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ObjectiveTo adapt to the dynamic multidimensional changes in traditional Chinese medicine (TCM) constitution, the paths of improving the quality of life through TCM constitution intervention are proposed from a configuration perspective. MethodsFive hundred and nine subjects were included in the study, all of whom voluntarily participated in and completed TCM constitution interventions, and completed 60-item Constitution in Chinese Medicine Questionnaire (CCMQ) (including 9 subscales: neutral type, qi deficient type, yang deficient type, yin deficient type, phlegm-dampness type, damp-heat type, blood stasis type, qi stagnation type, and special constitution type) to evaluate the TCM constitution, and the Short Form Health Questionnaire (SF-36) in Chinese version (including overall, physical component scores (PCS), and mental component scores (MCS)) before and 6 months after the intervention to evaluate the quality of life. The necessary condition analysis (NCA) and fuzzy set qualitative comparative analysis (fsQCA) were used to explore the necessary conditions and advantage configurations for improving the overall, physical and mental quality of life of TCM constitution dimension changes. ResultsThe results of NCA showed that the changes in the scores of neutral type and qi stagnation type can serve as necessary conditions for improving the SF-36 overall quality of life scores (P<0.05). The changes in the scores of neutral type and blood stasis type can serve as necessary conditions for improving PCS scores. The changes in scores of the other 7 types can serve as necessary conditions for improving MCS scores. The fsQCA results showed that the necessary consistency of a change in a particular physical subscale score alone did not reach to a necessary condition for a change in SF-36 total score, PCS score, and MCS score (consistency < 0.9 for all), so the results of NCA were considered. The results of configuration analysis found that 6 configurations were included in increasing the overall quality of life scores and PCS scores, and 7 in increasing the MCS scores, with overall consistency > 0.7. Improving the overall quality of life scores required a focus on lowering the qi deficient type scores, or reducing the yang deficient type scores while increasing the neutral type scores; reducing the scores of phlegm-dampness type and qi stagnation type is beneficial for improving the PCS scores; increasing the neutral type scores and reducing the scores of deficient type, yang deficient type, phlegm-dampness type, and stagnation type is beneficial for increasing MCS scores. ConclusionTCM constitution interventions can improve physical, mental and overall quality of life, and its improvement in the mental domain of quality of life is closely related to the paths of overall quality of life. In order to improve the quality of life, in addition to increasing the tendency of the neutral type, more focused and targeted measures should also be taken to decrease the degrees of qi deficient type, yang deficient type, qi stagnation type, and phlegm-dampness type.
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ObjectiveTo present the health status of traditional Chinese medicine (TCM) constitutions more intuitively and comprehensively based on improved radar chart. MethodsParticipants who completed a 26-week comprehensive intervention based on TCM constitution from February 2013 to January 2014 in Zhuhai branch of Guangdong Provincial Hospital of Chinese Medicine were included in the study. They were divided into groups according to gender and age, i.e. young, middle-aged, and elderly male and female groups. TCM constitution scale and health survey short form (SF-36) were used to evaluate the 9 basic TCM constitution types and quality of life at three time points, including pre-intervention (T1), at 13-week intervention (T2), and at 26-week intervention (T3). The improved radar charts were drawn to visually present the comprehensive evaluation results on the health status of 9 TCM constitutions, and graphic features (area S value, perimeter L value) were extracted to construct a comprehensive health index for TCM constitutions (H value). Spearman correlation analysis was used to analyze the correlation between H value and SF-36 total score. ResultsAmong the included 509 participants, there were 45 elderly male, 76 elderly female, 60 middle-aged male, 140 middle-aged female, 53 young male and 135 young female. The radar charts for comprehensive evaluation of TCM constitution health status showed that the total areas for all groups increased at T3 compared to T1, with the most significant increase in the young population. In the middle-aged population, the fan-shaped areas of certain constitutions decreased at T2 than T1. At T3, the radar chart shapes for females were more balanced than males in the same age group. By calculating the features of function graphs, it was found that the S, L, and H values for the elderly population were relatively higher than those for the middle-aged and young population with the same gender, and the young population increased by highest ratio. The values measured at T3 compared to T1 showed average increase of 26% for S value (11% for the middle-aged and 14% for the elderly), 22% for L value (10% for the middle-aged and the elderly each), and 22% for H value (10% for the middle-aged and 9% for the elderly). The female had lower S and L values, as well as higher H value than the male of the same age group measured at T3. The correlation coefficient between the H value of all participants and the total SF-36 score was 0.662 (P<0.01). ConclusionThe comprehensive evaluation model for the health status of TCM constitution based on the improved radar chart constructed in this study can present the health status of TCM constitutions and intervention effectiveness more comprehensively and intuitively. It is suggested to regulate the constitution in pursuit of the dynamic balance of the constitution health status, as well as consider the parts from the whole, and put focus on the balance of nine TCM constitutions.
