Evaluation of the Effect and Efficiency of Ear Tip Bloodletting Combined with Xianfang Huoming Yin in the Treatment of Early-Stage Wheals

Objective:To evaluate the effect and efficiency of ear tip bloodletting combined with Xianfang Huoming Yin(XFH)in the treatment of early-stage wheals.Methods:70 patients with early-stage wheals admitted from September 2020 to September 2022 were divided into two groups by randomized numerical table method,with 35 cases/group.Both groups received conventional treatment,the control group combined with XFH,and the observation group combined with ear tip bloodletting therapy and XFH.Conscious symptom scores,ocular indexes,therapeutic effects,and sleep quality between the two groups were compared.Results:After the treatment,the patients in the observation group had lower self-awareness symptom scores and sleep quality scores as compared to those in the control group;the diameter of the mass in the observation group was smaller than that of the control group after treatment;the average tear film rupture time and the time taken for the first non-contact tear film to rupture were longer in the observation group than those in the control group;the total effective rate of the treatment in the observation group was higher than that of the control group(P<0.05).Conclusion:Ear tip bloodletting combined with XFH was ideal for the treatment of early-stage wheals and has a high effective rate.

Clinical characteristics and risk factors of intracranial hemorrhage after spinal surgery

BACKGROUND Intracranial hemorrhage after spinal surgery is a rare and devastating complication.AIM To investigate the economic burden,clinical characteristics,risk factors,and mechanisms of intracranial hemorrhage after spinal surgery.METHODS A retrospective cohort study was conducted from January 1,2015,to December 31,2022.Patients aged≥18 years,who had undergone spinal surgery were included.Intracranial hemorrhage patients were selected after spinal surgery during hospitalization.Based on the type of spinal surgery,patients with intracranial hemorrhage were randomly matched in a 1:5 ratio with control patients without intracranial hemorrhage.The patients'pre-,intra-,and post-operative data and clinical manifestations were recorded.RESULTS A total of 24472 patients underwent spinal surgery.Six patients(3 males and 3 females,average age 71.3 years)developed intracranial hemorrhage after posterior spinal fusion procedures,with an incidence of 0.025%(6/24472).The prevailing type of intracranial hemorrhage was cerebellar hemorrhage.Two patients had a poor clinical outcome.Based on the type of surgery,30 control patients were randomly matched in 1:5 ratio.The intracranial hemorrhage group showed significant differences compared with the control group with regard to age(71.33±7.45 years vs 58.39±8.07 years,P=0.001),previous history of cerebrovascular disease(50%vs 6.7%,P=0.024),spinal dura mater injury(50%vs 3.3%,P=0.010),hospital expenses(RMB 242119.1±87610.0 vs RMB 96290.7±32029.9,P=0.009),and discharge activity daily living score(40.00±25.88 vs 75.40±18.29,P=0.019).CONCLUSION The incidence of intracranial hemorrhage after spinal surgery was extremely low,with poor clinical outcomes.Patient age,previous stroke history,and dura mater damage were possible risk factors.It is suggested that spinal dura mater injury should be avoided during surgery in high-risk patients.

肿瘤专科医护人员职业倦怠及风险因素的单中心研究

目的:调查肿瘤专科医护人员职业倦怠状况,分析其与人口统计学特征、职业相关特征、心理痛苦(焦虑/抑郁)、失眠等因素相关性。方法:采用横断面研究,于2020年9月至2020年10月对北京大学肿瘤医院的医护人员进行线上问卷调查,分析人口统计学特征、职业相关特征与焦虑、抑郁、失眠和职业倦怠的关系。结果:503例肿瘤专科医护人员中情绪衰竭问题24例(4.8%),去人格化问题38例(7.6%),个人成就感低93例(18.5%),抑郁情绪163例(32.4%),焦虑情绪113例(22.5%),失眠问题105例(20.9%)。抑郁、焦虑和失眠状态与职业倦怠3个维度呈显著性相关(P<0.01)。护士、工龄超过10年、认为工作时间/收入减少和感觉自己生活质量变差的医务人员更易出现职业倦怠、情绪或失眠问题。结论:肿瘤专科医护人员的职业倦怠、情绪和失眠问题虽然发生率不高,其中最显著的个人成就感低和抑郁问题应加强关注,定期筛查,并及时干预。

Symptom burden in advanced breast cancer patients and its association between death anxiety and psychological distress

