Multivariate Unconditional Logistic Regression Analysis Research Articles

Associations of breastfeeding history with metabolic syndrome and cardiovascular risk factors in community-dwelling parous women: The Japan Multi-Institutional Collaborative Cohort Study.

The aim of the present study was to investigate the associations between breastfeeding and the prevalence of metabolic syndrome in community-dwelling parous women and to clarify whether the associations depend on age. The present cross-sectional study included 11,118 women, aged 35-69 years. Participants' longest breastfeeding duration for one child and their number of breastfed children were assessed using a self-administered questionnaire, and their total breastfeeding duration was approximated as a product of the number of breastfed children and the longest breastfeeding duration. The longest and the total breastfeeding durations were categorized into none and tertiles above 0 months. Metabolic syndrome and cardiovascular risk factors (obesity, hypertension, dyslipidemia, and hyperglycemia) were defined as primary and secondary outcomes, respectively. Associations between breastfeeding history and metabolic syndrome or each cardiovascular risk factor were assessed using multivariable unconditional logistic regression analysis. Among a total of 11,118 women, 10,432 (93.8%) had ever breastfed, and 1,236 (11.1%) had metabolic syndrome. In participants aged <55 years, an inverse dose-response relationship was found between the number of breastfed children and the prevalence of metabolic syndrome; multivariable-adjusted odds ratios for 1, 2, 3, and ≥4 breastfed children were 0.60 (95% confidence interval [CI]: 0.31 to 1.17), 0.50 (95% CI: 0.29 to 0.87), 0.44 (95% CI: 0.24 to 0.84), and 0.35 (95% CI: 0.14 to 0.89), respectively. The longest and total breastfeeding durations of longer than 0 months were also associated with lower odds of metabolic syndrome relative to no breastfeeding history in participants aged <55 years. In contrast, all measures of breastfeeding history were not significantly associated with metabolic syndrome and cardiovascular risk factors in participants aged ≥55 years old. Breastfeeding history may be related to lower prevalence of metabolic syndrome in middle-aged parous women.

The Prediction Model of Risk Factors for COVID-19 Developing into Severe Illness Based on 1046 Patients with COVID-19.

This study analyzed the risk factors for patients with COVID-19 developing severe illnesses and explored the value of applying the logistic model combined with ROC curve analysis to predict the risk of severe illnesses at COVID-19 patients' admissions. The clinical data of 1046 COVID-19 patients admitted to a designated hospital in a certain city from July to September 2020 were retrospectively analyzed, the clinical characteristics of the patients were collected, and a multivariate unconditional logistic regression analysis was used to determine the risk factors for severe illnesses in COVID-19 patients during hospitalization. Based on the analysis results, a prediction model for severe conditions and the ROC curve were constructed, and the predictive value of the model was assessed. Logistic regression analysis showed that age (OR = 3.257, 95% CI 10.466–18.584), complications with chronic obstructive pulmonary disease (OR = 7.337, 95% CI 0.227–87.021), cough (OR = 5517, 95% CI 0.258–65.024), and venous thrombosis (OR = 7322, 95% CI 0.278–95.020) were risk factors for COVID-19 patients developing severe conditions during hospitalization. When complications were not taken into consideration, COVID-19 patients' ages, number of diseases, and underlying diseases were risk factors influencing the development of severe illnesses. The ROC curve analysis results showed that the AUC that predicted the severity of COVID-19 patients at admission was 0.943, the optimal threshold was −3.24, and the specificity was 0.824, while the sensitivity was 0.827. The changes in the condition of severe COVID-19 patients are related to many factors such as age, clinical symptoms, and underlying diseases. This study has a certain value in predicting COVID-19 patients that develop from mild to severe conditions, and this prediction model is a useful tool in the quick prediction of the changes in patients' conditions and providing early intervention for those with risk factors.

Health status and its influencing factors among the elderly dwelling in pension institutions providing integrated medication in Qingdao city

Objective To explore self-rated health and its influencing factors among the elderly in pension institutions providing integrated medication in Qingdao city, Shandong province, and to provide evidences for improving health status of the elderly. Methods With stratified random sampling, totally 2 040 dwellers aged ≥ 60 years were recruited in 43 pension institutions providing integrated medication in 7 districts of Qingdao city and a face-to-face interview was conducted among the elderly with a self-designed questionnaire and Activity of Daily Living (ADL) Scale from June 2017 to August 2018. Results Good self-rated health was reported by 687 (36.03%) of the 1 907 respondents with valid information. The results of unconditional multivariate logistic regression analysis demonstrated that the elderly without an extremely poor economic condition, with rural household registration, having the medical insurance other than medical insurance for urban/rural residents and for urban workers, and being capable to pay medical expenses were more likely to report a good self-rated health; however, the elderly with the education of high school and above, being professionals, participating in medical insurance for urban residents, and with impaired ADL were less likely to report a good self-rated health. Conclusion Among the elderly dwelling in pension institutions providing integrated medication in Qingdao city, the self-rated health is at a low level and mainly influenced by education, occupation, economic condition, type of household registration, type of medical insurance, affordability of medical expenses, and ADL level.

