Objective To evaluate the effect of different kinesio taping(KT)patches on the improvement of upper limb function and activities of daily living in patients with stroke by using a reticulated Meta-analysis.Methods PubMed,Web of Science,Cochrane Library,EMbase,China Knowledge,Wanfang,and VIP databases were searched for randomised controlled trials on the effect of KT on improving the functional status of the upper limbs or the ability to perform activities of daily living in patients with stroke,using a computer,with a timeframe ranging from 2000 January to 2024 March.Twenty-six articles were included,accounting for a total of 1037 patients.Literature was screened individually,evaluated for quality,and identified for inclusion using RevMan 5.4 and Stata 17.0 software for reticulation Meta-analysis.Results Meta-analysis showed that the effect of different KT patches improved upper limb function in stroke patients:I+X+claw＞I+Y＞I+X+Y＞X+claw＞claw+Y＞I+claw＞X+Y+claw＞I+X＞Y+T＞I+I＞control.Order of the efficacy of different KT patch types on improving the daily life ability of stroke patients:I+X+claw＞X+claw＞I+X＞I+X+Y＞Y+T＞I+Y＞X+Y+claw＞I+claw＞I+I＞control.The improvement effect of different ligation maintenance time ranked:24-48h＞over 72h＞49-72h.Conclusion With the combination of I+X+claw muscle KT,the best maintenance time of a single patch was 24-48h,which had the best improvement effect on the upper limb function and daily living ability of stroke patients.

OBJECTIVE: To explore the relationship between the geriatric nutritional risk index (GNRI) and cognitive function. METHODS: A cross-sectional study method was conducted. People aged ≥ 60 years from the National Health and Nutrition Examination Survey (NHANES) databases from 1999 to 2002 and 2011 to 2014 were included as study subjects. The participants were divided into three groups based on their GNRI scores: a medium-high risk group (82 ≤ GNRI < 92), a low risk group (92 ≤ GNRI < 98), and a no-risk group (GNRI ≥ 98). Demographic characteristics (gender, age, race, education), chronic diseases [chronic bronchitis, emphysema, thyroid problems, coronary heart disease, angina pectoris, stroke, hypertension, diabetes mellitus, and depression score on the patient health questionnaire (PHQ-9)], lifestyle habits (history of smoking, hours of sleep), etc., were collected. Cognitive function was assessed using the consortium to establish a registry for Alzheimer's disease word learning subtest (CERAD-WL), animal fluency test (AFT), and digit symbol substitution test (DSST) for the 2011-2014 data, while only the DSST was used for the 1999-2002 data. Differences in the above information among the GNRI cohorts were compared. Factors affecting cognitive function in the population were analyzed using multifactorial Logistic regression. RESULTS: 2 653 participants from 2011 to 2014 and 2 380 participants from 1999 to 2002 were enrolled, with a total of 5 033 participants in the study. There were statistically significant differences in age, stroke, diabetes mellitus, DSST score, AFT score, CERAD score test 1 recall (Cst1), and CERAD score test 2 recall (Cst2) among the GNRI groups. Multifactorial Logistic regression analysis of data from 2011 to 2014 showed that in model 3 (DSST score, age, gender, race, marriage, education, hours of sleep, history of smoking, emphysema, thyroid problems, chronic bronchitis, coronary heart disease, angina pectoris, hypertension, diabetes mellitus, depression score on the PHQ-9, and stroke) adjusted for all covariates, GNRI was a protective factor for DSST [odds ratio (OR) = 1.03, 95% confidence interval (95%CI) was 1.00 to 1.05, P = 0.03]; Logistic regression analyse for 1999 to 2002 and 2011 to 2014 showed a significant association even after adjustment for covariates (OR = 1.02, 95%CI was 1.00 to 1.03, P = 0.02). Subgroup Logistic regression analyses of the total population from 2011 to 2014 showed a significant association between GNRI and DSST scores (OR = 1.02, 95%CI was 1.01 to 1.03, P < 0.001), with significant associations in the age subgroups of 60 to 64 years old, across gender, non-Hispanic Whites and Blacks, by education, and by marital status associations were significant (all P < 0.05). Subgroup Logistic regression analyse of the total populations from 1999 to 2002 and 2011 to 2014 showed a significant association between the GNRI and DSST score (OR = 1.01, 95%CI was 1.01 to 1.02, P < 0.001), but did not show a significant year difference (interaction P = 0.503), and the newly found in the smoking population the association was also more significant (P < 0.01). CONCLUSION The GNRI correlates with the presence of cognitive functions related to processing speed, sustained attention, and executive function, and may be able to serve as an indicator for the assessment or prediction of related cognitive functions.
Humans ; Cross-Sectional Studies ; Aged ; Middle Aged ; Nutrition Surveys ; Cognition ; Female ; Male ; Nutritional Status ; Risk Factors ; Geriatric Assessment

