ObjectivesTo systematically review the efficacy of home-based telerehabilitation (HTR) for stroke survivors.MethodsPubMed, EMbase, Web of Science, Joanna Briggs Institute Library, The Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on HTR for stroke survivors from inception to January 1st, 2019. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 RCTs involving 793 patients were included. The results of meta-analysis showed that: after 1 to 2 years of treatment, BI scores (MD=20.22, 95%CI 17.10 to 23.35, P<0.000 01) in HTR group were higher than those in the traditional rehabilitation group. However, there were no statistical differences between two groups in ARAT scores (SMD=0.16, 95%CI ?0.14 to 0.45, P=0.30) after 1 to 2 months of treatment, as well as MBI scores (SMD=0.98, 95%CI ?0.33 to 2.29, P=0.14) and FMA scores (SMD=0.57, 95%CI ?0.08 to 1.23, P=0.09) after 3 months of treatment, and CSI scores (MD=?1.48, 95%CI ?3.90 to 0.94, P=0.23) and BBS scores (MD=1.33, 95%CI ?1.15 to 3.81, P=0.29) after 6 months of treatment. The results of descriptive analysis indicated that there was no statistically significant difference in quality of life between the two groups at 6 months after intervention. However, the HTR group was superior to the traditional rehabilitation group after 2 years of treatment.ConclusionsCurrent evidence shows that, compared with traditional rehabilitation, long-term intervention (1-2 years) with HTR can improve the ability to perform activities of daily living and quality of life of stroke survivors. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
Objective To investigate the family-dependence status in patients with tumor, and analyze the related factors of family dependence. Methods The self-made family-dependence scale was distributed to 432 patients with tumor to asses their family dependence status. Results The mean score of family-dependence was 40±5.8. A total of 198 cases (45.8%) were family-dependent, including 52 mild cases, 98 moderate cases, and 48 severe cases. The logistic regression analyses showed that sex (OR=3.873, P=0.022), age (OR=2.378, P=0.035), and personality type (OR=1.079, P=0.028) were the related factors of family-dependence. Conclusion More attention should be paid to patients with tumor about their family-dependence. After being instructed, the family members should use proper emotional expression method to provide family support to the patients with tumor. The female patients, older patients, and patients with dependent personality should be encouraged to improve their self-care ability to avoid family-dependence as possible as they can.
ObjectiveTo collect and analyze the clinical data and quality of life of hemophilic children, understand the present condition of these patients in Sichuan Province, and analyze related influencing factors.
MethodWe retrospectively analyzed the clinical data of hemophilic children treated in our hospital from January 1, 2008 to May 30, 2015.
ResultsThere were 92 child patients from Sichuan Province with a median age of 9.6 years old (ranging from 3.6 to 18.0). There were 87 cases (94.6%) of hemophilia A and 5 (5.4%) of hemophilia B; the number of light cases was 4 (4.3%), of moderate cases was 67 (72.8%), and of severe cases was 21 (22.9%); eighteen (19.6) of the patients had family history. First bleeding episode occurred at a median age of 11 months (0-48 months). Mild bleeding occurred in 23 cases (25.0%), moderate bleeding in 31 cases (33.7%), and severe bleeding in 38 cases (41.3%). First bleeding site was mainly the mucous membrane of the skin, followed by the joint muscles. Fist joint bleeding occurred at a median age of 18 months (2-107 months). Forty-six patients (59.0%) had severe joint damage during the course of the disease. Intracranial hemorrhage occurred in 4 patients (4.3%), among whom 3 were cured and discharged from the hospital, and 1 had neurological sequelae. Median diagnostic age was 12 months (0-120 months). Sixty-two (67.4%) were diagnosed in a short period of time, 9 (9.8%) in a mediate period of time, and 21 (22.8%) in a long period of time. Forty (43.5%) of the patients had been given sufficient coagulation factors, while all the others had not received sufficient replacement therapy. Fifty-six (60.9%) children had received prophylactic treatment. First prophylaxis was administrated at a median age of 36 months (1-199 months), but 27 (48.2%) discontinued. The median score of the 29 retreated Disease Burden Scale was 22.7±11.6 (4-43), and among them, 11 (37.9%) could not care for themselves. Twenty-three participated in the assessment of social activity ability, among whom, 2 did not attend school, and 6 could not take part in the assessment because of school learning. Correlation analysis showed that there was no significant relationship between diagnostic timing and family history (P=0.795) or between diagnostic timing and areas they came from (P=0.495). However, significant association was found between diagnostic timing and the severity of first bleeding (r=0.392, P=0.035). Disease burden of family was significantly correlated with the number of target joints (r=0.370, P=0.048), and was not closely related with area, severity of bleeding, frequency of hemorrhage, medical insurance, or physical and social activities.
ConclusionsThe general diagnosis and treatment condition of child hemophilia in Sichuan is relatively under-developed with a high prevalence of joint damage, poor quality of life, and high disease burden to the family. Improvement in the care of hemophilia children is urgently needed.
