In order to guide diagnosis and treatment in children with sleep disordered breathing aged 1 to 23 months, the European Respiratory Society(ERS) summarized the evidence and released the European Respiratory Society statement based on clinical experience in 2016. This article aims to interpret the ERS statement. Children with apparent upper airway obstruction during wakefulness and those with SDB symptoms and complex conditions requires treatment. Adenotonsillectomy and continuous positive airway pressure are the most frequently used treatment measures along with interventions targeting specific conditions. Obstructive SDB in children aged 1 to 23 months is a multifactorial disorder that requires objective assessment and treatment of all underlying abnormalities.
ObjectiveTo investigate the effect and significance of early coronary artery bypass graft (CABG) on the expression level of ionophorous protein at infracted border zone (IBZ) in dog with acute myocardial infarction. MethodsThe anterior descending coronary artery of all thirty healthy mongrel dogs were ligated into myocardial infarction model, whose successful criteria was that the regional myocardium supplied by ligated coronary artery became darker. Coronary artery bypass surgery performed at different time points after myocardial infarction (in the 1st week, the 2nd week, the 4th week, the 6th week respectively) was as an experimental group. While myocardial infarction without coronary artery bypass surgery was set up as a control group. Myocardial tissue without ligation of coronary artery was as a normal group. After 8 weeks, myocardial specimens were cut out in the experimental group and the control group. The local expression levels of ionophorous proteins such as Cav1.2, Kv4.3 and KchIP2 mRNA were detected by means of reverse transcription- polymerase chain reaction (RT-PCR) at normal myocardium and IBZ of the experimental group and the control group. ResultsFour dogs in every experimental group and all dogs in the control group survived to the end of the study. Three myocardial ion channel proteins expression in the control group were lower than those of the normal group or the experimental group significantly (P<0.01). Cav1.2 mRNA expression in the experimental group in the 4th week or the 6th week was lower than that in the normal group significantly (P<0.05). Kv4.3 and KchIP2 mRNA expression in the experimental group in the 4th week or the 6th week were lower than those in the normal group and the experimental group significantly in the 1st week or the 2nd week (P<0.05). ConclusionEarly CABG surgery for acute myocardial infarction could lessen the changes of expression level of ionophorous protein at infracted border zone (IBZ) of dog with acute myocardial infarction. Especially, CABG surgery among two weeks could improve expression level of ionophorous protein, and reduce the effect of ischemia for ionophorous protein and myocardial electrophysiology at IBZ.
The aim of this study was to design a simple, economic, with high Common Mode Rejection Ratio (CMRR), preamplifier and multi-channel masticatory muscle surface electromyography (sEMG) signal acquisition system assisting to diagnose temporomandibular disorders (TMD). We used the USB interface technology in the EMG data with the aid of the windows to operate system and graphical interface. Eight patients with TMD and eight controls were analyzed separately using this system. In this system, we analyzed sEMG by an optional combination of time domain, frequency domain, time-frequency, several spectral analysis, wavelets and other special algorithms under multi-parameter. Multi-channel sEMG System of Masticatory Muscles is a simple, economic system. It has high sensitivity and specificity. The sEMG signals were changed in patients with TMD. The system would pave the way for diagnosis TMD and help us to assess the treatment effect. A novel and objective method is provided for diagnosis and treatment of oral-maxillofacial disease and functional reconstruction.
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.
