¿Cuál es la importancia de diferenciar entre síntoma y trastorno al momento de llevar a cabo un tratamiento? Estrategias de trabajo que se abren frente a estas presentaciones / What is the importance of differentiating between symptom and disorder when carrying out treatment?work strategies that open in face of these presentations / Quelle est l'importance de différencier entre symptôme et trouble lors de la réalisation d'un traitement? stratégies de travail qui s'ouvrent face à ces présentations / Qual é a importância de diferenciar entre sintoma e transtorno ao realizar o tratamento? Estratégias de trabalho que se abrem diante destas apresentações

En este escrito los autores puntualizan la diferencia entre los conceptos de síntoma y trastorno en la infancia. A los fines diagnósticos establecer esta diferenciación permite pensar estrategias de intervención adecuadas a las características metapsicológicas de estos modos de presentación de sufrimiento en la infancia AU

In this writing the authors point out the difference between the concepts of symptom and disorder in childhood.For diagnostic purposes, establishing this differentiation allows us to think about intervention strategies appropriate to the metapsychological characteristics of these modes of presentation of suffering in childhood AU

Dans cet écrit, les auteurs soulignent la différence entre les concepts de symptôme et de trouble dans l'enfance.À des fins diagnostiques, établir cette différenciation permet de réfléchir à des stratégies d'intervention adaptées aux caractéristiques métapsychologiques de ces modes de présentation de la souffrance dans l'enfance AU

Neste escrito os autores apontam a diferença entre os conceitos de sintoma e transtorno na infância.Para fins diagnósticos, estabelecer essa diferenciação permite pensar estratégias de intervenção adequadas às características metapsicológicas desses modos de apresentação do sofrimento na infancia AU

O desmentido da privação como sintoma do discurso capitalista / Le déni de la privation comme symptôme du discours capitaliste / The denial of deprivation as a symptom of capitalist discourse

Na esteira das lógicas da economia psíquica e da economia política desenvolvidas por Freud e Lacan, tomamos como cerne um tipo de defesa que aparece em muitos casos da clínica contemporânea - o desmentido da privação - para colocar em evidência sua relação com o discurso capitalista pensado por Lacan. O desmentido da privação é um modo de defesa subjetivo que aparece como um índice do fracasso do pai privador na passagem do segundo para o terceiro tempo do complexo de Édipo. Trata-se de uma forma de se defender da castração buscando satisfação pulsional sem mediação simbólica ­ busca essa que é fracassada e extrapola o princípio de prazer. Conclui-se que esse desmentido contemporâneo é um sintoma do próprio discurso capitalista. Se a for aclusão da castração no discurso capitalista é uma promessa igualmente fracassada, o desmentido da privação aparece na subjetividade tentando solucionar esse fracasso. Ele é um sinal de que o discurso capitalista não cumpre sua promessa - e isso por sua própria engrenagem lógica.

Dans le sillage des logiques d'économie psychique et d'économie politique développées par Freud et Lacan, nous nous concentrons sur un type de défense qui apparaît dans de nombreux cas de pratique clinique contemporaine - le déni de la privation - pour mettre en évidence sa relation avec le discours capitaliste d' accord avec ce qui fut pensé par Lacan. Le déni de la privation est une défense subjective qui apparaît comme un indice de l'échec du père qui prive dans le passage du deuxième au troisième stade du complexe d'Œdipe. C'est une manière de se défendre de la castration en recherchant une satisfaction pulsionnelle sans médiation symbolique ­ une recherche qui échoue et dépasse le principe du plaisir. Nous concluons que ce déni contemporain est un symptôme du discours capitaliste lui-même. Si la for clusion de la castration dans le discours capitaliste est une promesse également ratée, le déni de la privation apparaît dans la subjectivité qui tente de résoudre cet échec. C'est le signe que le discours capitalistene tient pas ses promesses - et cela par sa propre logique.

Following the logics of psychic economy and political economy developed by Freud and Lacan, we target a type of defense that appears in many cases of contemporary clinical practice - the denial of deprivation - to highlight its relationship with the capitalist discourse as thought by Lacan. The denial of deprivation is a subjective defense that appears as an index of the failure of the depriving father in the transition from the second to the third stage of the Oedipus complex. It is a way of defending oneself from castration by seeking instinctual satisfaction without symbolic mediation ­ a search that fails and goes beyond the pleasure principle. The conclusion is that this contemporary denial is a symptom of capitalist discourse itself. If the foreclosure of castration in capitalist discourse is an equally failed promise, the denial of deprivation appears in subjectivity trying to resolve this failure. It is a sign that capitalist discourse does not fulfill its promise - and this by its own logical perspective.

