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Objective:To investigate the relationship between C3, C4, Th1/Th2 levels and the Myasthenia Gravis Daily Living Scale (MG-ADL) score in patients with myasthenia gravis (MG) and its efficacy in predicting the transition of ocular muscle type to systemic type.Methods:A retrospective study of 94 patients with ophthalmic MG admitted to Haikou People's Hospital from April 2017 to April 2020 was conducted. According to whether they had converted to systemic MG within 6 months, they were divided into transformation group ( n=35) and non-transformation group ( n=59). The levels of C3, C4 and Th1/Th2, as well as the score of MG-ADL and Quantitative Myasthenia Gravis (QMG) were compared between the two groups before and 1 and 3 months after treatment. The correlation between C3, C4 and Th1/Th2 levels and MG-ADL and OMG scores, as well as the related influencing factors of the transformation from ocular muscle type to systemic type was analyzed. The efficiency of each index in predicting the transformation from ocular muscle type to systemic type was analyzed. Results:At 1 and 3 months after treatment, the C3 and C4 in both groups were significantly higher than before treatment, and Th1/Th2 was significantly lower than before treatment; the C3 and C4 in the non-transformation group were higher than that in the transformation group, while Th1/Th2 was lower than that in the transformation group (all P<0.05). The MG-ADL and QMG scores in 2 groups at 1 and 3 months after treatment were significantly lower than those before treatment, and those in the non-transformation group were lower than those in the transformation group (all P<0.05). C3 and C4 levels were negatively correlated with MG-ADL and QMG scores (all P<0.05), while Th1/Th2 levels were positively correlated with MG-ADL and QMG scores (all P<0.05). At 1 and 3 months after treatment, C3, C4 and Th1/Th2 were the influencing factors for the transformation from ocular muscle type to systemic type (all P<0.05). The area under the curve (AUC) of C3, C4 and Th1/Th2 combined to predict the transformation from ocular muscle type to systemic type at 3 months after treatment was 0.939, and the best predictive sensitivity and specificity were 91.43% and 88.14%, respectively. Conclusions:There is a good linear relationship between C3, C4, Th1/Th2 levels and MG-ADL scores in MG patients, and it has a high efficiency in predicting the transition of ocular muscle type to systemic type.
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Objective To investigate the incidence and influencing factors of geriatric syndrome (GS) in Beijing area, and to analyze the relationship between GS and Barthel Index (Barthel ADL) score and quality of life. Methods From June 2018 to December 2018, a community-based or door-to-door survey of elderly people >65 years old in some communities in Beijing was conducted. The incidence of GS and its gender distribution, age distribution, and type distribution were investigated. At the same time, GS patients were selected as the observation group, and among people without GS in physical examination, a random sampling method was used to select the control group. The general data, Barthel ADL score, and World Health Organization Quality of Life (WHOQOL-BREF) score were compared between the two groups. The relevant influencing factors of GS and its correlation with the Barthel ADL score and WHOQOL-BREF scores were analyzed. Results Among 500 elderly people in the community investigated in the present study, 97.00% of patients had ≥1 types of GS, 84.80% of patients had ≥2 types, and 70.20% of patients had ≥3 types of GS. High education level (OR=0.329, 95%CI: 0.259-0.418) and retirement pension (OR=0.727, 95%CI: 0.576-0.918) were the protective factors for the occurrence of GS. Hyperlipidemia (OR=3.176, 95%CI: 2.518-4.007), diabetes (OR=2.473, 95%CI: 1.718-3.559), coronary heart disease (OR=2.658, 95%CI:1.649-4.286), hypertension (OR=3.230, 95%CI:2.008-5.197), osteoarthropathy (OR=4.166, 95%CI: 3.008-5.769), cancer (OR=3.008, 95%CI: 1.894-4.778), acute cerebral infarction (OR=3.420, 95%CI: 2.335-5.009), and acute myocardial infarction (OR=2.112, 95%CI: 1.169-3.814) were the risk factors for GS (P<0.05). The Barthel ADL score and WHOQOL-BREF score of the observation group were lower than those of the control group (P<0.05). GS was negatively correlated with Barthel ADL and WHOQOL-BREF scores (P<0.05). Conclusion GS was common in the elderly in Beijing, and its occurrence was related to factors such as education level, retirement pension, hyperlipidemia, diabetes, coronary heart disease, hypertension, osteoarthropathy, cancer, acute cerebral infarction, and acute myocardial infarction. Strengthening the early assessment and management of GS will help improve the daily life and quality of life of the elderly.
