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This paper provided a comprehensive review of the concept, current situation and influencing factors of survivors returning to work after hematopoietic stem cell transplantation, both in domestic and international contexts. The research analyzed and elaborates on four aspects of individual factors, disease-related factors, occupational factors, and social support, in order to provide references for constructing an intervention program for the return to work of hematopoietic stem cell transplantation survivors based on the cultural background in China.
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To summarize the nursing experience of a patient with gastric cancer who developed cytokine release syndrome after using immune checkpoint inhibitors.Key points of nursing care:development of nursing assessment decisions with a holistic view to guide safe nursing care;taking into account the contradiction between bleeding and thrombosis and providing good care for upper gastrointestinal bleeding;implementing a nursing strategy focusing on cleaning and anti-infection for IV oral mucositis;implementing risk management for severe pulmonary lesions;providing good hormone medication care and discharge follow-up management.The patient was successfully discharged on 52nd day with a 3-month follow-up in good condition.
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Objective:To build a practical strategy set for outpatient elderly care station, for references for improving the quality of outpatient elderly care services in hospitals.Methods:From January to December 2022, based on the 4Ms model and in view of needs of elderly outpatients, this study developed preliminary screening items of the practical strategy set for outpatient elderly care station by means of document analysis and semi-structured interviews. Two rounds of Delphi methods were used to construct the practice strategy set.Results:The effective response rates of the two rounds of Delphi methods were both 100%, and the expert authority coefficients were both 0.86. The practical strategy set for outpatient elderly care station included 4 first level items (what patients consider important, medication safety, activity safety and mental care), 10 second level items (friendly culture, friendly management, friendly service, friendly environment, including fall assessment, preventive measures, medication assessment, medication education, psychological assessment and psychological care), and 37 third level items. The importance and feasibility scores for all first and second level items were 5.00 points, while the third level items were all greater than 4.50 points.Conclusions:The practical strategy set for outpatient elderly care stations was led by nurses, reflecting the connotation of friendly services and covering the entire process of outpatient visits for elderly patients, with high feasibility.
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Neurogenic bowel dysfunction is one of the common complications after spinal cord injury. Long-term constipation and fecal incontinence can cause great troubles in the daily life of patients and seriously affect their quality of life. The key to the solution is effective intestinal intervention, including the establishment of defecation patterns, dietary interventions, and drug interventions, enema, electromagnetic stimulation, and enterostomy, etc. At the same time, a personalized bowel management plan is formulated based on the specific conditions of the patient to better manage the bowel and improve the patient′s quality of life.
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Objective:To explore the clinical manifestations of familial cortical myoclonic tremor with epilepsy (FCMTE).Methods:A retrospective analysis was performed. The clinical data of 7 pedigrees with FCMTE (10 patients), admitted to our hospital from May 2010 to November 2016, were collected. Medical history of family members were investigated.Results:A total of 113 family members from 7 pedigrees, including 61 affected individuals (30 males and 31 females) were recorded; all were consistent with autosomal dominant inheritance. In these 10 patients, the age of onset ranged from 13 to 50; there were 5 females and 5 males; tremor was found as first symptom, accompanied by epileptic seizures; the main trigger factors included tiredness, emotional excitement or lack of sleep; all patients presented with generalized tonic-clonic seizure, including 2 with partial seizures accompanied by perceptual disturbance; migraine was noted in 4 patients; cognitive decline was noted in 3 patients, stiffness in 1 patient, paroxysmal weakness in 1 patient, and blurred vision at dark in 1 patient, and dizziness in 1 patient. EEG showed epileptiform discharges in 8 patients. Electromyography was completed in 3 patients, giant somatosensory evoked potentials and long-latency C-reflex were observed when peripheral nerves were stimulated. Intronic pentanucleotide TTTTA and TTTCA repeat insertion in the SAMD12 gene was identified in 3 patients by genetic testing. Antiepileptic drugs were given to 8 patients and their condition was effectively controlled. Conclusions:FCMTE is autosomal dominant disease characterized by myoclonic tremor and epilepsy, usually occurs in adults, and tremor often occurs earlier than epilepsy. Epilepsy is related to emotional excitement and sleep deprivation. Neuroelectrophysiology shows that tremor comes from cerebral cortex.
