Objective To investigate the injury characteristics of 33 children of Lushan earthquake victims no more than 14 years old treated in the West China Hospital of Sichuan University, and to put forward the early rehabilitation strategy. Methods A total of 33 earthquake children victims were investigated with the modified barthel index score (MBI) and analyzed in following aspects: age, causes, and injury. Results a) The 33 children victims accounted for 10.28% of the total earthquake victims treated in the hospital, they were all no more than 14 years old, and the average age was 7.24 years old. 17 cases were fractures of trunk and limbs, six were traumatic brain injury, and four were soft tissue injury. b) The main traumatic causes were crush by falling objects and heavy stuffs; and some children rarely suffered from hurt, burn and fall injury when running. c) Most children victims were simple open injuries and fractures, especially the limbs fractures accounted for 51.51% of the total cases, and there was only one case suffered from abdominal organ injuries. d) Among 33 children victims, 30 (90.9%) were from the towns and villages. They mainly got injured by the collapse of house or courtyard walls which were not as ber as the house in the cities, so the incidence of severe injury was lower, the degree of injury was milder, and the injury of major organ was rarer. Conclusion Early rehabilitation treatment is helpful to prevent the complications and early recover the functions. It suggests the early rehabilitation treatment should be carried out for the earthquake children victims in order to promote the fracture healing and functional recovery, as well as to prevent the complications. In addition, attention should also be paid to the psychological problems while concerning rehabilitation training.
Objective To systematically review the psychological resilience intervention in China, so as to evaluate its effectiveness. Methods Studies published as of October 2012 were searched in CBM, VIP, CNKI and WanFang Data. The randomized controlled trials (RCTs) and controlled before-and-after trials (CBAs) about psychological resilience intervention were included. Two reviewers independently performed screening, quality assessment and data extraction, and then reached a consensus after cross-check and discussion. Qualitative synthesis was adopted instead of meta-analysis for the existed significant deviations in outcomes of included studies. Results A total of 8 studies including 3 RCTs and 5 CBAs were included for the analysis. All the studies referred to the objects of students, including 6 for college students, 1 for secondary school students and 1 for left behind students in rural junior school. All 8 studies evaluated the effectiveness of group psychological guidance, 1 of which also compared the outcomes of psychological lectures. All the included trials suggested that group psychological guidance and psychological lectures might significantly improve the psychological resilience of subjects. Conclusion Current studies on psychological resilience intervention are limited, the measure has been taken seems relatively single, which mainly focuses on students and lacks of high-quality research design. It suggests take more diverse psychological resilience interventions for different population, and evaluate both short-term and long-term effectiveness by performing large sample, strictly designed and high-quality trials.
In the hospital where centralized treatment was applied for the victims after Yiliang earthquake (on 7th September, 2012), a holistic rehabilitation service mode which centred on supportive psychological intervention promoting was developed by the Yiliang psychological crisis intervention team designated by the National Health and Family Planning Commision of the People’s Republic of China. The pattern takes psychological nurses as liaison, bases on the integrity and continuity of medical service, roots in comprehensive health assessment and key assessment of mental trauma stress, emphasizes on solving realistic problems for patients and their caregivers, provides supportive psychological intervention, and encourages psychological nurses to offer psychological support for earthquake victims with the help of quantitative self-assessment of social psychological support service. In practice, the mode of psychological services, which could be contiuously conducted, is welcomed by hospital managers, work staff, and earthquake victims and their caregivers.
Shortly after the earthquake in Min county and Zhang county, the department of health of Gansu province immediately established a leadership team for earthquake relief and medical rescue, subordinated by psychological crisis intervention teams, which was responsible for training relevant personnel to carry out psychological intervention, and spreading related knowledge about earthquake. Then, emergency psychological intervention was provided for the key population (more than 90 times in total, involving 8 194 person-times). We also offered individualized psychological services (617 person-times), and diagnosed 31 patients with mental disorders through consultation. After the earthquake, the emotion of victims including depression, anxiety and acute stress disorder increased. The workload of psychological crisis intervention after earthquake was heavy and hard. However, Gansu province needs national support due to poor resources.
