Life in Triviality: Reinterpretation of The Hours Based on Philip Glass' Scores

The movie The Hours, adapted from Michael Cunningham's novel, presents us three different women's life in a day to reflect trivial people's struggle, contemplation of self-worth and death, with Philip Glass' scores and the well-designed settings. This paper focuses on Glass' scores and analyzes its connection with other elements, reflection of those people and coherence of the movie.

Value of quality of life analysis in liver cancer: A clinician's perspective

Health related quality of life(HRQOL) is increasingly recognized as an important clinical parameter and research endpoint in patients with hepatocellular carcinoma(HCC). HRQOL in HCC patients is multifaceted and affected by medical factor which encompasses HCC and its complications, oncological and palliative treatment for HCC, underlying liver disease, as well as the psychological, social or spiritual reaction to the disease. Many patients presented late with advanced disease and limited survival, plagued with multiple symptoms, rendering QOL a very important aspect in their general well being. Various instruments have been developed and validated to measure and report HRQOL in HCC patients, these included general HRQOL instruments, e.g., Short form(SF)-36, SF-12, Euro Qo L-5D, World Health Organization Quality of Life Assessment 100(WHOQOL-100), World Health Organization Quality of Life Assessment abbreviated version; general cancer HRQOL instruments, e.g., the European Organisation for Research and Treatment of Cancer(EORTC) QLQ-C30, Functional Assessment of Cancer Therapy(FACT)-General, Spitzer Quality of Life Index; and liver-cancer specific HRQOL instruments, e.g., EORTC QLQ-HCC18, FACT-Hepatobiliary(FACT-Hep), FACT-Hep Symptom Index, Trial Outcome Index. Important utilization of HRQOL in HCC patients included description of symptomatology and HRQOL of patients, treatment endpoint in clinical trial, prognostication of survival, benchmarking of palliative care service and health care valuation. In this review, difficulties regarding the use of HRQOL data in research and clinical practice, including choosing a suitable instrument, problems of missing data, data interpretation, analysis and presentation are examined. Potential solutions are also discussed.

Assessment of disease specific knowledge and health-relatedquality of life among United States military veterans withinflammatory bowel disease

AIM To evaluate the association between patientdisease knowledge of inflammatory bowel disease （IBD）and health related quality of life （HRQoL） and identifypatient and disease related predictors of patientknowledge of IBD.METHODS： We performed a cross-sectional study ofIBD patients with an established diagnosis of IBD longerthan 3 mo prior to enrollment. The Crohn＇s and colitisknowledge score （CCKNOW） and short inflammatorybowel disease questionnaire （SIBDQ） were selfadministeredto assess patient knowledge of IBDand HRQoL, respectively. Demographic and diseasecharacteristics were abstracted from the electronicmedical record. The correlation between CCKNOWand SIBDQ scores was assessed by a linear regressionmodel. Associations of patient knowledge and thevariables of interest were calculated using ANOVA.RESULTS： A total of 101 patients were recruited.Caucasian race, younger age at diagnosis, and having a college or post-graduate degree were significantlyassociated with higher CCKNOW scores. Patients withCD had higher CCKNOW scores compared to patientswith ulcerative colitis and inflammatory bowel diseasetype unclassified, P 〈 0.01. There was no significantcorrelation between overall CCKNOW and SIBDQ scores（r^2 = 0.34, P = 0.13）. The knowledge sub-domain ofdiet in CCKNOW was negatively correlated with HRQoL（r^2 = 0.69, P 〈 0.01）.CONCLUSION： IBD diagnosis at a younger age inaddition to Caucasian race and higher education weresignificantly associated with higher knowledge aboutIBD. However, patient knowledge of IBD was notcorrelated with HRQoL. Further studies are required tostudy the effect of patient knowledge of IBD on otherclinical outcomes.

