ObjectivesTo systematically review the efficacy and safety of plasminogen activator assist external ventricular drainage in cerebral hemorrhage.MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP, CBM and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of plasminogen activator assist external ventricular drainage in cerebral hemorrhage from inception to March 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 23 RCTs involving 1 560 patients were included. The results of meta-analysis showed that, compared with the blank control or placebo, the addition of plasminogen activator urokinase after puncture and drainage could improve the clinical efficacy (RR=1.36, 95%CI 1.26 to 1.47, P<0.000 01), shorten removal time of hematoma (MD=?3.37, 95%CI ?3.89 to ?2.85, P<0.000 01), reduce postoperative re-bleeding rate (Peto OR=0.30, 95%CI 0.18 to 0.51, P<0.000 01), reduce the incidence of intracranial infection (Peto OR=0.47, 95%CI 0.25 to 0.87, P=0.02), and reduce mortality (Peto OR=0.45, 95%CI 0.27 to 0.76, P=0.003). The differences were statistically significant between two groups.ConclusionsCurrent evidence shows that the combination with urokinase can improve curative effect of hypertension cerebral hemorrhage patients with external ventricular drainage. In reducing hemorrhage, intracranial infection and mortality, urokinase also has great curative effect. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
【摘要】 目的 研究綜合醫院心理咨詢初診患者的特征。 方法 對2007年1月1日-2009年12月31日初診患者的性別、年齡、居住地、學歷、職業、咨詢目的與疾病分布等特征進行統計分析。 結果 共納入1 933例初診患者，女性略多于男性（男女比1∶1.1）；年齡3~75歲，以青少年（10~19歲，34.5%）和青年（20~29歲，29.7%）為主；當地居民居多（66.0%），外地居民亦占較大比例（34.0%）；學歷主要分布在中學（初中:21.5%；高中:35.6%）和大學（33.6%）；職業分布以學生比例最大（40.0%），其次為無固定職業者（14.9%），專業技術人員（12.5%），商業、服務人員（9.4%），辦事人員和有關人員（7.7%）。患者中有心理問題的健康人占27.5%，以親子教育咨詢（53.4%）和婚戀咨詢（41.5%）為主；患精神障礙的患者占72.5%，以心境障礙（30.6%）、神經癥（23.1%）和精神分裂癥（10.1%）為主，新確立的精神障礙網絡成癮占1.1%。 結論 綜合醫院心理咨詢初診患者來源廣泛，需要更加關注青少年、學生和無固定職業者的心理問題。【Abstract】 Objective To investigate the characteristics of the new clients from the psychological counseling clinic in general hospital. Methods The clients’ data were prospectively analyzed from the successively registered database of the counseling clinic from January 1, 2007 to December 31, 2009. The data included sex, age, habitation, educational background, career, problems, and diagnosis of the new clients. Results A total of 1 933 clients were included in the study, and the sex ratio was 1∶1.1(male∶female). The age ranged from three to 75 years old. The clients aging from 10 to 29 yeas old accounted for 64.2%. Sixty-six percent of the clients were local residents. The education backgrounds of them were middle school (21.5%), high school (35.6%), and graduate (33.6%). Forty percent of the clients were students and 14.9% had no regular works. Special technician, business and service workers, and office workers accounted for 12.5%, 9.4%, and 7.7%, respectively. The percentage of healthy clients was 27.5%, whose main problems were child education (53.4%), and marriage relationship (41.5%). And 72.5% of the clients suffered from mental disorders, with mood disorder (30.6%), neurosis (23.1%), and schizophrenia (10.1%). Internet addiction, as a new established mental disorder in China, accounted for 1.1%. Conclusion At present, the clients of counseling clinic in general hospital are more widespread, and more attention should be paid to the young, the students, and the people without regular work.
目的:觀察A型肉毒毒素(BTXA)對面肌痙攣(HFS)患者痙攣程度的改善和生存質量的影響。方法: 對68例HFS患者進行局部注射BTXA,治療前及治療后1個月分別對患者的痙攣程度進行判定和使用世界衛生組織生存質量評定量表簡表(WHOQOL-BREF)評價生存質量。 結果: 97.04%的HFS患者在BXTA治療后1個月痙攣明顯改善緩解,而且患者在WHOQOL-BREF的生理領域、心理領域、社會關系領域、總的健康狀況和總的生存質量的評分均明顯高于治療前,差異有統計學意義(Plt;0.01)。 結論: 局部注射BTXA可迅速緩解或消除HFS患者肌肉痙攣,提高患者的生存質量。
To understand the current situation of community epilepsy management in China, summarize the experience of international community epilepsy management, and provide reference for strengthening community epilepsy management in China. Summarize the current situation of epilepsy development in China, summarize and analyze the international experience of community epilepsy management in the United States, Australia, Britain and other countries, as well as the reference significance for domestic community epilepsy management. According to the evaluation criteria of community epilepsy management, it is suggested that the Chinese government should increase its support, formulate various strategic objectives, strengthen publicity and health education, improve patients' self-management support, explore the prevention and control mode of promoting epilepsy management in urban and rural communities, strengthen the training of medical service teams and design a reasonable referral system.
Epilepsy is one of the chronic central nervous system diseases that can occur repeatedly for a long time. About 70 million people worldwide suffer from epilepsy. Two thirds of epileptic patients do not receive proper treatment because of inadequate health care services and social discrimination based on cultural beliefs. Effective health management mode can reduce the morbidity and mortality of patients and improve the quality of life of patients. This article divides management modes into five types: Hospital-based health management model, community-based health management model, family health management model, self-health management model and health management model based on network technology. By referring to relevant literature, the research status of epilepsy health management model at home and abroad was summarized, which provides reference for the health management and reasonable intervention of patients with epilepsy.
ObjectiveTo systematically evaluate the effect of repeated transcranial magnetic stimulation (rTMS) in treating epilepsy.MethodsThe randomized controlled trials (RCTs) of rTMS for epilepsy and related diseases were collected from PubMed, EMbase, Cochrane Library, CBM, CNKI, VIP, and Wanfang databases by computer. The retrieval time was from establishment to June 2019. Two researchers independently screened the literature, extracted the data and evaluated the deviation risks of the included studies. RevMan5.3 software was used for Meta analysis.ResultsA total of 21 RCTs were included, including 1 587 patients. The results showed that rTMS assisted antiepileptics drugs (AEDs) could improve the effective rate of epilepsy treatment [RR=1.28, 95% CI (1.19, 1.37)], significantly reduced HAMA, HAMD and NFDS scores in the treatment of patients with epilepsy combined with anxiety and depression [MD=?3.94, 95% CI (?4.25, ?3.63)], and improve DQ and GMFM-88 scores in children with cerebral palsy combined with epilepsy [MD=7.95, 95% CI (7.00, 8.90)]. In addition, using rTMS will not cause additional adverse reaction [peto OR=0.52, 95% CI (0.31, 0.84)].ConclusionsThe current evidence showed that rTMS combined AEDs can improve the efficient of AEDs therapy. When treat anxiety depression comorbidity, it can significantly reduce the anxiety depression score. In addition in children with cerebral palsy merger, it can improve muscle strength and development. And rTMS will not cause additional adverse reactions. Limited by the quantity and quality of the selected studies, the conclusions need to be verified by more high-quality studies.