1.Application of six-minute walk test in preoperative evaluation of patients undergoing pulmonary lobectomy
Longping WANG ; Xuening YANG ; Bin ZENG ; Guangqing XU
Chinese Journal of Rehabilitation Theory and Practice 2022;28(2):242-248
Objective To analyze the feasibility of six-minute walk test (6MWT) before pulmonary lobectomy and prediction for postoperative outcome. Methods A total of 580 patients who were hospitalized in the department of lung surgery from May, 2017 to May, 2019 were reviewed, and 274 eligible patients were selected, who underwent first surgery and the surgical method was pulmonary lobectomy. They were divided into two groups based on the results of 6MWT before operation. The cut-off value of six-minute walk distance (6MWD) was obtained by receiver operating characteristic curve (ROC) area under curve (AUC). The postoperative outcome and the occurrence of cardiopulmonary complications in the two groups were analyzed. Results Compared to patients with 6MWD > 449 meters, the age was significantly older (P < 0.001), the forced expiratory volume in the first second (FEV1) was poor in patients with 6MWD ≤ 449 meters (P < 0.05), and other factors such as surgical resection site, pathological stage, gender, etc., were not significantly different (P > 0.05). The incidence of postoperative cardiopulmonary complications was significantly higher (OR = 2.672, 95%CI 1.488 to 4.798, P = 0.002), and the postoperative extubation time and hospital stay was longer in patients with 6MWD ≤ 449 meters than in patients with 6MWD > 449 meters (P < 0.05). 6MWD ≤ 449 meters was an independent risk factor for postoperative cardiopulmonary complications (OR = 2.395, 95%CI 1.299 to 4.415, P = 0.005). Conclusion As a simple function test, 6MWT can be routinely used to assess the physiological function of patients undergoing pulmonary lobectomy. Patients with 6MWD ≤ 449 meters may be in higher risks of postoperative cardiopulmonary complications.
2.Intermittent theta burst stimulation can improve the spatially-delayed responses of working memory
Lin ZHANG ; Dongxu LIU ; Yue LAN ; Ge LI ; Xiaolin LIU ; Rui CHEN ; Cheng WU ; Zhong PEI ; Guangqing XU
Chinese Journal of Physical Medicine and Rehabilitation 2022;44(5):385-389
Objective:To observe any effect of intermittent theta burst stimulation (iTBS) on the spatially-delayed responses of working memory using cynomolgus macaques.Methods:The working memory of six male cynomolgus macaques (8-9 years old) was trained using a spatially-delayed response task. They were then randomly divided into an iTBS group and a control group, each of 3. The iTBS group was given iTBS at an intensity of 35% of the maximum output, with 2 seconds of stimulation followed by 8 seconds of rest with trains of 50Hz bursts repeated at a frequency of 5Hz over a period of 192 seconds once daily for 5 days, while the control group was given sham iTBS. Before and after the 5 days, the body weight and working memory of each animal were evaluated. The total number of effective feeding episodes, and of effective feeding episodes with short and long delay periods were recorded.Results:There was no significant change in the average body weight of either group before and after the modeling and iTBS intervention. After the intervention the number of total effective feeding cases and those with a short delay period were both significantly higher in the iTBS group than in the control group. However, no significant inter-group differences in the effective feeding cases with a long delay period were observed.Conclusions:iTBS is effective in improving the spatially-delayed responses of working memory, at least in cynomolgus macaques.
