子宫内膜癌腹膜后盆腔淋巴结转移相关因素分析

[目的]探讨子宫内膜癌患者腹膜后盆腔淋巴结转移的相关因素.[方法]选取43例于2000年1月至2001年8月行广泛性子宫加双附件切除加腹膜后盆腔淋巴结清扫的子宫内膜癌患者,分析腹膜后盆腔淋巴结(retroperitoneal lymph node,RLN)转移与临床病理和5年生存率的关系.[结果]RLN转移在病理分级,肌层浸润深度,宫颈浸润深度和宫旁血管浸润组间差异有显著性(P＜0.05);在腹腔冲洗液细胞学阴性组和阳性组间差异无显著性(P＞0.05);5年生存率在病理分级,肌层浸润深度,腹腔冲洗液细胞学检查,RLN转移和宫旁血管浸润组间差异有显著性(P＜0.05);宫颈浸润深度不同组间5年生存率差异无显著性(P＞0.05).[结论]RLN转移与病理分级,肌层浸润深度,宫颈浸润和宫旁血管浸润有关;5年生存率与病理分级,肌层浸润深度,腹腔冲洗液细胞学阳性,RLN转移和宫旁血管浸润有关.     

子宫腺肌病合并子宫内膜癌的临床病理分析

目的研究子宫腺肌病合并子宫内膜癌患者的临床病理特征,并比较子宫腺肌病合并子宫内膜癌患者与单纯子宫内膜癌患者的高危影响因素及其对复发与预后意义。方法对2002年2月至2015年7月期间治疗的307例子宫内膜癌患者的临床病理资料进行了回顾性分析,其中子宫腺肌病合并子宫内膜癌患者31例(A组,10.1%),其余276例为单纯子宫内膜癌患者(B组,89.9%)。观察两组患者临床资料,比较分析手术病理分期、病理类型、肌层浸润深度、雌激素受体(ER)和孕激素受体(PR)的表达、细胞学分型、腹水细胞学、淋巴结转移,复发率,3年无病存活率,3年总存活率等。结果与B组比较,A组肌层深度浸润较浅,组织分化程度好,PR阳性检测率高,复发率低,3年无病存活率高,3年总存活率高,差异具有统计学意义(P0.05)。其他指标如手术病理分期、年龄、绝经率、体重指数、雌激素受体(ER)、腹水细胞学阳性率、淋巴结转移及病理类型两组比较差异无统计学意义(P0.05)。结论子宫腺肌病合并子宫内膜癌可能为雌激素依赖性肿瘤,肌层浸润较浅,组织分化好,相较单纯的子宫内膜癌患者其高危因素少,患者术后复发率低,3年无病存活率高,3年总存活率高,预后较好。     

探讨子宫颈癌的临床病理特征和影响盆腔淋巴结转移的Logistic危险因素分析

目的探究与分析子宫颈癌的临床病理特征和影响盆腔淋巴结转移的Logistic危险因素分析结果。方法回顾性分析本院自2017年12月至2019年12月收治的65例子宫颈癌患者的临床以及术后病理资料,按照是否发生淋巴结转移分为淋巴结转移组(n=19例)及淋巴结未转移组(n=46例),采用单因素以及多因素的Logistic回归分析该组子宫颈癌临床病理特征以及影响盆腔淋巴结的转移危险因素。结果行Logistic分析可见,影响子宫颈癌合并发生盆腔淋巴结转移的危险因素包括了肿瘤直径≥2cm、肿瘤浸润深度>1/2子宫颈全层、存在宫旁浸润、肿瘤累及子宫下段(P<0.05)。结论影响子宫颈癌合并发生盆腔淋巴结转移的危险因素包括了肿瘤直径≥2cm、肿瘤浸润深度>1/2子宫颈全层、存在宫旁浸润、肿瘤累及子宫下段等,妇科工作者需要根据盆腔淋巴结转移情况实施规范性的盆腔淋巴结切除术等其他措施,以达到促进预后的目的。     

