Patient-reported Outcomes (PROs): An Approach to Evaluate Treatment Efficacy of Chinese Medicine or Integrative Medicine

Chinese medicine (CM) has been an experience based practice over the past three thousand years. The safety and efficacy of CM has been practised through experience, rather than nowadays’ modern scientific measurements. In this way, the development of CM has not been keeping pace with the advance in science and technology and the progress in orthodox medicine. In order to meet the requirements of modern science and technology, an evidence based approach must be adopted. Reassurance is needed to convince people for safety and efficacy of CM and give confidence to the evidence based demands ——“Tradition is confirmed by Modern Science” (1) .

Patient-Reported Outcomes in Prostate Cancer: Prospective Changes Analysis for Prognosis Prediction

Prostate cancer is affecting a higher proportion of male population. Health Related Quality of Life assessment can guide the development of an interdisciplinary and patient-centered care intervention. This study is aimed to assess Health Related Quality of Life in prostate cancer patients. Relationships between socio-demographic, clinical characteristics and patient-reported outcomes have been considered. Consecutive outpatients with prostate cancer, admitted at the Urology Clinic of the Instituto Português de Oncologia do Porto, were studied (n = 300). Health Related Quality of Life was assessed as part of the routine practice. The European Organisation for Research and Treatment of Cancer general questionnaire, QLQ-C30, and its specific module for prostate cancer patients, QLQ-PR25, were used. Evolution along time (elapsed since diagnosis, and up to 5 years) was considered in order to search for a prognosis prediction in prostate cancer patients. This study confirms the feasibility of a systematic Health Related Quality of Life assessment. Global Health Related Quality of Life was found to be higher 6 months after diagnosis, decreasing then until the second year after diagnosis and improving thereafter. A peak with better scores was identified at the fifth year after diagnosis. Social and physical dimensions revealed a similar pattern. Clinical significance was found 6 months and 5 years after diagnosis. The prospective analysis of Health Related Quality of Life changes is able to explore the patients’ outcomes in order to find patterns and relationships for prognosis prediction along the disease course. Such approach might promote patient confidence and thus a better cancer experience.

Insulin therapy in type 2 diabetes: Insights into clinical efficacy, patient-reported outcomes, and adherence challenges

Insulin therapy plays a crucial role in the management of type 2 diabetes as the disease progresses.Over the past century,insulin formulations have undergone significant modifications and bioengineering,resulting in a diverse range of available insulin products.These products show distinct pharmacokinetic and pharmacodynamic profiles.Consequently,various insulin regimens have em-erged for the management of type 2 diabetes,including premixed formulations and combinations of basal and bolus insulins.The utilization of different insulin regimens yields disparate clinical outcomes,adverse events,and,notably,patient-reported outcomes(PROs).PROs provide valuable insights from the patient’s perspective,serving as a valuable mine of information for enhancing healthcare and informing clinical decisions.Adherence to insulin therapy,a critical patient-reported outcome,significantly affects clinical outcomes and is influenced by multiple factors.This review provides insights into the clinical effectiveness of various insulin preparations,PROs,and factors impacting insulin therapy adherence,with the aim of enhancing healthcare practices and informing clinical decisions for individuals with type 2 diabetes.

Clinical study inpatient-reported outcomes after binocular implantation of aspheric intraocular lens of different negative spherical aberrations

Objective: To compare patient-reported outcomes after implantation of the ZA9003 intraocular lens(IOLs), or the MCX11 ASP IOLs or the spherical IOLs(HQ-201HEP). Methods: Prospective nonrandomized controlled trial was used. A total of 105 patients(210 eyes) were divided into three groups according to the type of IOLs: ZA9003(35 patients, 70 eyes), MCX11 ASP(35 patients, 70 eyes) or HQ-201HEP(35 patients, 70 eyes). The main outcome was scores of Catquest nine-item short-form questionnaire. Additional outcome was best corrected visual acuities, spherical aberration(SA) and total higher-order aberrations(HOAs). Results: The global score was significantly lower in the spherical IOL group than the aspherical IOL group of-020 μm SA(P < 0.05) and the aspherical IOL group of-027 μm SA(P < 0.05), and no significant difference was found in the global score between the aspherical IOL group of-020 μm SA than the aspherical IOL group of-027 μm SA(P > 0.05). Significant differences were also found in question 2, question 5, question 6 and question 8 between the spherical IOLs and the aspherical IOLs. Conclusion: Implantation of an aspherical IOL could improve vision-related quality of life compared with a spherical IOL. However, there were no statistically significant differences in vision-related quality of life between aspheric IOLs with different negative spherical aberrations.

