Change in Functional Status from Preoperative to One Year Postoperative in Patients Who Have Undergone Elective Open-Heart Surgery: A Repeated-Measures Study

Purpose: Although patient-related factors affect surgical outcomes, preoperative functional status is not measured by any cardiac risk score. Functional status can, however, be objectively measured using validated outcome tools such as the Late-Life Function and Disability Instrument (LLFDI). The purpose of this study was to determine 1) if there was a change over time in functional status, as measured by the LLFDI, in patients who underwent elective cardiac surgery, and if so, 2) what specific aspect(s) of functional status changed. Methods: A prospective longitudinal study of one year was conducted on elective cardiac surgery patients (n = 43) using the self-reported LLFDI, which measures Disability Frequency (frequency of participation in social tasks), Disability Limitation (ability to participate in social tasks) and Function Total (ease in performing routine activities). Higher scores indicate increased function and decreased disability. LLFDI scores were compared at three times (preoperative, six-week and one-year postoperative) using repeated measures ANOVA. Post hoc pairwise comparison was conducted for specific interactions. Results: Both Function Total and Disability Frequency significantly changed over time (p = 0.047 and p = 0.013, respectively). Specifically, patients’ function level was significantly higher one-year postoperative compared to preoperative (M difference = +3.48, SE = 1.48, p = 0.026). Likewise, Disability Frequency scores were significantly higher (i.e. more active) at one-year postoperative versus preoperative (M difference= +5.98, SE = 2.19, p = 0.033). Disability Limitation scores were not significantly different between any time points (p > 0.05). Conclusion: By one-year postoperative, patients demonstrated increased ease in their routine physical activities and were more participatory in social life tasks. Individuals who underwent elective cardiac surgery took more than six weeks to detect notable improvement in functional status, which was expected with a sternotomy approach. This study provides support for the use of the LLFDI as an effective tool to capture functional status in the cardiac population. These findings may assist cardiac patients in recovery timeline expectations.

Laparoscopy-assisted pylorus-preserving gastrectomy for early gastric cancer: A retrospective study of long-term functional outcomes and quality of life

BACKGROUND Laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG) was known to have benefits of function-preserving surgery compared to laparoscopy-assisted distal gastrectomy (LADG). However, in clinical settings, delayed gastric emptying and esophageal reflux following LAPPG can be serious issues, making surgeons reluctant to perform LAPPG. It is unclear that LAPPG had better longterm functional outcomes and quality of life compared to LADG. AIM To evaluate the long-term functional outcomes and patient-reported quality of life of LAPPG compared to those of LADG. METHODS We reviewed the clinicopathological data of 195 patients who underwent LADG with Billroth II anastomosis and 101 patients who underwent LAPPG for cT1N0 gastric cancer in the middle third of the stomach between 2012 and 2015. Postoperative complications, nutritional parameters, and survey results of the European Organization for Research and Treatment of Cancer Questionnaire C30 and STO22 questionnaire were compared between the two groups. RESULTS The serum hemoglobin level was significantly higher in the LAPPG group than in the LADG group (P < 0.001). In the endoscopic findings, incidence of bile reflux was lower (P < 0.001);however, the incidence of residual food was higher in the LAPPG group than in the LADG group (P < 0.001). Regarding the quality of life score, the LAPPG group had a better physical functioning score (86.7 vs 90.0, P = 0.032) but also greater pain and reflux when compared to the LADG group [8.3 vs 16.7 in pain, 11.1 (interquartile range, 0, 22.2) vs 11.1 (interquartile range, 11.1, 33.3) in reflux, P = 0.034 and 0.001, respectively]. CONCLUSION LAPPG is beneficial to recovery of anemia and to bile reflux, however, it might be unfavorable in terms of pain and reflux symptoms compared to LADG with Billroth II anastomosis.

