Effect of Auricular Acupressure on Acute Pain in Nursing Home Residents with Mild Dementia: A Single-Blind, Randomized, Sham-Controlled Study.

Introduction: Acute pain is a prevalent problem for dementia residents in nursing homes. A variety of intervention strategies have been applied to address this problem. However, there remains an issue of inadequate pain control. This study aims to explore the analgesic efficacy of auricular acupressure (AA) for dementia residents with acute pain in nursing homes. Methods: A multicenter, single-blind, randomized, and sham-controlled clinical trial was performed in three nursing homes in Yinchuan, China. All of the 206 eligible patients with acute pain were randomly divided into two groups for real AA therapy or sham AA (at sham point stimulation) therapy. The primary outcome was measured with a face pain scale revised (FPS-R) score before the procedure, 5 min after the start of the intervention, and 5 min after finishing the procedure. Secondary outcomes covered three physiological parameters, adverse reactions observed, satisfaction level of caregivers, acceptance of patients, and additional use of analgesics. Results: There was a significant difference in pain scores based on FPS-R between the two groups (p < 0.01). Pain score in the true AA group was 1.84 ± 0.23, compared with 2.22 ± 0.81 in the sham AA group. No adverse events were found during the whole procedure for all patients. The satisfaction level of caregivers and acceptance of patients in the real AA group were significantly higher than those in the sham AA group. Conclusion: This study shows that real AA was an alternative analgesic modality in reducing acute pain in patients with mild dementia.

Identifying the Unmet Supportive Care Needs, with Concomitant Influencing Factors, in Family Caregivers of Cancer Patients in China.

OBJECTIVE: The objective of the study is to assess the unmet needs of cancer caregivers and to identify the possible predictors of their supportive care needs in China. METHODS: This multicenter, cross-sectional study enrolled 449 cancer patients' family caregivers' dyads. Patients provided general information and Karnofsky performance status (KPS); caregivers provided general information and completed a survey of Chinese version of the Supportive Care Needs Survey-Partners and Caregivers Scale. The independent samples t-test, one-way analysis of variance, and multiple stepwise regression were used to analyze the factors that influence the needs of caregivers. RESULTS: A proportion of caregivers who had no needs were 5.6%. A proportion of caregivers with ≥ 5 moderate or high unmet needs and with ≥ 10 moderate or high unmet needs were 77.7% and 63.2%, respectively. Healthcare services and information needs and communication and relationship needs were the most prominent areas of caregivers' unmet needs. The item "Finding out about financial support and government benefits for you and/or the person with cancer" was the highest level of unmet needs at 78.6%. The level of unmet needs was related to the patient's physical function (KPS score), caregiver's educational levels, financial burden of healthcare, as well as the level of burden related to caregiving (working status, caring for others, caregiving experience, and total caregiving time). CONCLUSIONS: The level of unmet needs of family caregivers of cancer patients in China was higher. In clinical practice, more attention should be paid to family caregivers who take care of the patient with poor physical function, those who are highly educated, faced with higher financial burden of healthcare, and are currently working, as well as those who need to take care of others, spend more time caregiving, and have no caregiving experience.

Identifying the unmet supportive care needs, with concomitant influencing factors, in adult acute leukemia patients in China.

PURPOSE: To understand the supportive care needs (SCNs), with associated influencing factors, related to five unmet need dimensions in adult Acute Leukemia (AL) patients, in China. METHODS: This multi-center cross-sectional study enrolled 340 pathologically confirmed adult, Chinese AL patients who were requested to complete a self-reported questionnaire, detailing demographic information, general status and physical functions, and Supportive Care Needs Survey-Short Form 34 (SCNS-SF34), revealing their unmet SCNs. The variables were statistically analyzed. RESULTS: A total of 311 (91.4%) effective questionnaires were retrieved. Among the 5 dimensions, the health information dimension scored the highest, 47.72(43.18), followed by psychological dimension, 35.00(32.50), while the sexual need scored the lowest, 0.00(24.99). As per multiple stepwise regression analysis, marital status, treatment stages and Karnofsky Performance Status index (KPS) score significantly influenced the health information dimension, while the age and "whether the treatment was the initial one or not" influenced sexual need dimension. KPS score and income were the common factors influencing the rest of the three dimensions with treatment stage adding to two of them except "physiological and daily living needs" dimension. "Being informed about your test results as soon as possible", "Being informed about things you can do to help yourself to get well" and "Being informed about cancer which is under control or in remission" were the three highest scoring entries. CONCLUSIONS: The results of this study reveal the unmet SCN's, with its influencing factors, in AL patients, the understanding of which may be of assistance in designing/delivering effective clinical nursing intervention.

