The importance of quality of life (QoL) in cancer care has gained increasing recognition, but no scale for renal cancer was developed based on the modular approach. This paper is aimed to develop and validate a renal cancer-specific assessment tool, QLICP-RE (V2.0), to provide a scientific basis for evaluating the QoL of kidney cancer patients and informing relevant policy development. The QLICP-RE (V2.0) was developed based on procedural decision-making methods and combining the general module and the specific module. Based on the data from 179 admitted and discharged renal cancer patients, the psychometric properties of the scale were evaluated. Reliability of the QLICP-RE (V2.0) was evaluated using Cronbach’s α and Test-retest reliability correlation. The construct validity and criteria-related validity was assessed through correlation analysis and structural equation modeling. The responsiveness was evaluated by comparing the differences in scores of the scale before and after treatment using paired t-tests, and computing the Standard Response Mean (SRM). The QLICP-RE(V2.0) was developed with a 32 items general module and a 11 items specific module. Regarding the Cronbach’s α coefficients for each domain of the QLICP-RE (V2.0), all domains showed satisfactory reliability (α ≥ 0.7), except for the social functioning domain (α = 0.34). The test-retest reliability coefficients demonstrated good stability, with values exceeding 0.80 for all domains except the social functioning domain (r = 0.50). The correlation analysis and structural equation modeling confirmed good construct validity and criterion-related validity. There were significant differences (P < 0.05) for all domains exception of psychological function and common symptoms and side effects, and also specific module and the total scale before and after treatments, with standardized response mean (SRM) values ranged from − 2.54 to 0.23. QLICP-RE(V2.0) has good validity, reliability and moderate responsiveness. In the future, more patients should be enrolled and the sample size should be expanded to continuously optimize the scale and evaluate the quality of life of patients with renal cancer more scientifically.

Cisplatin is the most commonly used platinum-based treatment for nasopharyngeal carcinoma (NPC). However, its clinical application is limited owing to its nephrotoxicity and gastrointestinal reactions. Proton pump inhibitors (PPIs) have been reported to increase nephrotoxicity risk in previous studies. We aimed to evaluate whether PPIs increase cisplatin-induced nephrotoxicity in patients with NPC. In total, 295 patients were included in this prospective cohort study: 145 in the PPIs group and 150 in the non-PPIs group. All patients underwent cisplatin-based induction chemotherapy, followed by cisplatin-based concurrent chemoradiotherapy. The PPIs group received 40 mg of intravenous esomeprazole sodium for 7 days in each chemotherapy cycle. Chi-squared test and logistic regression analyses with odds ratios and 95% confidence intervals were applied to assess the association between PPIs and the risk of acute kidney injury (AKI). AKI incidence in the PPIs group was significantly higher than that in the non-PPIs group (P = 0.005). After adjusting for various confounders including demographic features, clinical features, and renal function indices, PPIs use was significantly associated with a higher AKI risk (odds ratio: 2.775; 95% confidence interval 1.280–6.020; P = 0.010). The incidences of acute and chronic kidney diseases were similar between both groups (P > 0.05), whereas the incidence of nausea was lower in the PPIs group than in the non-PPIs group (P = 0.029). This study has shown that PPIs use may increase the risk of cisplatin-induced acute nephrotoxicity in patients with NPC.

