Objective To explore the value of fecal calprotectin （FCP） in the activity evaluation for ulcerative colitis （UC）. Methods Sixty three patients with UC （UC group） and 30 patients with gastrointestinal symptoms but without abnormal results of colonoscopy （control group）， who were treated in The Forth Affiliated Hospital of China Medical University between Sep. 2007 to Dec. 2009 were enrolled to examine the FCP， C-creative protein （CRP）， and erythrocyte sedimentation rate （ESR）. Then comparison between UC group and control group was performed. Results Levels of FCP and CRP in active gradeⅠ，Ⅱ， and Ⅲ group were all significantly higher than those of control group and inactive UC group （P＜0.05）， with the increase of active grade of UC， the level of FCP gradually increased （P＜0.05）. The levels of CRP in active grade Ⅱ and Ⅲ group were all significantly higher than those of gradeⅠgroup （P＜0.05）， but didn’t differed between active grade Ⅱ and Ⅲ group （P＞0.05）. There were no significant difference among 5 groups on ESR （P＞0.05）. Levels of FCP （rs=0.807， P＜0.01）， CRP（rs=0.651， P＜0.01）， and ESR （rs=0.371， P＜0.05） in active grade group were significantly related to histological grade under colonoscopy. Conclusion FCP examination is simple， inexpensive， repeatable， and noninvasive， and FCP can be used as an marker of activity evaluation in UC.
ObjectivesTo investigate and analyze the activities of daily living status and influencing factors for the elderly of long-term care in Shangrao City of Jiangxi Province, and provide a basis for Shangrao City to carry out long-term care insurance for the elderly. MethodsCluster sampling was used to investigate the elderly aged 60 and over in 12 counties (cities, districts)of Shangrao, including the elderly general demographic characteristics and activity of daily living survey. ResultsA total of 1 087 elderly people were surveyed, with an average age of 77.75±8.12 and a total 70.6±21.4 score of activity of daily living. Comparing different age groups, the elder age group had a worse activity of daily living (P<0.001). Those with a higher education level had relatively poor activity of daily living (P<0.001), and those with spouse also had poor activity of daily living (P<0.05). Multiple linear regression analysis showed that age (P<0.001), education level (P<0.001), marital status (P<0.05) and income level (P<0.05) were important factors affecting the scores of activity of daily living of the elderly. ConclusionsAge, education level, marital status, low-income situation, chronic disease, and household registration are the main risk factors affecting the score of the long-term care of the elderly in daily life. The establishment of a long-term care insurance system should be based on chronic diseases, age, marital status and other factors to determine the corresponding long-term care standard scoring system and compensation standards.
Crohn’s disease (CD) is one of inflammatory bowel diseases, characterized by lifelong relapsing-remitting clinical course. The choice of treatment protocols is based on the comprehensive evaluation of the disease. And the treatment protocols should be adjusted according to the response to the treatment and the drug tolerance. Repeated assessment of the activity of intestinal inflammation is very necessary. Each of endoscopy, Crohn’s Disease Activity Index, CT, magnetic resonance enterography, and ultrasonography (US) has its own disadvantages. US is widely used in clinical practice because of its no radiation, convenience, low cost, and high degree of patient tolerance. The two-dimensional ultrasound, Doppler ultrasound, elastosonography, and contrast-enhanced ultrasonography each provides some effective parameters for evaluation of CD activity. Some parameters are of high value, such as bowl wall thichness, bowl wall stratification, color Doppler signal, strain ratio, and relative enhancement, etc. The values of some parameters are disputed, such as the blood flow of superior mesenteric artery, time to peak, etc. Some studies combine several ultrasound parameters and calculate their respective weights to obtain an ultrasound scoring method. US, as a valid tool to evaluate CD activity, provides valuable help in solving clinical problems such as evaluation of therapeutic effect, mucosal healing, and postoperative recurrence.