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Objective To evaluate the sleep structure of rapid eye movement sleep disorder (RBD) patients and its correlations with emotional state,autonomic nerve system function symptoms,and sleep quality.Methods Twenty-two RBD patients examined in our hospital from October 2014 to May 2016 who complained of behavior disorders and conformed diagnosis by video-polysomnography (v-PSG) were chosen as RBD group;23 healthy gender,age and education-level matched subjects confirmed without RBD by v-PSG were selected as control group.Their emotional state,autonomic nerve function and sleep quality were assessed by center for epidemiological survey depression scale (CES-D),apathy evaluation scale (AES),scale for outcomes in PD for autonomic symptoms (SCOPA-AUT),and scale for outcomes in PD for sleep (SCOPA-SLEEP).The differences in sleep structures,periodic leg movement index (PLMI),apnea hypopnea index (AHI) and arousal index between RBD group and control group were compared.The differences of scores of emotional state,autonomic nerve system function symptoms were compared between the two groups.The correlations of sleep structure with emotional state,autonomic nerve system function symptom,and sleep quality in RBD group were analyzed.Results As compared with those of the control group,the proportion of non-rapid eye movement (NREM)-Ⅰ sleep of RBD group was significantly increased,proportions of NREM-Ⅱ sleep and NREM-Ⅲ sleep were statistically reduced,PLMI,CES-D scores,urinary and digestive system questionnaire and overall scores in the RBD group were significantly increased (P＜0.05).In patients from RBD group,CES-D scores were positively correlated with proportion of NREM-I sleep (r=0.520,P=0.000);nighttime sleepiness questionnaire and overall scores were positively correlated with PLMI (r=0.465,P=0.029;r=0.444,P=0.039);daytime sleepiness scores were negatively correlated with proportion of NREM-Ⅲ sleep (r=-0.480,P=0.041);cardiovascular system symptom was correlated with PLMI (r=0.439,P=0.041).Conclusion RBD patients suffer sleep structure disturbance,depression tendency,digestive and urinary system of autonomic nerve symptoms;sleep quality scores and total scores,cardiovascular system symptoms scores are positively correlated with LMI;daytime sleepiness is negatively correlated with reducing phase Ⅲ sleep,CES-D scores are correlated with increasing NREM-I sleep and unbalanced neurotransmitter,especially,5-TH level.
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The integral and individual-scale wavelet entropy of electroencephalogram (EEG) were employed to investigate the information complexity in EEG and to explore the dynamic mechanism of child absence epilepsy (CAE). The digital EEG signals were collected from patients with CAE and normal controls. Time-frequency features were extracted by continuous wavelet transformation. Individual scale power spectrum characteristics were represented by wavelet-transform. The integral and individual-scale wavelet entropy of EEG were computed on the basis of individual scale power spectrum. The evolutions of wavelet entropy across ictal EEG of CAE were investigated and compared with normal controls. The integral wavelet entropy of ictal EEG is lower than inter-ictal EEG for CAE, and it also lower than normal controls. The individual-scale wavelet entropies of 12th scale (centered at 3 Hz) of ictal EEG in CAE was significantly higher than normal controls. The individual-scale wavelet entropies for α band (centered at 10 Hz) of ictal EEG in CAE were much lower than normal controls. The integral wavelet entropy of EEG can be considered as a quantitative parameter of complexity for EEG signals. The complexity of ictal EEG for CAE is obviously declined in CAE. The wavelet entropies declined could become quantitative electrophysiological parameters for epileptic seizures, and it also could provide a theoretical basis for the study of neuromodulation techniques in epileptic seizures.
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In view of the problems of more artificial interventions and segmentation defects in existing two-dimensional segmentation methods and abnormal liver segmentation errors in three-dimensional segmentation methods, this paper presents a semi-automatic liver organ segmentation method based on the image sequence context. The method takes advantage of the existing similarity between the image sequence contexts of the prior knowledge of liver organs, and combines region growing and level set method to carry out semi-automatic segmentation of livers, along with the aid of a small amount of manual intervention to deal with liver mutation situations. The experiment results showed that the liver segmentation algorithm presented in this paper had a high precision, and a good segmentation effect on livers which have greater variability, and can meet clinical application demands quite well.
