Disease attributes

疾病属性
  • 文章类型: Journal Article
    目的:家族性克罗恩病(CD)约占全球所有CD病例的1.5%-22.5%。我们的目的是评估疾病亚型和表型特征的一致性与患者和他们的亲属基于大量的数据,特征良好,中国以转诊中心为基础的队列。
    方法:回顾性研究2012年1月至2022年6月中山大学附属第六医院收治的家族性CD患者。我们分析了家族性CD患者的疾病特征,并在同一家庭中进行了一致性分析。
    结果:在5150名患者中,70人(1.4%)有克罗恩病家族史。初次诊断时患者的中位年龄在先证者和CD家庭成员的继任者之间没有显着差异(p=0.25)。在最初的诊断中,54位一级亲属在年龄(κ=0.50)和疾病部位(κ=0.44)上表现出中等一致性。在最后一次后续访问中,所有家庭成员和一级亲属在上消化道受累(κ=0.67和0.62)和狭窄或穿透行为(κ=0.69和0.77)方面表现出良好的一致性,分别。同一家族中的家族性CD患者在抗肿瘤坏死因子α单克隆抗体的使用和治疗效果方面表现出中等的一致性(κ=0.44和0.42),在硫嘌呤的疗效和不良反应方面表现出轻度的一致性(κ=0.26和0.35)。
    结论:中国家族性CD患者的比例可能相对较低。家族性CD中某些疾病特征的一致性可能与血缘关系和融合程度有关,随访时间较长。
    OBJECTIVE: Familial Crohn\'s disease (CD) accounts for approximately 1.5%-22.5% of all CD cases worldwide. We aimed to assess the concordance in disease subtype and phenotypic features among patients with CD and their relatives based on data from a large, well-characterized, referral center-based cohort in China.
    METHODS: A retrospective study was conducted on patients with familial CD who were admitted to the Sixth Affiliated Hospital of Sun Yat-sen University between January 2012 and June 2022. We analyzed the disease characteristics and performed a concordance analysis within the same family among patients with familial CD.
    RESULTS: Among 5150 patients, 70 (1.4%) had a family history of Crohn\'s disease. The median age of the patients at initial diagnosis did not differ significantly between the probands and successors of family members with CD (p = 0.25). At the initial diagnosis, 54 first-degree relatives showed moderate concordance in age (κ = 0.50) and disease location (κ = 0.44). At the last follow-up visit, all family members and first-degree relatives showed good concordance in upper gastrointestinal involvement (κ = 0.67 and 0.62) and stricturing or penetrating behavior (κ = 0.69 and  0.77), respectively. Patients with familial CD within the same family showed moderate agreement regarding anti-tumor necrosis factor α monoclonal antibody use and treatment efficacy (κ = 0.44 and 0.42) and mild agreement regarding the efficacy and adverse reactions of thiopurine (κ = 0.26 and 0.35).
    CONCLUSIONS: The proportion of patients with familial CD in China may be relatively low. The consistency of certain disease features in familial CD may be associated with the degree of kinship and convergence with longer follow-up duration.
