Objective To understand the quality of life of patients with acute mild to moderate ischemic stroke one year after stroke, analyze the factors affecting their quality of life, and provide a scientific basis for improving their health-related quality of life. Methods This study included patients who were diagnosed with acute mild to moderate ischemic stroke between March 2019 and March 2021 in four hospitals in Nanchang. Sociodemographic information and relevant clinical data were collected during hospitalization. The EQ-5D-5L questionnaire was administered to assess health-related quality of life one year after discharge. The Mann-Whitney U test (for two groups) and Kruskal-Wallis one-way ANOVA (for multiple groups) were used to analyze differences in utility scores among various factors. A Tobit regression model was built to investigate the factors influencing quality of life one-year post-stroke. Results A total of 1 181 patients participated in the study, including 791 males (66.98%) and 390 females (33.02%), with an average age of 63.7±10.9 years. Health-related quality of life data collected one year after the stroke revealed that 22.69% of patients experienced pain/discomfort, 17.27% suffered anxiety/depression, 15.66% had mobility issues, 10.33% had difficulties with daily activities, and 8.64% had trouble with self-care. Tobit regression results showed that age (β=−0.263, 95%CI −0.327 to −0.198), gender (β=−0.134, 95%CI −0.189 to −0.080), previous hypertension (β=−0.068, 95%CI −0.120 to −0.016), previous dyslipidemia (β=−0.068, 95%CI −0.126 to −0.011), admission NIHSS score (β=−0.158, 95%CI −0.198 to −0.118), and discharge mRS score (β=−0.193, 95%CI −0.250 to −0.136) were negatively associated with health utility values. Current employment status (β=0.141, 95%CI 0.102 to 0.181) and admission GCS score (β=0.209, 95%CI 0.142 to 0.276) were positively correlated with health utility values. Conclusion One year after an acute mild to moderate ischemic stroke, patients commonly face pain/discomfort and anxiety/depression. Factors affecting overall quality of life include age, sex, current employment status, previous hypertension, previous dyslipidemia, admission NIHSS score, admission GCS score, and discharge mRS score. Clinically, developing scientifically sound and reasonable rehabilitation plans post-discharge is crucial for improving long-term quality of life.
ObjectivesTo compare the efficacy of acute physiology and chronic health evaluationⅡ (APACHEⅡ), national early warning score (NEWS), pulmonary embolism severity index (PESI) and Charlson comorbidity index (CCI) on pulmonary embolism (PE) prognosis.MethodsClinical data of patients with PE treated in The Second Xiangya Hospital of Central South University from 2010 to 2017 were retrospectively analyzed. They were divided into death group and survival group, and four clinical scores were calculated. The differences of risk factors between the two groups were compared. Logistic regression analysis was used to obtain the independent risk factors related to mortality. The ROC working curve was used to compare the capability of four clinical scores for PE mortality. SPSS 24.0 and Medcalc 18.2.1 software were used for statistical analysis. ResultsA total of 318 patients with PE were included, and the mortality rate was 13.2%. The APACHEⅡ, NEWS, PESI and CCI of the death group were higher than those of the survival group. There were significant differences between two groups (P<0.05). It was confirmed by logistic regression analysis that cerebrovascular disease, heart rate, leukocyte, troponin T, arterial partial pressure of oxygen, right ventricular dysfunction (RVD) were independent risk factors for 90-day mortality. The areas under the ROC curve of APACHEⅡ, CCI, PESI, NEWS were 0.886, 0.728, 0.715 and 0.731, respectively. The area under the ROC curve of APACHEⅡ was the largest, which was better than NEWS, CCI and PESI (P<0.05), and there was no significant difference among NEWS, CCI and PESI.ConclusionsAPACHEⅡ may be the best predictor of mortality in PE patients, which is superior to NEWS, CCI and PESI.
