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OBJECTIVES@#Gonadal hormone is essential for the health of postmenopausal women, however, few studies have focused on the epidemiological distribution of gonadal hormones in postmenopausal women in very late postmenopausal women. This study aims to investigate and analyze the differences of serum gonadal hormone content and its influential factors among female centenarians in Hainan, China.@*METHODS@#The questionnaire and physical examination data of 741 female centenarians and 401 elderly females in Hainan Province were collected, and venous blood samples were taken to detect the indexes of lipid metabolism, bone metabolism, and gonadal hormone. The differences of gonadal hormones and relavant factors in female centenarians were analyzed and compared.@*RESULTS@#The serum levels of estradiol and progesterone of female centenarians were significantly higher than those of the elderly females (both P<0.001). The serum levels of estradiol and testosterone of ethnic minority centenarians were higher than those in Han nationality (P<0.001), and the serum estradiol and testosterone concentrations were relatively higher when the daily activities were more than 10 min (both P<0.05). Serum estradiol concentration was negatively correlated with apolipoprotein A-I, high density lipoprotein, triglyceride and bone formation markers such as calcium, inorganic phosphorus and vitamin D3, and was positively correlated with the special sequence of β-collagen (markers of bone resorption) (all P<0.01).@*CONCLUSIONS@#For the extremely late postmenopausal women (such as centenarians), there may be characteristic expressions of gonadal hormones, especially estradiol. There is an unprotective correlation of serum estradiol with lipid metabolism index and bone metabolism index in female centenarians, so it is necessary to evaluate the estrogen content and the use of estrogen therapy in postmenopausal women.
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Aged , Aged, 80 and over , Female , Humans , Centenarians , China , Cross-Sectional Studies , Estradiol , Estrogens , Ethnicity , Minority Groups , TestosteroneABSTRACT
Objective To investigate the characteristics of serum lipid levels in centenarians in Hainan province.Methods A total of 899 centenarians were enrolled.Fasting venous blood samples were collected,and serum levels of total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol (HDL-C),apolipoprotein A-1 (Apo A1),apolipoprotein B(Apo B) and lipoprotein (a) [Lp (a)] were determined.Characteristics of serum lipid levels in centenarians with different age and gender were analyzed.Results The ratio of male to female in this study was 1 ∶ 4,101 years of age comprised the largest proportion(20.4 ％,183 cases),and the highest age was 109 years old for men and 116 years old for women.People aged 102 years had the highest levels of TC,TG,LDL-C and Apo B,and also had the lowest levels of HDL-C and Apo A1.Serum levels of TC and LDL-C reached the peak at the age of 102 years and showed downward trends year by year.Serum levels of TC,TG,LDL-C,Apo A1 and Apo B were lower in males than in females(P＜0.01),and HDL-C had no significant difference between males and females(P ＞0.05).The detection rates for abnormal serum lipid levels were higher in females than in males(P＜0.01).Serum Lp(a) level was higher in females than in males.Conclusions Serum lipid levels show a peak expression at a certain age in centenarians of Hainan,and the types and ratio of abnormal blood lipids are higher in female centenarians than in male centenarians.
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ObjectiveTo explore the feasibility of psychiatric assessment scale of cognitive and volition capacity(PASCVC) in violent crimes.MethodsThe PASCVC,criminal responsibility rating scale for violence(CRRSV) and criminal responsibility rating scale(CRRS)were used respectively in 244 forensic psychiatric cases.All cases were classified by the judicial surveyor into three grades including complete lost,partial lost and normal,the results were compared with expert's opinions.Results①PASCVC was composed of two subscales:cognitive capacity and volition capacity.There were significant differences in rating average score of three groups (complete lost,partial lost and normal) of total scale,cognitive capacity and volition capacity subscales were 9.96±7.53,69.15±10.290,101.16±6.034;20.29±4.971,37.13±5.388,2.55±2.612;18.32±2.595,30.07±4.595,48.34±4.147 respectively and there were significant differences between them.②27 items had good correlation with the scale(r=0.157~0.915).③According to the reference demarcation points of scale,12 criteria were carried out by using stepwise discriminant analysis.The accuracy of retrospective cumulative square was 97.1%.④Total scale and subscales consistency of three demarcation point grading assessment results were consistent with expert's opinions,the Kappa values were 0.925,0.848 and 0.930 respectively (P<0.01);PASCVC consistency with CRRSV and CRRS,the correlation coefficients were 0.952 and 0.961 respectively (P<0.01),the Kappa values were 0.830 and 0.881 respectively (P<0.01).Conclusion The PASCVC is feasible to be used in violent crimes.
