Prevalence and Risk Factors for Fatigue in Adults With Inflammatory Bowel Disease: A Systematic Review With Meta-Analysis

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宫颈癌放疗患者家庭功能对癌因性疲乏的影响

目的：了解宫颈癌放疗患者的家庭功能现状,分析家庭功能对癌因性疲乏的影响。方法采用配额抽样法,应用一般情况调查表、家庭功能量表( FAD)与疲劳评定量表( FAI)对乌鲁木齐市3所三级甲等医院放疗科124例宫颈癌患者进行调查。结果本次调查轻、中、重度家庭功能障碍的患者分别占41.9%,32.3%,25.8%;轻、中、重度癌因性疲乏的患者分别占31.5%,11.3%,57.3%。Pearson相关分析显示,家庭功能各维度与癌因性疲乏各维度呈正相关(r=0.336~0.933;P<0.01)。重度家庭功能障碍患者癌因性疲乏程度最重,轻度、中度和重度家庭功能障碍患者的疲劳程度比较,差异有统计学意义(P<0.01)。结论宫颈癌放疗患者存在不同程度的家庭功能障碍和癌因性疲乏,且两者关系密切。医护人员应加强家庭功能知识的学习,了解宫颈癌患者家庭存在的问题,有针对性地指导家庭成员关爱和支持患者,可在一定程度上预防和减轻患者癌因性疲乏。     

Prostatic Arterial Embolization with Small Sized Particles for the Treatment of Lower Urinary Tract Symptoms Due to Large Benign Prostatic Hyperplasia: Preliminary Results

Background:The clinical failure after prostatic artery embolization (PAE) with conventional particles was relatively high,in treatment for lower urinary tract symptoms (LUTS) due to benign prostatic hy...     

Efficacy and Safety Investigation of Kuntai Capsule for the Add-back Therapy of Gonadotropin Releasing Hormone Agonist Administration to Endometriosis Patients: A Randomized,Double-blind,Blank- and Tibolone-controlled Study

Background:

As a Chinese Traditional Medicine product, Kuntai capsule could improve the peri-menopausal symptoms in postmenopausal women. But it is still not clear whether Kuntai capsule has a good effect on alleviating peri-menopausal symptoms induced by gonadotropin releasing hormone agonist (GnRH-a) treatment. The purpose of this study was to investigate the clinical effectiveness and safety of Kuntai capsule, on peri-menopausal symptoms in endometriosis (EMS) patients, with postoperative GnRH-a treatment.

Methods:

Ninety EMS ovarian cyst women with postoperative GnRH-a administration were enrolled in the study, and were randomly divided into Kuntai group, Tibolone group, or blank Control group. The therapeutic strategy in Kuntai group was 4 Kuntai capsules tid,po for 12 weeks after the first GnRH-a injection, while Tibolone 2.5 mg qd, po for 12 weeks in Tibolone group. There was no drug addition in Control group. Climacteric complaints were evaluated by Kupperman menopausal index (KMI) and hot flash/sweating score. Liver and renal functions, lipid profile, serum sex hormone levels and endometrial thickness were measured, and the frequency of adverse events in Kuntai and Tibolone groups was recorded.

Results:

(1) Before GnRH-a therapy, the baseline parameter results were comparable in the three groups (P > 0.05). (2) After GnRH-a therapy, KMI and hot flash/sweating scores in all the three groups increased significantly (P < 0.05). At the 4^th week after GnRH-a therapy, KMI and hot flash/sweating score results were as follows: Control group > Kuntai group > Tibolone group (P < 0.05); at the 8^th and 12^th week after GnRH-a therapy, KMI and hot flash/sweating score in Control group were significantly higher than the other two groups (P < 0.05), and no significant difference was identified between Kuntai and Tibolone group (P > 0.05). (3) No statistical change took place in the liver and renal functions and lipid profile in all the three groups after the treatment (P > 0.05). (4) The posttherapeutic serum follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) level and endometrial thickness decreased significantly in all the three groups (P < 0.05). After therapy, serum E2 level in Tibolone group was obviously higher than the other two groups (P < 0.05), while FSH and LH levels were obviously lower (P < 0.05). (5) The incidence of vaginal bleeding, breast distending pain in Tibolne group was obviously higher than Kuntai group (P < 0. 05).

Conclusions:

Kuntai capsule is effective on the peri-menopausal symptoms induced by postoperative GnRH-a administration to EMS patients, although its clinical effect might be a few weeks later than Tibolone. Kuntai capsule might be a little safer than Tibolone tablet.     