Objective To understand the situation of commonly-used drugs, medical device and their storages in rural households among model well-off township hospitals in eastern, central and western China, and to provide the basis for the guidance of reasonably using and scientifically storing drugs. Methods The methods of combining simple random sampling and cluster sampling were used to investigate and analyze the situation of commonly-used drugs, medical device and their storages in 162 households from three well-off township hospitals in Shanghai, Zhejiang, and Sichuan provinces, respectively. Results The storage rates of commonly-used drugs of rural households in well-off towns were cold medicine (72.2%), wound paste (51.9%), cooling oil (39.5%), essential balm (36.4%), antihypertensive (27.8%), iodine tincture (14.2%), anti-diabetic drugs (13.0%) and other drugs (17.3%). The storage rates of medical devices were thermometer (50.0%), cotton swab (47.5%), sphygmomanometer (9.3%), injector (1.2%) and other devices (22.2%). A total of 66% of respondent families stored drugs and medical devices in a fixed drawer. Only 3.1% families stored drugs and medical devices in the special portable medical kit. Conclusion Rural families have a higher rate of household drugs among model well-off township hospitals in eastern, central and western China, and most drugs are OTC drugs. The storage rates of medical devices are not high. Many rural family-owned medical devices are linked with special chronic diseases in the family. A lot of rural families place drugs and medical devices randomly. There are many security risks, and it may affect the rational utilization of drugs.
ObjectiveTo explore the relationship between hand grip strength and depression and the moderating role of monthly household income level between grip strength and depression of community-dwelling female patients with type 2 diabetes.MethodsFrom March to June 2021, 3 communities in Chengdu were selected by convenience sampling method, and elderly female patients with type 2 diabetes were randomly selected from these communities. The patients were investigated through a self-made demographic and disease-related questionnaire and the Geriatric Depression Scale-15, and their grip strength was measured by a grip meter. The Process V3.3 plugin in SPSS 25.0 software was used to test the moderation effect.ResultsA total of 389 elderly female patients with type 2 diabetes were enrolled in this study. Spearman correlation analyses indicated that the grip strength was negatively correlated with the depression score (rs=?0.125, P=0.014), and positively correlated with the monthly household income level (rs=0.157, P=0.002); the depression score was negatively correlated with the monthly household income level (rs=?0.147, P=0.004). The results of the moderating effect showed that grip strength and monthly household income level could independently affect the patients’ depression scores [unstandardized partial regression coefficient (b)=?0.254, P=0.002; b=?1.552, P=0.009], and the interaction item of grip strength and monthly household income level was statistically significant for depression scores (b=0.065, P=0.031).ConclusionThe hand grip strength of community-dwelling elderly female patients with type 2 diabetes can negatively predict the level of depression, and the monthly household income level has a moderating effect between grip strength and depression.
ObjectiveTo evaluate the effects of home mechanical ventilation (HMV) for stable chronic obstructive pulmonary disease (COPD) patients with respiratory failure in Tongzhou district of Beijing city.
MethodsTwenty stable COPD patients with respiratory failure were included in the study.During the one-year follow-up period,4 patients died and 1 withdrew and 15 patients finished the follow-up.The patients was followed up by telephone each month and guided in drug administration,HMV,and rehabilitation therapy.At the beginning of the study and one year later,the patients were interviewed and accessed on the general data,nutritional status,COPD assessment test (CAT),Borg dyspnea and respiratory fatigue score,Hamilton depression scale,Hamilton anxiety scale,and arterial blood gas analysis.
ResultsAt the end of one-year follow-up,nutrition index,CAT,Borg dyspnea and respiratory fatigue score,Hamilton depression scale,Hamilton anxiety scale,pH,and PaO2 did not change significantly (P>0.05),while PaCO2 decreased significantly compared with those at the beginning of the study (P<0.05).Compared with the past year,the times of hospitalization due to acute exacerbation of COPD was significantly reduced during the follow-up year (P<0.05).
ConclusionHMV can ameliorate carbon dioxide retention and reduce times of hospitalization due to acute exacerbation of COPD for COPD patients with respiratory failure.
ObjectiveTo investigate the epidemiological characteristics of the first cluster of patients with coronavirus diseases 2019 (COVID-19) in Gansu.MethodsAll 6 COVID-19 patients from a non-familial cluster in Gansu, were extracted from Gansu Provincial Health Information System until Feb 20, 2020. The patients were confirmed by nucleic acid detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The analyses were included via retrospective method: patient clinical characteristics, the summary of epidemiology, and CT image characteristics.ResultsThis clustered outbreak was the first non-family clustered outbreak in Gansu after traveled to Thailand. All 6 COVID-19 confirmed patients were a kindergarten staff in Gansu, aged from 26 to 51 years, and were female. They traveled to Thailand in the same period, and had the same epidemiological exposure history. They were diagnosed as COVID-19 by transnasopharyngeal swab real-time fluorescent reverse transcription-PCR for SARS-CoV-2 nucleic acid examination at different time points after return to Gansu. The first patient was ill on January 21, 2020, with fever as first symptom. She was diagnosed at the Xigu District People’s Hospital in Lanzhou and was transferred to Lanzhou Pulmonary Hospital after being diagnosed. She was cured with one week’s antiviral treatment. The remaining 5 patients were treated in Longxi People’s Hospital. The common clinical symptoms were fever, throat discomfort, headache, and fatigue. Through 7 to 10 days’ antiviral treatment, they all were cured. All patients belonged to common type and had good prognosis.ConclusionThe COVID-19 patients in a non-familial cluster have the same epidemiological history. Early medical observation, SARS-CoV-2 nucleic acid examination and comprehensive chest CT should be arranged promptly to make diagnosis and give responsive treatment, so that the prognosis is often good.
