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Selection of the apposite vacuum extractor during operative delivery: A biomechanical study. 在手术分娩过程中选择合适的真空提取器:一项生物力学研究。
Pub Date : 2024-12-30 DOI: 10.1097/JCMA.0000000000001204
Ping-Lin Hsieh, Peng-Hui Wang, Jyun-Cheng Ke, Kai-Jo Chiang, Chi-Kang Lin, Fung-Wei Chang, Kuo-Min Su, Kuo-Chih Su

Background: Operative delivery is a technique used during vaginal or cesarean birth to facilitate the patient's labor course through the assistance of a vacuum extractor. This method is increasingly used compared with forceps. This study aimed to investigate the forced effects of vacuum extractors comprising vacuum cups with different thicknesses on the fetal head and the vacuum extractor during vacuum-assisted delivery and to determine the optimal thickness for reducing the failure rate and minimizing neonatal and maternal morbidity.

Methods: A biomechanical model was developed to examine the impact of vacuum cups with varying thicknesses. This simulation three-dimensional (3D) geometry model was used to evaluate hemispherical-shaped vacuum extractors made of silicone rubber having a similar cup diameter of 70 mm with varying thicknesses (1 mm to 5 mm), which were applied to the three models (flat surfaces, hemispherical balls, and fetal head). Under one boundary condition and two different loading conditions, finite element analysis was utilized to simulate the force of vacuum extractors on the fetal head during the process of operative delivery. The main observation indicators were the reaction forces of the constructed model, and von Mises stress on both the vacuum extractors and fetal head.

Results: For the reaction forces on each axis, we found that the sum of the reaction force values on each axis was increased as the thickness of the vacuum extractor was increased, regardless of the surface type. Additionally, the reaction force of the fixed-support end was increased with the increased thickness of the vacuum extractor. The von Mises stress distributions of vacuum extractors comprising vacuum cups with different thicknesses, revealed that the thinner the cup, the greater the von Mises stress exerted on the extractor itself regardless of the surface type. The distribution of von Mises stress on the skull structure of the fetal head, showed that the thinner the cup, the greater the von Mises stress exerted on the skull structure regardless of the surface type.

Conclusion: A thinner vacuum extractor cup may result in greater injury to the fetus; hence, a thicker vacuum extractor cup is preferably utilized during vacuum-assisted operative delivery. Using a thicker vacuum extractor should yield a higher successful delivery rate and reduce fetal injury.

