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Objective:To investigate the effects of butylphthalide combined with ozagrel sodium on the National Institutes of Health Stroke Scale (NIHSS) score, activities of daily living (ADL) score, and coagulation function in patients with acute cerebral infarction.Methods:Ninety-four patients with acute cerebral infarction who were admitted to Gujiao Medical Group Central Hospital from January 2019 to November 2021 were included in this study. They were randomly assigned to undergo treatment with either ozagrel sodium (control group, n = 47) or butylphthalide combined with ozagrel sodium (observation group, n = 47) for 14 consecutive days. Before and after treatment, NIHSS score, ADL score, coagulation function (thrombin time, prothrombin time, D-dimer, activated partial thrombin time), bilateral middle cerebral artery blood flow status (mean blood flow velocity (Vm), resistance index, pulsatility index), brain tissue damage factor (brain natriuretic peptide, neuron-specific enolase, S100 β protein) and the incidence of adverse drug reactions were compared between the two groups. Results:Before treatment, there were no significant differences in NIHSS and ADL scores between the two groups (both P > 0.05). After treatment, the NIHSS score was significantly lower in the observation group than that in the control group [(8.70 ± 1.62) points vs. (9.45 ± 1.2) points, t = 2.51, P < 0.05]; the ADL score was significantly higher in the observation group than that in the control group [(65.15 ± 7.41) points vs. (61.20 ± 6.32) points, t = 2.78, P < 0.05]. Before treatment, there were no significant differences in thrombin time, prothrombin time, D-dimer, and activated partial thrombin time between the two groups (all P > 0.05). After treatment, thrombin time, prothrombin time, and activated partial thrombin time were significantly higher in the observation group than those in the control group ( t = 4.34, 3.00, 2.63, all P < 0.05). After treatment, D-dimer level in the observation group was significantly lower than that in the control group ( t = 3.39, P < 0.05). Before treatment, mean blood flow velocity, resistance index, and pulsatility index were similar between the two groups (all P > 0.05). After treatment, the mean blood flow velocity in the observation group was significantly higher than that in the control group ( t = 3.23, P < 0.05). The pulsatility index and resistance index were significantly lower in the observation group than those in the control group ( t = 2.14, 3.16, both P < 0.05). Before treatment, there were no significant differences in brain natriuretic peptide, neuron-specific enolase, and S100 β protein levels between the two groups (all P > 0.05). After treatment, brain natriuretic peptide, neuron-specific enolase, and S100 β protein levels in the observation group were significantly lower than those in the control group ( t = 3.09, 2.18, 3.33, all P < 0.05). There was no significant difference in incidence of adverse reactions between the observation and control groups [6.38% (3/47) vs. 2.13% (1/47), P > 0.05]. Conclusion:Butylphthalide combined with ozagrel sodium for the treatment of acute cerebral infarction can reduce neurological dysfunction and brain tissue injury, and improve coagulation function, hemodynamic state of the middle cerebral artery, and activities of daily life, without increasing adverse reactions.
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Objective:To explore the effectiveness of Acute Care of the Elderly(ACE)model and its existing problems in the clinical practice for older adults with acute clinical conditions.Methods:Using the random number table method, a random number sequence was generated, and the patients admitted to the Department of Geriatrics of Shenzhen Nanshan Hospital due to acute diseases From January 2019 to September 2021 were enrolled in the ACE model intervention group(160 cases)and the control group(77 cases)in a 2: 1 ratio.The inclusion criteria were based on disease severity, frailty assessment, and activity of daily living(ADL)assessment.The intervention time was 1-3 weeks.Outcomes of the patients include ADL, hospitalization days, hospitalization expenses, drug proportion, human resource investments, adverse events, 30-day readmission rate, and 1-year mortality.Results:There were no significant difference in baseline indicators such as frailty index and ADL score between the two groups at admission.The ADL score(Barthel index)of the ACE group was significantly improved compared with the control group at discharge(81.71±14.23 vs.70.9±23.89, P<0.001)and at 30 days after discharge(85.84±15.25 vs.68.29±30.91, P<0.001). The hospital cost[(12 735.81±6 541.41)￥ vs.(16 391.54±12 962.34)￥, P=0.002], drug proportion(21.34% vs.28.93 %, P=0.036)and 30-day readmission rate(13.1% vs.23.4%, P=0.037)of the ACE group were significantly lower compared to the control group.The human resource input(32.97±6.72 vs.25.03±5.31, P=0.008)and patient satisfaction(98.23% vs.90.66%, P=0.031)in the ACE group were significantly higher than those of the control group.(4)The incidence of adverse events during hospitalization was significantly lower in the ACE group than in the control group in terms of aspiration(0.63% vs.20.8%, P<0.001), falls(0 vs.10.4%, P<0.001), incontinence dermatitis(0 vs.3.9%, P=0.033), and 1-year mortality(6.3% vs.24.7%, P<0.001). There was no significant difference in the average length of stay(8.98±4.25 vs.10.03±5.32, P=0.101), pressure sores(13.01±4.77 vs.13.27±4.89, P=0.364), DVT risk score(8.53±2.79 vs.8.89±2.76, P=0.340)and medical staff satisfaction(73% vs.80%, P=0.240)between the two groups. Conclusions:The ACE model helps to reduce the disability rate of elderly patients with frailty, adverse events during hospitalization, save drug costs, and improve patient satisfaction.It is worth promoting in geriatric practice, but its localization management details and processes still face many challenges.
