on FDG PET and bulky tumor were found to be statistically significant prognostic factors for both RFS and OS in early-stage high-risk cervical cancer patients. [ABSTRACT FROM AUTHOR]

Background/Aim: This study analyzed the characteristics of patients with COVID-19 with major events during the first days of hospitalization. Patients and Methods: This is a retrospective analysis of prospectively collected data from consecutive patients admitted to two hospitals in Athens, Greece. The characteristics of patients with COVID-19 who suffered the primary endpoint (venous thromboembolic events, intubation, and death) during the first days of hospitalization were analyzed. Results: Among 95 patients included in the analysis, 21 presented with major adverse events during a median follow-up of 13 days. More than 50% of these patients presented with a major event during the first 3 days. Anticoagulation treatment was inversely associated with the cumulative incidence of the primary endpoint [hazard ratio=0.16 (95% confidence interval=0.06-0.47)]. Patients with major events were older, with lower baseline SatO2, and higher number of Wells’ criteria and Charlson comorbidity index. Among these patients, those with hypertension were at higher risk for early occurrence of events (≤ first three days of hospitalization). Conclusion: Major adverse events may occur early in hospitalized patients with COVID-19 with a high-risk profile. Anticoagulation treatment appears to reduce this risk and thus prompt thromboprophylaxis should be employed in these patients. [ABSTRACT FROM AUTHOR]

Objective: To analyze the effect of additional surgery on the survival and prognosis of high-risk T1 colorectal cancer patients who have undergone endoscopic resection., Methods: The clinical data of patients with high-risk T1 colorectal cancer were retrospectively collected. The patients were divided into the endoscopic resection (ER) plus additional surgical resection (SR) group, or the ER+SR group, and the ER group according to whether additional SR were performed after ER. Baseline data of the patients and information on the location, size, and postoperative pathology of the lesions were collected. Patient survival-related information was obtained through the medical record system and patient follow-up. The primary outcome indicators were the overall survival and the colorectal cancer-specific survival. Univariate Cox regression analysis was used to screen survival-related risk factors and hazard ratio ( HR ) was calculated. Multivariate Cox regression analysis was used to analyze the independent influencing factors., Results: The data of 109 patients with T1 high-risk colorectal cancer were collected, with 52 patients in the ER group and 57 patients in the ER+SR group. The mean age of patients in the ER group was higher than that in the ER+SR group (65.21 years old vs. 60.54 years old, P =0.035), and the median endoscopic measurement of the size of lesions in the ER group was slightly lower than that in the ER+SR group (2.00 cm vs. 2.50 cm, P =0.026). The median follow-up time was 30.00 months, with the maximum follow-up time being 119 months, in the ER+SR group and there were 4 patients deaths, including one colorectal cancer-related death. Whereas the median follow-up time in the ER group was 28.50 months, with the maximum follow-up time being 78.00 months, and there were 4 patient deaths, including one caused by colorectal cancer. The overall 5-year cumulative survival rates in the ER+SR group and the ER group were 94.44% and 81.65%, respectively, and the cancer-specific 5-year cumulative survival rates in the ER+SR group and the ER group were 97.18% and 98.06%, respectively. The Kaplan-Meier analysis showed no significant difference in the overall cumulative survival or cancer-specific cumulative survival between the ER+SR and the ER groups. Univariate Cox regression analysis showed that age and the number of reviews were the risk factors of overall survival ( HR =1.16 and HR =0.27, respectively), with age identified as an independent risk factor of overall survival in the multivariate Cox regression analysis ( HR =1.10, P =0.045)., Conclusion: For T1 colorectal cancer patients with high risk factors after ER, factors such as patient age and their personal treatment decisions should not be overlooked. In clinical practice, additional caution should be exercised in decision-making concerning additional surgery., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Board of Journal of Sichuan University (Medical Sciences).)