ObjectiveThe measurement of the quality of life (QOL) in patients with breast cancer can evaluate the therapeutic effects of medical treatments and help to provide reference for clinical decisions. The minimum clinically important difference (MCID) can be better used in clinical interpretation than the traditional statistical significance. Based on the anchors, a variety of ways including traditional and updated anchor-based methods were used to explore most suitable MCID, so that to find better interpretation on scores of the scale QLICP-BR(V2.0) (Quality of Life Instruments for Cancer Patients-Breast cancer).MethodsAccording to the investigation data of breast cancer patients before and after treatment, the most relevant indicators in various domains of QLICP-BR (V2.0) was found as an anchor to statistically analyze the value of MCID, and three analysis methods of anchors were used: Traditional anchor-based method, ROC curve method, multiple linear regression model analysis. Anchors are divided into four standards according to the degree of change in the treatment effect: one grade difference (Standard A), at least one grade difference (Standard B), one grade better (Standard C), better (Standard D). The final MCID value is selected from different statistical methods and classification standards that are most suitable for clinicians to use.ResultsUsing Q29 of the EORTC QLQ-C30 as an anchor has the highest correlation with each domain of QLICP. The order of magnitude of MCID values among the four standard groups is: standard A< Standard C< Standard B< Standard D. The MCID value obtained by the ROC curve method is the most stable and is least affected by the sample size, and the MCID value obtained by the multiple linear regression model is the least. After comparisons and discussions, Standard C in the multiple linear regression model is used to determine the final MCID, which is the closest to other methods. After integer the MCID values of Physical domain (PHD), Psychological domain (PSD), Social domain (SOD), Common symptoms and side effect domain (SSD), Core/general module (CGD), Specific domain (SPD), Total score(TOT) can be taken as 15,10, 10, 11, 10, 9 and 9, respectively.ConclusionIn the evaluation of the QOL of breast cancer patients, although the results of MCID values produced by different methods are different, the results are relatively close. The anchor-based methods make the results of MCID more clinically interpretable by introducing clinical variables, and clinicians and researchers can choose the appropriate method according to the research purpose.

ObjectivesTo provide a comprehensive assessment of the estimated burden and trend of urolithiasis at the global, regional, and national levels.MethodsThe age-standardized rates (ASRs) of the incidence and disability-adjusted life years (DALYs) of urolithiasis from 1990 to 2019 were obtained from the Global Burden of Disease Study 2019 database. Estimated annual percentage changes (EAPCs) were calculated to quantify the temporal trends in urolithiasis burden.ResultsIn 2019, the ASRs of the incidence and DALYs were 1,394.03/100,000 and 7.35/100,000, respectively. The ASRs of the incidence and DALYs of urolithiasis decreased from 1990 to 2019 with EAPCs of −0.83 and −1.77, respectively. Males had a higher burden of urolithiasis than females. In 2019, the highest burden of urolithiasis was observed in regions with high–middle sociodemographic index (SDI), particularly in Eastern Europe, Central Asia, and Southeast Asia. The burden of urolithiasis increased in most countries or territories. The burden of urolithiasis and SDI had a non-linear relationship, and the estimated value of urolithiasis burden was the highest when the SDI value was ~0.7.ConclusionGlobally, the ASRs of the incidence and DALYs of urolithiasis decreased from 1990 to 2019, but an increasing trend was observed among many countries. More effective and appropriate medical and health policies are needed to prevent and early intervene in urolithiasis.

Abstract [Objective] To analyze the QLICP-NA (V2.0) items using classical test theory and item response theory. [Methods]One hundred twenty-one nasopharyngeal carcinoma patients were investigated using QLICP-NA (V2.0). SPSS15.0 software was used to manage the data and Multilog 7.03 software was used for parameter analysis. IRT was used to calculate the discrimination, difficulty, and item information for each item in the scale. [Results] The scale covered five domains: physical (PHD); psychological (PSD); social (SOD); general symptoms and side effects (SSD); and special module (SNA). PHD contains eight items (coded GPH1-8), PSD comprises nine items (coded GPS1-9), SOD covers eight items (coded GSO1-8), SSD includes seven items (coded GSS1-7), and SNA covers eleven items (coded SNA1-11). The correlation coefficient between SNA1 and SNA8 was < 0.4, and the correlation was poor. GPS4, GOS4, SNA1, and SNA3 had low correlation with the field. The five items were deleted. SNA4 and SNA8 discrimination was poor, thus deletion was recommended. SNA2 and SNA10 discrimination was not good, thus SNA2 and SNA10 were modified and retained. The results of item information showed that the information content of the specific module, SNA1-11, was poor, but because deleting too many items had a great impact on the total table and deleting two items (SNA6 and SNA10) with < 0.2 information, 34 items were finally reserved. [Conclusion] The analysis of scale items can be evaluated from different angles and applied comprehensively.

