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Objective:To explore the prognostic risk factors of patients with multiple injuries and establish a nomogram prediction model.Methods:The clinical data of 291 patients with multiple injuries admitted to the Emergency Intensive Care Unit (EICU) of General Hospital of Ningxia Medical University were collected, including sex, age, open injury, norepinephrine use, mechanical ventilation, time to hospital after injury, distance to hospital, relative lymphocyte value, platelet count, lactic acid, injury severity score (ISS), acute physiology and chronic health evaluationⅡ (APACHE Ⅱ), Glasgow coma scale (GCS), number of blood transfusions, number of operations, and previous history of diabetes, hypertension and smoking within 24 h after admission. According to whether the condition worsened during the hospitalization of EICU, the patients were divided into the deterioration group and improvement group. SPSS26.0 software was used for statistical analysis of the data, univariate and multivariate analysis were used to screen the factors affecting the prognosis of patients with multiple injuries, receiver operating characteristic (ROC) curve and forest chart were drawn, and the influencing factors in binary Logistic regression model were used to make the nomogram.Results:Mechanical ventilation, norepinephrine use, age, relative lymphocyte value, lactic acid, APACHE-II score, GCS score, and number of operations were significant for predicting the prognosis of patients with multiple injuries ( P<0.05). The independent influencing factors obtained by binary Logistic regression model were age, lactic acid, APACHE-Ⅱ score and number of operations. ROC curve analysis showed that the area under the curve was the largest in multi-factor combined prediction, followed by APACHE-Ⅱ score. The diagnostic cut-off value of each index was as follows: age >58 years old, relative lymphocyte value≤ 8.62%, lactic acid >1.72, APACHE-Ⅱ score >16, GCS score≤ 6, and number of operations≤ 0. The R software was used to establish a nomogram of the influencing factors in the binary Logistic regression model, which had good predictive value. Conclusions:The nomogram constructed by age, relative lymphocyte value, lactic acid, APACHE-Ⅱ score, GCS score, number of operations, mechanical ventilation, and norepinephrine use has a good predictive value for the prognosis of patients with multiple injuries, and is worthy of promotion..
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ABSTRACT Objective: To investigate the risk factors for predicting atrial high-rate episodes (AHREs) detected by cardiac implantable electronic devices (CIEDs). Methods: A total of 140 patients with CIED in our hospital from June 2013 to June 2018 were included and were followed up to observe whether they had AHREs. AHRE are defined as atrial rate ≥ 175 times/minute, lasting > 5 minutes, and reviewed by an experienced electrophysiologist with unclear clinical diagnosis. The patients fasted for 12 hours after implantation, and blood samples were collected for biochemical, lipid, and whole blood count detection. Follow-up was regular after discharge to record follow-up data of each patient and conduct statistical analysis. Results: One hundred and forty patients were implanted with dual-chamber pacemakers, their median age was 70 years old, 44.29% were male, 27 patients had AHRE within one year, and AHRE incidence rate was 19.29%. The microcytic to hypochromic (M/H) ratio was calculated for all AHRE patients and compared with the patients without AHRE; the M/H value of AHRE patients was significantly higher. Throughout the entire follow-up period, a total of 44 patients developed AHRE; when adjusted by multivariate analysis, only M/H ratio ≥ 4.5 vs. < 4.5 had statistical significance, and the adjusted hazard ratio value was 4.313 (1.675-11.105). Conclusion: As an indicator, M/H ratio may play an important role in the occurrence and development of atrial fibrillation and can be used as a predictor of AHRE in patients with CIED.
