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Objective:To analyze the relationship between self-disclosure, self-efficacy and medical coping modes in adolescent depression, and explore the mediating effect of self-efficacy between self-disclosure and medical coping modes.Methods:Using the convenience sampling method, a total of 403 adolescents with depression in a tertiary psychiatric hospital in Beijing were recruited from March 2020 to March 2021. The data of general information questionnaire, distress disclosure index scale, medical coping modes questionnaire and general self-efficacy scale were collected.SPSS 26.0 software was used to analyze the correlation between self-disclosure, self-efficacy and medical coping modes of adolescent patients with depression, and Stata 13.1 software was used to analyze the mediating effect of self-efficacy between self-disclosure and medical coping modes.Results:The scores of dimension of the medical coping modes of adolescent depression patients were(16.90±3.84) for facing, (16.34±2.88) for yielding, (12.48±4.31) for avoiding, (30.47±9.91) for self-disclosure and (19.63±6.54) for self-efficacy, respectively. Self-disclosure and self-efficacy were positively correlated with facing of medical coping modes ( r=0.301, 0.327, both P<0.01), and negatively correlated with yielding of medical coping modes ( r=-0.465, -0.487, both P<0.01). Self-disclosure was negatively correlated with avoidance of medical coping modes ( r=-0.118, P=0.018). The direct effect of self-efficacy on medical coping modes was 0.103, and the total effect was 0.365, and the mediating effect accounted for 28.22%. Conclusion:Self-efficacy partially mediates between self-disclosure and medical coping modes in adolescents with depression.
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Objective:To explore the influence of mindfulness on perceived stress in psychiatric nurses and the mediating effect of resilience.Methods:A total of 427 psychiatric nurses from a psychiatric hospital in Beijing were selected.Five-facet mindfulness questionnaire(FFMQ), Chinese-version perceived stress scale (CPSS) and Connor-Davidson resilience scale (CD-RISC) were used in this survey.Pearson correlation analysis and multiple stepwise regression analysis were performed using SPSS 24.0.And mediating effect was performed using AMOS 24.0.Results:The total score of psychiatric nurses' perceived stress was (37.89±7.16). Among all psychiatric nurses, 66.74% were under high pressure and 20.84% were under great pressure.The perceived stress was negatively correlated with mindfulness(123.69±10.82, r=-0.65, P<0.01) and resilience(85.40±17.87, r=-0.67, P<0.01), and mindfulness was positively correlated with resilience ( r=0.50, P<0.01). The direct effect of mindfulness on perceived stress was -0.15, the indirect effect was -0.34, and the total effect was -0.49. Conclusion:Resilience plays a partial mediating role between mindfulness and perceived stress psychiatric nurses.
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To understand the survival stress of community-dwelling people with mental disorder. Fifteen cases were selected by purposive sampling and received semi-structured individualized interviews.The data were analyzed by Colaizzi framework and themes were extracted. Four themes were extracted:physiological stress due to psychiatric symptoms and side effects of drugs;psychological stress due to the outcome of mental illness and to conflict of roles in daily life;social and environmental stress such as social discrimination,lack of job opportunities,and difficulty in obtaining social welfare resources;and interpersonal stress caused by discrimination and deteriorating family relations. Community-dwelling people with mental illness have a higher level survival stress after returning to their families and society,with the stressors including symptoms of illness,social discrimination,and interpersonal relationship.Eliminating self-discrimination of the patients,improving social support and social welfare system,and increasing individualized community mental rehabilitation activities may reduce the survival stress of these patients and promote their rehabilitation.
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Humans , Independent Living , Mental Disorders , Qualitative Research , Social SupportABSTRACT
Objective:To prepare a drug release system of drug-loaded cross-linked decellularized corneal stromal lenticules and evaluate its drug release characteristics in vitro. Methods:Lenticules were obtained during femtosecond laser-assisted small incision lenticule extraction (SMILE) surgery in Chongqing Aier Ophthalmology Hospital.Decellularized corneal stromal lenticules were prepared using high concentration sodium chloride (NaCl) combining nuclease.The decellularized corneal stromal lenticules were randomly divided into normal group, 0.5% levofloxacin group, 3% levofloxacin group and 5% levofloxacin group, with 4 lenticules in each group.The lenticules did not receive any treatment in the normal group, and drug-loading those were soaked in different doses of levofloxacin solution for three hours according to grouping.In the crosslinking test, 12 decellularized corneal stromal lenticules were randomly divided into non-crosslinking group, 0.01 mmol 1-(3-dimethylamino) propylimine (EDC) group, 0.05 mmol EDC group and 0.25 mmol EDC group.The lenticules for cross-linking were soaked in different contents of mixed solution of EDC with N-hydroxysuccinyl (NHS) for four hours respectively according to grouping, and then in 3% levofloxacin solution for three hours.Only 3% levofloxacin solution soaking was carried in the non-crosslinking group.High performance liquid chromatography (HPLC) was employed to detect the drug release concentration of the lenticules, and spectral scanning method was performed to measure