ObjectiveTo conduct a bioinformatics analysis of gene expression profiles in frontal lobe of patients with Parkinson disease (PD), in order to explore the potential mechanism related to depression in PD.MethodsAll the bioinformatics data before March 20th 2019 were acquired from Gene Expression Omnibus (GEO) database, using " Parkinson disease” as the key word. The species was limited to human (Homo sapiens), and the detective method was limited to expression profiling by array. ImgGEO (Integrative Gene Expression Meta-Analysis from GEO database), DAVID (the Database for Annotation, Visualization and Integrated Discovery), STRING and Cytoscape 3.6.1 software were utilized for data analysis.ResultsTotally, 45 samples (24 PD cases and 21 healthy controls) were obtained from 2 datasets. We identified 236 differentially expressed genes (DEGs) in the post-mortem frontal lobe between PD cases and healthy controls, in which 146 genes were up-regulated and 90 genes were down-regulated. Based on Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis, the DEGs were mainly enriched in the structures of postsynaptic membrane, cell membrane component, postsynaptic membrane dense area, and myelin sheath, and were involved in the occurrence of PD, depression, and other diseases. These genes were involved in the biological processes of dopaminergic, glutamate-nergic, GABA-nergic synapses, and some other synapses, as well as several signaling pathways (e.g. mitogen- activated protein kinase signal pathway, p53 signal pathway, and Wnt signal pathway), which were associated with PD and depression pathogenesis. Besides, we found that NFKBIA, NRXN1, and RPL35A were the Hub proteins.ConclusionsGene expression in frontal lobe of patients with PD is associated with the pathogenesis of PD. This study provides a theoretical basis for understanding the mechanism of PD occurrence and progression, as well as the potential mechanism of depression in PD.
ObjectiveTo systematically review the methodological quality of evidence-based guidelines on non-pharmacology management of behavioral and psychological symptoms of dementia, so as to provide references for taking caring for the dementia with behavioral and psychological symptoms. MethodsGuidelines concerning non-pharmacology treatment of behavioral and psychological symptoms were searched from websites of guideline development, websites of medical association and literature databases from inception to May 31st 2016. The methodological quality of included guidelines were evaluated according to the AGREE Ⅱ instrument, and the differences and similarities between recommendations of included guidelines were compared. ResultsA total of 544 literatures were identified and 6 of them were included. All the included guidelines were from abroad. The average scores of guidelines in six domains of AGREE Ⅱ were:scope and purpose 88.89%, stakeholder involvement 65.74%, rigor of development 63.72%, clarity of presentations 86.11%, applicability 50.69%, and independence 37.50%. The overall qualities of the included guidelines were grade B. The recommendations of the included guidelines were almost consistent. Recommended non-pharmacology management of behavioral and psychological symptoms of dementia included leisure and recreation activity, reminiscence therapy, behavioral therapy, training of caregivers, physical environment modification, animal-assisted therapy, massage, physical activity and patient-centered approach. ConclusionThe overall quality of included guidelines is relatively high. More efforts are needed to improve the applicability and independence of guidelines. There is still no local guideline concerning non-pharmacology recommendations on behavioral and psychological symptoms of dementia in China. It is suggested to develop guideline that is suitable for Chinese condition as soon as possible.
Objective To cluster the symptoms of patients with chronic heart failure (CHF) through the cluster analysis, and to explore the relationships among symptom clusters of CHF, patients’ self-care behaviors and sleep quality, as well as the pathways influencing sleep quality of CHF patients. Methods A convenience sampling approach was used to provide a questionnaire survey to CHF patients who were being followed up with between January and December 2021. The Pittsburgh Sleep Quality Index, Memorial Symptom Assessment Scale-Heart Failure, European Heart Failure Self- care Behavior Scale and a self-created questionnaire on sociodemographic and clinical data characteristics were all included in the survey. Results A total of 304 CHF patients were included. Among them, there were 178 males and 126 females; the average age was (61.31±14.00) years; the average sleep quality score was (8.17±4.51) points, while the average overall self-care behavior score was (21.28±3.80) points. According to the cluster analysis of the symptoms of CHF patients, the patients’ symptoms were separated into clusters related to exhaustion, disease perception, and a single symptom of dry mouth. The sleep quality score was positively correlated with the following factors: age, number of comorbidities, overall score of symptom assessment, fatigue symptom cluster score, and illness perception symptom cluster score (P<0.05). There was no significant correlation between the self-care behavior score and sleep quality (P>0.05). However, sleep quality scores were negatively correlated with body mass index and education level, respectively (P<0.05). Age, gender, score of illness perception symptom cluster, and fatigue symptom cluster all had direct effects on sleep quality of 0.014, 0.206, 0.487, and 0.165 (P<0.05), respectively, according to path analysis. Self-care behavior also had a direct influence of 0.018 (P=0.686). Conclusions CHF patients have somewhat high levels of self-care behaviors, but they have poor sleep quality. They still have a lot of symptoms after being released. Sleep quality is significantly impacted by the patients’ age, body mass index, educational attainment, number of comorbidities, symptom ratings, fatigue symptom clusters, and disease perception symptom clusters. While the route effects of the patients’ self-care actions are not statistically significant, the age, gender, disease perception, and fatigue symptom cluster scores of CHF patients have a direct impact on the quality of their sleep. By managing the same clusters of symptoms, nursing staff can help patients with CHF feel better. They can also help patients sleep better by adopting practical measures.
