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Identifying the risk factors for pancreatic fistula after laparoscopic pancreaticoduodenectomy in patients with pancreatic cancer

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1609-1617页

作者： Hang Xu Qing-Cai Meng Jie Hua Wei Wang Department of Pancreatic Surgery Fudan University Shanghai Cancer CenterShanghai 200032China Department of Oncology Shanghai Medical CollegeFudan UniversityShanghai 200032China

BACKGROUND Laparoscopic pancreaticoduodenectomy(LPD)is a surgical procedure for treating pancreatic cancer;however,the risk of complications remains high owing to the wide range of organs involved during the surgery and the difficulty of *** fistula(PF)is a major complication that not only increases the risk of postoperative infection and abdominal hemorrhage but may also cause multi-organ failure,which is a serious threat to the patient’s *** study hypothesized the risk factors for PF after *** To identify the risk factors for PF after laparoscopic pancreatoduodenectomy in patients with pancreatic *** We retrospectively analyzed the data of 201 patients admitted to the Fudan University Shanghai Cancer Center between August 2022 and August 2023 who underwent LPD for pancreatic *** the basis of the PF’s incidence(grades B and C),patients were categorized into the PF(n=15)and non-PF groups(n=186).Differences in general data,preoperative laboratory indicators,and surgery-related factors between the two groups were compared and analyzed using multifactorial logistic regression and receiver-operating characteristic(ROC)curve *** The proportions of males,combined hypertension,soft pancreatic texture,and pancreatic duct diameter≤3 mm;surgery time;body mass index(BMI);and amylase(Am)level in the drainage fluid on the first postoperative day(Am>1069 U/L)were greater in the PF group than in the non-PF group(P24.91 kg/m²[odds ratio(OR)=13.978,95%confidence interval(CI):1.886-103.581],hypertension(OR=8.484,95%CI:1.22-58.994),soft pancreatic texture(OR=42.015,95%CI:5.698-309.782),and operation time>414 min(OR=15.41,95%CI:1.63-145.674)were risk factors for the development of PF after LPD for pancreatic cancer(all P<0.05).The areas under the ROC curve for BMI,

关键词： Pancreatic cancer Laparoscopy Pancreaticoduodenectomy Pancreatic fistula risk factors Receiver-operating characteristic curve

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Analysis of risk factors leading to anxiety and depression in patients with prostate cancer after castration and the construction of a risk prediction model

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World Journal of Psychiatry 2024年第2期14卷 255-265页

作者： Rui-Xiao Li Xue-Lian Li Guo-Jun Wu Yong-Hua Lei Xiao-Shun Li Bo Li Jian-Xin Ni Urology Hospital Xi'an People's Hospital(Xi'an Fourth Hospital)Xi'an 710199Shaanxi ProvinceChina Department of Surgery Xi'an Hospital of Traditional Chinese MedicineXi'an 710199Shaanxi ProvinceChina

BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and *** cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone ***,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical *** To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction *** A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January *** patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:*** patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),*** regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was *** In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,*** on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(Prisk scores than emotionally stable patients(Prisk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation

关键词： Prostate cancer Castration Anxiety and depression risk factors risk prediction model

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Prevalence and risk factors of depression among patients with perianal fistulizing Crohn’s disease

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World Journal of Psychiatry 2024年第5期14卷 715-725页

作者： Jing Li Wing-Yi Ng Li-Chao Qiao Fen Yuan Xing Lan Li-Bei Zhu Bo-Lin Yang Zhong-Qiu Wang Department of Radiology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese MedicineNanjing 210029Jiangsu ProvinceChina Department of Acupuncture and Rehabilitation Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese MedicineNanjing 210029Jiangsu ProvinceChina Department of Colorectal Surgery Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese MedicineNanjing 210029Jiangsu ProvinceChina

