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Relationships between selfreflectiveness and clinical symptoms in individuals during pre-morbid and early clinical stages of psychosis

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General Psychiatry 2022年第3期35卷 163-172页

作者： Lihua Xu Huiru Cui Yanyan Wei Zhenying Qian Xiaochen Tang Yegang Hu Yingchan Wang Hao Hu Qian Guo Yingying Tang Tianhong Zhang Jijun Wang Shanghai Intelligent Psychological Evaluation and Intervention Engineering Technology Research Center Shanghai Key Laboratory of Psychotic DisordersShanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina Department of Psychiatry Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina Department of Early Psychotic Disorders Shanghai Mental Health CenterShanghai Jiao Tong University School of MedicineShanghaiChina Center for Excellence in Brain Science and Intelligence Technology(CEBSIT) Chinese Academy of ScienceShanghaiChina Brain Science and Technology Research Center Shanghai Jiao Tong UniversityShanghaiChina

Background Self-reflectiveness,one dimension of cognitive insight,plays a protective role in an individual’s mental state.Both high and low levels of self-reflectiveness have been reported in patients with schizophrenia and individuals at clinical high risk for the illness.Aims This study aimed to explore the relationship patterns between self-reflectiveness and clinical symptoms in individuals during the pre-morbid and early clinical stages of psychosis.Methods A total of 181 subjects,including individuals with attenuated positive symptoms(APS,n=122)and patients with first-episode psychosis(FEP,n=59),completed the Beck Cognitive Insight Scale and were evaluated using the Schedule of Assessment of Insight and Positive and Negative Syndrome Scale.All subjects were classified into three groups according to their level of selfreflectiveness:low level(LSR,n=59),medium level(MSR,n=67)and high level(HSR,n=55).Both linear and nonlinear relationships between self-reflectiveness and clinical symptoms were explored.Results More individuals with APS were classified into the MSR group,while more patients with FEP were classified into the LSR group.The LSR group demonstrated less awareness of illness than the MSR and HSR groups,more stereotyped thinking and poorer impulse control but less anxiety than the MSR group,and lower levels of blunted affect and guilt feelings than the HSR group.The MSR group demonstrated lower stereotyped thinking than the HSR group.Compared to the LSR group,the MSR group had increased selfreflectiveness,improved awareness of illness,decreased stereotyped thinking,and better impulse control,but increased feelings of guilt.The HSR group showed increased stereotyped thinking when compared to the MSR group,but the other variables did not change significantly between these two groups.Overall,self-reflectiveness demonstrated an approximately inverse S-shaped relationship with the awareness of illness,a U-shaped relationship with stereotyped thinking and poor impulse control,and an almost linear relationsh

关键词： clinical symptoms morbid

Prevalence and Types of Comorbidities in Pneumoconiosis—China,2018–2021

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China CDC weekly 2023年第38期5卷 837-843页

作者： Huanqiang Wang Xiangpei Lyu Dong Luo Huaping Dai Department of Occupational Respiratory Disease National Institute for Occupational Health and Poison ControlChinese Center for Disease Control and PreventionBeijingChina Department of Occupational Hygiene and Poisoning Emergency The First Affiliated Hospital of Chongqing Medical and Pharmaceutical CollegeChongqingChina National Center for Respiratory Medicine State Key Laboratory of Respiratory Health and MultimorbidityNational Clinical Research Center for Respiratory DiseasesInstitute of Respiratory MedicineChinese Academy of Medical SciencesPeking Union Medical CollegeDepartment of Pulmonary and Critical Care MedicineChina-Japan Friendship HospitalBeijingChina.

Summary What is already known about this topic?Pneumoconiosis,recognized as one of the most detrimental occupational diseases in China,exhibits a multimorbidity profile due to a plethora of comorbidities and complications.These factors significantly influence the treatment outcomes,progression,prognosis,and overall quality of life of the afflicted patients.

关键词： morbid diseases prognosis

Impact of comorbidities on the prognosis of pediatric vasovagal syncope

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World Journal of Pediatrics 2022年第9期18卷 624-628页

作者： Ya-Ru Wang Xue-Ying Li Jun-Bao Du Yan Sun Wen-Rui Xu Yu-Li Wang Ying Liao Hong-Fang Jin Department of Pediatrics Peking University First HospitalNo.1 Xi’an-men StreetWest DistrictBeijing100034China Department of Medical Statistics Peking University First HospitalBeijingChina Key Laboratory of Molecular Cardiovascular Sciences Ministry of EducationBeijingChina

Vasovagal syncope(VVS)is the primary entity of neurally mediated syncope(NMS)in childhood,and its prognosis is usually considered benign.However,it is found in clini-cal practice that some children with VVS appear to have a frequent recurrence of syncope and poor response to treat-ment[1],which might seriously affect their quality of life[2].In recent years,an increasing number of comorbidities of VVS have been reported.Liao et al.found that 31%of pediatric patients with NMS suffered from allergic disease[3],and Vallejo M reported that more than 50%of patients had headaches[4].These comorbidities might make the clinical manifestations even more complex.However,until now,it has been unclear whether comorbidities are associated with the prognosis of children and adolescents suffering from VVS.Therefore,the present study was conducted to examine whether there is any impact of comorbidities on the prognosis of pediatric VVS to better understand the outcome and management of children and adolescents with VVS.