Preventive and therapeutic assessment program for mucositis in patients with cancer: promising advances in stomatological care / Programa de avaliação preventiva e terapêutica de mucosite em pacientes com câncer: avanços promissores na assistência estomatológica

OBJECTIVES: We propose a preventive and therapeutic assessment program for mucositis in patients with cancer based on a comprehensive review of scientific evidence. MATERIAL AND METHODS: This methodological study, designed as a non-systematic review, entails a thorough review of the scientific evidence on the management of mucositis in patients with cancer. The PICO method was used, allowing for a structured approach to explore and synthesize relevant evidence. RESULTS: Effective mucositis management requires regular assessments, dental exams, preventive strategies, and consideration of modifiable risk factors. Pharmacological therapies may be considered for severe cases, while oral antimicrobials, prophylactic antiviral and antifungal therapy can prevent infections. Topical anesthetics o?er pain relief but require careful administration. A gradual management plan, from gentle rinses to analgesics, is recommended. CONCLUSION: The suggested program may improve the identification, prevention, and management of this complication to achieve optimal management outcomes.

OBJETIVOS: Propomos um programa de avaliação preventiva e terapêutica de mucosite em pacientes com câncer com base em uma revisão abrangente de evidências científicas. MATERIAL E MÉTODOS: Este estudo metodológico, concebido como uma revisão não sistemática, envolve uma revisão aprofundada da evidência científica sobre o manejo de mucosite em pacientes com câncer. Foi utilizado o método PICO, permitindo uma abordagem estruturada para explorar e sintetizar evidências relevantes. RESULTADOS: O manejo eficaz da mucosite requer avaliações regulares, exames odontológicos, estratégias preventivas e consideração de fatores de risco modificáveis. As terapias farmacológicas podem ser consideradas para casos graves, enquanto os antimicrobianos orais e a terapia antiviral e antifúngica profilática podem prevenir infecções. Os anestésicos tópicos oferecem alívio da dor, mas requerem administração cuidadosa. Recomenda-se uma administração gradual, desde enxágues suaves até analgésicos. CONCLUSÃO: O programa sugerido pode melhorar a identificação, prevenção e manejo desta complicação para alcançar resultados de conduta ideais.

Abnormal gray matter volume of MRI in the somatic symptoms of depression / 中国神经精神疾病杂志

Objective To explore specific magnetic resonance imaging(MRI)features of somatic symptoms in depression by comparing the differences of brain gray matter volume in depression patients with and without somatic symptoms using voxel-based morphometry(VBM).Methods A total of 52 depression patients were recruited and divided into somatic and no somatic symptoms group according to the patient health questionnaire-15 score(＞9 and≤9,respectively).Forty gender-age-matched healthy volunteers were recruited as the control group.All subjects underwent MRI scanning.Imaging data were analyzed to explore the differences in brain gray matter between groups using VBM.Results Compared with control group,gray matter volume increased in the right superior temporal gyrus,and decreased in the right inferior orbitofrontal gyrus,right inferior temporal gyrus,left inferior orbitofrontal gyrus,and left superior temporal gyrus for depressive patients with somatic symptoms(P＜0.001);gray matter volume increased in the right middle temporal gyrus,and decreased in the right superior temporal gyrus and right inferior temporal gyrus for depressive patients without somatic symptoms(P＜0.001).Only the volume in the right tongue and left cingulate gyrus increased in depressive patients with somatic symptoms compared with that in patients without somatic symptoms(P＜0.01).Conclusion VBM-MRI has demonstrated increased volume in the tongue and cingulate gyrus in the somatic symptoms of depression.

