简介：AIM:Toinvestigatethelatentstructureofanirritablebowelsyndrome(IBS)symptomseverityscaleinapopulationofhealthyadults.METHODS:TheBirminghamIBSsymptomquestionnairewhichconsistsofthreesymptomspecificscales(diarrhea,constipation,pain)wasevaluatedbymeansofstructuralequationmodeling.Wecomparedtheoriginal3-factorsolutiontoageneralfactormodelandabifactorsolutioninalargeinternetsampleofcollegestudents(n=875).Statisticalcomparisonsofcompetingmodelswereconductedbymeansofχ2differencetests.Regardingtheevaluationofmodelfit,weexaminedthecomparativefitindex(CFI)andtheRootMeanSquareErrorofApproximation(RMSEA).RESULTS:ResultsclearlyfavoredabifactormodelofIBSsymptomseverity(CFI=0.99,RMSEA=0.05)whichconsistedofastronggeneralIBSsomatizationfactorandthreesymptomspecificfactors(diarrhea,constipation,pain)basedonthesubscalesoftheBirminghamIBSsymptomquestionnaire.Thefitindicesofthecompetingonefactormodel(CFI=0.85,RMSEA=0.17)andthreefactormodel(CFI=0.97,RMSEA=0.08)wereclearlyinferior.χ2differencetestsshowedthatthedifferencesbetweenthemodelswereindeedsignificantinfavorofthebifactormodel(P<0.001).Correlationsofthefourlatentfactorswithmeasuresofpainsensitivity,somatoformdissociation,fatigueseverity,anddemographicvariablessupportthevalidityofourbifactormodelofIBSspecificsymptomseverity.CONCLUSION:ThefindingssuggestthatIBSsymptomseveritymightbestbeunderstoodasacontinuousandmultidimensionalconstructwhichcanbereliablyandvalidlyassessedwiththeB-IBS.

简介：AbstractBackground:The coronavirus disease 2019 (COVID-19) outbreak occurred during the flu season around the world. This study aimed to analyze the impact of influenza A virus (IAV) exposure on COVID-19.Methods:Seventy COVID-19 patients admitted to the hospital during January and February 2020 in Wuhan, China were included in this retrospective study. Serum tests including respiratory pathogen immunoglobulin M (IgM) and inflammation biomarkers were performed upon admission. Patients were divided into common, severe, and critical types according to disease severity. Symptoms, inflammation indices, disease severity, and fatality rate were compared between anti-IAV IgM-positive and anti-IAV IgM-negative groups. The effects of the empirical use of oseltamivir were also analyzed in both groups. For comparison between groups, t tests and the Mann-Whitney U test were used according to data distribution. The Chi-squared test was used to compare disease severity and fatality between groups.Results:Thirty-two (45.71%) of the 70 patients had positive anti-IAV IgM. Compared with the IAV-negative group, the positive group showed significantly higher proportions of female patients (59.38% vs. 34.21%, χ2 = 4.43, P = 0.035) and patients with fatigue (59.38% vs. 34.21%, χ2 = 4.43, P = 0.035). The levels of soluble interleukin 2 receptor (median 791.00 vs. 1075.50 IU/mL, Z = -2.70, P = 0.007) and tumor necrosis factor α (median 10.75 vs. 11.50 pg/mL, Z = -2.18, P = 0.029) were significantly lower in the IAV-positive group. Furthermore, this group tended to have a higher proportion of critical patients (31.25% vs. 15.79%, P = 0.066) and a higher fatality rate (21.88% vs. 7.89%, P = 0.169). Notably, in the IAV-positive group, patients who received oseltamivir had a significantly lower fatality rate (0 vs. 36.84%, P = 0.025) compared with those not receiving oseltamivir.Conclusions:The study suggests that during the flu season, close attention should be paid to the probability of IAV exposure in COVID-19 patients. Prospective studies with larger sample sizes are needed to clarify whether IAV increases the fatality rate of COVID-19 and to elucidate any benefits of empirical usage of oseltamivir.

简介：AbstractBackground:Unawareness of stroke symptoms and low income are two barriers that affect the seeking of emergency medical service (EMS). This study aimed to assess the effect of unawareness and low income on seeking EMS and to investigate the regional distribution of the unawareness and low-income status and their associations with failing to call EMS in China.Methods:A total of 187,723 samples from the China National Stroke Screening Survey was interviewed cross-sectionally. Four status of awareness and annual income were identified: unaware and low-income, unaware-only, low-income-only, and aware and regular income. The outcomes were whether they intended to call EMS or not. The regional distribution of each status and their associations with not calling EMS were presented.Results:The status of unaware and low-income, unaware-only, and low-income-only accounted for 6.3 % (11,806/187,673), 11.9% (22,241/187,673), and 21.5% (40,289/187,673) of the total sample, respectively. Not calling EMS was significantly associated with the status of unaware and low-income (odds ratio [OR]: 3.21, 95% confidence interval [CI]: 3.07-3.35), unaware-only (OR: 2.38, 95% CI: 2.31-2.46), and low-income-only (OR: 1.67, 95% CI: 1.63-1.71), compared with the aware and regular income status. The Midwest regions had higher percentages of people in the unaware and low-income status; the East, South, and Central had higher percentages of unaware-only status; the North and Northeast regions had a higher percentage of low-income-only status, compared with other regions.Conclusion:The existence of the regional difference in unawareness and low income justifies the specific stroke education strategies for the targeted regions and population.