Introduction: Retinoblastoma is the most common intraocular tumour of childhood. The incidence has been estimated to be 1 in 15,000 to 1 in 34,000 births. All races and both sexes are affected equally Unilateral (70%) or bilateral (30%). Sporadic (60%) or familial (40%). The mean age at diagnosis is 18 months, and about 90% of cases are diagnosed before 3 years of age Objectives: • Aim of this study is find out incidence rate of retinoblastoma from at M. J Institute tertiary care ophthalmic centre, civil hospital, Ahmedabad. • Histopathological analysis for to establish relationship between age, degree of differentiation and high risk features. • Histopathological analysis is essential for early diagnosis, treatment, improve prognosis, reduce morbidity and mortality. Material & Method: 41 enucleated eyes received out of 41 prospectively registered case from june-2017 to june- 2019 were included in study which was carried out at histopathology department, M.J western regional institute of ophthalmology, civil hospital Ahmedabad. Histopathological findings were evaluated according to age, sex, laterality, extent of invasion into vitreous, choroid, sclera, optic nerve, surrounding tissue, necrosis, calcification, degree of differentiation. Grading and staging were performed according to 8th AJCC classification of eye tumour. Results: Out of 41 eyes, 11(26.83%) cases were under 2 year of age and 30(73.17%) cases were above 2 year of age. 23(56.1%) cases were female and 18(43.90%) cases were male, 19(46.34%) cases were found in right eye, 22(53.66%) cases were found in left eye, all cases were unilateral, vitreous seeding was observed in 33 (80.49%) cases, Choroid invasion was observed in 36(87.80%) cases, Optic nerve involvement was observed in 16(39.02%) cases, Necrosis and Calcification were observed in 31(75.60%) and 28 (68.90%) cases respectively. 20(48.78%) cases were found in pathological stage pT3 . Conclusion: Rosettes, Necrosis and calcification were commonly observed findings in the study. Optic nerve and choroidal invasion were important prognostic factors for staging, prognosis and patient outcome. High incidence of pathological stage pT3 and poorly differentiated tumours were observed in this study. This could be due to late age of diagnosis. [ABSTRACT FROM AUTHOR]

Objective To establish a mathematical model for predicting brain metastasis in locally advanced non-small cell lung cancer(NSCLC)by multiple regression analysis, to provide theoretical support for the application of the model in the early warning of brain metastasis of lung cancer. Methods The clinical features, pathological changes and the expression of related molecular markers of 106 patients with brain metastases in locally advanced NSCLC after surgery from June 2011 to June 2013 in the hospital were retrospectively analyzed. The risk factors of brain metastasis were analyzed by multiple regression analysis, and the relevant mathematical model was established. Results The incidence of brain metastasis in locally advanced NSCLC were related to the number of mediastinal lymph node metastasis, preoperative serum CEA level, tumor pathological type, EGFR gene mutation, VGFR/Ki-67 expression(P<0.05). The mediastinal multiple lymph node metastasis, preoperative serum CEA greater than10μg/L, adenocarcinoma, EGFR gene mutation, VGFR/Ki-67 over expression were high risk factors for brain metastasis(P<0.05), but the occurrence of brain metastasis were not related to age, sex, smoking history, tumor differentiation degree and surgical method, P53 expression(P>0.05). Multivariate analysis:logit(P)was 9.198-0.721×pathological type-0.892×mediastinal lymph node positive number-0.639×preoperative serum CEA level-0.629×EGFR genotype-1.907×VGFR-1.041×Ki-67. When P=0.48 was used, sensitivity and specificity were the highest(sensitivity was 80%, specificity was 78%). That was to say, when P≥0.48 was high risk of brain metastases, P<0.48 was a low risk of brain metastases. Conclusions The model is accurate in predicting brain metastasis in patients with locally advanced NSCLC. Considering many high risk factors of brain metastasis, digital quantification can predict the patients at high risk of brain metastasis more comprehensively and accurately. It can be used as a basis for screening patients at high risk of brain metastasis after operation of locally advanced NSCLC, and provide evidence support for the follow-up treatment of early prevention of brain metastasis. [ABSTRACT FROM AUTHOR]

