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Analysis of the Effect of Incentive Nursing Intervention in Children with Severe Viral Encephalitis and Myocarditis during Rehabilitation Based on Diffusion Weighted MRI

Analysis of the Effect of Incentive Nursing Intervention in Children with Severe Viral... Hindawi Journal of Healthcare Engineering Volume 2021, Article ID 9993264, 8 pages https://doi.org/10.1155/2021/9993264 Research Article Analysis of the Effect of Incentive Nursing Intervention in Children with Severe Viral Encephalitis and Myocarditis during Rehabilitation Based on Diffusion Weighted MRI 1 2 3 3 4 Qiuai Ren , Li Guo , XiuLan Liu , PengFei Xiao , Shuifang Tang , 5 6 7 Ashutosh Sharma , Tarandeep Singh Walia , and Mohd Asif Shah Weinan Vocational and Technical College, Weinan, China Department of Educational Administration, Brain Hospital of Hunan, ChangSha 410007, China Department of Emergency Medicine, Brain Hospital of Hunan, ChangSha 410007, China Brain Hospital of Hunan, ChangSha 410007, China Institute of Computer Technology and Information Security, Southern Federal University, Rostov-on-Don, Russia School of Computer Application, Lovely Professional University, Phagwara, India Bakhtar University, Kabul, Afghanistan Correspondence should be addressed to Qiuai Ren; qiuairen4@outlook.com and Mohd Asif Shah; ohaasif@bakhtar.edu.af Received 17 March 2021; Revised 23 April 2021; Accepted 7 May 2021; Published 15 May 2021 Academic Editor: Dilbag Singh Copyright © 2021 Qiuai Ren et al. *is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Severe viral encephalitis in children causes a viral infection that damages their central nervous system. *is situation arises the mental abnormalities, sudden rise in body temperature, disturbance of consciousness, and so forth in children, which can be life-threatening. Objective. *is work aimed at exploring the effect of diffusion weighted MRI on children with severe viral encephalitis and myocarditis. Methods. *is work presents a diffusion weighted MRI scanning method that involves scanning through a serial imaging device, axial scanning, and sagittal and coronal scanning. 60 children with severe viral encephalitis and myocarditis who admitted to Brain Hospital of Hunan Province from April 2017 to May 2020 were deemed as research subjects. All the children underwent CT and MRI examination, blood routine examination, and cerebrospinal fluid examination after admission. *is work uses the random number table method to classify the subjects into control group and observation group, each consisting of 30 cases. Children in the control group were provided with the routine nursing intervention, whereas children in the observation group were subjected to incentive nursing intervention. *e baseline data, ECG monitoring indicators, body abnormalities, and clinical symptom relief time of the two groups of children were compared and the results of diffusion weighted MRI scans were analyzed and the ADC values were counted. Results. *e two groups of children were compared on the basis of baseline data, and the variation was not statistically substantial (P> 0.05). *e cases of children in the control group had higher heart rate and respiration, and physical dysfunction, language dysfunction, unconsciousness, and nervous dysfunction were more than those in the observation group. However, the cases of blood oxygen saturation were less than those of the observation group. After nursing intervention done for the control group, remission time of clinical symptoms such as convulsion, physical dysfunction, unconsciousness, and nerve dysfunction was longer relative to the observation group (all P< 0.05 are considered). Conclusion. *e diffusion weighted MRI had diagnostic significance for severe viral encephalitis and myocarditis. For children with severe viral encephalitis and myocarditis, clinical incentive nursing intervention was particularly imperative. It can not only help children to relieve symptoms and control the deterioration of the disease in a short time but also help improve the quality of life of the children and the confidence of family members to cope with the disease. 2 Journal of Healthcare Engineering 1.Introduction Considering the research subjects with severe viral encephalitis and Viral encephalitis refers to brain inflammation caused by a myocarditis virus directly invading the brain parenchyma. *e main cause of this disease is enterovirus infection, which mainly includes polio virus, Coxsackie virus A and B, and Echo virus. *e disease has the characteristics of seasonality, epidemic, and so forth. It mostly occurs in winter and MRI diffusion weighted imaging spring and is often self-limiting [1]. Children’s viral en- cephalitis mainly refers to the viral infection invading the pia mater and causing damage to the central nervous system. Children manifested with obvious mental abnor- malities, sudden rise in body temperature, disturbance of Control group Observation group consciousness, and so forth, which can be severely life- threatening. In the clinic, children with viral encephalitis are mostly classified into two types: mild type and critical type. Critically ill children are often complicated with myocarditis, which is clinically manifested as damage to brain and heart function at the same time [2]. Myocarditis refers to a disease in which localized or diffuse inflam- Comparison and analysis of control and matory lesions of the myocardium are the main manifes- observation groups tations, and the pathogenesis is not yet completely diagnosed. According to the investigation of rat samples, Figure 1: Block diagram for effective analysis of incentive nursing viral myocarditis can be divided into 3 stages. *e virus innovation. invades myocardial cells to multiply through specific re- ceptors, leading to myocardial necrosis. *e continuous Salazar et al. [16] presented a case study in which anti-N- response can cause myocardial remodeling and eventually cause progressive heart failure. Most children are with methyl-D-aspartate receptor encephalitis is seen, which is related to the involuntary movement as well as hypersali- severe arrhythmia, heart failure, and other clinical mani- festations [3]. If the clinical treatment is not timely or the vation symptoms. *ese situations can only be controlled by narcotics and other high-dosage sedation which is not at all care is improper, it can lead to aggravated damage to the brain tissue or heart function of the child and have a serious good for patients’ health. *e authors suggested that the impact on the growth and development of the child and the change in hypothalamic neurotransmitter levels can stim- ulate the parasympathetic neurons of nervous system. quality of life [4]. A basic block diagram of the entire research process for effective analysis of incentive nursing Taguchi et al. [17] presented an instance of viral encephalitis who already had a medical history of ovarian teratoma, innovation based on diffusion weighted MRI is depicted in Figure 1. which can be reduced using anesthetic drugs. It was found that patients having fever symptoms is very consistent in the In the developing countries, the literature survey sug- gests that approximately 50% to 60% patients are identified literature [18–20] and the incidents of teratomas were also found to be common in the previous reports [21]. Com- with the viral encephalitis and possess long-term prognosis [5–7]. *is situation leads to a tremendous stress and fi- parative to the patients suffering from tumors, the consis- tency was found in the reoccurrence rates of the patients nancial burden on the families of patients and also on the society [8–12]. *us, this scenario leads to the research for [22, 23]. *e authors in [24] reported that the patients with identification of prognosis factors in the patients suffering MRI abnormalities have disorders like epilepsy, involuntary movement of the limbs, and other mental disorders, which from viral encephalitis. *e research is oriented towards the early decision-making and timely treatment for improving can indicate the MRI related clinical severities. *erefore, they presented a specific mechanism for viral encephalitis as the capabilities of the framework in favor of patients while improving the living standard. *is type of improvement in a further research challenge. *e review of literature for viral encephalitis reveals that the research domain leads to the improved clinical diagnosis as well as social consequences. *e epidemiological data the early diagnosis is of great significance for the clinical treatment and prognosis of children with viral meningitis should be considered for diagnosis along with the clinical indicators, previous medical history of the patients, and a and myocarditis. MRI is currently widely adopted in clinics due to its high tissue resolution. However, its sequence is comprehensive analysis of auxiliary examinations per- simple, including only T1W1, T2W1, T2FLAIR, and