子宫内膜癌患者腹腔镜手术治疗后预后不良的影响因素分析

目的探讨子宫内膜癌(EC)患者腹腔镜手术治疗后预后不良的影响因素。方法选取2019年1月至2020年6月我院收治的完成腹腔镜手术治疗的104例EC患者,104例EC患者术后完成为期1年的跟踪随访,将17例预后不良(病死+复发+转移)的EC患者纳入预后不良组,将剩余87例患者纳入预后良好组。查阅患者基线资料并记录研究所需资料,分析EC患者腹腔镜手术治疗后预后不良的影响因素。结果预后不良组年龄大于预后良好组,有淋巴结转移、肌层浸润深度≥1/2肌层、子宫下段受累占比高于预后良好组,差异有统计学意义(P<0.05);预后不良组吸烟史、饮酒史、是否绝经、是否孕育、腹部手术史、合并高血压、合并糖尿病、术中出血量、肿瘤大小、病理类型、肿瘤分期、术后辅助治疗与预后良好组比较,差异无统计学意义(P>0.05);经Logistic回归分析结果显示,年龄大、有淋巴结转移、肌层浸润深度≥1/2肌层、子宫下段受累是EC患者腹腔镜手术治疗后预后不良的危险因素(OR>1,P<0.05)。结论年龄大、有淋巴结转移、肌层浸润深度≥1/2肌层、子宫下段受累是EC患者腹腔镜手术治疗后预后不良的影响因素。     

贲门癌淋巴结转移规律及相关因素分析

目的探讨贲门癌淋巴结转移规律及相关因素分析。方法对河南省安阳市肿瘤医院2010年1月至2019年1月收治的132例贲门癌患者的临床资料进行回顾性分析,分析其淋巴结转移的分布情况,并对其相关因素进行单因素和多因素logistic回归分析。结果132例贲门癌患者共清扫淋巴结1494枚,平均11.32枚;淋巴结转移总数为471枚,平均3.57枚;淋巴结转移度为31.53%,发生淋巴结转移患者89例(67.42%),主要转移部位为贲门旁、胃小弯、胃左动脉旁、胃大弯。根据是否发生淋巴结转移分为发生转移组89例和未发生转移组43例,单因素分析显示,分化程度、肌层浸润深度、病变直径及病理分型是淋巴结转移的影响因素,组间差异有显著性(P<0.05)。多因素Logistic回归分析结果显示:分化程度、肌层浸润深度、病变直径以及病理分型为贲门癌患者发生淋巴结转移的独立影响因素(P<0.05)。结论贲门旁、胃小弯、胃左动脉旁、胃大弯是贲门癌淋巴结最常转移的部位;分化程度、肌层浸润深度、病变直径以及病理分型为贲门癌患者发生淋巴结转移的独立影响因素。     

182例子宫内膜癌临床特征分析

【目的】探讨子宫内膜癌的临床及诊疗特点，指导临床工作。【方法】回顾性分析本院收治的182例子宫内膜癌患者的临床资料，分析患者的年龄、病理类型、组织学分级、肌层浸润深度、淋巴结转移与附件转移的关系。【结果】组织学分级越高、肌层浸润越深、淋巴转移率越高，附件转移率越高，差异有显著性（P〈0．05），而不同年龄、术后不同病理类型间的附件转移率相比较，差异无显著性（P〉0．05）；术后各病理类型、组织学各分级、肌层不同浸润深度、附件有无转移的淋巴结转移率相比较差异有显著性（P〈0．05）。【结论】附件转移与组织学低分化、深肌层浸润或伴有淋巴结转移相关，对无附件转移高危因素的年轻早期患者可考虑保留远离癌灶侧卵巢；腺鳞癌、组织学低分化、深肌层浸润、附件转移者淋巴结转移发生率较高，对合并以上淋巴转移高危因素者，治疗上应选择盆腔淋巴切除。     

