Motivation ; Forensic Psychiatry ; Violence ; Wounds and Injuries ; Crime/psychology*

BACKGROUND: Biportal endoscopic spine surgery (BESS) is a recent addition to minimally invasive spine surgery treatments. It boasts excellent magnification and fine discrimination of neural structures. Selective decompression with preservation of facet joints for structural stability is also feasible owing to access to the spinal canal and foramen deeper inside. This study has a purpose to investigate clinical benefits of BESS for spinal stenosis in comparison to the other common surgical treatments such as microscopic decompression-only (DO) and fusion and instrumentation (FI). METHODS: From December 2013 to March 2015, 30 cases of DO, 48 cases of FI, and 66 consecutive cases of BESS for lumbar spinal stenosis (LSS) were enrolled to evaluate the relative clinical efficacy of BESS. Visual analog scale (VAS) for back pain and leg pain, postoperative hemoglobin, C-reactive protein (CRP) changes, transfusion, and postoperative complications were examined. RESULTS: All the patients were followed up until 6 months, and 98 patients (86.7%) for 2 years. At the 6-month follow-up, VAS for back pain improved from 6.8 to 2.8, 6.8 to 3.2, and 6.8 to 2.8 (p = 0.078) for BESS, DO, and FI, respectively; VAS for leg pain improved from 6.3 to 2.2, 7.0 to 2.5, and 7.2 to 2.5 (p = 0.291), respectively. Two cases in the BESS group underwent additional foraminal decompression, but no fusion surgery was performed. Postoperative hemoglobin changes for BESS, DO, and FI were −2.5, −2.4, and −1.3 mL, respectively. The BESS group had no transfusion cases, whereas 10 cases (33.3%) in DO and 41 cases (85.4%) in FI had transfusion (p = 0.000). CRP changes for BESS, DO, and FI were 0.32, 6.53, and 6.00, respectively, at day 2 postoperatively (p = 0.000); the complication rate for each group was 8.6% (two dural tears and one root injury), 6.7% (two dural tears), and 8.3% (two dural tears and two wound infections), respectively. CONCLUSIONS: BESS for LSS showed clinical results not inferior to those of the other open surgery methods in the short-term. Stable hemodynamic changes with no need for blood transfusion and minimal changes in CRP were thought to cause less injury to the back muscles with minimal bleeding. Foraminal stenosis decompression should be simultaneously conducted with central decompression to avoid an additional surgery.
Back Muscles ; Back Pain ; Blood Transfusion ; C-Reactive Protein ; Constriction, Pathologic ; Decompression ; Discrimination (Psychology) ; Endoscopy ; Follow-Up Studies ; Hemodynamics ; Hemorrhage ; Humans ; Leg ; Lumbar Vertebrae ; Minimally Invasive Surgical Procedures ; Pain, Postoperative ; Postoperative Complications ; Spinal Canal ; Spinal Stenosis ; Spine ; Tears ; Treatment Outcome ; Visual Analog Scale ; Wounds and Injuries ; Zygapophyseal Joint

To investigate the influential factors for depression and anxiety in patients with chronic wounds, and the relationship between depression and anxiety and social support or quality of life.
 Methods: We used convenience sampling method to enroll 150 patients with chronic wounds. Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Short Form 36 Health Survey (SF-36) and Social Support Rating Scale (SSRS) were used to assess the level of depression and anxiety, quality of life, and social support in patients with chronic wounds.
 Results: The detection rate of depression and anxiety in patients with chronic wounds was 45.3% and 14% respectively. In patients with chronic wounds, age was positively correlated with SDS and SAS scores (P<0.05), while education, eight factors of SF-36, objective support, subjective support, and social support scores of SSRS were negatively correlated with SDS and SAS scores (P<0.05). Further multiple regression analysis showed that the duration of wounds, physical functional score, role physical score and role emotional score of SF-36, objective support score, subjective support score, support utilization score, and social support score of SSRS were the independent influential factors for SDS score (P<0.05). Education, general health score, social functional score, and mental health score of SSRS were the independent factors for SAS score (P<0.05).
 Conclusion: The lower quality of life and social support of patients with chronic wounds could increase their depression and anxiety. While treating patients with chronic wounds, medical staff should also pay attention to the mutual influence between anxiety and depression, or quality of life and social support.
Anxiety ; complications ; psychology ; Depression ; complications ; psychology ; Humans ; Quality of Life ; psychology ; Social Support ; Wounds and Injuries ; complications

