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@#Objective To discuss the paradigm and contents of rehabilitation psychology using bio-psycho-social model of functioning, disability and health of International Classification of Functioning, Disability and Health (ICF). Methods In perspectives of rehabilitation sciences and psychological sciences, paradigm and contents of modern rehabilitation psychology with the functioning framework of ICF were constructed in accordance with the development of modern rehabilitation science. Results A holistic rehabilitation model was constructed based on ICF, involving the body, mind and environment. Based on the functional model of ICF, the main contents of modern rehabilitation psychology were not only related to the function and structure of the body, but also related to the activities and participation, and emphasized the interaction with environment. The modern rehabilitation psychology would not only research about the physical dysfunction, but also the intervention of activity and environment. Based on ICF, common terminology and coding methods might be used to enable rehabilitation psychologists to communicate with relevant professionals in the multidisciplinary and interdisciplinary field of rehabilitation. Conclusion Constructing the theoretical framework and research paradigm of modern rehabilitation psychology based on ICF can form the system of rehabilitation psychology integrated with psychological science and rehabilitation science.
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Objective To investigate the efficacy and safety of MatrixRIB fixation system in the treatment of severe rib fractures.Methods A total of 131 patients with severe rib fractures undergoing open reduction and internal fixation using MatrixRIB fixation system in our department were enrolled.Data including demographics,injury characteristics,surgical procedure details and postoperative recovery were collected.The operation experiences were summarized,and complications,postoperative and follow-up data were analyzed.Results Totally 637 (637/891)rib fractures were fixed.No internal fixation disorder was found,but 1 case had displacement after internal fixation.The majority of patients were extubated immediately after surgery.The mean time of pressure-support ventilation after surgery was 47.6(7 143)hours.The chest instability and pain were improved in all patients after surgery.At 3 to 6 months after treatment,70 patients(70/102)returned to work,and 87 patients(87/89)recovered previous normal life.Conclusions MatrixRIB fixation system is easy to operate in the treatment of severe rib fractures and has good clinical outcomes with few complications.Patients' pain is significantly relieved with satisfactory rehabilitation.
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Objective To investigate the effects of endoscopic transthoracic sympathectomy on the treatment of hyperhidrosis palmaris(sweaty hands)and quality of life.Methods The clinical data of 62 patients with sweaty hands admitted from June 2010 to May 2016 were retrospectively analyzed.The 62 patients were randomly divided into two groups:thoracoscopic sympathectomy was performed at T2-3 in the control group,while at T3-4 in the experimental group.The self-reports of quality of life(QOL)before and after the operation were collected as follows:the severity of sweaty hands assessed by hyperhidrosis disease severity scale (HDSS:the higher score the more severe hyperhidrosis),the improvement of QOL assessed by sweaty hands assessment scale(the higher score the more improvement)and surgical efficacy.Results The improvements of HDSS and satisfaction score were higher in the experimental group than in the control group(P＜0.05).The differences between pre-and post-operation in the five dimensions of social interaction,gestation,daily behavior,work and social psychology were better in the experimental group than in the control group(all P＜ 0.05).Conclusions Thoracoscopic sympathectomy at T2-4 and T3-4 is an effective treatment for sweaty hands.But surgery at T3-4 levels,which is associated with a larger improvement in quality of life and fewer complications,is recommended as a priority option for a surgical treatment.
