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This paper interprets the content and recommendations of the guidelines on infection prevention and control in long-term care facilities put forward by the World Health Organization （WHO） during the 2019 coronavirus disease （COVID-19） pandemic， and actively explores the key points of nursing and infection prevention and control measures for the long-term care facilities under the background of repeated outbreaks， with the aim of providing care measures and infection prevention and control measures that suit our national conditions to improve the living standards of the elderly and protect them from viral infection amid the recurring pandemic.
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Exosomes are a class of extracellular vesicles with a structure of lipid bilayer-membrane. In the central nervous system (CNS), exosomes can be secreted from both neurons and glial cells. Exosomes released into the extracellular matrix can freely cross the blood-brain barrier and function as crucial carriers of cellular communication and substance exchange in the CNS. Exosomes play a key role in the pathological process of mental disorders such as schizophrenia, depression, and bipolar disorder, and they have the potential to be used as a targeted carrier of antipsychotic medications. Exosomes are likely to become a new tool in the future to aid in the early prevention, accurate diagnosis, and effective treatment for people with mental disorders.
Subject(s)
Humans , Exosomes/physiology , Extracellular Vesicles/physiology , Central Nervous System , Mental Disorders , Blood-Brain BarrierABSTRACT
The increasing prevalence of the aging population, and inadequate and uneven distribution of medical resources, have led to a growing demand for telemedicine services. Gait disturbance is a primary symptom of neurological disorders such as Parkinson's disease (PD). This study proposed a novel approach for the quantitative assessment and analysis of gait disturbance from two-dimensional (2D) videos captured using smartphones. The approach used a convolutional pose machine to extract human body joints and a gait phase segmentation algorithm based on node motion characteristics to identify the gait phase. Moreover, it extracted features of the upper and lower limbs. A height ratio-based spatial feature extraction method was proposed that effectively captures spatial information. The proposed method underwent validation via error analysis, correction compensation, and accuracy verification using the motion capture system. Specifically, the proposed method achieved an extracted step length error of less than 3 cm. The proposed method underwent clinical validation, recruiting 64 patients with Parkinson's disease and 46 healthy controls of the same age group. Various gait indicators were statistically analyzed using three classic classification methods, with the random forest method achieving a classification accuracy of 91%. This method provides an objective, convenient, and intelligent solution for telemedicine focused on movement disorders in neurological diseases.
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Humans , Aged , Parkinson Disease/diagnosis , Aging , Algorithms , Gait , Lower ExtremityABSTRACT
@#Objective To explore the effects of Valpar Component Work Sample on Parkinson's disease (PD). Methods From June, 2015 to June, 2017, 40 patients with PD were randomly divided into control group (n=20) and observation group (n=20). Both groups received routine treatment and occupational therapy, while the observation group accepted rehabilitation with Valpar Component Work Sample in addition, for eight weeks. They were assessed with Unified Parkinson's Disease Rating Score II and III (UPDRSII and UPDRSIII), Mini-Mental State Examination (MMSE), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and the Parkinson's Disease Questionnaire-39 (PDQ-39) before and after treatment. Results The scores of UPDRSII, UPDRSIII, MMSE, HAMD, and HAMA, and Summary Index of PDQ-39 improved in both groups (t>2.864, P<0.05) after treatment, and improved more in the observation group than in the control group (t>2.237, P<0.05). Conclusion Combined with Valpar Component Work Sample may further improve the activities of daily living, motor, cognitive function, depression and anxiety, and then quality of life in patients with PD.
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Objective To evaluate the clinical value of serum carcinoembryonic antigen(CEA),neuron specific enolization enzyme(NSE),21-1 non-small cell lung cancer associated antigen(CYFRA21-1),carbohydrate antigen 125(CA125) and ferritin(Fer) in the diagnosis of lung cancer.Methods The levels of CEA,NSE,CYFRA21-1,CA125 and Fer were measured by electrochemlium-inescence in 103 patients with lung cancer,32 patients with benign lung diseases and 40 healthy people.Results The serum levels of CEA,NSE,CYFRA21-1,CA125 and Fer in patients with lung cancer[(110.2±95.5)ng/mL,(50.6±43.4)ng/mL,(32.8±29.5)ng/L,(122.7±110.4)U/L,(854.6±497.2)ng/mL] were significantly higher than those in patients with benign lung diseases and those in healthy people(t=6.21,5.71,6.75,6.62,7.74,P<0.05;t=5.26,4.86,5.81,5.20,6.26,P<0.05).The sensitivity values of CEA,NSE,CYFRA21-1,CA125,Fer and the combined determination containing five tumor markers were 39.81%,24.27%,71.84%,68.93%,77.66% respectively.The sensitivity and specificity of the combined determination containing five tumormarkers were 96.12%,95.00%.Conclusion The joint detection in the diagnosis of lung cancer could improve the sensitivity significantly,to help for early diagnosis of lung cancer,which is value to widely applied in clinic.
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The Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire was used for appraisal in a newly-built general hospital for all the nursing staff, and they were provided with a six-month safety culture training according to appraisal results.The training has elevated the positive response rate of the nursing staff towards all dimensions of patient safety culture, proving that scientific and reasonable safety culture training is conducive to nurses' perception of patient safety culture.