Study of the relationship between selfstigma and subjective quality of life for individuals with chronic schizophrenia in the community

Background Studies conducted outside of China have found that stigma can predict low quality of life, and research in China has shown that stigma has an impact on the quality of life of convalescent patients with schizophrenia. Nevertheless, there is no indepth research on the impact of stigma on the quality of life of patients.Aims To research the correlation of stigma and the subjective quality of life of persons with chronic schizophrenia in the community.Methods We adopted a stratified sampling method.General questionnaire, quality of life scale and stigma scale were given to 602 persons with chronic schizophrenia in the community.Results The mean(SD) value of the Subjective Quality of Life Scale total scores was 32.99(13.85). The mean(SD)value of the total stigma scores was 43.50(5.02). After correlation analysis and multivariate stepwise regression analysis, it was shown that the total scores for self-stigma and each factor were positively correlated with subjective quality of life(r=0.462, p<0.001), psychosocial factors(r=0.517, p<0.001), and symptoms and adverse reaction factor scores(r=0.363, p<0.001),and the correlation coefficients were statistically significant.Conclusions The higher the stigma of persons with schizophrenia in the community, the lower the subjective quality of life is. This suggests that reduction of self-stigma should be considered in the improvement of the quality of life of persons with schizophrenia in the community.

Malnutrition and Quality of Life in Chinese Cancer Patients: a Clinical Study of 23,994 Subjects

Background Malnutrition is common in patients with cancer,and can negatively impact their quality of life(QoL)and even survival.However,there is currently no large data available on the prevalence of malnutrition in Chinese cancer patients.This study evaluated the prevalence of malnutrition and the QoL of Chinese patients with locoregional,recurrent or metastatic cancer.Methods We conducted a nationwide observational,multi-center,hospital-based cross-sectional study within the Chinese Society of Nutritional Oncology(CSNO)Network.All of the patients were diagnosed with one of the following 18 different types of malignant tumors:lung cancer,gastric cancer,liver cancer,colorectal cancer,breast cancer,esophageal cancer,cervical cancer,endometrial cancer,nasopharyngeal carcinoma,malignant lymphoma,leukemia,pancreatic cancer,ovarian cancer,prostate cancer,bladder cancer,brain cancer,biliary tract malignant tumors or gastrointestinal stromal tumors.These patients were enrolled from 72 hospitals located in different regions of China.The patients’nutritional status was evaluated based on the body mass index(BMI),loss of bodyweight,laboratory measurements and patient generated-subjective global assessment(PG-SGA)scores.The cancer patients’physical status and QoL were assessed by the Karnofsky Performance Status(KPS)questionnaire and the European Organization for Research and Treatment of Cancer(EORTC)QLQ-C30 questionnaire,respectively.Results From December 2013 to April 2016,23,994 patients hospitalized for cancer treatment(such as surgery,chemotherapy or radiotherapy)were enrolled in the study.The patients included 12,494(52.9%)males and 11,124(47.1%)females.The mean age was 55.8±13.7 years.The proportions of patients in cancer stagesⅠ,Ⅱ,Ⅲ,Ⅳand uncertain were 11.5%,20.3%,27.5%,30.2%and 10.5%,respectively.Among the 23,994 inpatients,the proportions of patients who were underweight(BMI<18.5 kg/m2),normal(18.5 kg/m2<BMI<24 kg/m2),overweight(24 kg/m2≤BMI<28 kg/m2)and obese(BMI≥28 kg/m2)were 9.3%,59.9%,26.1%and 4.7%,respectively.A total of 18.3%(4,101/22,424)of patients had lost 5%or more of their bodyweight within the past month and 19.6%(2,463/12,538)of patients had lost 10%or more of their bodyweight within the past 6 months.According to the PG-SGA scores,26.6%of the patients were severely malnourished(score≥9),31.3%were moderately malnourished(scores 4~8).A total of 22.2%of patients had a serum albumin level lower than 35g/L.Only 8.6%(2056/23,991)of the patients had severe KPS scores(≤60).The patients with these severe KPS scores were most frequently among those with cancers of the brain(19.7%),prostate(18.0%),pancreas(15.5%)and bladder(15.0%).Based on the QLQ-C30 score,11.6%of patients had a poor QoL.The PG-SGA score and global QoL were correlated(r=-0.593,P<0.001).Conclusion The prevalence of malnutrition in patients with cancer is relatively high,and is related to a poorer QoL.The present findings should be kept in mind when assessing cancer patients,because addressing the patient’s problems in nutritional status would be expected to improve both the clinical outcomes and QoL in cancer patients with malnutrition.

