Incidence and influencing factors of postpartum depression and anxiety among 2 490 puerpera in Urumqi in 2020 / 上海预防医学

ObjectiveTo investigate the incidence and influencing factors of postpartum depression and anxiety in Urumqi during the coronavirus disease （COVID-19） epidemic period in 2020. MethodsResearch subjects were the parturients who underwent postpartum health checkups in a third class hospital in Urumqi from January 2020 to December 2020. The maternal socio demographic and obstetric information were collected， and PHQ-9 and GAD-7 scales were used for screening of PPD and PPA. Calcaneal bone mineral density of the parturients was measured by French Pegasus ultrasonic bone densitometer. After univariate analysis of the related influencing factors of PPD and PPA， multivariate binary logistic regression analysis was used to explore the relationship between mental disorders and various influencing factors. ResultsA total of 2 490 puerpera participated in the survey. The incidences of PPD and PPA in 2020 were 13.4 % and 10.8 %， respectively. Six factors with statistical differences after univariate analysis were included in multivariate binary logistic regression analysis. The final results suggested that age over 35 （OR=1.707，95%CI：1.142‒2.551）， unemployment （OR=1.478，95%CI：1.003‒2.205）， multipara（OR=1.340，95%CI：1.037‒1.733）， bone loss and osteoporosis （OR=1.434，95%CI： 1.076‒1.910） were the risk factors of PPD， while breastfeeding （OR=0.466，95%CI： 0.301‒0.721） was a protective factor. Ages between 18‒24 （OR=1.559，95%CI：1.282‒3.097） and cesarean section （OR=1.433，95%CI： 1.105‒1.859） were the risk factors of PPA， while ages between 30‒34 years old （OR=0.524，95%CI： 0.332‒0.827）， occupation as medical staff （OR=0.282，95%CI： 0.807‒0.919）， breastfeeding （OR=0.530，95%CI： 0.330‒0.850） were protective factors. ConclusionIncidences of PPD and PPA are in middle-low levels during COVID-19 epidemic period. Age， occupation， delivery mode， delivery times， feeding pattern and bone mineral density are the influencing factors. Screen coverage of PPD and PPA in special period should be strengthened， and measures should be taken to reduce the risk.

Clinical characteristics and risk factors of rheumatoid arthritis with ulcerative keratitis / 北京大学学报(医学版)

OBJECTIVE@#To investigate the clinical characteristics, risk factors and prognosis of ulcerative keratitis (UK) in patients with rheumatoid arthritis (RA).@*METHODS@#Sixteen patients with UK (the UK group) were screened among 4 773 RA patients hospitalized at Peking University People's Hospital from January 2003 to May 2021, and 72 patients with RA without UK in the control group were selected by propensity score matching (PSM). The clinical features, laboratory data and medications between the two groups were collected and analyzed.@*RESULTS@#The average age of the patients with RA was 60 years at the time of the complication of UK. UK appeared on average in the 16th year of RA, with the majority of UK occurring in the 7th year of RA and beyond (14 cases), however, a minority of UK was the first symptom of RA (1 case). UK associated with RA manifested as simple marginal UK in 8 cases, marginal UK with perforation in 5 cases, marginal UK with uveitis in 2 cases and central UK with perforation in 1 case. The number of swollen joints was significantly higher in the UK group than in the control group [6.0(2.5, 23.0) vs. 3.0(1.0, 9.8), Z=-2.047, P=0.041], and the proportion of secondary Sjögren syndrome (SS, 37.5% vs. 6.9%, χ2=11.175, P=0.004) and interstitial lung disease (ILD, 37.5% vs. 8.3%, χ2=9.456, P=0.008) were significantly higher in the RA patients with UK than the patients without UK. The uses of sulfasalazine (12.5% vs. 48.6%, χ2=7.006, P=0.008), leflunomide (31.3% vs. 63.9%, χ2=5.723, P=0.017) and gold salt(6.3% vs. 33.8%, χ2=4.841, P=0.032)were significantly lower in the UK group than in the control group. However, there was no statistically significant comparison between the two groups for the 28-joint disease activity score-erythrocyte sedimentation rate (5.3±1.8 vs. 5.1±1.6, t=0.309, P=0.761). Logistic analysis showed the number of swollen joints (OR=1.148), secondary SS (OR=79.118), complicated with ILD (OR=6.596) and the use of sulfasalazine (OR=0.037) were independent relevant factors (P < 0.05) for UK in RA patients.@*CONCLUSION@#The number of swollen joints, secondary SS, complicated with ILD and the use of sulfasalazine are independent relevant factors for UK in patients with RA.