Raising medium function of environmental engineering by using life rubbish to produce carpet turf

Abundant material with low cost was utilized to raise medium function of producing carpet turf by life rubbish. The results showed that the material used could strikingly raise water retentiveness and ventilating of medium. Through the determination of the effect of each growth index of several turfgrass, emergence density, plant height, root growth and individual plant′s net primary production were all positively related to the material′s amount mixed, showing that the mixture of material could promote turfgrass growth, further proving that the material used raised medium function of producing carpet turf by life rubbish and made most use of life rubbish resources. It provided a scientific base is for application of environmental engineering by using life rubbish to produce carpet turf. So the study had both important theoretic meaning and applied value.

Pancreatic function,quality of life and costs at long-term follow-up after acute pancreatitis

AIM:To evaluate long-term endocrine and exocrine pancreatic function,quality of life and health care costs after mild acute pancreatitis and severe acute pancreatitis(SAP).METHODS:Patients prospectively included in 2001-2005 were followed-up after 42(36-53)mo.Pancreatic function was evaluated with laboratory tests,the oral glucose tolerance test(OGTT),fecal elastase-1 and a questionnaire.Short Form(SF)-36,was completed.RESULTS:Fourteen patients with a history of SAP and 26 with mild acute pancreatitis were included.Plasma glucose after OGTT was higher after SAP(9.2 mmol/L vs 7.0 mmol/L,P=0.044).Diabetes mellitus or impaired glucose tolerance in fasting plasma glucose and/or 120 min plasma glucose were more common in SAP patients(11/14 vs 11/25,P=0.037).Sick leave,time until the patients could take up recreational activities and time until they had recovered were all longer after SAP(P <0.001).No significant differences in SF-36 were seen between the groups,or when comparing with age and gender matched reference groups.Total hospital costs,including primary care,follow-up and treatment of complications,were higher after SAP(median€16572 vs €5000,P<0.001).CONCLUSION:Endocrine pancreatic function was affected,especially after severe disease.SAP requires greater resource use with long recovery,but most patients regained a good quality of life.

Gender differences in ghrelin, nociception genes, psychological factors and quality of life in functional dyspepsia

AIM to evaluate gender differences in the aspect of ghrelin,nociception-related genes and psychological aspects and the quality of life(Qo L) in Korean functional dyspepsia(FD) patients.METHODS Total of 191 persons were prospectively enrolled between March 2013 and May 2016 in Seoul National Bundang Hospital,and classified into control and FD group based on ROME Ⅲ criteria. Questionnaire included assessment for dyspepsia symptoms,Qo L and anxiety or depression. Preproghrelin and nociception genes in the gastric mucosa and plasma acyl/des-acyl ghrelin were measured. RESULTS Lower level of plasma acyl ghrelin in FD patients compared to control was significant only in male(15.9 fmol/m L vs 10.4 fmol/m L,P = 0.017). Significantly higher m RNA expressions of nerve growth factor and transient receptor potential vanilloid receptor 1 were observed in male(P = 0.002 and P = 0.014,respectively) than in female. In contrast,female FD patients had a higher anxiety and depression score than male FD(P = 0.029),and anxiety score was correlated with epigastric pain only in female FD patients(female: Spearman rho = 0.420,P = 0.037). The impairment of overall Qo L was more prominent in female FD patients than male patients(5.4 ± 0.3 vs 6.5 ± 0.3,P = 0.020). CONCLUSION Gender differences of ghrelin and nociception-related genes in male and psychological factors in female underlie FD symptoms. More careful assessment of psychological or emotional status is required particularly for the female FD patients.

A Brief Study of the Pragmatic Functions of English Euphemism in Social Life

Euphemism,as a unique form in language expression,conveys a lot about the society and culture in which it exits.This paper studies the functions of euphemism and its application of euphemisms in social-cultural activities.

