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Objective:To examine the effect of minimally invasive radiofrequency(RF)thermocoagulation of the posterior medial branch of the spinal nerves on lumbar facet joint(LFJ)pain in the elderly.Methods:Patients over 60 years old with LFJ pain were randomly divided into an RF group and a control group.The primary outcome measures were the numerical rating scale(NRS)for pain assessment and the proportion of patients whose NRS decreased by 2 points or more, while the secondary outcome measures were the lumbar Oswestry dysfunction index(ODI), the proportion of patients whose ODI score decreased by 15 points or more, and the Macnab criteria.Results:Patients who met the inclusion criteria were divided into an RF group and a control group, with 135 patients in each group, including 171 women and 99 men.Compared with baseline values, changes in NRS scores in the RF group were significantly different from those in the control group at the 1st, 3rd and 6th months[(-2.3±1.1) vs.(-1.2±1.2), (-2.3±1.1) vs.(-1.2±1.2), (-2.3±1.1) vs.(-1.2±1.2), t=13.204, 16.366, 20.319, all P<0.001], and the proportions of patients whose NRS decreased by ≥2 at the 3rd and 6th months were higher in the RF group than in the control group[61.1%(80/131) vs.26.0%(32/123), 52.9%(64/121) vs.22.5%(25/111), χ2=18.287, 11.844, both P<0.001]. Compared with baseline values, there were also significant differences in ODI score changes between the RF group and the control group at the 1st, 3rd and 6th months[(-15.2±6.7) vs.(-10.1±7.4), (-14.6±6.8) vs.(-8.6±6.2), (-13.6±8.8) vs.(-7.7±9.2), t=5.563, 8.912, 7.721, all P<0.001], and the proportions of ODI reduction ≥15 were higher in the RF group than in the control group at the 3rd and 6th months[45.8%(60/131) vs.34.1%(42/123), 36.4%(44/121) vs.27.0%(30/111), χ2=6.668, 9.825, P=0.024, 0.031]. The proportions of patients achieving outcomes categorized as excellent and effective based on the Macnab criteria were significantly higher in the RF group than in the control group at the 6th month[60.3%(73/121) vs.36.0%(40/111), 81.0%(98/121) vs.54.1%(60/111), χ2=11.787, 8.890, both P<0.001)]. Conclusions:Minimally invasive radiofrequency thermocoagulation in the posterior medial branch of the spinal nerves can effectively reduce pain of the lumbar facet joints and improve movement disorders in the elderly, and the therapeutic effect is good 6 months after the procedure.
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Objective To explore the impact of mindfulness on sleep and the mediating role of resilience.Methods A total of 540 medical staff in a three first-class hospital were assessed by five facet mindfulness questionnaire (FFMQ),Pittsburgh sleep quality index(PSQI) and Connor-Davidson resilience scale(CD-RISC).Results The average PSQI scores of medical staff was (6.67±3.20),of which the total score was equal or above 8 accounting for 37.04％.The positive rate of each factor of PSQI (factor score ≥2) was 51.67％ for daytime function,37.22％ for sleeping time,and 24.07％ for subjective sleep quality.The total score of PSQI was (6.67±3.20),the score of FFMQ was (119.55±9.90),and the score of CDRISC was (59.50± 12.77).PSQI was negatively correlated with FFMQ and CD-RISC (r=-0.29,-0.24;both P＜0.01),and there was a significant positive correlation between FFMQ and CD-RISC (r=0.48,P＜0.01).The factors of FFMQ associated with CD-RISC were followed by the description of mindfulness,the action of awareness,the non-reaction and the observation of mindfulness.The multi-linear regression analysis showed that resilience played a part mediating role between mindfulness and sleep quality,with a mediating effect of 20.9％.Conclusion Mindfulness has a positive impact on the quality of sleep of medical staff through resilience.