背景:手术分娩是一种在阴道或剖宫产过程中使用的技术,通过真空抽吸器的辅助来促进患者的分娩过程。与钳子相比,这种方法越来越多地被使用。本研究旨在探讨不同厚度的真空吸盘在真空辅助分娩过程中对胎儿头部和真空吸盘的强迫作用,并确定最佳厚度以降低失败率,最大限度地降低新生儿和产妇的发病率。方法:建立生物力学模型,研究不同厚度的真空杯对人体的影响。该仿真三维几何模型应用于三种模型(平面、半球形球和胎头)上,对杯径为70 mm的硅橡胶半球形真空抽提器进行了评价,该半球形真空抽提器具有不同的厚度(1 mm至5 mm)。在一种边界条件和两种不同载荷条件下,采用有限元方法模拟了真空抽吸器在手术分娩过程中对胎儿头部的作用力。主要观察指标为所构建模型的反作用力,以及真空抽吸器和胎头的von Mises应力。结果:对于各轴上的反作用力,我们发现,无论表面类型如何,各轴上的反作用力值之和都随着真空抽提器厚度的增加而增加。固支端反力随抽吸器厚度的增加而增大。由不同厚度的真空吸盘组成的真空吸盘的von Mises应力分布表明,无论表面类型如何,吸盘越薄,施加在吸盘上的von Mises应力越大。von Mises应力在胎头颅骨结构上的分布表明,无论表面类型如何,杯子越薄,对颅骨结构施加的von Mises应力越大。结论:真空抽采杯越薄,对胎儿的伤害越大;因此,在真空辅助手术分娩时,最好使用较厚的真空抽吸杯。使用较厚的真空抽吸器可以提高分娩成功率,减少胎儿损伤。
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引用次数: 0
Predictive biosignatures for hospitalization in patients with virologically confirmed COVID-19. 病毒学确诊的COVID-19患者住院治疗的预测性生物特征
Pub Date : 2024-12-30 DOI: 10.1097/JCMA.0000000000001203
Kung-Hao Liang, Yu-Chun Chen, Chun-Yi Hsu, Zih-Kai Kao, Ping-Hsing Tsai, Hsin-Yi Huang, Yuan-Chia Chu, Hsiang-Ling Ho, Yi-Chu Liao, Yi-Chung Lee, Chi-Cheng Huang, Tzu-Chun Wei, Yi-Jia Liao, Yung-Hsiu Lu, Chen-Tsung Kuo, Shih-Hua Chiou
<p><strong>Background: </strong>COVID-19, caused by the SARS-CoV-2 virus, presents with varying severity among individuals. Both viral and host factors can influence the severity of acute and chronic COVID-19, with chronic COVID-19 commonly referred to as long COVID. SARS-CoV-2 infection can be properly diagnosed by performing real-time reverse transcription PCR analysis of nasal swab samples. Pulse oximetry, chest X-ray, and complete blood count (CBC) analysis can be used to assess the condition of the patient to ensure that the appropriate medical care is delivered. This study aimed to develop biosignatures that can be used to distinguish between patients who are likely to develop severe disease and require hospitalization from patients who can be safely monitored in less intensive settings.</p><p><strong>Methods: </strong>A retrospective investigation was conducted on 7897 adult patients with virologically confirmed SARS-CoV-2 infection between January 26, 2020, and November 30, 2023; all patients underwent comprehensive CBC testing at Taipei Veterans General Hospital). Among them, 1867 patients were independently recruited for a population study involving genome-wide genotyping of approximately 424 000 genomic variants. Therefore, the participants were divided into two patient cohorts, one with genomic data (n = 1867) and one without (n = 6030) for model validation and training, respectively.</p><p><strong>Results: </strong>We constructed and validated a biosignature model by using a combination of CBC measurements to predict subsequent hospitalization events (hazard ratio [95% confidence interval] = 3.38, [3.07, 3.73] for the training cohort and 3.03 [2.46, 3.73] for the validation cohort; both p < 10-8). The obtained scores were used to identify the top quartile of patients, who formed the "very high risk" group with a significantly higher cumulative incidence of hospitalization (log-rank p < 10-8 in both the training and validation cohorts). The "very high risk" group exhibited a cumulative hospitalization rate of >60%, whereas the rate for the other patients was approximately 30% over a 1.5-year period, providing a binary classification of patients with distinct hospitalization risks. To investigate the genetic factors mediating this risk, we conducted a genome-wide association study. Specific regions in chromosomes 7 and 10 and the mitochondrial chromosome (M), harboring IKZF1, ABLIM1 and MT-ND3, exhibited prominent associations with binary risk classification. The identified exonic variants of IKZF1 are linked to several autoimmune diseases. Notably, people with different genotypes of the leading variants (rs4132601, rs141492519, and Affx-120744614) exhibited varying cumulative hospitalization rates following infection.</p><p><strong>Conclusion: </strong>We successfully developed and validated a biosignature model of COVID-19 severe disease in virologically confirmed patients. The identified genomic variants provide new insights for inf
背景:由SARS-CoV-2病毒引起的COVID-19在个体中表现出不同的严重程度。病毒和宿主因素都会影响急性和慢性COVID-19的严重程度,慢性COVID-19通常被称为长COVID。通过对鼻拭子样本进行实时反转录PCR分析,可以正确诊断SARS-CoV-2感染。脉搏血氧仪、胸部x光和全血细胞计数(CBC)分析可用于评估患者的病情,以确保提供适当的医疗护理。这项研究旨在开发可用于区分可能发展为严重疾病并需要住院治疗的患者与可在非密集环境中安全监测的患者的生物特征。方法:对2020年1月26日至2023年11月30日病毒学确诊的成年SARS-CoV-2感染患者7897例进行回顾性调查;所有患者均在台北退伍军人总医院接受全面的全血细胞计数检测)。其中,1867名患者被独立招募,参与一项涉及约42.4万个基因组变异的全基因组基因分型的人群研究。因此,参与者被分为两组患者,一组有基因组数据(n = 1867),另一组没有(n = 6030),分别用于模型验证和训练。结果:我们构建并验证了一个生物特征模型,通过联合使用CBC测量来预测随后的住院事件(训练组的风险比[95%置信区间]= 3.38,[3.07,3.73],验证组的风险比[2.46,3.73];p < 10-8)。获得的评分用于确定患者的前四分之一,这些患者构成“非常高风险”组,其累积住院发生率显著较高(在训练和验证队列中log-rank p < 10-8)。“非常高风险”组的累计住院率为60 - 60%,而其他患者的住院率在1.5年期间约为30%,提供了具有不同住院风险的患者的二元分类。为了研究介导这种风险的遗传因素,我们进行了一项全基因组关联研究。7号染色体和10号染色体以及线粒体染色体(M)中包含IKZF1、ABLIM1和MT-ND3的特定区域与二元风险分类有显著关联。已确定的IKZF1外显子变异与几种自身免疫性疾病有关。值得注意的是,具有主要变异(rs4132601、rs141492519和Affx-120744614)不同基因型的人在感染后表现出不同的累积住院率。结论:成功建立并验证了病毒学确诊患者COVID-19重症生物特征模型。确定的基因组变异为传染病研究和医疗保健提供了新的见解。
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引用次数: 0
Complex causal relationships between genetic predictions of 731 immune cell phenotypes and novel coronavirus: A two-sample mendelian randomization analysis. 731种免疫细胞表型的遗传预测与新型冠状病毒之间复杂的因果关系:两样本孟德尔随机化分析
Pub Date : 2024-12-27 DOI: 10.1097/JCMA.0000000000001201
Ze-Su Niu, Ru-Xin Liu, Yi Hu, Xiao-Rui Meng, Li-Hong Liu, Li-Ting Yang, Xue Bai, Meng-Fei Chen, Dong-Feng Pan

Background: COVID-19, caused by SARS-CoV-2, has had a significant impact on global health. While the virus primarily affects the respiratory system, the intricate interplay between immune cells and the virus remains poorly understood. This study investigates the causal relationship between 731 immune cell phenotypes and COVID-19 using Mendelian randomization analysis.

Methods: A bidirectional two-sample Mendelian randomization (MR) analysis was conducted using genetic variants strongly associated with immune cell phenotypes as instrumental variables. Data for 731 immune cell phenotypes were sourced from the GWAS Catalog, while data for COVID-19 susceptibility were obtained from the OPEN GWAS database. Five MR methods (IVW, MR-Egger, weighted median, simple mode, and weighted mode) were employed to estimate causal effects, with IVW as the primary analysis method.

Results: The study identified 57 immune cell phenotypes causally associated with COVID-19 risk across two independent GWAS datasets. Five immune cell phenotypes were consistently associated with COVID-19 risk across both datasets: CD3-lymphocyte %lymphocyte (protective), CD27 on CD20- (protective), CD20 on IgD+ CD38- unsw mem (increased risk), CD27 on IgD- CD38- (increased risk), and CD19 on B cell (increased risk). Sensitivity analyses confirmed the robustness of the findings.

Conclusion: This study provides compelling evidence for a causal relationship between specific immune cell phenotypes and COVID-19 risk. These findings highlight the potential for targeting these immune cell phenotypes as novel therapeutic targets for COVID-19 treatment and prevention.

