康莱特注射液对晚期癌症患者生存质量的影响

目的观察康莱特注射液提高晚期癌症患者生存质量的作用。方法本组收集两家医院肿瘤科126例晚期癌症患者临床治疗资料,每位患者给予康莱特注射液100ml VDqd×20天,观察治疗后疼痛缓解,KPS变化,体重变化及不良反应。结果癌症疼痛缓解总有效率达76.99%(部分缓解60.32%,完全缓解16.67%),用药结束后疼痛缓解仍可维持2～6天;经康莱特治疗后91.27%(115126)的患者KPS评分提高,其中提高20以上达69.84%;未发现康莱特注射液对心、肝、肾功能方面的毒副作用。结论康莱特有明显提高晚期癌症患者的生存质量,且无明显毒副作用。     

肺癌局部与肺叶切除术对高龄患者生存质量的影响

目的:探讨不同术式对高龄肺癌患者近期生存质量的影响.方法:将2004年1月-2006年12月＞70岁手术治疗后一年以上的212例肺癌患者分为A,B两组:A组93例,行肺叶切除术及淋巴结清扫术;B组119例,行肺内包块局部切除术及局部淋巴结清扫术.采用欧洲癌症治疗研究组织生存质量核心量表EORTC QLQ-C30及肺癌专用量表EORTC QLQ-LC13测评所有患者的生存质量.结果:与术前相比,出院时所有患者的生存质量均有所下降,于3-12月之内逐渐恢复.两组间比较,在整体健康状态、躯体功能、角色功能及疲劳、疼痛、呼吸困难、气促与咳嗽症状等方面B组优于A组,存在显著差异(P<0.05).结论:高龄肺癌患者术后近期内生存质量明显下降,在术后一年内逐渐恢复;肺叶切除术并淋巴结清扫术比局部切除术对高龄肺癌患者的生存质量影响更大.     

肝细胞癌手术切缘对患者术后复发与生存的影响

目的 比较不同的手术切缘对肝癌患者术后复发及生存的影响,为肝癌患者手术中选择合理切缘提供参考。方法 将152例初治的可手术切除肝癌患者随机分为两组,分别按以下标准手术：74例宽切缘组患者按门静脉血流方向远端距肿瘤边缘2cm,近端距肿瘤边缘1cm完整切除;78例窄切缘组患者切除范围距离肿瘤〈1cm,切缘无癌残留。应用Kaplan-Meier法进行生存分析,用Log rank检验分别比较两组的无瘤生存期和总生存期。结果 宽切缘组患者平均无瘤生存期为35．5个月,平均总生存期为42．0个月;窄切缘组患者平均无瘤生存期为28．8个月,平均总生存期为37．5个月,两组无瘤生存期（t=6．01,P=0．0142）和总生存期（t=6．23,P=0．0125）比较,差异均有统计学意义。结论 按门静脉血流方向远端距肿瘤2cm,近端距肿瘤1cm切除为标准的手术范围可较合理地延长肝癌患者术后无瘤生存期和总生存期。     

康莱特静滴对晚期肝癌患者生存质量影响的研究

目的:评价康莱特注射液静滴对晚期肝癌患者生存质量的影响,为临床提供更有效的治疗方法.方法: 治疗组静滴康莱特注射液100ml,每日1次,10天为1疗程,连续应用2个疗程,同时给予保肝护肝、生物反应调节剂及支持对症治疗.对照组仅给予保肝护肝、生物反应调节剂及支持对症治疗.结果: 全组共48例,治疗组24例,对照组24例.治疗组与对照组在进食量的变化、体重变化、疼痛变化及卡氏评分的变化等方面相比较,均有显著性差异(P<0.05).结论: 康莱特注射液可提高晚期肝癌患者的生活质量,改善临床症状,对晚期肝癌患者有较好疗效.     

