At present the parkinsonian rigidity assessment depends on subjective judgment of neurologists according to their experience. This study presents a parkinsonian rigidity quantification system based on the electromechanical driving device and mechanical impedance measurement method. The quantification system applies the electromechanical driving device to perform the rigidity clinical assessment tasks (flexion-extension movements) in Parkinson’s disease (PD) patients, which captures their motion and biomechanical information synchronously. Qualified rigidity features were obtained through statistical analysis method such as least-squares parameter estimation. By comparing the judgments from both the parkinsonian rigidity quantification system and neurologists, correlation analysis was performed to find the optimal quantitative feature. Clinical experiments showed that the mechanical impedance has the best correlation (Pearson correlation coefficient r = 0.872, P < 0.001) with the clinical unified Parkinson’s disease rating scale (UPDRS) rigidity score. Results confirmed that this measurement system is capable of quantifying parkinsonian rigidity with advantages of simple operation and effective assessment. In addition, the mechanical impedance can be adopted to help doctors to diagnose and monitor parkinsonian rigidity objectively and accurately.
Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic at the end of December 2019, more than 85% of the population in China has been infected. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mainly affects the respiratory system, especially the lungs. The mortality rate of patients with severe infection is high. A percentage of 6% to 10% of patients will eventually develop into COVID-related acute respiratory distress syndrome (CARDS), which requires mechanical ventilation and extracorporeal membrane oxygenation (ECMO) support. Some patients who survive acute lung injury will subsequently develop post COVID-19 pulmonary fibrosis (PCPF). Both fully treated CARDS and severe PCPF are suitable candidates for lung transplantation. Due to the special course, evaluation strategies are different from those used in patients with common end-stage lung disease. After lung transplantation in COVID-19 patients, special treatment is required, including standardized nucleic acid testing for the novel coronavirus, adjustment strategy of immunosuppressive drugs, and rational use of antiviral drugs, which is a big challenge for the postoperative management of lung transplantation. This consensus was evidence-based written and was reached by experts after multiple rounds of discussions, providing reference for assessment and postoperative management of patients with interstitial pneumonia after COVID-19 infection.
The standard treatment for locally advanced rectal cancer is neoadjuvant chemoradiotherapy combined with surgery, but patients after the same treatment regimen show a large difference in outcomes. For patients with good response to neoadjuvant therapy, the waiting & observation scheme can be selected to avoid surgery and other complications. Therefore, accurate assessment of the response of patients with locally advanced rectal cancer after neoadjuvant therapy can better develop personalized treatment strategies. Current studies have found that blood sample detection, endoscopy, imaging examination and artificial intelligence have their own advantages and disadvantages in evaluating the response of neoadjuvant therapy. Therefore, this article reviews the application of different clinical tools in evaluating and predicting the response of neoadjuvant therapy for locally advanced rectal cancer, and looks forward to the future development direction.
Exercise intervention is an important non-pharmacological intervention for various diseases, and establishing precise exercise load assessment techniques can improve the quality of exercise intervention and the efficiency of disease prevention and control. Based on data collection from wearable devices, this study conducts nonlinear optimization and empirical verification of the original "Fitness-Fatigue Model". By constructing a time-varying attenuation function and specific coefficients, this study develops an optimized mathematical model that reflects the nonlinear characteristics of training responses. Thirteen participants underwent 12 weeks of moderate-intensity continuous cycling, three times per week. For each training session, external load (actual work done) and internal load (heart rate variability index) data were collected for each individual to conduct a performance comparison between the optimized model and the original model. The results show that the optimized model demonstrates a significantly improved overall goodness of fit and superior predictive ability. In summary, the findings of this study can support dynamic adjustments to participants' training programs and aid in the prevention and control of chronic diseases.
China is a country with a high incidence of esophageal cancer. Most patients are already in the locally advanced stage when first diagnosed. Preoperative neoadjuvant therapy followed by surgery has become the standard treatment mode for them. Closely related to prognosis, the evaluation of tumor response is essential. Response evaluation criteria in solid tumors is the gold standard to evaluate tumor response, but the lesions must meet the measurement standards. Tumor regression grading (TRG) systems are designed to classify regressive changes after neoadjuvant treatment based on histopathological results to reveal prognostic information. Concentrating on pathologic assessment of esophageal cancer following neoadjuvant therapy, this article reviews histopathological changes, commonly used TRG systems and current debate.
