1.Analysis of Glaucoma Quality of Life 17 based on the item response theory
Qiyuan LYU ; Wenmin HUANG ; Gaofeng LI ; Weixin ZHENG ; Huiming XIAO
Chinese Journal of Modern Nursing 2019;25(25):3211-3214
Objective? To evaluate the Chinese version of Glaucoma Quality of Life 17 (Glau-QoL17) by item analysis on each item using item response theory(IRT), so as to provide tools in life quality evaluation in patients with glaucoma in China. Methods? By convenience sampling, 198 glaucoma patients admitted in the outpatient department of Opthalmic Center affiliated to Sun Yat-Sen University from May 2017 to July 2018 were selected and their life quality were evaluated by using the Chinese version of Glau-QoL17. MULTILOG 7.0 was used to analyze the collected data in IRT and calculate the discrimination and difficulty parameters of each item. Results? The Chinese version of Glau-QoL17 had good discrimination. The discrimination parameter (α) ranged from 1.50 to 5.23, and the difficulty increased monotonously. Except for the entry "Are you afraid of surgeries?", the other items ranged from-3 to 3; the coverage area under the item information curve was relatively large except for item "Currently, I am very well-informed about my visual problems." Conclusions? The Chinese version of Glau-QoL17 can be used in the evaluation of the glaucoma patients' quality of life in our country, however, it still needs further modification on its content so as to improve the accuracy of the evaluation.
2.Effects of low-frequency and high-frequency repetitive transcranial magnetic stimulation combined with levodopa and benserazide hydrochloride on mild cognitive impairment in patients with Parkinson disease
Qiyuan ZHAO ; Guangyan CONG ; Hongyan LYU ; Yong ZHANG ; Wei LI ; Panpan HU ; Kai WANG
Chinese Journal of Behavioral Medicine and Brain Science 2024;33(3):199-205
Objective:To investigate the effects of low-frequency and high frequency repetitive transcranial magnetic stimulation (rTMS) combined with levodopa and benserazide hydrochloride on mild cognitive impairment in patients with Parkinson disease (PD).Methods:Totally 90 PD patients with mild cognitive impairment who visited from January 2020 to June 2022 were included , and they were divided into a simple drug group ( n=30), drug+ low-frequency group ( n=30), and drug+ high-frequency group ( n=30) according to the order of admission.The patients in the simple drug group were treated with oral levodopa and benserazide hydrochloride, while the patients in drug+ low-frequency and drug+ high-frequency groups were treated with low-frequency or high-frequency rTMS on the basis of oral levodopa and benserazide hydrochloride.Montreal cognitive assessment(MoCA), digital span (DS), Chinese auditory learning test (CALT), the judgment of line orientation test (JLOT) and verbal fluency test (VFT) were used to evaluate the cognitive function of patients before and after 4 weeks of treatment.SPSS 26.0 was used for statistical analysis.The paired t-test was used for intra-group comparison before and after treatment, while one-way ANOVA was used for inter-group comparison. Results:There were no significant differences in MoCA, DS anterograde, DS backward, CALT immediate recall, CALT delayed recall, JLOT, and VFT scores among patients in the simple drug group before and after 4 weeks of treatment( t=-1.157, -0.648, -0.215, -0.290, -0.154, -0.782, -0.960, all P>0.05). After 4 weeks of treatment, MoCA, DS anterograde, DS backward, CALT immediate recall, CALT delayed recall, JLOT and VFT scores in drug+ low-frequency group and drug+ high-frequency group were higher than before treatment (drug+ low frequency group: t=-16.357, -11.379, -7.999, -11.805, -16.624, -15.996, -17.241, all P<0.05; drug+ high-frequency group: t=-25.198, -13.971, -13.904, -25.831, -26.382, -20.108, -15.643, all P<0.05). There were no statistically significant differences in the scores of MoCA, DS anterograde, DS backward, CALT immediate recall, CALT delayed recall, JLOT and VFT among the three groups before treatment (all P>0.05). After treatment, there were statistically significant differences in the scores of MoCA, DS anterograde, DS backward, CALT immediate recall, CALT delayed recall, JLOT and VFT among the three groups (simple drug group : (20.37±1.96), (4.37±1.19), (2.80±0.55), (6.93±1.70), (5.17±1.09), (15.50±2.69), (10.73±1.55); drug+ low-frequency group: (23.83±2.32), (5.87±0.94), (3.87±0.73), (9.17±1.74), (8.13±1.50), (20.77±2.19), (13.30±1.73); drug+ high-frequency group: (27.17±1.64), (6.73±1.01), (4.80±0.81), (11.20±2.06), (10.03±1.54), (25.17±3.14), (15.87±2.05)) (all P<0.05). Further analysis showed that both the drug+ low-frequency and drug+ high-frequency groups had higher scores than the simple drug group, and the drug+ high-frequency group had higher scores than the drug+ low-frequency group(all P<0.05). Conclusion:The combination of drug+ low-frequency or drug+ high-frequency rTMS and drug therapy can help improve cognitive function in patients with PD, and the efficacy of drug+ high-frequency rTMS may be more significant, which provides a new therapeutic idea for clinical treatment of patients with PD.