Polygenic Risk Scores for Prediction of Gastric Cancer Based on Bioinformatics Screening and Validation of Functional lncRNA SNPs.

INTRODUCTION:Single-nucleotide polymorphisms (SNPs) are used to stratify the risk of gastric cancer. However, no study included gastric cancer–related long noncoding RNA (lncRNA) SNPs into the risk model for evaluation. This study aimed to replicate the associations of 21 lncRNA SNPs and to construct an individual risk prediction model for gastric cancer.METHODS:The bioinformatics method was used to screen gastric cancer–related lncRNA functional SNPs and verified in population. Gastric cancer risk prediction models were constructed using verified SNPs based on polygenic risk scores (PRSs).RESULTS:Twenty-one SNPs were screened, and the multivariate unconditional logistic regression analysis showed that 14 lncRNA SNPs were significantly associated with gastric cancer. In the distribution of genetic risk score in cases and controls, the mean value of PRS in cases was higher than that in controls. Approximately 20.1% of the cases was caused by genetic variation (P = 1.9 × 10−34) in optimal PRS model. The individual risk of gastric cancer in the lowest 10% of PRS was 82.1% (95% confidence interval [CI]: 0.102, 0.314) lower than that of the general population. The risk of gastric cancer in the highest 10% of PRS was 5.75-fold that of the general population (95% CI: 3.09, 10.70). The introduction of family history of tumor (area under the curve, 95% CI: 0.752, 0.69–0.814) and Helicobacter pylori infection (area under the curve, 95% CI: 0.773, 0.702–0.843) on the basis of PRS could significantly improve the recognition ability of the model.DISCUSSION:PRSs based on lncRNA SNPs could identify individuals with high risk of gastric cancer and combined with risk factors could improve the stratification.

Correlation between metabolic syndrome and adverse events after internal fixation of femoral intertrochanteric fracture in the elderly

To explore the effect of metabolic syndrome on 15 days postoperative adverse events of femoral intertrochanteric fractures with internal fixation. From January 2011 to June 2019, 986 elderly patients with intertrochanteric fracture were treated with internal fixation, including 312 males and 674 females, with an average age of(77.71± 7.58) years old. And there were 97 patients with metabolic syndrome and 889 patients without metabolic syndrome. Through the electronic medical record system, the patient's age, gender, fracture type, cause of trauma, body mass index, smoking history, preoperative comorbidities, preoperative bloodtransfusion, operation timing, ASA classification, anesthesia method, internal fixation type, operation duration, and 15 days postoperative adverse events, which include surgical site infection, acute heart failure, acute respiratory failure, pulmonary infection, acute renal failure, DVT, embolism in important organs, urinary tract infection, death, and blood transfusion after surgery were collected. The differences of preoperative and intraoperative baseline datas and 15 days postoperative adverse events between the two groups were compared and analyzed by t text or univariate χ2 test. Adjusted for the preoperative and intraoperative mixed factors with P<0.05, and 15 days postoperative adverse events with P<0.05 were then analyzed by multivariate unconditional Logistic regression analysis to further study the independent effects of metabolic syndrome on 15 days postoperative adverse events. There were statistical differences in age, body mass index, history of cardiac insufficiency, history of COPD, history of renal insufficiency, operation timing, ASA classification, operation duration, surgical site infection, acute heart failure, DVT, urinary tract infection and blood transfusion between two groups (P<0.05). Adjusted for the preoperative and intraoperative mixed factors, multivariate unconditional logistic regression analysis showed that metabolic syndrome could increase the infection rate of the surgical site [OR=3.785, 95%CI (1.086-13.188), P= 0.037], DVT incidence rate[OR=2.265, 95%CI(1.096-4.682), P=0.027], urinary tract infection rate[OR=2.703, 95%CI (1.049-6.963), P=0.0390], and blood transfusion rate [OR=1.811, 95%CI (1.142-2.870), P=0.012]. Elderly patients with intertrochanteric fracture with metabolic syndrome had higher postoperative surgical site infection rate, DVT incidence rate, urinary tract infection rate, and postoperative blood transfusion rate. Therefore, the orthopedic treatment team should give more attentionand optimize the treatment plan during the perioperative period with the cooperation of internal physician and anesthesiologist.

