Linkage Disequilibrium in Natural and Experimental Populations of Drosophila Melanogaster

We have studied linkage disequilibrium in Drosophila melanogaster in two samples from a wild population and in four large laboratory populations derived from the wild samples. We have assayed four polymorphic enzyme loci, fairly closely linked in the third chromosome: Sod Est-6, Pgm, and Odh. The assay method used allows us to identify the allele associations separately in each of the two homologous chromosomes from each male sampled. We have detected significant linkage disequilibrium between two loci in 16.7% of the cases in the wild samples and in 27.8% of the cases in the experimental populations, considerably more than would be expected by chance alone. We have also found three-locus disequilibria in more instances than would be expected by chance. Some disequilibria present in the wild samples disappear in the experimental populations derived from them, but new ones appear over the generations. The effective population sizes required to generate the observed disequilibria by randomness range from 40 to more than 60,000 individuals in the natural population, depending on which locus pair is considered, and from 100 to more than 60,000 in the experimental populations. These population sizes are unrealistic; the fact that different locus-pairs yield disparate estimates within the same population argues against the likelihood that the disequilibria may have arisen as a consequence of population bottlenecks. Migration, or population mixing, cannot be excluded as the process generating the disequilibria in the wild samples, but can in the experimental populations. We conclude that linkage disequilibrium in these populations is most likely due to natural selection acting on the allozymes, or on loci very tightly linked to them.     

Positive epistasis between co-infecting plasmids promotes plasmid survival in bacterial populations

Plasmids have a key role in the horizontal transfer of genes among bacteria. Although plasmids are catalysts for bacterial evolution, it is challenging to understand how they can persist in bacterial populations over the long term because of the burden they impose on their hosts (the ‘plasmid paradox''). This paradox is especially perplexing in the case of ‘small'' plasmids, which are unable to self-transfer by conjugation. Here, for the first time, we investigate how interactions between co-infecting plasmids influence plasmid persistence. Using an experimental model system based on interactions between a diverse assemblage of ‘large'' plasmids and a single small plasmid, pNI105, in the pathogenic bacterium Pseudomonas aeruginosa, we demonstrate that positive epistasis minimizes the cost associated with carrying multiple plasmids over the short term and increases the stability of the small plasmid over a longer time scale. In support of these experimental data, bioinformatic analysis showed that associations between small and large plasmids are more common than would be expected owing to chance alone across a range of families of bacteria; more generally, we find that co-infection with multiple plasmids is more common than would be expected owing to chance across a wide range of bacterial phyla. Collectively, these results suggest that positive epistasis promotes plasmid stability in bacterial populations. These findings pave the way for future mechanistic studies aimed at elucidating the molecular mechanisms of plasmid–plasmid interaction, and evolutionary studies aimed at understanding how the coevolution of plasmids drives the spread of plasmid-encoded traits.     

幽门螺旋杆菌感染与慢性胃炎患者IL-8、IL-10、CRP水平以及血脂指标的关系研究

目的:研究幽门螺旋杆菌(Hp)感染与慢性胃炎患者白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、C反应蛋白(CRP)水平以及血脂指标的关系。方法:选择从2015年6月到2017年6月在我院接受治疗的慢性胃炎患者150例作为观察组,根据13C-尿素呼吸实验的结果将观察组患者分成HP阳性组71例和Hp阴性组79例,另选同期在我院进行健康体检的志愿者150例作为对照组,对比观察组以及对照组的炎症因子IL-8、IL-10、CRP及血脂指标[低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、甘油三酯(TG)、总胆固醇(TC)]水平,并对比观察组不同HP感染情况的炎症因子及血脂指标水平,分析Hp感染与患者炎症因子及血脂指标水平的相关性。结果:观察组的IL-8、IL-10、CRP、LDL-C及TG水平均分别高于对照组,差异均有统计学意义(均P0.05)。Hp阳性组患者治疗前的IL-8、IL-10、CRP、LDL-C及TG水平均分别高于HP阴性组,但Hp阳性组患者治疗后的上述指标水平均分别低于HP阴性组,差异均有统计学意义(均P0.05)。两组治疗后的IL-10、CRP水平均分别低于治疗前,且Hp阳性组患者的IL-8、LDL-C及TG水平也低于治疗前,差异均有统计学意义(均P0.05),Spearman相关性分析结果显示,Hp感染与患者IL-8、IL-10、CRP、LDL-C及TG水平均呈正相关(均P0.05),但Hp感染与HDL-C和TC并无明显的相关性(P0.05)。结论:Hp感染与慢性胃炎患者的炎症指标及血脂指标关系紧密,临床上可考虑将此类指标作为存在Hp感染的慢性胃炎患者的监测指标,从而更好地辅助临床诊治。     

