乳腺癌根治术患者术前焦虑的影响因素分析及其对术后恢复、细胞免疫功能和生命质量的影响

摘要 目的：分析乳腺癌根治术患者术前焦虑的影响因素,并探讨术前焦虑对患者术后恢复、细胞免疫功能和生命质量的影响。方法：选择我院2020年3月~2021年12月期间收治的拟行乳腺癌根治术的120例患者作为研究对象,术前1 d采用焦虑自评量表（SAS）评估所有患者的焦虑状况,根据是否存在焦虑分为焦虑组和无焦虑组,乳腺癌根治术患者术前焦虑的影响因素采用多因素Logistic回归分析。对比焦虑组和无焦虑组的术后恢复、细胞免疫功能和生命质量情况。结果：120例乳腺癌根治术患者中,有31例患者无术前焦虑,89例患者存在焦虑症状,根据是否存在术前焦虑分为焦虑组（n=89）和无焦虑组（n=31）。乳腺癌根治术患者术前焦虑与年龄、文化程度、家庭人均月收入、付费方式、婚姻状况、家庭支持、既往有无全麻史、术前住院时长、定期体检有关（P<0.05）。多因素Logistic回归分析结果表明：年龄＜60岁、文化程度为小学及其以下、家庭人均月收入＜3000元、婚姻状况为未婚、无家庭支持、既往无全麻史、术前住院时长>1 d是乳腺癌根治术患者术前焦虑的危险因素（P<0.05）。焦虑组的术后首次肛门排气时间、首次下床活动时间、术后住院时间均长于无焦虑组（P<0.05）。两组术后1个月CD3⁺、CD4⁺、CD4⁺/CD8⁺水平升高,且无焦虑组高于焦虑组（P<0.05）,两组术后1个月CD8⁺水平下降,且无焦虑组低于焦虑组（P<0.05）。两组术后1个月生理状况、情感状况、社会/家庭状况、功能状况、附加关注评分和总分下降,且无焦虑组低于焦虑组（P<0.05）。结论：乳腺癌根治术患者术前焦虑发生率较高,其发生受到年龄、文化程度、家庭人均月收入、婚姻状况、家庭支持、既往有无全麻史、术前住院时长等多种因素的影响,可导致患者术后恢复时间延长,细胞免疫功能和生命质量降低。     

Prevalence and trends of common mental disorders from 2007-2009 to 2019-2022: results from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS), including comparison of prevalence rates before vs. during the COVID-19 pandemic

Up-to-date information on the prevalence and trends of common mental disorders is relevant to health care policy and planning, owing to the high burden associated with these disorders. In the first wave of the third Netherlands Mental Health Survey and Incidence Study (NEMESIS-3), a nationally representative sample was interviewed face-to-face from November 2019 to March 2022 (6,194 subjects; 1,576 interviewed before and 4,618 during the COVID-19 pandemic; age range: 18-75 years). A slightly modified version of the Composite International Diagnostic Interview 3.0 was used to assess DSM-IV and DSM-5 diagnoses. Trends in 12-month prevalence rates of DSM-IV mental disorders were examined by comparing these rates between NEMESIS-3 and NEMESIS-2 (6,646 subjects; age range: 18-64 years; interviewed from November 2007 to July 2009). Lifetime DSM-5 prevalence estimates in NEMESIS-3 were 28.6% for anxiety disorders, 27.6% for mood disorders, 16.7% for substance use disorders, and 3.6% for attention-deficit/hyperactivity disorder. Over the last 12 months, prevalence rates were 15.2%, 9.8%, 7.1%, and 3.2%, respectively. No differences in 12-month prevalence rates before vs. during the COVID-19 pandemic were found (26.7% pre-pandemic vs. 25.7% during the pandemic), even after controlling for differences in socio-demographic characteristics of the respondents interviewed in these two periods. This was the case for all four disorder categories. From 2007-2009 to 2019-2022, the 12-month prevalence rate of any DSM-IV disorder significantly increased from 17.4% to 26.1%. A stronger increase in prevalence was found for students, younger adults (18-34 years) and city dwellers. These data suggest that the prevalence of mental disorders has increased in the past decade, but this is not explained by the COVID-19 pandemic. The already high mental disorder risk of young adults has particularly further increased in recent years.     

