Neuromyelitis optica spectrum disorder(NMOSD)is a rare autoimmune disease that can cause severe inflammation of the central nervous system(CNS),mainly affecting the optic nerve and spinal cord.This disease not only causes damage to physical function,but also brings a series of psychological and fatigue problems.Sleep disorders are common in patients with neuromyelitis optica spectrum disorder,co-appear with other clinical symptoms,and affect each other,seriously affecting the prognosis and physical and mental health of patients.More and more scholars have carried out related research.This article reviews the assessment tools and influencing factors of sleep disorders in patients with neuromyelitis optica spectrum disorder,in order to provide reference for early identification of sleep disorders in patients with neuromyelitis optica spectrum disorder and carry out related interventions.
This study aims to investigate the clinical manifestations,risk factors and treatment status of mental disorders after craniopharyngioma surgery in adults.The possible influencing factors for mental disorders in adult craniopharyngioma were discussed in detail,such as personal related factors,tumor-related factors,and treatment-related factors.It is intended to provide some references for the prevention and intervention of mental disorders in clinical adults with craniopharyngioma.Futhermore,it's aimed to provide new ideas for the research and treatment of craniopharyngioma psychological,behavioral and cognitive functions,to promote the research progress of postoperative mental disorders related to craniopharyngioma surgery.Finally,this study hopes to provide new solutions to alleviate other serious complications caused by craniopharyngioma surgery,and promote the long-term recovery and quality of life of craniopharyngioma.
Objective To investigate the psychological pain trajectory and influencing factors for first-episode stroke patients.Methods Totally 242 first-episode stroke patients who visited the Second Affiliated Hospital of Zhengzhou University from January 2022 to January 2023 were included in the study,with a loss of follow-up rate of 17.4%.A total of 200 patients participated in the study throughout the entire process.The psychological pain trajectory of patients at 1 month,3 months,and 6 months after discharge was investigated using general information survey questionnaire,disease related information survey questionnaire,and psychological pain temperature scale,and the influencing factors for psychological pain in first-episode stroke patients were investigated through Logistic regression analysis.Results The psychological pain trajectory of 200 first-episode stroke patients showed a certain decreasing trend from 1 month to 6 months after discharge.According to the DT score evaluation,the patients were divided into three types,namely 76 cases of no psychological pain,36 cases of sustained psychological pain,and 88 cases of reduced psychological pain.Logistic regression analysis showed that age,education level,working status,whether or not to take care of,and dysphagia were the main influencing factors for psychological pain in stroke patients(P<0.05).Conclusion The incidence of psychological pain in first-episode stroke patients is high,and patients present different psychological pain trajectories.Age,education level,working status,unattended,and dysphagia are the main factors affecting the psychological pain of patients.Personalized intervention should be carried out according to the risk factors in clinical work.
Objective To analyze the research status and hotspots of acupuncture intervention in insomnia by bibliometric method.Methods The researches related to acupuncture and moxibustion intervention in insomnia were obtained by searching the Web of Science core collection database,and the retrieval time limit was from the establishment of the database to March 31,2023.VOSviewer 1.6.16 was used to extract the authors,countries,institutions,and keywords included in the research,and generate high-yield co-authors,countries,and institution network diagrams and cluster maps of high-frequency keywords.CiteSpace 5.7.R5W burst word detection function was used to search for the mutation point of the keywords.Results Totally 901 documents were finally included,and the annual publication volume showed an increasing trend.China is the country with the most publications(297 articles),and the University of Hong Kong is the institution with the most publications(41 articles),3 863 authors participated in the study of acupuncture intervention for insomnia,among which Yeung Wingfai(19 articles)published the most articles,the main authors formed 6 teams,and there was a lack of close cooperation between the teams.The research hotspots of acupuncture-moxibustion intervention insomnia focus on clinical efficacy evaluation,insomnia caused by chronic pain,anxiety and depression after insomnia.Conclusion The research on acupuncture-moxibustion intervention for insomnia is in the development stage,and the amount of literature is increasing.China is in the leading position in this field.The internal cooperation of the team is relatively close,but the communication and cooperation between the teams need to be strengthened.Clinical efficacy evaluation is a research hotspot and a key research content at present.