Association between Statin Use and Sensorineural Hearing Loss in Type 2 Diabetic Patients: A Hospital-Based Study.

Statins have emerged as protective agents against sensorineural hearing loss (SNHL) associated with dyslipidemia, but the effects of statins on SNHL are not consistent. The purpose of this study was to investigate the association between statin use and the risk of SNHL using a hospital cohort. This nested case-control study included type 2 diabetic patients over the age of 18 years without a history of hearing loss. Of these, 1379 patients newly diagnosed with SNHL or tinnitus were classified as cases, and 5512 patients matched to the cases based on age, sex, and index year were classified as controls. Chi-squared tests were used to compare categorical variables between the two groups. Odds ratios (ORs) and adjusted odds ratios (AOR) were calculated from univariate and multivariable unconditional logistic regression analyses, respectively. There was a significant difference in the prevalence of statin use between the cases and controls (53.7% vs. 61.2%, respectively; p < 0.001). The use of statins in type 2 diabetic patients significantly reduced the risk of SNHL or tinnitus by 24.8% (95% CI 14.2–34.1%, p < 0.001) after controlling for confounders. Similar results were found for the association between statin use and SNHL (AOR = 0.706; 95% CI 0.616–0.811, p < 0.001). The protective effects of statins against SNHL were consistent regardless of age and sex. The use of statins for type 2 diabetic patients was significantly associated with a reduced risk of SNHL, regardless of age and sex. Further studies are needed, especially large cohort studies, to evaluate the long-term protective effects of statins.

The Association of Metabolic Parameters with Gout in Thai Adults

Background: Despite the close relationships between metabolic parameters and gout, there is no data concerning this relation in the Thai adult population. Objective: The aim of the present study was to determine the association between metabolic parameters and gout. Materials and Methods: We conducted a 1:2 case-control study that included 90 gout patients as the case and 180 non-gout patients as the control group. Gout was defined as Rome criteria and confirmed by a rheumatologist. Diagnosis of metabolic syndrome was based on ATP III criteria. Multivariate unconditional logistic regression analysis was used to analyze the data and presented in terms of adjusted odds ratio (aOR) and 95% confidence interval (95% CI). Results: Our results revealed that gout was significantly associated with age increase every 10 years, men, high fasting blood glucose (FBG), and high blood pressure (BP). The aOR and 95% CI were 1.64 (1.29 to 2.07), 14.51 (6.17 to 34.27), 2.16 (1.08 to 4.46), and 2.01 (1.88 to 4.62), respectively. In addition, obesity with metabolic syndrome participants had an increased risk of gout (aOR = 2.78, 95% CI = 1.16 to 6.67). Conclusion: The present study indicates a significant association between gout and older age, men, high fasting blood glucose, and high blood pressure among Thai adults. Furthermore, a greater body mass index with metabolic syndrome increases the risk of gout. Subjects with these risk factors should be provided with appropriate management and treatment options. Keywords: Gout; Thai adults; Metabolic parameters

Effect of urban air pollution on CRP and coagulation: a study on inpatients with acute exacerbation of chronic obstructive pulmonary disease

