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BackgroundThe incidence of delirium in critically ill psychiatric patients is high， and there are many factors affecting delirium occurrence. At present， epidemiological studies on delirium among critically ill patients in psychiatric hospitals are limited. ObjectiveTo explore the risk factors for delirium in critically ill patients in a psychiatric hospital， so as to guide the clinical management of delirium in psychiatric hospitals. MethodsThis retrospective study included 427 critically ill patients who were admitted to Shenzhen Kangning Hospital from January 1， 2019 to May 31， 2021. The delirium situation， gender， age， pre-admission course of illness （duration from the onset of acute mental state changes to in-patient registration at a psychiatric hospital）， history of mental illness， history of cognitive dysfunction， history of using psychoactive substances， history of using sedative and hypnotic drugs， number of combined chronic diseases， number of combined drugs and type of disease were examined as potential risk factors for delirium. Single Logistic regression was used to analyze the potential risk factors for delirium， and the potential risk factors were incorporated into the multi-factor Logistic regression analysis model so as to gradually screen out the risk factors for delirium in critically ill psychiatric patients. ResultsDelirium was present in 33.49% （143/427） of critically ill patients. Multi-factor Logistic regression analysis demonstrated that the presence of delirium was associated with mental and behavioral disorders caused by psychoactive substances （OR=8.949， P<0.01）， absent history of mental illness （OR=4.202， P<0.01）， number of combined chronic diseases （OR=1.249， P<0.01）， age （OR=1.031， P<0.01） and pre-admission course of illness （OR=0.942， P<0.01） . ConclusionDelirium was present in nearly 1/3 critically ill patients in the psychiatric hospital. The risk factors for delirium included short course of illness before admission， age， more combined chronic diseases， absent history of mental illness， mental and behavioral disorders caused by psychoactive substances. ［Funded by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties （number， SZGSP013）］
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ObjectiveTo investigate the prevenance rate and related factors of anxiety among the public before and after outbreak of COVID-19， and to provide scientific guidance for public health emergency response in psychological intervention field. MethodsBy using the convenient sampling method， residents in Chinese mainland participated in predesigned questionnaire survey from February 7th to February 14th， 2020， meantime， all the selected individuals were assessed using Self-rating Anxiety Scale （SAS）. The anxiety status was also retrospectively evaluated before January 20th， prior to the outbreak. Thereafter， a before-and-after comparison was conducted on the anxiety status， and the related influencing factors were discussed. ResultsA total of 1 222 valid questionnaires were collected， with a valid rate of 93.8%. After the outbreak， the number of people with anxiety symptoms increased from 90 （7.4%） to 172 （14.1%）， with statistical difference （P<0.01）. The SAS score increased from （40.65±10.43） to （36.32±8.46）， with statistical difference （P<0.01）. For overall sample， the independent risk factors of anxiety aggravation included serious disruptions of daily life （P<0.01）， older age （P<0.01）， female （P<0.01）， poor education background （P=0.005）， occupied in medical staff （P=0.031） and lack of medical education （P=0.039）. For medical staff， the independent risk factors of anxiety aggravation included sense of being-alienated （P<0.01）， older age （P<0.01）， female （P=0.002） and serious disruptions of daily life （P=0.044）. ConclusionThe prevalence rate of anxiety is increased after the outbreak of COVID-19， especially among the general public with serious disruptions of daily life， older age， females， poor education background， and the lack of medical education， and among medical staff with sense of being-alienated， older age， females， and serious disruptions of daily life.
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Objective:To explore the new mode of screening and intervention for obstructive sleep apnea (OSA) in civil servants and its influencing factors.Methods:From September to December 2017, 1 241 civil servants who underwent annual physical examination in the outpatient department of a civil servant unit in Guangdong province were enrolled. They were screened for high-risk patients with OSA by Berlin questionnaire, and then those high-risk patients would receive type 3 home sleep testing (HST). Patients diagnosed with OSA were given free continuous positive airway pressure (CPAP) intervention and follow-up. The HST acceptance of high-risk OSA patients, OSA prevalence, CPAP initial treatment response rate and adherence trend and influencing factors were analyzed among the civil servants.Results:A total of 1036 civil servants completed the Berlin Questionnaire screening, of which 22.0% (228/1 036) were positive for the Berlin Questionnaire and were considered to be at high risk for OSA. A total of 228 high-risk OSA patients underwent free HST screening, and 32.5% (74/228) refused sleep monitoring. 154 people received sleep monitoring, 103 people were eventually diagnosed with OSA, of which 41 were mild (40.2%), 35 were moderate (33.3%), and 27 were severe (26.5%). The estimated prevalence of OSA among civil servants was 9.9% (103/1 036). All OSA patients were provided with free auto-CPAP treatment, and only 55.3% (57/103) received initial CPAP treatment. Multivariate logistic regression analysis showed that the CPAP treatment response rate was positively correlated with the severity of OSA ( OR=5.65, 95% CI: 1.007―31.693); it was negatively correlated with the general health status score of the 36-Item Short Form of the Medical Outcomes Survey (SF-36, OR=0.968, 95% CI: 0.938―0.998).Self-determined behavioral interventions and self-perceptions that treatment not needed were the reasons for not receiving treatment.In the first week of initial CPAP treatment follow-up, 70.2% (40/57) patients had good adherence ≥4 h/night, and the median adherence was 5.0(4.0, 6.0) h/night. The adherence of 17 cases (29.8%) was less than 4 h/night, and the median adherence was 0 (0, 2.0) h/night. Univariate analysis showed that those with difficulty falling asleep, anxiety, depression, and adverse reactions to CPAP (nasal mask discomfort and suffocation) had worse adherence. The long-term adherence to CPAP treatment gradually declined, and by the 2-year follow-up period, only 22.0% of patients had good adherence. Conclusions:Even with free sleep screening and disease intervention mode, the acceptance of sleep monitoring and CPAP treatment is still low, and the short-term and long-term adherence to CPAP is poor. Epworth sleepiness Score, hypertension, and disease cognition affected the acceptance of sleep monitoring. Psycho psychological factors and adverse reactions to CPAP affect patient compliance.
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OBJECTIVE:To establish the method for preparation of compound fluconazole eye drops and to determine the content of fluconazole in the preparation METHODS:Detection was performed by second order derivative spectrophotometry RESULTS:Linear relationship was found in the fluconazole concentrations ranging from 80?g/ml to 400?g/ml The regression equation was D=0 0 094+0 002C,r=0 9 998 The recovery of fluconazole was 99 83%(RSD=0 69%,n=5) CO_NCLUSION:The eye drops was stable The method of determination of the content is simple,rapid and reliable