Regression analysis of mean quality-adjusted lifetime with censored data

In clinical trials of chronic diseases such as acquired immunodeficiency syndrome, cancer, or cardiovascular diseases, the concept of quality-adjusted lifetime (QAL) has received more and more attention. In this paper, we consider the problem of how the covariates affect the mean QAL when the data are subject to right censoring. We allow a very general form for the mean model as a function of covariates. Using the idea of inverse probability weighting, we first construct a simple weighted estimating equation for the parameters in our mean model. We then find the form of the most efficient estimating equation, which yields the most efficient estimator for the regression parameters. Since the most efficient estimator depends on the distribution of the health history processes, and thus cannot be estimated nonparametrically, we consider different approaches for improving the efficiency of the simple weighted estimating equation using observed data. The applicability of these methods is demonstrated by both simulation experiments and a data example from a breast cancer clinical trial study.     

加速康复外科理论对老年股骨颈骨折患者髋关节功能、生活质量及术后认知功能的影响

摘要 目的：探讨加速康复外科理论（ERAS）对老年股骨颈骨折（FNF）患者髋关节功能、生活质量以及术后认知功能的影响。方法：选取2018年7月~2019年10月期间我院收治的80例老年FNF患者,按照随机数字表法分为对照组（n=40）和研究组（n=40）,对照组给予常规围术期处理,研究组围术期应用ERAS进行处理,比较两组患者围术期指标、髋关节功能、生活质量、术后认知功能及并发症发生情况。结果：研究组术中出血量少于对照组,手术时间、住院时间短于对照组（P<0.05）。研究组术后6个月髋关节功能的优良率为92.50%（37/40）,高于对照组的70.00%（28/40）（P<0.05）。两组术后6个月SF-36各维度评分均升高,且研究组高于对照组（P<0.05）。两组术后简易智力状态量表（MMSE）评分均较术前降低,但研究组高于对照组（P<0.05）;研究组的认知功能障碍（POCD）发生率低于对照组（P<0.05）。研究组的并发症总发生率为7.50%（3/40）,低于对照组的25.00%（10/40）（P<0.05）。结论：老年FNF患者应用ERAS进行围术期处理,可促进患者术后恢复,减轻认知功能损害及并发症发生率,同时还可有效改善髋关节功能及生活质量。     

Rapid evaluation and quality control of next generation sequencing data with FaQCs

Background

Next generation sequencing (NGS) technologies that parallelize the sequencing process and produce thousands to millions, or even hundreds of millions of sequences in a single sequencing run, have revolutionized genomic and genetic research. Because of the vagaries of any platform’s sequencing chemistry, the experimental processing, machine failure, and so on, the quality of sequencing reads is never perfect, and often declines as the read is extended. These errors invariably affect downstream analysis/application and should therefore be identified early on to mitigate any unforeseen effects.

Results

Here we present a novel FastQ Quality Control Software (FaQCs) that can rapidly process large volumes of data, and which improves upon previous solutions to monitor the quality and remove poor quality data from sequencing runs. Both the speed of processing and the memory footprint of storing all required information have been optimized via algorithmic and parallel processing solutions. The trimmed output compared side-by-side with the original data is part of the automated PDF output. We show how this tool can help data analysis by providing a few examples, including an increased percentage of reads recruited to references, improved single nucleotide polymorphism identification as well as de novo sequence assembly metrics.

Conclusion

FaQCs combines several features of currently available applications into a single, user-friendly process, and includes additional unique capabilities such as filtering the PhiX control sequences, conversion of FASTQ formats, and multi-threading. The original data and trimmed summaries are reported within a variety of graphics and reports, providing a simple way to do data quality control and assurance.

Electronic supplementary material

The online version of this article (doi:10.1186/s12859-014-0366-2) contains supplementary material, which is available to authorized users.     