背景:由SARS-CoV-2引起的COVID-19对全球卫生产生了重大影响。虽然病毒主要影响呼吸系统,但免疫细胞和病毒之间复杂的相互作用仍然知之甚少。本研究采用孟德尔随机化分析研究了731种免疫细胞表型与COVID-19之间的因果关系。方法:使用与免疫细胞表型密切相关的遗传变异作为工具变量,进行双向双样本孟德尔随机化(MR)分析。731种免疫细胞表型数据来自GWAS目录,而COVID-19易感性数据来自OPEN GWAS数据库。采用五种MR方法(IVW、MR- egger、加权中位数、简单模式和加权模式)估计因果效应,以IVW为主要分析方法。结果:该研究在两个独立的GWAS数据集中确定了57种与COVID-19风险因果相关的免疫细胞表型。在两个数据集中,五种免疫细胞表型与COVID-19风险一致相关:cd3淋巴细胞%淋巴细胞(保护性),CD27在CD20-(保护性),CD20在IgD+ CD38- unsw mem(风险增加),CD27在IgD- CD38-(风险增加),CD19在B细胞(风险增加)。敏感性分析证实了研究结果的稳健性。结论:本研究为特异性免疫细胞表型与COVID-19风险之间的因果关系提供了令人信服的证据。这些发现突出了靶向这些免疫细胞表型作为COVID-19治疗和预防的新治疗靶点的潜力。
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引用次数: 0
Comparison between virtual reality and traditional lecture methods in educating respiratory therapy students on pediatric difficult airway diseases. 在对呼吸治疗专业学生进行儿科困难气道疾病教育时,比较虚拟现实与传统授课方法。
Pub Date : 2024-12-27 DOI: 10.1097/JCMA.0000000000001200
Wen-Jing Hsu, Yi-Hsuan Tang, Wei-Chih Chen, Yu-Sheng Lee, Pei-Chen Tsao, Wei-Yu Chen, Ying-Ying Yang, Hsin-Kuo Ko, Sheng-Wei Pan, Yu-Fen Ting, Shih-Hsing Yang, Mei-Jy Jeng

Background: Pediatric airway diseases are associated with complex challenges because of smaller and more dynamic airway structures in children. These conditions, along with specialized management by medical care staff, should be immediately and precisely recognized to prevent life-threatening obstructions and long-term respiratory complications. Recently, virtual reality (VR) has emerged as an innovative approach to clinical medical education. To evaluate and compare the effectiveness of VR-based education and traditional lectures in enhancing knowledge retention, clinical reasoning, and motivation among senior respiratory therapy students.

Methods: This experimental research was conducted between November 2020 and September 2022, involving 54 students from a School of Respiratory Therapy, with 43 completing a pre-test and undergoing random assignment into either a VR or a traditional education (non-VR) group. Samsung Gear VR Oculus headsets were used by the VR group for instructions on conditions such as laryngeal malacia, subglottic stenosis, and tracheomalacia. Theoretical exams, objective structured clinical examinations (OSCE), and instructional material motivation survey (IMMS) were used to evaluate participants' knowledge retention, clinical reasoning, and application capabilities, followed by statistical analysis comparing both study groups.

Results: No significant differences in pre-test scores were observed between the two groups. However, the VR group outperformed the non-VR group in OSCE scores significantly (p = 0.003) and demonstrated greater learning motivation and satisfaction based on IMMS scores. No notable difference in immediate post-education theoretical examination scores was observed between the groups.

Conclusion: VR-based education markedly improved the clinical reasoning and application skills of respiratory therapy students over traditional lecture methods. VR learning also increased students' motivation and satisfaction, indicating a more immersive and effective educational experience. These findings reveal that VR may be best utilized as a supplemental educational tool in clinical training programs. Future studies with larger samples and longer follow-up are warranted to further explore the optimal integration of VR in education.

背景:儿童气道疾病具有复杂的挑战,因为儿童气道结构更小、更动态。在医护人员的专门管理下,应立即准确地识别这些情况,以防止危及生命的阻塞和长期呼吸道并发症。近年来,虚拟现实(VR)作为一种创新的临床医学教育方法应运而生。评估和比较基于虚拟现实的教育与传统讲座在提高呼吸治疗高级学生知识记忆、临床推理和学习动机方面的效果。方法:本实验研究于2020年11月至2022年9月期间进行,涉及来自呼吸治疗学院的54名学生,其中43名完成了预测试,并随机分配到VR或传统教育(非VR)组。VR组使用三星Gear VR Oculus头显来指导喉软化症、声门下狭窄症和气管软化症等疾病。采用理论考试、客观结构化临床考试(OSCE)和教材动机调查(IMMS)评估参与者的知识保留、临床推理和应用能力,并对两组进行统计分析比较。结果:两组前测成绩无显著差异。然而,VR组在OSCE得分上明显优于非VR组(p = 0.003),并且基于IMMS得分表现出更大的学习动机和满意度。两组间教育后理论考试成绩无显著差异。结论:基于vr的呼吸治疗学生临床推理能力和应用能力较传统课堂教学有明显提高。VR学习也提高了学生的学习动机和满意度,表明了一种更加身临其境和有效的教育体验。这些发现表明,VR可能是临床培训计划中最好的辅助教育工具。未来的研究需要更大的样本和更长的随访时间来进一步探索VR在教育中的最佳整合。
{"title":"Comparison between virtual reality and traditional lecture methods in educating respiratory therapy students on pediatric difficult airway diseases.","authors":"Wen-Jing Hsu, Yi-Hsuan Tang, Wei-Chih Chen, Yu-Sheng Lee, Pei-Chen Tsao, Wei-Yu Chen, Ying-Ying Yang, Hsin-Kuo Ko, Sheng-Wei Pan, Yu-Fen Ting, Shih-Hsing Yang, Mei-Jy Jeng","doi":"10.1097/JCMA.0000000000001200","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001200","url":null,"abstract":"<p><strong>Background: </strong>Pediatric airway diseases are associated with complex challenges because of smaller and more dynamic airway structures in children. These conditions, along with specialized management by medical care staff, should be immediately and precisely recognized to prevent life-threatening obstructions and long-term respiratory complications. Recently, virtual reality (VR) has emerged as an innovative approach to clinical medical education. To evaluate and compare the effectiveness of VR-based education and traditional lectures in enhancing knowledge retention, clinical reasoning, and motivation among senior respiratory therapy students.</p><p><strong>Methods: </strong>This experimental research was conducted between November 2020 and September 2022, involving 54 students from a School of Respiratory Therapy, with 43 completing a pre-test and undergoing random assignment into either a VR or a traditional education (non-VR) group. Samsung Gear VR Oculus headsets were used by the VR group for instructions on conditions such as laryngeal malacia, subglottic stenosis, and tracheomalacia. Theoretical exams, objective structured clinical examinations (OSCE), and instructional material motivation survey (IMMS) were used to evaluate participants' knowledge retention, clinical reasoning, and application capabilities, followed by statistical analysis comparing both study groups.</p><p><strong>Results: </strong>No significant differences in pre-test scores were observed between the two groups. However, the VR group outperformed the non-VR group in OSCE scores significantly (p = 0.003) and demonstrated greater learning motivation and satisfaction based on IMMS scores. No notable difference in immediate post-education theoretical examination scores was observed between the groups.</p><p><strong>Conclusion: </strong>VR-based education markedly improved the clinical reasoning and application skills of respiratory therapy students over traditional lecture methods. VR learning also increased students' motivation and satisfaction, indicating a more immersive and effective educational experience. These findings reveal that VR may be best utilized as a supplemental educational tool in clinical training programs. Future studies with larger samples and longer follow-up are warranted to further explore the optimal integration of VR in education.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The surgical safety margin after neoadjuvant chemotherapy combined with nimotuzumab leading to tumor regression. 新辅助化疗联合尼莫单抗导致肿瘤消退后的手术安全界限。
Pub Date : 2024-12-23 DOI: 10.1097/JCMA.0000000000001199
Suxin Zhang, Si Chen, Guochao Chai, Yaoyao Shi, Yang Bao, Shixiong Peng, Zifeng Cui, Jiamei Hao