Objective To investigate the effect of constipation on the freezing of gait(FOG)in Parkinson's disease(PD)and provide the evidence for the management of PD-FOG.Methods We recruited 1 135 cases which were diagnosed as PD in the Neurological Department of Xuanwu Hospital from May 26,2015 to January 8,2022.All cases were stratified into two groups according the manifestation of FOG and UPDRS-Ⅲ.All clinical materials were collected which included Hoehn-Yahr stages,UPDRS-Ⅲ,MMSE,HAMA and HAMD assessment.Serum complements and immunoglobulins were detected by ELISIA.The association between constipation and PD-FOG were analyzed.Results The ratios of PD-FOG and constipation were 23.96%and 51.36%,respectively.Longer duration,older age and constipation were independent risk factors for PD-FOG after adjusting age and sex by Logistic regression.Constipation could increase 1.77-fold risk for PD-FOG.The serum complement C3 was higher in constipation group than non-constipation group in PD patients.Conclusion Constipation could increase 1.77-fold risk for PD-FOG,and serum C3 may be involved in the process.
Objective To investigate the factors of cognitive dysfunction in patients with temporal lobe epilepsy(TLE)and its relationship with MRI subcortical structure volume.Methods A total of 166 patients with TLE who were treated in the Affiliated Hospital of Qinghai University from February 2019 to May 2022 were selected as the research objects.According to whether they had cognitive dysfunction,they were divided into abnormal group(n=86)and normal group(n=80).The propensity score matching(PSM)method was used to match the two groups according to 1∶1.The general data of the two groups were compared.Multivariate Logistic regression analysis was used to analyze the risk factors affecting the cognitive function of patients.The cognitive function of the two groups was compared,and the MRI subcortical structure volume of the two groups of patients was analyzed.Pearson correlation test was used to analyze the correlation between MRI subcortical structure volume and cognitive function in TLE patients.Results After matching,there was significant difference in family history of epilepsy between the two groups(P＜0.05).Compared with the normal group,the scores of WAIS-RC knowledge,WAIS-RC arithmetic,DSST,BDT,FDST,BDST,MoCA and VFT in the abnormal group were lower than those in the normal group(P＜0.05).CPS,seizure frequency of 1 time/month,family history of epilepsy and reduction of subcortical structure volume were independent risk factors affecting cognitive function(P＜0.05).The volume of bilateral thalamus,bilateral hippocampus and bilateral amygdala was significantly correlated with WAIS-RC knowledge,WAIS-RC arithmetic,VFT,MoCA,FDST,TMT-A and TMT-B scores(P＜0.05).Conclusion The volume of subcortical structures in patients with abnormal TLE cognition was less than that in patients with normal cognition.The volume of MRI subcortical structure is closely related to the cognitive function of TLE patients.
Objective To explore the clinical efficacy of anterior circulating aneurysmal wrapping and clamping method and the subsequent wrapping and clamping method by making a suitable diaphragm and fixing it on the aneurysmal clamp.Methods Forty-six patients with anterior circulating aneurysms who underwent intracranial aneurysm encapsulation and clipping in Ya'an People's Hospital from January 2018 to July 2022 were selected and divided into two groups according to intraoperative encapsulation methods for retrospective analysis.In group A,24 patients were treated by traditional aneurysmal encapsulation,which was followed by aneurysmal encapsulation and clipping.In group B,22 patients underwent aneurysm wrapping and clamping after making appropriate diaphragm and fixing it on appropriate aneurysm clamp according to the condition of aneurysm.The general situation,intraoperative aneurysm rupture,intraoperative blood loss,intraoperative occlusion time,postoperative infarction and rebleeding,and Glasgow outcome scale(GOS)score 6 months after surgery were compared between the two groups.Results There were no significant differences in age,sex,aneurysm site and size,preoperative Hunt-Hess scores and Fisher grades between the two groups(all P>0.05).The rates of intraoperative aneurysm rerupture(22.7%),postoperative infarction and rebleeding(9.1%)in group B were lower than those in group A(33.3%,20.1%),but the differences were not significant enough(χ2=1.183,0.486,respectively,all P>0.05).However,in terms of intraoperative occlusion time,intraoperative blood loss and GOS score 6 months after surgery,group B was significantly better than group A,and the differences were statistically significant(χ2=4.330,t=1.516,χ2=6.303,respectively,all P<0.05).Conclusion The appropriate diaphragm is made to fix on the aneurysm clip and then wrapped and closed during surgery,which can reduce the amount of intraoperative bleeding,shorten the blocking time,and have better clinical efficacy.