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ObjectiveTo construct and evaluate the transformation model of the Constitution in Chinese Medicine Questionnaire (CCMQ) to SF-6Dv1 health utility and broaden the applications of CCMQ. MethodsThe data of CCMQ and SF-6Dv1 were collected from 595 participants at baseline, 3 months and 6 months after the comprehensive intervention suitable for the corresponding traditional Chinese medicine (TCM) constitution. The estimation and validation datasets were constructed, and four statistical algorithms including the ordinary least squares (OLS), MM robust regression (MM), censored least absolute deviations (CLAD) and the Tobit model were used to create alternative models. The mean absolute error (MAE), root mean square error (RMSE) and intraclass correlation coefficient (ICC) were used to evaluate the prediction performance of the model. ResultsThe constitution scores of all TCM constitutions by CCMQ was significantly correlated with the SF-6Dv1 health utility value measured at three timepoints; the health utility value of the SF-6Dv1 was positively correlated with gentleness type (r=0.596, r=0.578, r=0.606, all P<0.05) and negatively correlated with eight unbalanced constitutions (r=-0.586~-0.301, all P<0.05). The MM established based on the subscale scores of CCMQ was the optimal mapping model, and the MAE, RMSE, and ICC values were 0.0741, 0.0930 and 0.766, respectively. Gentleness type, qi-deficiency type, phlegm-wetness type, qi-constraint type, and age were the primary factors included in the model. The measured and predicted value of SF-6Dv1 had a moderate positive correlation (r=0.673, r=0.617, P<0.05) and a good consistency as shown by the Bland-Altman plot. ConclusionBy using MM, the CCMQ can be transformed into SF-6Dv1 health utility value for health economics analysis.
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Objective:To investigate the characteristics of the sleep quality and health-related quality of life (HRQoL), and analyze the different effects of sleep quality on HRQoL among young and middle-aged people.Methods:A cross-sectional study recruited 1 976 participants.All participants completed a self-designed questionnaire for the adults' general condition, the Pittsburgh sleep quality index (PSQI) and Short-Form health survey (SF-36). All participants were divided into 3 age groups: 18-29-year-old group( n=1 148), 30-44-year-old group( n=586) and 45-59-year-old group ( n=242). SPSS 23.0 software was used for statistical analysis.Chi-square test was used to analyze the general characteristics of the three age groups.Non-parametric test was used to analyze the scores of the three age groups in different dimensions of sleep quality. One-way ANOVA was used to analyze the mean scores of the three age groups in different dimensions of HRQoL. Stepwise regression analysis was used to analyze the effect of sleep quality on HRQoL among the three groups after control the confounding factors such as marital status, education, smoking, drinking and exercise habits and past medical history. Results:In terms of sleep quality, the total PSQI scores of 18-29-year-old, 30-44-year-old and 45-59-year-old groups(4(2, 6), 4(2, 6), 4(2, 6)) showed statistically significant differences ( Z=10.951, P=0.004). In terms of HRQoL, there were statistically significant differences in physical component summary scores (18-29-year-old: 82.51±12.62, 30-44-year-old: 80.72±13.63, 45-59-year-old: 82.04±13.07, F=3.667, P=0.026) and mental component summary scores(18-29-year-old: 76.09±15.46, 30-44-year-old: 77.20±16.14, 45-59-year-old: 81.82±14.14, F=13.649, P<0.001) among young and middle-aged people in different age groups.Regression analysis found that daytime dysfunction was an independent influencing factor for HRQoL in young and middle-aged population ( β=-0.308--0.425, all P<0.01). Sleep disorders significantly decreased Physical Component Summary of HRQoL in young-aged people ( β=-0.127--0.215, all P<0.01). The use of hypnotic drugs significantly reduced the scores in the physiological field in the young adults aged 30-44 ( β=-0.076, P<0.05). The duration of sleep significantly decreased the scores in the mental domain of young adults aged 30-44 ( β=-0.112, P<0.01). Subjective sleep quality was an independent factor that significantly decreased HRQoL in young adults aged 18-29 and 30-44 years ( β=-0.089--0.169, all P<0.01). Conclusion:Sleep quality and HRQoL of young and middle-aged people in different age groups show different characteristics.The effect of sleep quality on HRQoL is different among people in different ages.Taking targeted interventions for people of different ages to improve the sleep quality may be an effective way to improve their HRQoL.
