ObjectiveTo explore the relationship between morning symptoms and other clinical characteristics in patients with chronic obstructive pulmonary disease (COPD), and to look for related risk factors affecting morning symptoms.MethodsThis cross-sectional observational study included 153 patients with stable COPD. Morning symptoms were evaluated with the Chinese-version of Chronic Obstructive Pulmonary Disease Morning Symptom Diary (Ch-COPD-MSD). And modified version of the British medical association respiratory questionnaire (mMRC), COPD assessment test (CAT), questionnaire clinical COPD questionnaire (CCQ) score were scored, and the BODEx index was calculated.ResultsA total of 153 stable COPD patients were included. The patients aged 59.6±7.6 years with a mean forced expiratory volume in one second of (52.0±20.7)% predicted (FEV1%pred). The median score of morning symptoms was 31.00. Morning symptoms severity was different between GOLD groups A to D: median (interquartile range) score in GOLD A was 23.50 (20.00 - 27.25), in GOLD B was 31.00 (26.00 - 38.00), in GOLD C was 30.00 (23.75 - 35.75), and in GOLD D was 36.50 (27.00 - 47.50) (P<0.001). Meanwhile, under different mMRC, CAT, CCQ scores, the difference in the median score of morning symptoms was statistically significant (all P=0.000). Score of morning symptoms was negatively correlated with the FEV1%pred (r=–0.24, P<0.001), and positively correlated with the score of mMRC, CAT, CCQ, and the BODEx index (r value was 0.50, 0.60, 0.53, 0.40, respectively, P<0.001). Multiple linear regression analysis showed that CAT score was the important factor associated with morning symptoms severity in COPD (B=0.829, P<0.001).ConclusionsMorning symptoms are associated with multiple clinical indicators for assessing the severity of COPD, and health status is the most strongly associated with morning symptoms. Clinical evaluation of morning symptoms in patients with COPD can be helpful in comprehensive assessment of the patient’s condition.
ObjectiveTo analyze the symptom characteristics and influencing factors in order to provide reference for symptom management of patients with esophageal cancer after operation.MethodsA total of 216 esophageal cancer patients, including 180 males and 36 females with an average age of 63.7±8.3 years, who underwent surgical operation in our hospital from March to October 2018 were recruited and investigated with self-designed symptom questionnaire at 1 month after surgery.ResultsThe top five symptoms were acid reflux (48.6%), cough (42.6%), dysphagia (40.7%), hoarseness (12.0%), and diarrhea (11.6%). Women were more prone to acid reflux (OR=2.053), fatigue (OR=1.932), chest pain (OR=3.681), sleep disturbance (OR=2.419), abdominal pain (OR=3.882), nausea (OR=3.014) and vomiting (OR=2.505). Patients over 60 years were more prone to dysphagia (OR=2.274). Patients with lower thoracic esophageal cancer had a higher incidence of dysphagia compared with patients with carcinoma of esophagogastric junction (OR=0.326). Patients who had neoadjuvant chemotherapy were more likely to suffer acid reflux (OR=1.594). Open surgery (OR=3.681) and neoadjuvant radiotherapy (OR=2.495) were the risk factors of chest pain.ConclusionThere are many symptoms in patients with esophageal cancer after operation, and the occurrence of symptoms is closely related to gender, age, tumor location, surgical procedure and neoadjuvant chemoradiotherapy.
摘要:目的:探討盆腔膿腫的臨床表現,超聲診斷結果及手術探查情況以提高診療水平。方法:對2000年1月~2006年12月我科收治的25 例手術治療的盆腔膿腫病例進行回顧性分析。結果：其臨床表現主要為腹痛、發熱、腹部或盆腔包塊等。超聲聲像顯示:盆腔內不規則囊性或多房性輸卵管卵巢腫塊,囊內不均質光點,伴有或不伴有盆腔積液。手術探查表現為:盆腔粘連,一側或雙側輸卵管膿腫或輸卵管卵巢膿腫。結論:盆腔膿腫的臨床表現不典型,術前易出現誤診和漏診;隨著病情的變化,結合臨床表現、 陽性體征的發現及超聲診斷可以提高其檢測率。Abstract: Objective: To explore the clinical symptoms, ultrasonography diagnosis results and surgical treatment results of pelvic abscess, thus to raise the diagnosing standard and treatment level from Jan.2000 to Dec. 2006. Methods: Carries on the review analysis to 25 example feminine pelvic abscess patient’s clinical diagnosis material. Results: The principal clinical symptoms of pelvic abscess are abdominal pain and fever,tissue mass is palpated in the abdomen or pelvic cavity and is detected. Sonographic appearance of the pelvis demonstrated irregular, uniloculated or multiseptated cystic tuboovarian mass with nonhomogenic internal echoes, with or without pelvic fluid collection. Surgical results showed some adhesions in pelvis, uniorbilateral pyosalpinx or tuboovarian complex abscess. Conclusion: The pelvic abscess displays not typically,,there is a comparatively high rate of misdiagnosis and missed diagnosis before the surgical treatment.The rate of missed diagnosis is by mistake high.Unifies the clinical symptoms,the masculine symptom, the auxiliary inspection and the guidance of ultrasound,may raise the diagnosis rate of accuracy.
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 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.