Acupuncture-moxibustion for lung cancer patient-reported outcomes:A systematic review and meta-analysis protocol

Background:Lung cancer is one of the most common cancers globally with high incidence and mortality rate.Acupuncture and moxibustion have been used as adjuvant therapies to relieve the symptoms and complications of lung cancer.At present,acupuncture and moxibustion can partially improve the quality of life(QOL)of cancer patients.However,the evidence that acupuncture and moxibustion can improve patient-reported outcomes(PROs)in patients with lung cancer is still insufficient.We aimed to conduct a systematic review and meta-analysis of published randomized controlled trials(RCTs)to determine whether acupuncture and moxibustion can improve PROs among patients with lung cancer,providing a support basis for acupuncture and moxibustion inclusion in relevant guidelines.Methods:We will search the following electronic databases:PubMed,Embase,Cochrane Library,Web of Science,CNKI,CQVIP,Wanfang Data,Sinomed,and gray literature including the ClinicalTrials.gov Database(clinicaltrials.gov)and Chinese Clinical Trial Register(chictr.org.cn).All English and Chinese articles will be searched until July 1,2021.Two researchers independently extracted data.Any disagreement was resolved by discussion until consensus was reached or by consulting a third researcher.The primary outcomes mainly included the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),functional assessment of cancer therapy-lung(FACT-L),and Karnofsky Performance Status(KPS).The secondary outcomes included improvement of individual lung cancerrelated symptoms and the safety of acupuncture intervention.Discussion:Our study is the first to focus on the PROs of acupuncture and moxibustion for lung cancer treatment.The results will contribute to a deeper understanding of the evidence distribution of acupuncture and moxibustion in PROs,which may support the use of acupuncture and moxibustion in lung cancer patients.

Research Application of Patient-Reported Outcomes in Assessing the Nutritional Status of Patients with Gastrointestinal Tumors

Objective:To investigate and analyze the changes of nutritional status in patients undergoing postoperative adjuvant chemotherapy for gastrointestinal tumors based on patient-reported outcomes.Methods:From July 2020 to March 2021,60 patients with gastrointestinal tumor who received adjuvant chemotherapy for the first time after surgery under the oncology department of a third-level,first-class hospital in Shaanxi Province were recruited by convenience sampling.The patient-reported nutritional evaluation outcomes within 24 hours after admission and during the fourth chemotherapy cycle incorporated nutritional risk screening 2002(NRS2002),Functional Assessment of Anorexia/Cachexia Therapy(FAACT),psychological pain screening,Generalized Anxiety Disorder Assessment(GAD-7),Patient Health Questionnaire-9(PHQ-9)to screen for depression,dietary self-assessment,health index scale(EQ-5D),and nutrition supervisor overall assessment scale.Results:The self-reported nutritional evaluation outcomes by adjuvant chemotherapy patients showed an upward trend along with their chemotherapy cycle.Their PG-SGA score,FAACT score,psychological pain score,and EQ-5D score during the fourth cycle were better than those during the first chemotherapy cycle(p<0.05)・Conclusion:Based on the patient・reported nutritional evaluation outcomes,the nutritional status and quality of life of patients with gastrointestinal tumors during chemotherapy did not worsen.Medical staff should timely evaluate the nutritional status of patients with gastrointestinal tumors during chemotherapy and implement reasonable nutritional intervention to improve the quality of life of patients.In the future,patient-reported outcomes should be considered for integration into clinical practice in order to facilitate patient participation in decision-making and improve their medical experience.

Establishing minimum clinically important difference values for the Patient-Reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis out

AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.