en- formed. *e detection of brain tissues acts as a gold standard for the diagnosis of viral antigens or for determining the hanced scanning [25]. *e new technology diffusion weighted MRI imaging is based on the movement of water antibodies in cerebrospinal fluid. However, it should be noted that the diagnostic frequency of viral encephalitis is molecules, which provides information based on the physiological state of the brain. *e sensitivity of clinical low around the world and still there are several cases that remain unknown [13–15]. diagnosis of acute cerebral infarction is as high as 94%, and Journal of Healthcare Engineering 3 the specificity is 100%. Moreover, it is also employed to 2.1. Research Route. For the effective analysis of incentive distinguish between arachnoid cyst and epidermoid cyst, nursing innovation based on diffusion weighted MRI, the subdural empyema and effusion, abscess, and tumor ne- research route for this work is described in Figure 2. crosis. It can provide valuable information in the diagnosis *is research route is designed to analyze the effect of and differential diagnosis of other intracranial lesions such incentive nursing innovation based on diffusion weighted as tumors, infections, trauma, and demyelination [26]. MRI in the children suffering from viral encephalitis and *e objective of this work is to explore the diffusion myocarditis. *e method is initially applied on sixty children effect in weighted MRI for children having symptoms of with the symptoms of viral encephalitis and myocarditis, and viral encephalitis and myocarditis. *e major contributions MRI diffusion is performed. Based on the result analysis of of this article are heighted as follows: diffusion process, the control group and the observation group are formed. *e control group is provided with the (i) *e diffusion weighted MRI scanning method is routine nursing intervention and the observation group is employed using a single-shot SE-EPI serial imaging subjected to the incentive nursing intervention. *e results device for scanning. A 9-channel head coil is adopted of both groups are compared and the effect of MRI inter- with layer thickness of 6 mm, spacing of 2 mm, and vention is analyzed and summarized. NEX � 3. *e enhanced scan Meglumine acid was used for contrast agent gadolinium injection fol- lowed by axial, sagittal, and coronal scanning. 2.2. Research Subjects. A total of 60 children with severe viral (ii) *e experimentation was conducted on 60 children encephalitis and myocarditis were selected from Brain with severe viral encephalitis and myocarditis Hospital of Hunan Province from April 2017 to May 2020. symptoms between April 2017 and May 2020 who All the children underwent CT and MRI examination, blood admitted to Brain Hospital of Hunan Province. *e routine examination, and cerebrospinal fluid examination children underwent CT and MRI examination, after admission. *is work uses the random number table blood routine examination, and cerebrospinal fluid method to classify the subjects into control group and ob- examination, on the basis of which they were servation group, each consisting of 30 cases. *e control classified into control and observation groups, each group comprises 21 male children and 9 female children. *e with 30 cases. *e children in the control group age ranged from 4 months to 8 years, with an average of were provided with the routine nursing interven- 3.09± 1.42 years of age. However, the observation group tion, while children in the observation group were comprises 20 male children and 10 female children. *e age subjected to incentive nursing intervention. was 3 months to 9 years, with an average of 3.16± 1.39 years (iii) *e baseline data, ECG monitoring indicators, body of age. *e general data is not statistically significant based on the gender and age of both groups and, therefore, they are abnormalities, and clinical symptom relief time of the two groups of children were compared, and the comparable. *e medical ethics committee of Brain Hospital of Hunan Province studied and approved this investigation. appropriate nursing methods were selected according to the inspection results. *e results of *e relevant diagnostic criteria of severe viral encephalitis in “Diagnosis and Treatment of Children’s Viral Encephalitis” diffusion weighted MRI scans were analyzed and the and the related content of myocarditis in “Diagnostic Cri- ADC values were also computed, on the basis of teria of Viral Myocarditis” were discussed. *e inclusion which the diagnostic significance of diffusion criteria are as follows: the patients who met the above- weighted MRI for severe viral encephalitis and mentioned conditions and have not received any other myocarditis is observed. treatment in the recent years; and family members of the (iv) *is significant contribution can control the dete- children knew and signed the informed consents. *e ex- rioration of the disease in a short time, thereby clusion criteria are as follows: the patients who suffer from improving the living standard of the children and any sort of immune system diseases, those with other the confidence of family members to cope with the nonviral infections in the cranium, those who were allergic disease. to the relevant treatments used in this investigation, and *e rest of this article is organized as follows: research those with poor compliance to this investigation. methods including the description of the subjects, research routes, and MRI analysis methods are discussed in Section 2. Section 3 presents the research results trailed by the ex- 2.3. Diffusion Weighted MRI Scanning Method and Image perimental discussion in Section 4. Section 5 presents the Analysis. *e scanning was conducted by a single-shot SE- concluding remarks along with future research directions. EPI sequence imaging device, and a 9-channel head coil was employed, which mainly included inversion recovery se- quence, fast spin echo, and water suppression sequence, with 2.Research Methods layer thickness of 6 mm, spacing of 2 mm, and NEX � 3. During the enhanced scan, the child needed to be injected *is section provides a research route, research subjects with the contrast agent gadopentetate meglumine injection along with diffusion weighted MRI scanning method and at a dose of 0.1 mmol/kg. After injection, scan was performed image analysis, nursing methods, observation indicators, in axial, sagittal, and coronal positions. If the child cannot and the information of statistical software. 4 Journal of Healthcare Engineering Effect analysis of incentive nursing intervention based on diffusion weighted MRI in children with severe viral encephalitis and myocarditis Methods: sixty children with severe viral encephalitis and myocarditis were selected MR diffusion weighted imaging was performed in the children, and the results of DWI were analyzed The control group was given The observation group was routine nursing intervention given incentive nursing mode intervention The results of different nursing intervention modes were compared between the two groups Discussion: the diagnosis of severe viral encephalitis and the effect of MRI intervention were analyzed The results of this study are summarized Figure 2: Research route. should communicate with children and their families more, cooperate, he/she needed to drink 5% water and 1 mL/kg of chloric acid half an hour before the scan. be familiar with the children’s hobbies, establish a friendly When the scan results were analyzed, two experienced care relationship with the children, and use touch, whisper, diagnostic physicians evaluated them separately. If the and other methods to comfort the children. In addition, it evaluation results of the two were inconsistent, a third, was necessary to comfort and encourage the children’s more senior imaging physician would conduct the diag- family members and promptly inform them with the nostic evaluation. *e specific content included the loca- treatment results. Parents should understand the necessity of tion, number, size, and scope of the lesion. ADC treatment, maintain an optimistic attitude, actively respond, measurement was implemented via the ADC statistical and cooperate with the doctor to help the children recover as software, the lesion and the normal brain tissue on the soon as possible. Rehabilitation care was performed to help opposite side were measured, and finally the average result children perform more physical activities, including upper was calculated. and lower limb exercises, wrists, elbows, fingers, hips, knees, and ankle joints, 3 times a day. 2.4. Nursing Methods. According to the results of diffusion weighted MRI scans, children in the control group are 2.5. Indicators for the Observation. provided with the routine nursing intervention. It mainly (i) *e baseline data of the control and the observation included the monitoring of the vital signs, consciousness groups of the children were compared. state, and physical activity of the child. *e child’s family (ii) Diffusion weighted MRI scan results of severe viral members were informed of the disease-related knowledge encephalitis and myocarditis were analyzed, and the and the current treatment of the child. Incentive nursing ADC value was calculated. intervention was given to children in the observation group. *e content of routine nursing was the same as that of the (iii) *e ECG monitoring indicators of the two groups of control group, and psychological nursing and rehabilitation children were compared, including heart rate, res- nursing were also implemented. In daily nursing, nurses piration, and blood oxygen saturation. Journal of Healthcare Engineering 5 (iv) *e number of cases of physical abnormalities in the 25 two groups of children were compared, including physical impairment, language impairment, and intellectual impairment. (v) *e clinical symptoms relief times of the two groups of children after the incentive nursing intervention were compared, including convulsions, physical dysfunction, unconsciousness, and nerve dysfunction. 