Interactivity of obesity and central obesity on hypertension in Wuwei of Gansu province / 中国基层医药

Objective:To analyze the interaction between obesity and diabetes, obesity and central obesity, central obesity and diabetes on hypertension.Methods:A questionnaire survey on 7 622 residents of Han Chinese ethnicity, aged 35-75 years, of Liangzhou district of Wuwei city were performed using multi-stage random sampling method in September to December 2018. Relative excess risk due to interaction, attributable proportion, synergy index, and 95% CI of the three were used to evaluate the additive interaction. Logistic regression analysis was used to analyze the multiplicative interaction. Results:Among the 7 622 residents, hypertension was detected in 3 212 residents, with a crude prevalence rate of 42.14% and a standardized incidence of 33.81%. There was a significant difference in incidence of hypertension between residents of different sexes, between residents at different ages, between obese residents and normal weight residents, between residents who had central obesity and those who had no central obesity, between residents who smoked and those who did not, between residents of different family economic situations, between residents who had different occupations, and between residents who had diabetes and those who had no diabetes (all P < 0.05). Getting primary, middle, and high school education was a protective factor against hypertension, while obesity, central obesity, diabetes, male gender, age greater than 45 years were the risk factors for hypertension. Multivariate logistic regression analysis showed that there was no additive interaction between obesity and diabetes, obesity and central obesity, central obesity and diabetes on hypertension. There was a multiplicative interaction between obesity and central obesity on hypertension ( P = 0.031, 95% CI: 0.53-0.97) and the interaction was antagonistic, but there were no multiplicative interaction between obesity and diabetes, central obesity and diabetes on hypertension. Conclusion:There was a negative multiplicative interaction between obesity and central obesity on hypertension.

Insights into Conflicts and Harmony in Doctor Patient Relationship through Transactional Analysis

Doctor Patient Relationship (DPR) in India seems to be deteriorating. Remedial measures are incoherent compared to the multitude of factors associated. Transactional Analysis (TA) is a Social Psychology Theory and practice appropriate to analyse changing paradigms of DPR. TA shows that traditional stable DPR model was symbiosis inappropriate for modern era. Current DPR model is game relationship occurring due to failed attempts at symbiosis. Contractual relationship is a stable model of DPR appropriate for modern era and medical fraternity shall work towards bringing a paradigm shift in a coherent manner. TA may be one of the systems that offers models and tools useful for a paradigm shift

Effect of Karnofsky performance status scale and lactate dehydrogenase as well as their interaction on the therapeutic efficacy of diffuse large B-cell lymphoma / 白血病·淋巴瘤

Objective:To explore the factors influencing complete remission in patients with diffuse large B-cell lymphoma (DLBCL), and to explore the effect of the interaction of Karnofsky performance status scale (KPS) scores and the level of lactate dehydrogenases (LDH) on whether patients with DLBCL are completely relieved.Methods:The clinical data of 373 DLBCL patients admitted to Shanxi Province Cancer Hospital from January 2014 to December 2020 were retrospectively analyzed. SPSS 25.0 logistic regression model and Cox proportional risk regression models were used to explore the factors affecting complete remission in patients with DLBCL and to explore whether there was a multiplicative interaction between the factors. For factors with multiplicative interactions, the Matrix package, epiR package, and survival package in R 4.2.0 software were used to analyze whether there was an additive interaction. The relative excess risk of interaction (RERI), attributable proportion due to interaction (AP), and the synergy index (S) were used to evaluate the presence of additive interactions.Results:Elevated β 2 macroglobulin (β 2-MG), KPS scores below 80, and elevated LDH were risk factors for incomplete remission in patients with DLBCL (all P < 0.05). The risk of incomplete remission in patients with elevated β 2-MG, KPS scores below 80 and LDH was 1.971 times ( OR = 1.971, 95% CI 1.161-3.346), 2.056 times ( OR = 2.056, 95% CI 1.057-4.000) and 3.351 times ( OR = 3.351, 95% CI 1.783-6.300) higher than those in patients with normal β 2-MG, KPS scores above 80 and non-elevated LDH, respectively. There was a negative multiplicative interaction between the two risk factors of KPS scores below 80 and elevated LDH ( OR = 0.317, 95% CI 0.126-0.785). The estimated value of RERI, AP and S was -2.07 (95% CI -4.79-0.64),0.50 (95% CI -1.68-0.32),0.50 (95% CI 0.22-1.13), respectively; and there was no additive interaction among them. Conclusions:Elevated β 2-MG, KPS scores below 80, and elevated LDH are risk factors influencing incomplete remission for patients with DLBCL. The combined effect in patients with the combination of elevated LDH and KPS scores below 80 is lower than the single effect of the multiple of the both. There is a negative multiplicative interaction and no additive interaction in DLBCL patients with KPS scores below 80 and elevated LDH level.

