Analysis of Risk Factors for a Poor Prognosis in Patients with Anti-N-Methyl-D-Aspartate Receptor Encephalitis and Construction of a Prognostic Composite Score

Background@#and Purpose: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most-common form of autoimmune encephalitis, but its early diagnosis is challenging.This study aimed to identify the risk factors for a poor prognosis in anti-NMDAR encephalitis and construct a prognostic composite score for obtaining earlier predictions of a poor prognosis. @*Methods@#We retrospectively analyzed the clinical data, laboratory indexes, imaging findings, and electroencephalogram (EEG) data of 60 patients with anti-NMDAR encephalitis. The modified Rankin Scale (mRS) scores of patients were collected when they were discharged from the hospital. The mRS scores were used to divide the patients into two groups, with mRS scores of 3–6 defined as a poor prognosis. Logistic regression analysis was used to analyze independent risk factors related to a poor prognosis. @*Results@#This study found that 23 (38.3%) and 37 (61.7%) patients had good and poor prognoses, respectively. Logistic regression analysis showed that age, disturbance of consciousness at admission, and ≥50% slow waves on the EEG were significantly associated with patient outcomes. An age, consciousness, and slow waves (ACS) composite score was constructed to predict the prognosis of patients with anti-NMDAR encephalitis at an early stage based on regression coefficients. @*Conclusions@#Age, disturbance of consciousness at admission, and ≥50% slow waves on the EEG were independent risk factors for a poor prognosis. The ACS prognostic composite score could play a role in facilitating early predictions of the prognosis of anti-NMDAR encephalitis.

Analysis on present situation of post-hospital care needs scale in patients with colostomy and validity of the research / 中国实用护理杂志

Objective To build demand scale for Post-hospital intestinal colostomy patients and test the reliability and validity. Methods Through the investigation of relevant literature at home and abroad,Based on the Maslow's Need Hierarchy Theory, in combination with intestinal colostomy patients psychological scale, using qualitative research, a semi-structured interview was conducted in 12 patients with colostomy A thorough understanding of colostomy patients Post-hospital care needs content (interview time as follows:September-October 2015), to analysis the interview recording data, the item pool of the scale for post-hospital care needs in patients with colostomy was constructed. Choosing 200 patients from the department of Proctology of third-grade class-A hospitals of Jilin province, and carries on the scale of clinical testing, after collecting the relative data , and make use of Critical Ration、the correlation coefficient method and the internal consistency coefficient method、further concludes that the scale items should be added or not, and picking up the internal consistency reliability 1/2 reliability retest reliability content validity and structure validity to analysis each item. Results The demand scale for Post-hospital intestinal colostomy patients included 6 dimensions and 24 items. The total content validity index (S-CVI) of the scale was 0.968, and the content validity index (I-CVI) of each item was 0.78-1.00. By exploratory factor analysis, 6 principal components were extracted, and the cumulative explanation variation of 6 principal components was 91.753％. This indicated that the scale had good validity. The total Cronbach a coefficient of the scale was 0.751, and the Cronbach a coefficient of each dimension was 0.968-0.974, all above 0.7, which indicated that the internal consistency was good. The half-fold reliability and retest reliability of the scale were 0.794 and 0.827 respectively. Conclusion The scale designed in this study has good reliability and validity, and can be used as an effective assessment tool for nursing needs of patients after discharge from enterotomy.

Research progress of postural deformities in Parkinson's disease / 中华神经科杂志

Parkinson's disease patients are often combined with postural deformities , including antecollis, camptocormia, pisa syndrome, scoliosis and striatal deformities in addition to the most common stooped simian appearance.These postural deformities , which have serious effects on the patient's quality of life, generally appear in the later period of Parkinson's disease, and fortunately are usually reversible. Therefore, early identification together with intervention are necessary.The advances in the definition , clinical manifestations, pathogenesis and treatment of postural deformities in Parkinson's disease are reviewed in this article.

influence of body mass index and hip anatomy on direct anterior approach total hip replacement

Objective: To investigate the influence of body mass index [BMI] and hip anatomy on direct anterior approach [DAA] total hip replacement