Culturally-transmitted feeding behaviour in primates: Evidence for accelerating learning rates

Cultural transmission implies the rapid spread of behavioural innovations when initially naïve individuals copy more informed ones. Mathematical models of transmission feature accelerating (and in most cases, logistic) rates of learning as animals that acquire an innovation provide ever increasing numbers of informers for potential learners. Conversely, non-accelerating rates have been proposed as a null hypothesis for apparent cases of cultural transmission that can best be explained by simpler mechanisms such as trial-and-error learning. Using the AIC technique for comparing models with different numbers of parameters, this paper examines the 21 cases in the primate literature where quantifiable data are available on learning rates for presumed culturally-transmitted feeding innovations. In each case, cumulative distributions over time of the frequency or proportion of individuals that acquire an innovation are compared with three accelerating functions (logistic, positive exponential, and hyperbolic sine) and two non-accelerating ones (linear and logarithmic). In 16 cases, the best fit is given by an accelerating function: nine of these support the logistic, four support the positive exponential and three, the reverse S-shaped hyperbolic sine. Individual cases often show small differences between alternative functions, but overall trends support the cultural assumption of accelerating learning rates.     

Absence of within-colony kin discrimination in behavioural interactions of swarm-founding wasps

Within-colony kin discrimination has not been demonstrated conclusively for any social insect, perhaps partly because highly polymorphic genetic markers necessary to assess within-colony relatednesses have only recently become available. We use microsatellite loci to investigate within-colony kin discrimination in behavioural interactions in the neotropical multiple-queen wasp, Parachartergus colobopterus. Within-colony kin discrimination would be particularly advantageous in this species since average genetic relatedness among colony members overall is low (0.32 =/- 0.06), compared to the relatedness value between full sisters of 0.75. Using seven colonies of individually marked females, we recorded behavioural interactions that were cooperative (222 grooming, 2438 feeding), aggressive (511 body or wing biting, 240 mandible biting) or neutral (1676 antennating). We expected cooperative behaviours to favour closer kin and aggressive behaviours to be directed towards more distant kin, but found that none of the behaviours we investigated showed discrimination on the basis of relatedness. We could have detected a difference in relatedness values of as little as between 0.03 and 0.12, depending on the behaviour being analysed. Thus, we found no evidence for kin discrimination in within-colony behaviour in this species.     

Relationships in six groups of rhesus monkeys II. Dyads

Dyadic relationships are described for rhesus monkeys living in six groups. The kinds, frequencies, directionality, and overall patterning of interactions are examined over a twelve-month period for adult males, adult females, and young monkeys. Kinship, sex, age, reproductive conditions, time, events, and other social relations all affected dyadic relationship. Certain patterns of interactions characterized different relationships, such as those termed “special,” “tense,” “affiliative,” “conflicting.” A component approach is recommended for the understanding of relationships based on an appraisal of attraction, familiarity, and deference between individuals. The importance of assessing relationships in the group context is stressed.     

Parental investment related to social systems in microtines

Summary Laboratory offspring of wild-caught voles Clethrionomys glareolus and Microtus agrestis, bred for 1 year under constant conditions, were examined with regard to sex ratios and weights at weaning and at 2 months of age. C. glareolus exhibits female territoriality and M. agrestis male territoriality in summer. The adults die away in late summer-autumn. Early-summer young mature in the year of birth but late-summer young do not reach maturity until the following year. C. glareolus young showed a male bias in early summer and a female bias in late summer. Conditions were the opposite but less clear in M. agrestis. C. glareolus males grew comparatively faster than M. agrestis males and showed a markedly higher early summer male: female weight ratio at 2 months of age. Maternal investment thus appears clearly related to the social system; the sex with the largest number and highest quality of young was that which was not limited in number by territoriality. However, the investment depended also on the time until maturation of the young.     

Ecological studies ofRoparidia fasciata in Okinawa island I. Distribution of single- and multiple-foundress colonies

To compare between a single-foundress colony and a multiple-foundress colony at the pre-emergence state of a social wasp, R. fasciata, nest distributions and colony terminations were investigated in 8 sites with different environmental conditions. Marking experiments were also conducted in two sites at high wasp density.

1. Foundress populations were composed of single-foundress colonies in sites C, D and E, new environments where have recently suited for inhaviting, at low wasp density. In sites like A and B which were used year after year, at high wasp density, coexistence of multiple-and single-foundress colonies was observed.
2. From the marking experiment, nests initiated by a single foundress were more distant away from the nest where the original foundress emerged the fall before, compared to multiple-foundress nests which were initiated by multiple foundress.
3. Greater percentage of colony termination was observed in single-foundress nests than in multiple-foundress nests, and the colony termination in single-foundress colonies increased with the nest density.
4. Ant predation was the key factor causing the variation of the percentage of colony termination.

     

Troop fission in free-ranging baboons in the Gombe Stream National Park, Tanzania.

During a 13 month field study of baboons in the Gombe Stream National Park, Tanzania, the troop under observation divided into two groups. One group left the main troop to become ultimately an independent troop with a separate range. The troop fission followed a period of instability in the male status hierarchy. The events prior to and during the troop fission are described in detail and the membership of the group which left is analyzed. Social bonds prior to the fission, including kinship, determined membership in the group which left. Aggression from members of the main troop played a major role in causing the group which left to establish a new range. This fission is compared with troop fissions observed in rhesus and Japances macaques.