Introduction: Cervical cancer is the fourth most common cancer in women across the globe. Women prisoners are a vulnerable population, so timely provision of screening programs is of utmost importance in this population. Aim: To screen female prisoners for cervical cancer using visual inspection with acetic acid method. Materials and Methods: This was a cross-sectional study conducted on women inmates in one of the largest prisons of North India. A total of 181 women prisoners aged 18 and older were interviewed using a questionnaire. After an informed consent, women were screened using Visual Inspection with Acetic acid (VIA). Results: Majority of the women (74.03%) were between 21 to 40 years. Ninety-one women (50.2%) were illiterate. Majority of the women (123) had between one and three pregnancies. Majority (43) used condoms as a birth control method. Thirtyeight women (20.9%) had multiple partners. Among 181 women who were screened for cervical cancer, 22.6% were VIA positive. Conclusion: Women prisoners are at a high risk of cervical cancer because of increased prevalence of risk factors in them. Screening and intervention programs must be in place to ensure organisation of health services within the prison environment so that screening, diagnosis and treatment for cervical carcinoma can be provided at early stages with improved prognosis. [ABSTRACT FROM AUTHOR]

Objective To investigate the risk and protective factors of cesarean section scar site pregnancy(CSP, and to provide evidence for prevention of CSP. Methods 98 cases of CSP patients admitted to the hospital from January 2015 to January 2019 were selected as the case group, while 265 cases of normal pregnancy with scar in utero were selected as the control group. Univariate and multivariate logistic regression analysis was used to analyze the relationship between age, cesarean section frequency, induced abortion frequency, breech cesarean section, last cesarean section time, uterine suture mode and CSP. Results Unifactor logistic regression analysis showed that there was a significant relationship between pregnancy in scar area of cesarean section and the number of cesarean sections, number of induced abortion, breech cesarean section, time of last cesarean section, mode of uterine suture and other factors (P<0.05). The results of multivariate logistic regress ion analysis showed that the ratio (OR) of the number of cesarean sections, the number of induced abortions and breech cesarean sections were greater than 1. The OR of the time of last cesarean section and uterine suture mode were less than 1, which were all correlated with CSP (P <0.05). Conclusion Age has no significant effect on the occurrence of CSP. The incidence of CSP can be reduced by double layer uterine suture and the next pregnancy is more than 2 years from the previous cesarean section. The frequency of cesarean section and gluteal cesarean section are the high risk factors of CSP. [ABSTRACT FROM AUTHOR]

