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Objective:To explore the chain mediating effects of anxiety/depression and metacognition between somatic symptoms and fear of disease progression (FoP) in gynecological tumor patients.Methods:A total of 208 gynecological tumor patients were investigated by general demographic data, fear of progression questionnaire-short form(FoP-Q-SF), hospital anxiety and depression scale(HADS), metacognition questionnaire(MCQ) and somatic symptom scale(SSS). SPSS 25.0 was used for Pearson correlation analysis. The significance of mediating effect was tested by deviation corrected nonparametric percentile Bootstrap method using SPSS macro program PROCESS.Results:The scores of FoP-Q-SF, depression, anxiety, MCQ and SSS were (32.41±10.43), (6.43±4.17), (7.51±4.10), (68.44±16.04), (20.58±15.70) respectively. 48.56% of gynecological tumor patients had dysfunctional fear of disease progression. Correlation analysis showed that FoP was significantly positively correlated with somatic symptoms ( r=0.394, P<0.01), anxiety ( r=0.640, P<0.01), depression ( r=0.533, P<0.01) and metacognition ( r=0.489, P<0.01). Mediating effect test showed that anxiety, depression and metacognition played a complete chain mediating role between somatic symptoms and FoP in gynecological tumor patients.The total effect of somatic symptoms on FoP was 0.320. Somatic symptoms indirectly affected FoP by influencing anxiety and metacognition, and the intermediary effect value was 0.242. Somatic symptoms indirectly affected FoP by influencing depression and metacognition, and the intermediary effect value was 0.212. Conclusion:Somatic symptoms can indirectly affect FoP through the chain mediation of anxiety/depression and metacognition.
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During the occurrence, development and treatment of gynecological tumors, mainly including cervical cancer, endometrial cancer and ovarian cancer, patients are prone to sleep disorders which seriously affect the quality of life. At present, there are few relevant studies on gynecological tumors associated with sleep disorders, and there is a lack of research on TCM syndromes, so there is no targeted treatment plan. This article mainly introduces the present situation of diagnosis and treatment of sleep disorders caused by gynecological tumors in Chinese and western medicine, to provide reference for further study.
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Objective:To explore the application value of nutritional support comprehensive nursing in patients with advanced gynecological tumor and analyze its impact on patients' quality of life.Methods:From May 2016 to August 2019, 110 patients with advanced gynecological tumors were enrolled in the First People′s Hospital of Lianyungang City. According to the random number table method, they were divided into control group and observation group with 55 cases in each group. The control group received standard nutritional nursing and the observation group received nutrition support comprehensive nursing. Three milliliters of fasting venous blood were collected at the time of admission and discharge for centrifugation. The serum albumin (ALB) and prealbumin (PA) levels of the two groups were measured. The body mass index (BMI) of the patients was calculated and the changes of their nutritional status were analyzed.The quality of life of cancer patients was evaluated by the European Cancer Research and Treatment Organization Quality of Life Questionnaire-Core 30 at the time of admission and discharge.Results:There was no significant difference in the serum ALB, PA and quality of life at the time of admission between the two groups( P>0.05). There was no significant difference in BMI at the time of admission and discharge in the two groups( P>0.05). The serum ALB and PA were (36.92±2.68), (0.26±0.07) g/L at discharge in the observation group, significantly higher than (35.42±2.71), (0.23±0.06) g/L in the control group ( t values were 2.918, 2.413, P<0.05). The scores of social function, emotional function, role function, physical function and total life quality score were 63.42±4.18,62.83±6.24,63.19±6.12,64.43±4.31,70.42±6.91 at discharge in the observation group,significantly higher than 57.34±5.06,56.39±7.37,60.45±5.99,61.46±5.08,66.35±5.96 in the control group ( t values were 2.373-6.870, P<0.05). The scores of diarrhea, constipation, insomnia, anorexia, nausea, fatigue in the observation group were 36.42±5.06,34.54±6.23,34.49±5.56,36.41±4.57,40.38±7.24,37.94±4.65,significantly lower than 40.83±4.81,38.74±5.12,38.43±4.97,40.43±6.24,43.29±5.12,40.19±3.97 in the control group ( t values were 2.434-4.685, P<0.05). Conclusions:Nutrition support comprehensive nursing for patients with advanced gynecological tumor can further improve their nutritional status and improve their quality of life.