light transittance of the lenticules.The surface ultrastructure of the decellularized lenticules among different cross-linking groups was examined and compared with scanning electron microscope.The use of the human corneal lenticules was approved by an Ethics Committee of Chongqing Aier Ophthalmology Hospital (No.2019012). Written informed consent was obtained from each patient before surgery.Results:The release concentrations of decellularized corneal stroma lenticules were significantly different at 1 day, 7, 14, and 21 days among 0.5%, 3%, and 5% levofloxacin group ( P<0.05) or also among the 0.01 mmol EDC, 0.05 mmol EDC, and 0.25 mmol EDC cross-linked groups ( P<0.01). The drug release concentrations in 0.05 mmol EDC group were the highest at various time points, and the release time of the three cross-linked groups lasted until 21 days after release concentrations of decellularized corneal stroma lenticules.The drug release concentrations in cross-linked groups and non-crosslinking group were gradually declined with the prolong of drug-loading time, showing a significant difference at different time points ( P<0.05). The transmittance of the lenticules was (88.68±1.19)% and (91.55±1.16)% in the non-crosslinking group and normal group, respectively, with no significant difference ( P>0.05). The average transmittance of the lenticules was significantly reduced in the drug-loaded groups compared with the normal group ( P<0.05). The smaller collagen fiber voids and closely arranged collagen fibers were displayed in the cross-linking groups under the scanning electron microscope with the best effect in the 0.25 mmol EDC group. Conclusions:EDC/NHS cross-linking can improve the drug-loading effect of decellularized corneal stromal lenticules probably by lessening collagen fiber voids.The drug-loaded cross-linked decellularized corneal stromal lenticules have a good drug release effect in vitro.
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Objective To investigate the value of rosuvastatin in alleviating early inflammatory reaction and in preventing early recurrence of persistent atrial fibrillation (AF) after catheter ablation treatment. Methods A total of 84 patients with persistent AF who had received catheter ablation were enrolled in this study. The patients were randomly and equally divided into group A (n = 42, study group) and group B (n = 42, control group). Rosuvastatin therapy (10 mg/d, 42 patients) was employed in the patients of group A, while no medication was used in the patients of group B. One month after the ablation treatment, the serum lipid level, hs-CRP and IL-6, as well as the recurrence rate of all kinds of arrhythmia were determined. The preoperative and postoperative levels of inflammatory markers were also determined, the results were compared between the two groups, and its correlation with the early recurrence of AF was evaluated. Results One month after the ablation treatment, the levels of inflammatory markers, including hs-CRP and IL-6, in the study group were significantly lower than those in the control group, as well as lower than those determined before treatment, while in the control group the serum hs-CRP and IL-6 levels became significantly higher than the preoperative ones. Sinus rhythm was successfully maintained in 29 cases (69%) of the study group and in 25 cases (59.5%) of the control group, while the difference was not statistically significant (P = 0.362). The patients of the study group were further divided into non-recurrence sub-group (n = 29) and recurrence sub-group (n = 13). The reduction in inflammatory marker level in the non-recurrence sub-group was greater than that in the recurrence sub-group although the difference was not statistically significant. Conclusion There is remarkable inflammatory reactions during the early period after catheter ablation. Rosuvastatin can effectively relieve the degree of inflammatory reaction, although it has only a slight effect in reducing the early recurrence rate after catheter ablation of AF. The greater the inflammatory markers levels are reduced, the lower the recurrence rate of AF will be, although the difference is not statistically significant.
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Objective To evaluate the safety and effectiveness of circumferential pulmonary vein(PV) isolation in cases with persistent/permanent atrial fibrillation(AF) guided by the EnSite-NavX system.Methods Sixty cases(43 males,mean age 59.2?13.6 years) with persistent/permanent AF were enrolled from September 2004 to August 2005.The mean duration of AF was 4?6 years(6 months-24 years).The mean left atrium diameter was 43.2?6.4(42-58)mm.Circumferential PV isolation was performed guided by the EnSite-NavX system,combined with linear ablation of the superior-posterior wall of left atrium and mitral isthmus.Results All 60 cases underwent the procedure successfully,with the mean procedural time 170?34(150-240)min and the mean fluoroscopic time 23?10(12-45)min.The pulmonary vein isolation rate for the left ipsilateral PVs was 83.3% and was 78.3% for the right PVs.Segmental ostial ablation was applied for the rest cases.AF was terminated in 7 cases and was converted to atrial tachycardia(AT) or atrial flutter(AFL) in 5 cases.Sinus rhythm was restored by cardioversion in 48 cases.Post-ablation AT/AFL was documented in 10 cases (16.7%) which diminished automatically in 8 cases,and was abolished by re-ablation in 2 cases.After a mean of 6.5?3.2(4-11)months of follow-up,43 cases (71.7%) were free of AF(18 cases with anti-arrhythmic drugs).Complications: pseudo-aneurysm of femoral artery was found in 1 case and was cured after proper treatment.Conclusion Circumferential PV isolation and combination with left atrial linear ablation guided by the EnSite-NavX system was safe and effective for eliminating persistent/permanent AF.