【摘要】 目的 探讨开展优质护理服务对早期慢性肾功能衰竭患者治疗的影响。 方法 将2009年9月-2010年6月收治的80名早期慢性肾功能衰竭患者，随机分成对照组和试验组，每组各40例。试验组实施优质护理服务，对照组按常规护理，半年后采用自测健康评定量表（SRHMS V1.0）对患者进行问卷调查，从而了解和评判优质服务对早期慢性肾功能衰竭患者治疗的影响及效果。 结果 试验组在器官功能、日常生活功能、生理健康子量表总分3个维度，在负向情绪、正向情绪、认知功能、心理健康子量表总分4个维度，在角色活动、社会健康子量表总分2个维度与对照组比较，差异均有统计学意义（Plt;0.05），在社会支持和社会资源方面与对照组的差异无统计学意义（Pgt;0.05）。 结论 开展优质护理服务能明显提高患者治疗疾病的信心，对有效控制患者病情发展有一定的影响与作用。【Abstract】 Objective To investigate the impact of quality care on early chronic renal failure patients. Methods Eighty patients in early stages of chronic renal failure in our department between September 2009 and June 2010 were randomly divided into the control group and the experimental group with 40 patients in each group. Quality and Conventional care were implemented on the two groups respectively. Six months later, self-rated health measurement scale (SRHMS V1.0) was used to analyze the impact of quality care on the patients. Results The results of the measurement showed that there were significant differences between the two groups in organ function, daily life function, physiologic health, negative emotion, positive emotion, cognitive ability, psychological health, role activity and social health (Plt;0.05). There were no significant differences between them in social support and social resources. Conclusion Carrying out high-quality care can significantly improve the active treatment confidence of the patients and can effectively control the development of the disease.
Objective To broaden the current understanding of the usage willingness about artificial intelligence (AI) robots and relevant influence factors for elderly patients. Methods The elderly patients in the inpatient ward, outpatient department and physical examination of the Department of Geriatrics, West China Hospital of Sichuan University were selected by convenient sampling for investigation between February and April 2020, to explore the willingness of elderly patients to use AI robots and related influencing factors. Results A total of 446 elderly patients were included. There were 244 males and 202 females. The willingness to use AI robots was (14.40±3.62) points. There were statistically significant differences among the elderly patients with different ages, marital status, living conditions, educational level, current health status, current vision status, current hearing status, self-care ability and family support in their willingness to use AI robots (P<0.05). Multiple linear regression analysis showed that age, education level and family support were the influencing factors of use intention (P<0.05). Among the elderly patients, 60.76% had heard of AI robots, but only 28.03% knew the medical application of AI robots, and only 13.90% had used AI robot services. Most elderly patients (>60%) thought that some adverse factors may reduce their usage willingness, like “the price is too expensive” and “the use is complex, or I don’t know how to use”. Conclusions Elderly patients’ cognition of AI robots is still at a low level, and their willingness to use AI robots is mainly affected by age, education level and family support. It is suggested to consider the personalized needs of the elderly in terms of different ages, education levels and family support, and promote the cheap and user-friendly AI robots, so as to improve the use of AI robots by elderly patients.
