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Antecedentes: Existe un aumento sostenido de la prevalencia de trastornos mentales en estudiantes universitarios, situación agudizada por la pandemia por COVID-19. Objetivo: Caracterizar la sintomatología de salud mental y el bienestar psicológico en un grupo de universitarios chilenos y explorar cambios en su situación durante el año académico en pandemia. Metodología: Diseño longitudinal, con dos mediciones utilizando un conjunto de instrumentos validados incluidos en un sistema de seguimiento del bienestar psicológico estudiantil (SIS-BP) disponible en una plataforma en línea. La muestra, de 1176 estudiantes, no probabilística, fue obtenida por participación voluntaria. Resultados: Se encontraron diferencias entre las administraciones, mostrando que, junto con producirse deterioro de la salud mental y el bienestar psicológico, también se desarrollan procesos de fortalecimiento de capacidades. Conclusión: Se destaca la importancia de acciones institucionales oportunas para sostener la trayectoria estudiantil frente al impacto de situaciones de emergencia en la salud mental de esta población.
Background: There is a sustained increase in the prevalence of mental disorders in college students, a situation exacerbated in 2020 by the COVID-19 pandemic. Objectives. To characterize the symptoms of mental health and psychological well-being in Chilean college students and to explore changes in the situation of students throughout the academic year during the pandemic. Methodology: A longitudinal survey design was used, with two measurements using a set of validated instruments included in a student psychological well-being monitoring system (SIS-BP), available on an online platform. The non-probabilistic sample of 1176 students were obtained by voluntary participation. Results: Differences were found between the administrations, showing that, along with the deterioration of mental health and psychological well-being, capacity building processes are also developed. Conclusion: The importance of timely institutional actions to sustain the trajectory of its students in the face of the impact of emergency situations on the mental health of this population is highlighted.
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Resumen La influencia del estrés de los padres y el efecto moderador de las estrategias de afrontamiento y apoyo social en niños con autismo están bien documentados. El número de trabajos con un di seño transversal contrasta con la escasez de estudios con diseño longitudinal que permitirían profundizar en las relaciones entre las características del contexto familiar y la evolución del trastorno. El presente trabajo de seguimiento está dedicado al análisis de esas relaciones en el tiempo transcurrido desde la infancia (T1) a la adolescencia (T2), valorando además los resultados en diferentes dominios del desarrollo. Participaron 45 adolescentes con TEA divididos en dos grupos en función del ambiente familiar, de alto riesgo (AR; N= 18) y de bajo riesgo (BR; N=27). Los resultados confirman y extienden los que han aportado trabajos transversales, evidenciando la influencia negativa de un ambiente familiar de riesgo en la severidad del TEA y en el desarrollo de habilidades socio-adaptativas. La psicoeducación, la terapia cognitivo-conductual y el mindfulness han de mostrado que pueden disminuir el estrés de los padres y aumentar el sentimiento de auto-eficacia.
Abstract The influence of parental stress and the moderating effect of coping strategies and social support in children with autism is well documented. The number of works with a cross-sectional design contrasts with the scarcity of studies with a longitudinal design that would allow to deepen in the relationships between characteristics of the family context and the evolution of the disorder. The present follow-up study is devoted to the analysis of these relationships over time from childhood (T1) to adolescence (T2), also assessing the results in different developmental domains. Forty-five adolescents with ASD participated, divided into two groups according to family environment, high risk (HR; N=18) and low risk (LR; N=27). The results confirm and extend those obtained in cross-sectional work, showing the negative influence of a risky family environment on the severity of ASD and the development of socio-adaptive skills. Psychoeducation, cognitive-behavioural therapy and mindfulness have been shown to decrease parental stress and increase feelings of self-efficacy.
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【Objective】 To investigate the penile appearance, sexual function, psychological status and related influencing factors of adult patients who underwent hypospadias repair surgery in their minors, so as to provide reference for the diagnosis, treatment and prognosis of hypospadias. 【Methods】 This study included 50 adult hypospadias patients who underwent urethroplasty in our hospital during May 2005 and Aug. 2018. The present appearance, sexual function and psychological status were evaluated. The correlation and consistency between hypospadias objective scoring evaluation (HOSE) and pediatric penile perception score (PPPS) were analyzed. Factors affecting the results were determined with univariate and multivariate regression analysis. 【Results】 The satisfaction rate of HOSE was significantly correlated with the urethral length and complications (P=0.024, P=0.033). The satisfaction rate of PPPS was significantly correlated with the number of urethral operations and postoperative complications (P=0.041, P=0.023). There was a weak correlation between HOSE and PPPS (r=0.291, P=0.040), but almost no consistency (Kappa=0.2, P=0.107). Sixty percent of the patients paid attention to the ventral appearance of penis, whose dissatisfaction rate of PPPS was higher than those who did not pay attention to the ventral appearance of the penis (19/30 vs. 6/20, P=0.021). Patients with multiple operations (>1), postoperative complications or unsatisfactory penile appearance were more likely to have inferiority complex (52.6% vs. 22.6%, P=0.029; 59.1% vs.14.3%, P=0.001;61.5% vs. 24.3%, P=0.015). Multivariate regression analysis showed that dissatisfaction with the appearance of the penis was an independent risk factor for patients’ perception of their own physical defects. Among the patients who believed that they had physical defects, the percentage of patients with grade IV penile erectile hardness was significantly lower than that of those who denied they had physical defects (9/17 vs. 27/33, P=0.047). 【Conclusion】 The undesirable postoperative penis appearance is likely to have a negative impact on patients’ long-term psychological state, which might further damage the sexual function in adulthood. Surgeons should pay attention to the penile appearance during the conduction of hypospadias repair.