Ego State Analysis in Stroke Rehabilitation / 中国康复理论与实践

@#Because the rehabilitation process is too long and its effect is non-significant, stroke patients are prone to showing over-reliance on their families, being unconfident in their abilities, and they usually miscommunicate with medical staff, in fact, the reason why they have these problems is that they didn't manifest appropriate ego states, so they couldn't communicate with families and medical staff healthily,which is extremely unfavorable for stroke rehabilitation. So-called ego state is individual mentality and corresponding behavior patterns.This paper used ego state concept in transactional analysis theory to describe the change of stroke patients' ego states, and analyze the communication patterns among patients, medical staffs and families, in order to assist patients to be aware of their own ego states, and present them properly, develop healthy communication, and promote the rehabilitation of the disease in the end.

Injunctions in Chronic Disease Patients and Coping Methods / 中国康复理论与实践

Injunction is a conception of transactional analysis. It is an injunctive message delivered from parent to children. Injunction is important for development of personality. We suppose that a person who received more injunctions may tend to have more psychological problems. If chronic disease patients have some injunctions, they may show some psychological characteristics which are not conductive for rehabilitation. This article analyzed the injunctions in chronic disease patients and some coping methods were also dicussed.

Ego State Analysis in Stroke Rehabilitation / 中国康复理论与实践

Because the rehabilitation process is too long and its effect is non-significant, stroke patients are prone to showing over-reli-ance on their families, being unconfident in their abilities, and they usually miscommunicate with medical staff, in fact, the reason why they have these problems is that they didn't manifest appropriate ego states, so they couldn't communicate with families and medical staff healthi-ly, which is extremely unfavorable for stroke rehabilitation. So-called ego state is individual mentality and corresponding behavior patterns. This paper used ego state concept in transactional analysis theory to describe the change of stroke patients' ego states, and analyze the com-munication patterns among patients, medical staffs and families, in order to assist patients to be aware of their own ego states, and present them properly, develop healthy communication, and promote the rehabilitation of the disease in the end.

The relationship between ego-state and communication skills in medical students / 한국의학교육

PURPOSE: The purpose of this study was to examine the relationship between ego-states and communication skills in medical students. METHODS: A total of 109 medical school students participated in this study, which used the communication skills self-test papers and the Egogram checklist. The data were analyzed by frequency analysis, and Pearson correlation analysis. RESULTS: Ego-state was related to communication skills. In particular, adapted child ego-state was negatively associated with each sphere of communication skills. CONCLUSION: Our results suggested that ego-state types should be considered in developing a communication skills education program for medical students.

Uma experiência de psicoterapia de grupo dentro da Estratégia Saúde da Família / An experience of group psychotherapy in the Brazilian Family Health Program / Una experiencia de psicoterapia de grupo dentro de la Estrategia Salud de la Familia