Objective To analyze the relation between the marital status of patients with colorectal cancer and neoadjuvant therapy (NAT) regimen decision-making and outcomes in the current version of the Database from Colorectal Cancer (DACCA). Methods The version of DACCA selected for this analysis was updated on June 29, 2022. The patients were enrolled according to the established screening criteria and then assigned to 5 groups: the unmarried, married, divorced, remarried and widowed groups. The differences in the NAT regimen decision-making and changes of symptom, imaging, and cancer markers in these 5 groups were analyzed. Results A total of 3 053 data that met the screened criteria were enrolled. The results of statistical analysis reflected that the difference in the constituent ratio of patients chosen NAT strategies among 5 groups was obviously statistically significant (χ2=27.944, P=0.004), showing that remarried patients were inclined to adopt combined target drug. No statistical differences were found in changes of symptom (H=5.717, P=0.221), image (H=8.551, P=0.073), and cancer markers (H=11.351, P=0.183) of the 5 groups after NAT. Conclusion Through analysis of DACCA data, it is found that in the selection of NAT strategy for colorectal cancer, more married and remarried patients tended to choose chemotherapy combined target drug regimen.
ObjectiveTo investigate the health status of elderly peptic ulcer patients in Haikou city and its influencing factors. MethodsSeventy-eight elderly peptic ulcer patients treated in the Department of Gastroenterology, Haikou Hospital between February 2012 and December 2014 were chosen to be the observation group, and at the same time, another 78 healthy elderly people examined in the same hospital were designated as the control group. The general information and health status of the study subjects were investigated for correlation analysis. ResultsThe health status, physical function, body pain, life quality and mental health scores in the observation group were significantly lower than those in the control group (P<0.05). Univariate analysis showed that age, smoking, high-salt diet, body mass index (BMI) were significantly associated with the incidence of peptic ulcer (P<0.05). Multivariate logistic regression analysis showed that age, smoking, high-salt diet, BMI were all independent risk factors for peptic ulcer occurrence (P<0.05). ConclusionThe health status of elderly peptic ulcer patients in Haikou city is relatively low. Age, smoking, high-salt diet and BMI are the major independent risk factors for the occurrence of peptic ulcer. We need to actively strengthen symptomatic prevention and intervention.
ObjectiveTo investigate the effects of health education pathway intervention on the mental status and coping capacity in family members of brain injury patients receiving surgery. MethodsOne hundred and eighty-eight family members were randomly divided into control group (n=93) and intervention group (n=95) between September 2013 and October 2014. The control group received conventional health education only, while the intervention group was given health education pathway intervention. The mental status and coping capacity of family members in the two groups on admission and at discharge were surveyed and compared based on symptom checklist 90 (SCL-90) and coping styles questionnaire (CSQ). The hospitalization stay and expenditure and the satisfaction degree were also compared. ResultsThere was no significant differences in mental status and coping capacity in family members between the two groups on admission (P > 0.05). After health education pathway intervention, the positive rate of SCL-90 in the control group was significantly higher than that in the intervention group, and the total score and score for each factor were also obviously higher (P < 0.05). As for coping capacity, the scores of self-blaming, avoidance, fancy and rationalization of CSQ in the control group were significantly higher than those in the intervention group, and the scores of appealing help and resolving problems were obviously lower (P < 0.05). Furthermore, the hospitalization stay and expenditure were significantly shorter or lower in the intervention group than those in the control group, and the satisfaction degree on nursing service was obviously higher (P < 0.05). ConclusionThe health education pathway intervention can greatly improve mental status and coping capacity in family members of brain injury patients.
Objective To study the earthquake emergency response capability and post-earthquake psychological state of students after the Wenchuan earthquake. And also, to investigate the level of earthquake-related knowledge so as to provide basic information for enhancing the emergency response capabilities among college students. Methods We selected 1% Sichuan University students by convenience sample method and conducted the survey in person with a self-designed questionnaire. Results were analyzed with Epidata 3.0 and SPSS13.0 software. Results We distributed 527 questionnaires and 517 (97.27%) valid questionnaires were retrieved. Most college students had a good grasp of earthquake knowledge: 65.4% to 97.7% of the responders gave the correct answers, but only 12.77% said they had ever received earthquake survival training. 15.2% suffered from fear after the earthquake, 59.4% became uneasy, and 25.4% remained calm. Gender, grade, or major were not the factors influencing the psychological state of college students after the earthquake (P= 0.246, 0.216, and 0.406, respectively). Also, earthquake survival training did not influence the psychological state of college students after the earthquake (P=0.090). Psychological intervention after the earthquake was identified as an important factor that affected the psychological state of students (P=0.002). Conclusion College students have a good grasp of the basic knowledge regarding earthquake, but relevant survival training is far from sufficient. Universities should strengthen earthquake survival training, enhance the post-earthquake emergency response capacity of students, and carry out post-disaster psychological intervention directly following an earthquake. There is no significant difference in the mental status among students of different genders, grades, or professional backgrounds.
