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Objective To investigate the emotional state and its influencing factors in children with nocturnal enuresis,so as to improve clinical attention and give appropriate intervention.Methods Totally 166 nocturnal enuresis patients aged 9 -15 years old were admitted to Beijing Children′s Hospital Affiliated to Capital Medical University from August 2011 to August 2014.Specifically,Screen for Child Anxiety Related Emotional Disorders (SCARED)and Depres-sive Self -Rating Scale for Childhood (DSRSC)were utilized to test the patients′emotional state.The comparison be-tween the general norm data of the healthy children and the psychological test of enuresis children were performed,the lat-ter emotional state and its influence factors were evaluated.Analysis of variance and t -test were performed.Frequency comparison was done by using χ2 test.Influence factors analysis was made by Logistic or multiple regression analysis. Results The incidence of children′s anxiety with enuresis was 39.2%(65 /166 cases).Anxiety overall scores of children with enuresis amounted to 21 .16 ±11 .88 which were significantly higher than the norm(14.40 ±9.41 )(P 0.05).The emotional disorders mainly appeared in patients with primary enuresis,without family history,poor grade and poor relationships with family members and peers.The school performance was an important factor for enuresis patients with anxiety disorders(P <0.05).Conclusions Children with nocturnal enuresis are more likely to have anxiety disorders than normal children.Their emotional states is related to the enuresis type,family history,school performance, family and peer relationship.Therefore,attention should be paid to the emotional state of children with nocturnal enuresis. According to the adverse factors for nocturnal enuresis patients,effective treatment and appropriate psychological interven-tion should be given at the same time.
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Objective To explore the therapy efficacy for children with primary nocturnal enuresis by meta-analysis on the efficiency of alarm treatment versus desmopressin.Methods PubMed, Central, Elesvier, CNKI and some other databases were browsed to obtain all randomized controlled trails(RCT) and to compare the therapy between alarm treatment and desmopressin.Data extraction and quality evaluation were done by methods recommended by Cochrane center.The results of short-term and long-term efficacy and compliance were analyzed by Review Manager 5.0.Results Fifty-four RCT were retrieved and 11 RCT were included in the study.There was no statistical difference between alarm treatment and desmopressin when analyzing by no wetting episode,wetting no more than 1 night per month,wetting nights' decrease over 90％ or wetting nights decrease over 50％.By 3-month follow-up after treatment stopped,alarm treatment significantly reduced the wetting nights to over 50％ or less than 1 night per month than desmopressin.By 6-month follow-ups after treatment stopped, there was no difference between alarm treatment and desmopressin when analyzed by wetting no more than 1 night.The relapse rate of desmopressin was higher than that of alarm treatment (P =0.007).However, the withdrawal and abandonment rate of alarm treatment was higher than that of desmopressin(P ＜0.000 01).Severe adverse effects were not found in both of the treatment groups.Conclusions There is no statistical difference between alarm and desmopressin therapy in short-term treatment.The efficiency of alarm device is better than that of desmopressin in long-term treatment.The follow-up of alarm treatment lost more than that of desmopressin.Desmopressin is better than the alarm treatment in compliance but has higher recurrence rate.
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Objective To understand the clinical characteristics, treatment effect and prognosis of children with methylmalonic acidemia (MMA) combined with renal damage, and to provide experiences about how to improve the level of diagnosis and treatment.Methods The medical records of children with MMA were collected from January of 2007 to December of 2013 in Beijing Children's Hospital Affiliated to Capital University of Medical Sciences,while the clinical manifestations,laboratory findings, imaging material, inspection results were analyzed, and the renal pathological gene analysis, treatment effect, and prognosis of MMA children with renal damage were studied, and follow-up was carried out for 3 months up to 7 years.Results Among the two hundred and ninety-six cases of MMA,28 cases (9.5％) with renal damage,including 19 boys and 9 girls, 18 patients with hyperhomocysteinemia.Their ages varied from 2 days to 13 years old when confirmed.The first symptoms of 16 cases were proteinuria, hematuria, and edema, 9 cases were complicated with acute renal failure,5 cases were diagnosed as hemolytic uremic syndrome,6 patients were diagnosed as nephrotic syndrome, receiving enough glucocorticoids treatment without improvement.The routine examination of the urine showed that proteinuria (241-3 060 mg/d), methylmalonic acid levels and urinary protein were positively correlated (r =0.982, P =0.003), as urinary β2-microglobulin [(360.386 ± 231.496) μg/L], retinol binding protein [(338.537 ± 243.293) μg/L] increased.Extrarenal clinical manifestations were the spiritual, mental and physical development retardations, seizures, anemia etc.Two cases had a positive family history.Renal pathology showed mesangial cells and mesangial matrix proliferation broadening, no electron dense deposits in mesangial area, renal tubular epithelial cell swelling degeneration, and immunofluorescence was negative.Gene analysis of 3 cases showed exon1:c.80A ＞ G,p.Q27R and exon1 :c.365A ＞ T,p.H122L/c.609 G ＞ A,p.W203X.Children with MMA were treated with vitamin B12 treatment.Two cases of multiple organ failure died during hospitalization, and 2 cases died after leaving hospital.After treatment, the level of urinary methylmalonic acid was significantly decreased, while nervous system symptoms improved significantly, and the mental state and the renal function were improved.Conclusions MMA may be associated with kidney damage,usually with severe renal tubular and glomerular impairment.Early diagnosis is the key,and timely treatment can effectively control the disease, improve the prognosis.
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OBJECTIVE:To evaluate the economic effectiveness of different drugs for the same disease.METHODS:Using pharmacoeconomic cost-effect analysis,the short-term effects of three therapeutic schemes on duodenal bulbar ulcer,including A,B and C schemes,were compared.RESULTS:A was the best scheme.CONCLUSION:The results show that pharmacoeconomic cost-effect analysis plays an important role in optimizing therapeutic scheme,guiding rational drug use and increasing economic effectiveness.
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OBJECTIVE:To evaluate the cost-effectiveness of5kinds of drug treatment regimes in the treatment of ac_ ute pancreatitis.METHODS:The cost-effectiveness method in pharmacoeconomics was adopted in the retrospective analysis of the following5treatment schemes:octreotide in group A,ulinastatin in group B,fluorouracil in group C,nifedipine in group D and rhei decoction in group E.RESULTS:The costs for the5treatment schemes were2678.24,3071.68,1101.70,1089.04,and1098.04yuan respectively;The effective rates of the5schemes were96.88%,93.55%,92.86%,92.00%and96.55%respectively;The cost effectiveness ratio of schemes E was the minimum,which was11.53yuan;On the basis of group D,the superaddition costs for gaining one effectiveness unit for scheme A,B,C and E were324.33,1321.76,14.07,1.96yuan respectively.CONCLUSIONS:Among the5schemes,scheme E was the best one.