Patient-Reported Outcomes of Surgery of Non-Small Cell Lung Cancer: Evaluation Based on the Questionnaires of Anti-Aging Quality of Life and the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire

Background: Patient-reported outcomes of the quality of life (QOL) after an open thoracotomy have not been studied. To determine the physical and mental changes in surgical patients is very important for medical staffs. The surgical patient’s satisfaction and overall healthy changes were evaluated by the patient-self assessment questionnaires. Materials and Methods: From July 2007 to April 2008, 26 patients with non-small cell lung cancer (NSCLC) underwent surgical resection. The outcome of the QOL was evaluated by using two kinds of questionnaire surveys from the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the anti-aging QOL assessment (AA-QOL). The EORTC QLQ-C30 consisted of five domains (physical, role, cognitive, emotional, and social functionings) and global QOL. The AA-QOL contained 51 items;30 physical and 21 mental symptoms regarding the elderly and the aging population. The patients replied to the two questionnaires at two different times, i.e., at pre-surgery (baseline) and at post-surgery (2 weeks after the operation). The obtained data of these scores were averaged and compared between the two points of the pre-surgery and post-surgery. Results: Regarding the outcomes of the EORTC QLQ-C30, the physical and social functioning became significantly worse after the surgery. In contrast, the global QOL significantly became better after the surgery. For the symptom at post-surgery, three of which were “nausea and vomiting”, “pain”, and “appetite loss”, became significantly worse compared to those at pre-surgery. Regarding the outcomes of the AA-QOL, the physical symptoms (muscular pain/stiffness, palpitations, dyspnea, no feeling of good health, anorexia, and coughing and sputum) became significantly worse after the surgery. Regarding the mental symptoms, there were no significant differences. Conclusions: Regarding the outcomes based on the changes in the QOL after surgery, the physical symptoms became worse compared to the mental symptoms. To clarify the perioperative healthy changes of the QOL reported by patients with lung cancers is very important for multidisciplinary teamwork, which should play a role in providing the appropriate care and treatment and useful information for a preoperative patient’s decision making of receiving surgical treatment.

Patient-Reported Outcomes of Chemotherapy Involving Non-Small Cell Lung Cancer: Evaluation by Questionnaires of Quality of Life Regarding Anti-Aging and Anti-Cancer Drugs

Background: Patient-reported outcomes (PROs) of quality of life (QOL) during chemotherapy involving lung cancer are very important for the medical staffs. Patients’ satisfaction and healthy changes were evaluated by the patient-self assessment. Materials and Methods: From July 2007 to April 2008, a total of 19 patients received chemotherapy. The QOL data were collected by using the QOL questionnaire for cancer patients treated with anticancer drugs (QOL-ACD) and the anti-aging QOL assessment (AA-QOL). The AA-QOL contained 51 items: 30 of physical and 21 of mental symptoms of the elderly and the aging population. The patients replied to the questions at two different times, i.e., at pre-chemotherapy (baseline) and at post-chemotherapy (2 weeks after the chemotherapy). Results: Regarding the hematological toxicities, for the grade 3/4 toxicities, there were 12 neutropenia (12/19, 63.2%) and 3 thrombocytopenia (3/19, 15.8%). For the grade 3 febrile neutropenia, there were 5 cases (5/19, 26.3%). Regarding the non-hematological toxicities, there was no grade 3 and grade 4 toxicities. Based on the outcomes of the QOL-ACD, the three items (“physical condition”, “social attitude”, and “overall QOL”) at post-chemotherapy became significantly worse compared to the baseline. Regarding the outcomes of the AA-QOL, 4 items of physical symptoms (“thirst”, “anorexia”, “early satiety”, and “diarrhea”) became significantly worse compared to the baseline. Regarding the mental symptoms, 2 items (“nothing to look forward in life” and “a sense of uselessness”) became significantly worse compared to the baseline. Conclusion: Regarding the PROs of the QOL during the chemotherapy term, both the physical and mental symptoms had become worse. To clarify the changes in the QOL during chemotherapy is very important for multidisciplinary teamwork, which should play the role of providing the appropriate cares and treatment as patient-support.