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ABSTRACT Multiple clinical specialties are usually needed for a successful long-term treatment in buccal cavity. The aim of this article is to report a clinical case of multi-disciplinary rehabilitation of fracture upper incisors without pulp exposure, concerning about endodontics, periodontics and restorative dentistry comments or procedures. A case of a patient reporting trauma that resulted in fracture and substantial loss of hard tissue, in mesial angle of both upper central incisors (11 and 21). In palatal side, fracture extended beyond cingulum up to subgingival region. Periodontal surgery was performed in order to reestablish biological space. Clinical and radiographic assessments demonstrated no need for endodontic treatment, since pulp was vital and non-altered. Preparations for restorative procedures were minimally invasive, followed by composite direct. A three-year follow-up was performed, consisting in re-assessment of clinical and radiographic aspects, re-polishing of the restorations and photographic documentation. No pulp tissue alteration was observed after the follow-up period. Restorative procedures, adjacent tissues and pulp vitality were considered adequate, and the patient was satisfied with the treatment.
RESUMO O objetivo deste artigo é relatar um caso clínico de reabilitação de incisivos superiores fraturados sem exposição pulpar, com considerações na área de endodontia, periodontia e dentística restauradora. O caso relata um trauma que resultou em perda substancial de tecido dentário em ângulo mesial de ambos os incisivos centrais superiores. Na parede palatina, a fratura se estendeu além do cíngulo até a região subgengival. A cirurgia periodontal foi realizada para restabelecer o espaço biológico. As avaliações clínicas e radiográficas não demonstraram necessidade de tratamento endodôntico, pois a polpa se apresentava vital e sem alterações. Os procedimentos restauradores foram minimamente invasivos através da realização de restauração direta com resina composta. Foi realizado acompanhamento de três anos, consistindo em reavaliação dos aspectos clínicos e radiográficos, polimento das restaurações e documentação fotográfica. Nenhuma alteração do tecido pulpar foi observada após o período de acompanhamento. Os procedimentos restauradores, tecidos adjacentes e vitalidade pulpar foram considerados adequados e a paciente demonstrou satisfação com o tratamento.
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Introduction Asahikawa Medical University (AMU) has conducted a 7-week JICA training course “Health Systems Management for Regional and District Health Management Officers” since 2008 and trained a total of 132 participants from 22 countries. In order to assess how trainees applied their public health knowledge and skills obtained through the training course to their communities, we conducted interviews in Kenya, Malawi, and Liberia to explore their current public health problems and to identify what programs are required for our further training course to improve their health system.Methods Among 29 trainees in three countries in total, 15 were face-to-face interviewed and 6 were phone-interviewed on February 2019. The rest was missing but we identified five of their current position.Results The trainees made best use of knowledge and skills obtained from following lectures and/or field trips in their communities, such as “Project Cycle Management”, “Maternal and child health”, “Public health centers’ visit”, “Waste management including water supply and sewage treatment”, “School health”, “Tele-medicine”, and “5S-KAIZEN”. They also requested us to provide following lectures and field visits to tackle with their future health problems, such as “Japan’s experience to achieve the Universal Health Coverage”, “Health system strengthening”, “Disaster medicine and management”, “Non-communicable diseases”, and “Capacity development”.Discussion & Conclusions By face-to-face or phone interviews in three countries, we grasped ideas of current health problems and verified an effectiveness of our training programs in each country. We also helped the trainees, their co-workers, community people (volunteers) to increase the motivation of their relevant works and activities through the field visit. Therefore, in order to provide a better training program, we further need to enhance international cooperation between us and African countries as well as to strengthen our training capacities including regular follow-up systems to ex-trainees.