This study aimed to explore the relationship between tumor size (Ts) and prognosis in endometrial cancer (EC). A total of 52,208 patients with EC who underwent total hysterectomy were selected from the Surveillance, Epidemiology, and End Results Program database. Overall survival (OS) and endometrial cancer-specific survival (ESS) were chosen as survival outcomes. The Cox proportional hazards model was used to explore the effect of Ts on prognosis. The restricted cubic splines based on the Cox regression model were used to determine the nonlinear relationship between Ts and survival. When Ts was analyzed as a categorical variable, the risk of death increased with Ts, with the highest risk in patients with Ts > 9 cm with regard to all-cause death (ACD) (hazard ratio [HR] 1.317; 95% confidence interval [CI], 1.196-1.450; P < 0.001) and endometrial cancer-specific death (ESD) (HR, 1.378; 95% CI, 1.226-1.549; P < 0.001). As a continuous variable, Ts showed a nonlinear relationship with ACD (HR, 1.061; 95% CI, 1.053-1.069; P < 0.001) and ESD (HR, 1.062; 95% CI, 1.052-1.073; P < 0.001). The risk of mortality increased quickly with Ts when Ts was less than 7.5 cm and then leveled off when Ts was larger than 7.5 cm in all patients. Among patients with lymph node metastasis, the risk of poor prognosis decreased rapidly with Ts when Ts was less than 3.5 cm, and subsequently increased sharply with Ts when Ts ranged from 3.5 cm to 7.5 cm, and then increased slowly when Ts was larger than 7.5 cm (P < 0.001 for nonlinearity). There was a nonlinear relationship between Ts and prognosis in patients with EC. Clinicians should not ignore the impact of small tumors on prognosis in EC patients with lymph node metastasis.

目的 确定自制第二版鼻咽癌患者生命质量测定量表(QLICP-NA)的最小临床重要性差值(minimal clinically important difference,MCID).方法 121例鼻咽癌患者,均采用QLICP-NA V2.0评价生命质量,分别采用锚法、分布法及受试者工作特征曲线(ROC)法确定QLICP-NA V2.0量表各领域得分及总量表MCID值,最终确定QLICP-NA V2.0的MCID.结果 QLICP-NA V2.0量表躯体功能领域、心理功能领域、社会功能领域、共性症状与副作用领域、特异性模块领域、总量表领域的MCID值分别为8.81、7.99、11.00、9.96、8.93、7.05.结论 综合锚法、ES法、SEM法、RCI法以及ROC法最终得到QLICP-NA V2.0量表各领域的MCID值.

Objective To determine the quality of life (QoL) of patients with nasopharyngeal carcinoma (NPC) and the clinical factors that influence QoL. Methods Multiple linear regression, simple and canonical correlation analyses were used to analyze the factors that affected QoL in patients with NPC. Results The QoL scores were as follows: physical function domain, 61.03±15.03; mental function domain, 60.95±15.35; social function domain, 59.17±14.16; specific module domain, 75.62±14.87; and total scale score, 66.10±97.18. Multiple linear regression analyses showed that family economic status and clinical stage of the disease are the factors affecting the overall QoL among NPC patients. The simple correlation analysis showed that the hemoglobin level had a positive correlation with physical function, social function, specific module domains, and the total score of the total scale. Canonical correlation analysis revealed a pair of statistically significant typical variables and the canonical correlation coefficient was 0.561 (P<0.05). Conclusion The indicators related to the QoL among patients with NPC included family economic status, clinical stage of the disease, red blood cell count, and albumin, total bilirubin, blood urea nitrogen, creatinine, aspartate aminotransferase, and hemoglobin levels. A focus on these indicators and implementing the corresponding treatment measures had value in improving the QoL among patients with NPC.

The original version of this article, unfortunately, contained errors.

