循经冥想训练干预大学生抑郁情绪的效果分析

背景　现有研究表明，抑郁是影响大学生心理健康的重要原因之一。因此，有必要采取有效的方法干预大学生抑郁情绪。目的　探究循经冥想训练干预大学生抑郁情绪的效果。方法　2018年4月，在以循经冥想课题组的名义招募的某大学本科生中，发放抑郁自评量表（SDS），筛选出自愿接受循经冥想训练的60人。根据受试者性别比例，采用随机数字表法随机分为循冥组和静息组。其中循冥组30人进行4周循经冥想训练，在开始循经冥想训练前和循经冥想训练结束后填写SDS并进行E-prime情绪图片评价任务。静息组30人进行静息训练，其余与循经冥想组相同。比较两组前测、后测及前后测差值有无差异。结果　两组前测积极、中性、消极情绪图片评分比较，差异均无统计学意义（P>0.05）；两组后测积极、中性、消极情绪图片评分比较，差异均无统计学意义（P>0.05）；两组积极、中性、消极情绪图片评分前测与后测差值比较，差异均无统计学意义（P>0.05）。静息组前测与后测积极、中性、消极情绪图片评分比较，差异均无统计学意义（P>0.05）。循冥组后测积极情绪图片评分低于前测、消极情绪图片评分高于前测（P<0.05）。两组前测SDS评分比较，差异无统计学意义（P>0.05）。循冥组后测SDS评分低于静息组，SDS评分前测与后测差值高于静息组（P<0.05）。循冥组和静息组后测SDS评分均低于前测（P<0.05）。结论　循经冥想能降低大学生抑郁水平，可能是由于其能够改变人的情绪认知评价和睡眠质量，使人变得平和。     

Influence of respiratory allergy and restless sleep on definite sleep bruxism: a cross-sectional clinical study

ObjectiveThis cross-sectional clinical study evaluated the associations between sociodemographic, occupational, clinical conditions, psychological and sleep quality variables on definite sleep bruxism (SB).MethodsAll records obtained from adults (aged 20–60 years) and the elderly (aged >60 years) who had undergone polysomnography (PSG) at a private medical outpatients’ clinic from July 2017 to February 2018 were reviewed. Data from a questionnaire, based on the criteria of the American Academy of Sleep Medicine (AASM), were also gathered. Definite SB data pattern distribution was analyzed, and multivariate Poisson regression with robust variance was used to assess the associations between definite SB diagnosis, determined via PSG recordings, and the independent variables. A significance level of 5% was adopted.ResultsA total of 240 individuals were included in the study and the SB prevalence was 7.08% (n = 17). The adjusted Poisson regression analysis revealed association between definitive SB and individuals with respiratory allergy (PR = 3.63; 95% CI:1.01–13; P = 0.047) and restless sleep (PR = 2.97; 95% CI:1.04–8.50; P = 0.042).ConclusionThis study found associations between definite SB and clinical conditions (respiratory allergy) and sleep behavior (restless sleep). Knowledge regarding factors associated with definite SB can contribute to decision making in the clinical setting and management strategies involving a multidisciplinary approach.     

Analysis of early mortality and related risk factors in maintenance hemodialysis patients