3.Effect of the nitroglycerin-controlled low central venous pressure technique on cerebral metabolic markers and cerebral blood oxygen saturation in patients undergoing laparoscopic hepatectomy for liver cancer
Bo WANG ; Xia FU ; Conghai LYU ; Chunfang YIN ; Qiyuan WU
Journal of Clinical Hepatology 2025;41(3):478-484
ObjectiveTo investigate the effect of the nitroglycerin-controlled low central venous pressure (CLCVP) technique on brain metabolic markers and cerebral blood oxygen saturation in patients undergoing laparoscopic hepatectomy for liver cancer, and to reduce the risk of neurological complications. MethodsA total of 105 patients who underwent elective laparoscopic hepatectomy for liver cancer in Haikou Hospital Affiliated to Xiangya Hospital of Central South University from April 2020 to May 2023 were enrolled and randomly divided into CLCVP group with 54 patients and non-CLCVP group with 51 patients. The patients in the CLCVP group were treated with the nitroglycerin CLCVP technique during surgery, while those in the non-CLCVP group were given conventional surgical treatment. The two groups were compared in terms of the following indicators: perioperative indicators; hemodynamic parameters and cerebral oxygen metabolism before anesthesia induction (T0), at 5 minutes after anesthesia induction (T1), at 5 minutes after the beginning of liver parenchyma dissection (T2), at 5 minutes after the end of hepatectomy (T3), and immediately after the end of surgery (T4); the changes in liver function parameters after surgery; the incidence rate of adverse reactions. The independent-samples t test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups; the analysis of variance with repeated measures was used for comparison between multiple time points. ResultsCompared with the non-CLCVP group, the CLCVP group had significantly lower intraoperative blood loss and intraoperative fluid infusion volume (t=5.408 and 7.220, both P<0.05), while there were no significant differences between the two groups in time of operation, anesthesia time, extubation time, resuscitation time and intraoperative urine volume (all P>0.05). Compared with the data at T0, both groups had significant reductions in mean arterial pressure, heart rate, and central venous pressure during surgery (all P<0.05), and compared with the non-CLCVP group, the CLCVP group had significantly lower mean arterial pressure and central venous pressure (P<0.05) and a significantly higher heart rate (P<0.05) at T2 and T3. Compared with the data at T0, both groups had a significant reduction in Ca-jvDO2 at T2 — T4 time points (all P<0.05), while there was no significant difference in Ca-jvDO2 between the two groups at each time point (all P>0.05). Compared with the data at T0, the CLCVP group had a significant reduction in rSO2 at T2 — T4 time points (all P<0.05), and the CLCVP group had a significantly lower level of rSO2 than the non-CLCVP group at T2 — T3 time points (both P<0.05); there were no significant changes in CERO2 and Djv-aBL in either group at each time point (all P>0.05). At 3 and 7 days after surgery, both groups had significant increases in the liver function parameters of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin (TBil) (all P<0.05), and the CLCVP group had significantly lower levels of AST and ALT than the non-CLCVP group (all P<0.05); there was no significant difference in TBil between the two groups at each time point (all P>0.05). There was no significant difference in the incidence rate of perioperative complications between the two groups (χ2=0.729, P=0.394). ConclusionThe application of the nitroglycerin CLCVP technique in laparoscopic hepatectomy for liver cancer can reduce the amount of intraoperative blood loss in patients, but it is necessary to further enhance the monitoring of cerebral blood oxygen saturation during surgery, so as to reduce the risk of neurological complications as much as possible.