ObjectiveTo understand the current status of psychotherapy and counseling resources in mental health institutions in Chinese mainland, and provide a reference for the formulation of relevant policies. MethodsFrom May to June 2021, the National Mental Health Program Office conducted a resource survey using a self-designed questionnaire on 3 833 institutions providing psychotherapy/counseling services across all 31 provinces (autonomous regions and municipalities) in Chinese mainland. The data were collected and summarized by mental health program offices at all levels in each region and reported to the National Mental Health Program Office. ResultsNationwide, 64.56% of mental health institutions provided psychotherapy/counseling services, with 65.24% of psychiatric specialty hospitals and 69.44% of psychiatric (psychological) departments in general hospitals offering these services. Among the mental health institutions providing psychotherapy/counseling services, 52.54% had independent departments undertaking these services. Psychiatrists accounted for the largest proportion (65.61%) of the personnel providing psychotherapy/counseling services. The quantity of psychotherapy/counseling service resources (1 663 institutions and 13 061 personnel) and the number of service providers per unit land area (122.14 per 10,000 square kilometers) in mental health institutions in eastern China were higher than those in central (1 022 institutions, 9 064 personnel, and 53.63 per 10 000 square kilometers) and western regions (1 148 institutions, 9 259 personnel, and 13.52 per 10 000 square kilometers). ConclusionIn recent years, the number of mental health institutions providing psychotherapy/counseling services has increased significantly. However, the coverage and distribution of resources across eastern, central, and western regions remain uneven, requiring further improvement.
Objective To investigate the causal relationship between body mass index(BMI)and lumbar disc herniation,to provide recommendations for clinical prevention and treatment.Methods Summary data from the Genome-wide Association Study(GWAS)in the UK Biobank of the IEU Open GWAS project()were used for analysis.Single nucleotide polymorphisms(SNPs)closely related to BMI were selected as instrumental variables,and lumbar disc herniation was the outcome variable.The sample data were extracted from European populations,with the BMI group consisting of 454 884 individuals and 9 851 867 SNPs,and the lumbar disc herniation group consisting of 462 933 individuals and 9 851867 SNPs.The main analysis methods included inverse-variance weighted(IVW),MR-Egger regression,and weighted median estimator(WME),with the simple mode and weighted mode as auxiliary analyses.Mendelian randomization(MR)analysis was conducted to explore the causal relationship between BMI and lumbar disc herniation.Sensitivity analysis was performed using the leave-one-out method,and the MR-Egger regression intercept test,Cochran's Q test,funnel plot observation for heterogeneity,symmetry,and scatter plot observation for directional consistency were conducted.The odds ratio(OR)and 95％confidence interval(CI)were used to evaluate the causal relationship between BMI and lumbar disc herniation.Results A total of 419 SNPs associated with BMI(P＜5×10-8,r2＜0.001)were included as instrumental variables.The analysis using MR-Egger(OR=1.002,95％CI:0.997-1.007),WME(OR=1.003,95％CI:1.000-1.006),IVW(OR=1.004,95％CI:1.002-1.006),simple mode(OR=1.006,95％CI:0.998-1.014),and weighted mode(OR=1.004,95％CI:0.999-1.009)indicated that an increase in BMI was positively associated with lumbar disc herniation.The P values for WME and IVW were 0.030 and 3.35×10-6,respectively,with a significance level of α=0.05.The P values for MR-Egger,simple mode,and weighted mode were all＞0.05,indicating no statistical significance.The consistent direction of effect among the five analysis methods suggested that an increase in BMI was associated with a higher risk of lumbar disc herniation.The intercept for MR-Egger regression was 4.2×10-5,the standard error was 4.6×10-5,and the P value was 0.364,indicating the absence of pleiotropy in the instrumental variables.A forest plot generated using the leave-one-out method showed no obvious bias,and the funnel plot exhibited overallsymmetry.Conclusion There is a causal relationship between BMI and lumbar disc herniation,and an increase in BMI may be an important factor in triggering lumbar disc herniation.