Este trabalho avaliou um Grupo de Saúde Mental desenvolvido na Estratégia Saúde da Família, baseado na análise transacional associada à terapia cognitivo-comportamental, descrevendo o impacto desta intervenção na melhoria da qualidade de vida da população atendida. Na Unidade Básica de Saúde Cruz das Almas, da Prefeitura de São Paulo, desde janeiro de 2007, realiza-se um grupo de Saúde Mental, com a frequência de uma vez por semana, com duração de uma hora. Neste grupo, os participantes discutem temas de seus interesses e aprendem técnicas de psicoterapia para lidarem com eventos do cotidiano e manejarem suas emoções e comportamentos de forma construtiva. O grupo é aberto aos interessados em participar das sessões de terapia, constituindo-se, em sua maioria, de pacientes acompanhados pelas equipes do Programa Saúde da Família e encaminhados ao Grupo de Saúde Mental. Ao ingressarem ao grupo, os pacientes preenchem o questionário sobre a saúde do(a) paciente, versão brasileira, conhecida pela sigla PHQ-9. Após frequentarem o grupo por, no mínimo, 12 sessões, os participantes preenchem um questionário de autoavaliação, informando sobre sua sensação de melhora em relação à sua saúde, melhora na autoestima e nos relacionamentos pessoais, e a visão mais positiva da vida e das outras pessoas. Dos participantes avaliados, 40 preencheram o questionário PHQ-9. Destes, nove (22,5%) tiveram pontuação de zero a quatro (sem depressão); seis (15%) tiveram pontuação de cinco a nove (depressão leve); dez (25%) tiveram pontuação de 10 a 14 (depressão moderada); sete (17,5%) tiveram pontuação de 15 a 19 (depressão moderada a grave); e oito (20%) tiveram pontuação de 20 ou mais (depressão grave). Dos 65 pacientes que responderam ao questionário de autoavaliação após pelo menos 12 sessões de terapia, 51 (78%) relataram visão mais positiva da vida e dos outros com a terapia; 44 (67%) referiram melhora da autoestima; 52 (80%), melhora nos relacionamentos e 53 (81%), melhora em relação à saúde. A melhora relatada pelos pacientes nas diversas áreas de suas vidas aponta para a importância desse tipo de abordagem dentro da Estratégia Saúde da Família, e para o impacto positivo da Psicoterapia baseada na Análise Transacional associada a técnicas cognitivo-comportamentais no tratamento de pacientes com transtornos mentais na Atenção Primária à Saúde.

This article evaluated an experiment carried out at the Family Health Program with the establishment of a Mental Health Group, based on transactional analysis associated with the cognitive-behavioral therapy, describing the impact of this intervention in improving the quality of life of the population served by the public system. In the Cruz das Almas Health Basic Unit, from São Paulo City Hall, a group of Mental Health has been happening since January, 2007, with the frequency of once a week, during one hour. In it, participants discuss topics of interest and learn psychotherapy techniques to deal with daily events and to manage their emotions and behaviors in a constructive way. The group is open to all those interested in participating in therapy sessions, being constituted, in most cases, by patients followed by the Family Health Program teams and sent to the Mental Health Group. When patients join the group, they fill out a questionnaire known as Patient Health Questionnaire, Brazilian version, known by the acronym PHQ-9. After attending the group for at least 12 sessions, participants complete a self-assessment questionnaire, informing about feeling better on their health, improved self-esteem, and personal relationships, and about having a more positive view of life and of other people. Of the evaluated participants, 40 completed the questionnaire. From these, nine (22.5%) had scores of zero to four (without depression); six (15%) scored five to nine (mild depression); ten (25%) had scores from 10 to 14 (moderate depression); seven (17.5%) had a score of 15 to 19 (moderate to severe depression); and eight (20%) had scores of 20 or more (severe depression). Of the 65 patients who completed the questionnaire for self-evaluation after at least 12 sessions of therapy, 51 (78%) reported a more positive view of life and of other people; 44 (67%) reported improved self-esteem; 52 (80%) related improvement in relationships and 53 (81%) improvement in relation to their health. The improvement reported by patients in different areas of their lives points to the importance of this approach within the Family Health Strategy and the positive impact of psychotherapy based on transactional analysis associated with cognitive-behavioral techniques in treating patients with mental disorders within the Health Primary Attention.