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Objective:To investigate the treatment of preterm and low birth weight infants with congenital diaphragmatic hernia (CDH) and to share the experience.Methods:This retrospective study enrolled 117 newborns with CDH who underwent major surgery at Children's Hospital, Capital Institute of Pediatrics from May 1, 2011, to March 31, 2022. Based on gestational age and birth weight, the infants were divided into the preterm and/or low birth weight group (gestational age < 37 weeks and/or birth weight less than 2 500 g, n=41) and the control group (gestational age ≥ 37 weeks and birth weight ≥ 2 500 g, n=76). Furthermore, the preterm and/or low birth weight infants were divided into the thoracoscopic surgery subgroup ( n=31) and the open surgery subgroup ( n=10) according to the surgical approach. Statistical analysis of the data was performed using two independent sample t-tests, rank sum tests, Chi-square test, or Fisher's exact probability test. Results:Preoperative data showed that the Apgar scores at 1 min [7.0 (6.0-8.0) vs 9.0 (8.0-9.8), Z=－4.03] and 5 min [9.0 (8.0-10.0) vs 9.0 (9.0-10.0), Z=－2.13] of the preterm and/or low birth weight infants were both lower than those in the control group (both P<0.05), while the proportion of infants with moderate to severe pulmonary hypertension was higher [68.3% (28/41) vs 38.2% (29/76), χ 2=9.68, P<0.05]. There were no statistically significant differences between the two groups in terms of the proportion of thoracoscopic surgery, operation time, right diaphragmatic hernia, presence of hernia sac, grading of the defect, presence of liver herniation, and application of mesh (all P>0.05). Regarding the postoperative outcomes, the death rate in the preterm and/or low birth weiht group was higher compared to the control group [36.6% (15/41) vs 13.2% (10/76), χ 2=8.70, P<0.05]. Additionally, the time required to resume full enteral nutrition after surgery was longer in the preterm and/or low birth weight group than that in the control group [25 d (18-29 d) vs 16 d (10-25 d), Z=2.31, P<0.05]. The thoracoscopic subgroup had a lower mortality compared to the open surgery subgroup [25.8% (8/31) vs 7/10, P<0.05]. The thoracoscopic surgery subgroup had a higher Apgar score at 1 min after birth [(7.4±1.6) vs (6.0±2.2), t=2.20, P<0.05], later age at operation (hours after birth) [31.0 h (23.0-48.0 h) vs 17.0 h (4.7-24.5 h), Z=2.57, P<0.05], a lower proportion of infants operated within 24 hours after birth [32.3% (10/31) vs 8/10, P<0.05], and longer duration of operation [170.0 min (122.0-200.0 min) vs 110.0 min (87.3-120.0 min), Z=3.65, P<0.05]. Conclusions:In this study, a higher mortality in the preterm and/or low birth weight group compared to the control group was observed, which may be attributed to the higher proportion of neonates with moderate-severe pulmonary hypertension. The thoracoscopic diaphragmatic repair can be attempted for preterm and low birth weight infants who have relatively stable respiratory and circulatory functions.
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Objective:To explore the application effects of standardized patient (SP) and breast visual palpation simulation system on clinical probation of breast surgery for medical students.Methods:A total of 110 students were randomly divided into experimental group and control group, and each group was further divided into 5 subgroups. In the experimental group, SP scripts of five common diseases in breast surgery department were designed according to the syllabus before probation, and the teachers were trained. During the probation, we first talked about the characteristics of disease diagnosis and treatment, and then the five subgroups collected the history of the disease according to the SP of different diseases mentioned above, and checked the corresponding lesions on the breast visual palpation simulation system. In the physical examination, SP responded to the students' questions. The control group also talked about the above-mentioned five diseases during the probation, and then the five subgroups carried out history collection and physical examination for specific patients in the hospital. Finally, the teaching effects were analyzed through medical record writing, theoretical examination, physical examination and student evaluation. SPSS 26.0 was used for chi-square test (or Fisher exact test) and Mann-Whitney U test. Results:There was no significant difference in the theoretical examination between the two groups. It was demonstrated that the correct rate of experimental group was significantly higher than that of the control group in medical history collection, especially in the main symptoms, incentives, aggravation and remission factors, accompanying and differential symptoms and so on. And the positive results of breast, nipple and axillary lymph node palpation in the experimental group were significantly higher than those in the control group through the physical examination operation of breast visual palpation simulation system. The analysis of students' evaluation showed that the teaching efficiency of the experimental group increased, and the students' satisfaction was improved (satisfaction rate: 92.73% vs. 76.36%).Conclusion:The application of SP and breast visual palpation simulation system in breast surgery probation teaching can not only protect the privacy of clinical patients, but also improve the teaching effects, which can be popularized in the clinical teaching of breast surgery.
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Juvenile idiopathic arthritis (JIA) is a genetically heterogeneous group of connective tissue diseases that are commonly characterized by chronic joint synovial inflammation with unknown etiology in childhood.It is cu-rrently incurable and the main therapeutic goal is to achieve clinical remission.The drugs currently used to treat JIA mainly include non-steroid anti-inflammatory drugs, glucocorticoid, disease modifying antirheumatic drugs, and biological agents.In this article, recent advances in the understanding of JIA treatment and related clinical research were reviewed, in an attempt to provide prospects for the future direction of drug development and treatment concepts.
