The Validation of the Chinese (Cantonese) Version of the Patient Dignity Inventory in a Hong Kong Palliative Care Setting.

Context: To assess and address a patient's dignity and dignity-related distress would greatly benefit patients who have advanced stage disease. The Patient Dignity Inventory (PDI) allows clinicians to identify sources of dignity-related distress for patients. The PDI should be evaluated for use in a local Chinese setting. Objectives: To validate the Patient Dignity Inventory Hong Kong-Chinese (Cantonese) version (PDI-HK) and assess the psychometric properties in patients in an inpatient palliative setting in Hong Kong. Method: The English version of the PDI was translated and back translated, then reviewed by a panel including a clinician, clinical psychologist, and nurse clinician. Recruited patients would complete the PDI-HK, the Chinese version of Hospital Anxiety and Depression Scale (HADS), the McGill Quality of Life Questionnaire-Hong Kong (MQOL-HK), and the Edmonton Symptom Assessment Scale. Psychometric properties including internal consistency, concurrent validity, test-retest reliability, and factor analysis were tested. Results: A total of 97 consecutive patients were recruited into the study. The mean PDI score was 51.85 (range 25-102). Cronbach's alpha was 0.953 (p < 0.001). Concurrent validity with the HADS and MQOL-HK questionnaire was established. Factor analysis showed four factors, namely Existential Distress, Physical Change and Function, Psychological Distress, and Support. These were similar to previous PDI validation studies. Conclusion: The PDI was translated into Chinese (Cantonese) and applied in an inpatient palliative care unit in Hong Kong, with adequate validity. The PDI-HK version can be further used in a larger Chinese population to assess and address dignity-related issues.

Association between the LINC00673 rs11655237 C> T polymorphisms with cancer risk in the Chinese population: A meta-analysis.

OBJECTIVES: The present study aimed to conduct a meta-analysis of previously published studies in order to clarify the association of long noncoding RNA (lncRNAs) LINC00673 rs11655237 C> T polymorphism with cancer risk. DESIGN: Systematic review and meta-analysis. SETTING: Electronic databases of PubMed, EMBASE, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure, and Wanfang Database were used to search relevant studies. Studies published up to October 20, 2019 were included. The included studies were assessed in the following genetic model: allelic model, homozygote model, Heterozygote model, dominant model, recessive model. Data syntheses were conducted using STATA 12.0. PARTICIPANTS: Participants with various types cancers were included. PRIMARY AND SECONDARY OUTCOME MEASURES: Odds ratio (ORs) and 95% confidence interval (CIs) were calculated to assess the risk of tumor. RESULTS: Seven articles including 7 case-control studies, 7423 cases and 11,049 controls were adopted for meta-analysis. Our result demonstrated that LINC00673 rs11655237 C> T was related to the cancer among all model including allelic model (T vs C: pooled OR = 1.24, 95% CI = 1.16-1.41, P < .001), homozygous model (TT vs CC: pooled OR=1.54, 95% CI = 1.36-1.76, P < .001), heterozygous model (CT vs CC: pooled OR=1.24, 95% CI = 1.16-1.32, P < .001), dominant model (CT + TT vs CC: pooled OR=1.28, 95% CI = 1.20-1.36, P < .001) and recessive model (TT vs CT+ CC: pooled OR=1.42, 95% CI = 1.25-1.61, P < .001). Subgroup analysis also demonstrated that polymorphisms at this site also increased the risk of neuroblastoma. CONCLUSIONS: Our results find that rs11655237 contributed to occurrence of cancer in all models in Chinese population.

Clinical application of red cell distribution width, mean platelet volume, and cancer antigen 125 detection in endometrial cancer.

BACKGROUND: Red cell distribution width (RDW) and mean platelet volume (MPV) are considered to be associated with tumors. We investigated the diagnostic value of RDW, MPV, and cancer antigen 125 (CA125), alone or in combination, in the diagnosis of endometrial cancer and endometrial hyperplasia. METHODS: This study included 144 patients with endometrial cancer (stage I: 32; II: 42; III: 48; and IV: 22), 104 patients with endometrial hyperplasia, and 80 healthy control subjects. The whole blood cell parameters were analyzed by a Mindray Blood Cell Analyzer (CAL8000), whereas CA125 was analyzed using an Architect i2000 Analyzer (Abbott). RESULTS: Significant differences in RDW, MPV, and CA125 level were observed in the endometrial cancer, endometrial hyperplasia, and control groups (P < .05). Red cell distribution width was positively correlated (r = .735) whereas MPV was negatively correlated with (r = -.736) endometrial cancer staging. The area under the receiver operating characteristic curve of the combined diagnosis of endometrial cancer based on RDW, MPV, and CA125 was 0.924 (95% CI: 0.881-0.955). The sensitivity and specificity of the combined diagnosis were larger than those of the independent detections involving RDW, MPV, and CA125. CONCLUSIONS: The combination of RDW, MPV, and CA125 can improve the differential diagnosis of endometrial cancer and endometrial hyperplasia.

Comparison of Three Immunoassays Systems for Determining Serum Estradiol.

