ObjectivTo investigate the incidence of depression and its etiological factors in patients with hypospadias after operation. MethodsFrom January to June 2015, we investigated the incidence of depression symptoms among patients with hypospadias after surgical treatment from January 1990 to December 1994 in Zhangzhou Affiliated Hospital of Fujian Medical University, and we matched them with mentally healthy adults of the same age to 1:1 ratio. Zung Self-Rating Depression Scale and Correlation Factor Questionnaire were used to investigate and analyze the related factors of depression symptoms between the patients with hypospadias and the healthy males. ResultsA total of 80 patients with hypospadias after surgical treatment and 80 healthy males as control were included. There were no significant differences in male secondary sexual development, testis development, serum testosterone levels and postoperative length and girth of the penis in two groups. The incidence rate of depression symptoms was 45.0% (16/80) in the hypospadias patients after operation, extremely significantly higher than 6.3% (5/80) in the control group (χ2=6.632, P=0.01). The result of multiple stepwise regression analysis showed that the main risk factors of depression symptoms were worries about dissatisfaction with penile and scrotal appearance (F=16.210 3, P=0.001), sexual satisfaction (F=4.621 2, P=0.036) and sexual function (F=4.103 2, P=0.043). ConclusionSymptoms of depression often occur in hypospadias patients after operation, and the major etiological factors are dissatisfaction with penile and scrotal appearance, sexual satisfaction and sexual function.
In this paper, the response of individual's physiological system under psychological stress state is discussed, and the theoretical support for psychological stress assessment research is provided. The two methods, i.e. the psychological stress assessment of questionnaire and physiological parameter assessment used for current psychological stress assessment are summarized. Then, the future trend of development of psychological stress assessment research is pointed out. We hope that this work could do and provide further support and help to psychological stress assessment studies.
ObjectivesTo develop a tool to assess the credibility of cohort studies regarding anticoagulants treatment for patients with atrial fibrillation.MethodsMEDLINE, EMbase and CBM databases were retrieved for eligible studies on the methodological quality and credibility of the cohort study. The retrieval period was from inception to December 19th, 2017, and the languages were limited to Chinese and English. Based on the search results, the items on the methodology quality of the research or the credibility of the results were collected. Through brainstorming of the core group, the collected items were expanded and sorted out to a preliminary scale. Furthermore, we conducted 4 rounds of internal expert seminars to discuss and evaluate the preliminary scale content and discuss the scale framework. Finally, we organized domestic authoritative experts to conduct 4 external evaluations on the scale and formed the final scale.ResultsA total of 7 734 literatures were obtained from primary search, in which 17 of which were included. Fifty-five tools with 780 items for the quality assessment of observational studies were collected from the included studies. After removing duplicated keywords with similar meanings, we obtained the " keyword pool” with 46 keywords, which were preliminarily formed 46 items. After discussion of the core group, which aimed to supplement the potential items, eliminate the items irrelevant to methodology, and integrate the items with partial overlapping meanings, a preliminary scale of 43 items was formed. According to the four rounds of internal expert consultative meetings, these items were integrated to form a preliminary scale of 40 items. After further evaluation by four rounds of external expert consultative meetings, a consensus was reached and a scale of 21 items from seven domains (i.e., definition of question, measurement, follow-up, confounder, missing data, statistical analysis, and results assessment) was finally formed.ConclusionsThis study developed an assessment tool for the credibility of the results from the cohort studies regarding anticoagulants treatment in patients with atrial fibrillation, which has practical clinical value. Clinicians can refer to the results of credibility assessment by using this tool to better assist clinical decision-making in clinical practice. In addition, in the preparation of relevant guidelines, this tool can be used to assess the credibility of results from cohort studies.
ObjectiveTo explore the value of three brief scales (BAP-65 class, DECAF score, and CAPS) on assessing the severity of acute exacerbation in patients with chronic obstructive pulmonary disease(COPD) complicated by hypercapnic respiratory failure. MethodsTwo hundred and forty-four cases with acute exacerbation of COPD complicated by hypercapnic respiratory failure, admitted in West China Hospital from August 2012 to December 2013, were analyzed retrospectively.The scores of each scale were calculated.The areas under the receiver operating characteristic curves (AUROC) of each scale for hospital mortality, mechanical ventilation use, mortality of patients requiring mechanical ventilation, invasive mechanical use were analyzed and compared. ResultsThe AUROCs of BAP-65 class, DECAF score and CAPS for hospital mortality were 0.731, 0.765, and 0.711; for mechanical ventilation were 0.638, 0.702, and 0.617; for mortality of patients requiring mechanical ventilation were 0.672, 0.707, and 0.677; for invasive mechanical ventilation use were 0.745, 0.732, and 0.627(BAP-65 vs.CAPS, P < 0.05).Mortality and mechanical ventilation use increased as the three scales escalated.In the patients whose BAP-65 or DECAF score were more than 4 points, the hospital mortality was nearly 50%, and about 95% of the patients underwent mechanical ventilation. ConclusionsThe BAP-65 class, DECAF score, and CAPS of patients on admission have predictive values on assessing the severity of acute exacerbation in patients with COPD complicated by hypercapnic respiratory failure, especially the simple and practical BAP-65 class and DECAF score.