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Objective To explore the characteristics of medical sexual orientation, sexual behavior and acquired immunodeficiency syndrome(AIDS) related knowledge changing with grade. Methods A group of 876 undergraduate students of 2015 in a medical university were selected to conduct an anonymous survey once a year and a total of four times using self-compiled questionnaires on AIDS-related knowledge, sexual orientation and behavior of college students. Descriptive epidemiological methods were adopted for statistical description. Results The distribution of sexual orientation among medical students with different survey batches was statistically significant ( 2=26.223, P=0.036). The proportion of openly gay people in the total number of homosexuals showed an increasing trend ( 2trend=4.150, P=0.042). Follow-up study of Chinese medicine students on AIDS related knowledge of the overall rate of increased ( 2trend=23.462, P<0.001). The incidence of general sexual behavior and male homosexual sex among medical students in the past six months showed an increasing trend with grade growth ( 2trend=4.450, P=0.035; 2trend=6.738，P=0.009). At the second and third follow-ups, the proportion of men who used condoms occasionally and never used condoms increased, and the difference was statistically significant ( 2=7.935, P=0.047). Conclusions Due to the weak awareness of medical sexual safety protection, the school should continue to strengthen the AIDS publicity and prevention education of medical students in all grades, and improve the school sexual health education mechanism.
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We examined the precision, accuracy, and capability of detecting changes of Dual-Energy X-ray Absorptiometry (DXA) for the measurements of total-body weight (TBW), total-body fat weight (TBFW), and total-body lean weight (TBLW) in an 8-week follow-up study of rats. Twenty male rats (4-week) were divided into 2 diet groups. For 8 weeks, we measured body composition (TBW, TBFW, TBLW) by DXA and TBW by an electronic scale once a week. In week 8, we measured body composition 5 times by DXA and TBFW by dissecting experiment (EXP) of euthanized rats (12-week). Total-body fat ratio (TBFR) was defined as TBFW/(TBFW+TBLW). The precision of DXA was evaluated by measuring the coefficient of variation (CV) and accuracy was evaluated by comparing DXA-derived data with EXP data. The capability of detecting changes of DXA in follow-up study was verified by analyzing the trend of DXA-derived values over the 8 weeks. For TBW, TBFW, TBLW of DXA, CVs were 0.02 ± 0.01, 0.10 ± 0.05, 0.03 ± 0.02 and errors were − 6.996 ± 3.429 (r = 0.999), + 14.729 ± 3.663 (r = 0.982), − 21.725 ± 4.223 (r = 0.991), respectively. Prediction models were [EXP TBW = − 31.767 + 1.085 (DXA TBW), R2 = 0.998, root mean square error (RMSE) = 1.842] and [EXP TBFR = − 0.056 + 1.177 (DXA TBFR), R2 = 0.948, RMSE = 0.007]. Over 8 weeks, DXA TBW and DXA TBLW steadily increased, DXA TBFW steadily increased followed by saturation or declination, difference of DXA TBFW between 2 diet groups steadily increased. In conclusion, our study verified that DXA (iNSiGHT VET DXA, OsteoSys, Korea) is accurate and precise enough to measure body composition of rats. Additionally, we confirmed the possibility that DXA could be used for the long-term follow-up studies.
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Animals , Humans , Male , Rats , Absorptiometry, Photon , Body Composition , Diet , Diet, High-Fat , Follow-Up Studies , ObesityABSTRACT
Objective To investigate six yearsˊ outcome of children with asthma. Methods Children with asthma diagnosed in the epidemiological survey of childhood asthma in urban area of Beijing in 2010 were selected in this study. The field follow-up was conducted in 2016(6 years later)to obtain information about asthma attack,di-sease control,medication usage,and comorbidities of allergic diseases. The skin prick test,lung function and exhaled ni-tric oxide were performed during field follow - up stage. Results Sixty - four children,aged 7 - 19 years old [(13. 59 ± 3. 48)years old],completed the field follow-up survey. Among 35. 9%(23/64 cases)children,the asth-ma symptoms still persisted within 2 years(without remission),while 64. 1%(41/64 cases)children had no symp-toms within 2 years and above(remission). The course of children without remission(9. 0 years)was significantly lon-ger than that of children with remission(5. 5 years),and there was statistical significance(z＝ -3. 775,P<0. 001). Among the children without remission,the number of uncontrolled children in the last month accounted for 13. 0%(3/23 cases),partially controlled for 17. 4%(4/23 cases),and under controlled for 69. 6%(16/23 cases). The majority of unrelieved children were treated with intermittent control drug[43. 5%(10/23 cases)υs. 12. 2%(5/41 cases), χ2 ＝8. 036,P<0. 01]. A total of 47. 8%(11/23 cases)of children without remission were completely unaffected by physical activity,while 92. 7%(38/41 cases)of children with clinical remission were completely unaffected by physi-cal activity(χ2 ＝14. 117,P<0. 001). The proportion of children without remission with eczema and atopic dermatitis lasting longer than 6 years old was 56. 5%(13/23 cases),which was significantly higher than that of children with re-mission[29. 3%(12/41 cases),χ2 ＝4. 598,P<0. 05]. In 2010 and 2016,there were 46 children with allergen re-sults. Compared with 2010,the proportion of animal fur and pollen allergy increased in 2016[19. 6%(9/46 cases)υs. 52. 2%(24/46 cases),36. 9%(17/46 cases)υs. 67. 4%(31/46 cases)],and there were statistical significances (χ2 ＝10. 632,8. 538,all P<0. 01). In 2016,the number and degree of total allergens in the clinical unrelieved chil-dren were higher than that in the relieved children. Further analysis showed that the unrelieved children had higher cigarette allergy positivity(21. 7% υs. 2. 5%,χ2 ＝4. 239,P<0. 05). There was no significant difference in lung func-tion and exhaling nitric oxide between the clinical unrelieved children and the relieved children. Conclusions Six years later,the proportion of animal fur and pollen allergy increased in children with asthma. Compared with children with remission,the children without remission had more treatment with intermittent control drug,with higher proportion of eczema and atopic dermatitis over six years old,and higher percentage of cigarette allergy positivity.