Copyright of Nursing of Integrated Traditional Chinese & Western Medicine is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To observe the incidence of secondary epilepsy in patients with cerebral infarction and explore the risk factors of secondary epilepsy. Methods Eighty-four patients with secondary epilepsy diagnosed as cerebral infarction from April 2016 to August 2017 in our hospital were selected as the observation group， and 84 patients of cerebral infarction without epilepsy in the same period were selected as the control group. Follow-up of secondary epileptic seizures， the general information of patients， basic diseases， hypertension grade， blood electrolytes， lesion location， diameter of lesion were recorded，and the risk factors of secondary epilepsy in cerebral infarction were screened， and the status of secondary epilepsy were analyzed. Results (1) The types of epilepsy in secondary epilepsy: partial seizure in 69 cases， complete attack in 15 cases; onset time: early onset in 60 cases， late in 24 cases. (2) There was no significant difference between the two groups in general information， underlying disease， lesion diameter and grade ofhypertension (p＞0.05). The differences statistically significento significance in the consist of lesion location and lesion specific location and blood electrolyte levels(p＜0.05). Unconditional multivariate logistic regression analysis showed thoao infarction involving the cortex， temporal lobe， and serum chloride value was correlated with the occurrence of secondary epilepsy (p＜0.05). (3) Multivariate Logistic regression analysis showed tthat infaretion involving the cortex(OR = 3.10， Pp=0.004， 95% CI = 1.52-7.41)，locating in the temporal lobe， (OR = 2.98， Pp=0.012， 95% CI = 1.32-7.35) and serum chlorine (OR = 1.25， Pp=0.017， 95%CI = 1.00-1.38) were the risk factors for secondary epilepsy in cerebral infarction．Conclusions Partial and early onset of seizures are the most common in cerebral infarction secondary epilepsy．Infarction involving the cortex， locating in the temporal lobe and serum chlorine are the risk factors for secondary epilepsy in patients with cerebral infarction. Necessary measures should be taken to intervene at high risk of secondary epilepsy and to improve the clinical quality of life of patients. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of nerve block on the treatment of herpes zoster (HZ) and prevention of postherpetic neuralgia (PHN), and to explore the factors that affect the occurrence of PHN. Methods From january 2015 to September 2016 in our hospital 80 acute HZ patients for the first time in the treatment of pain，were randomly assigned to the case group （nerve block + conventional medical treatment） 40 cases, and the control group （conventional medical treatment） 40 cases. The incidence of neuralgia in the two groups was analyzed， and the relationship between the age， sex， herpes， prodromal pain， initial pain, scab time, pain relief rate and PHN. Results PHN occurred in 4 cases （10.0%） in the case group and 19 cases （47.5%） in the control group (P <0.001) . (6.33 ± 0.86 days vs. 7.15 ± 0.66 days， P <0.001) . The number of hospital days decreased (7.43 ± 1.80 days vs. 12.90 ± 2.36 days，P <0.001). Ageing （OR: 8.24， 95% CI: 1.62-41.96） and prolonged crusting time (OR: 17.99， 95% CI: 2.14- 151.43)， are risk factors for PHN, significantly increased the incidence of PHN. The VAS remission rate after 1 week (OR <0.000， 95% CI: 0.000-0.001) was a protective factor for PHN and was negatively correlated with PHN. Conclusions Aging and onset of severe pain in patients should pay attention to the prevention of PHN. Nerve block helps to reduce the number of hospital stay in HZ patients, shorten the scab time, and reduce the incidence of PHN. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The current study aimed at determining the type and frequency of high-risk factors for hearing loss in a group of very-low-birth-weight (VLBW) neonates in a tertiary hospital in South Africa with the objective of collating evidence that could be used in arguing for or against revisiting targeted hearing screening in developing countries. Furthermore, the study aimed at investigating the relationship between the identified high-risk factors and hearing screening results. In a retrospective data review design, data were collated from files from the VLBW project; this included hearing screening records, as well as records from participant medical and audiology files. Records of 86 neonates with birth weights ranging between 680 g and 1 500 g were reviewed. Findings indicated that neonatal jaundice, exposure to human immunodeficiency virus (HIV), mechanical or assisted ventilation, and neonatal intensive care unit stay greater than 48 hours were the most frequently occurring high-risk factors for hearing loss in the current sample. These factors are consistent with those listed in the high-risk register of the Health Professions Council of South Africa for the South African context. Findings confirm the complexity of risk factors, and the influence that a variety of factors such as poor follow-up or return rate might have on the implementation of early hearing detection and intervention. The importance of establishing context-specific risk factors for effective implementation of targeted screening protocols where universal newborn hearing screening is not yet a reality was highlighted by the current study.

Over the past decades, cancer has become one of the toughest challenges for health professionals. The epidemiologists are increasingly directing their research efforts on various malignant tumor worldwide. Of note, incidence of cancers is on the rise more quickly in developed countries. Indeed, great endeavors have to be made in the control of the life-threatening disease. As we know it, pancreatic cancer (PC) is a malignant disease with the worst prognosis. While little is known about the etiology of the PC and measures to prevent the condition, so far, a number of risk factors have been identified. Genetic factors, pre-malignant lesions, predisposing diseases and exogenous factors have been found to be linked to PC. Genetic susceptibility was observed in 10% of PC cases, including inherited PC syndromes and familial PC. However, in the remaining 90%, their PC might be caused by genetic factors in combination with environmental factors. Nonetheless, the exact mechanism of the two kinds of factors, endogenous and exogenous, working together to cause PC remains poorly understood. The fact that most pancreatic neoplasms are diagnosed at an incurable stage of the disease highlights the need to identify risk factors and to understand their contribution to carcinogenesis. This article reviews the high risk factors contributing to the development of PC, to provide information for clinicians and epidemiologists. [ABSTRACT FROM AUTHOR]

Background: Postpartum hemorrhage (PPH) is the most common cause of parturient death worldwide [1]. However, most cases of PPH can be avoided.Objective: This paper employs statistical methods to screen risk factors of PPH and calculate relevant parameters.Methods: Multivariable logistic regression analysis was applied to obtain the regression equation and odds ratio (OR) value. The determined risk factors were assigned comprehensive and reasonable scores according to scientific relevance and reasoning according to the OR value. PPPH values were calculated in order to assess the morbidity of PPH.Results: The scores of pregnant women could be intuitively used to show the risk of getting PPH.Conclusions: Through the above methods, a comprehensive risk evaluation method of detecting PPH was developed. [ABSTRACT FROM AUTHOR]