康莱特静滴对晚期肝癌患者生存质量影响的研究

目的：评价康莱特注射液静滴对晚期肝癌患者生存质量的影响,为临床提供更有效的治疗方法。方法：治疗组静滴康莱特注射液100ml,每日1次,10天为1疗程,连续应用2个疗程,同时给予保肝护肝、生物反应调节剂及支持对症治疗。对照组仅给予保肝护肝、生物反应调节剂及支持对症治疗。结果：全组共48例,治疗组24例,对照组24例。治疗组与对照组在进食量的变化、体重变化、疼痛变化及卡氏评分的变化等方面相比较,均有显著性差异（P〈0．05）。结论：康莱特注射液可提高晚期肝癌患者的生活质量,改善临床症状,对晚期肝癌患者有较好疗效。     

不同鼻腔冲洗方式对鼻咽癌的远期生存、鼻窦炎及生存质量影响

目的 探讨不同鼻腔冲洗方式对鼻咽癌的远期生存、鼻窦炎发生率及生存质量影响,为鼻咽癌最佳鼻腔冲洗方式提供临床依据。方法 依据随机数字表将本院2003年8月至2010年12月的1134例鼻咽癌患者随机分为3组（n=378）：A组采用一次性鼻腔冲洗机;B组采用自制鼻腔冲洗接头联合灌肠器;C组采用鼻腔喷雾器。分析3组的放疗急性不良反应并随访远期生存情况,分别于治疗前（T0）、治疗6个月（T1）、治疗1年（T2）、治疗2年（T3）和治疗3年（T4）采用中文版鼻腔鼻窦结局测量20条（SNOT-20）调查各组的生存质量并记录各组鼻咽炎发生率。结果 全组共随访3～92个月,5年总生存率和无进展生存率分别为80.5％和73.2％。3组中位总生存期和无进展生存期的差异无统计学意义（P＞0.05）;3组唾液腺损伤和颈部皮肤损伤发生率的差异无统计学意义（P＞0.05）;C组3～4级口咽黏膜损伤的发生率高于其余两组（P＜0.05）,且A、B两组发生率的差异无统计学意义（P＞0.05）;全组T0、T1、T2、T3、T4的鼻窦炎发生率分别为41.7％、56.3％、74.0％、54.1％和69.6％,A组T2、T3、T4的鼻窦炎发生率均低于其余两组,B组T2的发生率低于C组,但T4高于C组,以上差异均有统计学意义（P＜0.05）;3组T1、T2的鼻窦炎症状积分均低于T0（P＜0.05）,仅C组T3、T4的积分低于T0（P＜0.05）,其余均与T0的差异无统计学意义（P＞0.05）,且C组T2、T4的积分均低于其余两组（P＜0.05）。结论 不同鼻腔冲洗方法对鼻咽癌患者的远期生存无明显影响,但鼻腔喷雾器可增加口咽黏膜损伤的风险,且采取该方法在随访期间内患者的生存质量最差。     

局部放疗对Ⅳ期食管鳞癌患者生存影响的回顾性分析

目的:探讨局部根治剂量及姑息剂量放疗对Ⅳ期食管鳞癌患者生存的影响。方法:回顾性分析2010年1月至2016年7月我院初治的36例Ⅳ期食管鳞癌患者的总体生存时间、1年、2年及3年生存率,同时比较化疗后根治剂量放疗及姑息剂量放疗对生存时间、局部有效率和不良反应的影响。结果:36例Ⅳ期食管鳞癌患者的1年、2年、3年生存率分别为66.7%、36.1%和19.4%,总体中位生存时间为13.5个月。高剂量放疗组和低剂量放疗组的中位生存时间分别是17个月和11个月,1年、2年、3年生存率分别是81%、42.9%、28.6%和46.7%、20%、6.7%,二者的中位生存时间有统计学差异（P=0.024）。高剂量放疗组和低剂量放疗组的放疗有效率分别为71.4%和26.7%,二者之间有统计学差异（P=0.017）。两组间的白细胞减少和血小板减少程度无统计学差异（P>0.05）,放射性食管炎及放射性肺炎发生率也无统计学差异（P>0.05）。结论:化疗后给予Ⅳ期食管癌患者局部病灶根治性放疗,有改善患者总体生存的趋势。     

肿瘤堆积物对胃癌手术患者生存状况的影响

目的探讨肿瘤堆积物(TDs)对胃癌手术患者生存状况的影响。方法将60例行胃癌根治手术的患者按照病理检查结果分为TDs阳性组20例与TDs阴性组40例,比较2组患者术后生存状况。结果 TDs阳性组肿瘤大小、未分化型胃癌占比、淋巴结转移个数、并发症发生率及TNMⅢ期占比等均显著高于TDs阴性组,差异有统计学意义(P<0.05);TDs阳性组术后3年、5年的生存率显著低于TDs阴性组,差异有统计学意义(P<0.05)。结论肿瘤堆积物阳性患者的术后生存状况差,可作为胃癌患者术后生存状况的判断指标。     