Influence of the Different Prosthesis Designs on Subjective Functional Evaluation after TKA: Medium-Term Outcome Using the 2011 Knee Society Score

Background: Patient-reported outcome (PRO) has become the focus of increased attention in the assessment of total knee arthroplasty (TKA). The purpose of this study was to investigate whether different prosthesis designs affected postoperative patient-reported performance. Materials and Methods: We reviewed 216 patients (234 knees) implanted with the Press-Fit Condylar Sigma prosthesis at our institution between January 2009 and December 2011. This study included 76 knees with fixed-bearing cruciate-retaining (FB-CR), 78 knees with fixed-bearing posterior-stabilized (FB-PS), and 80 knees with mobile-bearing posterior-stabilized (MB-PS) designs. The mean follow-up was 8.0 ± 0.74 years. Preoperative and follow-up ratings according to the 2011 Knee Society Score (2011 KSS), range of motion (ROM), and standing femoro-tibial angle (FTA) were obtained for all patients. Additionally, Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were collected at last follow-up. Results: Three separate subscales of the 2011 KSS of the three cohorts were significantly improved post-operatively compared to the pre-operative values (p < 0.05), except for expectation scores. At the time of follow-up, significantly higher the 2011 Knee Society Functional Scores <2011 KSFS> (P = 0.016) were found in the PS group. In particular, there were significant differences in advanced activities of the 2011 KSFS among the three groups (P = 0.017). Satisfaction scores showed no difference among the three groups (P = 0.251). On the other hand, WOMAC and expectation scores were significantly better in the PS groups. (P = 0.003, P = 0.004). ROM in the MB-PS group (124.0°) was better than that in FB-PS (119.4°) and FB-CR (118.9°) (P = 0.005). On the other hand, additional surgery was needed in five PS knees. Conclusion: The PS prostheses had superior 2011 KSFS, expectation scores, WOMAC scores and ROM than the CR prostheses. In contrast, the postoperative prosthesis-related complication rates were lower with CR prostheses. Further detailed evaluation is necessary to determine whether the characteristics of the different prostheses affect PRO.

出入院NT-proBNP比值与非选择危重症患者住院结局的关系分析

目的 观察出院与入院氨基末端脑钠肽前体(NT-proBNP)比值与非选择危重症患者住院结局的关系。方法 选取2013年1月至2018年12月我院重症监护室收治的非选择危重症住院患者108例,记录基线NT-proBNP、肌钙蛋白I、肌酸激酶、肌红蛋白、肌酐、尿素氮、钠离子、钾离子、白蛋白、血色素、心率、血压等,计算出院与入院NT-proBNP比值,分析与非选择危重症患者住院结局的关系。结果 共纳入非选择危重症患者108例,其中男74例(68%)。临床结局出现恶化的患者67例(62%),在调整了年龄、性别、收缩压和血色素后,多远逻辑回归分析结果显示NT-proBNP比值是为非选择重症患者住院结局恶化的独立危险因素(OR=1.27,95%CI 1.07~1.51,P=0.006),NT-proBNP比值增高患者住院结局恶化风险为NT-proBNP比值降低患者的8.34倍(95%CI 3.31~21.02,P<0.001)。结论 出院与入院NTproBNP比值增高与危重症患者的不良住院结局相关。

脑卒中PRO量表的信度效度分析

目的考察自行研制的用于临床疗效评价和新药临床试验的脑卒中患者报告的临床结局(PRO)评价量表的科学性。方法采用脑卒中PRO量表对595例样本(485例脑卒中患者、110例"健康人")进行自评量表式调查,对量表进行信度、效度和可行性的考核,并针对性别可能产生的量表选填差异进行项目功能差异分析。结果总量表的克朗巴赫系数为0.905。结构效度结果显示量表多维度的测量满足专业上的预期构想。项目功能差异(DIF)结果提示,仅PHD9和PSD3两个条目存在跨性别DIF。抽样调查脑卒中患者,量表回收率为99.2%,有效率为98.8%,平均作答时间为8.9分钟。结论本课题研制的脑卒中PRO量表具有较好的信度、效度、公平性和可行性。

慢性心衰PRO量表条目的初步筛选

目的研制适合国人的基于心力衰竭患者报告的临床结局评价量表。方法按照国际PRO量表的研制规范,通过询问患者主要和最期待改善的症状,查阅大量相关文献形成条目池;再通过各领域的专家和患者对形成的条目池和语言表达进行修正,形成初始量表。用初始量表分别在太原不同区的八所医院发放155份问卷进行预调查,回收后利用经典测量理论和项目反应理论(IRT)进行条目筛选和维度调整形成初量表;然后再在上述的八所医院进行大规模的正式调查,利用大规模调查的信息数据再一次进行条目筛选,形成终选量表。结果终选量表共有57个条目,分为生理领域、心理领域、社会领域、治疗领域4个领域,共计12个维度。结论形成的终选量表基本符合理论框架,较好的反映了慢性心衰患者生命质量的内涵。