Visual function and vision-related quality of life after vitrectomy for idiopathic macular hole: a 12mo followup study

· AIM: To investigate the visual function and the relationship with vision-related quality of life(VRQOL)after macular hole repair surgery.· METHODS: Prospective case series. Thirty-six consecutive eyes in 36 patients who underwent pars plana vitrectomy(PPV) and internal limiting membrane(ILM) peeling were included. The 25-item National Eye Institute Visual Function Questionnaire(VFQ-25) was answered by the participants before and 3 and 12 mo after operation. Follow-up visits examinations included best-corrected visual acuity(BCVA), clinical examination,and central macular thickness(CMT) measured by optical coherence tomography(OCT).·RESULTS: Macular-hole closure was achieved in 35 of36 eyes(97.2%). At baseline and months 3 and 12, the log MAR BCVAs(mean±SD) were 1.15±0.47, 0.68±0.53(P 【0.0001 versus baseline), and 0.55 ±0.49(P 【0.001 versus baseline, P =0.273 versus month 3), respectively; the CMTs(μm) were 330 ±81, 244 ±62(P 【0.001 versus baseline), and 225±58(P 【0.001 versus baseline, P =0.222 versus month 3), respectively; the median preoperative VFQ-25 composite score of 73.50(63.92-81.13) increased postoperatively to 85.50(80.04-89.63) at 3mo(P 【0.001)and 86.73(82.50-89.63) at 12mo(P 【0.001) respectively.The improved BCVA was correlated with improvements in five subscales(r =-0.605 to-0.336, P 【0.001 to P =0.046) at 12 mo.· CONCLUSION: PPV with ILM peeling improved anatomic outcome, visual function, and VRQOL. Theimproved BCVA was an important factor related to the improved VRQOL.

Do Birth Season and Sex Affect Adult Lung Function as Early Life Factors?

Objectives: Although lung function decline is a normal ageing process, it can be potentiated by risk factors. However, the potential impact of early life factors on lung function decline has been scarcely studied. The aim of this study was to investigate the potential correlation between birth season and adult lung function. Methods: We enrolled 1008 South Korean patients (530 men and 478 women;age range, 40 - 80 years) who were hospitalized for urological surgery, irrespective of respiratory disease. All patients underwent the pulmonary function test before any surgery or procedure. Based on their birth season, the patients were divided into two groups (spring, summer, and fall vs. winter). Results: Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1 % predicted of men born in winter were lower than those of men born in other seasons. Univariate and multivariate analyses using linear regression models also showed that birth season was a significant predictive factor for FVC, FEV1, and FEV1 % predicted in men. However, birth season was not correlated with lung function in women. Among male ever-smokers, FEV1 and FEV1 % predicted were lower for men born in winter than for those born in other seasons. Conclusions: Unlike women, men born in winter had lower lung function than did men born in other seasons. These results suggest that birth season might be an early life factor that predicts airway function. Furthermore, birth season has different effects on adult lung function depending on the patient’s sex.

Factors Related to Functional Capacity and Quality of Life for Elderly People in a Middle-Sized City of São Paulo, Brazil

Introduction: It is a fact that the elderly population has been increasing all around the world and also in Brazil. This has been a challenge for governments and managers in the development of public policies to promote healthy and quality aging. And one of the conditions for healthy aging is to assess the functional capacity and quality of life of elderly people. Objective: The aim of the present study was to evaluate the factors that influence the loss of functional capacity and the worsening of the quality of life of a representative sample of elderly people from a medium-sized city in the inner of São Paulo State, Brazil. Methodology: Questionnaires about activities of daily living (ADL), instrumental activities of daily living (IADL), Flanagan quality of life scale (FQOLS), sociodemographic and morbidities aspects were applied to the elderly people. In order to assess associated factors to functional capacity and quality of life, chi-square tests and logistic regression models were fitted including variables: gender, age group, marital status, income, education level, body mass index, abdominal circumference and some morbidities reported by the elderly people. The level of significance adopted for the statistical tests was 5%. Results: Elderly with age over 75 years old and not married had more risk to be dependent on ADL, while elderly with more than 75 years old, not married, income below one minimal wage, cardiovascular disease and be diabetic had more risk to be dependent by IADL. Already, people with excess of weight had smallest risk to be dependent by IADL, paradoxically. The elderly not married and with an income below a minimum wage had the worst quality of life. Conclusions: Population aging in Brazil is an evident factor, so it is hoped that this study will contribute to the greatest diligence on the issues of the elderly and related social problems.