2.6. Statistical Software. *e data analysis in this work is done employing the SPSS 22.0 statistical software. *e Male children Female children Age percentage count of the data is considered and the chi- Baseline data square test is done for the comparison between these groups. *e statistical significance of the data is inferred using the P Control group value (P< 0.05). It tests the variance between the data groups Observation group which are to be measured at the ordinal or continuous level. Figure 3: Comparative analysis of the baseline data. *is test does not need the data to be normally distributed and can be applied to a group of random samples from the entire population. *e chi-square test statistics rank the data using the chi-square distribution for computing the sig- nificant P values. *is test is useful in controlling the ex- perimental variability of data and can be applied to the group of random samples without checking the normality distri- bution of the dataset being used. *e P values of the test should be significantly less than 0.05 as the smaller P value of this test is suggestive of selection of the entire data for the analysis. *e comparative analysis is done to demonstrate the feasibility of the presented method utilizing the non- parametric data statistics. 3.Results *e experimental analysis of diffusion weighted MRI Figure 4: Severe viral encephalitis. scanning method and image analysis for discussing the effects of incentive nursing intervention in children with severe viral encephalitis and myocarditis during rehabili- tation are provided in this section. RV 3.1. Comparative Analysis of Baseline Data. *e control group contains the patients who are given the nursing in- RA LV tervention and the observation group contains the patients who are provided with the incentive nursing intervention. LA Both groups are compared on the basis of data. Figure 3 shows that the baseline data of both groups were compared, and the statistical implication of the difference was found to be not significant enough as P> 0.05. *is comparison reveals that the baseline data contain both male and female children of varying age groups. *e Figure 5: Myocarditis. numerical value of male children is higher than that of the female children, and they are evenly distributed into control and observation groups. lesions in the brain and heart areas showed obvious hyperintensity. 3.2. Diffusion Weighted MRI Scan Results. Diffusion *e results of diffusion weighted MRI scans were ana- lyzed in terms of ADC values to determine the diagnostic weighted MRI scans showed that the brain lesions of the children mostly involved the subcortex, thalamus, and significance of diffusion weighted MRI for severe viral en- cephalitis and myocarditis. *e ADC value of the severely midbrain. Figures 4 and 5 illustrate that the lesions were patches or large patches with slightly longer T1, while the infected portion was considerably lower as compared to the Numerical value 6 Journal of Healthcare Engineering healthier part as shown in Figure 6. *e statistical impli- 1.2 cation of the difference is significant enough as the signif- icant value comes out to be P< 0.05. 0.8 3.3. Comparison of ECG Monitoring Indicators between Two Groups of Children. After comparison, the heart rate and respiration of children in the control group were signifi- cantly higher than those of the observation group (Figure 7), while the blood oxygen saturation was lower for this group. 0.4 *e difference was substantial in terms of this statistical significance (P< 0.05). 0.0 3.4. Comparison of the Number of Abnormalities in the Two Affected side Contralateral Groups of Children. After comparison, the number of cases in the control group having physical, language, and intel- ADCmin lectual dysfunctions was more than that in the observation Figure 6: ADC value. group (Figure 8), and the variation has statistical significance (P< 0.05). 3.5. Comparison of Clinical Symptom Remission Time. After nursing intervention, in the control group, the re- mission time of clinical symptoms such as convulsion, physical dysfunction, unconsciousness, and nerve dys- function was longer compared to that in the observation group, and the variation was remarkable statistically pro- viding the significance value of P< 0.05, as illustrated in Figure 9. 4.Discussion 40 Severe viral encephalitis is a fatal intracranial infectious disease, in which the virus directly destroys the brain pa- renchyma and induces neuropathy. Imaging examination AB C reveals diffuse or focal changes in neuronal deformation and Observation index necrosis, as well as severe damage to functional areas. Normal cell metabolism in the brain is disordered, and a Control group large amount of necrosis occurs [27]. Some children may Observation group have cerebral edema myocarditis. *e cardiac function of Figure 7: ECG monitoring indicators. children with myocarditis is obviously seriously affected, causing the children to have obvious physical fatigue, pal- pitations, and other discomforts. Severe children may also of cerebral vasogenic edema gradually expands. At this time, have heart failure, shock, and so forth, and some children cytotoxic edema in the lesion still exists, and the two coexist. When scanned by diffusion weighted MRI, vasogenic edema may even die suddenly. *erefore, in clinical nursing work, the observation of the patient’s condition is the top priority produces transmission effect, while ADC value can remove this effect and reduce imaging error, so it has practical value. [28]. *e nursing work was carried out based on the results of At present, the domestic treatment of severe viral en- cephalitis and myocarditis has achieved remarkable results. diffusion weighted MRI. Diffusion weighted MRI imaging reflects tissue information by measuring the motion of water Most of the children can recover as long as they receive molecules in vivo. It can clearly distinguish cytotoxic edema timely clinical treatment, but there are still some children from vasogenic edema, so it has significant advantages and who have various adverse reactions, even disability and has been clinically applied in the diagnosis of intracerebral death, which increase the burden on the children and their diseases [29]. In this work, diffusion weighted MRI scan families. Studies suggested that effective nursing interven- revealed that brain lesions mainly involved subcortex, tion was of great significance for the recovery of children after treatment [30–32]. *erefore, according to the results thalamus, and midbrain, and the lesions were patches or large patches slightly longer than T1. *e lesions in brain and of imaging examination, two different nursing modes were implemented for the children to compare their effects. *e heart showed high signal intensity. With severe viral en- cephalitis as an example, as the disease progresses, the scope outcomes obtained for heart rate and respiration of the Numerical value Numerical value Journal of Healthcare Engineering 7 Hunan Province with the symptoms of viral encephalitis or myocarditis. *ese children underwent the CT and MRI examination and are divided into control and observation groups for analysis. *e various experimental analyses were performed on the baseline data using the ECG monitoring indicators and body abnormalities, and clinical symptom relief times of the two groups of children were compared. Using the nursing intervention, the remission times of clinical symptoms such as convulsion, physical dysfunction, 2 unconsciousness, and nerve dysfunction were observed to be statistically significant having P< 0.05. In summary, diffusion weighted MRI had great signif- icance for the diagnosis of severe viral encephalitis and myocarditis. For children with severe viral encephalitis and myocarditis, clinical incentive nursing intervention was AB C particularly imperative, which helped children relieve Observation index symptoms