PurposeAcute exacerbation of chronic obstructive pulmonary disease (AECOPD) is an important event in the course of chronic obstructive pulmonary disease that negatively affects patients’ quality of life and leads to higher socioeconomic costs. While previous studies have demonstrated a significant association between urban air pollution and hospitalization for AECOPD, there is a lack of research on the impact of particulate matter (PM) on inflammation and coagulation in AECOPD inpatients. Therefore, this study investigated the association of changes in coagulation function and C-reactive protein (CRP) with PM levels in the days preceding hospitalization.Patients and methodsWe reviewed the medical records of AECOPD patients admitted to Putuo Hospital, Shanghai University of Traditional Chinese Medicine, between March 2017 and September 2019. We analyzed the association of coagulation function and CRP level in AECOPD patients with PM levels in the days before hospitalization. Multivariate unconditional logistic regression analyses were used to evaluate the adjusted odds ratio (OR) and 95% confidence interval (CI) for the association of CRP data with hospitalization day. Kruskal–Wallis tests were used to evaluate mean aerodynamic diameter of ≥ 2.5 μm (PM2.5) exposure on the day before hospitalization; we assessed its association with changes in prothrombin time (PT) in AECOPD inpatients with different Global Initiative for Chronic Obstructive Lung Disease (GOLD) classes.ResultsThe peripheral blood PT of AECOPD patients with PM2.5 ≥ 25 mg/L on the day before hospitalization were lower than those of patients with PM2.5 < 25 mg/L (t = 2.052, p = 0.041). Patients with severe GOLD class exposed to greater than 25 mg/L of PM2.5on the day before hospitalization showed significant differences in PT (F = 9.683, p = 0.008). Peripheral blood CRP levels of AECOPD patients exposed to PM2.5 ≥ 25 mg/L and PM10 ≥ 50 mg/L on the day before hospitalization were higher than those of patients exposed to PM2.5 < 25 mg/L and PM10 < 50 mg/L (t = 2.008, p = 0.046; t = 2.637, p = 0.009). Exposure to < 25 mg/L of PM2.5 on the day before hospitalization was significantly associated with CRP levels (adjusted OR 1.91; 95% CI 1.101, 3.315; p = 0.024).ConclusionExposure of patients with AECOPD to high PM levels on the day before hospitalization was associated with an increased CRP level and shortened PT. Moreover, PM2.5 had a greater effect on CRP level and PT than mean aerodynamic diameter of ≥ 10 μm (PM10). AECOPD patients with severe GOLD class were more sensitive to PM2.5-induced shortening of PT than those with other GOLD classes.

Effects of seasonal and climate variations on in-hospital mortality and length of stay in patients with type A aortic dissection

ObjectiveTo investigate the effects of seasonal and climatic changes on postoperative in-hospital mortality and length of stay (LOS) in patients with type A acute aortic dissection (AAD).MethodsPatients undergoing implantation of the modified triple-branched stent graft to replace the descending aorta in addition to aortic root reconstruction for type A AAD in our hospital from January 2016 to December 2019 were included. Relevant data were retrospectively collected and analyzed.ResultsA total of 404 patients were included in our analyses. The multivariate unconditional logistic regression analysis showed that patients admitted in autumn (OR 4.027, 95% CI 1.023–17.301, P = 0.039) or with coronary heart disease (OR 8.938, 95% CI 1.991–29.560, P = 0.049) were independently associated with an increased risk of postoperative in-hospital mortality. Furthermore, patients admitted in autumn (OR 5.956, 95% CI 2.719–7.921, P = 0.041) or with hypertension (OR 3.486, 95% CI 1.192–5.106, P = 0.035) were independently associated with an increased risk of longer LOS.ConclusionPatients admitted in autumn or with coronary heart disease are at higher risk of in-hospital mortality following surgery for type A AAD. Also, patients admitted in autumn or with hypertension have a longer hospital LOS. In the autumn of the temperature transition, we may need to strengthen the management of medical quality after surgery for type A AAD.

Association of e-health literacy with lifestyle among 18 – 59 years old residents in Taian city

Objective To investigate current status of lifestyle and e-health literacy and to explore the association of e-health literacy and lifestyle among 18 – 59 years old residents in Taian city of Shandong province. Methods Using stratified multistage random cluster sampling, we recruited 4 580 residents aged 18 – 59 years in 6 districts/counties of Taian city, Shandong province and conducted face-to-face interviews with eHealth Literacy Scale – Chinese Version during August, 2020. Results For all the participants, the e-health literacy score was 22.55 ± 12.69; the self-reported prevalence rates were 12.10% for smoking, 17.29% for alcohol drinking, 12.29% for not eating vegetables/fruits frequently, and 53.10% for inadequate physical activity, respectively. Unconditional multivariate logistic regression analysis demonstrated that a one point increment in the score of e-health literacy could be associated with 1.5% decrease in smoking prevalence (odds ratio [OR] = 0.985, 95% confidence interval [95% CI]: 0.975 – 0.995), 1.9% increase in the prevalence of eating vegetables/fruits frequently (OR = 1.019, 95% CI: 1.010 – 1.029), and 2.3% increase in the prevalence of adequate physical activity (OR = 1.023, 95% CI: 1.017 – 1.030). Conclusion Higher e-health literacy may associate with decreased smoking and increased healthy dietary behavior and physical activity among 18 – 59 years old community residents.