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  • 文章类型: Journal Article
    曲霉菌胸膜炎是侵袭性肺曲霉病(IPA)的罕见并发症,主要发生在免疫受损的宿主中。临床情况很危急,尤其是那些发展为支气管胸膜瘘的人。本研究旨在评估胸膜炎的特征和预后。回顾性分析2000年1月至2022年12月在我院诊断为胸膜炎的13例患者的临床资料。包括13例曲霉性胸膜炎患者。有10名男性和3名女性,年龄中位数为65岁(范围:18-79岁)。8例患者存在支气管胸膜瘘。已证实的胸膜炎诊断是基于7例胸腔积液培养阳性和6例胸腔活检的组织病理学检查。四名患者拒绝进一步治疗,并在医疗建议下出院。9例经过多种抗真菌治疗(全身和局部抗真菌治疗,胸膜引流和冲洗,和手术修复)。随访期间,一个病人,患有潜在的支气管扩张症,出院后2年死于大咯血。其余8例仍在密切跟进中,中位随访时间为5.4年(范围:1.3-18.9年)。曲霉菌胸膜炎合并支气管胸膜瘘的预后较差。胸外科,尤其是肺切除术,是与胸膜炎的发病率相关的危险因素。全身抗真菌治疗和充分的胸腔冲洗可以改善预后。重要胸膜炎是侵袭性肺曲霉病(IPA)的罕见并发症,与预后不良有关。这种情况的发病率和死亡率尚未得到彻底研究,最近关于这个主题的研究是有限的。目前的研究包括13名诊断为胸膜炎的患者,大多数伴有支气管胸膜瘘。在这些患者中,九人有胸外科手术史,包括肺移植和肺叶切除术。四名病人拒绝进一步治疗,并在医生建议下出院,而一名患者出院后2年死于大咯血。本病例系列提供了对胸膜炎曲霉菌的基本见解,并基于有限的队列评估了治疗策略。
    Aspergillus pleurisy is a rare complication of invasive pulmonary aspergillosis (IPA), which mostly occurs in the immunocompromised host. The clinical condition is critical, especially to those who develop bronchopleural fistula. This study aimed to assess the characteristics and the prognosis of aspergillus pleurisy. Clinical data from 13 patients diagnosed with aspergillus pleurisy in our hospital from January 2000 to December 2022 were retrospectively studied. Thirteen patients with Aspergillus pleurisy were included. There were 10 males and 3 females, with a median age of 65 (range: 18-79) years. Bronchopleural fistula was present in eight patients. A proven diagnosis of Aspergillus pleurisy was based on positive pleural fluid culture in seven cases and histopathological examination of pleural biopsies in six cases. Four patients refused further treatment and were discharged from the hospital against medical advice. Nine cases recovered and were discharged after multiple antifungal treatments (systemic and topical antifungal therapies, pleural drainage and irrigation, and surgical repair). During follow-up, one patient, who suffered underlying bronchiectasis, died of massive hemoptysis 2 years after discharge. The remaining eight cases are still under close follow-up, with a median follow-up of 5.4 (range: 1.3-18.9) years. The prognosis of aspergillus pleurisy complicated with bronchopleural fistula is poor. Thoracic surgery, especially lung resection, is a risk factor associated with the incidence of Aspergillus pleurisy. Systemic antifungal therapy and adequate pleural irrigation could improve the prognosis.
    OBJECTIVE: Aspergillus pleurisy is a rare complication of invasive pulmonary aspergillosis (IPA), associated with a poor prognosis. The morbidity and mortality of this condition have not been thoroughly studied, and recent research on this topic is limited. The current study included 13 patients diagnosed with Aspergillus pleurisy, with the majority presenting concomitantly with a bronchopleural fistula. Among these patients, nine had a history of thoracic surgery, including lung transplantation and lobectomy. Four patients refused further treatment and were discharged against medical advice, while one patient succumbed to massive hemoptysis 2 years after discharge. This case series provides essential insights into Aspergillus pleurisy and evaluates the therapeutic strategy based on a limited cohort.
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  • 文章类型: Journal Article
    目的:这项研究的目的是应用机器学习(ML)算法来预测宫颈癌患者的生存率。旨在解决传统统计方法的局限性,由于问题的复杂性,往往无法提供准确的答案。
    方法:本研究采用可视化技术进行初始数据理解。随后,ML算法用于开发用于生存预测的分类和回归模型。在分类模型中,我们训练算法来预测最初诊断和病人死亡之间的时间间隔。间隔被归类为“<6个月,6个月到3年,\"\"3年到5年,\"和\">5年。“回归模型旨在预测生存时间(以月为单位)。我们使用属性权重来获得对模型的洞察力,突出对预测有重大影响的特征,并提供对模型行为和决策过程的有价值的见解。
    结果:梯度提升树算法在分类模型中实现了81.55%的准确率,而随机森林算法在回归模型中表现优异,均方根误差为22.432。值得注意的是,受影响区域周围的辐射剂量显着影响生存时间。
    结论:机器学习证明了在分类和回归问题中提供高准确度生存期预测的能力。这表明其在每个患者的治疗计划和资源分配过程中作为决策支持工具的潜在用途。
    OBJECTIVE: The objective of this research is to apply machine learning (ML) algorithms to predict the survival of cervical cancer patients. The aim was to address the limitations of traditional statistical methods, which often fail to provide accurate answers due to the complexity of the problem.