Objective To evaluate whether respiratory training can improve motor function, exercise endurance, and activity of daily living (ADL) in stroke patients. Methods The randomized controlled trials of the effects of respiratory training on motor function, exercise endurance, and ADL in stroke patients were searched in PubMed, Embase, Google Scholar, China National Knowledge Infrastructure, Wanfang, and VIP Database. The search date was from the establishment of each database to December 2018. The control group received routine rehabilitation, medical treatment or other interventions, and the trial group added respiratory training on that basis. Outcome measures included the Fugl-Meyer Assessment (FMA), the 6-minute walk test (6MWT), and the modified Barthel Index (BI). The literature was independently screened by two investigators according to the inclusion and exclusion criteria, and the quality of the included articles was evaluated using the Physiotherapy Evidence Database scale and Cochrane Library systematic review criteria. Statistical analysis was performed using RevMan 5.3 software. Results A total of 11 articles with 741 stroke patients were included. Meta-analysis showed that in the trial group the exercise endurance [mean difference (MD)=41.50 m, 95% confidence interval (CI) (7.63, 75.37) m, P=0.02], ADL [MD=9.97, 95%CI (3.99, 15.96), P=0.001], and motor function [MD=8.00, 95%CI (1.29, 14.70), P=0.02] were improved compared with those in the control group. Subgroup analysis showed that after 8-10 weeks of intervention, BI of the trial group was higher than that of the control group [MD=25.37, 95%CI (16.49, 34.25), P<0.000 01]; after 8 weeks and 12 weeks to 3 months of intervention, FMA of the trial group was higher than that of the control group [ after 8 weeks: MD=20.40, 95%CI (9.72, 31.08), P=0.000 2; after 12 weeks to 3 months: MD=6.18, 95%CI (3.57, 8.79), P<0.000 01]. Conclusions The results of this study showed that respiratory training can improve exercise tolerance, ADL, and motor function in stroke patients. In consideration of the limited number of included articles as well as the heterogeneity among included articles in the current study, and the lack of long-term follow-up period, further studies could use more optimized respiratory training programs to conduct high-quality researches with bigger sample sizes.
Occupational therapy practice should be informed by the model of practice, with a focus on the needs of the clients and conducting activity analysis and occupational analysis on these needs. Intervention plans are developed in collaboration with clients/family members and they should be in control in decision making. In occupational therapy, the client is the active agent of activity, and the therapist serves as a helper or a facilitator. The design of therapeutic activities should not only consider restoring lost function and using residual functions but also pay attention to the impact of environmental factors on the client’s role and occupational performance. Occupational therapy helps the clients to return to family and society through improving their occupational performance via grading and adapting activities, providing information such as social resources, and implementing individualized interventions. This paper reviews the clinical reasoning and implementation of occupational therapy.
ObjectiveTo explore the application and effect of integration of doctors-nurses-therapists continuous nursing management in patients with spinal cord injury.MethodsThe patients with spinal cord injury from June to December 2018 in the Department of Rehabilitation Medicine of West China Hospital of Sichuan University were selected. A set of numbers was generated by a computer. And the patients were randomly divided into the trial group and the control group. Patients in the control group were given routine discharge continuous nursing management, and patients in the trial group adopted the integration of doctors-nurses-therapists continuous nursing management to implement post-discharge guidance. The activity of daily living (ADL), quality of life or psychological status of the two groups were compared at discharge and 3 months after discharge. The compliance, satisfaction and readmission rates between the two groups were also compared 3 months after discharge.ResultsA total of 60 patients were included, with 30 cases in each group. There was no significant difference in the scores of ADL, quality of life or Huaxi Xinqing index between the two groups (P>0.05). Three months after discharge, the score of ADL (71.65±1.87 vs. 62.70±2.29), quality of life (302.90±2.71 vs. 292.95±3.39), compliance rate of medication on time (86.67% vs. 63.33%), compliance rate of exercise on time (86.67% vs. 60.00%), compliance rate of follow-up visit on time (90.00% vs. 63.33%), compliance rate of reasonable diet (83.33% vs. 60.00%), and satisfaction (90.45±1.82 vs. 79.55±1.39) of patients in the trial group were higher than those in the control group (P<0.05). There was significant difference in Huaxi Xinqing index between the trial group and the control group (14.57±1.36 vs. 21.60±1.88, P<0.001). The readmission rate of the trial group was lower than that of the control group (6.67% vs. 26.67%), but the difference was not statistically significant (P>0.05). Three months after discharge, the ADL and quality of life in both groups were significantly different from those at discharge (P<0.001); the score of Huaxi Xinqing index in the control group was higher than that at discharge (t=-17.971, P<0.001), which in the trial group was also higher than that at discharge, but the difference was not statistically significant (t=-1.352, P=0.187).ConclusionThe integration of doctors-nurses-therapists continuous nursing management can effectively improve the ADL, quality of life and compliance of discharged patients with spinal cord injury, improve the mental state of patients, and improve patient satisfaction, which is helpful for the rehabilitation of patients with spinal cord injury outside the hospital.