Objective To investgate the impacts of Baduanjin combined with EMG biofeedback therapy on EMG characteristics and self-dynamic balance of stroke hemiplegic patients.Methods One hundred stroke hemiplegic patients who received rehabilitation treatment in Nanjing First Hospital,Nanjing Medical University from June 2020 to June 2022 were selected,with 50 patients in each group.The routine group was treated by EMG biofeedback therapy,while the study group was treated by Baduanjin on the basis of the routine group.The self-dynamic balance,EMG characteristics,motor function[Fugl-Meyer assessment(FMA)score]and self-care ability[Barthel index(BI)score]were compared between the two groups.Results After treatment,the length of the movement trajectory of the center of gravity per unit area,the total length of the center of gravity movement trajectory and the average speed of the center of gravity swing in the standing position of the patients in the study group were lower than those in the conventional group(P<0.05).The iEMG of gastrocnemius,quadriceps and tibial anterior muscle in the study group were higher than those in the conventional group(P<0.05).The RMS of gastrocnemius,quadriceps and tibial anterior muscle in the study group were all lower than those in the conventional group(P<0.05).The FMA scores of upper and lower extremities were higher than those in the conventional group(P<0.05).The BI scores of the study group after 4 and 8 weeks of treatment were higher than those in the conventional group(P<0.05).Conclusion Baduanjin combined with EMG biofeedback can improve the self-dynamic balance ability of stroke hemiplegic patients,improve their muscle function and motor function,and improve their self-care ability.
Intracranial infection is one of the most common neurosurgical diseases and one of the most serious postoperative complications of neurosurgery.They progress as a result of the interaction of the infected microorganisms with the host.The key issues in curing intracranial infections are early and accurate identification of the infecting pathogen and precise use of pathogenically effective antibiotics.Identifying the pathogens responsible for intracranial infections is not an easy task when relying only on traditional testing methods.In recent years,the rapid development of second-generation sequencing technology(NGS)has made it possible to identify infectious pathogens at an early stage,and this technology can detect pathogens in a high-throughput,rapid,and efficient manner with high precision while also providing guidance for clinical drug use.NGS,as a new mean of detecting pathogens,has attracted a great deal of attention since its inception,and this article provides an overview of its application to intracranial infections caused by different pathogens,in order to let clinicians fully understand its advantages and disadvantages,so that NGS technology can play a greater role in the diagnosis of intracranial infections,thus alleviating the pain of patients.
Objective To investigate the efficacy and safety of intravenous thrombolysis in senile patients with different stroke types.Methods Elderly patients with ischemic stroke who received alteplase intravenous thrombolytic therapy in the Stroke Center of Zhengzhou Central Hospital from January 2018 to December 2021 were retrospectively analyzed and divided into small artery occlusion group,atherosclerosis group,cardiogenic embolism group and other groups with known causes according to TOAST etiological classification.Early effectiveness and incidence of bleeding within 36 hours were compared among patients with different etiologies.Results A total of 426 senile stroke patients with ischemic blood type were enrolled,including 171 patients(40.1%)in the small artery occlusion group,142 patients(33.4%)in the large atherosclerosis group,87 patients(20.4%)in the cardiogenic embolism group,and 26 patients(6.1%)in other known types.A total of 174 patients(40.8%)had hemorrhage after intravenous thrombolytic therapy,including 51 patients(12.0%)in the small artery occlusion group,65 patients(15.3%)in the atherosclerosis group,46 patients(10.8%)in the cardiogenic embolization group,and 12 patients(2.8%)in the other known classification group.There was significant difference in the early effective rate among all groups(χ 2=15.537,P=0.001).Multivariate regression results showed that stroke classification was an independent factor for bleeding within 36 hours after intravenous thrombolysis.Conclusion There are differences in the efficacy and safety of intravenous thrombolysis in elderly patients with ischemic stroke without any types.In clinical practice,patients with different etiology should take targeted intervention measures to improve the therapeutic effect.