    METHODS: This research employed visualization techniques for initial data understanding. Subsequently, ML algorithms were used to develop both classification and regression models for survival prediction. In the classification models, we trained the algorithms to predict the time interval between the initial diagnosis and the patient\'s death. The intervals were categorized as \"<6 months,\" \"6 months to 3 years,\" \"3 years to 5 years,\" and \">5 years.\" The regression model aimed to predict survival time (in months). We used attribute weights to gain insights into the model, highlighting features with a significant impact on predictions and offering valuable insights into the model\'s behavior and decision-making process.
    RESULTS: The gradient boosting trees algorithm achieved an 81.55% accuracy in the classification model, while the random forest algorithm excelled in the regression model, with a root mean square error of 22.432. Notably, radiation doses around the affected areas significantly influenced survival duration.
    CONCLUSIONS: Machine learning demonstrated the ability to provide high-accuracy predictions of survival periods in both classification and regression problems. This suggests its potential use as a decision-support tool in the process of treatment planning and resource allocation for each patient.
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  • 文章类型: Journal Article
    过敏性腮腺炎(AP),由于其非特异性症状,经常构成诊断挑战,导致临床医生忽视或误诊的病例。
    本研究旨在阐明AP的详细临床特征和常见诊断指标。
    对诊断为AP的患者的病历进行了全面的回顾和分析,包括人口统计,临床,和实验室数据,2019年1月至2022年3月在南京医科大学附属口腔医院就诊。
    该研究招募了17名患者,平均年龄为36.00±12.95岁。患者中常见的AP表现包括明显的症状,如腮腺肿胀,相关的疼痛,还有口干症.10例患者患有其他特应性疾病。触诊显示受影响的腮腺柔软且呈结节状,局部皮肤温度升高。未刺激的全唾液流速降低。超声检查显示体积增加,减少回声异质性,和受影响的腮腺淋巴结肿大。所有病例均观察到血清唾液淀粉酶和总IgE水平升高。对食物过敏原和吸入过敏原特异性IgE的调查显示,所有患者均怀疑食物过敏。食物激发试验(FPT)诱发AP13例,确认食物过敏原的作用。
    食物过敏原与AP的病因有关,强调综合临床评估的重要性,包括症状,标志,和验证性辅助测试,比如FPT,用于准确诊断和与其他唾液腺病理区分。
    UNASSIGNED: Allergic parotitis (AP), due to its non-specific symptoms, frequently poses a diagnostic challenge, leading to cases being overlooked or misdiagnosed by clinicians.
    UNASSIGNED: This study aimed to elucidate detailed clinical characteristics and common diagnostic indicators of AP.
    UNASSIGNED: A comprehensive review and analysis of medical records was conducted from patients diagnosed with AP, encompassing demographic, clinical, and laboratory data, at the Affiliated Stomatological Hospital of Nanjing Medical University between January 2019 and March 2022.
    UNASSIGNED: The study enrolled 17 patients, evidenced by an average age of 36.00 ± 12.95 years. Common presentations of AP among the patients included notable symptoms such as parotid gland swelling, associated pain, and xerostomia. Ten patients had other atopic diseases. Palpation revealed the affected parotid glands to be soft and nodular, with an elevated local skin temperature. The unstimulated whole saliva flow rate was decreased. Ultrasonography demonstrated increased volume, reduced echo heterogeneity, and lymph node enlargement in the affected parotid glands. All cases observed increased serum salivary amylase and total IgE levels. Investigation of food allergens and inhaled allergen-specific IgE showed that all patients had suspected food allergies. Food provocation tests (FPT) induced AP in 13 cases, confirming the role of food allergens.
