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20 October 2021, Volume 16 Issue 05 Previous Issue    Next Issue

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Cost of hospitalization of patients with hepatolenticular degeneration in southwest of China: data analysis during 2005-2020 HONG Peiwei, CONG Xue, XU Yanming 2021, 16 (05):  315-318.  DOI: 10.16138/j.1673-6087.2021.05.006 Abstract ( 125 )   HTML ( 2 )   PDF (451KB) ( 65 )   Objective To analyze the hospitalization cost of the patients with hepatolenticular degeneration in southwest of China. Methods The data of hospitalization cost of the patients with hepatolenticular degeneration were acquired from electronic medical record system in West China Fourth Hospital from 2005 to 2020. Multiple linear regression analysis was utilized for analyzing the factors of hospitalization cost retrospectively, and covariance analysis was used for controlling the confounding factors. SPSS 20.0 (IBM) was applied for data analysis. Results A total of 346 patients with hepatolenticular degeneration were enrolled in our analysis. The year of admission, age, number of comorbidities, days of hospitalization, and complication of decompensated liver cirrhosis were the factors to influence the cost of hospitalization. After the confounding factors were adjusted, the hospitalization cost grew following the increase of comorbidity number, and complication of decompensated liver cirrhosis also led to the increase of hospitalization cost. The hospitalization cost of 2005-2006 and 2007-2008 were lower than those in the rest of years. Conclusions Hospitalization cost of the patients with hepatolenticular degeneration in southwest of China were influenced by number of comorbidities, complication of decompensated liver cirrhosis, and year to admit. It was important to reduce the occurrence of complication and decompensated liver cirrhosis, as to reduce the cost of hospitalization. Figures and Tables | References | Related Articles | Metrics

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Clinical phenotype and survival analysis of 106 cases of hepatolenticular degeneration HUANG Qing, WANG Gang 2021, 16 (05):  319-324.  DOI: 10.16138/j.1673-6087.2021.05.007 Abstract ( 323 )   HTML ( 6 )   PDF (653KB) ( 94 )   Objective To analyze clinical phenotype and survival analysis of hepatolenticular degeneration to promote its early detection, diagnosis, and treatment, and improve the understanding of the disease. Methods Total 106 patients with hepatolenticular degeneration were enrolled and their demographic information, clinical manifestations,auxiliary examination, and survival information were collected and analyzed retrospectively. Results The average age of 106 patients was(20.65±13.06) years, and 81.1% of patients were younger than 30 years old. Regarding of the clinical phenotype of hepatolenticular degeneration, there were 70 cases(66.0%) of liver type, 13 cases(12.3%) of brain type, 0 case of other type, and 23 cases (21.7%) of mixed type. Sixty-two cases (58.5%) had Kayser-Fleischer (K-F) ring, while its distribution had no difference in all types. Among 94 patients who received detection, only 2 cases had normal level of ceruloplasmin, and the others showed decreased levels of it, which were less than 200 mg/L. Urine copper within 24 h was detected in 11 patients, of which the value of it in 10 cases were more than 100 μg. Only 13 patients had definite gene test results, which showed 11 patients had mutations, 7 patients had double mutations, and the most common mutation site was p.Arg778Leu. Follow up with 44 cases, 7 cases were dead from hepatic failure and pulmonary infection. Conclusions Hepatolenticular degeneration occurs in many adolescents, and its’ main clinical manifestations were liver damage and nervous system symptoms. The diagnosis of hepatolenticular degeneration is mainly based on K-F ring, abnormal copper metabolism index and liver function, and abnormal imaging of liver and head. The most common cause of death was liver failure. Figures and Tables | References | Related Articles | Metrics

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Analysis and predictive factors of resilience of caregivers for patients with Parkinson disease DONG Zhengchuan, WANG Gang 2021, 16 (05):  325-330.  DOI: 10.16138/j.1673-6087.2021.05.008 Abstract ( 159 )   HTML ( 2 )   PDF (679KB) ( 78 )   Objective To study the level of resilience of caregivers for the patients with Parkinson disease (PD) and its predictive factors. Methods A total of 149 caregivers for the patients with PD were investigated by general information questionnaire, Connor-Davidson resilience scale, Hoehn and Yahr scale, general self-efficacy scale and simplified coping style questionnaire. Results The total resilience score of caregivers for PD patients was 50.99±18.87. The scores of three dimensions including tenacity dimension, strength dimension, and optimism dimension were 26.10±10.65, 17.22±5.94, and 7.66±3.17, respectively. In multiple linear regression model(adjusted R2=0.654), the predictive factors of caregivers’ resilience for PD patients were self-efficacy, positive coping, average monthly income, and the relationship with family members (influence ranking from large to small). Conclusions The caregivers’ resilience of PD patients need to be improved. Combined with the predictive factors, caregivers’ resilience could be improved by providing counseling for PD patients’ families. Figures and Tables | References | Related Articles | Metrics