Quality of life issues in relation to the aromatase inhibitor

Maturing data from aromatase inhibitor (AI) trials reveal benefits to many women who might otherwise have relapsed and died from breast cancer. In advanced disease the case for the use of AIs is well established but in the adjuvant and chemoprevention settings some worries about long-term safety remain. Large numbers of women may already be cured by surgery, chemotherapy and radiotherapy making further adjuvant treatment unnecessary. In chemoprevention the ratio of risks to putative benefits remains very unclear, so results from major trials are needed to clarify. When making decisions about treatment women need information about: the available options, likely therapeutic gains, predicted side-effects and convenience of treatment. Adherence is then dependent on the actual burden experienced and impact on QoL. Healthcare professionals often underestimate non-life-threatening but QoL-threatening side-effects, making treatments appear more favorable and acceptable during discussion about therapeutic options. It was hoped that AIs would enhance efficacy without producing unacceptable side-effects that diminish QoL and reduce adherence. Recently published results from the QoL sub-protocols of ATAC, IES and MA-17, looking at anastrozole, exemestane and letrozole, respectively, provide useful indications about the QoL associated with AIs. More information gained from longer-term patient follow-up and preference studies are needed to help clinicians making treatment recommendations and to assist development of ameliorative interventions needed to accompany the most efficacious therapies.     

自我效能改善白血病晚期患者生活质量的应用

目的：在自我效能理论指导下对白血病晚期患者改进护理措施,改善其生活质量。方法：采用目的性抽样,对2010年1月至2012年5月间异常的患者,通过gses表格内容,supph测评内容评估,在临床医生和心理医生的指导下改善传统护理方法,对每个患者出现的不适症状分别对待,使患者意识到需要接受挑战而坚持到底的毅力,使患者相信自身对疾病的可控感。结果：根据护理评价结果建立新措施体系,结果显示抑郁得分显著高于国内常模,自我效能总分与抑郁总分无明显线性相关;作出决策维度与躯体性障碍存在负相关性（r=-0．319,P〈0．05：）;积极态度分别与抑郁总分（r=0．345,P〈0．05）、躯体性障碍（r=0．322,P〈0．05）存在正相关性。自我效能可改善白血病晚期患者生活质量,测评结果显示及专业医生的积极评价说明其具有可信度。结论：异常变化的micro RNA可能对高糖诱导的腹膜间皮细胞EMT具有重要调控作用。     

Dolor en el anciano: calidad de vida,funcionalidad y factores asociados. Estudio SABE,Bogotá, Colombia

ObjectiveTo determine the impact of pain on the quality of life in older adults and its association with functionality.Materials and methodsData was taken from SABE Bogota study. A cross-sectional study was carried out during 2012, interviewing 2,000 individuals of 60 years and older, as a probabilistic cluster and representative sample. The variable ‘presence of pain’ to was used to identify associations with sociodemographic factors, self-rated health, comorbidities, functional status, cognitive status, and quality of life. The latter was estimated using a visual analogue scale of the EuroQOL tool (EQ-VAS).ResultsThe majority of older adults were women (63.4%); the mean age was 71.17 years (SD = 8.05), with a higher frequency of individuals in the age group between 60 and 69 years (48%). When comparing groups with pain vs. no pain, significantly lower scores were found in the group with pain (P < .001) in both the functionality and quality of life EQ-VAS scales. The strongest associations with pain were: joint diseases (OR: 3.08 [2.24-4.23]), severe depression (OR: 2.80 [1.63-4.79]) and functional impairment of the Basic Activities of Daily Living (BADL) (OR: 2.45 [1.31-4.58]).ConclusionsPain negatively impacts the functional independence and the perception of the quality of life in older adults, predisposing them to adverse outcomes.     

授权教育联合Orem自理模式对提高UC患者自我效能效果显著

为探讨授权教育联合奥瑞姆自理模式(Orem self-care model)对溃疡性结肠炎(ulcerative colitis, UC)患者自我效能及生活质量的影响,本研究选取2015年1月至2017年4月98例我院UC患者,采用随机数字表法分为对照组(n=49)与研究组(n=49)。对照组采取常规健康教育,研究组采取授权教育联合奥瑞姆自理模式。入院时及干预后统计两组自我效能评分(IBD-SES)、生活质量分值(SF-36)、抑郁及焦虑分值(SDS,SAS)、治疗依从性、夜间排便次数。研究发现,干预后两组IBD-SES分值较干预前增高,且研究组较对照组高(p<0.05);干预后两组SF-36分值相比较于干预前均有所增高,且对照组较研究组低(p<0.05);干预后两组SDS及SAS分值较干预前降低,且研究组较对照组低(p<0.05);研究组治疗依从性(95.92%)较对照组(79.59%)高(p<0.05);干预后两组夜间排便次数较干预前减少,且研究组较对照组少(p<0.05)。本研究初步说明,联合采用授权教育及奥瑞姆自理模式对溃疡性结肠炎患者实施干预效果显著,可提高其自我效能及生活质量,缓解负性情绪状态,改善治疗依从性,并减少夜间排便次数。     

