Objective To investigate the family burden of depression inpatients, analyze the influencing factors and explore the approach to reduce the family burden. Methods On-the-spot investigation was conducted for the family members of 200 depression inpatients in Mental Health Center of West China Hospital of Sichuan University from January to December, 2008. Following questionnaires used for investigation were all self-scale and filled out by the family members: “Basic Information Scale of Patients and Family Members”, “Family Burden Scale of Patients with Depression” revised from Pai’s scale of “Burden on the Family of Disease” (scoring 0-48 points and covering 24 items under 6 dimensions, namely, financial burden, disruption of routine family activities, disruption of family leisure, disruption of family interactions, effect on physical health of family members, and effect on mental health of family members; rating each item on a 3-class scale, namely, zero for no burden, one for moderate burden, and two for severe burden) , and Xiao Shuiyuan’s “Social Support Scale” (10 items in total, a higher score indicates a better social support). SPSS 13.0 software was adopted to perform statistical analyses. Results The total score of family burden was 26.3±12.6, the positive answer rate of family burden was 100.0%, and the positive answer rate of the every dimension was above 80%. The score of family burden for parents and spouse was higher than that of children (Plt;0.05). The total score of social support was 40.22±9.06, and the correlation coefficient between family burden and family social support was –0.485 (Plt;0.001). Conclusion It is common for family members of depression patients to get family burden at different levels. The more social support family members get, the less the family burden is.
Objective To investigate the characteristics of cognitive function and its correlation to neuroendocrine status in patients with refractory depression. Methods A total of 41 patients diagnosed by ICD-10 as depression onset who have been treated with more than two antidepressants drugs, fulfilled the criteria of refractory depression. Another 40 patients diagnosed by ICD-10 as depression onset but who have not been treated, or have been treated with only one antidepressant drug were selected as controls. Patients in both groups were evaluated by WAIS-RC, STROOP, VF, TRAILS A, B, TOH and M-WCST, and the concentrations of CORT, ACTH, T3, FT3, T4, FT4, TSH were also determined. Results A significant difference was found in VF between the refractory depression group and the control group. This showed that the damage to short-term memory, attention and interference rejection capability was much more serious in the refractory depression group. The ACTH concentration in the refractory depression group was significantly different from that of the control group, which indicated that the damage to the Hypothalamic-pituitary-adrenal axis was more serious in the refractory depression group. In particular in relation to memory and attention defect. Conclusion Changes in the levels of CORT, ACTH, TSH, FT3 and T4 may be correlated to cognitive function damage in patients with refractory depression.
【摘要】 目的 评估四川省精神科专科医师培训基地带教师资培训效果、培训方式及提出建议。 方法 对2009年10月和2010年11月的两次培训均参加的59名带教师资采用自制评估表进行评估，其中男37名，女22名；年龄（39±9）岁。采用SPSS 13.0统计软件进行统计分析。 结果 参与培训带教师资对培训的效果总体评价，好22名，占37.29%，很好18名，占30.51%；对培训方式的总体评价，好25名，占42.37%，很好20名，占33.91%；参训教师各个方面较培训前均有显著提高。 结论 开展短期方式多样的集中培训可能是提高带教师资水平的一种快速途径。应该建立师资准入制度考核标准和标准培训内容，从而建立起一支高素质的精神专科医师培训的带教师资，保障精神专科医师培训的质量和顺利进行。【Abstract】 Objective To assess the results and styles of training process for faculty doctors in psychiatric specialist training center of Sichuan Province, and put forward suggestions. Methods We evaluated 59 psychiatric specialist training faculty doctors, including 37 males and 22 females aged (39±9) years old by giving out a self-made questionnaire. Factor analysis was done by adopting SPSS 13.0. Results Evaluation of the training results showed good in 22 doctors (37.29%), and very good in 18 doctors (30.51%); Evaluation of the training style showed good in 25 doctors (42.37%) and very good in 20 doctors (33.91%). After training, the faculty doctors got more progress than before in every aspects. Conclusions Short-term training with various training styles may be a quick way for faculty doctors in psychiatric specialist training center to increase their teaching ability. The standard enrollment criteria, standard training contents and standard exam criteria should be established. Through this, a high-quality faculty doctors in psychiatric specialist training center will be set up, which is very important in ensuring the quality and success of training for psychiatric specialist doctors.