Clustered environments and randomized genes: a fundamental distinction between conventional and genetic epidemiology

Background

In conventional epidemiology confounding of the exposure of interest with lifestyle or socioeconomic factors, and reverse causation whereby disease status influences exposure rather than vice versa, may invalidate causal interpretations of observed associations. Conversely, genetic variants should not be related to the confounding factors that distort associations in conventional observational epidemiological studies. Furthermore, disease onset will not influence genotype. Therefore, it has been suggested that genetic variants that are known to be associated with a modifiable (nongenetic) risk factor can be used to help determine the causal effect of this modifiable risk factor on disease outcomes. This approach, mendelian randomization, is increasingly being applied within epidemiological studies. However, there is debate about the underlying premise that associations between genotypes and disease outcomes are not confounded by other risk factors. We examined the extent to which genetic variants, on the one hand, and nongenetic environmental exposures or phenotypic characteristics on the other, tend to be associated with each other, to assess the degree of confounding that would exist in conventional epidemiological studies compared with mendelian randomization studies.

Methods and Findings

We estimated pairwise correlations between nongenetic baseline variables and genetic variables in a cross-sectional study comparing the number of correlations that were statistically significant at the 5%, 1%, and 0.01% level (α = 0.05, 0.01, and 0.0001, respectively) with the number expected by chance if all variables were in fact uncorrelated, using a two-sided binomial exact test. We demonstrate that behavioural, socioeconomic, and physiological factors are strongly interrelated, with 45% of all possible pairwise associations between 96 nongenetic characteristics (n = 4,560 correlations) being significant at the p < 0.01 level (the ratio of observed to expected significant associations was 45; p-value for difference between observed and expected < 0.000001). Similar findings were observed for other levels of significance. In contrast, genetic variants showed no greater association with each other, or with the 96 behavioural, socioeconomic, and physiological factors, than would be expected by chance.

Conclusions

These data illustrate why observational studies have produced misleading claims regarding potentially causal factors for disease. The findings demonstrate the potential power of a methodology that utilizes genetic variants as indicators of exposure level when studying environmentally modifiable risk factors.     

Homologous and non-homologous chromosome associations by interchromosomal chromatin connectives in Ornithogalum virens

Based on interchromosomal chromatin connectives, a statistical analysis of homologous and non-homologous chromosome associations was made on mitotic metaphase chromosomes of Ornithogalum virens. The great majority of connectives involve constitutive heterochromatin, and connections between homologous chromosomes are twice as common as would be expected by chance. It is suggested that constitutive heterochromatin with similar DNA is involved in both homologous and non-homologous chromosome associations.     

幽门螺杆菌感染并发消化性溃疡的危险因素及预防对策分析

目的:分析幽门螺杆菌感染并发消化性溃疡的危险因素,并实施预防对策。方法:选取我院收治的消化性溃疡的患者201例,对其临床资料进行回顾性分析,分析其危险因素。结果:消化性溃疡患者201例,Hp感染162例,Hp阳性率80.60%,不同类型的消化性溃疡的Hp阳性率比较,差异无统计学意义(P0.05)。单因素分析结果显示,年龄在36-60岁、共食、男性、暴饮暴食、喜爱辛辣食物、吸烟饮酒、个人卫生、家族病史、以往病史,均是消化性溃疡Hp感染的高危因素。进餐习惯、喜欢酸奶、个人卫生均是Hp感染的保护因素,而暴饮暴食、喜爱辛辣食物、年龄、以往病史、吸烟饮酒、家族病史均是Hp感染的危险因素。结论:分餐习惯、喜欢酸奶、个人卫生均是Hp感染的保护因素,而暴饮暴食、喜爱辛辣食物、年龄、以往病史、吸烟饮酒、家族病史是Hp感染的危险因素,进行有针对性的预防可降低疾病发生率。     

