Serious motor dysfunction is the leading cause of disability in individuals with stroke. Rehabilitation is the most effective intervention. Taking “stroke” “cerebrovascular accident” “rehabilitation” “motor dysfunction” and other key words, the relevant studies published from January 2015 to January 2020 were searched in Web of Science database to explore the advance in rehabilitation of motor dysfunction in individuals with stroke based on basic and clinical researches. Basic researches mainly focused on the mechanism of neural plasticity, neural loop and various intervention measures, and clinical researches mainly focused on novel rehabilitation intervention technologies for motor dysfunction in individuals with stroke. In addition, mechanism and rehabilitation are still two hotpots in the field of the disease. This paper reviews the search results in order to provide reference for subsequent relevant clinical work and scientific research.
摘要:目的: 觀察01%他扎羅汀乳膏(樂為)治療尋常型痤瘡的臨床療效和安全性。 方法 :以輕中度痤瘡患者40例,隨機分為治療組20例,外用01%他扎羅汀乳膏每晚1次,連用4周;對照組20例,外用01%維A酸霜每晚1次,連用4周,停藥后觀察療效。 結果 : 治療組基愈8例,顯效7例,總有效率75%; 對照組基愈5例,顯效6例,總有效率55%。兩組結果經統計學處理,差異有顯著性,P lt;005。 結論 : 他扎羅汀乳膏治療尋常型痤瘡安全、有效。Abstract: Objective: To evaluate the efficacy and safety of 01% Tazarotene Cream (Tazhaluoting Rugao)in the treatment of acne vulgaris. Methods : 40 patients, diagnosed clinically to have mild to moderate acne vulgaris were randomly and averagely assigned to two groups. 01% Tazarotene Cream and 01%Tretinoin Cream were used respectively daily night for 4 weeks on these two groups. Observe the efficacy after the ointment withdrawal. Results : 8 patients were basically cured and 7 improved in the experiment group, the total effective rate was 750%. 5 patients were basically cured and 6 improved in the control group, the total effective rate was 550%. There is significant difference between these two groups statistically (P lt;005). Conclusion : Tazarotene Cream is quite effective and safe in the treatment of acne vulgaris.
Objective To investigate the clinical application value of GeneXpert Mycobacterium tuberculosis (MTB)/ rifampin (RIF) in urine samples for tuberculosis diagnosis. Methods The patients with clinically highly suspected tuberculosis admitted to West China Hospital of Sichuan University between January 1, 2018 and June 1, 2023 were selected retrospectively. The diagnostic efficacy of urine GeneXpert MTB/RIF detection, such as sensitivity, specificity, positive predictive value, and negative predictive value, were retrospectively analyzed to evaluate its clinical value in the diagnosis of tuberculosis. Correlation analysis was further conducted to explore the correlation between positive levels of GeneXpert MTB/RIF in urine samples and laboratory test indicators. Results A total of 400 patients were included. Among them, 163 cases were in the clinical tuberculosis group and 237 cases were in the clinical non tuberculosis group. In the clinical tuberculosis group, 112 cases were urogenital tuberculosis patients and 51 cases were non-urogenital tuberculosis patients. The sensitivity, specificity, positive predictive value, and negative predictive value of urine GeneXpert MTB/RIF in the diagnosis of tuberculosis were 55.2%, 97.5%, 93.8% and 76.0%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of urine GeneXpert MTB/RIF in the diagnosis of urogenital tuberculosis were 65.2%, 92.0%, 76.0% and 87.2%, respectively, and the diagnostic sensitivity was further improved. Correlation analysis showed that the positive degree of urine GeneXpert MTB/RIF was correlated with the levels of hemoglobin, serum total protein, blood serum albumin, and other indicators. Conclusions Urine GeneXpert MTB/RIF detection offers high sensitivity and specificity in the diagnosis of tuberculosis, especially in urogenital tuberculosis, which is helpful for the early and rapid diagnosis of tuberculosis patients. The positive degree reported by the GeneXpert MTB/RIF in urine may indicate disease severity.
Objective
To study the clinical protective effect of hemoperfusion combined with hemofiltration on inflammatory reaction of hyperlipidemia severe acute pancreatitis (HLSAP).
