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Objective@#To investigate the incidence and risk factors of peripartum mood disorder (PPMD) in order to improve clinical prevention and intervention of this condition.@*Methods@#This was a prospective cohort study recruiting first-trimester pregnant women (<13 gestational weeks) from Beijing Daxing Maternal and Child Care Hospital from October 1, 2016 to December 31, 2017. Zung Self-rating Anxiety Scale (SAS) and Zung Self-rating Depression Scale (SDS) were used to evaluate the anxiety and depression status in the second and third trimesters, respectively. Their life styles, social and environmental factors exposure during pregnancy were also collected. Statistical analysis was conducted using Chi-square test, student's t test, Mann-Whitney U test and multivariate logistic regression.@*Results@#(1) A total of 478 subjects were enrolled in early pregnancy and 460 (96.2%) and 431 (90.2%) of them completed SAS and SDS assessment in the second and third trimesters, respectively, and 413 (86.4%) of the subjects finished both assessments on two occasions. (2) The prevalence of anxiety and depression was 7.1% (30/425) and 13.9% (59/425) in the second trimester, and 11.2% (44/392) and 21.5% (84/390) in the third. The incidence of anxiety and depression in the third trimester was 7.7% (26/336) and 9.6% (30/313). (3) Cross-sectional data analysis showed that prolonged television watching was a risk factor of anxiety in the second (OR=1.216, 95%CI: 1.055-1.402) and third (OR=1.166, 95%CI: 1.044-1.303) trimester, while exercise was a protect factor (OR=0.238, 95%CI: 0.105-0.541; OR=0.432, 95%CI: 0.212-0.879). Pregnant women with longer sleeping time had lower risks of depression in the second trimester (OR=0.725, 95%CI: 0.554-0.950); those who did exercise had lower risks of depression in the third trimester (OR=0.450, 95%CI: 0.252-0.803). (4) Longitudinal-data analysis revealed that longer television watching time in the second trimester was a risk factor for anxiety (OR=1.264, 95%CI: 1.117-1.432) and depression (OR=1.119, 95%CI: 1.005-1.246) in the third trimester.@*Conclusions@#The prevalence of anxiety and depression in the third trimester is higher than that in the second trimester. The incidence of depression is higher than that of anxiety in the third trimester. Prolonged television viewing time in the second trimester is a risk factor for both anxiety and depression in the third trimester.
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Objective To investigate the incidence and risk factors of peripartum mood disorder (PPMD) in order to improve clinical prevention and intervention of this condition.Methods This was a prospective cohort study recruiting first-trimester pregnant women (＜13 gestational weeks) from Beijing Daxing Maternal and Child Care Hospital from October 1,2016 to December 31,2017.Zung Self-rating Anxiety Scale (SAS) and Zung Self-rating Depression Scale (SDS) were used to evaluate the anxiety and depression status in the second and third trimesters,respectively.Their life styles,social and environmental factors exposure during pregnancy were also collected.Statistical analysis was conducted using Chi-square test,student's t test,MannWhitney U test and multivariate logistic regression.Results (1) A total of 478 subjects were enrolled in early pregnancy and 460 (96.2％) and 431 (90.2％) of them completed SAS and SDS assessment in the second and third trimesters,respectively,and 413 (86.4％) of the subjects finished both assessments on two occasions.(2) The prevalence of anxiety and depression was 7.1％ (30/425) and 13.9％ (59/425) in the second trimester,and 11.2％ (44/392) and 21.5％ (84/390) in the third.The incidence of anxiety and depression in the third trimester was 7.7％ (26/336) and 9.6％ (30/313).(3) Cross-sectional data analysis showed that prolonged television watching was a risk factor of anxiety in the second (OR=1.216,95％CI:1.055-1.402) and third (OR=1.166,95％CI:1.044-1.303) trimester,while exercise was a protect factor (OR=0.238,95％CI:0.105-0.541;OR=0.432,95％CI:0.212-0.879).Pregnant women with longer sleeping time had lower risks of depression in the second trimester (OR=0.725,95％CI:0.554-0.950);those who did exercise had lower risks of depression in the third trimester (OR=0.450,95％CI:0.252-0.803).(4) Longitudinal-data analysis revealed that longer television watching time in the second trimester was a risk factor for anxiety (OR=1.264,95％CI:1.117-1.432) and depression (OR=1.119,95％CI:1.005-1.246) in the third trimester.Conclusions The prevalence of anxiety and depression in the third trimester is higher than that in the second trimester.The incidence of depression is higher than that of anxiety in the third trimester.Prolonged television viewing time in the second trimester is a risk factor for both anxiety and depression in the third trimester.
