1.The pathophysiological mechanisms of HIV-related neuropathic pain
Qiang CHEN ; Shanshan QIN ; Changshui XU
Journal of Medical Postgraduates 2015;(8):860-864
HIV-related sensory neuropathy ( HIV-SN) mainly contains the HIV infection-related distal sensory polyneuropa-thy (DSP) and antiretroviral toxic neuropathies (ATN).HIV-DSP is associated with proinflammatory cytokines , chemokines, ros and which is induced by gp 120;and HIV-ATN may be related to mitochondrial toxicity which is induced by the application of anti retroviral drugs, such as ddC, and similar as the molecular mechanism of HIV-DSP, this means that the current conventional method for the treatment of neuropathic pain in AIDS may further aggravate the neuropathic pain of the patient .Therefore, developing the study on the neurochemical and pharmacological mechanisms of HIV-related neuropathic pain will provide novel targets for the new effective drugs .
2.Epidemiology and outcome of out-of-hospital cardiac arrest in Zhejiang province
Min FEI ; Wenwei CAI ; Feng GAO ; Changshui CHEN
Chinese Critical Care Medicine 2016;28(12):1099-1103
Objective To investigate the epidemiological features of out-of-hospital cardiac arrest (OHCA) in Zhejiang and to analysis factors associated with outcomes for providing evidence on improving the success rate of cardiopulmonary resuscitation (CPR). Methods Clinical data of 493 patients with OHCA collected from the emergency department (ED) of Zhejiang Provincial People's Hospital, Ningbo Emergency Medical Service Center and Shaoxing Emergency Medical Service Center from January 2012 to August 2016 were analyzed retrospectively. All the data were recorded following the Utstein style included causes of arrest, location of arrest, first arrest rhythm, witnessed by bystanders, bystander CPR, pre-hospital defibrillation, pre-hospital intubation, pre-hospital epinephrine administration, emergency medical services (EMS) response time, return of spontaneous circulation (ROSC) at scene/enroute, ROSC at ED, admission to hospital, survival to hospital discharge and neurological outcomes at discharge. Factors associated with 30 days survival rate of patients with OHCA were analyzed. Results 493 patients were enrolled, of whom 342 were male and 151 were female. The average age was (58.8±21.4) years. The causes of arrests consisted of cardiac etiology (219 cases), trauma (155 cases), respiratory disease (22 cases), drowning (19 cases), electrocution (8 cases) and others (70 cases). Most of the events occurred at home (65.1%) and public places (22.7%). 55.2% patients were witnessed by bystanders while bystander CPR was performed in only 2.6% cases. Asystole was the predominant rhythm (78.7%) observed by the ambulance crew at the arrest site while only 5.5% first arrest rhythms were ventricular fibrillation/ventricular tachycardia (VF/VT). Only 6.9% patients underwent pre-hospital defibrillation. Pre-hospital intubations were attempted in 16.4% patients. Epinephrine was administered in 56.4% patients at scene or in ambulances. EMS response time was (13.6±8.0) minutes. 4.5% patients had ROSC at scene/enroute and 7.7% had ROSC at ED. Only 9.7% patients were admitted to hospital and 1.2% discharged alive. 0.8% patients were still in hospital on 30th day. The 30-day survival rate was 2.0% (10/493) and only 0.8% patients had neurologically favorable survivals [with the cerebral performance category (CPC) score of 1 or 2]. Witnessed by bystanders (3.31% vs. 0.45%), VF/VT as the first arrest rhythm (7.41% vs. 1.72%), bystander CPR (15.38% vs. 1.67%), pre-hospital defibrillation (8.82% vs. 1.53%) and EMS response time < 10 minutes (3.57% vs. 0.74%) could improve 30-day survival rate of OHCA significantly (all P < 0.05). Conclusion Resuscitation survival of OHCA in Zhejiang province was unsatisfactory. Improvements are required in series aspects of OHCA survival chain.
3.Association of isokinetic strength with pain and functional status in knee osteoarthritis patients aged 80 years and over
Changshui WENG ; Yanmei GUO ; Wei CHEN ; Chunhua LI ; Na WANG
Chinese Journal of Geriatrics 2014;33(7):718-721
Objective To evaluate the difference in isokinetic strength of the knee muscles between knee osteoarthritis (KOA) patients aged 80 years and over and matched healthy controls,and to establish the association of isokinetic strength with pain and functional status in patients with KOA.Methods The study enrolled 32 patients aged 80 and over diagnosed with unilateral knee OA and 10 matched controls.Pain was evaluated by the visual analogue scale (VAS),the pain intensity scale and the Lequesne index for patients with knee OA.Functional status was assessed by the Timed Up and Go Test (TUGT),the Five Times Sit to Stand Test (FTSST) and the Timed 10 Meter Walk Test (TWT).Muscle strength was measured using the isokinetic dynamometer Biodex System 4 Pro.Bilateral isokinetic (concentric) knee flexion and extension with the protocol of 60 degrees/sec,180 degrees/sec was also performed.Results The difference in two angular velocities of extensor and flexor peak torques between the knee OA group and the control group was statistically significant (t=2.747,P< 0.05).The extensor peak torque was negatively correlated with age,Liquesce index scores,FTSST,TUGT and TWT (r=-0.39~~-0.75,P<0.05),but had no correlation with the VAS score or the Lequesne index pain score (r=-0.23~ 0.31,P>0.05).The regression analysis results suggested that the extensor peak torque and the VAS score together were important predictors for the Liquesce index (adjusted R2 =0.41).Conclusions The degree of knee muscle damage is closely related to the functional performance of the muscles in knee OA patients aged 80 years or over.The strength of the quadriceps and the intensity of pain are important predictors of disability for those patients.