Botulinum toxin type A plus rehabilitative training for improving the motor function of the upper limbs and activities of daily life in patients with stroke and brain injury

BACKGROUND: Botulinum toxin type A (BTX-A) is mostly to be used to treat various diseases of motor disorders, whereas its effect on muscle spasm after stroke and brain injury needs further observation. OBJECTIVE: To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury. DESIGN: A randomized controlled observation. SETTINGS: Department of Rehabilitation, Department of Neurology and Department of Neurosurgery, the Second Hospital of Hebei Medical University. PARTICIPANTS: Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation, Department of Neurology and Department of Neurosurgery, the Second Hospital of Hebei Medical University from January 2001 to August 2006. They were all confirmed by CT and MRI, and had obvious increase of spastic muscle strength in upper limbs, their Ashworth grades were grade 2 or above. The patients were randomly divided into treatment group (n =30) and control group (n =30). METHODS: ① Patients in the treatment group undertook comprehensive rehabilitative trainings, and they were administrated with domestic BTX-A, which was provided by Lanzhou Institute of Biological Products, Ministry of Health (S10970037), and the muscles of flexion spasm were selected for upper limbs, 20-25 IU for each site. ② Patients in the treatment group were assessed before injection and at 1 and 2 weeks, 1 and 3 months after injection respectively, and those in the control group were assessed at corresponding time points. The recovery of muscle spasm was assessed by modified Ashworth scale (MAS, grade 0-Ⅳ; Grade 0 for without increase of muscle strength; Grade Ⅳ for rigidity at passive flexion and extension); The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment (FMA, total score was 226 points, including 100 for exercise, 14 for balance, 24 for sense, 44 for joint motion, 44 for pain and 66 for upper limb); The ADL were evaluated with Barthel index, the total score was 100 points, 60 for mild dysfunction, 60-41 for moderate dysfunction, < 40 for severe dysfunction). MAIN OUTCOME MEASURES: Changes of MAS grade, FMA scores and Barthel index before and after BTX-A injection. RESULTS: All the 60 patients with brain injury and stroke were involved in the analysis of results. ① FMA scores of upper limbs: The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment [(14.98±10.14), (13.10±9.28) points, P < 0.05], whereas there was no significant difference at corresponding time point in the control group. The FMA scores at 1 and 3 months in the treatment group [(23.36±10.69), (35.36±11.36) points] were higher than those in the control group [(20.55±10.22), (30.33±10.96) points, P < 0.01]. ② MAS grades of upper limbs: There were obviously fewer cases of grade Ⅲ in MAS at 2 weeks after treatment than before treatment in the treatment group (0, 9 cases, P < 0.05), whereas there was no obvious difference in the control group. There were obviously fewer cases of grade Ⅲ in MAS at 2 weeks and 1 month after treatment in the treatment group (0, 0 case) than the control group (5, 2 cases, P < 0.01). ③ Barthel index of upper limbs: The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group [(30.36±22.25), (28.22±26.21) points, P < 0.05], whereas there was no significant difference in the control group. The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group [(20.55±10.22), (30.33±10.96) points, P < 0.01]. CONCLUSION: BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury, and relieving muscle spasm; Meanwhile, the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.

Long-term renal function, complications and life expectancy in living kidney donors

Living kidney transplantation is now a widely accepted treatment for end stage renal disease(ESRD) because it provides excellent outcomes for recipients. However, long-term outcomes of living kidney donors have not been well understood. Because securing the safety of the donor is essential to the continued success of this procedure, we reviewed articles discussing long-term outcomes of living kidney donors. Most studies found no decrease in long-term survival or progressive renal dysfunction in previous kidney donors. Moreover, the prevalence of hypertension was comparable to that expected in the general population, although some did report otherwise. Urinary protein showed small increases in this population and was associated with hypertension and a lower glomerular filtration rate. Quality of life following living kidney donation seems to be better than the national norm. We also encountered several reports of ESRD in previous living kidney donors. Regular follow-up of kidney donors is recommended and future controlled, prospective studies will better delineate risk factors which cause health problems following living kidney donation.

