ObjectiveTo recognize the convulsion caused by hypoglycemia, and to analyze its genotype and clinical phenotype, so as to deepen the understanding of hyperinsulinemia.MethodFull exon detection were performed on 2 children with hypoglycemia and convulsions, who had been treated with antiepileptic drugs for 1 year in pediatric neurology department, Henan Provincial People’s Hospital in 2012 and 2014 respectively, but with poor curative effect.ResultABCC8 gene mutations were found in a child. The mutations located in Chromosome 11, with the nucleic acid changes of c.4607C>T (exon38) and the amino acid change of p.A1536V, rs745918247. The inheritancemode of ABCC8 gene could be autosomal dominant or autosomal recessive inheritance. Both of the parents were wild type on this genelocus. The gene mutation is associated with type 1 familial hyperinsulinemic hypoglycemia/nesidioblastosis. The other child was carrying GLUD1 gene mutation, witch is located in chromosome 10, with the nucleic acid changes of c.1498G>A (exon12) and the amino acid change of p.A500T. The inheritance mode of GLUD1 gene is autosomal dominant andthe child’s parents were both wild type. This gene mutationis associated with type 6 familial hyperinsulinemic hypoglycemia/nesidioblastosis. The 2 mutations have not been reported, which are new mutations.ConclusionMutations in these 2 gene loci may be the underlying cause of hypoglycemic convulsions, and are the best explanation for the poor convulsionscontrol of antiepileptic drugs.
ObjectiveTo systematically review the willingness rate of Chinese residents to renew family doctors contract services. MethodsPubMed, Web of Science, EMbase, ScienceDirect, CNKI, WanFang Data and VIP databases were electronically searched to collect cross-sectional studies related to the willingness of Chinese residents to renew family doctors contract services from inception to November 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 23 cross-sectional studies involving 22 629 subjects were included. The results of meta-analysis showed that the willingness rate of Chinese residents to renew family doctors contract services was 84.2% (95%CI 80.0% to 88.3%). The results of subgroup analysis showed that contracted residents who were surveyed in 2011 to 2015 (85.7%), living in eastern (87.0%) and urban (84.7%), above age 60 (88.5%), females (85.1%), non-married (86.5%), with primary school and below education level (91.4%), with employee medical insurance (84.5%) and residents medical insurance (85.2%), not working (77.9%), with high and medium levels of health status (84.5%), with chronic diseases (86.7%), preferred to consult general diseases in primary health care institutions (89.5%), and walking to nearby community health service institutions requiring less than 30 minutes (86.9%) had a relatively high willingness to renew contracts. The contracted residents whose health status improved (91.0%), medical expenses reduced (91.5%) and medical portability improved (88.4%), more satisfied with contracted services (85.3%), more trusted in contracted doctors (87.9%), knowing family doctors’ name (86.7%) and contact information (84.2%) and enjoying visiting medical service (79.7%), telephone follow-up (79.6%), and health files establishment (80.1%) were more willing to renew contracts. ConclusionCurrent evidence suggests that the willingness of Chinese residents to renew family doctors contract services is high, however, it remains to be improved. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To understand the situation of commonly-used drugs, medical device and their storages in rural households among model well-off township hospitals in eastern, central and western China, and to provide the basis for the guidance of reasonably using and scientifically storing drugs. Methods The methods of combining simple random sampling and cluster sampling were used to investigate and analyze the situation of commonly-used drugs, medical device and their storages in 162 households from three well-off township hospitals in Shanghai, Zhejiang, and Sichuan provinces, respectively. Results The storage rates of commonly-used drugs of rural households in well-off towns were cold medicine (72.2%), wound paste (51.9%), cooling oil (39.5%), essential balm (36.4%), antihypertensive (27.8%), iodine tincture (14.2%), anti-diabetic drugs (13.0%) and other drugs (17.3%). The storage rates of medical devices were thermometer (50.0%), cotton swab (47.5%), sphygmomanometer (9.3%), injector (1.2%) and other devices (22.2%). A total of 66% of respondent families stored drugs and medical devices in a fixed drawer. Only 3.1% families stored drugs and medical devices in the special portable medical kit. Conclusion Rural families have a higher rate of household drugs among model well-off township hospitals in eastern, central and western China, and most drugs are OTC drugs. The storage rates of medical devices are not high. Many rural family-owned medical devices are linked with special chronic diseases in the family. A lot of rural families place drugs and medical devices randomly. There are many security risks, and it may affect the rational utilization of drugs.