Clinical characteristics and related factors of patients with schizophrenia in different ages of onset / 中国心理卫生杂志

Objective:To explore the clinical characteristics and related socio-demographic factors of schizo-phrenia patients with different ages of onset.Methods:Totally 2 016 patients with schizophrenia aged 15 to 70 were selected according to the diagnostic criteria for schizophrenia in the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition.All of the patients were interviewed by psychiatrists using the Mini International Neuropsy-chiatric Interview to diagnose schizophrenia,Clinical-Rated Dimensions of Psychosis Symptom Severity(CRDPSS)and the Positive and Negative Syndrome Scale(PANSS)to assess symptoms.The cut-off points were 18 and 25 years old for three age groups,i.e.early onset(EOS),youth onset(YOS)and adult onset(AOS).Statistical analy-ses were performed by analysis of variance Pearson correlation analysis,and multivariate linear regression.Results:The early-onset patients had the highest total PANSS score(73.8±28.0)and CRDPSS score(11.7±5.4).Fe-male gender,high education level,Han ethnicity,early onset age,and slower onset of illness were negatively corre-lated with the total and dimension score of PANSS scale and CRDPSS scale(standardized regression coefficient:0.04-0.47),and income level and smoking were negatively correlated with those score(standardized regression coefficient:-0.04--0.14).Conclusion:Early-onset schizophrenia patients have more severe symptoms,and fe-male,high education level,early-onset disease,and chronic onset are the risk factors of symptom severity in patients with schizophrenia.

Anxiety symptom and personality disorder among medical aesthetic clients / 中国心理卫生杂志

Objective:To describe the prevalence of anxiety symptom and personality disorder among medical aesthetic clients,and explore related factors of anxiety symptoms among them.Methods:Totally 788 clients who consulted in a cosmetic plastic surgery department were recruited in a tertiary hospital in Beijing from November 2021 to July 2023.Using the Personality Diagnostic Questionnaire-4(PDQ-4)and the Self-Rating Anxiety Scale(SAS)as assessment instruments,with a cutoff point of 42 and 50 points respectively,for screening out personality disorder and anxiety symptom.Statistical analysis was conducted by analysis of variance,chi-square tests,multivari-ate linear regression and logistic regression.Results:The rate of anxiety symptom among the medical aesthetic cli-ents was of 15.23％(120/788),and the prevalence of personality disorder was 3.50％(28/788).Age was nega-tively associated with SAS scores(β=-0.82,P=0.009),PDQ-4 score was positively associated with SAS score(β=0.15,P＜0.001),eye plastic surgery,facial contouring and minimally invasive plastic surgery were positively associated with SAS score(β=2.00-3.64,P＜0.05).Conclusion:The younger and the more prominent the per-sonality dysfunction the clients are,the severer anxiety symptom they have.The clients who consult for eye plastic surgery,facial contouring,and minimally invasive plastic surgery have severer anxiety symptom.

Meta-analysis of efficacy and feasibility of exercise interventions as adjunctive therapy for patients with schizophrenia / 中华行为医学与脑科学杂志

Objective:To systematically evaluate the effectiveness and feasibility of aerobic exercise intervention in schizophrenia patients.Methods:Randomized controlled trials on exercise interventions for patients with schizophrenia were searched in eight databases from built up to March 2023, including China National Knowledge Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals (VIP), WanFang Data, China Biomedical Literature Database, PubMed, Cochrane Library, EMBASE and Web of Science. The positive and negative symptom scale (PANSS) and its sub-scales were used as primary outcome indicators, and the negative symptom scale (SANS) and body mass index (BMI) were used as secondary indicators, and Meta-analysis was performed using R 4.1.0 and Stata 14.0.Results:Forty-seven studies including 3 139 patients with schizophrenia were included. Results of a network Meta-analysis based on 24 studies showed that aerobic exercise may be the most effective measure for reducing total PANSS scores in patients with schizophrenia. Compared to conventional treatment, combining aerobic exercise intervention improved patients' PANSS total score (MD= -5.09, 95% CI: -5.90~-4.28), SANS (MD= -12.17, 95% CI: -14.25~-10.10), and BMI (MD=-1.59, 95% CI: -1.93~-1.25). Meanwhile, subgroup analysis showed that 2 months of intervention was more appropriate (MD=-6.12, 95% CI: -7.22~-5.02) and the weekly total exercise time for 140-260 min was more appropriate (MD=-8.59, 95% CI: -12.93~-4.25) in terms of total PANSS score. The adherence rates between the trial and control groups showed no significant difference between the aerobic exercise intervention combined with conventional treatment and conventional treatment alone( P>0.05). Conclusion:Aerobic exercise intervention is an effective measure to relieve the symptoms of schizophrenia patients and has good compliance among inpatients.