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ObjectiveTo discuss the effect of forgetting curve based self-management on cognitive function， daily living ability and treatment efficacy of patients with mild cognitive impairment （MCI）. MethodsSimple random sampling method was adopted to enroll 162 MCI patients who met the diagnostic criteria of "Expert Consensus on the Prevention and Treatment of Cognitive Impairment in China" in Nanchong Physical and Mental Hospital and Gaoping Ledele Seniors-Oriented Apartment from April 2020 to June 2021. The selected individuals were classified into study group and control group according to random number table methods， each with 81 cases. Both groups received routine intervention， based on this， study group received the forgetting curve based self-management. The interventions lasted for 3 months in two groups， and patients were assessed using Montreal Cognitive Assessment Scale （MoCA） and Activity of Daily Living Scale （ADL） at the baseline and end of interventions. Then the clinical efficacy was compared between groups. ResultsAfter intervention， an increase was found in MoCA and ADL scores in both groups （tcontrol group=25.004， 12.503， tstudy group=48.211， 24.949， P<0.01）， and post-intervention MoCA and ADL scores in study group were higher than those in control group （t=28.527， 9.433， P<0.01）. The overall efficacy rate was 86.42% in control group， which was lower than 96.30% in study group， with statistical difference （χ²=5.004， P<0.05）. ConclusionForgetting curve based self-management may ameliorate the cognitive function and daily living ability in MCI patients， thus improving the treatment efficacy.
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Objective@#To investigate the effects of health management based on the theory of protection motivation on fatigue status, neurological function recovery and life ability of stroke patients, and evaluate its clinical effects.@*Methods@#A total of 120 stroke patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2019 were selected as subjects. Randomized digital table method was used to divided them into observation group and control group, 60 cases in each group; the control group underwent routine nursing and follow-up of neurology, and the observation group was given health management based on protection motivation theory on the basis of the control group. The Fatigue Severity Scale (FSS) was used to assess the patient's fatigue, the European Stroke Scale (ESS) was used to evaluate the patient's neurological function, the modified Barthel index was used to assess the patient's viability. The fatigue, neurological recovery, and changes in living ability were compared between the two groups before and after the nursing intervention.@*Results@#The Scores of FSS, MBI and ESS of the observation group were 45.34±8.84, 54.3±4.69 and 45.24±4.18 before intervention and 32.48±5.80, 75.50±4.93, 63.12±3.32 after intervention. The Scores of FSS, MBI and ESS of the control group was 44.97±8.47, 53.47±4.20, 43.48±5.67 before intervention and 39.59±7.43, 63.81±3.25, 55.32±3.48 after intervention. The difference after intervention between the two groups was statistically significant (t values were 15.335, 12.562, 5.843, P<0.01). The difference in the observation group before and after intervention was statistically significant (t values were 9.422, 24.133, 25.945, P<0.01). The differences in the control group before and after intervention was statistically significant (t values were 3.699, 15.082, 13.786, P<0.01).@*Conclusions@#Health management based on the theory of protection motivation is more effective than routine nursing to improve the fatigue, neurological function and life ability of stroke patients.
