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    30 October 2023, Volume 18 Issue 05 Previous Issue    Next Issue
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    Original article
    Mental health status of patients with esophageal symptoms and esophageal motility disorders during coronavirus pandemic
    SONG Jiani, ZHU Ying, HUANG Jia, TANG Yuming, YAO Weiyan
    2023, 18 (05):  309-315.  DOI: 10.16138/j.1673-6087.2023.05.001
    Abstract ( 46 )   HTML ( 25 )  
    Objective To investigate the mental health status of the patients with different esophageal symptoms and/or esophageal motility disorders during the coronavirus pandemic. Methods The data of 137 coronavirus-negative patients with different esophageal symptoms, who underwent high-resolution manometry(HRM) from April in 2020 to December in 2021 were retrospectively analyzed. The demographic characteristics, esophageal symptoms, HRM results, scores of 9-item patient health questionnaire (PHQ-9) and scores of 7-item generalized anxiety disorder (GAD-7) scale and the risk factors for psychological disorders were analyzed. Results In 137 patients who underwent HRM, 62.0%(85/137) cases had depression, and 59.9%(82/137) cases had anxiety. Most of the patients(97/137) with regurgitation presented anxiety (71.1%, P=0.045). However, the GAD-7 score in the patients with chest pain [18.00 (10.00-20.00)] was higher than that in the patients with other symptoms(P=0.049). The GAD-7 score[15.00(7.50-18.50)] in the patients without esophageal motility disorder was higher than that [9.00(6.00-13.00)] in the patients with esophageal motility disorder(P=0.012). A lower body mass index (BMI) was discovered in the moderate depression group(P=0.034) and in the severe anxiety group(P=0.008). There were more patients with regurgitation in severe anxiety group(P=0.035), while the mild anxiety group contained more patients with achalasia (P=0.009). Age<40 years[odds ratio (OR)=15.02, 95% confidence interval (CI): 2.50-90.30], BMI<18 kg/m2 (OR=9.37, 95%CI: 1.11-79.46), globus (OR=5.89, 95%CI: 1.09-31.75), regurgitation (OR=5.57, 95%CI: 1.12-27.64) and achalasia (OR=15.72, 95%CI: 2.82-87.71) were risk factors for anxiety, while single (OR=0.03, 95%CI: 0.00-0.61) was protective factors for anxiety. Conclusions Psychological disorders are common in the patients with esophageal symptoms and esophageal motility disorders during the coronavirus pandemic. Young age, low BMI, globus, regurgitation and achalasia are risk factors for anxiety, while single is protective factors of anxiety.
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    Mental health status and its related factors among healthcare workers during novel coronavirus epidemics in Shanghai
    LI Xiaoli, Mukadas Rahman, ZHENG Li, GE Yuxin, JIANG Jie, TONG Jianjing
    2023, 18 (05):  316-321.  DOI: 10.16138/j.1673-6087.2023.05.002
    Abstract ( 39 )   HTML ( 19 )   PDF (608KB) ( 32 )  
    Objective To evaluate the psychological status of primary healthcare workers in Shanghai during the novel coronavirus epidemic in the past three years, analyze the related factors, and provide a scientific basis for follow-up intervention and management. Methods A questionnaire survey was conducted from January to February in 2023 among the healthcare workers in Shanghai primary care institutions, their basic personal information and survey results were collected to clarify the mental health status during the epidemic, and the related factors were analyzed. Results There were 72.0% and 57.6% of Shanghai primary health care workers suffered depression and anxiety, respectively. Work-family conflict was positively associated with depression(r=0.391, P<0.05) and anxiety(r=0.370, P<0.05). The total work-family conflict scores were higher among nurses and the healthcare workers who had associate or lower degree, had higher job stress, work intensity or lower salary satisfaction, 11%-30% decreased annual income than that before the epidemic, or participated in public health emergency management previously (P<0.05); depression and anxiety scale scores were higher among nurse and healthcare workers who were female, 30-39 years old, had associate or lower degree, intermediate title, <10 years of work experience, and had higher job stress and work intensity, or less salary satisfaction, or participated in epidemic-related public health emergency management previously. Conclusions The novel coronavirus epidemic showed negative impact on the mental health of primary healthcare workers in Shanghai. Increasing salary and wages, conducting psychological counseling and guidance, and rationalizing work shift, rotation and scheduling can improve the psychological health in primary healthcare staff.