4.The test-retest reliability of a new measurement of lower extremity isometric muscle strength for patients with knee osteoarthritis
Yanmei GUO ; Changshui WENG ; Wei CHEN ; Qiuhua WANG ; Xiaoying LI
Chinese Journal of Physical Medicine and Rehabilitation 2010;32(10):760-763
Objective To determine the test-retest reliability of functional squat system (FSS) isometric muscle strength tests for patients with knee osteoarthritis. Methods The isometric muscle strength of thirty patientswith knee osteoarthritis (21 males and 9 females; age 45 to 89 years, mean age 68.73 ± 12.19 years) was tested twice within 1 week by the same tester. Three test results were obtained: maximum isometric extension strength, the time to initiate isometric extension and the average isometric extension strength. Intra-class correlation coefficients (ICCs) for the three tests were computed to evaluate their retest reliability. Results The ICCs of the maximum isometric extension strength and average isometric extension strength of the uninvolved and involved extremities were respectively 0.87, 0.88, 0.92 and 0.89. The ICCs of the initiation time for the uninvolved and involved legs were respectively 0.25 and 0.41. Conclusion In these tests of patients with knee osteoarthritis using the functional squat system, both the maximum isometric extension strength and the average isometric extension strength had very good test-retest reliability. These two test results could be used as reliable guidance for treatment and rehabilitation of osteoarthritic knees.
5.Characteristics of respiratory syncytial virus infection among hospitalized children in Ningbo City
MAO Bibo ; LU Wenbo ; CHEN Changshui ; QIU Haiyan ; LIU Wenyuan
Journal of Preventive Medicine 2024;36(12):1097-1100
Objective:
To investigate the epidemiological characteristics of respiratory syncytial virus (RSV) in hospitalized children in Ningbo City, so as to provide insights into developing prevention and control strategies for RSV.
Methods:
Basic information, clinical data and throat swab samples were collected from hospitalized children with respiratory infection in Ningbo University Affiliated Women and Children's Hospital from July 2019 to December 2023. Multiple fluorescence PCR-capillary electrophoresis was employed to detect nucleic acids of 11 non-bacterial respiratory pathogens. RSV detection in hospitalized children by time, gender and age was descriptively analyzed.
Results:
A total of 49 449 throat swab samples of hospitalized children with respiratory infections were detected. There were 4 310 samples positive for RSV, with a detection rate of 8.72%. The detection of positive specimens peaked from November to February in 2019 and 2020, from August to October in 2021, and from May to September in 2023. The RSV detection rate in boys was higher than that in girls (9.25% vs. 8.04%, P<0.05). The detection rate of RSV was highest in the children under 1 year of age (16.37%). The RSV detection rate tended to decrease with age (P<0.05). Among the specimens with positive RSV detection, 3 407 were positive for RSV alone (79.05%), while 903 were detected as mixed infections (20.95%). The non-bacterial pathogens with higher percentages of mixed detection were human rhinovirus, Mycoplasma pneumoniae and human parainfluenza virus.
Conclusion
Atypical seasonal epidemic of RSV infections appeared in 2021 and 2023 among hospitalized children in Ningbo City, with high detection rates in boys and children under 1 year of age, and a certain percentage of mixed infections.
6.Multidisciplinary Treatment on Older Knee Osteoarthritis: Short-term Observation
Yanmei GUO ; Li WAN ; Wei CHEN ; Weiguo JIAO ; Changshui WENG
Chinese Journal of Rehabilitation Theory and Practice 2010;16(12):1163-1166
ObjectiveTo observe the short-term efficacy of treatment with the diclofenac diethylamine emulge import by pulsed ultrasound, massage therapy and quadriceps muscle strengthen training to the patients with knee osteoarthritis for elderly.MethodsOn the basis of health education, 30 elderly patients with knee osteoarthritis were accepted treatments with 10 times of diclofenac diethylamine emulge import by pulsed ultrasound, 6 times of massage therapy and then they completed quadriceps muscle strengthen training once or twice a day.ResultsThe pain, walking ability, sit-to-stand ability and lower extremities muscle strength improved significantly for the patients after treatments (P<0.05 or P<0.001). ConclusionThe diclofenac diethylamine emulge import by pulsed ultrasound, massage therapy and quadriceps muscle strengthen training have a good short-term efficacy to the elderly patients with knee osteoarthritis.
