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Objective:To investigate the curative effect of endoscopic cyclophotocoagulation combined with trabeculectomy for primary open angle glaucoma.Methods:From January 2020 to May 2021, 30 eyes of 30 patients with advanced primary open angle glaucoma with cataract who underwent endoscopic cyclophotocoagulation combined with trabeculectomy in the Municipal Hospital Affiliated to Xuzhou Medical University were retrospectively analyzed. The preoperative best corrected visual acuity, preoperative intraocular pressure (IOP) and numbers of anti-glaucoma medication were recorded. IOP, numbers of anti-glaucoma medication at 1 day, 3 months, 6 months and 1 year after operation, postoperative complications, the numbers of absolute success and qualified success were recorded.Results:All cases were followed up for 1 year. The best corrected visual acuity improved by more than one line in 26 eyes at 1 year after operation. Preoperative visual acuity was maintained in 3 eyes visual acuity decreased in 1 eye. The IOP and numbers of anti-glaucoma medication at 1 day, 3 months, 6 months and 1 year after operation were significantly different from those before operation ( P<0.01). At 1 year after operation, 8 patients were qualified successful and 17 patients were absolutely successful. Early hyphema in 30 eyes, transient ocular hypertension in 3 eyes ciliary body detachment in 0 eyes, corneal edema in 9 eyes, and anterior chamber exudation in 8 eyes. Conclusions:In this small sample size of study with follow-up for 12 months, the results showed that endoscopic cyclophotocoagulation combined with trabeculectomy in the treatment of advanced open angle glaucoma has good preliminary efficacy and safety. However, a large sample of cases is still needed to further study its long-term safety and efficacy.
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The clinical and imaging data of 99 patients with Graves′ disease, 78 patients with thyroiditis and 28 patients with other diseases (resolving thyroiditis, non thyroid disease and simple goiter) who underwent thyroid scintigraphy in Beijing Shijingshan Hospital from January 2016 to March 2022 were retrospectively reviewed. The UR value of thyroid scintigraphy was calculated and ROC curve was used to assess the UR value in diagnosis of Graves′ disease. The UR value of patients with Graves′ hyperthyroidism was significantly higher than that of patients with thyroiditis and other diseases ( H=163.62, P<0.05). UR>4.84 was taken as optimal cutoff value to diagnose Graves′ hyperthyroidism, with the sensitivity and specificity of 95.0% and 98.1%, respectively.
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BackgroundInsomnia disorder has become a common disease in the current society. Cognitive Behavior Therapy for Insomnia （CBTI） is one of the non-drug treatment methods for insomnia disorder， but relevant studies of its effect on sleep quality and cognitive function of patients with insomnia disorder are limited. ObjectiveTo explore the effects of CBTI on sleep quality and cognitive function in patients with insomnia disorder， so as to provide references for non-drug treatment of insomnia disorder. MethodsA total of 47 patients with insomnia disorder were recruited as the study subjects. They all met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） and have visited Sichuan Mental Health Center from January 2021 to October 2022. The patients underwent CBTI for 6 weeks. Before the treatment， depression and anxiety symptoms were assessed using Hamilton Depression Scale-24 item （HAMD-24） and Hamilton Anxiety Scale （HAMA）. Sleep status and cognitive function were assessed using Pittsburgh Sleep Quality Index （PSQI） and Montreal Cognitive Assessment （MoCA） before and 6 weeks after the treatment. Spearman correlation analysis was used to examine the correlation between the reduction of PSQI score and the increase of MoCA score after treatment. ResultsAfter the 6-week treatment， the factor scores and total score of PSQI across 6 subscales （the sleep quality， sleep onset time， sleep time， sleep efficiency， sleep disorder and daytime dysfunction） were lower than those before the treatment， and the score differences were of statistical significance （t=5.569~15.290， P<0.01）. Both factor and total scores of MoCA across 6 items （visuospatial and executive， naming， attention， language， abstraction