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Objective:To develop a symptom assessment scale for tumor immune checkpoint inhibitor therapy, and test its reliability and validity.Methods:The test scale was formed through literature analysis, case investigation and Delphi expert correspondence. From June 2021 to February 2022, a questionnaire survey was conducted on 229 patients admitted in Tianjin Medical University Cancer Institute and Hospital treated with tumor immune checkpoint inhibitors to test its reliability and validity and formed a formal questionnaire.Results:The Symptom Assessment Scale for Patients Treated with Tumor Immune Checkpoint Inhibitors included 15 items, the Cronbach alpha coefficient of the scale was 0.792, each item was in the range of 0.753-0.785, and the test-retest reliability was 0.721. Exploratory factor analysis extracted 4 common factors, and the cumulative variance contribution rate was 53.79%; the content validity index was 0.811 while that of each item was 0.733-0.933; the correlation coefficient between the total score of the scale and the overall health status of the Cancer Quality of Life Core Scale was 0.504 ( P<0.01). Conclusions:The Symptom Assessment Scale for Patients Treated with Tumor Immune Checkpoint Inhibitors has good reliability and validity, and it is suitable for symptom assessment of related population.
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【Objective】 To conduct the laboratory quality assessment between 12 blood stations in Hebei province, analyze the results and explore the accuracy and comparability of testing, so as to improve the level of testing ability and quality management. 【Methods】 With reference to the external quality assessment rules of National Center for Clinical Laboratories and combined with the instructions of quality assessment samples, daily testing process of the laboratories were assessed. The quality indicators include blood cell count (WBC, RBC, Hb, HCT, MCV, MCH, MCHC and PLT), biochemical items (TP) and coagulation parameters (FIB and FⅧ). 【Results】 There are still problems in laboratories in terms of personnel operation, instrument maintenance and the impact of different reagent batches, especially in biochemical items and coagulation parameters. The pass rate of biochemical items was the lowest, only 72.75%, and that of blood cell count was the highest, reaching 98.75%. 【Conclusion】 With the progress of the project, the quality monitoring level of daily blood sampling tests in the quality control laboratory of each blood station has been improved. However, it is still necessary for each laboratory to improve the testing ability and quality management to a higher level in Hebei.
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Objective:To construct the follow-up index system for lymphoma survivors, so as to provide a basis for survivors to obtain effective care during the follow-up period and to explore the follow-up pattern of cancer survivors in our country.Methods:From April 2021 to April 2022, the first draft of the follow-up index system for lymphoma survivors was developed through literature search and semi-structured interviews. Delphi method and Analytic Hierarchy Process were used to determine the quality of index system and index weight.Results:Twenty experts were consulted for 2 rounds. The recovery rate of the two rounds of expert letter inquiry was 100%, The authoritative coefficients were 0.938, 0.960. The Kendall′s W value were 0.150, 0.284 and 0.246 respectively with good coordination degree ( χ2=9.00, 85.29, 240.69, all P<0.05). Finally, the follow-up index system for lymphoma survivors was constructed, which included 4 first-level indicators, 16 second-level indicators and 49 third-level indicators. Conclusions:The follow-up index system for lymphoma survivors was scientific and can guide nurses to develop personalized follow-up plans and standardized implementation.
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Objective:To explore the impact of Green model-based health education on the readiness for discharge of newly treated lymphoma patients undergoing chemotherapy, providing a reference for improving the quality of discharge guidance for such patients.Methods:From May 2021 to October 2021, 116 patients with newly treated malignant lymphoma who received chemotherapy in Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital were selected as the research subjects. According to the single or double date on the day of admission, they were divided into control group (59 cases) and intervention group (57 cases); the control group carried out health education according to the content of the lymphoma nursing routine, and the intervention group implemented Green model-based health education. After the second chemotherapy cycle, compared the differences in discharge readiness and the quality of discharge guidance between the two groups.Results:Before the intervention, there was no significant difference in the scores of the two groups of patients′discharge readiness and the quality of discharge guidance ( P>0.05). After the intervention, the three dimensions and total scores of hospital discharge readiness in the intervention group were (24.65 ± 4.29), (43.47 ± 3.49), (35.58 ± 5.73), and (103.70 ± 9.10) points, respectively, which were higher than those in the control group (20.64 ± 3.81), (37.24 ± 6.18), (30.42 ± 6.03), and (88.31 ± 12.07) points, and the differences were statistically significant ( t values were 4.72-7.74, all P<0.01); the two dimensions and total scores of the quality of discharge guidence in the intervention group were (48.05 ± 8.87), (109.26 ± 18.73), and (157.32 ± 23.84) points, respectively, which were higher than those in the control group (40.17 ± 12.81), (92.85 ± 22.58), and (133.02 ± 29.38) points, the differences were statistically significant ( t=3.84, 4.25, 4.88, all P<0.01). Conclusions:Green model-based health education can improve the readiness for discharge and the quality of discharge guidance for newly treated lymphoma patients undergoing chemotherapy.