Objective To evaluate the reliability and validity of the Chinese version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS) in preoperative anxiety in patients with local anesthesia. Methods From May to December 2020, a convenient sampling method was used to conduct an APAIS questionnaire survey on patients undergoing percutaneous renal biopsy in the Department of Nephrology, West China Hospital, Sichuan University, and the reliability and validity of the scale were analyzed. ResultsA total of 460 questionnaires were distributed and 444 valid questionnaires were returned, with a valid response rate of 96.5%. The Cronbach α of APAIS was 0.896, the Guttman split-half reliability was 0.811, and the content validity index was 0.891. The model fit was 12.122 for the chi-square fit index/degree of freedom, 0.916 for the goodness-of-fit index, 0.902 for the value-added fit index, 0.079 for the root mean square error of approximation, and 0.946 for the comparative fit index. The APAIS anxiety subscale score was positively correlated with the 7-item Generalized Anxiety Disorder Scale score (r=0.518, P<0.001). Conclusion The APAIS has good reliability and validity for evaluating the level of preoperative anxiety in patients with local anesthesia, but the application of the scale in other conditions requires further testing.
Objective To construct a nomogram model for predicting delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) in emergency departments. Methods All patients with acute carbon monoxide poisoning who visited the Department of Emergency of Zigong Fourth People’s Hospital between June 1st, 2011 and May 31st, 2023 were retrospectively enrolled and randomly divided into a training set and a testing set in a 6∶4 ratio. LASSO regression was used to screen variables in the training set to establish a nomogram model for predicting DEACMP. The discrimination, calibration, and clinical practicality were compared between the nomogram and Glasgow Coma Scale (GCS) in the training and testing sets. Results A total of 475 patients with acute carbon monoxide poisoning were included, of whom 41 patients had DEACMP. Age, GCS and aspartate aminotransferase were selected as risk factors through LASSO regression, and a nomogram model was constructed based on these factors. The areas under the receiver operating characteristic curves for nomogram and GCS to predict DEACMP in the training set were 0.897 [95% confidence interval (CI) (0.829, 0.966)] and 0.877 [95%CI (0.797, 0.957)], respectively; and those for nomogram and GCS to predict DEACMP in the testing set were 0.925 [95%CI (0.865, 0.985)] and 0.858 [95%CI (0.752, 0.965)], respectively. Compared with GCS, the performance of nomogram in the training set (net reclassification index=0.495, P=0.014; integrated discrimination improvement=0.070, P=0.011) and testing set (net reclassification index=0.721, P=0.004; integrated discrimination improvement=0.138, P=0.009) were both positively improved. The calibration of nomogram in the training set and testing set was higher than that of GCS. The decision curves in the training set and testing set showed that the nomogram had better clinical net benefits than GCS. Conclusion The age, GCS and aspartate aminotransferase are risk factors for DEACMP, and the nomogram model established based on these factors has better discrimination, calibration, and clinical practicality compared to GCS.
ObjectivesTo establish statistical analysis and result reporting model for evaluation of the applicability of the clinical guidelines. We conducted empirical study for clinical guidelines for diagnosis and treatment of renal transplantation rejection in China.MethodsA cross-sectional survey was conducted to select 16 medical institutions in China which had carried out kidney transplantations. In each medical institution, 6 to 8 clinicians from the kidney transplantation department or related departments were selected to complete the questionnaire. Descriptive analysis was carried out for characteristics of evaluators, scores of each dimension, access to guidelines and factors affecting implementation. The Kruskal-Wallis rank sum test and Nemenyi test were used for multi-group comparison and pairwise comparison. Multiple linear regression with stepwise strategy were used to screen out the association factors.ResultsIn this survey, 128 questionnaires were distributed, in which 105 valid questionnaires were collected, and the recovery rate was 82.03%. The subjects of this survey were all kidney transplant clinicians from public tertiary hospitals, with an average 10.95 years of working time. The results showed the accessibility score was lowest and the acceptability score was highest. The results of multi-group comparison and multiple linear regression analysis showed that familiarity with the guidelines was the influencing factor of each score (P<0.05). The guidelines were primarily obtained from biomedical literature database (73.3%), academic journals (55.2%) and academic conferences (55.2%). Among the evaluators, 44 (41.9%) believed that there were implementation obstacles in the guidelines, among which 40 (38.1%) believed that implementation obstacles were environmental factors.ConclusionsThe applicability of clinical guidelines for diagnosis and treatment of renal transplantation rejection in China is adequate. However, the publicity of the guideline requires improvement. As the guideline is updated, consideration should be given to including access to the guideline, adding free public information promotion, and familiarizing clinicians with the guidelines through training programs to promote application of the guideline.
