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Article in Chinese | WPRIM | ID: wpr-813230


To translate the English version of the 9-item Shared Decision Making Questionnaire (SDM-Q-9) into Chinese, and to test its reliability and validity in Chinese version.
 Methods: A total of 720 inpatients were recruited randomly from 6 hospitals in Changsha and were investigated using the Chinese version of SDM-Q-9. SPSS 23.0 and AMOS 23.0 were used to test the reliability and validity.
 Results: There were 660 participants completed and returned valid questionnaires (valid return rate was 91.7%). An analysis of internal consistency yielded a Cronbach's α at 0.945 and the correlation of test-retest reliability was 0.319 for whole instrument. The correlations between the items and total scale ranged from 0.790 to 0.879 (P<0.001). A single factor was extracted by exploratory factor analysis and it could explain 69.824% of the total variance. The confirmatory factor analysis revealed a good model fit. The goodness-of-fit index (GFI), adjusted goodness-of-fit index (AGFI), comparative fit index (CFI), normal fit index (NFI), and root mean square residual (RMR) were 0.870, 0.784, 0.926, 0.921, and 0.054, respectively.
 Conclusion: The Chinese version of SDM-Q-9 is proved to be reliable and eligible except the correlation of test-retest reliability is relatively low. It can be used to assess the patient's perspective in the process of shared decision making in clinical situation.

Decision Making , Factor Analysis, Statistical , Humans , Psychometrics , Reproducibility of Results , Surveys and Questionnaires
Article in Chinese | WPRIM | ID: wpr-464257


BACKGROUND:In recent years, the application of stem cel s to treat autoimmune diseases has become a hot spot. But, studies on umbilical cord blood mesenchymal stem cel s transplantation for the treatment of polymyositis/dermatomyositis are rarely reported. OBJECTIVE:To explore the immunologic mechanism of Th cytokines on the occurrence and development of polymyositis/dermatomyositis by observing the changes in serum interferon-γ, interleukin-4 and interleukin-17 in patients after umbilical cord blood mesenchymal stem cel s transplantation. METHODS:Eighty-one polymyositis/dermatomyositis patients were selected and divided into conventional therapy group (n=44) undergoing glucocorticoid and immunosuppressants therapy and cel transplantation group (n=37) undergoing intravenous infusion of umbilical cord blood mesenchymal stem cel s at a density of (3.5-5.2 )×107 . Dosing regimen was same in the two groups. After fol ow-up of 1, 3, 6 months, the changes of creatine kinase and myodynamia were evaluated;after fol ow-up of 3 and 6 months, lung imaging was evaluated;in the cel transplantation group, interferon-γ, interleukin-4 and interleukin-17 levels were detected before treatment and at 3 and 6 months after treatment. RESULTS AND CONCLUSION:At 1, 3, 6 months after treatment, the creatine kinase level was significantly decreased, and the muscle force grade was significantly increased in both groups (both P0.05). These findings indicate umbilical cord blood mesenchymal stem cel s transplantation combined with glucocorticoid and immunosuppressants therapy can adjust immune network effects and improve the immune tolerance in polymyositis/dermatomyositis patients, which is safe and effective.

Chinese Journal of Hematology ; (12): 277-281, 2015.
Article in Chinese | WPRIM | ID: wpr-282052


<p><b>OBJECTIVE</b>To analyze the clinical features, therapeutic methods and prognosis of primary breast lymphoma (PBL).</p><p><b>METHODS</b>Twenty-one PBL patients treated in Ruijin Hospital from January 2003 to December 2013 were included in this study, with 17 diffuse large cell lymphoma (DLBCL), 1 mucosa-associated lymphoid tumor (MALT), 1 follicular lymphoma (FL), 1 Burkitt lymphoma and 1 subcutaneous peniculitis T-cell lymphoma according to the WHO 2008 classification. Of 21 patients, only one patient with MALT has bulged tumor mass (>7 cm), other patients had tumor mass <5 cm. Six patients had core needle biopsy of tumor, 2 modified radical operation, and others tumor excision for diagnosis. All the patients received chemotherapy. The impacts of surgery, rituximab and prophylaxis with lumbar puncture on the outcomes of patients were analyzed. Survival was estimated using Kaplan-Meier method and compared by log-rank test. All the results were analyzed by SPSS 10.0.</p><p><b>RESULTS</b>Among 21 PBL patients, 19 achieved complete remission (CR), 1 partial remission (PR) and 1 disease progression (PD). Followed-up till July 2014, with median follow-up of 14 months (6-75 months), only one patient died, with 3-year survival of 92.3%. Compared with chemotherapy alone, the progression-free survival (PFS) of combination therapy (surgery plus chemotherapy) was significant longer (P=0.015), but without statistic differences of CR rate and overall survival (OS) between two groups. Among the 20 patients with CD20-positive tumor cells, 17 received Rituximab. PFS and OS, as well as CR rate of PBL had no difference between the treatment with and without Rituximab. The incidence of central nervous system (CNS) infiltration had no difference between patients with and without CNS prophylaxis through lumber-puncture and intrathecal injection.</p><p><b>CONCLUSION</b>With the common subtype of DLBCL, PBL patients had good outcome. Surgery, as a method to obtain tumor samples for diagnosis, could not prolong OS of patients. Therefore, radical operation shouldn't be recommended. PBL was reported to have high risk of CNS events, but prophylaxis with lumber puncture and intrathecal injection couldn't decrease the incidence of CNS infiltration.</p>

Breast Neoplasms , Combined Modality Therapy , Disease-Free Survival , Humans , Lymphoma , Prognosis , Remission Induction , Rituximab