7.Choice of Resistance Amount for Lumbar Muscles' Coordination Test
Yanmei GUO ; Binfen ZHENG ; Wei CHEN ; Changshui WENG
Chinese Journal of Rehabilitation Theory and Practice 2014;(10):971-974
Objective To explore the effect of different resistance amount on the reliability of the lumbar muscles' coordination test.Methods 30 young male adults participated the lumbar muscles' coordination test twice within 1 week by the same tester. In each test, the subjects took 5 kg, 10 kg and 15 kg of resistance randomly. The index included mean of concentric motion, deviation of concentric motion, mean of eccentric motion and deviation of eccentric motion. Intra-class correlation coefficient (ICC) for these 4 test results were applied to evaluate the reliability of those tests. Results The ICCs of the 4 test results were 0.303, 0.500, 0.358 and 0.360 respectively in the 5 kg of resistance group, 0.449, 0.382, 0.365 and 0.272 respectively in the 10 kg of resistance group, and 0.453, 0.442, 0.614 and 0.411 respectively in the 15 kg of resistance group. Conclusion The test-retest reliability can be satisfied in the lumbar muscles' coordination test with 15 kg of resistance.
8.Correlation among Static or Dynamic Position Sense, Function of Lower Extremity and Balance in Patients with Knee Osteoarthritis
Yanmei GUO ; Changshui WENG ; Wei CHEN ; Weiguo JIAO
Chinese Journal of Rehabilitation Theory and Practice 2013;19(11):1064-1068
Objective To study the relationship among static and dynamic position sense of lower extremity, physical function, and static and dynamic balance in patients with knee osteoarthritis. Methods 32 patients with knee osteoarthritis were tested with Lequesne Index, static and dynamic position sense of lower extremity, and fall risk of static and dynamic balance, and analyzed with Pearson correlation coefficient. Results The medium-to-high-frequency in postural sway correlated with Lequesne Index (r=0.36, P<0.05) and fall risk index of static balance (r=0.85, P<0.001), but not with the fall risk index of dynamic balance (r=0.30, P>0.05). The reposition accuracy error of the unaffected/ mild-affected lower extremity and affected/severe-affected lower extremity correlated with Lequesne Index (r=0.33~0.39, P<0.05), the fall risk index of static (r=0.38~0.45, P<0.05) and dynamic balance (r=0.65~0.70, P<0.05). Conclusion Lower extremity dysfunction post knee osteoarthritis would result in poor proprioception that maintains balance.
9.Balance Function and Falling Risk in Elderly Osteoarthritis Patients with Single or Double Knees Pain
Yanmei GUO ; Peng HUANG ; Wei CHEN ; Weiguo JIAO ; Changshui WENG
Chinese Journal of Rehabilitation Theory and Practice 2012;18(1):25-29
Objective To explore the feature of balance function and falling risk in the elderly knee osteoarthritis patients with single knee pain or double knees pain. Methods 30 elderly knee osteoarthritis patients without pain, 30 with single knee pain and 32 with double knees pain were tested with timed up and go test (TUG), postural stability (PS), limits of stability (LOS) and dynamic fall index (DFI). Results There was significant difference in the elderly between no pain and single or double knee pain (P<0.05) in TUG, but not between the single knee pain and double knees pain (P>0.05). There was no significant difference in the elderly between single knee pain and no pain (P>0.05) in PS, but was between double knees pain and the other 2 groups (P<0.05). There was significant difference between no pain and single or double knee pain (P<0.05) in LOS, but not between single knee pain and double knees pain (P>0.05). There was significant difference between no pain and single or double knee pain (P<0.05) in DFI, and between single knee pain and double knees pain (P<0.05). Conclusion The elderly osteoarthritis patients with single knee pain are in high falling risk with their dynamic balance injury, while those with double knees pain are in higher falling risk with their static and dynamic balance injury.
10.Assessment of Inter-rater Reliability of Lequesne Index (Chinese Version) in Knee Osteoarthritis
Chunhua LI ; Yanmei GUO ; Wei CHEN ; Qiuhua WANG ; Changshui WENG
Chinese Journal of Rehabilitation Theory and Practice 2010;16(6):554-555
ObjectiveTo examine the the inter-rater reliability of the Chinese version of Lequesne index as the effective treatment evaluation of patients with knee osteoarthritis.Methods30 patients with radiological findings and clinical symptoms of knee osteoarthritis were evaluated the Chinese version of Lequesne index twice by two staff who passed the Lequesne index formal training within 24 hours. Inter-rater reliability was assessed by the intra-class correlation coefficient (ICC) and the Bland & Altman method.ResultsInter-rater reliability was excellent with ICC=0.94. The Bland & Altman analysis revealed no systematic errors between inter-raters.ConclusionThe Chinese version of Lequesne index has high inter-rater reliability in subjects with knee osteoarthritis.