Post-surgery Quality of Life in Patients with Acromegaly Using SF36 Quality of Life Questionnaire-prospective Study

Introduction:Acromegaly is chronic progressive disease with multisystem involvement characterised by an excess secretion of growth hormone and increased circulating insulin like growth factor 1 concentration.Aims and Objectives:To assess surgical outcome of acromegaly patients at tertiary care institute using SF 36 quality of life questionnaire.SF-36 scores comprise 3 components:the physical component summary(PCS),the mental component summary(MCS)and role-social component summary(RCS).30 acromegaly patients admitted in Guwahati medical college were enrolled in study and followed up post operatively for surgical remission.All participants completed the SF-36 preoperatively,1 year and 2 years postoperatively.Material and Method:Out of 30 patients 6 patients had surgical remission post operatively on the basis of postoperative glucose suppressed GH Level done after 12 weeks.Preoperatively subscale scores(physical functioning,role physical,general health)which were below the set standards for the normal population show significant postoperative improvements along with mental health(MH)scores.Similarly,PCS,MCS and RCS scores changed significantly after surgery.We also compared the QOL of 6 patients whose peak GH level was<0.4μg/L during postoperative oral glucose tolerance testing with those patients whose nadir GH level was≥0.4μg/L.There was significant difference between partial and complete remission group in subscale score role physical,social function and mental health.Similarly,PCS and RCS score significantly different in partial and complete remission group than MCS score.Conclusions:QOL is considerably reduced in patients with acromegaly compared to general population which improves significantly after surgical treatment.Patients achieving the new remission criteria had significant improvement in physical and social components than those who did not.

The animal cachexia score(ACASCO)

Background:None of the published studies involving cancer cachexia experimental models have included a measure of the severity of the syndrome like the scoring system previously developed for human subjects.The aim of the present investigation was to define and validate a cachexia score usable in both rat and mouse tumor models.Methods:In order to achieve this goal,we included in the study one rat model(Yoshida AH‐130ascites hepatoma)and two mouse models(Lewis lung carcinoma and Colon26 carcinoma).The Animal cachexia score(ACASCO)includes five components:(a)body and muscle weight loss,(b)inflammation and metabolic disturbances,(c)physical performance,(d)anorexia,and(e)quality of life measured using discomfort symptoms and behavioral tests.Results:Using the ACASCO values,three cut‐off values were estimated by applying hierarchical cluster analysis.Four groups were originally described,one exactly below the observed mean,a second exactly over the mean,and two other groups adjusted to every cue(inferior and superior).The three cut‐off values were estimated through maximization of the classification function.This was accomplished by using a similarity matrix based on the metric properties of the variables and assuming multinormal distribution.The results show that the four groups were:no cachexia,mild cachexia,moderate cachexia and advanced cachexia.Conclusions:The results obtained allow us to conclude that the score could be very useful as an endpoint in pre‐clinical studies involving therapeutic strategies for cancer cachexia.The potential usefulness of ACASCO relates to the primary endpoint in pre‐clinical cancer cachexia drug evaluations.