    UNASSIGNED: Food allergens are involved in the etiology of AP, underscoring the importance of comprehensive clinical evaluation, including symptoms, signs, and confirmatory auxiliary tests, such as FPT, for accurate diagnosis and differentiation from other salivary gland pathologies.
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  • 文章类型: Journal Article
    目的:嗜酸性粒细胞相关疾病(EADs)的流行病学尚未完全了解。虽然已经对独立的嗜酸性粒细胞疾病进行了一些研究,很少有证据表明罕见条件之间的重叠程度。
    方法:对嗜酸性粒细胞相关疾病的回顾性真实世界调查研究(REVEAL)使用Optum®Clinformatics®保险索赔数据库中的数据来描述和表征11个EAD之间的疾病重叠:过敏性支气管肺曲霉病,特应性皮炎,慢性鼻-鼻窦炎伴鼻息肉,嗜酸性粒细胞性胃炎/胃肠炎,嗜酸性肉芽肿性多血管炎,嗜酸性粒细胞性食管炎,大疱性类天疱疮,慢性阻塞性肺疾病,慢性自发性荨麻疹,和非囊性纤维化支气管扩张。在2015年1月1日至2018年6月30日之间确定了感兴趣的EAD的患者记录。
    结果:总体而言,纳入1,326,645例患者;74.4%有1例EAD,20.5%有≥2个EAD,5.1%的患者有≥3个EAD。较高的疾病重叠率与年龄增长有关。在有更多重叠症状的患者中也观察到更高的血液嗜酸性粒细胞计数。提示嗜酸性粒细胞炎症在多种疾病的发病机制中的共同作用。此外,在大多数队列中,更大的疾病重叠与更高的疾病严重程度相关.
    结论:这项研究的结果对量化未满足的需求具有意义,可用于指导治疗指南,并提高来自一系列疾病专业的医疗保健专业人员对嗜酸性粒细胞炎症和EAD重叠的认识。
    OBJECTIVE: The epidemiology of eosinophil-associated diseases (EADs) is not yet fully understood. While some studies have been conducted on stand-alone eosinophilic diseases, there is scarce evidence on the degree of overlap among rarer conditions.
    METHODS: The retrospective Real-world inVestigation of Eosinophilic-Associated disease overLap (REVEAL) study used data from the Optum® Clinformatics® insurance claims database to describe and characterize disease overlap among 11 EADs: allergic bronchopulmonary aspergillosis, atopic dermatitis, chronic rhinosinusitis with nasal polyps, eosinophilic gastritis/gastroenteritis, eosinophilic granulomatosis with polyangiitis, eosinophilic esophagitis, bullous pemphigoid, chronic obstructive pulmonary disorder, chronic spontaneous urticaria, and non-cystic fibrosis bronchiectasis. Patient records with EADs of interest were identified between January 1, 2015, and June 30, 2018.
    RESULTS: Overall, 1,326,645 patients were included; 74.4% had 1 EAD, 20.5% had ≥ 2 EADs, and 5.1% had ≥ 3 EADs. Higher rates of disease overlap were associated with older age. Higher blood eosinophil counts were also observed in patients with a greater number of overlapping conditions, suggesting a common role for eosinophilic inflammation in the pathogenesis of multiple diseases. Furthermore, greater disease overlap was associated with higher disease severity in most cohorts.
    CONCLUSIONS: Results from this study have implications for quantifying unmet needs and can be used to inform treatment guidelines and raise the awareness of eosinophilic inflammation and EAD overlap among healthcare professionals from a range of disease specialties.
