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Purpose@#Numerous barriers hinder individuals with mental illness from seeking medical assistance in rural regions, yet a comprehensive understanding of these challenges remains elusive. This metasynthesis aims to understand the barriers and facilitators in medical help-seeking among rural individuals with mental illness. @*Methods@#We systematically searched seven databases [PubMed, CINAHL, Medline (OVID), PsycINFO (OVID), Cochrane, Embase, and ProQuest] in May 2023 and included the studies if they reported the barriers or/and facilitators to seek healthcare in rural patients with mental illness. We conducted hand search and citation search on Google Scholar for literature supplements. Thematic analysis was employed. @*Results@#The study included 27 articles reporting on the barriers and facilitators to seeking medical help in this population from 2007 to 2023. We ultimately identified themes at three levels: navigating the terrain of vulnerability and empowerment (the individual with mental illness), navigating the terrain of external environment (the external environment) and connectivity within the healthcare ecosystem for mental health (the health service system). @*Conclusions@#We must design more effective strategies to improve mental healthcare access for rural patients, considering cultural nuances and health service utilization patterns. This requires a multi-level approach, tailored to the unique needs of diverse populations.
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Objective:To test the factor structure and psychometric properties of the Chinese version of the Connor Davidson Resilience Scale (CD-RISC) in schizophrenia patients. In order to provide resilience scale for schizophrenia patients in China.Methods:A convenient sampling method was used to select 503 inpatients with schizophrenia in Chifeng Anding hospital from December 2017 to December 2018. The Chinese version of CD-RISC was used to conduct a questionnaire survey. Data processing was performed using SPSS 23.0 statistical software and AMOS 24.0 software.Results:The item analysis showed that the Chinese version of CD-RISC could discriminate the high-score group from the low-score group ( P<0.01). Pearson correlation analysis and principal component analysis showed that the correlation between item 3 and the total amount was poor, and it was considered to be deleted. A total of 6 common factors were extracted from the revised exploratory factor analysis of the CD-RISC, and the cumulative variance contribution rate was 50.79%. The Cronbach α coefficient was 0.882, and the test-retest reliability was 0.912 after two weeks. Confirmatory factor analysis fitted index: χ2/ df was 1.057, RMSEA was 0.015, GFI was 0.926, CFI was 0.989, and IFI was 0.989. Conclusions:The revision 24-item CD-RISC has good psychometric properties, it could be used to assess resilience in Chinese patients with schizophrenia.
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Extrathyroidal extension of thyroid cancer has been an important adverse factor affecting the prognosis of patients. According to the latest NCCN (National Comprehensive Cancer Network) guidelines, extrathyroidal extension is the surgical guide fortotal thyroidectomy in newly diagnosed patients, and its incidence in differentiated thyroid cancer is 5%-34%, belonging to T3-T4 stage.In the eighth edition of thyroid cancer AJCC staging, the T3 stage was first divided into T3a (tumor>4 cm and limited to the thyroid) and T3b (gross extrathyroidal extension invading only strap muscles from a tumor of any size), and the "minimal extrathyroidal extension(tumor invasion intoperithyroidal soft tissue or strap muscle invasion)"of the seventh edition was removed from the T stage and changed to the gross extrathyroidal extension invading only strap muscles, but there is still much controversy. It can be seen that different degrees of "extrathyroidal extension" have significant differences in the survival and prognosis of thyroid cancer. This article reviews the latest research progress of extrathyroidal extension, and discusses the significance and clinical research progress of it.
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Objective@#To review and summarize recent update on preoperative diagnostic criteria, treatment and postoperative follow-up for medullary thyroid carcinoma.@*Methods@#The relevant literatures and guidelines about medullary thyroid carcinoma were analyzed and summarized.@*Results@#In the early stages of the disease radical surgery still dominated. Ultrasound results suggested that prophylactic lateral neck dissection was required for patients with high risk factors or high levels of carcinoembryonic antigen and calcitonin need prophylactic. Early hereditary medullary carcinoma could receive prophylactic thyroidectomy based on RET gene test results. Advanced progressive medullary thyroid carcinoma could be treated with palliative surgery,molecular targeted drugs and chemotherapy.@*Conclusions@#The prognosis of medullary thyroid carcinoma is poor and lymph node metastasis is easy to occur early. The extent of initial operation should be enough. Locally advanced or distant metastatic medullary thyroid carcinoma can be treated with palliative surgery,molecular targeted drugs and chemotherapy.