Research progress of symptom cluster in patients with acute coronary syndrome / 中华护理杂志

Acute coronary syndrome(ACS)is a common type of acute and critical disease in Coronary Heart Disease(CHD).It is characterized by multiple and severe symptoms and rapid progression of the disease,which seriously threatens the life safety of patients.In this paper,the relevant studies on symptom cluster of patients with ACS were systematically searched at home and abroad,and the composition of symptom cluster,symptom assessment tools,symptom cluster establishment methods,influencing factors and intervention methods were reviewed,in order to provide references for nurses to manage ACS symptom cluster.

Intervention study of lung cancer patients undergoing postoperative chemotherapy based on sentinel symptoms / 中华护理杂志

Objective Based on sentinel symptoms,a nursing intervention program for gastrointestinal symptom group of postoperative chemotherapy for lung cancer was constructed and its application effect was evaluated.Methods The nursing intervention program of gastrointestinal symptom group was constructed on the basis of ref-erence guidelines,qualitative interview and expert consultation.From January 2021 to January 2022,a total of 330 patients with postoperative chemotherapy for lung cancer in a tertiary hospital in Shenyang were selected as re-search subjects.The experimental group received the gastrointestinal symptoms group nursing intervention program on the basis of routine nursing,and the control group received routine care.Patients were investigated with the M.D.Anderson Symptom Inventory and the MOS 36-Item Short-Form Health Survey before 1st chemotherapy(T1),3rd chemotherapy(T2)and 5th chemotherapy(T3).Results After the intervention,the total scores of the 2 groups and the total scores of each symptom in T2 and T3 were statistically significant(P＜0.05),and the score of the experi-mental group was lower than that of the control group.For the scores of 6 dimensions of physiological function,physical pain,overall health,vitality,emotional function,mental health in 2 groups between different time points,the differences are statistically significant(P＜0.05).Conclusion The nursing intervention program of the gastroin-testinal symptom group based on sentinel symptoms is beneficial to reduce the severity of the gastrointestinal symp-tom group and improve the quality of life for postoperative chemotherapy for lung cancer patients.

Analysis of influencing factors and pathway of self-regulatory fatigue in maintenance hemodialysis patients / 中华护理杂志

Objective Based on the process theory of stress effect,the structural equation model of the influencing factors of self-regulatory fatigue in maintenance hemodialysis patients is constructed,which provides theoretical bases and references for the formulation of intervention programs to relieve self-regulatory fatigue in patients.Method A total of 420 maintenance hemodialysis patients were surveyed using General Information Questionnaire,Self-Regulatory Fatigue Scale,Dialysis Symptom Index,Life Orientation Test-Revised,Perceived Social Support Scale,Brief Illness Perception Questionnaire and Medical Coping Styles Questionnaire.Results Total score of self-regulatory fatigue in maintenance hemodialysis patients was(49.52±10.93),and self-regulatory fatigue showed significant positive correlation with symptom distress,the illness perception,avoidance coping style,yieldly coping(r=0.476,0.428,0.303,0.611,all P＜0.01);self-regulatory fatigue showed significant negative correlation with perceived social support and dispositional optimism(r=-0.410,-0.652,all P＜0.01);it showed no significant correlation with facing coping(r=-0.032,P＞0.05).The Bootstrap analysis revealed that the mediation effect of yielding coping,dispositional optimism,perceived social support,and illness perception between symptom distress and self-regulatory fatigue was significant(95％CI:0.027～0.203).The overall effect of symptom distress on self-regulatory fatigue was(P＜0.001,95％CI:0.576～0.751);the direct effect was(P＜0.001,95％CI:0.170～0.357);the indirect effect was(P＜0.001,95％CI:0.332～0.485);the mediation effect accounted for 61.1％of the total effect value.Conclusion Maintenance hemodialysis patients have a high degree of self-regulatory fatigue,which needs to be further improved.Medical staff should timely identify and evaluate the symptom distress of patients,focus on guiding patients to adjust optimistic disease,provide patients with psychological guidance and stress coping strategies,reduce the negative coping behavior tendency,guide the patients correctly perceive support and care in social relations,help patients set up the correct disease cognition,thus reducing the patient's self-regulatory fatigue.