Objective To analyze the early mortality and related risk factors of new hemodialysis patients in Zhejiang province, and provide basis for reducing the death risk of hemodialysis patients. Methods The early mortality and related factors of new hemodialysis patients from January 1, 2010 to June 30, 2018 were retrospectively analyzed using the database of Zhejiang province hemodialysis registration. The early mortality was defined as death within 90 days of dialysis. Cox regression model was used to analyze the related risk factors of the early mortality in hemodialysis patients. Results The mortality was the highest in the first month after dialysis (46.40/100 person year), and gradually stabilized after three months. The early mortality was 25.33/100 person year. The mortality within 120 days and 360 days were 21.40/100 person year and 11.37/100 person year, respectively. The elderly (≥65 years old, HR=1.981, 95%CI 1.319-2.977, P＜0.001), primary tumor (HR=3.308, 95%CI 1.137-5.624, P=0.028), combined with tumors (not including the primary tumor, HR=2.327, 95%CI 1.200-4.513, P=0.012), temporary catheter (the initial dialysis pathway, HR=3.632, 95%CI 1.806-7.307, P＜0.001), lower albumin (＜30 g/L, HR=2.181, 95%CI 1.459-3.260, P＜0.001), lower hemoglobin (every 0.01 g/L increase, HR=0.861, 95%CI 0.793-0.935, P=0.001), lower high density lipoprotein (＜0.7 mmol/L, HR=1.796, 95%CI 1.068-3.019, P=0.027) and higher C reactive protein (≥40 mg/L, HR=1.889, 95%CI 1.185-3.012, P=0.008) were the risk factors of early death for hemodialysis patients. Conclusions The early mortality of hemodialysis patients is high after dialysis, and gradually stable after 3 months. The elderly, primary tumor, combined with tumors, the initial dialysis pathway, lower albumin, lower hemoglobin, lower high density lipoprotein and higher C reactive protein are the risk factors of early death for hemodialysis patients.     

Risks of androgen therapy

Elderly men with clinical and laboratory evidence of androgen deficiency are eligible for testosterone treatment.

With proper monitoring this is acceptably safe.

In the first year of testosterone treatment there should be a digital rectal examination of the prostate and measurement of prostate specific antigen every three months, thereafter yearly.

The rate of increase of prostate specific antigen (PSA) levels is more significant than its absolute values.

Levels of haemoglobin and the haematocrit should be monitored.     

A case of nocturnal fainting: supine vasovagal syncope.

Supine loss of consciousness is a relatively rare occurrence prompting investigations for underlying causes as diverse as cardiac arrhythmia, hypoglycaemia and nocturnal epilepsy. Neurally mediated syncope is rarely implicated as the cause of symptoms in supine loss of consciousness because of the absence of orthostatic stress and gravitational relative preservation of cerebral perfusion, but we report here on a case of recurrent, atypical and troublesome vasovagal syncope occurring at night while supine. Diagnosis aided by head-up tilt table testing and conservative management brought about complete resolution of symptoms.     

Modified Epworth Sleepiness Scale in Chinese children with obstructive sleep apnea: a retrospective study

Background and objective  The purpose of this study is to assess whether Chinese children with high apnea–hypopnea index (AHI) are sleepier by a modified Epworth Sleepiness Scale (ESS). Materials and methods  Records were retrospectively reviewed. We included children who were between 3 and 12 years old, admitted for overnight polysomnogram because of suspected obstructive sleep apnea syndrome (OSAS). A modified ESS was used to assess excessive daytime sleepiness (EDS) of the children. Results  One hundred ninety-two Chinese children were included. Children with high AHI, defined as AHI > 5.0, were sleepier than children with AHI less than or equal to 5. After adjustment by age, gender, and obesity, children with high AHI remained significantly sleepier. Modified ESS was significantly correlated with AHI (rho = 0.124, 95% CI = 0.004–0.281). Modified ESS score of >8 was the best cutoff point with the sensitivity and specificity of 0.29 and 0.91, respectively. The odds ratio of children with modified ESS > 10 having high AHI was 4.231 (95%CI = 1.248 to 14.338) and children with modified ESS > 8 had the highest odds ratio, 4.295(95%CI = 1.66 to 11.1), of having high AHI. Conclusion   Chinese children with high AHI appear to be sleepier than children with low AHI. Children with suspected OSAS and high modified ESS, i.e., ESS > 8, had significantly higher odds ratio of having high AHI. Increased sleepiness is a specific but not a sensitive symptom in snoring children with high AHI. Screening for EDS in snoring children may help us identify those with high AHI and prioritize the management of those children. All authors worked and the study was carried out in Kwong Wah Hospital in Hong Kong. There was no conflict of interest and no specific source of funding for the study.     

