ObjectiveTo investigate the quality of life (QoL) of patients with differentiated thyroid cancer (DTC) after surgery and analyze its relevant influencing factors. MethodsThe patients with DTC who underwent surgical resection in the First Affiliated Hospital of Zhengzhou University from December 1, 2021 to October 1, 2023 were investigated through the postoperative follow-up platform and follow-up management group. The postoperative QoL of DTC patients were evaluate using the Chinese version of the Thyroid Cancer Specific Quality of Life Questionnaire (THYCA-QoL) specific scale and the Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) developed a quality of life questionnaire consisting of 30 items (QLQ-C30). The higher overall average score of THYCA-QoL scale, the more clinical symptoms of patients, namely the negative QoL. The higher the EORTC QLQ-C30 overall health status score, the better QoL. In addition, multiple linear regression was used to explore the risk factors affecting the postoperative specific QoL score of DTC patients. ResultsA total of 1 076 patients’ questionnaires were collected. The EORTC QLQ-C30 overall health status score of 1 076 patients was 67±22 and the THYCA-QoL overall score was 22±13. The results of multivariate linear regression analysis showed that the early postoperative period (<6 months), male, age, without postoperative lifetime medication and without postoperative iodine-131 radiotherapy had negative effects on the overall score of THYCA-QoL scale (P<0.05), meanwhile the early postoperative period (<6 months) or later (≥12 months), without postoperative lifetime medication and without postoperative iodine-131 radiotherapy had positive effects on the overall health status score of EORTC QLQ-C30 (P<0.05). ConclusionsEORTC QLQ-C30 combined with THYCA-QoL can evaluate not only the common symptoms of cancer, but also the specific symptoms of thyroid cancer after surgery. And understanding the factors affecting the QoL of patients with thyroid cancer after surgery could provide targeted and supportive treatment and nursing for discharged patients to improve the QoL of patients with thyroid cancer after surgery.
Objective To study the factors that affect the prognosis of status epilepticus (SE) and to improve the understanding of clinicians. Methods A retrospective analysis of 57 patients with SE witch from the General Hospital of Ningxia Medical University and Cardio-cerebrovascular Disease Hospital were carried out to collect their clinical data. The data were analyzed by SPSS 17.0 software. The prognosis of the patients was assessed by the Status epilepticus severity score (STESS) scale. Results A total of 57 patients were included, 53 cases improved, 4 cases were automatically discharged. Telephone follow-up showed that 4 cases of automatic discharge were dead. The mortality rate of SE was 7.02%. The most common cause of SE was acute cerebrovascular disease (17.54%), followed by intracranial infection (10.53%); The most common incidence were the occasional medication, self-medication, withdrawal (15.79%). Age, state of consciousness and concurrent infection were associated with prognosis (improvement/death) (P<0.05). STESS score of 0 to 2 points were 45 patients, all improved; score of 3 to 5 points were 12 patients, 8 patients improved, 4 patients died. There were significant differences in the prognosis between the two groups (P<0.05). Conclusions Age, state of consciousness, concurrent infection were related to prognosis, more than 65 years, the state of consciousness for the sleeping or coma had the poor prognosis. STESS scale can predict the prognosis of patients effectively.
Abstract： Quality of life （QOL） refers to an individual’s perception and subjective evaluation of their health and well-being, and has become an important index to evaluate the outcomes of clinical treatment in the last past decades. There are a large number of different instruments to evaluate QOL, and the 36-Item Short Form Health Survey （SF-36） is currently one of the most widely used instruments. In recent years, SF-36 has been used to evaluate QOL of valvular heart disease patients to investigate the risk factors those influence their postoperative QOL, provide more preoperative evaluation tools for clinical physicians, and improve postoperative outcomes of patients with valvular heart disease. However, it is now just the beginning to use SF-36 to examine QOL of valvular heart disease patients. Because of significant differences in sample size, follow-up period, country and culture, current research has some controversial results. This review focuses on the progress in evaluating QOL in postoperative patients with valvular heart disease using SF-36.
