目的 探讨糖耐量异常患者的焦虑抑郁状况及其与生活质量的相关性，为糖尿病相关心理问题的早期识别与干预提供参考。 方法 以2010年1月－2012年6月糖耐量异常患者145例为试验组，健康人群147例作为对照组，两组分别填写焦虑自评量表（SAS）和抑郁自评量表（SDS），试验组还需填写世界卫生组织生活质量测定量表简表（WHOQOL-BREF）并对其焦虑、抑郁得分与WHOQOL-BREF的各因子的相关性进行分析。 结果 145例患者中有51例（35.2%）存在抑郁情绪，47例（32.4%）存在焦虑情绪，焦虑合并抑郁情绪者29例（20%）。糖耐量异常患者焦虑、抑郁评分明显高于对照组（P＜0.01），其生活质量多个领域评分低于对照组（P＜0.01），且生活质量与焦虑、抑郁情绪存在负相关（P＜0.05）。 结论 糖耐量异常患者焦虑、抑郁情绪明显高于正常人群，其生活质量偏低，提示了对在该人群进行早期心理干预的必要性。
Objective To explore the safety and clinical efficacy of right chest minithoracotomy for left atrial myxoma resection. Methods We retrospectively analyzed clinical data of 32 patients with left atrial myxoma resection by right chest minithoracotomy (a small incision group, 9 males, 23 females at age of 59.1±9.5 years) in our hospital from July 2011 through March 2015. Meanwhile, we selected 17 patients with left atrial myxoma treated by conventional chest median sternotomy as a control group (7 males, 10 females at age of 60.0±9.0 years). Clinical results of the two groups were compared. Results There was no statistical difference in preoperative clinical data of the patients between the two groups. All the patients were successfully operated. Patients in the small incision group had longer aortic clamping time than that in the control group. But there were shorter postoperative mechanical ventilation time (9.5±4.9 h), shorter ICU stay time (18.6 ± 6.2 h), less amount of thoracic cavity drainage 24 h after drainage (103.8±19.4 ml), lower bleeding reoperation rate (0.0), less blood transfusion after surgery (1.4±1.1U), shorter ambulation time (38.5±6.9 h), shorter hospital stay (8.1 ± 0.9 d), lower postoperative complication rate (0.0) than those of the control group (P<0.05). Conclusion Right chest minithoracotomy left atrial myxoma resection is feasible, safe and effective, is worth promoting.
ObjectiveTo investigate the status of quality of life and influencing factors among newly diagnosed epilepsy patients with co-morbid anxiety and depression. MethodsA total of 180 newly diagnosed epilepsy patients from June 2022 to December 2022 in a district of Shanghai were selected as the study subjects. The Quality of Life in Epilepsy-31 (QOLIE-31), Hamilton Depression Rating Scale (HAMD-24), Hamilton Anxiety Rating Scale (HAMA), and Epilepsy Self-Management Scale (ESMS) were used to assess patients' quality of life, depression levels, anxiety levels, and self-management abilities, respectively. Patients were divided into the co-morbid depression group (HAMA≥14 and HAMD>17) and the control group (HAMA<14 and HAMD≤17), and their general characteristics and scale scores were compared. Spearman correlation, Pearson correlation, and multiple linear regression analysis were used to identify influencing factors of quality of life in epilepsy patients with co-morbid depression. ResultsCompared to the control group, the anxiety comorbid with depression group of older adults had a higher proportion, higher unemployment rate, lower personal and family annual income in the past year, higher frequency of epileptic seizures, and lower medication adherence (P<0.05). The correlational analysis revealed a negative correlation between the quality of life abilities of epilepsy patients with comorbid anxiety and depression and the severity of anxiety and depression. (r=−0.589, −0.620, P<0.05). The results of multiple linear regression analysis showed that the frequency of seizures in the past year (β=−1.379, P<0.05), severity of anxiety (β=−0.279, P<0.05), and severity of depression (β=−0.361, P<0.05) have an impact on the ability to quality of life in epilepsy patients with co-morbid anxiety and depression. These factors account for 44.1% of the total variability in quality of life (R2=0.4411, P<0.05). ConclusionThe frequency of seizures in the past year, as well as the severity of anxiety and depression, are important factors that influence the ability to quality of life in epilepsy patients with comorbid anxiety and depression. For these patients, it is crucial to take into account these factors and provide appropriate support and interventions.