糖皮质激素联合免疫球蛋白治疗机械通气的吉兰巴雷综合征的临床疗效分析

目的:分析糖皮质激素联合免疫球蛋白治疗需要机械通气的吉兰巴雷综合征的临床疗效。方法:回顾性分析2008年1月至2016年7月西安市六家医院收治的采用机械通气的吉兰巴雷综合征患者的临床资料,并对其进行随访,比较单用免疫球蛋白与糖皮质激素联合免疫球蛋白的疗效差异。结果:两组在出院时及出院后6个月的总有效率(MRC及HFGS的改善率)、死亡率、机械通气时间、住院时间、在ICU住院时间、出院时及出院后6个月的MRC总得分和HFGS得分以及并发症发生率比较差异均无统计学意义(P0.05)。结论:对于机械通气的吉兰巴雷综合征患者,在使用免疫球蛋白的基础上增加糖皮质激素的使用,对其短期(出院时)及较长期(出院后6个月)的临床疗效和安全性均无显著影响。     

炎症性肠病患者希望水平与应对方式、心理韧性和社会支持的关系研究

摘要 目的：研究炎症性肠病（IBD）患者希望水平与应对方式、心理韧性和社会支持的关系。方法：选取我院于2018年10月~2020年10月期间收治的IBD患者137例。采用Herth希望量表（HHI）评价患者希望水平;采用医学应对方式问卷（MCMQ）评估患者面对疾病时所选取的应对方式;采用心理韧性量表（CD-RISC）对患者心理韧性进行评估;采用社会支持评定量表（SSRS）评价患者社会支持情况。将上述评分与国内常模进行对比,采用Pearson相关性分析IBD患者希望水平与应对方式、心理韧性和社会支持的关系。结果：IBD患者与他人保持亲密的态度关系、现实和未来的积极态度、采取积极的行动评分及总分均低于国内常模（P<0.05）。IBD患者面对评分低于国内常模,回避、屈服评分均高于国内常模（P<0.05）。IBD患者力量、乐观和坚韧评分均低于国内常模（P<0.05）。IBD患者主观支持、客观支持和对社会支持的利用度评分均低于国内常模（P<0.05）。Pearson相关性分析结果显示,HHI总分与面对、力量、乐观、坚韧、主观支持、客观支持和对社会支持的利用度呈正相关,而与回避、屈服呈负相关（P<0.05）。结论：大多数IBD患者处于中等希望水平,良好的应对方式、心理韧性和社会支持有助于患者希望水平的提高。     

兰索拉唑与奥美拉唑对胃溃疡患者氧化应激水平和内皮功能的影响

目的:探讨兰索拉唑(LAN)与奥美拉唑(OME)治疗胃溃疡的临床效果及对患者血浆氧化应激水平和血管内皮功能的影响。方法:选取我院2014年1月~2016年10月收治的138例胃溃疡患者,按照随机数字表法均分为LAN组和OME组,并选取我院同期69例健康体检者为对照组。对照组不用任何药物,LAN组予以LAN治疗,OME组给予OME治疗。记录比较LAN组和OME组的临床疗效、Hp根除率及胃镜疗效;对照组与LAN组、OME组两组治疗前后血浆氧化应激指标、血管内皮功能指标水平;并评价LAN组与OME组的用药安全性。结果:总疗程结束后,LAN组总有效率、Hp根除率分别为94.2%、89.9%,较OME组(91.3%、87.0%)相比差异无统计学意义(P0.05)。经4个疗程后,LAN组胃镜总有效率为95.7%,明显高于OME组的85.5%(P0.05)。与对照组相比,LAN组、OME组治疗前血浆MDA、ET-1水平均显著上升(P0.01),SOD、NO水平均显著降低(P0.01)。与本组治疗前对比,LAN组、OME组治疗后血浆MDA、SOD、NO及ET-1水平均显著改善(P0.01),且LAN组治疗后各血浆因子水平改善效果均显著优于OME组(P0.01)。结论:LAN治疗胃溃疡改善患者临床症状、根除Hp的效果及安全性与OME相当,但LAN更能有效降低机体的氧化应激水平,调节血管内皮功能,促进溃疡愈合。     