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After the status quo of medical treatment quality management and its relevant problems were analyzed, how to build the platform for medical treatment quality management was proposed by establishing perioperative clinical data center and intelligent management engine through data sharing, integration and reconstitution based on the present hospital information system in order to standardize perioperative medical behaviors and protect the safety of patients.
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<p><b>OBJECTIVE</b>To investigate the comorbidity rate of depression symptoms in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) in Henan province and to ascertain the risk factors.</p><p><b>METHODS</b>One thousand three hundred and twenty-seven patients with OSAHS determined by overnight polysomnogram (PSG) were enrolled in this study. After screening the Symptom Checklist 90 (SCL-90) and Self-rating Depression Scale (SDS), the patients were divided into two groups: OSAHS (control group, n = 698) and OSAHS+depression (n = 629). The correlation was explored between the depression symptoms in patients with OSAHS and the sociodemographic variables and health status including smoking, drinking, marital status, apnea hyponea index (AHI), anoxicity, Family Burden Scale of Disease (FBS), Family APGAR Index (APGAR), Perceived Social Support Scale (PSSS) and so on. Furthermore, In-depth analyses were carried out between the depression symptoms in patients with OSAHS and the social and family factor items (FBS, APGAR and PSSS).</p><p><b>RESULTS</b>The comorbidity rate of depression symptoms in patients with OSAHS in Henan province was 47.4%, and was correlated with the gender, marital status, FBS, APGAR, AHI, PSSS and anoxicity. Logistic regression analysis indicated that single marital status, APGAR, AHI, PSSS, hypoxemia and heart disease were all independent risk factors for depression in OSAHS patients. The total of the FBS score and three of its subfactors scores (family daily activities, family relationships and mental health of family members) were higher, and the total of the APGAR score and two of its subfactors scores (adaptabilith and affection) were lower in OSAHS with depression compared with the control group (P < 0.05). Besides, the total score for the PSSS AND Scores for its two subfactors (family support and social support) were all lower in OSAHS patients with depression than those of the control group (P < 0.05).</p><p><b>CONCLUSION</b>In patients with OSAHS, depression symptoms are common and are associated with marital status, AHI, anoxicity, concomitant diseases (hypertension, heart disease), concerns and supports from the family and society.</p>
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Humans , Depression , Hypertension , Hypoxia , Polysomnography , Research , Risk Factors , Sleep Apnea, Obstructive , SmokingABSTRACT
Objective To test reliability and validity on the scale of hurting factors participation for mental disorders (SHFP-MD).Methods 402 cases were retrospectively evaluated by SHFP-MD from 13 forensic psychiatric appraisal agencies in China,and all cases were involved causal relationships in mental injury from July 2010 to June 2012.42 cases were evaluated a month later again.13 raters evaluated respectively for five cases.52 cases involved causal relationship of mental impairment were evaluated prospectively in January 2013 to June 2014.The validity of the scale was tested by experts assessed as a criterion level of relationship.Results ①The retest correlation coefficient on all items of SHFP-MD were between 0.746-0.989,and the time reliability of test-retest on the full scale score was 0.970 interval of one month.Raters reliability between 0.57 to 1.00; overall average reliability was 0.84 (P＜0.01).②The total coincidence rate was 90.4％-91.0％ between the demarcation scores of SHFP-MD and the grade identification of forensic psychiatrists respectively and prospectively(P＞0.05).Conclusion SHFP-MD has good reliability and validity,and met the basic requirements of scale assessment.