Status quo and its influencing factors of social anxiety in school-age children with attention deficit hyperactivity disorder / 中国儿童保健杂志

【Objective】 To investigate the current situation of social anxiety in children with attention deficit hyperactivity disorder (ADHD), and to analyze the factors influencing social anxiety in ADHD children, in order to provide reference for improving the clinical management of ADHD children. 【Methods】 A total of 206 school-age children with ADHD were selected from the Children′s Psychology Clinic of Mianyang Central Hospital from January 2020 to January 2023. The relevant clinical data of the children were collected through the general data questionnaire. Children′s Social Anxiety Scale (SASC) was used to assess social anxiety, and the Social Response Scale (SRS) was used to assess social ability. The Chinese version of Swanson,Nolan and Pelham Rating Scale Ⅳ (SNAP-Ⅳ) was used to assess core symptoms. Multivariate Logistic regression analysis was used to determine influencing factors of social anxiety in children with ADHD. 【Results】 There were 128(62.14%) cases detected with social anxiety among 206 children with ADHD. The score of SASC was 14.02±4.06. The proportions of girls (χ2=6.057), comorbid autism spectrum disorder(ASD) (χ2=4.929), and main caregivers with junior high school education or below (χ2=13.345), the total score of SRS(t=5.842) and SNAP-Ⅳ(t=7.848) and the scores of all dimensions were significantly higher than those in the non-anxious group (P<0.05). Multivariate Logistic regression analysis showed that higher SRS total score(OR=5.217, 95%CI: 2.309 - 11.791), higher SNAP-Ⅳ total score(OR=4.150, 95%CI: 1.974 - 8.722), girls(OR=2.268, 95%CI: 1.423 - 3.616), primary caregivers with junior high school education or below (OR=1.527, 95%CI: 1.162 - 2.005), and comorbid ASD (OR=1.551, 95%CI: 1.209 - 1.990) were risk factors for social anxiety in ADHD children (P<0.05). 【Conclusions】 Children with ADHD have a higher prevalence rate of social anxiety. Cognitive behavioral therapy and psychological intervention should be strengthened for high-risk children to improve social ability and reduce the risk of social anxiety.

Opioid-induced fragile regulatory T cells contribute to NAc synaptic plasticity and withdrawal symptoms / 西安交通大学学报(医学版)

Decline of immunity is an epidemiological feature of opioid addicts. Recent work reveals a landscape of peripheral immune microenvironment in opioid addicts. Opioid addicts exhibit a significant expansion of fragile-like regulatory T cells (Tregs) and enhanced Treg-derived interferon-γ (IFN-γ) expression. IFN-γ signaling reshapes synaptic morphology in nucleus accumbens (NAc) neurons, modulating subsequent withdrawal symptoms. Treg fragility transformation from WT Tregs is primarily due to opioid-induced global hypoxia during acute withdrawal period. Opioids increase the expression of neuron-derived C-C motif chemokine ligand 2 (Ccl2) and disrupt blood-brain barrier (BBB) integrity through the downregulation of astrocyte-derived fatty-acid-binding protein 7 (Fabp7), both of which trigger peripheral Treg infiltration into NAc. Recent studies suggest that subtle homeostatic changes in the peripheralimmune milieu may also contribute to modulating synapses that are responsible for addictive behaviors, which may lead to the development of new therapeutic strategies.

Correlation between psychiatric symptoms and semi-essential amino acid levels in patients with schizophrenia / 西安交通大学学报(医学版)