We aimed to develop a nomogram based on a population-based cohort to estimate the individualized overall survival (OS) for patients with nasopharyngeal carcinoma (NPC) and compare its predictive value with that of the traditional staging system. Data for 3693 patients with NPC were extracted from the Surveillance, Epidemiology, and End Results dataset and randomly divided into two sets: training (n = 2585) and validation (n = 1108). On the basis of multivariate Cox regression analysis, a nomogram was constructed to predict the 3-, 5-, and 10-year survival probability for a patient. The performance of the nomogram was quantified with respect to discrimination, calibration, and clinical utility. In the training set, age, sex, race, marital status, histological type, T stage, N stage, M stage, radiotherapy, and chemotherapy were selected to develop a nomogram for predicting the OS probability based on the multivariate Cox regression model. The nomogram was generally more discriminative compared with the American Joint Committee on Cancer 7th staging system. Calibration plots exhibited an excellent consistency between the observed probability and the nomogram's prediction. Categorical net classification improvement and integrated discrimination improvement suggested that the predictive accuracy of the nomogram exceeded that of the classic staging system. With respect to decision curve analyses, the nomogram exhibited preferable net benefit gains than the staging system across a wide range of threshold probabilities. This proposed nomogram exhibits an excellent performance with regard to its predictive accuracy, discrimination capability, and clinical utility, and thus can be used as a convenient and reliable tool for prognosis prediction in patients with NPC.

目的 了解戒毒者自杀意念现状,探讨家庭功能和社会支持与戒毒者自杀意念发生的关系.方法 应用一般情况调查表、自编自杀情况调查表、领悟社会支持量表和家庭功能评估问卷表对488名戒毒所服刑的戒毒者进行调查.结果 488名戒毒者戒毒前自杀意念发生率为16.39％,戒毒后自杀意念发生率为24.59％,戒毒后自杀意念发生率高于戒毒前(P＜0.01);有自杀意念的戒毒者领悟社会支持总分、朋友支持得分、其他支持得分和家庭功能总分均低于无自杀意念戒毒者(P＜0.05或＜0.01);朋友支持(OR =0.52,95％CI=0.34～0.80)(P＜0.01)和首次吸毒年龄(OR=0.76,95％CI =0.59～0.97)与戒毒后戒毒者自杀意念发生呈负相关.结论 提高朋友支持以及保护低龄者免受毒品侵害,有利于改善戒毒者戒毒后自杀意念状态.

*These authors contributed equally to this work Background: The pretreatment aspartate aminotransferase-to-alanine aminotransferase (De Ritis) ratio is reportedly valuable in prognosis prediction of various malignancies. However, its value in the prognosis of nasopharyngeal carcinoma (NPC) has not yet been reported. This study aimed to evaluate the effect of the De Ritis ratio on the survival outcomes of patients with nonmetastatic NPC. Methods: We retrospectively reviewed the medical data of 1023 patients with nonmetastatic NPC admitted between 2009 and 2013 at a single center. The Fine and Gray competing risk regression model was used to analyze the associations between the De Ritis ratio and the survival outcomes of cancer-specific survival (CSS) and progression-free survival (PFS) by using the subdistribution hazard ratio (SHR) and 95% confidence interval (CI) as size effects. The Cox proportional hazard model was used to evaluate the correlation between the De Ritis ratio and overall survival (OS) by using hazard ratio (HR) and 95% CI as size effects. Results: Patients were divided into two groups in accordance with the pretreatment De Ritis ratio by using an optimal cutoff value of 1.65. Compared with the patients with low De Ritis ratio (< 1.65), those with elevated De Ritis ratio (≥ 1.65) had poorer prognosis with regard to CSS, PFS, and OS. Notably, multivariate analyses showed that high De Ritis ratio was independently associated with poor CSS (SHR = 1.64, 95% CI: 1.25–2.16), PFS (SHR = 1.69, 95% CI: 1.30–2.19), and OS (HR = 1.81, 95% CI: 1.39–2.40). Conclusion: Pretreatment De Ritis ratio can be an independent prognostic predictor for patients with nonmetastatic NPC.

目前应用于颈椎病患者的评定量表较多,缺乏统一标准,且有些量表的信度和效度有待科学的考核.检索中国知网,维普,Pubmed三个数据库中已经发表的与颈椎病评定量表相关文献78,对近年来国内外应用于颈椎病的各种评定量表进行总结和分类,以期为临床工作者在量表选取方面提供参考,进一步实现量表的标准化.

