Implementing Cognitive Training Into a Surgical Skill Course: A Pilot Study on Laparoscopic Suturing and Knot Tying.

Mini-invasive surgery-for example, laparoscopy-has challenged surgeons' skills by extending their usual haptic space and displaying indirect visual feedback through a screen. This may require new mental abilities, including spatial orientation and mental representation. This study aimed to test the effect of cognitive training based on motor imagery (MI) and action observation (AO) on surgical skills. A total of 28 postgraduate residents in surgery took part in our study and were randomly distributed into 1 of the 3 following groups: (1) the basic surgical skill, which is a short 2-day laparoscopic course + MI + AO group; (2) the basic surgical skill group; and (3) the control group. The MI + AO group underwent additional cognitive training, whereas the basic surgical skill group performed neutral activity during the same time. The laparoscopic suturing and knot tying performance as well as spatial ability and mental workload were assessed before and after the training period. We did not observe an effect of cognitive training on the laparoscopic performance. However, the basic surgical skill group significantly improved spatial orientation performance and rated lower mental workload, whereas the 2 others exhibited lower performance in a mental rotation test. Thus, actual and cognitive training pooled together during a short training period elicited too high a strain, thus limiting potential improvements. Because MI and AO already showed positive outcomes on surgical skills, this issue may, thus, be mitigated according to our specific learning conditions. Distributed learning may possibly better divide and share the strain associated with new surgical skills learning.

Effect of mirtazapine in depressive functional dyspepsia patients with weight loss / 中华行为医学与脑科学杂志

Objective To discuss the effect of mirtazapine in depressive functional dyspepsia patients with weight loss (FD-WL).Methods As a randomized and controlled trial,seventy-two FD patients with weight loss and depression were randomly divided into mirtazapine group(n=24),paroxetine group(n=23) and conventional group(n=25),and all patients were treated for 8 weeks.The Nepean Dyspepsia Index (NDI)-symptom checklist,the Hamilton Rating Scale of Depression (HAMD),body weight were assessed before the treatment and after 2,4,6,8 week.Results (1) After 2-week treatment,the scores of NDI-symptom checklist and HAMD in mirtazapine group were significantly lower than that in paroxetine group and conventional group.After 4-week,6-week and 8-week treatment,the score of HAMD in mirtazapine group((13.34±1.52),(11.65±1.56),(10.15±1.36)) and paroxetine group((13.65±1.81),(11.34±1.21),(9.58±1.41))was significantly lower than that in conventional group((18.15±1.61),(17.20±2.14),(15.30±1.56)) (all P0.05).(2) After 6-week and 8-week treatment,the body weight in mirtazapine group((53.17±6.46)kg,(53.55±6.52)kg)was significantly higher compared with that in paroxetine group((49.47±5.72)kg,(49.57±5.81)kg)and conventional group((48.69±5.60)kg,(48.68±5.65)kg)(all P<0.05).After 8-week treatment,patients in mirtazapine group experienced a weight gain of(3.34±1.82)kg.Conclusion Mirtazapine not only can significantly improve dyspepsia symptoms and depressive scoring,but also can increase body weight.

Clinic Trial of Chronic Nonbacterial Prostatitis Treated with Qingzhuo Qudu Pills Combined with Acupuncture / 广州中医药大学学报

Objective To investigate the clinical efficacy of Qingzhuo Qudu Pills combined with acupuncture in treating chronic nonbacterial prostatitis and to explore the possible molecular mechanism. Methods A total of 160 cases of chronic nonbacterial prostatitis were randomly divided into western medicine group, Chinese medicine group, acupuncture group and combined group, 40 cases in each group. The western medicine group was given Tamsulosin and Celecoxib tablets orally, Chinese medicine group was given Qingzhuo Qudu Pills, acupuncture group were given acupuncture, and the combined group were given Qingzhuo Qudu Pills plus acupuncture. Treatment period covered 30 days. Before and after treatment, the clinical efficiency of the four groups was assessed by the US National Institutes of Health chronic prostatitis symptom index ( NIH-CPSI) scores, and routine prostatic fluid examiantion and drug safety assessment were also carried out. Results ( 1) The total effective rate was 69.23%, 84.62%, 74.36% and 92.50% in the western medicine group, Chinese medicine group, acupuncture group and combined group, respectively; the combined group had the best clinical efficiency ( P0.05). (2) After treatment, the total scores and scores of each item of NIH-CPSI were decreased in the four groups ( P<0.05 compared with those before treatment) , and the improvement of general symptoms, the quality of life, pain and urination in the combined group was superior to that in the other 3 groups ( P<0.05) . ( 3) After treatment, levels of tumor necrosis factor alpha (TNF-α) and interleukin 1 beta (IL-1β) were decreased to various degrees (P<0.05 or P<0.01 compared with those before treatment), and the decrease in the combined group was superior to that in the other 3 groups (P<0.05). (4) The blood, urine and stool routine examination, electrocardiography, hepatic and renal function of the 4 groups stayed normal before and after treatment, and no adverse reaction was present in the 160 cases. Conclusion Qingzhuo Qudu Pills combined with acupuncture is safe and effective in treating chronic non-bacterial prostatitis through relieving symptoms and reducing the degrees of prostatitis. Cytokines may play an important role in the pathogenesis and treatment of chronic prostatitis.