Objective: A statistical analysis was performed of the clinicopathology of stages I a2 and Ib1 cervical cancer to analyse high risk factors of pelvic lymph node metastasis. Methods: A retrospective analysis was conducted of clinical data of a total of 117 patients with stage I a2 or I b1 cervical cancer who were hospitalized in Tianjin Central Hospital of Gynecology Obstetrics from January 2011 to June 2013. Use the X2 test and logistic regression to analyse the high risk factors of pelvic lymph node. Results: Of the 117 patients, there were 15 (12.8%) and 102 (87.2%) with and without lymphatic metastasis, respectively. Findings of univariate analysis showed that depth of myometrial invasion ≥1/2, lower uterine segment involvement, positive intravascular tumor thrombosis, tumor size ＞2 cm and level of SCC-Ag before treatment were influencing factors for early-stage lymphatic metastasis of cervical cancer (all P＜0.05). Findings of multivariate analysis showed that SCC-Ag≥1.5 ng/mL was the independent influencing factor for lymphatic metastasis (OR=25.007, 95%CI: 2.342~250.021, P=0.008). Conclusions: Level of SCC-Ag before treatment was the high risk factor for pelvic lymph node metastasis of stages玉a2 and 玉b1 cervical cancer. [ABSTRACT FROM AUTHOR]

Objective: To analyze the factors that influence maternal postpartum depression, to study its significance and effective treatment strategies, and to improve their quality of life. Methods: A total of 350 outpatients and inpatients, who were admitted to obstetrical department of Panzhihua Central Hospital from June 2013 to July 2014, were chosen for making a questionaire. Among the 350 parturients, there were 37 cases of depressive mood,who were randomly divided into two groups(intervention group and control group). The intervention group was given targeted nursing intervention and the control group, routine psychological nursing. The clinical treatment data of the two groups of parturients were comprehensively analyzed and an early nursing intervention were given to the parturients. Results: The probability of depression of the parturients aged between 25 and 34 years was significantly higher than that of other age groups, the difference was statistically significant(P<0.05). There were significant differences in the pregnancy complications of the parturients, adverse pregnancy outcomes, marital relationship, infant gender, economic income, infant condition, etc. between the intervention group and the control group, the differences were statistically significant(P<0.05). Meanwhile, the parturients' depression situation in the intervention group was improved apparently than that in the control group after the targeted care, the difference was statistically significant(P<0.05). Conclusions: There are many factors that result in the postpartum depression of parturients, so nurses should conduct a deep analysis and make a personalized early intervention care scheme to improve their quality of life. [ABSTRACT FROM AUTHOR]

Objective: For exploring the clinical efficacy of laparoscopic radical hepatectomy and laparotomy for hepatocellular carcinoma and analysing related factors of postoperative recurrence., Methods: Totally 212 patients with hepatocellular carcinoma admitted to our hospital between April 2017 and December 2020 were enrolled, and all of them were followed up after the operation. According to the treatment modes, the patients were assigned to a laparotomy group (n=106) and a laparoscopic group (n=106). Perioperative indicators, haematological examination results, complications and recurrence were compared between the two groups. The recurrence time of hepatocellular carcinoma after the operation was confirmed by imaging examination with definite mass, and logistic multivariate analysis was used for analyzing the risk factors associated with postoperative recurrence., Results: Patients in both groups were comparable in terms of general baseline data. The laparoscopic group experienced longer operation time and shorter incision length, less intraoperative blood loss, early time to have the first off-bed activity and time to eat liquid and shorter hospital stay than the laparotomy group (all P<0.05). Seven days after the operation, the laparoscopic group showed notably lower levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), tumour necrosis factor-α (TNF-α), interleukin-8 (IL-8), and C-reactive protein (CRP) than the laparotomy group (all P<0.05), and also showed notably higher levels of immunoglobulin A (IgA), IgG and IgM than the laparotomy group (all P<0.05). Additionally, the laparotomy group showed a higher total incidence rate of complications than the laparoscopic group (19.81% vs. 9.43%, P<0.05). During the one-year follow-up, the laparotomy group was not greatly different from the laparoscopic group in recurrence rate (22.64% (24/106) vs. 16.98% (18/106), P>0.05). Multivariate analysis showed that average tumour diameter and microvascular invasion were risk factors for postoperative recurrence (P<0.05)., Conclusion: Laparoscopic radical hepatectomy for hepatocellular carcinoma can reduce the influence on liver function and immune function, with less damage to tissues, and can ameliorate postoperative inflammatory reaction, and promote postoperative recovery of patients as soon as possible. There are many factors influencing the postoperative recurrence of hepatocellular carcinoma, and average tumour diameter and microvascular invasion are the risk factors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Cao, Yang, Zhou and Hu.)

