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.
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 clinical features and long-term prognosis of children with symptomatic epilepsy complicated by encephalofacial angiomatosis. Methods A total of 38 children with Sturge-Weber syndrome (SWS) complicated by symptomatic epilepsy who were diagnosed and treated in the Children's Hospital of Soochow University from January 2011 to June 2020 were selected as the research objects. Their clinical data were collected, and long-term follow-up studies were carried out. Results The clinical manifestations of SWS complicated by symptomatic epilepsy were diverse, with focal seizures being the most common (86.84%). Abnormalities were found in the cranial CT and MRI of all 38 children, mainly involving the parietal lobe and occipital lobe. Among the 38 children undergoing electroencephalogram (EEG) examinations, 31 had abnormal results. Among the abnormal EEGs, the background waves were asymmetrical on the left and right sides in 28 cases (the amplitude on the affected side was lower), 8 cases showed unilateral discharges to varying degrees, and 1 case showed bilateral high-amplitude discharges. Among the 38 cases, 2 did not use antiepileptic drugs, and 36 were treated with antiepileptic drugs, mainly with oxcarbazepine, topiramate, and levetiracetam. Eventually, 2 children were given surgical treatment due to drug-resistant epilepsy. Among the 38 cases, 19 (50.00%) were diagnosed with refractory epilepsy. Epilepsy occurring before the age of 2 are prone to develop into refractory epilepsy (P<0.05). All 38 children had sequelae to varying degrees, including 25 cases (65.79%) with severe sequelae and 13 cases (34.21%) with milder sequelae. Moreover, the earlier the age of epilepsy onset in children, the more likely it was to leave severe sequelae in the later stage (P=0.001). Conclusion Children with Sturge-Weber syndrome complicated by symptomatic epilepsy mainly have focal seizures. About half of them suffer from refractory epilepsy. The earlier the age of epileptic seizures, the more likely it is to develop into refractory epilepsy. The long-term prognosis of such children is rather poor. Among the 38 cases followed up, all had sequelae of varying degrees.
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 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 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 develop a preliminary "pulmonary nodule symptom scale" based on the Delphi method, providing a tailored, standardized, normalized, and promotable symptomatic evaluation tool for the efficacy assessment of pulmonary nodule patients treated with traditional Chinese medicine or integrated traditional Chinese and Western medicine interventions. Methods A preliminary pool of scale items was formed through literature review, interviews with doctors and patients, and reference to guidelines and consensus on pulmonary nodules and patient-reported outcome (PRO) scales related to lung cancer. Two rounds of expert consultation were conducted using the Delphi method. Based on the concentration and variation indicators of expert evaluations, and considering experts’ suggestions for specific item deletions and modifications, a core group meeting was held to screen and refine the scale items. Results Invitations were sent to 54 experts, with 51 accepting the consultation. The active coefficient for the first round of consultation was 94.4%, and for the second round, it was 100%. The average authority coefficient for the 51 experts was 0.896. The Kendall’s coefficient of concordance and the average coefficient of variation for the first and second rounds of consultation were 0.215 (P<0.001) and (0.34±0.07), 0.162 (P<0.001) and (0.24±0.05), respectively. Through two rounds of Delphi expert consultation, a preliminary "pulmonary nodule symptom scale" covering 17 items across four dimensions - respiratory symptoms, systemic manifestations, psychological state, and overall assessment - was formed. Conclusion The experts participating in this Delphi consultation had high authority and enthusiasm, and they have a good level of acceptance and consistency for the preliminary "pulmonary nodule symptom scale". Subsequent empirical research will be conducted on a large sample cohort of pulmonary nodule patients to verify the scale’s stability and effectiveness.