本文概括介绍癌症患者生命质量测定量表体系QLICP的研发及推广应用情况,包括研究背景意义、不同版本的研发情况与构成、量表的结构与特点、取得的成果与推广应用等.说明QLICP具有层次结构清晰、适用性和覆盖面广、测量学特性好且具有中国文化特色等特性,可作为癌症患者生命质量的测评工具.

目的:了解湛江市强制戒毒者家庭功能、领悟社会支持现状及对强制戒毒者生存质量的影响,为提高戒毒者生存质量提供参考.方法:采用家庭关怀度指数问卷、领悟社会支持量表和生存质量量表,对戒毒所488名男性戒毒者进行问卷调查.结果:强制戒毒者总体家庭功能轻度障碍.领悟社会支持总分、家庭和其他支持得分高于国内常模(P<0.01),朋友支持、生理和心理等领域得分低于国内常模(P<0.01).多元逐步回归分析显示,生理领域受年龄和户口地的影响(P<0.05);心理领域受年龄、成瘾程度和其他社会支持的影响(P<0.05);朋友支持和父母状况对社会关系领域有影响(P<0.05);环境领域受父母状况和APGAR得分的影响(P<0.05).自我感觉健康状况和领悟社会支持对生理、心理、社会关系和环境领域都有影响( P<0.05).结论:湛江市强制戒毒者生存质量较低,且受家庭功能和社会支持的影响,应联合政府、社会团体和家庭的力量,提高其生存质量.

BACKGROUND:The pretreatment aspartate aminotransferase-to-alanine aminotransferase (De Ritis) ratio is reportedly valuable in prognosis prediction of various malignancies. However, its value in the prognosis of nasopharyngeal carcinoma (NPC) has not yet been reported. This study aimed to evaluate the effect of the De Ritis ratio on the survival outcomes of patients with nonmetastatic NPC. METHODS:We retrospectively reviewed the medical data of 1023 patients with nonmetastatic NPC admitted between 2009 and 2013 at a single center. The Fine and Gray competing risk regression model was used to analyze the associations between the De Ritis ratio and the survival outcomes of cancer-specific survival (CSS) and progression-free survival (PFS) by using the subdistribution hazard ratio (SHR) and 95% confidence interval (CI) as size effects. The Cox proportional hazard model was used to evaluate the correlation between the De Ritis ratio and overall survival (OS) by using hazard ratio (HR) and 95% CI as size effects. RESULTS:Patients were divided into two groups in accordance with the pretreatment De Ritis ratio by using an optimal cutoff value of 1.65. Compared with the patients with low De Ritis ratio (< 1.65), those with elevated De Ritis ratio (≥ 1.65) had poorer prognosis with regard to CSS, PFS, and OS. Notably, multivariate analyses showed that high De Ritis ratio was independently associated with poor CSS (SHR = 1.64, 95% CI: 1.25-2.16), PFS (SHR = 1.69, 95% CI: 1.30-2.19), and OS (HR = 1.81, 95% CI: 1.39-2.40). CONCLUSION:Pretreatment De Ritis ratio can be an independent prognostic predictor for patients with nonmetastatic NPC.

目的 了解湛江市高校男大学生生殖健康知识认知情况并分析其影响因素.方法 2017年1～10月在湛江市三所高校抽取男大学生443人,采用自编的生殖健康知识认知调查问卷进行调查.结果 443名男大学生来自广东医科大学学生148人(33.41％),广东海洋大学学生165人(37.25％),岭南师范学院学生130人(29.35％);既往有泌尿生殖器感染(如尿道炎等)89人(20.09％),既往有泌尿生殖器周边感染(如股藓等)104人(23.48％),既往有前列腺炎47人(10.61％),既往有包皮过长119人(26.86％);第一次手淫年龄在15～16岁的有148人(33.41％),其次≤14岁的92人(20.77％),经常想手淫/性生活的95人(21.44％);多因素分析结果显示湛江高校男大学生生殖知识认知度影响因素有吃辛辣煎炸物、吃蔬菜、忍尿、躺10h以上、每周饮酒酗酒、体育锻炼、熬夜、专业和学校.结论 湛江市男性大学生泌尿生殖健康存在隐患,对生殖健康知识认知不足.

