Postoperative development of sarcopenia is a strong predictor of a poor prognosis in patients with adenocarcinoma of the esophagogastric junction and upper gastric cancer

Background

There were few studies assessed the postoperative sarcopenia in patients with cancers. The objective of present study was to assess whether postoperative development of sarcopenia could predict a poor prognosis in patients with adenocarcinoma of esophagogastric junction, (AEG) and upper gastric cancer (UGC).

行为-结构化-关系干预模式对短期住院孤独症谱系障碍儿童的疗效分析

目的 探讨以行为-结构化-关系(BSR)干预模式对短期住院孤独症谱系障碍(ASD)儿童的干预疗效,为改善ASD儿童的预后提供参考依据。方法 选取2015年12月－2016年12月确诊为ASD的2~6岁儿童141例,随机分为治疗组和对照组。治疗组ASD儿童均接受BSR模式的短期课程训练,训练课程包括个别辅导、游戏课、运动课、音乐课等,每天训练时间6 h,持续1个月;对照组ASD儿童处于干预等待,接受随访观察和评估。所有ASD儿童干预前、后均接受儿童心理教育评估(第三版)(PEP-3)来进行各方面能力变化的评估。结果 治疗组、对照组干预前各副测验的原积分差异无统计学意义(P>0.05)。两组ASD儿童干预后认知、语言理解、模仿、情感表达、社会互动、行为特征-非语言、适应行为的原积分比较,差异均有统计学意义(t=2.41、2.02、4.14、3.69、4.42、2.69、2.96,P<0.05);但小肌肉、大肌肉、自理的原积分比较,差异无统计学意义(t=-1.13、-1.05、-0.84,P>0.05)。结论 BSR干预模式能够有效改善短期住院ASD儿童的预后,可推广用于儿童ASD的治疗。     

园艺互动干预应用于维持性血液透析病人中的效果评价

目的:探讨园艺互动干预应用于维持性血液透析病人中的效果。方法:选择本院收治的行维持性血液透析病人157例,按照入院时间先后顺序分为对照组77例,观察组80例。对照组实施常规干预,观察组实施园艺互动干预。对比两组干预前后心理状态、应对方式、生活质量及总体幸福感变化。结果:观察组干预12周后症状自评量表(SCL-90)各维度评分低于对照组(P<0.05);观察组干预12周后积极应对评分高于对照组,消极应对评分低于对照组(P<0.05);观察组生活质量各维度评分高于对照组(P<0.05);观察组总体幸福感评分高于对照组(P<0.05)。结论:园艺互动干预应用于维持性血液透析病人可改善心理状态及应对方式,提升生活质量与总体幸福感。     

Conserving resources in the diagnosis of intraoral fibroepithelial polyps

Fibroepithelial polyps (FEPs) are common, benign intraoral lesions that tend to develop slowly at predictable sites, often in response to local irritation or trauma. Historical precedent often results in referral to oral and maxillofacial surgery (OMFS) departments for biopsy, often irrespective of symptoms, and histological assessment. OMFS and pathology services are struggling to cope with an increasing workload that will potentially lead to widespread delays to diagnosis and treatment. Over the past 20 years, clinical pathways and guidance have been developed to ensure that healthcare interventions, such as the removal of third molars, tonsils, skin tags, and benign moles, are evidence-based, have a net patient benefit, and ensure the best use of finite NHS resources. However, no such guidance exists for intraoral lesions and we regard this as an oversight. We analysed the removal of 682 FEPs over a seven-year period and report sensitivities of 92.4% for a “confirmed clinical suspicion of an FEP” and 99.7% for a “confirmed clinical suspicion of a benign diagnosis”. The incidence of non-benign disease was 0.3%. Primary care dentists should be able to diagnose and monitor FEPs and refer only if symptoms are serious or in high-risk patients or sites. Adopting this practice across the UK could free up to 1825 four-hour OMFS clinics, 405 hours of consultant histopathologists’ time, and recurring savings to the NHS estimated to be in the region of £620 000/annum. We believe that the removal of FEPs should be reclassified as an “intervention not normally funded”, and the time and resources put to better use treating patients with lesions of questionable pathology.     

全身运动质量评估指导高危儿早期干预的研究

目的 通过比较全身运动(GMs)评估正常的高危儿单纯家庭康复训练与家庭康复训练联合药物干预的预后,分析GMs对高危儿早期干预的指导意义。方法 选取2016年2月-2017年2月于潍坊市妇幼保健院康复科就诊并接受GMs评估正常的183例高危儿,随机分组为观察组和对照组,观察组为单纯家庭康复训练组89例,对照组为家庭康复训练联合药物干预组94例。采用Peabody运动发育量表对两组患儿分别于纠正月龄6、9、12个月龄进行评估,对Peabody运动发育量表中各指标应用SPSS 21.0进行统计分析。结果 干预后,纠正月龄6、9、12个月龄时,观察组和对照组Peabody运动发育量表中粗大运动商(GMQ)、精细运动商(FMQ)、总运动商(TMQ)比较,差异无统计学意义(P>0.05),重复测量方差分析发现观察组和对照组的GMQ、FMQ、TMQ评分的组间效应差异无统计学意义(P>0.05),时间效应差异有统计学意义(P<0.05),干预因素与时间因素不存在交互作用(P>0.05)。结论 GMs评估对高危儿早期干预具有指导意义。GMs评估正常者,家庭康复训练可达到促进高危儿运动功能发育的目的 ,避免仅因系高危儿而采取“过度干预”。     

PCI和静脉溶栓治疗急性心肌梗死的疗效比较

目的探讨经皮冠状动脉介入(PCI)和静脉溶栓在急性心肌梗死患者中的应用价值。方法选择我院2013年1月至2014年9月收治的60例急性心肌梗死患者作为研究对象,随机分为实验组和对照组各30例。实验组患者采用PCI治疗,对照组患者采用静脉溶栓治疗,比较两组患者血管再通率、死亡发生率、ST段回落情况、住院时间、近远期不良事件发生率、左室舒张末径和左室射血分数变化情况。结果实验组血管再通率显著高于对照组,差异有统计学意义(P<0.05),而近期和远期不良事件发生率均低于对照组,近期不良事件发生率组间比较差异有统计学意义(P<0.05),而远期不良事件发生率比较差异无统计学意义(P>0.05)。实验组患者死亡发生率、ST段回落和住院时间均低于对照组,差异均有统计学意义(P<0.05)。实验组左室射血分数在术后1个月、3个月和6个月时均显著高于对照组,差异均有统计学意义(P<0.05)。结论急性心肌梗死患者应用PCI治疗可显著提高血管再通率、降低死亡和不良事件发生率,有效改善心功能。