肠易激综合征PRO量表的计量心理学考核

【目的】考察肠易激综合征(IBS)患者报告的临床结局(PRO)量表(IBS-PRO)的科学性,对其信度、效度和反应度等进行计量心理学特性考核评价。【方法】运用经典分析、证实性因子分析等方法,对181例样本(健康人99例,患者82例)进行信度、效度和反应度考核。【结果】Sperman-Brown的分半信度为0.950,4个领域分别为生理领域0.767、独立性领域0.873、心理领域0.767、环境领域0.505。IBS-PRO量表的Cronbach’sα系数为0.949,4个领域分别为生理领域0.942、独立性领域0.873、心理领域0.766、环境领域0.591。内容效度中除环境领域外,各领域积分与量表总积分相关系数均r> 0.60;证实性因子分析结果表明,量表的总拟合优度指数(CFI)为0.80,生理领域、心理领域、环境领域亚结构的拟合优度指数分别为0.81、0.83、0.95;区分度结果表明,患病人群的总得分及各领域得分均高于健康人群,差异均有统计学意义(P <0.01)。【结论】IBS-PRO量表具有较好的信度、效度和反应度。

中医主症PRO量表在COPD合并肺心病疗效评价中的应用

病人报告结局(patient-reported outcome,PRO)在慢性疾病的治疗评价体系中日益受到重视。本文分析现有中西医对于COPD合并肺心病的临床疗效评价指标的相对不足,论述中医主症PRO量表的特点;提出在文献整理、专家意见及病人自我报告主症调查的基础上,借鉴国际上临床医学评分量表制作思路和方法,构建具有中医疗效评价功能的主症PRO量表并进行量表考评;最终应用中医主症PRO量表于COPD合并肺心病的中医疗效评价。

中医心系疾病PRO量表理论框架构建设想

通过对中医心系疾病病名的研究总结及脏腑学说对于心系疾病生理病理的认识进行探讨,将中医的健康理论与PRO量表理论框架结合在一起,提出了构建中医心系疾病PRO量表理论框架的思路,设定为生理领域、心理领域、社会和自然环境领域,作为心系疾病专用量表,生理领域根据脏腑学说,以心为主、五脏相关为理论,按生理领域分设胸闷痛、心悸、眩晕、气短4个主要方面,以及精神与疲倦、睡眠、小便等合计7个方面,为量表的进一步研制奠定理论基础。

Mid-term outcomes of a kinematically designed cruciate retaining total knee arthroplasty

BACKGROUND Advances in implant material and design have allowed for improvements in total knee arthroplasty(TKA)outcomes.A cruciate retaining(CR)TKA provides the least constraint of TKA designs by preserving the native posterior cruciate ligament.Limited research exists that has examined clinical outcomes or patient reported outcome measures(PROMs)of a large cohort of patients undergoing a CR TKA utilizing a kinematically designed implant.It was hypothesized that the studied CR Knee System would demonstrate favorable outcomes and a clinically significant improvement in pain and functional scores.AIM To assess both short-term and mid-term clinical outcomes and PROMs of a novel CR TKA design.METHODS A retrospective,multi-surgeon study identified 255 knees undergoing a TKA utilizing a kinematically designed CR Knee System(JOURNEY™II CR;Smith and Nephew,Inc.,Memphis,TN)at an urban,academic medical institution between March 2015 and July 2021 with a minimum of two-years of clinical follow-up with an orthopedic surgeon.Patient demographics,surgical information,clinical outcomes,and PROMs data were collected via query of electronic medical records.The PROMs collected in the present study included the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement(KOOS JR)and Patient-Reported Outcomes Measurement Information System(PROMIS■)scores.The significance of improvements in mean PROM scores from preoperative scores to scores collected at six months and two-years postoperatively was analyzed using Independent Samples t-tests.RESULTS Of the 255 patients,65.5%were female,43.8%were White,and patients had an average age of 60.6 years.Primary osteoarthritis(96.9%)was the most common primary diagnosis.The mean surgical time was 105.3 minutes and mean length of stay was 2.1 d with most patients discharged home(92.5%).There were 18 emergency department(ED)visits within 90 d of surgery resulting in a 90 d ED visit rate of 7.1%,including a 2.4%orthopedic-related ED visit rate and a 4.7%non-orthopedic-related ED visit rate.There were three(1.2%)hospital readmissions within 90 d postoperatively.With a mean time to latest follow-up of 3.3 years,four patients(1.6%)required revision,two for arthrofibrosis,one for aseptic femoral loosening,and one for peri-prosthetic joint infection.There were significant improvements in KOOS JR,PROMIS Pain Intensity,PROMIS Pain Interference,PROMIS Mobility,and PROMIS Physical Health from preoperative scores to six month and two-year postoperative scores.CONCLUSION The evaluated implant is an effective,novel design offering excellent outcomes and low complication rates.At a mean follow up of 3.3 years,four patients required revisions,three aseptic and one septic,resulting in an overall implant survival rate of 98.4%and an aseptic survival rate of 98.8%.The results of our study demonstrate the utility of this kinematically designed implant in the setting of primary TKA.

