Objective To explore the effect of kidney transplantation on chronic prostatitis-like symptoms. Methods A total of 300 male renal transplant recipients between January 2015 and January 2017 were collected in the study. All recipients received the questionnaire survey of the National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) preoperatively and at 3 months after transplantation. The score and relevant risk factors were statistically analyzed. Results A total of 210 recipients (70.0%) completed questionnaire effectively, in whom 150 (71.4%) had preoperative and 90 (42.9%) had postoperative chronic prostatitis-like symptoms, respectively. In the 210 patients, the preoperative and postoperative pain score was 6.57±3.12 vs. 3.57±3.16 (P<0.001), voiding score was 3.71±2.38vs. 3.29±2.66 (P=0.116), quality of life score was 7.57±1.60 vs. 5.14±2.75 (P<0.001), and the total NIH-CPSI score was 17.86±3.81vs. 12.00±6.65 (P<0.001), respectively. The severity of chronic prostatitis-like symptoms was alleviated significantly after kidney transplantation. Conclusion Kidney transplantation can alleviate the chronic prostatitis-like symptoms significantly, and improve the quality of life in uremia patients.
Objective To investigate the differences in clinical characteristics and polysomnographic characteristics between the elderly obstructive sleep apnea-hypopnea syndrome ( OSAHS) patients and the young and middle-aged OSAHS patients. Methods The clinical manifestations and the polysomnographic characteristics of 37 elderly OSAHS patients and 294 young and middle-aged patients were analyzed. The differences in polysomnographic indicators between two groups were compared according to the body mass index.Results The nocturia frequency in the elderly OSAHS patients was higher( P =0. 01) ,however, the othert clinical manifestations between the elderly group and the young and middle-aged group were not different significantly. The elderly group had a lower body mass index ( P =0. 018) , a smaller neck circumference ( P =0. 003) , and a larger chance of diabetes ( P = 0. 001) and hypertension( P lt; 0. 001) .The phase Ⅰ and phase Ⅱ sleep of the elderly group took a longer duration ( P lt; 0. 001) and a larger proportion( P lt;0. 001) . The sleep apnea-hypopnea index between two groups did not show any significant difference( P =0. 082) . The lowest night oxyhemoglobin saturation of the elderly group was higher than that of the young and middle-aged group( P =0. 009) , but such difference disappeared after adjustment by weight ( P =0. 114) . Conclusions The major clinical manifestations of the elderly OSAHS patients are similar to the young and middle-aged patients. The elderly patients are thinner than the young and middle-aged patients, but have more complications and a higher frequency of nocturia. The night oxyhemoglobin saturation is lower in young and middle-aged patients which is associated with higher body mass index.
ObjectiveTo observe and analyze the fundus of pregnancy-induced hypertension syndrome (PIHS) and optical coherence tomography (OCT) characteristics and its correlation with ocular symptoms and degree of the systemic disease. MethodsA total of 132 PIHS patients (264 eyes) received the examinations of corrected visual acuity, slit lamp microscope, direct ophthalmoscope, OCT and fundus color photography after obtaining informed consent in the study. There were 10 cases of gestational hypertension, 29 cases of preeclampsia (mild), 82 cases of pre-eclampsia (severe) and 11 cases of eclampsia. 91 patients (180 eyes) felt blurred vision and visual fatigue. 102 patients were examined at an average gestational age of (37.00±2.14) weeks and 30 patients were examined at an average (10.00±8.22) days postpartum. The ocular fundus was divided into normal fundus and abnormal fundus; the abnormal fundus had 3 stages, including stageⅠ(retinal arterial spasm), stageⅡ(retinal arteriosclerosis) and stageⅢ(retinopathy). If the OCT results seems to be abnormal, these patients were further selected to observe the changes of neurosensory serous retinal detachment, retinal pigment epithelium (RPE) and junction of inner and outer segment of photoreceptor (IS/OS). Kappa test was used to analyze the consistency between fundus performance and OCT results, and that of ocular symptoms with fundus changes and OCT results. Rank correlation test was used to analyze the degree of PIHS and OCT examinations. ResultsThere were 32 eyes with normal fundus (12.12%) and 232 eyes with abnormal fundus (87.88%). The 232 eyes with abnormal fundus were divided into three stages: stageⅠfor 16 eyes (6.90%), stageⅡfor 31 eyes (13.36%) and stageⅢfor 185 eyes (79.74%). 92 of 264 eyes (34.85%) had normal OCT findings, 172 eyes (65.15%) were abnormal, including 94 eyes with serous retinal neurosensory detachment (54.65%), 40 eyes with changes of RPE and IS/OS (23.26%) and 38 eyes with other manifestations (22.09%). Kappa test analysis showed highly consistency between OCT results and ocular symptoms (K=0.728, Po=0.591), and poor consistency between fundus abnormalities and ocular symptoms (K=-0.129, Po=0.879), and between fundus abnormalities and OCT results (K=0.174, Po=0.682). OCT results were positively correlated with the degree of PIHS (C=0.374, χ2=74.011; P=0.000). Conclusions87.88% of PIHS eyes had various degrees of retinal hemorrhage, cotton wool spots, retinal bumps or detachment, optic disc edema and other retinal abnormalities. 65.15% of that showed OCT abnormal results such as neurosensory retinal detachment, cystoid edema, RPE changes etc. The consistency was poor between the OCT results and fundus abnormalities. OCT results are positively correlated with the degree of PIHS.