3.Significance and future of anticoagulant therapy for sepsis
Weiwei XU ; Ming LI ; Guangqing CUI ; Ruilan WANG
Chinese Critical Care Medicine 2021;33(5):621-625
Sepsis is caused by the imbalance of the host body's response to infection, which causes life-threatening organ dysfunction. Disorders of blood coagulation play a very important role in the development of sepsis. In sepsis, the body's coagulation system is activated, leading to hypercoagulability, while the anticoagulation mechanism is significantly inhibited, causing a large number of microthrombi to form, and disseminated intravascular coagulation (DIC) may occur. Although there are obvious controversies about the anticoagulation treatment of sepsis at home and abroad, we cannot deny the significance of anticoagulation treatment in sepsis. Only appropriate anticoagulation can effectively reduce the mortality in septic DIC, septic shock and high-risk population, and ultimately effectively reduce the occurrence of multiple organ dysfunction syndrome. The sepsis-induced coagulation dysfunction (SIC) score is currently used internationally to guide anticoagulation. SIC score is optimized based on the International Society on Thrombosis and Haemostasis (ISTH) overt DIC score and Sepsis-3, including platelet, international normalized ratio (INR) and sequential organ failure assessment (SOFA). The SIC score can sensitively monitor sepsis-induced coagulation dysfunction. When the SIC score is≥4, it is the best timing to initiate anticoagulation therapy. At present, the internationally recommended anticoagulant drugs include antithrombin (AT), thrombomodulin (TM), tissue factor pathway inhibitor (TFPI), heparin, etc., while the domestically recommended anticoagulant drugs are only unfractionated heparin and low molecular weight heparin. Before using anticoagulant drugs, it is necessary to evaluate the possibility of bleeding and thrombosis in the patients. At the same time, it is necessary to pay attention to the patient's primary disease. Try to adopt the treatment strategy of transitioning from unfractionated heparin to low molecular weight heparin without obvious anticoagulation contraindications.
4.Influencing factors of self-management of diabetics in community and nursing instruction need
Jiying WANG ; Guangqing XIAO ; Yan WANG ; Weiyu XU ; Jiangnan YAN
Chinese Journal of Modern Nursing 2020;26(15):2061-2065
Objective:To explore the influencing factors of self-management of diabetics in community so as to provide a scientific basis for personalized self-management of diabetics.Methods:From March 2016 to August 2017, this study selected 980 diabetics from 6 communities in Chaoyang District of Beijing by convenience sampling. All of patients were investigated with the self-management, nursing instruction need and medication adherence questionnaire and the medication adherence scale to understand the self-management, such as blood glucose management, exercise, medication adherence and nursing instruction need. Simple correlation and multiple regression were used to analyze the influencing factors of self-management, nursing instruction need and medication adherence.Results:Among those diabetics in community, the score of self-management was (1.76±0.25) . The score of nursing instruction need was (1.73±0.29) with medication instruction need dimension for the highest and diabetic knowledge instruction need dimension for the lowest. The score of medication adherence was (3.48±0.64) with unauthorized drug withdrawal dimension for the highest and times of taking medicine dimension for the lowest. Simple correlation showed that there were statistical differences in the scores of self-management among patients with different on-the-job situations and education levels ( P<0.05) , and in the score of nursing instruction need among patients with different education levels ( P<0.05) , and in the scores of medication adherence among patients with different ages, on-the-job situations and diagnosed ages ( P<0.05) . Multiple regression analysis showed that the influencing factor of self-management and nursing instruction need was the education level ( P<0.05) , and the influencing factor of self-management was the on-the-job situation ( P<0.05) , and the influencing factor of medication adherence was the age ( P<0.05) . Conclusions:Among diabetics in community, the self-management is influenced by the education level and on-the-job situation; nursing instruction need is influenced by the education level; the medication adherence is influenced by the age. We should increase the self-management of patients with the low level of education and on-the-job, provide nursing instruction for patients with the high level of education, promote the medication adherence of diabetics with low ages so as to improve the self-management and quality of life of patients.
5.Influencing factors of self-care status in community patients with hypertension
Jiying WANG ; Guangqing XIAO ; Yan WANG ; Weiyu XU ; Jiangnan YAN
Chinese Journal of Modern Nursing 2018;24(24):2879-2882
Objective To investigate the influencing factors of self-care status of patients with hypertension in communities, so as to provide scientific evidences for personal self-care management of hypertension patients. Methods From March 2016 to August 2017, 1 010 hypertensive patients from 6 communities in Chaoyang District of Beijing were surveyed using general data questionnaire, Self-care Status and Nursing Guidance Needs Questionnaire and Medication Compliance Scale, to analyze the influencing factors of self-care status. Results In the 1 010 cases of hypertension patients in community, the score of self-care status was (1.70±0.22), the score of the demand of nursing education was (1.69±0.33), and the score of medication compliance was (3.54±0.58). The differences in the score of self-care status of patients with different education level and different years of hypertension diagnosis were statistically significant (P<0.05). There were significant differences in the scores of nursing guidance needs among patients of different ages and educational backgrounds (P<0.05). There were significant differences in the scores of medication compliance among patients of different ages, occupations and years of hypertension diagnosis (P<0.05). Multivariate linear regression analysis showed that age, education level, years of hypertension diagnosis and occupation were the influencing factors of self-care status of patients. Conclusions Self-care status of hypertensive patients are affected by age, education level, years of diagnosis and occupations. The personal health education and guidance should be given based on patients' different social background, so as to enhance the level of self-care status and improve the patients' life quality.