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Objective:To investigate the effect of V-Y advancement flap in the treatment of foot spoke injury in children.Methods:Clinical data of 8 patients, including 6 males and 2 females aged 2.5-5.0 (mean, 3.5) years old with foot spoke injury admitted to the Third Ward of Department of Orthopaedic Surgery, Xingtai General Hospital of North China Medical and Health Group from June 2019 to October 2021, were analysed retrospectively. Soft tissue defect around achilles tendon was 2.0 cm×3.0 cm-2.5 cm×4.0 cm. The size of the flap was 2.5 cm×3.5 cm-3.0 cm×4.5 cm. All patients underwent emergency debridement followed by V-Y advancement flap repair, and direct suture of the skin and tissues at donor site. The blood supply, survival and healing of flap of donor site were observed after operation. The shape of the heel and the functional recovery of the affected limb were examined on regular basis at the outpatient clinic.Results:All 8 flaps survived and the wounds had primary healing. The patients entered the follow-up for 6-12 months, with an average of 8 months. The texture and colour of the flap recipient site were good. The shape of the flap pedicle, the donor site and recipient site were satisfactory. The shoes wearing of the affected foot were not affected after surgery. The ankle function was good. The average extension was 25.8°(20°-30°), plantar flexion 32.5°(25°-40°), and the foot sensation and motion were close to normal. The average foot function score on American Association on Foot and Ankle Surgery(AOFAS) was 91.7±6.4. Five cases were excellent and 3 were good.Conclusion:The V-Y advancement flap demonstrates an ideal alternative method for treatment of small area of soft tissue defect around Achilles tendon, due to the simple operation, satisfactory shape of flap after repair, and favorable limb function.
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@#Abstract: Objective ， To explore the effects of lead exposure on copper level copper transporter protein expression and Methods oxidative stress in mouse cerebral cortex. The specific pathogen free adult male C57BL/6 mice were randomly ， - - - divided into control group low lead exposure group and high lead exposure group with 10 mice in each group. The mice in low - ， and high lead exposure groups were respectively given 250 and 500 mg/L lead acetate in drinking water every day and the mice - ， in the control group were given double distilled water for 12 weeks. Twenty four hours after exposure Morris water maze and ， elevated cross maze were used to test the neurobehavioral function of mice. The cerebral cortex of mice was isolated and the levels of lead and copper were detected by inductively coupled plasma mass spectrometry. The activities of glutathione （ - ）， （ ） （ ） peroxidase GSH Px catalase CAT and malondialdehyde MDA were detected by histochemical method. The relative （ ） ， ， expression levels of copper transporter such as synthesis of cytochrome C oxidase SCO 1 SCO 2 and cytochrome C oxidase （ ） Results - - assembly protein 11 COX11 were detected by western blot. The escape latencies of mice in the low and high lead （ P ）， ， - exposure groups were prolonged all <0.05 while the number of crossing the platform the percentage of open arm entry - （ P ） times and the percentage of open arm retention time decreased all <0.05 compared with the control group. Mice in both the - - （ P ）， - low and high lead exposure groups increased levels of lead and copper in the cerebral cortex all <0.05 decreased GSH Px （ P ）， （ P ） and CAT activity all <0.05 and increased SCO1 relative expression all <0.05 compared with the control group. Mice in - （P ）， - the high lead exposure group showed prolonged escape latency <0.05 reduced GSH Px and CAT activities in the cerebral （ P ）， （ P ） - cortex all <0.05 increased MDA level and relative expression of SCO1 and SCO2 all <0.05 compared to mice in the low Conclusion - lead exposure group. Lead exposure increased the expression of copper and copper transport related proteins in mouse cerebral cortex and induced oxidative stress leading to central nervous system damage resulting in neurobehavioral abnormalities in mice.