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Dyslipidemia is one of the most common complications of primary biliary cholangitis (PBC). This article reviews the latest research on lipid profile, the risk of cardiovascular diseases, and treatment of PBC with hyperlipidemia. Different from other liver diseases, PBC with hyperlipidemia has a unique lipid profile, which changes dynamically with disease progression. It is generally not considered that there are increased risks of atherosclerosis and cardiovascular disease. For those who have indications for treatment, statins are recommended as the first choice. In the future, more in-depth systematic studies are needed to clarify its diagnosis, treatment, and management processes.
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Objective:To explore the effect of Brain HQ visual training on memory function in lymphoma patients with chemotherapy-related cognitive impairment.Methods:From January to December 2019, 39 hospitalized patients in lymphoma department were selected as the research object, and divided into intervention group (19 cases) and control group (20 cases) by the order of admission. The control group was given routine nursing, and the intervention group was given Brain HQ visual training. The two groups of patients used the auditory learning test to evaluate the memory function effect at the time of enrollment, after 2 cycles and 4 cycles.Results:After 2 cycles intervention, there were no statistically significant indicators for immediate recall, short-term delayed recall, long-term delayed recall, re-recognition, and correct recall ( t values were 0.575-1.248, P> 0.05); After 4 cycles of chemotherapy, the three indicators of long-term delayed recall, recognition and correct recall of the intervention group were (6.00±1.59), (9.05±1.81), (36.00±4.27) points, while (4.75±1.55), (8.05±1.73), (32.85±3.59) points of the control group, there was a statistically significant difference in ( t values were 3.384, 2.373, 3.010, P < 0.05); repeated measures analysis of variance showed The total indicators of immediate recall, short-term delayed recall, long-term delayed recall, recognition and correct recall were not statistically significant in both groups ( F values were 0.329-1.462, P>0.05). Conclusion:The effect of Brain HQ visual training on memory function are not clear, but with the change of intervention time, memory indicators are constantly improving, Brain HQ visual training has certain practicability.
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Objective@#Apolipoprotein E (ApoE) is mainly synthesized in the liver. So far, it is unknown the relationship among APOE gene polymorphisms and WML, brain atrophy. Therefore, the aim of the study was to assess the associations of APOE gene polymorphisms in patients with WML and brain atrophy. @*Methods@#A total of 58 patients with WML, 128 patients with brain atrophy, 112 patients with co-occurrence of WML and brain atrophy and 95 healthy elderly volunteers were recruited from Renmin Hospital of WuHan University. @*Results@#Allele E3 was the most common allele. The alleles E2 had significantly higher levels of ApoB and lower age in WML group. The alleles E2 was associated with the lower level of ApoB, LDL-Ch, TCh, and sdLDL in co-occurrence group. The E3/E3 genotype has higher level of sdLDL, but lower age and female frequency in WML. The E3/E4 genotype had higher level of TG, but lower age in WML. Gender, Age, E2, Hyperhomocysteinemia and UA were also significantly associated with disease progression. @*Conclusion@#This study found that clinical data, lipids and metabolic complications were closely related to ApoE genotypes and alleles, and also disease progression and type.
