Risk factors of mental illness among adult survivors after the Wenchuan earthquake

Purpose

This study was to analyze the mental health status of the adults from the areas struck by the Wenchuan earthquake, to understand the factors that may have impact on their mental health after they were exposed to the earthquake, to obtain information specifically relevant to further research and future preventive measures.

Methods

We used multistage stratified random sampling methods in three areas that were severely damaged in the Wenchuan earthquake, Sichuan Province, China. For this study, 14,798 individuals were identified with simple random selection methods at the sampling sites, 14,207 were screened with the 12-item General Health Questionnaire (GHQ-12), and 3,692 individuals were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders by 180 investigators.

Results

The risk factors for post-traumatic stress disorder included old age, female gender, low school education and witness someone die in the earthquake (P < 0.05, 95 % CI). The risk factors for anxiety disorder included old age, female gender, low school education, living alone and witness someone die in the earthquake (P < 0.05, 95 % CI). The risk factors for depression included old age, female gender, low school education and living alone (P < 0.05, 95 % CI).

Conclusions

Given inadequate knowledge and practices concerning the mental health of disaster victims in China, the information provided by this study is useful for directing, strengthening, and evaluating disaster-related mental health needs and interventions after the earthquake.     

Validated five-factor model of Positive and Negative Syndrome Scale for schizophrenia in Chinese population

The Positive and Negative Syndrome Scale (PANSS) is the most widely used instrument to assess the severity of symptoms of schizophrenia. Most studies have showed that PANSS measures five dimensions of symptomatology of schizophrenia. However, few studies have ever investigated the structure of PANSS in Chinese schizophrenia population. We recruited two large independent study samples including 903 and 942 Chinese schizophrenia patients and examined the underlying structure of PANSS. By building a confirmatory factor analysis (CFA) model based on the factor loadings of the exploratory factor analysis (EFA) and by testing the CFA model in an independent validation sample, we found that PANSS scores consisted of five factors, which were positive factor, negative factor, excitement factor, depression factor, and cognitive factor. The items loaded on these factors were similar to the consensus items published in previous studies except for PANSS items P2 conceptual disorganization, P5 grandiosity, N5 abstract thinking, and G11 poor attention. This difference might be due to the influence of culture on clinical presentation of schizophrenia. By elucidating the structure, symptoms of Chinese schizophrenia patients could possibly be deconstructed and investigated in future studies.     

幕上海绵状血管瘤所致癫癎的手术预后及其相关影响因素分析

目的探讨颅内海绵状血管瘤（CCA）所致癫癎的手术效果及其相关影响因素。方法回顾性分析49例CCA所致癫癎病人的手术效果。并分析年龄、性别、病灶位置、病灶大小、病程、癫癎发作类型与手术预后的相关性。结果术后随访1~4年,EngelI级39例（79．6％）,EngelII～Ⅳ级10例（20．4％）。统计学分析显示：病灶〈1．5cm、病程≤1年及部分性癫癎发作的病人手术预后较好（P〈0．05）,而年龄、性别、病灶位置与手术预后没有明显的相关性（P〉O．05）。结论CCA所致癫癎的手术效果理想,病灶大小、病程和癫癎发作类型与手术预后相关。     

A novel fabrication technique for high-aspect-ratio nanopillar arrays for SERS application

A novel technique is demonstrated for the fabrication of silicon nanopillar arrays with high aspect ratios. Our technique leverages on an “antenna effect” present on a chromium (Cr) hard mask during ion-coupled plasma (ICP) etching. Randomly distributed sharp tips around the Cr edge act as antennas that attract etchant ions, which in turn enhance the etching of the Cr edge. This antenna effect leads to a smaller Cr mask size and thus a smaller nanopillar diameter. With optimized SF₆ and CHF₃ gas flow during ICP etching, we could achieve nanopillar arrays with sub-30 nm diameter, over 20 aspect ratio, and steep sidewall without collapse. The proposed technique may help break the limit of traditional nanopillar array fabrication, and be applied in many areas, such as Surface-Enhanced Raman Scattering (SERS). A series of SERS simulations performed on nanopillar arrays fabricated by this technique show an obvious Raman spectrum intensity enhancement. This enhancement becomes more obvious when the diameter of the nanopillar becomes smaller and the aspect ratio becomes higher, which may be explained by a high light absorption, the lightning-rod effect, and a greater number of free electrons available at the surface due to the higher density of the surface state.

