Epilepsy is one of the most common neurological diseases, and symptomatic epilepsy patients are the main group of epilepsy patients, and their etiologies mainly include structural, infectious, metabolic and autoimmune, and the seizures caused by each etiology may have different degrees of impact on the quality of life of patients. The purpose of this article is to review the research on the quality of life of patients with symptomatic epilepsy caused by structural and infectious etiologies, including cerebrovascular diseases, neurodegenerative diseases, brain tumors, traumatic brain injuries and neurocysticercosis, in order to help clinicians understand the quality of life of patients with symptomatic epilepsy and benefit patients in clinical practice.
Objective To explore the incidence and severity of symptoms of the lung cancer patients undergoing concurrent chemoradiation therapy, and reveal the influence of symptom clusters on the patients’ daily activities. Method From December 2016 to June 2017, a total of 150 patients with lung cancer who underwent concurrent chemoradiation therapy were investigated by using M. D. Anderson Symptom Inventory of Chinese Version and the revised lung cancer module. Results For the patients during the period of concurrent chemoradiation therapy, the symptoms with severity score >5 were fatigue, nausea, poor appetite, cough, distress, disturbed sleep, vomiting, expectoration, and grief; the symptoms with incidence >80% were fatigue, nausea, disturbed sleep, poor appetite, grief, and cough. Joy of life (87.33%), emotion (74.38%), and work (72.67%) were the top three in terms of high incidence of symptom distress. Exploratry factor analysis revealed 4 major symptom clusters, which were fatigue-related symptom cluster, gastrointestinal symptom cluster, emotion symptom cluster, and respiratory symptom cluster. Conclusions During the period of concurrent chemoradiation therapy, lung cancer patients suffer from multiple symptom clusters. Medical staff should assess symptoms timely, and provide effective interventions, to improve the patients’ quality of life.
ObjectiveTo explore the correlation of respiratory diseases in respiratory clinic with air quality and temperature in winter. MethodsThe data of patients in the respiratory clinic in Anyang District Hospital were collected from November 1, 2012 to February 28, 2013. The air quality and weather condition were investigated in the local environmental protection department and meteorological department simultaneously. The number of outpatients,prevalence of main symptoms and main respiratory diseases as preliminary diagnoses were recorded. Their relations with air pollution index (API) and air temperature were analyzed. ResultsPearson correlation coefficient of daily API with the outpatients number of the day,the next 1 day and the next 3 days were 0.725, 0.331 and 0.257, respectively (P<0.01), which indicating a positive correlation. The average number of outpatients per day increased by 21.4%, 42.6% and 50.4%, respectively with increased API scale, so did the prevalence of main symptoms and that of main respiratory diseases as preliminary diagnoses. Pearson correlation coefficient of API with cough with sputum, and asthma were 0.287 and 0.277, respectively (P<0.01), which indicating a positive correlation. Pearson correlation coefficient of API with upper respiratory infection, bronchitis, bronchial asthma, and pneumonia were 0.184, 0.251, 0.301 and 0.227, respectively (P<0.05), which indicating a positive correlation. The average number of outpatients was stable when temperature ranged from -3℃to 15℃,increased by 34.5% when temperature ranged from -4℃to -3℃,and increased by 9.3% more when temperature ranged from -5℃to -4℃. Cough was more sensitive to air temperature, and the prevalence of cough increased by 35.7% when temperature ranged from -4℃to -3℃,and increased by 14.0% more when temperature ranged from -5℃to -4℃. Pearson correlation coefficient of air temperature with sinusitis, bronchial asthma, and sputum were -0.194, -0.383 and -0.191, respectively (P<0.05), which indicating a negative correlation. ConclusionsIn winter,the number of outpatients increases with the increase of API. Respiratory diseases and symptoms are closely related to air quality and temperature.