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Objective To test the cut-off point and empirical validity of psychiatric assessment scale of cognitive and volition capacity for suspects in crime (PASCVC).Methods One thousand of forensic psychiatry cases from fifteen bodies of the seven administrative regions in China were collected for forensic assessment by the three scales of PASCVC,DCRRS and CRRSV in August 2009 to December 201 l.in all cases by the appraiser to make six grade judgment of the cognitive and volition capacity including completely lost,lost most,partial loss,partial loss of a small,slightly damaged and normal.Results ① Based on the results of frequency distribution table: complete loss of demarcation divided ＜ 56 minutes,lost most 57-66,partial loss 67-76,partial loss of a small 77-87,slightly damaged 88-100 and normal ≥ 101.②The correlation coefficient of six demarcation point grading assessment results and expert opinion was 0.939(P＜0.001).③PASCVC consistency with DCRRS and CRRSV,the Kappa values were 0.838 and 0.835 respectively(P＜0.001).④Discriminant function were established by two methods of PASCVC and expert assessment,the correct rates of PASCVC and expert judgment on back substitution determine were 86.9％ and 85.1％.Two kinds of classification results,the Kappa value of 0.857 (P＜0.001).Conclusion PASCVC has good empirical validity,and can be used as an objective assessment tool for forensic assessment of criminal cognitive and volition capacity.
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Objective To examine the reliability and validity of the Rating Scale of the Reliability in Mental Disorder Medical History (RSRMDMH) in order to develop a reliable measure to determine the reliability in mental disorder medical history.Methods RSRMDMH was conducted by concept,clinical feature in mental disorder medical history and assessment scales for malingering and compensationneurosis.Final 14 items was decided after initial usage and modification.It was administered to 600 subjects including the cases involved forensic problems,patients in general psychiatric clinic.Results ①The Cronbach' s α coefficients of RSRMDMH was 0.901.The split-half reliability was 0.803-0.924.The test-retest reliability and scorer reliability were more than 0.588 (P＜0.01).②The cut score of assessing different degree of the reliability in mental disorder medical history separately was ≤ 11,12-22,≥23.③Based on the experts diagnosis,the accuracy rate of RSRMDMH for evaluating different degree of the reliability in mental disorder medical history were more than 86.1％,and total accuracy rate was 94.8％.④Correlation analysis showed significantly correlation between RSRMDMH and assessment scales for malingering(self-report scale of brief psychopathological symptoms,SBPS).Conclusion The RSRMDMH has acceptable psychometrics properties on reliability and validity.It is a clinically reliable measure to determine the reliability in mental disorder medical history.
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Objective To test the reliability and validity of the rating scale of social function deficit due to mental disorders (SSFD-MD). Methods 1003 cases with mental disability evaluation were tested by SSFDMD. At sametime, 100 cases of 1003 cases were test-retested and back to back tested by two examiners. 300 cases of 1003 cases also were tested by social disability screening schedule( SDSS),scale of social function for psychosis inpatients(SSPI),global assessment function(GAF) ,the brief psychiatric rating scale(BPRS) ,WH0 disability assessment scale Ⅱ (WHO-DASⅡ ), adult rating scale of mentally disabled ( ARSMD) and rating scale for extrapyramidal side effects (RSESE). Results ①The Cronbach's α coefficients of the total score and all dimensions of SSFD-MD were more than 0.90. The test-retest reliability ranged from 0.67～0. 83 ,and the scorer reliability were 0. 87～0.97. ②The correlations between item scores ranged from 0.46 ～0.74(P＜0.01). The correlations between the factor scores and the total scores ranged from 0.73～0.87(P＜0.01). To extract five full-scale principal components after orthogonal rotation to maximize variance,the cumulative total variance explained was 82.25%.There were highly correlations between SSFD-MD and SDSS.SSPI and GAF,respectively ( r = 0. 71,0.72 and 0. 78). There were moderate correlations between SSFD-MD and BPRS WHO-DAS II ARSMD,respectively(0.62,0. 50 and 0.46). There was a low correlations between SSFD-MD and RSESE ( r = 0.22) ,but all correlations were significant(P＜0.01). Conclusion SSFD-MD has acceptable psychometrics properties on reliability and validity.