Factor analysis of the Caregiver Quality of Life Index-Cancer (CQOLC) scale for Chinese cancer caregivers: a preliminary reliability and validity study of the CQOLC-Chinese version.

The English version of the Caregiver Quality of Life Index-Cancer (CQOLC) was translated into simplified Chinese (CQOLC-C), following cultural translation, back-translation and pretest steps. Three hundred and sixty one cancer caregivers participated in this study. Cronbach's alpha was used to assess CQOLC-C reliability. Exploratory factor analyses (EFA) was used to generate two models of the measure's factor structure, and confirmatory factor analyses (CFA) were used to test each model, such that the best model to explain the latent structure of the CQOLC-C was identified. EFA using different factor extraction methods yielded two models including four and eight factors. According to the CFA results, model 2 was better fit for the original study data, based on the RMSEA criterion [0.058(90% CI = 0.051-0.065)], χ2 (531) = 853.92, p < 0.0001; CFI (0.96), NNFI (0.96), IFI (0.97), and NFI (0.92). We also examined the effect of removing three items on the CQOLC-C factor structure and discuss the resulting differences from other versions. These results indicate that the CQOLC-C's factor structure does not fully fit the original theorized model. This study provides preliminary support for further use of the CQOLC-C. However, the present work provides only partial support for the relevance and construct validity of the scale for Chinese caregivers.

Quality of life of male spouse caregivers for breast cancer patients in China.

BACKGROUND: The aim of this study was to describe the characteristics of male spouse caregivers of breast cancer patients in China, assess their quality of life (QOL), and investigate the influencing factors. MATERIALS AND METHODS: A total of 243 breast cancer patient-spouse caregiver dyads were recruited from four hospitals in Shanxi and Anhui province of China. A cross-sectional design was applied to collect data and the Chinese version of the Medical Outcomes Study 36-item Short Form (SF-36) was used to measure caregivers' QOL, and the Chinese version of M.D. Anderson Symptom Inventory (MDASI-C) was applied to measure patient symptom severity and interference. Pearson's correlation was used to examine the correlations between caregiver burden and QOL. The multiple regression analysis was used to determine the most predictive factors influencing QOL. RESULTS: The scores of all SF-36 scales were above 50.0, which were much lower than that of general mainland Chinese males. Mental QOL was significantly worse than physical QOL. Spouses demographic characteristics, caregiving-related variables and patient symptoms were related to spouse QOL. Caregiver burden has a negative relationship with QOL. CONCLUSIONS: A decrease in life events and patient symptoms, as well as increase in spouse sleeping time and family income, ought to improve QOL.

Quality of life in rectal cancer patients with permanent colostomy in Xi'an.

OBJECTIVES: To observe the quality of life (QOL) in rectal cancer patients with permanent colostomy in different periods after operation. METHODS: A 1-,3-,6-month prospective study of QOL in 51 rectal cancer patients with permanent colostomy and 50 without permanent colostomy was assessed using European Organization for Research and Treatment of Cancer (EORTC) QOL-30 and CR38 questionnaires. RESULTS: The variation of QOL in different periods was "v" type. In the 1st postoperative month, these patients had the lowest quality of life scores, accompanied significantly varied functions and severe symptoms. Almost of all indexes of these patients had improved consistently in the postoperative period. The scores of global QOL even better than pre-operative level at 6th months post-operation, but the social function, body image, chemotherapy side effects and financial difficulties had not restored to the baseline level. Patients without permanent colostomy had a better score in most of categories of QOL-30 and CR38. CONCLUSIONS: The 1st postoperative month was crucial for patients' recovery, in which we should pay great attention to these problems which relate to the recovery of rectal cancer patients with permanent colostomy.

Symptom clusters and quality of life in China patients with lung cancer undergoing chemotherapy.

OBJECTIVE: To explore the symptom clusters and quality of life in patients with lung cancer undergoing chemotherapy. METHODS: A cross-sectional survey was completed with 183 patients from three public hospitals in Xi'an, China. Patients completed a demographic questionnaire, the Functional Assessment of Cancer Therapy-Lung Cancer (FACT-L) and the M. D. Anderson Symptom Inventory (MDASI-C). Factor analysis was used to identify symptom clusters based on the severity of patients' symptom experiences. The resulting clusters were correlated with quality-of-life measures. RESULTS: The QOL scores of lung cancer patients on the functioning subscale were the lowest (9.70±5.30), while those of the family subscale were the highest (19.28±3.24). Three symptom clusters were identified: gastrointestinal, emotional and fatigue-related symptoms. There was a negative relationship between the symptom clusters and multiple dimensions of quality of life (r -0.178 ∼-0.805, p< 0. 05). Females, especially those women with low education level /chronic diseases, were experienced greater symptom distress than others. CONCLUSIONS: The clusters had a negative relationship with QOL. Identifying symptom clusters helped clarify possible inter-relationships which may lead to the establishment of more effective symptom management interventions for patients with lung cancer in order to improve the quality of life.

