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Objective:To investigate the influence of trimethylamine N-oxide(TMAO)on the development of early neurological deterioration(END)in diabetic patients with acute ischemic stroke.Methods:In this cross-sectional study, 108 type 2 diabetes patients with acute ischemic stroke treated at the Department of Neurology in the Affiliated Wuxi People’s Hospital of Nanjing Medical University between October 2019 and November 2020 were consecutively recruited.END was defined as an increase in the National Institutes of Health Stroke Scale(NIHSS)≥ 2 points and exclusion of intracranial hemorrhage or bleeding transformation in cranial imaging evaluation within 5 days of initial deterioration of neurological dysfunction.The patients were divided into 2 groups, an END(n=36)group and a non-END group(n=72). Fasting plasma TMAO was measured using isotope dilution liquid chromatography coupled to tandem mass spectrometry.Results:Of the 108 patients, 36(33.3%)were diagnosed with END, and their plasma TMAO levels were significantly higher compared with patients without END( Z=-3.500, P<0.001). For prediction of END, the area under the ROC curve for plasma TMAO levels was 0.707(95% CI: 0.603-0.811, P<0.001). The frequencies of END in subjects grouped via tertiles of TMAO were 22.2%, 19.4% and 58.3%, respectively, with significant differences between the 3 groups( χ2=14.979, P=0.001). Univariate analysis showed that elevated TMAO( OR=1.160, 95% CI: 1.050-1.282, P=0.004)was associated with END.A multivariate logistic regression model further confirmed the association between TMAO and END( OR=1.145, 95% CI: 1.033-1.269, P=0.010). Conclusions:Increased plasma TMAO levels are associated with END in diabetic patients with acute ischemic stroke.
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Biotin-thiamine-responsive basal ganglia disease is a rare treatable autosomal recessive neurometabolic disorder caused by mutations in SLC19A3 gene, encoding a transporter of thiamine across the plasma membrane. In the present study, a 29-year-old male patient with epilepsy as the first symptom, accompanied by hypokinesia, extraocular muscle paralysis and delayed dystonia was reported. The brain magnetic resonance imaging revealed abnormal symmetrical signals of bilateral caudate nucleus and lenticular nucleus. The patient was diagnosed as biotin-thiamine-responsive basal ganglia disease by gene detection. After treatment with biotin and thiamine, the symptoms were relieved and the brain lesions subsided.
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Objective To investigate the clinical efficacy of Enzaishi intramuscular injection on patients with postherpetic neuralgia.Methods 120 patients with post-herpetic neuralgia who were hospitalized in Wuxi People's Hospital from January 2014 to December 2016,were randomly divided into the observation group (n =60) and control group (n =60).All patients were treated with oral vitamin B1 and mecobalamin,with an added gabapentin as control group,and adding-on oral gabapentin and intramuscular injection of grace as observation group.The clinical curative effect,pain degree and incidence of adverse reactions were compared between two groups.Results Total effective rate was higher in observation group[86.7 ％ (52/60)]than in control group[70.0％ (42/60)] (x2 =4.910,P =0.000).Post-therapeutic visual analog scale(VAS)pain score was lower in observation group than in control group(2.0 ± 1.1 vs.3.6± 1.7,P＜0.05),although the pre-therapeutic VAS pain score was similar between two groups(P＞0.05).Additionally,no serious adverse reactions were observed in the two groups,although the incidence of adverse reactions was higher in the observation group than in the control group(P＞0.05).Conclusions Enzaishi is safe and effective for the patients with senile neuralgia after herpes zoster,and could effectively reduce the pain degree.
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Objective To explore the effect of social relationship quality intervention on blood pressure and mental state of patients after hypertensive hemorrhage. Methods From November 2014 to March 2016,48 patients with hypertensive intracerebral hemorrhage were assigned as control group and another 48 patients with the same disease in our hospitalfrom April 2016 to August 2017 as observation group:The former received routine nursing care and the latter was treated with social relationship quality intervention plus the routine nursing care.The blood pressure and mental states before intervention were compared with those 1 month after intervention. Result After intervention,the systolic and diastolic blood pressures in the observation group were significantly lower than those in the control group,and the scores on resilience,optimism and strength were all significantly higher than those in the control group (P<0.01, P<0.001). Conclusions The social relationship quality intervention is effective in the care to patients with hypertensive cerebral hemorrhage. It can effectively improve the clinical efficacy, reduce blood pressure and improve mental state, worthy of clinical application and promotion.