生存质量对鼻咽癌长期生存者预后的影响

 目的　分析生存质量对鼻咽癌长期生存者预后的影响。方法　1999年至2000年接受治疗并于2003年7月前无瘤生存的192例鼻咽癌患者纳入研究。患者于2003年7至8月接受生存质量测定。测定量表包括健康状况调查量表（SF-36）（中文版）和包含14个症状的自觉症状评价量表。随访时间2.67～9.55年,中位随访7.95年。分析生存质量以及社会人口学和临床因素对预后的影响。结果　单因素分析表明,生存质量对无瘤生存和总生存有影响。多因素分析表明,记忆力下降是无瘤生存的独立预后因素,张口困难、头痛和年龄是总生存的独立预后因素,生存质量越好、年龄越小者预后越佳,而其他社会人口学和临床因素未发现预后价值。结论　生存质量是影响鼻咽癌长期生存者预后的重要因素,随访时应常规评价患者的生存质量。     

乳腺癌不同手术方式对患者术后生存质量的影响

目的探讨不同手术方式对乳腺癌患者术后生存质量的影响。方法采用已通过检验的美国HopeCity医学研究中心编制的《乳腺癌生存质量评定量表》和Olson婚姻质量问卷，对149例乳腺癌术后1年的患者进行问卷调查分析。结果接受不同手术方式的乳腺癌患者的生存质量（QOL）评分，随手术范围的缩小呈上升趋势。经典根治术与改良根治术、保乳手术方式之间的差异有统计学意义（P〈0．05），而改良根治术与保乳手术之间的QOL差异无统计学意义（P〉0．05）。乳腺癌患者接受不同方式的手术后，其婚姻质量的评分随手术范围的缩小而呈上升趋势。并且，经典根治术、改良根治术与保乳手术方式之间差异有统计学意义（P〈0．05），但仍小于常模。结论接受改良根治术的乳腺癌患者术后生存质量优于接受经典根治术者；保乳手术有助于婚姻质量的提高。     

The Effects of Pelvic Radiotherapy on Cancer Survivors: Symptom Profile,Psychological Morbidity and Quality of Life

AimsAs cancer survival rates continue to increase, it is important to maximise the quality of life of cancer survivors. Pelvic radiotherapy is a common cancer treatment. Bladder, bowel and sexual dysfunction are recognised side-effects of treatment, and yet relatively little is known of the extent to which they remain problems in the longer term when patients are often managed by primary care, nor of the psychological impact of symptoms and effects on quality of life. Therefore, the aims of this study were to estimate the prevalence of bladder, bowel and sexual dysfunction late effects in a sample of cancer survivors; assess the impact of time since treatment on symptom prevalence; and explore the relationship between symptoms, psychological morbidity and quality of life.Materials and methodsA questionnaire was given to a sample of cancer survivors treated in Oxford who had pelvic radiotherapy 1–11 years previously. The questionnaire measured patient-reported toxicity (Common Toxicity Criteria of Adverse Events/Late Effects of Normal Tissues – Subjective, Objective, Management and Analytic Measure), psychological morbidity (Hospital Anxiety and Depression Scale) and quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30).ResultsIn total, 418 (57.1%) completed questionnaires were received. Moderate/severe problems with bowel, urinary and sexual functioning were relatively common: bowel urgency (59% women, 45% men); urine urgency (49% women, 46% men); ability to have a sexual relationship affected (24% women, 53% men). Symptoms were just as frequent in those 6–11 years after treatment as in those 1–5 years after treatment. Symptom severity was significantly associated with poorer overall quality of life and higher levels of depression.ConclusionsLate effects are common among long-term cancer survivors who have had pelvic radiotherapy, and are associated with reduced quality of life and psychological morbidity. It is imperative due attention is paid to this issue during the follow-up phase – both in secondary and primary care. Health care professionals providing follow-up care need to be aware of the importance of assessing and monitoring symptoms, and need to be adequately informed on the most appropriate management strategies.     