82例子宫内膜癌的临床分析

目的 探讨子宫内膜癌患者的临床及病理资料,为该肿瘤的诊断、治疗及判断预后提供依据.方法 回顾性分析82例子宫内膜癌患者临床病理资料和随访结果.结果 患者平均年龄56.2岁,5年生存率73.1%;临床表现以绝经后阴道出血最多,其次为月经量增多,不规则阴道出血,分别占43.9%、34.1%和22.0%,绝经前病例占36.7%;临床分期与手术病理分期存在很大误差率,达23.9%-77.8%,术前诊刮与术后标本病理类型符合率为86.5%;子宫内膜癌肌层浸润率高,肌层侵犯的深度与淋巴结转移及病理组织学分级密切相关,深肌层浸润者,易淋巴结转移、病理组织学分级也差.结论 不规则阴道出血特别是绝经后出血是子宫内膜癌的主要症状;诊刮是诊断内膜癌以及判断有无宫颈受累的经典方法;以手术为主的综合治疗是目前治疗子宫内膜癌的首选治疗措施;术前临床分期与手术病理分期,术前诊刮病理诊断结果与术后组织学类型间均存在差异,应进行综合检查及评估;临床病理分期、肌层浸润深度、病理组织学分级、淋巴结转移情况及孕激素的应用都是影响预后的重要因素.     

全面手术-病理分期对治疗子宫内膜癌的临床意义

目的　探讨子宫内膜癌全面的手术病理分期的临床意义。方法　对我院 1994年 1月至 2 0 0 3年 12月间手术治疗的 12 8例子宫内膜癌的临床资料进行回顾性分析 ,术前、术后分别采取临床分期和手术病理分期 ,将这两种分期进行比较。结果　两种分期的不符合率为 35 2 % (45/12 8) ,其中临床Ⅰ期为 18. 5 %(15/81) ,Ⅱ期为 80 . 0 % (2 4 / 30 ) ,Ⅲ期为 37. 5 % (6 /16 )。宫旁转移率为 4 .9%。Ⅰ期无 1例宫旁浸润 ,Ⅱ期、Ⅲ期、Ⅳ期分别有 2例、3例、1例宫旁浸润 ,经多重相关回归分析后发现临床分期、肌层浸润深度及腹水细胞学阳性与宫旁浸润有相关性 (P <0 . 0 5 )。淋巴结转移率为 9 4 % (12 / 12 8) ,临床分期、肌层浸润深度、肿瘤大小、腹水细胞阳性、病理类型以及组织学分级与淋巴结转移率有显著性意义 (P <0 . 0 5 )。结论　手术病理分期较临床分期准确 ,能真实反映病变范围 ,临床Ⅱ期的误差率较高 ,应引起临床足够的重视。子宫内膜癌淋巴结转移与临床分期、肌层浸润深度、肿瘤大小、腹水细胞阳性、病理类型以及组织学分级密切相关。宫旁浸润与临床分期、肌层浸润深度及腹水细胞学阳性有紧密联系。手术病理分期能客观判断预后 ,并指导治疗。     

82例子宫内膜癌复发的高危因素分析

目的 探讨子宫内膜癌复发的高危因素并进行分析.方法 本院2000年1月至2005年1月收治的子宫内膜癌患者82例进行定期随访,对复发和未复发进行高危因素的分析和探讨.结果 82例子宫内膜癌患者中复发26例,总复发率31.7%.单纯手术组26例,局部复发14例,复发率53.84%;远处复发9例,复发率34.61%.手术+综合治疗组56例,局部复发9例,局部复发率16.07%;远处复发10例,远处复发率17.285%.结论 子宫内膜癌复发的高危因素进行总结,复发与临床期别、组织学分级、肌层浸润、盆腔及腹主动脉旁淋巴结转移和腹腔细胞学检查阳性等有着密切关系.首次治疗方法对患者的生存率有较大的影响.     

早期浸润性宫颈癌盆腔淋巴结转移的因素分析

目的探讨早期浸润性宫颈癌淋巴结转移的相关临床病理因素。方法回顾性分析了行广泛性子宫切除和盆腔淋巴结清扫术的Ⅰ期和Ⅱ期患者88例。进行单因素、多因素分析早期浸润性宫颈癌淋巴结转移的相关高危因素。结果单因素分析显示：肿瘤大小、肌层浸润、组织分级、临床分期、脉管浸润等5个因素有统计学意义，进行逐步logistic回归分析，仅临床分期、肌层漫润、组织分级、脉管浸润与淋巴转移相关，P值分别为O．0002，0．0125，0．0001，0.0165。结论与盆腔淋巴结转移的相关因素，主要有临床分期、肌层浸润．组织分级、脉管浸润有关。     