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Objective To explore the effect of expressive writing intervention on social support,resilience and school maladjustment in university freshman.Methods Selecting the freshmen volunteer of 600 university freshmen of Shandong,through the scale before the test recovery and comprehensive scoring chosen the part of low grade college students as the intervention object and were divided into writing expression(n=60) person and control group(n=60).The intervention group received a positive subject writing expression and the control group in the normal writing.Before and after the intervention tested the social support rating scale,the resilience scale for Chinese adolescents and the the student adaptation to college questionnaire were tested to evaluate the effect of active writing expression intervention.Results (1)After intervention,the intervention group and the control group had significant differences among the scales,objective support (t =-2.36,P＜0.05),learning adaptation(t=-1.98,P＜0.05) and subjective support (t=-2.56,P＜0.05),target focus(t=-2.66,P＜0.01),emotional control(t=-2.81,P＜0.01),family support (t=-3.46,P＜0.01),adaptation (t=-2.73,P＜0.01),support utilization (t=-5.91,P＜0.01) and social support score (t =-4.04,P＜ 0.01),positive cognition (t=-2.73,P＜0.01),interpersonal assistance (t=-3.13,P＜0.01),resilience score (t=-7.40,P＜0.01),life adaptation (t=-3.83,P＜ 0.01),emotional state (t =-3.39,P＜ 0.01),and school adaptation score (t=-3.46,P＜0.01).(2)There was no significant difference in objective support between the control group before intervention and after intervention.In addition,the remaining dimensions such as subjective support (20.72±2.46,22.96±2.81,t=4.54,P＜0.01),support utilization (7.49± 1.40,9.86± 1.90,t =7.56,P＜0.01) and social support score (36.79±4.24,41.89±5.18,t=5.76,P＜0.01) were significantly increased.The intervention group had significant difference among target focus (15.98±2.86,17.89±3.35,t=3.28,P＜0.01),emotional control (14.98±2.77,15.70±2.71,t=3.35,P＜0.01),positive cognition (14.61 ± 2.04,16.26±3.09,t=3.36,P＜0.01),interpersonal assistance (15.30±2.44,17.49±2.73,t=4.52,P＜0.01),resilience score(77.65±6.01,88.25±5.74,t=9.63,P＜0.01) and family support(16.77±2.28,19.58± 2.44,t =6.35,P＜ 0.01).In the intervention group of school adaptation scale,life adaptation (40.44± 6.36,45.12± 7.21,t=3.68,P＜0.01),emotional state (34.04±6.99,38.84±5.95,t=3.95,P＜0.01) and school adaptation score (145.21 ±22.86,160.51±21.78,t=3.66,P＜0.01),interpersonal assistance (32.30±5.34,35.23±5.18,t=2.98,P＜0.01),learning adaptation (38.44±7.06,41.32± 5.92,t=2.36,P＜0.05) were significantly increased.Conclusion Written expression intervention has a positive effect on improving the low level of social support,the poor resilience and freshman's adaptation to college.
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Objective@#To study the characteristics of attentional bias to emotional stimulus in medical workers of emergency department and explore the relationship between the emotional Stroop effect and mood states, thus providing a reference to the assessment and intervention of emergency medical workers’ mental health.@*Methods@#Two kinds of emotional Stroop tasks with words and pictures and the Profile of Mood States (POMS) were administered to thirty-six medical workers of emergency department and thirty-six medical workers of other departments.@*Results@#The reaction time to negative and positive words and pictures were all higher than the reaction time to neutral stimulus, thus showing the significant Stroop effect in medical workers. The Stroop effect to negative emotional stimulus in medical workers of emergency department was significantly smaller than that in medical workers of other departments, while the difference of Stroop effect to positive stimulus was not significant between the two groups. Correlation analyses revealed that the correlations between Stroop effect size to positive pictures and tension and angry of POMS were all negatively significant (r value was -0.314 and -0.330 respectively) , and the correlation between Stroop effect size to negative pictures and fatigue was negatively significant (r=-0.303) .@*Conclusions@#There is a significant emotional Stroop effect in medical workers. Although the ability of anti-interference to emotional stimulus in medical workers of emergency department was better than medical workers of the other departments, the long-term avoidance to negative emotional stimulus was still has a negative effect on the mood states of individuals.
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Objective To compare the clinical safety and efficacy of conservative treatment and surgery for traumatic flail chest in elderly patients.Methods From January 2013 to January 2017,68 elderly patients with traumatic flail chest in the Department of Thoracic Surgery,Beijing Lu He Hospital were enrolled.Based on different treatment methods,patients were divided into a conservative treatment group (n =34) and a surgery group (n =34),and the clinical safety and efficacy were compared between the two different treatment groups.Results Patients in the surgery group were associated with significantly decreased mechanical ventilation time,and days stayed in ICU and hospital,compared with the conservative treatment group (all P＜0.05).However,incidences of atelectasis and/or pneumonia,duration of pain and oxygen therapy,total thoracic drainage volume and extubation time were similar between the two groups (all P＞0.05).Rates of delayed or nonunion (2.9％ vs.17.6％) and thoracic deformity (0.0％ vs.11.8％) were significantly lower in the surgery group than those in the conservative treatment group (x2=3.981 and 4.250,both P＜0.05).Conclusions Surgery can safely and effectively reduce incidences of complications in elderly patients with traumatic flail chest disease and shorten the time of hospitalization.Therefore,the short-and longterm effects are promising and warrant further investigation.