Effects of Bazhen Pills on Quality of Life and Immune Function of Postoperative Chemotherapy in Patients with Gallbladder Cancer

OBJECTIVE: To investigate the effects of Bazhen Pills on quality of life and immune function of patients undergoing chemotherapy after gallbladder cancer surgery. METHODS: A total of 64 patients with gallbladder cancer treated by surgery and postoperative basic nutritional support and symptomatic treatment in our hospital were selected and randomly divided into the control group and the observation group, with 32 cases in each group.The control group was treated with chemotherapy from 4^(th) to 6^(th) week after surgery. The observation group was treated by Bazhen Pills on the basis of the treatment in the control group. The blood cell count, immune function,TCM symptom scores, KPS scores, quality of life and adverse reactions were compared between the 2 groups.RESULTS: The WBC and PLT in 2 groups were decreased after the treatment, and the data in the observation group were higher than that in the control group(P < 0.05). The levels of CD3^+, CD4^+ and CD8^+ in the 2 groups were increased after the treatment(P < 0.05), and the data in the observation group were higher than that in the control group(P < 0.05). TCM syndrome scores of the 2 groups were decreased after the treatment(P < 0.05),and the KPS scores were increased after the treatment(P < 0.05). The improvement degrees of the 2 scores in the observation group were higher than that of the control group(P < 0.05). The fatigue symptom scores of the 2 groups were decreased while scores of physical function, role function and overall health were increased after the treatment(P < 0.05). The scores of the observation group were better than those of the control group(P < 0.05). The total incidence of grade I-II hematological toxicity and grade I-II gastrointestinal reactions in the observation group was lower than that in the control group(21.88% vs 50.00%)(P < 0.05). CONCLUSION: Bazhen Pills can effectively relieve clinical symptoms of patients undergoing chemotherapy after gallbladder cancer surgery, and improve their immune function and quality of life, with safety.

癫痫诊断延迟的原因及后果

癫痫是常见的神经系统疾病,有证据表明癫痫是进展性疾病,既有发作性症状,又有慢性健康问题,如儿童发育迟滞,认知功能受损,生活质量下降等。早期确诊和有效治疗可以达到发作消失,改善生活质量,但由于多种原因诊断常有延迟。诊断延迟的原因:(1)延迟决定(由于患者及其亲属),不认为是发作或其他原因未就医;(2)延迟推荐(由于医生),全科医生未及时推荐至专科医疗机构;(3)延迟到达专家讨论;(4)其他因素。诊断延迟的后果:(1)不能及时得到正规治疗,形成难治性癫痫;(2)神经心理及精神的不良影响,如耻辱感等;(3)导致不正规的治疗;(4)儿童发育及认知受损;(5)因发作导致外伤;(6)受社会交往、教育及就业影响。

虚拟现实技术对维持性血液透析患者影响的Meta分析

目的评价虚拟现实技术用于维持性血液透析患者的效果分析。方法计算机检索Cochrane Library、PubMed、Embase、Web of Science、CINAHL、中国知网、中国生物医学文献数据库、维普数据库、万方数据库中关于虚拟现实技术用于维持性血液透析患者的随机对照试验和类实验性研究,由2名研究人员独立进行文献筛选和资料提取,根据纳入和排除标准进行评估,并进行交叉核对。采用RevMan 5.4软件对纳入的文献进行Meta分析。结果最终纳入文献7篇,共涉及315例患者。Meta分析结果显示,虚拟现实技术可以显著改善血液透析患者生活质量中的生理功能[MD=11.68,95%CI(5.38,17.98),P<0.01]、生理职能[MD=18.41,95%CI(9.93,26.89),P<0.01]、躯体疼痛[MD=8.75,95%CI(2.12,15.37),P=0.01]、一般健康状况[MD=9.23,95%CI(3.77,14.68),P<0.01]、精力[MD=11.90,95%CI(5.71,18.08),P<0.01]、精神健康[MD=19.14,95%CI(8.80,29.47),P<0.01];虚拟现实技术能够改善身体功能中的60 s内坐-站-坐次数[MD=4.61,95%CI(0.41,8.82),P=0.03]。结论虚拟现实技术能够改善维持性血液透析患者总体生活质量以及部分身体功能,但对抑郁的影响并不显著。

