Objective To investigate the clinical characteristics of facial palsy after stroke (FPS) in order to enhance the understanding of FPS. Methods Patients with stroke and admitted to hospital from March to June 2015 were selected in this study. They were evaluated by Modified House-Braekmann (MHBN), Barthel Index (BI), National Institute of Health Stroke Scale (NIHSS), Standardized Swallowing Assessment and Patient Health Questionnaire-9 (PHQ-9) within 48 hours after admitting. According to the MHBN scores, the patients were divided into FPS group and non-FPS group, and the incidences of dysphagia and depression, and the scores of BI, NIHSS, and PHQ-9 were compared between the two group. Six months later, the patients’ prognosis of stroke was assessed by the Modified Rankin Scale. Results A total of 129 patients were enrolled in this study, including 81 (62.8%) with FPS, and 48 (37.2%) without FPS. The incidences of dysphagia and depression in the FPS group (64.2%, 59.3%) were higher than those in the non-FPS group (22.9%, 18.8%), and the differences were statistically significant (P<0.05). The BI, NIHSS, PHQ-9 scores in the FPS group were 41.79±14.19, 11.23±4.62, 11.54±3.43, respectively, while the scores in the non-FPS group were 66.39±19.96, 7.54±3.69, 7.67±2.89, respectively; the differences in the scores between the two groups were statistically significant (P<0.05). Six months later, the patients’ prognosis in the non-FPS group was better than that in the FPS group (67.4%vs. 32.9%, P<0.001). Conclusions There is a high incidence of FPS, and there are high incidences of dysphagia and depression in the FPS patients with stroke. FPS influences the patients’ prognosis, so the understanding and treatment of FPS should be enhanced.
ObjectiveTo investigate the role of mindfulness-based stress reduction in improving anxiety and depression in elderly patients with chronic heart failure.MethodsFrom August 2016 to August 2018, a total of 196 elderly patients with chronic heart failure were randomly divided into the treatment group and the control group, with 98 cases in each group. The control group received routine care. The treatment group received routine care plus mindfulness-based stress reduction in two 60-minute sessions a week for 8 weeks. The level of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) was detected by electrochemiluminescence immunoassay, and left ventricular ejection fraction (LVEF) was measured by echocardiography before intervention and at week 8 of intervention; the effective rate was calculated. Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and General Well-Being scale (GWB) were used to assess the degree of anxiety, depression, and well-being of patients before intervention and at week 8 of intervention.ResultsThe serum NT-proBNP levels at week 8 of intervention in the two groups were lower than those before intervention, and the LVEFs were higher than those before intervention (P<0.05). The treatment group showed significant changes when compared with the control group (P<0.05). The effective rate of the treatment group was higher than that of the control group (89.80% vs. 69.39%, P<0.05). Before intervention, the SAS scores in the treatment group and the control group were 56.61±8.25 and 55.98±6.32, respectively, the SDS scores were 59.98±7.21 and 58.86±6.17, respectively, and the GWB scores were 53.19±12.38 and 54.06±10.93, respectively; at week 8 of intervention, the SAS scores in the treatment group and the control group were 40.56±8.17 and 46.25±5.43, respectively, the SDS scores were 42.85±5.77 and 48.34±8.01, respectively, and the GWB scores were 76.17±9.63 and 68.58±13.30, respectively. At week 8 of intervention, the SAS and SDS scores of the two groups were both lower than those before intervention, and the GWB scores were higher than those before intervention (P<0.05). The treatment group showed significant changes when compared with the control group (P<0.05).ConclusionMindfulness-based stress reduction can improve the anxiety and depression of elderly patients with chronic heart failure, improve their well-being and promote the recovery of heart function.
Objective To explore the safety and clinical efficacy of right chest minithoracotomy for left atrial myxoma resection. Methods We retrospectively analyzed clinical data of 32 patients with left atrial myxoma resection by right chest minithoracotomy (a small incision group, 9 males, 23 females at age of 59.1±9.5 years) in our hospital from July 2011 through March 2015. Meanwhile, we selected 17 patients with left atrial myxoma treated by conventional chest median sternotomy as a control group (7 males, 10 females at age of 60.0±9.0 years). Clinical results of the two groups were compared. Results There was no statistical difference in preoperative clinical data of the patients between the two groups. All the patients were successfully operated. Patients in the small incision group had longer aortic clamping time than that in the control group. But there were shorter postoperative mechanical ventilation time (9.5±4.9 h), shorter ICU stay time (18.6 ± 6.2 h), less amount of thoracic cavity drainage 24 h after drainage (103.8±19.4 ml), lower bleeding reoperation rate (0.0), less blood transfusion after surgery (1.4±1.1U), shorter ambulation time (38.5±6.9 h), shorter hospital stay (8.1 ± 0.9 d), lower postoperative complication rate (0.0) than those of the control group (P<0.05). Conclusion Right chest minithoracotomy left atrial myxoma resection is feasible, safe and effective, is worth promoting.