Objective: To investigate the clinical audiological characteristics of children referred from maternal and child institutions and analyze the high risk factors of hearing loss, so as to provide scientific basis for further improvement of children's ear and hearing care. Methods: The subjects of this study were 868 children who were referred by maternal and child institutions in Beijing to the otology outpatient of Beijing Tongren Hospital, Capital Medical University for hearing diagnosis. All subjects underwent acoustic immittance, auditory brainstem response, distortion products otoacoustic emission and other audiological tests. Children were divided into groups according to the age of diagnosis: 0-<3 months group（242 cases）, 3-<6 months group（328 cases）, 6-<12 months group（180 cases）, ≥12 months group（118 cases）, the results of hearing diagnosis, hearing loss degree and types, the relationship between high risk factors and hearing loss in each group were compared and analyzed. Results: The age of diagnosis of 868 children was（7.13±8.29） months. 488 cases with hearing loss accounted for 56.22% and 380 cases with normal hearing accounted for 43.78%. Proportion of different degree of hearing loss of 792 ears from high to low was as follows: mild, 366 ears（46.21%）; moderate, 214 ears（27.02%）; severe, 151 ears（19.07%）; profound, 61 ears（7.70%）. There were statistically significant differences in the proportion of different hearing loss degree among 0-<3 months group, 3-<6 months group, 6-<12 months group and ≥12 months group（ P <0.001）. Pairwise comparison between groups showed that the proportion of mild hearing loss of 0-<3 months group was higher than that in the other three groups（ P <0.05）, there was no significant difference of moderate hearing loss among all groups（ P >0.05）, the proportion of severe hearing loss of ≥12 months group was higher than that of 0-<3 months group（ P <0.05）. The proportion of profound hearing loss with 0-<3 months group was lower than the other three groups（ P <0.05）. In 792 ears with hearing loss, sensorineural hearing loss accounted for 67.42%, conductive hearing loss accounted for 20.71% and mixed hearing loss accounted for 11.87%. Among 98 cases with high risk factors for hearing loss, 58 cases（59.18%） were diagnosed with hearing loss. The incidence of hearing loss with high risk factors ranked from high to low was: craniofacial malformation（93.75%）, family history/congenital genetic syndrome（61.11%）, neonatal intensive care unit（NICU） hospitalization（46.43%） and others（20.00%）. Conclusion: Referrals from maternal and child institutions play an important role in the early detection of children with mild to moderate sensorineural hearing loss. Children with craniofacial malformation, family history/congenital genetic syndrome, hospitalization history of NICU and other high risk factors have a high incidence of hearing loss and should be attached with great importance., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Introduction: Universal newborn hearing screening (UNHS) is mandatory in all developed country and is setting the trend in developing country too. Due to a large population, lack of education, less professionals, and limited access to such facilities in India few places targeted hearing screening (THS) is coming up. However, the comparison between UNHS and THS is less investigated till date. Aim of the Study: This study aimed to investigate the comparison between two hearing screening program that is UNHS and THS in the Indian context. Methods: In UNHS all the infants were screened at Tertiary Centre and for THS only infant with high-risk factors were screened at Advanced Audiological Centre. Further, all referral, screening, and diagnostic data were included in data analysis of both hearing screening program. Result: UNHS was difficult due to some system failure and a lot of time was wasted doing the different procedure. However, THS was much easier and false-positive and negative were lesser. Conclusion: In a vast population country with lack of manpower for the field, it is important to have an alternative approach to the system for better outcome of the program. [ABSTRACT FROM AUTHOR]

