1.Analysis of clinical characteristics and factors affecting activities of daily living in patients with neurosyphi-lis
Caidie XIE ; Shoucheng XU ; Ning ZHANG ; Wei WANG ; Shanshan HE ; Yabin ZHENG
Chinese Journal of Nervous and Mental Diseases 2025;51(3):135-141
Objective To analyze the clinical data of patients with neurosyphilis(NS)and explore factors influencing their activity of daily living(ADL).Methods The clinical data of 90 patients with NS was retrospectively analyzed,and the ADL scores at admission were assessed by using the Barthel index(BI).The patients were divided into no-dependency,mild-dependency,and moderate-to-severe-dependency groups.The influencing factors of ADL were explored through comparative analysis and multiple linear regression analysis.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of clinical indicators for poor ADL recovery(BI score≤60)at discharge in patients.Results Among the 90 NS patients,the average age was 54.17±12.45 years,with 70 males(77.78%).The most common clinical manifestation was abnormal mental behavior(44.44%),followed by limb sensory or motor disorders(25.56%)and dysarthria(16.67%).Based on the BI scores,41 patients(45.6%)were independent,31 patients(34.4%)had mild dependence,and 18 patients(20.0%)had moderate to severe dependence.The comparison results of the three groups showed that the neutrophil-to-lymphocyte ratio(NLR)was gradually increased[2.80(1.97,4.73)vs.3.80(2.28,4.89)vs.5.37(3.76,7.20)]which was higher in the moderate-to-severe-dependency group than in the independent and the mildly-dependent group(P<0.05);cerebrospinal fluid protein concentration[427(341,644)mg/L vs.553(425,830)mg/L vs.933(641,1706.5)mg/L]was gradually increased and there were significant differences in pairwise comparisons(P<0.05).Multiple linear regression analysis showed that NLR(β=-0.242,P=0.018)and cerebrospinal fluid protein concentration(β=-0.461,P<0.001)were negatively correlated with ADL at admission.The area under curve(AUC)for cerebrospinal fluid protein concentration in predicting poor ADL recovery at discharge was 0.806(95%CI:0.708-0.883,P<0.001),with an optimal cutoff value of 620 mg/L,sensitivity of 86.7%,and specificity of 69.4%.Conclusion The main clinical manifestations of NS patients are psychiatric/behavioral abnormalities.Elevated NLR and cerebrospinal fluid protein concentration may be associated with the decreased ADL.Early active intervention of inflammatory response and cerebrospinal fluid protein abnormalities may provide a new way to improve the prognosis of patients.
2.Analysis of clinical characteristics and factors affecting activities of daily living in patients with neurosyphi-lis
Caidie XIE ; Shoucheng XU ; Ning ZHANG ; Wei WANG ; Shanshan HE ; Yabin ZHENG
Chinese Journal of Nervous and Mental Diseases 2025;51(3):135-141
Objective To analyze the clinical data of patients with neurosyphilis(NS)and explore factors influencing their activity of daily living(ADL).Methods The clinical data of 90 patients with NS was retrospectively analyzed,and the ADL scores at admission were assessed by using the Barthel index(BI).The patients were divided into no-dependency,mild-dependency,and moderate-to-severe-dependency groups.The influencing factors of ADL were explored through comparative analysis and multiple linear regression analysis.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of clinical indicators for poor ADL recovery(BI score≤60)at discharge in patients.Results Among the 90 NS patients,the average age was 54.17±12.45 years,with 70 males(77.78%).The most common clinical manifestation was abnormal mental behavior(44.44%),followed by limb sensory or motor disorders(25.56%)and dysarthria(16.67%).Based on the BI scores,41 patients(45.6%)were independent,31 patients(34.4%)had mild dependence,and 18 patients(20.0%)had moderate to severe dependence.The comparison results of the three groups showed that the neutrophil-to-lymphocyte ratio(NLR)was gradually increased[2.80(1.97,4.73)vs.3.80(2.28,4.89)vs.5.37(3.76,7.20)]which was higher in the moderate-to-severe-dependency group than in the independent and the mildly-dependent group(P<0.05);cerebrospinal fluid protein concentration[427(341,644)mg/L vs.553(425,830)mg/L vs.933(641,1706.5)mg/L]was gradually increased and there were significant differences in pairwise comparisons(P<0.05).Multiple linear regression analysis showed that NLR(β=-0.242,P=0.018)and cerebrospinal fluid protein concentration(β=-0.461,P<0.001)were negatively correlated with ADL at admission.The area under curve(AUC)for cerebrospinal fluid protein concentration in predicting poor ADL recovery at discharge was 0.806(95%CI:0.708-0.883,P<0.001),with an optimal cutoff value of 620 mg/L,sensitivity of 86.7%,and specificity of 69.4%.Conclusion The main clinical manifestations of NS patients are psychiatric/behavioral abnormalities.Elevated NLR and cerebrospinal fluid protein concentration may be associated with the decreased ADL.Early active intervention of inflammatory response and cerebrospinal fluid protein abnormalities may provide a new way to improve the prognosis of patients.
3.Aspiration risk assessment of water-swallowing test in the occurrence of aspiration pneumonia in patients with cerebral infarction
Yuanzhou ZHU ; Wei ZHU ; Quanan HE ; Shoucheng HE ; Wei ZHU ; Liangzi HU
Clinical Medicine of China 2016;32(7):601-602,603
Objective To investigate the effect of swallowing water test in the occurrence of aspiration pneumonia in patients with cerebral infarction. Methods One hundred and twenty?seven cases patients with cerebrovascular disease were randomly divided into two groups:swallow water group and control group,who were guided food program according to the result of swallow water test or experience. The number of two groups to use nasal feeding and the number of cases of the two groups occurred aspiration pneumonia in 3, 6 months were observed. Results The nasal feeding rate of swallow water group was higher than that of control group( 27. 6%( 21/76) vs. 11. 8%( 6/51) ,χ2=4. 590,P=0. 032) . After 3,6 months,the incidence of aspiration pneumonia of control group were higher than that of swallow water group(17. 6%(9/51) vs. 1. 3%(1/76),19. 6%(10/51) vs. 3. 9%(3/76),χ2=9. 080,6. 530,P<0. 05). Conclusion Water?swallowing test is a simple and practical method for assessment risk of aspiration pneumonia of patients with cerebral infarction,which is more effectively to reduce the risk of aspiration pneumonia than the empiric selection method of nasal feeding.

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