目的：探讨半椎板切开入路切除椎管内肿瘤的优缺点。方法：回顾性分析2004～2006年经手术切除病理证实的椎管内肿瘤196例的临床资料。其中80例行了半椎板入路肿瘤切除，与同期的116例全椎板切除病人进行比较。结果：半椎板切除病人手术住院时间明显缩短，术后起床反应轻微，远期效果较全椎板好，对脊柱的稳定性影响小。结论：单侧半椎板入路切除椎管内肿瘤损伤小，最有利于脊柱稳定性的维持。病人手术后住院时间短，反应轻微，远期疗效好。但也有暴露局限的缺点.
Objective To compare quality of life for HIV infected people or AIDS patients and their family members of noninfected people in two counties (Zizhong and Zhaojue) with high AIDS morbidity and high HIV infective rates. Methods The quality of life for HIV infected people or AIDS patients and 162 of their family members and 97 people noninfected HIV/AIDS was measured by a questionnaire containing the generic quality of life inventory 74 (GQOLI-74) and the social support scale (SSS). Data were analyzed with SPSS. Results Total GQOLI-74 scores and each of the four dimensionality scores were significantly lower for HIV/AIDS people and their family members compared with noninfected people (total score for HIV/AIDS people 52.20 [9.41]; family members 60.46 [11.92]; noninfected people 66.36 [8.90] (Plt;0.01)). Scores for each of the disease status (physical function, psychological function, social function and material status) were all lower compared with noninfected people (all comparisons Plt;0.01). GQOLI-74 scores of HIV/AIDS people were significantly correlated with disease status and social support, but age, education level and substance abuse did not show significantly correlation. Conclusions The quality of life for HIV infected people or AIDS patients and their families is significantly lower than the general population, and this is particularly related to the severity of their disease and lack of social support.
目的 探讨显微手术治疗破裂大脑中动脉动脉瘤（MCAA）的适应证、术前评估及手术技巧。 方法 回顾性分析2008年1月－2011年1月经翼点入路行显微外科手术治疗的65例破裂MCAA患者的临床资料。其中男40例，女25例；年龄22～78岁，平均46.8岁。术前Hunt-Hess分级：Ⅰ级15例，Ⅱ级25例，Ⅲ级13例，Ⅳ级10例，Ⅴ级2例。动脉瘤直径＜5 mm 10个，5～15 mm 36个，15～25 mm 15个，＞25 mm 4个，平均7.8 mm。其中56例动脉瘤位于大脑中动脉分叉部，5例位于大脑中动脉的M1段，4例位于分叉后M2段。 结果 手术夹闭动脉瘤60例，余5例行动脉瘤夹闭加包裹术。患者术后获随访3～36个月，平均16个月，均无动脉瘤复发或再出血发生。按格拉斯哥预后评分（GOS）结果评定：恢复良好58例（GOS 4～5分），差5例（GOS 2～3分），死亡2例（GOS 1分）。 结论 充分的术前评估，合适的手术入路选择，以及手术技巧的灵活应用是显微外科手术成功治疗破裂MCAA的保证。
Objective To investigate the evaluation of nursing students on nurse teachers’ teaching quality between lessons ofBasic Nursing, in order to provide references for the improvement of teaching methods and promotion of teaching quality. Methods Questionnaire survey was used to investigate nurse students on the evaluation of nurse teachers’ teaching quality in three different clinical practice stages between lessons ofBasic Nursing. SPSS 19.0 statistical package was used to analyze the data. Results In the 5-point scale, the average score of all items was (4.72±0.38) points, and the average scores of three dimensions including timely project completion and gains in the practice, nurse teachers’ teaching, and teaching environment and resources were respectively (4.71±0.44), (4.76±0.35), and (4.66±0.52) points. The three items with the highest scores were teachers’ theoretical knowledge, teachers’ professional quality, and helping nurse students analyze existing problems; while the three with the lowest scores were teaching methods, timely completion of the practice, and participation by other nurses during the teaching. There were significant differences among the three stages in practice gains, reasonability of practice arrangement, instructing the students to solve problems, proficiency and standardization of the operation demonstration, basic theoretical knowledge, flexibility and enlightenment of the teaching methods, attitudes of the nurse teachers, participation by other nurses during the teaching, and head nurse’s support (P<0.05). Conclusions To improve the quality of clinical practice teaching, nurse teachers, other nurses in the ward, head nurse and the whole department should make collective effort. Nurse teachers should pay more attention to the improvement of teaching methods and reasonable planning of clinical practice.
Mental disorders are a type of behavioral, emotional, cognitive, or thinking disorder that cause pain and social dysfunction, and are one of the top ten global disease burdens. Cannabidiol (CBD) is one of the main components of cannabis, with high safety and tolerability, and is a hot topic in drug research. CBD has a wide range of therapeutic effects, and research has found that CBD has neuropsychiatric effects such as anti-addiction, anti-depression, anti-anxiety, and anti-stress, making it one of the candidate drugs for mental disorders. This article summarizes the mechanism and research progress of CBD for major mental disorders, in order to provide useful references for CBD-related compounds in the treatment of mental disorders.