二维超声心动图对主动脉瓣关闭不全病变鉴别诊断价值

本文报道用二维超声心动图对主动脉瓣关闭不全124例进行病变鉴别诊断。就其图象特征结合X线所见,心音图等进行了鉴别诊断的探讨。其中,有风湿性心脏病111例;感染性心内膜炎4例;冠状动脉粥样硬化性心脏病5例;马凡氏综合征2例;左室假腱索2例。认为此项检查对主动脉瓣关闭不全病变鉴别诊断有一定的价值。     

Heart insufficiency in traumatic arteriovenous fistulas

Objective: To analyse the incidence, clinical presentation, and outcome of heart insufficiency in patients with chronic arteriovenous fistulas (AVF). Methodology: From 1991 to 2000 we treated 49 patients with traumatic AVF. The present study included 19 patients with AVF present for 6 months or longer, as it was presumed that these AVF will have an impact on cardiac overload. There were 16 male and three female patients with a mean age of 36 years (17–59). The time from injury to admission varied from 6 months to 33 years. Cardiological examination checked for dyspnoea and palpitation. ECG, chest X‐ray and ECHO‐cardiography were also performed. All AVF were deleted, magistral vessels reconstructed, non‐magistral obliterated, either surgically or by percutaneous embolization. Results: Mean follow up was 44.2 months (3–93). Serious heart insufficiency was seen in two patients only, with AVF in the subclavial vessels. Both suffered from serious heart disease prior to the therapeutic procedures that resulted in iatrogenic AVF, so it was difficult to connect heart insufficiency to the AVF alone. Despite surgical closure of AVF and intensive medical treatment, signs of heart insufficiency remained in both patients. Signs of cardiac overload were seen in six patients with long‐standing AVF in major vessels. Except for one patient who refused surgical closure of femoral AVF, the remaining five were symptom free for cardiac overload during the follow‐up period. Conclusion: In our series, heart insufficiency was an infrequent complication in long‐standing AVF, even when major vessels were involved.     

盐酸丁咯地尔治疗椎-基底动脉供血不足的效果

①目的　观察盐酸丁咯地尔对椎 基底动脉供血不足的治疗作用。②方法　将 82例椎 基底动脉供血不足病人随机分为两组 ,治疗组 4 2例 ,给予盐酸丁咯地尔 2 5 0mL静滴 ,每日 1次 ;对照组 4 0例 ,给予维脑路通0 .5g、胞二磷胆碱 0 .5 g静滴 ,每日 1次 ,均治疗 7d。检测两组治疗前后血液流变学和血流动力学指标的变化。 ③结果　治疗后治疗组全血高切黏度明显低于对照组 ,椎动脉平均血流速度 (VA)明显快于对照组 ,差异均有显著性(t=3.96 0 ,P <0 .0 1 ;t=2 .0 92 ,P <0 .0 5 )。治疗组治疗后全血高切、低切和血浆黏度明显低于治疗前 ,差异有显著性 (t=2 .74 6～ 2 .95 1 ,P <0 .0 1 ) ;VA、基底动脉平均血流速度 (BA)和外周血管阻力指数 (PI)高于治疗前 ,差异有显著性 (t=2 .732～ 5 .1 0 4 ,P <0 .0 1 )。对照组治疗后血浆黏度、PI明显低于治疗前 ,VA高于治疗前 ,差异均有显著性 (t=2 .1 6 8～ 2 .732 ,P <0 .0 5 ) ;全血高切、低切黏度、BA治疗前后差异无显著性 (t=0 .346～ 2 .0 0 8,P >0 .0 5 )。④结论　盐酸丁咯地尔对椎 基底动脉供血不足有良好的改善作用 ,其疗效明显优于维脑路通加胞二磷胆碱的治疗效果