【Objective】 To elucidate the possible role of arginine and histidine in the pathogenesis of schizophrenia by exploring the serum levels of semi-essential amino acids (arginine and histidine) in patients with schizophrenia and their correlation with psychiatric symptoms. 【Methods】 We selected 72 inpatients with schizophrenia admitted to The First Affiliated Hospital of Xi’an Jiaotong University from March 2021 to October 2022 and 72 healthy volunteers enrolled in Yanta Community during the same period as the research subjects. Serum arginine and histidine levels were measured in patients with schizophrenia and healthy controls using serum liquid chromatography-mass spectrometry (LC-MS). We used the Positive and Negative Symptom Scale (PANSS) to evaluate the mental symptoms of patients with schizophrenia and analyzed the correlation of serum arginine and histidine levels with disease course, frequency of onset, and PANSS score. 【Results】 The levels of serum arginine (P<0.001) and histidine (P=0.011) in the schizophrenia group were significantly lower than those in the control group. The levels of serum arginine and histidine were significantly negatively correlated with the frequency of onset (rs=-0.410, rs=-0.262), total score of PANSS (rs=-0.298, rs=-0.256), positive factors (rs=-0.299, rs=-0.234) and cognitive impairment factors (rs=-0.251, rs=-0.296). In addition, serum arginine levels had significantly negative correlation with anxiety and depression factors (rs=-0.269, P<0.05). 【Conclusion】 The serum levels of arginine and histidine in patients with schizophrenia are significantly lower than those in healthy individuals, and are negatively correlated with overall mental symptoms, severity of positive symptoms and cognitive impairment. The severity of anxiety and depression symptoms is negatively correlated with arginine levels. The detection of serum arginine and histidine can provide reference for the diagnosis and assessment of the severity of schizophrenia in the future.

Exploration of correlation between multiple subjective and objective evaluation indicators in early stage with recovery time in combination of acupuncture and medication for treating facial neuritis / 重庆医学

Objective To analyze the correlation between the multiple evaluation indicators in the early stage and the cure time(needed time from treatment to cure)of the patients with facial neuritis treated by ac-upuncture combined with medication,and to optimize the subjective and objective indicators enable predicting the cure time of facial neuritis in early stage.Methods All patients were treated by acupuncture and medica-tion combination.The research subjects were 64 patients with facial neuritis from the outpatient of cupuncture and moxibustion department of this hospital.The correlation between the grade of facial nerve paralysis,sur-face electromyography related data,scores of self-made symptom scoring scale,Sunnybrook Facial Grading System(SFGS)score,Facial Disability Index-Physical(FDIP)score,Facial Disability Index-Social(FDIS)score on 7 d of onset with the cure time was analyzed.Results The cure time was positively correlated with the grade of facial nerve paralysis and FDIS score on 7 d of onset(P＜0.01),amd negatively correlated with the scores of self-made symptom scoring scale,FDIP score,SFGS score and the affected side to healthy ratio of CMAP amplitude of buccal temporal branch of facial nerve(P＜0.01 or P＜0.05);the cure time had no sig-nificant correlation with the ratio of affected side and healthy side of CMAP amplitude in zygomatic branch of facial nerve,the ratio of affected side and healthy side of CMAP latent period of temporal branch,buccal branch and zygomatic branch of facial nerve and F wave output rate(P＞0.05).Conclusion In the early stage subjective indicators of the acupuncture combined with medication for treating facial neuritis,grade of facial nerve paralysis,self-made symptom scoring scale,scores of self-made symptom scoring scale,FDIP and FDIS scores and the ratio of affected side to healthy side of CMAP amplitude of the buccal branch,temporal branch of the facial nerve in sEMG in the objective indicators could be used to predict the cure time,better guide the treatment and have more effective and accurate comunication with the patients.

Study of symptom clusters and their influencing factors in elderly patients with acute phase stroke / 中国实用护理杂志

Objective:To investigate the symptoms and symptom clusters of elderly stroke patients in the acute phase, analyze the factors influencing the symptom clusters and to provide a basis for the implementation of targeted symptom management in elderly stroke patients.Methods:Convenience sampling method was used to select 257 acute-phase elderly stroke patients who attended Fenyang Hospital in Shanxi Province from October 2022 to January 2023, and a cross-sectional survey was conducted by the General Information Questionnaire, Memory Symptom Evaluation Inventory, Modified Barthel Index Scale (MBI), and the National Institutes of Health Stroke Scale (NIHSS), and the symptom clusters were extracted by means of exploratory factor analysis, and the factors influencing symptom clusters were explored by means of binary logistic regression analysis.Results:Of the 257 patients, 138 were male and 119 were female, aged 60 to 90 (70.34 ± 6.94) years old. Factor analysis yielded four symptom clusters, which were named oral-intestinal symptom cluster, negative emotional symptom cluster, fatigue symptom cluster, and perceptual symptom cluster according to the symptom characteristics; regression analysis showed that: stroke site and NIHSS scores were the influencing factors of the oral-intestinal symptom cluster (all P<0.05); per capita monthly family income, number of episodes and MBI scores were the influencing factors of the negative emotional symptom cluster (all P<0.05); number of chronic diseases, type of stroke, and gender were the influencing factors of the fatigue emotional symptom cluster (all P<0.05); and literacy and stroke site were influencing factors of the perception symptom cluster (all P<0.05). Conclusions:Elderly stroke patients in the acute phase of the existence of more symptoms, symptoms interact with each other to form symptom clusters, health care personnel should be symptom clusters as a unit, the implementation of interventions for their influencing factors, effective symptom management, in order to improve the quality of life of patients.

