Death anxiety among advanced cancer patients: a cross-sectional survey.

PURPOSE: This study aimed to investigate death anxiety in advanced cancer patients and identify associated factors in the context of Chinese culture. METHODS: Participants (N = 270) with advanced cancer in a tertiary cancer hospital completed anonymous questionnaire surveys. Measures included the Chinese version of a Likert-type Templer-Death Anxiety Scale, Rosenberg's Self-esteem Scale, Medical Coping Modes Questionnaire, the Social Support Rating Scale, and Connor-Davidson Resilience Scale. Data were analyzed in SPSS using descriptive statistics, Student's t test, Pearson correlation test, and linear regression. RESULTS: Respondents returned 252 (93.33%) of the 270 questionnaires. The total CL-TDAS score was 39.56 ± 10.20. The top three items were "I fear dying a painful death" (3.59 ± 1.41), "I often think about how shortly life really is" (3.11 ± 1.33), and "1 am not particularly afraid of getting cancer" (3.09 ± 1.35). Associated factors of death anxiety (R2 = .333, F = 15.756, p < .001) were the medical coping mode (resignation, confronce), self-esteem, the participants' adult children, the patient-primary caregivers' relationship, resilience, and the level of activity of daily living. CONCLUSIONS: Our results demonstrate high levels of death anxiety in advanced cancer patients. Generally, patients with adult children, high self-esteem and resilience had low death anxiety. Conversely, patients with low levels of activity of daily living and high coping mode (resignation, confrontation) reported high death anxiety. We determined that associated factors contributed to reduce death anxiety. Social interventions are recommended to improve the end-of-life transition for patients and caregivers.

Effect of TET2 gene mutation on the curative efficacy of myelodysplastic syndromes in children / 白血病·淋巴瘤

Objective:To explore the therapeutic effect of low-dose arsenous acid/tretinoin with or without low-dose cytarabine induction regimen on myelodysplastic syndromes (MDS) with TET2 gene mutation in children.Methods:Nine children with MDS who were hospitalized at the First Hospital of Harbin from March 2009 to April 2018 were collected, including 3 cases of refractory cytopenia of childhood (RCC), 4 cases of MDS with excess of blasts type Ⅰ (MDS-EBⅠ) and 2 cases of MDS with excess of blasts type Ⅱ (MDS-EBⅡ). The next-generation gene sequencing method (NGS) was applied to detect the TET2 gene mutation in bone marrow cells of children with MDS. The low-dose arsenous acid/tretinoin with or without low-dose cytarabine induction regimen was adopted to conduct tiered therapy on children with MDS. The clinical efficacy was assessed in line with the MDS response evaluation criteria adopted by the MDS International Working Group (IWG) in 2006.Results:Among the 9 patients, the short-term clinical efficacy was observed in 8 cases. Two patients with TET2 gene mutation achieved the short-term clinical efficacy of bone marrow complete remission (mCR) and hematological improvement (HI). Among 7 patients without TET2 gene mutation, 4 patients obtained CR, 1 patients obtained mCR and HI, and 1 patients obtained stable disease (SD) in terms of the short-term clinical efficacy.Conclusion:The low-dose arsenous acid/tretinoin with or without low-dose cytarabine regimen may be beneficial to MDS children with TET2 gene mutation.

Clinical observation of mucosal injury after high-dose methotrexate chemotherapy in children with acute lymphoblastic leukemia / 白血病·淋巴瘤