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Thyroid cancer is a common head and neck malignant tumor,it has become a malignant tumor of the highest incidence in young women in China.The treatment of thyroid cancer is a surgery-based comprehensive therapy,and the protection of the parathyroid gland during surgery has always been a major problem for clinicians.The methods for protection of parathyroid glands are in situ preservation or immediate parathyroid autotransplantation according to whether or not the blood supply can be maintained.To identify the parathyroid gland is the key issue of the protection during thryoidectomy.This article reviews the recent progress of the identification and protection of parathyroid glands at home and abroad.
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Objective To analyze the components of attentional bias on anger and disgust emotional faces in college students with social anxiety disorder.Methods DSM-V was used for clinical diagnosis after the initial screening with Interaction Anxiousness Scale.The subjects meet the inclusion criteria were divided into social anxiety disorder group (SAD group) and healthy control group (HC group).Koster's improved dot-probe paradigm was used in a 2 (group:SAD group,HC group) ×2 (emotion categories:anger,disgust)mixed-design experiment,and the different characteristics of attentional bias between the two groups on different emotional faces were compared.Results In SAD group,under the condition of angry faces,the response times to the probe targets with the same or different positions from the negative faces were (369.7±53.0)ms and (447.2±54.3) ms,while the response times were (429.6±70.2) ms and (444.2±55.8) ms under the condition of disgust faces,and the SAD group showed attentional bias towards both anger and disgust faces (t =24.15 and 2.45,P＜0.05).Under the condition of anger faces,the response time of HC group to the consistent and inconsistent position of probe target were (466.9±40.0) ms and (483.8±43.8) ms,and the HC group had an attentional bias towards anger faces(t=6.58,P＜0.05).The response time under disgust faces was (493.8±43.6)ms and (498.0±46.7)ms in HC group,and did not show an attentional bias towards disgust(t=1.65,P=0.108).The scores of attentional orientation to anger faces in SAD group were significantly higher than those in the HC group(F=19.26,P＜0.001),but there was no significant difference between the two groups towards disgust faces (F=0.02,P=0.897).Compared with disgust faces,the attentional orientation to anger faces was faster in both HC and SAD groups (F=101.66 and 8.00,P＜0.05).Compared with the HC group,the SAD group had an impaired attentional disengagement from anger faces(F=8.66,P=0.004).Conclusion The students with social anxiety disorder have attentional bias towards both anger and disgust facial expressions,which manifested as facilitated attentional orientation and impaired attentional disengagement to anger faces.
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Objective@#To investigate the application of virtual reality technology in the preoperative evaluation of complex head and neck carcinoma and he value of virtual reality technology in surgical treatment of head and neck carcinoma.@*Methods@#The image data of eight patients with complex head and neck carcinoma treated from December 2016 to May 2017 was acquired. The data were put into virtual reality system to built the three-dimensional anatomical model of carcinoma and to created the surgical scene. The process of surgery was stimulated by recognizing the relationship between tumor and surrounding important structures. Finally all patients were treated with surgery. And two typical cases were reported.@*Results@#With the help of virtual reality, surgeons could adequately assess the condition of carcinoma and the security of operation and ensured the safety of operations.@*Conclusions@#Virtual reality can provide the surgeons with the sensory experience in virtual surgery scenes and achieve the man-computer cooperation and stereoscopic assessment, which will ensure the safety of surgery. Virtual reality has a huge impact on guiding the traditional surgical procedure of head and neck carcinoma.
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Sinonasal neoplasms are common tumors in the head and neck.The types of tumor pathological tissues are complex and diverse, and the incidence of malignant tumors is relatively low.The malignant tumor of paranasal sinuses is occult, and most of them are locally advanced.Although surgery is the main treatment for such diseases, the specific treatment plan is still controversial.This article reviews the treatment of sinonasal malignancy.