Objective To observe the multimodal imaging characteristics of the eyes in patients with presumed tuberculous retinal vasculitis. Methods A retrospective case series study. A total of 15 patients (22 eyes) diagnosed with presumed tuberculous retinal vasculitis and receiving anti-tuberculosis treatment (ATT) effectively in Department of Ophthalmology, Subei People's Hospital Affiliated to Yangzhou University from January 2018 to April 2021 were included. Among them, there were 5 males and 10 females. Seven had bilateral involvement and 8 had unilateral involvement. The age was 49.3±11.1 years old. The best corrected visual acuity (BCVA), fundus colour photography, wide-angle fundus fluorescein angiography (FFA), and optical coherence tomography (OCT) were performed in all patients. Indocyanine green angiography (ICGA) was performed in 7 eyes. The BCVA examination was performed with the international standard visual acuity chart, which was converted into the logarithm of minimal angel resolution vision (logMAR). Systemic tuberculosis-related examinations included chest CT, serum T-spot, purified protein derivative and other tuberculosis-related tests. All patients were treated with systemic anti-tuberculosis therapy. The follow-up time was ＞12 months. The multimodal imaging characteristics for affected eyes. Nonparametric test was used to compare BCVA before and after treatment. ResultsThe retinal vessels of all the affected eyes were tortuously dilated, including 3 eyes with vascular white scabbard, 5 eyes with scattered bleeding point at the retina inculding 3 eyes walking along the vessels. The lesions were mainly distributed in the middle and periphery of the retina, and some of them involved the posterior pole; 12 eyes (54.5%, 12/22) with simple retinal vasculitis and 10 eyes (45.5%, 10/22) with retinal vasculitis complicated with choroiditis. Tuberculous retinal vasculitis showed different degrees of retinal vascular leakage on FFA, mainly retinal vein and capillary leakage, not involving arteries; 16 eyes (72.7%, 16/22) of retinal vasculitis showed peripheral occlusive retinal vasculitis and 4 eyes (18.2%, 4/22) were associated with retinal neovascularization. In 10 eyes with choroiditis, there were multiple focal choroiditis lesions of different sizes under the retina. Of the 7 eyes examined by ICGA, the choroidal inflammatory lesions showed hypofluorescent dark dots (HDD) in 5 eyes (71.4%,5/7), showing HDDs of different sizes, most of which were distributed in the posterior pole and middle periphery. In 10 eyes with retinal vasculitis complicated with choroiditis after ATT, the accumulation of hyper-reflective substances above and below the retinal pigment epithelium layer of the retina was gradually absorbed, but not completely disappeared, and most of the disorders of retinal structure could not be recovered. The average logMAR visual acuity was 0.61±0.57 before treatment and 0.36±0.55 after treatment. The BCVA after treatment was significantly higher than that before treatment (Z=－3.102, P＜0.01). ConclusionsPeripheral occlusive retinal vasculitis is the most common manifestation of tuberculous retinal vasculitis in FFA, which may be accompanied by focal choroidal inflammatory lesions. Wide-angle FFA and ICGA are more important in the diagnosis of tuberculous retinal vasculitis. OCT can be used for monitoring the changes of inflammation.
Objective To examine the prevalence of post-traumatic stress disorder (PTSD), anxiety, and depression for medical staffs who took part in rescue in the disaster area after Wenchuan Earthquake. Methods According to purpose sampling method, from June 12th to June 18th, we investigated the medical staffs in eight areas, and the total number was 500. The eight areas included Mianzhu, Deyang, Shifang, Chengdu, Mianyang, Pengzhou, Zitong, and Anxian. The survey tools were PTSD Checklist-Civilian Version (PCL-C), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS). After collecting all questionnaires, we divided 500 medical staffs into 2 groups, according to the fact whether the rescue was carried out in the disaster area or not. Results A total of 500 questionnaires were given to the subjects, of which 481 effective ones were collected, and the effective rate was about 96.2%. In addition, the prevalence of PTSD for overall was 23.3%, anxiety was 21.6%, depression was 49.9%, and the anxiety plus depression was 19.54%. At the same time, we found out the averages of PCL-C (48.29±29.90 vs. 34.76±18.03), PCL-C frequency (16.27±15.14 vs. 9.99±10.25), PCL-C severity (32.03±15.26 vs. 24.85±8.60), SAS primitive (37.39±10.35 vs. 32.22±7.61), SAS standard (46.73±12.94 vs. 40.27±9.51), SDS primitive (42.00±8.32 vs. 37.99±9.63), and SDS standard (52.50±10.39 vs. 47.48±11.92) were different. The medical staffs in the disaster area were under more severe conditions, and there were significant differences between the 2 groups. The prevalence of PTSD (28.52% vs. 16.59), anxiety (28.89% vs. 12.32%), depression (58.15% vs. 39.34%), and anxiety plus depression (26.67% vs. 10.43%) between the 2 groups was significantly different, and the disaster area was under severe conditions. Additionally, the prevalences at three levels within SAS and SDS were much higher in the disaster area. There were also significant differences. Conclusion The prevalences of PTSD, SAS, and SDS within medical staffs who took part in rescue in the disaster area after Wenchuan Earthquake are higher than in the non-disaster area. Therefore, we should work out mental intervention and rehabilitation project for medical staffs, especially those who took part in rescue in the disaster area. Finally, the medical staffs’ ability to copy with stress can be improved.