Background: To investigate the effect of nimotuzumab (N) combined with nab-paclitaxel, cisplatin, and fluorouracil (APF) neoadjuvant chemotherapy on the surgical margin.

Methods: 55 patients were divided into three groups: neoadjuvant chemotherapy and surgery group (G1, 15 cases), chemotherapy and surgery group (G2 group, 20 cases), and surgery group (G3 group, 20 cases). Tissue samples of the tumor core zone (P0), adjacent (P1, 3-5mm from tumor), distal adjacent (P2, 7-10mm from tumor), and surgical margin (P3, 15mm from tumor) were collected. Morphological changes and pathological remission rates were observed. Immunohistochemistry was used to detect the expression of EGFR, elF4E, P53, and VEGF in each specimen by statistical analysis.

Results: In the G1 and G2 groups, various degrees of degeneration and necrosis were observed in the tumor retraction area. Nine cases of MPR (major pathologic response) and 4 cases of pCR (pathologic complete response) in the G1 group; 8 cases of MPR and 3 cases of pCR in the G2 group. The expressions of p53, eIF4E, and EGFR in the samples of the three groups decreased from P0 to P2 with statistical differences (p<0.05). In the molecular tumor shrinkage area, the expression levels of p53, eIF4E, and EGFR in the shrinkage zone were lower than those in the negative margin.

Conclusion: In summary, although there is no significant statistical difference between neoadjuvant chemotherapy with nimotuzumab combined with APF and APF alone in the pathological remission rate of locally advanced oral squamous cell carcinoma, there is a trend indicating that nimotuzumab combined with APF is superior.

背景:探讨尼莫单抗(N)联合nab-紫杉醇、顺铂、氟尿嘧啶(APF)新辅助化疗对手术缘的影响。方法:55例患者分为新辅助化疗手术组(G1, 15例)、化疗手术组(G2组,20例)、手术组(G3组,20例)3组。采集肿瘤核心区(P0)、邻近区(P1,距肿瘤3-5mm)、远端邻近区(P2,距肿瘤7-10mm)、手术缘区(P3,距肿瘤15mm)组织标本。观察形态学改变和病理缓解率。采用免疫组化方法对各标本中EGFR、elF4E、P53、VEGF的表达进行统计分析。结果:G1组、G2组肿瘤回缩区出现不同程度的退变、坏死。G1组MPR(主要病理缓解)9例,pCR(病理完全缓解)4例;G2组MPR 8例,pCR 3例。三组样本中p53、eIF4E、EGFR的表达由P0降至P2,差异有统计学意义(p)结论:综上所述,尼莫单抗联合APF新辅助化疗与单用APF治疗局部晚期口腔鳞状细胞癌的病理缓解率虽无统计学差异,但有尼莫单抗联合APF的趋势。
{"title":"The surgical safety margin after neoadjuvant chemotherapy combined with nimotuzumab leading to tumor regression.","authors":"Suxin Zhang, Si Chen, Guochao Chai, Yaoyao Shi, Yang Bao, Shixiong Peng, Zifeng Cui, Jiamei Hao","doi":"10.1097/JCMA.0000000000001199","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001199","url":null,"abstract":"<p><strong>Background: </strong>To investigate the effect of nimotuzumab (N) combined with nab-paclitaxel, cisplatin, and fluorouracil (APF) neoadjuvant chemotherapy on the surgical margin.</p><p><strong>Methods: </strong>55 patients were divided into three groups: neoadjuvant chemotherapy and surgery group (G1, 15 cases), chemotherapy and surgery group (G2 group, 20 cases), and surgery group (G3 group, 20 cases). Tissue samples of the tumor core zone (P0), adjacent (P1, 3-5mm from tumor), distal adjacent (P2, 7-10mm from tumor), and surgical margin (P3, 15mm from tumor) were collected. Morphological changes and pathological remission rates were observed. Immunohistochemistry was used to detect the expression of EGFR, elF4E, P53, and VEGF in each specimen by statistical analysis.</p><p><strong>Results: </strong>In the G1 and G2 groups, various degrees of degeneration and necrosis were observed in the tumor retraction area. Nine cases of MPR (major pathologic response) and 4 cases of pCR (pathologic complete response) in the G1 group; 8 cases of MPR and 3 cases of pCR in the G2 group. The expressions of p53, eIF4E, and EGFR in the samples of the three groups decreased from P0 to P2 with statistical differences (p<0.05). In the molecular tumor shrinkage area, the expression levels of p53, eIF4E, and EGFR in the shrinkage zone were lower than those in the negative margin.</p><p><strong>Conclusion: </strong>In summary, although there is no significant statistical difference between neoadjuvant chemotherapy with nimotuzumab combined with APF and APF alone in the pathological remission rate of locally advanced oral squamous cell carcinoma, there is a trend indicating that nimotuzumab combined with APF is superior.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Influence of endovascular surgery on abdominal aortic aneurysm management strategies from a national health insurance database survey. 全国医疗保险数据库调查显示血管内手术对腹主动脉瘤管理策略的影响。
Pub Date : 2024-12-01 Epub Date: 2024-08-22 DOI: 10.1097/JCMA.0000000000001156
Wei-Ling Chen, Chung-Dann Kan, Yi-Ting Huang, Hsin-I Shih

