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Objective@#To investigate the current status of uncertainty in illness and caregiving burden in family members of patients with chronic wounds, and to analyze the relationship between them.@*Methods@#A total of 180 patients with chronic wounds admitted to the Department of Emergency of our hospital from October 2017 to March 2018, conforming to the study criteria, were selected by adopting the convenience sampling method. Then one family member who took care of the patients for the longest time and conformed to the study criteria were included in this cross-sectional survey. General Information Questionnaire made by the authors was conducted to investigate the demographic data and wounds of patients, and demographic data of family members. Chinese version of Parent Perception of Uncertainty Scale-Family Member (PPUS-FM) and Caregiver Burden Inventory (CBI) were used to investigate the uncertainty in illness and caregiving burden. Data were processed with multiple linear regression analysis and partial correlation analysis.@*Results@#The effective recovery rate of questionnaire was 91.7% (165/180). (1) The ages of patients were (71±17) years. Among them, there were 89 males and 76 females. The course of chronic wounds was 0.5 to 120.0 months. The wounds were mainly primary occurrence (86.1%, 142 patients), and the main type of wound was pressure ulcer (43.6%, 72 patients). Fifty-seven patients (34.5%) had wound infection. The ages of family members were (56±13) years, and 61.8% (102 people) of them were female. Their daily time of taking care of patients was (10±8) h. (2) The total scores of PPUS-FM of family members were 33 to 125 (88±17) points, mainly in medium level, in which the item score of unpredictability dimension was the highest. (3) The total scores of CBI of family members were 7 to 79 (43±14) points, in which the item score of time-dependence burden dimension was the highest. (4) Uncertainty in PPUS-FM could independently influence 10% of the total variation of caregiving burden in family members of patients (t=3.18, P<0.01). (5) The total scores of PPUS-FM of family members were in significantly positive correlation with the total scores of CBI and scores of physical burden, emotional burden, and social burden, respectively (r=0.33, 0.32, 0.25, 0.36, P<0.05 or P<0.01), while there was no obvious correlation between total scores of PPUS-FM of family members and time-dependence burden/developmental burden (r=0.14, 0.16, P>0.05).@*Conclusion@#There is positive correlation between uncertainty in illness and caregiving burden.
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Objective To identify the factors related to prognosis of diabetic foot ulcer (DFU).Methods A total of 186 patients with type Ⅱ DFU from a single diabetic foot center was included in this prospective study.Follow-up of the final outcome (healing,major amputation or death) was made in 6 months.Influence of patient demographics and clinical data on outcome was detected using multivariate Logistic regression analysis.Results Follow-up was performed in 172 patients,of whom 147 were cured (55 cases cured after minor amputations),3 underwent major amputations,6 died,and 16 were not yet cured at the final follow-up.In multivariate Logistic regression analysis,the outcome was independently correlated with ischemia (P ＜0.01),infection (P ＜ 0.05),ulcer number (P ＜ 0.01) and peripheral neuropathy (P ＜ 0.05) ; the risk of poor outcome increased with ischemia [odds ratio (OR) =10.8],infection (OR =211.4),ulcer number (OR =39.5),and peripheral neuropathy (OR =181.1).Conclusion Prognosis of DFU is associated with ischemia,infection,ulcer number,and peripheral neuropathy.
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Objective To establish a paraspinal neural pathway of quadriceps femoris by end-to-end anastomoses between the spinal ventral root after spinal cord injury(SCI) in rats. Methods Twenty-fourweek old SD rats, with the weight of 120 g to 150 g, were included. The left side was the experimental side, while the right side served as a control. Electrostimulating of L1-L5 ventral root was done respectively to decide the predominant nerve of quadriceps femoris. The lumbar 1 ventral root was reveal to little innervation of quadriceps femoris, and the lumbar 3 ventral root was predominant innervation. End-to-end anastomosis between the left L1 and L3 ventral root was done. After axona regeneration, the new paraspinal neural pathway of quadriceps femoris was established. At 6 months postoperatively, the early function of the new pathway was observed by electrophysiological examinations, hindlimb locomotion and BBB (basso, beattie and bresnahan)scale at 1,3,7, 14,21,28 d after SCI. Results Sixteen rats survived for 6 months after operation and only ten rats got good results because of tissue adhesion postoperatively. Single stimuli (2.5 mA,0.2 ms, 1 Hz) of the left anastomoses nerve resulted in action potential recorded from the left quadriceps femoris before and after the spinal cord hemisection horizontally between L2 segmental levels. The amplitudes of the action potentials were (7.63 ± 1.86) mV and (6.00 ± 1.92)mV, respectively, and there was no significant difference (P ＞ 0.05). The left quadriceps femoris contraction was initiated by single stimuli (2.5mA, 0.2 ms, 1 Hz) of the left anastomoses nerve. After paraplegia, when the right L3 ventral root was stimulated, the amplitude of the action potential was (15.87 ± 1.16) mV. Locomotion of the left hindlimb was partially restored after spinal cord hemisection while creeping and climbing. According to BBB scale, there was significant difference at 1, 3, 7 d, and little difference at 14, 21, 28 d after SCI. Conclusion Spinal ventral roots cross-ananstomosis to reconstruct the paraspinal pathway of quadriceps femoris after SCI is efficient reinnervation of hindlamb muscles in a rat model and may have potential in clinical application.