1.Imaging study of lymphomatosis cerebri characterized by diffuse lesions of bilateral cerebral white matter
Zhibing RUAN ; Lan CHU ; Chunfeng LIU ; Yu HU ; Jinjin HUANG
Chinese Journal of Neurology 2021;54(11):1168-1175
Objective:To investigate multimodality imaging characteristics and clinical features of lymphomatosis cerebri (LC) and reasons for misdiagnosis,with the goal of potentially facilitating an early and accurate diagnosis for this often-missed disease.Methods:Clinical data and cerebral multimodality imaging findings from 11 patients with LC proven basing on pathology in the Affiliated Hospital of Guizhou Medical University from November 30, 2011 to December 28, 2020 were retrospectively extracted, analyzed, and reviewed in combination with the literatures.Results:The common presenting symptoms with subacute onset included cognitive decline (8/11), gait disturbance (9/11), and behavioral disturbance (5/11). Test of cerebrospinal fluid showed that the number of cells and the level of protein increased (8/10), the sugar content (2/10) and chloride (4/10) decreased. The imaging manifestations of 11 patients with LC were diffuse lesions of bilateral cerebral white matter in the both deep and lobar lesion distribution, involving the cerebral cortex and subcortical white matter in eight cases (8/11), basal ganglia in seven cases (7/11), thalamus in five cases (5/11), cerebellum in six cases and brain stem in six cases (6/11). All 11 patients showed equal or slightly low-density shadows on CT plain scan and slightly longer T 1WI and T 2WI signals on magnetic resonance imaging. Six cases (6/11) had no obvious enhancement in the early stage, and five cases and six follow-up cases showed heterogenous spots, patches, nodules or clusters of distinct enhancement. Diffusion-weighted imaging showed non restricted diffusion in nine (9/11) cases initially diagnosed, and restricted diffusion in two cases (2/11) and nine follow-up cases, which were hyperintense on diffusion-weighted imaging and hypointense on apparent diffusion coefficient maps. Five patients (5/5) presented a marked decrease in N-acetyl aspartic acid (NAA)/creatine (Cr) and increase in choline (Cho)/Cr on hydrogen proton magnetic resonance spectrum, including an increase in lipid/Cr in three cases. One case (1/3) showed no abnormal increase in lesion metabolism, and two cases (2/3) showed slightly increased uptake on positron emission tomography/CT. Conclusions:Diffuse bilateral cerebral lesions especially in deep and lobar region, without enhancement or with patchy enhancement, marked decrease in NAA/Cr and increase in Cho/Cr and Lip/Cr are suggestive of LC. Misdiagnosis may be mainly due to insufficient understanding and improper brain biopsy.
2.Construction of a Continuous Nursing Quality Evaluation Indicator System for Inflammatory Bowel Disease Patients Based on Donabedian's Three-Dimensional Quality Structure
Gairong MA ; Xinxian ZHAO ; Huiqin XI ; Ying JU ; Chunfeng RUAN ; Mei XU ; Jingjing WANG
Acta Academiae Medicinae Sinicae 2024;46(5):692-699
Objective To construct a continuous nursing quality evaluation indicator system for inflam-matory bowel disease patients and provide a basis for the evaluation of continuous nursing quality.Methods On the basis of Donabedian's three-dimensional(structure,process,and outcome)quality structure,we employed liter-ature review,qualitative interview,Delphi method,and hierarchical analysis to determine the content and weights of indicators of continuous nursing quality for the patients with inflammatory bowel disease.Results A total of 15 experts completed 2 rounds of consultation,which had the questionnaire recovery rates of 100%,the expert authority coefficients of 0.930 and 0.919,and the Kendall harmony coefficients of 0.149 and 0.177(both P<0.001),respectively.The established nursing quality evaluation indicator system included 3 first-level indicators,10 sec-ond-level indicators,and 39 third-level indicators.Conclusion The continuous nursing quality evaluation indi-cator system for the patients with inflammatory bowel disease that was constructed in this study was reasonable,reliable,and practical,providing reference for evaluating the continuous nursing quality for the patients with in-flammatory bowel disease.
3.Bibliometric analysis of symptom nursing of inflammatory bowel disease based on Web of Science
Gairong MA ; Wenfang XU ; Chunfeng RUAN ; Xinxian ZHAO
Chinese Journal of Modern Nursing 2024;30(27):3732-3737
Objective:To analyze the research status, hotspots and frontiers of symptom nursing of inflammatory bowel disease (IBD) .Methods:The Web of Science core collection database was searched, and CiteSpace 6.2.R4 software was used to analyze the literature visually.Results:A total of 350 articles were included. The number of articles on symptom nursing of inflammatory bowel disease showed an upward trend year by year. The author with the most significant number of articles was Christine. The authors were scattered and had not yet formed a core group. The country with the most significant number of articles was the United States. The keywords formed a total of 11 clusters, among which the home symptom monitoring of inflammatory bowel disease as a chronic disease, the current status of symptoms in inflammatory bowel disease patients and their relationship with other variables, the symptoms of active patients, and symptom intervention based on theoretical frameworks were research hotspots. The effectiveness of symptom-coping strategies and tools was at the forefront of research.Conclusions:The symptom nursing of inflammatory bowel disease shows a rapid development trend. In the future, researchers should develop more accurate symptom measurement tools based on previous research and construct precise symptom response strategies.