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Risk factor analysis of hematoma volume of cerebral hemorrhage in different location DENG Weiping, YANG Zhao, LIU Jianrong 2021, 16 (05):  331-336.  DOI: 10.16138/j.1673-6087.2021.05.009 Abstract ( 146 )   HTML ( 3 )   PDF (526KB) ( 56 )   Objective To analyze risk factors of hematoma volume of cerebral hemorrhage in different location. Methods A total of 373 patients with cerebral hemorrhage from 2013 to 2017 years in our hospital were enrolled. According to the hemorrhage location, the patients were divided into basal ganglia hemorrhage group and lobar hemorrhage group, and the clinical data were analyzed retrospectively. Results Compared with lobar hemorrhage group, the average systolic blood pressure (P=0.034) and diastolic blood pressure (P=0.001), the content of serum uric acid (P=0.001) were higher in basal ganglia hemorrhage group, in which the patient had a higher proportion of the history of hypertension (P<0.001) and alcohol drinking (P=0.034). The average age (P<0.001), the levels of fibrin degradation product(FDP)(P=0.001) and D-dimers (P=0.003), the hematoma volume(P<0.001) in lobar hemorrhage group were higher than ganglia hemorrhage group, and the patients in lobar group had a higher proportion of the history of cerebral hemorrhage (P=0.02). Binary Logistics regression analysis showed that the risk of lobar hemorrhage increased 5.7%(P<0.001) when age increased one additional year. The risk of recurrent lobar hemorrhage was 3.27 times than that of basal ganglia hemorrhage (P=0.025) as the patients had a history of cerebral hemorrhage, and the risk of recurrent lobar hemorrhage was 0.477 times (P=0.031) than that of basal ganglia hemorrhage as the patients had a history of hypertension. Using multivariable linear regression to analyze hematoma volume change, we found that age （β=-1.04, P=0.002）, international normalized ratio(INR)（β=14.219, P=0.008）, the content of uric acid （β=-0.008, P=0.046）, high density lipoprotein cholesterol (β=5.393, P=0.003), antiplatelet therapy (β=4.706, P=0.002) were independent predictive factors of basal ganglia cerebral hemorrhage. While the content of uric acid (β=-0.041, P=0.015), prior drinking history (β=-15.189, P=0.010), prior smoking history (β=12.579, P=0.005) and history of ischemic stroke (β=12.899, P=0.031) were independent predictive factors of lobar hemorrhage. Conclusions The risk factors of basal ganglia and lobar hematoma volume were different, and their independent predictive factors of hematoma volume were only partially overlapped. It suggests that the pathophysiological mechanisms determining the hematoma volume are not same in different locations. Figures and Tables | References | Related Articles | Metrics

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A preliminary study on evaluation of cognitive functions using complex Chinese characters ZHOU Rong, LUO Qi, CHEN Jie, WANG Pei, MA Jianfang 2021, 16 (05):  337-343.  DOI: 10.16138/j.1673-6087.2021.05.010 Abstract ( 191 )   HTML ( 2 )   PDF (733KB) ( 98 )   Objective To explore the feasibility of complex Chinese Character (CCC) “biang” as a simple cognitive assessment tool. Methods According to the Rey-Osterrieth complex figure test (ROCF) scoring system, CCC scoring system with a total score of 28 points was developed. Randomized outpatients (≥50 years old) were enrolled. The correlation between CCC and other neuropsychological test, namely ROCF, clock drawing test (CDT), bells test, auditory verbal learning test (AVLT), free and cued selective reminding test (FCSRT), digital span test (forward and backward), was preliminarily assessed by small sample study. Intra-class correlation coefficients(ICC) method was applied to assess retest reliability of CCC. The elderly(≥50 years old) patients were randomly enrolled in the community epidemiological investigation cohort, and CCC and other cognitive scales (trail making test A&B, word list, semantic verbal fluency) were evaluated. The exploratory factor analysis(EFA) and multiple regression analysis were used to evaluate the construct validity of CCC. Results In a small sample of 22 outpatients, CCC score was more correlated with verbal memory, CCC delay 20 min score had the highest correlation with index of sensitivity of cueing, and Spearman correlation coefficient was 0.634(P=0.002). By ICC method(n=12), the correlation coefficient of copying score of 6 months in ICC group was 0.657, and the correlation coefficient of delayed recall score in ICC group was 0.502, showing good consistency. In the large sample cohort population study (n=583), exploratory factor analysis showed that among five indicators of CCC scoring system (copy score, delay 5 min score, delay 20 min score, delay 5 min retention score, delay 20 min retention score), delay 20 min score was the most loaded in verbal memory factor. After adjusting for gender, age and education, the variance of 20.6% delayed 20 min score could be explained by 13.3% verbal memory storage (word list delayed recall score) and 7.3% verbal memory retrieval (word list recognition score). A total of 42 mild cognitive impairment (MCI) patients and 40 controls were recruited for the CCC scale test, and it showed that the sensitivity of the CCC scale to diagnose MCI was 67% and the specificity was 53%. Conclusions CCC scale has good reliability and validity. CCC test is mainly related to verbal memory, and the delay 20 min score consists of verbal memory. Figures and Tables | References | Related Articles | Metrics

