ObjectiveTo collect and analyze the clinical data and quality of life of hemophilic children, understand the present condition of these patients in Sichuan Province, and analyze related influencing factors. MethodWe retrospectively analyzed the clinical data of hemophilic children treated in our hospital from January 1, 2008 to May 30, 2015. ResultsThere were 92 child patients from Sichuan Province with a median age of 9.6 years old (ranging from 3.6 to 18.0). There were 87 cases (94.6%) of hemophilia A and 5 (5.4%) of hemophilia B; the number of light cases was 4 (4.3%), of moderate cases was 67 (72.8%), and of severe cases was 21 (22.9%); eighteen (19.6) of the patients had family history. First bleeding episode occurred at a median age of 11 months (0-48 months). Mild bleeding occurred in 23 cases (25.0%), moderate bleeding in 31 cases (33.7%), and severe bleeding in 38 cases (41.3%). First bleeding site was mainly the mucous membrane of the skin, followed by the joint muscles. Fist joint bleeding occurred at a median age of 18 months (2-107 months). Forty-six patients (59.0%) had severe joint damage during the course of the disease. Intracranial hemorrhage occurred in 4 patients (4.3%), among whom 3 were cured and discharged from the hospital, and 1 had neurological sequelae. Median diagnostic age was 12 months (0-120 months). Sixty-two (67.4%) were diagnosed in a short period of time, 9 (9.8%) in a mediate period of time, and 21 (22.8%) in a long period of time. Forty (43.5%) of the patients had been given sufficient coagulation factors, while all the others had not received sufficient replacement therapy. Fifty-six (60.9%) children had received prophylactic treatment. First prophylaxis was administrated at a median age of 36 months (1-199 months), but 27 (48.2%) discontinued. The median score of the 29 retreated Disease Burden Scale was 22.7±11.6 (4-43), and among them, 11 (37.9%) could not care for themselves. Twenty-three participated in the assessment of social activity ability, among whom, 2 did not attend school, and 6 could not take part in the assessment because of school learning. Correlation analysis showed that there was no significant relationship between diagnostic timing and family history (P=0.795) or between diagnostic timing and areas they came from (P=0.495). However, significant association was found between diagnostic timing and the severity of first bleeding (r=0.392, P=0.035). Disease burden of family was significantly correlated with the number of target joints (r=0.370, P=0.048), and was not closely related with area, severity of bleeding, frequency of hemorrhage, medical insurance, or physical and social activities. ConclusionsThe general diagnosis and treatment condition of child hemophilia in Sichuan is relatively under-developed with a high prevalence of joint damage, poor quality of life, and high disease burden to the family. Improvement in the care of hemophilia children is urgently needed.
ObjectiveTo explore the disability of social function of gastrointestinal outpatients with depressive or anxiety disorders in general hospitals. MethodsA multicenter cross-sectional study was conducted from May to June in 2007. A total of 1 995 subjects from 13 general hospitals in China were screened by using the Hospital Anxiety and Depression Scale (HADS). The subjects scored≥8 on HADS were diagnosed via the Mini International Neuropsychiatric Interview by psychiatrists. The Sheehan Disability Scale (SDS) was used to assessed patients' disability of life, work, and social intercourse aspects. Then, compared the subjective quality of life, number of doctor visits, and monthly loss of working days between outpatients with and without depressive or anxiety disorders in last six months. Further, compared the social dysfunction between patients with depression/anxiety disorders (the case group) and without depression/anxiety disorders (the control group) in functional disorders group and organic disease group of gastroenterology respectively. ResultsIn comparison to the control group, the case group had much higher score of SDS, including life, work, and social intercourse (P<0.05) aspect and had more doctor visits and loss of more working days (P<0.05). In functional disorders group of gastroenterology, the case group had much higher score of SDS, including life, work, and social intercourse (P<0.05) aspect and had more doctor visits, loss of more working days (P<0.05) compared with those in the control group. In organic disease group of gastroenterology, the case group had much higher score of SDS, including life, work, and social intercourse (P<0.05) aspect and had loss of more working days (Z=-4.307, P<0.001) compared with those in the control group. ConclusionFor the patients with functional disorders or organic disease of gastroenterology, the depressive and anxiety disorders may lead to the disability of social function.