Changes of disease structure in a tertiary general hospital during the COVID-19 pandemic / 中华医院管理杂志

Objective:To explore the changes of disease structure in a tertiary general hospital during the COVID-19 pandemic.Methods:A database of 783 diagnosis-related groups(DRG) patients in a tertiary general hospital from 2017 to 2020 was used. The rank sum test was used to compare the number of patients among different years, and the Chi-square test was used to compare the composition of patients among different years. With the patient composition ratio as the main index, the thermal cluster analysis was used to analyze the changes of disease structure during the COVID-19 pandemic, from the perspectives of major diagnostic categories(MDC) and the key DRG(the number of patients in any year more than 2 000)respectively. All analyses were performed in R software, with P<0.05 indicating significance. Results:There were significant differences in the number and composition of patients in MDC groups and key DRG groups among different years( P<0.05). The results of thermal clustering analysis showed that the MDC composition of patients in 2020 was significantly different from those in 2017 to 2019; the 26 MDC groups were classified into four main categories. The results of thermal clustering analysis also showed that the DRG composition of patients in 2020 were significantly different from those in 2017 to 2019; The RU14 group and the other 19 key DRG groups were classified into different groups; and the other 19 key DRG groups except RU14 were classified into five main categories. Conclusions:The disease structure of tertiary general hospitals has changed significantly during the COVID-19 pandemic.

Changes and clinical implications of the levels of serum NO and VEGF and HIF-1alpha in patients with obstructive sleep apnea-hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the levels of nitrogen oxide (NO), vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1alpha (HIF-1alpha) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to discuss their roles in the pathogenesis of cardiovascular disease in patients with OSAHS.@*METHOD@#NO, VEGF and HIF-1alpha levels were measured in 60 OSAHS patients and 26 healthy subjects; OSAHS patients were divided into mild, moderate and severe groups according to AHI.@*RESULT@#NO levels in the moderate and severe OSAHS groups were significantly lower than that in the control group, but the levels of VEGF and HIF-la were increased compared with the control group (P 0.05); NO levels showed negative correlations with VEGF levels (P < 0.01).@*CONCLUSION@#The serum level of NO was reduced in response to the acceleration of hypoxia, while the level of VEGF was increased with the hypoxia. The results indicate that the levels of both NO and VEGF are associated with the severity of the disease. Decreasing NO levels and increasing VEGF are both the factors leading to endothelial dysfunction, which play an important role in the physiopathological process of the cardiovascular diseases in OSAHS patients.

Clinical significances of serum NO and oxLDL in obstructive sleep apnea-hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the correlation between the serum levels of nitrogen oxide (NO) and oxidized low density lipoprotein (oxLDL) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).@*METHOD@#NO and oxLDL levels were measured in 60 OSAHS patients and 26 healthy subjects. OSAHS patients were divided into mild, moderate and severe groups according to AHI.@*RESULT@#NO levels in the moderate and sever OSAHS groups was significantly lower than that in the control group, but the levels of oxLDL was increased compared with the control group. (P < 0.05). The serum levels of NO was negatively correlated with AHI (P < 0.01) and positively correlated with the lowest SaO2 (P < 0.01), the serum levels of oxLDL was positively correlated with AHI (P < 0.01) and negatively correlated with the lowest SaO2 (P < 0.01), NO levels showed negative correlations with oxLDL levels (P < 0.01).@*CONCLUSION@#The serum level of NO is reduced in response to the increase of AHI and the acceleration of hypoxia, which indicated that there is a correlation between vascular endothelial dysfunction and the severity of hypoxia. The decrease of the level of NO and the increase of the oxLDL can promote the formation of atherosclerosis, which increased the incidence of cardiocerebrovascular disease in patients with OSAHS.