Objective:Recent research has documented psychological distress in advanced breast cancer(ABC)patients,but few studies have examined how death anxiety is affected by the symptom burden.Therefore,this study aims to explore the association among symptom burden,death anxiety and psychological distress(depression and anxiety)in ABC patients.Methods:This cross-sectional study used the Death and Dying Anxiety Scale(DADDS),9-item Patient Health Questionnaire(PHQ-9),General Anxiety Disorder-7(GAD-7)and MD Anderson Symptom Inventory(MDASI)to assess death anxiety,depression,anxiety,and symptom burden,respectively.Bias-corrected bootstrapping methods were used to estimate indirect effects and 95%confidence intervals.Results:Two hundred ABC patients completed the questionnaires.All of the respondents were females,with a mean age of 50±10 years.Initial correlation analyses revealed significant associations of death anxiety with depression(r=0.57,P<0.001),anxiety(r=0.60,P<0.001)and symptom burden(r=0.43,P<0.001).Moreover,depression(r=0.53,P<0.001)and anxiety(r=0.45,P<0.001)were significantly correlated with symptom burden.An analysis using Hayes’PROCESS macro revealed the partial effecting role of death anxiety in the relationship between depression and symptom burden,and between anxiety and symptom burden(contributions to the total effect of 0.247 and 0.469,respectively).Conclusions:This study provides insight into the relationship between death anxiety and symptom burden.The results suggest that interventions addressing death anxiety may be more effective for alleviating the depression and anxiety experienced by ABC patients with a symptom burden.

Psychosomatic symptoms affect radiotherapy setup errors in early breast cancer patients

Objective: To examine the trajectory of psychosomatic symptoms and to explore the impact of psychosomatic symptoms on setup error in patients undergoing breast cancer radiotherapy.Methods: A total of 102 patients with early breast cancer who received initial radiotherapy were consecutively recruited. The M.D. Anderson Symptom Inventory(MDASI) and three different anxiety scales, i.e., the Self-Rating Anxiety Scale(SAS), State-Trait Anxiety Inventory(STAI), and Anxiety Sensitivity Index(ASI), were used in this study. The radiotherapy setup errors were measured in millimetres by comparing the real-time isocratic verification film during radiotherapy with the digitally reconstructed radiograph(DRR). Patients completed the assessment at three time points: before the initial radiotherapy(T1), before the middle radiotherapy(T2), and before the last radiotherapy(T3).Results: The SAS and STAI-State scores of breast cancer patients at T1 were significantly higher than those at T2 and T3(F=24.44, P<0.001;F=30.25, P<0.001). The core symptoms of MDASI were positively correlated with anxiety severity. The setup errors of patients with high SAS scores were greater than those of patients with low anxiety levels at T1(Z=-2.01, P=0.044). We also found that higher SAS scores were associated with a higher risk of radiotherapy setup errors at T1(B=0.458, P<0.05).Conclusions: This study seeks to identify treatment-related psychosomatic symptoms and mitigate their impact on patients and treatment. Patients with early breast cancer experienced the highest level of anxiety before the initial radiotherapy, and then, anxiety levels declined. Patients with high somatic symptoms of anxiety may have a higher risk of radiotherapy setup errors.

高氧状态下应用血氧水平依赖MRI评估胎盘氧合情况的初步研究

目的探讨血氧水平依赖(BOLD)-MRI在母体高氧情况下评估胎盘氧合状态改变的价值。方法前瞻性收集2017年10月至2020年3月华中科技大学同济医学院附属同济医院超声提示胎盘正常的单胎妊娠孕妇22例,行BOLD-MRI检查,检查前带好吸氧面罩,检查时间10 min,前3 min吸入空气,后7 min持续吸入纯度大于90%的氧气(流速12 L/min)。测量并计算出吸氧前3 min及吸氧末期最后3 min的胎盘整体、胎盘胎儿侧、胎盘母体侧以及母体肾脏的BOLD信号的平均值,计算吸氧前后BOLD信号改变值ΔBOLD。胎盘和母体肾脏吸氧前后BOLD值比较采用配对t检验。胎盘整体、胎盘胎儿侧、胎盘母体侧的ΔBOLD的比较采用单因素方差分析,组间两两比较采用LSD法。结果吸氧前后胎盘整体、胎盘胎儿侧、胎盘母体侧BOLD值差异均有统计学意义(t=-4.62、P<0.001,t=-4.73、P<0.001,t=-3.57,P=0.002)。母体肾脏吸氧前后的BOLD值差异无统计学意义(t=0.35,P=0.740)。胎盘整体、胎盘胎儿侧及胎盘母体侧的ΔBOLD值分别为(12.8±2.2)%、(15.1±2.7)%和(6.4±1.3)%,总体差异有统计学意义(F=4.49,P=0.015)。两两比较胎盘整体与胎盘胎儿侧的ΔBOLD差异无统计学意义(P=0.450),胎盘整体与胎盘母体侧(P=0.037)、胎盘胎儿侧与胎盘母体侧(P=0.005)的ΔBOLD值之间差异有统计学意义。结论母体高氧状态下胎盘的BOLD信号明显增高,胎盘胎儿侧改变较母体侧更明显。BOLD-MRI技术具有半定量实时评估胎盘氧合功能的潜能。