Maternal insomnia during the COVID-19 pandemic: associations with depression and anxiety

Background

The COVID-19 outbreak has made people more prone to depression, anxiety and insomnia, and females are at a high risk of developing these conditions. As a special group, pregnant and lying-in women must pay close attention to their physical and mental health, as both have consequences for the mother and the fetus. However, knowledge regarding the status of depression, anxiety and insomnia among these women is limited.

Aim

This study aimed to examine insomnia and psychological factors among pregnant and lying-in women during the COVID-19 pandemic and provide theoretical support for intervention research.

Methods

In total, 2235 pregnant and lying-in women from 12 provinces in China were surveyed; their average age was 30.25 years (SD = 3.99, range = 19–47 years).

Participants and setting

The participants completed electronic questionnaires designed to collect demographic information and assess levels of depression, anxiety and insomnia.

Results

The prevalence of insomnia in the sample was 18.9%. Depression and anxiety were significant predictors of insomnia. Participants in high-risk areas, those with a disease history, those with economic losses due to the outbreak, and those in the postpartum period had significantly higher insomnia scores.

Discussion

The incidence of insomnia among pregnant and lying-in women is not serious in the context of the epidemic, which may be related to the sociocultural background and current epidemic situation in China.

Conclusion

Depression and anxiety are more indicative of insomnia than demographic variables.

     

Elevations of serum cancer biomarkers correlate with severity of COVID-19

In this retrospective study, we evaluated the levels of a series of serum biomarkers in coronavirus disease 2019 (COVID-19) patients (mild: 131; severe: 98; critical: 23). We found that there were significant increases in levels of human epididymis protein 4 (HE4) (73.6 ± 38.3 vs 46.5 ± 14.7 pmol/L; P < .001), cytokeratin-19 fragment (CYFRA21-1) (2.2 ± 0.9 vs 1.9 ± 0.8 μg/L; P < .001), carcinoembryonic antigen (CEA) (3.4 ± 2.2 vs 2.1 ± 1.2 μg/L; P < .001), carbohydrate antigens (CA) 125 (18.1 ± 13.5 vs 10.5 ± 4.6 μg/L; P < .001), and 153 (14.4 ± 8.9 vs 10.1 ± 4.4 μg/L; P < .001) in COVID-19 mild cases as compared to normal control subjects; their levels showed continuous and significant increases in severe and critical cases (HE4, CYFRA21-1, and CA125: P < .001; CEA and CA153: P < .01). Squamous cell carcinoma antigen (SCC) and CA199 increased significantly only in critical cases of COVID-19 as compared with mild and severe cases and normal controls (P < .01). There were positive associations between levels of C-reactive protein and levels of HE4 (R = .631; P < .001), CYFRA21-1 (R = .431; P < .001), CEA (R = .316; P < .001), SCC (R = .351; P < .001), CA153 (R = .359; P < .001) and CA125 (R = .223; P = .031). We concluded that elevations of serum cancer biomarkers positively correlated with the pathological progressions of COVID-19, demonstrating diffuse and acute pathophysiological injuries in COVID-19.     

基于患者出射EPID剂量验证的在体调强放疗质控技术研究

背景与目的：调强放疗（intensity-modulated radiation therapy,IMRT）中剂量投照失误可导致严重后果,而目前常用的治疗前计划验证方法并不能反映患者真实投照剂量。实现一种评估患者在体剂量执行准确度的方法,能够在分次治疗中及时发现较大剂量错误,避免发生患者投照剂量过高或不足。方法：复旦大学附属肿瘤医院收治的患者首次实施治疗前行锥形束计算机断层成像（cone beam computed tomography,CBCT）扫描,与定位CT图像进行配准保证治疗体位与模拟定位时一致,实时治疗中使用电子射野影像装置（electronic portal imaging device,EPID）获取患者出射剂量影像,并把首次出射EPID影像作为剩余分次治疗的基准值,后续分次实时治疗野结束后快速将其出射EPID影像与对应基准影像进行γ分析比较,以验证治疗计划是否准确执行于患者身上。设计模体实验对治疗部位错误和摆位误差情况进行分析,来评估本方法识别放疗差错的准确性。结果：本方法可有效地识别出IMRT放疗中患者治疗部位错误和非平行于射野角度方向的摆位误差,但对平行于射野角度方向的摆位误差并不敏感,30例鼻咽癌患者临床应用结果中能够直观显示分次治疗间摆位重复性情况。结论：基于EPID实现的一种在体剂量验证方法能够对调强放疗中患者实时剂量的准确性进行评估,在单个治疗野结束后可快速检测出较大治疗错误。     

IL-6/STAT3信号通路在结直肠癌发展和治疗中的进展

结直肠癌(colorectal cancer,CRC)是我国常见的恶性肿瘤,发病率逐年增长,探究CRC的发展机制及治疗方案尤为重要.IL-6/STAT3信号通路是CRC发展的关键途径之一,可通过参与肠癌细胞的抗凋亡、增殖及肿瘤血管生成等多种恶性表型促进肿瘤发展.此外,临床研究表明,针对IL-6/STAT3信号通路的靶向...     