Objective To investigate the value of serum C-X3-C motif chemokine ligand 1(CX3CL1)combined with retinol-binding protein 4(RBP4)in assessing the prognosis of patients with acute cerebral infarction(ACI)after intravenous thrombolysis.Methods The 120 patients with ACI admitted to the Affiliated Hospital of Inner Mongolia Medical University from January 2020 to June 2022 were selected as the ACI group and were divided into poor prognosis group and good prognosis group according to the modified Rankin scale,and another 60 healthy volunteers with physical examination in the same period were selected as the control group.Serum CX3CL1 and RBP4 levels were measured by ELISA.The factors influencing poor prognosis after intravenous thrombolysis in patients with ACI were analyzed,and the value of serum CX3CL1 and RBP4 levels on poor prognosis after intravenous thrombolysis in patients with ACI was assessed using receiver operating characteristic curves.Results Serum CX3CL1 and RBP4 levels were increased in the ACI group compared to the control group(P＜0.05).At 3 months follow-up,the incidence of poor prognosis in 120 ACI patients was 35.00%(42/120).Age,National Institutes of Health stroke scale score,CX3CL1,and RBP4 were independent risk factors for poor prognosis after intravenous thrombolysis in patients with ACI,and diffusion-weighted imaging-Alberta stroke project early computed tomography score was an independent protective factor(P＜0.05).The area under curve for serum CX3CL1,RBP4 and the combination of the two items to assess poor prognosis after intravenous thrombolysis in patients with ACI was 0.779,0.778 and 0.876,respectively,with the largest area under curve for the combination of the two items.Conclusion Elevated serum CX3CL1 and RBP4 levels in ACI patients are independently associated with poor prognosis after intravenous thrombolysis,and CX3CL1 combined with RBP4 is of high value in assessing poor prognosis after intravenous thrombolysis in ACI patients,and may be an adjunctive assessment index for prognosis after intravenous thrombolysis in ACI patients.
Objective To analyze the clinical efficacy of modified electroconvulsive therapy and escitalopram oxalate tablets in the treatment of patients with depressive episodes of bipolar disorder.Methods From October 2020 to December 2022,74 cases of bipolar disorder depression admitted to the Guangxi Zhuang Autonomous Region Brain Hospital were selected as the study objects.The patients was divided into observation group(37 cases)and control group(37 cases)by random number method.The control group was treated with oral quetiapine fumarate tablets,and the observation group was treated with escitalopram oxalate tablets and modified electroconvulsive therapy.Both groups were treated for 4 weeks,and the clinical efficacy,psychiatric symptoms,depression degree,cognitive function,neurotransmitter levels,and adverse effects were compared.Results The overall response rate of the patients in the observation group was 91.89%,which was higher than 72.97%of the control group(P<0.05).After treatment,PANSS score((34.96±5.23)points),HAMD-17 score((13.47±2.29)points),and TMT((131.42±8.97)s)in the observation group were lower than the control group((38.42±5.58)points,(15.51±2.44)points,(148.96±10.81)s,respectively),the neurotransmitter power of dopamine((14.96±1.39)Hz)and 5-HT((51.50±4.92)Hz)measured by EFG were higher than those in control group((13.79±1.15)Hz and(45.04±4.20)Hz,respectively),and the differences were statistically significant(P<0.05).The incidence of total adverse reactions in the observation group and control group was 29.73%and 43.24%,respectively,and the difference was not significant(P＞0.05).Conclusion The combination of modified electroconvulsive therapy with escitalopram tablets can relieve mental symptoms,depression degree,improve cognitive function,regulate neurotransmitter level,and have high safety.