Cities Make Life Better:Hukou and Household Satisfaction about Life

This paper examines the relationship between a change of hukou and househoM satisfaction about life based on large-sample China Family Panel Studies （CFPS） data. As horizontally shown by cross-section data, significant hukou identity differences exist in the subjective happiness of households reflected in life satisfaction. However, the traditional view that ＂rural residents are subjectively happier than urban residents＂ is not verified in this study. From a vertical perspective of tracing data, the estimation results of the DID model and the PSM model indicate that a change of hukou identity for rural residents has a significantly positive effect on their subjective happiness, lending credence to the saying that ＂cities make life better＂.

Does gastric stump cancer really differ from primary proximal gastric cancer? A multicentre, propensity score matching-used, retrospective cohort study

BACKGROUND Although the location of proximal cancer of the remnant stomach is the same as that of primary proximal cancer of the stomach,its clinical characteristics and prognosis are still controversial.AIM To evaluate the clinicopathological features and prognosis factors of gastric stump cancer(GSC)and primary proximal gastric cancer(PGC).METHODS From January,2005 to December,2016,178 patients with GSC and 957 cases with PGC who received surgical treatment were enrolled.Patients in both groups underwent 1:1 propensity score matching analysis,and both clinical and pathological data were systematically collected for statistical purposes.Quality of RESULTS One hundred and fifty-two pairs were successfully matched after propensity score matching analysis.Of the 15 demographic and pathological variables collected,the analysis further revealed that the number of lymph nodes and positive lymph nodes were different prognostic and clinicopathological factors between PGC and GSC.Univariate and multivariate analyses showed that gender,differentiation degree and tumor-node-metastasis stage were independent risk factors for patients with GSC.Gender,vascular invasion,differentiation degree,depth of infiltration,positive lymph nodes,and tumor-node-metastasis stage were independent risk factors for patients with PGC.The 5-year overall survival and cancer-specific survival of patients with GSC were significantly lower than those in the PGC group,the scores for overall quality of life in the GSC-malignant group were lower than the GSC-benign,and the differences were statistically significant.CONCLUSION The differences in clinicopathological characteristics between GSC and PGC were clarified,and PGC had a better prognosis than GSC.

The Self-Administered International Prostate Symptoms Score (IPSS) Questionnaire of Kosovo Men with Benign Prostatic Hyperplasia

Background: Benign prostatic hyperplasia (BPH) has been a major health problem for aging males because of its related symptoms and complications. Although it is not a life-threatening condition, BPH has an adverse effect on a patient’s quality of life, as manifested in community and clinical trials. Aim: The aim of the study was the perception of patients in their symptomatology by comparing the place of residence and quality of life in living with HBP using the IPSS questionnaire. Materials and Methods: This was a prospectively designed study conducted at University Clinical Centre of Kosovo—Urology Clinic. The study was conducted from October 2020 to January 2021. The study in criteria was as follows: all patients who presented to the urology outpatient clinic with BPH, Lower Urinary Tract Symptoms (LUTS) and aged > 40 years. The exclusion criteria included the following cases: patients with uncontrolled diabetes (prostate-specific antigen > 4 ng/dL);patients with a history of transurethral resection of the prostate. Results: This study was carried out on 100 consecutive patients with HBP and LUTS attending. The largest proportion of patients 51% was in the 46 - 55 age group. Most patients were between 45 - 65 years of 51%. The largest number of them (52%) was with severe symptoms and 41% of them were with moderate symptoms. Comparing the three levels of IPSS and the quality of life of patients with HBP and LUTS, when asked how they would feel if they still had problems with urination, 22% said they felt upset, analyzing the categorization of patients according to IPSS: mild symptoms were Mean/SD (1.71. ± 1.113), moderate symptoms (2.9 ± 1.49) and severe symptoms (4.31 ± 1.27) p < 0.156. Statistical reliability of 64% p < 0.000 was in patients where they were interested in learning about any invasive option that would allow them to discontinue medication for LUTS. Conclusion: The IPSS is a valid instrument to assess the impact of BPH symptoms on health and quality of life due to urinary symptoms.