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Objective To explore the elderly stroke patients into Maslow's hierarchy of needs theory to carry out the effect of nursing intervention on the Barthel and self efficacy, quality of diagnosis and treatment of this kind of special group that the accumulation of evidence-based care experience. Methods Eighty-two cases of elderly patients with stroke in our hospital from September 2015 to March 2017, with the random number table as the grouping criterion, will meet the inclusion criteria of the object is divided into study group and control group, 41 cases in each group. The control group received traditional nursing care, while the research group introduced the Maslow hierarchy of needs theory to intervene. The two groups of patients were evaluated before and after treatment, and the neurological function level, daily living ability, complication rate and nursing satisfaction were compared. Results After treatment, the score of basic knowledge, poor dietary harmful cognition, treatment knowledge, self-management knowledge and complication prevention knowledge were (2.3 ± 0.6), (2.4 ± 0.7), (2.3 ± 0.7), (2.5±0.7), (2.6±0.8) points respectively in study group, and (1.4 ± 0.4), (1.5 ± 0.4), (1.4 ± 0.4), (1.6 ± 0.5), (1.7 ± 0.5) points in control group. The difference was statistically significant (t=8.175-15.260, P<0.05).Neurological deficits after treatment in the study group were (7.8 ± 1.1) points lower than those in the control group (14.5±2.2) points. Barthel index was (61.5±5.4) higher than that in the control group (41.3± 4.0). The length of stay in hospital was (16.3±2.6) d, which was shorter than that in control group (25.3± 3.2) d, the difference was statistically significant (t=15.260, 12.352, 8.367, P<0.05). The complication rate was 9.8％ (4/41) in the study group, which was lower than 29.3％ (12/41) in the control group. The satisfaction rate in the study group was 97.6％(40/41), which was higher than 82.9％(34/41) in the control group), the difference was statistically significant (χ2=13.279, 13.267, P<0.05). Conclusions For elderly stroke patients, nursing intervention into Maslow's hierarchy of needs theory, help to improve their self-efficacy and nerve function level, and can improve the nursing satisfaction, is worthy of further promotion.
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Objective To explore the effect of collaborative nursing on the quality of life and nursing of stroke patients. Methods Toally 84 care-givers for 84 stroke patients hospitalized during February 2014 to March 2016 were chosen. In the control group(hospitalized from Feburary 2013 to Feburary 2014), traditional nursing was carried out, while in the research group(hospitalized from March 2014 to March 2016), the collaborative care intervention was done. The comparisons were done between the two groups in terms of quality of life and care ability by the GHQ-28 quality of life scale assessment, family caregiver task inventory (FCTI) before the intervention and 4 weeks after the intervention. Results Before the intervention, the two groups had no significant differences in life quality and care ability (all P > 0.05). After the intervention, the scores on symptoms, anxiety, depression, insomnia and social dysfunction were all significantly higher than those of the control group (all P<0.05). The scores on the care role, strain, assistance, personal emotion control, family assessment and community resources, and adjustment of life to meet the care needs were all significantly lower than those of the control group (all P<0.05). Conclusions The collaborative care is effective in improving the quality of life of stroke patients. It can improve the care ability of the caregiver.
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Objective To explore the effect of postweaning enriched environment and citalopram treatment during juvenility on the behaviour of male rats exposed to early adverse stress. Methods The newborn pups were randomly divided into maternal separation group (MS) and non-maternal separation group (NMS). Offspring were weaned on PND22 and housed in same-rearing groups under either standard or enriched conditions or citalopram treatment until adulthood. All of them were examined by sucrose consumption test, forced swimming test (FST) and morris water maze test (MWZ). Results (1) MS had significantly less consumption of sucrose intake (ml/g)(0.013 ±0.006, n = 10), compared with the following five groups (MS + EE (0.023 ±0.012, n = 8); MS + Drug (0.027 ±0.012, n = 9); NMS (0.022 ± 0. 007, n=11);NMS + EE (0.023 ±0.007, n = 7); NMS + Drug (0.032 ±0.011),n=7)), NMS + Drug had significantly increased the radio of sucrose consumption on NMS group. (2)The immobility in FST were longer in MS-experienced groups (MS (140. 19 ± 37.01) s, n = 8); MS + EE (129.41 ±29.50)s, n = 6) ;NMS + Drug (128.83 ±26. 11)s, n = 6)) than three non-MS groups (NMS (96.28 ±35.63)s,n = 7); NMS + EE (94.17 ±24. 87)s, n = 6) ;NMS + Drug (93.00 ±34. 21)s, n = 6)). (3) MS had shorter time and shorter percentage of distance spent in target quadrant in MWZ,citalopram treatment markedly improved spatial memory on NMS group. Conclusion Maternal separation applied in newborn rats induces a broad spectrum of behavioral changes reminiscent of depressive symptoms in humans, which might be reversed to some extent by EE and antidepressant in young adults.