BACKGROUND: Estrogens are responsible for the development of the secondary female gender characteristics. Serum estradiol concentration measurements depend widely on automated immunoassay systems such as the Architect i2000SR, Cobas e601, and UniCel DxI 800. Here, we compare the performance of three automated immunoassay systems and investigate the correlation of serum estradiol levels. METHODS: The precision of the three automated immunoassay systems were evaluated by the Bio-Rad Laboratories Quality Control products according to the EP15-A2 document. Measurements of 81 serum samples from routine clinical specimens were completed on the Architect i2000SR, Cobas e601, and UniCel DxI 800 on the same day in our laboratory. Method comparison was performed using Bland-Altman and Passing-Bablok analyses. The correlation between the three detection systems was analyzed using the concordance correlation coefficient r. RESULTS: With the Bio-Rad Laboratories Quality Control products, we clearly demonstrated that the total inaccuracy of the Architect i2000SR detection systems is in the range of 1.61 - 5.64, the Roche Cobas e601 inaccuracy is in the range of 1.88 - 6.56, and the inaccuracy of the UniCel DxI 800 is in the range of 4.69 - 8.33. A Bland-Altman plot showed that serum estradiol concentrations determined by the Architect i2000SR were about 0.69 times those of the Roche Cobas e601, the Architect i2000SR concentrations were about 0.65 times those of the UniCel DxI 800, and the Roche Cobas e601 concentrations were about 0.96 times those of the UniCel DxI 800. The correlation coefficient r was 0.9936, 0.9857, and 0.9774 for the Architect i2000SR versus the Roche Cobas e601, the Architect i2000SR versus the UniCel DxI 800, and the Roche Cobas e601 versus the UniCel DxI 800, respectively. CONCLUSIONS: The Architect i2000SR system had better precision. The three detection systems have good correlation with each other, but there is a large gap between the results of their detection of estradiol.

Comparison of Architect i2000sr and Cobas e601 Systems for Determining Serum Human Chorionic Gonadotropin-Beta.

BACKGROUND: Human chorionic gonadotropin-beta (ß-hCG) is an important index used to monitor embryonic development following embryo transfer. Architect i2000sr and Cobas e601 are widely used automated immunoassay systems used to measure serum ß-hCG concentrations; however, the correlations between serum ß-hCG levels measured with these two immunoassays and the accuracy of the immunoassays have not been fully evaluated. METHODS: Serum ß-hCG levels were measured in 133 serum samples using the Architect i2000sr and Cobas e601 automated immunoassay systems. Passing-Bablok regression analysis was used to compare the correlation in serum ß-hCG levels obtained using the two immunoassays. A Bland-Altman plot analysis was used to identify mean ratios and 95% CIs of the mean ratios of the ß-hCG results between the two immunoassays. In this graphical method the mean ratios between the two techniques were plotted against the averages of the two techniques. RESULTS: The total coefficients of variations (CVs) of serum ß-hCG ranged from 3.12 - 4.66% for Cobas e601 and 3.18 - 4.99% for Architect i2000sr. The measured value of serum ß-hCG detected by the two immunoassays was statistically significant (p < 0.001). The Passing-Bablok regression analysis showed good correlation between the serum ß-hCG values measured using the two systems. At a low concentration of serum ß-hCG (< 10000 IU/L, n = 52), the correlation coefficient r was 0.9628. At a high concentration of serum ß-hCG (> 10000 IU/L, n = 81), the correlation coefficient r was 0.8076. The Bland-Altman plot analysis showed that the measured value of serum ß-hCG detected by Architect i2000sr was about 1.25 times higher than that of Cobas e601. The mean ratio was 1.12 at a low concentration of serum ß-hCG, and it was 1.33 at a high concentration. CONCLUSIONS: Architect i2000sr and Cobas e601 have good concordance for determining serum ß-hCG. However, the ß-hCG values measured with Architect i2000sr were 25% higher than those obtained using Cobas e601.

Can botulinum toxin decrease carer burden in long term care residents with upper limb spasticity? A randomized controlled study.

OBJECTIVE: To evaluate whether botulinum toxin can decrease the burden for caregivers of long term care patients with severe upper limb spasticity. METHOD: This was a double-blind placebo-controlled trial with a 24-week follow-up period. SETTING: A 250-bed long term care hospital, the infirmary units of 3 regional hospitals, and 5 care and attention homes. PARTICIPANTS: Participants included 55 long term care patients with significant upper limb spasticity and difficulty in basic upper limb care. INTERVENTIONS: Patients were randomized into 2 groups that received either intramuscular botulinum toxin A or saline. MAIN OUTCOME MEASURES: The primary outcome measure was provided by the carer burden scale. Secondary outcomes included goal attainment scale, measure of spasticity by modified Ashworth score, passive range of movement for shoulder abduction, and elbow extension and finger extension. Pain was assessed using the Pain Assessment in Advanced Dementia Scale. RESULTS: A total of 55 patients (21 men; mean age = 69, SD =18) were recruited. At week 6 post-injection, 18 (60%) of 30 patients in the treatment group versus 2 (8%) of 25 patients in the control group had a significant 4-point reduction of carer burden scale (P < .001). There was also significant improvement in the goal attainment scale, as well as the modified Ashworth score, resting angle, and passive range of movement of the 3 regions (shoulder, elbow, and fingers) in the treatment group which persisted until week 24. There were also fewer spontaneous bone fractures after botulinum toxin injection, although this did not reach statistical significance. No significant difference in Pain Assessment in Advanced Dementia scale was found between the 2 groups. No serious botulinum toxin type A-related adverse effects were reported. CONCLUSION: Long term care patients who were treated for upper limb spasticity with intramuscular injections of botulinum toxin A had a significant decrease in the caregiver burden. The treatment was also associated with improved scores on patient-centered outcome measures.