Background: Abdominal aortic aneurysm (AAA) is a significant global health concern, yet comprehensive population-based studies remain limited. This study aimed to evaluate the hospitalization rates, surgical trends, mortality, and reintervention rates for ruptured (r-AAA) and nonruptured (nr-AAA) AAA using data from a national health insurance database.

Methods: A population-based retrospective cohort study was conducted utilizing data from the Taiwanese National Health Insurance Research Database from 2007 to 2018. The study included individuals aged 20 years and older with a newly diagnosed AAA.

Results: Among 70 457 patients diagnosed with aortic aneurysm or dissection, 22 538 (32%) adult patients (≥20 years) were identified with AAA. The annual incidence of AAA ranged from 7.7 to 10.3 per 100 000 population, with r-AAA decreasing from 1.3 to 0.8 per 100 000 and nr-AAA from 9.0 to 6.8 per 100 000. Most patients with AAA were older adults (85%), with 15 392 (68%) hospitalized and 4885 (32%) undergoing surgery within 14 days of diagnosis. The use of endovascular aneurysm repair (EVAR) significantly increased from 28% to 96% over the study period. Long-term survival was higher in patients who underwent open surgical repair (OSR) compared to those who received EVAR or conservative management, irrespective of whether they had r-AAA or nr-AAA.

Conclusion: AAA predominantly affects older individuals, and the annual incidence shows a declining trend. Since the introduction of EVAR, its use has steadily increased while OSR rates have decreased. Although both EVAR and OSR are associated with reduced mortality in patients with r-AAA, OSR is linked to superior long-term survival outcomes.

背景:腹主动脉瘤(AAA)对全球健康构成了相当大的挑战;然而,基于人群的 AAA 研究却很少。本研究通过使用全国健康保险数据库,确定了破裂型(r-AAA)和非破裂型(nr-AAA)AAA 的住院率、手术趋势、死亡率和再介入率:我们通过分析台湾国民健康保险研究数据库中 2007 年至 2018 年的数据,开展了一项基于人群的回顾性队列研究。结果:共有 70 457 名患者被纳入研究:研究期间,共有 70 457 名患者被诊断为主动脉瘤或夹层;22 538 名(32%)成年患者(≥20 岁)患有 AAA。AAA 的年发病率约为每 10 万人中 7.7 至 10.3 例(r-AAA:每 10 万人中 0.8 至 1.3 例;nr-AAA:每 10 万人中 6.8 至 9.0 例)。大多数 AAA 患者是老年人(85%);15 392 名患者(68%)有住院记录,4885 名患者(32%)在确诊后 14 天内接受了手术。在研究期间,接受血管内动脉瘤修补术(EVAR)的患者比例从 28% 增加到 96%。与接受EVAR或保守治疗的患者相比,无论患者是r-AAA还是nr-AAA,接受开放手术修复(OSR)的患者的长期存活率都更高:结论:AAA 在老年人中更为常见,每年的标准化发病率呈下降趋势。自EVAR问世以来,接受EVAR治疗的患者比例持续上升,而接受OSR治疗的患者比例则有所下降。虽然EVAR和OSR都能降低r-AAA患者的死亡率,但OSR的长期生存率更高。
{"title":"Influence of endovascular surgery on abdominal aortic aneurysm management strategies from a national health insurance database survey.","authors":"Wei-Ling Chen, Chung-Dann Kan, Yi-Ting Huang, Hsin-I Shih","doi":"10.1097/JCMA.0000000000001156","DOIUrl":"10.1097/JCMA.0000000000001156","url":null,"abstract":"<p><strong>Background: </strong>Abdominal aortic aneurysm (AAA) is a significant global health concern, yet comprehensive population-based studies remain limited. This study aimed to evaluate the hospitalization rates, surgical trends, mortality, and reintervention rates for ruptured (r-AAA) and nonruptured (nr-AAA) AAA using data from a national health insurance database.</p><p><strong>Methods: </strong>A population-based retrospective cohort study was conducted utilizing data from the Taiwanese National Health Insurance Research Database from 2007 to 2018. The study included individuals aged 20 years and older with a newly diagnosed AAA.</p><p><strong>Results: </strong>Among 70 457 patients diagnosed with aortic aneurysm or dissection, 22 538 (32%) adult patients (≥20 years) were identified with AAA. The annual incidence of AAA ranged from 7.7 to 10.3 per 100 000 population, with r-AAA decreasing from 1.3 to 0.8 per 100 000 and nr-AAA from 9.0 to 6.8 per 100 000. Most patients with AAA were older adults (85%), with 15 392 (68%) hospitalized and 4885 (32%) undergoing surgery within 14 days of diagnosis. The use of endovascular aneurysm repair (EVAR) significantly increased from 28% to 96% over the study period. Long-term survival was higher in patients who underwent open surgical repair (OSR) compared to those who received EVAR or conservative management, irrespective of whether they had r-AAA or nr-AAA.</p><p><strong>Conclusion: </strong>AAA predominantly affects older individuals, and the annual incidence shows a declining trend. Since the introduction of EVAR, its use has steadily increased while OSR rates have decreased. Although both EVAR and OSR are associated with reduced mortality in patients with r-AAA, OSR is linked to superior long-term survival outcomes.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"1060-1067"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Circulating T-lymphocyte subsets as promising biomarkers for the identification of sepsis-induced acute kidney injury. 循环 T 淋巴细胞亚群是识别脓毒症诱发急性肾损伤的理想生物标志物。
Pub Date : 2024-12-01 Epub Date: 2024-10-04 DOI: 10.1097/JCMA.0000000000001177
Xue-Ling Guo, Cheng-Xiang Lu, Yan Luo, Ping-Ping Wang, Wen-Song Su, Si-Jiu Yang, Ling-Hui Zhan

Background: This retrospective study investigated whether disturbances in circulating T-lymphocyte subsets could predict the incidence of acute kidney injury (AKI) and in-hospital mortality in patients with sepsis.