Objective To investigate the differences in clinical characteristics and polysomnographic characteristics between the elderly obstructive sleep apnea-hypopnea syndrome ( OSAHS) patients and the young and middle-aged OSAHS patients. Methods The clinical manifestations and the polysomnographic characteristics of 37 elderly OSAHS patients and 294 young and middle-aged patients were analyzed. The differences in polysomnographic indicators between two groups were compared according to the body mass index.Results The nocturia frequency in the elderly OSAHS patients was higher( P =0. 01) ,however, the othert clinical manifestations between the elderly group and the young and middle-aged group were not different significantly. The elderly group had a lower body mass index ( P =0. 018) , a smaller neck circumference ( P =0. 003) , and a larger chance of diabetes ( P = 0. 001) and hypertension( P lt; 0. 001) .The phase Ⅰ and phase Ⅱ sleep of the elderly group took a longer duration ( P lt; 0. 001) and a larger proportion( P lt;0. 001) . The sleep apnea-hypopnea index between two groups did not show any significant difference( P =0. 082) . The lowest night oxyhemoglobin saturation of the elderly group was higher than that of the young and middle-aged group( P =0. 009) , but such difference disappeared after adjustment by weight ( P =0. 114) . Conclusions The major clinical manifestations of the elderly OSAHS patients are similar to the young and middle-aged patients. The elderly patients are thinner than the young and middle-aged patients, but have more complications and a higher frequency of nocturia. The night oxyhemoglobin saturation is lower in young and middle-aged patients which is associated with higher body mass index.
ObjectiveTo explore coronary angiographic characteristics in patients with symptomatic recurrence after coronary artery bypass grafting (CABG). MethodsWe performed a retrospective study of 997 patients with symptomatic recurrence after CABG in Beijing Anzhen Hospital from 2010 to 2020. There were 762 males and 235 females, with an average age of 62.41±8.70 years.ResultsThere was a high prevalence of risk factors like hypertension, diabetes and a history of smoking. Diseased arterial grafts accounted for 27.44% while saphenous vein graft 54.40%; 240 (24.07%) patients had all patent grafts. The main lesion characteristics of diseased grafts were chronic total occlusion lesions (79.57%). Most patients had more diseased native vessels after CABG than before. The type C coronary artery disease in native vessels relevant to ischemic area occurred in 674 (67.60%) patients; 525 (52.66%) patients with recurrent symptom after CABG had both diseased grafts and diseased native vessels. Conclusion Graft status in patients with symptomatic recurrence after CABG is worse than we expected. The majority have newly developed lesions both in grafts and native vessels. Native vascular lesions will continue to progress after CABG.
ObjectiveTo investigate the long-term retention rate of Oxcabazepine (OXC) in Chinese young children with symptomatic epilepsy and to evaluate the withdrawal causes of OXC. MethodsClinical features of 89 cases (male/female:48/41) from January.2009 to June.2015 were collected. Patients with symptomatic epilepsy who received mono-or adjunctive therapy with OXC. The initial dose was 10mg/kg/d twice a daily, 3~4weeks to increased to the target dose. OXC doses ranged between 12~53 mg/(kg·d) (mean dose:34.0±8.59 mg/(kg·d). An investigator recorded the antiepileptic drugs, seizure frequency, electroencephalogram and side effects for 3, 6, 12, 24 and 36months during follow-up. ResultsA total of 89 patients were enrolled in this investigation. patients with 50% reduction in seizure frequency in 6, 12, 24 and 36 months were 56.5%, 55.3%, 44.7%, 24.7%, and with seizure-free were 36.5%, 34.1%, 29.4%, 16.5%. In this research, 16(18.0%) patients experienced at least one side effect. The most common side effects observed were drowsiness 8 (42.1%), rash 3 (15.8%), and most were mild in severity. The retention rate of OXC in 3, 6, 12, 24, and 36months were 95.5%, 87.6%, 75.3%, 56.2%, 25.8%, respectively. The predominant causes of withdrawal were lack of efficacy 36(54.5%), end point 10(15.2%), adverse effects 8(12.1%), seizure-free 5(7.6%), follow-up loss 3(4.5%). COX analysis reveals that the age of onset was associated with treatment failure. ConclusionOur study demonstrates that OXC is safe and well tolerated in infants and very young children with symptomatic epilepsy, but the long-term retention rate is low. Whereas, for the purpose of better retention rate and therapeutic benefits, we should treat discretely depending on the complicated etiology and clinical features.
