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This paper intends to systematically review the efficacy and imaging related studies of dialectical behavior therapy （DBT） in the treatment of non-suicidal self-injury （NSSI）， so as to provide references for DBT treatment of NSSI. NSSI has a very high incidence in the population and is a major threat to the physical and mental health of adolescents. DBT shows certain advantages in the treatment of NSSI. Previous studies have preliminarily revealed the neurological effects of DBT treatment on patients， which provides an important objective basis for the efficacy of DBT treatment. In this paper， the efficacy of DBT in the treatment of NSSI and the brain imaging evidence are described and discussed， so as to provide references for the effectiveness of DBT in the treatment of NSSI.
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Combining with the currently applied psychology teaching mode of medical colleges and universities, regarding the core curriculum, abnormal psychology, as the object, we have explored the new teaching mode of graduate students majoring in applied psychology based on massive open online courses (MOOC), and promoted the fusion of classroom theory teaching, hospital practice, and MOOC course, so as to guide teaching reform of applied psychology and improve the quality of personnel training.
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Objective:To observe the efficacy and safety of olaparib combined with bevacizumab in patients with recurrent platinum-sensitive ovarian cancer, and the effect on serum levels of human epididymis protein 4 (HE4), carbohydrate antigen 125 (CA125) and circulating tumor cells (CTCs).Methods:A total of 96 patients with recurrent platinum-sensitive ovarian cancer admitted to Dongfeng Hospital Affiliated to Hubei Medical College from June 2018 to June 2019 were selected and divided into control group ( n=48) and study group ( n=48) according to the random number table method. The control group was given doxorubicin liposomes combined with carboplatin chemotherapy for 6 cycles, and the study group was given olaparib combined with bevacizumab, continuous olaparib, and bevacizumab for 6 cycles. The median progression-free survival (PFS), the objective effective rate (ORR), disease control rate (DCR) of the two groups were evaluated, the changes of serum HE4, CA125 and CTCs levels of the two groups after treatment were compared, and the adverse drug reactions of patients during treatment were observed. Results:The median PFS of the study group was 8.3 months, which was longer than 5.5 months of the control group, with a statistically significant difference ( χ2=5.134, P=0.025). The ORR and DCR of the study group were 52.08% (25/48) and 81.25% (39/48), which were significantly higher than 31.25% (15/48) and 62.50% (30/48) of the control group, with statistically significant differences ( χ2=4.286, P=0.038; χ2=4.174, P=0.041). After 6 cycles treatment, serum HE4 [(123.60±31.52) pmol/L vs. (178.01±46.22) pmol/L], CA125 [(33.52±10.61)U/L vs. (50.32±11.09) U/L] and CTCs [(2.19±0.24) pcs/5 ml vs. (3.25±0.31) pcs/5 ml] of the study group were significantly lower than those of the control group, with statistically significant differences ( t=8.489, P=0.025; t=7.562, P=0.032; t=9.341, P=0.017). The incidences of gastrointestinal reactions [35.42% (17/48) vs. 64.58% (31/48)], bone marrow suppression [18.75% (9/48) vs. 41.67% (20/48)], liver and kidney function damage [2.08% (1/48) vs. 14.58% (7/48)], cardiotoxicity [4.17% (2/48) vs. 18.75% (9/48)], allergy reaction [0 (0) vs. 8.33% (4/48)], neurotoxicity [2.08% (1/48) vs. 16.67% (8/48)] and other adverse reactions of the study group were significantly lower than those of the control group, with statistically significant differences ( χ2=8.167, P=0.004; χ2=7.584, P=0.006; χ2=4.909, P=0.027; χ2=5.031, P=0.025; χ2=4.174, P=0.041; χ2=6.008, P=0.014). Conclusion:For patients with recurrent platinum-sensitive ovarian cancer, olalapril combined with bevacizumab has better curative effect than doxorubicin liposome combined with carboplatin chemotherapy, and can prolong the survival period of patients, down-regulate serum HE4, CA125 and CTCs levels, with low incidence of adverse reactions.
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Non-suicidal self-injury, which is especially common in depressed adolescents, has become an important public health issue of global concern.It’s an independent risk factor for suicide, which not only seriously affects the physical and mental health of individuals, but also brings a great burden to families and society.The research status of non-suicidal self-injury in adolescent depression were systematically evaluated, aiming to improve the understanding of non-suicidal non-suicidal self-injury in adolescent depression, and provide a basis for clinical treatment and prevention of serious suicidal behavior.