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Objective:To explore the effect of O2O model on young and middle-aged lymphoma patients undergoing chemotherapy.Methods:From February to December in 2019, 68 newly diagnosed lymphoma patients who were hospitalized in the lymphoma ward of our hospital were selected as the research object, and divided into intervention group (32 cases) and control group according to the order of admission (36 cases), the intervention group was used O2O model, and the control group was used general care combined with symptom diary, after 6 cycles′ intervention time, We compare the effects of the two groups of patients by using self-management scale and quality of life assessment scale.Results:Comparison of self-management ability: after intervention, the patients in the intervention group scored in the six dimensions of total self-management, daily life management, symptom management, psychological management, communication with medical staff, information management and self-efficacy, respectively(4.37±0.31), (4.05±0.47), (4.45±0.54), (4.10±0.45), (4.30±0.49), (3.88±0.59), (4.73±0.34) points, the control group were (3.92±0.43), (3.75±0.61), (3.55±0.69), (3.75±0.66), (3.58±0.86), (3.26±0.80), (4.40±0.74) points, the difference between the two groups was statistically significant ( t value was 2.263-5.944, P <0.05). Comparison of quality of life: after intervention, the scores of the patients in the intervention group in the two dimensions of total quality of life, physical condition and condition were (68.52±9.02), (16.97±2.31), (15.13±2.60) points, the control group were (64.06±6.84), (14.81±2.04), (13.97±1.99) points, the difference between the two groups was statistically significant ( t value was 2.337, 4.101, 2.065, P<0.05). Conclusions:The O2O model can improve the self-management ability of patients with lymphoma and improve the quality of life of patients during chemotherapy.
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Objective:To investigate the positive rate for 2019-nCoV tests and co-infections in Wuhan district.Methods:A total of 8 274 cases in Wuhan were enrolled in this cross-sectional study during January 20 to February 9 in 2020, and were tested for 2019-nCoV using fluorescence quantitative PCR. Both respiratory tract samples (nasopharynx, oropharynx, sputum and alveolar lavage fluid) and non-respiratory tract samples (urine, feces, anal swabs, blood and conjunctival sac swabs) were collected. If both orf1ab and N genes are positive, they are classified as nucleic acid test positive group; if both orf1ab and N genes are negative, they are classified as negative group; if single gene target is positive, they are classified as suspicious group. Individuals were divided into male group and female group according to sex. At the same time, 316 patients were tested for 13 respiratory pathogens by multiplex PCR.Results:Among the 8 274 subjects, 2 745 (33.17%) were 2019-nCoV infected; 5 277 (63.77%) subjects showed negative results in the 2019-nCoV nucleic acid test; and 252 cases (3.05%) was not definitive (inconclusive result). The age of cases with COVID-19 patients and inconclusive cases was significantly higher than that of cases without 2019-nCoV infection (56>40, t=27.569, P<0.001; 52>40, t=6.774, P<0.001). The positive rate of 13 respiratory pathogens multiple tests was significantly lower in 104 subjects who were positive for 2019-nCoV compared with those in subjects who were negative for 2019-nCoV test (5.77% vs 18.39%, χ 2=24.105, P=0.003). Four types of respiratory tract samples and five types of non-respiratory tract sampleswere found to be positive for 2019-nCoV nucleic acid test. Conclusion:The 2019-nCoV nucleic acid positive rate inmale is higher than infemale. Co-infections should be pay close attention in COVID-19 patients. 2019-nCoV nucleic acid can be detected in non-respiratory tract samples.
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Objective@#To investigate the positive rate for 2019-nCoV tests and co-infections in Wuhan district.@*Methods@#A total of 8 274 cases in Wuhan were enrolled in this cross-sectional study during January 20 to February 9, 2020, and were tested for 2019-nCoV using fluorescence quantitative PCR. Both respiratory tract samples (nasopharynx, oropharynx, sputum and alveolar lavage fluid) and non-respiratory tract samples (urine, feces, anal swabs, blood and conjunctival sac swabs) were collected. If both orf1ab and N genes are positive, they are classified as nucleic acid test positive group; if both orf1ab and N genes are negative, they are classified as negative group; if single gene target is positive, they are classified as suspicious group. Individuals were divided into male group and female group according to sex. At the same time, 316 patients were tested for 13 respiratory pathogens by multiplex PCR.@*Results@#Among the 8 274 subjects, 2 745 (33.2%) were 2019-nCoV infected; 5 277 (63.8%) subjects showed negative results in the 2019-nCoV nucleic acid test; and 252 cases (3.05%) was not definitive (inconclusive result). The age of cases with COVID-19 patients and inconclusive cases was significantly higher than that of cases without 2019-nCoV infection (40 vs 56, t=27.569, P<0.001; 52 vs 56, t=6.774, P<0.001). The positive rate of 13 respiratory pathogens multiple tests was significantly lower in 104 subjects who were positive for 2019-nCoV compared with those in subjects who were negative for 2019-nCoV test (5.77% vs 18.39%, χ2=24.105, P=0.003). Four types of respiratory tract samples and five types of non-respiratory tract samples were found to be positive for 2019-nCoV nucleic acid test.@*Conclusion@#The 2019-nCoV nucleic acid positive rate in male is higher than in female. Co-infections should be pay close attention in COVID-19 patients. 2019-nCoV nucleic acid can be detected in non-respiratory tract samples.
