目的 調查安置永久性人工心臟起搏器的老年患者術前焦慮狀況，為制訂護理對策提供依據。 方法 2004年7月-2008年7月收治需安置永久性人工心臟起搏器的心臟病患者78例，術前采用焦慮自評量表（SAS）對其進行問卷調查，并采用自制一般情況問卷調查了解情況。 結果 植入永久性心臟起搏器的老年患者術前SAS得分高于國內常模（Plt;0.05）。根據自制調查問卷結果，差異有統計學意義（Plt;0.05）的項目:老年患者隨年齡增長焦慮量表評分降低；喪偶者焦慮評分高于有配偶者；完全公費、部分公費、自費的焦慮量表評分依次增高；老年患者對起搏器知識了解程度越少，焦慮評分越高；無家人陪伴者比有家人陪伴者焦慮評分高。而性別、文化水平差異無統計學意義。 結論 植入永久性起搏器的老年患者術前多數存在焦慮情緒，且焦慮與年齡、婚姻、費用支付方式、有無家人陪伴、相關知識等有一定關系，醫護人員應針對性地做好患者術前護理，幫助患者面對現實，以積極的心態接受手術治療。
目的 了解老年患者住院期間睡眠影響因素及質量。 方法 對2009年7月－12月入住老年科的108例患者運用匹茲保睡眠質量指數（PSQI）和自編影響睡眠因素調查表進行調查分析。 結果 92.6%的老年患者有睡眠質量問題，病情不穩定患者比病情穩定者睡眠障礙發生率高，病房溫濕度、氣味、夜間光線、夜間查房等環境因素和擔心家事、家人朋友不關心等社會因素，夜間喝濃茶、咖啡的不良習慣對睡眠質量的影響差異有統計學意義（P＜0.05）。 結論 多數老年患者住院期間睡眠質量差，醫護人員應對此予以高度重視，針對性地采取有效治療、護理措施及健康指導方式，改善老年患者睡眠質量。
Objective To investigate the prevalence of cognitive impairment and identify its influencing factors among lung cancer patients undergoing chemotherapy, providing a scientific basis for targeted interventions. Methods A convenience sample of lung cancer patients receiving chemotherapy at West China Hospital, Sichuan University between April and October 2024 was enrolled. Data were collected using a general information questionnaire, the Mini-Mental State Examination, Nutritional Risk Screening 2002, Hospital Anxiety and Depression Scale, Barthel index, and FRAIL scale. Univariate analyses and multivariate logistic regression were performed to determine factors associated with cognitive impairment. Results A total of 380 patients undergoing chemotherapy for lung cancer were enrolled, and 205 (53.9%) of them had cognitive impairment. Univariate analyses revealed that there were statistically significant differences between the cognitively normal group and the cognitive impairment group in age, educational level, work status, nutritional status, Barthel index, and FRAIL scale score (P<0.05). Multivariate logistic regression showed that advanced age [odds ratio (OR)=1.045, 95% confidence interval (CI) (1.015, 1.075), P=0.002] and FRAIL scale score [OR=1.369, 95%CI (1.165, 1.609), P<0.001] were identified as independent risk factors for cognitive impairment, whereas higher educational attainment served as a protective factor, compared with patients with primary school education or below, patients with junior high school, high school/secondary vocational school, college, or undergraduate education and above had a lower risk of cognitive impairment [OR=0.437, 0.258, 0.243, 0.120, P<0.05]. Conclusions Cognitive impairment is highly prevalent among lung cancer patients undergoing chemotherapy and is significantly influenced by age, educational level, and frailty. Healthcare providers should develop targeted interventions based on these factors to reduce the prevalence of cognitive impairment.