枇杷叶水提物的急性毒性和遗传毒性

目的：研究枇杷叶水提物（AEEJL）的急性毒性和遗传毒性。方法：采用急性经口毒性试验、Ames试验、哺乳动物骨髓微核试验及体外哺乳细胞染色体畸变试验对枇杷叶水提物进行急性毒性和遗传毒性研究。结果：急性经口毒性试验显示枇杷叶水提物对小鼠的半数致死量（LD₅₀）大于20.00 g/kg。Ames试验在剂量为8~5 000 μg/皿范围内,回变菌落数均未达到自发回变菌落数的2倍,亦无剂量-反应关系;微核试验在剂量为20.0、10.0和5.00 g/kg时微核细胞率均<3.0‰,与阴性对照组比较差异均无统计学意义（P>0.05）;染色体畸变试验在剂量为625~5 000 μg/mL范围内,畸变细胞率均≤5.0%,与阴性对照组比较差异均无统计学意义（P>0.05）。结论：在本实验条件下,枇杷叶水提物属无毒级物质,未显示遗传毒性。     

疫苗对日本血吸虫肝虫卵肉芽肿细胞作用的定量形态学的研究

应用形态计量学的方法，研究了日本血吸虫尾蚴减毒疫苗作用于小鼠后，宿主对再感染肝内虫卵肉芽肿细胞核形态计量学参数的变化。结果表明免疫组动物肝内形成的虫卵肉芽肿细胞数密度与面密度减小，与对照组有明显差异（Ｐ＜０００１）。细胞核的平均面积、平均周长、平均直径均改变明显（Ｐ＜００１）。而细胞核凹凸度改变不大（Ｐ＞００５）。揭示经疫苗作用后，宿主肝内虫卵肉芽肿反应下调现象明显，组织病理学改变减少。证明减毒疫苗产生保护性免疫力的机理。     

The Impact of Chemotherapy on the Quality of Life of Breast Cancer Patients

One hundred and thirty-seven breast cancer patients, 102 receiving adjuvant chemotherapy and 35 receiving palliative chemotherapy for metastatic disease underwent a 37-item quality-of-life questionnaire to evaluate the impact of disease and treatment on physical, psychological and social well being. Patient groups were designated as follows — Adj CT: patients undergoing the questionnaire during their adjuvant chemotherapy program; Post Adj CT: patients evaluated 3 to 8 months after termination of adjuvant chemotherapy; Mts CT: patients assessed during palliative chemotherapy for metastatic disease, and Post Mts CT: patients 3 to 8 months after termination of palliative chemotherapy. Physical and social activities were reported as unaltered or normal by 64 to 70% and 52 to 67% of patients, respectively. Psychological status was judged normal by 39 to 45% of patients. No significant differences were observed between the patient groups. In 83 to 90% of cases the patient normally took care of herself. In 62 to 87% of cases time dedicated to recreational activities was reported as unaltered. The majority of patients (84%) judged that their relationship with partner and/or family were good. Severe anxiety was reported in 19 to 28% of patients and severe depression was infrequent (3.9%). Information regarding disease and treatment given by health professionals was considered satisfactory by 80 to 100% of patients. This pilot experience indicates that the majority of breast cancer patients respond normally to the stresses of both adjuvant and palliative chemotherapy; quality of life does not appear to improve 3-8 months after termination of chemotherapy; family support is good in the majority of cases and that a subset of patients with severe anxiety who could benefit from pharmacological and/or psychological intervention can be identified.     

乳腺癌患者化疗后抗抑郁治疗对患者生活质量及其免疫功能的影响

目的观察乳腺癌患者化疗后抗抑郁治疗对患者生活质量及其免疫功能的影响。方法选择80例乳腺癌化疗后伴抑郁的患者作为研究对象,随机分为试验组和对照组,每组40例。对照组术后不给予抗抑郁药物治疗,试验组给予帕罗西汀。比较2组患者汉密尔顿抑郁量表(HAMD)评分情况,比较2组患者生活质量评分情况,检测2组患者免疫功能。结果2组患者HAMD评分治疗前比较,无明显差异(P>0.05)。试验组治疗后HAMD评分较治疗前降低,差异有统计学意义(P<0.05)。治疗后,试验组HAMD评分较对照组降低,差异有统计学意义(P<0.05)。生活质量调查表结果表明,试验组治疗后躯体功能、角色功能、情绪功能评分、疲乏、疼痛、失眠、食欲减退方面评分大于对照组,差异有统计学差异(P<0.05);试验组整体生活质量评分(63.22±1.78)高于对照组(43.22±1.73),差异有统计学意义(P<0.05)。治疗后,试验组患者CD_3^+T细胞、CD_4^+T细胞、IgG、IgA、IgM均明显高于对照组,差异有统计学意义(P<0.05);治疗后,2组患者CD_8^+T细胞水平差异无统计学意义(P>0.05)。结论乳腺癌化疗后伴抑郁的患者采取帕罗西汀抗抑郁治疗的疗效显著,同时还可改善患者生活质量和免疫功能,值得临床推广。     