新型冠状病毒肺炎与流感病毒肺炎临床特征对比研究

目的 探讨新型冠状病毒肺炎(COVID-19)与流感病毒肺炎(IVP)病例临床表现、实验室指标和影像学特征之间的差异。方法 选取2020年1月20日～2月22日六安市人民医院确诊的COVID-19患者62例纳入COVID-19组,选取排除COVID-19且确诊为IVP患者31例纳入IVP组,比较分析两组患者的临床症状、体征、血常规、生化指标、炎症指标,以及肺部CT影像学病灶的性状、分布、累及的肺段数量等资料的差异。结果 COVID-19组患者中咳痰比例11.29% (7例),低于IVP组38.71%(12例);COVID-19组患者β-2微球蛋白>3.0 pg/mL比例为48.39%(30例),高于IVP组25.81%(8例),差异均有统计学意义(P均<0.05)。COVID-19组患者肺部CT影像病灶形态表现为磨玻璃影比例91.94%(57例),高于IVP组29.03%(9例),呈现片絮影比例1.61%(1例),低于IVP组74.19%(23例),差异均有统计学意义(P<0.05)。COVID-19组病灶分布多位于肺野外侧带、胸膜下,高于IVP组[56.45%(35例）比 9.68%(3例）],病灶散在分布表现高于IVP组[40.32%(25例) 比 9.68%(3例）];病灶呈双侧肺野分布比例82.26%(51例),高于IVP组35.48% (11例),差异均有统计学意义(P均<0.05);COVID-19组病灶累及肺段数目≥10个比例为32.26%(20例),高于IVP组3.22%(1例),差异有统计学意义(P<0.05)。结论 IVP表现咳痰较COVID-19多;COVID-19患者β-2微球蛋白升高更多;肺部CT影像多表现斑片磨玻璃影,病灶多呈双肺散在分布,多位于肺野外侧带(胸膜下),累及肺段较多,而IVP多表现密度稍高的片絮影,病灶多沿细支气管纹理分布,累及肺段相对较少。     

Two decades of pediatric celiac disease in a tertiary referral center: What has changed?

BackgroundCeliac disease (CD) is common worldwide with increasing prevalence and changing presentation.AimsTo evaluate changes in the presentation and management of CD over the last two decades.MethodsRetrospective chart review of pediatric patients with CD between 01.1999 to 12.2018 was performed. Comparisons were made between an early (1999 to 2008) and late (2009 to 2018) decade, regarding clinical and laboratory parameters at presentation and follow-up.ResultsIn a cohort of 932 patients (early decade n = 316, late decade n = 616), patients from the late decade presented with lower rates of weight loss and abdominal distention (24.2% vs 34.7% and 6% vs 11%, respectively p < 0.01), and with higher rates of abdominal pain or asymptomatic presentation (41.4% vs 27.4%, p < 0.01, and 18% vs 13%, p < 0.05, respectively). Good adherence to gluten-free diet was reported more often in the late decade (64% vs 50.6%, p < 0.001), and fewer patients were lost to follow-up. During the late decade, significantly higher rates of celiac serology normalization were achieved during the first two years of follow-up.ConclusionIn recent years, children with CD were diagnosed with milder symptoms, showed better adherence and demonstrated earlier normalization of celiac serology.     

The Influence of Depression,Anxiety and Somatization on the Clinical Symptoms and Treatment Response in Patients with Symptoms of Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia

This is the first study to investigate the influence of depression, anxiety and somatization on the treatment response for lower urinary tract symptoms/benign prostatic hyperplasia (LUTS/BPH). The LUTS/BPH patients were evaluated with the Korean versions of the International Prostate Symptom Score (IPSS), the Patient Health Questionnaire-9 (PHQ-9), the 7-item Generalized Anxiety Disorder Scale (GAD-7) and the PHQ-15. The primary endpoint was a responder rate defined by the total score of IPSS (≤ 7) at the end of treatment. The LUTS/BPH severity was significantly higher in patients with depression (whole symptoms P = 0.024; storage sub-symptom P = 0.021) or somatization (P = 0.024) than in those without, while the quality of life (QOL) was significantly higher in patients with anxiety (P = 0.038) than in those without. Anxious patients showed significantly higher proportion of non-response (odds ratio [OR], 3.294, P = 0.022) than those without, while somatic patients had a trend toward having more non-responders (OR, 2.552, P = 0.067). Our exploratory results suggest that depression, anxiety and somatization may have some influences on the clinical manifestation of LUTS/BPH. Further, anxious patients had a lower response to treatment in patients with LUTS/BPH. Despite of limitations, the present study demonstrates that clinicians may need careful evaluation of psychiatric symptoms for proper management of patients with LUTS/BPH.

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