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Objective To investigate the short-term safety of raltitrexed intraperitoneal perfusion in patients with rectal cancer undergoing laparoscopic Dixon surgery.Methods Totally 175 patients with rectal cancer at the Department of Colorectal Oncological Surgery,Shengjing Hospital of China Medical University were analyzed retrospectively from June 2016 to December 2017.All the patients were divided into raltitrexed intraperitoneal perfusion group (n =89) and saline intraperitoneal peffusion group (n =86) according to whether given raltitrexed intraperitoneal perfusion or not.The hematological indexes of the two groups before operation and 3 days after operation were recorded.The postoperative exhaust time and postoperative drainage volume within 24 hours were calculated.The postoperative complications including anastomotic leakage,peritoneal irritation sign,incision infection and pulmonary infection were evaluated.Results The surgery was performed successfully in all patients.There were no significant differences in the sex (x2 =0.000,P =0.990),depth of tumor invasion (x2 =0.003,P =0.956),degree of lymph node metastasis (Z =-0.590,P =0.556),TNM stage (Z =0.081,P =0.936) or pathological type (Z =1.092,P =0.896) between the two groups.There were no significant differences in postoperative exhaust time [(75.49 ± 3.97) h vs.(74.28 ±3.46) h,t =0.479,P =0.523],postoperative drainage volume within 24 hours [(201.1 ±54.1) ml vs.(242.8±25.7) ml,t=0.338,P=0.656],anastomotic leakage (1.1％ vs.2.3％,x2 =0.351,P=0.554),peritoneal irritation sign (1.1％ vs.2.3％,x2 =0.351,P =0.554),incision infection (2.2％ vs.3.5％,x2 =0.243,P =0.622) and pulmonary infection (2.2％ vs.2.3％,x2 =0.001,P =0.972) between the two groups.Additionally,there were no significant differences in the counts of erythrocytes [(3.56 ±0.27) × 1012/L vs.(3.63 ±0.26) × 1012/L,t =0.716,P =0.152],leukocytes [(7.63 ±0.20) x 109/L vs.(8.24 ±0.26) × 109/L,t =0.176,P =0.872],blood platelets [(170.13 ±20.12) × 109/L vs.(180.18 ±21.03) × 109/L,t =0.103,P =0.975],glutamic-pyruvic transaminase [(13.25 ± 2.31) U/L vs.(13.28 ± 1.46) U/L,t =0.321,P =0.713],glutamic-oxalacetic transaminase [(16.51 ± 1.28) U/L vs.(16.23 ±2.03) U/L,t=0.131,P=0.894] and creatinine [(77.36 ±6.49) μmol/L vs.(78.39 ±6.64)μmol/L,t =0.499,P =0.519] 3 days after operation between the two groups.Conclusion Raltitrexed intraperitoneal perfusion in Dixon surgery exhibits high safety,and no significant effect on postoperative recovery.It is easy to operate and has good feasibility,which is worthy to be used in clinic.
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Objective To explore the effect of perioperative continuous use of aspirin on bleeding in laparoscopic anterior resection for rectal cancer (RC) in patients taking low dose aspirin.Methods The prospective study was conducted.The clinicopathological data of 96 RC patients taking low dose aspirin who were admitted to the Shengjing Hospital of China Medical University from September 2014 to September 2016 were collected.All the 96 patients were divided into the aspirin group (perioperative continuous use of aspirin) and non-aspirin group (discontinuation of aspirin at 7 days preoperatively and taking aspirin at 3 days postoperatively)by random number table.Laparoscopic anterior resection for RC was applied to patients by the same team of doctors.Observation indicators:(1) comparison of surgical and postoperative situations between the 2 groups;(2) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative survival of patients up to January 2017.Measurement data with normal distribution were represented as (x)±s.Comparisons between groups were evaluated with the t test.Comparisons of count data were analyzed using the chi-square test and Fisher exact probability.Comparison of ordinal data was analyzed using the nonparametric test.Results All the 96 patients were enrolled into the study,including 50 in the aspirin group and 46 in the non-aspirin group.