Diagnosis of multiple tuberculous muscle abscesses in a patient with systemic lupus erythematosus by metagenomic next-generation sequencing- a case report and literature review.

BACKGROUND: Early diagnosis of muscular tuberculosis (TB) without coexistent active skeletal involvement is often challenging because the disease is very rare and its clinical manifestation is nonspecific and misleading. To raise the awareness and emphasize early diagnosis of muscular TB, we present a case of multiple tuberculous muscle abscesses in a systemic lupus erythematosus (SLE) female, but without pulmonary tuberculosis (PTB), in order to increase awareness of and stress the need of early detection of muscular TB. CASE PRESENTATION: A 44-year-old woman with a 6-year history of SLE who had been treated with methylprednisolone for a long time complained of erythema on her trunk and extremities for five months, along with edema and myalgia for two months, and fever for one month. The patient was first misdiagnosed as SLE overlap dermatomyositis. However, an ultrasound-guided drainage of muscle abscesses revealed positive acid-fast staining combined with positive deoxyribonucleic acid fragment of Mycobacterium tuberculosis using metagenomic next-generation sequencing (mNGS). The patient was cured and released following standard anti-tuberculosis medication, local puncture drainage, and an intravitreal injection of streptomycin. Literature search found only 19 cases of tuberculous muscle abscesses occurring in the extremities reported from 1999 to 2023. CONCLUSIONS: Extrapulmonary TB with predominantly muscle involvement is rare and with no specific clinical presentation. Muscular tuberculosis may be disdiagnosed for dermatomyositis due to the high muscle enzyme levels, delaying diagnosis and treatment. mNGS technology is helpful in the early and rapid diagnosis of muscular TB. On the basis of traditional anti-tuberculosis treatment, an ultrasound-guided percutaneous puncture drainage and intracavitary injection of streptomycin for the treatment of tuberculous muscle abscess is easy to operate, safe and effective, which is worthy of clinical popularization and application.

Correlation between health beliefs and family environment in stroke patients / 中国实用护理杂志

Objective To understand the correlation between health beliefs and family environment of stroke patients. Methods A questionnaire survey was carried out on 115 stroke patients with the first onset of stroke by using the special health belief simple table (SF-HBMS) and the family environment scale (Chinese version FES-CV), and the correlation was analyzed. The scores of each subscale of the family environment were compared with the domestic norm. Results The total score of health belief (75.15 ± 10.20) was at the middle level. There were significant differences in age (F=8.41), education level (F=4.44), complications (F=4.05), family history (t=2.68) and first visit time (F=3.76) among different characteristics of health belief scores (P < 0.01 or 0.05). The score of intimacy (6.23 ± 1.27) in family environment, emotional expression score (5.30 ± 1.97), success score (5.88 ±1.62), cultural score (4.54 ± 2.20) and organizational score (5.60 ±1.67) were all lower than the domestic norm and spear. The score of shield score (3.16 ± 2.00) was higher than that of domestic norm (P<0.01 or 0.05), and the total score of health belief was positively correlated with family intimacy (r=0.190), emotional expression (r=0.204), culture (r=0.206) and tissue (r=0.227) (P<0.05), and was negatively correlated with the contradiction (r=-0.186, P<0.05); regression analysis, whether there were family history (β=0.338, P<0.01), first onset time (β=0.242, P<0.01), family intimacy (β=1.614, P<0.05), emotional expression (β=1.114, P<0.05) were the factors affecting the health belief level of first stroke patients. Conclusions The level of health belief is closely related to family environment. It is suggested that the clinical medical staff should pay attention to the negative emotion and family psychological intervention, provide psychological support for the patients and their families, promote the promotion of their health beliefs, and reduce the rate of recurrence and disability.