5α-Reductase Inhibitors Are Associated with Reduced Risk of SARS-CoV-2 Infection: A Matched-Pair, Registry-Based Analysis.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a disproportionately severe effect on men, suggesting that the androgen pathway plays a role in the disease. Studies on the effect of castration and androgen receptor blockade have been mixed, while 5α-reductase inhibitor (5ARI) use in men with COVID-19 (2019 novel coronavirus) have shown potential benefits. We assessed the association of 5ARI use on risk of community acquired SARS-CoV-2 infection. A total of 60,474 males in a prospective registry of people tested for SARS-CoV-2 between March 8, 2020 and February 15, 2021 were included. Using a matched cohort design, men using 5ARIs were matched 1:1 to non5ARI users. Independent analysis using unconditional multivariable logistic regression on the entire unmatched data set was completed for validation. Primary outcome measures were the association of 5ARI use on rates of SARS-Cov-2 positivity and disease severity. Of the men 1,079 (1.8%) reported 5ARI use and 55,100 were available for matching. The final matched cohorts included 944 men each. Mean duration of use was 60.4 months (IQR 17-84 months). Absolute risk for infection was significantly lower in 5ARI users compared to nonusers, 42.3% (399/944) vs 47.2% (446/944), respectively (absolute risk reduction [ARR] 4.9%, OR 0.81, 95% CI 0.67-0.97, p=0.026). Unconditional multivariable logistic regression analysis of the entire study cohort of 55,100 men confirmed the protective association of 5ARI use (ARR 5.3%, OR=0.877, 95% CI 0.774-0.995, p=0.042). Use of 5ARIs was not associated with disease severity. Use of 5ARIs in men without prostate cancer was associated with a reduction in community acquired SARS-CoV-2 infection.

Prevalence and risk factors of diabetic retinopathy in patients with type 2 diabetes in Shanghai.

To investigate the prevalence of diabetic retinopathy (DR) in residents of Shanghai and analyze the risk factors of DR. This study involved 7233 patients with diabetes in 2016. The demographic data of the participants were collected using a questionnaire survey. Physical examination, laboratory tests, and ophthalmological examinations were conducted. Two professional ophthalmologists diagnosed and graded DR by fundus examination and then combined the results with fundus images. The unconditional multivariate Logistic regression analysis was used to determine the risk factors. In total, 6978 patients with type 2 diabetes in Shanghai with a mean age of 68.33±8.40y were recruited, including 2975 males (42.6%) and 4003 females (57.4%). Overall, 1184 patients were diagnosed with DR, with a prevalence rate of 16.97%. Regression analysis showed that duration of diabetes (OR 1.061, 95%CI 1.049-1.073), high systolic blood pressure (SBP; OR 1.071, 95%CI 1.037-1.106), increased glycosylated hemoglobin level (OR 1.234, 95%CI 1.162-1.311), high blood glucose level (OR 1.061, 95%CI 1.023-1.099), increased neutrophil-to-lymphocyte ratio (NLR; OR 1.132, 95%CI 1.053-1.217) and mean platelet volume (MPV; OR 1.077, 95%CI 1.016-1.142) were risk factors of DR. Conversely, hematocrit (HCT; OR 0.971, 95%CI 0.954-0.988) and mean corpuscular volume (MCV; OR 0.980, 95%CI 0.965-0.994) were protective factors. The prevalence rate of DR in Shanghai is 16.97%. The duration of diabetes, high SBP, increased glycosylated hemoglobin, NLR, and MPV were determined as risk factors of DR.

Risk of Symptomatic Kidney Stones During and After Pregnancy

There are several well-known anatomical and physiological changes during pregnancy that could contribute to kidney stone formation, but evidence that they increase the risk of kidney stones during pregnancy is lacking. We determined whether there was an increased risk of a first-time symptomatic kidney stone during and after pregnancy. A population-based matched case-control study. 945 female first-time symptomatic kidney stone formers aged 15-45 years and 1,890 age-matched female controls in Olmsted County, MN, from 1984-2012. The index date was the date of onset of a symptomatic kidney stone for both the case and her matched controls. The primary exposure was pregnancy with assessment for variation in risk across different time intervals before, during, and after pregnancy. Medical records were manually reviewed to determine the conception and delivery dates for pregnancies. Medical record-validated first-time symptomatic kidney stone. Conditional and unconditional multivariable logistic regression analysis. Compared with nonpregnant women, the odds of a symptomatic kidney stone forming in women was similar in the first trimester (OR, 0.92; P=0.8), began to increase during the second trimester (OR, 2.00; P=0.007), further increased during the third trimester (OR, 2.69; P=0.001), peaked at 0 to 3 months after delivery (OR, 3.53; P<0.001), and returned to baseline by 1year after delivery. These associations persisted after adjustment for age and race or for diabetes mellitus, hypertension, and obesity. These results did not significantly differ by age, race, time period, or number of prior pregnancies. Having a prior pregnancy (delivery date>1year ago) was also associated with a first-time symptomatic kidney stone (OR, 1.27; P=0.01). Observational study design in a predominantly White population. The exact timing of stone formation cannot be determined. Pregnancy increases the risk of a first-time symptomatic kidney stone. This risk peaks close to delivery and then improves by 1 year after delivery, though a modest risk of a kidney stone still exists beyond 1 year after delivery.