(1) Comparison of surgical and postoperative situations between the 2 groups:96patients underwent successful laparoscopic anterior resection for RC,including 1 with conversion to open surgery and 95 undergoing laparoscopic anterior resection for RC,without perioperative death,postoperative blood transfusion and rcoperation.Cases with conversion to open surgery,operation time,volume of intraoperative blood loss,decreasing value of postoperative hemoglobin (Hb),time to anal exsufflation,peritoneal drainage volume from 1-3 days postoperatively,cases with postoperative hematoehezia,cardio-cerebrovascular complications and overall complications (including postoperative hematochezia and cardio-cerebrovascular complications),duration of hospital stay,hospital expenses,cases in stage Ⅰ,Ⅱ and Ⅲ of postoperative TNM stage,postoperative coagulation indexes of platelet,prothrombin time,international normalized ratio,prothrombin activity,activated partial thromboplastin time,thrombin time and fibrinogen were 0,(112± 18) minutes,(39± 18) mL,(4.3±2.8)g/L,(57±24)hours,(22±9)mL/d,6,0,10,(8.6±2.5)days,(6 739±481)yuan,11,35,4,(236±80) × 109/L,(12.7± 1.1) seconds,1.00±0.08,101％ ± 15％,(28 ±4) seconds,(15.5 ± 1.9) seconds,(3.2±1.0)g/L in the aspirin group and 1,(118±16)minutes,(38±22)mL,(3.5±3.0)g/L,(55±29)hours,(20±8)mL/d,4,1,8,(9.1±2.3)days,(6606±510)yuan,5,36,5,(211±49)×109/L,(12.5±0.7)seconds,1.00±0.06,103％±11％,(29±3)seconds,(15.3±1.7)seconds,(3.1±0.7)g/L in the non-aspirin group,respectively,with no statistically significant difference between the 2 groups (t =-1.737,0.204,1.416,0.380,1.365,x2=0.038,0.107,t=-1.082,1.322,Z=-1.370,t=1.850,0.978,0.872,-0.712,-1.291,0.311,0.585,P＞0.05).Ten patients with postoperative hematochezia in the 2 groups were cured,without special treatment.One patient in the non-aspirin group was complicated with deep venous thrombosis and then was cured by single anticoagulant drug.Two and 2 patients in the aspirin group were respectively complicated with urinary retention and urinary tract infection.One,1 and 1 patients in the non-aspirin group were respectively complicated with inflammatory intestinal obstruction,urinary retention and urinary tract infection,and then were cured by conservative treatment.(2) Follow-up situations:of 96 patients,95 were followed-up for 4-27 months,with a median time of 13 months.During the follow-up,3 patients died and 92 had survival.Conclusion The perioperative continuous use of aspirin cannot increase risk of bleeding in laparoscopic anterior resection for RC in patients taking low dose aspirin.
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Objective:To investigate the clinical security and feasibility of neoadjuvant chemotherapy with imatinib following lap-aroscopy-guided intersphincteric resection for patients with gastrointestinal stromal tumor of the low rectum (GSTLR). Methods:Clini-cal data of nine patients with GSTLR who were admitted to the Shengjing Hospital between January 2007 and January 2011 were re-viewed. These patients were treated with neoadjuvant imatinib chemotherapy after laparoscopic intersphincteric resection. Results:Pri-or to neoadjuvant chemotherapy, the tumor diameter ranged between from 5 cm to 9 cm (median=7.0 cm). After imatinib chemothera-py, the tumor diameter decreased to 2-4.5 cm (median=3.5 cm, P<0.001). Laparoscopic surgery through intersphincteric resection was performed after imatinib treatment for 3-24 months (median=7 months). All patients received a protective stoma, which was closed 3 months after the surgery. The Wexner scale scores ranged from 1 and 4 (median=2) prior to neoadjuvant imatinib chemotherapy and changed to 1-5 (median=2) after the chemotherapy (P=0.397). After stomal closure operation, the scores significantly increased to 4-9 (median=7, P<0.001) but were not statistically significantly different from those before the therapy. One year after laparoscopic surgery, the Wexner scale scores ranged from 1 to 5 (median=2, P=0.842). Six patients were treated with imatinib for 24 and 30 months after lap-aroscopic surgery. Recurrence in pelvis occurred in only one patient, who ceased imatinib administration at the 30th month after the sur-gery. Conclusions: Laparoscopic surgery through intersphincteric resection was secure and feasible and thus could be used for treat-ment of GSTLR.