The Effect of Adenotonsillectomy on Quality of Life in Adults and Pediatric Patients

The aim of this study was to evaluate the benefits, impact, and overall efficacy of tonsillectomy or adenotonsillectomy on quality of life in patients with recurrent, chronic tonsillitis or adenotonsillar hypertrophy before and after surgery in adults and children. A multi-center, observational, retrospective study of all adults and children who had undergone tonsillectomy in adults (14 years or older) and adenotonsillectomy in children for chronic, recurrent tonsillitis or adenotonsillar hypertrophy between September 2003–September 2008 in Ahwaz Imam and Apadana Hospitals. Patients were asked by questionnaire to compare their symptoms 6-months period before and after tonsillectomy or adenotonsillectomy. Outcome measures included the frequency of tonsillitis per year, days off work (or school), doctor visits and feelings of well-being. 812 adults and children were sent a questionnaire regarding their symptoms in the 6 months before and 6 months after surgery. A total of 812 patients (81 adults and 731 children) were enrolled in the study. The age of the patients ranged from 3 to 42 years. In adults group there were 34 men and 47 women. In child group there were 325 boys and 406 girls. The mean age of the children patients was 8.6 years and adults 26.5 years. The mean duration of symptoms was 3.6 years. The mean frequency of tonsillitis per year, days off work (or school), doctor visits decreased postoperatively. We concluded that tonsillectomy in adult and adenotonsillectomy in children is benefit for patients with adenotonsillar hypertrophy and/or recurrent, chronic tonsillitis and results in significant improvement in overall quality of life, physical health and general well-being.     

肺癌患者生命质量测定研究概况

较全面地报道肺癌患者的患病情况、生命质量量表研究及其生命质量测评应用状况。结果表明：（1）有50多种量表用于肺癌患者生命质量测定,但较好的EORTC QLO－C30和QLQ－LC13、FACT、FLIC等。（2）肺癌患者的生命质量测评主要用于：评价肺癌治疗效果,选择治疗方案;筛选抗癌药;分析癌症患者的预后和远期生存状态。     

Effects of a 4-Week Multimodal Rehabilitation Program on Quality of Life,Cardiopulmonary Function,and Fatigue in Breast Cancer Patients

Purpose

This study examines the effects of a rehabilitation program on quality of life (QoL), cardiopulmonary function, and fatigue in breast cancer patients. The program included aerobic exercises as well as stretching and strengthening exercises.

Methods

Breast cancer patients (n=62) who had completed chemotherapy were randomly assigned to an early exercise group (EEG; n=32) or a delayed exercise group (DEG; n=30). The EEG underwent 4 weeks of a multimodal rehabilitation program for 80 min/day, 5 times/wk for 4 weeks. The DEG completed the same program during the next 4 weeks. The European Organization for Research and Treatment of Cancer-Core Quality of Life Questionnaire (EORTC QLQ-C30), EORTC Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23), predicted maximal volume of oxygen consumption (VO₂max), and fatigue severity scale (FSS) were used for assessment at baseline, and at 2, 4, 6, and 8 weeks.

Results

After 8 weeks, statistically significant differences were apparent in global health, physical, role, and emotional functions, and cancer-related symptoms such as fatigue and pain, nausea, and dyspnea on the EORTC QLQ-C30; cancer-related symptoms involving the arm and breast on the EORTC QLQ-BR23; the predicted VO₂max; muscular strength; and FSS (p<0.050), according to time, between the two groups.

Conclusion

The results of our study suggest that a supervised multimodal rehabilitation program may improve the physical symptoms, QoL, and fatigue in patients with breast cancer.