in a short period of time and control the dete- Control group rioration of their condition. Moreover, it also helped to Observation group improve the living standard of children and the confidence Figure 8: Number of cases of body abnormalities. of family members in coping with the disease, which was worthy of further clinical promotion and adoption. *is investigation uses the smaller sample size, which certainly 20 affects the research results; therefore, the future perspective of this work requires the expansion of sample size for the establishment of incentive nursing intervention-based al- gorithms in the current scenario. Data Availability All data are shared in the main manuscript. Conflicts of Interest *e authors declare that they have no conflicts of interest. AB C D References Observation index [1] M. Adenot, E. Frobert, G. Blanchard et al., “Clinical pre- Control group sentation of severe viral encephalitis with known causative Observation group agents in children,” Journal of Child Neurology, vol. 29, no. 11, Figure 9: Remission time of clinical symptoms. pp. 1508–1518, 2014. [2] Y. Inui, K. Yakushijin, A. Okamura, Y. Tanaka, and I. Shinzato, “Human herpesvirus 6 encephalitis in patients children in the control group are higher than those in the administered mycophenolate mofetil as prophylaxis for graft- observation group, while the saturation of oxygen is lower versus-host disease after allogeneic hematopoietic stem cell than that in the observation group. Additionally, the transplantation,” Transplant Infectious Disease, vol. 21, no. 1, physical, language, and mental dysfunctions in the children Article ID e13024, 2019. of the control group were higher than those in the obser- [3] K. K. Koeller and R. Y. Shih, “Viral and prion infections of the vation group. After clinical nursing intervention, the time of central nervous system: radiologic-pathologic correlation: remission for clinical symptoms, convulsion, physical dys- from the radiologic pathology archives,” Radiographics, function, unconsciousness, and nerve dysfunction, in the vol. 37, no. 1, pp. 199–233, 2017. control group was greater than that in the observation group. [4] Y. F. Chen, L. Hu, F. Xu, C. J. Liu, and J. Li, “A case report of a teenager with severe hand, foot, and mouth disease with brainstem encephalitis caused by enterovirus 71,” BMC Pe- 5.Conclusion diatrics, vol. 19, no. 1, pp. 1–4, 2019. *is work contributed to the analysis of diffusion effect in [5] F. Raschilas, M. Wolff, F. Delatour et al., “Outcome of and weighted MRI for children having symptoms of viral en- prognostic factors for herpes simplex encephalitis in adult cephalitis and myocarditis. *e experimentation was con- patients: results of a multicenter study,” Clinical Infectious ducted on 60 children who admitted to Brain Hospital of Diseases, vol. 35, no. 3, pp. 254–260, 2002. Number of cases Remission time 8 Journal of Healthcare Engineering [6] G. Dhiman, D. Oliva, A. Kaur et al., “BEPO: a novel binary [23] J. Dalmau, A. J. Gleichman, E. G. Hughes et al., “Anti-NMDA- receptor encephalitis: case series and analysis of the effects of emperor penguin optimizer for automatic feature selection,” Knowledge-Based Systems, vol. 211, Article ID 106560, 2021. antibodies,” =e Lancet Neurology, vol. 7, no. 12, pp. 1091–1098, 2008. [7] T. E. Erlanger, S. Weiss, J. Keiser, J. Utzinger, and K. Wiedenmayer, “Past, present, and future of Japanese en- [24] F. Graus, M. J. Titulaer, R. Balu et al., “A clinical approach to diagnosis of autoimmune encephalitis,” =e Lancet Neurology, cephalitis,” Emerging Infectious Diseases, vol. 15, no. 1, pp. 1–7, vol. 15, no. 4, pp. 391–404, 2016. [25] M. Ogata, T. Satou, Y. Miyazaki, E. Otsuka, N. ., ... Saito, and [8] T. Solomon, “Control of Japanese encephalitis - within our K. Shirao, “Correlations of cytokine levels in cerebrospinal grasp?,” New England Journal of Medicine, vol. 355, no. 9, fluid and peripheral blood with outcome of HHV-6B en- pp. 869–871, 2006. cephalitis after hematopoietic stem cell transplantation,” [9] G. Dhiman, K. K. Singh, M. Soni et al., “MOSOA: a new multi- Transplant Infectious Disease, vol. 21, no. 6, Article ID e13172, objective seagull optimization algorithm,” Expert Systems with Applications, vol. 167, Article ID 114150, 2021. [26] A. Imaz, N. Cayuela, J. Niubo´ et al., “Short communication: [10] A. Venkatesan, “Epidemiology and outcomes of acute en- focal encephalitis related to viral escape and resistance cephalitis,” Current Opinion in Neurology, vol. 28, no. 3, emergence in cerebrospinal fluid in a patient on lopinavir/ pp. 277–282, 2015. ritonavir monotherapy with plasma HIV-1 RNA suppres- [11] M. Poongodi, A. Sharma, V. Vijayakumar et al., “Prediction of sion,” AIDS Research and Human Retroviruses, vol. 30, no. 10, the price of Ethereum blockchain cryptocurrency in an in- pp. 984–987, 2014. dustrial finance system,” Computers & Electrical Engineering, [27] T. Baumer, C. Fry, S. Luppe, H. Gunawardena, and vol. 81, Article ID 106527, 2020. K. Sieradzan, “Human herpes virus-6 encephalitis causing [12] G. Rathee, A. Sharma, R. Kumar, F. Ahmad, and R. Iqbal, “A severe anterograde amnesia associated with rituximab, aza- trust management scheme to secure mobile information thioprine and prednisolone combination therapy for der- centric networks,” Computer Communications, vol. 151, matomyositis,” Journal of Neurovirology, vol. 23, no. 3, pp. 66–75, 2020. pp. 508–510, 2017. [13] J. Lohitharajah, N. Malavige, J. Wanigasinghe, R. Gamage, ´ ´ [28] B. Vidaña, N. Johnson, A. R. Fooks, P. J. Sanchez-Cordon, P. ., ... Gunaratne, and T. Chang, “Viral aetiologies of acute D. J. Hicks, and A. Nuñez, “West Nile Virus spread and encephalitis in a hospital-based South Asian population,” differential chemokine response in the central nervous system BMC Infectious Diseases, vol. 17, no. 1, pp. 1–7, 2017. of mice: role in pathogenic mechanisms of encephalitis,” [14] K. Srihari, G. Dhiman, K. Somasundaram, A. Sharma, Transboundary and Emerging Diseases, vol. 67, no. 2, S. ., ... Rajeskannan, and M. Masud, “Nature-inspired-based pp. 799–810, 2020. approach for automated cyberbullying classification on [29] P. Sovinz, W. Schwinger, H. Lackner et al., “Severe epstein- multimedia social networking,” Mathematical Problems in barr virus encephalitis with hemophagocytic syndrome,” Engineering, vol. 2021, Article ID 6644652, 12 pages, 2021. Pediatric Infectious Disease Journal, vol. 29, no. 6, pp. 553– [15] G. Feng, L. Zhou, F. Li, Y. Hu, X. Wang, and X. Tian, 556, 2010. “Predictors of outcome in clinically diagnosed viral en- [30] L. Sisinni, M. Gasior, R. de Paz et al., “Unexpected high cephalitis patients: a 5-year prospective study,” BioMed Re- incidence of human herpesvirus-6 encephalitis after naive search International, vol. 2020, Article ID 2832418, 9 pages, T cell-depleted graft of haploidentical stem cell transplanta- tion in pediatric patients,” Biology of Blood and Marrow [16] R. Salazar, E. James, M. Elsayed et al., “Profuse sialorrhea in a Transplantation, vol. 24, no. 11, pp. 2316–2323, 2018. case of anti N-methyl-D-aspartate receptor (NMDAR) en- [31] D. Singh, V. Kumar, V. Yadav, and M. Kaur, “Deep neural cephalitis,” Clinical Neurology and Neurosurgery, vol. 114, network-based screening model for COVID-19-infected pa- no. 7, pp. 1066–1069, 2012. tients using chest X-ray images,” International Journal of [17] Y. Taguchi, S. Takashima, T. Nukui, and K. Tanaka, “Hy- Pattern Recognition and Artificial Intelligence, vol. 35, no. 03, persalivation in a patient with anti-NMDAR encephalitis with Article ID 2151004, 2020. ovarian teratoma,” Internal Medicine, vol. 49, no. 8, [32] N. Gianchandani, A. Jaiswal, D. Singh, V. Kumar, and pp. 803-804, 2010. M. Kaur, “Rapid COVID-19 diagnosis using ensemble deep [18] K. Miya, Y. Takahashi, and H. Mori, “Anti-NMDAR auto- transfer learning models from chest radiographic images,” immune encephalitis,” Brain and Development, vol. 36, no. 8, Journal of Ambient Intelligence and Humanized Computing, pp. 645–652, 2014. vol. 16, pp. 1–13, 2020. [19] H. E. Peery, G. S. Day, S. Dunn et al., “Anti-NMDA receptor encephalitis. *e disorder, the diagnosis and the immu- nobiology,” Autoimmunity Reviews, vol. 11, no. 12, pp. 863–872, 2012. [20] I. Gabilondo, A. Saiz, L. Galan ´ et al., “Analysis of relapses in anti-NMDAR encephalitis,” Neurology, vol. 77, no. 10, pp. 996–999, 2011. [21] R. J. Wang, B. D. Chen, and D. Qi, “Anti-N-methyl-D-aspartate receptor encephalitis concomitant with multifocal subcortical white matter lesions on magnetic resonance imaging: a case report and review of the literature,” BMC Neurology, vol. 15, no. 1, pp. 1–4, 2015. [22] L. Yang, Q. Jiang, H. Guan, and H. Bo, “Nursing care in anti- N-methyl-d-aspartate receptor encephalitis: a case series,” Medicine, vol. 98, no. 46, 2019. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Healthcare Engineering Hindawi Publishing Corporation

