Assessment of treatment response in patients with laryngopharyngeal reflux

To evaluate treatment response in patients with laryngopharyngeal reflux (LPR). A prospective study of 100 patients with voice disorders was conducted. Patients were evaluated using reflux symptom index (RSI) and reflux finding score (RFS) by 70° rigid laryngoscope. Patients with RFS score of 7 or more were diagnosed of having LPR and were started with anti-reflux therapy for a period of 6 months. Patients were assessed at regular intervals using RSI and RFS. The prevalence of LPR in patients with voice disorders was found to be 25%. The mean RSI score improved gradually and significantly over a period of 6 months from 11.84 at presentation to 2.04 after 6 months of treatment (p value <0.001). The mean value of RFS improved from 7.92 at entry to 1.52 after 6 months of treatment (p value <0.001). However, it was found that the improvement was not significant at end of first month of treatment, and improvement in RSI and RFS scores was found only after 2 months of treatment. RSI and RFS improve significantly after treatment for 6 months with PPI like Omeprazole. But the improvement starts from the 2nd month from the onset of treatment. Treatment of LPR for at least 6 months may be indicated to attain a full resolution of physical findings.     

Role of Laryngopharyngeal Reflux in Complications of Tonsillectomy in Pediatric Patients

Tonsillectomy and tonsillectomy with adenoidectomy are among the most common surgical procedures in otolaryngology practice. Gastroesophageal reflux was identified as a risk factor for complications in tonsillectomy. This prospective study was designed to assess the role of reflux in the development of complications following tonsillectomy in pediatric patients. Children (n = 60) who underwent tonsillectomy with adenoidectomy were divided into two groups, i.e., the laryngopharyngeal reflux (LPR) group and control group. Patients with LPR were identified by reflux symptom index and reflux finding score. Pain, hemorrhage, fever, nausea, vomiting, fever, dehydration, infection, and pulmonary problems were evaluated post operatively. The mean lengths of hospital stay were 2.11 days in the reflux group and 1.05 days in the control group. The difference was statistically significant. Visual analogue scores of both groups were similar on day 1 but it was significantly higher on day 7 and 14 in LPR group. Nausea and vomiting rates were 11.1 and 9.5 % for the patients in the LPR group and the controls, respectively. The difference between the two groups was not significant. The mean fever was 37.6 °C in the reflux group and 37.3 °C in the controls, which were not significantly different. 19 % of the controls and 22 % of the LPR group patients were readmitted. This difference was not statistically significant. There were two cases of bleeding in the reflux group, while no bleeding occurred in the control group. This difference was significant statistically. LPR is a risk factor for complications following tonsillectomy.     

Diagnosis and Management of Laryngo-Pharyngeal Reflux

The aim of the present paper was to analyze laryngo-pharyngeal reflux (LPR) manifestations in ENT patients, and present a diagnostic and treatment algorithm for appropriate management. Retrospective chart review of 150 patients, who had initially presented with symptoms suggestive of LPR. Treatment included the administration of omeprazole 20 mg twice daily for at least 4 weeks. Unresponsive patients were also given metoclopramide 10 mg twice daily for four additional weeks, and the dose of omeprazole was increased to 40 mg twice daily, if they did not achieve complete symptom resolution. Only patients who became completely asymptomatic after LPR treatment were included in the study. As many as 18 % of patients attending an ENT outpatient department benefited from anti-reflux treatment. A need to clear the throat represented the most common symptom, whereas interarytenoid oedema/congestion was the most common finding on flexible naso-endoscopy (62.67 and 72.7 % of patients, respectively). The vast majority of patients responded after 4 weeks of treatment with omeprazole, however, as many as 32 % of LPR patients achieved complete symptom control after the initial 4 week trial period. LPR seems to be more common than previously reported in the literature. Appropriate management of LPR can prevent the symptomatic use of various medical treatments for related manifestations, and even surgical interventions, thus decreasing the overall patient morbidity.     