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 assess the effectiveness and safety of fukangpian in the treatment of opiate withdrawl symptoms. Methods We performed an electronic search for Cochrane Library (2004 version of Cochrane Controlled Trials Register), Medline (1966-2004), EMbase (1974-2004), and handsearched some Chinese journals for additional articles (such as CBM disc, VIP, CNKI, CMCC) (1980-2004). The quality of included randomized controlled trials was evaluated and meta-analysis was performed. Results We collected 31 studies about fukangpian, of which two studies involving 403 patients met the inclusion criteria. These two studies were of poor quality. Cmpared with clonidine, fukangpian showed a greater decrease than Clonidine group in the withdrawal symptom score for day 1 to day 4 (WMD of 9 points at day 4, 95%CI 5.47 to 12.52). Cmpared with placebo, the two studies for change in the withdrawal symptom score, fukangpian showed a greater decrease at day 1 to 3, but not at day 4 (WMD of 4.10 points at day 4, 95%CI -8.36 to 16.56; 1 study). Conclusions Based on the current evidence fukangpian is an effective and safe drug for abstinence of drug addiction. More high quality randomized controlled trials are required to promote the strength of evidence.
Objective To design the surgical strategy of percutaneous full-endoscopic bilateral decompression via unilateral posterior approach for bilateral lumbar spinal stenosis (LSS) and to evaluate the effectiveness. Methods The percutaneous full-endoscopic bilateral decompression via unilateral posterior approach for bilateral LSS was designed according to the pathological features of LSS. The technique was used to treat 42 patients with LSS between January 2016 and January 2018. There were 18 males and 24 females with an average age of 61.7 years (range, 46-81 years). The duration of symptoms was 1-20 years, with an average of 9.7 years. The surgical segment at L4, 5 were 27 cases, at L5, S1 were 15 cases. The operation time and perioperative complications were recorded. Lumbar X-ray, CT, and MRI examinations were performed at 1 week, 3 months, and 1 year after operation. Visual analogue scale (VAS) score was used to evaluate the low back pain and leg pain, Oswestry disability index (ODI) was used to evaluate the lumbar function, and single continuous walking distance (SCWD) was used to evaluate lower extremity nerve function. The clinical efficacy was evaluated by MacNab criteria at 1 year after operation. Results All patients underwent surgery successfully. The operation time was 68-141 minutes with an average of 98.2 minutes. All 42 patients were followed up 12-24 months with an average of 18.8 months. There were 2 cases of dural tears during operation, and 1 case of transient dysfunction of the lower limbs of the decompression channel after operation. All of them were cured after corresponding treatment. No serious complications such as death, major bleeding, or irreversible nerve injury occurred during follow-up. No segmental instability was found according to postoperative lumbar hyperextension and flexion X-ray films, and postoperative CT and MRI imaging showed that the stenotic lumbar spinal canal was significantly enlarged, and the compression of the nerve root was sufficient. The VAS score of low back pain and leg pain, ODI score, and SCWD at each time point after operation were significantly improved when compared with those before operation (P<0.05); the indexes were significantly improved over time after operation, and the differences were significantly (P<0.05). The clinical efficacy was evaluated by MacNab standard at 1 year after operation, and the results were excellent in 18 cases, good in 20 cases, fair in 3 cases, and poor in 1 case. The excellent and good rate was 90.5%. Conclusion The percutaneous full-endoscopic bilateral decompression via unilateral posterior approach for LSS is a safe and effective procedure. A well-designed surgical strategy and mastery of its technical points are important guarantees for successful operation and satisfactory results.
Objective To evaluate the clinical effectiveness and safety of Jiu Wei Lv Ping particle in the treatment of generalized anxiety disorder (GAD). Methods The multi-center, randomized double-blind method was used to observe 227 GAD patients who were divided into the treatment group (n=114, treated with Jiu Wei Lv Ping particle 6 g, three times a day) and the control group (n=113, treated with buspirone 10 mg, three times a day). HAMD score, and CGI-GI score were used to evaluate the clinical efficacy. TESS score and the list of symptom-recording were used to observe the safety. All the outcomes for evaluation before and after treatment at week 1, week 2, week 3 and week 4. Results According to intention-to-treat analysis (ITT), the level of decrease of HAMA score from baseline at each observational point of the treatment group was similar to that of the control group (t test, Pgt;0.05). At the end point, the effective rate of treatment group was 87.72％, and the effective rate of the control group was 87.61%. There was no significant difference between the two groups (CMH test, Pgt;0.05). According to the score of CGI-GI at each observational point, there was no difference of the effective rate between the treatment group and the control group (student test, Pgt;0.05). The side effect rate of the treatment group was 16.67%, The frequent symptoms were thirst (8.77%), dizziness (7.02%), nausea (2.63%), constipation (2.63%) and diarrhea (1.75%). The side effect rate of the control group was 30.97%, The frequent symptoms were thirst (15.04%), constipation (6.19%), nausea (4.42%), diarrhea (4.42%), dizziness (3.45%) and tachycardia (1.77%). The side effect of the treatment group was lower than that of the control group. But there was no significant difference between the two groups according to the score of TESS (F test, Pgt;0.05). Conclusions The therapeutic action of Jiu Wei Lv Ping particle in the treatment of GAD is affirmed with less side effects. It is valuable to use clinically.