【摘要】 目的 探討3分法畫鐘測驗（clock drawing test，CDT）對阿爾茨海默病患者（Alzheimer disease，AD）與血管性癡呆患者（vascular dementia，VD）的鑒別作用。 方法 收集四川大學華西醫院神經內科門診及住院部2009年9月-2010年6月就診的認知功能障礙患者150例，進行病史采集及神經心理測試量表，篩選出AD患者57例及VD患者43例，共計納入100例。在兩者間進行CDT，分析兩者間CDT有無差別、CDT與中文版簡易智能量表（Chinese version of the mini-mental state examination，MMSE）及臨床癡呆評定量表（clinical dementia rating scale，CDR）的相關性。 結果 AD患者及VD患者間CDT差異無統計學意義（Pgt;0.05）；CDT與MMSE及CDR有相關性，Spearman相關系數分別為0.573和-0.542（Plt;0.001）。 結論 3分法畫鐘測驗無法準確區分AD和VD，但對粗略判斷AD及VD程度可能有一定效果。【Abstract】 Objective To investigate the differential function of the three-point scoring system for the clock drawing test (CDT) between Alzheimer’s disease (AD) and vascular dementia (VD). Methods We analyzed the clinical data of 150 patients with cognitive impairment treated in the neurology and inpatient departments of our hospital from September 2009 to July 2010. Medical history of the subjects were collected. Through the assessment by neurological and psychological rating scale, we picked out 57 patients with AD and 43 with VD and tested them with CDT. The difference of CDT results between the two groups, and the correlation of CDT with Chinese version of the mini-mental state examination (MMSE) and clinical dementia rating scale (CDR) were analyzed. Results There was no statistical difference of CDT results between AD and VD patients (Pgt;0.005). CDT had a correlations with MMSE and CDR, the Spearman correlation coefficient being 0.573 and -0.542 respectively (Plt;0.001). Conclusion The three-point scoring system for the clock drawing test cannot differentiate exactly between Alzheimer Disease and Vascular Dementia, but it can make a gross judgment of the degree of AD and VD.
Objective To investigate the effect of different treatment methods on the vertebral stability of osteoporotic vertebral compression fracture (OVCF) by finite element analysis. MethodsTen patients with thoracolumbar OVCF admitted between January 2020 and June 2021 were selected, 5 of whom underwent operation (operation group), 5 underwent conservative treatment (conservative treatment group). Another 5 healthy volunteers were selected as the control group. There was no significant difference in gender and age between groups (P>0.05). The operation group and the conservative treatment group received CT examination of the fractured vertebral body and adjacent segments before and after treatments, while the control group received CT examination of T12-L2. By importing CT data into Mimics 10.01 software, the finite element model was constructed. After comparing the finite element model of control group with the previous relevant literature measurement results to verify the validity, the spinal structural stress and range of motion (ROM) in each group under different conditions were measured. Results The three-dimensional finite element model was verified to be valid. There were significant differences in spinal structural stress after treatment between groups under different conditions (P<0.05). Before treatment, the ROMs of operation group and conservative treatment group under difference conditions were significantly lower than those of control group (P<0.05), and there was no difference between conservative treatment group and operation group (P>0.05). After treatment, the ROMs of the control group and the operation group were significantly higher than those of the conservative treatment group (P<0.05), and there was no significant difference between the operation group and the control group (P>0.05). Conclusion For patients with OVCF, the minimally invasive operation can achieve better results. Compared with conservative treatment, it can reduce the effect on spinal stability, and can be as a preferred treatment method, which is helpful to improve the prognosis of patients.
Objective To overview the systematic review(SR) of efficacy and safety of fecal microbiota transplantation (FMT) in clostridium difficile infection (CDI). Methods PubMed, The Cochrane Library, EMbase, CNKI, VIP, WanFang Data databases and related website (http://scholar.google.com/) were electronically searched to collect SR and meta-analysis on FMT of CDI. The quality of collected documents and evidences were evaluated by OQAQ (Overview Quality Assessment Questionnaire) and GRADE (Grading of Recommendations Assessment, Development and Evaluation), respectively. Results Eleven SRs were included, in which 4 were completed by meta-analysis. The results of OQAQ showed that the score of one review was 2, the others SR received scores from 5 to 9. There were 9 SRs had reported the CDI clinical resolution rate (CRR), of which one SR showed CRR was 36.2%, and the others showed CRR were about 90%. Compared to upper gastrointestinal FMT, all studies showed lower gastrointestinal FMT (colonoscopy, enemas, etc.) had a higher CRR. The outcomes of selection and random fecal donor had no significant differences, and authors suggested that there should be made a standardization of donor screening table for safe fecal. Present evidence showed FMT were safety, and the majority of adverse events of FMT appeared to be mild, self-limiting and gastrointestinal in nature. The GRADE quality level of SR indicated from very low to moderate. Conclusion FMT, as a treatment for CDI, shows significant efficacy and safety, but need more high-level evidences because of its clinical translation difficulties. The study also give a reference to develop standardized clinical pathways of FMT to policy researchers.