Objective To evaluate the effect of different kinesio taping(KT)patches on the improvement of upper limb function and activities of daily living in patients with stroke by using a reticulated Meta-analysis.Methods PubMed,Web of Science,Cochrane Library,EMbase,China Knowledge,Wanfang,and VIP databases were searched for randomised controlled trials on the effect of KT on improving the functional status of the upper limbs or the ability to perform activities of daily living in patients with stroke,using a computer,with a timeframe ranging from 2000 January to 2024 March.Twenty-six articles were included,accounting for a total of 1037 patients.Literature was screened individually,evaluated for quality,and identified for inclusion using RevMan 5.4 and Stata 17.0 software for reticulation Meta-analysis.Results Meta-analysis showed that the effect of different KT patches improved upper limb function in stroke patients:I+X+claw＞I+Y＞I+X+Y＞X+claw＞claw+Y＞I+claw＞X+Y+claw＞I+X＞Y+T＞I+I＞control.Order of the efficacy of different KT patch types on improving the daily life ability of stroke patients:I+X+claw＞X+claw＞I+X＞I+X+Y＞Y+T＞I+Y＞X+Y+claw＞I+claw＞I+I＞control.The improvement effect of different ligation maintenance time ranked:24-48h＞over 72h＞49-72h.Conclusion With the combination of I+X+claw muscle KT,the best maintenance time of a single patch was 24-48h,which had the best improvement effect on the upper limb function and daily living ability of stroke patients.

Objective To explore the relationship between atherosclerotic index of plasma(AIP)and cognitive function in older adults.Methods A cross-sectional study method was used to include the National Health and Nutrition Examination Survey(NHANES)2011 to 2014 population aged>60 years as study subjects,and the population was divided into>-2.158 to≤-0.624 AIP group,>-0.624 to≤-0.123 AIP group,>-0.123 to≤0.309 AIP group,>0.309 AIP group 4 groups.Demographic data(including gender,age,race,education,marriage,height,and body mass),chronic disease-related data(including angina pectoris,emphysema,depression score,chronic bronchitis,coronary heart disease,history of stroke,hypertension,and diabetes mellitus),lifestyle-related data(including smoking and sleep duration),and cognitive function assessment[including the United Registry for consortium to establish a registry for Alzheimer's disease word list(CERAD W-L)score,animal fluency test(AFT)score and digit symbol substitution test(DSST)score],and to compare the differences in the above information between groups with different levels of AIP;and to analyze the factors affecting the cognitive function of the population by using multifactorial Logistic regression.Results A total of 1 335 participants were included in the analysis,and the results of the multivariate linear regression suggested that in model 3 after adjusting for all covariates,no linear relationship existed between AIP and CERAD W-L score for the>-0.624-≤-0.123 AIP group,the>-0.123-≤-0.309 AIP group,and the>-0.309 AIP group,compared with the>-2.158-≤-0.624 AIP group have a linear relationship(P=0.500 for the>-0.624-≤-0.123 AIP group,P=0.110 for the>-0.123-≤0.309 AIP group,and P=0.200 for the>0.309 AIP group).Weighted multifactor Logistic regression analyses after adjusting for covariates showed that AIP was a risk correlate for decline in representing immediate and delayed recall CERAD W-L score[odds ratio(OR)=0.970,95％confidence interval(95％CI)of 0.950-1.000,P=0.050].Restricted Cubic Splines of AIP versus CERAD W-L score restricted cubic spline(RCS)curves suggested a significant overall effect of CERAD W-L score on AIP(overall P=0.005),but not a significant nonlinear relationship(nonlinear P=0.278);and subgroup analyses showed that among 65-70 years old who were college-educated or better,married,and free of hypertension,AIP was the most prevalent among CERAD W-L scores.AIP is an associated risk factor for the development of CERAD W-L decline in people(OR<1,P<0.05).Conclusion AIP is a risk factor for cognitive decline associated with delayed and immediate memory,suggesting that AIP can be used as a predictor or assessment of cognitive function.

Objective To explore the relationship between atherosclerotic index of plasma(AIP)and cognitive function in older adults.Methods A cross-sectional study method was used to include the National Health and Nutrition Examination Survey(NHANES)2011 to 2014 population aged>60 years as study subjects,and the population was divided into>-2.158 to≤-0.624 AIP group,>-0.624 to≤-0.123 AIP group,>-0.123 to≤0.309 AIP group,>0.309 AIP group 4 groups.Demographic data(including gender,age,race,education,marriage,height,and body mass),chronic disease-related data(including angina pectoris,emphysema,depression score,chronic bronchitis,coronary heart disease,history of stroke,hypertension,and diabetes mellitus),lifestyle-related data(including smoking and sleep duration),and cognitive function assessment[including the United Registry for consortium to establish a registry for Alzheimer's disease word list(CERAD W-L)score,animal fluency test(AFT)score and digit symbol substitution test(DSST)score],and to compare the differences in the above information between groups with different levels of AIP;and to analyze the factors affecting the cognitive function of the population by using multifactorial Logistic regression.Results A total of 1 335 participants were included in the analysis,and the results of the multivariate linear regression suggested that in model 3 after adjusting for all covariates,no linear relationship existed between AIP and CERAD W-L score for the>-0.624-≤-0.123 AIP group,the>-0.123-≤-0.309 AIP group,and the>-0.309 AIP group,compared with the>-2.158-≤-0.624 AIP group have a linear relationship(P=0.500 for the>-0.624-≤-0.123 AIP group,P=0.110 for the>-0.123-≤0.309 AIP group,and P=0.200 for the>0.309 AIP group).Weighted multifactor Logistic regression analyses after adjusting for covariates showed that AIP was a risk correlate for decline in representing immediate and delayed recall CERAD W-L score[odds ratio(OR)=0.970,95％confidence interval(95％CI)of 0.950-1.000,P=0.050].Restricted Cubic Splines of AIP versus CERAD W-L score restricted cubic spline(RCS)curves suggested a significant overall effect of CERAD W-L score on AIP(overall P=0.005),but not a significant nonlinear relationship(nonlinear P=0.278);and subgroup analyses showed that among 65-70 years old who were college-educated or better,married,and free of hypertension,AIP was the most prevalent among CERAD W-L scores.AIP is an associated risk factor for the development of CERAD W-L decline in people(OR<1,P<0.05).Conclusion AIP is a risk factor for cognitive decline associated with delayed and immediate memory,suggesting that AIP can be used as a predictor or assessment of cognitive function.