To aim directly at the individualized character and tendency about clinical assessment of Traditional Chinese Medicine (TCM), we draw off a new pathway which is evidence-based goal attainment scale(EBGAS) in the text. i.e., we will develop clinical individualized assessment method of TCM on account of GAS by the approach of evidence based medicine.
Objective To develop a behavioral assessment scale for medication management plans in women of childbearing age with epilepsy and to test its reliability and validity. Methods Based on the Theory of Planned Behavior, a pool of questionnaire items was initially drafted through literature review and focus group discussions. A two-round Delphi expert consultation was conducted with 15 experts to form a test version of the behavioral assessment scale for medication management plans in women of childbearing age with epilepsy (including 27 items and 5 dimensions). Convenience sampling was used to conduct surveys among women of childbearing age with epilepsy in some tertiary hospitals in Chuxiong, Shenzhen and Wuhan from February to May 2024 (the first time) and from June to October 2024 (the second time). ResultsThe effective recovery rates of the two rounds of questionnaires were 95.5% and 94.6%, respectively. The final scale included 24 items and 5 dimensions, with good reliability and validity: the content validity index (S-CVI) was 0.934, Cronbach's α coefficient was 0.876, split-half reliability was 0.819, and test-retest reliability was 0.901; exploratory factor analysis extracted 5 factors (cumulative variance explained rate 73.97%, item load 0.42~0.85), and confirmatory factor analysis showed that the model had good fit (χ2/df=1.849, RMSEA=0.075, CFI, GFI, AGFI, IFI, TLI all>0.85). Conclusion The scale meets the reliability and validity standards and can be used to assess the medication management plans and behaviors of women of childbearing age with epilepsy.
ObjectiveTo explore the prevalence of depression and anxiety of chronic obstructive pulmonary disease complicated coronary artery disease before and after percutaneous intracoronary arterial stenting. MethodsA total of 114 chronic obstructive pulmonary disease complicated coronary artery disease patients were enrolled in this study and were measured with the Hospital Anxiety and Depression Scale before and after percutaneous intracoronary arterial stenting. ResultsA total of 71 patients (62.3%) had depression symptom and 68 patients (59.6%) had anxiety symptom before percutaneous intracoronary arterial stenting. There were 46 patients (40.4%) had significant depression symptom and 40 patients (35.1%) had significant anxiety symptom before percutaneous intracoronary arterial stenting. A total of 85 patients (74.6%) had depression symptom and 83 patients (72.8%) had anxiety symptom after percutaneous intracoronary arterial stenting. There were 60 patients (52.6%) had significant depression symptom and 48 patients (42.1%) had significant anxiety symptom after percutaneous intracoronary arterial stenting. There was significant difference in prevalence rate of depression and anxiety before and after percutaneous intracoronary arterial stenting (P < 0.05). ConclusionsThe patients with chronic obstructive pulmonary disease complicated coronary artery disease show higher prevalence of depression and anxiety. The prevalence of depression and anxiety increases significantly after percutaneous intracoronary arterial stenting.
ObjectiveTo observe the effect of kinesio tape (KT) combined with progressive resistance training (PRT) in patients with subacromial impingement syndrome (SIS), and to explore whether the direction of KT affects the therapeutic effect of SIS.MethodsBetween May 2017 and March 2019, 90 participants with SIS in West China Hospital, Sichuan University were randomly divided into three groups, with 30 participants in each group. Participants were treated with KT combined with PRT, and the direction of the KT is from the proximal end of the rotator cuff muscles to the distal end in group A. Participants were treated with KT combined with PRT, and the direction of the KT is from the distal end of the rotator cuff muscles to the proximal end in group B. Participants were treated with PRT alone in group C. Visual Analog Scale (VAS) was used to evaluate the pain in patients at rest, during movement and at night; range of motion (ROM) of shoulder and the disabilities of the arm, shoulder and hand (DASH) outcome questionnaire were used to measure the physical function before treatment and after 1 week and 2 weeks.ResultsAfter 1 week of treatment, ROM of shoulder abduction, internal rotation and DASH scores in group A were significantly improved compared with those in group B and C (P<0.05). After 2 weeks of treatment, the nighttime VAS score, ROM of shoulder abduction, internal rotation and DASH score scores in group A were significantly improved compared with those in group B and C (P<0.05). The VAS score during movement, nighttime VAS score, ROM of shoulder (except external rotation) and DASH score in group A were significantly improved after 1 week and 2 weeks of treatment (P<0.05); and after 2 weeks of treatment, the nighttime VAS score, ROM of shoulder flexion and internal rotation in group B were significantly improved compared with those before treatment (P<0.05). After 2 weeks of treatment, the VAS score during movement, nighttime VAS score, ROM of shoulder (except external rotation) in group C were significantly improved compared with those before treatment (P<0.05).ConclusionKT combined with PRT is more effective than PRT alone in the treatment of SIS, and the therapeutic effect is related to the direction of the tape.