Anti-diabetic activities of Acanthopanax senticosus polysaccharide (ASP) in combination with metformin.

Combination therapy had become very popular currently for the diabetes mellitus and its complications, because of long term unreasonable drug use and adverse reaction to human body. In this study, a polysaccharide (ASP) from the roots of Acanthopanax senticosus was evaluated as an adjuvant with metformin for antidiabetic therapy in alloxan-induced diabetic rats. The result identified ASP plus metformin had a more beneficial promotion for relieving the symptoms of diabetes and reversing liver and kidney damage to normal level than only metfomin administration to diabetic rats. The blood glucose, blood lipid (TC and TG), thiobarbituric acid reactive substances (TBARS), AST, ALT, ALP, total bilirubin, creatinine and urea levels in diabetic rats were decreased by combination of ASP and metformin. Furthermore, the body weight, liver glycogen formation, antioxidant substance (GSH) and antioxidant enzyme (SOD and GPX) levels increased evidently in diabetic mice treated with both ASP and metformin. In particular, sometimes ASP plus metformin could significantly reverse the pathophysiologic parameters of diabetic rats to normal level than only metformin administration. Therefore ASP could be developed to a new adjuvant combined with metformin for diabetes mellitus therapy in the future.

CD147 and VEGF co-expression predicts prognosis in patients with acute myeloid leukemia.

OBJECTIVE: To investigate the possible role of CD147 and vascular endothelial growth factor in progression and prognosis of acute myeloid leukemia. METHODS: Immunohistochemical staining was performed to detect the expression of CD147 and vascular endothelial growth factor in paraffin-embedded sections from 62 bone marrow biopsies obtained from an equal number of patients with newly diagnosed acute myeloid leukemia. RESULTS: CD147 and vascular endothelial growth factor expression in the bone marrow of acute myeloid leukemia patients were significantly higher than those in normal controls (both P < 0.001). Expression of them was significantly increased in patients with a high degree of microvessel density compared with those with a low degree (CD147: P = 0.009; vascular endothelial growth factor: P = 0.01) and correlated well with bone marrow microvessel density (CD147: P = 0.01; vascular endothelial growth factor: P = 0.02). In addition, higher levels of CD147 and vascular endothelial growth factor were also found in acute myeloid leukemia patients with an unfavorable karyotype compared with those with intermediate and favorable karyotypes (both P = 0.01). Moreover, the expression of CD147 was significantly correlated with that of vascular endothelial growth factor (P < 0.001). Furthermore, the co-expression of CD147 and vascular endothelial growth factor in the bone marrow indicated a poor prognosis in acute myeloid leukemia and was an independent prognostic factor for overall survival by multivariate analysis. CONCLUSIONS: Our data show for the first time that the co-expression of CD147 and vascular endothelial growth factor may indicate a poor prognosis in acute myeloid leukemia and may be a highly sensitive marker for predicting the clinical outcome of patients.

Expression patterns of ClC-3 mRNA and protein in aortic smooth muscle, kidney and brain in diabetic rats.

ClC-3, a member of the ClC family of voltage-gated chloride channels, regulates cell proliferation of cultured rat aortic vascular smooth muscle cells, pathogenesis of allergic rhinitis and tumor cell migration. However, its role in diabetic animals is still unknown. To address this issue, we investigated the expression patterns of ClC-3 in diabetic rats. Five-week-old Sprague-Dawley rats were divided into two groups, 50 non-diabetic control rats (non-DM) and 50 diabetic model rats (DM). ClC-3 mRNA and protein expression in aortic smooth muscle, kidney and brain tissues were examined by fluorimeter-based quantitive RT-PCR assay and Western blot analysis, respectively. ClC-3 mRNA and protein were endogenously expressed in aortic smooth muscle, kidney (cortex and medulla) and brain tissues of both control and streptozotocin-induced diabetic rats. ClC-3 mRNA and protein expression levels were significantly higher in aortic smooth muscle and brain tissues of diabetic rats, but significantly decreased in kidney medulla tissue, relative to non-DM controls. There were no significant differences in ClC-3 mRNA and protein expression in kidney cortex between non-diabetic control and diabetic rats. Furthermore, the altered ClC-3 expression patterns in diabetic rat aortic smooth muscle, brain, and kidney medulla tissues all correlated with the changes in blood glucose levels (p < 0.05). In conclusion, our data show for the first time that diabetes alters both the gene and protein expression of ClC-3 channels. These changes may contribute to the impaired vascular, brain and kidney functions observed in diabetes.