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Objective To explore the effect of emergency nursing combined with predictive rehabilitation nursing on rehabilitation and prognosis of patients with acute stroke. Methods One hundred and thirty patients with acute stroke admitted to Zhejiang Hospital from June 2017 to December 2018 were enrolled, and they were divided into an emergency nursing group and a combined nursing group according to different nursing methods, 65 cases in each group. The emergency nursing group was given emergency nursing; and the combined nursing group was given emergency nursing combined with predictive rehabilitation nursing. After 2 weeks, the clinical efficacy was evaluated. The neurological function, motor ability, cognitive function, activities of daily living, clinical efficacy and the incidence of complications were observed in the two groups. Results After treatment, the scores of American National Institutes of Health Stroke Scale (NIHSS) in two groups was significantly lower than that before treatment, the scores of simple Fugl-Meyer motor function (FMA) and simple intelligent mental state examination scale (MMSE), Barthel index (BI) were obviously higher than those before treatment, and the changes of the above indexes in the combined nursing group were more significant than those in the emergency nursing group after treatment (NIHSS score: 13.68±4.01 vs. 19.47±3.82, FMA score: 31.65±4.11 vs. 26.47±4.53, MMSE: 25.34±3.71 vs. 20.07±3.08, BI: 54.68±7.01 vs. 47.37±6.51), the differences were statistically significant (all P < 0.05). The total effective rate of the combined nursing group was significantly higher than that of the emergency nursing group [90.77% (59/65) vs. 75.39% (49/65), P < 0.05], and the incidence of complications in the combined nursing group was obviously lower than that in the emergency nursing group [21.51% (14/65) vs. 40.00% (26/65), P < 0.05]. Conclusion The emergency nursing combined with predictive rehabilitation nursing has good clinical effect on patients with acute stroke, it can effectively elevate the neurological function, motor ability, cognitive function and daily living ability, improve blood lipid and coagulation function indicators, reduce the incidence of complications, facilitate rehabilitation and improve prognosis.
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<p><b>OBJECTIVE</b>To compare the effects of "paraplegic triple needling" and conventional needling on psychological and daily living ability of patients with spinal cord injury.</p><p><b>METHODS</b>A total of 50 patients with spinal cord injury were randomized into an observation group and a control group, 25 cases in each one. Rehabilitation training was applied in the two groups. In the observation group, on the basis of rehabilitation training, "paraplegic triple needling" was added, namely, puncturing the governor vessel (GV) and back- points respectively in the upper and lower segments of the injury plane and locating the key muscle movement points of the lower extremities by the peripheral nerve electrical stimulation device. Electroacupuncture (EA) was given at the points up and down the two sections of the GV points, back- points, the key muscle movement points. In the control group, conventional needling was applied at the points of GV, back- points, Huantiao (GB 30), Zusanli (ST 36), Xuanzhong (GB 39) and Yanglingquan (GB 34). The treatment was given once a day, the treatment for a month as one course and a total of 2 course were required. In addition, 25 health checkers were selected at the physical examination center of General Hospital of Chengdu Military Region as a normal control group. The content of peripheral serum 5-hydroxy tryptamine (5-HT) was tested before treatment, 1 course and 2 courses of treatment, The modified Barthel index (MBI) was used to observe the daily living activities, the Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to evaluate the psychological status.</p><p><b>RESULTS</b>In the two groups, the content of serum 5-HT was lower than that in the normal control group before treatment (both <0.05). After one course of treatment, the MBI score and content of serum 5-HT were all increase in the two groups; the HAMA score and HAMD score were all reduced (all <0.05); the results in the observation were better than those in the control group (all <0.05). After 2 courses of treatment, the MBI score and content of serum 5-HT were all increased in the two groups, and the HAMA score and HAMD score were all reduced (all <0.05), but the difference was not significant statistically between the two groups (all >0.05). Pearson correlation analysis showed that the content of serum 5-HT in patients with spinal cord injury was negatively correlated with disease course, HAMA and HAMD score (all <0.05), and positively correlated with MBI score (<0.05).</p><p><b>CONCLUSION</b>There are differences in the content of serum 5-HT between the normal person and the patients with pinal cord injury. The content of serum 5-HT can early predict the depression and anxiety in patients with spinal cord injury. Compared with the conventional needling, "paraplegic triple needling" can improve depression and anxiety in the early stage and improve the daily living ability of patients with spinal cord injury.</p>
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Humans , Activities of Daily Living , Acupuncture Points , Anxiety , Electroacupuncture , Methods , Spinal Cord Injuries , Rehabilitation , TherapeuticsABSTRACT
Objective To explore the effect of mobile phone-based health education on independent living ability of postoperative patients with hypertensive intracerebral hemorrhage. Methods Sixty patients with postoperative hypertensive intracerebral hemorrhage who underwent craniotomy in our hospital during March 2016 and December 2017 were divided into experimental and control groups, 30 cases in each group, according to the random number table method. Functional training conducted during hospitalization in both groups. After discharge, the control group used a telephone for follow-ups every 2 weeks and took part in a face-to-face training in the first month to implement continuous nursing intervention for a total of 3 months. After discharge, in the experimental group, various information forms of rehabilitation training for hypertensive intracerebral hemorrhage were comprehensively integrated, and mobile phone education was used for a total of 3 months in addition to the training as in the control group. The two groups were compared in terms of independent living ability between the two groups. Result The scores of independent living ability and self-care ability, action ability, metastatic ability, social cognitive ability and communication ability of the experimental group were significantly higher than those of the control group (P＜0.05). Conclusion The mobile phone-based education can promote the effect of rehabilitation exercise in patients with hypertensive intracerebral hemorrhage, so as to promote the independent living ability of patients.