Analysis of the Effect of Incentive Nursing Intervention in Children with Severe Viral Encephalitis and Myocarditis during Rehabilitation Based on Diffusion Weighted MRI

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Copyright © 2021 Qiuai Ren et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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10.1155/2021/9993264
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Abstract

Hindawi Journal of Healthcare Engineering Volume 2021, Article ID 9993264, 8 pages https://doi.org/10.1155/2021/9993264 Research Article Analysis of the Effect of Incentive Nursing Intervention in Children with Severe Viral Encephalitis and Myocarditis during Rehabilitation Based on Diffusion Weighted MRI 1 2 3 3 4 Qiuai Ren , Li Guo , XiuLan Liu , PengFei Xiao , Shuifang Tang , 5 6 7 Ashutosh Sharma , Tarandeep Singh Walia , and Mohd Asif Shah Weinan Vocational and Technical College, Weinan, China Department of Educational Administration, Brain Hospital of Hunan, ChangSha 410007, China Department of Emergency Medicine, Brain Hospital of Hunan, ChangSha 410007, China Brain Hospital of Hunan, ChangSha 410007, China Institute of Computer Technology and Information Security, Southern Federal University, Rostov-on-Don, Russia School of Computer Application, Lovely Professional University, Phagwara, India Bakhtar University, Kabul, Afghanistan Correspondence should be addressed to Qiuai Ren; qiuairen4@outlook.com and Mohd Asif Shah; ohaasif@bakhtar.edu.af Received 17 March 2021; Revised 23 April 2021; Accepted 7 May 2021; Published 15 May 2021 Academic Editor: Dilbag Singh Copyright © 2021 Qiuai Ren et al. *is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Severe viral encephalitis in children causes a viral infection that damages their central nervous system. *is situation arises the mental abnormalities, sudden rise in body temperature, disturbance of consciousness, and so forth in children, which can be life-threatening. Objective. *is work aimed at exploring the effect of diffusion weighted MRI on children with severe viral encephalitis and myocarditis. Methods. *is work presents a diffusion weighted MRI scanning method that involves scanning through a serial imaging device, axial scanning, and sagittal and coronal scanning. 60 children with severe viral encephalitis and myocarditis who admitted to Brain Hospital of Hunan Province from April 2017 to May 2020 were deemed as research subjects. All the children underwent CT and MRI examination, blood routine examination, and cerebrospinal fluid examination after admission. *is work uses the random number table method to classify the subjects into control group and observation group, each consisting of 30 cases. Children in the control group were provided with the routine nursing intervention, whereas children in the observation group were subjected to incentive nursing intervention. *e baseline data, ECG monitoring indicators, body abnormalities, and clinical symptom relief time of the two groups of children were compared and the results of diffusion weighted MRI scans were analyzed and the ADC values were counted. Results. *e two groups of children were compared on the basis of baseline data, and the variation was not statistically substantial (P> 0.05). *e cases of children in the control group had higher heart rate and respiration, and physical dysfunction, language dysfunction, unconsciousness, and nervous dysfunction were more than those in the observation group. However, the cases of blood oxygen saturation were less than those of the observation group. After nursing intervention done for the control group, remission time of clinical symptoms such as convulsion, physical dysfunction, unconsciousness, and nerve dysfunction was longer relative to the observation group (all P< 0.05 are considered). Conclusion. *e diffusion weighted MRI had diagnostic significance for severe viral encephalitis and myocarditis. For children with severe viral encephalitis and myocarditis, clinical incentive nursing intervention was particularly imperative. It can not only help children to relieve symptoms and control the deterioration of the disease in a short time but also help improve the quality of life of the children and the confidence of family members to cope with the disease. 2 Journal of Healthcare Engineering 1.Introduction Considering the research subjects with severe viral encephalitis and Viral encephalitis refers to brain inflammation caused by a myocarditis virus directly invading the brain parenchyma. *e main cause of this disease is enterovirus infection, which mainly includes polio virus, Coxsackie virus A and B, and Echo virus. *e disease has the characteristics of seasonality, epidemic, and so forth. It mostly occurs in winter and MRI diffusion weighted imaging spring and is often self-limiting [1]. Children’s viral en- cephalitis mainly refers to the viral infection invading the pia mater and causing damage to the central nervous system. Children manifested with obvious mental abnor- malities, sudden rise in body temperature, disturbance of Control group Observation group consciousness, and so forth, which can be severely life- threatening. In the clinic, children with viral encephalitis are mostly classified into two types: mild type and critical type. Critically ill children are often complicated with myocarditis, which is clinically manifested as damage to brain and heart function at the same time [2]. Myocarditis refers to a disease in which localized or diffuse inflam- Comparison and analysis of control and matory lesions of the myocardium are the main manifes- observation groups tations, and the pathogenesis is not yet completely diagnosed. According to the investigation of rat samples, Figure 1: Block diagram for effective analysis of incentive nursing viral myocarditis can be divided into 3 stages. *e virus innovation. invades myocardial cells to multiply through specific re- ceptors, leading to myocardial necrosis. *e continuous Salazar et al. [16] presented a case study in which anti-N- response can cause myocardial remodeling and eventually cause progressive heart failure. Most children are with methyl-D-aspartate receptor encephalitis is seen, which is related to the involuntary movement as well as hypersali- severe arrhythmia, heart failure, and other clinical mani- festations [3]. If the clinical treatment is not timely or the vation symptoms. *ese situations can only be controlled by narcotics and other high-dosage sedation which is not at all care is improper, it can lead to aggravated damage to the brain tissue or heart function of the child and have a serious good for patients’ health. *e authors suggested that the impact on the growth and development of the child and the change in hypothalamic neurotransmitter levels can stim- ulate the parasympathetic neurons of nervous system. quality of life [4]. A basic block diagram of the entire research process for effective analysis of incentive nursing Taguchi et al. [17] presented an instance of viral encephalitis who already had a medical history of ovarian teratoma, innovation based on diffusion weighted MRI is depicted in Figure 1. which can be reduced using anesthetic drugs. It was found that patients having fever symptoms is very consistent in the In the developing countries, the literature survey sug- gests that approximately 50% to 60% patients are identified literature [18–20] and the incidents of teratomas were also found to be common in the previous reports [21]. Com- with the viral encephalitis and possess long-term prognosis [5–7]. *is situation leads to a tremendous stress and fi- parative to the patients suffering from tumors, the consis- tency was found in the reoccurrence rates of the patients nancial burden on the families of patients and also on the society [8–12]. *us, this scenario leads to the research for [22, 23]. *e authors in [24] reported that the patients with identification of prognosis factors in the patients suffering MRI abnormalities have disorders like epilepsy, involuntary movement of the limbs, and other mental disorders, which from viral encephalitis. *e research is oriented towards the early decision-making and timely treatment for improving can indicate the MRI related clinical severities. *erefore, they presented a specific mechanism for viral encephalitis as the capabilities of the framework in favor of patients while improving the living standard. *is type of improvement in a further research challenge. *e review of literature for viral encephalitis reveals that the research domain leads to the improved clinical diagnosis as well as social consequences. *e epidemiological data the early diagnosis is of great significance for the clinical treatment and prognosis of children with viral meningitis should be considered for diagnosis along with the clinical indicators, previous medical history of the patients, and a and myocarditis. MRI is currently widely adopted in clinics due to its high tissue resolution. However, its sequence is comprehensive analysis of auxiliary examinations