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Humanos , Algoritmos , Interpretación de Imagen Asistida por Computador , Imagenología Tridimensional , HígadoRESUMEN
Objective To analyze the outcome of patients receiving intrauterine insemination with husband sperm,in order to evaluate the effect of relative factors on pregnancy rate after intrauterine insemination. Methods Ninety-eight infertile couples who received intrauterine insemination in the Affiliated Hospital of Nantong University from March 2013 to May 2014 were selected as our subjects and 181 cycles were included. The information including clinical factors including maternal age,infertile time,infertile causes, ovulation induction protocol,time of insemination and postwash total motitle sperm(TMS)and pregnancy rate were recorded. Results (1)Totally 26 patients received clinical pregnancies,and clinical pregnancy rate(CPR) was 14. 36% per cycle. With age increase pregnancy rate decreased( χ2 = 1. 654 9,P = 0. 647).(2)The pregnancy rate of the patients was the same within the infertile time( χ2 = 1. 588 5,P = 0. 662).(3)The pregnancy rate of the patients with secondary infertility was lower than that of the patients with primary infertility,but there was no significant difference(χ2 = 0. 923 3,P = 0. 337).(4)The pregnancy rate of ovulation induction cycles was lower than that of nature cycles,but there was no significant difference(χ2 = 2. 222 0,P= 0. 136).(5)Postwash TMS was showed the same trend(χ2 = 0. 643 4,P = 0. 422). Conclusion In terms of intrauterine insemination with husband sperm,age,infertile time,infertile types,ovulation induction protocol and posrwash TMS can affect pregnancy rate,and the effects of various factors should be considered comprehensively in the process of therapy.
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The building and operation of the evidence-based nursing team of the hospital follow the elite,task-oriented,and team-based model,which is promoted from points to area.This paper described the organizational framework,selection of training contents and training methods of the team in the hospital.It also covered the outcomes achieved for the past year, and analyzed the focal points, difficulties and future emphasis during the team's construction and operation.
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Wavelet entropy is a quantitative index to describe the complexity of signals. Continuous wavelet transform method was employed to analyze the spontaneous electroencephalogram (EEG) signals of mild, moderate and severe Alzheimer's disease (AD) patients and normal elderly control people in this study. Wavelet power spectrums of EEG signals were calculated based on wavelet coefficients. Wavelet entropies of mild, moderate and severe AD patients were compared with those of normal controls. The correlation analysis between wavelet entropy and MMSE score was carried out. There existed significant difference on wavelet entropy among mild, moderate, severe AD patients and normal controls (P<0.01). Group comparisons showed that wavelet entropy for mild, moderate, severe AD patients was significantly lower than that for normal controls, which was related to the narrow distribution of their wavelet power spectrums. The statistical difference was significant (P<0.05). Further studies showed that the wavelet entropy of EEG and the MMSE score were significantly correlated (r= 0. 601-0. 799, P<0.01). Wavelet entropy is a quantitative indicator describing the complexity of EEG signals. Wavelet entropy is likely to be an electrophysiological index for AD diagnosis and severity assessment.