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  • 文章类型: Journal Article
    目的:阐明类风湿关节炎(RA)机化性肺炎(OP)的临床特征以及OP发展与RA加重的关系,并确定OP复发的预测因素。
    方法:对我院2006-2016年收治的33例RA-OP患者的资料进行回顾性分析。
    结果:在82%的患者中,RA发作先于OP发作;在9%的患者中,OP发作先于RA或与RA同时发生。第一次OP发作的中位年龄为64.0岁,从RA发作到第一次OP发作的时间为5.5年。在OP发作时,42%的患者表现为单侧受累,76%的患者KL-6正常;RA疾病控制在52%的患者中保持最佳,在18%的患者中恶化。10例(30%)患者发生OP复发,间隔时间为13.0个月,首次OP复发率为127/1,000人年。与非复发病例(n=14)相比,复发病例(n=10)在首次OP发作时显示年龄较低(59.5与67.1年;p=0.04),从RA发作到第一次OP发作的时间较短(6.4vs.14.2年;p=0.047);此外,这些病例包括更多的OP前患者(30%vs.0%;p=0.03)和反嘲讽者(80%与36%;p=0.03)。OP前患者的中位无复发生存时间较短(15vs.136个月;p=0.01)和更高的复发风险(风险比,5.45;p=0.02)。
    结论:RA-OP显示出较高的复发率,并且与RA恶化无关。确定了四种RA-OP复发预测因子。
    To clarify the clinical characteristics of organizing pneumonia (OP) in rheumatoid arthritis (RA; RA-OP) and the association of OP development with RA exacerbation, and to identify OP recurrence predictors.
    Data from 33 patients with RA-OP admitted to our hospital were retrospectively analyzed (2006-2016).
    RA onset preceded OP onset in 82% of patients, whereas OP onset preceded (OP-preceding) or co-occurred with RA in 9% of patients each. Median age at first OP onset was 64.0 years, and the period from RA onset to first OP onset was 5.5 years. At OP onset, 42% of events exhibited unilateral involvement and 76% had normal Krebs von den Lungen-6. RA disease control remained optimal in 52% of events and was exacerbated in 18% of events. Ten patients (30%) experienced OP recurrence with an interval of 13.0 months between events, and the first OP recurrence rate was 127/1000 person-years. Compared with nonrecurrent cases (n = 14), recurrent cases (n = 10) showed lower age at first OP onset (59.5 vs 67.1 yrs; P = 0.04) and a shorter period from RA onset to first OP onset (6.4 vs 14.2 yrs; P = 0.047); moreover, these cases included a higher number of OP-preceding patients (30% vs 0%; P = 0.03) and ever smokers (80% vs 36%; P = 0.03). OP-preceding patients showed shorter median recurrence-free survival time (15 vs 136 months; P = 0.01) and higher recurrence risk (hazard ratio 5.45; P = 0.02).
    RA-OP showed a high recurrence rate and was not associated with RA exacerbation. Four RA-OP recurrence predictors were identified.
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  • 文章类型: Journal Article
    过去30年台湾的哮喘患病率呈上升趋势,对青少年健康造成很大影响。本研究旨在调查目前的患病率,影响,台湾青少年哮喘的相关因素。
    父母或监护人在调查前在家中提供了被动同意。13-14岁的青少年于2017年在台北完成问卷调查,台湾。患病率,影响,分析哮喘的相关因素。我们还将哮喘患病率与1995年和2001年的患病率进行了比较。
    我们分析了3474份经过验证的问卷。医生诊断的哮喘患病率为12.4%。目前喘息的患病率在2017年为9.2%,1995年为5.2%,2001年为7.0%。3.3%的13-14岁青少年有严重的哮喘症状。哮喘严重影响青少年的生活。在患有哮喘的学生中,10.9%的人缺勤,16.5%急需去看医生,9.5%去了急诊室,3.5%在过去12个月内住院。台湾青少年医生诊断哮喘的相关因素为男性(患病率[PR],1.38;95%置信区间[CI],1.05-1.83;p=0.02),母亲的哮喘病史(PR,2.61;95%CI,1.69-4.02;p<0.01),最近每月至少使用一次扑热息痛(PR,2.60;95%CI,1.24-5.42;p=0.01)。缺勤的相关因素是夜间咳嗽(PR,1.99;95%CI,1.16-3.41;p=0.01),当前喘息(PR,7.52;95%CI,4.39-12.9;p<0.01),和最近使用扑热息痛(每月至少一次,PR,3.16;95%CI,1.10-9.06;p=0.03;每年至少一次,PR,2.19;95%CI,1.25-3.83;p<0.01)。
    医生诊断的哮喘患病率为12.4%。哮喘严重影响青少年的生活。减少夜间咳嗽,喘息频率,和扑热息痛的使用可能有助于减少学校缺勤。
    UNASSIGNED: The prevalence of asthma in Taiwan was increasing in the past 30 years, causing a great impact on adolescent health. This study aimed to investigate the current prevalence, impact, and associated factors of asthma in Taiwanese adolescents.
