乳腺癌内分泌治疗患者症状评估量表的编制和信效度检验

目的 根据乳腺癌内分泌治疗患者的症状特征,编制适用于我国乳腺癌内分泌治疗患者的症状评估量表,并检验其信效度。方法 在文献回顾及参照现有症状评估量表的基础上编制量表初始条目池;通过2轮德尔菲专家函询,形成初始版量表;通过对11例患者的认知性访谈,对量表条目进一步修订,形成临床测试版量表。便利选取2020年7月—9月在浙江省某三级甲等肿瘤医院门诊或住院的325例乳腺癌内分泌治疗患者进行问卷调查,检验量表信效度。 结果 形成的最终版乳腺癌内分泌治疗患者症状评估量表包括33个条目,探索性因子分析提取7个公因子,累计方差贡献率为68.76%;各条目内容效度指数为0.78~1.00,量表内容效度指数为0.91;内在相关性检验结果显示,量表各维度与总量表相关系数为0.58~0.79（P<0.05）;维度间相关系数为0.26~0.52（P<0.05）;总量表Cronbach’s α系数为0.94,重测信度为0.95,折半信度为0.84。结论 编制的乳腺癌内分泌治疗患者症状评估量表具有良好的信效度,适用于相关人群的症状测评。     

中医药治疗糖尿病周围神经病变的研究进展

糖尿病渐以年轻化的趋势呈现,糖尿病周围神经病变(DPN)是糖尿病最常见的慢性并发症之一,因其高致残率严重影响病患的生活品质。本文简单阐述糖尿病周围神经病变的病因,并就中医药的角度对该病的治疗概况进行综述,以期为临床诊治提供新见解和新研究策略。     

Intravesical Bacillus Calmette-Guérin Treatment Is Inversely Associated With the Risk of Developing Alzheimer Disease or Other Dementia Among Patients With Non–muscle-invasive Bladder Cancer

BackgroundThe immune system plays an important role in the pathogenesis of Alzheimer disease (AD), but it remains unclear whether bacillus Calmette-Guérin (BCG) may affect the risk of AD or not.MethodsUsing retrospective chart review, we collected data regarding demographics, comorbidities, cancer diagnosis, BCG treatment, and subsequent diagnosis of AD or other dementia in a racially/ethnically diverse cohort of patients with non–muscle-invasive bladder cancer (NIMBC) receiving treatment between 1984 and 2020 in the Bronx, New York. We used Cox proportional hazard models to examine association between BCG treatment and risk of incident AD or other dementia, adjusting for age, gender, race/ethnicity, and major comorbidities.ResultsIn our cohort of 1290 patients with NMIBC, a total of 99 (7.7%) patients developed AD or other dementia during follow-up. Patients who received BCG treatment (25%) had a 60% lowered incidence of AD or other dementia (adjusted hazard ratio [HR], 0.41; 95% confidence interval [CI], 0.21-0.80) in comparison to those who did not receive BCG. There was also suggestive evidence that the reduction in risk of AD or other dementia associated with BCG treatment was stronger in men (adjusted HR, 0.34; 95% CI, 0.15-0.81) but not in women (adjusted HR, 0.75; 95% CI 0.25-2.24). When we stratified the patients who received BCG by type of treatments, patients who received both induction and maintenance rounds of BCG had a further lowered incidence of AD or other dementia (HR, 0.23; 95% CI, 0.06-0.96) than patients who did not receive BCG.ConclusionsTo our knowledge, our study is one of the first to suggest that BCG treatment is associated with a reduced risk of developing AD or other dementia in a multiethnic population, independent of significant comorbidities. Larger cohort studies are needed to corroborate our findings.     

Effect of a Device-Free Compressed Shell Fixation Method on Hepatic Respiratory Movement: Analysis for Respiratory Amplitude of the Liver and Internal Motions of a Fiducial Marker

Purpose

Suppression of respiratory movement of the liver would be desirable for high-precision radiation therapy for liver tumors. We aimed to investigate the effect of our original device-free compressed shell fixation method and breathing instruction on suppression of respiratory movement. The characteristics of liver motion based on the movement of a fiducial marker were also analyzed.

高强度聚焦超声消融治疗子宫肌瘤时妊娠一例报告并文献复习

高强度聚焦超声(high-intensity focused ultrasound,HIFU)消融治疗子宫肌瘤作为一种新的非侵入性的治疗方式,已越来越广泛地用于子宫肌瘤的治疗。但是对于HIFU治疗时妊娠的处理及妊娠结局鲜有文献报道。本文报道1例HIFU消融治疗子宫肌瘤时妊娠的病例,结合文献复习,探讨子宫平滑肌瘤对妊娠的影响、子宫平滑肌瘤不同处理方式对妊娠的影响、HIFU消融治疗子宫肌瘤时机选择的问题、HIFU消融治疗子宫肌瘤若同时合并妊娠时胎儿去留的问题以及近期HIFU消融治疗子宫肌瘤后对流产手术操作的影响等,以期对HIFU治疗子宫肌瘤的适应证、选择合适的治疗时间及术后选择合适的妊娠时机展开讨论。     

Adjuvant chemotherapy could improve the survival of pulmonary sarcomatoid carcinoma: A systematic review and meta-analysis

BackgroundComplete surgical removal is currently considered to be the best treatment option for pulmonary sarcomatoid carcinoma (PSC) especially in early stage operable disease; however, the reported recurrence-free survival is low. Benefits of adjuvant chemotherapy in PSC patients are still controversial, and there is no obvious agreement on the optimal treatment modalities of this disease. Therefore, we aimed to investigate the prognosis in terms of overall survival (OS) in patients with PSC who received adjuvant chemotherapy.MethodsThe review protocol was registered in PROSPERO (CRD42022306084). Patients with PSC who underwent surgical therapy with or without adjuvant chemotherapy were included into the meta-analysis. Hazard ratios (HR) with 95% confidence intervals (CIs) for OS were pooled and ROBINS-I tool was used to assess risk of bias of the included studies.ResultsWe identified four retrospective cohort studies with 6768 records from MEDLINE, Embase, and CENTRAL databases up to 9th September 2021, and altogether 1835 patients were included to the analysis. The present meta-analysis shows that patients receiving adjuvant chemotherapy had a significantly longer OS than patients who underwent surgical treatment alone (HR = 0.5657, 95%CI: 0.4391–0.7290, p < 0.0001).ConclusionsDespite the limited information on the chemotherapy regimens in the included studies, patients with PSC may benefit from adjuvant chemotherapy. More publications are required to evaluate and compare efficient adjuvant chemotherapy protocols in PSC cases.