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Objective To investigate the changes of nutrients in colostrum， transitional milk， mature milk and late milk after storage at indoor temperature for 3 h， at 4 ℃ for 24 h， at -18 ℃ for 30 d， and at -18 ℃ for 90 d， so as to select the most suitable storage method of milk. Methods Fifteen pregnant women registered in the Shanghai Hongkou Liangcheng Village Street Community Health Service Center， who were expected to give birth from January to June in 2019， were selected. The breast milk of each woman was followed from delivery to 10 months after breast-feeding. Colostrum， transitional milk， mature milk and late milk were sampled， and each sample was divided into 5 parts. Changes in protein， fat， lactose， minerals， carbohydrates， vitamins and bacterial colony number of breast milk were detected according to 0 h（16-18 ℃）， 3 h （16-18 ℃）， 24 h （4 ℃） to 37 ℃， 30 d （-18 ℃） to 37 ℃ after thawing at 40 ℃ and 90 d （-18 ℃） to 37 ℃ after thawing at 40 ℃. Results The results showed that the nutritional components of milk in different stages decreased with time. However， there was no significant difference in the decline of nutritional components in different stages of milk after the same duration of time （ P >0.05）. Conclusion The milk at each stage can be stored， and the lactating mother can store the excess milk at any stage as she wishes.
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Objective To investigate the changes of nutrients in colostrum， transitional milk， mature milk and late milk after storage at indoor temperature for 3 h， at 4 ℃ for 24 h， at -18 ℃ for 30 d， and at -18 ℃ for 90 d， so as to select the most suitable storage method of milk. Methods Fifteen pregnant women registered in the Shanghai Hongkou Liangcheng Village Street Community Health Service Center， who were expected to give birth from January to June in 2019， were selected. The breast milk of each woman was followed from delivery to 10 months after breast-feeding. Colostrum， transitional milk， mature milk and late milk were sampled， and each sample was divided into 5 parts. Changes in protein， fat， lactose， minerals， carbohydrates， vitamins and bacterial colony number of breast milk were detected according to 0 h（16-18 ℃）， 3 h （16-18 ℃）， 24 h （4 ℃） to 37 ℃， 30 d （-18 ℃） to 37 ℃ after thawing at 40 ℃ and 90 d （-18 ℃） to 37 ℃ after thawing at 40 ℃. Results The results showed that the nutritional components of milk in different stages decreased with time. However， there was no significant difference in the decline of nutritional components in different stages of milk after the same duration of time （ P >0.05）. Conclusion The milk at each stage can be stored， and the lactating mother can store the excess milk at any stage as she wishes.
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Objective:To explore the dosimetry difference between volumetric modulated arc therapy (VMAT) and tomo direct (TD) in tumor bed simultaneous push radiotherapy after left breast-conserving surgery, and to provide more dosimetry reference for clinic.Methods:A total of 22 patients with left breast cancer who underwent simultaneous quantitative radiotherapy after breast-conserving surgery were selected from the Department of Radiation Oncology, Yunnan Cancer Hospital from December 2018 to June 2020. The localized CT images and target organs at risk and other structural data were collected. Two radiotherapy plans, VMAT and TD, were designed for the same patient, and the dosimetry differences of target areas and organs at risk were compared and analyzed between the two groups.Results:In terms of target dosimetry, there were statistically significant differences in the D 2% [ (59.99±0.19) Gy vs. (59.55±0.51) Gy, t=4.09, P<0.001], D 98% [ (57.19±0.08) Gy vs. (57.46±0.22) Gy, t=-5.10, P<0.001], conformal index (CI) (0.76±0.05 vs. 0.58±0.13, t=8.19, P<0.001) and homogeneity index (HI) (0.05±0.00 vs. 0.04±0.01, t=4.89, P<0.001) of the planning gross tumor volume (PGTV) between VMAT and TD plans. However, there was no statistically significant difference in the D 50% [ (58.73±0.10) Gy vs. (58.73±0.24) Gy, t=-0.03, P=0.974]. There were statistically significant differences in the D 50% [ (52.21±0.33) Gy vs. (53.00±0.72) Gy, t=-4.81, P<0.001], D 98% [ (48.44±0.43) Gy vs. (49.09±0.21) Gy, t=-6.80, P<0.001], CI (0.83±0.06 vs. 0.67±0.06, t=10.52, P<0.001) and HI (0.20±0.01 vs. 0.19±0.01, t=8.75, P<0.001) of the planned target volume (PTV) between the two plans. However, there was no statistically significant difference in the D 2% [ (59.01±0.45) Gy vs. (59.00±0.48) Gy, t=0.22, P=0.830]. In terms of organs at risk, there were statistically significant differences in the V 20 [ (18.81±2.86) % vs. (22.03±1.91) %, t=-5.36, P<0.001] and D mean [ (11.66±1.32) Gy vs. (12.85±1.46) Gy, t=-4.10, P=0.007] of left lung, V 5 [ (5.70±2.90) % vs. (0.30±0.13) %, t=16.44, P<0.001] and D mean [ (2.45±0.29) Gy vs. (0.43±0.14) Gy, t=9.09, P<0.001] of right lung, D mean [ (3.22±0.72) Gy vs. (1.69±0.80) Gy, t=5.41, P<0.001] of right breast, D 2% [ (5.37±1.97) Gy vs. (0.46±0.09) Gy, t=11.75, P<0.001] of cord between VMAT and TD plans. There were no significant differences in the V 5 of left lung [ (53.00±5.99) % vs. (50.00±7.69) %, t=1.91, P=0.061], V 5 of right breast [ (11.51±4.60) % vs. (8.06±3.49) %, t=1.59, P=0.120], V 30 [ (1.49±0.69) % vs. (1.51±0.71) %, t=-0.06, P=0.952] and D mean [ (3.99±0.97) Gy vs. (3.90±1.03) Gy, t=0.56, P=0.581] of heart between the two plans. Conclusion:TD and VMAT can meet the clinical dosimetry requirements for patients with left breast cancer after breast-conserving surgery. However, the two techniques have their own characteristics. VMAT has better conformity and TD has better uniformity. TD is significantly better than VMAT in protecting the right lung, right breast and spinal cord of healthy organs at risk. VMAT is better in protecting the left lung. Both VMAT and TD basically achieve the same protection for heart.