    UNASSIGNED: Parents or guardians provided passive consent at home prior to the survey. Adolescents aged 13-14 years completed a questionnaire survey in 2017 in Taipei, Taiwan. The prevalence, impact, and associated factors of asthma were analyzed. We also compared the asthma prevalence with the prevalence in 1995 and 2001.
    UNASSIGNED: We analyzed 3474 validated questionnaires. The prevalence of physician-diagnosed asthma was 12.4%. The prevalence of current wheezing was 9.2% in 2017, which was 5.2% in 1995 and 7.0% in 2001. 3.3% of 13-14-year-old adolescents had severe asthma symptoms. Asthma significantly impacted the lives of adolescents. Of the students with asthma, 10.9% had school absenteeism, 16.5% urgently needed to see a doctor, 9.5% went to the emergency department, and 3.5% were admitted to hospitals within the preceding 12 months. The associated factors for physician-diagnosed asthma in Taiwanese adolescents were male (prevalence ratio [PR], 1.38; 95% confidence interval [CI], 1.05-1.83; p = 0.02), maternal history of asthma (PR, 2.61; 95% CI, 1.69-4.02; p < 0.01), and recent paracetamol use at least once per month (PR, 2.60; 95% CI, 1.24-5.42; p = 0.01). The associated factors for school absenteeism were nocturnal cough (PR, 1.99; 95% CI, 1.16-3.41; p = 0.01), current wheezing (PR, 7.52; 95% CI, 4.39-12.9; p < 0.01), and recent paracetamol use (at least once per month, PR, 3.16; 95% CI, 1.10-9.06; p = 0.03; at least once per year, PR, 2.19; 95% CI, 1.25-3.83; p < 0.01).
    UNASSIGNED: The prevalence of physician-diagnosed asthma was 12.4%. Asthma substantially impacted the lives of adolescents. Reducing nocturnal cough, wheezing frequency, and paracetamol usage might help decrease school absenteeism.