Objective To investigate the correlation between grip strength and subjective cognitive decline in a gender-specific elderly population.Methods From January to March 2021,we selected the permanent residents in Yongqiao District of Suzhou City by convenient sampling method,of whom 245(40.6%)were males and 358(59.4%)were females.The subjects were divided into SCD group(395 cases)and non-SCD group(208 cases)based on the results of the subjective cognitive decline questionnaire 9(SCD-Q9).General information questionnaires,height and weight measurements,biochemical indexes and other related examinations were performed on all the respondent groups,and grip strength of both hands was measured using a grip strength device.Multi-factor Logistic regression was used to analyze the relationship between grip strength in different genders and SCD.Results Among 603 subjects,395 cases(65.5%)had subjective cognitive decline.The grip strength in the SCD group[(28.10±11.63)kg]was significantly lower than that in the non-SCD group[(33.31±9.71)kg],and the difference was statistically significant(t=5.522,P<0.001).The differences in smoking,education,waist circumference,age,and grip strength between the SCD and non-SCD group populations were statistically significant(all P<0.05).Logistic regression in the female population showed that grip strength was correlated with SCD without adjusting for confounders(OR=0.940,95%CI:0.920-0.960,P<0.001)and remained correlated with SCD after adjusting for the corresponding confounders(OR=0.942,95%CI:0.922-0.963,P<0.001).Conclusion In the male population,waist circumference is a risk factor for SCD.In the female population,low grip strength,smoking,high cholesterol,and low education level were risk factors for SCD.Grip strength measurement has the advantages of being simpler,more convenient,less expensive,and more efficient,and can be used as an indicator of subjective cognitive decline in the community to assess the elderly female population.
Objective To explore the effect of early comprehensive rehabilitation therapy combined with continuous right median nerve stimulation therapy on the awakening process in coma patients with severe craniocerebral injury.Methods A total of 110 severe craniocerebral injury coma patients admitted to Cangzhou People's Hospital from May 2021 to May 2022 were selected,and were divided into control group and study group according to the random number table method,with 55 cases in each group.The patients in control group received continuous right median nerve stimulation therapy,and the research group chose to add the early comprehensive rehabilitation treatment of biological wave based on the control group.Recovery status,expression of plasma markers of brain injury,cerebral perfusion related indexes,Glasgow coma scale(GCS)score,Glasgow outcome scale(GOS)score,NIHSS score and prognosis of patients in two groups were analyzed.Results Compared with the control group wake rate(2 weeks:21.82%;4 weeks:45.45%),wake duration(27.39±4.63)d),the wake rate(2 weeks:54.55%,4 weeks:76.36%)increased and wake duration((21.47±3.35)d)decreased(P<0.05).The neuron-specific enolase(NSE),plasma human S100B protein(S-100B),myelin basic protein(MBP)level and the NIHSS score decreased,and cerebral blood volume(CBV),cerebral blood flow(CBF),GCS score and GOS score increased.The improvement degrees of the study group were higher than those of the control group(P<0.05).The overall clinical response rate of the study group(89.09%)was higher than the control group(70.91%),P<0.05.Conclusion Early comprehensive rehabilitation treatment by biological wave combined with continuous right median nerve stimulation therapy can effectively reduce NSE,S-100B and MBP levels in coma patients with severe craniocerebral injury,and play a positive role in improving cerebral blood perfusion in patients and accelerate the recovery.
