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Objective To investigate the value of serum markers in the early diagnosis of liver cirrhosis with minimal hepatic encephalopathy (MHE). Methods A prospective analysis was performed for 81 patients who were hospitalized and treated in General Hospital of Ningxia Medical University from April 2020 to February 2022, and all these patients were diagnosed with hepatitis B cirrhosis based on clinical manifestation, laboratory examination, and radiological examination or liver biopsy. According to digital connection test A (NCT-A) and digital symbol test (DST), these patients were divided into simple cirrhosis group with 45 patients and MHE group with 36 patients. Related indices were measured, including liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and total bilirubin (TBil)], albumin, blood ammonia, cholinesterase, and prothrombin time. The independent samples t -test was used for comparison of normally distributed continuous data between two groups; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups; the chi-square test was used for comparison of categorical data between groups. The logistic regression analysis and the area under the ROC curve (AUC) were used to investigate the predictive factors for MHE. Results Compared with the simple cirrhosis group, the MHE group had a significant increase in NCT-A score ( Z =-7.110, P < 0.001) and a significant reduction in DST score ( t =12.223, P < 0.001). The univariate analysis showed that there were significant changes in AST, albumin, prothrombin time, cholinesterase, and blood ammonia in the patients with MHE ( Z =-2.319, -2.643, -1.982, -6.594, and -5.331, all P < 0.05), while the multivariate analysis showed that only cholinesterase and blood ammonia were significant predictive factors (all P < 0.05) and were correlated with Child-Pugh score (all P < 0.05). Cholinesterase, blood ammonia, and their combination had an AUC of 0.925, 0.845, and 0.941, respectively, in the diagnosis of MHE, with an optimal cut-off value of 2966, 60, and 0.513, respectively. Conclusion Blood ammonia, cholinesterase, and their combined measurement have a potential clinical value in the early diagnosis of liver cirrhosis with MHE.
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Objective To explore the effect of core competence oriented advanced course in wound ostomy specialist nurse training.Methods A total of 101 Chongqing municipal wound ostomy specialist nurse training students from September 2016 to June 2017 were selected.Among them,50 students in 2016 served as the control group and trained by traditional training methods;51 students in 2017 served as the observation group and adopted the core competence oriented advanced courses for conducting the training.Then the effects after training were compared between the two groups.Results The core competence score after training in the observation group [(3.11±0.11) point]was higher than that in the control group [(2.87±0.13) point],the difference was statistically significant (P＜0.05).Conclusion The core competency oriented advanced course is effective for training the wound ostomy nurses.
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Objective To survey the current situation of core competence of wound ostomy continence nurses (WOCN),and provide reference for their training and core competence evaluation.Methods A total of 141 WOCN in the Chongqing Municipal training base participated in the questionnaire survey by adopting the purposive sampling and WOCN core competence questionnaire table.Then the score results of core competence were analyzed by using the descriptive analysis,one-way ANOVA and t test.Results The average total score of WOCN core competency self-evaluation in Chongqing City was (2.42± 0.83) points,the item scores of core competence from high to low were the communication ability,clinical practical ability,critical thinking,professional development ability and management ability;the scores had statistical differences in different qualification certification years,employment characteristics,whether participating in the nursing team and different job titles (P＜0.05).Conclusion The WOCN core competence in Chongqing City is in the middle level,which prompts that it is needed to strengthen the training of professional development ability and critical thinking to improve the core competence.
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This study was aimed to observe clinical efficacy of Bushen Huoxue Kaiqiao (BSHXKQ) treatment of diabetes-induced vascular mild cognitive impairment . A total of 30 cases of diabetes-induced vascular mild cognitive impairment were randomly divided into the treatment group ( 15 cases ) and the control group ( 15 cas-es). The treatment group received free-fried BSHXKQ prescription (Cistanche 10 g, Shichangpu 5 g, Sanqi 2 . 5 g ) for treatment 3 times a day , and in combination of 30 mg of nimodipine , 3 times a day . In the con-trol group , 30 mg of nimodipine was orally administrated 3 times a day . The treatment was continued for 6 months. Clinical Dementia Rating (CDR), Activity of Daily Living Scale (ADL), Montreal Cognitive Assessment Beijing Edition ( MoCA ) and TCM Syndrome Score were used in the evaluation before and after the treatment . The results showed that the rate of progress was in both groups after treatment . In the treatment group , the rate was 86 . 70%, and in the control group the rate was 33 . 33%. The total effective rate in the treatment group was superior to the control group ( P < 0 . 05 ) . There were statistical significances in the MoCa Scale , ADL Scale and TCM Syndrome Score before and after treatment in each group ( P < 0 . 05 ) . The treatment ef-fect in the treatment group was superior to the control group ( P < 0 . 05 ) . There was no statistical significance in the incidence of adverse events in both groups . It was concluded that the effect of BSHXKQ prescription in the treatment of diabetes-induced vascular mild cognitive impairment was superior to nimodipine in improving activities of daily living , cognitive function , degree of dementia and TCM syndrome score . There was no differ-ence in the incidence of adverse events compared with nimodipine .
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Objective To investigate the map and pattern of blood oxygen level dependent(BOLD)signal changes correlated to interictal epileptiform discharges(IEDs)with EEG-fMRI in patients with partial epilepsy and then to explore the pathophysiological mechanisms of epileptic discharges and their effect on brain function in partial epilepsy.Methods Through the method of EEG-fMRI,2 patients with parial epilepsy were studied.The relationship between the regions of BOLD signal changes linked to IEDs and the electroelinical localization of epileptogenic zone in patients with partial epilepsy were investigated.Results The epileptogenic areas localized by electroclinical findings in the 2 patients all showed maximal activation and 2 sites of significant activation were found in 1 of the 2 patients;Weak activation were also manifested in the opposite side corresponding to lesions.Conclusions IED-linked BOLD response in patients with partial epilepsy is mainly in epileptogenic zones and weak activation can also be seen in the corresponding contralateral areas of epileptogenic zoiles.Activation areas ale well concordant with epileptogenie areas localized by electroclinical findings.
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Using simultaneous EEG-correlated functional MRI (EEG-fMRI), we studied the blood oxygenation level-dependent (BOLD) signals in a juvenile myoclonic epilepsy (JME) patient with interictal epileptiform discharges. Extensive and symmetric activation and deactivation areas were assessed in bilateral hemispheric regions respectively, and these signals decreased gradually from the parieto-occipital region to the frontal region. Activations were found in cuneus, insulae, mesial midfrontal region, midline and bilateral cerebellum and thalamus, while the deactivities were in the bilateral anterior frontal region and parietal region as well as the posterior cingulate gyri. These findings suggest that the synchronized neuronal activities represented by spike and wave complex in EEG be reflected in the activation of BLOD signals in thalamocortical regions. However, those regions of deactivation reflect the suspension of the default state of brain function resulting indirectly from this discharge. There is good correspondence between neuronal activity (EEG) and fMRI. The combination of EEG and fMRI is a powerful tool in studying brain function.
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Adolescent , Female , Humans , Brain , Electroencephalography , Methods , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Methods , Myoclonic Epilepsy, Juvenile , Oxygen , BloodABSTRACT
Objective To observe weight and serum leptin changes in epileptic women who taking valproate or topiramate. Method All 40 epileptic women were treated with valproate or topiramate. Weight and body mass index and serum leptin were measured before and after three months treatment. Result Nine of 20 patients taking valproate gained weight (≥4 kg), and their serum leptin concentration was increased as well [(13.2?3.6) ng/ml vs (7.4?3.0)ng/ml, P