Background Potassium plays an important role in the occurrence and progression of heart failure patients,Hypokalemia is one of the most common electrolyte disorders in hospitalized patients with heart failure , which poses a significant threat to the prognosis of patients. Identifying risk factors for hypokalaemia is crucial.The primary aim of this study was to investigate the incidence and risk factors of hypokalemia in patients with heart failure within one week of admission, and to provide a reference for the prevention of hypokalemia. MethodsA total of 535 patients with heart failure who were hospitalized in the Department of Cardiovascular Medicine of the Affiliated Hospital of Zunyi Medical University from 2019 to 2022 were retrospectively selected by convenience sampling method, and were divided into hypokalemia group (160 cases) and non-hypokalemia group (375 cases) according to whether hypokalemia occurred within one week of admission.To select most relevant variables, the Least Absolute Shrinkage Selection Operator(LASSO) was applied, and then multivariate logistic regression analysis was further used to identify the risk factors of hypokalemia within one week of admission in patients with heart failure. Results Among the 535 patients with heart failure, 160 patients developed hypokalemia within one week of admission, with an incidence rate of 29.90%. The results of LASSO regression analysis showed that gender, peripheral edema, baseline serum potassium, calcium, albumin, prealbumin, and furosemide dose on the day of admission were the most correlated with hypokalemia within one week of admission. Multivariate Logistic regression analysis showed that female (OR: 2.171; 95%CI: 1.445~3.261), peripheral edema (OR: 1.692; 95%CI: 1.118~2.561), and furosemide dose on the day of admission (OR: 1.013; 95%CI: 1.005~1.021) were risk factors for hypokalemia within one week of admission, and the baseline serum potassium value was higher than that of normal low serum potassium (OR：0.355;95%CI: 0.217~0.581) was a protective factor for hypokalemia within one week of admission in patients with heart failure. Conclusion Even if the serum potassium is at a normal value at the time of admission, the incidence of hypokalemia in patients with heart failure is still high within one week of admission, and gender, peripheral edema, furosemide dose on the day of admission, and baseline serum potassium are closely related to the occurrence of hypokalemia.

Background It has been confirmed in other fields that perioperative blood transfusion (PBT) will increase the incidence of complications after free-flap reconstruction and increase the risk of patients returning to the operating room within 48 hours after the initial operation. However, for head and neck tumors, whether PBT is related to postoperative complications is debatable. The aim of this study was to control the demographic and comorbidity characteristics of patients by propensity score matching (PSM) as well as to investigate the relationship between PBT and postoperative complications after oral cancer free-flap reconstruction.

AIM:To analyse factors associated with cognitive frailty among older chronic heart failure patients in China. DESIGN:A cross-sectional design. METHODS:Between August 2021 and November 2022, a total of 421 chronic heart failure patients (age ≥60 years) were randomly selected from the cardiology department of the affiliated hospital of Zunyi Medical University. The FRAIL scale, Mini-Mental State Examination, 15-item Geriatric Depression Scale, Social Support Rating Scale, Short-form Mini Nutritional Assessment and Pittsburgh Sleep Quality Index were utilized for measurement and evaluation. The demographic and clinical characteristics of patients were collected. To select initial variables, the Least Absolute Shrinkage Selection Operator was applied, and then logistic regression analysis was used to confirm associating factors. RESULTS:Among 421 elderly people with chronic heart failure, 83 cases (19.7%) showed cognitive frailty. Of 31 variables, seven were selected by Least Absolute Shrinkage Selection Operator regression. Finally, multivariate logistic regression revealed that the age, monthly salary, drinking, NYHA classification, length of hospital stay, depression and malnutrition risk/malnutrition were independently associated with cognitive frailty. CONCLUSION:The high proportion of cognitive frailty in older people with chronic heart failure should be concerned. Additionally, in the setting of cognitive frailty, efforts to diagnose it and develop interventions to prevent or reverse cognitive frailty status among older chronic heart failure patients are necessary. IMPACT:The findings of our study highlight the necessity to evaluate cognitive frailty in older people with chronic heart failure and provide a new perspective and scientific basis for medical staff to develop individualized and specific interventions to prevent or reverse cognitive frailty status. REPORTING METHOD:This study has been reported in compliance with STROBE reporting guidelines for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION:No Patient or Public Contribution.

目的:系统评价口腔癌患者术后肺部感染的危险因素.方法:计算机检索PubMed、Web of Science、Embase、Cochrane Library、ScoPus、中国知网、万方、维普、中国生物医学文献数据库中关于口腔癌患者术后肺部感染危险因素的研究,包括病例对照研究和队列研究,检索时限为建库至 2022 年 11 月 1 日.结果:最终纳入 11 篇文献,共 3458 例患者.Meta分析结果显示,吸烟史[OR=5.88,95%CI(1.49,23.26),P=0.011]、糖尿病史[OR=2.64,95%CI(1.20,17.54),P=0.023]、既往放疗史[OR=8.21,95%CI(1.45,46.468),P=0.017]、术前口腔卫生不良[OR=10.17,95%CI(2.14,48.32),P=0.004]、手术时间[OR=1.34,95%CI(1.12,1.61),P=0.001]、麻醉时间[OR=2.04,95%CI(1.262,3.298),P=0.004]、皮瓣大小[OR= 1.02,95%CI(1.008,1.034),P=0.001]、皮瓣类型[OR=17.71,95%CI(4.15,75.56),P=0.0001]、延迟活动(＞4 天)[OR= 4.20,95%CI(1.057,17.074),P=0.04]、术后住院时间[OR=1.14,95%CI(1.05,1.24),P=0.002]是口腔癌患者术后肺部感染的独立危险因素,术前血清白蛋白水平[OR=0.79,95%CI(0.67,0.94),P=0.005]是口腔癌患者术后肺部感染的保护因素.单因素分析显示,年龄、气管切开、术中失血量、下颌骨切除、气管套管留置时间、皮瓣修复与口腔癌患者术后肺部感染密切相关,但尚无证据证明是口腔癌患者发生术后肺部感染的独立危险因素.结论:口腔癌患者术后肺部感染影响因素较多,应进行针对性、个体化干预,预防肺部感染发生,对促进口腔癌患者术后康复具有重要意义.