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Objective@#To investigate the effect of symptom diary on the self-management ability of lymphoma patients.@*Methods@#A convenient sampling method was adopted to select 57 cases of lymphoma patients who received chemotherapy from February to October 2018 as the study subjects. According to the order of admission, they were divided into the intervention group (n = 25) and the control group (n = 32). The control group received the lymphoma department chemotherapy nursing routine; The intervention group applied symptom diary intervention on the basis of routine nursing, and evaluated the self-management ability of patients in the two groups before the first cycle and after the sixth cycle of chemotherapy, respectively.@*Results@#There was no significant difference in the scores of self-management ability between the two groups before intervention (P>0.05). The self-management scores of the two groups were both improved before and after the intervention, and the intervention group was higher than the control group. The difference was statistically significant (P<0.05); after intervention, for total self-management ability and the four dimensions of daily life management, symptom management, medical staff communication, and information management. the intervention group scored (4.16±0.28), (4.31±0.44),(4.31 ± 0.44), (4.38 ± 0.48), (3.96 ± 0.60) points, significantly higher than the control group (3.85 ± 0.45), (3.96 ± 0.45), (3.96 ± 0.57), (3.64 ± 0.77), (3.26±0.68) points, the difference was statistically significant (t=2.235-4.175, P<0.05).@*Conclusion@#The application of symptom diary can effectively improve the self-management ability of patients with lymphoma during chemotherapy, stimulate the ability of patients to cope with disease, improve the quality of life of patients, and promote rapid recovery.
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Objective@#To evaluate the effects of early mobilization combined with occupational therapy on delirium of mechanical ventilated patients.@*Methods@#Sixty-eight patients who were undergoing mechanical ventilation and met the inclusion as well as exclusion criteria were randomized into an intervention group (35 patients) and a control group (33 patients). Patients in both group were provided with ICU routine care to prevent delirium, while early mobilization combined with occupational therapy was given in intervention group. Incidence rate of delirium, length of delirium, dosage of sedation, length of mechanical ventilation, length of ICU stay and physical restraint rate were compared. Occurrence of adverse events during intervention was also observed.@*Results@#In intervention group,the incidence rate of delirium was 25.71%(9/35), length of delirium was (1.69±2.98) days, dosage of propofol was (2 189.71±1 222.23) mg, length of ventilation was (4.86±1.31)days, and physical restraint rate was 43.64%(146/275), all of which were significantly better than those in control group, which were 53.28%(17/33), (2 736.36±1 298.99) mg, (5.88±1.52)days, 53.28%(160/254) (χ2=4.788, 7.251, t=3.910, 2.980, P<0.05 or 0.01). There was no unpredicted issue occurred during intervention.@*Conclusions@#Early mobilization combined with occupational therapy is feasible which could alleviate ICU delirium, reduce the dosage of sedation, the length of mechanical ventilation, and the physical restraint rate.
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Objective To investigate the effect of symptom diary on the self-management ability of lymphoma patients. Methods A convenient sampling method was adopted to select 57 cases of lymphoma patients who received chemotherapy from February to October 2018 as the study subjects. According to the order of admission, they were divided into the intervention group (n=25) and the control group (n=32). The control group received the lymphoma department chemotherapy nursing routine; The intervention group applied symptom diary intervention on the basis of routine nursing, and evaluated the self-management ability of patients in the two groups before the first cycle and after the sixth cycle of chemotherapy, respectively. Results There was no significant difference in the scores of self-management ability between the two groups before intervention (P>0.05). The self-management scores of the two groups were both improved before and after the intervention, and the intervention group was higher than the control group. The difference was statistically significant (P<0.05); after intervention, for total self-management ability and the four dimensions of daily life management, symptom management, medical staff communication, and information management. The intervention group scored (4.16±0.28) , (4.31±0.44) ,(4.31 ± 0.44), (4.38 ± 0.48), (3.96 ± 0.60) points, significantly higher than the control group (3.85 ± 0.45), (3.96 ± 0.45), (3.96 ± 0.57), (3.64 ± 0.77), (3.26±0.68) points, the difference was statistically significant (t=2.235-4.175, P<0.05). Conclusion The application of symptom diary can effectively improve the self-management ability of patients with lymphoma during chemotherapy, stimulate the ability of patients to cope with disease, improve the quality of life of patients, and promote rapid recovery.