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    Comparison of ordinary calcium-containing dialysate segmented regional citrate anticoagulation hemodialysis and heparin-free hemodialysis in patients with high risk of bleeding
    ZHANG Yu, WANG Zhihong, DONG Cui, KUAI Tingting, YOU Lianlian, LIU Shuxin
    2023, 18 (05):  322-327.  DOI: 10.16138/j.1673-6087.2023.05.003
    Abstract ( 45 )   HTML ( 3 )   PDF (671KB) ( 29 )  
    Objective To investigate the safety and efficacy of regional citrate anticoagulation (RCA) with ordinary calcium-containing dialysate in hemodialysis, and compare its differences in coagulation status and treatment time with heparin-free hemodialysis in high-risk bleeding patients. Methods Maintenance hemodialysis patients with high risk of bleeding from Dalian Municipal Central Hospital from January in 2019 to December in 2021 were selected, a total of 35 patients were enrolled (19 males and 16 females), and they received heparin-free hemodialysis or 4% sodium regional citrate anticoagulation treated hemodialysis. Citrate was infused into the arterial line and vein line through the dialyzer. The electrolyte, blood pressure, and coagulation system in hemodialysis patient were compared before and after the application of segmented citrate anticoagulation. The differences of coagulation and treatment time between the two methods were compared. Results In the citrate treated group, through adjusting the parameters of the dialysis machine online, the serum sodium could be kept stable after dialysis(P>0.05). Hypocalcemia didn’t occur in the application of calcium-containing dialysate (1.5 mmol/L), while serum calcium increased after dialysis (P<0.05). The blood pressure and heart rate of the patients in the citrate treated group were stable before and after dialysis(P>0.05). Activated partial thromboplastin time (APTT) of patients after local citrate anticoagulation was prolonged compared with that before dialysis(P<0.05), and the remaining coagulation time was not significantly different from that before dialysis (P>0.05). In the citrate treated group, the anticoagulation efficacy of the dialyzer and venous pot (P<0.05), ultrafiltration volume (P<0.05) and urea clearance index(Kt/V)(P<0.001) were significantly higher than those in the non-heparin group, while the actual dialysis time was longer than that in the non-heparin group (P<0.001). Conclusions The segmented regional citrate anticoagulation of ordinary calcium-containing dialysate is safe and effective in high-risk bleeding risk dialysis patients, and its anticoagulant effect is better than that in heparin-free hemodialysis.
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    Genetic diagnosis and clinical analysis of congenital dysfibrinogenemia with polycystic disease: a case report and literature review
    ZHOU Liyang, ZHANG Chunli, DING Qiulan, LI Ya
    2023, 18 (05):  328-333.  DOI: 10.16138/j.1673-6087.2023.05.004
    Abstract ( 50 )   HTML ( 5 )   PDF (778KB) ( 31 )  
    Objective To analyze the genetic diagnosis and related clinical manifestations of a Chinese pedigree with inherited dysfibrinogenemia and polycystic kidney disease, investigate the molecular mechanism of the diseases and provide guidance for clinical treatment. Methods Ultrasonography was performed to examine polycystic kidney disease. The activity and antigen of fibrinogen in plasma were measured by Clauss and immunoturbidimetry methods, respectively. The genomic DNA was extracted from peripheral venous blood of the patient. Mutations in whole-exome genotypes were screened with the next generation sequencing technology, and were verified through PCR and Sanger sequencing technology. Domestic and foreign literature related to two diseases were searched and reviewed. Results The polycystic kidney disease was diagnosed by conducting ultrasound examination. The plasma fibrinogen activity level in the patient was reduced, while fibrinogen antigen level was normal. The sequencing results showed the patient had nonsense heterozygous nonsense mutation c.6586C>T, p.Q2196X in polycystic kidney disease 1(PKD1) gene and missense heterozygous mutation c.130C>T，p.R44C in fibrinogen beta chain(FGB) gene. The two mutations had been reported in foreign publications, but they were reported for the first time in China. Conclusions PKD1 p.Q2196X heterozygous nonsense mutation in the patients leads to polycystic kidney disease and the dysfibrinogenemia of the proband is caused by FGB p.R44C heterozygous mutation. At present, the clinical phenotype of the proband is mainly related to polycystic kidney disease. Treatment should be focused on renal function protection in polycystic kidney disease, and the patients should receive regular follow-up care.