Objective To explore the relationship between cognitive impairment and microvascular dysfunction in elderly depression population.Methods Totally 108 elderly depression patients who were treated in the Third People's Hospital of Chengdu from January 2020 to February 2023 were selected,including 48 patients with cognitive impairment and 60 patients without cognitive impairment.The differences in clinical general information and factors related to microvascular dysfunction between patients with and without cognitive impairment were compared.Results The age of patients with cognitive impairment was(75.54±5.02)years old,which was higher than that of patients without cognitive impairment(69.03±4.42)years old(P<0.05).The proportion of patients with cognitive impairment living alone was 47.92%,which was higher than that of patients without cognitive impairment 21.67%(P<0.05).The proportion of moderate to severe depression in patients with cognitive impairment was 75.00%,which was higher than that in patients without cognitive impairment 40.00%(P<0.05).The homocysteine(Hcy)of patients with cognitive impairment was(31.19±8.18)μ mol/L,which was higher than that of patients without cognitive impairment(16.65±7.55)mol/L(P<0.05).The proportion moderate to severe of enlargement of the perivascular space around the central oval(EPVS)and EPVS in the basal ganglia area of patients with cognitive impairment was 64.58%and 66.67%,respectively,which was higher than those without cognitive impairment 36.67%and 41.67%(P<0.05).There was a negative correlation between Hcy,central oval EPVS,basal ganglia EPVS,and MMSE scores in elderly depression patients(P<0.05).There was no correlation between factors related to microvascular dysfunction and depression severity score in elderly depression patients(P>0.05).Logistic regression analysis showed that age,degree of depression,Hcy,and central oval EPVS were the influencing factors for cognitive impairment in patients(P<0.05).Conclusion Cognitive impairment in elderly depression is associated with risk factors related to microvascular dysfunction,and risk factors related to microvascular dysfunction,there is a correlation between Hcy,EPVS,and patient cognitive score.
Objective To compare the efficacy of aneurysm interventional embolization and microsurgical clipping in the treatment of Hunt-Hess grade Ⅰ-Ⅲ ruptured aneurysms.Methods The data of patients with Hunt-Hess grade Ⅰ-Ⅲ ruptured aneurysms admitted to the Dazhou central Hospital from September 2019 to September 2022 were retrospectively analyzed,and the patients were divided into embolization group(aneurysm interventional embolization,102 cases)and clipping group(microsurgical clipping,106 cases)according to different surgical methods.Surgical indicators(surgical time,intraoperative blood loss and hospital stay)and occurrence of postoperative complications were recorded in the two groups.National Institutes of Health stroke scale(NIHSS)score and modified Barthel index(MBI)before surgery and at 1 month after surgery and prognosis results[Glasgow outcome scale(GOS)]and imaging results(recurrence,residual stability,disappearance of aneurysms)at 6 months after surgery were compared between the two groups.Multivariate risk factors for prognosis of patients were analyzed.Results The surgical time and hospital stay were significantly shorter or less in embolization group than those in clipping group(P<0.05).There were no significant differences in the occurrence of complications between the two groups(P>0.05).At 1 month after surgery,the NIHSS score in both groups was declined(P<0.05),while the modified Barthel index was risen(P<0.05),but there were no statistical difference in the NIHSS and modified Barthel index between both groups(P>0.05).There were no significant differences in the prognosis results at 6 months after surgery between the two groups(P>0.05).However,the recurrence rate in embolization group was significantly higher than that in clipping group(P<0.05),and the disappearance state of aneurysm was lower than that in clipping group(P<0.05).There were 178 cases(85.58%)with good prognosis and 30 cases(14.42%)with poor prognosis.Univariate analysis showed that there were statistical differences in the Hunt-Hess grading and aneurysm diameter(P<0.05),but there were no statistically significant differences between the two groups in terms of gender,age,aneurysm site,surgical method and postoperative related complications(P>0.05).Multivariate binary Logistic regression analysis indicated that Hunt-Hess grading and aneurysm diameter were postoperative independent risk factors(P<0.05).Conclusion The application of aneurysm interventional embolization in patients with Hunt-Hess gradeⅠ-Ⅲruptured aneurysms can effectively shorten the surgical time and hospital stay and reduce the incidence rates of postoperative complications,but its postoperative recurrence rate and disappearance state of aneurysms are worse than those of microsurgical clipping.The prognosis of patients is closely related to Hunt-Hess grading and aneurysm diameter.