ObjectiveBased on the localization of resource-based relative value scale (RBRVS) in H Hospital, to implement a surgical performance management model reform with the main surgery as the core, and to construct a more scientific and fair surgical performance distribution system. MethodsA surgical performance management model with the main surgery as the core was constructed. Relevant data such as RBRVS, diagnosis related groups (DRG), case mixed index (CMI), and surgical time of 65 915 inpatient elective surgeries in H Hospital in 2023 were collected and organized. Large sample historical data analysis was conducted using SPSS software, and the rationality of the optimized surgical performance management model was verified through key indicators. ResultsThe total coefficient of multiple orders for surgery in the 22 departments included in the study was highly correlated with the main surgery coefficient (γ>0.85), and the matching coefficients for each specialty were significantly different (P<0.001). The surgical performance management model with the main surgery as the core showed a significant improvement in the key indicators (doctor’s time resource investment and surgical risk and difficulty). ConclusionBy implementing a surgical performance management model with the main surgery as the core, we aim to strengthen the performance orientation that reflects the risks and difficulty of diagnosis and treatment, as well as the value of doctor services. This will guide clinical practice to return to the essence of medicine, support the development of discipline construction, and further stimulate the vitality and motivation of clinical work.
Objective To study the effects of anxious condition on asthma symptom burden and asthma control in elderly asthma patients in primary care settings. Methods Totally 128 elderly asthma patients were recruited in this study. The patients were required to fill in the questionnaire，then the score of asthma control test （ACT） and Hamilton anxious meter（HAMA） were calculated. Risk factors of anxious condition were analyzed by logistic analysis. Results The ACT scores in the anxious patients were significantly lower than those of the non-anxious patients [17.45±3.14 vs. 21.45±2.37，Plt;0.05）. The patients with lower incoming and more complications had more severe anxious condition，lower asthma control level，and more asthmatic medications. Meanwhile the latter conditions also increased the incidence of anxiety in the elderly asthma patients significantly （Plt;0.05）. Conclusions The elderly asthma patients in primary care settings are also complicated with anxiety，and the anxious condition can significantly increase asthma symptom burden and decrease asthma control level.
ObjectiveTo analyze the quality of life (QOL) and psychological status among patients having undergone cardiac resynchronization therapy (CRT). MethodsA total of 42 patients underwent CRT in our hospital during January 2011 to January 2014. All the patients were studied by MOS SF-36 scale and symptom checklist-90 (SCL-90) on overall QOL and psychological QOL, respectively. Another 42 healthy people in matched control group were also tested. ResultsThe QOL of patients after CRT was significantly lower than that of healthy subjects (P<0.05). The psychological status score, which was obtained by the examination of SCL-90, was significantly higher in patients after CRT than in the healthy population (P<0.05). The length of the disease course and leveling exercise tolerance are the influence factors for the QOL and psychological status in patients undergoing CRT. Gender does not make any difference between the two groups. ConclusionThe QOL of patients having undergone CRT is significantly lower than that of healthy people, and the psychological status score is higher. Medical staff need to pay attention to the mental illness (such as depression, anxiety and panic) of patients after CRT, especially in patients with long course of disease, and patients who fail to improve exercise tolerance or who are mateless. Psychological interventions can further improve the QOL of patients.