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    Effect of total parathyroidectomy on quality of life in maintenance hemodialysis patients
    MA Yan, HU Mengyuan, FANG Shifei, WANG Lin
    2023, 18 (05):  334-338.  DOI: 10.16138/j.1673-6087.2023.05.005
    Abstract ( 43 )   HTML ( 4 )  
    Objective To observe the effect of total parathyroidectomy(TPTX) on quality of life in maintenance hemodialysis (MHD) patients. Methods The changes of biochemical indicators including serum calcium (Ga), phosphorus (P), intact parathyroid hormone (IPTH), alkaline phosphatase (ALP), hemoglobin (Hb) and albumin (ALB) in 61 patients with secondary hyperparathyroidism (SHPT) before and after operation were retrospectively analyzed. KDQOL-36 scale and SF-36 scale were used to evaluate the quality of life of patients before and 1 year after operation. Results Postoperative symptoms such as fatigue, bone pain and skin itching were significantly improved. Postoperative serum calcium, phosphorus, alkaline phosphatase and IPTH were significantly lower than those before operation, and hemoglobin and albumin were significantly higher than those before operation. The preoperative quality of life scores was low, while the quality of life scores were significantly increased after TPTX. Preoperative kidney disease-related quality of life, general health-related quality of life, and comprehensive quality of life were positively correlated with hemoglobin and albumin, and negatively correlated with age. Nephropathy-related quality of life and comprehensive quality of life were positively correlated with education level. General health-related quality of life was negatively correlated with serum urea nitrogen and phosphorus. Conclusions PTX can significantly improve the clinical indicators and the quality of life in refractory SHPT patients.
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    Application of rehabilitation exercise based on protective motivation theory in patients with Parkinson’s disease
    CHEN Yan, NI Xinghuan, ZHU Qian, LIU Qiong
    2023, 18 (05):  339-343.  DOI: 10.16138/j.1673-6087.2023.05.006
    Abstract ( 45 )   HTML ( 1 )  
    Objective To explore the intervention effect of rehabilitation exercise based on protective motivation theory on exercise compliance, motor function and activities of daily living of patients with Parkinson’s disease(PD). Methods From July in 2021 to June in 2022, 56 PD patients who were hospitalized in the department of neurology of our hospital were enrolled as the study subjects. The control group was trained with a traditional rehabilitation exercise guidance plan, while the experimental group was trained with a rehabilitation exercise plan based on the theory of protective motivation. The scores of exercise compliance, motor function assessment [unified PD rating scale (UPDRS) - Ⅲ] and activity of daily living (Barthel index) before and 3 months after the intervention were compared between two groups. Results After 3 months of intervention, the exercise compliance and Barthel index in the experimental group were higher than those in the control group, and the UPDRS - Ⅲ score of the experimental group was lower than that in the control group (P<0.05). Conclusions Rehabilitation exercise based on the protective motivation theory can improve the exercise compliance, motor function and activities of daily living in the PD patients.
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    Application of case management extended care model based on WeChat platform in cirrhosis patients with esophageal and gastric varices
    CAI Boer, ZHU Feng, BAI Xiaojin, ZHANG Jiawen, CHEN Xiangjun
    2023, 18 (05):  344-347.  DOI: 10.16138/j.1673-6087.2023.05.007
    Abstract ( 44 )   HTML ( 1 )   PDF (518KB) ( 23 )  
    Objective To explore the effect of application of case management extended care model in cirrhosis patient with esophageal and gastric varices. Methods A total of 110 cirrhosis patient with esophageal and gastric varices admitted to the Department of Gastroenterology from January 2021 to December 2022 were divided into observation group and control group using random number table, and each group had 55 patients. The control group was given the routine care mode, and the observation group received extended care service of professional case management based on the WeChat platform beside given the routine care mode. The self-management ability and the incidence of major complications in two group during the whole intervention period were observed. Results After the intervention, the self-management behavior scale scores including daily life management and medication management in the observation group were higher than those in the control group (P<0.05), and its complication rate was lower than that in the control group (25.5% vs. 43.6%, P<0.05). Conclusions The case management extended care model through WeChat platform can strengthen the self-management ability of cirrhosis patient with esophageal and gastric varices, improve the compliance behavior and reduce the incidence of disease complications.