Characterization of laryngopharyngeal reflux in patients with premalignant or early carcinomas of the larynx

BACKGROUND: An association between laryngopharyngeal reflux (LPR) and laryngeal carcinoma has been suggested, but remains unproven. The current pilot study was performed to determine the incidence of LPR among patients with early laryngeal carcinomas or dysplasia and to examine the associations between levels of LPR and histologic stage, smoking status, the symptom of heartburn, and body position during reflux episodes. METHODS: Behavioral and 24 hour pH monitoring data were prospectively acquired and analyzed for 40 previously untreated adults with dysplasia, T1 or T2 laryngeal carcinomas. RESULTS: Eighty-five percent of patients had LPR. No significant association was shown between the level of LPR and histologic stage or smoking status. Heartburn did not predict LPR. The incidence of LPR in the upright body position was 91%, compared with 9% in the supine position, among patients with LPR. CONCLUSIONS: When compared to available normative data, the current findings show a high incidence of LPR in patients with premalignant and early laryngeal cancer. These findings highlight the need for a matched-control study evaluating LPR as a potential predisposing factor for laryngeal carcinoma.     

Reflux Finding Score (RFS) a Quantitative Guide for Diagnosis and Treatment of Laryngopharyngeal Reflux

The study was under taken to know the prevalence of reflux signs in an individuals with throat complaints on the basis of reflux finding score (RFS) and quantitatively assess the effect of treatment. A cross-sectional study was done to evaluate the presence of laryngo-pharyngeal reflux signs in patients visiting ENT clinic with throat or voice problems in central India. There were 80 patients included in the study from 2017 to 2018 individuals. They were questioned regarding their symptoms. Their pharyngeal findings on rigid 70° laryngoscopy were viewed and RFS was made. The patients were reviewed at monthly intervals. Laryngopharyngeal reflux changes were seen in 36 of the 80 patients (45%). The reflux was graded as per the reflux finding score. The score ranged from 7 to maximum of 17 out of 26 in the patients with LPRD. Majority of the patients the score decreased with lifestyle changes and pantaprazole twice daily. There was poor response in 5% (4) patients, who were then advised to undergo upper gastro intestinal endoscopy for further assessment. Laryngopharyngeal reflux has become a very common entity in urban lifestyle. On careful examination the signs can be picked and assessed with the RFS, which is a very useful tool to grade and reassess patient on subsequent follow up.     

Gastrointestinal function testing model using a new laryngopharyngeal pH probe (Restech) in patients after Ivor-Lewis esophagectomy

BACKGROUNDThere is no established correlation between 24-h esophageal pH-metry (Eso-pH) and the new laryngopharyngeal pH-monitoring system (Restech) as only small case series exist. Eso-pH was not designed to detect laryngopharyngeal reflux (LPR) and Restech may detect LPR better. We have previously published a dataset using the two techniques in a large patient collective with gastroesophageal reflux disease. Anatomically, patients after esophagectomy were reported to represent an ideal human reflux model as no reflux barrier exists. AIMTo use a human reflux model to examine our previously published correlation in these patients. METHODSPatients after Ivor Lewis esophagectomy underwent our routine follow-up program with surveillance endoscopies, computed tomography scans and further exams following surgery. Only patients with a complete check-up program and reflux symptoms were offered inclusion into this prospective study and evaluated using Restech and simultaneous Eso-pH. Subsequently, the relationship between the two techniques was evaluatedRESULTSA total of 43 patients from May 2016 - November 2018 were included. All patients presented with mainly typical reflux symptoms such as heartburn (74%), regurgitation (84%), chest pain (58%), and dysphagia (47%). Extraesophageal symptoms such as cough, hoarseness, asthma symptoms, and globus sensation were also present. Esophageal 24-hour pH-metry was abnormal in 88% of patients with a mean DeMeester Score of 229.45 [range 26.4-319.5]. Restech evaluation was abnormal in 61% of cases in this highly selective patient cohort. All patients with abnormal supine LPR were also abnormal for supine esophageal reflux measured by conventional Eso-pH. CONCLUSIONPatients following esophagectomy and reconstruction with gastric interposition can ideally serve as a human reflux model. Interestingly, laryngopharyngeal reflux phases occur mainly in the upright position. In this human volume-reflux model, results of simultaneous esophageal and laryngopharyngeal (Restech) pH-metry showed 100% correlation as being explicable by one of our reflux scenarios.     