A clinical randomized case-control study of donepezil in the treatment of aphasia after stroke / 中华行为医学与脑科学杂志

Objective To explore the efficacy and safety of the donepezil hydrochloride in the treatment of post-stroke aphasia.Methods 60 patients with post-stroke aphasia were divided randomly into donepezil hydrochloride group (30 cases) and control group (30 cases).Trail group patients were received 5 mg per time,and once a day for oral administration of 2 weeks.From the third week they were received 10 mg per time,once a day,for continuous 10 weeks,and finally implemented four weeks washout period.The control group patients were received conventional treatment of neurology.The language function of patients were assessed with the Western Aphasia Battery (WAB) and the adverse reactions after treatment were evaluated by Treatment Emergent Symptom Scale (TESS).Assessments were implemented at the three time points,the start of trail,12 weeks,a washout period of 4 weeks.Results After 12 weeks of treatment,the AQ,PQ,CQ scores of WAB in the experimental group were (91.35±8.14),(32.74±8.12),(91.53±7.89).After 4-week washout period,they were (94.69±5.21),(33.70±4.94),(93.33±5.59) respectively.After the trail for 12 and 16 weeks,the score of each WAB item in the trail group was significantly higher than that before treatment.Compared with the control group,there was significant difference between the two groups(P＜0.01).The trail group had no significant adverse reactions.Conclusion Donepezil hydrochloride in the early treatment of post-stroke aphasia is safe,effective and the therapeutic effect is stable.

Clinical features, quality of life and psychological factors in functional dyspepsia patients with weight loss / 中华消化内镜杂志

Objective To investigate clinical characteristics,quality of life,and psychological factors in functional dyspepsia (FD) patients with weight loss.Methods A multi-center and prospective investigation was conducted (Clinical trial registration number:ChiCTR-TRC-12001968) which recruited 1341 consecutive FD outpatients from three Guangdong hospitals according to Rome Ⅲ criteria between June and September in 2012.Of these,1057 patients with complete information were divided into group A as having weight loss more than 5％ (n =207) and group B as having weight loss less than 5％ (n =850).Nepean Dyspepsia Index-symptom checklist,appetite,Hamilton Rating Scale of Anxiety/Depression (HAMA/HAMD),Pittsburgh Sleep Quality Index (PSQI),Nepean Dyspepsia Index-quality of life,direct medical costs were used to compare the differences between the two groups.Results There were no significant differences in total scores of NDI-symptom checklist,the severity or bothersome items between two groups (t =-1.301、-0.918、0.138,P =0.193、0.359、0.890),but significant differences were observed in the frequence item and the rating of appetite as poor or very poor between two groups (t =-2.122,P =0.035 ;x2 =35.448,P =0.000 ;x2 =35.274,P =0.000).Significant differences were observed in the incidence of anxiety and depression and total scores of PSQI between the two groups (x2 =73.939,P =0.000;x2 =47.046,P =0.000 ; t =-4.904,P =0.000).Subscales scores of NDI-quality of life in group B were all significantly higher than those in group A (t =5.348、2.569、5.809、4.704,P =0.000、0.010、0.000、0.000).There were significant differences in the frequency of care-seeking and direct medical costs between the two groups (t =-4.860、-3.011,P =0.000、0.003).The frequency of gastroscopic examinations in group A was slightly higher than that in group B (t =-1.505,P =0.133).Conclusion FD patients with weight loss is not rare,and most of them have psychological disorders,loss of appetite and sleep disturbance.Moreover,care-seeking are more frequent,direct medical costs are more expensive,and impairment as assessed by NDI-QOL is more severe.Therefore,we should pay more attention to FD with weight loss in clinical setting.