Methods
Thirty-seven patients with HLSAP treated between January 2012 and December 2014 were selected and divided into three groups based on different treatments. Thirteen patients were allocated into hemoperfusion combined with continuous veno-venous hemofiltration group (HP+CVVH group) and treated with hemoperfusion combined with hemofiltration; 11 patients were allocated into continuous veno-venous hemofiltration group (CVVH group) and treated with hemofiltration; and all the other patients were allocated into control group and treated with conventional treatment. The levels of blood triglyceride, C-reactive protein, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8) and acute physiology and chronic health evaluation (APACHE)Ⅱ score of the patients after treatment were observed. The hospital stay, organ dysfunction rate and mortality of the patients were measured.
Results
Compared with the control group, the levels of blood triglyceride, C-reactive protein, TNF-α, IL-6, IL-8 and APACHE Ⅱ score of the patients in the HP+CVVH group and CVVH group were both significantly reduced 72 hours after therapy (P<0.05). However, the levels of blood triglyceride, C-reactive protein, TNF-α, IL-6, IL-8 and APACHE Ⅱ score of the patients in the HP+CVVH group were significantly lower than those in the CVVH group at the same time point (P<0.05). The hospital stay of the patients in the HP+CVVH group and CVVH group was significantly shorter than that in the control group (P<0.05). Compared with the CVVH group, the hospital stay of patients in the HP+CVVH group was significantly shorter (P<0.05). There was no statistical difference in organ dysfunction rate and mortality among the three groups (P>0.05).
Conclusion
Hemoperfusion combined with hemofiltration is an effective method for HLSAP by cleaning the inflammatory mediators availably and inhibiting the excessive inflammatory reaction.
Chronic kidney disease (CKD) is a public health issue of global concern, and nutritional management of CKD can improve the nutritional status of patients and slow down the progression of the disease. However, nutrition management is a complex scientific issue, and there are few clinical practices of nutrition management in CKD, so there is an urgent need for a theoretical framework of nutrition management to guide the construction of a scientific and standardized program. This review will systematically describe the relationship between nutrition and kidney disease, sort out the current status of nutrition management in CKD in China, introduce the experience of CKD medical and nursing nutrition integration in West China Hospital of Sichuan University, and provide thoughts for further improvement of standardized scientific formulation of nutrition management strategy.
ObjectiveTo explore the current status of treatment adherence in patients with chronic kidney disease without dialysis and to analyze its influencing factors.MethodsThe patients who visited the Outpatient Department of Nephrology of West China Hospital of Sichuan University from September to December 2020 were taken as the research objects. Self-designed general information questionnaire, treatment adherence questionnaire, physician-patient communication satisfaction, health information seeking behavior questionnaire, and physician-patient concordance questionnaire were used to investigate, and path analysis was used to explore the influencing factors of treatment adherence.ResultsA total of 203 valid questionnaires were obtained. Treatment adherence score was (21.69±2.42) points, self-reported health status was (2.48±0.91) points, physician-patient concordance was (20.39±2.70) points, physician-patient communication satisfaction was (67.73±5.52) points, and health information seeking behavior was (13.17±2.65) points. Health information seeking behavior (r=0.214, P=0.002), physicians-patient concordance (r=0.494, P<0.001), physician-patient communication satisfaction (r=0.229, P=0.001) were positively correlated with treatment adherence. Self-reported health status was negatively correlated with treatment adherence (r=?0.225, P=0.001). Path analysis showed that physicians-patient concordance was the most influencing factor of treatment adherence (total effect=0.474).ConclusionHealth information-seeking behavior and physicians-patient concordance are important factors affecting treatment adherence in chronic kidney disease patients without dialysis. In order to improve treatment adherence of chronic kidney disease patients, healthcare providers can provide various ways to provide information, which can help make more disease-related health knowledge available to patients. Moreover, healthcare workers should also further explore ways to improve the concordance related to reaching agreement between doctors and patients on medical and treatment options.
Based on the national 2020 and 2022 versions of Accreditation Standards for Tertiary Hospital, the Hospitals Accreditation Office of the Sichuan Provincial Health Commission organized to develop Implementation Rules for the Accreditation Standards for Tertiary Comprehensive Hospitals in Sichuan Province (2023 Edition). In order to guide the evaluated hospitals to comprehensively understand and master the content of hospital infection prevention and control (IPC), this article interprets the main evaluation points and scoring methods of hospital infection management in the detailed rules, emphasizes on organizational management, system implementation, monitoring/supervision, and connotation improvement for IPC. The purpose is to make the evaluated hospitals attach importance to the standardized implementation of daily work of IPC, focus on the routine, objective, and quantitative approach to accreditation work, and continuously achieve the effect of quality improvement in IPC.