Objective To evaluate the effectiveness ofradiofrequency volumetric tissue reduction （RFVTR） in the treatment of sleep disordered breathing （SDB ）. Methods We searched The Cochrane Central Register of Controlled Trials （Issue 1, 2005）, MEDLINE （1966 to Apr. 2005）, EMBASE （1989 to Apr. 2005）, CINAHL （1982 to Dec. 2000）, VIP （1989 to Dec. 2004） , CJFD （1979 to 2005）, WANFANG DATA （1977 to 2004） , and CBMdisc （1978 to 2005）. The bibliographies of all papers retrieved in full text form and relevant narrative reviews were searched for additional publications. All randomized controlled clinical trials （RCT） or quasi-randomized controlled trials （quasi-RCT） or prospective cohort studies of RFVTR alone or in combination with other treatments compared with placebo or other treatments were included. Data were extracted independently from the trial reports by the two authors. Meta-analysis was performed using RevMan software. Results There were 11 studies including 540 patients met the inclusion criteria for this review, among which five were RCTs, six were prospective cohort studies, and all trials were of lower methodological quality. RFVTR showed benefit over placebo in apnea index （AI）, but this benefit was not seen in other polysorrmography （PSG） parameters, symptom and quality of life, psychomotor vigilance pain, swallowing difficulty and adverse events. Compared with continuous positive airway pressure （CPAP）, uvulopalatopharyngoplasty （UPPP） and laser assisted uvulopalatoplasty （LAUP） , RFVTR was more effective in psychomotor vigilance pain and swallowing difficulty, but this effect was not seen in PSG parameters, symptom and quality of life. Conclusions RFVTR is more effective than placebo in AI improvement and other treatments in decreasing postoperative pain and other adverse events ; but this benefit was not seen in improving quality of sleeping and life. More well-designed randomized trials need to be conducted to identify the effectiveness and the influence on effectiveness of severity and frequency of treatment.
Objective Anorexia nervosa is a disorder of high morbidity and significant mortality. The aim of the present review was to evaluate the evidence from randomized controlled trials for the efficacy of outpatient psychotherapies used in the treatment of older adolescents ( aged ＞16 years) and adults with anorexia nervosa. Methods The search strat egy comprised database searches of Medline, EXTRAMED, EMBASE, PSYCLIT, Current Contents, Cochrane Con trolled Trials Register and the Depression and Anxiety Neurosis Cochrane Group ( CCDAN), the search date was Novem ber 2002. A hand-search of The International Journal of Eating Disorders from its first issue up to March 2003, and the ref erence lists of all papers selected. Personal letters were sent to identified leading researchers published in the area, requesting information on trials that are unpublished. All randomized controlled trials of adult individual outpatient therapy for anorexia nervosa, as defined by the DSM-IV or similar international criterion, were included. Quality ratings were made according to the CCDAN criteria. A range of outcome variables were selected, including physical state, severity of eating disorder attitudes and behefs, interpersonal function, and general psychiatric symptom severity. Continuous outcome data comparisons were planned with the standardized mean difference statistic, and binary outcome comparisons planned with the relative risk statistic. Results Six small trials only, two of which included children or adolescents, were identified from the search and aggregation of data was not possible. Bias was possible due to lack of blinding of outcome assessments. The results in two trials suggested that "treatment as usual" or similar may be less efficacious than a specific psychotherapy. No specific treatment was consistently superior to any other specific approach. Dietary advice as a control arm had a 100% non-completion rate in one trial. Conclusions No specific approach can be recommended from this review. It is unclear why "treatment as usual" performed so poorly, or why dietary advice alone appeared so unacceptable. There is an urgent need for large well-designed trials in this area.
Postoperative gastrointestinal disorder (POGD) is a common complication after surgery under anesthesia. Strategies in combination with traditional Chinese medicine and Western medicine have shown some distinct effects but standardized clinical practice guidelines are not available. Thus, a multidisciplinary expert team from various professional bodies including the Perioperative and Anesthesia Professional Committees of the Chinese Association of Integrative Medicine (CAIM), jointly with Gansu Province Clinical Research Center of Integrative Anesthesiology/Anesthesia and Pain Medical Center of Gansu Provincial Hospital of Traditional Chinese Medicine and WHO Collaborating Center for Guideline Implementation and Knowledge Translation/Chinese Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Center /Gansu Provincial Center for Medical Guideline Industry Technology/Evidence-based Medicine Center of Lanzhou University was established to develop evidence-based guidelines. Clinical questions (7 background and 12 clinical questions) were identified through literature reviews and expert consensus meetings. Based on systematic reviews/meta-analyses, evidence quality was analyzed and the advantages and disadvantages of interventional measures were weighed with input from patients’ preferences. Finally, 20 recommendations were developed through the Delphi-based consensus meetings. These recommendations include disease definitions, etiologies, pathogenesis, syndrome differentiation, diagnosis, and perioperative prevention and treatment.