Impact of MASP2 gene polymorphism and gene-tea drinking interaction on susceptibility to tuberculosis

Mannan-binding lectin-associated serine protease-2 (MASP-2) has been reported to play an important role as a key enzyme in the lectin pathway of the complement system. The objectives of our study were to determine whether the single-nucleotide polymorphism (SNPs) of MASP2 and the gene-tea drinking interaction were associated with the susceptibility to TB. In total, 503 patients and 494 healthy controls were contained. Three SNPs (rs12142107, rs12711521, and rs7548659) were genotyped. The association between the SNPs and susceptibility to TB were investigated by conducting multivariate unconditional logistic regression analysis. The gene-tea drinking interactions were analyzed by the additive model of marginal structural linear odds models. Both genotype AC + AA at rs12711521 of MASP2 genes and genotype GT + GG at rs7548659 of MASP2 genes were more prevalent in the TB patient group than the healthy control group (OR: 1.423 and 1.439, respectively, P < 0.05). In addition, The relative excess risk of interaction (RERI) between tea drinking and rs12142107, rs12711521, and rs7548659 of MASP2 genes was found to suggest negative interactions, which reached − 0.2311 (95% confidence interval (CI): − 0.4736, − 0.0113), − 0.7080 (95% CI − 1.3998, − 0.0163), and − 0.5140 (95% CI − 0.8988, − 0.1291), respectively (P < 0.05). Our finding indicated that the SNPs (rs12711521 and rs7548659) of MASP2 were associated with the susceptibility to TB. Furthermore, there were negative interactions between tea drinking and rs12142107, rs12711521, and rs75548659 of MASP2 gene, respectively. Our research provides a basis for studying the pathogenesis and prevention of tuberculosis.

High expression of Dll4 and CD44V6 is associated with clinicopathological characteristics and poor prognosis in osteosarcoma patients.

BackgroundOsteosarcoma is a malignant tumor with a poor prognosis. Dll4 and CD44V6 are involved in the regulation of tumor development. This study aims to analyze the expression of Dll4 and CD44V6 in osteosarcoma and the correlation with clinicopathological characteristics and prognosis.MethodsClinical data of 47 patients with osteosarcoma admitted to our hospital from April 2016 to May 2018 and confirmed by surgery or pathological examination were retrospectively analyzed. Osteochondroma and normal bone tissues from these cases were taken as controls. The protein levels of Dll4 and CD44V were detected by immunohistochemistry (IHC). The relationship between the expression of Dll4 and CD44V and the clinicopathological characteristics of patients with osteosarcoma was analyzed. An unconditional multi-factor logistic regression model was used to analyze the risk factors affecting the prognosis of patients with osteosarcoma.ResultsThe positive expression rates of Dll4 and CD44V6 in osteosarcoma were 85.11% (Dll4) and 91.49% (CD44V6), which were significantly higher than those in normal bone tissues of 18.52% (Dll4) and 7.41% (CD44V6), and in osteochondroma of 22.22% (Dll4) and 7.41% (CD44V6). The expression of CD44V6 and Dll4 were related to the Enneking stage and metastasis (P<0.05), and the expression of Dll4 was closely related to the degree of tumor differentiation (P<0.05). The 2-year survival rates of patients with Dll4 or CD44V6 positive expression were 25.00% and 21.88%, respectively, which were significantly lower than those with Dll4 or CD44V6 negative expression (85.71% and 93.33%) (P<0.05). The results of the unconditional multivariate logistic regression analysis showed that low tumor differentiation, high Enneking stage, metastasis, and positive expression of Dll4 and CD44V6 were risk factors affecting the mortality rate and prognosis of patients with osteosarcoma (P<0.05).ConclusionsThe positive expression rate of Dll4 and CD44V6 in osteosarcoma is high, and the expression level is closely related to the degree of tumor differentiation, Enneking stage, and metastasis. Dll4 and CD44V6 are risk factors affecting the survival prognosis for patients. Therefore, in clinical settings, the prognosis for patients could be evaluated by detecting the expression of Dll4 and CD44V6.

