Acupuncture Therapy ; Humans ; Male ; Moyamoya Disease ; therapy ; Posterior Cerebral Artery ; abnormalities ; Young Adult

Objective To observe the clinical efficacy ofXing Nao Kai Qiao (brain awakening and orifice opening) Needling plus mountain-burning fire manipulation in treating post-stroke limb numbness.Method Eighty patients with post-stroke limb numbness were randomized into a treatment group and a control group, 40 cases in each group. The treatment group was intervened byXing Nao Kai Qiao needling plus mountain-burning fire manipulation, while the control group was byXing Nao Kai Qiao needling alone. The sensory function and motor function (Fugl-Meyer Assessment, FMA), National Institute of Health Stroke Scale (NIHSS), and Barthel Index (BI) were observed before and after intervention.Result The component scores of FMA (motor function, sensory function, range of motion, and joint pain intensity), NIHSS scores, and BI scores were significantly changed respectively after 1 and 2 treatment courses in both groups (P<0.05). The component scores of FMA, NIHSS scores, and BI scores after 2 treatment course were significantly different from that after 1 treatment course in both groups (P<0.05). After 2 treatment courses, the sensory function score, joint pain intensity in the treatment group were significantly different from that in the control group (P<0.05).ConclusionXing Nao Kai Qiaoneedling plus mountain-burning fire manipulation is an effective method in treating post-stroke limb numbness.

Objective:To explore the effectiveness of humanism concept in the management of patients with spi-nal cord injury care.Methods:Choose between January 2011 and February 2011 hospitalized in our hospital 112 cases of spinal cord injury patients, randomly divided into control group and observation group ( 56 cases) , com-pared two groups of nursing effect.Control group routine nursing management, observation group will humanistic nursing management idea runs through in the routine nursing management.Results:Aware of knowledge about health education group is significantly higher than the control group, patients satisfaction survey in nursing, be-tween the two groups statistically significant depression levels lower than the control group.Conclusions:In the nursing management of patients with spinal cord injury in the application of humanistic nursing concept effect is good, not only improve the effect of the nursing, and obviously improve the patient′s satisfaction, promote the pa-tient′s psychological adaptability.

Objective To investigate the pressure changes of cuff in the tapered-cuff endotracheal tubes and the frequency of cuff pressure monitoring in patient with trachea intubation. Methods From December 2016 to October 2017, 80 patients with oral tracheal intubation in the emergency department were divided into group A (n =25) and group B (n =23) according to the principle of randomized control. Group A with odd number was treated and tapered-cuff endotracheal tubes and group B with ever number and cylindrical-cuff endotracheal tubes. Continuous cuff pressure monitoring device was used to continuously monitor the cuff pressure. The two groups were compared in terms of time for keeping the normal cuff pressure and cuff pressure (average pressure, maximum pressure and minimum pressure). Results The total time for keeping the normal cuff pressure in group A was significantly shorter than that in group B (P＜0.05). The average cuff pressure in group A was smaller than that of group B (P＜0.05). The maximum pressure in group A is larger than that in group B and the maximum cuff pressure in group A was smaller than that of group B (P＜0.05). Conclusion Compared with the cylindrical cuff catheter, the tapered-cuff tube can maintain the normal pressure for a shorter period and easily produce needed pressure. It is a need to enhance the monitoring of cuff pressure to ensure good airway closure and reduce artificial airway complications.

Objective:To investigate the mastery and application of medical ethics basic knowledge in geriatric ward medical staffs,and the way which they receive relevant education. Methods:From November 2016 to January 2017,240 questionnaires about medical ethics were distributed among medical staffs in clinical department in the Chinese PLA General Hospital,among them,30 were medical groups and 210 were nursing groups;and a total of 233 valid questionnaires were collected. The nurses were divided into geriatric ward nursing group and non - geriat-ric ward nursing group,according to whether they work in the geriatric wards or not. Results:Only 2. 14％ and 7. 72％ participants fully and correctly answered the core concepts and basic principles of medical ethics,respec-tively. The rate of informed consent in medical staffs in geriatric group was significantly higher than that of non -geriatric group (92. 66％ vs 82. 11％ ,P = 0. 02);the patient' s privacy protection in geriatric nursing group was significantly higher than that of non - geriatric nursing group (92. 66％ vs 31. 57％ ,P < 0. 001). 28. 75％ of the respondents received medical ethics continuing education curriculum,and the proportion of correctly receiving ex-pectable death in these medical staffs (71. 40％ ) was significantly higher than that of other education pathway groups (36. 17％ ). Conclusion:Medical staffs lack more knowledge on medical ethics. Clinical work in geriatric medicine has higher demand for medical ethics knowledge,and continuing medical education can help to improve the cognitive level of medical ethics in medical staffs.