6.Assessing pharyngeal function for brainstem stroke survivors with dysphagia using videofluoroscopy digital analysis
Yue LAN ; Guangqing XU ; Tuo LIN ; Lisheng JIANG ; Zulin DOU
Chinese Journal of Physical Medicine and Rehabilitation 2015;37(8):577-580
Objective To evaluate the effect of the modified balloon dilatation intervention on the pharyngeal constriction function of the brainstem stroke survivors with dysphagia using videofluoroscopy-based digital analysis.Methods Thirty brainstem stroke survivors with pharyngeal dysphagia were recruited and randomly divided into a treatment group and a control group,with 15 in each.The treatment group was treated with the modified balloon dilatation in addition to the routine treatment of 30min,respectively,once a daily,3 days a week,whiled a control group was treated with routine treatment of 30min twice a day,3 days a week.Before and after the treatment,the rate and duration of pharyngeal constriction were measured in both groups.Results After the treatment,the rate of pharyngeal constriction in the treatment group was (0.20 ± 0.030),(0.14 ± 0.05) and (0.15 ± 0.04) when swallowing thin liquid,thick liquid and pasty food,significantly better than before the treatment.The duration of the pharyngeal constriction was (990.34 ±96.14),(1010.47 ± 133.64) and (1180.10 ± 121.27) ms,respectively,also significantly better than before the treatment.In the control group,significant differences were also observed in the rate and duration of pharyngeal constriction before and after the treatment.Conclusions Digital analysis based on videofluoroscopy can be used to quantify swallowing function effectively,and the rate and duration of pharyngeal constriction can be used to evaluate the pharyngeal function before and after treatment.
7.Clinical significance of serum levels of procalcitonin,C-reactive protein and white blood cell count in children with infectious diseases
Meiqiong HUANG ; Guangqing ZHANG ; Jingjing GE ; Lihan XU ; Zhaobin YU
International Journal of Laboratory Medicine 2015;(12):1670-1671,1673
Objective To explore the diagnostic value of serum procalcitonin ,C‐reactive protein and white blood cell count in children with different diseases .Methods Retrospective analysis 94 cases of pathogenic infectious children from June 2013 to May 2014 in our hospital ,according to the results of pathogen detection was divided into bacterial infection 36 cases ,mycoplasma infec‐tion group 28 cases ,30 cases of viral infection ,detection and analysis serum PCT ,CRP and WBC levels .Results Bacterial infection group serum PCT ,CRP and WBC were (2 .41 ± 0 .94)ng/mL ,(47 .91 ± 18 .26)mg/L and (13 .18 ± 6 .03) × 109/L ,significantly higher than the mycoplasma infection and viral infection group (F=133 .4 ,F=60 .1 ,F=8 .5 ,P<0 .05);diagnosis of bacterial in‐fections ,PCT sensitivity and specificity were 92 .11% and 91 .05% ,positive and negative predictive value of 89 .84 % and 94 .01%were significantly higher than CPR and WBC ,Mycoplasma infection as the control group ,PCT ,CRP and WBC in the diagnosis of bacterial infections ,the area of under the ROC curves were 0 .816 ,0 .728 and 0 .614 ,respectively .Conclusion Serum PCT for the i‐dentification of bacterial infections has a high diagnostic value ,worth generalizing and applying .
8.Virtual reality-enhanced body weight-supported treadmill training improved lower limb motor function in patients with cerebral infarction
Xiang XIAO ; Yurong MAO ; Jiangli ZHAO ; Le LI ; Guangqing XU ; Dongfeng HUANG
Chinese Journal of Tissue Engineering Research 2014;(7):1143-1148
BACKGROUND:Most stroke patients affected walking dysfunction. Virtual reality-enhanced body weight-supported treadmil training has been proposed as a strategy for gait training of cerebral infarction subjects.