Prospective study of red meat intake in the first and second trimesters and the risk of gestational diabetes mellitus in Chengdu in 2017

To evaluate the red meat intake of pregnant women in Chengdu area and explore the effect of red meat intake in the first and second trimesters on gestational diabetes mellitus(GDM). From February to July 2017, a prospective study was conducted among healthy singleton pregnant women within 8-14 weeks of gestation in a prenatal clinic of maternal-and-child medical institution in Chengdu City through purposive sampling. Data on maternal demographic characteristics was collected through questionnaire in early pregnancy. 3-day 24 hour dietary recall was used to collect dietary intake information in the first and second trimesters. The 75 g oral glucose tolerance test(OGTT)was conducted at 24 to 28 weeks of gestation, and GDM was diagnosed according to the Guidelines for the Diagnosis and Treatment of Pregnancy Diabetes in China(2014). Multivariate unconditional Logistic regression model was used to explore the association between tertiles of red meat intake and the risk of GDM in the first and second trimesters. A total of 985 valid samples were followed up. The mean intake of total meat and red meat in middle pregnancy(102. 9 g/d and 74. 6 g/d) was higher than that in early pregnancy(70. 7 g/d and 52. 0 g/d). The difference was statistically significant(P&lt;0. 05). Red meat accounted for 73. 6% and 72. 5% of total meat intake in early and middle pregnancy, respectively. After adjusting the confounding factors, multivariate unconditional Logistic regression analysis showed the risk of GDM was 1. 499 times(95%CI 1. 028-2. 185) in the highest red meat intake(&gt;86 g/d)women compared with the lowest red meat intake(&lt;44 g/d) women in the second trimester. No association was found between red meat intake in the first trimester and the occurrence of GDM(OR=1. 029, 95%CI 0. 716-1. 481). Pregnant women in Chengdu area have excessive intake of red meat in the second trimester. Higher intake of red meat in the second trimester(&gt;86 g/d) may increase the risk of gestational diabetes.

Risk Factors of Hypertension Disease during Pregnancy and their Influence on Pregnancy Outcome and Newborns

The high-risk factors of hypertension disease during pregnancy were retrospectively analyzed for their influence on pregnancy outcome and newborns. 72 patients with pregnancy hypertension admitted to the Department of Obstetrics and Gynecology in our hospital from December 2019 to December 2020 were retrospectively analyzed and set as the study group. At the same time, the 72 cases of healthy pregnancy subjects who received birth checkups during the same period were included as the control group. Self-made questionnaire was used to survey the basic information of the subjects, including age, income, emotions, living habits, education level and other related factors. Pregnancy outcome and neonatal complications were statistically measured and then univariate and multivariate logistic analysis methods were adopted to investigate their main risk factors. Univariate analysis found that 7 factors including age, body mass index, monthly income, education level, family history of hypertension, pregnancy complications and negative emotions are related to the onset of hypertension disease in pregnancy, and further multivariate unconditional logistic regression analysis showed that body mass index, education level, family history of hypertension and negative emotions are risk factors for the onset of hypertension disease in pregnancy; the incidence of fetal distress, low birth weight infants, perinatal death and neonatal asphyxia in the study group were significantly higher than that in the control group, the difference was statistically significant (p<0.05). In the study group, there were 17 cases of serious complications and 11 cases of more than two complications and in the control group, there were 8 cases of serious complications and 4 cases of more than two complications. The difference was statistically significant after testing (p<0.05). Obesity during pregnancy, low education level, family history of hypertension and negative emotions are risk factors for hypertension disease during pregnancy. In addition, hypertension disease during pregnancy can adversely affect pregnancy outcome and newborns, and clinical prevention and health care should be strengthened.

Analysis of postoperative complications and risk factors in patients with permanent pacemaker implantation.