Analysis on characteristics of externalizing problems behavior and related factors in new generation migrant workers / 重庆医学

Objective to investigate the characteristics of externalizing problems behavior and related factors in new generation migrant workers so as to provide a decision making basis for consensus propaganda,psychological assistance and intervention.Methods A total of 1 340 new generation migrant workers(male 862,femal 478) were extracted from the gathering areas of mi grant workers in the three cities of Chongqing,Shenzhen and Hangzhou,the questionnaire survey and evaluation were performed by adopting the Youth Self-Report (YSR),Harter Self-Perception Profile(HSPP),Lum Emotional Availability of Parents (LEAP),Perceived Availability of Social Support Questionnaire(PASSQ) and Psychological Acculturation Scale(PAS).Results The tested externalizing problems were slightly higher than the non-clinical tested reasonable scoring range,the peer support had statistical difference between sexes(P＜ 0.01),the personal ability and comprehensive self value had significantly positive correlation (P ＜ 0.01),and both were negatively correlated to the externalizing behavior problems(P＜0.01),parents' emotional availability and support showed significantly negative correlation to externalizing behavior problems(P＜0.01),the working environment support was negatively related to externalizing behavior problems(P＜0.05).The prediction of personal effectiveness to externalizing prob lems behavior was obvious(P＜0.01),the social acceptance(P＜0.01) and overall self value(P＜0.01)were the predictive factors of externalizing problems behavior,and the work environmental support had the predictive effect on externalizing problems behavior (P＜0.05).Conclusion Personal ability,parents' emotional availability and support,work environmental support and social acceptance are correlated with externalizing behavior problems in new generation migrant workers.The overall self value,social accept ance,mother's emotional availability and parents' emotional support have significant prediction,while the work environmental support has a predictive effect on externalizing behavior problems.

Multivariate Analysis for Early Stage Hyponatremia in Patients with Complete Cervical Spinal Cord Injury / 中国微创外科杂志

Objective To investigate the relevant factors of early stage hyponatremia in patients with complete cervical spinal cord injury (CSCI). Methods A retrospective study was conducted in consecutive 49 individuals with complete CSCI from January 2010 to December 2015.The diagnostic criteria for hyponatremia was two consecutive tests (interval <24 h) of serum sodium <135 mmol/L.Twenty-six patients with hyponatremia were classified as hyponatremia group , and the other 23 patients without hyponatremia were classified as control group .Ten factors were included in the univariate analysis: age, gender, the highest level of CSCI , the degree of CSCI , the blood albumin when transferred to ICU , the serum sodium when transferred to ICU , the use of glucocorticoid , the incidence of neurogenic shock , the average daily urine output , and the average daily liquid balance .The variables with significance (P<0.05) in the univariate analysis then entered stepwise logistic regression analysis .The optimal critical point of the continuous variables with statistical significance in the univariate analysis was determined by drawing the receiver operator characteristic curve . Results There were differences in two variables between the two groups ( P<0.05 ) .The incidence of neurogenic shock before the occurrence of hyponatremia was 57.7% ( 15/26 ) in the patients with hyponatremia and 26.1% ( 6/23 ) in the patients without hyponatremia(χ2 =6.516,P=0.011).The average daily urine output was (2225 ±389) ml in the patients with hyponatremia and (1936 ±289) ml in the patients without hyponatremia (t=2.924,P=0.005).The stepwise logistic regression analysis indicated that these two factors may be the independent relevant factors (OR =13.708 and 0.996, P =0.004 and 0.002, respectively).The receiver operator characteristic curve demonstrated the average daily urine output more than 2331 ml was the optimal critical point . Conclusion The neurogenic shock and the average daily urine volume more than 2331 ml are the independent relevant factors of early stage hyponatremia in patients with complete CSCI .

The relevant research of ventilator associated pneumonia and sedative therapy / 中国医学装备

Objective:To discuss the relevant factors between occurrence rate of ventilator associated pneumonia (VAP) and sedative therapy of patients adopted mechanical ventilation in intensive care unit (ICU) so as to improve strategy of sedation and reduce occurrence rate of VAP.Methods: The clinical data of 218 patients of ICU who were implemented mechanical ventilation combined with sedative were retrospectively analyzed. All of patients were divided into observation group (61cases) and control group(157cases) according to whether happened VAP. And the differences of sedative time, score of sedation, time of mechanical ventilation and stayed time in ICU between the two groups were analyzed and compared.Results: In observation group, the total sedative time was (7.51±7.86)d, score of sedation was (-2.69±1.09), time of mechanical ventilation was (8.52±17.11)d and stayed time in ICU was (24.44±21.93)d. In control group, all of these indicators were (3.83±2.91)d, (-1.22±1.52), (6.47±5.70)d, and (11.63±7.49)d, respectively. And the differences of them between the two groups were statistically significant (t=6.8850,t=5.0334,t=7.8012,t=6.4368,P<0.05).Conclusion: The sedative time, sedative depth of patient adopted mechanical ventilation are positively relevant with the occurrence rate of VAP, and the occurrence rate can be reduced through improving the strategy of sedation.