Prediction of severe reflux after oesophageal cancer surgery

IntroductionA common and burdensome consequence of oesophagectomy for cancer is reflux. This study aimed to develop a risk prediction model for postoperative reflux using variables available at the time of surgery enabling tailored preventive symptom management.MethodsData were obtained from a nationwide, population-based cohort of 921 adults who underwent oesophagectomy for cancer between 2013 and 2019. Among 569 eligible patients, 383 (67%) participated in the study. Patient and clinical characteristics were retrieved from national health registries and medical records. Postoperative reflux was self-reported 1 year after surgery in the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire module for gastroesophageal symptoms. Multivariable regression models provided odds ratios (OR) with 95% confidence intervals (CI). The performance of the model was evaluated using the area under the receiver-operating characteristic curve.ResultsFemale sex (OR 2.24, 95% CI: 1.00–5.00), preoperative reflux (OR 2.99, 95% CI: 1.61–5.52), and preoperative body mass index ≥30 (OR 2.45, 95% CI: 1.32–4.54) increased the risk of postoperative reflux. A model based on age, sex, preoperative reflux, body mass index, chronic obstructive pulmonary disease, and ventricle substitute predicted 72% of the severe cases.ConclusionFemale sex, preoperative reflux, and preoperative body mass index increased the risk of postoperative reflux. A combination of readily available patient and preoperative clinical variables showed fairly good accuracy in predicting postoperative reflux after oesophagectomy. The clinical risk prediction model may be helpful for early symptom management but needs to be externally validated before wider use.     

Higher levels of total pepsin and bile acids in the saliva as a possible risk factor for early laryngeal cancer

Background

Gastroesophageal reflux is suspected to be an etiological factor in laryngeal and pharyngeal cancer. The aim of this study was to establish, using a non-invasive method, whether laryngopharyngeal reflux (LPR) appears more often in patients with early laryngeal cancer than in a control group.

Patients and methods

We compared the pH, the level of bile acids, the total pepsin and the pepsin enzymatic activity in saliva in a group of 30 patients with T1 laryngeal carcinoma and a group of 34 healthy volunteers.

Results

The groups differed significantly in terms of levels of total pepsin and bile acids in the saliva sample. Higher levels of total pepsin and bile acids were detected in the group of cancer patients. No significant impact of other known factors influencing laryngeal mucosa (e.g. smoking, alcohol consumption, and the presence of irritating substances in the workplace) on the results of saliva analysis was found.

Conclusions

A higher level of typical components of LPR in the saliva of patients with early laryngeal cancer than in the controls suggests the possibility that LPR, especially biliary reflux, has a role in the development of laryngeal carcinoma.     

Validation of a palliative prognostic index to predict life expectancy for terminally ill cancer patients in a hospice consultation setting in Taiwan

Background: The aim of our study was to assess the practical utility of the palliative prognostic index (PPI)as a prognostic tool used by nurse specialists in a hospice consultation setting in Taiwan. Methods: In total, 623terminal cancer patients under hospice consultation care from one medical center in northern Taiwan wereenrolled between January 1 and June 30, 2011. PPI was assessed by a nurse specialist at first hospice consultationand patients categorized into groups by prognosis (good, intermediate, poor). Patient survival was analyzedretrospectively to determine significance of between-group differences. Results: By PPI sum score, 37.2% ofpatients were in the good prognosis group, 18% in the intermediate prognosis group and 44.8% in the poorprognosis group. The death rates were 56%, 81.2% and 89.6% and median survivals were 76, 18 and 7 days,respectively. The hazard ratio was 0.19 (95% confidence interval [CI] 0.10-0.24, p<0.001) for the poor versusgood prognosis group and 0.54 (95% CI 0.43-0.69, p<0.001) for the poor versus intermediate prognosis group.The sensitivity and specificity for the poor prognosis group was 66% and 71%; the positive predictive value andnegative predictive value were 81% and 52%, respectively, to predict patient death within 21 days (area underthe curve of the receiver operating characteristic was 0.68). Conclusions: Assessment by PPI can accuratelypredict survival of terminal cancer patients receiving hospice consultation care. PPI is a simple tool and can beadministered by nurse members of hospice consultation teams.     