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Head and neck squamous cell carcinoma (HNSCC) is the sixth common malignant tumors of whole body with a high incidence, which accounts for 90% of the head and neck malignant tumors. Previous studies have shown the risk factors, such as tobacco and alcohol, are related to the occurrence and development of HNSCC. However, recent studies have shown that the non-tobacco and non-alcohol related HNSCC increased year by year. At the same time, more and more studies have shown that HNSCC is related to the infection with human papilloma virus (HPV), and the occurrence and development of HPV-positive HNSCC has own characteristics in epidemiology, pathogenesis, treatment and prognosis. In this paper the research progress for HPV-positive HNSCC is reviewed.
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Objective To investigate the application of modified negative pressure closure drainage in early stage of snakebite .Methods 60 patients with early bite ulcer were selected as study objects ,and they were randomly divided into two groups according to the digital table .30 patients in the observation group received vacuum sealing drainage(VSD) combined with chymotrypsin continuous rinsing treatment .30 patients in the control group were given conventional dressing bandaging treatment .The two stage skin grafting time,wound healing time,complications,disa-bility rate,hospitalization time and C reactive protein ( CRP) levels of the two groups were observed .And the treatment effect was analyzed .Results The incidence rates of complications and disability in the observation group were 0.00％and 3.33％,respectively,which were significantly lower than 16.67％and 26.67％in the control group ,and the differences between the two groups were statistically significant (χ2 =4.356,6.405,all P<0.05).The CRP levels of 3 d and 7 d in the observation group were (15.8 ±1.7)mg/L,(6.9 ±1.6)mg/L,respectively,which in the control group were (18.6 ±2.3) mg/L,(13.8 ±1.9) mg/L,respectively,there were statistically significant differences between two groups(t=5.362,15.214,all P<0.01).The two stage skin grafting,wound healing,hospital stay of the observation group were (9.5 ±1.8) d,(24 ±1.8) d,(25.3 ±1.9) d,respectively,which were significantly shorter than those of the control group [(16.2 ±2.6)d,(32.0 ±3.2)d,(33.2 ±3.7)d],the differences were statistically significant(t=11.604,11.93410.403,all P<0.01).Conclusion For patients with injury of cobra bite to early ulcer,using VSD technology combined with chymotrypsin continuous irrigation ,can significantly reduce the level of CRP and the occurrence of complications and disability rate ,shorten the time of two stage skin grafting ,wound healing time,hospitalization time,reduce the pain of patients,it is the best treatment to accelerate recovery .
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Objective To investigate the relationship between depression and personality and social support of the urban and rural empty-nest, clear the influence factors of depression in the empty-nest elderly. Methods 398 cases of urban and rural empty-nesters selected from the Chifeng district, were valuated with the general information questionnaire, the Geriatric Depression Scale (GDS), Eysenck personality Questionnaire- Revised Short Scalr for Chinese (EPQ-RSC) and the Social Support Scale (SSRS), and to investigate the demographic data, depression, personality and social support. Results Rural cases had a higher level (14.41±3.09) points of depression than (12.90±2.64) points of urban cases, and the difference was statistically significant (t=5.254, P<0.01);rural empty nesters′subjective support (18.35 ± 2.14) points, objective support (6.37 ± 1.40) points, support utilization degree (6.01 ± 1.17) points and social support score (30.37 ± 4.24) points, were lower than (19.83 ± 2.27) points, (7.34 ± 1.13) points, (6.95 ± 1.12) points, (34.12 ± 3.73) points of urban′s, and the difference was statistically significant (t=6.673-8.490, P<0.01); the extraversion score of urban empty nesters was (7.58 ± 2.51) points which was higher than (6.37 ± 2.02) points of rural empty nesters, and the difference was statistically significant (t=5.273, P<0.01);the neuroticism score (10.38 ± 2.06) points and psychoticism score (9.42 ± 2.17) points of urban empty-nest were lower than (12.41 ± 2.25) points, (10.94 ± 2.10) points of empty-nest′s, and the difference was statistically significant (t=9.401, 7.107, P<0.01). Neuroticism and psychoticism was shown to be positively associated with depression while extraversion and social support to be negatively associated with depression (P<0.01). Regression analysis showed that marital status, income, children visit frequency and the education level were the main influencing factors of depression in the urban and rural empty-nesters. Conclusions There are differences between rural and urban empty-nest elderly in the aspect of general data, depression status, personality and social support, and should intervention them effectively according to their different characteristics.