Objective To assess the psychological status of patients with lung cancer in ward preliminarily for providing the theoretical support for further clinical treatment. Methods Lung cancer patients were enrolled in this study during the period from January 2016 to January 2017, when they were being treated in the respiratory ward of Nanjing General Hospital. Their psychological status was assessed by using Symptom Check List 90, and the results with their demographic information and somatic symptoms were combined. Data were analyzed by using SPSS 18.0 software. Results This study included 239 inpatients, out of them 161 patients were male (67.4%), and the average age was 60.7±9.9 years. Sixty patients had a positive psychological status. The incidence of depression was 11.3% (27/239), of anxiety 4.2% (10/239), and of the total psychological disorder 25.1%. The patients had more serious psychological problems, when they had a longer course, more autonomic symptoms, or a lower score of Karnofsky performance scale, etc. Conclusion More serious psychological problems exist in patients with lung cancer, so it has the clinical significance for their timely psychological assessment.
ObjectiveTo observe and analyze the fundus of pregnancy-induced hypertension syndrome (PIHS) and optical coherence tomography (OCT) characteristics and its correlation with ocular symptoms and degree of the systemic disease. MethodsA total of 132 PIHS patients (264 eyes) received the examinations of corrected visual acuity, slit lamp microscope, direct ophthalmoscope, OCT and fundus color photography after obtaining informed consent in the study. There were 10 cases of gestational hypertension, 29 cases of preeclampsia (mild), 82 cases of pre-eclampsia (severe) and 11 cases of eclampsia. 91 patients (180 eyes) felt blurred vision and visual fatigue. 102 patients were examined at an average gestational age of (37.00±2.14) weeks and 30 patients were examined at an average (10.00±8.22) days postpartum. The ocular fundus was divided into normal fundus and abnormal fundus; the abnormal fundus had 3 stages, including stageⅠ(retinal arterial spasm), stageⅡ(retinal arteriosclerosis) and stageⅢ(retinopathy). If the OCT results seems to be abnormal, these patients were further selected to observe the changes of neurosensory serous retinal detachment, retinal pigment epithelium (RPE) and junction of inner and outer segment of photoreceptor (IS/OS). Kappa test was used to analyze the consistency between fundus performance and OCT results, and that of ocular symptoms with fundus changes and OCT results. Rank correlation test was used to analyze the degree of PIHS and OCT examinations. ResultsThere were 32 eyes with normal fundus (12.12%) and 232 eyes with abnormal fundus (87.88%). The 232 eyes with abnormal fundus were divided into three stages: stageⅠfor 16 eyes (6.90%), stageⅡfor 31 eyes (13.36%) and stageⅢfor 185 eyes (79.74%). 92 of 264 eyes (34.85%) had normal OCT findings, 172 eyes (65.15%) were abnormal, including 94 eyes with serous retinal neurosensory detachment (54.65%), 40 eyes with changes of RPE and IS/OS (23.26%) and 38 eyes with other manifestations (22.09%). Kappa test analysis showed highly consistency between OCT results and ocular symptoms (K=0.728, Po=0.591), and poor consistency between fundus abnormalities and ocular symptoms (K=-0.129, Po=0.879), and between fundus abnormalities and OCT results (K=0.174, Po=0.682). OCT results were positively correlated with the degree of PIHS (C=0.374, χ2=74.011; P=0.000). Conclusions87.88% of PIHS eyes had various degrees of retinal hemorrhage, cotton wool spots, retinal bumps or detachment, optic disc edema and other retinal abnormalities. 65.15% of that showed OCT abnormal results such as neurosensory retinal detachment, cystoid edema, RPE changes etc. The consistency was poor between the OCT results and fundus abnormalities. OCT results are positively correlated with the degree of PIHS.
