目的 了解老年患者住院期间睡眠影响因素及质量。 方法 对2009年7月－12月入住老年科的108例患者运用匹兹保睡眠质量指数（PSQI）和自编影响睡眠因素调查表进行调查分析。 结果 92.6%的老年患者有睡眠质量问题，病情不稳定患者比病情稳定者睡眠障碍发生率高，病房温湿度、气味、夜间光线、夜间查房等环境因素和担心家事、家人朋友不关心等社会因素，夜间喝浓茶、咖啡的不良习惯对睡眠质量的影响差异有统计学意义（P＜0.05）。 结论 多数老年患者住院期间睡眠质量差，医护人员应对此予以高度重视，针对性地采取有效治疗、护理措施及健康指导方式，改善老年患者睡眠质量。
Objective To explore the expression of long non-coding RNA (LncRNA) KCNQ1OT1 and its clinical significance in non-small cell lung cancer (NSCLC). Methods Eighty-nine NSCLC patients who underwent surgery were recruited in Sichuan Cancer Hospital from January 2011 to December 2013. Quantitative real-time PCR was used to detect the expression of LncRNA KCNQ1OT1 in tumor tissues and paracarcinoma tissues (5cm or above away from tumor). The relationship between LncRNA KCNQ1OT1 expression and clinicopathologic features was analyzed by univariate analysis and Cox regression analysis. Results The expression of LncRNA KCNQ1OT1 significantly increased in tumor tissues than that in paracarcinoma tissues (P < 001). The patients were divided into a high expression group and a low expression group according to the relative expression of LncRNA KCNQ1OT1. Univariate analysis showed that the differences between two groups were not significant in age, gender or histological type, but were significant in tumor size (χ2=12.619, P < 001), lymph node metastasis(χ2=10.298, P=0.001), TNM stage(χ2=7.199, P=0.007), and history of smoking(χ2=24.005, P < 001). Kaplan-Meier analysis showed the patients with high LncRNA KCNQ1OT1 expression had significantly lower overall survival time (20.0 months vs. 35.0 months, χ2=45.860, P < 001) and significantly lower progression-free survival time (12.0 months vs. 24.0 months, χ2=31.510, P < 001) than those with low LncRNA KCNQ1OT1 expression. Cox regression analysis revealed that the disease stage and the expression of LncRNA KCNQ1OT1 could be used as independent prognostic markers for poor prognosis. Conclusion LncRNA KCNQ1OT1 is highly expressed in tumor tissues and associated with the prognosis of NSCLC patients, thus can be used as a potential marker for predicting the prognosis of lung cancer.
In this study we performed Tissue Doppler Imaging (TDI), two-dimensional speckle tracking imaging (2D-STI) and three-dimensional speckle tracking imaging (3D-STI) on enrolled healthy, overweight and obese groups (34 subjects in each group), respectively, to analyze cardiac structure and its function. Compared with healthy group, global longitudinal strain (GLS), global circumferential strain (GCS), global area strain(GAS) and global radial strain (GRS) decreased progressively (P＜0.05). The ratio of early diastolic mitral inflow velocity to global early diastolic strain rate of left ventricle (E/e′sr) (r=0.466, P＜0.001), GLS(r=0.502, P＜0.001), GCS(r=0.426, P＜0.001), GAS(r=0.535, P＜0.001) and GRS(r=-0.554, P＜0.001) were correlated with body mass index (BMI). E/e′sr (r=0.37, P=0.003), GLS(r=0.455, P＜0.001), GCS(r=0.282, P=0.02), GAS(r=0.412, P＜0.001) and GRS (r=-0.471, P＜0.001) were correlated with free fatty acid (FFA). Stepwise multiple linear regression revealed that BMI was independently correlated with E/e′sr, GLS, GCS, GAS and GRS. Waist to hip ratio (WHR) was independently correlated with GLS, GCS, GAS and GRS. FFA was independently correlated with E/e′sr(P＜0.05). The study showed that cardiac structure changed and impaired left ventricular global systolic and diastolic function in overweight and obes population. Moreover, BMI, WHR and FFA may be independent influence factors of cardiac function in overweight and obese population.