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Anciano , Humanos , Enfermedad de Alzheimer , Diagnóstico , Estudios de Casos y Controles , Electroencefalografía , Entropía , Análisis de OndículasRESUMEN
Objective To investigate the brain glucose metabolism in different stage of mixed-type multiple system atrophy (MSA).Methods Forty-six MSA patients with cerebellar or Parkinsonian symptoms and 18 healthy controls with similar age as patients were included.According to the disease duration,the patients were divided into three groups: group 1 (≤ 12 months,n=14),group 2 (13-24 months,n=13),group 3 (≥ 25 months,n =19).All patients and controls underwent 18F-FDG PET/CT brain imaging.To compare metabolic distributions between different groups,SPM 8 software and two-sample t test were used for image data analysis.When P＜0.005,the result was considered statistically significant.Results At the level of P＜0.005,the hypometabolism in group 1 (all t＞3.49) was identified in the frontal lobe,lateral temporal lobe,insula lobe,anterior cingulate cortex,caudate nucleus and anterior cerebellar hemisphere.The regions of hypometabolism extended to posterolateral putamen and part of posterior cerebellar hemisphere in group 2 (all t＞3.21).In group 3,the whole parts of putamen and cerebellar hemisphere were involved as hypometabolism (all t＞4.08).In addition to the hypometabolism regions,there were also stabled hypermetabolism regions mainly in the parietal lobe,medial temporal lobe and the thalamus in all patient groups (all t＞3.27 in group 1,all t＞3.02 in group 2,all t＞3.30 in group 3).Conclusions Disease duration is closely related to the FDG metabolism in the MSA patients.Frontal lobe,lateral temporal lobe,anterior cingulate cortex and caudate nucleus can be involved at early stage of the disease.Putaminal hypometabolism begins in its posterolateral part.Cerebellar hypometabolism occurs early at its anterior part.Besides,thalamus shows hypermetabolism in the whole duration.18F-FDG metabolic changes of brain can reflect the development of mixed-type MSA.
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Wavelet entropy,as a powerful quantitative parameter to measure the ordering/disordering level of multi-scale dynamical behavior for nonlinear signals,provides information of complex degree in nonlinear dynamical process.Recently,the wavelet entropy is attracting more and more attention in electroencephalogram (EEG) signal analysis,which is employed by domestic and overseas scholars to investigate the complex degree of EEG,evoked potential and event-related potential,and to profoundly reveal the dynamic mechanism of physiological electrical activity in the brain.It is mainly used in the research of perception,cognitive activity,dynamic observation of epileptic EEG signals,sleeping,internet addiction and rehabilitation of brain after injury.Not only can the wavelet entropy represent the dynamic evolution process of the frequency synchronization for stimulated EEG signals,but also distinguish the states before and after epileptic seizure,as well as to deepen the understanding of brain dynamics mechanism.The wavelet entropy is becoming a new tool for investigating cognition and exhibits a good application prospect in EEG signal analysis.
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Objective To investigate clinical and imaging features of corticobasal degeneration syndrome (CBDS). MethodsA clinical, imaging and therapeutic analysis of 4 cases of clinically diagnosed with corticobasal degeneration was conducted. Results Asymmetric parkinsonism was the first symptom in all 4 cases who lacked of response to levodopa. Other symptoms including limb apraxia and anarthria occurred in all 4 cases,myoclonus occurred in three,dementia occurred in two,and involuntary movement occurred in one. All the patients had asymmetric frontoparietal cortical atrophy in the contralateral to the dominantly affected limbs on MRI.Asymmetric hypometabolism of the frontoparietal cortex and basal ganglia was observed on 18 F-FDG PET in all 4 cases.ConclusionsThe clinical features of CBDS are asymmetric parkinsonism,dementia,apraxia,anarthria,myoclonus,and involuntary movement.Brain MRI and 18 F-FDG PET are helpful to diagnosis of CBDS.There is no effective treatment for CBDS at this time.
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The association between the adverse pregnancy outcome and the exposure to air pollutants has recently become a major concern.The researches on the relationship between air pollutants and preterm delivery and low birth weight need to be further studied.This paper reviewed the epidemiological studies on the impact of air pollutants(PM10,CO,NO2,SO2 etc) on preterm delivery and low birth weight,aimed to provide some references for the control of air pollution and the occurrence of adverse pregnancy outcome and the further study on the mechanism.
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ve To explore the characteristics of water quality of underground water in chronic endemic arsenic poisoning areas of Hohhot. Methods 74 underground water samples were collected from chronic endemic ar-senic poisoning areas of Hohhot in Nov. 1998 and Apr. 1999 respectively for water quality analysis. The analysis and comparision of every indexes of water quality of high-arsenic water samples (As≥50?g/L) and low-arsenic water samples (As