Objective To investigate the mental health status, perceived social support, as well as the relationship between them among middle school students in Wenchuan Earthquake region, so as to provide references for the relevant department to formulate appropriate strategies and intervention measures. Methods A cluster sampling method was adopted to select all 1698 students (excluded the students in Grade 3) as the research subjects from three middle schools in the disaster regions. All students were investigated with self-designed basic information questionnaire, Symptom CheckList 90 (SCL-90) and Perceived Social Support Scale (PSSS) through self-administered questionnaire. Results The overall positive rate on the SCL-90 was 46.3% among 1690 students, of whom 66.6% had mild psychological problems and 26.5% had moderate to severe psychological problems. The positive rate on the SCL-90 and the score for each factor of SCL-90 were statistically higher in the female students than male students (Plt;0.05). Compared with the senior middle school students, the score on the phobic anxiety subscale of the SCL-90 was statistically higher in the junior middle school students (Plt;0.05), while the score on the obsessive-compulsive subscale was otherwise statistically lower (Plt;0.05). With the exception of the hostility subscale, the score on each subscale of the SCL-90 in the urban students was statistically lower than the rural students (Plt;0.05). The median score on the perceived social support subscale was 60.00, with significant differences between the students of different sexes and grades (Plt;0.05). The overall score on the perceived social support subscale was negatively correlated with the SCL-90 score (r= –0.261, Plt;0.05). The score was negatively correlated with the SCL-90 score in the students regarding different sexes, grades and living areas prior to the earthquake (Plt;0.05). Conclusion The middle school students in the disaster regions have prominent psychological problems; perceived social support is helpful to promote the development of their mental health. In conducting psychological intervention, the difference of individuals’ mental health among different student groups should be concerned, so as to carry out targeted counseling and education.
Objective To systematically analyze the factors influencing the left-behind children’s mental health. Methods After the search term and strategy were confirmed by researchers, four Chinese databases including Chinese Biological Medical Literature Database (CBM), Chinese Science and Technology Periodical Database (VIP), China National Knowledge Infrastructure (CNKI) and WanFang Database (WF) were searched to collect papers, published before March 2011, on relevant factors influencing mental health of left-behind children in China. Then two reviewers independently screened, extracted and cross-checked the data, and the disagreements were resolved by discussion or by consulting a third reviewer. Qualitative synthesis method was used to analyze the study results. Results Of the total 3 252 records, 49 studies were included. The results of qualitative analysis showed that factors influencing left-behind children’s mental health could be classified into four categories including social factors, family factors, school factors and personal factors. Of the nearly 30 kinds of specific factors, the main ones were gender, age, parent-child relationship, social support, personality and characteristics, and outgoing condition of parents, etc. Conclusion Current research results indicate that many factors have influences on mental health of left-behind children, but the research quality is not high with low argument efficiency. There are still controversies on several factors’ impact. Longitudinal studies with rigorous design are needed to analyze the impact of different factors on the left-behind children’s mental health and to summarize the interaction between various factors, so as to provide scientific evidence for developing practical and effective intervention measures.
Objective To assess the effectiveness of psychotherapy for depression in older patients. Methods We searched the Cochrane Central Register of Controlled Trials (1990 to August 2007), MEDLINE (1966 to August 2007), EMbase (1980 to August 2007), and CMB-disk (1990 to August 2007) to collect randomized controlled trials (RCTs) in which psychotherapy was used to treat depression in older patients. We screened the retrieved studies according to the predefined inclusion and exclusion criteria, evaluated the quality of included studies, and performed meta-analyses by using The Cochrane Collaboration’s RevMan 4.2 software. Results Ten RCTs were included. Compared with placebo, psychotherapy was more effective in decreasing depression score (SMD 0.63, 95%CI – 0.84 to – 0.42). Subgroup analysis showed that cognitive-behavioral therapy, reminiscence therapy, and general psychological therapy were more effective than placebo (SMD – 0.70, 95%CI – 1.12 to – 0.27; SMD – 0.54, 95%CI – 0.81 to – 0.26; SMD – 0.84, 95%CI – 1.34 to – 0.34, respectively). However, psychotherapy as an adjunct treatment could not significantly improve the effectiveness of antidepressant medication (SMD – 0.35, 95%CI – 0.74 to 0.05). There was no significant difference between cognitive-behavioral therapy and reminiscence therapy in improving depression symptoms (SMD 0.13, 95%CI – 0.30 to 0.56). The dropout rate was similar between patients treated with or without psychotherapy (RR 1.03, 95%CI 0.55 to 1.94). Conclusion Various kinds of psychotherapy are effective for depression in older patients. But psychotherapy as an adjunct treatment could not significantly improve the effectiveness of antidepressant medication.