基于治未病理论灸药同治对实体恶性肿瘤化疗患者骨髓抑制的预防作用

目的:基于治未病理论探讨灸药同治对实体恶性肿瘤化疗患者骨髓抑制的预防作用。方法:选取2019年1月至2022年1月于武汉科技大学附属武汉亚心总医院接受治疗的实体恶性肿瘤化疗患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组常规接受化疗,观察组化疗前连续3 d给予灸药同治(艾灸+加味八珍汤)。比较治疗前、化疗后7 d 2组患者中医证候积分、血常规[血红蛋白(Hb)、白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞计数(NEUT)]、生命质量[卡诺夫斯凯计分(KPS)、中国癌症患者生命质量(QOL_(2))调查问卷],比较化疗后7 d 2组患者骨髓抑制情况[发生率、严重程度、重组人粒细胞集落刺激因子(rhG-CSF)使用情况]。结果:化疗后7 d,2组患者中医证候积分升高,但观察组低于对照组(P<0.05);Hb、WBC、PLT、NEUT、KPS评分及QOL_(2)评分降低,但观察组高于对照组(均P<0.05);观察组骨髓抑制发生率、rhG-CSF使用率低于对照组,0、Ⅰ度比例高于对照组(均P<0.05)。结论:基于治未病理论,灸药同治能够改善实体恶性肿瘤化疗患者临床症状及血常规,提高患者生命质量,减少骨髓抑制的发生。

Analysis of the Effect of Different Treatment Schemes on Helicobacter Pylori Infection on Improving the Quality of Life of Patients

Objective:To analyze the effect of different treatment schemes on the quality of life of patients with Helicobacter pylori infection.Methods:From June 2019 to November 2020,96 patients with Helicobacter pylori infection were selected and randomly assigned Combined treatment with omeprazole,amoxicillin and clarithromycin was named group A;Group B was treated with omeprazole,amoxicillin,clarithromycin and colloidal bismuth pectin;Group C was given omeprazole,amoxicillin,clarithromycin and metronidazole.Results:The symptom score and gastroscope score of group B or C were lower than those of group A(P<0.05);The incidence of adverse reactions and HP eradication rate in group C were lower than those in group B,and those in group B were lower than those in group A(P<0.05);The quality of life score of group C was higher than that of group B,and that of group B was higher than that of group A,P<0.05.Conclusions:The sequential therapy of omeprazole,amoxicillin,clarithromycin and metronidazole in patients with Helicobacter pylori infection can improve the HP eradication rate,improve the quality of life of patients,which is safe and efficient.

百令胶囊预防PD-1抑制剂肺癌患者免疫相关性肺炎的临床观察

目的 探讨百令胶囊预防PD-1抑制剂肺癌患者免疫相关性肺炎(CIP)的临床效果。方法 选取2021年5月至2022年5月九江市第一人民医院肿瘤内科住院且使用免疫检查点抑制剂(ICIs)的晚期肺癌患者60例,按随机数字表法分为对照组和试验组,每组各30例。对照组给予PD-1抑制剂治疗,试验组在对照组基础上加用口服百令胶囊。比较两组临床疗效,生活质量[生存质量卡氏(KPS)评分],不良反应,1年后生存情况,CIP发生情况。结果 治疗4个周期后,试验组疾病控制率(DCR)高于对照组,差异有统计学意义(P<0.05)。两组治疗前KPS评分比较,差异无统计学意义(P>0.05);两组治疗4个周期后KPS评分均高于治疗前,且试验组KPS评分高于对照组,差异有统计学意义(P<0.05)。试验组各项不良反应发生率均低于对照组,差异有统计学意义(P<0.05);随访1年,试验组生存率为90.00%(27/30),高于对照组的63.33%(19/30),差异有统计学意义(P<0.05)。治疗期间试验组CIP发生率低于对照组,差异有统计学意义(P<0.05)。结论 使用PD-1抑制剂肺癌患者应用百令胶囊治疗能够有效改善患者病情,提升患者生活质量,降低CIP发生风险,且不良反应较少,安全可靠,并可提升患者生存率,值得推广应用。