Objective To detect the contingent negative variation (CNV) in first episode deficit and non-deficit schizophrenia and the relationship between CNV and clinical symptoms. Methods Nihon Kohden evoked brain potentials machine were used to measure CNV in 60 patients with non-deficit schizophrenia (NDS), including 50 patients with deficit schizophrenia (DS) and 60 unrelated healthy controls (HC). Click-flashing paradigm was used to record the CNV and the differences among three groups were compared. The clinical status of patients with schizophrenia was determined using the Positive and Negative Syndrome Scale (PANSS). The overall functioning status was assessed using the Global Assessment of Functioning Scale (GAF). Partial correlations were computed to explore associations among the CNV in DS and the clinical data, controlling the sex, age, and education level. Results Compared to HC, both DS and NDS groups showed significantly reduced amplitude of B (F=27.38, P=0.00), significantly delayed reaction time (F=50.30, P=0.00). Compared to HC, the course of PINV in the DS group significantly shortened, while it was significantly delayed in the NDS group (F=15.32, P=0.00). Only in DS, when compared with that in HC, the latency of point A in CNV was delayed (F=61.01, P=0.00). There was no significant difference among three groups in both area of A-S2’ (F=2.34, P=0.10) and area of PINV (F=1.07, P=0.35). Amplitude of B and the course of PINV in the DS group correlated negatively with PANSS subscale of negative symptoms (r= –0.94, –0.89, respectively, Plt;0.05), whereas in the NDS group amplitude of B correlated negatively with PANSS subscale of positive symptoms (r= –0.87, Plt;0.05), but the course of PINV correlated positively with PANSS subscale of positive symptoms (r=0.88, Plt;0.05). Latency of point A in CNV, which was delayed in the DS group, correlated negatively with GAF (r= –0.48, Plt;0.05). Conclusion Generalized abnormalities of CNV existed in DS and NDS, while DS may cause more impairments in CNV than in NDS. The latency of point A in CNV may predict the social function outcomes of DS.
ObjectiveTo evaluate the effect of smoking and drinking status on the prognosis of patients with esophageal squamous cell carcinoma (ESCC).MethodsThe clinical data of 483 patients with ESCC who underwent surgical treatment in Shannxi Provincial People's Hospital from 2007 to 2016 were retrospectively analyzed. Among them, 352 patients were male and 131 were female, with a median age of 64 (37-80) years. There were 311 smokers and 172 drinkers. The relationship between preoperative drinking or smoking status and the clinicopathological characteristics of patients with ESCC was analyzed. Log-rank method and Cox risk regression were used to conduct univariate and multivariate survival analysis, respectively.ResultsThe preoperative smoking status was related to the patient's tumor location (P=0.030). Drinking status was associated with tumor location (P=0.001), degree of differentiation (P=0.030), pathological T stage (P=0.024) and pathological N stage (P=0.029). Univariate survival analysis showed that smoking status did not affect the disease-free survival (DFS) (P=0.188) and overall survival (OS) (P=0.127) of patients with ESCC. However, patients who drank alcohol had worse PFS than non-drinking patients (29.37 months vs. 42.87 months, P=0.009). It was further proved that alcohol consumption was an independent risk factor affecting patients' recurrence and metastasis by using multivariate analysis (RR=1.28, P=0.040). Alcohol consumption also reduced the OS of patients by 21.47 months (P=0.014), however, multivariate analysis did not yield significant results.ConclusionPreoperative drinking status is related to the stage and differentiation of patients with ESCC. It is an independent risk factor affecting the recurrence and metastasis of ESCC.