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Objective@#To investigate the expression levels of long non-coding RNA LincROR in plasma and tissues of ovarian cancer patients and its value in the screening of ovarian cancer. @*Methods@#The plasma samples from 30 healthy women, 56 cases of ovarian cysts, 23 cases of endometriosis, 38 cases of endometrial carcinoma, 35 cases of cervical cancer, 42 cases of ovarian cancer, 21 cases of ovarian cancer after operation and 26 cases of ovarian cancer after chemotherapy were collected, and the expression levels of LincROR in these samples were detected by quantitative PCR. The diagnostic value of LincROR in common clinical gynecological diseases was evaluated combined with clinical data. @*Results@#The expression levels of LincROR in plasma of ovarian cancer patients (2.90± 4.42 ) were significantly higher than that in healthy women (0.23±0.28) and the patients with benign ovarian cysts (0.62±0.55, P ＜ 0.01 ). The results of ROC curve analysis showed that the diagnostic value of plasma LincROR in the screening of breast cancer was better than that of CA125, CA199, CA153, AFP and CEA. The sensitivity and specificity of combined screening of LincROR and CA125 for ovarian cancer were 89.7% and 86.7%, respectively (AUCROC=0.918, 95% CI :0.817-0.973). In addition, the expression levels of plasma LincROR in the postoperative patients were significantly lower than that in the ovarian cancer patients without any treatment (0.50±1.72 vs 2.90±4.42, P ＜0.01). The ROC curve analysis showed that plasma LincROR was more sensitive than CA125 in evaluating the efficacy of chemotherapy for ovarian cancer (AUCROC: 0.866 vs 0.738). @*Conclusion@#LincROR is expected to be an ideal biomarker for the screening of ovarian cancer, and has potential clinical value in evaluating the efficacy of chemotherapy for ovarian cancer. Combination of LincROR with CA125 may improve the sensitivity and specificity of the screening of ovarian cancer
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Radiotherapy is an important method in the treatment of gynecological malignant tumors,but it also causes great damage to female reproductive and endocrine function.This article reviews the effects of radiotherapy on reproductive and endocrine function in women and protective methods.
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Objective • To explore therapeutic effects of far-infrared radiation (FIR) therapy on chronic lower extremity lymphedema accompanied with dermatolymphangioadenitis (DLA), occurring after gynecological tumor resection. Methods • The enrolled patients received regular sessions using the FIR therapy machine over the 20-day treatment course (five days in each week). Clinical and laboratory outcome measures were carried out before and after treatment. Clinical outcome measures included DLA seizure frequency, patients' subjective feedback, quality of life, and side effects. Laboratory outcome measures included bacterial cultures and concentrations of in.ammatory cytokines, detected in serum and local lymphedema tissue.uid samples. Results • A total of 64 cases completed FIR treatment and clinical curative effect evaluation, including 11 cases at the same time completing the laboratory tests. The frequency of DLA decreased during treatment (P=0.000). The ef.ciency rate was more than 50% for 63 (98%) patients receiving treatment. Even 50 patients (78%) did not experience a single episode of DLA recurrence in the whole year after treatment. Patients reported a subjective decrease in lymphedema-related symptoms (all P<0.05), including tightness, heaviness, pain, hardness, soreness, discomfort, heat, fullness, weakness, and numbness. Patients' quality of life was improved after treatment (P=0.000). Laboratory analysis showed an elevation in serum concentration of IL-1β after FIR therapy (P<0.05) and reduction in local tissue.uid concentrations of IL-2, IL-10 and IL-18 (all P<0.05). Bacterial culture results were both negative before and after treatment. Conclusion • FIR therapy provides an effective treatment modality for patients with chronic lymphedema accompanied with DLA that develops secondarily from the treatment of gynecological malignancies, whose therapeutic effects may be due to reduce immune dysfunction within local lymphedema tissues.