BACKGROUND: Donor site seroma is the most common complication after latissimus dorsi (LD) flap harvest. This study aimed to evaluate the efficacy of negative-pressure wound therapy (NPWT) in preventing donor site seroma formation after the harvest of an LD flap for breast reconstruction. METHODS: In this prospective matched-pair study, 40 patients in whom an LD flap was harvested for breast reconstruction were enrolled. NPWT was used in 20 patients, and in a control group composed of another 20 patients, the conventional donor site dressing technique was used. Information was collected regarding postoperative complications, the incidence of seroma, total drainage volume, the number of percutaneous seroma aspirations, and the volume aspirated. RESULTS: In the NPWT group, the incidence of seroma formation after drain removal was significantly lower than in the control group (15% vs. 70%; odds ratio=0.07; relative risk, 0.24). Both the mean percutaneous aspirated volume (P=0.004) and the number of percutaneous aspirations (P=0.001) were also significantly lower in the NPWT group. There were no significant differences in the total drainage volume or the duration of wound drainage between the NPWT dressing group and the control group (P>0.05). CONCLUSIONS: This study showed that NPWT is a promising tool for reducing the incidence of seroma formation after removing the drain at the donor site after LD flap harvesting. It is a simple and safe technique.
Aspirations (Psychology) ; Bandages ; Cohort Studies* ; Drainage ; Female ; Humans ; Incidence ; Mammaplasty ; Negative-Pressure Wound Therapy* ; Postoperative Complications ; Prospective Studies ; Seroma* ; Superficial Back Muscles* ; Surgical Flaps ; Tissue Donors* ; Wounds and Injuries

PURPOSE: A systematic literature review and meta-analysis were conducted to synthesis research findings on relationships of quality of life with multi-dimensional correlates in Korean breast cancer patients. METHODS: For the study purpose, 18 studies were selected through a systematic process of searching the literature. RESULTS: Among the general characteristics, variables having a significant relationship with quality of life were age (ES=.19), marital status (ES=.15), education (ES=.19), economic status (ES=.16), job status (ES=.10), and religion (ES=.13). Among the disease characteristics, type of treatment (ES=.12), length of time since diagnosis (ES=.13), stage of disease (ES=.14), length of time since operation (ES=.10), frequency of treatment (ES=.19), wound site and pain (ES=.16) were shown to have a significant relationship with quality of life. Depression (ES=-.60), one of the psychological factor, was the variable most significantly related to quality of life. CONCLUSION: The findings indicate that the variables which strongly impact quality of life in breast cancer patients are depression and pain.
Breast Neoplasms* ; Breast* ; Depression ; Diagnosis ; Education ; Humans ; Marital Status ; Psychology ; Quality of Life* ; Wounds and Injuries

Acupuncture has remarkable effects of pain relieving and functional restoration on injuries of soft tissue and joint due to military training. As more and more attention has been attached to the impact of psychological states and biorhythm disorder on the fighting ability of military staff, acupuncture has found its place in treating chronic fatigue, combat stress reaction, traumatic brain injury and post-traumatic stress disorder as well as regulating circadian rhythms. The therapeutic effect of acupuncture in military training-related physical damage and psychological trauma has already been proved by numerous clinical practices and researches. It is held that using acupuncture as an alternative could not only save medical resources, but also enhance the fighting ability of the army. However, the current clinical studies is facing the problem of limited sample size. Therefore, randomized controlled trials in large scale and multiple centers should be further carried out toward military staff, so as to provide more speaking evidences to the prevention and treatment of physical and psychological diseases.
Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Military Personnel ; psychology ; Pain Management ; Stress Disorders, Post-Traumatic ; therapy ; Wounds and Injuries ; therapy ; Young Adult