Este artículo evaluó un Grupo de Salud Mental desarrollado en la Estrategia de Salud de la Familia, basado en el análisis transaccional asociada con la terapia cognitivo-conductual, que describe el impacto de esta intervención en la mejora de la calidad de vida de la población atendida. En la Unidad Básica de Salud Cruz das Almas, de la Municipalidad de São Paulo, ha estado funcionando desde enero de 2007 un grupo de Salud Mental, con la frecuencia de una vez por semana, con una duración de una hora. En este grupo, los participantes discuten temas de su interés y aprenden técnicas de psicoterapia para hacer frente a los acontecimientos cotidianos y gestionar sus emociones y conductas de una manera constructiva. El grupo está abierto a todos los interesados en participar en las sesiones de terapia, siendo, en su mayoría, pacientes seguidos por los equipos de la del Programa Salud de la Familia y enviados al Grupo de Salud Mental. Al participar en el grupo, los pacientes completan el cuestionario sobre la salud del paciente, versión brasileña, conocida como el PHQ-9. Después de asistir al grupo por lo menos 12 sesiones, los participantes llenan un cuestionario de auto-evaluación, informando sobre su sensación de mejora en relación con su salud, la mejora de la autoestima y las relaciones personales y sobre su visión más positiva de la vida y de las otras personas. De los participantes evaluados, 40 completaron el cuestionario PHQ-9. De estos, nove (22,5%) tuvieron una puntuación de cero a cuatro (sin depresión); seis (15%) tuvieron una puntuación de cinco a nove (depresión leve); dez (25%) tuvieron una puntuación de 10 a 14 (depresión moderada); siete (17,5%) tuvieron una puntuación de 15 a 19 (depresión moderada a severa); y ocho (20%) tuvieron puntuaciones de 20 o más (depresión severa). De los 65 pacientes que completaron el cuestionario de auto-evaluación después de al menos 12 sesiones de terapia, 51 (78%) reportaron una visión más positiva de la vida y de las otras personas; 44 (67%) reportaron mejora de la autoestima; 52 (80%) reportaron mejora en las relaciones y 53 (81%), mejora en relación con su salud. La mejora reportada por los pacientes en las diferentes áreas de sus vidas muestra la importancia de este enfoque dentro de la Estrategia de Salud de la Familia y para el impacto positivo de la Psicoterapia basada en el Análisis Transaccional asociada con técnicas cognitivo-conductuales en el tratamiento de pacientes con trastornos mentales en la Atención Primaria de Salud.

A Follow Up Study of Brain Evoked Potentials in Patients with Post-Traumatic Stress Disorder / 中国心理卫生杂志

Objective:To investigate the status of brain evoked potentials (BEP) and the relationship between BEP and psychiatric symptoms before and after treatment in patients with post-traumatic stress disorder (PTSD). Methods: P_(300), auditory evoked potential (AEP), visual evoked potential (VEP) of BEP, Symptom Checklist-90 (SCL-90) and Impact of Event Scale (IES) were used to evaluate 86 patients with PTSD (PTSD group) and 56 normal controls (control group), PTSD patients were followed up with the same markers after 3.5 months treatment.Results:Compared with the control group, PTSD patients showed delayed latency and increased amplitude of P_(300)-P_3, delayed AEP-N_2 latency, and delayed VEP-P_2 latency. Shortened latency and decreased amplitude of P_(300)-P_3, and shorted VEP-P_2 latency were found after treatment. The mostly items of BEP were significantly related to psychical symptoms before treatment, and the changes of BEP were significantly related to the alleviation of psychical symptoms after treatment.Conclusion:BEP might be state markers of PTSD. The clinical application of BEP in PTSD is emphasized.

The relevant factors of hypophosphatemia in postoperative patients of general surgery / 中国现代普通外科进展

Objective:To study the correlative clinical factors that causing hypophosphatemia in postoperative patients of general surgery.Methods:Serum phosphate levels of 101 patients of general surgery were monitored at the preoperative day,and the first,forth and seventh postoperative day.Influence factors of the serum phosphate levels were analysed.Results:The serum phosphate levels in patients elder than 55 years were lower than those younger than 55 years on the first and forth postoperative day(P