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Objective:To explore the predictive value of human serum epididymis protein 4 (HE4), carbohydrate antigen 72-4 (CA72-4) and vascular endothelial growth factor (VEGF) for the recurrent risk of gynecological tumor. Methods: A total of 142 patients with gynecologic malignant tumors were divided into the observation group, and all of them were followed up, and their recurrence rate within 2 years after operation was calculated. At the same time, 50 healthy women were divided into control group. The peripheral venous blood of all subjects were collected to test serum HE4 and VEGF levels by using enzyme-linked immunosorbent assay (ELISA). The serum CA72-4 was detected by using Roche electrochemiluminescence immunoassay. Three indicators of two groups were compared. Results: Before treatment, the serum HE4, CA72-4 and VEGF levels of the observation group were significantly higher than those of the control group (t=58.971,t=26.795,t=42.021;P<0.01). And the positive rate of HE4, CA72-4 and VEGF of the gynecological tumor group were significantly higher than those of the control group (x2=50.061, x2=37.596,x2=43.765,P<0.01). Within post-operative 2 years, there were 84 cases were recurrence in observation group. And the HE4, CA72-4 and VEGF of recurrent patients were significantly higher than that of non-recurrent patients (t=53.075,t=22.211,t=55.948,P<0.01).The sensitivity and negative predictive value of the combined detection of 3 indicators were significantly larger than that of single detection of CA72-4 (x2=8.537,x2=5.345, P<0.05).Conclusion: Patients with gynecological malignant tumor have high expression of serum HE4, CA72-4 and VEGF and the combined detection of 3 indexes possessed more sensitive, and it has greater predictive value for the recurrent risk of gynecologic malignant tumor.
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Objective To analyze rationality of blood transfusion in gynecologic tumor patients during perioperative period and provide policy suggestions for reasonable blood transfusion .Methods Clinical data of 110 patients with gynecologic tumor were ex‐tracted and retrospectively analyzed .All the 110 patients underwent operations ,including 50 benign tumor and 60 malignant tumor . To analyze the rationality and specialty of blood transfusion in preoperative period of gynecologic tumor .Results The total ration‐ality of blood transfusion in perioperative period of gynecologic tumor was 75 .5% .The rationality blood transfusion proportions of pre‐operation ,during operation with bleeding volume less than or equal 500 mL ,during operation with bleeding volume more than 500 mL ,post‐operation were 78 .2% ,54 .5% ,79 .5% ,75 .7% respectively .The rationality of the four blood transfusion had no sta‐tistical significance(F = 8 .19 ,P > 0 .05) .Conclusion The unreasonable blood transfusion in perioperative period of gynecologic tumor is 24 .5% ,blood transfusion in perioperative period should be further strengthened .
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Laparoscopic surgery is widely used in the treatment of gynecological malignancies,including the radical surgery or staging surgery of early cervical cancer,endometrial cancer and ovarian cancer.Its feasibility and safety of clinical practice in gynecologic malignancies has been approved,and the postoperative follow-up results indicate that the effectiveness of laparoscopic surgery is similar to open surgery.But the laparoscopic surgery treatment of gynecological malignancies is still in dispute.The research will focus on the affects of pneumoperitoneum to the malignant behavior of tumor cells and the mechanism about implantation metastasis of puncture site in future.
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Objective:To apply positive composite training on gynecologic tumor patients for psychological intervention,comparing with the general intervention,and to provide a new way to alleviate physical and psychological symptoms of patients and improve their quality of life.Methods:In Beijing Cancer Hospital,80 surgery and chemotherapy patients with gynecologic tumor were chosen and divided into control group (40 cases,to receive health education and supportive treatment) and intervention group (40 cases,to receive comprehensive training),whose condition and basic situation were matching.After intervention,the scores of Symptom Checklist 90 (SCL-90) and Quality of Life Questionnaire- Core 30 (QLQ-C30) were compared between the two groups.Results:After intervention,the SCL-90 scores in intervention group (outside terrorist and interpersonal sensitivity factor) were lower than that in control group[such as total score,(1.43±0.34) vs.(1.87±0.43),P<0.001].The scores of physical function,role function,emotional function,cognitive function,and general health in the QLQ-C30 about patients with chemotherapy in intervention group were higher than those in controls[such as general health,(62.50±10.29) vs.(52.50±15.78),P=0.024].And the scores of fatigue,nausea and vomiting,pain,insomnia,appetite loss,constipation,and diarrhea factors were lower than those in control group[such as fatigue,(52.77±16.07) vs.(65.55±20.36),P=0.034].Conclusion:The positive composite training is able to alleviate the physical and mental symptoms and improve their quality of life in gynecologic tumor patients.