OBJECTIVE: To summarize the solved homicide cases taking place in Suzhou city and to find out the characteristics and commonness of them in order to analyze the key points of investigation at the scene. METHODS: The data of 483 solved homicide cases occurring from January 2006 to March 2010 in the city were analyzed. RESULTS: Most cases involved 1 victim and 1 suspect, with young male adults dominated. Most of them were non-local residents. The majority of suspects were intentional by passion due to quarrel and dispute. The most common weapons were sharp instruments generally carried by the suspects. Mechanical asphyxia and mechanical injury were the two most common causes of death in these cases. CONCLUSION The social characteristics of suspects, criminal motivation, injury instruments, distribution of injuries, cause of death, and manner of death in Suzhou showed similar general characteristics as the experience for detecting homicide cases in the future.
Adult ; Age Distribution ; Asphyxia/mortality* ; Cause of Death ; Crime Victims/statistics & numerical data* ; Criminal Psychology ; Female ; Forensic Pathology ; Homicide/statistics & numerical data* ; Humans ; Male ; Retrospective Studies ; Sex Distribution ; Shock, Hemorrhagic/mortality* ; Socioeconomic Factors ; Weapons/statistics & numerical data* ; Wounds and Injuries/pathology*

In forensic psychiatric evaluation, experts frequently need to assess the contribution degree of hurting factors to the victims. The contribution degree reflects the extent of hurt caused by the injurer and is the quantitative index of the responsibility which should be undertaken by the injurer. It is also important evidence for the judgement. Presently, there is no accepted and practicable quantitative tool to reflect the objective contribution degree. This article reviews domestic and international researches on the contribution degree of hurting factors in mental injury, including the concept, connotation, related assessment methods, problems in assessment and its future study trend.
Age Factors ; Brain Injuries/complications* ; Expert Testimony ; Forensic Psychiatry ; Humans ; Injury Severity Score ; Mental Disorders/psychology* ; Psychology, Social ; Sex Factors ; Stress Disorders, Post-Traumatic/psychology* ; Wounds and Injuries/complications*

OBJECTIVETo assess the depression and anxious status among transferred injured survivors in Wenchuan earthquake in Sichuan province.

METHODSA total of 43 transferred injured survivors were investigated by questionnaire exploring their trauma symptoms and mental health status.

RESULTSHigh rates of trauma symptoms were remarkably observed in these survivors. Of all the respondents, 60% had some emotional symptoms and sleeping difficulties. About one third of respondents experienced recurrent and intrusive distressing recollection of event, 16 (37.21%) experienced nightmare, 15 (34.88%) had flashback and 7 (16.28%) of them tried to avoid relative stress.

CONCLUSIONMany mental symptoms were observed in transferred injured survivors. The two major factors of mental stress were emotional symptoms and re-experience of the disaster.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Disasters ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Stress Disorders, Post-Traumatic ; psychology ; Stress, Psychological ; Survivors ; psychology ; statistics & numerical data ; Wounds and Injuries ; psychology ; Young Adult

OBJECTIVETo investigate the psychological stress in the survivors of the May 12, 2008 Wenchuan earthquake transferred to Guangzhou for treatment, and explore the association between the psychological stress and the physical injuries related to the earthquake to promote both the physical and psychological recoveries of the survivors.

METHODSFifty-five earthquake survivors, including 27 with 28 without physical injuries, were transferred in our hospital 1 week after the earthquake. The Posttraumatic Stress Disorder (PTSD) Checklist-Civilian version (PCL-C) and the Self Reporting Questionnaire (SRQ) were used to investigate the psychological stress in these survivors.

RESULTSThe earthquake caused serious psychological stress in these survivors, and 43.63% of the survivors had high PCL-C scores (50 or above) and 78.18% had high SRQ scores (over 7), with 41.82% having high scores for both PCL-C and SRQ. The survivors with physical injuries generally had high PCL-C and SRQ scores (49.780-/+14.503 and 12.110-/+4.619, respectively), which, however, were not statistically different from the scores of the survivors without injuries (44.460-/+13.206 and 10.460-/+5.000, respectively, P>0.05). The injured survivors showed high scores for the subscales of persistent avoidance symptoms and of anger and irritability, in which the item scores for "efforts to avoid activities or places that arouse recollections of the earthquake" and "feeling of detachment or estrangement from others" were significantly different between the survivor with physical injuries and those without (P=0.034 and 0.018, respectively).

CONCLUSIONThe Wenchuan earthquake causes serious psychological stress in the survivors, and the wounded are more inclined to have persistent avoidance symptoms and enhanced irritability. In addition to the care of the physical injuries, psychological counseling and social support may help ameliorate the psychological trauma in the survivors and reduce the incidence of PTSD.

Adolescent ; Adult ; Aged ; China ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Stress, Psychological ; psychology ; Surveys and Questionnaires ; Survivors ; psychology ; Wounds and Injuries ; psychology ; Young Adult