Objective To analyze the clinical presentations and radiological characteristics of acute exacerbation of idiopathic pulmonary fibrosis ( IPF) . Methods Clinical and radiological data of 2 patients with acute exacerbation of IPF from April 2006 to July 2008 were retrospectively analyzed and literatures were reviewed. Results Both patients were senior male patients over 60 years old. Dyspnea, cough and inspiratory crackles were the major symptoms and signs. Two patients were experiencing an exacerbation of dyspnea for one week and half of month, respectively. PaO2 /FiO2 of both patients was less than225 mm Hg. In both patients, high-resolution computed tomography ( HRCT) scans at the exacerbation showed typical signs of IPF including peripheral predominant, basal predominant reticular abnormality, with honeycombing and traction bronchiectasis and bronchiolectasis, and newly developing alveolar opacity. HRCT scan showed peripheral area of ground-glass attenuation adjacent to subpleural honeycombing in one patient, and diffusely distributed ground-glass opacity in another patient. Two patients had received corticosteroid treatment. For one patient, the symptoms improved, and ground-glass attenuation adjacent to subpleural honeycombing had almostly resolved. The other patient died of respiratory failure. Conclusions Some acute exacerbation in idiopatic pulmonary fibrosis can be idiopathic. The clinical presentations mainly include the worsening of dyspnea within short time. HRCT generally demonstrates new bilateral ground-glass abnormality with or without areas of consolidation, superimposed on typical changes of IPF.
ObjectiveTo investigate the current status of symptom burden and psychological distress among lung cancer patients in the diagnostic phase, and to explore the chain mediating role of social support and resilience between symptom burden and psychological distress. MethodsThe patients with lung cancer in the diagnostic phase who were treated in the Department of Thoracic Surgery of the Second Xiangya Hospital of Central South University from October 2022 to June 2023 were investigated by a general information questionnaire using the MD Anderson Symptom Inventory, the Social Support Rating Scale, the Connor-Davidson Resilience Scale, and the Distress Thermometer. The chain mediating role of social support and resilience between symptom burden and psychological distress was analyzed. ResultsA total of 413 lung cancer patients were enrolled, including 173 males and 240 females, aged (54.69±10.82) years. The detection rate of psychological distress among lung cancer patients in the diagnostic phase was 48.18%, and the average score was (3.84±2.50) points. Psychological distress was positively correlated with symptom burden (P<0.01), and negatively correlated with social support and resilience (P<0.01). The mediating effect of resilience between symptom burden and psychological distress was significant. The chain mediating effect of social support and resilience between symptom burden and psychological distress was also significant. ConclusionLung cancer patients in the diagnostic phase have a high detection rate of psychological distress. Symptom burden can directly impact psychological distress, and can affect psychological distress through the indirect path of resilience as well as the chain mediating path between social support and resilience among lung cancer patients in the diagnostic phase.
ObjectiveTo investigate the long-term retention rate of Oxcabazepine (OXC) in Chinese young children with symptomatic epilepsy and to evaluate the withdrawal causes of OXC. MethodsClinical features of 89 cases (male/female:48/41) from January.2009 to June.2015 were collected. Patients with symptomatic epilepsy who received mono-or adjunctive therapy with OXC. The initial dose was 10mg/kg/d twice a daily, 3~4weeks to increased to the target dose. OXC doses ranged between 12~53 mg/(kg·d) (mean dose:34.0±8.59 mg/(kg·d). An investigator recorded the antiepileptic drugs, seizure frequency, electroencephalogram and side effects for 3, 6, 12, 24 and 36months during follow-up. ResultsA total of 89 patients were enrolled in this investigation. patients with 50% reduction in seizure frequency in 6, 12, 24 and 36 months were 56.5%, 55.3%, 44.7%, 24.7%, and with seizure-free were 36.5%, 34.1%, 29.4%, 16.5%. In this research, 16(18.0%) patients experienced at least one side effect. The most common side effects observed were drowsiness 8 (42.1%), rash 3 (15.8%), and most were mild in severity. The retention rate of OXC in 3, 6, 12, 24, and 36months were 95.5%, 87.6%, 75.3%, 56.2%, 25.8%, respectively. The predominant causes of withdrawal were lack of efficacy 36(54.5%), end point 10(15.2%), adverse effects 8(12.1%), seizure-free 5(7.6%), follow-up loss 3(4.5%). COX analysis reveals that the age of onset was associated with treatment failure. ConclusionOur study demonstrates that OXC is safe and well tolerated in infants and very young children with symptomatic epilepsy, but the long-term retention rate is low. Whereas, for the purpose of better retention rate and therapeutic benefits, we should treat discretely depending on the complicated etiology and clinical features.