临床运用PLGC-PRO评价CAG患者肠上皮化生程度的相关性研究

目的:运用慢性萎缩性胃炎(CAG)患者报告的临床结局分级量化评分表,即(PLGC-PRO)量表,与CAG患者胃镜活检报告进行相关性分析,研究CAG患者肠上皮化生程度与CAG患者PLGC-PRO中5个维度的30项指标的相关程度,探讨CAG患者肠上皮化生程度与患者报告的临床结局的相关性规律。方法:于2016年1月至2017年1月,对符合病例要求的300例慢性萎缩性胃炎患者依据PLGC-PRO量表研究该病的中医症状、中医证型和证素分布等相关患病情况进行回顾性调查研究及统计分析。结果:临床中CAG患者肠上皮化生患者症状主要以食欲减退、胃脘胀满、口干、情绪易激动、气候因素为主。其中维度多表现为心理状态改变,影响较大。主要中医证型分布多为脾胃气虚证(46.7%);中医证素分布情况多为气虚(58.3%)。基本病因病机为脾胃气虚,其虚则多以气虚为主。结论:临床中CAG肠上皮化生患者症状主要以食欲减退、胃脘胀满、口干、情绪易激动、气候因素为主。新疆慢性萎缩性胃炎伴肠上皮化生的患者,基本病因病机为脾胃气虚,其虚则多以气虚为主。故在临床中补益脾胃、健脾益气是治疗该病的重要法则。

Unveiling hidden outcomes in malignant gastric outlet obstruction research–insights from a"Pancreas 2000"review

Malignant gastric outlet obstruction(mGOO)is a major condition affecting patients with periampullary tumors,including pancreatic cancer.The current treatment options include surgical gastroenterostomy,endoscopic stenting and more recently EUS-guided gastroenterostomy.Most studies comparing the outcomes of the three procedures focus on technical success,clinical success and safety.Several“occult”outcomes relevant to the patient’s viewpoints and perspective may ultimately impact on cancer-related and overall survival,such as body mass composition,nutritional biomarkers,chemotherapy tolerance and patient-reported quality of life.The aim of this review is to provide an overview of potential key outcomes that should be explored in future comparative research around mGOO treatment options.

综合治疗脑卒中后痉挛性瘫痪的PRO疗效评价及相关性分析

目的采用基于患者报告结局(PRO)的原则对综合治疗脑卒中后痉挛性瘫痪的疗效进行评价,并分析本结局与其他疗效评价指标之间的相关性。方法对365例患者采用综合治疗方案,脑卒中痉挛性瘫痪PRO量表为主要疗效指标,Ashworth量表、Barthel指数量表、Fugl-Meyer量表、Rankin量表为相关性指标,分别在治疗前、治疗1、6个月后随访3个时点进行观察。结果治疗后及随访期PRO得分均低于治疗前。Ashworth量表评分与PRO评分相关性最高(0.425、0.581、0.658),PRO量表与Barthel指数量表有一定相关性(-0.319、-0.301、-0.421),PRO量表与Fugl-Meyer量表(-0.290、-0.265、-0.414)、Rankin量表(0.262、0.269、0.417)相关系数较小,无明显相关。结论综合疗法治疗脑卒中后痉挛性瘫痪在患者自身感受的改善方面有较好的疗效。对疗效评价要以患者为中心并旨在测量患者所认为最重要的结局。