Methods: Clinical data from patients with sepsis admitted to the intensive care unit were reviewed. Logistic regression analyses were used to identify independent predictors of in-hospital mortality and the development of AKI.

Results: Of 81 patients with sepsis, 50 developed AKI. Both nonsurvivors and patients with septic AKI exhibited higher Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II scores. Nonsurvivors exhibited more organ damage, with significantly lower levels of peripheral T-lymphocyte subsets, including total circulating lymphocytes, and CD3 + , CD3 + CD4 + , and CD3 + CD8 + T-lymphocytes. Patients with septic AKI exhibited fewer total peripheral lymphocytes and fewer CD3 + , CD3 + CD4 + , and CD3 + CD8 + T-lymphocytes, with higher serum lactate levels and lower nadir platelet counts. Independent predictors of 30-day hospital mortality included maximum SOFA and APACHE II scores, occurrence of encephalopathy, and peripheral CD3 + and CD3 + CD8 + T-lymphocyte counts. Moreover, the maximum SOFA score and CD3 + and CD3 + CD8 + T-lymphocyte counts demonstrated good predictive power for AKI in receiver operating characteristic (ROC) curve analyses, with an area under the ROC curve of 0.810 (95% confidence interval [CI], 0.712-0.908) for SOFA score, 0.849 (95% CI, 0.764-0.934) for CD3 + T-lymphocytes, and 0.856 (95% CI, 0.772-0.941) for CD3 + CD8 + T-lymphocytes.

Conclusion: Patients with sepsis-induced AKI experienced T lymphopenia and increased in-hospital mortality. Higher maximum SOFA scores and reduced peripheral CD3 + and CD3 + CD8 + T-lymphocyte levels were associated with in-hospital mortality and the development of AKI in patients with sepsis.

背景:这项回顾性研究探讨了循环 T 淋巴细胞亚群的紊乱是否能预测脓毒症患者急性肾损伤(AKI)的发生率和院内死亡率:研究回顾了重症监护室收治的败血症患者的临床数据。方法:研究人员回顾了重症监护室收治的脓毒症患者的临床数据,并使用逻辑回归分析确定了院内死亡率和急性肾损伤发生的独立预测因素:81名脓毒症患者中有50人出现了AKI。非存活患者和脓毒症 AKI 患者的序贯器官衰竭评估(SOFA)和急性生理学与慢性健康评估(APACHE)II 评分均显著升高。非幸存者表现出更多的器官损伤,外周T淋巴细胞亚群(包括循环淋巴细胞总数、CD3+、CD3+CD4+和CD3+CD8+T淋巴细胞)水平明显降低。脓毒症 AKI 患者的外周淋巴细胞总数较少,CD3+、CD3+CD4+ 和 CD3+CD8+ T 淋巴细胞较少,血清乳酸水平较高,最低血小板计数较低。30 天住院死亡率的独立预测因素包括 SOFA 和 APACHE II 最高评分、脑病发生率以及外周 CD3+ 和 CD3+CD8+ T 淋巴细胞计数。此外,在接收器操作特征曲线(ROC)分析中,SOFA 最大评分和 CD3+ 及 CD3+CD8+ T 淋巴细胞计数对 AKI 具有良好的预测能力,ROC 曲线下面积为 0.SOFA评分的ROC曲线下面积为0.810(95%置信区间[CI] 0.712-0.908),CD3+ T淋巴细胞的ROC曲线下面积为0.849(95%置信区间[CI] 0.764-0.934),CD3+CD8+ T淋巴细胞的ROC曲线下面积为0.856(95%置信区间[CI] 0.772-0.941):结论:脓毒症诱发的 AKI 患者会出现 T 淋巴细胞减少,并增加院内死亡率。脓毒症患者较高的SOFA最高评分和较低的外周CD3+和CD3+CD8+ T淋巴细胞水平与院内死亡率和AKI的发生有关。
{"title":"Circulating T-lymphocyte subsets as promising biomarkers for the identification of sepsis-induced acute kidney injury.","authors":"Xue-Ling Guo, Cheng-Xiang Lu, Yan Luo, Ping-Ping Wang, Wen-Song Su, Si-Jiu Yang, Ling-Hui Zhan","doi":"10.1097/JCMA.0000000000001177","DOIUrl":"10.1097/JCMA.0000000000001177","url":null,"abstract":"<p><strong>Background: </strong>This retrospective study investigated whether disturbances in circulating T-lymphocyte subsets could predict the incidence of acute kidney injury (AKI) and in-hospital mortality in patients with sepsis.</p><p><strong>Methods: </strong>Clinical data from patients with sepsis admitted to the intensive care unit were reviewed. Logistic regression analyses were used to identify independent predictors of in-hospital mortality and the development of AKI.</p><p><strong>Results: </strong>Of 81 patients with sepsis, 50 developed AKI. Both nonsurvivors and patients with septic AKI exhibited higher Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II scores. Nonsurvivors exhibited more organ damage, with significantly lower levels of peripheral T-lymphocyte subsets, including total circulating lymphocytes, and CD3 + , CD3 + CD4 + , and CD3 + CD8 + T-lymphocytes. Patients with septic AKI exhibited fewer total peripheral lymphocytes and fewer CD3 + , CD3 + CD4 + , and CD3 + CD8 + T-lymphocytes, with higher serum lactate levels and lower nadir platelet counts. Independent predictors of 30-day hospital mortality included maximum SOFA and APACHE II scores, occurrence of encephalopathy, and peripheral CD3 + and CD3 + CD8 + T-lymphocyte counts. Moreover, the maximum SOFA score and CD3 + and CD3 + CD8 + T-lymphocyte counts demonstrated good predictive power for AKI in receiver operating characteristic (ROC) curve analyses, with an area under the ROC curve of 0.810 (95% confidence interval [CI], 0.712-0.908) for SOFA score, 0.849 (95% CI, 0.764-0.934) for CD3 + T-lymphocytes, and 0.856 (95% CI, 0.772-0.941) for CD3 + CD8 + T-lymphocytes.</p><p><strong>Conclusion: </strong>Patients with sepsis-induced AKI experienced T lymphopenia and increased in-hospital mortality. Higher maximum SOFA scores and reduced peripheral CD3 + and CD3 + CD8 + T-lymphocyte levels were associated with in-hospital mortality and the development of AKI in patients with sepsis.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"1068-1077"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long-term prognostic effect of serum albumin concentration in diabetic patients with stable coronary artery disease: A multicenter cohort study. 稳定型冠心病糖尿病患者血清白蛋白浓度对预后的长期影响:一项多中心队列研究。
Pub Date : 2024-12-01 Epub Date: 2024-08-23 DOI: 10.1097/JCMA.0000000000001158
Ting-Wei Lu, Shih-Chieh Chien, Hsin-Bang Leu, Wei-Hsian Yin, Wei-Kung Tseng, Yen-Wen Wu, Tsung-Hsien Lin, Kuan-Cheng Chang, Ji-Hung Wang, Chau-Chung Wu, Hung-I Yeh, Jaw-Wen Chen