关键词： syncope morbid pediatric

Symptoms and comorbidities associated with abnormal levels of serum calcium,magnesium,and phosphate in the emergency department:a prospective observational study

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World Journal of Emergency Medicine 2023年第1期14卷 59-61页

作者： Korsin Laohavisudhi Phichayut Phinyo Borwon Wittayachamnankul Boriboon Chenthanakij Theerapon Tangsuwanaruk Parinya Tianwibool Pavita Laohakul Wachira Wongtanasarasin Department of Emergency Medicine Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Department of Family Medicine Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Center for Clinical Epidemiology and Clinical Statistics Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Department of Emergency Medicine University of California Davis School of MedicineSacramentoCalifornia 95817USA

Emergency departments(EDs)play a significant role in hospital healthcare systems.[1]According to the US Centers for Disease Control and Prevention,130 million individuals visited the ED in 2018.[2]A previous study has demonstrated that unnecessary laboratory tests did not change the management plan.[3]These actions led to ED overcrowding,causing consequences to patient outcomes.

关键词： morbid magnesium prospective

Comorbidities,clinical characteristics and outcomes of COVID‑19 in pediatric patients in a tertiary medical center in the Netherlands

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World Journal of Pediatrics 2022年第8期18卷 558-563页

作者： Amrita Biharie Maya WKeuning Katja CWolthers Dasja Pajkrt Department of Pediatric Infectious Diseases Rheumatology and ImmunologyAmsterdam University Medical Centers Location Academic Medical CenterUniversity of AmsterdamMeibergdreef 91105 AZ AmsterdamNetherlands Department of Medical Microbiology Amsterdam University Medical Centers Location Academic Medical CenterUniversity of AmsterdamAmsterdamNetherlands

Having pre-existing comorbidities is described as a risk factor for more severe disease in adult corona virus disease 2019(COVID-19)and in infections with SARS-CoV-1 and MERS-CoV[1].In adult SARS-CoV-2 infections,patients with pre-existing underlying comorbidities,such as chronic obstructive pulmonary disease,cardiovascular disease,diabetes and obesity,are more likely to have severe disease compared to healthy adults[2].An inconsistency is seen in current fndings on the association with comorbidities and pediatric COVID-19 severity.An important limitation in currently available studies is limited data:severe disease is rare in children compared to adults,and most studies describe COVID-19 severity merely by reporting intensive care unit(ICU)admission or mortality rates instead of detailed data on clinical presentation and outcomes.

关键词： morbid pediatric patients

Laryngeal mask airway bougie ultrasonography guided intubation in a morbidly obese patient with diffi cult airway

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World Journal of Emergency Medicine 2023年第3期14卷 241-243页

作者： Rachana Bhat Preeti Yadav Jyothiswaroop Bhaskararayuni Akhil Neseem Savan Kumar Nagesh Prakash Ranjan Mishra Department of Emergency Medicine Kasturba Medical CollegeManipal Academy of Higher EducationManipal 576104India Department of Emergency Medicine All India Institute of Medical SciencesNew Delhi 110029India Department of Anaesthesiology All India Institute of Medical SciencesNew Delhi 110029India Department of Anaesthesiology Kasturba Medical CollegeManipal Academy of Higher EducationManipal 576104India

Airway management of morbidly obese patients is challenging due to inherent anatomical and physiological variations.[1]The frequent association of compromised hemodynamics,hypoxemia,or acidosis in an emergency department(ED)setting adds to the difficulty of the procedure.Rapid airway management position(RAMP),awake fiber-optic guided intubation,use of intubating laryngeal mask airway(ILMA),and video-laryngoscope are a few techniques that have been described to tackle difficult airways in these patients.[2]Studies have shown that the availability of fi ber-optic scopes(3%–60%),videolaryngoscopes(39%–88%),and laryngeal mask airways(LMA)(65%–83%)varies in different ED settings.[3,4]Furthermore,a lack of adequate training and the need for time-bound resuscitation make implementation of the above techniques challenging.

关键词： airway morbid obese

Effects of adalimumab and secukinumab on comorbidities associated with metabolism in patients with plaque psoriasis

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Chinese Medical Journal 2022年第18期135卷 2248-2250页

作者： Si Zhang Lin Cai Heng Zhang Zheng Zhao Xiaoyang Liu Yan Zhao Jianzhong Zhang Department of Dermatology Peking University People’s HospitalBeijing 100044China Department of Dermatology Peking University International HospitalBeijing 102206China

To the Editor:Psoriasis is often associated with comorbidities such as cardiovascular diseases,obesity,and metabolic syndrome(MS).However,the prevalence of abovementioned diseases in Chinese patients with plaque psoriasis is still unknown.Recently,biologics such as tumor necrosis alpha inhibitors,interleukin-17A inhibitors have been successfully used in the treatment of plaque psoriasis.However,the effects of biological treatment on comorbidities associated with metabolism are still controversial.Study on the relationship between the comorbidities associated with metabolism and plaque psoriasis and the effects of biologics are necessary.

