地牡宁神口服液治疗3~6岁多动症患儿有效性、安全性

目的探究地牡宁神口服液治疗3~6岁多动症患儿临床疗效及安全性,为证实中医药治疗儿童多动症有效性及安全性提供临床依据。方法文章采用自身对照研究,2014年3月-2018年9月,将符合入组标准的3~6岁多动症儿童31人作为研究对象,疗程为24周,以Conners父母用症状问卷(parent symptom questionnaire,PSQ)、中医证候量表及韦氏智力量表评估其疗效,以血生化、血常规、心电图及不良反应发生率评价其安全性。结果在第24周,患儿PSQ在第24周末与治疗前相比,PSQ中各维度评分均较治疗前降低,且除心身障碍维度外[治疗前(0.37±0.29)分,第24周(0.26±0.21)分,Z=-1.490,P=0.140],余差异均具有统计学意义(P<0.05)。中医症候疗效:在第8周、16周、24周,中医证候主、次症积分及总积分均低于治疗前(P<0.05),且总有效率分别为61.29%、80.65%、83.87%。第24周时,韦氏幼儿智力结果显示:总智商,知觉推理、工作记忆、加工速度得分,皆高于基线分,差异具有统计学意义(P<0.05)。血常规、血生化差异皆无统计学意义(P>0.05),治疗前后心电图检查均未有异常发现,不良反应发生率为约13%。结论地牡宁神口服液治疗小儿多动症疗效确切,且不良反应少,安全性高。     

四川省居民抑郁症状及其影响因素研究

目的 了解四川省居民抑郁症状的流行情况,并探讨其影响因素,为抑郁症状防治提供参考依据。 方法 利用2018年中国家庭追踪调查数据,纳入四川省16岁及以上居民1727人,用多水平模型（家庭和个体两水平）分析抑郁症状的影响因素。 结果 四川省16岁及以上居民抑郁症状检出率为22.2%、多水平模型分析结果显示,居民抑郁症状具有家庭聚集性（VPC=0.175）。人均年收入低、家庭人口数少、患有慢性病、丧偶、记忆力差的居民抑郁症状的发生率较高（P＜0.05）,健康自评良好的居民发生抑郁症状的风险较低（OR=0.21,P＜0.05）,常锻炼的居民发生抑郁症状的风险较低（OR=0.65,P＜0.05）。结论 居民健康状况、生活方式、社会人口学特征和经济状况等多种因素均对居民抑郁情况有影响,应采取综合防治措施,改善居民精神状况,促进其心理健康。     

The shadow of context: Neighborhood and school socioeconomic disadvantage,perceived social integration,and the mental and behavioral health of adolescents

The number of youths who experience mental distress has been increasing over the past years. Adolescents with mental health problems also show high rates of co-occurring substance-related behaviors such as illicit drug use. This study leverages large-scale and nationally representative Add Health data to evaluate whether the risks conferred by neighborhood and school socioeconomic disadvantages adversely impact adolescents' mental and behavioral health (i.e., depressive symptoms and illicit drug use). We further investigate whether levels of perceived social support from friends, parents, and teachers moderate the associations between contextual disadvantages and adolescents' mental and behavioral outcomes. Results from cross-classified multilevel modeling analysis suggest that neighborhood socioeconomic disadvantages, and to a lesser degree, school socioeconomic disadvantages, uniquely and simultaneously predict mental and behavioral outcomes of adolescents. Although social support is likely to offset the mental and behavioral consequences of disadvantaged social context to all, high levels of social support is most protective for adolescents of least disadvantaged neighborhoods. This study highlights the possibility that structural disadvantage— within both the school and neighborhood contexts—may adversely impact adolescents’ mental well-being and increase their risk for illicit drug use.     