ObjectiveTo investigate the effect of positive family behavior support on emotional and behavioral problems in preschool children with epilepsy. Methods A total of 80 preschool epileptic children and their parents who were admitted to the Department of Neurology of our hospital from October 2022 to February 2023 were selected as the research objects, and were divided into experimental group and control group with 40 cases each by random number table method. The control group received neurology routine nursing, and the experimental group received positive family behavior support intervention based on the control group. The scores of family intimacy and adaptability scale, strengths and difficulties questionnaire, medication compliance and quality of life of epilepsy children were compared before and after intervention between the two groups. ResultsAfter intervention, the scores of strength and difficulty questionnaire in experimental group were lower than those in control group (P<0.05), and the scores of family intimacy and adaptability scale, quality of life and medication compliance in experimental group were higher than those in control group (all P<0.05). ConclusionThe application of positive family behavior support program can reduce the occurrence of emotional behavior problems, improve family closeness and adaptability, improve medication compliance, and improve the quality of life of preschool children with epilepsy.
ObjectiveTo explore the effect of family-school-hospital application in continuous nursing care for children with epilepsy. Methods120 children with epilepsy admitted to Children's Hospital Affiliated to Jiangnan University from January 2021 to October 2022 were randomly divided into two groups, each with 60 cases. The control group received routine care, while the experimental group received family-school-hospital continuous care. Compare the awareness of epilepsy knowledge, disease control effectiveness, medication compliance, negative emotions, physical and mental status, and quality of life before and after nursing between the families of two groups of children with epilepsy. ResultsAfter 2 months of nursing care, the scores of family members' knowledge of epilepsy in the experimental group were higher than the control group (P<0.05). The effect of disease control in the experimental group was better the control group (P<0.05). The drug compliance of the experimental group was higher than the control group (P<0.05). The quality of life score in the intervention group was higher than the control group (P<0.05). ConclusionThe application of family-school-hospital in the continuous care of children with epilepsy can improve their family members' awareness of epilepsy knowledge, effectively control the disease, improve medication compliance, improve negative emotions and physical and mental conditions, and thus improve the quality of life of children.
ObjectiveTo explore the family function on patients with depression and its influential factors, in order to provide a basis for family support treatment for the patients. MethodsA total of 122 depressed patients from Mental Health Center of West China Hospital between February 2012 and June 2013, and one of their family members were chosen to be the study subjects. Another 122 non-clinical controls and one of their family members were recruited from a community near Sichuan University were regarded as the controls. All the subjects were asked to finish the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Family Assessment Device (FAD). Additionally, the patients received a diagnostic interview to provide the features of their depression. ResultsThe general average score of Q-LES-Q in families with depressed patients was significantly lower than that in the control families (t=-6.243, P<0.01). The general average score of each dimension in FAD for families with depressed patients was significantly higher than that for control families (t=3.644, 3.872, 2.694, 3.369, 5.369, 4.941, 5.241; P<0.01). According to FAD health division scoring, the unhealthy proportion in terms of communication, emotional reaction, emotional link, behavioral control and general function for families with depressed patients was significantly higher than that for control families (χ2=6.778, 23.698, 26.580, 39.875, 17.123, 10.712; P<0.05). The Q-LES-Q scores and the five FAD dimensional scores (except role and affective involvement) were negatively correlated (r=-0.388, -0.188, -0.200, -0.276, -0.370; P<0.05). The scores of perceived social support for families with depressed patients had significant positive correlations with the scores of all FAD dimensions except affective involvement (r=0.363, 0.345, 0.244, 0.418, 0.328, 0.457; P<0.05). The risk factors for unhealthy family function included: female (OR=1.141, P<0.05), poor education (OR=0.948, P<0.01), first-episode (OR=1.416, P<0.05), suicidal attempt (OR=1.014, P<0.05), incomplete suicide (OR=1.367, P<0.01) and depression episode number (OR=1.035, P<0.05). ConclusionDepression is associated with impaired family function in Chinese families. Female, poor education, first episode of depression, suicidal attempt, incomplete suicide and depression episode number are the influential factors for family function on patients with depression.