ObjectiveTo explore coronary angiographic characteristics in patients with symptomatic recurrence after coronary artery bypass grafting (CABG). MethodsWe performed a retrospective study of 997 patients with symptomatic recurrence after CABG in Beijing Anzhen Hospital from 2010 to 2020. There were 762 males and 235 females, with an average age of 62.41±8.70 years.ResultsThere was a high prevalence of risk factors like hypertension, diabetes and a history of smoking. Diseased arterial grafts accounted for 27.44% while saphenous vein graft 54.40%; 240 (24.07%) patients had all patent grafts. The main lesion characteristics of diseased grafts were chronic total occlusion lesions (79.57%). Most patients had more diseased native vessels after CABG than before. The type C coronary artery disease in native vessels relevant to ischemic area occurred in 674 (67.60%) patients; 525 (52.66%) patients with recurrent symptom after CABG had both diseased grafts and diseased native vessels. Conclusion Graft status in patients with symptomatic recurrence after CABG is worse than we expected. The majority have newly developed lesions both in grafts and native vessels. Native vascular lesions will continue to progress after CABG.
Objective To examine the clinical utility of postoperation symptom inventory. Methods According to the current cancer symptom assessment tools, clinical guidelines and expert interviews, we preliminarily selected 10 common symptoms as an alternative item. Postoperative symptom assessment scale of lung cancer patients was formulated through expert evaluation. And 383 patients in eight hospitals were evaluated and validated using the scale to analyze the reliability and validity. Results Postoperation symptom inventory was easy to operate and evaluate for postoperative lung cancer patients in 8 symptoms (pain, shortness of breath, fatigue, cough, insomnia, throat pain, sweating and constipation). The scale was with high reliability. Cronbach' s α was 0.888. This scale was also with reliable validity. Content validity index was 0.900. There were two common factors with high cumulative proportion in variance(47.70% and 57.46%). And each question had high factor load and communality (>0.40) in the exploratory factor analysis. Conclusion The postoperation symptom inventory has excellent reliability and validity in patients with lung cancer surgery.
Objective To investigate the mental status of medical staffs in the orthopedics department during the earthquake, providing evidence for psychological intervention. Methods Choosing 104 staffs in the orthopedics department as eligible subject with convenient sampling; the research tool was Symptom Checklist-90. The questionnaire was done by the participants with the same instruction from psychological professionals; analyze the results. Results The score in somatization, anxiety and phobic anxiety of staffs in the orthopedics department was significantly higher than the national norm. Conclusion There exists disorder in mental health of medical staffs in orthopedics department, it is necessary to implement mental intervention.
Objective To explore the incidence and severity of symptoms of the lung cancer patients undergoing concurrent chemoradiation therapy, and reveal the influence of symptom clusters on the patients’ daily activities. Method From December 2016 to June 2017, a total of 150 patients with lung cancer who underwent concurrent chemoradiation therapy were investigated by using M. D. Anderson Symptom Inventory of Chinese Version and the revised lung cancer module. Results For the patients during the period of concurrent chemoradiation therapy, the symptoms with severity score >5 were fatigue, nausea, poor appetite, cough, distress, disturbed sleep, vomiting, expectoration, and grief; the symptoms with incidence >80% were fatigue, nausea, disturbed sleep, poor appetite, grief, and cough. Joy of life (87.33%), emotion (74.38%), and work (72.67%) were the top three in terms of high incidence of symptom distress. Exploratry factor analysis revealed 4 major symptom clusters, which were fatigue-related symptom cluster, gastrointestinal symptom cluster, emotion symptom cluster, and respiratory symptom cluster. Conclusions During the period of concurrent chemoradiation therapy, lung cancer patients suffer from multiple symptom clusters. Medical staff should assess symptoms timely, and provide effective interventions, to improve the patients’ quality of life.