Patients with adanced cancer self- perceived burden with family cohesion and adaptability correlation studies / 中国实用护理杂志

Objective To investigate the correlation of self perceived burden, family cohesion and adaptability in advanced cancer patients. Methods The Chinese version self perceived burden scale (SPBS), Chinese version of family cohesion and Adaptability Scale (FACES-CV) were used to investigate 139 cases of patients with advanced cancer, and to analyze their correlation with family cohesion and adaptability compared with the norm. Results Patients' self perceived burden score (35.83 ± 5.59) points in the moderate level. The 3 dimensions of the item score from high to low was economic burden (4.12 ± 0.86), body burden (3.63 ± 0.53), emotional burden (3.49 ± 0.63); survey of patients with family cohesion and adaptability, intimacy score (67.96 ± 9.35) points, the ideal intimacy score (83.68 ± 6.05), satisfaction score (15.71 ± 9.39) points, were higher than the national norm, the actual adaptability score (48.00 ± 6.92) and ideal adaptability score (56.47 ± 4.99) points lower than the national norm, the difference was statistically significant (P<0.01 or 0.05). Patients' self perceived burden score and intimacy was negatively correlated (r=-0.186, P<0.05), and positively correlated with intimacy satisfaction (r=0.175, P<0.05). Regression analysis, gender (B=0.236, P<0.01), family medical burden (B=0.183, P<0.05), actual family cohesion (B=-0.111, P<0.05) was the influencing factors of patients' self perceived burden. Conclusions The burden of self perception in advanced cancer patients is closely related to family cohesion and adaptability. It is suggested that the medical staff should pay attention to the family psychological intervention and provide emotional connection for the patients and their families, so as to reduce the negative emotion of the patients with advanced cancer.

Effect evaluation of health education of TCM rehabilitation after hepatobiliary surgery / 中国实用护理杂志

ObjectiveTo investigate and analyze the health education needs of TCM rehabilitation after hepatobiliary surgery,and the application effect of health education. Methods105 cases of hepatobiliary surgery patients were chosen.Homemade questionnaires with TCM rehabilitation related knowledge needs were used in the investigation.And then the health education of TCM rehabilitation was given to the patients.After these patients accepted the education and were rehabilitated,these patients were again taken TCM and rehabilitation of health education needs for investigation.The changes of the needs of the patients before and after education for the rehabilitation of health education on TCM were compared.The evaluation of the recovery effect for patients with TCM rehabilitation of health education in the liver and gallbladder surgery were taken for investigation. Results105 cases of patients with TCM and rehabilitation health knowledge education before and after the survey results showed that,the urgent need on the knowledge of TCM health rehabilitation rate after hepatobiliary surgery in patients increased significantly compared with before education.In the evaluation of the recovery effect of patients for TCM rehabilitation of health education in theliver and gallbladder surgery,the rate of thinking it effective in promoting postoperative recovery was 91.43％. ConclusionsHepatobiliary surgery patients were lack of knowledge of postoperative recovery of health knowledge of TCM and rehabilitation.By education and practical application,the patients understand the importance of health education on their postoperative rehabilitation,so TCM rehabilitation of health education has an important clinical significance in hepatobiliary surgery patients.

Study on the polysomnography of the patients with depression / 中华行为医学与脑科学杂志

Objective To investigate the variations of polysomnography of the patients with retardative depression and non-retardative depression. Methods Twenty-eight patients with depression without any medicine at least for 1 month and fifteen normal controls were assessed in this study. Based on the scores of retardation of Hamilton Depression Scale( HAMD), the patients were divided into the group of retardative depression and the group of non-retardative depression. Polysomnography was given to all the subjects. Results Compared with the normal controls, the depressive patients both in the retardative depression group and in the non-retardative depression group showed significant differences of lower total sleep time (TST), sleep efficiency (SE), SWS% , rapid eye movement ) sleep time ( RT), REM sleep latency (RL) ( all P ＜ 0. 05 ), and higher sleep latency (SL) , awakening time( AT), awakening number( AN ), the percentage of AT( A/TST% ), the percentage of 1 sleep( S1 % ), the percentage of RT( RT% ), REM activity ( RA), and REM intensity (RI). REM density (RD) in the retardative depression group was significantly higher than both the non-retardative depression group and the control group ( t =2.36, P＜ 0. 05; t = 2.75, P＜ 0. 05 ). Conclusion Abnormalities of PSG in depression are proved, and RD may be relative to retardation. The differences of PSG do not existed between different kinds of depression such as retardative depression and non-retardative depression.