A quantitative exploration of symptoms in COVID-19 patients: an observational cohort study

Background: As the spreading of the COVID-19 around the global, we investigated the characteristics and changes of symptoms in COVID-19 patients.Methods: This was an ambispective observational cohort study, and 133 confirmed COVID-19 patients were included and all symptoms over the course were analyzed qualitatively. The symptoms, their changes over the course in the cohort and in the different clinical types, etc. were illustrated. Differences in different periods and severities were analyzed through Chi square test, association with severity was analyzed through LASSO binomial logistic regression analysis. Inter-correlation and classification of symptoms were completed. Major symptoms were screened and their changes were illustrated.Results: A total of 43 symptoms with frequencies as 6067 in this cohort. Differences of symptoms in different stages and clinical types were significant. Expectoration, shortness of breath, dyspnea, diarrhea, poor appetite were positively but vomiting, waist discomfort, pharyngeal discomfort, acid reflux were negatively correlated with the combined-severe and critical type; dyspnea was correlated with the critical type. The 17 major symptoms were identified. The average daily frequency of symptoms per case was decreased continuously before the transition into the severe type and increased immediately one day before the transition and then decreased. It was decreased continuously before the transition date of the critical type and increased from the transition into the critical type to the next day and decreased thereafter. Dyspnea (P<0.001), shortness of breath (P<0.01) and chest distress (P<0.05) were correlated with death and their corresponding coefficient was 0.393, 0.258, 0.214, respectively.Conclusion: The symptoms of COVID-19 patients mainly related to upper respiratory tract infection, cardiopulmonary function, and digestive system. The mild type and the early stage in other types mainly related to upper respiratory tract infection. The cardiopulmonary function and digestive system associated symptoms were found in all other types and stages. Dyspnea was correlated with critical type, and dyspnea, shortness of breath and chest distress were correlated with death. Respiratory dysfunction (or incompleteness) associated symptoms were the characteristic symptoms. The changes of symptoms did not synchronously with the changes of severity before the transition into the severe or critical type.     

Insomnia: An Underrecognized Nonmotor Symptom in Parkinson Disease

Insomnia is a highly prevalent nonmotor symptom among patients with Parkinson disease (PD) and significantly impacts their quality of life. It is typically an underdiagnosed and untreated symptom of PD. Accurate assessment, ruling out other potential etiologies, and a combination of nonpharmacologic and pharmacologic interventions are important strategies in the management of insomnia in patients with PD. The goal of treatment is to improve sleep duration, sleep quality, and overall quality of life. Nurse practitioners play an integral role in the recognition, assessment, and management of insomnia in PD.     

300例缺血性脑血管病患者中医证候的多元统计研究

目的研究300例缺血性脑血管病患者的中医证候。方法临床系统采集300例缺血性脑血管病患者中医四诊信息,运用SPSS 11.5软件,进行多元统计主因子提取、系统聚类。结果缺血性脑血管病患者临床中医证候以风阳上扰(型)兼督脉不利、或气郁血瘀;气虚血瘀(型)兼瘀热内盛;肝肾阴亏(型)兼痰湿内滞;痰浊上蒙(型)兼气虚血瘀四大证型为主。结论将多元统计主因子提取、系统聚类方法结合应用,可较好地对缺血性脑血管病患者的中医证候进行归类分析,有益于揭示缺血性脑血管病患者的中医证候特点。     

精神分裂症患者凶杀犯罪研究进展

重性精神病以精神分裂症为主,患者受精神症状等多种因素的影响,易发生暴力或凶杀等行为,严重威胁着社会的公共安全,已日益受到社会各界的重视。本文对国内外有关精神分裂症患者凶杀犯罪的研究文献作一综述,为开展精神病患者凶杀研究提供参考。     

喹硫平与舒必利治疗以阴性症状为主的精神分裂症对照研究

目的：探讨喹硫平与舒必利治疗以阴性症状为主的精神分裂症患者的临床疗效及安全性。方法将106例以阴性症状为主的精神分裂症患者随机分为两组,分别口服喹硫平、舒必利治疗,比较两组的临床疗效及不良反应。结果喹硫平组总有效率为88．7％,舒必利组为62．3％,喹硫平组显著高于舒必利组（ P＜0．01）。喹硫平组副反应量表的行为、神经系统、植物神经系统不良反应评分均显著低于舒必利组（P＜0．01）。结论喹硫平治疗以阴性症状为主的精神分裂症临床疗效显著优于舒必利,能有效改善患者的阴性症状,安全性高,值得在临床推广应用。     

个体化护理干预在胆石症合并肝硬化择期手术患者中的应用价值

目的 探讨个体化护理干预在胆石症合并肝硬化患者中的应用价值.方法 100例胆石症合并肝硬化患者,随机分为观察组和对照组,各50例.所有患者完善各项检查后制定手术方案,择期手术,对照组在此基础上给予一般护理,观察组在对照组基础上给予个体化护理干预.结果 2组治疗和护理干预前SCL-90评分,除强迫、恐怖和偏执外,其他评分均高于国内常模(P＜0.01);干预后,观察组除强迫、恐怖和偏执外,其他各项评分均显著下降(P＜0.01),对照组患者的躯体化、抑郁、焦虑和精神病性评分显著下降,但仍高于常模(P＜0.01);组间比较,除强迫、恐怖和偏执外,观察组其他各项评分均低于对照组(P＜0.01).观察组的护理满意度和疾病知晓程度评分均高于对照组(P＜0.01).结论 个体化护理干预可有效改善胆石症合并肝硬化患者的负性情绪,提高其对自身病情的了解程度,促进病情恢复.