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Objective@#To construct an evidence-based nursing plan for stroke patients with dysphagia for nursing by searching guidelines and using Delphi method.@*Methods@#The evidence-based nursing plan for stroke patients with dysphagia was constructed by literature review and guideline search. 15 experts from neurology, rehabilitation and nursing were selected to participate in two rounds Delphi consultation.@*Results@#The two-round response rates were 15/15. The expert authority coefficient was 0.877. The coordination coefficients were 0.180, 0.132 and 0.185 (P<0.05). The final plan included 4 first-grade indicators, 14 second-grade indicators and 20 third-grade indicators.@*Conclusion@#The evidence-based nursing intervention plan for stroke patients with dysphagia based on Delphi method is reliable, which can provide reference for the rehabilitation nursing of stroke patients with dysphagia.
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Objective To determine the impact of new methods in teaching and examination on students' learning of psychiatry by increasing the proportion of objective questions in the final exam papers through examination reform, so as to help students adapt to the Practitioner Examination. Methods A total of 483 students from grade 2011&2012 were selected as research subjects. Through the comparative study of the test scores under different teaching methods before and after the examination reform, the SPSS 22.0 statistical software was used to analyze the structure, reliability, difficulty and level of differentiation of the examine papers via t tests. Results Examination papers after the reform showed an increase in difficulty in all question types; some question types also had higher levels of differentiation. Students receiving PBL-based education had higher scores compared to those under traditional teaching methods. The difference was statistically significant. Conclusion PBL teaching mode is more conducive to the mastering of knowledge points and helps students improve grades in objective questions. Medical schools should increase the use of PBL teaching reform in psychiatry courses and conduct examination reform, so as to improve the teaching effect and the passing rate of Practitioners Examination.
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Objective To construct an evidence-based nursing plan for stroke patients with dysphagia for nursing by searching guidelines and using Delphi method. Methods The evidence-based nursing plan for stroke patients with dysphagia was constructed by literature review and guideline search. 15 experts from neurology, rehabilitation and nursing were selected to participate in two rounds Delphi consultation. Results The two-round response rates were 15/15. The expert authority coefficient was 0.877. The coordination coefficients were 0.180, 0.132 and 0.185 (P＜0.05). The final plan included 4 first-grade indicators, 14 second-grade indicators and 20 third-grade indicators. Conclusion The evidence-based nursing intervention plan for stroke patients with dysphagia based on Delphi method is reliable, which can provide reference for the rehabilitation nursing of stroke patients with dysphagia.
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Objective To analyze the content of clinical practice guidelines and provide references for developing Chinese clinical practice guideline of dysphagia with stroke. Methods Content analysis was used to analyze the contents of clinical practice guideline related to dysphagia with stroke which were searched from Internet. Results Ten guidelines were included which were consisted of 2 Chinese guidelines and 8 English guidelines. These guidelines' themes were stroke involving dysphagia, and only two of them were targeted on dysphagia. And one of them was targeted on dyshagia with stroke. Only one guideline hadn't been revised yet, and the rest had been updated. Twenty items were identified from 10 guidelines as been concerning to dysphagia with stroke. Conclusions Current clinical practice guideline about dysphagia with stroke can be used to guide clinical practice. However, some recommendations of guidelines are not clear and not updated in time which can't provide specific references for dysphagia. A clinical practice guideline which is suitable for dysphagia with stroke in China should be developed based on best evidece and Chinese actual conditions.
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Objective To explore the correlation between polymorphisms (SNPs) of locus rs2269272 of glial high-affinity glutamate transporter (SLC1A3) gene and suicide attempt among Chinese adolescents.Methods iMLDRTM genotyping technology was used to detect the polymorphism of rs2269272 SLC1A3 gene loci in 55 suicide attempters and 112 healthy controls,and survival analysis was applied to analyze the relationship between allele (T) and the age of suicide attempt.Results The differences of rs2269272 locus allele distribution between two groups were statistically significant(x2=4.208,P=0.040),but genotype distribution of two groups had no significantly differences(x2 =4.011,P=0.135).Non-suicidal self-injury adolescents with locus rs2269272 (15.6 ± 0.4) were younger than adolescents without locus rs2269272(16.4±0.7),but the difference was not statistically significant.Conclusion Preliminary findings suggest that rs2269272 SLC1 A3 may be relevant to non-suicidal self-injury acts,and rs2269272 locus allele is not related to earlier suicide attempt.