Objective:To investigate the radiation field and dose selection of patients with isolated chest wall recurrence (ICWR) after modified radical mastectomy, and analyze the prognostic factors related to subsequent chest wall recurrence.Methods:Clinical data of 201 patients with ICWR after mastectomy admitted to the Fifth Medical Center, Chinese PLA General Hospital from 1998 to 2018 were retrospectively analyzed. None of the patients received postoperative adjuvant radiotherapy. After ICWR, 48 patients (73.6%) underwent surgery and 155 patients (77.1%) received radiotherapy. Kaplan-Meier method was used to calculate the post-recurrence progression-free survival (PFS) rates and the difference was compared by log-rank test. Multivariate analysis was performed using Cox regression model. Competing risk model was adopted to estimate the subsequent local recurrence (sLR) rates after ICWR and the difference was compared with Gray test. Multivariate analysis was conducted using F&G analysis. Results:With a median follow up of 92.8 months after ICWR, the 5-year PFS rate was 23.2%, and the 5-year sLR rate was 35.7%. Multivariate analysis showed that patients with surgery plus radiotherapy and recurrence interval o F>12 months had a lower sLR rate. Patients with recurrence interval o F>48 months, local plus systemic treatment and surgery plus radiotherapy had a higher PFS rate. Among the 155 patients who received chest wall radiotherapy after ICWR, total chest wall irradiation plus local boost could improve the 5-year PFS rate compared with total chest wall irradiation alone (34.0% vs. 15.4%, P=0.004). Chest wall radiation dose (≤60 Gy vs.>60 Gy) exerted no significant effect upon the sLR and PFS rates (both P>0.05). In the 53 patients without surgery, the 5-year PFS rates were 9.1% and 20.5%( P=0.061) with tumor bed dose ≤60 Gy and>60 Gy, respectively. Conclusions:Local radiotherapy is recommended for patients with ICWR after modified radical mastectomy of breast cancer, including total chest wall radiation plus local boost. The radiation dose for recurrence should be increased to 60 Gy, and it should be above 60 Gy for those who have not undergone surgical resection. In addition, patients with ICWR still have a high risk of sLR, and more effective treatments need to be explored.

Objective·To compare the physical activities of stroke population and non-stroke population based on the baseline survey of the elderly population cohort in Shanghai communities,and explore the participation in different types of physical activities of stroke population.Methods·The subjects were screened from Shanghai Community Elderly Cohort constructed from February to August,2019 according to the admission criteria.The subjects were divided into non-stroke group and stroke group according to whether they had reported a history of stroke by themselves,and the two groups were matched 2 to 1 by controlling age and sex with propensity score matching.The baseline characteristics of the two groups were collected,and the physical activities related to sports,transportation and housework in the last week were investigated with the International Physical Activity Questionnaire(IPAQ).Pittsburgh Sleep Quality Index(PSQ1)was used to evaluate the sleep quality of the subjects.Generalized Anxiety Disorder(GAD-7)and Patient Health Questionnaire-9(PHQ-9)were used to evaluate anxiety and depression of the subjects,respectively.The above characteristics were compared between the stroke group and non-stroke group,and the participation of different types of physical activities were compared between the two groups by multivariate Logistic regression model.Results·Among the 17 948 people included,there were 993(5.5％)in the stroke group and 16 955(94.5％)in the non-stroke group.After propensity score matching,there were 1 984 people(66.7％)in the non-stroke group and 992 people(33.3％)in the stroke group.There were significant differences in education level,pre-retirement occupation,waist circumference,body mass index,sleep status,anxiety symptoms,depression symptoms and disease history between the two groups(all P＜0.05).In terms of physical activities,the female stroke group had shorter daily moderate exercises time,fewer riding and walking days in one week,and shorter daily riding time,compared with the non-stroke people,with statistical significance(all P＜0.05).Compared with the non-stroke people,the weekly housework days and daily housework time in the male and female stroke groups were lower than those in the non-stroke group,while the daily sedentary time was longer,with statistical significance(all P=0.000).In terms of physical activity level,the proportions of men and women in the stroke group who reached medium or high level were lower than those in the non-stroke group,and the differences were statistically significant(all P=0.000).After adjusting for gender,age,occupation,anxiety symptoms,history of hyperlipidemia,history of atrial fibrillation,history of chronic gastritis and history of hip fracture by multivariate Logistic regression model,the level of vigorous exercise participation in the stroke group was lower,the proportions of no housework in the last week and sedentary time greater than 180 min per day were higher,and the proportion at medium and high activity levels was lower(all P＜0.05).Conclusion·The frequency and duration of housework participation and the physical activity level of elderly people with a history of stroke in Shanghai communities are at a lower level than those without stroke,and they also have a longer sedentary time.

Objective:To analyze the prognosis of patients with isolated regional recurrence (RR) after mastectomy, and evaluate the efficacy of radiotherapy and identify the optimal radiation target volumes.Methods:Clinical data of 144 patients with first isolated RR after mastectomy between 2001 and 2018 were retrospectively analyzed. All patients had not received post-mastectomy radiotherapy. The primary endpoints consisted of the subsequent locoregional recurrence (sLRR), distant metastasis (DM), progression-free survival (PFS) and overall survival (OS).Results:With a median follow-up of 82.5 months after RR, the 5-year sLRR, DM, PFS and OS rates for the entire group were 42.1%, 71.9%, 22.9% and 62.6%, respectively. Local plus systemic therapy was an independent favorable prognostic factor for sLRR ( P<0.001) and PFS ( P=0.013). The sLRR rate in the surgery plus radiotherapy group was the lowest ( P<0.001). Surgery plus radiotherapy significantly reduced the 5-year risk of recurrence within the initially involved nodal regions ( P<0.001). Patients with chest wall irradiation obtained the 5-year subsequent chest wall recurrence rate of 12.1% compared to 14.8%( P=0.873) for those without chest wall irradiation. The subsequent supraclavicular recurrence rate was lower in patients with prophylactic supraclavicular irradiation than that without prophylactic supraclavicular irradiation (9.9% vs. 23.8%, P=0.206). The incidence rates of initially uninvolved axillary and internal mammary nodal recurrence were below 10% regardless of prophylactic irradiation or not. Conclusions:Patients with RR alone have an optimistic 5-year OS in the contemporary era. Comprehensive locoregional treatment including surgery and radiotherapy combined with systemic therapy is recommended. The chest wall, axillary and internal mammary nodal prophylactic irradiation should not be routinely performed for all patients with RR. The value of supraclavicular prophylactic irradiation remains to be evaluated.