功能性鼻内镜手术九步法标准化疗法对慢性鼻窦炎患者疼痛程度和鼻内镜Lund-Kennedy评分与鼻窦CT

目的探究功能性鼻内镜手术九步法标准化疗法对慢性鼻窦炎患者疼痛程度、鼻内镜Lund-Kennedy评分、鼻窦CTLund-Mackay评分及生命质量的影响。方法选取2019年1月至2021年6月于吉安市中心人民医院就诊的82例慢性鼻窦炎患者作为研究对象,按照随机抽签法分为对照组与观察组,每组41例。对照组采用传统开放式手术,观察组采用功能性鼻内镜手术九步法标准化疗法,比较两组临床疗效、疼痛程度、病情严重程度、鼻窦恢复情况、并发症发生情况及生命质量。结果观察组治疗总有效率为95.12%,高于对照组的78.05%,差异有统计学意义(P<0.05)。术后6个月,两组视觉模拟评分法(VAS)、鼻窦CTLund-Mackay、鼻内镜Lund-Kennedy评分均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率为4.88%,低于对照组的21.95%,差异有统计学意义(P<0.05)。术后6个月,两组鼻腔鼻窦结局测试-20(SNOT-20)评分均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论与传统开放式手术比较,功能性鼻内镜手术九步法标准化疗法治疗慢性鼻窦炎的近期效果较理想,可减轻患者疼痛及病情严重程度,促进鼻窦恢复,提高患者生命质量,且安全性高,可作为慢性鼻窦炎患者的理想治疗术式之一,值得临床推广应用。

膝关节骨性关节炎致内侧疼痛患者的腓骨截骨治疗效果及对生活质量、关节功能、疼痛评分的影响

目的探讨膝关节骨性关节炎致内侧疼痛患者的腓骨截骨治疗效果及对生活质量、关节功能、疼痛评分的影响。方法选择2022年3月—2023年6月本院收治的54例膝关节骨性关节炎致内侧疼痛患者,随机分为对照组(n=27)和观察组(n=27),对照组采用关节镜下膝关节清理术治疗,观察组采用腓骨截骨术联合关节镜下膝关节清理术治疗。对比两组生活质量、关节功能、疼痛评分。结果观察组生活质量评分方面显著高于对照组,组间差异有统计学意义(P<0.05);观察组VAS评分显著低于对照组,组间差异有统计学意义(P<0.05);观察组HSS评分显著高于对照组,组间差异有统计学意义(P<0.05)。结论膝关节骨性关节炎致内侧疼痛患者在常规关节镜下膝关节清理术治疗的基础上给予腓骨截骨治疗,有利于减轻疼痛感,改善关节功能状况,提升生活质量,临床应用价值较高。

红萸饮治疗放射性肠炎临床研究

目的:观察红萸饮对放射性肠炎患者临床症状及生活质量的影响。方法:将68例患者随机分为观察组和对照组各34例,两组均有2例脱落,各余32例。观察组采用红萸饮口服治疗30 d,对照组采用柳氮磺胺吡啶(SASP)联合诺氟沙星(NOR)口服治疗,SASP口服30 d,NOR口服7 d,观察比较两组患者症状积分、肠鸣音次数、直肠黏膜积分、生活质量评分、不良反应情况及总有效率。结果:治疗过程中,两组患者均未发生严重不良反应;治疗后,两组上述观察指标均较治疗前改善(P<0.05),且除腹痛积分外,观察组其他症状积分及肠鸣音次数、直肠黏膜积分均低于对照组(P<0.05),生活质量评分高于对照组(P<0.05);总有效率为观察组87.5%,对照组68.8%,两组疗效比较,差异无统计学意义(P>0.05)。结论:红萸饮口服更能缓解放射性肠炎患者便血、里急后重、大便次数增多等症状,提高生活质量。