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Objective To explore the dynamic changes and correlation of self-acceptance and automatic thoughts in permanent colostomy patients. Methods There were 89 low position rectal cancer patients after Miles and permanent colostomy were recruited from the Department of Oncological Surgery of the First Affiliated Hospital of Xi'an Jiaotong UniversityfromFebruary 2016 to October 2016. Self-acceptance Questionnaire and Automatic Thoughts Questionnaire were used to collect data in 1 month, 3 months, 6 months and 12 months after colostomy. Results The self-acceptance scores were 33.64 ± 5.52, 33.24 ± 5.71, 34.56 ± 6.04 and 38.91 ± 6.33 respectively, which had significant differences (F=11.012, P<0.01). The automatic thoughts scores were 63.20 ± 16.78, 60.88 ± 16.53, 58.64 ± 15.87 and 55.32 ± 14.76 respectively, which had significant differences (F=3.462, P<0.05). The correlation between self-acceptance and automatic thoughts were-0.576--0.372, which were all significant (P<0.01). Conclusion There were negative correlations between self-acceptance and automatic thoughts in permanent colostomy patients within 1 year after operation. Health professionals should learn to identify patients′automatic thoughts accurately, lead off negative emotions, promote early self-acceptance and improve their quality of life.
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Objective To investigate the predictive factors affecting the efficacy of cyclophosphamide (CTX) combined with glucocorticoids in the treatment of idiopathic membranous nephropathy (IMN),and to evaluate the efficacy of calcineurin inhibitor (CNI) adjustment due to poor treatment.Methods A retrospective cohort study was conducted.Two hundreds and twenty-eight patients with IMN diagnosed by renal biopsy in the People's Hospital of Guangxi Zhuang Autonomous Region from January 1,2007 to December 1,2016 were enrolled.All subjects were treated with CTX in combination with glucocorticoids.The patients were divided into two groups:remission group and no remission group.Multivariable logistic regression analysis was used to determine the baseline clinical-pathological influencing factors for the remission of IMN in the enrolled patients.Results The number of total remission (including complete and partial remission) of the first CTX combined with glucocorticoid treatment in 228 patients with IMN was 188(82.5％).Among them,141 patients (61.8％) had complete remission (CR),the median time for CR was 8(6,12) months,and the median time for partial remission (PR) was 3(1,4) months.The median follow-up time for this study was 25(13,43) months.Compared with the remission group,the serum albumin level was lower in the non-remission group,the 24-hour urine protein content,the blood complement C3 and C4 levels were higher,and the pathological stage was milder (all P ＜ 0.05).Multivariate logistic regression analysis suggested that the levels of baseline serum albumin,complement C4,and pathological stage were independent predictors of clinical remission in IMN patients.Twenty-four non-remission patients were treated with CNI.The overall response rate was 66.7％(16/24) at 6 months and 77.3％(17/22) at 12 months.Conclusions The levels of baseline albumin,blood complement C4,and pathological stage were independent predictors of clinical remission in IMN patients treated with CTX plus glucocorticoids.The non-remission patients with CTX combined with glucocorticoid therapy can still achieve a higher response rate after adjusting for CNI.