Background Pneumoconiosis mostly combines pulmonary and cardiovascular diseases, among which pulmonary heart disease (PHD) is of major concern due to its significant impact on the survival of pneumoconiosis patients. White cell count (WCC), red cell distribution width (RDW) and platelet parameters are thought to affect inflammatory responses and may be predictors of various cardiovascular diseases. However, very few studies have focused on PHD.Objectives To examine the relationship between baseline complete blood count parameters (WCC, RDW, platelet parameters) and the risk of incident PHD in pneumoconiosis patients.Design A retrospective cohort study.Setting This was a single-centre, retrospective cohort study that used data from an Occupational Disease Hospital, Chengdu, Sichuan.Participants A total of 946 pneumoconiosis patients from January 2012 to November 2021 were included in the study. Female patients and patients who had PHD, coronary heart disease, hypertensive heart disease, cardiomyopathy, heart failure, oncological disease, multiple organ dysfunction, AIDS at baseline and follow-up time of less than 6 months were also excluded.Outcome measures We identified PHD according to the patient’s discharge diagnosis. We constructed Cox proportional hazard regression models to assess the HR of incident PHD in pneumoconiosis, as well as 95% CIs.Results In the multiple Cox proportional hazard regression analysis, platelet count (PLT) and plateletcrit (PCT) above the median at baseline were associated with an increased risk of PHD in pneumoconiosis with adjusted HR of 1.52 (95% CI 1.09 to 2.12) and 1.42 (95% CI 1.02 to 1.99), respectively.Conclusion Higher baseline PLT and PCT are associated with a higher risk of PHD in pneumoconiosis.
目的 检验心率变异性(heart rate variability,HRV)对模拟高原环境中急性高山病(acute mountain sickness,AMS)发生的诊断价值.方法 招募45名受试者(33名纳入分析),在北京小汤山高原适应研究康复中心测量其在常压常氧环境、初进低压低氧环境15 min后和低压低氧环境6 h后共3种状态下的HRV参数和血氧饱和度(oxygen saturation,Sp02)数据,并进行AMS评分问卷调查,通过logistic逐步回归模型构建联合预测因子,利用受试者工作特征(receiver operating characteristic,ROC)曲线比较联合预测因子和血氧饱和度的诊断价值.结果 (1)Logistic逐步回归模型结果中发现,在常压常氧状态下静息15 min后测得的HFnu、LF/HF两个HRV的参数和AMS发病具有显著关系,构成联合预测因子Y(√Y=-0.26*HFnu-3.105*LF/HF).(2)ROC曲线显示该模型预测AMS发病的曲线下面积(area under the curve,AUC)为 0.906(95％CI=0.806～1.000,灵敏度=0.947,特异性=0.714,约登指数=0.661),相比之下,在低压低氧环境中的Sp02的只有中等的诊断能力(低压低氧静息15 min后Sp02的AUC值=0.799,95％CI=0.646～0.952,一整晚后的Sp02的AUC值=0.733,95％CI=0.556～0.910).结论 HRV构建联合预测因子具有较好的AMS预测价值,可为有急进高原计划的人们提供参考.
目的 分析江苏省中老年人群体质指数(body mass index,BMI)与慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患病间的关联以及潜在的交互作用,为制定COPD防控策略和措施提供理论依据.方法 2015年7-12月,采用多阶段整群随机抽样的方法抽取江苏省6个市(区)共3 600名≥40岁常住居民为研究对象,进行问卷调查、体格检查以及肺功能检测.采用R 3.5.3软件进行方差分析、x2检验、多因素线性回归分析和多因素logistic回归分析.结果 最终3 365名研究对象纳入数据分析,其中COPD患者428名(12.7％).低体重者38人(1.1％),体重正常者1 257人(37.4％),超重者1 480人(44.0％),肥胖者590人(17.5％).多因素线性回归分析结果显示,使用支气管扩张剂后的FEV1/FVC水平随BMI增加而上升(β=0.30);与体重正常的人群相比,超重及肥胖的人群支扩后的FEV1/FVC水平更高(β=1.14,2.14),均有统计学意义(P＜0.05).多因素logistic回归分析结果显示,BMI与COPD患病呈负相关(OR=0.89,95％CI:0.84～0.95);与体重正常的人群相比,低体重与COPD患病增加相关(OR=3.14,95％CI:1.38～7.17),肥胖与COPD患病降低相关(OR=0.46,95％CI:0.28～0.75),均有统计学意义(P＜0.05).此外,在男性(P交互＜0.001)、当前吸烟者(P交互＜0.001)以及暴露于生物燃料者(P交互=0.009)中观察到BMI与FEV1/FVC间具有更强的关联强度.结论 江苏省中老年人群BMI与支气管扩张后的FEV1/FVC呈正相关,与COPD患病呈负相关,提示适宜的体重增长或许能够改善肺功能.