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We report the intrauterine treatment of a case of fetal persistent supraventricular tachycardia complicated by heart failure. The ultrasound findings at 32 +1 weeks of gestation showed fetal tachycardia of 242 beats/min, fetal generalized edema, ascites, and visible pulsation spectrum in the intra-abdominal segment of the umbilical vein. Fetal cardiac arrhythmia persisted after maternal oral digoxin for 46 hours. In view of the continuous deterioration of the fetal condition with the persistent umbilical vein pulsation spectrum and worsening edema, fetal intramuscular injection of cedilanid under ultrasound guidance was performed, resulting in successful cardioversion. The pregnant woman gave birth to a baby girl by cesarean section due to premature rupture of membranes and oligohydramnios at 34 +6 weeks of gestation, with normal functions of heart and other organs. During a follow-up to 8 months, no obvious abnormalities were found.
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Objective:To explore the effects of different approaches for second-trimester multifetal pregnancy reduction on pregnancy outcome in women with dichorionic triamniotic (DCTA) triplet.Methods:A retrospective study was performed on 51 women with DCTA triplet pregnancies who were referred to Guangdong Women and Children Hospital for second-trimester multifetal pregnancy reduction from January 2014 to January 2020. All participants were divided into either preventive group ( n=39) or treatment group ( n=12) according to the indication for multifetal pregnancy reduction, and they were further allocated to three subgroups based on different reduction methods, which were reduction to dichorionic twin by radiofrequency ablation (RFA) (RFA subgroup), reduction to monochorionic singleton (KCl-singleton subgroup) or monochorionic twin (KCl-twin subgroup) by cardiac injection of potassium chloride. Pregnancy loss rate, neonatal birth weight, gestational age at delivery, incidence of intrauterine death, and neonatal death were compared and analyzed between different groups using t-test, analysis of variance, Chi-square test, Fisher's exact test and Bonferroni correction. Results:(1) The mean gestational week at operation in the treatment group was significantly later than that in the preventive group [(18.5±3.1) vs (15.0±2.3) weeks, t=-4.209, P<0.001]. In the preventive group, the mean gestational week at operation in the RFA subgroup was later than the KCl-singleton and KCl-twin subgroup[(17.2±1.6) vs (13.8±1.5) and (12.7±1.0) weeks, t=6.630 and 3.875, respectively, both P<0.05]. (2) The postoperative pregnancy loss rate in the preventive group was decreased compared with the treatment group [10.3%(4/39) vs 5/12, Fisher's exact test, P<0.05], and the live birth ratio was increased [ 85.7%(48/56) vs 10/18, χ2=5.640, P=0.018]. No live birth infants with birth weight <1 500 g was reported in the KCl-singleton subgroup in preventive group, and the statistical significance was observed in the intra-group differences ( P<0.05) rather than the pairwise comparison differences in the preventive group. For the proportion of live births, there was a statistically significant difference in the intra-group comparison in the treatment group, which was higher in the RFA subgroup than that in the KCl-twin subgroup (6/6 vs 1/6, P=0.045). No significant difference was revealed among pregnancy loss rate, gestational weeks at delivery, the mean birth weight, premature delivery <32 gestational weeks, and full-term birth rate among three different approaches within the two groups. (3) No monochorionic twin complications or perinatal death occurred in any RFA or KCl-singleton subgroups in the two groups. In the KCl-twin subgroups including five cases with ten fetuses, including three live birth, four miscarriage, three intrauterine death occured, while no neonatal death was reported. One case with selective fetal uterine growth restriction in the preventive group delivered two live births, and one case with twin-to-twin transfusion syndrome in the treatment group had intrauterine death in one fetus and one survival neonate. Conclusions:The pregnancy outcome of multifetal pregnancy reduction to dichorionic diamniotic twins by RFA or reduction to singleton by cardiac injection of potassium chloride are comparative in women with DCTA triplet, regardless of whether it is a preventive or therapeutic reduction.