ObjectiveTo explore the relation between ultrasound images of endometriosis and its clinical symptoms. MethodsChoosing clinical data of 300 patients with endometriosis pathologically diagnosed between January 2009 and January 2014, we retrospectively analyzed ultrasound images and clinical symptoms, using Chisquare test for statistical analysis, and the index P<0.05 was statistically significant. ResultsIn patients with big endometriosis' nidus, the menstrual quantity increased, menstrual cycle prolonged, the incidence of abnormally vaginal bleeding was high (χ2=11.749, P=0.001; χ2=4.847, P=0.028; χ2=5.686, P=0.017). In patients whose endometriosis were located in posterior uterine wall, the menstrual quantity increased, and the incidence of abnormally vaginal bleeding was high (χ2=5.188, P=0.023; χ2=49.691, P<0.001). The size of endometriosis' nidus had nothing to do with dysmenorrhea, constipation and frequent micturition (P>0.05). The position of endometriosis' nidus had nothing to do with menostaxis, dysmenorrhea, constipation and frequent micturition (P>0.05). ConclusionThe size of endometriosis' nidus has a connection with the clinical symptoms of menorrhea, menostaxis and abnormally vaginal bleeding; the position of endometriosis' nidus has a connection with the clinical symptoms of menorrhea and abnormally vaginal bleeding. The results of ultrasonography should be combined with clinical symptoms in diagnosing endometriosis, avoiding missed-diagnosis and misdiagnosis.
Objective To explore if the modified unilaterally-open expansive laminoplasty using bridge grafting and reconstructing posterior ligamentous complex methods is effective in preventing persisting axial symptoms, restriction of neck motion, and loss of cervical curvature. Methods From June 2000 to October 2005, 138 patients with cervical spondylotic myelopathy underwent this procedure. Of them, 78 who were followed for more than 2 years (group A) were included in this study. Another 69 patients who underwent conventional unilaterally opendoor laminoplasty served as controls(groupB). The JOA scores and the incidence of newly developed or deteriorated axial symptoms were recorded. Preoperative and postoperative ranges of neck motion were measured on lateral flexion and extension radiographs. Preoperative and postoperative cervical curvature indices were calculated according to Ishihara’s method. Results The patients of group A were followed 24-44 months (mean 33 months), and the patients of group B were followed 2453 months(mean 35 months). The operative time was 114±20 min in group A and 70±25 min in group B,showing statistically significant difference(P＜0.05). The operative blood loss was 280±72 ml in group A and 210±80 ml in group B(P＞0.05). Accordingto JOA scoring, the average recovery rates were 67.0%±17.3% in group A and 65.0%±21.4% in group B(P＞0.05). Postoperative development or deterioration of axial symptoms occurred in 12% of patients in group A and 51% of patients in group B, showing statistically significant difference(P＜0.05). Postoperative range of neck motion was 88.0%±10.1% of the preoperative one in group A and 64.0%±16.3% in group B(P＜0.05). There was no significant difference between preoperative(15.3±8.2) and postoperative(13.5±9.3) cervical curvature index in group A, whereas the mean value of postoperative index (11.1±5.7) was significantly smaller than that of preoperative one (17.2±13.5) in group B (Plt;0.05). Conclusion This new procedure was less invasive to the posterior extensor mechanism than the conventional unilaterally-open laminoplasty and was effective in preventing postoperative morbidities.
ObjectiveTo conduct item analysis on the Pulmonary Nodule Symptom Scale preliminarily developed through Delphi consultation, establish the final version of the scale, and evaluate its reliability and validity. MethodsPatients with pulmonary nodules who visited the outpatient department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from May to October 2024 were enrolled according to diagnostic criteria for pulmonary nodules and predefined inclusion/exclusion standards. Demographic data, medical history, and imaging characteristics of pulmonary nodules were collected, and participants completed the preliminary Pulmonary Nodule Symptom Scale developed through Delphi consultation. Four item analysis methods, including discrete trend method, critical ration method, correlation coefficient method, and Cronbach’s α coefficient, were employed for final item screening to determine the definitive version of the scale. Reliability and validity were systematically assessed via Cronbach’s α, split-half reliability, content validity, and construct validity. ResultsA total of 153 patients with pulmonary nodules were included, comprising 56 (36.60%) males and 97 (63.40%) females, with a mean age of (53.77±12.61) years. The median disease duration was 6 (1, 20) months, and mean nodule diameter was (7.64±4.37) mm, including 38 (24.84%) solitary patients and 115 (75.16%) multiple patients, as well as 39 (25.49%) solid nodules and 114 (74.51%) ground-glass nodules. Based on comprehensive results from four item analysis methods and core group discussion, two items ("symptom severity" and "quality of life") in the overall evaluation dimension were removed. The final scale comprised 15 items across three dimensions: respiratory symptoms, systemic manifestations, and psychological state. The Cronbach’s α coefficient was 0.84, with a Spearman-Brown coefficient of 0.912. Item-level content validity indices ranged from 0.824 to 1.000, while the scale-level content validity index reached 0.933. Kaiser-Meyer-Olkin (KMO) measure was 0.803, with Bartlett’s test of sphericity showing statistical significance (P<0.001). Exploratory factor analysis extracted three factors explaining 52.48% of total variance, and the rotated component matrix distribution generally aligned with the predefined three dimensions. ConclusionThe definitive version of the Pulmonary Nodule Symptom Scale contains 15 items across three dimensions (respiratory symptoms, systemic manifestations, and psychological state). Reliability and validity evaluations demonstrate good reliability and satisfactory validity for the scale.
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.
Long-term chronic internal jugular vein (IJV) insufficiency, originally viewed as a non-pathological finding, may result in cerebral venous outflow disturbance, leading to cerebral venous ischemia and cerebral nervous functional disorders. In this article we discuss probable etiologies, symptoms, diagnosis and treatment of IJV disturbance, so as to provide some insights for clinicians.