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Objective To assess the perioperative efficacy and complications of intra-aortic balloon pump(IABP) in patients with cardiac operation.Methods A total of 36 cases with IABP patients from January 2011 to September 2016 were studied in Luhe Hospital of Beijing Affiliated to Capital Medical University,inluding 27 patients with coronary atherosclerotic heart disease(CAD),8 patients with valvular heart diseaseand and 1 patient with left atrial myxoma.The clinical data was collected to analyze IABP efficacy and complications.Results There were 10(27.8%) patients died,the mortality rate of CAD patients was lower than that of non-CAD patients(18.5% vs.55.6%,X2=4.615,P=0.032).The related complications after IABP implantation included:6(16.7%) cases suffered from thrombocytopenia,3(8.3%) cases with lower limb ischemia,2(5.6%) cases with lower extremity arterial thromboembolism,2(5.6%) cases with femoral artery pseudoaneurysm,2(5.6%) cases with acute pancreatitis,1(2.8%) cases with intestinal necrosis by mesenteric ischemia,2(5.6%) cases with gastrointestinal bleeding,3(8.3%) cases with hemorrhage in puncture site,4(11.1%) cases of fever,1(2.8%) case with pipeline leak,and 1(2.8%) case no pressure lumen data.After treatment with IABP,in 26 cases survival patients,the hemodynamic indexes(mean arterial pressure,heart rate,central venous pressure,urine volume) were significantly improved and the amount of dopamine and epinephrine decreased(t=-22.35,64.41,53.31,-23.82,26.07,14.15 respectively,P<0.05).Conclusion IABP can significantly improve the perioperative efficacy.The active treatment on complications is important to reduce the death induced by IABP.
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Objective To evaluate the antidepressant action of melatonin in stress model of depres-sion and the effects of the melatonin on depressive-like behavior.Methods Forty male Wistar rats were ran-domly divided into four groups(n=10):controls group(CON),chronic unpredictable mild stress group (CUS),chronic unpredictable mild stress group + melatonin group(CUS+MT)and chronic unpredictable mild stress group +ketamine group(CUS+KET).The rats in CUS group,CUS+MT group and CUS+KET group were given different stress stimulation for 42 days to establish the chronic mild unpredictable stress ani-mal model.Sucrose preference experiments was used to detect the depression model and the level of depres-sion was tested by forced swim test.The influence of Short-term low doses of melatonin on the level of BDNF and GluR1 in the prefrontal cortex,was detected by immunohistochemistry(IHC)on 58 day after the start of the experiment.Results (1)The CUS showed depressant-like behavior,and the percent sucrose uptake scores and the cumulative immobility time of the CUS group were decreased significantly(P<0.05).(2)After injection melatonin 14 d,the cumulative immobility time of CUS+MT group((60.70±18.56)s)and CUS+KET group((56.43±20.46)s)were decreased significantly in comparison to the CUS group(146.34±34.10) s).It was observed a highly significant(P<0.05)decrease of and up-regulation of the BDNF cells in CUS+MT group((1 328.99±282.46)/mm2)and CUS+KET group((1 224.76±116.53)/mm2)in comparison to the CUS group,the number of BDNF cells in CUS+MT group was increased significantly in comparison to the CUS+KET group;(3)After administration drug 14 days,the number of GluR1 cells of CUS+KET((807.82± 153.25)/mm2)but not CUS+MT((632 ± 156.34)mm2)significantly increased compared with CUS ((807.82±193.25)/mm2).Conclusion The results indicate that the melatonin induce an antidepressant-like action like ketamine.The antidepressant effects of melatonin may be related with the level of BNDF.