补肾健脾通络方治疗老年衰弱综合征临床疗效观察

目的观察补肾健脾通络方治疗老年衰弱综合征临床疗效及安全性。方法研究纳入2021年1月—2022年6月收治的老年衰弱综合征患者共计102例,以随机数字表法将患者分为对照组与观察组,每组51例,对照组患者采取临床常规治疗,观察组患者采取常规治疗结合补肾健脾通络方治疗。观察各组数据:治疗总有效率、治疗前后患者中医证候总积分变化及Fried表型衰弱量表(frailty phenotype,FP)评分变化及白介素-6(interleukin 6,IL-6)、超敏C反应蛋白(C-ReactiveProtein,hs-CRP)水平变化、握力变化及起立-行走计时测试(Timed Up and Go test,TUG)变化、5次坐立试验(five-times-sit-to-stand test,FTSST)变化、步速变化、体质指数(Body Mass Index,BMI)变化及四肢骨骼肌质量指数(appendicular skeletal muscle mass index,ASMI)变化、简易精神状态评分(Mini-mental State Examination,MMSE)变化、匹兹堡睡眠指数(Pittsburgh sleep quality index,PSQI)评分变化、日常生活能力(Activity of Daily Living,ADL)评分变化、微型营养评估(mini nutritionaal assessment,MNA)评分变化、患者治疗满意度、不良反应。结果观察组患者治疗总有效率比对照组高[96.08%(49/51)vs84.31%(43/51)],P<0.05;治疗前,各组患者中医证候总积分、FP评分、IL-6、hs-CRP水平、握力、TUG测试结果及FTSST测试结果、步速、BMI、ASMI、MMSE评分、PSQI评分、ADL评分、MNA评分比较,P>0.05,治疗后各组患者中医证候总积分、FP评分、IL-6、hs-CRP水平、握力、TUG测试结果及FTSST测试结果、步速、BMI、ASMI、MMSE评分、PSQI评分、ADL评分、MNA评分均改善,观察组患者治疗后中医证候总积分、FP评分、IL-6、hs-CRP水平、握力、TUG测试结果及FTSST测试结果、步速、BMI、ASMI、MMSE评分、PSQI评分、ADL评分、MNA评分均优于对照组患者,P<0.05;观察组患者治疗满意度高于对照组[98.04%(50/51)vs84.31%(43/51)],P<0.05;观察组与对照组不良反应率均较低,且可自行缓解,P>0.05。结论补肾健脾通络方治疗老年衰弱综合征临床疗效显著,能缓解衰弱综合征患者的临床症状,抑制患者机体炎性反应,增加肌肉质量,改善睡眠,提高生活质量,且无不良反应,较为安全可靠,值得应用。

Diagnostic tools for fecal incontinence: Scoring systems are the crucial first step

The main aim of this editorial is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593-4603.This original research presents a new scoring system for fecal incontinence.Fecal incontinence is a chronic disease with a severe impact on the quality of life of the patients.Substantial social stigmatization often leads to significant underreporting of the condition even during visits to a specialist and could lead to further misman-agement or non-existent management of the disease.An important fact is that patients are often unable to describe their condition when not asked precisely defined questions.This problem is partially resolved by scoring questionnaires.Several scoring systems are commonly used;however,each of them has their shortcomings.For example,the absence of different kinds of leakage besides flatus and stool could further lead to underscoring the incontinence severity.Therefore,there has long been a call for a more precise scoring system.The correct identification of the presence and severity of fecal incontinence is paramount for further diagnostic approach and for choosing the appropriate therapy option.This editorial describes fecal incontinence,its effect on quality of life in general and further evaluates the diagnostic approach with a particular focus on symptom scoring systems and their implications for clinical practice.