ObjectiveTo summarize the clinical features and imaging features of CT in the omental torsion, and in order to reduce the misdiagnosis and missed diagnosis rate of imaging features. MethodsThe data of 16 cases of omental torsion (secondary 15 cases, primary 1 case) and 286 cases of acute appendicitis (eliminated the subhepatic and retroperitoneal ectopic appendix) in our hospital from 1998 to 2014 were retrospectively analyzed. ResultsEleven cases of omental torsion suffered from the shifting pain in right lower quadrant. No obvious shifting abdominal pain was observed in other 4 cases whose main manifestations were abdominal tenderness and rebound tenderness around umbilicus. The patient of the remaining 1 case had enclosed mass in the area of left groin with pain and suffered from continuous periumbilical pain. Abdominal spiral CT examination was performed in 16 patients before operation. Increased signal intensity of globular soft tissue, which deviating from McBurney's point, was found at level of distal umbilicus by preoperative spiral CT in 13 cases. One case of omental torsion associated with ncarcerated inguinal hernia was missed. ConclusionsOmental torsion manifests chiefly shifting pain in right lower quadrant, abdominal tenderness, and rebound tenderness around umbilicus. It is easily confused with appendicitis. Abdominal spiral CT should be chosen as a preferred means in preoperative diagnosis of omental torsion.
Objective To evaluate the applicability of the cut-off points of different versions of the Asthma Control Questionnaire (ACQ) in the Chinese population and their consistency with the symptom control criteria of the Global Initiative for Asthma (GINA), so as to provide strategies for cut-off point selection in clinical practice. Methods Based on baseline data from a multicenter prospective cohort study, asthma patients who completed pulmonary function tests, GINA symptom control assessments, and the ACQ-7 questionnaire were included. Taking the GINA symptom control level as the gold standard, the Receiver Operating Characteristic Curve (ROC) was used to determine the optimal cut-off points of the ACQ for discriminating the GINA symptom control levels, and the consistency was analyzed by kappa statistics. Results Among 399 patients (58.9% female; mean age 44.5 ± 12.8 years), asthma symptom control, partial control, and uncontrolled rates were 61.7%, 27.6%, and 10.8%, respectively. ROC analysis revealed the following optimal cutoffs for identifying symptom control: ACQ-5 (0.5), ACQ-6Res (0.42), ACQ-6PFT (0.92), and ACQ-7 (0.93); for identifying uncontrolled symptoms: ACQ-5 (0.9), ACQ-6Res (1.08), ACQ-6PFT (1.42), and ACQ-7 (1.36). All corresponding areas under the ROC curve (AUC) exceeded 0.9. Consistency between ACQ and GINA symptom control levels was moderate (Fleiss’ κ = 0.453–0.531). Performance characteristics varied between traditional (0.75/1.5) and optimized cutoffs. After optimization, ACQ-5 emerged as the only version achieving balanced sensitivity-specificity (Youden index = 0.75) in dual tasks: ACQ-5 ≤ 0.5 demonstrated sensitivity (91%) and specificity (84%) for symptom control, while ACQ-5 ≥ 0.9 showed sensitivity (95%) and specificity (80%) for uncontrolled status. Conclusions Region-specific calibration of ACQ cutoffs enhances clinical utility in the Chinese population. A stratified application strategy is recommended: high-sensitivity cutoffs for initial screening to reduce underdiagnosis, high-specificity cutoffs for resource-constrained settings to minimize overtreatment, and optimized ACQ-5 cutoffs (≤0.5/≥0.9) for comprehensive management to balance sensitivity and specificity. Flexible combination of cutoff protocols tailored to screening objectives may optimize hierarchical asthma management.