Subjects and Methods: The study is a retrospective analysis of 124 cases of DAA total hip replacement from 2009 to 2012. The BMI, the ratio of the greater trochanter [GT] and anterior superior iliac spine [ASIS] bilaterally [GT/ASIS], and the vertical distance between the ASIS and GT [AGVD] were obtained from medical records. All cases were categorized into three groups [43, 49, and 32 cases in each group, respectively] based on BMI [BMI <18.5, BMI 18.5-25, and BMI >25] or divided into two groups based on GT/ASIS [ 1.17] or AGVD [ 86 mm]. Operating time, intraoperative bleeding, and surgical complications were compared between different groups

Results: A longer average operating time, more intraoperative bleeding, and a higher rate of complications were observed in the group with the highest BMI. The complications included a case of intraoperative femur fracture, a wound hematoma, and a lateral femoral cutaneous nerve injury. The group with higher GT/ASIS had a shorter average operating time, less bleeding, and a lower complication rate than the group with lower GT/ASIS. Moreover, the group with higher AGVD showed a shorter average operating time, less bleeding, and a lower complication rate compared with the group with lower AGVD

Conclusion: Our study suggests that lower BMI and larger GT/ASIS and AGVD are associated with a shorter operating time, less bleeding, and a lower complication rate in DAA total hip replacement. These findings are valuable for clinicians to make the appropriate choice of surgery types for different individuals

Research advances on the role of mast cells in pelvic pain of endometriosis / 浙江大学学报·医学版

Endometriosis (EMs) is a common gynecologic disease that affects women's physical and mental health seriously. The pathogenesis is still unknown and the mechanism of endometriosis-associated pain remains unclear. Mast cells (MC) are known to be multifunctional players in the immune system. Recent studies have shown that nerve fibers in EMs lesions can release neural peptides such as nerve growth factor and substance P to induce MC degranulating and releasing histamine, proteases, cytokines, chemokines etc., which contributes to the development of pain and hyperalgesia in patients with endometriosis.

Total hip arthroplasty for acetabular protrusion / 中国矫形外科杂志

[Objective]To discuss the outcome of acetabular protrusion after total hip arthroplasty. [Method]Fifteen patients(M=7,F=9) having painful acetabular protrusion received total hip arthroplasty with reinforcement of the acetabulum with bone grafts(autogenous or allogeneous bone).The results were reported at 1~4 years(mean,3 years) of follow-up.Of the 15 cases,5 were mild protrusion and 10 were moderate protrusion.The Harris hip-rating and radiographs were taken pre-and postoperatively. [Result]The average Harris hip-rating was improved from 45 points(range,39~60 points) preoperatively to 85 points(range,70~100 points) postoperatively.The average preoperative protrusion of the femoral head medial to the Kohler line was 8.8 mm(6~18 mm).The average postoperative placement of the prosthetic femoral head was 10 mm(6~13 mm) lateral to the Kohler line.None acetabulum prothesis failure or bone grafts absorption was seen.The grafts were well incorporated on radiograms in all patients one year after operation by radiographs. [Conclusion]Good results can be obtained in hips with acetabular protrusion after reconstructed with autogeneous or allogeneous bone grafting and total hip arthroplasty.

Changes of bone mineral density of the proximal femur in patients with revision total hip arthroplasty / 中国矫形外科杂志

[Objective]To understand the changes of periprosthetic bone mineral density(BMD) of the proximal femur in patients with failed hip arthroplasty by measuring with dual energy X-ray absorptiometry(DEXA). [Method]Periprosthetic BMD was determined in 9 patients with revision total hip arthroplasty by dual energy X-ray absorptiometry(DEXA),defining regions of interest according to Gruen(1~7),and comparing the operation side with the nonoperation side.Clinic results of the cases were evaluated according to Harris Hip Score(HHS).[Result]The mean HHS was 61 points in 9 patients at this follow-up examination.There was a significant decrease(8.9%~27.6 %) in BMD in every Gruen zone as compared with the nonoperation side.[Conclusion]The bone loss in the proximal femur in patients with failed hip arthroplasty is significant,and the pattern of bone loss around failed hip arthroplasty may be different from the typical remodeling seen after successful hip arthroplasty.