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Objective To explore the application value and clinical efficacy of the transanal specimen extraction via prolapsing approach in laparoscopic anterior resection for ultra-low rectal cancer.Methods The clinical data of 27 patients with ultra-low rectal cancer who underwent transanal specimen extraction via prolapsing approach in laparoscopic anterior resection for ultra-low rectal cancer at the Shengjing Hospital of China Medical University from July 2010 to July 2013 were analyzed retrospectively.The average operation time, average volume of intraoperative blood loss, average number of lymph nodes dissection, average distance to resection margin, average length of resected specimen, results of postoperative pathological examination, time for postoperative outoff-bed activity, time to anal exsufflation, gastric tube removal time and postoperative complications were recorded.The visual analogue scale (VSA) pain score and Wexner score for evaluating fecal incontinence were performed at postoperative week 1 and at postoperative month 1, respectively.The anal function was tested at postoperative month 3 and 12.The follow-up including tumor metastasis and recurrence, Wexner score and anorectal anometry was performed by outpatient examination and telephone interview once every 3 months for 2 years after operation and then once every year up to October 2014.Measurement data with normal distribution was presented as-x ± s and average (range).Repeated measures data were analyzed by the repeated measures ANOVA.Results All the patients received successful operations without procedure change or intraoperative accident.The average operating time, average volume of intraoperative blood loss, average number of lymph nodes dissection, average distance to distal resection margin and average length of resected specimen were 140 minutes (range, 115-173 mintues), 27 mL(range, 15-55 mL), 17(range, 14-20), 1.7 cm(range, 1.3-2.2 cm) and 18.5 cm(range, 14.7-22.4 cm), respectively.Postoperative TNM stages: T2N0M0 was detected in 19 patients, T2N1M0 in 3 patients,T3N0M0 in 4 patients and T3N1M0 in 1 patients.The time for postoperative out-off-bed activity and time to anal exsufflation were 8.8 hours (range, 7.0-13.0 hours) and 51 hours (range, 30-79 hours).Twenty-seven patients had the gastric tube removal after operation with fluid diet intake at postoperative hour 24 and semi-fluid diet intake at postoperative hour 48.One male patient was complicated with urinary retention at postoperative day 3 and 1 with anastomotic leakage at postoperative day 9, they were cured by symptomatic treatment.VSA pain scores in all patients from 1 day to 6 days postoperatively were 5.6, 4.6, 4.0, 3.2, 2.2 and 1.3.The average duration of hospital stay was 11.1 days (range, 7.0-19.0 days).Patients had good healing of abdominal incision at postoperative week 2.All the patients were followed up for a average time of 24.8 months (range, 15.0-32.0 months) without tumor metastasis and recurrence.Wexner score was 2.6 (range, 1.0-4.0) at postoperative month 1.The results of anorectal anometry: maximum anorectal resting pressure (MARP) and maximum anorectal systolic pressure were (267 ±23)mmHg (1 mmHg =0.133 kPa) and (305 ± 23)mmHg before operation, (266 ± 40)mmHg and (300 ± 38)mmHg at postoperative month 3, (267 ± 33)mmHg and (315 ± 30)mmHg at postoperative month 12, respectively, with no significant difference in the changing trend between pre-and post-operation (F =0.510, 1.390, P ＞ 0.05).Anorectal resting vector volume and anorectal systolic vector volume were (45 594 ± 1 981) cm (mmHg) 2 and (98 480 ± 8 165) cm (mmHg) 2 before operation, (40 310 ±3 465)cm(mmHg)2 and (78 461 ±6 777)cm(mmHg)2 at postoperative month 3, (40 385 ± 3 379) cm(mmHg) 2 and (82 082 ± 10 383) cm(mmHg) 2 at postoperative month 12, respectively, with significant differences in the changing trend between pre-and post-operation (F =26.845, 48.090, P ＜ 0.05).Conclusion Transanal specimen extraction via prolapsing approach in laparoscopic anterior resection for ultra-low rectal cancer is safe, aesthetic and minimally invasive compared with the traditional laparoscopic surgery, with the advantages of radical cure of tumor and protection of anal function.
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<p><b>OBJECTIVE</b>To analyze the impact of implementation on health management programs among the community-based 0-36-month-olds regarding their growth and development.</p><p><b>METHODS</b>18 Monitoring Bodies in 8 pilot areas were selected to enroll this study, using a multistage stratified cluster sampling method. All the children aged 0 to 36 months were followed, according to the health management specification, and their health archives were collected.</p><p><b>RESULTS</b>A total of 13 464 children were involved in the specified management program with a total of 59 648 person-time under follow-up, with 54.26% of them were boys. Results from the multi-layer linear model indicated that the average height of children in the specified management group was higher than that in the non-standardized management group. Children in the specification management group, their weight gain had also been more effectively controlled. At the same time, with the increasing number of follow-ups according to the specification, the prevalence rates of under weight, stunt, emaciation and overweight were all significantly decreased (P < 0.05).</p><p><b>CONCLUSION</b>The implementation of the community-based programs on 0-36-month-olds regarding their health management specification had improved children's growth and development.</p>
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Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Community Health Services , Emaciation , Epidemiology , Follow-Up Studies , Growth Disorders , Epidemiology , Overweight , Epidemiology , Prevalence , Program Evaluation , Thinness , EpidemiologyABSTRACT
A baseline survey on health knowledge was conducted in Yayuncun (Asian Games Village) Community in 2004 and 2005 respectively. A sample consisting of 1765 residents aged 15 and above from 600 households, who had lived in the community at least 5 years, was randomly taken; the "Beijing Typical Community Resident Questionnaire" was used for survey and the participants were followedup annually from 2006 to 2008. The results showed that the awareness rate of food nutrition and disease prevention increased year by year; however, the participants with educational level lower than junior middle school had the lowest rate of overall health knowledge. The main channels for local residents to acquire health knowledge were activities, lectures and other programs with the title of the Olympic Games; the educational level and the year of survey were independent affecting factors on overall health knowledge among residents.