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Objective:To evaluate the relationship between the mechanism of promoting wound healing by modified autologous blood transfusion and metastasis-associated lung adenocarcinoma transcript 1 ( MALAT1) in diabetic mice. Methods:Twenty SPF ICR mice, weighing 21-25 g, in which the diabetic model was successfully established, were divided into 2 groups ( n=10 each) using a random number table method: modified preservation group (group I) and ordinary preservation group (group O). Peripheral venous blood samples were collected and stored in the corresponding preservation solution for 7 days.The platelet aggregation rate, blood glucose, serum glycosylated hemoglobin (GHB) and phosphodiesterase (DPG) concentrations and WBC were measured.Autologous blood was transfused back immediately after the wound model was established.The percentage of wound healing area was calculated at 7, 10 and 14 days after autologous blood transfusion.The expression of hypoxia-inducible factor-1α, vascular endothelial growth factor, matrix metalloproteinase-9, β-actin, type Ⅰ collagen (Col Ⅰ), Col Ⅲ protein and mRNA and MALAT1 was determined by Western blot, immunohistochemistry and quantitative real-time polymerase chain reaction respectively, at 14 days after transfusion. Results:Compared with group O, the blood glucose, serum concentrations of GHB and DPG, and WBC were significantly decreased, platelet aggregation rate was increased, the percentage of wound healing area was increased, the positive staining rate of Col Ⅰ and Col Ⅲ was increased, and the expression of hypoxia-inducible factor-1α, vascular endothelial growth factor, matrix metalloproteinase-9, ColⅠ, Col Ⅲ and β-actin protein and mRNA and MALAT1 was up-regulated in group I ( P<0.05). Conclusion:The mechanism by which modified autologous blood transfusion promotes wound healing may be related to up-regulating MALAT1 expression in diabetic mice.
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Objective:To explore the effect of situational simulation interactive training on rehabilitation compliance and motor function of stroke patients with hemiplegia.Methods:A total of 140 hemiplegic patients with stroke from July 2017 to October 2019 in Beijing Rehabilitation Hospital Affiliated to Capital Medical University were selected and divided into control group and observation group, 70 cases in each group. Routine treatment and rehabilitation nursing were used in the control group, and situational simulation interactive training were used in the observation group on the basis of the control group. Both groups were followed up for 6 months. Fugl-Meyer Assessment (FMA), World Health Organization Quality of Life Scale Brief (WHOQOL-BREF), Fugl-Meyer Assessment (FMA), self-made rehabilitation training compliance questionnaire and self-made nursing satisfaction questionnaire were used to evaluate the quality of life, motor ability, cognitive ability before intervention and after follow-up, rehabilitation compliance and nursing satisfaction after follow-up of the two groups.Results:There was no significant difference in FMA, WHOQOL-BREF and MMSE scores between the two groups before intervention ( P>0.05). After follow-up, the scores of FMA, WHOQOL-BREF and MMSE in the observation group were 62.57±6.52, 80.65±9.25, 25.30±3.24, significantly higher than 52.68±7.23, 66.68±8.34, 20.36±3.12 in the control group, the difference was statistically significant ( t value was 8.499, 9.385,9.189, P<0.05). After follow-up, the total compliance rate and satisfaction rate of the observation group were 92.86% (65/70) and 94.29% (66/70), respectively, while those of the control group were 78.57% (55/70) and 80.00% (56/70), respectively, the difference between the two groups was statistically significant (Fisher's exact test, P<0.05). Conclusions:The situation simulation rehabilitation training can effectively improve the motor function, rehabilitation compliance and nursing satisfaction of stroke patients with hemiplegia.