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Objective To investigate the effect of different degree lipidemia on time-resolved fluoroimmunoassay(TRFIA)for determination of unconjugated estriol(uE3).Methods Mixed serum was prepared by collecting different levels of lipidemia samples which were normal and chylous appearance from male and by mixing with definite value serum of uE3.The levels of uE3 in the sam-ples were measured by TRFIA and the effect of lipidemia on TRFIA for determination of uE3 was evaluated.Results For the ap-pearance of chylous specimens,mild lipidemia increased uE3,mid-or hiper-lipidemia samples reduced uE3 and the effect of both was considerable.Conclusion The chylous lipidemia has variant degree of influence to TRFIA for determination of uE3,then the results effect accuracy of Down′s screening.
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Objective To evaluate the necessity and feasibility by using two different PCR-based techniques for prenatal diagnosis of thalassemia. Methods 509 specimens for prenatal diagnosis of thalassemia were detected respectively by single tube multiplex PCR(STMP),reverse dot blot(RDB)or probe melting curve assay(PMCA)for commonα-thalassemia orβ-thalassemia mutations in double-blind tests. Samples with different detection results were confirmed with DNA sequencing analysis. Prenatal diagnosis of thalassemia results were verified or followed up after birth. Results In detectingα-thalassemia andβ-thalassemia,there was one case in STMP + RDB and another case PMCA indicating differentiating results. The detection sensitivity of STMP + RDB was higher than that of PMCA,and its difference can be used as an indication for maternal blood contamination. Conclusion The two PCR methods with different principles were necessary and feasible for the prenatal diagnosis of thalassemia. The two methods were complementary to each other ,which can ensure the reliability of the prenatal diagnosis results and reduce the defects of single technique. It is worthy to be popularized in clinical application.
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Objective To systematically evaluate the effects of psychiatric nurse-led adherence therapy on clinical outcomes and medication adherence in schizophrenia patients.Methods Searched databases to collect randomized controlled trials about psychiatric nurse-led adherence therapy for patients with schizophrenia.Two reviewers independently screened literature,extracted data,and assessed the risk of bias of included studies.Then,meta-analysis was performed using Rev Man 5.2 software.Results Fifteen studies were recruited,including 683 cases of AT and 681 cases of TAU.The results showed that adherence therapy could improve attitude towards adherence,adherence behaviors,psychotic symptoms,function,insight and reduce hospital stay.But regarding stigma,quality of life and side effects,adherence therapy did not show benefits (P＞0.05).Conclusion Psychiatric nurse-led adherence therapy is effective to improve schizophrenia patients' adherence,psychotic symptoms,function,insight and reduce hospital stay.
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Objective To evaluate the effect of transitional care intervention on quality of life for patients with chronic obstructive pulmonary disease (COPD). Methods The Cochrane library, PubMed, Embase, Chinese biomedical literature database(CBM), Chinese scientific journals full-text database, Wanfang data were searched up to June 2015 to identify randomized controlled trials(RCTs) comparing continuity of patient care with conventional treatment.The data were analyzed using Revman 5.2 software. Results 26 RCTs involving 2 443 participants were included.The results of Meta-analysis showed continuity of care couldreduce the scores of The COPD Assessment Test [ SMD=-2.24, 95%CI=(-3.52--0.96), P<0.01],and St George′s Respiratory Questionnaire [SMD=-0.26, 95%CI(-0.50--0.02), P≤0.05], and could improve the scores of Chronic Respiratory Disease Questionnaires [SMD=0.46, 95%CI(0.08-0.84), P≤0.05]. Conclusions Transitional care can improve the quality of life of patients with COPD.
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This paper reviewed the subjective and objective evaluation tools of sleep disorders, and summarized evaluation indicators of sleep disorders, so as to provide a theoretical support and practical reference for the diagnosis of sleep disorders, intervention and related researches.