化瘀消癥剂多途径联合治疗慢性盆腔痛的临床研究

目的:探讨化瘀消癥剂口服、灌肠联合穴位离子导入多途径联合疗法治疗慢性盆腔痛(子宫内膜异位症、慢性盆腔炎性疾病)的临床疗效。方法:将60例慢性盆腔痛患者随机分为2组,每组28例。治疗组患者采用化瘀消癥剂口服、灌肠联合穴位离子导入方法;对照组患者采用散结镇痛胶囊进行口服,排除月经周期连续用药20天当做1个疗程,治疗持续3个疗程。治疗后,比较两组患者的总有效率、治疗前后中医症候以及局部体征评分、糖类抗原125(CA125)水平的变化。结果:治疗后,治疗组总有效率显著高于对照组(89.28%vs. 57.14%,P0.05)。两组患者的局部体征评分、中医症候评分和总积分均比治疗前有一定程度下降(P0.05)。两组患者治疗后的中医症候积分、总积分、体征积分均较治疗前明显降低,且治疗组以上指标均明显低于对照组(P0.05)。两种患者治疗后血清CA125水平均较治疗前明显降低(P0.05),但两组间比较差异无统计学意义(P0.05)。两组治疗期间不良反应的发生率对比差异无统计学意义(14.29%vs. 10.71%, P0.05)。结论:通过口服、灌肠外加穴位离子导入三种途径联合给予化瘀消癥剂治疗慢性盆腔痛患者可以显著提高其临床效果,有效改善患者的盆腔疼痛程度、中医症候和局部体征,安全有效,值得临床应用。     

Representing species in reserves from patterns of assemblage diversity

Aim A positive relationship between assemblage diversity (AD) – equivalent to the biotic version of the environment diversity, ED, method – and species diversity has been reported. This being true, reserve networks with many different assemblages would be expected to represent more species than reserve networks including fewer and less different assemblages. This idea was tested using European species atlas distributions of terrestrial vertebrates and plants. It is asked whether: (1) maximizing AD within one group would represent species diversity of this group better than expected by chance; and (2) maximizing AD within one group would represent species diversity of other groups better than expected by chance. Location Europe. Methods Three ordination techniques (non‐metric multidimensional scaling, detrended correspondence analysis and correspondence analysis) are used to summarize patterns of compositional turnover within assemblages. p‐Median location‐allocation models are then calculated from ordination space to measure the degree of expected species representation within the group being sampled as well as the expected representation within other groups. Results are compared with near‐optimal solutions obtained with complementarity‐based algorithms and to a null model obtained by simulating selection of areas at random. Matrix correlation analysis was also performed to investigate broad patterns of covariation in compositional turnover of assemblages of species belonging to different taxonomic groups and these values were compared with correlation in species richness scores between groups. Results The AD model did not always represent more species of the group being sampled than expected by chance (P < 0.05). Results were independent of the method and taxonomic group considered. Effectiveness of AD within one group to represent species of other groups varied, but in most cases it was worse than using complementarity‐based algorithms as a surrogate strategy. Even when correlations indicated high coincidence between assemblages, taxonomic‐based surrogates did not always recover more species than expected by chance (P < 0.05). Main conclusions Results are discussed in the light of two possible explanations: (1) the AD model is based on unrealistic assumptions, namely that species have equal probability of having the centre of their distributions anywhere in ordination space and that species display unimodal, symmetrical, bell‐shaped response curves to gradients; (2) particular implementation of methods may be inadequate to summarize useful complementarity among assemblages, especially for restricted‐range species. We conclude that both arguments are likely to play a role in explaining results, but that opportunities exist to improve performance of existing surrogate strategies.     

Leprosy and cutaneous leishmaniasis affecting the same individuals: A retrospective cohort analysis in a hyperendemic area in Brazil