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Objective To explore the clinical diagnostic value of four kinds of diagnostic methods ,including pulmonary tubercu‐losis ,including T‐cell‐based spot test for tuberculosis infection(T‐SPOT .TB) ,rapid culture test for Mycobacterium tuberculosis , combined detection of IgM and IgG antibodies in tuberculosis and sputum or bronchoalveolar lavage fluid smear .Methods A total of 516 cases of patients who were initially diagnosed with tuberculosis and without medication were collected from October 2014 to May 2015 in this hospital .T‐SPOT .TB ,rapid culture test for Mycobacterium tuberculosis ,combined detection of IgM and IgG anti‐bodies in tuberculosis and sputum or bronchoalveolar lavage fluid smear were performed in all patients .The sensitivity of these methods were calculated and compared .Results The sensitivity of T‐SPOT .TB(88 .76% ) was higher than that of rapid culture test for Mycobacterium tuberculosis(45 .74% ) ,combined detection of IgM and IgG antibodies in tuberculosis(72 .87% ) and sputum or bronchoalveolar lavage fluid smear(17 .25% ) ,all had statistically significant differences(P< 0 .01) .Conclusion T‐SPOT .TB might have significant application value for detecting Mycobacterium tuberculosis infection and assisting the diagnosis of tuberculo‐sis .Meanwhile ,combining with other detection methods could greatly improve the diagnostic rate and meet different clinical needs .
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Objective To evaluate the differences of the lower extremity atherosclerosis between patients with and without type 2 diabetes using dual-source CT angiography.Methods Dual-source CT angiography of lower extremity was performed in 87 patients with (n=30)or without (n= 57 )diabetes.Extent of luminal stenosis,and the type,distribution and range of the plaques were compared.Results 342 plaques in 540 segments (63.3%)in diabetic patients,and 500 plaques in 1 026 segments (48.7%)in non-diabetic ones were detected respectively.Compared with non-diabetic patients,the diabetic ones had a higher overall incidence of plaques (P <0.05).Calcified plaques were the most common in both kinds of patients,and the incidence of mixed plaques was high-er in diabetic patients than that in non-diabetic ones (35.6 % vs.28.4%,P <0.05).Light to moderate stenosis occurred in most diabetic patients,and fewer occlusion was found compared with non-diabetic ones (9.1% vs.1 7.0%,P <0.05).The most common sites of the plaques in diabetic patients were located at distal small arteries below the knee.However,those were located at proximal arteries above the knee for non-diabetic ones.The involvement of atherosclerosis in diabetic patients was more diffused,and the de-gree of Ⅳ (75%-100%)was higher than that in non-diabetic ones (P <0.05).Conclusion Atherosclerosis in lower extremity on dual-source CT angiography is very common in diabetic patients with multi-segmental,diffused,non-obstructive involvement of dis-tal small arteries below the knee.
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Objective To study the reliability and validity of the clinical neurologic deficit scale in evaluating stroke patients. Methods A total of 222 inpatients with acute stroke onset were included in the study. They were assessed when admitted, at the 14th and 90th day of hospitalization by different physicians using the clinical neurologic deficit scale. Intrarater and interrater reliability were determined using Kappa correlation. The split-half rehability and internal consistency were evaluated using Cranbach's a coefficient. Concurrent validity and the predictive validity were determined by spearman rank correlation coefficients. Construct validity was assessed by the factor analysis and the construct validity of the scale was measured according to the classifications of the Oxfordshire Community Stroke Project ischemic stroke subtypes in the patients with cerebral infarction. Results The scores of intrarater reliability in all items were higher than 0.6, the score of interrater reliability in the item "walking" was 0.542, the split-half reliability and the internal consistency were good as demonstrated by the score of 0.911 and 0.886 respectively, and assessment of reliability of different methods showed that "strength in upper limb" and "strength in hand", were poor as shown by the score of 0.393 and 0.386 respectively. The scale is highly correlated with the NIHSS ( both P=0.000) in both total and subtypes of stroke patients according to the classifications of the Oxfordshire Community Stroke Project by concurrent validity analysis. There was a high correlation between the scores of the scale and Barthel Index and the modified Rankin scales at the 90th day of hospitalization (both P=0.000). Conclusions The clinical neurologic deficit scale has a good internal consistency. There is concurrent validity between the scale and the NIHSS and could predict stroke outcome. Factor analysis of the scale displays the best construct validity in the patients with partial anterior circulation infarction, and could be used to evaluate the focus of vertebrobasilar artery despite its insensitivity.
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Objective: To investigate the impact of stroke unit (SU) on the compliance of secondary prevention in patients with stroke at 12 months after stroke. Methods: Research subjects were stroke patients who were treated in SU (n = 500) and in general ward (GW) (n =445) using a design of retrospective study. The patients in the SU group were followed up by hospital, telephone and home interviews for 12 months, and the patients in the GW group were followed up by telephone interview for 12 months. The main outcome measures were the rate of using antithrombotics, the rate of smoking cessation, and the rates of awareness of early stroke symptom and stroke risk factors of patients. Results: he rate of using antithrombotics was 92.76% in the SU group, and it was significantly higher than 51.49% in the GW group (P ＜0.01); the rate of smoking cessation, and the rates of awareness of early stroke symptom and stroke risk factors of patients were 82.33%, 91.04%, and 94.03% respectively in the SU group, and they were significantly higher than 54.75%, 6.53%, and 70.37% in the GW group(P all ＜ 0.01 ). Conclusions: SU attaches importance to the secondary stroke prevention and emphasizes standardized treatment, and the compliance of the secondary stroke prevention in patient with stroke is improved significantly.