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As the improvement of patient experience and medical experience has become the key goal of medical model reform,patient experience has gradually guided the development direction of future medical treatment and dominated the model of patient management.Patient journey mapping,as a patient-centered tool for visualizing patient experience,has been widely used in patient management in recent years.It will introduce the definition,construction method,application progress,problems,and prospects of patient journey mapping in the field of patient management at home and abroad to encourage more medical staff to use patient journey mapping to gain insight into patient needs,optimize patient experience and gather strength in patient management.
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BackgroundLittle is known about the SARS-CoV-2 contamination of environmental surfaces and air in non-health care settings among COVID-19 cases. Methods and findingsWe explored the SARS-CoV-2 contamination of environmental surfaces and air by collecting air and swabbing environmental surfaces among 39 COVID-19 cases in Guangzhou, China. The specimens were tested by RT-PCR testing. The information collected for COVID-19 cases included basic demographic, clinical severity, onset of symptoms, radiological testing, laboratory testing and hospital admission. A total of 641 environmental surfaces and air specimens were collected among 39 COVID-19 cases before disinfection. Among them, 20 specimens (20/641, 3.1%) were tested positive from 9 COVID-19 cases (9/39, 23.1%), with 5 (5/101, 5.0%) positive specimens from 3 asymptomatic cases, 5 (5/220, 2.3%) from 3 mild cases, and 10 (10/374, 2.7%) from 3 moderate cases. All positive specimens were collected within 3 days after diagnosis, and 10 (10/42, 23.8%) were found in toilet (5 on toilet bowl, 4 on sink/faucet/shower, 1 on floor drain), 4 (4/21, 19.0%) in anteroom (2 on water dispenser/cup/bottle, 1 on chair/table, 1 on TV remote), 1 (1/8, 12.5%) in kitchen (1 on dining-table), 1 (1/18, 5.6%) in bedroom (1 on bed/sheet pillow/bedside table), 1 (1/5, 20.0%) in car (1 on steering wheel/seat/handlebar) and 3 (3/20, 21.4%) on door knobs. Air specimens in room (0/10, 0.0%) and car (0/1, 0.0%) were all negative. ConclusionsSARS-CoV-2 was found on environmental surfaces especially in toilet, and could survive for several days. We provided evidence of potential for SARS-CoV-2 transmission through contamination of environmental surfaces.
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Objective@#To investigate the association between estimated glomerular filtration rate (eGFR) and all-cause mortality in the elderly aged 65 years and older in longevity areas in China.@*Methods@#Data used in this study were obtained from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey, 1 802 elderly adults were collected in the study during 2012-2017/2018. In this study, the elderly were classified into 4 groups, moderate-to-severe group [<45 ml·min-1·(1.73 m2)-1], mild-to-moderate group [45- ml·min-1·(1.73 m2)-1], mild group [60- ml·min-1·(1.73 m2)-1] and normal group [≥90 ml·min-1·(1.73 m2)-1] according to their eGFR levels.@*Results@#After 6 years of follow-up, 852 participants died, with a mortality rate of 47.3%. Multivariate Cox regression analysis showed that the levels of eGFR were negatively correlated with all-cause mortality risk in the elderly (the HR of elderly was 0.993 and the 95%CI was 0.989-0.997 for every unit of eGFR increased, P=0.001), while compared with the group with normal eGFR, the HRs (95%CI) of the elderly in the moderate-to-severe group, mild-to-moderate group, and mild group were 1.690 (1.224-2.332, P=0.001), 1.312 (0.978-1.758, P=0.070), 1.349 (1.047-1.737, P=0.020) respectively [trend test P<0.001].@*Conclusion@#The decrease in eGFR was associated with higher mortality risk among the elderly in longevity areas in China.
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Objective To analyze the magnetic resonance imaging (MRI) of the spinal cord and clinical characteristics in patients with autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy.Methods A total of 1 040 samples of cerebrospinal fluid (CSF) and sera collected in the Second Affiliated Hospital of Guangzhou Medical University from March 2013 to June 2018 were tested with tissue-and cell-based assays,and 42 patients were found positive for GFAP-IgG.The clinical data and MRI characteristics of the spinal cord of 19 patients who were positive for GFAP-IgG in CSF with autoimmune GFAP astrocytopathy and lesions in the spinal cord were retrospectively reviewed.Results There were 12 females and seven males among the 19 patients,with onset age of (44±17) years.The main manifestations of these patients included limb weakness (14/19),abnormal vision (5/19),headache (4/19),seizure (4/19),dementia (3/19),etc.On MRI of the spinal cord,five patients showed involvement in the cervical cord alone,eight showed involvement in the thoracic cord alone and six had both cervical and thoracic segment involvement.Fifteen patients had longitudinally extensive myelitic abnormalities (≥3 vertebral segments long).Seven enhancement patterns were encountered.Lesions were displayed in the spinal cord and brain in eight patients.Central gray matter involvement in the spinal cord was found in all the 19 patients.Conclusions Autoimmune GFAP astrocytopathy more frequently presents in females than in males.MRI of the spinal cord has complex presentations and longitudinally extensive myelitic abnormalities usually.Patients often show central gray matter involvement in the spinal cord.Myelitic abnormalities present more often in thoracic segment than in cervical segment.Abnormalities in lumbar segment are less encountered.