和胃降逆汤治疗食管贲门癌术后反流性食管病的疗效

目的观察和胃降逆汤对食管贲门癌术后反流性食管病的临床疗效。方法将90例食管贲门癌术后反流性食管病患者随机分为治疗组和对照组,分别给予和胃降逆汤和奥美拉唑、吗丁啉治疗,疗程8周。观察治疗后两组患者的疗效。结果治疗组总有效率为86.7%;对照组总有效率为71.1%,治疗组总有效率优于对照组(P<0.05)。结论和胃降逆汤能明显改善食管贲门癌术后食管反流病患者的临床症状及粘膜损伤,疗效优于对照组。     

Temporal Profiles of Symptom Scores After Palliative Radiotherapy for Bleeding Gastric Cancer With Adjustment for the Palliative Prognostic Index: An Exploratory Analysis of a Multicentre Prospective Observational Study (JROSG 17–3)

AimsAlthough palliative radiotherapy for gastric cancer may improve some symptoms, it may also have a negative impact due to its toxicity. We investigated whether symptoms improved after radiotherapy with adjustment for the Palliative Prognostic Index (PPI) considering that patients with limited survival tend to experience deterioration of symptoms.Materials and methodsThis study was an exploratory analysis of the Japanese Radiation Oncology Study Group study (JROSG 17-3). We assessed six symptom scores (nausea, anorexia, fatigue, shortness of breath, pain at the irradiated area and distress) at registration and 2, 4 and 8 weeks thereafter. We tested whether symptoms linearly improved after adjusting for the baseline PPI. Shared parameter models were used to adjust for potential bias in missing data.ResultsThe present study analysed all 55 patients enrolled in JROSG 17-3. With time from registration as the only explanatory variable in the model, a significant linear decrease was observed in shortness of breath, pain and distress (slopes, ?0.26, ?0.22 and ?0.19, respectively). Given that the interaction terms (i.e. PPI × time) were not significantly associated with symptom scores in any of the six symptoms, only PPI was included as the main effect in the final multivariable models. After adjusting for the PPI, shortness of breath, pain and distress significantly improved (slope, ?0.25, ?0.19 and ?0.17; P < 0.001, 0.002 and 0.047, respectively). An improvement in fatigue and distress was observed only in patients treated with a biologically effective dose ≤14.4 Gy.ConclusionShortness of breath, pain and distress improved after radiotherapy. Moreover, a higher PPI was significantly associated with higher symptom scores at all time points, including baseline. In contrast, PPI did not seem to influence the improvement of these symptoms. Regardless of the expected survival, patients receiving radiotherapy for gastric cancer can expect an improvement in shortness of breath, pain and distress over 8 weeks. Multiple-fraction radiotherapy might hamper the improvement in fatigue and distress by its toxicity or treatment burden.     

Clinical and endoscopic factors predict higher pathologic grades of Barrett dysplasia

BACKGROUND: Barrett esophagus is highly prevalent in the Western world; however, only a minority of affected individuals progress to esophageal adenocarcinoma. Whereas many studies have examined risk factors for development of Barrett metaplasia, few data are available on risk factors for progression to neoplasia. Identifying simple, reliable, clinical, and endoscopic predictors of high-grade dysplasia and adenocarcinoma would be helpful for risk stratification in screening and surveillance programs. METHODS: Clinical, endoscopic, and histologic data were reviewed for patients with a new Barrett diagnosis between 2002 and 2005. Patients were classified, by an expert gastrointestinal pathologist, as having intestinal metaplasia, indefinite-for-dysplasia, low-grade dysplasia, high-grade dysplasia, and esophageal adenocarcinoma. Gender, age, race, ethnicity, hiatal hernia presence and size, Barrett segment length, H. pylori status, alcohol, smoking, proton pump inhibitor (PPI) use and duration, and reflux symptom duration were evaluated by logistic regression analysis for their association with dysplasia severity. RESULTS: In all, 109 patients (26 women, 83 men, mean age: 58.8) were newly diagnosed with Barrett metaplasia (n = 39), indefinite/low-grade dysplasia (n = 35), and high-grade dysplasia/esophageal adenocarcinoma (n = 35) over a 3-year period. On logistic regression analysis, duration of reflux symptoms for >or=20 years (odds ratio [OR]: 5.66, P = .012), longer Barrett segment length (OR for 3-6 cm vs. <3 cm: 9.05, P < .0001; OR for >or=6 cm: 8.374, P < .0001), hernia size >or=4 cm (OR: 10.63, P = .014), and male gender (OR: 4.03, P = .0019) were associated with higher pathologic grade. Duration of reflux symptoms and Barrett length were significant as both discrete and continuous variables. Absence of H. pylori (OR: 2.731, P = .060) approached significance in predicting dysplasia severity. In bivariate models, gender and Barrett length (continuous form) were significantly associated with grade when considered together (OR: 2.52, P = .0490 and OR: 1.30, P < .0001), as were gender and hernia size >4 cm (OR: 4.64, P = .0049 and OR: 12.18, P = .0197). CONCLUSIONS: Male gender, longstanding gastroesophageal reflux disease, hiatal hernia size, and segment length are strongly associated with higher grades of dysplasia at index diagnosis. These factors along with H. pylori status warrant further prospective evaluation as predictors of risk for development of high-grade dysplasia and esophageal adenocarcinoma.     