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  • 文章类型: Journal Article
    目的:本研究旨在探讨临床特点,预后因素,生存时间,以及结直肠癌(CRC)脑转移(BM)的治疗结果。
    方法:回顾性分析25例结直肠癌BM患者的临床特点。记录诊断CRC后BM发生的时间。同时,从肺发生的时间,骨头,肝脏,和其他颅外转移到BM的发生也被记录。我们评估了影响BM发生时间的时间因素以及BM诊断后的潜在预后因素。对手术为主的综合治疗患者的影响,以放疗为主的综合治疗,和共同用药也进行了评估。
    结果:在来自CRC的BM患者中,肺转移(13/25)的发生频率高于肝转移(8/25)和骨转移(6/25)。BM发展的中位时间要短得多(3.7vs.25.3个月,p=0.027),大脑是转移的起点。中位总生存期为9.9个月。诊断BM和骨之间的间隔,肝脏,肺转移持续3、6.5和11个月,分别。单纯BM患者的脑损害发生率较高(88.9%),而那些有颅外转移的患者的幕下转移发生率为62.5%。差异有统计学意义(p<0.05)。67岁以下患者BM发生时间分别为16.1个月和30.1个月,分别。它们之间的差异有统计学意义(p=0.043)。左侧和右侧结肠癌的BM时间分别为26.5和7.8个月,代表统计学上的显著差异(p=0.015)。切除和不切除原发性病变的患者的BM起效时间分别为25.4和4.5个月。显示了统计学上的显著差异(p=0.007)。单因素分析显示患者预后与KPS评分有关,BM的数量,治疗方法,肺转移的发生(p<0.05)。多因素分析显示,治疗方式和肺转移是合并BM的CRC患者的独立预后因素。右侧有BM的CRC患者预后不良(8.1与10.2个月,p=0.31)。尽管使用和不使用贝伐单抗联合治疗的患者的中位生存时间没有显着差异,贝伐单抗治疗与更好的生存时间相关(9.9vs.7.1个月,p=0.27)。
    结论:左侧CRC患者,尤其是那些有肺转移的人,容易发生脑转移,以脑转移为第一转移部位的患者幕上转移率较高。年轻的右半结肠癌患者和未进行原发灶切除的患者发生BM的时间较短。结直肠肺转移患者,尤其是那些有右边CRC的年轻人,需要密切的BM影像监测。有BM和肺转移的CRC患者预后较差,以手术为主的综合治疗可显着延长患者的生存时间。
    OBJECTIVE: The study aimed to investigate the clinical characteristics, prognostic factors, survival times, and therapy outcomes of brain metastases (BM) from colorectal cancer (CRC).
    METHODS: The clinical characteristics of 25 patients with BM from CRC were retrospectively analyzed. The time of the occurrence of BM after diagnosis of CRC was recorded. Meanwhile, the time from the occurrence of lung, bone, liver, and other extracranial metastases to the occurrence of BM was also recorded. We evaluate the time factors affecting the length of the occurrence of BM and the potential prognostic factors after BM diagnosis. The influences of patients undergoing surgery-based comprehensive treatment, radiotherapy-based comprehensive treatment, and co-medication were also assessed.
    RESULTS: In patients with BM from CRC, lung metastases (13/25) occurred at a higher frequency than liver metastases (8/25) and bone metastases (6/25). The median time to the development of BM was much shorter (3.7 vs. 25.3 months, p = 0.027), with the brain being the origin site for the metastasis. The median overall survival reached 9.9 months. The interval between diagnosis of BM and bone, liver, and lung metastasis remains 3, 6.5, and 11 months, respectively. The brain lesions of patients with BM alone had higher rates in supratentorial (88.9%), while those with extracranial metastasis had a 62.5% incidence of infratentorial metastasis. The difference was statistically significant (p < 0.05). The time of occurrence of BM in patients aged 67 years and younger was 16.1 and 30.1 months, respectively. The differences between them were statistically significant (p = 0.043). The BM time for left- and right-sided colon cancer were 26.5 and 7.8 months, representing a statistically significant difference (p = 0.015). The time to onset of BM for patients with and without the resection of primary lesions was 25.4 and 4.5 months. Statistically significant differences are shown (p = 0.007). Univariate analysis demonstrated that the prognosis of patients was related to the KPS score, the number of BM, the treatment methods, and the occurrence of lung metastasis (p < 0.05). The multivariate analysis revealed that the treatment modality and lung metastasis were independent prognostic factors for CRC patients with BM. Right-sided CRC patients with BM have a poor prognosis (8.1 vs. 10.2 months, p = 0.31). Although median survival time was not significantly different between patients with and without bevacizumab combination therapy, bevacizumab therapy is associated with a better survival time (9.9 vs. 7.1 months, p = 0.27).