Clinical study on non-drug treatment of BPSD in senile dementia and its correlation with ApoE gene polymorphism / 中国现代医生

Objective To analyze the effect of non-drug therapy on behavioral and psychological symptom of dementia(BPSD)and its correlation with apolipoprotein E(ApoE)gene polymorphism.Methods A total of 90 patients with senile dementia admitted to Jiangxi Provincial People's Hospital from January 2016 to December 2022 were selected as study objects,they were divided into routine group,control group and observation group according to random number table method,with 30 cases in each group.Patients in routine group were treated with memantine hydrochloride tablets,patients in control group were treated with music therapy on the basis of routine group,patients in observation group were treated with repeated transcranial magnetic stimulation on the basis of routine group,and they were all treated for 12 weeks.BPSD severity,dementia severity,cognitive function,ability of daily living and ApoE gene polymorphism were compared among the three groups.Results Before treatment,there were no significant differences in the scores of neuropsychiatric inventory(NPI),clinical dementia rating(CDR),mini-mental state examination(MMSE)and activity of daily living(ADL)scale among the three groups(P>0.05).After treatment,the NPI and CDR scores of three groups were significantly lower than before treatment,and the MMSE and ADL scores were significantly higher than before treatment(P<0.05).The scores of NPI and CDR in observation group and control group were significantly lower than those in routine group,while the scores of MMSE and ADL were significantly higher than those in routine group(P<0.05).There were ε2,ε3 and ε4 alleles in ApoE,of which ε3 had the highest expression frequency(55 cases),followed by ε4 and ε2.There was no significant difference in detection rate of different ApoE genes among the three groups(P>0.05).The NPI scores of ApoE ε4 patients were significantly higher than those of ApoE ε3 and ApoE ε2 patients(P<0.05).Conclusion Non-drug therapy has a significant effect on senile dementia patients,which can effectively alleviate dementia and BPSD,improve cognitive function and daily living ability.ApoE ε4 gene is closely associated with BPSD in senile dementia patients.

Correlations between self-advocacy and symptom burden of breast cancer patients undergoing chemotherapy / 现代临床护理

Objective To investigate the status of self-advocacy and symptom burden in breast cancer patients undergoing chemotherapy and explore the correlations between them so as to provide a reference for relieving their symptom burden.Methods A total of 240 breast cancer patients undergoing chemotherapy who were treated in a general hospital in Hubei province from July 2021 to January 2022 were enrolled in the study by convenience sampling method.The general data questionnaire,female self-advocacy in cancer survivorship scale,and Chinese version of Anderson symptom assessment scale(MDASI)were applied in the investigation.Pearson correlation analysis was employed to explore the correlation between self-advocacy and symptom burden among breast cancer patients undergoing chemotherapy.Hierarchical regression was employed to analyze the effect of self-advocacy on symptom burden.Results A total of 240 patients completed the study.The total score of self-advocacy of the patients was(68.89±10.66),and the total score of symptom burden was(66.70±18.80).The two variables were significantly correlated in a negative way(r=-0.683,P<0.05).Hierarchical regression showed that self-advocacy ability independently explained 9.3%of the total variation in the symptom burden.Conclusions The incidences of various symptoms in breast cancer patients undergoing chemotherapy are high,and multiple symptoms coexist in the whole chemotherapy cycle.Symptom burden cannot be ignored,for it is negatively correlated with self-advocacy.Therefore,strengthening the concept and ability of self-advocacy can help reduce symptom burden of patients.