Objective To estimate the incidence of post-myocardial infarction depression among Chinese acute myocardial infarction (AMI) patients by meta-analysis and to provide references for the management of AMI patients. Methods We searched databases including PubMed, The Cochrane Library (Issue 6, 2016), CNKI, CBM, WanFang Data and VIP from January 2000 to July 2016, to collect literature regarding the incidence of post-myocardial infarction depression among patients with AMI. Two reviewers independently screened literature, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed by using Comprehensive Meta Analysis (CMA) 2.0 software. Results Totally, 22 cross-sectional studies were included, involving 2 986 AMI patients, of which1 239 were post-myocardial infarction depression patients. The overall incidence of post-myocardial infarction depression among the AMI patients was 42.7% (95%CI 36.3% to 49.4%). There was no statistical differences observed when the studies were stratified by sex, regions, scales and years (allP values>0.05). Conclusion In China, the incidence of post-myocardial infarction depression is high and rising year by year roughly among AMI patients. The status should be paid more attention.
Objective To observe the serum levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), platelet 5-HT and blood platelet count, emotion and burn injury healing of patients with moderate and severe burn injury and anxiety-depression symptoms. Methods In-patients with moderate and severe burn injury were selected from 2003.4 to 2005.2 and then divided into anxiety-depression group and control group according to their anxiety-depression scores by Hamilton Rating Scale for Depression (HAMD ) and Hamilton Rating Scale for Anxiety (HAMA) 3 days after being burnt. Routine therapy was given to two groups, which lasted 1 month. Their scores of anxiety and depression and the degree of injury healing were observed, and the serum levels of TNF-α and IL-6, platelet 5-HT and blood platelet count were measured in the two groups. Results Fifty-one in-patients with moderate and severe burn injury were divided into the anxiety-depression group (24 cases) and the control group (27 cases). After 30-day treatment, the depression scores did not decrease in the anxiety-depression group (P=0.12), but the anxiety scores decreased (P=0.00). In the anxiety-depression group, the burn injury healing time was postponed (P=0.00), the serum levels of TNF-α increased (P=0.00), and the platelet 5-HT levels decreased (P=0.04) before and after treatment. Conclusion Depressive reaction occurs in patients with moderate and severe burn injury, which is a continuously negative emotion. It can lead to high levels of serum TNF-α, reduction in platelet 5-HT, and delayed burn injury healing time. Due to the limited sample size and different location of patients, there may be some bias in this conclusion. We are prepared to increase the sample size and select patients in the same region in further relevant studies.
ObjectivesTo systematically review the detection rate of depression in Chinese individuals with type 2 diabetes mellitus (T2DM).MethodsPubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect observational studies on the detection rate of depression in Chinese with T2DM from inception to January, 2019. Two reviewers independently screened literature, extracted data and evaluated the quality of included studies. Meta-analysis was performed by R 3.6.1 software.ResultsA total of 29 studies involving 96 557 cases were included. Meta-analysis results showed that the total detection rate of depression in Chinese with T2DM was 27% (95%CI 24% to 30%). Subgroup analysis showed that the detection rate of depression in female was 32% (95%CI 20% to 45%), and in male was 26% (95%CI 18% to 37%). The detection rate of depression in rural areas was 36% (95%CI 18% to 54%), and in urban areas was 30% (95%CI 16% to 43%). The detection rate of depression in individuals aged 60 and above was 31% (95%CI 24% to 39%), and in individuals aged less than 60 was 23% (95%CI 10% to 36%). Individuals with a primary school education and below, a middle or high school education and college degree and above education had detection rate of 31%, 23% and 22%, respectively. Individuals with diabetes duration less than 5 years, 5 to 10 years and more than 10 years had detection rates of 23%, 25% and 30%, respectively. Individuals with and without complications had detection rates of 43% and 26%, respectively. The detection rates of mild and moderate to major depression were 20% and 10%, respectively.ConclusionsThe detection rate of depression in Chinese with T2DM is high. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
For the increasing number of patients with depression, this paper proposes an artificial intelligence method to effectively identify depression through voice signals, with the aim of improving the efficiency of diagnosis and treatment. Firstly, a pre-training model called wav2vec 2.0 is fine-tuned to encode and contextualize the speech, thereby obtaining high-quality voice features. This model is applied to the publicly available dataset - the distress analysis interview corpus-wizard of OZ (DAIC-WOZ). The results demonstrate a precision rate of 93.96%, a recall rate of 94.87%, and an F1 score of 94.41% for the binary classification task of depression recognition, resulting in an overall classification accuracy of 96.48%. For the four-class classification task evaluating the severity of depression, the precision rates are all above 92.59%, the recall rates are all above 92.89%, the F1 scores are all above 93.12%, and the overall classification accuracy is 94.80%. The research findings indicate that the proposed method effectively enhances classification accuracy in scenarios with limited data, exhibiting strong performance in depression identification and severity evaluation. In the future, this method has the potential to serve as a valuable supportive tool for depression diagnosis.