目的 分析口腔颌面肿瘤患者修复重建后游离皮瓣血栓形成的危险因素.方法 回顾性分析自 2015 年 1 月至2022 年 8 月,遵义医科大学附属口腔医院和西南医科大学附属医院 320 例行游离皮瓣修复口腔颌面肿瘤患者的临床资料,收集患者的性别、年龄、BMI、术前红细胞数目、术前空腹血糖、术前甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白、吸烟史、饮酒史、糖尿病史、高血压史、TNM分期、肿瘤位置、ASA评分、外周血管疾病等临床资料,分析游离皮瓣血栓形成的危险因素.结果 320 例患者中形成血栓 24 例,其中静脉血栓19 例(79.17%)、动脉血栓 1例(4.16%)、混合血栓 4 例(16.67%).单因素分析显示,年龄(＞60 岁)、低密度脂蛋白、术前红细胞数目、术前空腹血糖偏高(≥6.1 mmol/L)、淋巴结转移是血栓形成的影响因素.多因素Logistic回归分析显示,术前红细胞数目偏低、淋巴结转移、术前空腹血糖偏高(≥6.1 mmol/L)是血栓形成的独立危险因素(P＜0.05);其中糖代谢受损(6.1～7.0 mmol/L)患者修复重建后发生血栓的风险是正常血糖(＜6.1 mmol/L)患者的 3.551 倍;淋巴结转移(N2)患者是未转移患者的 4.126 倍.结论 术前红细胞数目偏低、口腔肿瘤合并糖代谢受损或淋巴结转移患者,修复重建后血栓形成的风险较高,建议临床多重视此类患者.

To investigate the influencing factors of lower limb amputation in patients with diabetic foot ulcers. Patients with diabetic foot ulcers who were hospitalised in a tertiary general hospital in Guizhou Province from January 2019 to March 2022 were retrospectively collected. Sociological information of the general population, comorbidities, laboratory-related indicators, and information on the specialty situation, using univariate analysis and multifactor analysis, compared the influencing factors of amputation and non-amputee patients. A total of 205 patients with diabetic foot and 69 ampute patients (33.7%) were enrolled. The univariate analysis found that the decrease in HDL cholesterol levels was associated with the occurrence of lower extremity amputation, and logistic stepwise regression analysis showed that HDL-C was inversely correlated with the amputation rate of patients with diabetic foot ulcers, and the risk of amputation at low levels of HDL-C was 2.452 times higher than that of high-level HDL-C (95% CI: 1.105-5.846). Decreased HDL cholesterol levels are an independent predictor of amputation in patients with diabetic foot ulcers.

Objective:To discuss the application value of debridement combined with antibiotic bone cement in the treatment of severe infection of diabetic foot ulcer (DFU).Methods:Nineteen patients with severe infection of DFU (Wagner grade 3 or above, severe infection) hospitalized in the Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University from June 2019 to June 2020 were retrospectively analyzed. Their wounds were expanded and filled with antibiotic bone cement. After infection control, direct sutures, skin grafting or flap transplantation were performed. White blood cell count, C-reactive protein, absolute value of neutrophil and procalcitonin were collected before and 7 days after debridement combined with antibiotic bone cement treatment, and the time, frequency of bone cement coverageand were recorded and the efficacy of treatment was evaluated. Data were compared with t test and variance analysis.Results:The infection of 19 patients was controlled effectively. After 7 days of treatment, the white blood cell count, C-reactive protein, absolute value of neutrophil and procalcitonin were (6.39±1.55)×109/L, (25.47±14.65) mg/L, 5.55±1.64, which were significantly lower than before treatmen [(12.97±5.27)×109/L, (126.13±42.64) mg/L, (9.68±4.04)], the differences were statistically significant (t=2.995, 3.842, 4.743; P<0.05); the level of procalcitonin decrease compared with before treatment, but the difference was not statistically significant (P>0.05). The covering time of bone cement were 10-61 days, and the covering frequency of bone cement was 1.4 times per person. Among the 19 cases, 12 cases were cured by direct suture, skin graft or skin flap transplantation after antibiotic bone cement filling, 2 cases were changed dressing until cured after bone cement treatment, amputation in 2 cases and loss of follow-up in 3 cases. The patient was not hospitalized again during the follow-up period.Conclusion:Antibiotic bone cement is an effective method in the treatment of DFU with severe infection, which could provide wound bed preparation for the following wound repair.