BackgroundLeprosy and cutaneous leishmaniasis (CL) are neglected tropical diseases (NTDs) affecting the skin. Their control is challenging but the integration of skin NTDs control programs is recommended to improve timely detection and treatment. However, little is known about the occurrence of leprosy and CL in the same individuals, and what are the characteristics of such patients. This study aimed to identify and characterize patients diagnosed with both leprosy and CL (i.e., outcome) in the hyperendemic state of Mato Grosso, Brazil. Also, we investigated the demographic risk factors associated with the period between the diagnosis of both diseases.Methodology/principal findingsA retrospective cohort study was conducted with patients diagnosed between 2008 and 2017. From the leprosy (n = 28,204) and CL (n = 24,771) databases of the national reporting system, 414 (0.8%; 414/52,561) patients presenting both diseases were identified through a probabilistic linkage procedure. This observed number was much higher than the number of patients that would be expected by chance alone (n = 22). The spatial distribution of patients presenting the outcome was concentrated in the North and Northeast mesoregions of the state. Through survival analysis, we detected that the probability of a patient developing both diseases increased over time from 0.2% in the first year to 1.0% within seven years. Further, using a Cox model we identified male sex (HR: 2.3; 95% CI: 1.7–2.9) and low schooling level (HR: 1.5; 95% CI: 1.2–1.9) as positively associated with the outcome. Furthermore, the hazard of developing the outcome was higher among individuals aged 40–55 years.Conclusions/significanceLeprosy and CL are affecting the same individuals in the area. Integration of control policies for both diseases will help to efficiently cover such patients. Measures should be focused on timely diagnosis by following-up patients diagnosed with CL, active case detection, and training of health professionals.     

Evaluation of Clustering and Genotype Distribution for Replication in Genome Wide Association Studies: The Age-Related Eye Disease Study

Genome-wide association studies (GWASs) assess correlation between traits and DNA sequence variation using large numbers of genetic variants such as single nucleotide polymorphisms (SNPs) distributed across the genome. A GWAS produces many trait-SNP associations with low p-values, but few are replicated in subsequent studies. We sought to determine if characteristics of the genomic loci associated with a trait could be used to identify initial associations with a higher chance of replication in a second cohort. Data from the age-related eye disease study (AREDS) of 100,000 SNPs on 395 subjects with and 198 without age-related macular degeneration (AMD) were employed. Loci highly associated with AMD were characterized based on the distribution of genotypes, level of significance, and clustering of adjacent SNPs also associated with AMD suggesting linkage disequilibrium or multiple effects. Forty nine loci were highly associated with AMD, including 3 loci (CFH, C2/BF, LOC387715/HTRA1) already known to contain important genetic risks for AMD. One additional locus (C3) reported during the course of this study was identified and replicated in an additional study group. Tag-SNPs and haplotypes for each locus were evaluated for association with AMD in additional cohorts to account for population differences between discovery and replication subjects, but no additional clearly significant associations were identified. Relying on a significant genotype tests using a log-additive model would have excluded 57% of the non-replicated and none of the replicated loci, while use of other SNP features and clustering might have missed true associations.     

重复经颅磁刺激联合阿普唑仑治疗失眠症伴焦虑患者的效果分析

摘要 目的：研究重复经颅磁刺激以及阿普唑仑联用治疗失眠症伴焦虑患者的效果。方法：选择2015年1月～2019年12月我院神经内科收治的81例失眠症伴焦虑患者,将其随机分为两组。对照组每晚在睡前30 min服用阿普唑仑0.8 mg,观察组联用重复经颅磁刺激。比较两组的临床疗效,治疗前后焦虑评分、生活质量和睡眠质量评分的变化。结果：治疗后,观察组的有效率为95.00 %,明显高于对照组(73.17 %,P<0.05);两组焦虑评分均较治疗前明显降低(P<0.05),心理领域、社会领域、环境领域和生理领域评分均较治疗前明显升高(P<0.05),且观察组的焦虑评分和心理领域、社会领域、环境领域、生理领域评分明显优于对照组(P<0.05);两组的睡眠持续性、主观睡眠质量、睡眠障碍、日间功能、睡眠潜伏期、安眠药物和入睡时间评分均较治疗前明显升高(P<0.05),且观察组以上指标均明显高于对照组(P<0.05)。结论：重复经颅磁刺激以及阿普唑仑联用治疗失眠症伴焦虑患者的效果明显优于单用阿普唑仑治疗,其能有效减轻其焦虑程度,提高患者生活质量及睡眠质量。     