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Objective To examine the independent effect of depression on activities of daily living of patients with mild cognitive impairment (MCI). Methods Data were obtained through the face-to-face interview. Totally 154 elderly patients that were screened from 552 old people by the Montreal Cognitive Assessment (MoCA) were diagnosed as MCI. They were investigated with the Geriatric Depression Scale, and instrumental ability of daily living (IADL) were measured by the Functional Activities Questionnaire. The effect of depression on IADL of patients with MCI was analyzed by logistic regression analysis. Results The prevalence of depressive symptoms among Chinese elders with MCI was 31.82％. The scores of Medical Outcomes Study Social Support Survey, and Functional Activity Questionnaire of depression group and non-depression group were significantly different (P<0.05) . Logistic regression analysis showed that scores of Functional Activity Questionnaire was positively associated with the scores of Memory Inventory for the Chinese (OR=1.36, 95％ CI: 1.15-1.61) and depression (OR=6.19, 95％ CI:2.07-18.55) . Conclusion The prevalence of depression in elderly patients with MCI was high. Depression would significantly reduce the IADL of the old patients with MCI. Medical workers should be aware of the extent and impact of depressive symptoms in MCI and take active measures in evaluating and treating the depressive symptoms.
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Objective To explore the effect of dressing techniques under Orem self-care theory on the ability of daily living of stroke patients with hemiplegia. Methods About 96 stroke patients with hemiplegia were randomly divided into an experimental group and a control group, 48 cases in each group. The patients in the experimental group received training on dressing techniques under Orem self-care theory, while those in the control group received routine training on dressing techniques.The daily life ability of both groups was comfared. Result After one month, the Barthel scores in the experimental group were higher than those of the control group (P<0.05). Conclusion Dressing techniques under Orem self-care theory can improve the ability of daily living of stroke patients with hemiplegia.
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Objective To explore the rehabilitation outcome and influencing factors of functional recovery in patients with nontraumatic spinal cord injury (NTSCI). Methods A retrospective analysis was done on 49 cases suffering from NTSCI who recepted rehabilitation therapy from December 2014 to November 2016. The main indicator of the rehabilitation effect was Modified Barthel Index (MBI). A total of 49 cases were divided into two groups, effective group (31 cases) and ineffective group (18 cases) according to whether their MBI on discharge had beated the target setted on admission. The following factors:ages, gender, injury causes, injury level, injury grade, injury severity, the types of paralysis, hospitalization time, sick time, complications number, MBI on admission and discharge, operation, early rehabilitation were evaluated by Univarite analysis and Logistic stepwise regression to assess how they influenced rehabilitation outcome. Results After systematically rehabilitation training, MBI had apparent improvement, from (38.98 ± 24.90) score on admission to (56.35 ± 22.69) score on discharge and had statistical significance(Z=-4.95, P=0.00), which showed that rehabilitation training can effectively improve patients′ self-care ability of daily living. Regression analysis found that the MBI on admission (OR=1.044, P=0.010) and hospitalization time(OR=1.044, P=0.039) had a noticeable effect on the rehabilitation outcome, while all the other factors, such as age, sex, injury grade, injury level, injury severity, complications number hadn′t show concrete effect on rehabilitation outcome. Conclusions Patients with NTSCI should have early rehabilitation, medical staff should assess their admission MBI, make a strict rehabilitation training plan to improve rehabilitation efficiency, shorten hospitalization time, improve the patients quality of life.
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Objective To study the effect of group rehabilitation therapy on upper limb and hand function in hemiplegic patients after stroke.Methods Sixty-four stroke survivors with hemiplegia were randomly divided into a group rehabilitation group (GG) (32 cases) and a control group (CG) (32 cases).All patients in both groups were given basic medication and conventional rehabilitation treatment.In addition,the patients in CG were given routine upper limb function training,while the patients in GG were provided with the group rehabilitation therapy.Before and after eight weeks of training,the upper limb function and hand function of both groups were measured using the up-per-extremity portion of the Fugl-Meyer Motor Assessment (FMA-UE) and upper extremities functional test (UEFT).Abilities of daily living were measured using the modified Barthel index (MBI).Anxiety and depression were evaluated using the self-rating anxiety scale (SAS) and self-rating depression scale (SDS).Results Before intervention there was no significant difference between the two groups in any of the assessments (P ＞ 0.05).At the end of training,all measurements in both groups were significantly better than those before training (P ＜ 0.05),and the UEFT,MBI,SAS and SDS scores were significantly better in GG than in the CG (P ＜ 0.05).Conclusion The group rehabilitation therapy,in addition to routine training,can improve the upper extremity function,hand function and abilities of daily living,and alleviate anxiety and depression in patients with post-stroke hemiplegia.