BACKGROUND Psychological distress,especially depression,associated with perianal fistulizing Crohn’s disease(PFCD)is widespread and ***,there is a surprising paucity of studies to date that have sought to identify the prevalence and risk factors of depression associated with *** To estimate the prevalence of depressive symptoms and investigate the depression-related risk factors in patients with *** The study was conducted in the form of survey and clinical data collection via questionnaire and specialized medical *** symptoms,life quality,and fatigue severity of patients with PFCD were assessed by Patient Health Questionnaire-9,Inflammatory Bowel Disease Patient Quality of Life Questionnaire(IBDQ),and Inflammatory Bowel Disease(IBD)Fatigue Patient Self-assessment *** basic demographic information,overall disease features,perianal clinical information,and laboratory inflammation indicators were also *** regression analysis was ultimately used to ascertain the risk factors of depression associated with *** A total of 123 patients with PFCD were involved,and 56.91%were suffering from *** to multivariate logistic regression analysis,Perianal Disease Activity Index(PDAI)score[odds ratio(OR)=0.69,95%confidence interval(CI):0.50 to 0.95],IBDQ score(OR=0.93,95%CI:0.88 to 0.97),modified Van Assche index(OR=1.24,95%CI:1.01 to 1.53),and IBD Fatigue score(OR=1.72,95%CI:1.23 to 2.42)were independent risk factors of depression-related prevalence among patients with PFCD(P<0.05).Multiple linear regression analysis revealed that the increasing perianal modified Van Assche index(βvalue=0.166,95%CI:0.02 to 0.31)and decreasing IBDQ score(βvalue=-0.116,95%CI:-0.14 to-0.09)were independently associated with the severity of depression(P<0.05).CONCLUSION Depressive symptoms in PFCD patients have significantly high *** score,modified Van Assche index,quality of life,and fatigue severity

关键词： Crohn’s disease Fistula Depression Inflammatory bowel diseases risk factors

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Clinical risk factors for preterm birth and evaluating maternal psychology in the postpartum period

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World Journal of Psychiatry 2024年第5期14卷 661-669页

作者： Jia-Jun Chen Xue-Jin Chen Qiu-Min She Jie-Xi Li Qiu-Hong Luo Department of Clinical Laboratory Shenzhen Bao’an District Songgang People’s HospitalShenzhen 518000Guangdong ProvinceChina Department of Otolaryngology Head and Neck Surgery Outpatient Shenzhen Children’s HospitalShenzhen 518000Guangdong ProvinceChina Department of Prevention and Health Care Shenzhen Bao’an District Songgang People’s HospitalShenzhen 518000Guangdong ProvinceChina Department of Obstetrics Shenzhen Bao’an District Songgang People’s HospitalShenzhen 518000Guangdong ProvinceChina

BACKGROUND Although the specific pathogenesis of preterm birth(PTB)has not been thoroughly clarified,it is known to be related to various factors,such as pregnancy complications,maternal socioeconomic factors,lifestyle habits,reproductive history,environmental and psychological factors,prenatal care,and nutritional *** has serious implications for newborns and families and is associated with high mortality and ***,the prediction of PTB risk can facilitate early intervention and reduce its resultant adverse *** To analyze the risk factors for PTB to establish a PTB risk prediction model and to assess postpartum anxiety and depression in *** A retrospective analysis of 648 consecutive parturients who delivered at Shenzhen Bao’an District Songgang People’s Hospital between January 2019 and January 2022 was *** to the diagnostic criteria for premature infants,the parturients were divided into a PTB group(n=60)and a full-term(FT)group(n=588).Puerperae were assessed by the Self-rating Anxiety Scale(SAS)and Self rating Depression Scale(SDS),based on which the mothers with anxiety and depression symptoms were screened for further *** factors affecting PTB were analyzed by univariate analysis,and the related risk factors were identified by logistic *** According to univariate analysis,the PTB group was older than the FT group,with a smaller weight change and greater proportions of women who underwent artificial insemination and had gestational diabetes mellitus(P<0.05).In addition,greater proportions of women with reproductive tract infections and greater white blood cell(WBC)counts(P<0.05),shorter cervical lengths in the second trimester and lower neutrophil percentages(P<0.001)were detected in the PTB group than in the FT *** PTB group exhibited higher postpartum SAS and SDS scores than did the FT group(P<0.0001),with a higher number of mothers experiencing anxiety and depress

关键词： Preterm birth risk factors Postpartum psychological state risk model Prediction

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The clinical characteristics and risk factors for necrotizing soft tissue infection in children

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Pediatric Investigation 2024年第1期8卷 21-26页

作者： Jing Liu Jigang Chen Yanni Wang Hongyan Qi Jing Yu Department of Burn and Plastic Surgery Beijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina