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Effect of low intensity resistance training on balance function and depression state in elderly patients CHEN Mei, FU Conghui, YU Xiaoping, WANG Gang, XU Ying 2021, 16 (05):  344-348.  DOI: 10.16138/j.1673-6087.2021.05.011 Abstract ( 176 )   HTML ( 6 )   PDF (588KB) ( 65 )   Objective To explore the effect of low-intensity resistance training on balance function and depression in elderly patients in nursing hospital. Methods Totally 60 elderly patients were randomly divided into study group (30 cases) and control group (30 cases). Based on routine drug treatment and nursing, the control group received routine exercise training once a day, 30 min each time, 5 d a week for 6 months, while the study group received both routine exercise training and low-intensity resistance training every day, 30 min each time, 5 d a week, and continuous training for 6 months. One week before treatment, 3 months, and 6 months after treatment, BioRescue & BioVal whole body intelligent rehabilitation system was used to calculate the surface area scores of gravity moving trajectory to evaluate their balance ability for the patients in two groups. In addition, the elderly depression scale was used to evaluate the emotional state of the elderly patients before and after treatment. Results In control group, the surface area score of gravity moving trajectory and geriatric depression scale score after 6 months were improved than those in 1 week before treatment (P<0.05), while both scores after 3 months didn’t show difference (P>0.05). In the study group, compared with 1 week before treatment and 3 months after training, the surface area score of gravity moving trajectory and the geriatric depression scale score were improved after 6 months training (both P<0.05). In addition, two scores after 6 months in study group were better than those in control group (P<0.05). Conclusions Low intensity resistance training combined with conventional drug therapy and nursing has a positive effect on improving balance function and depression state of elderly patients in nursing hospital. Figures and Tables | References | Related Articles | Metrics

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Influence of thyroid hormone levels on prognosis of community-acquired pneumonia LI Cong, WANG Yonghui, GAO Lei, GAO Jingjing, BAO Peng, GAO Yanhong 2021, 16 (05):  349-353.  DOI: 10.16138/j.1673-6087.2021.05.012 Abstract ( 155 )   HTML ( 4 )   PDF (540KB) ( 78 )   Objective To evaluate the influence of thyroid hormone levels on prognosis of the patients with community-acquired pneumonia(CAP). Methods A total of 343 CAP patients admitted to the Emergency Department of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2018 to October 2020 were enrolled in this study. The clinical data of patients, including gender, age, basic diseases, thyroid hormone levels [total 3, 5, 3’triiodothyronine (TT3), total thyroxine (TT4), free T3 (FT3), free T4 (FT4), thyroid stimulating hormone (TSH), reverse T3 (rT3)] and serum albumin, white blood cell (WBC）, procalcitonin (PCT), C-reactive protein (CRP), D-dimer, pneumonia severity index (PSI) scores and CURB-65 scores were collected. According to the prognosis, they were divided into survival group (n=321) and death group(n=22). The relation between the factors mentioned above and prognosis was analyzed. Results The levels of TT3, TT4, rT3, TSH and serum albumin in the death group were lower than those in the survival group (all P<0.05), while the levels of D-dimer, PSI scores and CURB-65 scores in the death group were higher than those in the survival group (all P<0.001). There was no significant difference in the levels of FT3, FT4, PCT, CRP and WBC between two groups (all P>0.05). The average age of death group was higher than that of survival group (80.55±7.80 vs 73.66±13.57, P=0.019). Univariate Logistic regression analysis showed that TT3 ( β=-3.389) was the best predictor of CAP mortality, which was higher than serum albumin level ( β=-0.213), D-dimer ( β=0.909), PSI scores ( β=0.027) and CURB-65 scores (β=0.597). Multivariate logistic regression analysis showed that TT3 was independently associated with mortality in patients with CAP, and negatively correlated with PSI scores (r=-0.489, P<0.001), CURB-65 scores (r=-0.474, P<0.001), age (r=-0.344, P<0.001), D-dimer (r=-0.374, P<0.001), and positively correlated with albumin (r=0.353, P<0.001). Conclusions Thyroid hormone levels, age, serum albumin, D-dimer, PSI scores and CURB-65 scores were related to the prognosis of CAP. TT3 was an independent predictor of the prognosis of CAP among all thyroid hormone indicators, and TT3 combined with PSI scores, or CURB-65 scores can improve the efficacy to predict CAP outcome. Figures and Tables | References | Related Articles | Metrics