Objective: To investigate the status and risk factors of type 2 diabetes patients complicated with infection in the Department of Endocrinology, so as to provide reference for clinical prevention and treatment of infection in diabetes patients. Methods; Medical records of type 2 diabetes inpatients, who sought medical care in the Department of Endocrinology, Second Xiangva Hospital of Central South University in 2014 were retrospectively analyzed. The risk factors of infection in diabetes patients were summarized. Results: Of the 1117 cases of diabetes mellitus, 422 were complicated with infection, accounting for 37.78%.The main infection sites were respiratory system (39.16%), urinary system (24.57%), skin and soft tissues (24.57%).Sixty-three strains of pathogens were isolated from the 180 specimens tested with the detection rate of 35%.Detection rates for gram-positive bacteria, gram-negative bacteria. fungi and mycoplasma were 24 strains (38.10%), 32 strains (50.79%), 6 strains (9.52%) and 1 strain(1.59%),respectively. Logistic regression analysis showed that female sex, duration of diabetes level of 2-hour postprandial blood glucose and smoking were closely related to infection in diabetes patients (0.05).Conclusion: The infection rate in diabetes patients was high, and the pathogens were mainly gram-negative bacteria. The female sex high level of 2-hour postprandial blood glucose, long duration of diabetes and smoking were the main risk factors of diabetic infection. [ABSTRACT FROM AUTHOR]

Venous thromboembolism (VTE) is a life-threatening complication that often occurs in ovarian tumors. However, the risk factors for VTE are still undetermined.We retrospectively analyzed VTE occurrence and its potential risk factors in 254 Chinese patients with ovarian tumor at Fudan University Cancer Hospital from July 2007 to June 2011.The VTE incidence was 7.1% (13/183) in epithelial ovarian cancer (EOC), and no VTE was found in ovarian borderline or benign tumor. D-dimer levels were significantly higher in EOC than in ovarian benign and borderline tumors. Furthermore, D-dimer levels increased with the advancement of EOC stages. Correlation analysis suggested that D-dimer levels were well correlated with platelet counting (PLT), prothrombin time (PT), white blood cell counting (WBC), cancer antigen (CA) 125, and CA153. Univariate logistic regression analysis found that D-dimer levels greater than 788 μg/L, PLT levels greater than 261 × 109/L, PT greater than 11.7 seconds, CA125 greater than 760 U/mL, and ascites greater than 1500 mL are risk factors for VTE in EOC. Moreover, multivariate analysis grouped primary EOC, low differentiated grade, D-dimer greater than 788 μg/L, PT greater than 11.7 seconds, and CA125 greater than 760 U/mL as prediction factors for VTE.In addition to D-dimer and ascites, high levels of PLT, PT, and CA125, which are highly correlated with D-dimer, are independent risk factors for VTE [ABSTRACT FROM AUTHOR]