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With the cooperation of Kurobe City, we conducted a basic survey using the nine classification of constitution and an intervention survey using a constitutional guidance program. The basic survey was conducted by the Kurobe group (Kurobe River alluvial fan spring water drinker n=155, 60.6±10.4 years old) and the non-Kurobe group (normal tap water drinker n=99, 50.7±12.8 living in the Hokuriku region without Kurobe City). A total of three surveys were conducted using the constitution Questionnaire (CCMQ-J). As a result, the Gentleness type, which is usually called the healthy constitution, was clearly higher in the Kurobe group, with 44.6 % in the Kurobe group and 22.5 % in the non-Kurobe group. In the proportion of each biased constitution(Mibyo constitution), the Kurobe group had less Wet-heat type (4.5 % vs 11.8 %), Qi-depression type (5.4 % vs 10.7 %), Yin-deficiency type (7.1 % vs 12.3 %) , and Phlegm-wetness type (5.8 % vs 9.6 %) than the non-Kurobe group. After the basic survey was completed, the Kurobe group was randomly divided into two groups, an intervention group (n=65, 62.3±9.3 years old) and a non-intervention group (n=68, 62.7±9.8 years old), and compared with the non-Kurobe group (control group) (n=80, 51.9±13.6 years old). The survey design was a simple comparative study, and the primary endpoint was a comparative study of changes in constitutional scores before and after intervention. As a result, in the Yang-deficiency type, a significant difference was observed between the intervention group, the non-intervention group and the control group at the first time after the intervention (One-way ANOVA p=0.04). No change was seen in the second survey after the intervention. In the comparison of Phlegm-wetness type between the three groups, there was a tendency in the amount of change in the constitutional score (One-way ANOVA p=0.087). From the above, it was suggested that the constitutional survey can not only grasp the health and the pre-symptomatic state, but also improve the pre-symptomatic by combining the guidance methods according to the constitution.
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Recently, evidences show that cancer stem cells (CSCs) are a type of cancer cell group with self-renewal and play a huge role in tumor recurrence, metastasis, and drug resistance. Finding new treatment directions and targets for cancer prognosis and reducing mortality has become a top priority. OCT4, as a transcription factor, participates in maintaining the stem characteristics of CSCs, but the mechanism of OCT4 is often overlooked. In this review, we try to illustrate the mechanism by which OCT4 plays a role in CSCs from the perspective of genetic modification of OCT4, non-coding RNA, complexes and signaling pathways associated with OCT4. Our ultimate goal is to provide new targets for cancer treatment to prolong the survival of cancer patients.
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Chinese Medicine Questionnaire (CCMQ-J) consists of sixty independent questionnaires and 9 physical constitutions called subscales. One type is balanced constitution (i.e., gentleness), and the following eight types represent unbalanced constitution: Qi-deficiency constitution, Yang-deficiency constitution, Yin-deficiency constitution, Phlegm-dampness constitution, Damp-heat constitution, Stagnant Blood constitution, Stagnant Qi constitution, and Inherited Special constitution. In this study, we proposed to determine optimal number of groups in 851 participants recruited from crowdsourcing answered CCMQ-J questionnaire consisting of 60 questions. In the present study, we applied k-means clustering with gap statistics to the questionnaire data and the number of optimal groups was estimated by five. The five groups are mainly characterized by 3 subscales in CCMQ-J, i.e. (i) two subscales corresponding to Yang-deficiency and Qi-depress, (ii) three subscales corresponding to gentleness, Yang-deficiency and Qi-depress (iii) Yang-deficiency, (iv) gentleness, and (v) Qi-depress. In the crowdsourcing survey, two subscales, Yang-deficient and Qi-depress are the most frequently occurred in current Japanese people.