ObjectiveTo investigate the clinical feature, prognosis and prognostic factors of early post-traumatic seizures in children. MethodsRetrospective review was performed on 101 individuals with early post-traumatic seizures (EPTS) who were diagnosed in Department of Neurosurgery in Children's Hospital of Chongqing Medical University from January 2008 to June 2013. The record was collected, which included patient's demographics, clinical and radiological presentation, management, and follow-up results of 12 months. The individuals were divided into late post-traumatic seizures (LPTS) group and control group according to the occurrence of LPTS or not. The SAS 9.2 was used for statistical analysis. ResultsDuring 101 cases in our study, male accounted for 60.4%, female accounted for 39.6%, and the ratio was 1.5 to 1. The percentage of patients who were under 6 years old was 74.3%, and the number of cases decreased with age. The peak time of EPTS was within 24 hours after traumatic brain injury. 55.4% of EPTS was the generalized seizures, 34.7% was the partial seizures, and 9.9% was the partial seizures and evolved to secondarily generalized seizures. The incidence of LPTS observed in our study was 26.7% within 12 months follow-up. The electroencephalogram displayed epileptiform discharges in 3 individuals who were without epileptic seizures. There was statistically significant difference in group LPTS compared to control group on these factors which included GSC score≤8(P=0.0064), complicated necrencephalus and/or encephalatrophy(P < 0.0001), multiple brain injuries(P=0.0210), subdural hemorrhage(P=0.0151) and intracranial operation(P=0.0029). The age, history, epileptic seizure type of EPTS, brain contusion, skull fracture and the early use of antiepileptic drugs (AEDs) had no statistically significant difference between LPTS group and control group(P > 0.05). ConclusionsEPTS is prone to occur in children under 6 years old. Male is obviously more than female, and the ratio is 1.5:1. The peak time of EPTS is within 24 hours after traumatic brain injury and most of EPTS are generalized seizures. The incidence of LPTS in children with EPTS exceeds those previously reported. Periodical electroencephalogram examination is essential to decrease the missed diagnosis of LPTS. The GSC score≤8 and complicated necrencephalus and/or encephalatrophy will dramaticlly increase the risk of LPTS. Multiple brain injuries, subdural hemorrhage and intracranial operation are also risk factors for the prognosis of EPTS. Although the use of AEDs is unable to decrease the incidence of LPTS after 12 months follow-up, it is probably beneficial to improving the cognition and brain development. The controversial finding in our study is whether intracranial operation can influence the prognosis of EPTS or not.
Objective To understand the quality of life of patients with acute mild to moderate ischemic stroke one year after stroke, analyze the factors affecting their quality of life, and provide a scientific basis for improving their health-related quality of life. Methods This study included patients who were diagnosed with acute mild to moderate ischemic stroke between March 2019 and March 2021 in four hospitals in Nanchang. Sociodemographic information and relevant clinical data were collected during hospitalization. The EQ-5D-5L questionnaire was administered to assess health-related quality of life one year after discharge. The Mann-Whitney U test (for two groups) and Kruskal-Wallis one-way ANOVA (for multiple groups) were used to analyze differences in utility scores among various factors. A Tobit regression model was built to investigate the factors influencing quality of life one-year post-stroke. Results A total of 1 181 patients participated in the study, including 791 males (66.98%) and 390 females (33.02%), with an average age of 63.7±10.9 years. Health-related quality of life data collected one year after the stroke revealed that 22.69% of patients experienced pain/discomfort, 17.27% suffered anxiety/depression, 15.66% had mobility issues, 10.33% had difficulties with daily activities, and 8.64% had trouble with self-care. Tobit regression results showed that age (β=−0.263, 95%CI −0.327 to −0.198), gender (β=−0.134, 95%CI −0.189 to −0.080), previous hypertension (β=−0.068, 95%CI −0.120 to −0.016), previous dyslipidemia (β=−0.068, 95%CI −0.126 to −0.011), admission NIHSS score (β=−0.158, 95%CI −0.198 to −0.118), and discharge mRS score (β=−0.193, 95%CI −0.250 to −0.136) were negatively associated with health utility values. Current employment status (β=0.141, 95%CI 0.102 to 0.181) and admission GCS score (β=0.209, 95%CI 0.142 to 0.276) were positively correlated with health utility values. Conclusion One year after an acute mild to moderate ischemic stroke, patients commonly face pain/discomfort and anxiety/depression. Factors affecting overall quality of life include age, sex, current employment status, previous hypertension, previous dyslipidemia, admission NIHSS score, admission GCS score, and discharge mRS score. Clinically, developing scientifically sound and reasonable rehabilitation plans post-discharge is crucial for improving long-term quality of life.
