ABSTRACT
Objective To investigate the relationship between aggressive trait of patients,patient-physician trust and illness perception. Methods Totally 500 patients were recruited from different medical departments from eight hospitals in Guangdong and 384 samples' valid data were obtained. The aggressive trait of patients,patient-physician trust and illness perception were assessed with the Buss-Perry aggression questionnaire( BPAQ), the Wake Forest physician trust scale ( WFPTS), and the brief illness perception questionnaire(BIPQ) respectively. SPSS 23. 0 and AMOS 20. 0 were used for data analysis and structural e-quation model construction. Results Pearson correlation analysis showed that the BPAQ (53. 2±13. 9) and BIPQ(38. 6±9. 1) were negatively correlated respectively with WFPTS (35. 3±6. 1) and benevolence (17. 6 ±3. 2) and technical competence (17. 8±3. 3),(r=-0. 14~-0. 18,P<0. 01). And there was positive corre-lation between BPAQ scores and BIPQ score(r=0. 37,P<0. 01). Mediation effect test showed that patient-physician trust mediated the associations between patient aggression and illness perception (B=0. 039,95% CI= (0. 002,0. 120)). Conclusion Aggressive trait and patient-physician are significantly related with ill-ness perception. Patient-physician trust exerts mediating effect on the relationship between aggression of pa-tients and illness perception.
ABSTRACT
Objective To evaluate the efficacy, safety and the prognosis of rituximab combined with CHOP (R-CHOP) or combined with EPOCH (R-EPOCH) regimen in treatment of newly diagnosed myc/bcl-2 double-expression diffuse large B-cell lymphoma (DLBCL). Methods The clinical efficacy, adverse reactions and survival of 16 DLBCL patients who received R-CHOP regimen with double-expression and 15 DLBCL patients who received R-EPOCH regimen with double-expression between August 2014 and December 2017 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed, and all patients with double or triple-hit lymphoma were excluded. Results The ratio of the International Prognostic Index (IPI) score ≥3 in R-EPOCH group was higher than that in R-CHOP group [10 cases vs. 5 cases, χ2＝ 3.888, P＝0.049]. There were no statistical differences in other clinical data of both groups. Complete remission (CR) was achieved in 75% (12/16) of R-CHOP group and 67% (10/15) of R-EPOCH group, and there was no statistical difference between the two groups (χ2＝ 0.013, P＝ 0.908). The incidence of grade 3-4 leukopenia and grade 3-4 thrombocytopenia in R-EPOCH group was higher than that in R-CHOP group, and the difference was statistically significant [93% (14/15) vs. 38% (6/16), χ 2＝ 10.542, P＝ 0.01; 73% (11/15) vs. 6% (1/16), χ 2＝ 14.685, P< 0.01]. The 1-year overall survival (OS) rate and progression-free survival (PFS) rate was 86.5% and 81.3% in R-CHOP group, 76.0% and 51.4% in R-EPOCH group. There was no statistical difference in the 1-year OS rate between the two groups (P＞0.05), and the 1-year PFS rate in R-CHOP group was higher than that in R-EPOCH group (P<0.01). The 1-year OS rate and PFS rate was 100.0% and 93.8% in IPI<3 group, 65.5% and 45.0% in IPI≥3 group. The 1-year OS rate and PFS rate in IPI<3 group were superior to those in IPI≥3 group (all P ＞0.01). The 1-year OS rate and PFS rate of the female group were lower than those of the male group (59.6% vs. 100.0%, 44.2% vs. 86.3%), and there were statistical differences (all P<0.01). Cox regression analysis showed that high IPI score was an independent prognostic factor for all patients ( HR＝6.335, 95% CI 0.740-54.261, P＝0.092). Conclusions R-EPOCH and R-CHOP are the ideal treatment methods for the double-expression lymphoma. Both regimens have similarities in the treatment outcome of myc/bcl-2 double-expression DLBCL. The adverse reactions in R-EPOCH group are severer than those in R-CHOP group.