Importance:Necrotizing soft tissue infection(NSTI)is a serious infectious ***,the early clinical manifestations and indicators of NSTI in children are still ***:The purpose of this study was to analyze the clinical characteristics and risk factors of NSTI in pediatric ***:A total of 127 children with skin and soft tissue infection(SSTI)were treated at our hospital and divided into two groups:the NSTI group and the non-NSTI group,based on their discharge diagnosis from January 2011 to December ***,we collected and analyzed the clinical characteristics and risk factors of all patients,including sex and age,disease inducement,admission temperature,local skin manifestations,infection site,the presence of sepsis,bacterial culture,and laboratory ***:In our study,there was a statistical difference in the age distribution and disease inducement between NSTI and non-NSTI *** occurrence of local skin manifestations(blisters/bullae and ecchymosis)and the presence of sepsis significantly increased in the NSTI group compared to the non-NSTI ***,only the platelet count on laboratory tests was statistically different between the NSTI and non-NSTI ***,the logistic regression analysis suggested that local skin manifestations such as blisters/bullae,and ecchymosis,as well as the presence of sepsis,were identified as risk factors for ***:Children with SSTI and skin manifestations such as blisters/bullae,ecchymosis,and the presence of sepsis are at a higher risk of developing *** symptoms serve as useful indicators for early detection of NSTI.

关键词： Clinical characteristics risk factors Necrotizing soft tissue infection Skin andsofttissueinfection

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Dislocation of primary total hip arthroplasty:Analysis of risk factors and preventive options

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World Journal of Orthopedics 2024年第6期15卷 501-511页

作者： Dario Regis Mattia Cason Bruno Magnan Department of Orthopedic and Trauma Surgery Integrated University HospitalVerona 37126VenetoItaly

Total hip arthroplasty(THA)is one of the most successful elective operations in orthopedic surgery for improving pain and functional disability in patients with end-stage joint ***,dislocation continues to be a troublesome complication after THA,as it is a leading cause of revision and is associated with substantial social,health,and economic *** is a relatively rare,usually early occurrence that depends on both the patients’characteristics and the surgical *** most recent and important finding is the special attention to be given preoperatively to spinopelvic mobility,which is closely related to the incidence of ***,clinical and radiographic assessment of the lumbar spine is mandatory to identify an altered pelvic tilt that could suggest a different positioning of the *** spinal fusion is currently considered a risk factor for dislocation and revision regardless of whether it is performed prior to or after *** options for its treatment and prevention include the use of prostheses with large diameter of femoral head size,dual mobility constructs,constrained liners,and modular neck stems.

关键词： Dislocation Total hip arthroplasty Revision surgery Review risk factors Complication

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Klebsiella pneumoniae infections after liver transplantation:Drug resistance and distribution of pathogens,risk factors,and influence on outcomes

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World Journal of Hepatology 2024年第4期16卷 612-624页

作者： Long Guo Peng Peng Wei-Ting Peng Jie Zhao Qi-Quan Wan Department of Respiratory and Critical Care Medicine The Third Xiangya Hospital of Central South UniversityChangsha 410013Hunan ProvinceChina Clinical Laboratory Medicine Center Zhuzhou Hospital Affiliated to Xiangya School of MedicineCentral South UniversityZhuzhou 421007Hunan ProvinceChina The Second Affiliated Hospital Class Xiangya School of MedicineCentral South UniversityChangsha 410013Hunan ProvinceChina Department of Liver Surgery Renji HospitalShanghai Jiaotong University School of MedicineShanghai 200127China Department of Transplant Surgery The Third Xiangya Hospital of Central South UniversityChangsha 410013Hunan ProvinceChina Engineering and Technology Research Center for Transplantation Medicine of National Health Commission The Third Xiangya Hospital of Central South UniversityChangsha 410013Hunan ProvinceChina