关键词： metabolism psoriasis morbid

Non-invasive prediction of non-alcoholic steatohepatitis in Japanese patients with morbid obesity by artificial intelligence using rule extraction technology

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World Journal of Hepatology 2018年第12期10卷 934-943页

作者： Daisuke Uehara Yoichi Hayashi Yosuke Seki Satoru Kakizaki Norio Horiguchi Hiroki Tojima Yuichi Yamazaki Ken Sato Kazuki Yasuda Masanobu Yamada Toshio Uraoka Kazunori Kasama Department of Medicine and Molecular Science Gunma University Graduate School of Medicine Department of Gastroenterology and Hepatology Gunma University Graduate School of Medicine Department of Computer Science Meiji University Tama-ku Weight Loss and Metabolic Surgery Center Yotsuya Medical Cube Department of Metabolic Disorder Diabetes Research Center Research Institute National Center for Global Health and Medicine Department of Internal Medicine Division of Endocrinology and Metabolism Gunma University Graduate School of Medicine

AIM To construct a non-invasive prediction algorithm for predicting non-alcoholic steatohepatitis(NASH), we investigated Japanese morbidly obese patients using artificial intelligence with rule extraction technology.METHODS Consecutive patients who required bariatric surgery underwent a liver biopsy during the operation. Standard clinical, anthropometric, biochemical measurements were used as parameters to predict NASH and were analyzed using rule extraction technology. One hundred and two patients, including 79 NASH and 23 non-NASH patients were analyzed in order to create the predictionmodel, another cohort with 77 patients including 65 NASH and 12 non-NASH patients were analyzed to validate the algorithm.RESULTS Alanine aminotransferase, C-reactive protein, homeostasis model assessment insulin resistance, albumin were extracted as predictors of NASH using a recursive-rule extraction algorithm. When we adopted the extracted rules for the validation cohort using a highly accurate rule extraction algorithm, the predictive accuracy was 79.2%. The positive predictive value, negative predictive value,sensitivity and specificity were 88.9%, 35.7%, 86.2% and 41.7%, respectively.CONCLUSION We successfully generated a useful model for predicting NASH in Japanese morbidly obese patients based on their biochemical profile using a rule extraction algorithm.

关键词： Non-alcoholic steatohepatitis Artificial intelligence Rule extraction morbid obesity Liver biopsy Non-invasive prediction

Effects of sodium-glucose cotransporter 2 inhibitors on cardiovascular outcomes in elderly patients with comorbid coronary heart disease and diabetes mellitus

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Journal of Geriatric Cardiology 2021年第6期18卷 440-448页

作者： Hu XU Wen-Zhe CAO Yong-Yi BAI Rui-Hua CAO Lei TIAN Feng CAO Li FAN Chinese PLA Medical School Chinese PLA General HospitalBeijingChina Department of Cardiology the Second Medical CenterNational Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijingChina Institute of Geriatrics the Second Medical CenterChinese PLA General HospitalBeijingChina

OBJECTIVE To investigate the effects of sodium-glucose cotransporter 2 inhibitors(SGLT2i)on cardiovascular outcomes in elderly Chinese patients with comorbid coronary heart disease(CHD)and type 2 diabetes mellitus(T2DM).METHODS A retrospective cohort study was conducted on 501 elderly inpatients(≥60 years)with comorbid CHD/T2DM in Department of Cardiovascular Medicine and Endocrinology,Chinese PLA General Hospital from January 2018 to December 2019.These patients were divided into two groups according to the administration of SGLT2i.All the demographic characteristics and clinical data were collected.Cardiovascular outcomes,including all-cause mortality,major adverse cardiovascular events(MACE),and hospitalization for heart failure(HHF),were followed up.RESULTS In the cohort,there were 167 patients in the SGLT2i group and 334 patients in the control group.In the efficacy analyses,the incidence of MACE was lower in the SGLT2i group than in the control group:3.6%vs.9.3%(P=0.022).A lower risk of MACE was observed in the SGLT2i group[hazard ratio(HR)=0.40,95%CI:0.17-0.95].There was no significant difference in the incidence of all-cause mortality or HHF between the two groups.No significant difference of HR was observed for all-cause mortality(HR=0.41,95%CI:0.12-1.41)or HHF(HR=0.58,95%CI:0.12-2.81).CONCLUSIONS SGLT2i treatment exhibited benefits for elderly patients with comorbid CHD/T2DM with a lower risk for MACE.

关键词： patients morbid mortality