BackgroundPermanent pacemaker implantation (PPI) is widely used for the treatment of chronic arrhythmia. The aim of the present study was to investigate the incidence of postoperative complications and the risk factors in patients with PPI.MethodsThe clinical data of 124 patients who underwent PPI in our hospital from January 2014 to January 2018 were collected and analyzed retrospectively. Data on sex, age, status of disease, and related complications of all patients were recorded, and differences were compared. The factors affecting postoperative complications in patients with PPI were analyzed.ResultsThe incidence of postoperative complications in 124 patients with PPI was 8.06% (10/124), including 4 cases with capsular hematoma (3.23%), 2 cases with capsular rupture (1.61%), 3 cases with capsular infection (2.42%) and 1 case with venous thrombosis (0.81%). Unconditional single-factor logistic regression model showed that the incidence of postoperative complications in patients with PPI was significantly greater with older age, high body mass index (BMI), smoking history, poor nutritional status, and decreased platelet counts (P<0.05). Results of the unconditional multivariate logistic regression analysis showed that older age, high BMI, smoking history, poor nutritional status, and decreased platelet counts were all independent risk factors of postoperative complications in patients with PPI (P<0.05).ConclusionsThe incidence of postoperative complications in patients with PPI was low, and the complications were mainly related to capsular bag. Factors, such as older age, high BMI, smoking history, poor nutritional status, and decreased platelet counts, were independent risk factors resulting in postoperative complications in patients with PPI.

Successful aging and its influencing factors among permanent residents in Guangzhou city

Objective To estimate the prevalence and influencing factors of successful aging among permanent elderly residents in Guangzhou city, Guangdong province and to provide a reference for community health institutions in improving their services for successful aging of the elderly. Methods Using convenient sampling, we recruited 617 permanent local residents aged ≥ 60 years in a tertiary hospital, two nursing homes and two communities in Guangzhou city and conducted a questionnaire survey among the elderly from July to December 2018. Results For the 594 respondents with valid information, the mean total score of successful aging was 164.74 ± 21.69 and the average score for all successful aging items was 4.22 ± 0.56, with the mean domain scores of 4.35 ± 0.92 for health autonomy, 4.45 ± 0.83 for economic security, 4.21 ± 0.75 for life adaptation, 3.93 ± 0.80 for social and kinship relationships, 3.89 ± 0.88 for learning, and 4.63 ± 0.67 for family, respectively; 443 (74.6%) of the respondents were assessed as having successful aging based on an average score of greater than 3.95 for all the items for successful aging. Unconditional multivariate logistic regression analysis showed that the respondents with following characteristics were more likely to have successful aging: with the education of senior high school, living with spouse, having a personal monthly income of 3 000 yuan (RMB) and more, with a general or good self-rated health, and residing in nursing homes or in communities; while the respondents with rural registered permanent residence were less likely to have successful aging. Conclusion The level of successful aging is relatively high and mainly influenced by education, registered residence, personal monthly income, self-rated health, and living place among permanent elderly residents in Guangzhou city.

Associations between the concentrations of CD68, TGF-β1, renal injury index and prognosis in glomerular diseases.

The present study aimed to investigate the association between the concentrations of CD68, TGF-β1, renal injury index and prognosis in glomerular diseases. Altogether 218 patients with glomerular diseases admitted to Weifang People's Hospital from January, 2014 to March, 2017 were used as the study group. A total of 100 healthy individuals who visited Weifang People's Hospital for a physical examination during the same time period were used as the control group. The levels of CD68 in peripheral blood obtained from the 2 groups of subjects were detected by flow cytometry, and the expression of TGF-β1 in serum was detected by enzyme-linked immunosorbent assay (ELISA). The concentrations of CD68 and TGF-β1 between the 2 groups were compared. The correlation between the concentrations of CD68, TGF-β1 and renal injury indexes in the study group was analyzed, as well as prognostic significance. The diagnostic value of CD68 and TGF-β1 in patients with glomerular disease was analyzed using a ROC curve, and the recovery of the patients was observed. The serum concentrations of CD68 and TGF-β1 in the study group were higher than those in the control group (P<0.05). The concentrations of CD68 and TGF-β1 in the study group positively correlated with the renal injury indexes, such as blood urea nitrogen (BUN), serum creatinine (SCR), uric acid (UA) and the 24-h urinary protein quantity (P<0.05). ROC curve analysis revealed that the area under the curve of CD68 and TGF-β1 as regards the diagnostic value in patients with glomerular disease was 0.808 and 0.738, respectively, while the area under the combined detection curve was 0.866. Multivariate unconditional logistic regression analysis revealed that the clinical classification and the concentrations of CD68 and TGF-β1 were independent prognostic factors in the study group. On the whole, the findings of the present study demonstrate that clinical classification, and the CD68 and TGF-β1 concentrations are independent prognostic factors for patients with glomerular disease. CD68 and TGF-β1 have certain value in the diagnosis of glomerular diseases, and may thus be used as predictors of the diagnosis and recovery of glomerular disease.