OBJECTIVE:To evaluate the effectiveness of virtual reality-enhanced body weight-supported treadmil training on lower limb motor function in subacute cerebral infarction patients.
METHODS:Twenty cerebral infarction patients (within 3 months of onset) were randomly divided into experiment group (virtual reality-enhanced body weight-supported treadmil training) and control group (conventional physiotherapy). Three-dimensional gait analysis in lower limb motor function was carried out before and after 3-week gait training. Intergroup and intragroup comparisons in the fol owing parameters were done before and after training:walking speed, cadence, step time, single limb support time (%), double limb support time (%), nonparetic swing (%), step length, pace, range of motion in the lower limb, functional ambulation category, Fugl-Meyer Assessment of the lower limbs and Brunel Balance Assessment.
RESULTS AND CONCLUSION:No significant differences in patient’s gender, age, course of disease, affected. side, walking speed, functional ambulation category, Fugl-Meyer Assessment of the lower limbs and Brunel Balance Assessment were detected between the two groups before training (P>0.05). Fugl-Meyer Assessment and functional ambulation category were improved in patients of the two groups after training (P<0.05). The improvement in walking speed, cadence, step time in affected side, step time in healthy side, single limb support time in affected side (%), nonparetic swing (%), pace, step lengths in affected and healthy sides were better in the experimental group than those in the control group.
9.Gait parameters in lower extremities of patients in sequela period after unilateral total hip arthroplasty
Jiangli ZHAO ; Peihui WU ; Guangqing XU ; Yurong MAO ; Weiming LIAO ; Dongfeng HUANG
Chinese Journal of Tissue Engineering Research 2014;(13):1981-1987
BACKGROUND:Total hip arthroplasty is known to be a successful surgical procedure to al eviate hip pain and to regain gait ability, but there are many debates on whether patients’ gait could reach a normal level several years later. OBJECTIVE:To investigate spatiotemporal parameter characters of lower extremities in patients during walking in sequela period fol owing unilateral total hip arthroplasty, and to probe into patients’ walking abilities.
METHODS:In accordance with the method of Case Database Data Analysis detected by Motion Reconstruction Laboratory, 14 patients at 5-10 years after total hip arthroplasty served as the experimental group, and 14 matched healthy persons served as the control group. Gait parameters of lower extremities during walking were col ected by Vicon Nexus. Spatiotemporal parameter characters of lower extremities during gait cycle were analyzed by using Polygon.
RESULTS AND CONCLUSION:Compared with the control group, walking speed, cadence, stride length and step length decreased, but double support and opposite foot off increased on both affected and unaffected sides in the experimental group (P<0.05). Both stride time and step time of the operated lower extremities increased (P<0.05). Foot off of non-operated lower extremities increased (P<0.05). There was no significant difference in al spatiotemporal parameters between operated and non-operated lower extremities (P>0.05). The results suggested that gaits of patients showed good gait symmetry at 5-10 years after surgery. However, they do not reach the level that observed in healthy subjects, and walking ability was poorer than normal persons. Systematic rehabilitation training is needed to improve walking ability.
10.The effect of virtual reality prism adaptation on visuospatial neglect in stroke patients
Guangqing XU ; Yue LAN ; Minghui DING ; Xiaofei HE ; Zhenghong CHEN ; Jiangli ZHAO ; Dongfeng HUANG
Chinese Journal of Physical Medicine and Rehabilitation 2014;36(2):104-108
Objective To investigate the effects of virtual reality prism adaptation on visuospatial neglect in stroke patients.Methods Thirty stroke patients with visuospatial neglect were studied.The subjects were divided into atreatment group and a control group.The subjects in the treatment group were treated with virtual reality prism adaptation and routine rehabilitation interventions for 2 weeks,while those in the control group were treated with routine rehabilitation interventions only.All the patients performed a battery of spatial attention tests including line bisection,letter cancellation,clock drawing and the Attention Network Test at the beginning and after 2 weeks of treatment.Results The virtual reality prism adaptation training had significant positive effects on all the measures of visuospatial neglect.Pair-wise comparisons confirmed significant differences between the treatment and control groups after 2 weeks of treatment with regard to all of the measures.Conclusions Virtual reality prism adaptation treatzment combined with routine rehabilitation can be more effective than conventional measures alone in improving the visuospatial performance of stroke survivors.

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