简介：AbstractObjective:To compare and correlate the efficacy of the NOSE score & the VAS score in determining the symptomatic benefit in patients undergoing septoplasty.Materials and methods:Eighty patients with deviated nasal septum undergoing septoplasty were included in the study. NOSE score & VAS score (out of 100) was documented before and after surgery. Results were correlated and compared statistically.Results:In the NOSE score, the most bothersome symptom was trouble breathing through the nose (85.83); followed by Nasal obstruction or blockage (82.50). Wilcoxon test showed significant improvement with NOSE score and VAS score in all patients at 1 month and 3 months. Spearman’s coefficient showed a positive correlation between the two, though the score improvement and patient satisfaction rate was significantly high with NOSE score.Conclusions:NOSE score and the VAS score both provide effective framework for evaluating treatment responses after septoplasty. However, the NOSE score showed higher improvement and better patient satisfaction rate when used to measure of nasal obstruction as compared to the VAS score.

简介：AbstractBackground:Postural tachycardia syndrome (POTS) is a common childhood disease that seriously affects the patient’s physical and mental health. This study aimed to investigate whether pre-treatment baseline left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) values were associated with symptom improvement after metoprolol therapy for children and adolescents with POTS.Methods:This retrospective study evaluated 51 children and adolescents with POTS who received metoprolol therapy at the Peking University First Hospital between November 2010 and July 2019. All patients had completed a standing test or basic head-up tilt test and cardiac echocardiography before treatment. Treatment response was evaluated 3 months after starting metoprolol therapy. The pre-treatment baseline LVEF and LVFS values were evaluated for correlations with decreases in the symptom score after treatment (ΔSS). Multivariable analysis was performed using factors with a P value of <0.100 in the univariate analyses and the demographic characteristics.Results:A comparison of responders and non-responders revealed no significant differences in demographic, hemodynamic characteristics, and urine specific gravity (all P > 0.050). However, responders had significantly higher baseline LVEF (71.09% ± 4.44% vs. 67.17% ± 4.88%, t = -2.789, P = 0.008) and LVFS values (40.00 [38.00, 42.00]% vs. 36.79% ± 4.11%, Z = -2.542, P = 0.010) than the non-responders. The baseline LVEF and LVFS were positively correlated with ΔSS (r = 0.378, P = 0.006; r = 0.363, P = 0.009), respectively. Logistic regression analysis revealed that LVEF was independently associated with the response to metoprolol therapy in children and adolescents with POTS (odds ratio: 1.201, 95% confidence interval: 1.039-1.387, P = 0.013).Conclusions:Pre-treatment baseline LVEF was associated with symptom improvement after metoprolol treatment for children and adolescents with POTS.

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简介：Thisstudyadaptedastatisticalprobabilisticanatomicalmapofthebrainforsinglephotonemissioncomputedtomographyimagesofdepressiveend-stagerenaldiseasepatients.Thisresearchaimedtoinvestigatetherelationshipbetweensymptomclusters,diseaseseverity,andcerebralbloodflow.Twenty-sevenpatients(16males,11females)withstages4and5end-stagerenaldiseasewereenrolled,alongwith25healthycontrols.Allpatientsunderwentdepressivemoodassessmentandbrainsinglephotonemissioncomputedtomography.Thestatisticalprobabilisticanatomicalmapimageswereusedtocalculatethebrainsinglephotonemissioncomputedtomographycounts.AsymmetricindexwasacquiredandPearsoncorrelationanalysiswasperformedtoanalyzethecorrelationbetweensymptomfactors,severity,andregionalcerebralbloodflow.ThedepressionfactorsoftheHamiltonDepressionRatingScaleshowedanegativecorrelationwithcerebralbloodflowintheleftamygdale.Theinsomniafactorshowednegativecorrelationswithcerebralbloodflowintheleftamygdala,rightsuperiorfrontalgyrus,rightmiddlefrontalgyrus,andleftmiddlefrontalgyrus.Theanxietyfactorshowedapositivecorrelationwithcerebralglucosemetabolisminthecerebellarvermisandanegativecorrelationwithcerebralglucosemetabolismintheleftglobuspallidus,rightinferiorfrontalgyrus,bothtemporalpoles,andleftparahippocampus.Theoveralldepressionseverity(totalscoresofHamiltonDepressionRatingScale)wasnegativelycorrelatedwiththestatisticalprobabilisticanatomicalmapresultsintheleftamygdalaandrightinferiorfrontalgyrus.Inconclusion,ourresultsdemonstratedthatthediseaseseverityandextentofcerebralbloodflowquantifiedbyaprobabilisticbrainatlaswasrelatedtovariousbrainareasintermsoftheoverallseverityandsymptomfactorsinend-stagerenaldiseasepatients.