Complementary and alternative therapies for symptom clusters in cancer patients:a scoping review / 现代临床护理

Objective To identify the characteristics of complementary and alternative therapies for cancer patients and investigate the effect on symptom clusters in cancer patients,in order to provide references in management of the symptom clusters.Methods A scoping review was conducted to search nine databases,namely PubMed,Cochrane Library,Web of Science,Embase,PsycINFO,CINAHL,CNKI,Wanfang Data,and VIP,for literatures published between January 2016 and January 2024.Results Twenty articles focusing on complementary and alternative therapies were included.Four themes were identified from the retrieved articles:cancer research subjects,characteristics of complementary alternative therapies,type of symptom cluster and effectiveness of complementary alternative therapies.Specifically,the cancer research subjects in relation to symptom cluster management included those of breast cancer,advanced cancer and the cancer under radio or chemotherapy.The most commonly used types of complementary and alternative therapies in managing the symptom clusters were exercise therapies,cognitive-behavioural interventions,traditional Chinese medicine therapies,multidisciplinary collaborative models and specific interventions.Interventions for symptom clusters predominantly targeted fatigue,mental status,pain,and gastrointestinal symptoms.Conclusion The interventions for symptom clusters in complementary and alternative therapies vary across different types of complementary and alternative therapies,so as the effectiveness.Some of the complementary and alternative therapies have unidentified effects and further investigations are required.The complementary and alternative therapies currently that have been used in managing the symptom clusters were found to have shortcomings.Further studies should focus on sentinel and core symptoms of symptom clusters and emphasize the development of standardised and individualised intervention plans based on symptom management theories,hence to improve the management of symptom clusters in cancer patients.

Establishment of a risk assessment model based early warning system for infectious diseases / 现代医院

Objective To establish a risk assessment model based infectious disease early warning system and promote the improvement of infectious disease management level.Methods By collecting and organizing the latest research results,and referring to the theoretical framework of the relevant infectious disease early warning evaluation index system,a risk assessment model based infectious disease early warning system is constructed.Results A total of 12 experts were included in this study,and three primary indicators were selected,including pre-epidemic indicators,typical symptom period indicators,atypical symp-tom period indicators,and 7 secondary indicators.The average score for necessity of the system was 8.27±0.24 points,and the average score for accessibility was 7.74±0.34 points.Conclusion The establishment of an infectious disease early warning sys-tem based on risk assessment models is conducive to timely following the epidemic trend of infectious diseases in the local area,analyzing the distribution trend of survey indicators,and proposing corresponding early warning plans,which can provide relevant basis for effective prevention of infectious diseases.

Application of mind mapping in combination with scenario simulation teaching based on symptom management theory in geriatric symptom nursing education / 中华医学教育探索杂志

Objective:To evaluate the application of mind mapping in combination with scenario simulation teaching based on symptom management theory (SMT) in geriatric symptom nursing education, and to provide a basis for improving the quality of geriatric symptom nursing education.Methods:A total of 80 nursing students who interned in the Department of Geriatric Medicine of Peking Union Medical College Hospital from August 2022 to April 2023 were included in the study. They were divided into control group and experimental group according to the order of enrollment, with 40 students in each group. The control group employed traditional teaching methods, while the experimental group implemented a method of mind mapping in combination with scenario simulation teaching based on SMT. The general data, training assessment results, and teaching quality satisfaction were compared and analyzed between the two groups. SPSS 22.0 statistical software was used for t-test and chi-square test. Results:There were no significant differences between the two groups in general data such as age, gender, educational background, academic performance, and school of study. The experimental group showed higher scores in geriatric symptom nursing theory assessment [(86.57±8.41) vs. (80.83±9.16), P=0.018] and comprehensive skill assessment [(91.26±7.29) vs. (81.92±8.64), P<0.001], as compared with the control group. The experimental group also showed higher scores in teaching process [(24.52±1.56) vs. (20.18±0.98), P<0.001], teaching methods [(24.49±1.72) vs. (20.65±1.02), P<0.001], teaching effectiveness [(24.35±1.19) vs. (20.01±0.86), P<0.001], teaching content [(24.31±1.83) vs. (20.27±1.21), P<0.001], and overall satisfaction [(97.67±2.80) vs. (81.11±2.53), P<0.001]. Conclusions:The method of mind mapping in combination with scenario simulation teaching based on SMT has a significant positive effect on geriatric symptom nursing education. This method can improve the theoretical and comprehensive skill levels as well as the teaching quality satisfaction of nursing interns.