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Objective To evaluate the effects of early mobilization combined with occupational therapy on delirium of mechanical ventilated patients. Methods Sixty- eight patients who were undergoing mechanical ventilation and met the inclusion as well as exclusion criteria were randomized into an intervention group (35 patients) and a control group (33 patients). Patients in both group were provided with ICU routine care to prevent delirium, while early mobilization combined with occupational therapy was given in intervention group. Incidence rate of delirium, length of delirium, dosage of sedation, length of mechanical ventilation, length of ICU stay and physical restraint rate were compared. Occurrence of adverse events during intervention was also observed. Results In intervention group ,the incidence rate of delirium was 25.71% (9/35), length of delirium was (1.69 ± 2.98)days, dosage of propofol was(2 189.71±1 222.23)mg, length of ventilation was (4.86±1.31)days, and physical restraint rate was 43.64% (146/275), all of which were significantly better than those in control group, which were 53.28%(17/33), (2 736.36±1 298.99) mg, (5.88±1.52)days, 53.28%(160/254) (χ2=4.788, 7.251, t=3.910, 2.980, P＜0.05 or 0.01). There was no unpredicted issue occurred during intervention. Conclusions Early mobilization combined with occupational therapy is feasible which could alleviate ICU delirium, reduce the dosage of sedation, the length of mechanical ventilation, and the physical restraint rate.
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Objective To investigate the current state of psychological distress of lymphoma patients'caregivers, and analyze its influencing factors. Methods From October 2017 to February 2018, 96 pairs (patients and their caregivers) from the department of lymphoma were enrolled. Distress Thermometer and self-designed general scale were adopted to conduct survey. Results The psychological distress score of lymphoma caregivers was as high as (4.76 ± 2.28) points, which was significantly higher than the patient's score (3.81±2.33) points, the difference was statistically significant (t=4.070,P<0.05 ). Different ages, economic status, and patient's disease of caregivers had different psychological distress, and the difference was statistically significant (P<0.05). Meta-linear regression analysis showed that age and patient psychological distress were the main influencing factors of psychological distress of lymphoma patients'caregivers, which could explain the variability of 32.7％(P<0.05). Conclusions The psychological distress of lymphoma patients'caregiver is at a moderate level, which is affected by their age and psychological distress of the patients. It suggests that clinical medical staff should pay attention to the psychological distress of patients and strengthen the psychological support of caregivers to better promote patient care.
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Objective To evaluate the value of matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) in detecting carbapenemases-producing Enterobacteriaceae. Methods Sixty-one carbapenemase-producing Enterobacteriaceae (CPE) and 108 carbapenemase-none-producing Enterobacteriaceae(NCPE) strains that isolated in the Renmin Hospital of Wuhan University from February 2016 to February 2017 were used in this study. Twenty CPE strains and 20 NCPE strains were se-lected and used to establish the optimum reaction system of MALDI-TOF MS for the detection of carbapene-mase-producing Enterobacteriaceae strains. Results The optimal reaction system of MALDI-TOF MS was successfully established:equal volumes of imipenem solution (1 mg/ml) and bacterial suspension (2 Mc-Farland turbidity standard) were first mixed together and incubated at 37℃ for 20 min,and then the super-natant was detected by MALDI-TOF MS after centrifugating. It would be a carbapenemase-producing strain if the peak of (300±0.55) m/z in the mass spectrum of imipenem disappeared completely. MALDI-TOF MS was used to identify carbapenemase-producing Enterobacteriaceae strains among the 169 strains and the result was consistant with that by using carbapenemase gene detection. Conclusion MALDI-TOF MS could accu-rately and rapidly detect carbapenemases-producing Enterobacteriaceae. It could be used as a routine method to provide references for early anti-infective treatment and infection control in hospitals.