足量营养支持改善肿瘤化疗患者癌因性疲乏和营养状况

目的:观察足量营养支持对肿瘤化疗患者癌因性疲乏（CRF）以及营养状况改善的影响。方法:选取我院自2018年03月-2019年03月间收治的恶性肿瘤化疗患者90例作为实验对象,按照数字随机原则分成两组,对照组45例行常规营养支持,观察组45例给予足量营养支持,采用营养风险筛查工具、Piper疲乏评估量表（RPFS-CV）以及癌症患者生命质量核心量表（EORTCQLQ-C30）对两组患者营养状况、癌因性疲乏、生活质量进行评估。结果:观察组营养风险评分明显低于对照组(P＜0.05);治疗前两组患者体质量指数（BMI）、前白蛋白（PA）、血清白蛋白（ALB）差异无统计学意义（P＞0.05）,治疗后观察组3项指标均显著升高,与对照组对比差异有统计学意义（P＜0.05）;治疗后两组情感疲乏、躯体疲乏和认知疲乏评分均显著下降,观察组降幅优于对照组（P＜0.05）;治疗后观察组EORTCQLQ-C30评分中功能领域、整体健康评分显著高于对照组,症状评分显著低于对照组（P＜0.05）。结论:肿瘤患者化疗期间采用足量营养支持能改善其营养状况,缓解癌因性疲乏等症状表现,全面提升患者的生活质量。     

Mitogen-induced lymphoproliferative response and phagocytic-activity of monocytes in renal-cell carcinoma patients treated by interferon a alone or in combination with vinblastine

The functions of T cells and monocytes were studied in relation to the clinical stage and clinical course of renal cell carcinoma (RCC) patients, treated by interferon alpha (LFN-alpha). Lymphoproliferative response (LPR) to phytohemagglutinin and phagocytic activity of peripheral blood monocytes were estimated before, immediately after, and six months after completion of therapy with IFN-alpha alone (applied in stage II RCC) or in combination with vinblastine (in stages III and IV). The number of total T cells and their mitogen-induced proliferative response were diminished in all patient groups before therapy, the decrease of LPR being more pronounced in advanced (III and IV) stages of the disease. The pretreatment number of monocytes and their phagocytic activity were increased in RCC patients regardless of clinical stage. The initial level of the lymphocyte and monocyte functions did not correlate with the clinical course of the disease. The pretreatment levels of LPR and phagocytic activity were not changed immediately after IFN treatment, irrespective of the clinical response to therapy. Similar results were obtained six months after therapy; the only exception was the increased LPR in stage III patients, which was unrelated to clinical response to the therapy, since it was seen in patients with progression of the disease. These findings suggest that the pretreatment level of LPR and monocyte phagocytic activity in RCC patients in different clinical stages of RCC were not predictive of the clinical response to IFN therapy. IFN-alpha, as used in this study, had no major influence on LPR and phagocytic activity of monocytes irrespective of the clinical stage or clinical course of the disease.     