目的 探讨地震应激对胃泌素、生长抑素、血清超氧化物歧化酶（SOD）活性和丙二醛（MDA）水平的影响，为震后灾区人群应激性溃疡的防治提供理论依据。 方法 随机抽取四川省人民医院2008年5月15日－31日间收治的60名5.12汶川地震灾民为研究组，58名健康体检者作为对照组。分别对两组人群进行心理调查，采用酶联免疫吸附法测定血清胃泌素和生长抑素水平，利用生化法检测血清SOD活性和MDA含量，并对上述各指标在两组间的分布进行比较。 结果 研究组症状自评量表得分高于对照组（P＜0.05）；两组血清胃泌素分别为（1.04 ± 0.67）、（0.74 ± 0.58） ng/mL，研究组高于对照组（P＜0.01）；两组MDA水平分别为（7.16 ± 5.58）、（4.83 ± 4.48） nmol/mL，研究组高于对照组（P＜0.05）；而两组生长抑素分别为（0.74 ± 0.94）、（1.92 ± 3.05） ng/mL，研究组低于对照组（P＜0.01）；两组SOD分别为（6.06 ± 2.20）、（7.79 ± 1.58）U/mL，研究组低于对照组（P＜0.01）。 结论 地震可引起生理应激状态，导致机体在免疫、抗氧化能力、胃肠激素等方面出现一系列变化，胃泌素、生长抑素等均参与应激性疾病的形成，这些变化可能导致地震灾区消化性溃疡高发。
【摘要】 目的 通过比较遗忘型轻度认知障碍（amnestic mild cognitive impairment，aMCI）和血管性认知障碍非痴呆型（vascular cognitive impairment-no dementia，VCI-ND）患者及正常老年人群在简易智能精神状态检查量表（mini mental state examination，MMSE）、听觉词语学习测验（auditory verbal learning test，AVLT）、画钟试验（clock drawing test，CDT）及临床痴呆评定量表（clinical dementia rating scales，CDR）中的表现，进一步分析aMCI和VCI-ND在认知损害方面的不同特点。 方法 选取首都医科大学宣武医院神经内科门诊收治aMCI患者23例及VCI-ND患者27例（CDR＝0.5分），同时选取40名正常老年人（CDR=0分）作为对照组。每位受试者均进行MMSE、AVLT、CDT及CDR等神经心理学量表测查，分析以上3组被试各项神经心理学测查得分之间的差异。 结果 各组受试者的年龄、性别及受教育程度差异无统计学意义（Pgt;0.05），具有可比性。aMCI和VCI-ND组在MMSE、CDT、即刻记忆、延迟记忆及延迟再认检测中的平均值均低于对照组，且差异均具有统计学意义（Plt;0.05）。aMCI和VCI-ND两组除延迟再认检测外，其余各项测查的平均分均无统计学意义（Pgt;0.05）。在延迟再认检测中，aMCI组（6.65±4.00）较VCI-ND组（8.67±2.76）再认词语数量少，两组延迟再认的得分均低于对照组（12.83±1.77），差异有统计学意义（Plt;0.05）。 结论 aMCI和VCI-ND在记忆力、执行能力和信息处理能力方面较正常老年人均有所损害。由于aMCI和VCI-ND不同的病理改变，导致患者存在不同类型的记忆储存和提取机制。【Abstract】 Objective To investigate the different patterns of cognitive impairment in patients with amnestic mild cognitive impairment (amci), vascular cognitive impairment-no dementia (VCI-ND) and normal elder people. Methods A total of 23 patients with aMCI and 27 patients with VCI-ND (CDR＝0.5) and another 40 healthy elder people (CDR=0) were selected. Each individual underwent the neuropsychological tests, including mini mental state examination (MMSE), auditory verbal learning test (AVLT), clock drawing test (CDT), clinical dementia rating scales (CDR) and hamilton rating scale for depression (HAMD). The differences between the three groups were analyzed. Results The differences in age, sexes, and the education background among the three groups were not significant (Pgt;0.05) which meant comparability. The mean scores of MMSE, CDT, instant memory and delayed awareness in aMCI and VIC-ND group were much lower than that in the control group (Plt;0.05). The differences in all the test items except for delayed awareness between aMCI group and VCI-ND groups were not significant (Pgt;0.05). However, in the recall recognition test, these three groups had significant differences: the score in patients with aMCI (6.65±4.00) was much lower than that in patients with VCI-ND (8.67±2.76; Plt;0.05), and the scores of the two groups were both lower than that in the normal aging group (12.83±1.77; Plt;0.05). Conclusion Compared with normal elder people, the cognition of aMCI and VCI-ND patients is impaired severely. The memory tests suggeste that compared with aMCI patients, VCI-ND patients may have different neuropathological changes leading to different mechanism of memory encoding and retrieval.