per- simple, including only T1W1, T2W1, T2FLAIR, and en- formed. *e detection of brain tissues acts as a gold standard for the diagnosis of viral antigens or for determining the hanced scanning [25]. *e new technology diffusion weighted MRI imaging is based on the movement of water antibodies in cerebrospinal fluid. However, it should be noted that the diagnostic frequency of viral encephalitis is molecules, which provides information based on the physiological state of the brain. *e sensitivity of clinical low around the world and still there are several cases that remain unknown [13–15]. diagnosis of acute cerebral infarction is as high as 94%, and Journal of Healthcare Engineering 3 the specificity is 100%. Moreover, it is also employed to 2.1. Research Route. For the effective analysis of incentive distinguish between arachnoid cyst and epidermoid cyst, nursing innovation based on diffusion weighted MRI, the subdural empyema and effusion, abscess, and tumor ne- research route for this work is described in Figure 2. crosis. It can provide valuable information in the diagnosis *is research route is designed to analyze the effect of and differential diagnosis of other intracranial lesions such incentive nursing innovation based on diffusion weighted as tumors, infections, trauma, and demyelination [26]. MRI in the children suffering from viral encephalitis and *e objective of this work is to explore the diffusion myocarditis. *e method is initially applied on sixty children effect in weighted MRI for children having symptoms of with the symptoms of viral encephalitis and myocarditis, and viral encephalitis and myocarditis. *e major contributions MRI diffusion is performed. Based on the result analysis of of this article are heighted as follows: diffusion process, the control group and the observation group are formed. *e control group is provided with the (i) *e diffusion weighted MRI scanning method is routine nursing intervention and the observation group is employed using a single-shot SE-EPI serial imaging subjected to the incentive nursing intervention. *e results device for scanning. A 9-channel head coil is adopted of both groups are compared and the effect of MRI inter- with layer thickness of 6 mm, spacing of 2 mm, and vention is analyzed and summarized. NEX � 3. *e enhanced scan Meglumine acid was used for contrast agent gadolinium injection fol- lowed by axial, sagittal, and coronal scanning. 2.2. Research Subjects. A total of 60 children with severe viral (ii) *e experimentation was conducted on 60 children encephalitis and myocarditis were selected from Brain with severe viral encephalitis and myocarditis Hospital of Hunan Province from April 2017 to May 2020. symptoms between April 2017 and May 2020 who All the children underwent CT and MRI examination, blood admitted to Brain Hospital of Hunan Province. *e routine examination, and cerebrospinal fluid examination children underwent CT and MRI examination, after admission. *is work uses the random number table blood routine examination, and cerebrospinal fluid method to classify the subjects into control group and ob- examination, on the basis of which they were servation group, each consisting of 30 cases. *e control classified into control and observation groups, each group comprises 21 male children and 9 female children. *e with 30 cases. *e children in the control group age ranged from 4 months to 8 years, with an average of were provided with the routine nursing interven- 3.09± 1.42 years of age. However, the observation group tion, while children in the observation group were comprises 20 male children and 10 female children. *e age subjected to incentive nursing intervention. was 3 months to 9 years, with an average of 3.16± 1.39 years (iii) *e baseline data, ECG monitoring indicators, body of age. *e general data is not statistically significant based on the gender and age of both groups and, therefore, they are abnormalities, and clinical symptom relief time of the two groups of children were compared, and the comparable. *e medical ethics committee of Brain Hospital of Hunan Province studied and approved this investigation. appropriate nursing methods were selected according to the inspection results. *e results of *e relevant diagnostic criteria of severe viral encephalitis in “Diagnosis and Treatment of Children’s Viral Encephalitis” diffusion weighted MRI scans were analyzed and the and the related content of myocarditis in “Diagnostic Cri- ADC values were also computed, on the basis of teria of Viral Myocarditis” were discussed. *e inclusion which the diagnostic significance of diffusion criteria are as follows: the patients who met the above- weighted MRI for severe viral encephalitis and mentioned conditions and have not received any other myocarditis is observed. treatment in the recent years; and family members of the (iv) *is significant contribution can control the dete- children knew and signed the informed consents. *e ex- rioration of the disease in a short time, thereby clusion criteria are as follows: the patients who suffer from improving the living standard of the children and any sort of immune system diseases, those with other the confidence of family members to cope with the nonviral infections in the cranium, those who were allergic disease. to the relevant treatments used in this investigation, and *e rest of this article is organized as follows: research those with poor compliance to this investigation. methods including the description of the subjects, research routes, and MRI analysis methods are discussed in Section 2. Section 3 presents the research results trailed by the ex- 2.3. Diffusion Weighted MRI Scanning Method and Image perimental discussion in Section 4. Section 5 presents the Analysis. *e scanning was conducted by a single-shot SE- concluding remarks along with future research directions. EPI sequence imaging device, and a 9-channel head coil was employed, which mainly included inversion recovery se- quence, fast spin echo, and water suppression sequence, with 2.Research Methods layer thickness of 6 mm, spacing of 2 mm, and NEX � 3. During the enhanced scan, the child needed to be injected *is section provides a research route, research subjects with the contrast agent gadopentetate meglumine injection along with diffusion weighted MRI scanning method and at a dose of 0.1 mmol/kg. After injection, scan was performed image analysis, nursing methods, observation indicators, in axial, sagittal, and coronal positions. If the child cannot and the information of statistical software. 4 Journal of Healthcare Engineering Effect analysis of incentive nursing intervention based on diffusion weighted MRI in children with severe viral encephalitis and myocarditis Methods: sixty children with severe viral encephalitis and myocarditis were selected MR diffusion weighted imaging was performed in the children, and the results of DWI were analyzed The control group was given The observation group was routine nursing intervention given incentive nursing mode intervention The results of different nursing intervention modes were compared between the two groups Discussion: the diagnosis of severe viral encephalitis and the effect of MRI intervention were analyzed The results of this study are summarized Figure 2: Research route. should communicate with children and their families more, cooperate, he/she needed to drink 5% water and 1 mL/kg of chloric acid half an hour before the scan. be familiar with the children’s hobbies, establish a friendly When the scan results were analyzed, two experienced care relationship with the children, and use touch, whisper, diagnostic physicians evaluated them separately. If the and other methods to comfort the children. In addition, it evaluation results of the two were inconsistent, a third, was necessary to comfort and encourage the children’s more senior imaging physician would conduct the diag- family members and promptly inform them with the nostic evaluation. *e specific content included the loca- treatment results. Parents should understand the necessity of tion, number, size, and scope of the lesion. ADC treatment, maintain an optimistic attitude, actively respond, measurement was implemented via the ADC statistical and cooperate with the doctor to help the children recover as software, the lesion and the normal brain tissue on the soon as possible. Rehabilitation care was performed to help opposite side were measured, and finally the average result children perform more physical activities, including upper was calculated. and lower limb exercises, wrists, elbows, fingers, hips, knees, and ankle joints, 3 times a day. 2.4. Nursing Methods. According to the results of diffusion weighted MRI scans, children in the control group are 2.5. Indicators for the Observation. provided with the routine nursing intervention. It mainly (i) *e baseline data of the control and the observation included the monitoring of the vital signs, consciousness groups of the children were compared. state, and physical activity of the child. *e child’s family (ii) Diffusion weighted MRI scan results of severe viral members were informed of the disease-related knowledge encephalitis and myocarditis were analyzed, and the and the current treatment of the child. Incentive nursing ADC value was calculated. intervention was given to children in the observation group. *e content of routine nursing was the same as that of the (iii) *e ECG monitoring indicators of the two groups of control group, and psychological nursing and rehabilitation children were compared, including heart rate, res- nursing were also implemented. In daily nursing, nurses piration, and blood oxygen saturation. Journal of Healthcare Engineering 5 (iv) *e number of cases of physical abnormalities in the 25 two groups of children were compared, including physical impairment, language impairment, and intellectual impairment. (v) *e clinical symptoms relief times of the two groups of children after the incentive nursing intervention were compared, including convulsions, physical dysfunction, unconsciousness, and nerve dysfunction. 