目的:探讨5·12地震灾区11~16岁少年儿童的心理健康状况及其影响因素,为下一步开展创伤后心理危机干预提供依据。方法:在地震发生后一个月,使用长处与困难问卷(SDQ)学生版,调查了1268名来自于灾区的少年儿童(平均年龄14.20±1.02岁,男女比例1:1.02)的心理健康状况及其影响因素。结果:(1)灾区少年儿童SDQ总困难因子平均得分为13.66±5.75,74.9%的人报告自身存在主观困难;(2)女性的总困难因子、情绪因子、亲社会因子得分高于男性(z=-4.317,-7.963,-3.717;Pslt;0.001);(3)困难对少年儿童社会功能的影响程度随年龄增加(χ2=7.684,P=0.021)。年龄越大,多动因子得分有增加的趋势(χ2=13.881,P=0.001);(4)重度暴露组其总困难因子、情绪因子、影响因子得分高于轻度暴露组(z=-2.374,-4.279,-2.114;Pslt;0.05),困难造成的主观精神困扰程度前组高于后组(z=-2.920,P=0.004);(5)女性、高年龄者、教师/同学伤亡较重者、震后被转移至安全的帐篷或房屋的间隔时间越长者,SDQ总困难因子异常的危险性越高。结论:震后灾区少年儿童的心理健康状况受到暴露水平、性别、年龄以及震后被转移至安全地点的时间的影响,心理干预应综合考虑相关因素。
Objective To study the mid-term and long-term postoperative results of Bentall procedure in patients with Marfan syndrome. Methods From February 2009 to July 2016, ten adolescent patients (mean age of 12.30±2.31 years ranged 9-16 years, mean height of 172.50±12.55 mm, mean weight of 48.60±17.08 kg) underwent Bentall procedure in our hospital. All these teenage patients were with Marfan syndrome, 6 boys and 4 girls. Five of them underwent mitral valve replacement procedure at the same time while 2 of them with tricuspid valvuloplasty. Results No mortality was found in hospitalization. One patient suffered respiratory failure after surgery. No renal failure, mediastinal infection or re-operation caused by bleeding were observed. All were well followed up for 62 months. One died of malignant arrhythmia, the other were in good condition with the latest interview. Conclusion Teenage patients with Marfan syndrome who underwent Bentall procedure have favorable outcomes in mid-term and long-term follow-up, they probably will not suffer anti-coagulation complications and restriction of growth.
ObjectivesTo evaluate the improvement of symptoms in patients with moderate to severe asthma aged 5-18 years treated with GINA (Global Initiative for Asthma) guidelines by network meta-analysis. Methods Randomized controlled trials (RCTs) about asthma patients aged 5 to 18 years with reported asthma symptom scores were collected from PubMed, Embase, Cochrane Library, CNKI, WanFang Data, VIP, SinoMed and clinical trial registry platform (ClinicalTrials.gov). The search time limit was from the inception to August 26, 2023. After two researchers independently screened literature, extracted data and evaluated the risk of bias of included studies, Stata 15.0 software was used for network meta-analysis. ResultsA total of 23 studies were included, 23 of which reported daytime asthma symptom scores. Compared with symptom scores in the low-dose ICS group, there was a statistically significant difference in improvement of daytime symptoms between low-dose ICS+LABA+LTRA (SMD=−1.4, 95%CI −1.99 to −0.81) and low-dose ICS+LABA+SABA (SMD=−1.43, 95%CI −2.48 to −0.39). Symptom scores for nighttime asthma were reported in 20 RCTs, and there was a statistically significant difference in symptom scores for low-dose ICS+LABA+LTRA (SMD=−1.20, 95%CI −2.20 to −0.21) compared with the low-dose ICS group. After the ranking of efficacy, the number one asthma symptom score in both daytime and nighttime was low-dose ICS+LABA+LTRA group. ConclusionLow dose ICS+LABA+LTRA has the best efficacy in improving daytime and nighttime asthma symptom scores.