Objective To explore the occurrence condition of the neck axial symptom (AS) after cervical Bryan artificial disc replacement combined with anterior cervical discectomy and fusion (Hybrid surgery) and traditional anterior cervical discectomy and fusion (ACDF surgery) to treat the two-level cervical disease, and to do contrastive analysis. Methods Between August 2006 and March 2010, 18 patients underwent Hybrid surgery (group A) and 30 patients underwent two-level ACDF surgery (group B). There was no significant difference in age, gender, disease duration, type, and operated segment between 2 groups (P gt; 0.05). The Japanese Orthopaedic Association (JOA) score, neck disability index (NDI) score, cervical curvature of the operated segment, total range of motion (ROM) of C2-7, ROM of the adjacent segment, and incidence of neck AS were recorded and compared between before operation and at last follow-up. Results All the patients were followed up 18-34 months (24.1 months on average). In both groups, the JOA and NDI scores at last follow-up had significantly improvement when compared with preoperative scores (P lt; 0.01), but there was no significant difference between 2 groups at preoperation and last follow-up (P gt; 0.05). The kyphosis incidence of the operated segment in group B was significantly higher than that in group A (χ2=5.333, P=0.021). There was no significant difference in the total ROM of C2-7 between at preoperation and last follow-up in group A (t=0.410, P=0.685); the total ROM of C2-7 at last follow-up was significantly lower than that at preoperation in group B (t=3.007, P=0.006); and significant difference was found between 2 groups at last follow-up (t=2.664, P=0.013). At last follow-up, ROM of the superior and inferior adjacent segments in group B increased obviously (P lt; 0.05) and was significantly higher than that in group A (t=2.252, P=0.033; t=2.203, P=0.037). The incidence of neck AS were 16.7% in group A and 46.7% in group B, showing significant difference at last follow-up (χ2=4.427, P=0.035). Conclusion Compared with two-level ACDF surgery, Hybrid surgery has good outcomes. At the same time, it can maintain the curvature of operated segments and total ROM, avoid excessive increased ROM of the adjacent segments, and reduce the incidence of neck AS.
Objective To analyze the changes of perioperative symptoms of lung cancer patients by using patient-reported outcomes at different time points. MethodsA total of 109 patients who underwent thoracoscopic lung cancer resection in the department of thoracic surgery of our hospital from March to April 2021 were selected, including 55 (50.46%) males and 54 (49.54%) females. The mean age was 55.19±12.12 years. The postoperative symptom scale for lung cancer patients was used to investigate the changes of symptoms before surgery, 1 day after surgery, the day of discharge, and 30 days after surgery. Results The mean hospital stay was 6.89±2.25 days. None of the patients reported any clinical symptoms related to lung cancer before surgery. The most prominent symptoms 1 day after surgery were pain (3.33±0.96 points), nausea (2.81±1.18 points), dizziness (2.00±0.85 points), fatigue (1.89±0.79 points) and shortness of breath (1.79±1.37 points). The patients with dizziness, nausea, fatigue and other symptoms gradually decreased, and the symptoms were relieved significantly (P<0.05). However, the symptoms of conscious pain, cough and shortness of breath lasted for a long time. At 30 days after surgery, 70.64%, 64.22% and 33.03% of patients felt pain, cough and shortness of breath, respectively, and the degree of cough was aggravated (P<0.001). Conclusion Pain, cough, dizziness, shortness of breath and fatigue are the core postoperative symptoms of lung cancer patients. Most postoperative adverse symptoms can be effectively controlled in a short period of time, but pain, cough and shortness of breath still present persistent characteristics, which deserve further study.