Background: Diabetes and insulin resistance alter the physiological state of serum albumin (SA), which is a prognostic marker for stable coronary artery disease (CAD). However, whether the SA concentration is associated with long-term cardiovascular (CV) outcomes in diabetic patients with stable CAD remains unclear.

Methods: In total, 1148 patients were retrospectively identified from a nationwide multicenter cohort study on patients with stable CAD. They were categorized into four groups according to their diabetes mellitus (DM) status and SA concentration (cutoff: 4 g/dL).

Results: The patients' mean age was 62.5 years, and 83.5% were male. Of the total patients, 405 were included in group 1 (SA ≥4/non-DM), 322 in group 2 (SA <4/non-DM), 201 in group 3 (SA ≥4/DM), and 220 in group 4 (SA <4/DM). Group 4 had the oldest age and a higher prevalence of prior myocardial infarction and stroke. During the median 4.5-year follow-up (interquartile range: 1.5-6.7 years), the highest and lowest survival rates in terms of all-cause and CV mortality were found in groups 1 and 4, respectively. However, no prognostic differences were noted in nonfatal stroke and myocardial infarction among the groups. The data were consistent after covariate adjustment. Using group 1 as the reference, hazard ratio (HRs) (95% CIs) for all-cause mortality in groups 2, 3, and 4 were 3.64 (1.22-10.83), 3.26 (0.95-11.33), and 5.74 (1.92-16.95), respectively, and those for CV mortality were 2.8 (0.57-13.67), 2.62 (0.40-17.28), and 6.15 (1.32-28.58), respectively.

Conclusion: In diabetic patients with stable CAD, a low SA concentration (<4 g/dL) was associated with increased long-term mortality regardless of all-cause or CV reasons but not nonfatal CV events.

背景:糖尿病和胰岛素抵抗会改变血清白蛋白(SA)的生理状态:糖尿病和胰岛素抵抗会改变血清白蛋白(SA)的生理状态,而白蛋白是稳定型冠状动脉疾病(CAD)的预后指标。然而,SA 浓度是否与患有稳定型冠状动脉疾病的糖尿病患者的长期心血管(CV)预后相关仍不清楚:方法:从一项全国性多中心队列研究中回顾性地发现了 1148 名稳定型 CAD 患者。根据糖尿病(DM)状态和 SA 浓度(临界值:4 g/dL)将患者分为四组:患者的平均年龄为 62.5 岁,83.5% 为男性。在所有患者中,第 1 组(SA ≥ 4/非 DM)有 405 人,第 2 组(SA < 4/非 DM)有 322 人,第 3 组(SA ≥ 4/ DM)有 201 人,第 4 组(SA < 4/DM)有 220 人。第 4 组年龄最大,曾患心肌梗死和中风的比例较高。在中位 4.5 年的随访期间(四分位间范围:1.5-6.7 年),第 1 组和第 4 组的全因死亡率和冠心病死亡率分别最高和最低。然而,在非致死性中风和心肌梗死方面,各组间并无预后差异。经协变量调整后,数据保持一致。以第 1 组为参照,第 2、3 和 4 组的全因死亡率 HRs(95% CIs)分别为 3.64(1.22-10.83)、3.26(0.95-11.33)和 5.74(1.92-16.95),CV 死亡率 HRs 分别为 2.8(0.57-13.67)、2.62(0.40-17.28)和 6.15(1.32-28.58):结论:在患有稳定型冠状动脉粥样硬化的糖尿病患者中,低SA浓度 (
{"title":"Long-term prognostic effect of serum albumin concentration in diabetic patients with stable coronary artery disease: A multicenter cohort study.","authors":"Ting-Wei Lu, Shih-Chieh Chien, Hsin-Bang Leu, Wei-Hsian Yin, Wei-Kung Tseng, Yen-Wen Wu, Tsung-Hsien Lin, Kuan-Cheng Chang, Ji-Hung Wang, Chau-Chung Wu, Hung-I Yeh, Jaw-Wen Chen","doi":"10.1097/JCMA.0000000000001158","DOIUrl":"10.1097/JCMA.0000000000001158","url":null,"abstract":"<p><strong>Background: </strong>Diabetes and insulin resistance alter the physiological state of serum albumin (SA), which is a prognostic marker for stable coronary artery disease (CAD). However, whether the SA concentration is associated with long-term cardiovascular (CV) outcomes in diabetic patients with stable CAD remains unclear.</p><p><strong>Methods: </strong>In total, 1148 patients were retrospectively identified from a nationwide multicenter cohort study on patients with stable CAD. They were categorized into four groups according to their diabetes mellitus (DM) status and SA concentration (cutoff: 4 g/dL).</p><p><strong>Results: </strong>The patients' mean age was 62.5 years, and 83.5% were male. Of the total patients, 405 were included in group 1 (SA ≥4/non-DM), 322 in group 2 (SA <4/non-DM), 201 in group 3 (SA ≥4/DM), and 220 in group 4 (SA <4/DM). Group 4 had the oldest age and a higher prevalence of prior myocardial infarction and stroke. During the median 4.5-year follow-up (interquartile range: 1.5-6.7 years), the highest and lowest survival rates in terms of all-cause and CV mortality were found in groups 1 and 4, respectively. However, no prognostic differences were noted in nonfatal stroke and myocardial infarction among the groups. The data were consistent after covariate adjustment. Using group 1 as the reference, hazard ratio (HRs) (95% CIs) for all-cause mortality in groups 2, 3, and 4 were 3.64 (1.22-10.83), 3.26 (0.95-11.33), and 5.74 (1.92-16.95), respectively, and those for CV mortality were 2.8 (0.57-13.67), 2.62 (0.40-17.28), and 6.15 (1.32-28.58), respectively.</p><p><strong>Conclusion: </strong>In diabetic patients with stable CAD, a low SA concentration (<4 g/dL) was associated with increased long-term mortality regardless of all-cause or CV reasons but not nonfatal CV events.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"1054-1059"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of the COVID-19 pandemic on dyslipidemia in peritoneal dialysis patients. COVID-19 大流行对腹膜透析患者血脂异常的影响。
Pub Date : 2024-12-01 Epub Date: 2024-09-19 DOI: 10.1097/JCMA.0000000000001170
Fan-Yu Chen, Shu-En Li, Jen-En Tsai, Po-Yen Lu, Yu-Hsuan Li, Ann Charis Tan, Szu-Yuan Li, Yi-Fang Chuang, Chyong-Mei Chen, Chih-Ching Lin