基于前哨症状的耳穴贴压预防胃癌化疗患者症状群的效果

目的 对胃癌化疗患者进行预防性症状管理,降低症状群发生率及相关症状严重程度。方法 将肿瘤科收治的胃癌化疗患者120例按随机序列分为试验Ⅰ组40例、试验Ⅱ组40例、对照组40例。三组均在常规护理的基础上行耳穴贴压,试验Ⅰ组选取症状群相关穴位行耳穴贴压,试验Ⅱ组选取疼痛相关穴位行耳穴贴压,对照组选取假穴位贴压,连续干预1周。比较三组干预前后疼痛-疲乏-睡眠障碍症状群发生率、症状严重程度的差异。结果 干预后,试验Ⅰ组症状群发生率显著低于对照组(P<0.0125),试验Ⅰ组、试验Ⅱ组疼痛程度显著低于对照组,试验Ⅰ组疲乏得分、睡眠得分显著低于试验Ⅱ组与对照组(均P<0.05)。结论 基于前哨症状行耳穴贴压预见性干预胃癌化疗患者,可显著降低疼痛-疲乏-睡眠障碍症状群发生率,减轻患者症状困扰程度。     

自我报告结局手册在肿瘤患者免疫治疗居家期症状管理中的应用

目的 探索肿瘤患者免疫治疗居家期症状管理的有效方法。方法 将132例肿瘤免疫治疗患者随机分为对照组和干预组各66例。对照组给予常规健康教育和护理,干预组在对照组的基础上使用自制自我报告结局手册。干预6个月后,比较两组免疫治疗相关不良反应报告准确率、报告时间、严重程度、症状负担和生存质量。结果 对照组与干预组分别有62例、63例完成全程研究。干预组免疫治疗相关不良反应报告准确率显著高于对照组,报告时间显著短于对照组,症状负担轻于对照组,生存质量高于对照组(均P<0.05)。结论 自我报告结局手册可帮助患者辨别免疫治疗相关不良反应,提高报告准确性和缩短报告时间,减轻患者的症状负担,提高生活质量。     

中药汤剂内服联合夫西地酸乳膏外敷治疗寻常痤疮的效果

目的 探讨中药汤剂内服联合夫西地酸乳膏外敷治疗寻常痤疮的应用效果。方法 选取2021年 5月-2023年2月我院收治60例寻常痤疮患者作为研究对象,按照随机数字表法分为对照组和观察组,每 组30例。对照组给予夫西地酸乳膏治疗,观察组给予中药汤剂内服联合夫西地酸乳膏外敷治疗,比较两 组中医症状积分、心理状态、舒适度及临床疗效。结果 观察组治疗后颜面潮红、瘙痒肿痛以及热脱屑 积分均低于对照组,差异有统计学意义（P＜0.05）;观察组治疗后SAS以及SDS评分均低于对照组,差 异有统计学意义（P＜0.05）;观察组生理、社会、心理、环境以及整体上舒适度评分均低于对照组,差 异有统计学意义（P＜0.05）;观察组治疗总有效率高于对照组,差异有统计学意义（P＜0.05）。结论 采用中药汤剂内服联合夫西地酸乳膏外敷治疗寻常痤疮,临床疗效确切,可改善患者临床症状,缓解不 良情绪,且舒适度较高。     

中国8个长寿地区65岁及以上老年人抑郁症状影响因素分析

目的分析中国8个长寿地区老年人抑郁症状影响因素。方法利用"中国老年健康影响因素跟踪调查"子队列-"老年健康生物标志物队列研究"。2017年8个长寿地区数据,共纳入2180名≥65岁老年人,采用logistic回归分析老年人社会人口学特征、行为生活方式、慢性病患病情况、功能状况、亲友和社会支持对抑郁症状的影响。结果中国8个长寿地区≥65岁老年人抑郁症状检出率为15.0%,其中男、女性抑郁症状检出率分别为11.5%和18.5%。多因素logistic回归分析结果显示,锻炼身体(OR=0.44,95%CI:0.26~0.74)、经常吃鱼类(OR=0.57,95%CI:0.39~0.83)、参加文娱活动(OR=0.65,95%CI:0.44~0.96)、参加社会活动(OR=0.28,95%CI:0.11~0.73)和能够享受社区服务(OR=0.68,95%CI:0.50~0.93)的老年人抑郁症状检出率较低。睡眠不足(OR=2.04,95%CI:1.49~2.80)、视力障碍(OR=1.54,95%CI:1.08~2.18)、患胃肠溃疡(OR=2.97,95%CI:1.53~5.77)、患关节炎(OR=2.63,95%CI:1.61~4.32)、家庭支出大于收入(OR=1.80,95%CI:1.17~2.78)和自评经济条件差(OR=4.58,95%CI:2.48~8.47)的老年人抑郁症状检出率较高。结论老年人是否锻炼身体、饮食有鱼类、参加文娱和社会活动、享受社区服务、睡眠时长、视力情况、是否有胃肠溃疡和关节炎与抑郁症状的检出率相关。     