Objective:To investigate mucosal injury after high-dose methotrexate (HD-MTX) chemotherapy in treatment of children with acute lymphoblastic leukemia (ALL), and to analyze the association with methotrexate blood concentration, risk stratification and clinical efficacy.Methods:The data of 95 children with ALL who received 539 times of HD-MTX chemotherapy in the First Hospital of Harbin from November 2015 to October 2018 were retrospectively analyzed, and the association of mucosal injury with methotrexate blood concentration, disease risk degree and clinical efficacy was also analyzed.Results:Among 95 children who received 539 times of HD-MTX chemotherapy, the total incidence of mucosal injury was 8.4% (45/539); the incidence of mucosal injury was 4.6% (11/239), 7.6% (8/105), 13.3% (26/195), respectively in the low-risk group, middle-risk group and high-risk group. With the elevation of disease risk, the incidence of mucosal injury was increased ( χ2 = 10.787, P < 0.05). There was no correlation of the degree of mucosal injury with methotrexate blood concentration and disease risk degree (all P > 0.05), and the mucosal injury was not related with the clinical efficacy ( P > 0.05). Conclusion:After the application of HD-MTX in children with ALL, adjustment of the dose of rescue drug by monitoring of methotrexate blood concentration can improve the safety of therapeutic drugs.

Clinical observation and adverse reactions of different doses of mifepristone in treatment of uterine fibroids / 中国基层医药

Objective To investigate the adverse reactions of different doses of mifepristone in treatment of uterine fibroids.Methods 60 patients with uterine fibroids were randomly divided into observation group and control group,30 cases in each group.The control group was treated with high dose mifepristone of 20 mg/d, while the observation group was given 10mg/d of low dose mifepristone.The clinical efficacy,uterine fibroid volume,uterine volume and adverse reactions occurrence between the two groups were compared.Results The effective rate of the observation group was 90.00%,which was significantly higher than 73.33% of the control group,the difference was statistically significant (χ2 =7.584,P<0.05).The uterine myoma size and uterine volume in the two groups after treatment were significantly lower than before treatment,which in the observation group after treatment were (35.74 ± 7.69)cm3,(139.54 ±12.57)cm3 and significantly lower than (49.21 ±8.55)cm3,(178.36 ±14.02)cm3 in the control group,the differences were statistically significant (t=7.846,8.229,all P<0.05).The occurrence rate of headache,loss of libido and the incidence of nausea and vomiting in the observation group were 0.00%,0.00%, 3.33%,which were significantly lower than 13.33%,16.67%,20.00% in the control group,the differences were statistically significant(χ2 =9.523,10.885,8.527,all P <0.05).Conclusion Low dose mifepristone in the treatment of uterine fibroids can significantly improve the clinical efficacy,reduce the incidence of adverse reactions, which is worthy of clinical promotion.

Study of heparin on pregnant woman with recurrent pregnant loss and positive anti-phospholipid antibody / 中华围产医学杂志

0.05). The rate of antibody elimination [70.83% (17/24)]was significantly higher than that of control group [29.17%(7/24 ) ( P

The role of complement activation in D-galactosamine/lipopolysaccharide-induced acute hepatic necrosis of rat / 中国免疫学杂志

Objective:To investigate the important role of the activation of complement system on the experimental hepatic necrosis.Methods:The complement activation of classic pathway was evaluated by detecting sexum CH50.The local hepatic deposition of C3 in rat hepatic necxosis was detected by immunohistochemical technique.Results:Compared with the controlled,serum CH50 decreased on different degree in all the administrated groups alone with prolonged observing time-page.Submassive hepatic necrosis was observed in Ga1N/LPS treated rats in H-E sections,and SP.Stainning showed the local hepatic deposition of C3 existed limited to the kupffer cells,the membrane,hepatocyte and the necrotic hepatocyte zone.GaIN caused gentle liver tissue injury,namly monocyie infiltration,hepatocyte balloon degeneration and focus necrosis,but none of deposition of C3 was observed.LPS caused the same changes as that by Ga1N,but the local hepatic deposition of C3 was limited to the endothelial cells and kupffer cells.Conclusion:The activation of complement in serum,especially the local hepatic activation of complement,play an important role in Ga1N/LPS-induced acute hepatic necrosis of rat.Extra-LPS may cause the activation of complement system the in classic activation of C3.Pathway of rat,but the hepatic injury may probably be related to the local hepatic deposion.Ga1N induced hepatic injury may has no direct relationship to the complement activation in serum.