Background: The coronavirus disease 2019 (COVID-19) pandemic has had a profound impacted on various aspects of society, including the healthcare system and patient care. In this context, this study aimed to evaluate the impact of COVID-19 control strategies on the lipid profile and blood sugar levels of peritoneal dialysis (PD) patients in Taiwan, a crucial focus for understanding the pandemic's influence on individuals with chronic kidney disease (CKD).

Methods: A retrospective cohort study was conducted, analyzing data from the medical records of 170 PD patients who visited the nephrology division of Taipei Veterans General Hospital in 2021. The generalized estimating equations method was used to analyze the longitudinal data and assess the changes in biomarker levels over different periods. Covariates were taken into consideration in the statistical models.

Results: The study enrolled 70 (41%) males and 100 (59%) females, with an average age of 56 years old. Over 12 months in 2021, from the first period (January to April: pre-COVID-19) to the second period (May to August: COVID-19 surge), there was a notable decline in both high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels, and a significant surge in triglyceride (TG) levels. However, total cholesterol (TC) and hemoglobin (HbA1c) levels remained stable. Furthermore, the TG to HDL, TG to LDL, TC to HDL, and TC to LDL ratios were analyzed, revealing a pronounced increase during the second period.

Conclusion: Our findings underscore the significant impact of COVID-19 pandemic-related disruptions in the healthcare system and the subsequent management strategies on dyslipidemia in PD patients while not affecting dysglycemia. These results provide valuable insights for healthcare professionals to enhance their strategies and interventions for CKD patients undergoing PD during a pandemic.

背景:COVID-19大流行对社会的各个方面都产生了深远的影响,包括医疗系统和患者护理。在此背景下,本研究旨在评估 COVID-19 控制策略对台湾腹膜透析(PD)患者血脂和血糖水平的影响:方法:我们进行了一项回顾性队列研究,分析了 2021 年到台北荣民总医院肾脏内科就诊的 170 名腹膜透析患者的病历数据。研究采用广义估计方程法分析纵向数据,评估不同时期生物标志物水平的变化。统计模型中考虑了相关变量。数据使用 R 4.3.0 进行分析:研究共招募了 70 名男性(41%)和 100 名女性(59%),平均年龄为 56 岁。在 2021 年的 12 个月中,从第一阶段(1 月至 4 月:COVID-19 前)到第二阶段(5 月至 8 月:COVID-19 激增),高密度脂蛋白(HDL)和低密度脂蛋白(LDL)水平明显下降,甘油三酯(TG)水平显著上升。不过,总胆固醇(TC)和血红蛋白(HbA1c)水平保持稳定。此外,我们还分析了甘油三酯与高密度脂蛋白、甘油三酯与低密度脂蛋白、总胆固醇与高密度脂蛋白以及总胆固醇与低密度脂蛋白的比率,结果显示,在第二阶段,这一比率明显上升:我们的研究结果表明,与 COVID-19 大流行相关的医疗系统混乱和随后的管理策略对腹泻患者的血脂异常产生了重大影响,而对血糖异常却没有影响。这些结果为医护人员在大流行期间加强对接受肺结核治疗的慢性肾脏病患者的策略和干预提供了宝贵的见解。
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引用次数: 0
Keyword Index. 关键字索引。
Pub Date : 2024-12-01 Epub Date: 2024-12-05 DOI: 10.1097/01.JCMA.0001096044.67105.d8
{"title":"Keyword Index.","authors":"","doi":"10.1097/01.JCMA.0001096044.67105.d8","DOIUrl":"https://doi.org/10.1097/01.JCMA.0001096044.67105.d8","url":null,"abstract":"","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":"87 12","pages":"X-XV"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of the Chinese Medical Association : JCMA
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