Objective To explore the characteristics of EEG discharge mode patterns and risk factors for seizures in children with cerebral palsy.Methods From January 2018 to January 2022,36 children with cerebral palsy admitted to Ningde Municipal Hospital were selected as the research subjects.According to whether they had epilepsy,they were divided into cerebral palsy with epilepsy group(n=16)and cerebral palsy without epilepsy group(n=20),and the characteristics and risk factors for brain discharge patterns were analyzed.Results The incidence of abnormal EEG discharge in the cerebral palsy with epilepsy group was 93.75%,and was significantly higher than 30.00%in the cerebral palsy without epilepsy group,with a statistically significant difference(P<0.05).The EEG findings in 16 children of cerebral palsy with epilepsy were 6(37.50%)cases of focal discharges,3(18.75%)cases of multifocal discharges,5(31.25%)cases of hyperdisturbed,and 1(6.25%)case of generalized discharge.The results of univariate analysis showed that the incidence of maternal multiple pregnancy,perinatal asphyxia,intrauterine distress,congenital malformation,and spasm in the cerebral palsy with epilepsy group was higher than that of cerebral palsy without epilepsy group,and the difference was statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that maternal multiple pregnancy,perinatal asphyxia,intrauterine distress,congenital malformation,and spspasm were independent risk factors for cerebral palsy with epilepsy,with statistically significant differences(P<0.05).Conclusion The EEG discharge mode of epilepsy in children with cerebral palsy is mainly focal discharge and high arrhythmia.The main risk factors include maternal multiple pregnancy,neonatal perinatal asphyxia,intrauterine distress,congenital malformation,spasm and limb cerebral palsy,which should be paid attention to clinically and given active intervention measures.
Objective To analyze the incidence of venous thromboembolism(VTE)in patients with cerebral apoplexy during hospitalization and its influencing factors.Methods A total of 96 cases of stroke patients admitted to the Emergency Department of Jiangsu Provincial People's Hospital from July 2019 to July 2022 were selected.According to the incidence of VTE during hospitalization,they were divided into VTE group(n=26)and non-VTE group(n=70).The clinical data of the two groups were compared,and the influencing factors for VTE were determined by multivariate Logistic regression analysis.Results The age,NIHSS score,serum D-D level,the proportion of female,long-term bed rest,smoking history,previous VTE history,use of dehydrating agent,femoral vein puncture/catheterization,lower limb swelling in VTE group were higher than those in non-VTE group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that age(OR=1.633,95%CI:1.108-2.407),NIHSS score(OR=1.809,95%CI:1.156-2.831),serum D-D(OR=1.493,95%CI:1.077-2.070),long-term bed rest(OR=2.240,95%CI:1.245-4.030),previous VTE history(OR=2.711,95%CI:1.239-5.932),femoral vein puncture/catheterization(OR=2.465,95%CI:1.188-5.115)and lower limb swelling(OR=2.933,95%CI:1.357-6.339)were the influencing factors for VTE in stroke patients during hospitalization(P<0.05).Conclusion Stroke patients with older age,high NIHSS score,serum D-D level,long-term bed rest and lower limb swelling,previous history of VTE,and femoral vein puncture/catheterization are more likely to develop VTE.Early intervention and prevention can be carried out for these patients to reduce the risk of VTE.