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    Research report
    Efficacy and safety of daratumumab in treatment of relapsed/refractory multiple myeloma
    ZHOU Rui, WU Tao, XUE Feng, TIAN Hongjuan, LIU Wenhui, MAO Dongfeng
    2023, 18 (05):  348-351.  DOI: 10.16138/j.1673-6087.2023.05.008
    Abstract ( 67 )   HTML ( 1 )   PDF (455KB) ( 26 )  
    Objective To explore the efficacy and safety of daratumumab(DARA) in the treatment of relapsed/refractory multiple myeloma (R/RMM). Methods We retrospectively analyzed 14 patients treated with DARA, who were diagnosed with R/RMM at our hospital during January 2020 to June 2022. The clinical efficacy, progress free survival (PFS), overall response rate (ORR) and safety after treatment were evaluated. Results Total of 14 patients included 8 males and 6 females, in which the median age was 56.5(33-72) years, and the median disease duration was 29.5(10-96) months. The diagnostic classifications were 2 cases of IgA-κ type, 1 case of IgA-λ type, 7 cases of IgG-κ type, 2 cases of IgG-λ type, 2 cases of unsecretory type, respectively. In 14 patients, 5 patients received 2-line therapy in the past, 6 patients received 3-line therapy, and 3 patients received 4-line therapy. All 14 patients completed the first course of DARA treatment and the treatment efficacy was able to be evaluated. Among them, 5 patients achieved hematological complete response (CR), 4 patients achieved very good partial response (VGPR), 2 patients achieved partial response (PR) and 3 patients achieved stable disease(SD). Among them, 13 patients survived, and 1 patient died of lung infection during non-treatment period. The median duration of the disease was 29.5(10-96) months, the median follow-up time was 6(2-14) months, the PFS time was 5(2-12) months, and the ORR was 78.6%. There were no grade Ⅳ adverse reactions during the treatment period. Among them, blood pressure in 1 patient increased and frequent ventricular premature beats occurred in 1 patient. These adverse reactions were both grade Ⅰ adverse reactions., and could be effectively controlled and improved after active treatment. Conclusions R/RMM treated with DARA on the basis of conventional treatment can improve ORR and depth of remission and prolong the PFS of patients, and shows high safety; but its long-term efficacy still needs to be further observed.
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    Case report
    Acute suppurative thyroiditis complicated with esophageal fistula and literature review: a case report
    WEI Min, LI Yuanyuan, ZHAO Yueting, XU Shuhang, DING Wenbo, CHEN Guofang, LIU Chao
    2023, 18 (05):  352-355.  DOI: 10.16138/j.1673-6087.2023.05.009
    Abstract ( 43 )   HTML ( 0 )  
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    Review article
    Glucose in the target range of time is associated with chronic complications of diabetes
    HUANG Yuanhao, SHEN Yuanyuan, HAN Tao, ZHANG Bingqing, FENG Wenhuan
    2023, 18 (05):  359-362.  DOI: 10.16138/j.1673-6087.2023.05.011
    Abstract ( 43 )   HTML ( 2 )   PDF (472KB) ( 37 )  
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    Progress in the pathogenesis and treatment of focal segmental glomerulosclerosis
    XU Lichen, LI Guisen
    2023, 18 (05):  363-367.  DOI: 10.16138/j.1673-6087.2023.05.012
    Abstract ( 48 )   HTML ( 3 )   PDF (538KB) ( 45 )  
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    Research progress on the effects of coffee on malignant tumors of digestive system
    Mukadas Rahman, JIANG Jie, TONG Jianjing
    2023, 18 (05):  368-371.  DOI: 10.16138/j.1673-6087.2023.05.013
    Abstract ( 46 )   HTML ( 1 )   PDF (351KB) ( 50 )  
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