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Objective To investigate the relationships between mindfulness,anxiety and depression in surface warship soldiers and the mediating role of attentional control.Methods Chinese versions of State-Trait Anxiety Inventory ( STAI ) , Center for Epidemiologic Studies Depression Scale ( CES-D ) , Attentional Control Scale ( ACS) and the Five Facet Mindfulness Questionnaire ( FFMQ) were used to survey 475 sur-face warship soldiers. Single factor analysis of variance,correlation analysis and path analysis were conducted by SPSS 20.0 and Amos18.0. Results ①The scores of the state anxiety,trait anxiety and depression in the soldiers and noncommissioned officers were significantly higher than that of commissioned officers (P<0.05) . As for the state anxiety,trait anxiety,depression and attentional focusing,there were statistically significant differences among different educational levels (P<0.05) . Specifically,the lower educational level,the higher anxiety and depression,the lower control focusing. ② There were significant positive correlations among at-tentional focusing (27.12±4.43),attentional shifting (29.43±3.78) and mindfulness (120.27±11.16,r=0.49-0.51,P<0.01). State anxiety (38.65±10.07) was negatively correlated with attentional focusing,atten-tional shifting and mindfulness (r=-0.32--0.54, P<0.01). Similar results were observed for trait anxiety (41.28±8.79) and depression (9.97±10.13). ③Attentional focusing partially mediated the relationships be-tween state anxiety,trait anxiety,depression and mindfulness. Conclusion Anxiety and depression of sol-diers have obvious relationships with kinds of soldiers' rank and education level. Mindfulness and attentional control are vital protective factors for marine army's mental health. This study indicates that mindfulness may improve individuals' attentional focusing and attentional shifting,and ameliorate negative moods such as anx-iety and depression.
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Objective To investigate the effect of combination therapy of Gabapentin and Cobamamide in treatment of painful diabetic neuropathy (PDN).Methods A total of 96 patients with type 2 diabetes (T2DM) and PDN were enrolled in this study and randomly divided into control group (Con,n=32),Cobamamide group,(n=32),and Gabapentin+Cobamamide group,(n=32).FPG and HbA1c were actively controlled in each group.Con group was treated with vitamin B1.Clinical and biochemical data of all the subjects were collected.The degree of pain was assessed by visual analogue scale (VAS).The changes of median nerve,peroneal nerve motor nerve conduction velocity (MNCV),and sensory nerve conduction velocity (SNCV) were evaluated by EMG assessment.The assessment of sleep quality was done by Pittsburgh sleep quality index scale (PSQI).Results There was no significant differences of baseline MNCV,SNCV and the degree of pain among the three groups (P>0.05).After treatment,all the above index were improved in both Cobamamide group and Gabapentin+Cobamamide group.MNCV and SNCV were higher in Gabapentin+Cobamamide group than in Cobamamide group (P0.05).Conclusion The combination therapy of Gabapentin and adenosine cobalt amine could reduce pain,improve nerve conduction velocity,and improve the quality of sleep.
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Objective To analyze psychological stress level and features of recruits in training camp.Methods Psychological stress self-evaluation test (PSET) was applied to 1 600 recruits in training camp.Results ①There were 64 recruits(64/1600,4％) who had high level of psychological stress(T score ≥70).②The psychological stress symptoms of recruits in training camp mainly manifested as increased alertness (87.7％),sleep deprivation (57.6％),mental and physical fatigue (48.7％) and nervous irritability (45.2％).③Psychological stress levels of recruits with different ages and different levels of self-feeling in camp had significant differences(P＜0.05).Conclusion Recruits in training camp have partly excessive psychological stress responses,targeted emergency decompression trainings should be carried out in recruits.
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Objective To study military medical graduates' psychological elastic characteris-tics and the key influencing factors. Methods A comparative study of 817 graduate students and 597 undergraduate students in a military academy was conducted by using positive negative emotions, pos-itive and negative cognitive bias and Mental Resilience Scale. Independent sample t-test, single factor analysis of variance, correlation analysis, and step-wise regression analysis were conducted by SPSS 18.0 for data analysis. Results ①Resilience scores of postgraduate students were significantly lower than those of undergraduate students (76.01 ±11.43 vs. 80.00 ±10.26, t=-6.76, P<0.01). Resilience scores of military postgraduates were significantly higher than those of local postgraduates (77.18 ± 11.59 vs. 74.97±11.19, t=2.77, P<0.05). Resilience scores of female postgraduates were significantly lower than those of males (74.79 ±10.83 vs. 76.94 ±11.78, t=2.68, P<0.05), reflected in factors of tenacity and strength. ②Resilience and its factors were positively related to positive affect and atten-tion to positive information (r=0.448~0.625, P<0.01), while negatively related to negative affect and attention to negative information (r=-0.206~-0.448, P<0.01). ③Regression analysis showed that posi-tive and negative emotion, attention to positive and negative information can significantly predict re-silience, accounting for the variance of 53.7%. ④Positive and negative affect partially mediated the relationship between attention to positive information and positive affect and resilience. Conclusion Attention to positive information and positive affect may be potential targets for intervention to enhance the level of resilience among military medical postgraduate students.