Epilepsy and sleep disorders are common health problems in the world, and sleep disorders as a common comorbidity of epilepsy patients, there are high prevalence, low attention rate, low treatment rate phenomenon. In addition, epilepsy and sleep disorders can affect each other, exacerbating the onset of their own symptoms. Therefore, timely identification and treatment of these comorbidities are crucial to improve patients' quality of life, increase daytime alertness and reduce the occurrence of seizures. This article reviews the effects of different anti-seizure programs on patients with epilepsy comorbidities sleep disorders, in order to provide references for how to better choose epilepsy treatment measures for these patients.
Objective To survey the relations between the rural residents’ occupational satisfaction, the health policies and demographic factors in Henan province and then to confirm the health policy order and its key target populations. Methods The questionnaires were distributed to 1 117 rural residents in 156 villages among 44 townships in 19 counties (cities, districts). The frequency analysis, multivariate linear regression analysis and multiple comparisons were conducted. Results The average value of rural residents’ occupational satisfaction scored 68.23, among which the complete dissatisfaction scored 0 accounting for 1.9%, the complete satisfaction scored 100 accounting for 9.0%, the one scoring no more than 50 accounted for 20.9%, and the one scoreing equal 80 or more than 80 accounted for 37.5%. By regarding the occupational satisfaction as the dependent variable, the independent variables stayed in the model were as follows in order according to their influence from heavy to little on the dependent variable: new rural cooperative medical system (NRCMS), occupation, village general practitioner’s work, family formation, age, disease prevention and control efforts. The occupational satisfaction was much higher when there were the following conditions: the higher satisfaction with the NRCMS, the more financial burden relieved by the NRCMS, and the higher satisfaction with village general practitioners’ work. The occupational satisfaction was the highest when villagers lived with their spouses, while it was the lowest when villagers lived with their spouses and children, as well as they lived with their parents, spouses and children. The peasants’ occupational satisfaction was the lowest. The occupational satisfaction had significantly negative correlation with cultural level, and had positive correlation with age. Conclusion The occupational satisfaction is an important indicator for assessing the level of social harmony, and is the basis for policy decision-making, implementation, and evaluation. The overall occupational satisfaction of the rural residents in Henan is lower, so the social harmoniy and stability should be alerted. The priority order of the existing rural health policy should be the NRCMS policy, village general practitioner work policy, and village disease prevention and control policy. When we are formulating and implementing the rural health policy, the key target populations should be considered among the people whose families comprise two or three generations, whose occupations are farmers, whose cultural level is lower, and whose ages are younger.
Objective To evaluate the mental status of survivors after Wenchuan earthquake, so as to provide relevant information for psychological and medical intervention. Methods Demographic data was recorded and the post-traumatic stress disorder (PTSD) Checklist-Civilian Version (PCL-C) was evaluated. The acute stress disorder (ASD) were assessed with the DSM-IV criteria in the survivors from the central earthquake area who are now living in two shelters in Chengdu. Results Among the 780 retrieved questionnaires, 729 baseline registration forms and 450 PCL-C were valid. In the 729 baseline registration forms, male to female ratio was 1:1.31 and the mean age was 36.73±20.82. 9.5% of subjects suffered from physical diseases, 9.7% needed assistance in daily activities, 70.7% were passive and didn’t participate in community activities, 9.1% suffered from severe psychological problems. In the present study, 30.9% of subjects were found to meet the DSM-IV criteria for ASD. 41.3%, 22.2% and 18.4% of subjects had a PCL-C score ≥ 38, ≥ 45 and ≥50, respectively. Consistency check showed there was no significant difference between the screening result of PCL-C score ≥45 and clinical diagnosis (Kappa=0.780, P=0.033). There was significant difference in the age of subjects between ASD and non-ASD groups (Plt;0.05). Conclusion The earthquake survivors suffered from psychological problems after the disaster in the early stage. Thus, in addition to life rescue, we should pay more attention to psychological intervention.