2.6. Statistical Software. *e data analysis in this work is done employing the SPSS 22.0 statistical software. *e Male children Female children Age percentage count of the data is considered and the chi- Baseline data square test is done for the comparison between these groups. *e statistical significance of the data is inferred using the P Control group value (P< 0.05). It tests the variance between the data groups Observation group which are to be measured at the ordinal or continuous level. Figure 3: Comparative analysis of the baseline data. *is test does not need the data to be normally distributed and can be applied to a group of random samples from the entire population. *e chi-square test statistics rank the data using the chi-square distribution for computing the sig- nificant P values. *is test is useful in controlling the ex- perimental variability of data and can be applied to the group of random samples without checking the normality distri- bution of the dataset being used. *e P values of the test should be significantly less than 0.05 as the smaller P value of this test is suggestive of selection of the entire data for the analysis. *e comparative analysis is done to demonstrate the feasibility of the presented method utilizing the non- parametric data statistics. 3.Results *e experimental analysis of diffusion weighted MRI Figure 4: Severe viral encephalitis. scanning method and image analysis for discussing the effects of incentive nursing intervention in children with severe viral encephalitis and myocarditis during rehabili- tation are provided in this section. RV 3.1. Comparative Analysis of Baseline Data. *e control group contains the patients who are given the nursing in- RA LV tervention and the observation group contains the patients who are provided with the incentive nursing intervention. LA Both groups are compared on the basis of data. Figure 3 shows that the baseline data of both groups were compared, and the statistical implication of the difference was found to be not significant enough as P> 0.05. *is comparison reveals that the baseline data contain both male and female children of varying age groups. *e Figure 5: Myocarditis. numerical value of male children is higher than that of the female children, and they are evenly distributed into control and observation groups. lesions in the brain and heart areas showed obvious hyperintensity. 3.2. Diffusion Weighted MRI Scan Results. Diffusion *e results of diffusion weighted MRI scans were ana- lyzed in terms of ADC values to determine the diagnostic weighted MRI scans showed that the brain lesions of the children mostly involved the subcortex, thalamus, and significance of diffusion weighted MRI for severe viral en- cephalitis and myocarditis. *e ADC value of the severely midbrain. Figures 4 and 5 illustrate that the lesions were patches or large patches with slightly longer T1, while the infected portion was considerably lower as compared to the Numerical value 6 Journal of Healthcare Engineering healthier part as shown in Figure 6. *e statistical impli- 1.2 cation of the difference is significant enough as the signif- icant value comes out to be P< 0.05. 0.8 3.3. Comparison of ECG Monitoring Indicators between Two Groups of Children. After comparison, the heart rate and respiration of children in the control group were signifi- cantly higher than those of the observation group (Figure 7), while the blood oxygen saturation was lower for this group. 0.4 *e difference was substantial in terms of this statistical significance (P< 0.05). 0.0 3.4. Comparison of the Number of Abnormalities in the Two Affected side Contralateral Groups of Children. After comparison, the number of cases in the control group having physical, language, and intel- ADCmin lectual dysfunctions was more than that in the observation Figure 6: ADC value. group (Figure 8), and the variation has statistical significance (P< 0.05). 3.5. Comparison of Clinical Symptom Remission Time. After nursing intervention, in the control group, the re- mission time of clinical symptoms such as convulsion, physical dysfunction, unconsciousness, and nerve dys- function was longer compared to that in the observation group, and the variation was remarkable statistically pro- viding the significance value of P< 0.05, as illustrated in Figure 9. 4.Discussion 40 Severe viral encephalitis is a fatal intracranial infectious disease, in which the virus directly destroys the brain pa- renchyma and induces neuropathy. Imaging examination AB C reveals diffuse or focal changes in neuronal deformation and Observation index necrosis, as well as severe damage to functional areas. Normal cell metabolism in the brain is disordered, and a Control group large amount of necrosis occurs [27]. Some children may Observation group have cerebral edema myocarditis. *e cardiac function of Figure 7: ECG monitoring indicators. children with myocarditis is obviously seriously affected, causing the children to have obvious physical fatigue, pal- pitations, and other discomforts. Severe children may also of cerebral vasogenic edema gradually expands. At this time, have heart failure, shock, and so forth, and some children cytotoxic edema in the lesion still exists, and the two coexist. When scanned by diffusion weighted MRI, vasogenic edema may even die suddenly. *erefore, in clinical nursing work, the observation of the patient’s condition is the top priority produces transmission effect, while ADC value can remove this effect and reduce imaging error, so it has practical value. [28]. *e nursing work was carried out based on the results of At present, the domestic treatment of severe viral en- cephalitis and myocarditis has achieved remarkable results. diffusion weighted MRI. Diffusion weighted MRI imaging reflects tissue information by measuring the motion of water Most of the children can recover as long as they receive molecules in vivo. It can clearly distinguish cytotoxic edema timely clinical treatment, but there are still some children from vasogenic edema, so it has significant advantages and who have various adverse reactions, even disability and has been clinically applied in the diagnosis of intracerebral death, which increase the burden on the children and their diseases [29]. In this work, diffusion weighted MRI scan families. Studies suggested that effective nursing interven- revealed that brain lesions mainly involved subcortex, tion was of great significance for the recovery of children after treatment [30–32]. *erefore, according to the results thalamus, and midbrain, and the lesions were patches or large patches slightly longer than T1. *e lesions in brain and of imaging examination, two different nursing modes were implemented for the children to compare their effects. *e heart showed high signal intensity. With severe viral en- cephalitis as an example, as the disease progresses, the scope outcomes obtained for heart rate and respiration of the Numerical value Numerical value Journal of Healthcare Engineering 7 Hunan Province with the symptoms of viral encephalitis or myocarditis. *ese children underwent the CT and MRI examination and are divided into control and observation groups for analysis. *e various experimental analyses were performed on the baseline data using the ECG monitoring indicators and body abnormalities, and clinical symptom relief times of the two groups of children were compared. Using the nursing intervention, the remission times of clinical symptoms such as convulsion, physical dysfunction, 2 unconsciousness, and nerve dysfunction were observed to be statistically significant having P< 0.05. In summary, diffusion weighted MRI had great signif- icance for the diagnosis of severe viral encephalitis and myocarditis. For children with severe viral encephalitis and myocarditis, clinical incentive nursing intervention was AB C particularly imperative, which