A novel technique is demonstrated for the fabrication of silicon nanopillar arrays with high aspect ratios.     

Synthesis of imatinib,a tyrosine kinase inhibitor,labeled with carbon-14

Imatinib (Gleevec) is a multiple tyrosine kinase inhibitor that decreases the activity of the fusion oncogene called BCR-ABL (breakpoint cluster region protein-Abelson murine leukemia viral oncogene homolog) and is clinically used for the treatment of chronic myelogenous leukemia and acute lymphocytic leukemia. Small molecule drugs, such as imatinib, can bind to several cellular proteins including the target proteins in the cells, inducing undesirable effects along with the effects against the disease. In this study, we report the synthetic optimization for ¹⁴C-labeling and radiosynthesis of [¹⁴C]imatinib to analyze binding with cellular proteins using accelerator mass spectroscopy. ¹⁴C-labeling of imatinib was performed by the synthesis of ¹⁴C-labeld 2-aminopyrimidine intermediate using [¹⁴C]guanidine·HCl, which includes an in situ reduction of an inseparable byproduct for easy purification by HPLC, followed by a cross-coupling reaction with aryl bromide precursor. The radiosynthesis of [¹⁴C]imatinib (specific activity, 631 MBq/mmol; radiochemical purity, 99.6%) was achieved in six steps with a total chemical yield of 29.2%.     

Navigating Uncertainty in the Management of Incidental Findings

The lack of prospective outcomes studies for many types of incidental findings limits our understanding of both their natural history and the potential efficacy of treatment. To support decision making for the management of incidental findings, major sources of uncertainty in management pathways can be mapped and analyzed using mathematical models. This process yields important insights into how uncertainty influences the best treatment decision. Here, we consider a classification scheme, grounded in decision science, which exposes various levels and types of uncertainty in the management of incidental findings and addresses (1) disease-related risks, which are considered in context of a patient’s competing causes of mortality; (2) potential degrees of intervention; (3) strength of evidence; and (4) patients’ treatment-related preferences. Herein we describe how categorizing uncertainty by the sources, issues, and locus can build a framework from which to improve the management of incidental findings. Accurate and comprehensive handling of uncertainty will improve the quality of related decision making and will help guide future research priorities.     

两种手术入路方式对C型桡骨远端骨折锁定加压接骨板结合克氏针内固定术疗效的影响

目的探讨两种手术入路方式对C型桡骨远端骨折锁定加压接骨板结合克氏针内固定术疗效的影响。方法 2016年1月—2017年8月威海市立医院治疗96例C型桡骨远端骨折患者,均采用锁定加压接骨板结合克氏针内固定术治疗;随机分为掌侧入路组和背侧入路组,各48例;随访12～33个月,平均17.6个月。比较两组手术情况、不同时间点X线片参数、术后8周及术后12个月腕关节功能优良率、手术并发症发生情况。结果两组手术时间、术中出血量、术后住院时间、骨折愈合时间比较,差异均无统计学意义(P>0.05);两组术后及术后12个月与术前的掌倾角、尺偏角、桡骨高度比较,差异均有统计学意义(P<0.05),其中两组术前、术后及术后12个月的X线片参数比较,差异均无统计学意义(P>0.05);背侧入路组术后8周腕关节功能优良率为70.83%,明显高于掌侧入路组的50.00%,差异有统计学意义(P<0.05);两组术后12个月腕关节功能优良率比较,差异无统计学意义(P>0.05);两组患者均获得随访,其中两组早期并发症发生率比较,差异无统计学意义(P>0.05);掌侧入路组晚期并发症发生率为4.17%,明显低于背侧入路组的18.75%,差异有统计学意义(P<0.05)。结论不同手术入路影响C型桡骨远端骨折锁定加压接骨板结合克氏针内固定术的疗效,掌侧入路手术后早期腕关节旋前功能受影响,背侧入路手术后远期并发症较多,宜选用低切迹锁定加压接骨板并尽早拆除。