Objective To compare the cl inical results between high-flexion and standard cruciate-stabling prostheses in total knee arthroplasty (TKA) by using the 36-item short form health survey (SF-36). Methods Between August 2007 and January 2009, 98 patients (106 knees) underwent TKA with standard cruciate-stabl ing prostheses (standard group), and 46 patients (50 knees) underwent TKA with high-flexion prostheses (high-flexion group). In standard group, there were30 males (32 knees) and 68 females (74 knees) with an age of (70.0 ± 3.5) years, including 78 cases (82 knees) of osteoarthritis (OA) and 20 cases (24 knees) of rheumatoid arthritis (RA) with a disease duration of (14.5 ± 3.3) years; the Hospital for Special Surgery Scoring System (HSS) and the range of motion (ROM) were 56.1 ± 21.6 and (89.0 ± 16.1)°, respectively. In high-flexion group, there were 8 males (10 knees) and 38 females (40 knees) with an age of (68.6 ± 8.9) years, including 44 cases (47 knees) of OA and 2 cases (3 knees) of RA with a disease duration of (13.9 ± 4.1) years; the HSS and ROM were 58.9 ± 25.3 and (91.0 ± 19.3)°, respectively. There was no significant difference in the general data (P gt; 0.05) between 2 groups, so the cl inical data of 2 groups had comparabil ity. Results In standard group, poor wound heal ing and persistent headache caused by cerebrospinal fluid leakage occurred in 1 case, respectively. In high-flexion group, transient common peroneal nerve palsy occurred in 1 case. There was significant difference (P lt; 0.05) in the hospital ization expense between standard group [ (39 000 ± 6 000)] and highflexion goup [ (52 000 ± 8 000)]. The follow-up time was 12-26 months (18 months on average) in standard group (91 cases, 98 knees) and 11-19 months (13 months on average) in high-flexion group (44 cases, 47 knees). The SF-36 showed significant difference in role-physical score (P lt; 0.05), but no significant difference in other 7 indices scores (P gt; 0.05). At the final follow-up, the ROM was (129.1 ± 19.2)° in high-flexion group and (123.6 ± 16.7)° in standard group; showing significant difference (P lt; 0.05). The HSS was 91.2 ± 17.6 in high-flexion group and 92.5 ± 14.5 in standard group; showing no significant difference (P gt; 0.05). Conclusion After TKA, the ROM in high-flexion group is superior to that in standard group, but there is no obvious advantages in terms of the HSS and SF- 36 outcomes.
Objective To explore the mental health status of college students in the Xining region. Methods A total of 1 875 college students were surveyed by the Symptom Checklist-90 (SCL-90) and the Eysenck Personality Questionnaire (EPQ).Results Out of the 1 875 college students, 21.5% had at least one item scoring more than 3. Compared with the normal samples, college students scored significantly higher on SCL-90 indicating that the students had worse mental health. Significant differences were noted in the dimensions of EPQ between college students and the normal samples. The total score of SCL-90 was found to be significantly related to four factors, namely neuroticism, family economic status, school and nationality. Conclusion The mental health status of college students in Xining region is lower than that of the normal population, and factors of neuroticism, family economic status, school and nationality are related to their mental health.
