ABSTRACT
Objective: To explore the role of psychological problems of somatization, anxiety, and depression in patients presenting chest pain who underwent coronary angiography (CAG). Methods: Altogether, 908 patients with chest pain referred to the cardiology inpatient department were enrolled in the present study. The enrolled patients underwent CAG and coronary angiographic results were classified into negative (<30% diameter stenosis in all vessels), mild to moderate coronary stenosis (≥30% and <75% diameter stenosis in all vessels) and severe coronary stenosis group (≥75% diameter stenosis in at least a single vessel). Patients also completed a battery of self-reported inventories before the CAG: the Self-Rating Somatic Symptom Scale (SSS), the Generalized Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9). Results: Compared with severe coronary stenosis group, male patients in the mild to moderate coronary stenosis group (n=189) seemed to have higher rate of somatization (20.6% vs 18.5%, P=0.014), higher rate of depression (20.6% vs 10.6%, P=0.008), and higher rate of anxiety (13.4% vs 6.6%, P=0.028). Compared with severe coronary stenosis group, female patients in the mild to moderate coronary stenosis group seemed to have higher rate of somatization (57.6% vs 39.4%, P=0.008). Conclusion: The positive rate of somatization symptoms in patients with mild to moderate coronary stenosis was higher than that in patients with severe coronary stenosis. These findings suggest that psychological problems may contribute in part to the development of chest pain and other physical symptoms. It is also needed to evaluate the clinical and economic benefits of early psychological interventions, especially in mild to moderate coronary stenosis patients who are presenting chest pain.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and safty of the humanized anti-epidermal factor receptor monoclonal antibody h-R3 in combination with radiotherapy for locoregionally advanced nasopharyngeal carcinoma.</p><p><b>METHODS</b>Totally, 137 patients from 7 medical center around China were randomly divided into combined therapy group or control group. There was no difference in Karnofsky performance score between two groups. All patients in both groups received radical conventionally fractionated radiotherapy to the total dose of D(T) 70-76 Gy. For the combined therapy group, h-R3 was added at a dose of 100 mg i.v. weekly for 8 weeks started at the beginning of radiotherapy.</p><p><b>RESULTS</b>Of the 137 eligilbe patients, 70 were in the combined therapy group treated by h-R3 plus radiotherapy and 67 in the control group by radiotherapy alone. The intent-to-treat (ITT) population consisted of 130 patients, while the per-protocol (PP) population was composed of 126 patients. The efficacy was assessed respectively at three point of time: the end of treatment, the 5th- and 17th-week after treatment. The complete response (CR) of the combined therapy group was significantly higher than that of the control group in both ITT and PP (ITT: 65.63%, 87.50%, 90.63% versus 27.27%, 42.42%, 51.52%; PP: 67.21%, 90.16%, 93.44% versus 27.69%, 43.08%, 52.31%; P < 0.05, respectively). The most common h-R3-related adverse reactions were fever (4.3%), hypotension (2.9%), nausea (1.4%), dizziness (2.9%) and rash (1.4%), which could be reversible if treated properly. Radiotherapy combined with 100 mg h-R3 i. v. weekly was tolerable and did not aggravate the side effects of radiation. The quality of life in the combined therapy group was comparable to that in the control group.</p><p><b>CONCLUSION</b>This phase 1 multicenter clinical trial shows that h-R3 in combination with radiotherapy is effective and well-tolerated for the treatment of locoregionally advanced nasopharyngeal carcinoma.</p>