单因子相关分析与多因子回归分析微量及常量元素与急性心肌梗塞关系的研究

报告38例急性心肌梗塞（AMI）患者和40例对照组患者6种元素的测定值，并进行单因子相关分析和多因子回归分析。结果：AMI血清硒（Se）、锌（Zn）、钙（Ca）、镁（Mg）降低，铜（Cu）增高，均有非常显著性差异（P＜0．01或＜0．001），锶（Sr）则无显著性差异（P＞0．05）；同时设计多元回归判断式，使AMI阳性符合率为73．68％，而对照组阴性符合率达85．00％。说明单因子相关分析与多因子回归分析有相同趋势。作者探讨了各种元素与AMI的联系及发生机制，措出各种元素的检测和人体元素的平衡调整对防治AMI和冠心病有重要的临床意义。     

Examining the hierarchical factor structure of the SF-36 Taiwan version by exploratory and confirmatory factor analysis

RATIONALE: The purpose of this study was to examine the factor structure of the Medical Outcome Study Short Form-36 Taiwan version (SF-36 Taiwan version) using data from the 2001 National Health Interview Survey in Taiwan. METHOD: The 2001 National Health Interview Survey was conducted by stratified multistage systematic sampling, resulting in 19,777 valid responses for the SF-36 Taiwan version. In this study, the 19,777 participants were randomly divided into two independent samples. One sample (n = 9856) was used for exploratory factor analysis (EFA), and the other (n = 9921) was used for confirmatory factor analysis (CFA). RESULTS: The EFA suggested a seven-first-order-factor structure for the SF-36 Taiwan version. In addition, hierarchical EFA revealed that there was only one second-order factor underlying the seven first-order factors. Further, CFA was conducted on the other sample to compare the performances of the original model with eight first-order factors and two second-order factors, and the revised model with seven first-order factors and one second-order factor. The CFA results revealed that the original model was better than the revised model. CONCLUSION: According to the EFA and CFA, it can be concluded that the original structure is still acceptable for the SF-36 Taiwan version.     

Examining factor structure of Maslach burnout inventory among nurses in Taiwan

lee h.-f., chien t.-w. & yen m. (2013) Journal of Nursing Management  21 , 648–656 Examining factor structure of Maslach burnout inventory among nurses in Taiwan Aim  To investigate the factorial structure of a Chinese version of the MBI-HSS for nurses in Taiwan. Background  Previous studies have presented different factorial structures using the Maslach burnout inventory-human services survey (MBI-HSS). Methods  Secondary data analysis was implemented to explore the factor structure of MBI-HSS using exploratory factor analysis. Confirmatory factor analysis was then performed to verify the modified structure for nurses in Taiwan. Results  The EFA found that three factors explaining 57% of the variance were extracted, and 20 of the 22 items were retained. The goodness-of-fit test was performed using the CFA approach, and it was verified that the modified version of MBI-HSS is a suitable instrument for measuring burnout for nurses in Taiwan. Conclusions  A nationwide sample confirmed the factorial structure of MBI-HSS for nurses in Taiwan with a three-dimension, 20-item assessment, and the variance was not diminished in this sample. Implications for nursing management  These findings demonstrate that the modified version of MBI-HSS provides a suitable instrument for measuring burnout for nurses in Taiwan. Therefore, the modified version of MBI-HSS can be used to compare burnout of nurses across cultures, providing valuable information for policies or preventions in the future.     

Developing and testing a tool to evaluate the quality of home aid services

This study aimed to develop a tool to measure the quality of home aid services in Taiwan. A 28-item scale for quality of home aid was drafter based on the literature; a cross-sectional survey was conducted for those using home aid services provided by long-term care centers in southern Taiwan. A total of 537 service users responded. Participants were randomly divided into two sample groups for item analysis (n = 102) and factor analysis (n = 435). Reliability was assessed by repeated measurements for 30 participants. During 2010–2011, a second survey was conducted and 590 questionnaires were collected.     