ObjectiveTo investigate the related factors of the retina1 hemorrhage in newborns. Methods9558 newborns included in this observation between March of 2012 and July of 2013 in our hospital. The fundus was examined by the fully-integrated wide-field digital imaging system RetCamⅢat 0-4 days after born. According to the literature, retinal hemorrhage was classified into degreeⅠ, ⅡandⅢ. The condition for baby and the mother during pregnancy were correlatively analyzed. The other factors were analyzed including twins, premature delivery, big baby, mode of delivery, fetal birth, forceps delivery, suction delivery, asphyxia, jaundice, ABO hemolytic, cranial hematoma, intracranial hemorrhage, maternal age, first-time mom, the maternal previous mode of production, emergency delivery, the first stage of labor prolonged, the second stage of labor prolonged, the third stage of labor prolonged, pregnancy-induced hypertension, gestational diabetes, oxytocin, prenatal body mass index (BMI). Multivariate logistic regression analysis was used. ResultsIn 9558 cases of newborns, retinal hemorrhages were found in 2753 infants (28.8%), including 1137 degreeⅠ(41.3%), 895 degreeⅡ(32.5%) and 721 degreeⅢ(26.2%). Multivariate logistic regression analysis showed that the mode of delivery, asphyxia, jaundice, advanced maternal age, maternal previous birth, prenatal BMI is a risk factor for neonatal values retinal hemorrhage (r=0.146, 5.841, 1.847, 0.071, 0.246, 0.965;P < 0.05). The degree of fundus hemorrhage was not related to birth weight and BMI (P > 0.05). ConclusionsThe neonatal retinal hemorrhage rate was 28.8%. Mode of delivery, asphyxia, neonatal jaundice, maternal age, the previous mode of delivery of mothers with more than one previous birth, prenatal BMI values may be risk factors lead to retinal hemorrhage.
Objective To analyze the current state, evaluate the accuracy, and determine the influencing factors of hypertension-related subscriptions from official health WeChat accounts. Methods The 36 official health WeChat accounts on the WeChat official accounts monthly list │ September 2022 China WeChat Top 500·New Rank certification were searched using the term "hypertension". We identified diabetes-related subscriptions published from April 1, 2022 to September 30, 2022. The accuracy of subscriptions was analyzed according to the consistency with clinical practice guidelines and was independently assessed by two specialists. SPSS 22.0 software was used for data analysis. Results One hundred and one subscriptions from 36 official health WeChat accounts were included. Forty-seven (46.5%) subscriptions were evaluated as consistent, seven (6.9%) subscriptions were evaluated as inconsistent, and forty-seven (46.5%) subscriptions were evaluated as unconfirmed. The differences between the numbers of reads, "wow" and "like" per thousand reads, were statistically significant. Consistency rates were higher for tweets backed by evidence and experts, and for tweets posted by public figures with the accreditation type "government". Conclusion Hypertension tweets have a good audience base, some of the content is inconsistent with current clinical guideline recommendations, and readers have little ability to screen them. There is a need to develop and improve the review mechanism for writing and publishing hypertension tweets on WeChat.
ObjectiveTo figure out the factors affecting the prognosis of liver transplantation and the research progress on methods for predicting the prognosis of liver transplantation so as to provide guidance and reference for the distribution of liver sources and the perioperative treatment of liver transplantation.MethodThe literatures related to the factors influencing the prognosis of liver transplantation and the methods in predicting the prognosis were searched in the PubMed, CNKI, Wanfang, and other databases and the results were analyzed and summarized.ResultsThe liver transplantation was an effective method in the treatment of end-stage liver diseases. The main factors affecting the prognosis of liver transplantation included the change of internal environment, systemic inflammatory response, and general systemic conditions. On the basis of Model for End-stage Liver Disease (MELD), the new prediction model built in combination with the blood sodium ion, lactate, muscle mass, or reticulocyte count and hemoglobin concentration had improved the prognostic prediction ability of liver transplantation.ConclusionsIt is possible to predict the prognosis of patients with liver transplantation more accurately by selecting a more targeted prediction model combined with the factors affecting the prognosis of liver transplantation. It might provide a reference for perioperative management and treatment and make the limited liver source play the most role and save more lives.