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Objective The objective of this study was to compare the differences between Volumetric Modulated Arc Radiotherapy(VMAT)and Fixed Field dynamic Intensity Modulated Radiotherapy(dIMRT)in dose distribution of target and organ at risk and treatment time,and to provide basis for clinical treatment.Methods Ten patients with postoperative of cervical carcinoma were selected,VMAT and seven fields dIMRT plans were designed for each patient in Monaco 5.11 planning system.We compared the differences of dose distribution of target and organ at risk,monitor units and treatment time between VMAT and 7dIMRT.Results The average dose of target for VMAT plan(46.86 Gy)was higher than that of 7dIMRT plan(46.68 Gy)(P<0.05).The percentage of the V10 and V20 of rectum and the V30 of small intestine in VMAT plan was 0.63%,3.34% and 4.14% higher than that in 7dIMRT plan,respectively(P<0.05).The conformal index(CI),homogeneity index(HI)of PTV and the other exposure dose of organ at risk for both plans were no significant differences.The average monitor units and treatment time of VMAT plan were 13.4% and 50.6% than that of 7dIMRT plan,respectively(P<0.05).Conclusion The dose distribution of VMAT plan is better or equal to that of 7dIMRT plan,but the monitor units and treatment time of VMAT plan is decreased significantly,we suggest that VMAT plan should be used for postoperative of cervical carcinoma in clinical.
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Bacterial resistance has become a serious problem that the whole world is facing.Routine bacterial drug resistance testing methods such as K-B test and dilution method are time-consuming and incapable to identify the specific drug resistance mechanism , which can not meet the needs of clinicians. MALDI-TOF MS overcomes the shortcomings of traditional methods and has broad application prospects in detection of bacterial resistance and drug resistance mechanism.This article reviews the recent progress on the application of MALDI-TOF MS in detection of bacterial drug resistance mechanisms.
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Objective To explore related symptom clusters of patients with lymphoma receiving chemotherapy, and to investigate the categories and influencing factors. Methods From the period of September to December 2016, 111 inpatients with lymphoma receiving chemotherapy were enrolled from the department of lymphoma. Anderson Syptom Assessment Scale Chinese version (MDASI-C), Self-designed general scale and ECOG physical status score were adopted to conduct survey. Results During chemotherapy, the first three syndromes with the highest incidence and most severe were dry mouth, sleep disturbed and fatigue, their incidence rates were 79.3%(88/111), 75.7%(84/111) ,73.0%(81/111), the severity degree was 2(1-4), 2(1-4), 2(0-5). By exploratory factor analysis, three syndrome clusters were found out: sleep-gastrointestinal symptom group, fatigue-psychological symptom group and disease symptom group. Multiple linear regression analysis showed that the influencing factors of the digestive tract symptom group were gender, number of chemotherapy. The fatigue-psychological symptoms were sex, ECOG score, marriage. The disease symptom group was timess of chemotherapy (t=-2.326-3.917, P<0.05 or 0.01). Conclusions The incidence of related syndromes in patients with chemotherapy is high, some constitute syndrome clusters. Gender, marriage, ECOG score, number of chemotherapy are related factors of the syndrome clusters.
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Objective We aimed to explore the difference of dosimetry among intensity modulated radia-tion therapy(IMRT),volumetric modulated arc therapy(VMAT)and helical tomotherapy(TOMO)in the radio-therapy of medulloblastoma.Methods Ten children's patients with the medulloblastoma were selected and de-signed in this study.A clinically feasible radiotherapy plan was designed for IMRT(5 fields),VMAT and TOMO. Conformality index(CI),homogeneity index(HI),V107,maximum dose(Dmax),organ at risk(OAR)dose-volume level,monitor units and treatment time were used to analyze in these groups.Results CI,HI,V107,Dmaxand OAR of target areas were significantly superior to VMAT and IMRT in the TOMO group of target PTV for whole brain full radiotherapy.The organ at risk dose-volume level in the TOMO group was lower than that in VMAT and IM-RT(5 fields)groups(P<0.05).The TOMO group also had the most monitor units and the longest treatment time (P<0.05).Hence,the patients in the TOMO group could irradiate completely the whole brain and full spinal cord without moving treatment couch to avoid the error from the man-made movement in VMAT and IMRT(5 fields)treatments.Conclusion In the radiotherapy of medulloblastoma,the dose distribution of patients in the TOMO group are superior to the VMAT and IMRT groups(5 fields).However,the number of monitor units and treatment time is significantly increased during treatment,and its clinical effect needed to be further studies.