Résumé
ObjectiveTo evaluate the efficacy and safety of 7 atypical antipsychotics combined with selective serotonin reuptake inhibitors（SSRIs） in the treatment of refractory obsessive-compulsive disorder by network Meta-analysis. MethodsRandomized controlled trials （RCTs） about atypical antipsychotics and SSRIs in the treatment of refractory obsessive-compulsive disorder were searched in CNKI， Wanfang Data， VIP， CBM， PubMed， Embase and Cochrane Library databases from inception to June 2020. Based on inclusion and exclusion criteria， the literature screening， date extraction and assessing risk of bias were performed by two researchers independently. Then all statistical analyses were performed using Stata 15.0 software. ResultsA total of 36 RCTs covering 7 atypical antipsychotics and 2 362 patients were included. Network Meta-analysis showed that the surface under the cumulative ranking （SUCAR） of total response rate was the largest in Olanzapine + SSRIs， followed by Paliperidone + SSRIs， Amisulpride + SSRIs， Risperidone + SSRIs， Quetiapine + SSRIs， Ziprasidone + SSRIs， Aripiprazole + SSRIs， SSRIs， and Placebo + SSRIs in turn. In terms of Hamilton Anxiety Scale （HAMA） score， the SUCAR was the largest in Amisulpride + SSRIs， followed by Aripiprazole + SSRIs， Quetiapine + SSRIs， Risperidone + SSRIs， and SSRIs in turn. In terms of Treatment Emergent Symptom Scale （TESS） score， the SUCAR was the largest in Amisulpride + SSRIs， followed by SSRIs， Paliperidone + SSRIs， Quetiapine + SSRIs， Ziprasidone + SSRIs， Risperidone + SSRIs， Aripiprazole + SSRIs， and Placebo + SSRIs in turn. ConclusionCompared with single application of SSRIs， its combination with atypical antipsychotics achieves better efficacy and higher safety in treating refractory obsessive-compulsive disorder， with Olanzapine+SSRIs being the most effective and Amisulpride+SSRIs the safest.
Résumé
Objective This paper aims to describe the prevalence of unhealthy weight control behaviors and its related factors amongst female medical college students. Method Questionnaire surveys were conducted among a total of 798 medical students recruited by cluster random sampling in Jining Medical College from April 5 to 16, 2013. Result A total of 728 valid questionnaires were collected; 29 participants (4.0%) were overweight and 9 participants (1.2%) were obese; 250 participants (34.3%) were losing weight. Among participants who had experience of losing weight, unhealthy weight control methods mainly included not eating staple food (17.3%), drinking diet tea (16.1%), fasting (12.9%), taking diet drug (8.6%), inducing diarrhea (5.4%), inducing vomiting (2.0%), enema (1.5%), etc.; 29.0% (211/728) of participants had unhealthy weight control behaviors. The rates of being weak (c2=19.681, P=0.000), failure to concentrate (c2=12.031, P=0.001), dizziness (c2=5.461, P=0.019), irregular menstruation (c2=24.628, P=0.000), anorexia (c2=32.008, P=0.000), insomnia (c2=11.021, P=0.001) and anxiety (c2=14.402, P=0.000) among participants who had unhealthy weight-control behaviors were higher than those of participants without unhealthy weight?control behaviors. Multinomial logistic regression indicated that the factors associated with unhealthy weight control behaviors were senior class (OR=2.041;95%CI:1.336-3.111), high average family income (OR=1.758;95%CI:1.183-2.611), weight loss intention (OR=6.756;95%CI:1.541-29.626),not hesitating to delay learning (OR=1.594;95%CI:1.078-2.359),insisting on weight loss process regardless of discomfort (OR=2.008;95%CI:1.245-3.238), slimming purpose (body beauty) (OR=1.786;95% CI: 1.095-2.913), and slimming purpose (fashion) (OR=3.169; 95%CI: 1.545-6.498). Subjects with longer dinner time (OR=0.556; 95% CI: 0.341-0.907) and preferring light diet (OR=0.593; 95% CI: 0.406-0.865) had lower rate of unhealthy weight control behaviors. Conclusion Part of female college students are lacking proper understanding of self body shape and unhealthy weight control behaviors and had done harm to their health.