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PURPOSE: It is not a simple task to achieve the ideal isodose curve with a standard vaginal applicator or single plane needle impant in the paravaginal tissue when primary or recurrent gynecological neoplasms (cervical cancers, vaginal cancers and vulvar cancers) are treated as a boost following external beam radiotherapy. The authors introduce the development and construction of a simple, inexpensive, customized applicator for volume implant to maximize the radiation dose to the tumor while minimizing the dose to the rectum and the bladder. MATERIALS AND METHODS: Nine patients underwent Ir-192 transperineal interstitial implantation for either recurrent (5 cases) or primary (3 cases) cervical cancers or primary vaginal cancer (1 case) between August 1994 and February 1998 at Ajou university hospital. First 3 cases were performed with a single plane implant guided by digital palpation. Because of inadequate isodose coverage in the tumor volume in first 3 cases, we designed and constructed interstitial vaginal applicator for volume implant to improve tumor dose distribution and homogeneity while sparing the surrounding normal tissue. Our applicators consist of vaginal obturator and perineal template that made of the clear acrylamide and dental mold material (Provil ). The applicators were customized individually according to the tumor size and its location. Both HDR and LDR irradiation were given with these applicators accomodating 6 Fr needles (Microselectron, Nucletron). The pretreatment planning prior to actual implant was performed whenever possible. RESULTS: Needles can be inserted easily and evenly into the tumor volume through the holes of templates, requiring less efforts and time for the implant prodecure. Our applicators made of materials available from commercial vendors. These have an advantage that require easy procedure, and spend relatively short time to construct. Also it was possible to fabricate applicators to individualize according to the tumor size and its location and to achieve the ideal isodose coverage. We found an accurate needle arrangement and ideal dose distribution through the CT scan that was obtained in 3 cases after needle implant. Three patients with primary cervical and vaginal cancers were controlled locally at final follow up. But all recurrent cases failed to do so. CONCLUSION: The authors introduce inexpensive, simple interstitial vaginal templates which were self-designed and constructed using materials available from commercial vendors such as acrylamide and dental mold material (Provil ).
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Humanos , Acrilamida , Braquiterapia , Comercio , Estudios de Seguimiento , Hongos , Agujas , Palpación , Radioterapia , Recto , Tomografía Computarizada por Rayos X , Carga Tumoral , Vejiga Urinaria , Neoplasias VaginalesRESUMEN
PURPOSE: It is not a simple task to achieve the ideal isodose curve with a standard vaginal applicator or single plane needle impant in the paravaginal tissue when primary or recurrent gynecological neoplasms (cervical cancers, vaginal cancers and vulvar cancers) are treated as a boost following external beam radiotherapy. The authors introduce the development and construction of a simple, inexpensive, customized applicator for volume implant to maximize the radiation dose to the tumor while minimizing the dose to the rectum and the bladder. MATERIALS AND METHODS: Nine patients underwent Ir-192 transperineal interstitial implantation for either recurrent (5 cases) or primary (3 cases) cervical cancers or primary vaginal cancer (1 case) between August 1994 and February 1998 at Ajou university hospital. First 3 cases were performed with a single plane implant guided by digital palpation. Because of inadequate isodose coverage in the tumor volume in first 3 cases, we designed and constructed interstitial vaginal applicator for volume implant to improve tumor dose distribution and homogeneity while sparing the surrounding normal tissue. Our applicators consist of vaginal obturator and perineal template that made of the clear acrylamide and dental mold material (Provil ). The applicators were customized individually according to the tumor size and its location. Both HDR and LDR irradiation were given with these applicators accomodating 6 Fr needles (Microselectron, Nucletron). The pretreatment planning prior to actual implant was performed whenever possible. RESULTS: Needles can be inserted easily and evenly into the tumor volume through the holes of templates, requiring less efforts and time for the implant prodecure. Our applicators made of materials available from commercial vendors. These have an advantage that require easy procedure, and spend relatively short time to construct. Also it was possible to fabricate applicators to individualize according to the tumor size and its location and to achieve the ideal isodose coverage. We found an accurate needle arrangement and ideal dose distribution through the CT scan that was obtained in 3 cases after needle implant. Three patients with primary cervical and vaginal cancers were controlled locally at final follow up. But all recurrent cases failed to do so. CONCLUSION: The authors introduce inexpensive, simple interstitial vaginal templates which were self-designed and constructed using materials available from commercial vendors such as acrylamide and dental mold material (Provil ).