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OBJECTIVE:To investigate clinical efficacy and safety of levetiracetam add-on therapy in the treatment of elderly epileptic patients. METHODS:Totally 88 elderly epileptic patients in Chongqing Yunyang County Hospital of TCM during Jan. 2014-Jan. 2016 were divided into observation group and control group according to random number table,with 44 cases in each group. Control group was given routine antiepileptic therapy of carbamazepine+phenobarbital;observation group was additionally given Levetiracetam tablet with initial dose of 0.25g,increasing to 0.5 g according to disease condition,bid,on the basis of con-trol group. Treatment courses of 2 groups lasted for 6 months. Clinical efficacies,GCS score,Barthel index score,MoCA score and the occurrence of ADR were observed in 2 groups. RESULTS:Total response rate,control rate and MoCA score of observation group were significantly higher than those of control group,with statistical significance(P<0.05). GCS and Barthel index score of 2 group after treatment were significantly higher than before treatment,and those 2 scores of observation group were significantly higher than those of control group,with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLU-SIONS:Levetiracetam add-on therapy is better than routine therapy plan in the treatment of elderly epilepsy,and significantly re-duce coma degree,increase daily living ability and cognitive function with good safety.
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Objective To explore the improvement effect of humanistic care on cognitive function impairment and living ability of patients with Alzheimer's disease. Methods 76 patients with Alzheimer's disease from January 2009 to May 2011 were taken as the research object.They were randomly divided into the control group and the observation group with 38 cases in each group.The control group was given conventional procedures for nursing care,and the observation group used humanistic nursing care as the guidance.The MMSE scale score,living ability index and family satisfaction degree before nursing and 1 month and 3 months after nursing for the two groups were taken for statistical comparison. Results The proportion of patients whose MMSE scale≥ 21 points and living ability score ranging from71 to 95 1 month and 3 months after care were higher than those of the control group.The satisfaction degree of patients in the observation group was also higher than the control group. Conclusions Humanistic care can significantly improve the cognitive dysfunction and living ability of patients with Alzheimer's disease,besides,family members of patients are more satisfied with this nursing model.
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Objective To discuss alexithymia in patients with maintenance hemodialysis and its impact on medical coping style and the ability of daily living. Methods The patients with end-stage renal disease treated by the maintenance hemodialysis (MHD) were divided into 2 groups, namely, alexithymia group (total score>60) and non-alexithymia group (total score <50) ,according to the Toronto Alexithymia Scale (TAS-20). The Medical response to the questionnaire (MCMQ) and the activities of daily living scale (ADL) were used to evaluate the patients. Results The TAS-20 score was (72.31±12.28) in 67 cases of patients with MHD. Among these, 31 cases for TAS-20 total score>60 points ,with an average score (82.37±15.84) and 26 cases for TAS-20 total score <50 points, with an average score (50.17±10.24). There was significant difference (t=8.90, P<0.01). The face factor score of MCMQ was significantly lower in alexithymia groups than that in non-alexithymia group,while the avoidance and subordination factor score was significantly higher than that in non-alexithymia group(P<0.01 or 0.05). The ADL scores and factor scores of the alexithymia group were significantly higher than that of non-alexithymia group,and there was a significant difference (t=3.53, P<0.01). Correlation analysis showed that TAS-20 score and the face factor score of MCMQ was significantly negatively correlated with MCMQ e-vasive and subordination factor,and factor scores and ADL score was significantly positively correlated (P<0.01 or 0.05). Conclusion MHD patients in the alexithymia group tend to use and yield response to avoid negative cop-ing style and less use of active coping style. The quality of life and activities of daily living of MHD patients in alex-ithymia group are worse than that of the non-alexithymia group.