Objective To summarize the evaluation methods of return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR) in recent years, in order to provide reference for clinical practice. Methods The literature related to the RTS after ACLR was searched from CNKI, Wanfang, PubMed, and Foreign Medical Information Resources Retrieval Platform (FMRS) databases. The retrieval range was from 2010 to 2023, and 66 papers were finally included for review. The relevant literature was summarized and analyzed from the aspects of RTS time, objective evaluation indicators, and psychological evaluation. Results RTS is the common desire of patients with ACL injury and doctors, as well as the initial intention of selecting surgery. A reasonable and perfect evaluation method of RTS can not only help patients recover to preoperative exercise level, but also protect patients from re-injury. At present, the main criterion for clinical judgement of RTS is time. It is basically agreed that RTS after 9 months can reduce the re-injury. In addition to time, it is also necessary to test the lower limb muscle strength, jumping, balance, and other aspects of the patient, comprehensively assess the degree of functional recovery and determine the different time of RTS according to the type of exercise. Psychological assessment plays an important role in RTS and has a good clinical predictive effect. ConclusionRTS is one of the research hotspots after ACLR. At present, there are many related evaluation methods, which need to be further optimized by more research to build a comprehensive and standardized evaluation system.
This study systematically explores the assessment tools for balance function in elderly patients after total hip arthroplasty and their clinical applications, while also envisioning future trends toward multidimensional integration and intelligent development. By summarizing the commonly used subjective and objective assessment in clinical practice and analyzing the application of these methods in preoperative prehabilitation and postoperative rehabilitation monitoring for elderly total hip arthroplasty patients, this article proposes that future efforts should focus on promoting the integration of subjective and objective assessment, developing intelligent predictive models, and establishing closed-loop rehabilitation systems to enhance the precision and effectiveness of assessment and rehabilitation.
Objective To investigate the current situation of anxiety and depression in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and analyze the related influencing factors. Methods A questionnaire survey was conducted among AECOPD patients admitted to the Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Anhui Medical University from August 2022 to October 2023. The survey included basic demographic information, anxiety and depression scores, quality of life and dyspnea symptoms in the AECOPD patients. The clinical data of patients in the electronic medical record system were also collected. According to the anxiety score or depression score, the patients were divided into an anxiety group and a non-anxiety group, or a depression group and a non-depression group. The indicators between two groups were compared and the influencing factors were analyzed. Results Among the 164 patients with AECOPD, 123 patients (75.0%) were complicated with anxiety, 125 patients (76.2%) were complicated with depression, and 105 patients (64.0%) were complicated with anxiety and depression. Education level, place of residence, monthly income, smoking index, and chronic obstructive pulmonary disease assessment test (CAT) score were associated with AECOPD and anxiety (P<0.05). Higher CAT score was an independent risk factor for anxiety in the patients with AECOPD. Residence, monthly income, smoking index, CAT score, modified British Medical Research Council (mMRC) dyspnea questionnaire rating, actual bicarbonate, neutrophilic granulocyte percentage (NEU%), lymphocyte percentage (LYM%), basophile percentage (BASO%), alkaline phosphatase, total carbon dioxide concentration, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were associated with AECOPD and depression (P<0.05). Among them, higher CAT score and PLR value were independent risk factors of AECOPD and depression. Conclusion Anxiety and depression have higher prevalence in AECOPD patients, and the influencing factors include quality of life, dyspnea symptoms, education level, place of residence, monthly income, smoking index, acid base balance, NEU%, LYM%, BASO%, NLR和PLR, etc.
Aortic valve disease is one of the major diseases threatening human health. Transcatheter aortic valve replacement (TAVR) is a new treatment for aortic disease. Preoperative evaluation is of great significance to the successful operation and the long-term quality of life of patients. The 3D printing technology can fully simulate the cardiac anatomy of patients, create personalized molds for patients, improve surgical efficiency, reduce surgical time and surgical trauma, and thus achieve better surgical results. In this review, the relevant literatures were searched, and the evaluation effect of 3D printing technology on the operation of TAVR was reviewed, so as to provide clinical reference.
【摘要】 目的 探讨高血压危象评估和处理原则及对高血压危象急诊处理的指导意义。 方法 依据高血压危象评估和处理原则对2008年1月-2009年12月期间收治的160例高血压危象患者进行诊断和治疗。结果 160例高血压危象患者中,高血压急症134例,高血压亚急症26例。高血压急症中,以心脑血管病变为主,包括脑卒中、急性冠脉综合征和急性左侧心力衰竭。依据高血压危象评估和处理原则进行急诊处理,能够对高血压危象进行准确评估和有效处理,减少诊治失误,降低死亡率并改善预后。结论 有关高血压危象的评估和处理原则能够指导高血压危象的急诊处理,取得良好的预后。【Abstract】 Objective To investigate the principles of evaluation and management of hypertensive crises in order to guide emergency clinical practice for better managements and prognosis. Methods One hundred and sixty patients with hypertensive crises admitted to our department from January 2008 to December 2009 had been diagnosed and treated. Results There were 134 patients with hypertensive emergencies (HE) and 26 patients with hypertensive urgencies(HU)in accordance with those principle. Cardiocerebralvascular diseases were the main symptom of HE including stroke, acute coronary syndrome and acute left ventricular failure. According to those principles,the emergency management was carried out, accuracy evaluation and effective management of hypertensive crises could reduce wrong diagnosis and treatment,decrease mortality and improve prognosis. Conclusion The principle of evaluation and management of hypertensive crises could guide the emergency management of hypertensive crises and obtain better prognosis．