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<p><b>OBJECTIVE</b>To compare the clinical efficacy and safety among different chemotherapeutic regimens in treatment of refractory/relapsed acute myeloid leukemia (AML).</p><p><b>METHODS</b>The clinical data of 67 refractory/relapsed AML patients enrolled from September 2008 to April 2013 were collected. The differences of clinical outcome and adverse events among the patients treated with decitabine combined with DAG regimen, CAG regimen or "3+7" regimen were analyzed.</p><p><b>RESULTS</b>Among 19 patients in decitabine treatment group, 5 (26.3%) achieved complete remission (CR), 4 (21.1%) partial remission (PR), with overall response rate (ORR) of 47.4 %. Of 26 patients in CAG regimen group, 8 (30.8%) achieved CR, 1 (3.8%) PR, with ORR of 34.6%. Of 22 patients in "3+7" regimen group, 4 (18.2%) achieved CR, with ORR of 18.2%. The ORR of decitabine group was significantly higher than that of "3+7" group (P<0.05). However, no significant difference of ORR was observed among the three groups (P>0.05). It was interesting to note that in decitabine group, the marrow blast counts were lower in CR patients compared with those in non-CR patients (P<0.05), while this was not found in "3+7" group (P>0.05) and CAG regimen group (P>0.05). Adverse events in the three groups were similar, mainly including myelosuppression, pulmonary infection, nausea, vomiting and liver dysfunction, and could be well tolerated. Followed- up to September 2013, the median overall survival (OS) of decitabine group, CAG regimen group and "3+7" group after relapse was 7.5, 4 and 3 months, respectively (P>0.05), while significant difference was obtained between decitabine group and "3+7" regimen group (P<0.05).</p><p><b>CONCLUSION</b>Decitabine combined with DAG regimen is effective and well tolerated in refractory/relapsed AML patients who were unsuitable for intensive chemotherapy and hematopoietic stem cell transplantation, and the patients with low marrow blast counts are more suitable for the application of decitabine combined with DAG regimen.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Azacitidine , Leukemia, Myeloid, Acute , Drug Therapy , Neoplasm Recurrence, Local , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To explore which method is more advantaged by comparing two kinds of tubular stomach in esophageal cancer operation and the occurrence of postoperative complications.Methods There were 47 esophageal cancer patients and they were randomly divided into two groups:A group including 24 patients and making mechanical clipping lesser curvature,B group including 23 patients and hand-sewn shrink lesser,and the major complications were analyzed and compared.Results All patients underwent radical tumor resection without the operative mortality.There was 1 patient of acute hemorrhagic of gastric resection margin in A group,and there was 1 patient of thoracic gastric leakage and 1 patient of anastomotic fistula in B group.In 12-month follow-up,there was 1 patient of anastomotic narrow in A group and 4 cases in B group (P ＞ 0.05).After 3,6 and 12 months,emptying dysfunction was not found by upper gastrointestinal imaging and CT,but the thoracic stomach expansion was found in two groups,and the degree of thoracic stomach expansion in B group was more serious than that in A group,the part of the thoracic stomach of 3 patients in B group protruding into the opposite chest.There was 1 patient with thoracic-gastro syndrome after eating in A group and 3 patients in B group (P ＞ 0.05).There were 3 patients with mild reflux esophagitis in A group and 10 patients with serious reflux esophagitis in B group (P＜0.05).Conclusion Comparing two operative methods,the mechanical clipping lesser curvature is more advantaged than hand-sewn shrink lesser.
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Objective To explore the operation procedures,result of bilateral video-assisted thoracoscopic bleb resection.Methods Bilateral bullae of lung successfully underwent bilateral video-assisted thoracoscopic interthoracic operation were analyzed.Results All cases recovered well postoperatively.There were no intermediate thoracotomy and operative mortality.The mean operation time was 150min.The mean operation blood loss was 105ml.The mean duration of chest tube drainage was 3～6d.The mean postoperative capacity of chest tube drainage was 860ml.Conclusion This technique is safe,effective procedure,and reduce operative expenses.
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ObjectiveTo study the ability of response inhibition of depression.Methods30 depressed patients( depression group) and 30 healthy subjects (control group)were recruited in this study.The two groups were age,gender and education matched.All the subjects performed three visual Go/Nogo tasks using E-prime.The three Go/Nogo tasks were Happy Nogo Task(HNT),Normal Task (NT)and Sad Nogo Task (SNT).The two groups were instructed to press a button as quickly and correctly as possible when the Go trials were presented,but not to response when the Nogo trials were presented.In each task,the differences of accuracy (ACC) and response Time (RT) between the two groups were compared.Results ( 1 ) In HNT,during Go trials,ACC of depression group ( 0.85 ± 0.12 ) was higher than that of control group (0.75 ± 0.15 ) (P ＜ 0.05 ) ; during Nogo trials,ACC of depression group ( 0.91 ± 0.63 ) was lower than that of control group ( 0.95 ± 0.05 ) (P ＜ 0.05 ).(2) In NT,During Nogo trials,ACC of depression group(0.95 ± 0.04) was higher than that of control group (0.97 ± 0.03 ) (P ＜0.05 ).(3) There were no significant differences in RT between the two groups in any trails (P ＞ 0.05 ).ConclusionCompared with control group,depressed patients have a much higher recognize incline to the stimulus of sad emotion and a lower ability to complete normal response inhibition task.This is a new way to explain the depression pathogenesis mechanisms.