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Objective To explore the dynamic change and relationship between post-traumatic stress disorder (PTSD) and cognition in patients transferred from ICU. Methods Participants patients were selected from Critical Medical Department of the First Affiliated Hospital of Xi'an Jiaotong University by convenience sampling method between October 2016 to February 2017. The Montreal Cognitive Assessment (MoCA) and the PTSD Cheeklist-Vivilian Version (PCL-C) were used to collect data at 3 days, 3 months and 6 months after transferring from ICU. Results The incidence of cognitive disorder at 3 time points were 29.4％(30/102), 20.0％(18/90), 17.8％(13/73)respectively, and MoCA scores was 25.83 ± 6.29,28.57 ± 5.43,28.86 ± 5.11, the difference was significant (F=6.204,P<0.01). The incidence of PTSD symptoms were 42.2％(43/102), 23.3％(21/90), 19.2％(14/73)respectively, and PCL-C scores was 35.24 ± 5.94, 28.68 ± 5.13, 26.92 ± 4.85, the difference was significant (F=10.125,P<0.01). There were significant relationship between cognition and PTSD level (r =0.299-0.543,P <0.05). The PTSD level in cognitive disorder patients was 37.52 ± 5.88, 31.15 ± 5.12, 29.84 ± 4.82, and that in non-cognitive disorder patients was 34.32 ± 5.76, 27.68 ± 4.91, 25.74 ± 4.59 the difference was significant (t =2.117, 2.651, 3.334,P<0.05). Conclusions Health workers should pay attention to the mental status and cognitive impairment of patients transferred from ICU, implement psychological and cognitive interventions early, which could improve the cognitive status and PTSD progression of patients, and improve their quality of life.
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Objective To explore the change trend of parenting sense of competence and rumination in mothers of premature infants and their relationship. Methods Qualified participants were selected from the First Affiliated Hospital of Xi′an Jiaotong University between April and August 2016 by convenience sampling. Chinese version of Parenting Sense of Competence Scale and Chinese version of Nolen-Hoeksema Ruminative Responses Scale were used to collect data in 1 month,3 months,6 months and 12 months after premature leaving hospital. Results The parenting sense of competence scores were 62.20 ± 11.94, 67.32 ± 12.28, 68.13 ± 12.33 and 72.56 ± 13.39 respectively, which had significant differences(F=9.457,P<0.01).The rumination scores were 50.52±11.26,46.18±10.12,44.36±9.85 and 42.64 ± 9.13 respectively, which had significant differences (F=9.187,P<0.01). There were significant negative relationships between the parenting sense of competence and rumination,symptoms of rumination and forced thinking (r=-0.722--0.332, P<0.01). Rumination, income and marital status were the associated factors of parenting sense of competence after multiple linear regression analysis (t=-5.871, 2.782, 2.048, P<0.01 or 0.05). Conclusion Medical workers should pay attention to mobilize social support system and alleviate negative emotions of preterm mothers, teach them parenting skills and positive pressure coping style,in order to improve their parenting sense of competence.
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Objective To study the clinical efficacy of glucocorticoid in treatment of primary endocardial fibroelastosis (EFE) in children.Methods Fifty-eight primary EFE cases admitted in the Children's Hospital of Chongqing Medical University from Jan.2006 to Dec.2013 were treated and followed-up for more than 3 years.Based on whether the application of glucocorticoid and the length of time of glucocorticoid therapy,cases were divided into three groups:no glucocorticoid group (n=15),glucocorticoid 0.5-1 year group (n=17) and glucocorticoid 1-2 year group (n=26).The following indicators were followed up and observed:the cardiac function indexes before and after treatment [Modified ROSS score,left ventricular ejection fraction (LVEF),left ventricular fractional shortening (LVFS)],cardiac size [cardiothoracic ratio (C/T)] and the proportion of death.The efficacy and safety of glucocorticoid were studied.Results No statistically significant difference of modified ROSS scores,LVEF,LVFS and C/T existed among the 3 groups before treatment (P＞0.05).After treatment,the modified ROSS score,LVEF,LVFS and C/T in glucocorticoid 0.5-1 year group were 2.06 ± 1.78,59.29 ± 8.34,31.24 ± 6.0 and 0.580 ± 0.055,respectively,which were significantly different from those before treatment (5.06 ± 1.92,38.76 ± 6.31,18.47 ± 3.14 and 0.67 ± 0.05,respectively,P＜0.05);the modified ROSS score,LVEF LVFS and C/T in glucocorticoid 1-2 years group were 1.28 ± 1.54,64.64 ± 9.08,35.44 ± 5.44 and 0.57 ± 0.06,which were significantly different from those before treatment (5.28 ± 2.26,37.88 ± 8.48,18.12 ± 4.99 and 0.67 ± 0.04,P＜0.05).After treatment,the modified ROSS score,LVEF,LVFS and C/T in no glucocorticoid group were 6.00 ± 1.48,42.91 ± 14.36,21.55 ± 8.63 and 0.63 ± 0.05,which were significantly different compared with those in glucocorticoid 0.5-1 year group and glucocorticoid 1-2 years group (P＜0.05).However,no significant difference existed between glucocorticoid 0.5-1 year group and 1-2 years group on the modified ROSS score,LVEF and C/T after treatment (P＞0.05).Conclusion The glucocorticoid has good clinical effect on endocardial fibroelastosis,and no significant difference is found on the efficacy between the total course of glucocorticoid therapy 0.5-1 year group and 1-2 years group.
