ABSTRACT
Objective:To evaluate the safety of thymic surgery in patients aged 65 years and over.Methods:A total of 696 patients who underwent thymectomy/thymoma resection in the Department of Thoracic Surgery of Beijing Hospital from November 2011 to March 2022 were collected and divided into two groups according to the age of 65 years old.The preoperative course of disease, MG stage, dosage of pyridostigmine bromide, American College of Anesthesiologists(ASA)score, surgical method, intraoperative bleeding, postoperative drainage, postoperative complications, Clavien-dindo score(CDC), and myasthenic crisis were recorded and statistically analyzed.Results:A total of 696 patients were enrolled, including 364 males and 332 females, aged 15~86 years, with an average age of 49.1 years.There were 309 patients with thymoma, 565 patients with MG, and 178 patients with both.There were 124 cases in the elderly group(≥65 years old)and 572 cases in the non-elderly group(<65 years old). The incidence of thymoma was higher in the elderly group(54.8 % versus 42.1 %, χ2=6.664, P=0.010), while the incidence of MG was lower(67.7 % versus 84.1 %, χ2=17.827, P<0.001). The ASA score of the elderly group was higher than that of the non-elderly group( χ2=52.372, P=0.000), and the preoperative ventilation function FEV1 and FEV1/FVC were also significantly lower than those of the non-elderly group( z=8.187, 4.580, P=0.000 for all). The drainage volume in the first 3 days after operation and postoperative drainage tube time in the elderly group were significantly higher than those in the non-elderly group( P=0.018, P=0.003). The incidence of postoperative myasthenia crisis in the elderly group was higher than that in the non-elderly group( P=0.034). There was no significant difference in the incidence of postoperative complications between the two groups, but after Clavien-dindo classification, the score of the elderly group was higher than that of the non-elderly group( P=0.003). Although the ASA score and Clavien-dindo score of the elderly group were both higher than those of the non-elderly group, there was no correlation between the two. Conclusions:Although the preoperative ASA score and pulmonary function of elderly patients were poorer than those in the non-elderly group, while the incidence of postoperative myasthenia crisis was higher, and the incidence of postoperative complications was not higher, the Clavien-dindo classification, however, was higher in elderly patients than that of the non-elderly group.After careful preoperative evaluation and strengthening perioperative management, most elderly patients can receive thymus surgery safely with acceptable risks.
ABSTRACT
Objective:To explore the effect of childhood trauma on non-suicidal self-injury and the chain mediating effect of rejection sensitivity and experiential avoidance.Methods:From June 2021 to April 2022, totally 1 130 college students were investigated with childhood trauma questionnaire-short form(CTQ-SF), the tendency to expect rejection scale, acceptance and action questionnaire-2nd edition(AAQ-Ⅱ) and Ottwa self-injury inventory(OSI). SPSS 25.0 and Mplus 8.0 software were used for descriptive analysis, Spearman correlation analysis, structural equation model construction and Bootstrap mediation effect test.Results:Correlation analysis showed that childhood trauma (34.64±8.25), rejection sensitivity (58.02±9.54), experiential avoidance (23.90±7.96) and non-suicidal self-injury (0(0, 1)) were all significantly positively correlated with each other( r=0.163-0.532, all P<0.01). Structural equation model showed that empirical avoidance played a partial mediating effect between childhood trauma and non-suicidal self-injury in college students, with an effect size of 0.045(95% CI=0.013-0.084). Rejection sensitivity and experiential avoidance played a chain mediating effect between childhood trauma and non-suicidal self-injury in college students, with an effect size of 0.017(95% CI=0.005-0.035). Conclusion:Childhood trauma can directly predict non-suicidal self-injury in college students, and it can also indirectly predict non-suicidal self-injury through the partial mediation effect of experiential avoidance and the chain mediation effect of rejection sensitivity and experiential avoidance.
ABSTRACT
Objective:A two-sample Mendelian randomized study was used to investigate the relationship between psychiatric disorders and the risk of developing obstructive sleep apnea(OSA).Methods:Genetic variations in bipolar disorder, depression, Alzheimer's disease and schizophrenia were used as instrumental variables and data from genome-wide association studies of OSA patients from the Finngen Consortium were used.In this study, inverse variance weighted method was used as the main analysis method, and three sensitivity analyses including weighted median analysis, MR-Egger regression analysis and MR-PRESSO analysis were jointly applied.Results:Higher genetic predisposition for depression and bipolar disorder increased the risk of developing OSA, the odds ratio is 1.18(95% CI: 1.02-1.37, P=0.026)and 1.06(95% CI: 1.01-1.12, P=0.038)for each unit increase with log-transformed odds ratios of depression and bipolar disorder, respectively.Genetic susceptibility to Alzheimer's disease and schizophrenia was not associated with the risk of developing OSA. Conclusions:This study suggests that a higher genetic predisposition for depression and bipolar disorder may lead to a higher risk of developing OSA.OSA and psychiatric disorders such as depression and bipolar disorder have a high incidence in the elderly, however, their causal effects still need to be studied.