Selection of modes of delivery in the oligohydramnios patients / 中国综合临床

Objective To explore the prognosis of children under different modes of delivery in the oli?gohydramnios patients,in order to reduce unnecessary cesarean section rate. Methods One hundred and forty?eight cases of oligohydramnios from September 2013 to October 2015 in the First Affiliated Hospital of Tsinghua University were reviewed,including 74 cases of vaginal delivery,54 cases of vaginal delivery group,20 cases for fetal heart abnormalities in the induction of labor or labor in the process or abortion failure emergency caesarean birth operation( pilot transfer of emergency cesarean section delivery group);direct line selective cesarean section in 74 cases. The delivery surround unripe ending of three kinds of delivery mode was compared,and gestational weeks,estate, cervical score, maximal amniotic fluid dark area vertical depth ( AFV), amniotic fluid index ( AFI) ,fetal size,water treatment and abortion case of the vaginal delivery and emergency caesarean birth were statistically compared. Results Both fetal heart abnormality and amniotic fluid of third degree incidence of trial production of emergency cesarean section group was 80. 00%( 16/20) ,of vaginal delivery group was respectively 11. 11%( 6/54) ,29. 63 ( 16/54) ,and of selective cesarean section delivery group was 0 and 9. 50%( 7/74) re?spectively,the difference between the 3 groups was statistically significant( P2 cm,the high rate of abortion sensi?tive pregnant women with high rate of vaginal delivery.

Relevant factors of pulmonary arterial smooth muscle cells proliferation and pulmonary arterial hypertension / 中华实用儿科临床杂志

Pulmonary arterial hypertension (PAH)is a disease of unknown etiology that leads to a progressive increase in pulmonary vascular resistance (PVR),if untreated,ultimately right heart failure and high mortality.It is concerted pulmonary vascular contraction and vascular remodeling are the 2 main courses of physiology and pathology leading to PAH,especially the significant role of proliferation of pulmonary arterial smooth muscle cells.A lot of relevant factors are revealed to take a participation into regulating the proliferation of pulmonary arterial smooth muscle cells and finally PAH.

Establishment and evaluation of prognostic model of severe traumatic brain injury / 重庆医学

Objective To build the prognostic model of STBI and provide guidance for making clinical decision .Methods A total of 486 patients with STBI was collected .Six months after injury ,according to GOS ,the patients were divided into five levels :good , mild-to-moderate disability ,serious disability ,persistent vegetative state and death .Ordinal regression analysis were used to find out the main factors of different populations .Results There were significant differences between different levels in nine factors .The re-sult of ordinal regression analysis showed that GCS ,age ,rescue time and reaction of pupil to light stood as independent variables in prognosis of patients with STBI(P<0 .05) .The outcomes from the prognostic model were pretty much exactly the same as the ac-tual results(Kappa= 0 .640 ,P= 0 .026) .Conclusion Though using the prognostic model of STBI ,the present study found out prognosis was closely related to GCS ,age ,rescue time and reaction of pupil to light in patients with STBI ;thus it could provide guidance for prognosis evaluation .

Relevent factors,prevention and treatment of neonatal ventilator-associated pneumonia / 中国小儿急救医学

Objective To investigate the relevant factors of neonatal ventilator-associated pneumonia(VAP),and to provide a theoretical basis of prevention and treatment.Methods Retrospective analyed the clinical data of 145 critically ill neonates,who were treated with mechanical ventilator from Jan 2006 to Dec 2009 in the Third People′s Hospital of Wenzhou City,NICU.According to whether the neonates were occurred VAP,they were divided into two groups:VAP group(52 cases) and without VAP group(93 cases).Results Fifty-two out of the 145 neonates developed VAP.The incidence of VAP was 35.86%,the main relevent factors were the gestational ages,birth weights,the duration of mechanical ventilation and the times of intubation.There was significant difference between the two groups (P<0.05).The main pathogens were opportunistic bacteria,and mostly were G-bacilli.Conclusion The incidence of VAP has a close conclusion with the gestational ages,the birth weights,the duration of mechanical ventilation and the times of intubation.Regulate the use of breathing machine,strengthen aseptic operation,and select effective antibiotic can control the occurrence and development of VAP.