ObjectiveTo investigate the anxiety of family members of patients with Parkinson's disease, and explore the risk factors. MethodsSelf-rating Anxiety Scale (SAS) was employed to assess a total of 107 family members of Parkinson disease patients from October 2014 to October 2015. The scores were compared with the domestic norm, and the risk factors of anxiety were analyzed with Logistic regression. ResultsThe scores of SAS (38.83±10.97) were significantly higher in patients' family members than the norm (P<0.01). Disturbance of the life and work by caring the patients, late stage of the patients, and disability of self care were independent risk factors for the anxiety of the patients' family members (P<0.01), and the three factors could increase the anxiety (OR>1). ConclusionAnxietsy exists in family members of patients with Parkinson disease. More attention should be paid when they have the factors of disturbance of the life or work by caring the patients, late stage of the patients, and self care disability of patients.
Family resilience is an important ability for families to cope with stress and adversity. This article systematically sorts out the theoretical system and practical application of family resilience, focusing on the improvement path of family resilience for caregiver. It integrates domestic and foreign research results from the dimensions of theoretical connotation, influencing factors, and intervention projects. Based on the analysis of the systemic deficiencies and weak sustainability of existing intervention plans, this paper proposes a research outlook on the resilience of caregivers’ families in the future, which has important reference value for improving the research paradigm of family resilience.
Objective To research whether systemic family therapy is a useful intervention for behavioral problems. Methods Two hundred and seventy six children who were in the fourth grade of elementary school were assessed by family dynamics questionnaires and their parents were tested by Achenbach Child Behavioral Checklist. Fifty-seven children with behavioral problems were divided into two groups: 20 children and their parents agreed to receive systemic therapy for four weeks and 37 children and their parents who refused this therapy formed the control group.All children and their parents were reassessed after four months. Data were analyzed by SPSS 11.5. Results The characteristics of family dymanmic and children’s behavior improved significantly after systemic therapy. The "depressing and hostile family" at mosphere became "harmonious and open" (P=0.000) and this was also significantly better than the control group after therapy(P=0.000). "Self-differentiation of family members" was significantly improved after therapy (P=0.000) and also was significantly better than the control group after therapy (P=0.005). "Patient is helpless victim" changed to "Patient can do something" (P=0.000) and this was significantly better than the control group after therapy (P=0.003) . Total CBCL score decreased in the treatment group after therapy (P=0.003 for father, P=0.000 for mother). Compared with the control group. Total CBCL score also showed decreases (P=0.033 for father, P=0.014 for mother). Conclusions The techniques of systemic family therapy are practical and effective methods to intervene children’s behavioral problems.
ObjectiveTo explore the effects of drug management skill training on lightening the family burden of schizophrenic patients in their recovery period. MethodsBetween December 2011 and December 2013, 101 patients with schizophrenia were randomly divided into experimental group (n=56) and control group (n=45). The experimental group was given drug management skill training, while the control group only received routine follow-up. The course of the research was six months. Both groups were assessed by the positive and negative syndrome scale on patients' psychological symptoms, and family burden scale of diseases was used to assess the burden of the family. ResultsCompared with the controls, patients in the experimental group improved more in their positive symptoms (t=2.692, P=0.008), negative symptoms (t=2.729, P=0.008), general psychopathology symptoms (t=3.231, P=0.002) and the whole psychiatric symptoms (t=3.870, P<0.001). Moreover, the degree of patients' symptom improvement was positively correlated with the degree of family burden lightening (r=0.44, P<0.001). ConclusionFor patients with schizophrenia, reasonable drug management skill training can effectively improve patients' medication compliance, promote treatment effect and lighten family burden.