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Objective To construct the diabetic home care platform and to explore its effects in follow-up man agement of patients with gestational diabetes mellitus.Methods The diabetic home care platform contained clientsides for both nurses and patients,who could use the platform via identification and binding technology.Totally 200 patients with gestational diabetes mellitus in outpatient department from November 2015 to December 2016 were recruited using convenience sampling.Patients were divided into the experimental group and the control group with 100 cases in each group based on the voluntary principle.Both groups received routine follow-up management,and the experimental group also used diabetic home care platform management.Results There were no differences in gestational weeks,mode of delivery,postpartum hemorrhage,other complications,fetal intrauterine distress,neonatal hypoglycemia,and deformity between two groups(P＞0.05).Rate of macrosomia in the experimental group was lower than that in the control group(P＜0.05),and rate of breastfeeding was higher than the control group(P＜0.05).The total score of Diabetes Self-Care Activeties-6 and scores of each dimension in the experiential group were higher than those in the control group 8 weeks after intervention(P＜0.001);the total score of Problem Areas in Diabetes Scale and scores of each dimension in the experimental group were lower than those in the control group(P＜0.05).Conclusion Application of diabetic home care platform is helpful for fetal weight control,and can improve rate of breastfeeding,promote women's self-management behavior and emotional disorders.
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Objective To evaluate the effect of vagus nerve stimulation (VNS)on post－encephalitic intrac-table epilepsy and the improvement of postoperative cognitive function and quality of life.Methods The patients with post－encephalitic epilepsy in Sanbo Brain Hospital,Capital Medical University from January 2008 to December 2016 were selected.A single center and retrospective study method was used to evaluate the cognitive function,social function of preoperative and postoperative and postoperative seizure classification.The follow－up time points included preopera-tive,posto-perative in 6 months,1 year after operation and postoperative annual review.Results A total of 43 patients were followed up,including 19 females and 24 males,with an average age of (9.37 ± 4.18)years old.The time of fol-low－up was (43.90 ± 33.04)months.According to Engel classification:GradeⅠ3 cases (7.0%),gradeⅡ3 ca-ses (7. 0%),grade Ⅲ14 cases (32.6%),grade Ⅳ21 cases (48.8%).According to McHugh classification:GradeⅠ8 cases (18.6%),grade Ⅱ12 cases (28%),gradeⅢ11 cases (25.5%),gradeⅣ6 cases (14.0%),gradeⅤ4 cases (9.3%).Speech improvement of postoperative:significant improvement in 3 cases (7.0%),slightly improved in 17 cases (39.6%);interpersonal communication improvement of postoperative:significantly increased 7 cases (16. 4%), slightly improved 16 cases(37.2%);learning/working ability improvement of postoperative:significantly improved 6 cases (14. 0%),slightly increased 14 cases(32. 6%).The postoperative VIQ (6.21 ±5.02)scores,PIQ (7.28 ±6.10)scores,FIQ (2.93 ±3.74)scores and MQ were (4.81 ± 2.98)scores higher than preoperative.Conclusions VNS can effectively im-prove the seizures of post－encephalitic epilepsy as well as the children's quality of life,cognition and social function.
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Objective To study the influencing factors for outcomes of gastric low-grade intraepithelial neoplasia ( LGIN) for better LGIN treatment regimen. Methods Using magnifying endoscopy combined with narrow-band imaging ( ME-NBI ) follow-up strategy, the endoscopic features of 47 cases of LGIN in Fujian Provincial Hospital, including location, size, surface situation, demarcation line, microvascular pattern and microsurface pattern, were prospectively observed, then the factors influencing the outcome were analyzed. Results Among the 47 cases of LGIN, there were 35 cases in stable condition, whose results of biopsy and ME-NBI had no changes (stable LGIN), and the mean follow-up time was 20. 7±6. 9 months. The remaining 12 patients had progressive dysplasia (progressive LGIN), including 4 cases of high-grade intraepithelial neoplasia, and 8 cases of moderate dysplasia. The mean follow-up time was 16. 3 ± 11. 8 months. There were no significant differences between the two groups in gender (P=0. 33), mean age (P=0. 13), lesion distribution (P=0. 70), and lesion morphology (P=0. 97). The lesion size was less than 20 mm in the stable group ( 71. 4％, 25/35) , and over 20 mm in the progressive group ( 66. 7％, 8/12) , and the difference was statistically significant ( P=0. 02) . The proportion of the lesion surface heterogeneity in the progressive group was significantly higher than that in the stable group[75. 0％ (9/12) VS 34. 3％ (12/35),P= 0. 01 ] . The proportion of positive manifestations under ME-NBI in the progressive group was also significantly higher than that in the stable group [ 83. 3％ ( 10/12 ) VS 8. 6％ ( 3/35 ) , P = 0. 00 ] . Conclusion The size of lesions over 20 mm, the uneven surface and positive ME-NBI are the important factors influencing the outcome of LGIN, which are of significance for the diagnosis and treatment of LGIN.