Observation on cervical intraepithelial neoplasia and early cervical carcinoma / 中国基层医药

Objective To discuss the correlation between cervical intraepithelial neoplasia(CIN) and uterine cervix cancer and the combination of TCT and colposcope for the investigation of cervical lesion.Methods 5545 patients were preliminarily screened by cervical fluid basement cell folium smear,in which 307 patients are masculine and 219 are negative,the 526 patients are suspected cervical lesions in clinical symptoms and they further underwent colposcopy and biopsy,the results were analyzed by pathohistology which is golden standard.Results CIN coherent dangerous factors analyzed by single factor Logistic regression analysis are:cervical HPV pollution,age of sexual activity,sexual partners numbers,protection of sexual life, STD history,age and frequency of miscarriage ( P < 0.05 ).The coincidence between TCT,colposeopy and pathologic diagnosis are 49.4%, 83.8% ;the omission diagnostic rate of LSIL,HSIL and CC from TCT are 63.63% ,74.44% ,100% ;the omission diagnostic rate of LSIL,HSIL and CC from colposcopy are 33.37%, 12.22% ,0;the sensitivity of TCT,colposcopy and TCT combine colposcopy for CIN are 61.2% ,84.6% ,94.5% and specificity are 85.4% ,88.2.% ,90.8%.Conclusions (1)The generation of CIN and cervical cancer are correlated with cervical HPV pollution,sexual behavior and various kinds of lower genital tract infection.(2) Fluid basement cell folium smear can promote the property of diagnosis,meet the demands of early stage uterus neck cancer and precancer lesion investigation,are suitable to be routine cheek methods in primary hospital.

Analysis of Factors Relevant to the Onset of Eczema in 479 Infants in Taiyuan / 中国中医药信息杂志

0.05). 73.96% of eczema were taken place at the age of 1～6 months, 13.02% were at the age of 6 months to 2 years, and 13.61% were at the age of 2～3 years. The incidence of eczema is also relevant to feeding patterns, which is 62.23%, 23.08% and 14.79% respectively by breast-feeding, mixed feeding and artificial feeding. Some other factors that relevant to the onset of eczema also have been found in the study, such as constitution, weather, genetic background, and so on. Conclusion Feeding pattern, genetic background and some other factors were relevant to the onset of eczema.

Acomparative study on domestic violence in psychotics and its related factors / 重庆医科大学学报

Objective:To study the features of domestic violence of psychosis patients and its related factors.Methods:Demographic information questionnaire,past history questionnaire,Minnesota Multiphasic Personality Inventory(MMPI),Personality Diagnostic Questionnaire-4th Version(PDQ4+),early deviant family environment questionnaire(before 18 years old),BPRS and Family Environment Scale-Chinese version(FES-CV) were used to analyze the features of domestic violence and its related factors.Results:(1) There were 39 deaths and 28 injuries caused by 38 cases of domestic violence.(2) There were more cases with history of aggressive behavior in psychosis than without domestic violent behavior.There were more cases with history of alcohol abuse,parental unsound rearing styles,suffering parental abuse and family defect in early years in domestic violent patients than patients without.Diagnoses included more schizophrenia and depression in patients with domestic violence than patients without.Psychosis patients with domestic violent behavior had higher F,D,Hs,Hy,Pa scores of MMPI than patients without.Significant differences were found in cohesion,affection expression,entertainment.Compared with non-domestic violence patients,domestic violence patients had higher scores in paranoid,dependent,passive aggressive and depressive personality disorder of PDQ4+.There were deferences between two groups in total score,hostile—suspiciousness and anxiety—depression of the BPRS.(3) Logistic regression analyses suggested that the main risk factors for violent behavior of psychosis patients were the history of aggressive behavior,the D、Pa scores of MMPI and total score 、hostile—suspiciousness and anxiety—depression of the BPRS,parental abuse、parental unsound rearing styles,depressive personality disorder of PDQ4+.Conclusion:The domestic violence of psychosis patients brings about serous results.The high incidence among schizophrenic and depress patients should arouse the clinical and social awareness.Psychosocial factor 、personality disorder and symptom of psychopathology are causing factors of domestic violence,which can be considered to predict and direct intervention.