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Comprehensiveness of care is one of the core attributes of primary health care, and it has a great impact on the first diagnosis,accessibility,coordination and continuity to form the primary health care high perform-ance mechanism. Comprehensiveness of care has been playing an increasingly significant role in case when faced with the challenges of the aging of Chinese population,the high prevalence of chronic diseases,and the rapidly rising cost of health care. It is a fundamental problem for researchers,policy makers,and practitioners to clarify the definition of comprehensiveness of primary health care,which is the basis for managing comprehensive services. This article has systematically reviewed the current researches on definitions of comprehensiveness of basic health care, ascertained the key elements of comprehensiveness,and pinpointed the relationship between the dominant and recessive elements. Then,it defined the conception and the boundary of comprehensiveness of care in the context of primary health care,ac-cording to three principles-controllability, exhaustion, and exclusiveness, and finally conceptualized the primary health care comprehensiveness for further study on the operational definition of primary health care attributes.
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European psychiatric specialist training system has been maturely developed for 6 decades.The institutional framework for psychiatric training during specialization has been conformed to European standards,including training content,assessment and training base.In Europe,psychiatry specialist education lasts 5-7 years.Trainees should have experience of psychiatric internships and get assessed prospectively.After the training,trainees will receive the qualifications of the association for psychiatric training in Europe.While in China,the training time of psychiatrists is 3 years,the training of related departments is nearly 1 year,and psychiatric training is only 2 years.The training time of psychotherapy and clinical practice of psychiatry is still not enough.There is also a lack of consistency in the implementation of theoretical and practical training in all the bases in China.Therefore,by comparing the advantages and disadvantages of the Chinese and European psychiatry training system,this paper proposes optimizing the training program in China,increasing the students' humanistic cultivation and psychological care,and further improving the input of special training funds.
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General practice is the core of primary care.The attributes of primary care includes five core attributes (first-contact, accessibility, continuity, comprehensiveness and coordination) and three derived attributes (community orientation, family base and patient-centerdness).Only if the general practitioners integrate these attributes in their daily provision of health care, may the genaral medical care be transformed into high quality health care.The conceptualization of the core attributes lays the groundwork for theories of core attributes, which is an essential part of primary care theories.However, there exists an overlapping between the existing definitions and concepts of primary health care and their boundaries are not clear.Therefore, this paper first reviews the current literature on definitions and connotations of primary care attributes, then discusses the potential problems and solutions that may emerge during conceptualization, and finally provides the three principles to define the concepts and connotations of general practice attributes, namely controllability, exclusiveness and exhaustion.
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Accessibility is one of the core attributes of primary care, which is closely associated with first-contact, positively interacts with comprehensiveness, and is very influential to continuity and coordination.This paper first reviews the current literature on definition and concept of accessibility and highlights the characteristics and contents of primary care accessibility, then simplifies the overlapping between accessibility and other core attributes of primary care, and finally provides the definition of primary care accessibility and its core elements to lay the foundation for the development of measurement and evaluation tools for the core attributes of general practice.
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Continuity of care is one of the core attributes of primary care, which interacts with first-contact, accessibility, coordination and comprehensiveness in a mutual, supportive, and strengthening way to form an interactive mechanism of primary care.This paper first reviews the current literature on definitions and concepts of continuity of care, ascertain the key elements of continuity, and pinpoint the relationship between the dominant and recessive elements.Then, it defines the connotations of continuity of care and their boundaries in the context of primary care, according to the principles of controllability, exhaustion and exclusiveness.Finally it conceptualizes the primary care continuity to lay the foundation for further studies on operationally defining the primary care attributes of general practice.
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Amisulpride,a kind of the second generation antipsychotics,was marketed in China in 2010.A series of clinical research and experience before and after listed,especially the data based on Chinese population,provided evidence for the generalization and application of amisulpride.In order to optimize the clinical application of amisulpride,and improve the prognosis of patients,Expert Advice on the Practical Use of Amisulpride in the Treatment of Schizophrenia is presented here.This advice is based on the recent evidence and clinical experience,for guiding the clinical medication of amisulpride.
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Objective To understand the occurrence situation of negative life events in the past year among college students with suicidal ideation and to explore the correlation between negative life events and suicidal ideation. Methods The stratified and cluster sampling method was applied to conduct the questionnaire survey on 12 114 students from 11 universities in Chongqing City. The questionnaire of general demographic information was used to learn sociodemographic characteristics;the perspective on personal life questionnaire was applied to evaluate the suicidal ideation within recent 1 month and the self-designed life event scale was used to investigate the occurrence of negative life events in the past 1 year. Results The report rate of suicidal ideation within 1 month was 9.6%, the occurrence rate of short term suicidal ideation was increased with experiencing more negative life events. The x2 test showed that there was statistically significant difference in the proportion of suicidal ideation occurrence between college students experiencing 1 negative life event and those without experiencing the negative life event (x2 = 37.72,P<0.01) ;besides, the occurrence proportion of recent suicidal ideation had statistical difference between the college students with experiencing two or more negative life events and those without experiencing negative life event (x2 = 65.46,P<0.01). The multivariate Logistic regression analysis showed that the conflict with other family members (OR=0. 295,95%CI 0. 017-0. 571),abuse (OR=7. 295, 95%CI 6. 049-9. 701) were independentrisk factor for the recent suicidal ideation in college students. Conclusion Experiencing more negative life events, conflicting with other family members and abused by others have a correlation with the appearance of short term suicidal ideation in college students.