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Objective To investigate prevalence of long-term mental disorders following traumatic brain injury (TBI) in 4 ～ 13 years. Methods Of the 4287 patients with traumatic brain injury by systematic sampling.675 subjects were screened by the manual of the psychiatric consequences following traumatic brain injury. The final diagnoses of mental disorders were determined by two advanced psychiatrists based on CCMD-3 on the criteria of organic mental disorders. Results ① Of the 675 subjects with traumatic brain injury,206 had satisfied diagnosed criteria of one or more organic mental disorder syndromes by CCMD-3, and with dementia 17.48% , amnestic syndrome 1. 04% , personality or behaviour change 13. 84% , psychotic syndrome 1. 19% , depressive syndrome 7.41% ,manic syndrome 0.30% ,hysteric syndrome 0.98% , neurotic syndrome 10. 22%. ②The incidence of the mental disorders in the subjects with severe TBI was significantly higher than that of moderate and mild TBI,separately 66.01% (134/203) ,18.04% (46/255) and 11.98% (26/217 ),λ2 =109.03 and 129.82 separately(P< 0.01). ③The incidence of the personality or behaviour change in male was significantly higher than that of female, separately 15.31% and 6.98% (λ2 =5.65, P<0.05). The incidence of the neurotic syndrome in female was significantly higher than that of male, separately 15. 12% and 8. 55% (λ2 = 6. 02, P < 0.05). Conclusion The high incidence of the mental disorders in the patients with TBI should not neglect. There are more high occurrence rate with more severe degree of brain injuries.
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Objective To examine the dissimulation in memory test by event-related potentials (ERP).Methods Recording the ERP of 20 students in the choosing tasks according to Binomial Forced-Choice Digit Memory Test (BFMDT) in three situations including reality,dissimulation and forced wrong choose. Results The reaction time was lengthened gradually by the situation of reality ( 681 ± 21 ) ms, dissimulation ( 741 ± 25 ) ms and forced wrong choose( 946 ± 31 ) ms (F= 115.73, P = 0.000). The main components in ERP waveforms, N2 ( 180 ～184 ms) and P2 ( 214 ～ 243 ms) had higher amplitudes in situations of dissimulation and forced wrong choose than that of reality. The amplitude of N2 showed significant difference in three groups(F=6. 896, P＜0.01 ). The amplitudes were increased gradually by the situation with reality( -0.376 ± 0.58 )μV, dissimulation( 0. 86 ± 0.71 )μV and forced wrong choose( 1.77 ±0.82)μV. Conclusion ERP may be an electrophysiological index of the intention of dissimulation in memory test.
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Objective To examine the reliability and validity of compensative neurosis assessing scale (CNAS) and in order to develop the quantitative assessing method for distinguishing the compensation neurosis from malingering and typical neurosis. Methods The reliability and validity of the scale was tested based on the subjects including the cases involved forensic problems, the patients with typical neurosis in general psychiatric 0.944. The test-retest reliability was more than 0.820. The scorer reliability was more than 0. 812. The total accu-racy rate of CNAS for evaluating three groups of subjects based on the experts diagnosis, and with 91.2% of speci-ficity and 79.3% of sensitivity for evaluating compensation neurosis. Condusion The CNAS has acceptable psy-chometrics properties on reliability and validity. It will provide method to distinguish the compensation neurosis from malingering and typical neuroses.
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Objective: To develop the norms of Chinese Words and Vocabulary Discerning Test (CWVDT). Methods: According to the principle of stratified proportional sampling,a total of 1605 adult subjects from 17 cities and their surrounding rural areas of China was measured by CWVDT. Results: ①There was significant difference in two dimensions scores and total score of CWVDT between city and countryside(P0.05). Conclusion: The nationwide norms of city and countryside with educated degrees on CWVDT have been developed and with a good representation.