and memory） were significantly higher than those before the treatment with score differences reaching statistical significance （t=-11.273~-4.277， P<0.01）. Spearman correlation analysis demonstrated that there was a positive correlation between the decrease in PSQI total score and the increase in MoCA total score after the 6-week CBTI treatment （r=0.323， P=0.027）. ConclusionCBTI may help improve sleep quality and cognitive function in patients with insomnia disorders. The improvement of sleep quality after CBTI intervention may be related to the improvement of cognitive function. ［Funded by Scientific Research Project of Sichuan Provincial Health Commission （number， 19PJ216）］
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Objective:To investigate the value of central vein sign (CVS) and iron deposition on quantitative susceptibility imaging (QSM) of 3.0 T MRI in differentiating multiple sclerosis (MS) from neuromyelitis optica spectrum disease (NMOSD).Methods:This study was a retrospective study. A total of 54 MS patients and 49 NMOSD patients were enrolled from July 2018 to December 2020 in People′s Hospital of Leshan and the First Affiliated Hospital of Chongqing Medical University. All patients underwent conventional MRI and three-dimensional enhanced T 2*-weighted angiography (3D-ESWAN), and ESWAN-filtered phase and QSM were reconstructed from 3D-ESWAN data. First, brain lesions of MS and NMOSD were screened on proton density (PD)-T 2WI, and then the location of lesions, CVS and nodular/annular iron deposition were observed on phase and QSM images. The χ 2 test was used to compare the differences in intracranial lesion location, CVS and iron deposition between MS and NMOSD patients. Receiver operating characteristic curve and area under the curve (AUC) were used to assess the efficiency of CVS and QSM iron deposition to differentiate MS from NMOSD. Results:A total of 968 MS lesions were observed in 54 MS patients, of which CVSs were found in 354 lesions and 227 CVSs were located around the lateral ventricles, 117 in deep white matter (DWM) and 10 in the cortex/subcortex; 372 lesions showed nodular iron deposition, and 193 lesions ring iron deposition on QSM. Totally 247 brain lesions were observed in 41 of 48 patients with NMOSD, of which CVSs were found in 4 lesions and 1 located around the lateral ventricle, 3 located in the DWM; 3 lesions showed nodular iron deposition on QSM. There were significant differences in cortex/subcortex lesions, CVS and iron deposition between MS and NMOSD patients (χ 2 were 29.33, 115.66 and 258.21, respectively, all P<0.001). The AUC of CVS for differentiating MS from NMOSD was 0.941 (95%CI 0.887-0.994), with a sensitivity of 96.3% and a specificity of 91.8%; the AUC of iron deposition for differentiating MS from NMOSD was 0.969 (95%CI 0.930-1.000), with a sensitivity of 100% and a specificity of 93.9%. Conclusion:CVS and iron deposition on 3.0 T MRI are distinct radiologic features of MS lesions from those of NMOSD lesions, and have certain value in the differential diagnosis.
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Objective@#To construct and determine the weight of Index System for Assessing Parent s Ability on Child Injury Prevention, and to provide the basis for childhood injury intervention in family.@*Methods@#Twenty four experts majored in related fields were invited to participate in Delphi consultation. The final index system was constructed according to the consulting results and the weight of primary and secondary indicators were calculated.@*Results@#The final index system consisted of 5 subscales corresponding to 5 age groups: 0,1-2,3-5,6-11 and 12-17 years old. Each scale included 4 primary indicators and 11 secondary indicators. The weight of primary indicators obtained by analytic hierarchy process is 0.28 for "environment", 0.16 for "product", 0.31 for "behaviors and skills", and 0.25 for "psychology". The highest weight of secondary indicators for "environment", "product" and "behaviors and skills" was "water area", while the top secondary indicators for "psychology" included "parental style""emotional control" "family atmosphere", with all indicators weighted higher than 0.2.@*Conclusion@#The Index System for Assessing Parent s Ability on Child Injury Prevention by Delphi consultation is comprehensive in content, and with the focus on parental behaviors and skills on injury prevention.