Objective To explore the diagnostic value of video-electroencephalogram in aged patients with mechanical ventilation delirium in intensive care unit(ICU),and observe the characteristics of electroencephalogram burst inhibition.Methods A total of 98 cases of suspected delirium induced by mechanical ventilation in the elderly ICU were included from June 2020 to June 2022.All patients were given continuous video-electroencephalogram monitoring.With the confusion assessment method(CAM)scale as the gold standard,the diagnostic value of video-electroencephalogram in the elderly ICU patients with mechanical ventilation delirium was analyzed,and the electroencephalogram burst inhibition characteristics of the elderly ICU patients with mechanical ventilation delirium were observed.The baseline data of delirium patients and non-delirium patients were compared,and the related factors that affect the occurrence of delirium were andyzed.Results The results evaluated by CAM showed that among the 98 elderly ICU mechanical ventilation suspected delirium patients,76 cases(77.55%)experienced delirium,and 22 cases(22.45%)experienced non-delirium.Based on the results of CAM evaluation as the gold standard,the sensitivity,specificity and accuracy of video-electroencephalogram in the diagnosis of delirium in elderly ICU patients undergoing mechanical ventilation were 89.47%(68/76),81.82%(18/22)and 87.76%(86/98),respectively,indicating that it had certain diagnostic value.The incidence of burst inhibition by video-EEG in delirium patients was significantly higher than that in non-delirium patients(χ 2=37.473,P<0.05).The main symptoms in the outbreak inhibition period were sleep-waking disorder,building ability disorder,and rapid behavior change.In the awake period,the consciousness level,language clarity,and attention were restored best.Logistic regression analysis showed that mechanical ventilation time and sedative drugs were the risk factors for delirium in elderly ICU patients undergoing mechanical ventilation(OR>1,P<0.05).Conclusion Video-electroencephalogram has certain diagnostic value in elderly patients with mechanical ventilation delirium in ICU.The main characteristics of video-electroencephalogram in burst inhibition stage are sleep-waking disorder,structural ability disorder and rapid behavior change,which may be the early warning of delirium.
Objective To investigate the prognostic factors for patients with intracranial hemorrhage based on intracranial pressure,brain-derived neurotrophic factor(BDNF)and clinical factors,and to construct a Nomogram prediction model,so as to provide reference for clinical development of reasonable prevention and treatment measures and improvement of patient prognosis.Methods Totally 212 patients with intracranial hemorrhage admitted to Hebei Province Chest Hospital from January 2020 to June 2022 were selected as the study objects,and were divided into the good prognosis group and the poor prognosis group according to Glasgow outcome scale(GOS)6 months after removal of neuroendoscopic hematoma.The levels of BDNF,tissue matrix metalloproteinase-1(TIMP-1)and matrix metalloproteinase-9(MMP-9)were statistically compared between the two groups.The influencing factors for prognosis were analyzed by univariate analysis,and collinear diagnosis was carried out.Variables were screened and included in COX regression equation analysis to construct Nomogram prediction model.According to 3︰1 ratio,the data set was divided into training set and validation set.Receiver operating characteristic(ROC)curve,Calibration curve and decision curve were used to verify the distinguishing ability,calibration degree and clinical validity of the model.Results There were significant differences between the two groups in age,hematoma clearance rate,GCS score,intracranial pressure,BDNF,TIMP-1,MMP-9,operation timing,blood loss,ventricle rupture,standard postoperative rehabilitation exercise and postoperative rebleeding(P<0.05).Collinear diagnosis showed that age,hematoma clearance rate,and operation timing were excluded to analyze the influencing factors for prognosis.GCS score,postoperative rebleeding,MMP-9,BDNF,TIMP-1,amount of blood loss,intracranial pressure,standard postoperative rehabilitation exercise,and ventricle rupture were the adverse influencing factors for prognosis(P<0.05).In the training set and validation set,the AUC of Nomogram prediction model for predicting poor prognosis was 0.953 and 0.980,respectively,with good calibration degree and clinical benefit.Conclusion GCS score,postoperative rebleeding,MMP-9,BDNF,TIMP-1,amount of bleeding,intracranial pressure,standardized rehabilitation exercise after surgery,and ventricle rupture are the influential factors for the adverse prognosis of patients with intracranial hemorrhage.Based on the above influential factors,the Nomogram prediction model was constructed,which has certain predictive value for the adverse prognosis and has clinical practical value.The model can be used to screen high-risk groups and formulate early intervention measures to improve the prognosis of patients.