ObjectiveTo analyze the relation between marital status and prognosis of patients with colorectal cancer (CRC) in the Database from Colorectal Cancer (DACCA). MethodsThe DACCA version selected for this data analysis was updated on January 13, 2023. The data items analysis included the age, gender, marital status, tumor location, tumor property, pathological TNM (pTNM) stage, survival status, and survival time. According to the marital status, the patients were assigned into five marital statuses: the first marriage, unmarried, divorced, remarriage, and widowed groups. The overall survival (OS) and disease specific survival (DSS) of the 5 marital statuses were analyzed, and then the risk factors affecting OS and DSS were analyzed by the Cox proportional hazards regression model. ResultsA total of 7 373 data were obtained from the DACCA according to the screening conditions, of which 6 696 (90.8%) were first marriage, 108 (1.5%) were unmarried, 198 (2.7%) were divorced, 22 (0.3%) were remarriage, and 349 (4.7%) were widowed. The OS and DSS curves had no statistical differences among the CRC patients with 5 marital statuses (χ2=2.692, P=0.611; χ2=2.927, P=0.570). The 3-year cumulative overall survival rate and disease specific survival rate among the 5 marital status patients had statistical differences among the patients with five marital statuses (χ2=24.65, P<0.001; χ2=18.63, P=0.001), further pairwise comparison showed that the 3-year cumulative overall survival rate and disease specific survival rate in the CRC patients with first marriage were higher than those in the widowed patients (Z=3.36, P<0.01; Z=3.02, P<0.01). The multivariate analysis results by the Cox proportional hazards regression model did not find the marital status was associated with the OS and DSS (P>0.05). ConclusionsFrom the real-world analysis results of this study, it is found that 3-year cumulative overall survival rate and disease specific survival rate in patients with first marriage are higher as compared with widowed patients. It is necessary to pay more attention to the long-term follow-up of CRC patients in unmarried or widowed status.
Objective To evaluate the effects and the clinical significances of liquid resuscitation on blood gas analysis， acid-base balance， electrolytes， acute physiology and chronic health evaluationsⅡ（APACHEⅡ） score of patients with septic shock， and then to analyze the relations between serum chlorine （Cl－） level and APACHEⅡscore and the volume of liquid resuscitation. Methods According to the target of resuscitation （centre venous pressure 8-12mm Hg and mean arterial pressure≥65mm Hg）， 21 patients with septic shock received enough fluid for resuscitation during 24h . The results of blood gas analysis， acid-base balance， electrolytes， and APACHE Ⅱ score were compared between pre-resuscitation and 24h post-resuscitation by self-controlled prospective study. The relationships of the level of serum Cl－ and APACHEⅡ score with the volume of liquid used in resuscitation were analyzed . Results The mean resus-citation duration was （18.09±4.57） h， and the volume of liquid during 24 h resuscitation was 5 320-11 028mL with mean volume of （7 775±1 735） mL in 21 patients with septic shock. Serum sodium （Na＋， mmol/L） and Cl－（mmol/L）levels of post-resuscitation were significant higher than those of pre-resuscitation （Na＋：138.71±5.67 versus 135.62±7.23， P=0.024；Cl－：109.10±4.90 versus 101.67±8.59， P=0.000）. Compared with the levels of pre-resuscitation， the blood pH value， hematocrit （Hct，%）， anion gap （AG， mmol/L）， lactic acid （mmol/L）， and APACHE Ⅱscore significantly decreased （pH：7.31±0.05 versus 7.37±0.06， P=0.000；Hct：28.48±2.56 versus 32.76±9.19， P=0.049；AG：8.33±3.45 versus 14.17±8.83， P=0.004；lactic acid：1.66±0.89 versus 2.96±1.23， P=0.001；APACHEⅡ：10.90±3.73 versus 17.24±4.06， P=0.000） after 24h resuscitation. The correlation analysis showed that the level of serum Cl- was positively correlated with the volume of liquid used in resuscitation （r=0.717，P＜0.01）. However， there was no correlation between APACHEⅡscore and the volume of liquid used in resuscitation （P＞0.05）. Conclusions The target of liquid resuscitation in patients with septic shock should be cautiously determined， including control of the volume of crystal liquid for resuscitation， in order to avoid acid-base imbalance or hyperchloraemia. At the same time， the change in internal environment should be monitored. An optimistic fluid resuscitation to decrease APACHE Ⅱ score in patients with septic shock is unrelated to the volume of liquid resuscitation.