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Objective To evaluate the application of 3.0 T magnetic resonance angiography (MRA) in follow-up after embolization of intracranial aneurysms with stent-assisted coils.Methods From June 2013 to June 2015,32 consecutive patients with subarachnoid hemorrhage due to ruptured intracranial aneurysms underwent stent-assisted coil embolization at the Department of Neurosurgery,the Sixth People′s Hospital of Shenzhen were enrolled retrospectively,including 12 males and 20 female,their mean age was 56±10 years.All patients were confirmed to be solitary intracranial aneurysms by digital subtraction angiography (DSA) before embolization.They were followed up with 3.0 T time of flight MRA (TOF-MRA) and contrast enhanced MRA (CE-MRA) at 1 to 2 years after embolization.DSA findings were served as the golden standard.The effect of aneurysm embolization (stabilization,further embolization,recanalization/recurrence) and patency of the parent arteries (without stenosis/mild stenosis,moderate to severe stenosis and occlusion) were compared.Results (1) The comparisons of evaluating the aneurysmal effects and consistencies of DSA among TOF-MRA,CE-MRA and TOF-MRA+source images after stent-assisted coil embolization were poor (Kappa=0.039,P=0.002),medium (Kappa=0.582,P<0.01),and higher (Kappa=0.615,P<0.01),respectively.(2) The comparison of the consistencies in the patency of the parent artery after stent-assisted coil embolization between TOF-MRA,CE-MRA and DSA were poor (Kappa=0.171,P=0.211;Kappa=0.376,P=0.010).(3) With the DSA findings as reference,the accuracy rates of TOF-MRA,TOF-MRA+source images and CE-MRA for interpretation of aneurysm embolization were 37.5% (12/32),75.0% (24/32),and 71.9% (23/32),respectively.TOF-MRA compared with TOF-MRA+source images and CE-MRA respectively,there were significant differences in the accuracy rates (χ2=9.04,P=0.003;χ2=7.63,P=0.006);there were no significant differences in the accuracy rates between TOF-MRA+source images and CE-MRA (χ2=0.08,P=0.777).(4) With the DSA findings as reference,the accuracy rates of TOF-MRA and CE-MRA for interpretation of the patency of the parent artery were 37.5% (12/32) and 62.5% (20/32) respectively.There was no significant difference in the accuracy rate (χ2=4.67,P=0.097).Conclusions The accuracy rate of 3.0 T CE-MRA for evaluating the embolization effect of intracranial aneurysms after stent-assisted coil embolization was superior to that of TOF-MRA.It can be used as a preferred non-invasive examination during the follow-up.TOF-MRA+source images are equivalent to CE-MRA,however,TOF-MRA and CE-MRA for the evaluation of the accuracy of patency of the parent arteries are low.For positive or indeterminate results of MRA examinations,the individualized analysis should be performed,if necessary,perform DSA examination.
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Objective To observe the effect of medication compliance and self-efficacy of schizophrenia patients with diabetes by continuing self-management education. Methods A total of 60 patients with schizophrenia with diabetes diagnostic criteria were divided into experimental group (30 cases) and control group (30 cases) by the admission number, 2 groups received conventional drug treatment, the control group received general preaching health education pattern, were each issued a health education manual, with schizophrenia and diabetes health knowledge division, the test group on the basis of the continuation of the implementation of self-management education, followed up 12 months after discharge, compared 2 groups of patients with medication compliance and recurrence rate, with General Perceived Self-Efficacy Scale (GSES) assessment level of 2 groups of patients with self-efficacy, fasting blood glucose (FPG) was determined by automatic biochemical analyzer, 2 hours postprandial blood glucose (2 hPBG). Results Six months after discharge, 82.1%(23/28) cases were complete compliance, 14.3%(4/28) cases of partial compliance, 3.6%(1/28) cases of non-compliance, 55.2%(16/29)cases of the control group complete compliance, 27.6%(8/29) cases of partial compliance, 17.2%(5/29) cases of non-compliance, the differences between two groups were statistically significant (χ2=37.41, P<0.05). The 12 month test group of full compliance discharged 75.0%(21/28) cases, 14.3%(4/28) cases of partial compliance, 10.7%(3/28) cases of non-compliance, 31.0%(9/29) cases of the control group complete compliance, 31.0%(9/29) cases of partial compliance, 37.9%(11/29) cases of non-compliance, the test group compliance was higher than the control group (χ2=11.27, P<0.05). The score after 6 months and 12 months respectively for the test group general self-efficacy scored 35.32 ± 2.02, 34.18 ± 1.77, control group scored 24.03 ± 3.04, 22.48 ± 2.01, the differences between two groups were statistically significant (t=16.445, 23.304, P<0.01). After 6 months in test group FPG and 2 hPBG were (5.71 ± 1.05), (9.46 ± 1.37) mmol/L, control group were (7.79 ± 1.05),(12.28 ± 2.07) mmol/L, the differences between two groups were statistically significant (t=7.483, 6.023, P<0.01). 12 months after discharge in test group FPG and 2 hPBG respectively (5.89±1.13), (9.68±1.09) mmol/L, control group (9.14±1.19), (13.17±1.42) mmol/L, test group FPG and 2 hPBG were lower than the control group (t=10.550, 7.431, P<0.01). After 6 months and 12 months, the recurrence rate of experimental group were 7.1% (2/28) and 24.1% (7/29) respectively, and control group were 14.3%(4/28) and 44.8%(13/29), the recurrence rate of experimental group was lower than the control group, there was significant difference between 2 groups (χ2=4.326, 6.225, P< 0.05 or 0.01). Conclusions Self-management education can improve the medication compliance and self-efficacy, improve mental symptoms and sugar metabolism, and reduce the recurrence rate.