放疗全流程管理及QA的初步应用经验

目的 回顾复旦大学附属肿瘤医院放疗QA工作历史及发展,提供全流程管理和QA工作初步应用经验。方法 采用失效模式与效应分析和PDCA循环为工具,从2015年4月开始在放疗中心实施全流程QA工作,并采集了实施前后近6000例患者的数据进行对比。结果 实施全流程QA后可能出错概率由1.7%下降到0.9%。结论 放疗全流程QA有效提高放疗准确性和安全性。     

不同职业男性不育患者精液分析

目的 探讨不同职业及环境因素对生育的影响。 方法 将862例男性不育患者按照职业不同分为农民、工人、干部及其他人员4组,又将工人分为司机、石油工人及其他3组,进行精液常规分析。 结果 4组人员的精子密度比较,差异有显著性(P<0.01);司机、石油工人及其他工人的精子密度、活动度比较,差异有显著性(P<0.01),司机、石油工人分别与其他工人精子的穿透力比较,差异有显著性(P<0.05)。 结论 长期工作在有毒有害环境中是引起男性不育的因素之一。     

全程关护诊疗模式对肝癌患者预后的影响

目的 探讨全程关护诊疗（total care and treatment,TCT）模式对肝癌患者预后的影响。方法 回顾性分析2012年1月至2015年12月广西医科大学附属肿瘤医院、贵港市人民医院1 810例肝癌患者资料,按照是否行TCT模式诊疗将患者分成TCT模式组和常规诊疗模式组,比较两组行根治性治疗术患者1年、2年复发率、复发后治疗率及生存率。结果 共收集行TCT模式诊疗肝癌患者1 054例（TCT模式组）和常规诊疗模式患者756例（常规诊疗模式组）,其中TCT模式组行根治性治疗术784例,常规诊疗模式组556例。 TCT模式组行根治性治疗患者1年和2年复发率与常规诊疗模式组比较,差异均无统计学意义（20.54% vs 21.22%,χ²=0.093,P=0.760;40.31% vs 41.19%,χ²=0.105,P=0.746）;TCT模式组1年和2年复发后治疗率高于常规诊疗模式组（100% vs 57.63%,χ²=9.836,P=0.020;100% vs 56.77%,χ²=7.679,P=0.060）。1年、2年总生存率亦高于常规诊疗模式组（83.20% vs 79.28%,P＜0.05;67.12% vs 59.31%,P＜0.05） 结论 肝癌全程关护诊疗模式符合肝癌治疗系统、序贯、个体化需求的规律,在行根治性治疗术患者中,两种诊疗模式患者复发率相当,但TCT模式诊疗患者复发后治疗率提高。     

基于Xenapp虚拟系统在放疗流程中的应用

目的 放疗流程中牵涉到许多软件应用系统和复杂的硬件设备,借助基于Xenapp虚拟系统整合放疗流程中的各个应用系统。方法 采用windows2008r2操作系统,Citrix Xenapp 6.5 sp1企业版,sqlserverr2008 express 数据库。安装Xenapp服务器,将放疗科常用的软件应用在服务器上安装并发布,在放疗科局域网内的电脑上安装CitrixReceiver,并使用网页浏览器登录Xenapp服务器站点,即可使用站点发布的所有应用。结果 使用了Citrix Xenapp的虚拟化系统,大大减少了计算机硬件的开销,使得计算机硬件的开销减少50%以上,减少了技术人员的维护成本,使得放疗科的工作做到无缝衔接,提高了放疗科工作人员的办公效率。结论 基于Xenapp的虚拟化系统在放疗流程中可以起到节约开销,提高效率的作用,值得在临床工作中大力推广。     

基于图像引导的小动物立体放疗系统介绍

小动物放疗模型的相关理论及其应用,对于放射生物学和临床肿瘤放疗学的研究与发展至关重要。而综合考虑普适性与成本效应等因素,研究人员常运用小鼠模型来研究肿瘤与正常组织的放射生物学机制。近年来,基于不同图像引导的小动物立体放疗设备也取得了巨大发展,它们已能较好模拟人体放疗流程。本文着重介绍了基于不同图像方式(如CBCT与MRI)引导的小动物放疗系统,其次对小动物荧光成像技术进行理解学习,总结对比了不同生物发光与荧光成像设备在小动物成像系统中的应用,最后对未来小动物放疗设备优化方向提出展望。