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General practice is the core of primary care, and it has become the fundamental part of some high-valued health care system. The function-orientated definition of primary care comprise of five core attributes, which are first-contact, accessibility, continuity, coordination and comprehensiveness of service. This paper started from the definition of general practice and sought to clarify and summarize the definitions, contents and functions of its five core attributes;meanwhile, the high-performance functional mechanism of health care system was also explored. On this basis, four suggestions are put forward: The basic medical health care system should be renamed primary care system;Five core attributes of primary care should be emphasized when strengthening the primary care system; the primary care system should be improved, and the key points are the number of general practitioners (GPs), payment system, primary care purchasing, educational system of GPs and etc.;The management system and service process should be developed which would benefit the implementation of the core attributes of primary care at an organizational level.
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Objective:The general practice attributes constitute a basis for the high primary care performance. In this paper, the general practice attributes are measured, their influencing factors are analyzed, the causes of exist-ing problems are explored, and suggestions are straight forwarded to strengthen the general practice function. Meth-ods:In this study, a PCAT-AE modified Chinese edition was adopted. The research was conducted into 8 community health centers and the general outpatient clinic of the University of Hong Kong, Shenzhen Hospital. They were eligi-ble adult patients who could communicate properly and had visited the same general practitioners at least three times. One-to-one interviews were conducted and a total of 1 712 patients participated in the survey, a number of which 1 645 effective samples were considered for analysis. Results: The total general practice attributes score was 49. 0. The first-contact score of 69 . 8 , continuity score being 63 . 1 and the cultural competence score of 51 . 2 were relatively high. The scores for the access (40. 8) and community orientation (31. 0) were relatively low. The general practice attribute scores were influenced by the social demographic and health characteristics, and the health care service uti-lization. Also, the general practice core attributes were positively related to the patient satisfaction (OR>1). Con-clusion:Comparing to the numbers in the developed countries, the general practice attribute scores were still low in China. Therefore, to strengthen the general practice function, works could be done at the individual, organization and system levels.
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The definition and connotation of tiered health care system ( THCS ) is a fundamental field of re-search for the system and a logic orientation of institution establishment and smoothing as well. Through analyzing and distinguishing the related international and domestic THCS concepts and exploring its essence from the general prac-tice attributes perspective, we found several problems existing in the Chinese THCS. First of all, the three-tiered pa-tient transfer principle which, merely based on the disease, have seriously neglected patient’s health care system serv-ice requirements. Second, the specialty of the general practice lost the function of making a supplement of specialized disciplines. Third, it did not generate a straightforward boundary between the general practice and special care sys-tem. Forth, the organizational management was adopted to replace the professional one required by two specialties. Based on these findings, we gave a clear and smooth THCS definition and answered three fundamental TMSS ques-tions. Additionally, we proposed a concept for which TMSS management should be composed of micro-, medium-and macro-level institutions.
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Objective:The objective of this study was to evaluate and compare the core attributes of the four general practice models in Guangzhou, Dongguan and Shenzhen, and to provide the suggestions for strengthening the general practice functions. Methods: We used the two stage sampling method in this study. Firstly, three CHCs in Guangzhou, two in Dongguan and two in Shenzhen, and the general medical outpatient department in the Shenzhen Hospital of the University of Hong Kong were selected. Secondly, we used the convenience sam-pling method to perform investigation. A PCAT-AE modified Chinese edition was adapted to measure the patients’ primary care experience. A total of 1 712 patients participated in the questionnaire survey, the number of which 1 645 copies were valid. Results: Generally, the general practice core attributes’ total scores from that hospital were higher than those from Guangzhou communities (55. 3 vs. 45. 9, P<0. 05), Dongguan commu-nities (55. 3 vs. 49. 2, P<0. 05) and the Shenzhen communities (55. 3vs. 51. 7, P<0. 05). Conclusion:The primary care implementation was different in accordance with the characteristics of regions, and the general practice core attributes had different characteristics in different models. It could constantly improve the primary care services to each model’s specific circumstances.