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Objective:To explore the effect of sports training guidance based on Internet platform on the limb function and quality of life in home rehabilitation of stroke hemiplegic patients.Methods:Eighty patients with stroke and hemiplegia admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University from June 2018 to December 2019 were selected and divided into observation group and control group with 40 cases in each group by random digits table method. The control group was given routine rehabilitation training. In addition to the regular rehabilitation training, the observation group was supplemented with home rehabilitation based on the WeChat platform for modified constraint-induced movement therapy. The limb motor function Fugl-Meyer Assessment (FMA) score, Upper Extremity Function Test (UEFT) score, Stroke-Specific Quality of Life scale (SS-QOL) score before and after intervention, and patients′ satisfaction and cares′ satisfaction score were compared between the two groups.Results:There was no significant difference in the score of FMA, UEFT, SS-QOL before intervention between the two groups( P>0.05). After discharge, the FMA score, UEFT score and physical function, physiological function, mental health, social function of SS-QOL score were (68.87±6.64),(72.38±7.33), (35.28±4.13), (36.55±4.23), (37.22±3.84), (38.23±3.44) points in the observation group and (55.25±6.20), (61.24±6.47), (28.72±4.56), (30.85±5.30), (31.28±4.63), (31.02±5.16) points in the control group, and the differences were statistically significant between the two groups( t values were 5.316-9.482, P<0.01). During the nursing period, the patients′ satisfaction and cares′ satisfaction score were 92.50%(37/40), 87.50%(35/40) in the observation group and 72.50%(29/40), 67.50%(27/40) in the control group, and the differences were statistically significant between the two groups( χ 2 values were 5.541, 4.588, P<0.05). Conclusions:The home rehabilitation based on the Internet platform for modified constraint-induced movement therapy helps to promote the recovery of limb motor function in stroke hemiplegic patients, improve the nursing satisfaction of patients and their families, and has a positive effect on improving the quality of life of patients.
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Symptoms and prognosis of infants with congenital diaphragmatic hernia (CDH) are various, as all mild cases might survive while those severe ones have higher mortality. Therefore, an applicable tool that can screen out high-risk CDH children may help clinicians develop an individualized treatment plan and increase the survival rate. A growing number of international studies for CDH postnatal prediction tools, including single factor index and five score models, have been conducted in recent years, whereas few in China. We hereby summarized the advances in postnatal evaluation tools to predict the outcomes of CDH.
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OBJECTIVE@#To study the effect of functional chewing training (FuCT) on masticatory function, the severity of tongue thrust, and the severity and frequency of drooling in children with cerebral palsy.@*METHODS@#A prospective study was performed for 48 children who were diagnosed with oral motor dysfunction from January 2019 to January 2020, and they were randomly divided into an FuCT group and an oral motor training group, with 24 children in each group. Both groups received FuCT or oral motor training for 12 weeks, and then they were evaluated in terms of the changes in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling.@*RESULTS@#There were no significant differences between the two groups in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling before treatment (P>0.05). After the 12-week training, the FuCT group showed significant improvements in the masticatory function and the severity of tongue thrust and drooling (P0.05), while the oral motor training group had no improvements in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling (P>0.05). After the 12-week training, the FuCT group had more significantly improvements in the severity of tongue thrust and the severity and frequency of drooling than the oral motor training group (P<0.05).@*CONCLUSIONS@#FuCT can effectively improve the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling in children with cerebral palsy.
Subject(s)
Child , Humans , Cerebral Palsy , Mastication , Prospective Studies , SialorrheaABSTRACT
Symptoms and prognosis of infants with congenital diaphragmatic hernia (CDH) are various,as all mild cases might survive while those severe ones have higher mortality.Therefore,an applicable tool that can screen out high-risk CDH children may help clinicians develop an individualized treatment plan and increase the survival rate.A growing number of international studies for CDH postnatal prediction tools,including single factor index and five score models,have been conducted in recent years,whereas few in China.We hereby summarized the advances in postnatal evaluation tools to predict the outcomes of CDH.