Objective To compare the difference in efficacy of early precut of pancreatic duct sphincter and pancreatic duct stent placement in the prevention of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) during high-risk patients. Methods A prospective study was conducted on 61 eligible patients who underwent ERCP treatment in Department of Hepatobiliary Surgery of The First Affiliated Hospital of Xi’an Jiaotong University and Xianyang Hospital of Yan’an University, from November 2016 to November 2017. All cases were randomly divided into early pancreatic sphincterotomy group (n=30) and pancreatic duct stenting group (n=31) . The success rate of intubation, intubation, and incidence of complication were compared. Results There was no significant difference in the success rate of the first intubation between the 2 groups (P=0.580), but the intubation time of the early pancreatic sphincterotomy group was shorter than that of the pancreatic duct stenting group (P=0.007). In the early pancreatic sphincterotomy group, there was 1 case of post-ERCP pancreatitis, 1 case of biliary tract infection, and 1 case of postoperative bleeding. In the pancreatic duct stenting group, there was 1 case of post-ERCP pancreatitis, and 2 cases of biliary tract infection. No severe complications such as perforation or severe acute pancreatitis occurred in both 2 groups. There was no significant difference in the incidence of total complications and specified complication (included post-ERCP pancreatitis, biliary tract infection, and postoperative bleeding) between the 2 groups (P>0.05). Conclusions Thereis no significant difference in the incidence of postoperative pancreatitis after early precut of pancreatic duct sphincter and pancreatic duct stenting placement in patients with high-risk, but intubation time of early precut of pancreatic duct sphincter method is shorter than the pancreatic duct stenting placement method.
ObjectiveTo systematically review the association between the level of plasma YKL-40 and obstructive sleep apnea hypopnea syndrome (OSAHS).MethodsWe searched PubMed, EMbase, MEDLINE, CNKI, WanFang Data, VIP database and supplemented by Google academic retrieval to collect case-control studies about the association between the level of plasma YKL-40 and OSAHS from inception to April 2017. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. And then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 5 case-control studies were included, involving 755 OSAHS patients and control population. The results of meta-analysis showed that the level of plasma YKL-40 in OSAHS patients was higher than that in control group (SMD=1.20, 95%CI 0.33 to 2.06, P=0.007). The subgroup analysis showed that the level of plasma YKL-40 in OSAHS patients from Asia was significantly higher than that in control group (SMD=1.79, 95%CI 0.83 to 2.75, P=0.000 2). The comparison between different severity of OSAHS showed that the wild-medium group had lower plasma level of YKL-40 than the severe group (SMD=–0.83, 95%CI –1.46 to –0.19, P=0.01).ConclusionYKL-40 may play an important role in the pathogenesis of OSAHS. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify above conclusions.
Objective To evaluate the association between N-acetyltransferase 2 (NAT2) gene polymorphisms and the risk of antituberculosis drug-induced liver injury (ATDILI). Methods We searched the PubMed, Embase, Wanfang, China National Knowledge Internet and VIP databases to find case-control studies, with the last updated search being performed on June 2017. Odds ratio (OR) with 95% confidence interval (CI) was calculated to evaluate the strength of association. Results A total of 29 studies, involving 1 382 cases and 5 967 controls were included. The results of the Meta-analysis indicated that NAT2 slow acetylators were associated with increased risk of ATDILI compared with fast and intermediate acetylators [OR=3.08, 95%CI (2.44, 3.88), P<0.000 01]. Similar results were also found in subgroup analysis when stratified by ethnicity, isoniazid dosage and diagnostic criteria of ATDILI. Conclusion Individuals with NAT2 slow acetylators may have increased risk of ATDILI.
ObjectivesTo systematically review the prevalence of methicillin-resistant staphylococcus aureus (MRSA) in healthy Chinese population.MethodsPubMed, EMbase, WanFang Data and CNKI databases were electronically searched to collect cross-sectional studies of the prevalence of MRSA in China from inception to December 16th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, and then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 25 cross-sectional studies were included. The results of meta-analysis showed that: the pooled prevalence of MRSA in healthy population was 13.9% (95%CI 9.6% to 18.2%). The results of subgroup analysis showed that: the prevalence of MRSA in children was 16% (95%CI 8% to 24%), and that in adults (non-children) was 13% (95%CI 9% to 16%). The prevalence of MRSA in individuals with occupational livestock exposure was 28% (95%CI 5% to 51%), in medical staff it was 16% (95%CI 8% to 25%), in medical students it was 12% (95%CI 3% to 20%) and in community residents it was 5% (95%CI 2% to 8%).ConclusionsThe overall prevalence of MRSA in healthy Chinese population is approximately 13.9%. Effective prevention and control measures are required to reduce the spread of MRSA.