Socioeconomic Status Plays a Moderating Role in the Association Between Multimorbidity and Health-Related Quality of Life Among Cancer Patients.

This study aimed to explore the moderating role of socioeconomic status (SES) in the association between multimorbidity and health-related quality of life (HRQOL) among cancer patients in Anhui China. A total of 560 cancer patients were recruited for the cross-section study. Socio-demographic and clinical characteristics were analyzed using descriptive statistics. Tobit regression analysis was employed to investigate the relationship between multimorbidity and HRQOL as well as to assess the moderating effect of SES. The research findings indicated that 76.61% of cancer patients experienced multimorbidity, with psychological multimorbidity being the most prevalent (45.54%), followed by physical-psychological multimorbidity (20.89%). Moreover, physical-psychological multimorbidity had the most substantial adverse effect on HRQOL (P < .001). The presence of multimorbidity was correlated with a significant decline in HRQOL, with a 17.5% (P < .001) decrease in HRQOL for each additional multimorbidity. Additionally, SES played a significant role in moderating the impact of multimorbidity on HRQOL in cancer patients. (Marginal effect = -0.022, P < .01). The high SES group exhibited a higher overall HRQOL than the low SES group (Marginal effect = 0.068, P < .001). And with the increase of multimorbidity, HRQOL in the higher SES showed a more pronounced downward trend, compared with the lower SES (ß = -.270 vs ß = -.201, P < .001). Our findings underscore the importance of preventing and managing multimorbidity in cancer patients, particularly those with low SES. Furthermore, it is essential to consider the impact of the rapid decline in HRQOL as the number of multimorbidity increases in individuals with higher SES. It is imperative to explore interdisciplinary and continuous collaborative management models.

Transcriptomic study of the mechanism of anoikis resistance in head and neck squamous carcinoma.

BACKGROUND: Normal epithelial cells rapidly undergo apoptosis as soon as they lose contact with the extracellular matrix (ECM), which is termed as anoikis. However, cancer cells tend to develop a resistance mechanism to anoikis. This acquired ability is termed as anoikis resistance. Cancer cells, with anoikis resistance, can spread to distant tissues or organs via the peripheral circulatory system and cause cancer metastasis. Thus, inhibition of anoikis resistance blocks the metastatic ability of cancer cells. METHODS: Anoikis-resistant CAL27 (CAL27AR) cells were induced from CAL27 cells using the suspension culture approach. Transcriptome analysis was performed using RNA-Seq to study the differentially expressed genes (DEGs) between the CAL27ARcells and the parental CAL27 cells. Gene function annotation and Gene Ontology (GO) enrichment analysis were performed using DAVID database. Signaling pathways involved in DEGs were analyzed using Gene Set Enrichment Analysis (GSEA) software. Analysis results were confirmed by reverse transcription PCR (RT-PCR), western blotting, and gene correlation analysis based on the TCGA database. RESULTS: GO enrichment analysis indicated that the biological process (BP) of the DEGs was associated with epidermal development, DNA replication, and G1/S transition of the mitotic cell cycle. The analysis of cellular component (CC) showed that the most significant up-regulated genes were related to extracellular exosome. KEGG Pathway analysis revealed that 23 signaling pathways were activated (p-value ≤ 0.05, FDR q-value ≤ 0.05) and 22 signaling pathways were suppressed (p-value ≤ 0.05, FDR q-value ≤ 0.05). The results from the GSEA indicated that in contrast to the inhibition of EGFR signaling pathway, the VEGF signaling pathway was activated. The VEGF signaling pathway possibly activates STAT3 though induction of STAT3 phosphorylation. Gene correlation analysis revealed that the VEGFA- STAT3-KLF4-CDKN1A signal axis was not only present in head and neck squamous carcinoma (HNSCC) but also two other epithelial-derived carcinomas that highly express VEGFA, including kidney renal clear cell carcinoma (KIRC) and ovarian serous cystadenocarcinoma (OV).

[Cannulation related complications and prevention for extracorporeal membrane oxygenation: clinical report and reviews of experience of 34 cases].

OBJECTIVE: To review the cannulation strategies and associated vascular complications of extracorporeal membrane oxygenation (ECMO) and to investigate the etiology and preventive procedures for those complications. METHODS: From January 2007 to December 2011, 34 patients (21 male and 13 female patients, aged from 23 to 66 years) underwent ECMO support through open approach, semi-Seldinger method or full Seldinger method of cannulation. Bleeding and limb ischemia related to the approach as major complications were retrospectively analyzed. RESULTS: The ECMO duration were 2 to 21 days. Twenty-four patients (70.6%) successfully weaned from ECMO and 18 patients (52.9%) discharged. The venoarterial mode was used in 26 patients, and venovenous mode in 8 patients. Eight patients (30.8%, 6 for open approach and 2 for semi-seldinger) observed with limb ischemia, 2 of them required amputation, 1 had claudicatory sequela. Eleven and 6 patients suffered from bleeding and vessel injury respectively, all of them recovered by suitable treatment. CONCLUSIONS: The proper size of cannula, optimal approch and position adjustment, accurate cannula placement and carefully attendance are the key points to decrease the cannulation related complications.

[The effects of pulsatile perfusion during cardiopulmonary bypass procedures by radial artery pressure and waveform: the preliminary evaluation].

OBJECTIVE: To evaluate the possibility of radial artery pressure and waveform as a convenient definition of pulsatile flow and the the effect of pulsatile perfusion during cardiopulmonary bypass (CPB) procedures. METHODS: From March 2008 to December, Eighty patients underwent open heart surgery were randomly divided into a pulsatile group (P, n=45) and a nonpulsatile group (NP, n=35). Monitored by radial artery pressure and waveform, the pulsatile low was applied from the point of the aortic cross-clamp until its release in P group. A P group of patients whose radial artery pressure and waveform revealed "double peak" or "single peak" (>30 mm Hg, 1 mm Hg=0.133 kPa) were compared with NP group. Parameters examined were lactate, urine volume, high sensitivity C reactive protein, blood urea nitrogen, creatinine, blood uric acid, lactate dehydrogenase, glutamic oxalacetic transaminase, ratio of urine for occult blood test, prothrombin time and tracheal intubation time. RESULTS: The waveform with "double peak" or "single peak" (>30 mm Hg) presented in 35 (77.78%) in P group. The urine volume during CPB was significantly higher in P group. The lactate (P<0.01) during CPB, high sensitivity C reactive protein (P<0.05), increasing extend of lactic acid dehydrogenase (P<0.05) and the prothrombin time (P<0.01) after CPB were significantly lower in P group. The blood uric acid after CPB was increased in P group and decreased in NP group. CONCLUSIONS: Effective pulsatile flow can be generated by optimization of equipment and adjustment of pulsatile parameter. The radial artery pressure and waveform is a convenient definition of pulsatile flow. The pulsatile flow is predominant monitored by radial artery pressure and waveform.