    CONCLUSIONS: Patients with left-sided CRC, especially those with lung metastases, are prone to brain metastases, and patients with brain metastases as the first metastatic site have a higher rate of supratentorial metastases. Young patients with right hemicolon cancer and patients who have not undergone primary lesion resection have a shorter time for the occurrence of BM. Patients with colorectal lung metastases, especially those young with right-sided CRC, require close imaging surveillance of BM. The prognosis of CRC patients with BM and lung metastases is poor, and comprehensive treatment based on surgery could significantly prolong patients\' survival time.
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  • Carbon dioxide is a simple asphyxial gas, with low concentrations having an excitatory effect on the respiratory center, while high concentrations have an inhibitory effect on the respiratory center. Simple carbon dioxide poisoning is rarely seen clinically. This article reviews and analyzes the treatment process of 9 cases of acute inhalation carbon dioxide poisoning in a cargo ship carbon dioxide leakage accident in May 2019, summarizes clinical treatment experience, and provides timely and effective treatment for acute pulmonary edema caused by acute inhalation carbon dioxide poisoning. In particular, the application of hormones has a good prognosis, improving clinicians\' understanding of the disease.
    二氧化碳为单纯窒息性气体,低浓度时对呼吸中枢有兴奋作用,高浓度时对呼吸中枢有抑制作用,单纯的二氧化碳中毒临床上很少见。本文回顾分析2019年5月某货轮二氧化碳泄露事故中9例吸入性二氧化碳急性中毒的治疗经过,通过对急性吸入性二氧化碳中毒引起的急性肺水肿给予及时有效治疗,尤其是激素的应用预后良好,以期提高临床医生对该病的认识。.
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  • DOI:
    文章类型: Journal Article
    背景:关于与外生新生儿相比,新生儿死亡率的模式和决定因素的文献有限。该研究的目的是调查住院患者死亡的模式和危险因素,呼吸机上出生和出生的新生儿。
    方法:这是无与伦比的,病例控制,在2020年1月至12月之间进行的试点研究,使用从三级医疗机构的新生儿重症监护病房(NICU)患者的医疗记录中检索到的信息,即纳拉扬医学院和医院,位于印度东部。
    结果:先天性肺炎是导致新生儿死亡的主要原因,总死亡率为33.4%。同时,外产新生儿的总死亡率为43.3%,出生缺氧是最常见的原因。影响新生儿死亡率的唯一重要因素是低动脉血气(ABG)pH,而在出生的新生儿中,他们是早产儿,血小板减少症,低ABGpO2和高pCO2。总的来说,新生儿血小板减少症,与其他相比,低ABGpO2和高pCO2的死亡风险更高.
    结论:新生儿的死亡率高于新生儿。观察到影响死亡率的属性是早产,血小板减少症,低ABGpH,pO2和高pCO2。
    BACKGROUND: Limited literature was available on the pattern and determinants of mortality among inborn neonates in comparison to the out born ones. The study\'s goal was to investigate the patterns and risk factors for mortality among hospitalised, on-ventilator inborn and out born neonates.
    METHODS: It was an unmatched, case-control, pilot study conducted between January and December 2020 using information retrieved from the medical records of patients attending the neonatal intensive care unit (NICU) of a tertiary healthcare facility, namely Narayan Medical College & Hospital, situated in eastern India.
    RESULTS: Congenital pneumonia was the leading cause of death in inborn neonates, with an overall mortality rate of 33.4%. Meanwhile, the overall fatality rate for out born neonates was found to be 43.3%, with birth hypoxia being the most common cause. The only significant attribute affecting mortality in inborn neonates was low arterial blood gas (ABG) pH, whereas in out born neonates they were prematurity, thrombocytopenia, low ABG pO2, and high pCO2. Overall, new-borns with thrombocytopenia, low ABG pO2, and high pCO2 were observed to be at higher risk for mortality compared to others.
    CONCLUSIONS: The mortality rate of out born neonates was higher than inborn ones. The attributes affecting mortality were observed to be prematurity, thrombocytopenia, low ABG pH, pO2, and high pCO2.
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