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Objective:To evaluate the effect of stored autologous blood transfusion on the function of bone marrow hematopoietic stem cells and the recovery of reticulocytes in peripheral blood of rabbits.Methods:Thirty healthy male New Zealand rabbits, aged 3-6 months, weighing 2.5-3.0 kg, were divided into 5 groups ( n=6 each) using a random number table method: control group (C group), operation group (O group), blood collection group (O+ B group), stored autologous whole blood group (O+ WB group) and stored autologous component blood group (O+ CB group). In O+ B group, O+ WB group and O+ CB group, blood was collected via the right femoral artery at a rate of 3-5 ml/min at 7 days before surgery, the blood volume was 10% of the total blood volume, and blood was stored at 4-6 ℃.In O+ CB group, blood was centrifuged to remove plasma and white blood cells, and red blood cell suspension was prepared and placed in a blood storage bag.In O, O+ B, O+ WB and O+ CB groups, hepatectomy was performed, and bleeding was performed through the right femoral artery at a rate of 3-5 ml/min, and the blood volume was 10% of the total blood volume.Lactated Ringer′s solution 1 ml/min was intravenously infused during surgery in O and O+ B groups, stored autologous whole blood was intravenously infused during surgery in group O+ WB, and stored autologous red blood cell suspension 1 ml/min was intravenously infused during surgery in group O+ CB.Bone marrow blood samples were collected immediately before the start of surgery (T 2) and at 6 and 24 h after surgery (T 3, 4) to determine the percentage of CD34 + cells, cell cycle and relative expression of telomere DNA.Peripheral venous blood samples were collected before storage (T 1) and at T 4 for determination of the percentage of reticulocytes. Results:Compared with group C, the percentage of CD34 + cells was significantly increased at T 3 and T 4, the percentage of CD34 + cells in G1 phase was decreased, and the expression of telomere DNA in CD34 + cells was up-regulated in group O, and the percentage of reticulocyte in peripheral blood was increased at T 4 in the remaining 4 groups ( P<0.05). Compared with group O, the percentage of CD34 + cells was significantly increased at T 2-4, the percentage of CD34 + cells in G1 phase was decreased, and the expression of telomere DNA in CD34 + cells was up-regulated in O+ B, O+ WB and O+ CB groups, and the percentage of reticulocyte in peripheral blood was increased at T 4 in O+ WB and O+ CB groups ( P<0.05). Compared with group O+ B, the percentage of CD34 + cells was significantly increased at T 3 and T 4, the percentage of CD34 + cells in G1 phase was decreased, and the expression of telomere DNA in CD34 + cells was up-regulated in O+ WB and O+ CB groups, and the percentage of reticulocyte in peripheral blood was decreased at T 4 in O+ WB and O+ CB groups ( P<0.05). Compared with O+ WB group, the percentage of CD34 + cells was significantly decreased at T 3 and T 4, the percentage of CD34 + cells in G 1 phase was increased, the expression of telomere DNA in CD34 + cells was down-regulated, and the percentage of reticulocytes in peripheral blood was increased at T 4 in group O+ CB ( P<0.05). Conclusion:Stored autologous blood transfusion can inhibit the function of bone marrow hematopoietic stem cells and is not helpful for recovery of reticulocytes in peripheral blood of rabbits; stored autologous component blood transfusion has less effect on the hematopoietic function of bone marrow than stored autologous whole blood transfusion.
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OBJECTIVE@#To explore the correlation between fetal nuchal fold (NF) thickening and fetal chromosomal abnormality.@*METHODS@#In total 919 pregnant women undergoing ultrasound examination were selected for interventional prenatal diagnosis in order to detect fetal chromosomal abnormality.@*RESULTS@#The detection rate of chromosomal abnormality has significantly increased with NF thickness, advanced maternal age, presence of other ultrasound abnormalities (P<0.05). Trisomy 21 was the most common abnormality, and there was a prepondance for male fetuses.@*CONCLUSION@#Increased NF thickness is strongly associated with the risk of fetal chromosomal abnormalities, advanced maternal age and presence of additional ultrasound abnormalities.