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Objective:To explore the relationship between social anxiety and sex role in college students,and to analyze the mediating effect of self-acceptance between them.Methods:Data came from a sample of 2000 col-lege students in Daqing,who were selected by stratified random cluster sampling method according to the constitu-ent ratio of the college students.We used the Interaction Anxiety Scale (IAS)to assess subjective experience of so-cial anxiety,Bem Sex-Role Inventory (BSRI)to evaluate sex-role classification and Self-Acceptance Questionnaire (SAQ)to measure characteristics of self-acceptance.Results:In the college,the distribution of sex-role classifica-tion were androgynous 656 (34.9%),undifferentiated 650 (34.6%),masculine 287 (15.3%),feminine 284 (15.1%).The differences of gender in scores of IAS and SAQ were not significant (Ps >0.05),but there were significant differences among sex roles (P <0.001).IAS scores of feminine were significantly higher than the oth-ers,and the scores of androgyny and masculine were both lower than the other two significantly.SAQ scores offeminine and undifferentiated were both significantly lower than the other two respectively (Ps <0.05).By Boot-strap test,masculine,undifferentiated and feminine (vs.androgynous)could mediate IAS through self-acceptance, the mediating effects were 0.76 (95%CI:0.09 -1.42),4.14 (95%CI:3.43 -4.93),and 4.03 (95%CI:3.47 -4.64) respectively.There was a mediating effect.Both undifferentiated (vs.androgynous ) and feminine (vs.androgynous)directly influenced IAS significantly (Ps <0.05).Conclusion:Social anxiety may be related to sex role but not gender,social anxiety level of feminine students is higher,the sex-role types could influence social anxiety through self-concept indirectly.
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Objective To know the relationship between loneliness and the quality of life of urban and rural absent parents in the Inner Mongolia Autonomous Region,clear the influence factors of loneliness in the absent parents.Methods 441 cases of urban and rural absent parents were selected from the Chifeng district of the Inner Mongolia Autonomous Region were valuated with the general information questionnaire,UCLA Loneliness Scale and MOS 36 item short form health survey (SF-36).Results Rural cases had a higher level of loneliness when compared with the urban cases,t=4.60,P＜0.01.There were significant differences in the general score and the scores of each dimension between the two groups,P＜0.05.Loneliness score was significantly negative correlation with the quality of life in all dimensions,P＜0.01.Regression analysis showed that health,marital status,income and the education level were the main influence factor of loneliness in the urban and rural absent parents.Conclusions Compared with the urban absent parents,rural cases had more obvious loneliness and lower quality of life.Loneliness levels influence the quality of life of absent parents.Loneliness condition of urban and rural absent parents were influenced by various factors,the cases with characteristic of frail,single,low education level and poor economic condition should be the focus group to intervene.
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Objective To explore the mediator effect of coping styles in relationship between hope level and subjective well-being of empty-nesters in urban community.Methods 208 empty-nesters were tested with Herth Hope Scale,Coping Style Questionnaire and Subjective Well-Being to investigate the influence and the pathways of hope and coping styles on subjective well-being with structural equation modeling.Results Influence of hope level on subjective well-being of empty-nesters in urban community accorded with completely-mediated model (x2/df =1.971,GFI =0.955,AGFI =0.911,RMSEA =0.068),and influence of hope level mediated by positive coping styles accounted for 41.76％(Z=3.692,P＜0.01).Conclusion The influence of hope level on subjective well-being is mediated mainly by positive coping styles for empty-nesters in urban community.
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Objective To investigate epidemiological characteristics of Salmonella infection in children with infectious diarrhea in Zhuhai City from 2009 to 2014 .Methods Isolation ,culturing ,biochemical identification and serotyping of Salmonella were carried out in strains isolated from stool specimens of 4 395 children with infectious diarrhea in inpatient and outpatient settings in Zhuhai Municipal Maternal and Child Healthcare Hospital from 2009 to 2014 ,and data were statistically analysed .Results A total of 546 strains of Salmonella was isolated(the overall isolation rate was 12 .42% ) and 30 serotypes were identified .Among children with Salmonella infection ,those under 3 years old accounted for 93 .22% .There was no statistically significant difference of isolation rate between male and female children with infectious diarrhea(P<0 .05) .June and July were peak period of Salmonella infection ,and the isolation rate was 16 .40% and 16 .09% respectively .Isolates of Salmonella typhimurium ,Salmonella enteritidis and Salmonella stanley account for 50 .92% ,13 .55% and 10 .26% respectively ,which were dominant serotypes .Conclusion Salmonella is the main pathogenic bacteria in children with infectious diarrhea in Zhuhai area ,and Salmonella typhimurium is the main serotype .The infec‐tion of Salmonella might be correlated with children′s age and climate change .