ObjectiveTo explore the status of common comorbidities in adult epilepsy patients in western China, and to explore the related risk factors.MethodsThe Chinese version of Generalized Anxiety Disorder (GAD)-7, neurological disorders depression inventory for epilepsy (NDDI-E) scales, pittsburgh sleep quality index scale (PSQI) and epworth sleepiness scale (ESS) were used to evaluate the 199 epilepsy patients between April 2017 and March 2018 in the Epilepsy Center of Neurology Department of Sichuan People's Hospital. Logistic regression analysis was performed on the risk factors of epilepsy comorbidity.ResultsIn the 199 adult epilepsy patients, 28.1% had anxiety, 17.1% had depression, 33.2% had sleep disorder, and 2.5% had migraine. 140 patients received monotherapy, including 15 patients with carbamazepine (CBZ), 20 patients with lamotrigine (LTG), 26 patients with levetiracetam (LEV), 31 patients with topiramate (TPM), 25 patients with oxcarbazepine (OXC), and 23 patients with Valproate (VPA).Multivariate logistic regression analysis of epilepsy patients treated with monotherapy showed that seizure occurring more than once a month, LEV, TPM, sleep disorders were independent risk factors for anxiety in patients with epilepsy (P<0.05). Unemployment, seizure occurrence in the last three months, sleep disorders were independent risk factors for comorbid depression (P<0.05). Anxiety, depression, daytime sleepiness, CBZ, LTG were independent risk factors for comorbid sleep disorders (P<0.05).ConclusionsAnxiety, depression and sleep disorder are common comorbidities in adults with epilepsy in westChina. For patients with affective disorder and sleep disorder, early identification and intervention may be important to improve the quality of life and prognosis of patients. In addition, patients treated with LEV or TPM monotherapy had a higher risk of anxiety than other drugs. Patients with LTG and CBZ monotherapy are more likely to comorbid sleep disorders.
ObjectivesTo systematically review the prevalence of depression in the elderly in China.MethodsPubMed, Web of Science, CBM, CNKI, WanFang Data and VIP databases were electronically searched to collect cross-sectional studies on the prevalence of depression of Chinese elderly from January 2010 to July 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 22 cross-sectional studies involving 12 656 patients were included. Meta-analysis showed that the overall prevalence of depression in Chinese elderly was 25.55% (95%CI 19.81% to 31.29%). Subgroup analysis showed that the prevalence of females was higher than that of males; the prevalence in the north was higher than that in the south; the prevalence in rural areas was higher than that in cities; the prevalence of CES-D assessment scale was higher than that of GDS-30; the prevalence of depression increased annually of data collection.ConclusionThe prevalence of depression in the elderly (aged 60 years and above) in China is high. More attention should be paid to this situation and more psychological intervention should be provided to the elderly. Due to the limited quantity and quality of the included studies, more high-quality studies are required to verify the above conclusion.
Objective To investigate the association between types of rapid eye movements during sleep and ICD-10 as a mothod for diagnosing depression. Methods Depression was diagnosed according to ICD-10 and changes of 9 variables of REM sleep in 120 psychiatric outpatients and inpatients by calculating the Kappa values. Results In 120 psychiatric patients, 52 depressive patients were diagnosed by using ICD-10, and 58 patients were diagnosed as depression according to decreased REM sleep latency and increased REM activity, REM intensity, REM density, and increasing amount of REM sleep. Kappa value was 0.73, Plt;0.05, which implied that these two diagnosing ways were significantly consistent. Conclusions Measuremen of REM sleep variable should be investigated further as a supplementary method for diagnosing depression.