慢性胰腺炎病因相关因素分析

目的探讨慢性胰腺炎（CP）的病因构成及相关因素分析。方法回顾分析于2008年8月至2009年6月收治的108例CP患者的病因相关因素。结果长期饮酒50例次（46.3%）,其中男性49例,女性1例;患有胆道系统疾病7例次（6.5%）,其中男性3例,女性4例;吸烟43例次（39.8%）,男性41例,女性2例;高脂血症9例次（8.3%）;高钙血症1例次（0.9%）;有胰腺外伤和手术史为4（3.7%）;35例患者找不到相关因素（32.4%）。结论在本次资料中CP的病因中以酒精为主要因素,其次为特发性胰腺炎,胆道疾病为慢性胰腺炎的少见因素。     

Feeding difficulty in elderly patients with dementia: Confirmatory factor analysis

The latent structure of feeding difficulty in elderly patients with dementia was investigated using multivariate statistical techniques including exploratory and confirmatory factor analysis. A survey design of 345 elderly patients with the diagnosis of dementia using a questionnaire completed by key workers and primary nurses, was used in local psychogeriatric and continuing care of the elderly facilities.

Feeding difficulty and nursing intervention were estimated followed by fitting of latent variable models of feeding difficulty to the data using structural equation modelling. Three models of feeding difficulty in elderly patients with dementia, with 2, 3 and 4 factor structures respectively were compared. All three models showed a good fit to the data as assessed by several standard criteria. The 3 and 4 factor models, however, showed significantly better fit than the 2 factor model. The 4 factor model introduced a latent variable of “oral difficulty” with feeding which merits further investigation. This study demonstrates the possibility of developing reliable and validated scales for the assessment of feeding difficulty in elderly patients with dementia.     

Postgraduate Research Experience Questionnaire: reliability and factor structure with Master's in Nursing graduates

Title. Postgraduate Research Experience Questionnaire: reliability and factor structure with Master’s in Nursing graduates. Aim. This paper is a report of a study to measure the psychometric properties of the Postgraduate Experience Questionnaire when used to evaluate the research experience of graduates who had completed Master’s in Nursing programmes. Background. Evidence of standards and outcomes of Master's in Nursing programmes is lacking, despite their continuing growth worldwide. The Postgraduate Research Experience Questionnaire was introduced to evaluate the research experience of graduates. The instrument is a multidimensional measure of graduate students’ experiences of research and research supervision. Six constructs that comprise the research experience of graduates are measured: the supervision process, academic climate, goals and expectations, infrastructure, skill development and the dissertation examination process. Method. A cross‐sectional postal survey of graduates from coursework Master’s in Nursing programmes in Ireland was undertaken in 2006. The response rate was 71%. Exploratory and confirmatory factor analysis were used to test construct validity, while internal consistency measures were used to test reliability. Results. Factor analysis identified a six‐factor solution, as hypothesized by the instrument’s developers. According to oblique rotation and confirmatory factor analysis, the majority of scales that comprise the instrument were relatively robust. Internal consistency measures identified that the six scales were reliable. Conclusion. The construct validity of Postgraduate Research Experience Questionnaire when psychometrically evaluated with coursework master’s graduates differed slightly from the factor structure reported in the literature for the original scale. However, overall, adequate estimates of reliability and validity were found when the instrument was used to evaluate the research experience of graduates who complete a supervised dissertation as part of their degree.     

Structural Consistency of the Pain Sensitivity Questionnaire in the Cooperative Health Research In South Tyrol (CHRIS) Population-Based Study

The self-reported Pain Sensitivity Questionnaire (PSQ) is a valid supplement to experimental pain testing. However, the latent constructs determining the originally proposed 1 general score (PSQ-total) and 2 subscores (PSQ-moderate and PSQ-minor) have not been consistently investigated in population-based studies or between genders. Based on a single construct hypothesized by expert knowledge or alternative constructs upon empirical evidence, PSQ structures were explored and confirmed among 4,820 participants aged 18 to 93 years of the Cooperative Health Research In South Tyrol (CHRIS) study. By exploratory factor analysis, we identified 3 alternative sets of PSQ imagined painful situations comprising 14, 10, and 9 items, which displayed simple structures of the rotated factor loadings of direct interpretation. In confirmatory analysis (CFA) of 1 latent factor, the 10-item set yielded acceptable goodness-of-fit overall, better fit than the alternative sets and consistent structural properties between genders. Separate analyses based on 14- and 9-item sets returned considerable correlations between 2 latent constructs. In higher-order CFA with each set, 1 first-order general factor explained a large part of the variances of 2 second-order factors. One dominant construct consistently describes the factorial structure of the PSQ. Averaging across the 10-item set, the PSQ-short score represents a structurally robust, gender-consistent, and practical measure of general pain sensitivity.