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Objective:To explore the potential categories of post-traumatic stress disorder (PTSD) trajectories in women with multiple in vitro fertilization-embryo transfer (IVF-ET) failures, and to analyze the effects of different demographic characteristics and psychological factors on the potential categories of PTSD trajectories.Methods:This was a prospective empirical research, from May 2021 to October 2022, women with IVF-ET failure ≥ 2 times in the reproductive department of Shanghai First People′s Hospital from May 2021 to October 2022 were selected as the research objects. Post-traumatic stress disorder civilian version scale was used for 4 follow-ups at 3 d (T1), 10 d (T2), 20 d (T3) after the last transplantation failure and 3 d before the next transplantation cycle (T4). Telephone follow-up and online follow-up were combined to obtain the PTSD level at 4 time points. Potential categories of PTSD score trajectories at four time points were identified using a latent category growth model, and analyze influencing factors using unordered multi classification logistic analysis.Results:Totally 196 IVF-ET women were admitted, aged (29.42 ± 4.13) years. Three PTSD trajectories were fitted in this study, including 82 cases (42%) in non-PTSD group, 61 cases (31%) in mild PTSD group and 53 cases (27%) in elevated PTSD group. Logistic regression analysis showed that age, education level, fertility pressure and marital adjustment level were the predictors of PTSD trajectory in women with multiple IVF-ET failures. Compared with the non-PTSD group, women aged ≥35 years, with lower education level and marital adjustment level were more likely to enter the elevated PTSD group ( OR=4.570, 8.540, 0.949, all P<0.05). Women aged 35 years and with greater reproductive pressure were more likely to enter the mild PTSD group ( OR=3.871, 1.063, both P<0.05). Conclusions:There is group heterogeneity in the trajectories of PTSD in women with multiple IVF-ET failures in the next transplantation cycle. Old age, low education level, high fertility pressure and poor marital adjustment can predict the trajectories of PTSD. Fertility stress and marriage adjustment are changeable variables. Medical staff can relieve women′s fertility pressure through health education and mindfulness intervention, promote a good state of marriage adjustment, and minimize the adverse effects of PTSD on the next cycle of conception.
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Objective To investigate the abnormal region of gray matter and its' structural changes closely related to mild cognitive impairment in patients with Parkinson's disease (PD) using voxel-based morphometry(VBM) method.Methods Thirty-seven clinically defined PD patients and 20 normal controls (NC),collected in our hospital from March 2011 to February 2013,were examined using T1WI three-dimensional brain volume sequence (3D-fast spoiled gradient echo,3D-FSPGR).We classified PD patients into 2 subgroups according to the extent of cognitive impairment:20 patients with mild cognitive impairment (MCI) and 17 patients with none mild cognitive impairment (nMCI).The data of three groups were analyzed using VBM based on SPM5 to generate gray matter map.Results As compared with NC group,PD patients showed extensively decreased gray matter volume,involving bilateral frontal,temporal,occipital and parietal lobes,insular,parahippocampal gyrus,amygdale and right uncus.As compared with PD-nMCI patients,decreased gray matter volume in PD-MCI patients was observed in bilateral midfrontal gyrus,inferior frontal gyrus,bilateral insular,left precentral gyrus,left superior temporal gyrus and right midtemporal gyrus.Conclusions Areas of decreased gray volume in PD patients locate in widespread brain regions involving limbic system and neocortex.Gray matter atrophy in bilateral midfrontal gyrus,inferior frontal gyrus,insular and left precentral gyrus is related to the mild cognitive impairment.