Background: Chronic inflammation has been regarded as one of the causes of idiopathic sudden sensorineural hearing loss (ISSHL). Several individual studies have reported the association between neutrophil-to-lymphocyte ratio (NLR) and ISSHL. However, the findings have been inconsistent, and these data have not been systematically evaluated. Thus, we conducted this meta-analysis to further explore the predictive value of NLR on formation and prognosis of ISSHL. Methods: A comprehensive literature search was performed to identify eligible studies based on PubMed, Embase, Web of Science, and China National Knowledge Infrastructure. The Standardized mean deviation (SMD) with its 95% confidence interval (CI) was applied to be the effect size estimate. Results: A total 10 papers with 15 retrospective case-control studies, which included 1029 ISSHL patients (the case group) and 1020 healthy people (the control group), were selected for the meta-analysis of the relationship between NLR and onset of ISSHL. The NLR levels in the case group were observed to be higher than the control group (SMD= 1.65, 95% CI=1.20-2.09, P <. 001). The pooled results did not significantly change by the subgroup analyses based on study region, baseline matching, and laterality. Moreover, 9 publications with 12 retrospective cohort studies, which included 590 recovered ISSHL patients and 438 unrecovered ISSHL patients, explored the association between NLR and ISSHL prognosis, and the combined data showed that the NLR value was much higher in unrecovered patients rather than recovered patients (SMD= 1.27, 95% CI: 0.62-1.92, P <. 001). The subgroup analyses based on study region, laterality, type of steroid, medication administration, maintenance treatment, follow-up period, and definition of "recovered" further supported these results. Conclusion: The results of this meta-analysis suggest that NLR might be a useful biomarker to determine the onset and prognosis of ISSHL.

目的 了解湛江市男性戒毒学员的特殊嗜好和不良行为,探究不良行为嗜好与吸毒的相关性,并针对这些成因提出预防吸毒行为发生的措施.方法 应用自编的戒毒学员行为和基本情况调查表,对湛江市某戒毒所488名男性戒毒学员进行问卷调查.结果 调查488名戒毒学员,平均年龄为(39.32±7.90)岁,首次吸毒平均年龄为(27.09±8.14)岁,吸毒持续时间平均为(8.95±7.33)年.首次吸毒原因主要为主动好奇占59.43％.首次吸毒来源主要来自亲戚、朋友和同学占47.75％.戒毒学员不良行为中喝酒的占65.35％,吸烟占91.60％,纹身的占42.21％,赌博的占52.66％,不安全性行为占86.88％,商业性行为占32.17％,曾打架斗殴占22.75％,曾行窃或抢夺犯罪占10.04％.结论 特殊嗜好和不良行为生活方式影响吸毒行为的发生,进行毒品预防教育、就业帮扶和提高不良行为嗜好的自控力对预防吸毒有一定现实意义.

目的 了解湛江市女中学生对妇科疾病的认知情况,以便有针对性进行健康教育.方法 2017年7～8月抽取湛江市796名女中学生进行妇科疾病认知情况的问卷调查.结果 40.33％和39.95％的女中学生有痛经和月经不调症状,高中生比例高于初中生(P＜0.05);40.58％的女中学生有妇科病症状时不会及时告诉父母,高中生比例高于初中生(P＜0.05);35.42％的女中学生有妇科疾病不会及时就医;仅8.30％女中学生比较了解或十分了解妇科疾病;了解妇科疾病知识的途径主要是网络(55.03％)、父母(52.39％)和同龄人(45.60％);认为导致其妇科疾病知识相对匮乏的因素主要是学校少开展妇科健康相关讲座(60.43％)、因尴尬使同龄人很少交流(45.98％)和社会大环境的对妇科问题的隐晦(45.10％);93.84％女中学生认为有必要加强女性青春期卫生知识教育.结论 湛江市女中学生对妇科疾病认知相对不足,渴望充实自身妇科疾病知识.