孕期妇女体力活动变化对抑郁影响的队列研究

目的 探究孕妇在孕早-中期体力活动变化对孕中期抑郁的影响。方法 依托中国孕产妇队列研究·协和项目（2017年7月25日至2018年11月26日）,将有效完成孕早、中期体力活动和抑郁情况调查的2 454名孕妇纳入研究。采用国际体力活动短问卷和爱丁堡产后抑郁量表,调查研究对象孕早期和孕中期的体力活动和抑郁情况。以孕早期是否患有抑郁作分组。采用非条件logistic回归分析孕早期不患抑郁组的孕早、中期体力活动变化对预防孕中期抑郁的作用,在孕早期抑郁组中分析孕早、中期体力活动变化对减缓孕中期抑郁的作用。结果 孕妇基线和孕中期抑郁的检出率分别为23.83%和20.57%。调整年龄、文化程度、职业、家庭年收入和孕前BMI等因素后,logistic回归结果显示,对于基线不抑郁的孕妇,孕期增加和保持充足的体力活动能够预防孕中期抑郁（OR=0.479,95% CI：0.335～0.684;OR=0.566,95% CI：0.394～0.815）,但对于基线抑郁的孕妇,体力活动与减缓孕中期抑郁的相关性差异无统计学意义（P>0.05）。结论 孕期妇女增加和保持充足的体力活动对于抑郁有预防的作用,但对于孕早期已患抑郁的妇女来说,缓解效果不明显。应在鼓励孕妇加强体力活动的同时,开展抑郁筛查,以减少孕期抑郁的发生。     

The mediating effect of work–life interference on the relationship between work-time control and depressive and musculoskeletal symptoms

Objectives:Evidence shows that work-time control (WTC) affects health but underlying mechanisms are still unclear. Work–life interference (WLI) might be a step on the causal pathway. The present study examined whether WLI mediates effects on mental and physical health and contrasted these to other causal pathways.Methods:Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, N=26 804) were used. Cross-lagged analyses were conducted to estimate if WLI mediated effects from WTC (differentiating between control over daily hours and time off) to subsequent depressive and musculoskeletal symptoms. Other causal directions (reversed mediation, direct and reversed direct effects) and robustness of mediation (by including covariates) were examined.Results:WLI partially mediated the relationship of WTC (control over daily hours/time off) with both health outcomes. Indirect effect estimates were small for depressive symptoms (-0.053 for control over time off and -0.018 for control over daily hours) and very small for musculoskeletal symptoms (-0.007 and -0.003, respectively). While other causal directions were generally weaker than causal mediational pathways, they played a larger role for musculoskeletal compared to depressive symptoms. Estimates relating to control over time off were in general larger than for control over daily hours.Conclusions:Our results suggest that WLI mediates part of the effect from WTC to mental/musculoskeletal symptoms, but small estimates suggest that (i) WTC plays a small but consistent role in effects on health and (ii) particularly regarding musculoskeletal disorders, other causal directions and mediators need to be further examined.     

The role of social context in symptom appraisal and help‐seeking among people with lung or colorectal symptoms: A qualitative interview study

Prolonged diagnostic intervals are associated with poorer outcomes, and the patient interval appears to be a substantial contributor to the overall length of the diagnostic interval. This study sought to understand how the broader context of people's lives influenced symptom appraisal and help‐seeking, comparing experiences by length of the patient interval. Patients referred with a suspicion of lung or colorectal cancer were invited to complete a questionnaire about their symptoms, with 26 respondents purposively sampled to take part in a semi‐structured interview about their patient intervals. Embodied experience, appraisal, help‐seeking decision‐making and consultation were identified as component stages of the patient interval, with the factors affecting movement between these stages located in one of four contextual domains: individual experience, interpersonal relationships, healthcare system interactions and social and temporal context. The length of the patient interval was related to the type of symptom(s) experienced, discussion of symptoms with others and the social responsibilities people held during symptomatic periods. A contextual model of the patient interval illustrates the stages and domains of this interval, as grounded in the data from this study. The model has potential application to future studies examining the patient interval for a range of symptoms.