Objective:To identify the clinical and pathological characteristics of adrenocortical carcinoma(ACC) with hypercortisolism and analyze the prognostic factors.Methods:Clinical data of ACC patients between January 2003 and December 2022 from Nanjing Drum Tower Hospital were collected retrospectively. Clinical and pathological characteristics were compared between ACC patients with hypercortisolism and nonfunctional ACCs. Kaplan-Meier method was used for survival analyses and Cox regression models were performed to analyze prognostic factors for ACC patients.Results:In 61 cases of ACC patients, the average age was (49.33±16.32) years. After a median follow-up of 77 months(95% CI 47.49-106.51 months), median overall survival and progression-free survival were 50 months(95% CI 20.44-79.56 months) and 29 months(95% CI 22.87-35.13 months), respectively. Among 36 patients with complete endocrinologic evaluations, 19(52.77%) were diagnosed with hypercortisolism. Compared with nonfunctional ACC, patients with hypercortisolism had more hypokalemia(42.11% vs 6.25%, P=0.022), capsular invasion(68.42% vs 25.00%, P=0.018), and distant metastases(73.68% vs 25.00%, P=0.007). Median overall survival and progression-free survival were significantly shorter than nonfunctional ACC(overall survival: 39 months vs 67 months, P=0.009; progression-free survival: 30 months vs 51 months, P=0.040) as well. Multivariate Cox regression analyses indicated that Ki67 index( HR=1.078, P=0.024) was an independent risk factor for overall survival. Hypercortisolism( HR=71.112, P=0.006), Ki67 index( HR=1.345, P=0.003), adjuvant therapy( HR=176.652, P=0.012), and operation( HR=0.020, P=0.003), were associated with disease progression. Conclusion:ACC accompanied by hypercortisolism is more prone to invasion and distant metastasis, resulting in shorter survival. Hypercortisolism is an independent prognostic factor for ACC patients.

Objective:To explore the pathological characteristics of adrenal masses based on various tumor diameter and unenhanced computed tomography(CT) attenuation value, and evaluate the value of the two parameters in the assessment of the benign and malignant nature of adrenal masses.Methods:The data of 1 367 patients who underwent adrenalectomy in Nanjing Drum Tower Hospital from January 2017 to October 2022 were retrospectively collected. The adrenal masses were divided into four groups according to tumor diameter and unenhanced CT attenuation value, and the clinical and histopathological characteristics of the four groups were compared respectively. Logistic regression was used to analyze the correlation between tumor diameter, non-contrast CT attenuation value and malignant adrenal masses, and receiver operating characteristic(ROC) curve was used to assess the diagnostic value of both in benign and malignant adrenal masses.Results:The proportion of adrenocortical carcinoma and other malignant tumors increased with the rise of tumor diameter or unenhanced CT attenuation value. After adjusting for age and gender, tumor diameter( OR=1.624, 95% CI 1.464-1.803, P<0.001) and unenhanced CT attenuation value( OR=1.108, 95% CI 1.079-1.138, P<0.001) were predictors of malignant adrenal masses. The tumor diameter and unenhanced CT attenuation value in diagnosing malignant adrenal masses had area under the ROC curve(AUC) of 0.838 and 0.892, respectively. With the optimal cut-off values of >3.4 cm and >30 HU, the sensitivity was 75.5% and 83.7%, and the specificity was 80.5% and 84.4%, respectively. The combination of tumor diameter >3.4 cm and unenhanced CT attenuation value >20 HU had an AUC of 0.927, with a sensitivity of 71.4% and a specificity of 90.1% in diagnosing malignant adrenal masses. Conclusions:Tumor diameter and unenhanced CT attenuation value has important significance in the differential diagnosis of benign and malignant adrenal masses. A combination of tumor diameter (>3.4 cm) and unenhanced CT attenuation value (>20 HU) demonstrates best diagnostic efficiency. Clinical application of this combined index can effectively diagnose malignant adrenal masses while avoiding unnecessary investigations or surgery.