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Objective:To compare the concordance between subjective experience and clinician-rated in different treatment phrase of elderly patients with depressive disorder,and to explore the relevant factors.Methods:Sixty-nine consecutive elderly patiems with depressive disorder diagnosed with International Classification of Diseases-10 criteria were included.The Visual Scale for Depression(VSD) were used to evaluate subjective experience of depression,while the Hamilton Depression Scale (HAMD),Hamilton Anxiety Scale (HAMA),Minimum Mental State Examination (MMSE) were used by clinician to evaluate depression symptom,anxiety symptom and cognition at baseline,2-,4-and 52-week of the treatment respectively.Results:Compared with baseline,VSD scores were increased at 2 weeks and 4 weeks [(2.7 ± 1.6),(5.3 ± 2.0) vs.(7.0 ± 1.8),P ＜ 0.001],HAMD scores were decreased at 2 weeks and 4 weeks [(36 ± 11),(17 ±9) vs.(9 ±8),P ＜0.001],HAMA scores were decreased at 2 weeks and 4 weeks [(27 ± 10),(14 ±8) vs.(7 ±6),P ＜0.001].No significant differences were found between 4 weeks and 52 weeks.There was no correlation between VSD and HAMD scores at baseline and 2 weeks.There were significant correlations among scores of VSD and HAMD(r =-0.31,-0.74,Ps ＜ 0.05),HAMA (r =-0.36,-0.76,Ps ＜ 0.05) at 4 weeks and 52 weeks.Using logistic regression analysis,the concordance between VSD and HAMD related with the factors of HAMD,higher scores of anxiety/somatization factor were associated with lower concordance (OR =0.87),and higher scores of weight factor (OR =1.86),diurnal variation factor (OR =2.00),hopelessness factor (OR =1.13) were associated with higher concordance.Conclusion:Compared with acute depression phase,concordance between subjective experience and clinician-rated for depression may be higher at depression remission phase in elderly patients with depression,which suggests that characteristics of depression symptom may have a certain impact on the self-awareness for depression experience.
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Objective To analyze Clopidogrel Resistance (CR) and influencing factors of coronary heart disease (CHD) with diabetes (DM) patients and evaluatc the relationship of CR and major adverse cardiovascular events (MACE) and readmission of CHD with DM patients.Methods 270 CHD patients were enrolled.Clinical conditions of CR were measured by adenosine diphosphate (ADP) induced maximum platelet aggregation rate (MPAR).After 1-year follow-up,MACE events and rehospitalization were recorded.Results CR of NDM and DM patients were 45 (33.1％) and 78 cases (58.2％) respectively,and the difference was significant (P ＜ 0.001).Factors of CR of CHD DM patients included heart rate,TG level,the number of severe coronary artery disease.MACE events of CS and CR patients were 35 (23.8％) and 47 patients (38.2％) respectively,and the difference was significant (P =0.010).The readmitted patients of CS and CR groups were 15 cases (10.2％) and 27 patients (22.0％) respectively,and the differcnce was significant (P =0.008).The MACE of CR and CS patients in DM group were 32 (41.0％) and 12 cases (21.4％) respectively,and thc difference was significant (P ＜ 0.05).The Readmitted cases of CR and CS patients in DM group were 19 (24.4％) and 5 (8.9％) respectively,and the diffcrcnce was significant (P ＜ 0.05).Conclusions CR of CHD DM patients increased significantly.The influencing factors of CR of CHDDM are including heart rate,TG level,the number of severe coronary artery disease.MACE events and rehospitalization rate were significantly increased in CHD patients with DM AR.Therefore,it should be further strengthened the anti-platelet therapy for CHD patients with DM.