ObjectiveTo investigate Chinese psychiatrists' mental health. MethodsLiteratures published from January 1989 to March 31, 2013 were searched through Chinese network databases (CNKI, Weipu, Wanfang) and English network database (OVID). Factors of Symptom checklist-90 (SCL-90) were extracted and compared with Chinese norm. These were analyzed by Meta analysis method. ResultsEleven articles were obtained and analyzed, including 725 psychiatrists. The research illustrated that the differences between psychiatrists and Chinese norm of somatization[WMD=0.19, 95%CI (0.05, 0.33), P=0.008], depression[WMD=0.25, 95%CI (0.06, 0.43), P=0.009], anxiety[WMD=0.28, 95%CI (0.09, 0.47), P=0.004], hostility[WMD=0.15, 95%CI (0.01, 0.30), P=0.03], and phobia[WMD=0.11, 95%CI (0.02, 0.20), P=0.02] were significant, while the other 4 factors were not significant (P>0.05). ConclusionPsychiatrists' mental health is poor and intervention measures need to be adopted to improve psychiatrists' mental health.
Objective To explore the mental health status and the relevant influencing factors of the resident standardized trainees, and to provide reference for the psychological intervention. Methods All the resident standardized trainees in a first class of the third grade hospital in Sichuan from July 2012 to August 2015 were investigated by the questionnaire including symptom checklist 90, demographic characteristics and work condition. Results The detection rate of psychological problem among resident standardized trainees was 24.7% which was higher than the general population. The analysis of logistic regression showed that the training grade, identity, work time and working achievement were the main factors related to psychological problems. Conclusions The psychological problems of resident standardized trainees were prominent because they are in a transformation stage from medical students to clinical doctors. The related department should pay more attention and take measures to improve the resident standardized trainees’ mental health.
ObjectiveTo preliminarily evaluate the feasibility of ultra-wide-angle fundus imaging (UWFI) to observe the Weiss ring (vitreous floats) and the effectiveness and safety of neodymium-doped yttrium aluminum garnet (Nd: YAG) laser ablation in the treatment of symptomatic Weiss ring. MethodsA retrospective clinical study. From March 2016 to December 2019, 80 eyes of 68 patients with symptomatic Weiss ring who were diagnosed and treated at Guangzhou Aier Eye Hospital were included in the study. Among them, there were 39 eyes in 32 males and 41 eyes in 36 females; the average age was 53.7±10.8 years old. All the affected eyes were examined by slit lamp microscope combined with 90 D front lens and UWFI. The position and shape of the vitreous floating objects by drawing pictures were recorded. All the affected eyes underwent Nd: YAG laser ablation treatment. Three months after treatment, a questionnaire survey was conducted on the patients to assess the improvement of subjective symptoms. Those with a total score of 10, 7-9, 3-6, and ≤2 points were defined as cured, significant improvement, partial improvement, and no improvement, respectively. The measurement software Gauge 1.0 was used to manually measure the long diameter, circumference and area of the vitreous float on the UWFI image. The diameter of the optic disc to 1 Unit (U) was set as a standardized reference value. Those who did not show UWFI and no floating objects were found on the front mirror were recorded as 0. The changes of vitreous floats before and after treatment were compared by Wilcoxon rank sum test; the changes in their size before and after treatment and the patients' subjective symptom improvement scores after treatment were analyzed by Spearman rank correlation. ResultsAfter treatment, in 80 eyes, there were no vitreous floats in 59 eyes (73.8%, 59/80) on UWFI. Before treatment, the circumference of the vitreous float was 1.84 (1.07, 2.64) U, the long diameter was 1.17 (0.84, 1.66) U, and the area was 0.18 (0.08, 0.30) U2; after treatment, the circumference was 0.00 (0.00, 0.23) U, The long diameter is 0.00 (0.00, 0.23) U, and the area was 0.00 (0.00, 0.01) U2. There were statistically significant differences in the perimeter, diameter, and area of floating objects before and after treatment (Z=−7.722, −7.560, −7.655; P＜0.001). The results of the questionnaire survey showed that the patient's subjective symptoms were cured, significantly improved, and partially improved in 49 (61.3%, 49/80), 25 (31.2%, 25/80), and 6 (7.5%, 6/80) eyes, respectively. The results of correlation analysis showed that the degree of improvement of the patient's subjective symptoms was related to the circumference (r=0.812), long diameter (r=0.796), and area (r=0.791) of the vitreous float on UWFI before and after treatment (P＜0.01). During the follow-up period, no complications such as increased intraocular pressure or decreased vision occurred. ConclusionsUWFI can objectively image the Weiss ring, and its size can be quantified relatively to the measurement software. Nd: YAG laser ablation treatment of symptomatic Weiss ring is safe and effective.