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Objective To investigate the changes of brain tissue in bilateral temporal lobes at different stages after nasopharyngeal carcinoma radiotherapy by diffusion tensor imaging(DTI)and 1H-MR spectroscopy(1H-MRS).Methods DTI and 1H-MRS were performed in 48 patients with nasopharyngeal carcinoma.in which conventional MRI revealed normal findings after radiotherapy.Twenty-four healthy controls were enrolled in this study and underwent the galne MR scanning.After the image processing and spectral analysis,apparent diffusion coefficient(ADC),fractional anisotropy(FA) and 3 eigenvalue λ1,λ2,λ3 of DTI and the NAA/Cho,NAA/Cr,Cho/Cr of 1H-MRS were measured in bilateral temporal lobes.Forty-eight NPC patients were divided into 3 groups [ less than 6 months(16 cases),6 to 12 months (6 cases)and more than 12 months(26 cases)after radiotherapy]according to different stages of radiationinduced injury of brain.each group's DTI and 1H-MRS data were measured respectively and one-way ANOVA was applied to analyze each parameter. Results The FA value of each test group(less than 6 months.6 to 12 months and more than 12 months)and the control group were 0.445±0.017,0.460±0.016,0.461±0.025,0.473±0.023 respectively.The ADC values of each group were(8.51±0.43)×10-4.(8.48±0.34)×10-4,(8.40±0.33)×10-4,(8.68±0.57)×10-4mm2/s respectively.And the maximum eigenvalue λ1 of each group were(1.251±0.065)× 10-3,(1.293±0.051)×10-3,(1.317±0.074)×10-3,(1.350±0.091)× 10-3mm2/s.The three indicators were significantly difrerent among groups(F=10.873,3.399,9.750 respectively,P<0.05).λ2,λ3 values showed no significant difference among the groups.The NAA/Cho of 1H-MRS of each groups were0.910±0.112,0.972±0.101,1.060±0.095,1.261±0.105 respectively,and the NAA/Cr were 1.212±0.236,1.208±0.183,1.228±0.236,1.435±0.225 respectively.Both of them had significant differences among groups(F=52.840,8.176 respectively,P<0.01).Cho/Cr showed no significant difference among the groups.Conclusions DTI combining with 1H-MRS play a certain guiding role on monitoring and evaluating of radiation injury of brain tissue in nasopharyngeal carcinoma after radiotherapy.It Can provide a scientific basis for the dynamic monitoring of radiation brain injury.
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Objective To study the role of coping styles in the relationship between coping resources and psychosomatic health in patients with asthma. Methods 184 adult patients with asthma were investigated with General Serf-Efficacy Scale (GSES), Internality, Powerful Others, and Chance Scale (IPC), Social Support Rat-ing Scale (SSRS), Defensive Style Questionnaire (DSQ), Trait Coping Style Questionnaire (TCSQ) and Short Form 36 Health Survey Questionnaire (SF-36). Results Significant correlation between self-efficacy (r=0.356),locus of control(Ir=0.208, Pr=0.341, Cr=-0.349) ,subjective(r=0.201) and objective(r=0.189)social support, immature and middle ( r = - 0. 257 ) defensive styles and coping styles ( PCr = 0.231, NCr =-0.505 ) with Mental Component Summary (MCS) was found (all P <0.05), but Physical Component Summary (PCS) was only related to self-efficacy( r=0. 175) ,chance(r=0.150),immature(r=-0.256) and middle de-fensive Styles and negtive coping styles (all P < 0.05). PCS (t = - 5.189) and MCS (t = - 6. 758) could be predic-ted effectively by negative coping style (all P<0.01). Moreover, self-efficacy, powerful others and the use of so-cial support could had an effect on the health of patients through negative coping style. Conclusion Negative coping style could not only have a direct effect on the health of asthma patients but also be a mediator between self-efficacy, locus of control, social support and the health of patients.
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Objective To explore the association of physical and mental health with coping and defensive style in asthma patients. Methods 190 adult patients with asthma were investigated with trait coping style questionnaire, defensive style questionnaire and short form 36 health survey questionnaire. Results The scores in group with higher score of health status were lower than those in group with lower score of health status in negative coping style, immature and middle defensive style, but higher in positive coping style (P
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Objective To study the effect of personality characteristics on the quality of life in asthma patients. Methods A total of 769 cases asthma patients were investigated by schedule table EPQ-RSC, AQLQ. With the SPSS10.0, t-test, correlation analysis and multivariable stepwise regression analysis were carried out for the collected data. Results ①The total level of life quality of asthma patients was worse. ②The quality of life of asthma patients was related negatively to dimension N of personality characteristics, and it was related positively to dimension E of personality characteristics. ③ Dimension N of personality characteristics entered the regression equation of quality of life. Conclusion Dimension N of personality characteristics is an important factor for affecting the quality of life in asthma patients.