1.Effects of breathing exercises on motor and respiratory function and on ability in daily living of patients with Parkinson′s disease
Jiecheng FAN ; Jialiang WANG ; Chunfeng XIA ; Suping LIU ; Peiwu GUO ; Shuyun ZHANG
Chinese Journal of Physical Medicine and Rehabilitation 2021;43(8):693-697
Objective:To explore the effect of breathing exercises on motor, balance, respiration and ability in the activities of daily living (ADL) of patients with Parkinson′s disease.Methods:Sixty patients with idiopathic Parkinson′s disease who met the inclusion criteria were divided at random into a control group and a treatment group, each of 30. Both groups received routine drug therapy and 60 minute of rehabilitation training daily, including core muscle group control training, relaxation training, joint motion training, posture training, balance function training, gait training and facial muscle control training. There were 3 sessions a week for 24 weeks. The treatment group was also given breathing exercises, including training in abdominal breathing with the expiration time twice the inspiration time and inspiratory muscle training. The abdominal breathing training included 15 abdominal breaths, repeated twice after a 2-minute break; the inspiratory muscle training required 10 respirations and expirations at the maximum volume, repeated twice after an interval of 2 minutes. The training lasted 24 weeks, five times a week. The subjects′ motor functioning, balance, walking, respiration and daily living ability were evaluated before the treatment and after 12 and 24 weeks of treatment using the Parkinson′s Disease Rating Scale (part III) (UPDRS ⅲ), the Berg Balance Scale (BBS), the 6-minute walk test (6MWT), walking distance and the modified Barthel Index (MBI). Forced expiratory volume in the first second (FEV 1), forced vital capacity (FVC) and their ratio (FEV 1%) were also observed. Results:After 12 weeks of treatment, significant improvement was observed in the average UPDRS iii, BBS, 6MWT, MBI, FEV 1, FVC and FEV 1% results of both groups, but the improvement in the treatment group was significantly greater on average. After another twelve week the average UPDRS iii, BBS, 6MWT, MBI, FEV 1, FVC and FEV 1% results of the treatment group had improved significantly more than those of the control group. Conclusion:Breathing exercises can significantly improve the motor function, balance, walking, respiratory function and ADL ability of persons with Parkinson′s disease.
2.Risk factors of systolic dysfunction after isolated traumatic brain injury
Yuzhu MIAO ; Jungen LI ; Peng YANG ; Jiecheng XIAO ; Li DING ; Oiufang ZHANG ; Sisi SUN ; Xiaoqin LI ; Shiqi LU
Chinese Journal of Emergency Medicine 2020;29(7):954-958
Objective:To investigate the risk factors of systolic dysfunction early complicated in patients with isolated traumatic brain injury (iTBI) and to evaluate the influence of complicated systolic dysfunction on the prognosis of iTBI patients.Methods:From January 2017 to October 2018, 123 patients with moderate or severe iTBI admitted to Trauma Centre in our hospital were included in the study, and patients with previous cardiovascular diseases were excluded. Left ventricular systolic function was assessed by transthoracic echocardiography within 24 h after admission. The patients were divided into normal systolic function group ( n=100) and systolic dysfunction group ( n=23) according to the results of echocardiography. Data were collected from all patients on admission, including GCS score, systolic blood pressure, heart rate, high-sensitivity cardiac troponin T (hs-cTnT), clinical treatment variables (use of sedative drugs, vasoactive drugs, etc.), craniotomy or not and clinical outcomes (survival or death) during hospitalization. Logistic regression analysis was used to analyze the related factors for iTBI patients complicated with systolic dysfunction, and receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of each index for iTBI patients complicated with cardiac insufficiency. Results:The systolic blood pressure (147.3±23.3) mmHg, the heart rate (96.1±26.3) beats/min and the hs-cTnT level (16.48±8.17) pg/mL in the systolic dysfunction group were higher than those in the normal systolic function group on admission (all P<0.05); and the GCS score in the systolic dysfunction group was lower than that in the normal systolic function group ( P<0.05). Logistic regression analysis showed that the heart rate ( OR=1.129, 95% CI: 1.001-1.516; P=0.038), the GCS score ( OR=0.640, 95% CI: 0.445-0.920; P=0.016) and the hs-cTnT level ( OR=1.054, 95% CI: 1.009-1.101; P=0.002) on admission were independent risk factors for iTBI patients complicated with systolic dysfunction. The area under the ROC curve (AUC) of the hs-cTnT levelon admission was the largest (AUC=0.863, P<0.01). The in-hospital mortality of patients in the systolic dysfunction group was higher than that of patients in the normal systolic function group (52.5% vs 22%, P=0.004). Conclusions:The heart rate, the GCS score and the serum hs-cTnT level on admission were independent risk factors for iTBI patients complicated with systolic dysfunction. The hs-cTnT level could better predict the occurrence of cardiac systolic dysfuncion, and higher in-hospital mortality was found in iTBI patients complicated with systolic dysfunction. Therefore, early detection and timely intervention may improve the prognosis of these patients.
3. Predictive value of prostate biopsy results based on predictive model established by the PI-RADS version 2
Jinyang LUO ; Jiaxin ZHENG ; Zonglong CAI ; Xiongbo YAO ; Jiaxin CHEN ; Jiecheng ZHANG ; Rui WAN ; Guishuang LIANG ; Jinchun XING ; Xuan ZHUANG
Chinese Journal of Urology 2019;40(9):673-679
Objective:
To explore a predictive nomogram for the result of prostate biopsy based on Prostate Imaging Reporting and Data System version 2(PI-RADS v2)combined with prostate specific antigen (PSA) and its related parameters, and to assess its ability to diagnose prostate cancer by internal validation.
Methods:
We retrospectively analyzed the clinical data of 509 patients who underwent transrectal prostate biopsy guided by ultrasound during the period from January 2014 to December 2018 in the Department of Urology, First Affiliated Hospital of Xiamen University. In 509 cases, the mean age was (68.1±7.2) years. The mean prostate volume(PV) was (55.8±30.7) ml. The mean tPSA value was (19.86±18.94) ng/ml. The mean value of fPSA was (2.63±3.60) ng/ml and the mean f/tPSA was 0.14±0.08. The mean PSAD was (0.46±0.52) ng/ml2. Based on the PI-RADS v2, score 1 point have 37 cases, score 2 point have 131 cases, score 3 point have 152 cases, score 4 point have 102 cases, score 5 point have 87 cases. Of these patients, we randomly selected 80% (407 cases) as development group, and the other 20% (102 cases) as validation group. Univariate and multivariate logistic regression analysis of the development group was performed to identify the independent influence factors that can predict prostate cancer (PCa), thereby establishing a predictive model for the result of prostate biopsy. In the development group, validation group and tPSA was between 4.1-20.0 ng/ml, the model was evaluated by analyzing the receiver operating characteristic (ROC) curve, calibration curve and decision curve, and compared to PSA, fPSA, f/tPSA, PSAD, PI-RADS v2.
Results:
Among the 509 patients enrolled in the study, the detection rate of PCa was 43.0% (219/509). In the development group, the logistic regression analysis demonstrated that patient age (