ObjectiveTo systematically review the association between chronotype and depressive symptoms among adolescents. MethodsCNKI, VIP, WanFang Data, PubMed, ScienceDirect and Web of Science databases were electronically searched to collect studies on the association between adolescent chronotype and depressive symptoms from inception to January 17th, 2022. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using Stata 16.0 software. ResultsA total of 12 studies were included. The results of meta-analysis showed that there was an association between chronotype and depressive symptoms (Fisher’s Z=−0.19, 95%CI −0.21 to −0.17, P<0.001). ConclusionCurrent evidence shows that evening-type chronotype may be a risk factor for depressive symptoms among adolescents. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To evaluate the long-term effect of excessive length of bone graft via anterior cervical approach and over distraction of intervertebral space on cervical curvature and postoperative neck axial symptom (AS). Methods FromJune 2001 to June 2004, 30 patients with nerve root cervical spondylosis at the C5,6 level underwent anterior cervicaldecompression, autogenous il iac bone graft and internal fixation with titanium plate. There were 14 males and 16 females aged 32-73 years old (average 54.7 years old), and the course of disease was 1-31 months (average 7 months). No instabil ity of cervical vertebrae was noted on the cervical dynamic position x-ray films. Intervertebral height was measured immediately after operation, and accordingly the patients were divided into two groups: the over distraction group (n=11), in which the length of bone graft was excessive, the intervertebral space was over distracted, and the intervertebral height was increased by more than 3 mm compared with the preoperative value; the proper distraction group (n=19), in which the length of bone graft was proper, no over distraction of the intervertebral space occured, and the intervertebral height was increased by less than 3 mm compared with the preoperative value. Regular X-ray exams were performed 1 week and 3, 24, and 48 months after operation to analyze bone fusion condition of the grafted bone, changes of the intervertebral height of the fused segments, and variation of physiological curvature of the cervical vertebra. The postoperative neck AS was evaluated according to the the neck AS evaluation criteria set by ZENG Yan and co-workers. Results All patients were followed up for 48-66 months (average 54.5 months). Cl inical symptoms were el iminated in all cases. No compl ications occurred in the proper distraction group; 1 patient of the over distraction group had ostoperative nerve root paralysis at C5 level, and recovered 3 months after proactive treatment. Bone fusion was achieved in all patients 3-6 months after operation, except for 1 case in the proper distraction group suffering from non-fusion 12 months after operation. There was no occurrence of loosening or breakage of steel plate and screw, and no displacement of the grafted bone. At 48 months after operation, the intervertebral height of the proper distraction group and the over distraction group was increased by (1.9 ± 1.8) mm and (3.5 ± 2.7) mm, respectively, when compared with the preoperativevalue (P gt; 0.05). The physiological curvature of the operated cervical segment was well maintained. The curvature of the proper distraction group and the over distraction group at the final follow-up visit was increased by (2.17 ± 1.83)° and (3.32 ± 2.71)°, respectively, when compared with the preoperative value (P gt; 0.05). The physiological curvature of the whole cervical vertebra at the final follow-up visit was increased by (4.57 ± 3.71)° in the proper distraction group and decreased by (2.43 ± 2.13)° in the over distraction group, when compared with the preoperative value (P lt; 0.05). The incidence rate of postoperative neck S at 48 months after operation was 15.79% in the proper distraction group (11 cases excellent, 5 cases good, 3 cases fair) and 54.55% in the over distraction group (3 cases excellent, 2 cases good, 5 cases fair, 1 case poor), showing a significant difference between two groups (P lt; 0.05). Conclusion Excessive length of bone graft via anterior cervical approach and over distraction of intervertebral space are bad for maintaining the physiological curvature of the whole cervical vertebra, and increase the incidence of postoperative neck AS. Selection of bone graft at the proper height is essential in anterior cervical operation.