BACKGROUND Liver transplantation(LT)is the only curative treatment for end-stage liver ***,LT recipients are susceptible to infection,which is the leading cause of early mortality after *** pneumoniae infections(KPIs)in the bloodstream are common in LT *** hypothesized that KPIs and carbapenemresistant Klebsiella pneumoniae(CRKP)infections may affect the outcomes of LT *** To assess KPI incidence,timing,distribution,drug resistance,and risk factors following LT and its association with *** This retrospective study included 406 patients undergoing LT at The Third Xiangya Hospital of Central South University,a tertiary hospital,from January 2015 to January *** investigated the risk factors for KPIs and assessed the impact of KPIs and CRKP infections on the prognosis of LT recipients using logistic regression *** KPI incidence was 7.9%(n=32),with lung/thoracic cavity the most frequent site of infection;the median time from LT to KPI onset was 7.5 *** 44 Klebsiella pneumoniae isolates,43(97.7%)and 34(77.3%)were susceptible to polymyxin B or ceftazidime/avibactam and tigecycline,respectively;>70%were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and *** sex[odds ratio(OR)=2.827,95%confidence interval(CI):1.256-6.364;P=0.012],pre-LT diabetes(OR=2.794,95%CI:1.070-7.294;P=0.036),day 1 post-LT alanine aminotransferase(ALT)levels≥1500 U/L(OR=3.645,95%CI:1.671-7.950;P=0.001),and post-LT urethral catheter duration over 4 d(OR=2.266,95%CI:1.016-5.054;P=0.046)were risk factors for *** infections,but not KPIs,were risk factors for 6-month all-cause mortality *** KPIs occur frequently and rapidly after *** factors include female sex,pre-LT diabetes,increased post-LT ALT levels,and urethral catheter *** infections,and not KPIs,affect mortality.

关键词： Liver transplantation Klebsiella pneumoniae infections Carbapenem-resistant Klebsiella pneumoniae risk factors Outcomes

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Prospective study of hepatitis B and D epidemiology and risk factors in Romania:A 10-year update

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World Journal of Hepatology 2024年第4期16卷 640-649页

作者： Speranta Iacob Liana Gheorghe Mirela Onica Laura Huiban Corina Silvia Pop Ciprian Brisc Roxana Sirli Carmen Ester Cristina Mihaela Brisc Sorina Diaconu Ion Rogoveanu Larisa Sandulescu Deiana Vuletici Anca Trifan Department of Gastroenterology Carol Davila University of Medicine and PharmacyBucharest 050474Romania Department of Gastroenterology and Hepatology Fundeni Clinical InstituteBucharest 022328Romania Department of Gastroenterology Grigore T Popa University of Medicine and PharmacyIasi 700115Romania Institute of Gastroenterology and Hepatology Saint Spiridon County HospitalIasi 700111Romania Department of Gastroenterology and Medical Oncology University Emergency Clinical HospitalBucharest 050098Romania Faculty of Medicine and Pharmacy University of OradeaOradea 410087Romania Department of Gastroenterology Emergency County HospitalOradea 410169Romania Center for Advanced Research in Gastroenterology and Hepatology Department of Gastroenterology and Hepatology“Victor Babeş”University of Medicine and PharmacyTimisoara 300041Romania Department of Gastroenterology and Hepatology TimişCounty Emergency Clinical Hospital"Pius Branzeu"Timisoara 300723Romania Department of Internal Medicine II and Gastroenterology University Emergency Clinical HospitalBucharest 050098Romania Department of Gastroenterology University of Medicine and PharmacyCraiova 200349Romania Department of Cardiology Emergency County HospitalCraiova 200642Romania Department of Gastroenterology Research Center of Gastroenterology and HepatologyUniversity of Medicine and PharmacyCraiova 200349Romania Department of Gastroenterology Emergency County HospitalCraiova 200642Romania Department of Gastroenterology Faculty of MedicineGrigore T Popa University of Medicine and PharmacyIasi 700115Romania

BACKGROUND The global burden of hepatitis D virus(HDV)infection represents a major medical challenge and a public health crisis ***,there is a lack of accurate data on the epidemiology and risk factors for *** B virus(HBV)and HDV coinfection causes the most severe form of viral hepatitis,leading to a higher cumulative incidence of liver-related events compared with HBV monoinfection,including the need for liver transplantation and *** To investigate the epidemiology,natural history,risk factors and clinical management of HBV and HDV coinfection in Romanian *** This prospective study was conducted between January and July 2022 in six tertiary gastroenterology and hepatology referral centres in *** consecutive adults admitted for any gastroenterology diagnosis who were HBV-positive were *** with acute hepatitis or incomplete data were *** the 25390 individuals who presented with any type of gastroenterology diagnosis during the study period,963 met the inclusion *** for anti-HDV antibodies and HDV RNA was performed for all *** and risk factor data were collected by investigators using medical charts and patient *** data were stored in an anonymized online database during the *** The prevalence of HBV was 3.8%;among these patients,the prevalence of HBV/HDV coinfection was 33.1%.The median age of the study population was 54.0 years,and it consisted of 55.1%men.A higher prevalence of HBV/HDV coinfection was observed in patients 50–69 years *** with HBV/HDV coinfection were significantly older than those with HBV monoinfection(P=0.03).Multivariate multiple regression analysis identified female gender(P=0.0006),imprisonment(Prisk factors for *** This study shows that HDV infection among those with HBV re