全胰切除术与胰十二指肠切除术治疗胰腺癌的手术疗效和生活质量对比分析:基于倾向性评分匹配的回顾性队列研究

目的探究全胰切除术(total pancreatectomy,TP)与胰十二指肠切除术(pancreaticoduodenectomy,PD)治疗胰腺癌患者的术后短期并发症与长期预后差异。方法回顾性收集北京协和医院2016年1月至2021年12月行TP(TP组)和2019年1月至2021年12月行PD(PD组)的胰腺癌患者临床资料。根据危险因素的不同,将PD组患者分为胰瘘高风险PD组和复发高风险PD组。采用倾向性评分法匹配后,比较TP组与胰瘘高风险PD组、复发高风险PD组术后短期手术疗效指标(术后并发症发生率、30 d死亡率、住院时间等)、长期手术疗效指标(总生存期)及生活质量差异。结果共入选符合纳入与排除标准的TP组患者32例,PD组174例(胰瘘高风险PD组99例,复发高风险PD组15例)。(1)TP组与胰瘘高风险PD组:经倾向性评分匹配后,最终纳入TP组患者29例、胰瘘高风险PD组患者56例。TP组无胰瘘发生,胰瘘高风险PD组胰瘘发生率为19.64%(P=0.027),两组其他术后并发症发生率、Clavien-Dindo分级、住院时间、ICU停留时间、30 d死亡率等短期手术疗效指标均无统计学差异(P均>0.05)。中位随访时间36个月时,两组生命质量核心量表(quality of life questionnaire-core 30,QLQ-C30)评分均无显著差异(P均>0.05)。(2)TP组与复发高风险PD组:由于两组基线资料均无统计学差异(P均>0.05),故TP组32例患者、复发高风险PD组15例患者均纳入分析。TP组无胰瘘发生,复发高风险PD组胰瘘发生率为20.00%(P=0.028),两组其他术后并发症发生率、Clavien-Dindo分级、住院时间、ICU停留时间、30 d死亡率等短期手术疗效指标亦无统计学差异(P均>0.05)。截至末次随访,与复发高风险PD组比较,TP组中位总生存期更长(37.68个月比15.24个月,HR=2.551,95%CI:1.144~5.689,P=0.018);多因素Cox回归分析显示,复发高风险PD、术前合并梗阻性黄疸是胰腺癌患者长期预后不良的独立危险因素。结论对于胰瘘高风险胰腺癌患者,TP可取得与PD相当的短期手术疗效和长期生活质量,且术后无胰瘘负担。对于复发高风险胰腺癌患者,TP可在保证手术安全性的基础上显著延长患者生存期。

复方守宫散辅助治疗晚期结直肠恶性肿瘤的疗效观察

目的基于倾向性评分匹配法探讨复方守宫散辅助治疗晚期结直肠恶性肿瘤的疗效。方法采用倾向性评分匹配法,将匹配成功的70例患者分为对照组(化学治疗)和观察组(复方守宫散联合化学治疗),每组35例;比较两组患者瘤体客观疗效[客观缓解率(objective response rate,ORR),疾病控制率(disease control rate,DCR)]、生活质量评分、免疫功能指标、安全性指标,并对生存期进行分析。结果观察组ORR、DCR优于对照组(P<0.05);观察组患者治疗后功能维度(躯体功能、角色功能、情绪功能、认知功能、社会功能),症状领域(疲劳、疼痛、恶心呕吐)评分改善程度显著优于对照组(P<0.05);观察组患者血清CD4+T细胞、CD8+T细胞、自然杀伤细胞水平,CD4+/CD8+均显著高于对照组(P<0.05);治疗组患者总不良反应发生率显著低于对照组(P<0.05);观察组的中位无进展生存期显著高于对照组(P<0.05),中位总生存期高于对照组(P>0.05)。结论相较于单纯化学治疗,复方守宫散与化学治疗联合应用能显著提高疗效,增强机体免疫力,改善晚期结直肠癌患者生活质量,降低化学治疗的毒性及不良反应,在一定程度上延长患者生存时间。