ObjectiveTo observe intervention effect of Shenlingcao oral liquid on asymptomatic chronic hepatitis B virus carriers (AsC). MethodsA self control before-after trial was conducted in the First Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine and the Ninth People's Hospital of Nanchang City from November 2011 to May 2012. A total of 64 AsCs were treated by Shenlingcao oral liquid (1 bottle/d, 200 mL, once daily for 6 months). Serum HBV viral load, six specific serum markers of HBV and 11 liver function index were tested and recorded before and at the 1th, 3th, 6th months of the treatment. Analysis of variance of repeated data was conducted. ResultsAfter one month of the treatment, 35/57 (61.40%) AsCs' serum HBV-DNA loads decreased, 1 log decrease was observed in 15 cases, 2 log decrease was observed in 4 cases, and decrease under the detection limit was observed in 12 cases. 41/57 (71.93%) AsCs' serum HBV-DNA loads decreased after 3 months of treatment, 1 log decrease was observed in 21 cases, 2 log decrease was observed in 5 cases, and decrease under the detection limit was observed in 15 cases. 31/49 (63.26%) AsCs' serum HBV-DNA loads decreased after 6 months of the treatment, 1 log decrease was observed in 19 cases, decrease more than 2 log was observed in 7 cases, and decrease under the detection limit was observed in 12 cases. The serum HBV viral loads at different time points of the treatment were significantly different (P<0.001). As medication time went, AsCs' serum HBV viral loads presented a decrease trend after taking Shenlingcao oral liquid, especially obvious at the 3th month. ConclusionShenlingcao oral liquid could help promote AsCs' ability of clearing virus and controlling serum HBVDNA loads.
ObjectiveTo determine the symptom burden and functional status of patients with early-stage lung cancer at 4 weeks after discharge, and to investigate the influencing factors. MethodsAn analysis was conducted on the clinical data of patients with early-stage lung cancer in a multicenter prospective cohort study conducted in six hospitals in China from November 2017 to January 2020. The MD Anderson Symptom Assessment Scale-Lung Cancer Module (MDASI-LC) was used to evaluate symptoms and functions. Binary logistic regression analysis was used to analyze the influencing factors of moderate to severe functional impairment (≥2 points) and moderate to severe symptoms affecting recovery (≥4 points). ResultsA total of 158 patients were included, including 59 males and 99 females, with an average age of (55.5±9.9) years. At 4 weeks of discharge, the three most severe moderate to severe symptoms were cough (30.4%), shortness of breath (25.3%), and disturbed sleep (22.2%). The proportions of patients with moderate to severe physical and psychological impairment were 53.2% and 38.6%, respectively. Multivariate analysis results showed that shortness of breath was an independent risk factor for moderate to severe postoperative physical impairment [OR=10.12, 95%CI (1.51, 67.60), P=0.017]; cough [OR=5.66, 95%CI (1.52-21.15), P=0.007], pain [OR=12.35, 95%CI (1.21, 126.39), P=0.034], and female sex [OR=4.01, 95%CI (1.10, 14.67), P=0.036] were independent risk factors for moderate to severe psychological impairment; forced expiratory volume in the first second <1.5 L [OR=0.10, 95%CI (0.02, 0.58), P=0.010] and female [OR=2.80, 95%CI (1.17, 6.66), P=0.020] were independent risk factors for moderate to severe shortness of breath; open surgery [OR=6.18, 95%CI (1.54, 24.80), P=0.010] and female [OR=7.33, 95%CI (1.84, 29.20), P=0.005] were independent risk factors for moderate to severe pain. ConclusionPatients with early-stage lung cancer still have a significant symptom burden and functional impairment 4 weeks after discharge. Preoperative attention should be given to patients with poor lung function and female patients. During the operation, open surgery should be avoided as much as possible. Effective management of shortness of breath, pain, and cough symptoms in the postoperative period can promote the functional recovery of patients with early-stage lung cancer.
ObjectiveTo investigate whether novel coronavirus pneumonia (COVID-19) patients complicated with digestive tract symptoms and its influence on digestive system related biochemical indexes.MethodsSixteen novel coronavirus pneumonia patients in our hospital were observed, and their epidemiological data, clinical manifestations and clinical laboratory indicators were analyzed statistically.ResultsThe age of the patients ranged from 5 to 75 years old, and the median age was 46.0 years old. Most of them were male (9 cases, 56.25%), the occurrence of COVID-19 appeared in family aggregation (12 cases, 75.00%). Sixt patients (37.50%) were complicated with basic diseases. The initial symptom involving digestive system accounting for 18.75% (3 cases) of all participants. The main manifestation of a diarrhea in 2 (12.5%) and melena in 1 (6.25%) patients, respectively. Five patients (31.25%) had symptoms of digestive system during the course of the disease, the main symptoms were diarrhea in 3 (18.75%), melena in 1 (6.25%) and loss of appetitein in 5 (31.25%) patients, respectively. The SARS-Cov-2 nucleic acid in the feces of the patients were negative in all patients. In 50.00% of the patients, the SARS-Cov-2 nucleic acid in the feces were negative, but the throat swab/sputum nucleic acid were still positive at the same time or later. Two patients (12.50%) had elevated ALT and 1 patient (6.25%) had elevated AST at the time of admission.ConclusionsPatients with COVID-19 will show symptoms of digestive tract.