目的 调查抑郁症患者疾病应对方式现状，为心理护理干预提供科学依据。 方法 采用问卷调查方式对四川大学华西医院心身障碍病房2012年4月－10月住院的220例抑郁症患者进行一般资料及疾病应对方式调查，并就调查结果进行分析。 结果 抑郁症患者应对方式平均得分（31.5 ± 6.8）分；生活自理能力、兴趣爱好、健康状况及经济状况与应对方式总分存在相关关系（P值分别为0.007、0.000、0.036、0.028）。 结论 抑郁症患者普遍存在应对不良，其生活自理能力、兴趣爱好、健康及经济状况可能是影响抑郁症发展的相关因素。
ObjectiveTo investigate the prevalence and associated factors of diabetic retinopathy (DR) among diabetic residents in Longyan of Fujian Province. MethodsA investigative research. From January 2022 to December 2023, a total of 10 061 diabetic patients enrolled in the chronic disease follow-up management system from 112 towns and sub-districts in 7 counties and districts of Longyan of Fujian Province were selected as the target population. A questionnaire survey, routine physical examination, vision test, and non-mydriatic fundus photography were conducted. A total of 762 cases with missing height, weight, blood pressure, fasting plasma glucose (FPG), and diabetes duration, and 507 cases with unclear fundus photography were excluded, resulting in 8 792 cases included in the final statistical analysis. DR diagnosis and classification were based on the 2019 International Clinical Classification of DR. The prevalence of DR was calculated for single-eye or double-eye DR cases as 1 case; the more severe eye was used for DR grading in double-eye DR cases. Statistical analysis was performed by grouping based on the presence or absence of DR and dividing into age groups ≤67 years and >67 years. χ2 test was used to analyze factors associated with prevalence; binary multivariate logistic regression analysis was employed to identify influencing factors of DR. ResultsAmong the 8 792 cases, 888 (10.1%, 888/8 792) were diagnosed with DR (DR group), and 7 904 (89.9%, 7 904/8 792) had no DR (non-DR group). Compared to the non-DR group, the DR group showed significant increases in FPG (Z=−12.448), diabetes duration (Z=−18.936), systolic blood pressure (Z=−4.237), diastolic blood pressure (Z=−2.881), and body mass index (BMI) ≥24 kg/m² (P＜0.001). Significant differences were also found between the two groups in hypertension (χ2=11.450), hyperlipidemia (χ2=5.100), kidney disease (χ2=7.039), family history of diabetes (χ2=5.025), and regular medication use (χ2=66.034) (P＜0.05). There were 4 688 cases in the ≤67 years group and 4 104 in the ＞67 years group. In the ≤67 years group, significant differences in DR prevalence were found for FPG levels (χ2=111.754), diabetes duration (χ2=231.658), BMI (χ2=12.404), systolic blood pressure (χ2=17.912), regular medication use (χ2=40.727), hyperlipidemia (χ2=6.816), and hypertension history (χ2=6.775) (P＜0.05). In the >67 years group, significant differences in DR prevalence were found for FPG levels (χ2=59.916), diabetes duration (χ2=128.362), systolic blood pressure (χ2=5.183), regular medication use (χ2=22.097), kidney disease (χ2=6.251), and family history of diabetes duration (χ2=4.967) (P＜0.05). No significant differences in DR prevalence were found based on sex, education level, smoking history, alcohol consumption, exercise habits, heart disease history, or other family disease history (P＞0.05). Logistics regression analysis results show that patients aged ＞67 years, FPG [odds ratio (OR)=1.074, 95%confidence interval (CI) 1.046-1.102], diabetes duration (OR=1.088, 95%CI 1.071-1.106), systolic blood pressure (OR=1.007, 95%CI 1.001-1.013), and kidney disease (OR=3.617, 95%CI 1.268-10.320) were identified as risk factors for DR (P＜0.05). In patients aged ≤67 years, FPG (OR=1.088, 95%CI 1.067-1.110), diabetes duration (OR=1.108, 95%CI 1.091-1.125), and systolic blood pressure (OR=1.008, 95%CI 1.003-1.013) were identified as independent risk factors for DR (P＜0.05), while BMI ≥24 kg/m² (OR=0.934, 95%CI 0.908-0.965) was a protective factor for DR (P＜0.05). Age, regular medication use, hypertension, and hyperlipidemia were identified as potential confounding factors for DR occurrence. ConclusionsThe prevalence of DR among diabetes patients in Longyan of Fujian Province, is 10.1%. FPG, diabete duration, and systolic blood pressure are independent risk factors for DR, while age, regular medication use, hypertension, and hyperlipidemia are potential confounding factors for DR occurrence.