关键词： Epidemiology Hepatitis B Hepatitis D Natural history risk factors Romania

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risk factors associated with hepatic dysfunction after Sun's procedure for type A aortic dissection

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South China Journal of Cardiology 2024年第2期25卷 99-108页

作者：胡皓昀吴丽周勘朱平 Guangdong Medical University ZhanjiangGuangdong 524023China Guangdong Cardiovascular Institute Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouGuangdong 510100China

Background Type A aortic dissection,as a cardiovascular emergency,is best treated with early surgical *** advancements in surgical techniques and perioperative management,the clinical cure rate of surgery has significantly ***,the probability of postoperative complications remains high,among which postoperative hepatic dysfunction is one of the common and serious complications affecting *** purpose of this study was to explore the risk factors associated with postoperative hepatic dysfunction in patients with type A aortic dissection,hoping to identify high-risk patients early,prevent postoperative hepatic dysfunction,and improve patient *** A retrospective analysis was conducted on patients diagnosed with Stanford type A aortic dissection and treated with Sun's procedure at Guangdong Provincial People's Hospital from January 1,2021,to October 1,*** Model for End-Stage Liver Disease excluding International Normalized Ratio(MELD-XI)score was used as the evaluation index for postoperative hepatic dysfunction(HD).MELD-XI scores from postoperative day 1 to 7 were *** methods were employed to analyze the perioperative clinical data of the two groups of *** with statistical significance in univariate analysis were included in multivariate logistic regression analysis to identify independent risk factors associated with postoperative *** A total of 241 patients diagnosed with Stanford type A aortic dissection and hospitalized for Sun's procedure treatment were selected using specific inclusion and exclusion *** patients were divided into HD group(MELD-XI score≥12,n=108)and normal group(MELD-XI score<12,n=133),with a postoperative HD incidence rate of 44.81%.There were statistically significant differences(P<0.05)between the two groups in terms of whether the surgery was emergency,gender distribution,preoperative level of white blood cell count,alanine aminotransferase,a

关键词： Hepatic dysfunction Type A aortic dissection risk factors Complications

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risk factors for Acute Kidney Injury in Patients Receiving Antibiotic Therapy:A Systematic Review and Meta-Analysis

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Medicinal Plant 2024年第4期15卷 59-68页

作者： Feifan LIU Yuanmei BAI Yan WAN Yuhuan XIE Peixin GUO College of Ethnic Medicine Yunnan University of Chinese MedicineKunming 650500China College of Basic Medicine Yunnan University of Chinese MedicineKunming 650500China

[Objectives]To systematically analyze the risk factors for acute kidney injury(AKI)in patients treated with antibiotics and to conduct a meta-analysis of published clinical studies.[Methods]PubMed,Web of Science,and Embase were searched for relevant cohort and case-control studies from January 1,2001,to October 31,***-analysis was performed using RevMan5.4 and StataMP15.[Results]A total of 22 studies were *** patient factors,serum creatinine(SCr;MD=1.03,95%CI of-0.07 to-0.02)was associated with increased antibiotic-associated *** the comorbidities and clinical factors,diabetes(OR=1.34,95%CI of 1.06 to 1.69,tumor(OR=2.07,95%CI of 1.13 to 3.79),pneumonia(OR=1.83,95%CI of 1.24 to 2.71),mechanical ventilation(OR=3.44,95%CI of 1.93 to 6.12),and ICU admission(OR=2.83,95%CI of 2.13 to 3.75)increased the risk of AKI in patients receiving antibiotic *** drug factors,diuretics(OR=2.76,95%CI of 2.16 to 3.52)increased the risk of antibiotic-associated AKI.[Conclusions]This paper may assist clinicians in predicting the risk factors for AKI in patients receiving antibiotic therapy.

关键词： Acute kidney injury(AKI) Antibiotics risk factors Meta-analysis

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