Effect of Intermittent Pneumatic Compression on Functional Level and Quality of Life in Community-Dwelling Older Adults with Limited Ambulation Due to Leg Pain: A Randomized Controlled Trial

Background and Purpose: Walking difficulties are defined as any reduction in speed, balance, or change of gait, causing limited ambulation. These difficulties are a common problem in older adults and may greatly affect their quality of life (QOL) and restrict their personal independence and participation. This study aimed to determine the effect of intermittent pneumatic compression (IPC) on lower leg pain, walking capacity, functional mobility, ankle range of motion (AROM), and QOL of community-dwelling older people with walking difficulties. Methods: In this randomized controlled trial, 34 eligible participants with self-reported lower limb pain and limited ambulation were randomized either to the intermittent pneumatic compression intervention group (IPCIG) or static compression control group (SCCG). The IPCIG and SCCG were trained to receive IPC and SC respectively for both lower legs and instructed to continue the application independently at home for 15 minutes per session, 2 sessions a day, 7 days per week for 4 weeks independently at the home. Outcome measures of lower leg pain, AROM, walking capacity, and functional mobility were assessed at baseline and at the first, second, third, and fourth weeks after randomization. Quality of life was assessed at baseline and immediately after the intervention. Results and Discussion: IPCIG showed a more significant improvement compared to the SCCG at the post-interventional stage for QOL and all the subscales. The findings show that “80% improved QOL” is 53% higher with the application of IPC than with SC for 4 weeks. The IPCIG showed a more significant improvement in the 6-minute walk test (6 MWT) at the third and fourth weeks compared to the SCCG. A pairwise comparison of mean values of 6 MWT over 4 weeks within the IPCIG showed a significant difference between all the weeks. Pairwise comparisons between groups at each time point showed that the IPCIG showed a more significant improvement in the timed up and go (TUG) test at the third and fourth weeks compared to the SCCG. Pairwise comparison of mean values of TUG test within the IPCIG showed a significant difference over 4 weeks, except between the second and third weeks, fourth week, and third and fourth weeks. The IPCIG showed a more significant improvement in lower leg pain between all weeks except the first week compared to the SCCG. Pairwise comparison of mean values of lower leg pain over 4 weeks within the IPCIG showed a significant difference among all weekly outcomes except between 1 and 2 weeks. The IPCIG showed a more significant improvement in left and right ankle dorsiflexion ROM at the third and fourth weeks compared to the SCCG. Conclusions: The IPC was effective in reducing lower leg pain and increasing the AROM and improving the walking capacity, functional mobility level, and QOL of community-dwelling older people with walking disabilities. Walking disability in old age is a common condition requiring physical therapy. Intermittent pneumatic compression can be used as a physical therapy modality for this patient group.

Effect of TCM Combined with Chemotherapy on Immune Function and Quality of Life of Patients with Non-small Cell Lung Cancer inStage Ⅲ-Ⅳ

Objective: To observe and compare the effect of traditional Chinese medicine (TCM) combined with chemotherapy (CT) on immune function and quality of life (QOL)of patients with non-small cell lung cancer (NSCLC) in stage Ⅲ-Ⅳ. Methods: One hundred cases with stage Ⅲ-Ⅳ NSCLC were randomly divided into two groups. The treated group (n=50) received CT combined with TCM, and the control group received CT alone. The percentage of T lymphocyte subset in peripheral blood and the change of natural killer (NK) cell count were observed after treatment. The QOL and tolerance of CT were also compared between the two groups after treatment. Results: In the treated group, CD3 cell count, CD4 cell count, CD4/ CDg ratio and NK cell activity were higher than those in control group, while CD8 cell count in the treated group was lower than that in the control group (P<0.05), and QOL and tolerance of CT in the treated group were also better (P<0.05). Conclusion: TCM combined with CT could raise the patients' ability in tolerating CT in stage Ⅲ-ⅣNSCLC.