热疗在放射性肺炎治疗过程中的临床疗效观察

目的:观察深部热疗在放射性肺炎的治疗过程中对治疗效果的影响。方法:收集60例行胸部放射治疗后出现放射性肺炎的患者的病例资料,所有患者均为未行手术的肺癌患者。其为序贯或同步放化疗,放射治疗剂量为60~70 Gy（常规分割）,预计生存期超过6月,放射治疗后均出现急性放射性肺炎患者,根据治疗是否行深部热疗随机分为两组,每组30例。对照组30例给予糖皮质激素与抗感染治疗,辅以吸氧、止咳、解痉平喘等对症处理;治疗组30例在对照组基础上加用深部热疗。热疗设备使用HG-2000体外局部高频热疗机,加温温度42 ℃~43 ℃,时间为40 min,隔日1次,共10次,分别检测放射性肺炎治疗前、放射性肺炎治疗后肺功能、血气分析的变化趋势。结果:治疗组放射性肺炎的总有效率、生存质量KPS评分、症状积分改善显著优于对照组（P<0.05）;治疗后两组肺功能指标（VC、FEV1）、血气分析指标（PaO2、PaCO2）均有好转,且治疗组明显优于对照组（P<0.05）;炎性因子hs-CRP、IL-6、TNF-α水平均明显下降,且治疗组好于对照组（P<0.05）。结论:深部热疗联合传统糖皮质激素治疗放射性肺炎,有助于放射性肺炎患者的症状、肺功能、血气分析、炎性指标的恢复,提高患者生活质量。     

缩金胶囊对三阴性乳腺癌治疗后患者生存质量影响的观察

为了观察中药缩金胶囊对三阴性乳腺癌治疗后患者生存质量的影响,运用缩金胶囊治疗放化疗后的三阴性乳腺癌患者30例,并与放化疗后的30例后续无治疗和给予胸腺五肽增强免疫力治疗的30例患者的症状相比较.同时记录症状评分、总体健康质量及生存质量评分.中药治疗组各症状评分和总体生存质量评分均高于空白对照组,两组比较差异有统计学意义(P＜0.05),与胸腺五肽组比较差异无统计学意义,P＞0.05.初步研究结果提示,中药缩金胶囊可有效地改善经手术及放化疗后的三阴性乳腺癌患者的症状,提高患者生存质量.     

铝碳酸镁联合莫沙比利治疗胃癌术后胆汁反流性残胃炎的疗效分析

目的 探讨铝碳酸镁联合莫沙比利治疗胃癌术后胆汁反流性残胃炎的疗效.方法 选择胆汁反流性残胃炎患者59例,按照随机数字法分为观察组30例和对照组29例.所有患者常规给予口服奥美拉唑肠溶胶囊20 mg/次,餐前半小时服用,2次/天.对照组在常规治疗的基础上口服多潘立酮片10 mg/次、3次/天.观察组在常规治疗基础上给予口服莫沙必利10 mg/次、3次/天,餐后服用;铝碳酸镁1.0 g/次、3次/天,餐后嚼碎口服.2组疗程均为8周.结果 观察组患者的症状改善的有效率为86.7%,高于对照组的75.9%,差异有统计学意义(P<0.05).观察组患者治疗后腹胀、腹痛、烧心、呕吐症状积分显著低于对照组,差异有统计学意义(P<0.05).观察组胃镜下疗效为75.9%,高于对照组55.2%,差异有统计学意义(P<0.05).观察组治疗后胃腔胆汁量、胃黏膜充血水肿和糜烂积分显著低于对照组,差异有统计学意义(P<0.05).结论 铝碳酸镁联合莫沙必利用于治疗胃癌术后反流性残胃炎疗效确切,能明显改善患者的各种相关症状,值得临床推广使用.     

In Silico Identification and Validation of Cuproptosis-Related LncRNA Signature as a Novel Prognostic Model and Immune Function Analysis in Colon Adenocarcinoma