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Objective@#To investigate the current status of fear of cancer recurrence in bladder cancer patients, and to explore the correlation between fear of recurrence and quality of life.@*Methods@#A total of 96 bladder cancer patients were recruited by convenience sampling method from April 2017 to July 2017. They were investigated through general information questionnaire, Chinese version of Fear of Progression Questionnaire Short Form and Functional Assessment of Cancer Therapy-Bladder cancer form respectively.@*Results@#The total score of fears of recurrence was 28.76±10.33, the total score of quality of life was 123.66±20.63. A total of 28 patients had a dysfunctional level of fears of recurrence (total score ≥34), the incidence was 29.2% (28/96). There were significant differences in the total scores of fears of recurrence at different ages, fears of recurrence were not related to another sociodemographic factors (gender, educational attainment and income) or disease, treatment related factors. The total scores of fears of recurrence and the total score of quality of life showed a high degree of negative correlation (r=-0.726, P < 0.01), the quality of life in physical, social and family, emotional, functional well being were negatively correlated with fears of recurrence (r=-0.841--0.592, P < 0.01).@*Conclusions@#Bladder cancer patients have a higher incidence of fears of recurrence and had an impact on quality of life from the physical, psychological and social domains, nurses should perceive the fears of recurrence of patients as soon as possible and give corresponding intervention measures to improve the quality of life of bladder cancer patients.
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Objective Our study aimed to delineate the clinical and radiological features of patients with anti-myelin oligodendrocyte glycoprotein antibody (MOG-Ab)positive neuromyelitis optica spectrum disorder (NMOSD). Methods Fifty-seven patients with NMOSD and 29 patients with multiple sclerosis (MS) were collected. Data on clinical and radiological features of MOG-Ab positive patients with were analyzed retrospectively. Results MOG-Abs were present in 9/57 (15.8%) NMOSD patients and 2/29 (6.9%) MS patients. Both MOG and aquaporin-4 (AQP4) antibodies were positive in one case of NMOSD. There was no significant difference between the two groups (P>0.05). There were more females than males having MOG-Ab positive NMOSD (females: males=7:1) and the average onset age was 41.4 ± 11.5 years. There was no significant difference in gender and age between MOG-Ab negative and AQP4-Ab positive groups(P>0.05). The durations of disease were significantly shorter in either MOG-Ab positive NMOSD patients or MOG-Ab negative NMOSD patients than in AQP4-Ab positive group (P<0.05). Recurrence was the main disease pattern of all three groups and the frequency of recurrence was not significant different among three groups (P>0.05). The incidence of optic neuritis was 62.5% in NMOSD patients with MOG-Ab positive and 43.5% in AQP4-Ab positive NMOSD patients (P>0.05). There was no significant difference in the morphology and location of brain lesions among the three groups (P>0.05). MOG-Ab positive NMOSD patients had long segment spinal cord lesions. The median length of the spinal cord lesions in the MOG-Ab positive group was similar to the other two groups (P>0.05). Conclusions MOG-Ab positive NMOSD patients have higher proportion of females with shorter recurrence course, more likely complicated with optic neuritis. And the radiological features of brain and spinal cord were not specific to patients with AQP4-Ab positive.
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Objective To explore the value of brainstem auditory evoked potential(BAEP),visual evoked potential(VEP)and Revised Visual Retention Test(VRT)in detecting impairment of central nervous system in patients with acute leukemia(AL).Methods Neuropack-Ml type evoked potential machine(Japan)was used to check brainstem auditory evoked potential(BAEP)and visual evoked potential(VEP).BAEP,VEP and VRT were examined in 30 cases with acute leukemia(group AL)and in 30 age and sex matched healthy subjects as a control(groupC).Indexes of BAEP including peak latency(PL)of waves I ,IB ,V and inter-peak latency(IPL)of waves Ⅰ~Ⅲ,Ⅲ ~Ⅴ,Ⅰ~Ⅴand indexes of VEP(P100PL)were determined.VRT was accomplished meanwhile applying B method with C pattern,C method with D pattern,D method with E pattern.The correct scores and error scores were recorded separately.Results BAEP:the abnormal rate of the group AL was 23.3 %.Compared with control group,we found significant longer latency of wave Ⅲ、Ⅴ(P<0.05)and significant elongation in the mean inter-peak latencies of Ⅰ~Ⅴ(P<0.05).VEP:the abnormal rate of the group AL was 26.7% ,the P100 PL of the patients was longer than that in the control group(P<0.05).VRT:the abnormal rate of the group AL was 33.3%.The results of VRT showed that the score in the group AL in D method with E pattern was lower than that in the control group(P<0.05).Conclusion BEAP,VEP and VRT could detect the impairment of central nervous system in patients with acute leukemia sensitively,and give clues to early diagnosis of central nervous system leukemia(CNSL).
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Objective To observe the effects of Edaravone and Fleabane in treatment of acute cerebral in-farction(ACI). Methods 80 cases of patients with ACI were divided into two groups randomly. The treatment group (n=40) was treated by Edaravone and Fleabane, and tile control group(n =40) was treated by Fleabane. Before and 14 days after treatment, the neurologic impairment and clinical curative effect of the two groups were evaluated respectively. Results After treatment the neurologic impairment in the two groups were all improved significantly (P <0.01), and the difference between the two groups was significant (P <0.01). About the clinical curative effect, the effective rate in the treatment group was 82.5%, and that in the control group was 67.5%. The difference be-twcen the two gruups was significant (P < 0.05). Conclusion Edaravone and Fleabane in treatment of ACI is safe and effective.