胃康胶囊联合兰索拉唑肠溶胶囊对胃溃疡患者胃肠激素、炎症反应和T淋巴细胞亚群的影响

摘要 目的：观察胃康胶囊联合兰索拉唑肠溶胶囊治疗胃溃疡的疗效及对胃肠激素、炎症反应和T淋巴细胞亚群的影响。方法：选择2018年9月~2021年5月在中国人民解放军31694部队医院消化内科接受治疗的80例胃溃疡患者作为观察对象,根据信封抽签法分为对照组和观察组,各为40例。对照组患者接受兰索拉唑肠溶胶囊治疗,观察组患者接受胃康胶囊联合兰索拉唑肠溶胶囊治疗,连续治疗6周。对比两组临床疗效、幽门螺杆菌（Hp）根除率和溃疡愈合率,观察治疗期间不良反应发生情况,对比两组治疗前、治疗6周后的胃肠激素、血清炎症因子和T淋巴细胞亚群指标水平的变化。结果：观察组的临床总有效率较对照组高（P<0.05）。观察组的Hp根除率和溃疡愈合率均高于对照组（P<0.05）。治疗6周后,两组CD3⁺、CD4⁺、CD4⁺/CD8⁺较治疗前升高,CD8⁺ 较治疗前下降,且观察组的改善效果优于对照组（P<0.05）。治疗6周后,两组胃动素（MTL）水平较治疗前升高,胃泌素（GAS）水平较治疗前下降,且观察组的改善效果优于对照组（P<0.05）。治疗6周后,两组高迁移率族蛋白B1（HMGB1）、白介素-6（IL-6）、C反应蛋白（CRP）水平较治疗前下降,且观察组的改善效果优于对照组（P<0.05）。两组不良反应发生率对比无统计学差异（P>0.05）。结论：兰索拉唑肠溶胶囊联合胃康胶囊可提高胃溃疡患者的溃疡愈合率和Hp根除率,其作用机制可能与调节胃肠激素、炎症反应和T淋巴细胞亚群指标水平有关。     

I Just Ran a Thousand Analyses: Benefits of Multiple Testing in Understanding Equivocal Evidence on Gene-Environment Interactions

BackgroundIn psychiatric genetics research, the volume of ambivalent findings on gene-environment interactions (G x E) is growing at an accelerating pace. In response to the surging suspicions of systematic distortion, we challenge the notion of chance capitalization as a possible contributor. Beyond qualifying multiple testing as a mere methodological issue that, if uncorrected, leads to chance capitalization, we advance towards illustrating the potential benefits of multiple tests in understanding equivocal evidence in genetics literature.MethodWe focused on the interaction between the serotonin-transporter-linked promotor region (5-HTTLPR) and childhood adversities with regard to depression. After testing 2160 interactions with all relevant measures available within the Dutch population study of adolescents TRAILS, we calculated percentages of significant (p < .05) effects for several subsets of regressions. Using chance capitalization (i.e. overall significance rate of 5% alpha and randomly distributed findings) as a competing hypothesis, we expected more significant effects in the subsets of regressions involving: 1) interview-based instead of questionnaire-based measures; 2) abuse instead of milder childhood adversities; and 3) early instead of later adversities. Furthermore, we expected equal significance percentages across 4) male and female subsamples, and 5) various genotypic models of 5-HTTLPR.ResultsWe found differences in the percentages of significant interactions among the subsets of analyses, including those regarding sex-specific subsamples and genetic modeling, but often in unexpected directions. Overall, the percentage of significant interactions was 7.9% which is only slightly above the 5% that might be expected based on chance.ConclusionTaken together, multiple testing provides a novel approach to better understand equivocal evidence on G x E, showing that methodological differences across studies are a likely reason for heterogeneity in findings - but chance capitalization is at least equally plausible.     

Separating the Noise from the Noise: A Finding in Support of the “Niche Hypothesis,” That Birds are Influenced by Human-Induced Noise in Natural Habitats

ABSTRACT

Controlling for the confounding influence of physical disturbance, it was possible to test the hypothesis that ambient noise alone would play a role in structuring bird communities in riparian habitats in Boulder, Colorado, USA. Point counts of birds were conducted in open space/minimally disturbed, residential, commercial and industrial neighborhoods. Within the same disturbance parameters and land use, species richness and PIF scores (a weighted value based on species' importance) consistently and significantly decreased as ambient noise increased. These results can be viewed as support for the “Niche Hypothesis” (Krause 1987, 1998), that wildlife species' acoustic niches are adversely affected by human-induced noise pollution.     