Objective To analyse the consistency of perioperative self-reported pain scores of lung cancer patients with clinical records to provide a basis for optimal pain management. MethodsThe patients with lung cancer who underwent surgical treatment in the Department of Thoracic Surgery, Sichuan Cancer Hospital from November 2017 to January 2020 were selected. They were divided into two groups based on the source of pain data. The self-report group used a questionnaire in which patients self-reported their pain scores, and the pain scores for the clinical record group were extracted from the electronic medical record system. Kappa test was used to compare the concordance of pain scores between the two groups preoperatively, on postoperative 1-6 days and on the day of discharge. McNemar's paired χ2 test was used to compare the differences in pain intensity levels between the two groups. Binary logistic multi-factor regression was used to analyse the factors influencing the concordance of severe pain (7-10 points) between the two groups. Results Totally 354 patients were collected, including 191 males and 163 females, with an average age of 55.64±10.34 years. The median postoperative hospital stay was 6 days. The consistency of pain scores between the two groups was poor (Kappa=–0.035 to 0.262, P<0.05), and the distribution of pain levels at each time point was inconsistent and statistically significant (P<0.001). The percentage of inconsistent severe pain assessment ranged from 0.28% to 35.56%, with the highest percentage of inconsistent severe pain assessment on postoperative day 1 (35.56%). Single-port thoracoscopic surgical access was an influencing factor for inconsistent assessment of severe pain on postoperative day 3 (OR=2.571, P=0.005). Conclusion Self-reported perioperative pain scores of lung cancer patients are poorly aligned with clinical records. Clinical measures are needed to improve the accuracy of patient pain data reporting by choosing the correct assessment method, increasing education, and developing effective quality control measures.
A team with strong cohesion and high execution is an important guarantee for conducting high-quality and sustainable clinical researches. Combined with the previous literature and the author’s view, this paper summarizes the key points of team building, which include a clear research direction, a balanced composition of team members, an outstanding team leader, the competence enhancement of team members, and a member-oriented management philosophy. Clear research direction is the premise of the existence and development of a team. Multi-level, multi-disciplinary membership can avoid potential conflicts of interest caused by homogeneity, and enable research to be refined and strengthened in interdisciplinary collisions. Team leader is the key to team development. The enhancement of team members’ competence is the cornerstone of team development. Adherence to member-oriented principle can form a true team culture. This paper aims to summarize and analyze the key points of clinical research team construction for peer reference.
Objective To investigate the post-discharge exercise behavior and factors influencing moderate to vigorous intensity physical activity (MVPA) in patients undergoing lung surgery. Methods A survey was conducted using the Investigation of Exercise Behavior after Lung Surgery questionnaire and the International Physical Activity Questionnaire Short Form (IPAQ-SF) among patients who underwent lung surgery. Binary logistic regression was used to analyze the factors influencing patients’ engagement in MVPA. Results A total of 702 patients were surveyed, including 252 males and 450 females, with an average age of 52.4±10.2 years. Patients with lung cancer accounted for 85.9%. Only 36.0% of the patients had regular exercise habits, while 42.3% did not engage in any physical activity. The three main barriers were physical discomfort (pain, coughing, shortness of breath, etc, 54.7%), lack of professional guidance (41.7%), and concerns about the surgical wound (28.9%). The proportions of patients engaging in vigorous, moderate, and low-intensity physical activity were 5.7%, 28.2%, and 66.1%, respectively. Multivariate analysis showed that patients with a personal annual income ≥50000 yuan (OR=1.52, 95%CI 1.01-2.29, P=0.044), high school education or above (OR=1.92, 95%CI 1.33-2.76, P<0.001), and lobectomy (OR=1.44, 95%CI 1.02-2.03, P=0.037) engaged in more MVPA. Conclusion Patients undergoing lung surgery have inadequate physical activity after discharge, particularly lacking in MVPA. Patients with higher income, higher educational levels, and lobectomy are more frequently engaged in MVPA. Measures such as symptom control, providing exercise guidance, and enhancing education on wound care may potentially improve the inadequate physical activity in lung surgery patients after discharge.
The number of investigator initiated research (IIR) is increasing. But the recognition and management of IIR in China is still in its infancy, and there is a lack of specific and operable guidance for the implementation process. Based on our practical experiences, previous literature reports, and current policy regulations, the authors took prospective IIR as an example to summarize the implementation process of IIR into 14 steps, which are as the following: study initiation, ethical review, study registration, study filing, case report form design, database establishment, standard operating procedure making, investigator training, informed consent, data collection, data entry, data verification, data locking and data archiving.