Background: Colon adenocarcinoma (COAD) is the most common subtype of colon cancer, and cuproptosis is a recently newly defined form of cell death that plays an important role in the development of several malignant cancers. However, studies of cuproptosis-related lncRNAs (CRLs) involved in regulating colon adenocarcinoma are limited. The purpose of this study is to develop a new prognostic CRLs signature of colon adenocarcinoma and explore its underlying biological mechanism. Methods: In this study, we downloaded RNA-seq profiles, clinical data and tumor mutational burden (TMB) data from the TCGA database, identified cuproptosis-associated lncRNAs using univariate Cox, lasso regression analysis and multivariate Cox analysis, and constructed a prognostic model with risk score based on these lncRNAs. COAD patients were divided into high- and low-risk subgroups based on the risk score. Cox regression was also used to test whether they were independent prognostic factors. The accuracy of this prognostic model was further validated by receiver operating characteristic curve (ROC), C-index and Nomogram. In addition, the lncRNA/miRNA/mRNA competing endogenous RNA (ceRNA) network and protein–protein interaction (PPI) network were constructed based on the weighted gene co-expression network analysis (WGCNA). Results: We constructed a prognostic model based on 15 cuproptosis-associated lncRNAs. The validation results showed that the risk score of the model (HR = 1.003, 95% CI = 1.001–1.004; p < 0.001) could serve as an independent prognostic factor with accurate and credible predictive power. The risk score had the highest AUC (0.793) among various factors such as risk score, stage, gender and age, also indicating that the model we constructed to predict patient survival was better than other clinical characteristics. Meanwhile, the possible biological mechanisms of colon adenocarcinoma were explored based on the lncRNA/miRNA/mRNA ceRNA network and PPI network constructed by WGCNA. Conclusion: The prognostic model based on 15 cuproptosis-related lncRNAs has accurate and reliable predictive power to effectively predict clinical outcomes in colon adenocarcinoma patients.     

Chinese version of the M. D. Anderson Symptom Inventory: validation and application of symptom measurement in cancer patients

BACKGROUND: Symptom management is an essential component of cancer treatment for patients of every culture and nationality. Symptom assessment depends on subjective reporting, mandating linguistically equivalent versions of symptom assessment scales. Because disease-related and treatment-related symptoms most often occur in clusters, there is a global need for a standardized multiple-symptom assessment tool. METHODS: The authors sought to validate the Chinese version of the M. D. Anderson Symptom Inventory (MDASI-C) by enrolling patients who had received various diagnoses of and different types of treatment for cancer (n = 249) in a cross-sectional symptom study conducted at an urban cancer center in China. RESULTS: Factor analysis identified 2 underlying constructs, general symptoms and gastrointestinal symptoms, which had Cronbach alpha coefficients of 0.86 and 0.84, respectively. These results were consistent with English- and Japanese-language MDASI validation studies. Known-group validity was supported by the MDASI-C's ability to detect significant differences in symptom and interference levels according to Eastern Cooperative Oncology Group performance status (ECOG PS; P < 0.001) and chemotherapy status (P < 0.05). Fifty-five percent of the study cohort had > or = 1 symptom that was considered severe (score > or = 7 on a 0-10 scale). ECOG PS was strongly associated with symptom burden (total interference score: R(2) = 0.26; P < 0.001). Fatigue, sadness, drowsiness, and lack of appetite accounted for most of the variability in the total interference score (R(2) = 0.49; P < 0.05). CONCLUSIONS: The authors demonstrated that the MDASI-C is a valid, reliable, and concise tool for measuring symptom severity and interference with functioning in Chinese cancer patients.     

“健脾利湿化瘀方”联合治疗激素敏感性前列腺癌的真实世界研究

目的：观察“健脾利湿化瘀方”联合雄激素受体抑制剂/雄激素合成抑制剂+促性腺激素释放激素激动剂（MAB）治疗激素敏感性前列腺癌（hormone-sensitive prostate cancer,HSPC）的临床疗效。方法：选取2019年11月至2021年6月于天津中医药大学第一附属医院、天津医科大学总医院就诊的HSPC患者100例,随机分为治疗组和对照组各50例,对照组接受MAB治疗,治疗组在对照组基础上给予“健脾利湿化瘀方”。主要观察指标为中位无进展生存期（median progression-free survival,mPFS）、前列腺特异性抗原（prostate specific antigen,PSA）;次要观察指标为血清睾酮、中医临床症状评分、肿瘤生存质量调查表（EORTC QLQ-C30）、KPS功能状态评分。结果：治疗组较对照组可延长mPFS 4个月（16个月vs. 12个月）、明显降低PSA水平、改善中医临床症状、改善QLQ-C30、提高KPS评分（均P<0.05）。亚组预后因素分析显示,治疗前KPS评分90分组、PSA最低值≤1 ng/mL、PSA下降≥90%...