Objective To investigate the early motor development and the risk factors affecting motor development in children with congenital muscular torticollis (CMT) aged 0–3 months. Methods CMT infants admitting to the Department of Rehabilitation Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between January 1st, 2016 and April 30th, 2018 were enrolled as CMT group, and contemporaneous age-matched healthy infants were enrolled as the control group. Motor development was assessed with the Alberta Infant Motor scale (AIMS). We collected the birth weight, birth length, mode of birth, sleep position, and prone time when awake as dependent variables, and used multiple linear regression to find the variables that had significant effect on AIMS scores. Results There were 97 CMT infants (62 males and 35 females) with the mean age of (46.8±17.3) days, mean birth weight of (3.34±0.38) kg and mean birth length of (49.56±0.93) cm in the CMT group, while there were 97 healthy infants (60 males and 37 females) with the mean age of (45.1±19.4) days, mean birth weight of (3.38±0.35) kg and mean birth length of (49.84±1.03) cm in the control group, and the differences in sex, age, birth weight, birth length between the two groups were not statistically significant (P>0.05). AIMS centiles showed that 36 infants (37.1%) in CMT group had suspicious or abnormal motor development, while only 12 infants (12.4%) in the control group had; there was a significant statistical difference between the two groups (χ2=15.945, P<0.001). Multiple linear regression analysis showed that the time of prone position when awake and CMT had significant influence on the AIMS scores (F=64.851, P<0.001). Infants who had a long prone position when awake had significantly higher AIMS scores and CMT had a significantly lower AIMS scores (P<0.001). Conclusions The risk of early motor retardation in infants with CMT aged 0–3 months is higher than that in healthy infants of the same age. The decrease in prone position when awake and CMT may be the causes of delayed motor development. Clinical medical personnel and family caregivers should pay more attention to motor development and provide reasonable intervention to CMT infants.
ObjectiveTo investigate prevalence of anxiety and depression in chronic obstructive pulmonary disease (COPD) in order to increase the awareness of physicians on this comorbidity.MethodsPatients were from a multicenter prospective cohort study and 13 institutions or hospitals participated in the study. Four hundred and ten patients with a prior diagnosis of COPD were prospectively recruited from January 2017 to January 2019, and baseline date were analyzed. Hospital Anxiety and Depression Scale was used to identify anxiety and depression.ResultsThe cohort had a mean age of (60.7±10.0) years with 76.8% males and 74.3% smokers. Seventy-nine patients (19.3%) had anxiety or depression. Among them, 36 subjects (8.8%) had anxiety, and 64 patients (15.6%) were with depression, and 21 patients (5.1%) with anxiety and depression. The prevalence of severe anxiety (2.7%) and severe depression (2.4%) was low. Compared to patients without anxiety or depression, patients with anxiety or depression had significantly higher CAT scores (17.8±9.3 with anxiety, 17.4±8.4 with depression, 12.5±7.3 without anxiety or depression, P 0.002 and 0.000 respectively). The risk of acute exacerbations was higher in patients with depression (37.5% vs. 22.7%, P=0.016). Proportion of patients categorized into GOLD group D was higher in patients with depression (P=0.001).ConclusionsAbout 20% COPD patients has anxiety or depression. Prevalence of depression is two times that of anxiety. The prevalence of severe anxiety or severe depression is low. Patients with depression have lower quality of life, higher risk of acute exacerbations, and higher proportion of patients categorized into GOLD group D.
With the transformation of modern medical models, patient-reported outcomes, clinician-reported outcomes, observer-reported outcomes, and performance outcomes have become internationally recognized clinical outcome assessment indicators, and scales have also become important evaluation tools, among which translation and cross-cultural adaptation are one of the important sources of scales. However, at present, there are fewer guidelines for scale translation in China. At present, domestic scale translation has not yet been unified and standardized in clinical reporting. Most translation reports provide readers with incomplete information, which affects the development of scale translation, and the methodology related to the translation of clinical outcome assessment scales still focuses on patient-reported outcome scales, which creates a gap in terms of the recommendations for the rest of the types of translations, a gap which leads to inconsistencies in the translation methodology and process. In this paper, we will develop specific translation methods and processes for each of the four current types of clinical outcome assessments by combining scale translation guidelines to support a standardized approach to translation, cross-cultural adaptation, and linguistic validation for use in standardizing the process of recommending translations of patient-reported outcome scales, clinical-reported outcome scales, observer-reported outcome scales, and behavioral outcome scales.