Background: Microalbuminuria refers to the excretion of albumin in the urine at a rate that exceeds normal limits but is less than the detection level for traditional dipstick methods and is considered as a marker of diabetic nephropathy. Aims: To establish the prevalence of elevated urinary albumin levels (microalbuminuria) in a sequential sample of diabetic patients and to determine its relationship with known and putative risk factors, to ascertain relationship of serum angiotensin converting enzyme (ACE) activity with diabetic incipient nephropathy. Study design: This cross-sectional analytical study included 100 control and 325 diabetic patients (180 type 2 and 145 type 1 diabetic patients) subjects attending outpatient department of the hospital. Patients having clinical albuminuria and with other causes of proteinuria were excluded. Result: Microalbuminuria was observed in 34.48% in patients with type 1 and 28.33% in patients with type 2 diabetes mellitus respectively. Having the condition was significantly associated with advanced age, poor glycaemic control, dyslipidemia (with respect to total cholesterol, triglycerides and LDL-C), smoking, body mass index and coexisting hypertension. The duration of diabetes was a significant correlate in type 1 DM subjects only. No significant association with gender, HDL-C levels, age at onset of DM, mode of treatment, socio-economic status and other lifestyle variations was found. All clinical and biochemical parameters in patient with microalbuminuria was more adversely affected than patients with normoalbuminuria. Serum angiotensin converting enzyme (ACE) levels were significantly elevated (P<0.001) in both of the diabetic groups, moreover, its levels were higher in subjects with microalbuminuria than in those without this complication (P<0.05). Conclusions: Microalbuminuria in diabetes, which represents an earlier phase in the development of clinical nephropathy, is associated with many potentially modifiable risk factors. In estimating diabetic nephropathy risk, AER is most important and should be done frequently but there are gains to be made in predictive precision by considering family history, smoking habits, glycemia, B.P.,BMI lipid levels and ACE activity. Early screening for incipient diabetic nephropathy and aggressive management of these risk factors is important in optimising the renal outcome of patients with diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to explore the incidence and risk factors of, and summarize the involved pathogens in, neonates with ventilator-associated pneumonia (VAP) in the authors' neonatal intensive care unit (NICU) to determine the effective strategies for prevention. Methods: A retrospective case-control study including 117 VAP patients and 232 controls was conducted from January 2002 to July 2008. The antibiotics sensitivity spectrum was determined on quantitative microbiological evaluation. Multiple logistic regression and Cox model analysis were performed to determine independent and accumulative risk factors for VAP. Results: Multivariate analysis showed that birthweight, mechanical ventilation (MV), parenteral alimentation, dexamethasone and other respiratory disease were associated with the development of VAP. The cumulative risk for developing VAP increased over the duration of stay in the NICU. The most common isolated bacteria of the pathogen spectrum in VAP were Klebsiella spp. (33/146), Acinetobacter baumannii (26/146), Pseudomonas aeruginosa (18/146) and Staphylococcus aureus(13/146). Meanwhile, we found that previous use of antibiotics before VAP diagnosis was not associated with the onset of VAP. Conclusions: The daily risk for VAP increases with duration of stay in the NICU after ventilation. Drug-resistant bacteria are common pathogens for neonatal VAP in the authors' NICU. [ABSTRACT FROM AUTHOR]

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Objective To investigate the high risk factors of pelvic organ prolapse and urinary incontinence to provide the theoretical basis for its primary and secondary prevention. Methods Totally 548 women treated in the pelvic floor rehabilitation department of our hospital from October 2014 to February 2015 were performed the evaluation by the pelvic organ prolapse quantitative staging method (POP-Q) and pelvic floor muscle testing. The general data and disease history of the patients were collected for understanding their pelvic organ prolapse, urinary incontinence and pelvic muscle force, etc. and performed the statistical analysis. Results The univariate analysis results found that the age, pelvic floor muscle function and delivery mode all had the influence on pelvic organ prolapse (P<0.01); the multivariate logistic regression analysis results found that the pelvic floor muscle function and delivery mode had the influence on pelvic organ prolapse (P<0.01). The univariate analysis results of urinary incontinence found that the age, pelvic floor muscle function, delivery mode and postpartum time had the influence on urinary incontinence (P<0.01); the multivariate logistic regression analysis results found that the age, pelvic floor muscle function and delivery mode had the influence on urinary incontinence (P<0.01). Conclusion Pelvic floor muscle dysfunction and vaginal spontaneous delivery are the high risk factors of pelvic organ prolapse. Pelvic floor muscle dysfunction, vaginal spontaneous delivery and advanced age are the high risk factors of urinary incontinence. The patients with these high risk factors should strengthen the exercise of pelvic floor muscle function and conduct the treatment of pelvic floor functional rehabilitation if necessary to avoid and delay the occurrence and development of the pelvic organ prolapse or urinary incontinence. [ABSTRACT FROM AUTHOR]

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The authors retrospectively analyzed the case records of all the newborns admitted with the diagnosis of neonatal tetanus (NT) over a period of 36 mo. A total of 27 cases of neonatal tetanus were admitted over a period of 36 mo. Out of these 27 neonates, 17 died and thus the overall mortality was 63%. The mean age of onset of symptoms in those who survived was 8.1 ± 2.02 d whereas in those who died was 5.7 ± 1.39 d, which was statistically significant (p = 0.001). The babies with age of onset <7 d were almost 5 times more likely to die than those manifesting at 7 d or later. Thus, NT is still contributing to neonatal deaths especially in the backward areas of the country and onset of symptoms within a wk of birth is a very high risk factor for mortality. [ABSTRACT FROM AUTHOR]