非小细胞肺癌化疗患者应对方式与生活质量的相关性研究

目的:调查非小细胞肺癌(NSCLC)化疗患者应对方式与生活质量的相关性。方法:选择2016年5月-2018年5月在我院接受化疗的NSCLC患者共110例,分别采用肺癌生命质量量表(EORTC-QLQ.C30)、肺癌患者生活质量调查问卷(EORTC-QLQ.LC13)和医学应对方式问卷(MCMQ)对患者生活质量与应对方式进行调查,分析其相关性,并采用多元逐步回归分析整体生活质量的影响因素。结果:不同化疗阶段,患者功能维度得分和整体生活质量得分显著下降,差异有统计学意义(P0.05),症状维度得分和化疗相关副反应得分显著升高,差异有统计学意义(P0.05)。肺癌表现得分的差异和三种应对方式得分的差异均无统计学意义(P0.05)。患者采取面对方式和回避方式的得分均高于屈服方式(P0.05)。面对方式与患者整体生活质量呈正相关,回避方式、屈服方式与患者整体生活质量呈负相关。多元逐步回归分析显示:年龄、疾病转移及面对方式是NSCLC化疗患者整体生活质量的影响因素(P0.05)。结论:NSCLC化疗患者应对方式与生活质量存在一定的相关性,应有效的发挥积极应对方式对生活质量的促进作用,提高患者生活质量。     

参附注射液联合奥西替尼治疗晚期EGFR阳性非小细胞肺癌患者疗效及对患者免疫功能的影响

摘要 目的：探讨分析参附注射液联合奥西替尼治疗晚期EGFR阳性非小细胞肺癌（Non-small cell lung cancer,NSCLC）患者疗效及对患者免疫功能的影响。方法：选择2018年6月~2020年12月我院收治的EGFR突变阳性晚期NSCLC患者96例,随机分为观察组50例、对照组46例,对照组给予奥西替尼口服治疗,观察组在对照组基础上给予参附注射液,两组均治疗16周。比较两组治疗临床疗效、免疫功能指标及患者生活质量评分结果。结果：治疗前,两组T淋巴细胞亚群水平和EORCT-QLQ-C30评分差异均无统计学意义（P>0.05）;治疗后,与对照组相比,观察组患者治疗有效率、CD4⁺/CD8⁺比值、功能领域及总体健康状况评分均显著增加,而外周血CD8⁺水平、症状领域评分均显著降低（P<0.05）。结论：参附注射液联合奥西替尼治疗晚期EGFR阳性NSCLC患者可有效提高临床治疗效果,改善患者机体免疫功能并提高患者生活质量,值得临床推广。     

乳腺癌患者心理韧性相关影响因素分析及心理韧性与焦虑的关系

目的:分析乳腺癌患者心理韧性的影响因素,并分析心理韧性与焦虑的关系。方法:于2017年2月～2018年4月期间,选择蚌埠医学院第二附属医院收治的乳腺癌患者287例为研究对象,分别采用心理韧性量表(RS)、焦虑自评量表(SAS)评估研究对象的心理韧性及焦虑状态,并采用多因素Logistic回归分析法分析乳腺癌患者心理韧性相关的影响因素,应用多元逐步线性回归分析法分析乳腺癌患者心理韧性与焦虑的关系。结果:乳腺癌患者RS得分为(76.72±9.82)分。单因素分析显示,不同年龄、居住地、家庭月收入及费用支出形式患者的RS得分比较差异有统计学意义(P0.05);不同文化程度、婚姻状况、手术类型及肿瘤分期患者的RS得分比较差异无统计学意义(P0.05)。多因素Logistic回归分析结果显示,年龄为20～40岁、居住地为农村、家庭月收入3000元、费用支出形式为自费是乳腺癌患者心理韧性的影响因素(P0.05)。乳腺癌患者SAS得分为(5.02±1.42)分,以心理韧性为自变量,焦虑为因变量进行多元逐步线性回归分析,结果显示,乳腺癌患者心理韧性为焦虑的预测因子,其心理韧性水平越高,焦虑程度越低(P0.05)。结论:乳腺癌患者心理韧性水平偏低,且其对患者焦虑状态具有预测作用,年龄为20～40岁、居住地为农村、家庭月收入3000元、费用支出形式为自费是乳腺癌患者心理韧性的影响因素,临床治疗中应该根据以上影响因素进行相关干预。