Objective To explore the role of using a workshop combined with diversified teaching model in undergraduate general practice. Methods Undergraduate students who enrolled in the Class 2022 general medicine course of Shanghai Jiao Tong University School of Medicine were selected between February and June 2023. Two classes were selected from undergraduate students who enrolled in the Class 2022 general medicine course using a simple random sampling method. One class was selected as the control group (using the workshop teaching mode), while the other class was selected as the experimental group (using the workshop combined with diversified teaching mode). The evaluation of teaching effect, teaching satisfaction, career intention and final scores of the control group and the experimental group were compared. Results A total of 120 students were included, with 60 students in each group. There was no statistically significant difference in the gender, age, and previous general medicine course exam scores between the two groups (P>0.05). The evaluation of teaching effect by the experimental group was higher than that of the control group (P<0.05). The teaching satisfaction scores of the experimental group on teaching atmosphere (85.16±9.44 vs. 81.65±8.15), teaching mode (86.30±9.12 vs. 79.27±9.33), and teaching management (84.20±7.05 vs. 80.10±7.15) were higher than those of the control group (P<0.05). The experimental group had a higher career intention than the control group (45 vs. 32 people; χ2=6.125, P=0.013). The theoretical course scores (71.77±7.10 vs. 66.14±7.45), internship scores (10.32±3.34 vs. 8.58±2.56), and total scores (82.09±9.36 vs. 74.58±8.45) of the experimental group were higher than those of the control group (P<0.05). Conclusion The application of workshop combined with diversified teaching mode in undergraduate general medicine course teaching can improve students’ evaluation of teaching effect, teaching satisfaction and final scores, as well as change students’ career intention.
ObjectiveTo explore the application and effect of clinical nursing pathway based on information-knowledge-attitude-practice (IKPA) theory in percutaneous renal needle biopsy.MethodsThis is a historical control study. A total of 460 patients who underwent percutaneous renal biopsy in West China Hospital of Sichuan University between April and December 2020 were prospectively recruited as the pathway group, and a clinical nursing pathway based on IKAP theory was implemented. By contrast, the data of 617 patients who underwent percutaneous renal biopsy and received routine care in the same hospital between April and December 2019 were retrospectively collected as the control group. The length of hospital stay, hospitalization expenses, the incidences of postoperative complications (macroscopic haematuria, perirenal hematoma, and acute urinary retention), the incidence of postoperative postural hypotension, and the management enrollment rate of chronic kidney disease patients were compared between the two groups.ResultsThe length of hospital stay [median (lower quartile, upper quartile): 8 (7, 11) vs. 8 (7, 12) d] and the hospitalization expenses [median (lower quartile, upper quartile): 7380.50 (6401.86, 8789.21) vs. 8167.00 (6816.50, 10044.50) yuan] were less in the pathway group than those in the control group, the incidences of postoperative macroscopic haematuria (1.52% vs. 6.97%) and perirenal hematoma (2.61% vs. 5.02%) were lower in the pathway group than those in the control group, the management enrollment rate of chronic kidney disease patients was higher in the pathway group than that in the control group (26.09% vs. 6.16%), and the differences between the two groups were statistically significant (P<0.05). The differences in the incidences of acute urinary retention (8.26% vs. 11.18%) and postoperative postural hypotension (0.00% vs. 0.81%) between the two groups were not statistically significant (P>0.05).ConclusionThe application of clinical nursing pathway in percutaneous renal needle biopsy can effectively reduce the length of hospital stay and hospitalization expenses, and improve the management enrollment rate of chronic kidney disease patients.
In order to improve the accuracy and reliability of the electrodes implant location when using spinal functional electrical stimulation to rebuild hindlimb motor function, we measured the distributions of function core regions in rat spinal cord associated with hindlimb movements. In this study, we utilized three-dimensional scanning intraspinal microstimulation technology to stimulate the rat spinal cord to generate hip, knee and ankle joint movements, and acquired the coordinates of the sites in spinal cord which evoked these movements. In this article, 12 SD rats were used to overcome the individual differences in the functional region of the spinal cord. After normalized and overlaid the messages, we obtained the function core regions in spinal cord associated with ankle dorsiflexion movement, hip flexion movement, hip extension movement and hip adduction movement. It provides a reference for rebuilding the hindlimb movement function with micro-electronic neural bridge.