扶正驱邪方联合新辅助化疗对三阴性乳腺癌患者肿瘤复发、血清TK1 水平及免疫功能的影响

【目的】探究扶正驱邪方联合新辅助化疗对三阴性乳腺癌(TNBC)患者肿瘤复发、血清胸苷激酶1(TK1)水平及免疫功能的影响。【方法】将80例TNBC气阴两虚型患者随机分为联合组和对照组,每组各40例。对照组给予AC-T序贯化疗方案(多柔比星与环磷酰胺联合并序贯多西他赛)治疗,联合组在对照组的基础上加用扶正驱邪方治疗。1个疗程为21 d,连续治疗4个疗程。观察2组患者治疗前后中医证候积分、生活质量Karnofsky功能状态(KPS)评分、肿瘤标志物[糖类抗原125(CA125)、糖类抗原153(CA153)、TK1]水平及T淋巴细胞亚群的变化情况,比较2组患者的临床疗效以及肿瘤的转移、复发情况。【结果】(1)治疗4个疗程后,联合组的总有效率为87.50%(35/40),对照组为67.50%(27/40),组间比较(χ2检验),联合组的疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的中医证候积分均较治疗前明显降低(P<0.05),KPS评分均较治疗前明显升高(P<0.05),且联合组对中医证候积分的降低幅度及对KPS评分的升高幅度均明显优于对照组(P<0.05或P<0.01)。(3)治疗后,2组患者的血清CA125、CA153、TK1水平均较治疗前明显降低(P<0.05),且联合组对血清CA125、CA153、TK1水平的降低幅度均明显优于对照组(P<0.01)。(4)治疗后,2组患者的T细胞CD3+、CD4+水平和CD4+/CD8+比值均较治疗前明显升高(P<0.05),CD8+水平均较治疗前明显降低(P<0.05),且联合组对T细胞CD3+、CD4+水平和CD4+/CD8+比值的升高幅度及对CD8+水平的降低幅度均明显优于对照组(P<0.05或P<0.01)。(5)经过1年的随访调查,联合组的肿瘤复发率和肿瘤转移率分别为7.50%(3/40)和12.50%(5/40),明显低于对照组的25.00%(10/40)和35.00%(14/40),组间比较,差异均有统计学意义(P<0.05)。【结论】扶正驱邪方联合新辅助化疗对于TNBC气阴两虚型患者的治疗效果较好,能有效改善患者的免疫功能,降低血清肿瘤标志物水平,提高患者的生活质量,降低肿瘤复发和转移的发生率。

Functional Enrichment of Utopian Distribution of Plant Life-Forms

Adaptive fuzzy neural inference systems are used to illustrate the primary nodal number of plant life-forms. Categorization of two candidate areas is carried out using the water-energy dynamic (for Ecuador, South America) and Macedonia, Southern Europe), within which the life-form spectra are distributed. Genetic optimization methods are used to expand the primary nodal number to the complete number of life-form categories. The distribution of the elements exhibits a stochastic, binomial distribution and the utopia line and curve are summarized which enhance accuracy of the climatic data and of the consequent numbers of plant species occurrences. Expansion of the distribution of each life-form category is approximated within the Z utopia hyperplane with use of the functional approximation algorithm. This process gives additional structure and informative value to the Z plane, enhancing our ability to make informed policy decisions concerning species and ecosystem conservation.

耳穴压豆联合正念减压法对肝郁型乳腺癌患者术后生存质量及免疫功能的影响

目的探讨耳穴压豆联合正念减压法对肝郁型乳腺癌患者术后生存质量及免疫功能的影响。方法选取2021年11月至2022年12月滨州医学院烟台附属医院收治的120例肝郁型乳腺癌患者,按照随机数字表法分为观察组和对照组,每组各60例。对照组采用常规护理,观察组在对照组的基础上采用耳穴压豆联合正念减压法。比较两组生命质量评分及免疫功能。结果干预后,观察组社会/家庭状况、情感状况、功能状况及附加关注评分均高于对照组(P<0.05)。干预后,两组生理状况评分比较,差异无统计学意义(P>0.05)。干预后,观察组CD3^(+)及CD4^(+)水平均高于对照组(P<0.05)。结论耳穴压豆联合正念减压法可改善肝郁型乳腺癌患者术后生存质量及免疫功能,值得临床推广应用。