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Objective:To explore the method of establishing a modified demyelination and myelination regeneration model induced by dicyclohexanone oxalyl dihydrazone (CPZ) in mice with multiple sclerosis (MS), and to analyze the image markers of demyelination and myelination regeneration in mouse MS model.Methods:After the intragastrically administered with sodium carboxymethyl cellulose (CMCNa) for one week, a total of 30 C57BL/6 male mice were randomly divided into the control group ( n=10), the demyelination group ( n=10), and the remyelination group ( n=10). The mice of the control group were immediately performed MR scanning and pathological specimen obtaining; the mice in the demyelination group were administered with intragastrical CPZ-CMCNa once a day for 6 weeks for inducing demyelination, then received MR scanning and specimen obtaining with the same protocols used in control group; the mice in the remyelination group were administered with intragastrical CPZ-CMCNa once a day for six weeks for demyelination, then CPZ was withdrawn and normal diet was given for another four weeks. Then MR scanning and specimen obtaining were performed with the same protocols used in the other two groups. Regions of interest (ROIs) were set at the rostrum of corpus callosum (rCC), the bilateral normal appearing white matters (NAWM) of the rostrum of corpus callosum, and the bilateral cerebral cortex (Cx). The normalized T 2WI (T 2-normalized), fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) values were compared among the three groups by one-way ANOVA. Results:The demyelination and remyelination mice model of MS were successfully established. The T 2-normalized values of rCC in control group, demyelination group and remyelination group were 0.47±0.03, 0.72±0.04, 0.54±0.04, respectively, with statistically significant difference found ( F=90.511, P<0.05). Post-hoc multiple comparisons showed significant differences among those groups ( P<0.05). There was no significant difference of T 2-normalized value in NAWM and Cx among the three groups ( P>0.05). Moreover, there were significant differences in the FA values (0.36±0.04, 0.29±0.03, and 0.32±0.05), the MD values [(0.572±0.015), (0.598±0.034), and (0.626±0.043)×10 -3 mm 2/s], the AD values [(0.79±0.04), (0.77±0.06), and (0.83±0.04)×10 -3 mm 2/s], and the RD values [(0.46±0.02), (0.51±0.03), and (0.53±0.05)×10 -3 mm 2/s] of rCC of the control group, the demyelination group, and the remyelination group (all P<0.05). Significant difference was found in FA values between the demyelination group and the control group ( P<0.05), and in MD values between the remyelination group and the control group ( P<0.05), as well as in AD values between the remyelination group and the demyelination group ( P<0.05). There were also significant differences in RD values between the remyelination group and the control group, and the demyelination group and the control group (all P<0.05). However, no significant difference was found in all diffusion tensor imaging (DTI) metrics of NAWM and Cx among the three groups (all P>0.05). The LFB-eosin staining showed that the myelin sheath of rCC was lost in the demyelination group, and the rCC was partially regenerated and repaired in the remyelination group. Conclusion:The modified CPZ-CMCNa model can selectively induce demyelination and remyelination of rCC, and the changes of demyelination and remyelination of rCC in the modified CPZ-CMCNa model can be quantitatively detected by T 2WI combined with DTI, which might provide related theoretical basis for the study on dynamic changes of MS lesions.
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Objective@#To explore the dose-response relationship between duration of emotional experience of primary school students and the intensity of anxiety disorders, and to understand the risk of anxiety disorders corresponding to different emotional state levels.@*Methods@#A total of 7 152 primary students from grade 3 to 5 were investigated with questionnaire survey from 16 public primary schools, by using the Screen for Child Anxiety Related Emotional Disorder (SCARED) and Positive Affect and Negative Affect Scale.@*Results@#The prevalence of anxiety disorders was 19.91%, among which the prevalence rates of anxiety disorders in boys and girls were 19.41% and 20.43%, respectively. After adjusting for gender, grade, household register, the only child, parental marital status, parental occupation, parental educational level, family financial level, serving as a class leader, receiving special training or counseling in sports and art, and being bullied, the risk of anxiety disorder in children with positive emotions lasting for 7-16 days, 17-24 days and >24 days was lower compared to those with positive emotions lasting for less than 6 days(P<0.05); the risk of anxiety disorder in children with negative emotions lasting for 0.27-0.93 day, 0.94-2 days and >2 days was higher compared to those with negative emotions lasting less than 0.26 day(P<0.05). Restricted cubic spline analysis showed that the duration of emotional state and anxiety disorder showed a significant non-linear dose-response relationship (non-linear test, P<0.01), that is, as the number of days of positive emotions increases, the risk of anxiety disorder continues to decrease, and as the number of days of negative emotions increases, the risk of anxiety disorder continues to increase.@*Conclusion@#There is a significant dose-response relationship between the duration of the emotional state of primary school students and the prevalence of anxiety disorders. Acquirement and maintain positive emotions m be an important entry point for mental health promotion among primary school students.