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Objective To study the effect of trans-theoretical model of behavior on ambulation training in stroke hemiplegic patients. Methods Sixty hospitalized stroke hemiplegic patients from June to December 2013 were selected as control group. The control group was treated with routine nursing and ambulation training guidance. Sixty-two hospitalized stroke hemiplegia patients, from January 2014 to June 2014, were selected as intervention group. Patients in the intervention group received trans-theoretical model of behavior together with ambulation training guidance for 3 weeks and follow-up record for 6 months. Holden functional ambulation categories ( FAC ) and Bathel index were used to evaluate the effect of ambulation training . Result Trans-theoretical model of behavior training improved the walking function and activities of daily living in intervention group patients , compared with those of the control group. Conclusions Taking trans-theoretical model of behavior in walking training health education can improve the ambulation ability and ability of daily living of stroke hemiplegic patients. Therefore this theory can enhance the stroke hemiplegic patients′life quality.
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@#Objective To determine the clinical characteristics of comorbid anxiety and depression after cerebral infarction. Methods All the patients enrolled were divided into post-stroke comorbid anxiety and depression (PSCAD) group (84 cases) and the control group (121 cases). Their condition of smoke, alcohol intake, education background, carotid plaque and brain blood vessels were investigated, and they were evaluated with Hamilton Anxiety Scale (HAMA), Hamilton Depressive Scale (HAMD), Barthel index, and Mini-Mental State Examination (MMSE). Results There was not significant difference in condition of smoke, alcohol intake, education background, carotid plaque and brain blood vessels between these groups （P＞0.05）, but were in total scores and all the factors scores of HAMA and HAMD （P＜0.05）. PSCAD group showed more obvious anxious mood, depressive mood, tension, insomnia, cognitive impairment and autonomic nervous symptoms. Psycho-anxiety, soma-anxiety, despair, guiltiness, decreased interest were also more significant in the PSCAD group. The scores of MMSE and Barthel index were also impaired. Conclusion The cognitive function and daily living ability are worse in the patients with PSCAD. The prominent symptoms includes: anxious mood, depressive mood, tension, insomnia, cognitive impairment, autonomic nervous symptoms, soma-anxiety, despair, guiltiness, decreased interest.
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Objective To probe into the influence of active nursing intervention on the ability of daily living of patients with senile dementia. Methods Nursing of daily living, training for self-care and cognitive capacity, safety management and psychological nursing were carried out in a total of 33 patients who suffered from senile dementia. 6 months later, the effect of nursing intervention was appraised. Re-sults The ability of daily living of 33 patients with senile dementia had obvious improvement after nursing intervention compared with that before nursing intervention. Conclusions Active nursing intervention can largely facilitate the ability of daily living of patients with senile dementia.
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@#ObjectiveTo explore the relationship between depression in stroke patients with cognitive impairment and possible factors. Methods236 cognitive impaired patients whose score of Scale of Elderly Cognitive Function (SECF) ≤90 were selected in this study from inpatients with stroke from 1997 to 2004. They were evaluated with SECF, the Self-rating Depression Scale (SDS), the Self-rating Anxiety Scale (SAS) and the Ability of Daily Living (ADL) immediately and 2 months after hospitalization.72 patients were in the depression group(SDS≥50),and 164 patients were in the no-depression group(SDS<50). Gradual regression analysis was applied. One factor was taken as dependent variable selected from immediate scores of SECF, ADL, SAS, and the change of scores of SECF, ADL, SAS, SDS, respectively, while others were taken as independent variables. ResultsThe improvement of depression and ADL were helpful to reduce the anxiety and improve cognitive function in depression group (P<0.05), as well as the improvement of anxiety and cognitive function were helpful to improve the depression and ADL (P<0.05).The negative correlation were found between the difference former and latter score of SDS and ADL, as well as between those of SAS and SECF (P<0.05).ConclusionPatients with cognitive impairment can be beneficial from reducing depression and anxiety companied with improving the ADL and cognitive function, which is also mutually beneficial.
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@#ObjectiveTo investigate the relationship between strength of the paretic lower limb and motor function, balance, walking speed, ability of daily living (ADL) in hemiparetic stroke patients.Methods85 stroke subjects, who were able to walk in the study, were evaluated in the strength of the paretic lower limb, motor function, balance, walking speed and ADL with Motricity Index, Fugl-Meyer Assessment, Berg Balance Scale, 10 m walking speed test and Functional Independence Measure (FIM). The levels of association between them were examined with Pearson's correlation coefficients and with multiple linear regression analyses by using the stepwise method. ResultsStrengths of the paretic lower limb were significantly positive related to motor function, balance, walking speed and ADL (r=0.592-0.811,P<0.001). The paretic ankle dorsiflexors, knee extensors, hip flexors were important clinical factor to consider in determining motor function(R2=0.377,P<0.001), balance(R2=0.321,P<0.001)and walking speed(R2=0.173,P<0.001), ADL(R2=0.42,P<0.001). ConclusionStrengths of the paretic lower limb of stroke patients may play an important role in their motor function, balance, walking speed and ADL.