Pressure ulcers are a common complication of immobility and frequently occur in surgical patients. The occurrence of pressure ulcers is affected by many factors, such as operation time and position, anesthesia method, and postoperative nursing. The aim of this study was to investigate the Munro Pressure Ulcer Risk Assessment Scale's value in predicting acute pressure ulcers in general anesthesia patients. This case-control study included patients who underwent more than 2 hours of general anesthesia in our hospital from January 2018 to December 2020. The case group comprised 42 patients who had pressure sores in surgical compression sites within 3 days after surgery. The control group consisted of 84 patients without acute pressure sores after surgery. Baseline patient data were compared between the two groups, and a logistic multivariate model was used to analyze potential risk factors for acute pressure ulcers. The Munro Pressure Ulcer Risk Assessment Scale scores and Braden scale scores were compared between the two groups during and after surgery. A receiver operating characteristic curve was used to evaluate the clinical value of the two scales (administered at the two time points) in predicting the occurrence of acute pressure ulcers after surgery. The operation and anesthesia times of patients in the case group were longer than those in the control group (P < 0.05). The proportion of comatose patients and patients with diabetes were significantly higher in the case group. While the case group had higher Munro scores during and after surgery compared to the control group (P < 0.05), Braden scores at the corresponding time points were lower (P < 0.05). The following variables were identified as independent risk factors of acute pressure ulcers: prolonged operation time and anesthesia time, increase in Munro scores during and after operation, decrease in Braden scores during and after operation, and comatose status (P < 0.05). The area under the receiver operating characteristic curve (AUC) of the postoperative Munro score for predicting postoperative pressure ulcer risk was 0.774; the sensitivity and specificity were 67.73% and 80.58%, respectively. The AUC of the intraoperative Braden score for predicting postoperative pressure ulcer risk was 0.836, with a sensitivity of 78.95% and specificity of 78.00%. The AUC of the postoperative Braden score for predicting postoperative pressure ulcer risk was 0.809, with a sensitivity of 73.58% and specificity of 64.26% (P < 0.05). Our results indicate that the intraoperative Munro Pressure Ulcer Risk Assessment Scale is highly effective for predicting the risk of postoperative pressure ulcers in surgical patients who require general anesthesia.
Objective: The aim of this study was to investigate the physiological activity of intrinsic laryngeal muscle under different functional states of larynx by measuring the normal laryngeal electromyography parameters. Methods: Laryngeal electromyography (EMG) was performed in 112 patients with unilateral vocal cord movement disorder. The duration and amplitude of the motor unit potential (MUP) of the thyroarytenoid muscle (TA), posterior cricoarytenoid muscle (PCA), and cricothyroid muscle (CT) were measured when patients were asked to make a deep inspiration and phonate /i/. The normal side of the patients’ vocal chords was used as the research object. Results: (1) The motor unit potential of TA, CT, and PCA were measured when inspiration and phonating /i/. Waveforms were normal. (2) There were significant differences in duration of TA between inspiration and phonating /i/ in comfortable tone. (3) When comparing the duration and amplitude of any 2 of TA, CT, and PCA during inspiration and phonating /i/, there were significant differences in duration between CT and PCA when phonating /i/ only. There were no significant differences in any other comparisons. Conclusions: Under either deep inspiration or pronunciation, the TA, CT, and PCA muscles were activated. The TA may play a major role in phonating. The PCA may play a major role in the action of deep inspiration.
To investigate the alteration of glucocorticoid receptor(GR) in peripheral blood mononuclear cells (PBMC) from patients with myasthenia gravis(MG) and to explore its mechanism.3H-dexamethansone binding assay and Scatchard analysis were used to measure the number of GR and dissociation constant in PBMC from 193 MG patients, 10 patients with other neuroimmunological disorders, 66 with cerebral vascular disorders (CVD) and 35 healthy donors. Slot blot hybridization was used to detect GRmRNA.GR numbers in MG patients were much lower than those in healthy controls (P < 0.01), but GR affinity between these two groups was not remarkably different (P > 0.05). GR numbers of PBMC from MG patients after culture in normal plasma were not significantly different from those before culture. No obvious change was observed in GR numbers of PBMC from healthy donors after the cells were incubated with MG plasma. GRmRNA of PBMC in MG patients was significantly lower than that in healthy donors, and was well correlated with GR numbers (r = 0.89, P < 0.01).GR numbers are low in MG patients. The decrease of GR numbers may be related to the decrease of GRmRNA transcription.
The age effect on the diffusion pattern in the basal ganglia differs from that in the white matter. The main purpose of our study was to provide further insight into the change of water diffusion in the basal ganglia during human brain aging by using the eigenvalues of DTI.
MATERIALS AND METHODS:
We examined 71 healthy subjects (mean age, 41.8 ± 14.5 years; age range, 20–79 years). The values of MD, FA, and the eigenvalues λ1 and λ23 (λ23 = [λ2 + λ3] / 2) were determined in regions of the head of the caudate nucleus, putamen, globus pallidus, and in some regions of white matter. The age-dependence of these measurements was tested for statistical significance by using the Pearson correlation analysis.
RESULTS:
A significant reduction of MD with aging was found in the head of caudate nucleus (r = −0.319, P = .007) and putamen (r = −0.410, P < .001), and an increase in FA with aging was found in the putamen (r = 0.535, P < .001). Eigenvalue λ23 showed a significant age-related decrease in the putamen (r = −0.451, P < .001) and the head of the caudate nucleus (r = −0.312, P = .008), but no significant changes of λ23 were found in the globus pallidus. The results for eigenvalue λ1 in the head of caudate nucleus (r = −0.299, P = .011) were close to statistical significance.
CONCLUSIONS:
The eigenvalues provide more insights into the different diffusion patterns in the basal ganglia during human brain aging.
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