Objective To explore the relationship between depression and quality of life in schizophrenic patients, and the mediating role of sleep quality and weakness. Methods We selected inpatients with schizophrenia from 4 secondary and above psychiatric hospitals in Chengdu for questionnaire survey by convenient sampling method between March and July 2022. The questionnaires included general demographic data, disease-related questionnaire, Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Fried Frailty Phenotype (FFP) and Schizophrenia Quality of Life Scale (SQLS). Results A total of 594 patients were included, including 373 males (62.8%) and 221 females (37.2%). The univariate analysis of the factors affecting the quality of life of the patients showed that there was no significant difference in the age, sex, only child or not, education level, course of schizophrenia, and combined medication (P>0.05), except for the family history of mental disorders (P<0.05). SQLS score was positively correlated with SDS score (r=0.635, P<0.001), PSQI score (r=0.402, P<0.001) and FFP score (r=0.327, P<0.001). The mediation of sleep quality and weakness on depression and quality of life are significant, and chain-mediated effect of depression and quality of life was significant. Conclusion The depression level of schizophrenia patients can not only directly affect their quality of life, but also indirectly affect their quality of life through the mediation of sleep quality, weakness and chain mediation of sleep quality and weakness.
ObjectiveTo explore the trajectories of health-related quality of life (HRQoL) among adolescents after metabolic bariatric surgery and to identify influencing factors. MethodsThis retrospective cohort study included 208 adolescents who underwent metabolic bariatric surgery at the First Affiliated Hospital of Nanjing Medical University from June 2023 to December 2024. Data on quality of life were collected at baseline, 3 months, and 6 months postoperatively, along with related scale assessments at 6 months. Latent class growth modeling was applied to identify trajectory categories of quality of life. Demographic characteristics and scale points were compared across groups, and unordered multinomial logistic regression was used to analyze influencing factors. ResultsThree distinct HRQoL trajectories were identified by latent class growth model: low-level improvement group (102 cases, 49.0%), moderate-level stable group (74 cases, 35.6%), and high-level decline group (32 cases, 15.4%). Significant differences were observed among groups in BMI, percentage of excess weight loss (EWL%), points of body image, self-esteem, objective support, support utilization and appearance anxiety index at 6 months after operation (P<0.05). At 6 months postoperatively, patients in the low-level improvement group had the lowest BMI and the highest EWL%, along with higher body image and support utilization points. Patients in the moderate-level stable group experienced less weight reduction than those in the low-level improvement group, with only limited improvement in quality of life. Although patients in the high-level decline group initially had better preoperative quality of life, they showed the least postoperative weight loss, the lowest body image and support utilization points, and higher appearance anxiety points, with a progressive decline in quality of life. Results of unordered multinomial logistic regression analysis indicated that postoperative BMI, EWL%, points of body image, and support utilization were influencing factors associated with HRQoL trajectories (P<0.05). ConclusionsMetabolic bariatric surgery improves quality of life in most adolescents, yet a subgroup experiences unfavorable trajectories. Postoperative weight loss, body image, and social support are critical determinants. Early identification and targeted interventions are needed to optimize long-term outcomes.
Objective To assess the effects of lung transplantation (LT) in the treatment of end-stage pulmonary arterial hypertension (PAH) and evaluated its impact on quality of life (QoL). Methods A total of 54 patients with end-stage PAH admitted to the LT center of Wuxi People’s Hospital between January 2007 and June 2019 were retrospectively analyzed. The patients were divided into surgical and non-surgical groups. Clinical data were compared between the groups. The clinical data such as symptoms, signs, biochemistry, survival rate and quality of life were compared between the two groups. The effects of lung transplantation on survival and quality of life were analyzed. The quality of life was scored by SF-36 scale. Results A total of 54 patients with end-stage pulmonary arterial hypertension who met the indications for lung transplantation were enrolled. Among them, 36 patients underwent lung transplantation and 18 patients did not undergo surgery. There were no statistical differences in gender, course of disease, disease type, symptoms between the two groups. The uric acid of the non-operation group was significantly higher than that of the lung transplantation group (P=0.014). The systolic pulmonary artery pressure (SPAP) of the non-operation group was significantly lower than that of the lung transplantation group (P=0.046). Kaplan-Meier survival curve showed that the survival rate of the operation group was higher than that of the non-operation group (P=0.0087). The quality of life assessment showed that after lung transplantation, the physical component summary and mental component summary scores of operation group were higher than those before operation (P<0.01), and also higher than non-operation group in the same period (P<0.05). Preoperative low systemic circulation blood pressure, poor cardiac function, high NT-proBNP and high uric acid may be the risk factors for early death of patients with pulmonary arterial hypertension after lung transplantation. Conclusions Lung transplantation can effectively improve survival and also QoL for patients with end-stage PH. Early detection of risk factors and preoperative assessment can help improve the perioperative survival.