Recovery of severe COVID-19 complicated with cerebral infarction: Considerations on a case report.

RATIONALE: The standardization, individualization, and rationalization of intensive care and treatment for severe patients have improved. However, the combination of corona virus disease 2019 (COVID-19) and cerebral infarction presents new challenges beyond routine nursing care. PATIENT CONCERNS AND DIAGNOSES: This paper examines the rehabilitation nursing of patients with both COVID-19 and cerebral infarction as an example. It is necessary to develop a nursing plan for COVID-19 patients and implement early rehabilitation nursing for cerebral infarction patients. INTERVENTIONS: Timely rehabilitation nursing intervention is essential to enhance treatment outcomes and promote patient rehabilitation. After 20 days of rehabilitation nursing treatment, patients showed significant improvement in visual analogue scale score, drinking test, and upper and lower limb muscle strength. OUTCOMES: Treatment outcomes for complications, motor function, and daily activities also improved significantly. LESSONS: Critical care and rehabilitation specialist care play a positive role in ensuring patient safety and improving their quality of life by adapting measures to local conditions and the timing of care.

Predicting Risk of Insulin Resistance in a Chinese Population with Polycystic Ovary Syndrome: Designing and Testing a New Predictive Nomogram.

BACKGROUND: This research is aimed at establishing and internally validating the risk nomogram of insulin resistance (IR) in a Chinese population of patients with polycystic ovary syndrome (PCOS). METHODS: We developed a predictive model based on a training dataset of 145 PCOS patients, and data were collected between March 2018 and May 2019. The least absolute shrinkage and selection operator regression model was used to optimize function selection for the insulin resistance risk model. Multivariable logistic regression analysis was used to construct a prediction model integrating the function selected in the regression model of the least absolute shrinkage and selection operator. The predicting model's characteristics of prejudice, disease, and lifestyle were analyzed using the C-index, the calibration diagram, and the study of the decision curve. External validity was assessed using the validation of bootstrapping. RESULTS: Predictors contained in the prediction nomogram included occupation, disease durations (years), BMI, current use of metformin, and activities. With a C-index of 0.739 (95 percent confidence interval: 0.644-0.830), the model showed good differentiation and proper calibration. In the interval validation, a high C-index value of 0.681 could still be achieved. Examination of the decision curve found that the IR nomogram was clinically useful when the intervention was determined at the 11 percent IR potential threshold. CONCLUSION: This novel IR nomogram incorporates occupation, disease durations (years), BMI, current use of metformin, and activities. This nomogram could be used to promote the estimation of individual IR risk in patients with PCOS.

[Case control study on Mobi-C cervical artificial disc replacement and anterior cervical decompression MC+fusion for the treatment of cervical spondylosis].

OBJECTIVE: To compare the clinical effects and clinical indications between Mobi-C cervical artificial disc replacement (CADR) and MC+ anterior cervical decompression and fusion(ACDF) in treating cervical spondylosis. METHODS: The clinical data of 100 patients with cervical spondylosis treated ACDF or CADR from June 2009 to June 2015 were retrospectively analyzed. There were 53 males and 47 females, aged from 38 to 70 years old. Among them, 50 cases were treated by ACDF (ACDF group), follow-up time was for 22 to 42 months with an average of (32.24±5.20) months;other 50 cases were treated by CADR (CADR group), follow-up time was for 23 to 48 months with an average of (30.40±5.66) months. Odom criterion was used to evaluate the clinical effects in two groups. JOA score, including sensory function, motor function and bladder function was used to assess the spinal cord function. Preoperative and postoperative responsible intervertebral space heights, cervical curvatures were compared by image data between two groups. RESULTS: All incisions obtained good healing and no serious complications were found. At final follow-up, 30 cases got excellent results, 12 good, 8 fair in ACDF group;and 34 cases got excellent results, 10 good, 6 fair in CADR group;there was no significant difference between two groups(u=4.000, P=0.827). At final follow-up, the scores of sensory function and motor function were obviously improved(P<0.05), and bladder function had not obviously recovered (P>0.05) in two groups;and CADR group in the scores of sensory function and motor function were obviously better than of ACDF group(P<0.05). There was no significant difference in preoperative intervertebral space height, cervical curvature between two groups, and at final follow-up both had different recovered. The recovery of CADR group was obviously better than of ACDF group. CONCLUSIONS: CADR can quickly recover normal action for patients and retains the movement. CADR has certain advantages in recovering cervical curvature, improveing sensory function and motor function, but it is not able to completely replace ACDF.