半量睫状体光凝术对青光眼患者生活质量及血清Endothelin-1水平的影响

摘要 目的：探究半量睫状体光凝术对青光眼患者生活质量及血清内皮素（ET-1）水平的影响。方法：选择2018年4月至2021年4月于我院接受治疗的80例（80眼）青光眼患者为研究对象,将其按照接受术式的差异区分为研究组（n=40,接受半量睫状体光凝术治疗）与对照组（n=40,接受小梁切除术）,观察记录两组患者术后前房反应及角膜水肿情况,分析两组患者术前术后眼压、视力以及血清ET-1水平变化,记录两组患者手术成功率和术后并发症发生情况并实施组间差异性比较。结果：（1）术后1 d和术后7 d两个时间点上,研究组与对照组患者的前房反应以及角膜内皮水肿情况组间比较无差异（P>0.05）;（2）研究组患者手术完全成功20例,相对成功19例,手术总成功率为97.50 %,对照组患者手术完全成功15例,相对成功22例,手术总成功率为87.50 %,两组患者手术成功率方面组间比较无差异（P>0.05）;（3）术后7 d、术后1个月及术后3个月时,研究组患者的眼压均明显低于对照组（P<0.05）;（4）术后1个月时两组患者的ET-1水平组间比较无差异（P>0.05）,但研究组患者的生活质量高于对照组（P<0.05）;（5）两组患者在并发症发生率方面组间无差异（P>0.05）。结论：半量睫状体光凝术对青光眼具有较好的治疗效果,患者手术成功率相比小梁切除术更高,同时患者术后眼压降低明显,且手术安全性值得肯定。     

家庭干预对喉癌患者术后生活质量的影响

目的:探讨家庭干预对喉癌术后患者生活质量的影响。方法:将66例喉癌术后患者随机分为干预组和时照组,两组病人均进行常规治疗和护理,干预组在此基础上对患者实施针对性家庭干预。采用Terrell生活质量调查表分别在实施干预前及实施干预后进行评估。结果:干预组患者干预后对健康知识掌握率显著高于对照组(P<0.05),生活质量明显高于对照组(P<0.05)。结论:对喉癌术后病人实施针对性家庭干预,可以提高喉癌术后病人生活质量。     

纤维肌痛综合征患者的生存质量及其影响因素研究

目的:探讨纤维肌痛综合征患者生存质量及其影响因素。方法:选择2014年2月至2015年2月在哈医大一院风湿免疫科门诊就诊的纤维综合征患者共40例,采用医师与患者沟通以及问卷调查的方法收集患者的性别、年龄、病程以及并发症情况,并对患者疼痛、疲劳、焦虑抑郁、睡眠情况以及生存质量进行评估。同时随机选取一般正常人群40例作为对照组。应用SPSS l7.0统计软件进行统计学分析。结果:纤维肌痛综合征患者生存质量显著低于对照组(P0.05);疲劳程度、焦虑抑郁为影响生存质量的主要因素,呈负相关(P0.05);疼痛与生存质量中活力维度呈负相关(P0.05),疲劳程度与生理职能、一般健康状况、社会功能以及情感职能4个维度呈负相关(P0.05),焦虑抑郁程度以及睡眠质量与躯体功能、躯体疼痛以及社会功能3个维度呈负相关(P0.05)。结论:影响纤维肌痛综合征患者生存质量的因素是多方面的,要想提高患者的生存质量,不仅要缓解疼痛及其相关症状,更要同时改善如疲劳、抑郁焦虑等症状。     

Quality-of-life indicators at different scales: Theoretical background

The article is presenting the general analysis of the systems approach and model approaches for the development of QoL indicators and indices. In our study we propose the method of response function as a method of the construction of purposeful, credible integrated models from data and prior knowledge or information. The method of response function implies credible models in the sense that they are identifiable, and, hopefully, explains system output behaviour satisfactorily.Using response function method for the development of QoL models, we are able to obtain QoL indices as the direct output of the models.