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Objective To explore the effect of rational emotion therapy on negative emotional effects such as anxiety and depression in night nurses .Methods 36 night shift nurses were selected as the research subjects . According to the different means of intervention ,the nurses were divided into two groups ,18 cases in each group .The control group was not given psychological guidance , the observation group was given reasonable mood therapy .The negative emotions such as anxiety and depression were recorded in the nurses .Results After intervention,the anxiety self-rating scale,depression self-rating scale of the observation group were (48.05 ±2.54) points and (44.65 ± 2.03)points,respectively,which of the control group were (54.02 ±4.93)points and (48.77 ±4.26)points,respec-tively,the differences were statistically significant (t=4.567,3.704,all P<0.05).After intervention,the depersona-lization score,emotional exhaustion ,personal achievement ,total occupational burnout feeling of the observation group were (10.05 ±1.32)points,(14.43 ±2.13)points,(20.09 ±2.23)points and (44.65 ±3.76)points,respectively, which of the control group were (20.03 ±3.27)points,(34.65 ±5.19)points,(31.83 ±3.87)points,(75.54 ± 8.71)points,respectively,the differences between the two groups were statistically significant (t=12.007,15.291, 11.151,15.291,all P <0.05).The solve problems score,remorse score,help score,fantasy score,retreat score, rationalization score in the observation group were (0.92 ±0.14)points,(0.76 ±0.18)points,(0.88 ±0.19)points, (0.67 ±0.13)points,(0.54 ±0.19)points,(0.85 ±0.21)points,which were higher than those in the control group , the differences between the two groups were statistically significant ( t =9.300,11.392,7.499,15.944,9.104, 15.944,all P <0.05).Conclusion Adopting rational emotion therapy can effectively reduce the psychological resistance of night nurses , relieve psychological pressure , enhance the ability to cope with stress , and improve the well-being of nurses .
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Objective To investigate the effect of chain management on education among hypertensive patients of the community. Methods A total of 144 cases of hypertension patients in community were selected as the research objects, they were divided into the control group(72 cases, from February to July 2015) and the countryside group (72 cases, from September 2015 to February 2016).The control group was given routine education, and the countryside group received education with chain management. The treatment compliance and blood pressure values were compared between the two groups before and after intervention. Results The score of patients behavior of drug compliance, adverse drug, self life management and cigarettes-alcohol addiction management after intervention in the countryside group were (20.32±4.41), (34.62±5.08), (41.27±3.54), (10.02±1.79) points, while they were (13.41±3.07), (26.23 ± 5.12), (39.78 ± 2.47), (7.94 ± 1.83) points in the control group. And the scores of the countryside group were significantly higher than those of the control group (t=2.930-9.864, P 0.05). The systolic blood pressure, diastolic blood pressure and mean arterial pressure after intervention in the countryside group were (129.63 ± 8.07), (80.12 ± 7.62), (87.43 ± 9.35) mmHg(1 mmHg=0.133 kPa), while they were (135.42 ± 8.13), (87.56 ± 7.79), (99.31 ± 8.72) mmHg in the control group, and there were significant differences(t=4.295, 3.800, 9.201, P<0.01). Conclusions The chain management mode of community hypertension patients with education, can effectively improve the control of blood pressure in patients, improve the treatment compliance of patients.
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Objective To investigate the application effect of FMEA(failure mode and effect analysis) in prevention of aspiration after stroke.Methods From October 2011 to April 2012 48 stroke patients in our department without implementation of the FMEA management mode were set as the control group.From May 2012 to November 2012,another 48 cases were set as the observation group,in addition to the routine neurological nursing care,we also used FMEA to find forward-looking reason of the failure mode of aspiration and operation process analysis,evaluation,calculation and identify the risk factors of aspiration in patients with cerebral apoplexy and high-risk operation steps,prevention priority action plan and improvement measures.The incidence of aspiration,RPN value of six high risk factors,and satisfaction degree and mastering degree of aspiration related knowledge by patients and their families were compared.Results In the observation group,the crisis values of 6 high risk factors was significantly lower than those of the control group.Significant differences existed in satisfaction degree and mastering degree of aspiration related knowledge by patients and their families as well as hospitalization time.There was no aspiration cases during hospitalization in the observation group while 3 aspiration cases in the control group.Conclusions Application of FMEA to evaluate patients with swallowing disorder after stroke,analyzing and taking relevant measures can effectively prevent risks,reduce the occurrence of aspiration,improve the quality of nursing and promote patients' recovery.