helped children relieve Observation index symptoms in a short period of time and control the dete- Control group rioration of their condition. Moreover, it also helped to Observation group improve the living standard of children and the confidence Figure 8: Number of cases of body abnormalities. of family members in coping with the disease, which was worthy of further clinical promotion and adoption. *is investigation uses the smaller sample size, which certainly 20 affects the research results; therefore, the future perspective of this work requires the expansion of sample size for the establishment of incentive nursing intervention-based al- gorithms in the current scenario. Data Availability All data are shared in the main manuscript. Conflicts of Interest *e authors declare that they have no conflicts of interest. AB C D References Observation index [1] M. Adenot, E. Frobert, G. Blanchard et al., “Clinical pre- Control group sentation of severe viral encephalitis with known causative Observation group agents in children,” Journal of Child Neurology, vol. 29, no. 11, Figure 9: Remission time of clinical symptoms. pp. 1508–1518, 2014. [2] Y. Inui, K. Yakushijin, A. Okamura, Y. Tanaka, and I. Shinzato, “Human herpesvirus 6 encephalitis in patients children in the control group are higher than those in the administered mycophenolate mofetil as prophylaxis for graft- observation group, while the saturation of oxygen is lower versus-host disease after allogeneic hematopoietic stem cell than that in the observation group. Additionally, the transplantation,” Transplant Infectious Disease, vol. 21, no. 1, physical, language, and mental dysfunctions in the children Article ID e13024, 2019. of the control group were higher than those in the obser- [3] K. K. Koeller and R. Y. Shih, “Viral and prion infections of the vation group. After clinical nursing intervention, the time of central nervous system: radiologic-pathologic correlation: remission for clinical symptoms, convulsion, physical dys- from the radiologic pathology archives,” Radiographics, function, unconsciousness, and nerve dysfunction, in the vol. 37, no. 1, pp. 199–233, 2017. control group was greater than that in the observation group. [4] Y. F. Chen, L. Hu, F. Xu, C. J. Liu, and J. Li, “A case report of a teenager with severe hand, foot, and mouth disease with brainstem encephalitis caused by enterovirus 71,” BMC Pe- 5.Conclusion diatrics, vol. 19, no. 1, pp. 1–4, 2019. *is work contributed to the analysis of diffusion effect in [5] F. Raschilas, M. Wolff, F. Delatour et al., “Outcome of and weighted MRI for children having symptoms of viral en- prognostic factors for herpes simplex encephalitis in adult cephalitis and myocarditis. *e experimentation was con- patients: results of a multicenter study,” Clinical Infectious ducted on 60 children who admitted to Brain Hospital of Diseases, vol. 35, no. 3, pp. 254–260, 2002. Number of cases Remission time 8 Journal of Healthcare Engineering [6] G. Dhiman, D. Oliva, A. Kaur et al., “BEPO: a novel binary [23] J. Dalmau, A. J. Gleichman, E. G. Hughes et al., “Anti-NMDA- receptor encephalitis: case series and analysis of the effects of emperor penguin optimizer for automatic feature selection,” Knowledge-Based Systems, vol. 211, Article ID 106560, 2021. antibodies,” =e Lancet Neurology, vol. 7, no. 12, pp. 1091–1098, 2008. [7] T. E. Erlanger, S. Weiss, J. Keiser, J. Utzinger, and K. Wiedenmayer, “Past, present, and future of Japanese en- [24] F. Graus, M. J. Titulaer, R. Balu et al., “A clinical approach to diagnosis of autoimmune encephalitis,” =e Lancet Neurology, cephalitis,” Emerging Infectious Diseases, vol. 15, no. 1, pp. 1–7, vol. 15, no. 4, pp. 391–404, 2016. [25] M. Ogata, T. Satou, Y. Miyazaki, E. Otsuka, N. ., ... Saito, and [8] T. Solomon, “Control of Japanese encephalitis - within our K. Shirao, “Correlations of cytokine levels in cerebrospinal grasp?,” New England Journal of Medicine, vol. 355, no. 9, fluid and peripheral blood with outcome of HHV-6B en- pp. 869–871, 2006. cephalitis after hematopoietic stem cell transplantation,” [9] G. Dhiman, K. K. Singh, M. Soni et al., “MOSOA: a new multi- Transplant Infectious Disease, vol. 21, no. 6, Article ID e13172, objective seagull optimization algorithm,” Expert Systems with Applications, vol. 167, Article ID 114150, 2021. [26] A. Imaz, N. Cayuela, J. Niubo´ et al., “Short communication: [10] A. Venkatesan, “Epidemiology and outcomes of acute en- focal encephalitis related to viral escape and resistance cephalitis,” Current Opinion in Neurology, vol. 28, no. 3, emergence in cerebrospinal fluid in a patient on lopinavir/ pp. 277–282, 2015. ritonavir monotherapy with plasma HIV-1 RNA suppres- [11] M. Poongodi, A. Sharma, V. Vijayakumar et al., “Prediction of sion,” AIDS Research and Human Retroviruses, vol. 30, no. 10, the price of Ethereum blockchain cryptocurrency in an in- pp. 984–987, 2014. dustrial finance system,” Computers & Electrical Engineering, [27] T. Baumer, C. Fry, S. Luppe, H. Gunawardena, and vol. 81, Article ID 106527, 2020. K. Sieradzan, “Human herpes virus-6 encephalitis causing [12] G. Rathee, A. Sharma, R. Kumar, F. Ahmad, and R. Iqbal, “A severe anterograde amnesia associated with rituximab, aza- trust management scheme to secure mobile information thioprine and prednisolone combination therapy for der- centric networks,” Computer Communications, vol. 151, matomyositis,” Journal of Neurovirology, vol. 23, no. 3, pp. 66–75, 2020. pp. 508–510, 2017. [13] J. Lohitharajah, N. Malavige, J. Wanigasinghe, R. Gamage, ´ ´ [28] B. Vidaña, N. Johnson, A. R. Fooks, P. J. Sanchez-Cordon, P. ., ... Gunaratne, and T. Chang, “Viral aetiologies of acute D. J. Hicks, and A. Nuñez, “West Nile Virus spread and encephalitis in a hospital-based South Asian population,” differential chemokine response in the central nervous system BMC Infectious Diseases, vol. 17, no. 1, pp. 1–7, 2017. of mice: role in pathogenic mechanisms of encephalitis,” [14] K. Srihari, G. Dhiman, K. Somasundaram, A. Sharma, Transboundary and Emerging Diseases, vol. 67, no. 2, S. ., ... Rajeskannan, and M. Masud, “Nature-inspired-based pp. 799–810, 2020. approach for automated cyberbullying classification on [29] P. Sovinz, W. Schwinger, H. Lackner et al., “Severe epstein- multimedia social networking,” Mathematical Problems in barr virus encephalitis with hemophagocytic syndrome,” Engineering, vol. 2021, Article ID 6644652, 12 pages, 2021. Pediatric Infectious Disease Journal, vol. 29, no. 6, pp. 553– [15] G. Feng, L. Zhou, F. Li, Y. Hu, X. Wang, and X. Tian, 556, 2010. “Predictors of outcome in clinically diagnosed viral en- [30] L. Sisinni, M. Gasior, R. de Paz et al., “Unexpected high cephalitis patients: a 5-year prospective study,” BioMed Re- incidence of human herpesvirus-6 encephalitis after naive search International, vol. 2020, Article ID 2832418, 9 pages, T cell-depleted graft of haploidentical stem cell transplanta- tion in pediatric patients,” Biology of Blood and Marrow [16] R. Salazar, E. James, M. Elsayed et al., “Profuse sialorrhea in a Transplantation, vol. 24, no. 11, pp. 2316–2323, 2018. case of anti N-methyl-D-aspartate receptor (NMDAR) en- [31] D. Singh, V. Kumar, V. Yadav, and M. Kaur, “Deep neural cephalitis,” Clinical Neurology and Neurosurgery, vol. 114, network-based screening model for COVID-19-infected pa- no. 7, pp. 1066–1069, 2012. tients using chest X-ray images,” International Journal of [17] Y. Taguchi, S. Takashima, T. Nukui, and K. Tanaka, “Hy- Pattern Recognition and Artificial Intelligence, vol. 35, no. 03, persalivation in a patient with anti-NMDAR encephalitis with Article ID 2151004, 2020. ovarian teratoma,” Internal Medicine, vol. 49, no. 8, [32] N. Gianchandani, A. Jaiswal, D. Singh, V. Kumar, and pp. 803-804, 2010. M. Kaur, “Rapid COVID-19 diagnosis using ensemble deep [18] K. Miya, Y. Takahashi, and H. Mori, “Anti-NMDAR auto- transfer learning models from chest radiographic images,” immune encephalitis,” Brain and Development, vol. 36, no. 8, Journal of Ambient Intelligence and Humanized Computing, pp. 645–652, 2014. vol. 16, pp. 1–13, 2020. [19] H. E. Peery, G. S. Day, S. Dunn et al., “Anti-NMDA receptor encephalitis. *e disorder, the diagnosis and the immu- nobiology,” Autoimmunity Reviews, vol. 11, no. 12, pp. 863–872, 2012. [20] I. Gabilondo, A. Saiz, L. Galan ´ et al., “Analysis of relapses in anti-NMDAR encephalitis,” Neurology, vol. 77, no. 10, pp. 996–999, 2011. [21] R. J. Wang, B. D. Chen, and D. Qi, “Anti-N-methyl-D-aspartate receptor encephalitis concomitant with multifocal subcortical white matter lesions on magnetic resonance imaging: a case report and review of the literature,” BMC Neurology, vol. 15, no. 1, pp. 1–4, 2015. [22] L. Yang, Q. Jiang, H. Guan, and H. Bo, “Nursing care in anti- N-methyl-d-aspartate receptor encephalitis: a case series,” Medicine, vol. 98, no. 46, 2019.

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Published: May 15, 2021

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