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Objective:To observe the recovery of exercise tolerance among stroke survivors using the cardiopulmonary exercise test (CPET) and analyze the factors influencing it.Methods:A total of 81 stroke survivors hospitalized in the Department of Rehabilitation Medicine of our hospital in year 2018 and 2019 were selected. The general clinical data of all patients were collected retrospectively and combined with the data from CPET to establish a data set. Version 25.0 of the SPSS software was used for multiple linear regressions analysis, with the peak oxygen uptake as the dependent variable, and the age, Brunnstrom stage, peak power, peak heart rate, peak respiratory exchange ratio, peak breathing reserve, peak ventilation per minute, the slope of the VE-VCO 2 curve (ΔVE/ΔVCO 2) and peak end tidal partial pressure of carbon dioxide as independent variables. Results:Stroke survivors at Brunnstrom stage III Ⅲ, Ⅳ and Ⅴ or higher decreased sequentially with their age, but their peak oxygen uptake increased gradually. The multiple linear regression model constructed by " stepwise method" showed that the fitted multiple linear regression equation was statistically significant ( F=100.228, P<0.001). Moreover, the average peak power, peak heart rate, peak ventilation per minute and the slope of the VE-VCO 2 curve were all found to be significant independent predictors of peak oxygen uptake in these stroke survivors. Conclusions:Skeletal muscle power, cardiac function, pulmonary ventilation and ventilation efficiency are useful independent predictors of the exercise tolerance of stroke survivors.
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Objective To study the effect of multidisciplinary rehabilitation nursing on the number of acute exacerbation, quality of life and pulmonary function in patients with chronic obstructive pulmonary disease (COPD). Methods A total of 1088 cases of COPD patients admitted to department of respiratory medicine from February 2015 to July 2016 were divided into the study group and the control group by random digits table method, 544 cases in each group. The control group was given COPD related health education and routine care. The study group was given comprehensive rehabilitation of multidisciplinary lung care. After 1 years, the mental status, dyspnea grade improvement, acute exacerbation and 6 min walk test distance (6MWD) were compared between the two groups. Results One year after intervention, 6MWD and the times of acute exacerbation in the study group were (450.32 ± 67.21)m and (0.37 ± 0.28) times, and (394.12 ± 63.17)m and (2.08 ± 1.65) times in the control group, the study group was better than the control group (t=2.064, 2.029, P<0.05). One year after intervention, the scores of mental state, function, symptom were 1.76 ± 1.02, 1.69 ± 1.01, 1.61 ± 0.79 in the study group respectively, and 2.10 ± 1.08, 2.08 ± 2.03, 1.79 ± 0.80 in the control group,the difference was statistically significant (t=2.051, 2.017, 2.103, P<0.05). Conclusions After comprehensive nursing intervention of multidisciplinary rehabilitation, COPD patients can not only have obvious improvement in lung function, but also reduce the frequency of acute exacerbation of COPD.
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Objective To explore the diagnostic value of full-field digital mammography (FFDM) combined with digital breast tomosynthesis (DBT) in breast diseases.Methods 506 patients receiving mammary gland molybdenum target inspection from January 1, 2014 to December 31, 2014 were selected.The images from FFDM and DBT were analyzed, respectively.The breast imaging reports and pathological results were compared to investigate the sensitivity, specificity and accuracy of FFDM, DBT alone and combined use of DBT and FFDM.Results The results of preoperative mammography in the 506 women (bilateral breast) were as follows: FFDM combined with DBT detected 202 benign cases (39.9%) and 304 malignant cases (60.1%);FFDM alone detected 194 benign cases (38.3%) and 312 malignant cases (61.7%);DBT alone detected 187 benign cases (37.0%) and 319 malignant cases (63.0%).Pathologically, 214 benign cases (42.3%) were detected and 292 malignant cases (57.7%).In terms of the sensitivity, specificity and accuracy, The combined use of DBT combined with FFDM was the best, followed by FFDM alone and DBT alone.Conclusion The sensitivity, specificity and accuracy of FFDM combined with DBT for diagnosis are better than those of FFDM alone or DBT alone.
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Objective · To design and synthesize five new tropane compounds, and test their antagonistic activity against M3 receptor and inhibition activity to neutrophil elastase (NE), of which the structure-activity relationship were preliminarily investigated. Methods · The five compounds, A1-A3,B1 and C1, were prepared with 3α-hydroxy-tropane (A0) as the starting material by modifying the structure in C-3α position and N atom on the tropane skeleton. The antagonistic activity of the compounds to muscarinic M3 receptors on tracheal rings of guinea pigs was evaluated by functional assays in vitro. The hydrolysis of PGlu-Pro-Val-PNA as substrate was catalyzed by NE to get colorful nitroaniline (PNA). The NE inhibition activity of the tropane compounds was obtained by determining the absorbance [(D(405 nm)] of PNA. Results · The five new tropane compounds generated strong antagonistic activity against M3 receptors. Among them, A2 had the greatest activity [antagonistic parameter pA2(M3)=9.004], and elicited obvious inhibitory effect to NE (inhibition ratio YA2=20.29%). Conclusion · Introducing strong electron-attraction group, such as sulfuryl and hydrophobic group with large volume into C-3α position on the tropane skeleton can improve the M3 receptor antagonistic activity as well as the NE inhibition activity.