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Variety of accessibility to edible species in different regions has climatic and historical roots. In the present study, we try to systematically analyze 28,064 records of relationships between 11,752 edible species and 228 geographic zones by hierarchical clustering. The 228 geographic regions were classified into 11 super groups named as A to K, which were further divided into 39 clusters (CLs). Of them, at least one member of each of 28 CLs is associated to 20 or more edible species according to present information of KNApSAcK DB (http://kanaya.naist.jp/KNApSAcK_World/top.jsp). We examined those 28 CLs and found that majority of the members of each of the 27 CLs (96%) have specific type of climate. Diversity of accessibility to edible species makes it possible to separate 8 geographic regions on continental landmasses namely Mediterraneum, Baltic Sea, Western Europe, Yucatan Peninsula, South America, Africa and Arabian Peninsula, Southeast Asia, and Arctic Ocean; and three archipelagos namely, Caribbean Islands, Southeast Asian Islands and Pacific Islands. In addition, we also examined clusters based on cultural exchanges by colonization and migration and mass movement of people and material by modern transportation and trades as well as biogeographic factors. The era of big data science or data intensive science make it possible to systematically understand the content in huge data and how to acquire suitable data for specific purposes. Human healthcare should be considered on the basis of culture, climate, accessibility of edible foods and preferences, and based on molecular level information of genome and digestive systems.
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Objective To evaluate the effect of exercise on the relationship between body mass index (BMI) and health-related quality of life (HRQOL).Methods A total of 1 114 participants were recruited from the Physical Examination Center of two hospitals.SF-36 was used to measure HRQOL,and the classification of sports level was done according to the subjective evaluation of participants.Results The total score of HRQOL,physical component summary and mental component summary were 76.26± 16.10,75.97 ± 16.67 and 76.55± 18.33 respectively.The results of correlation analysis were as following:the positive correlation between BMI and general health (r=0.109),vitality (r=0.116),social functioning (r=0.092),role emotional (r=0.122),mental health (r =0.145) were significant (P< 0.01).The negative correlation between BMI and PF(r=-0.07,P=0.019)was significant.The mediation effects of exercise in was relationship between BMI and general health,vitality,mental health were significant,and the mediating effect were 5.84%,9.14% and 6.58%.Conclusion This study demonstrates that mediation effects of the exercise are significant in some dimensions of HRQOL,but the direct influence of BMI on the HRQOL plays a leading role.And BMI is a protective factor under certain conditions.
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Objective Aiming at detecting Staphylococcus aureus、Pseudomonas aeruginosa and Klebsiella pneumoniae in laboratory animals,the paper provides a rapid,sensitive and simple test method.Methods According to Staphylococcus aureus nuc gene,Pseudomonas aeruginosa LasI gene,Klebsiella pneumonia PhoE gene and general 16S rRNA gene, designed specific primers;Through the optimization of multiplex PCR primer concentrations and annealing temperature, the specificity and sensitivity of detection, establishing multiplex PCR system.Application of the PCR system test specimens of artificial infections and experiment animal feces is compared with traditional test method.Results Multiplex PCR amplification of Staphylococcus aureus (153 bp), Pseudomonas aeruginosa (600 bp) with Klebsiella pneumoniae (368 bp) and general (520 bp).The multiplex sensitivity for the purpose of 10pg, specificity of detection was not detected from other pathogens.Application of establishing multiplex PCR system to detect the artificial positive samples, and detect 1 Pseudomonas aeruginosa positive case in 76 fecals.Conclusions This paper established the multiplex PCR method which has the advantages of specific,sensitive,simple and rapid, and provides a reliable way for rapid test in laboratory animals microbiology.
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The aim of this study is to establish a multiplex polymerase chain raction (PCR) to identify of four kinds of laboratory animal pathogens: Pasteurella multocida, Bordetella bronchiseptica, Mycoplasma pneumoniae and Klebsiella pneumoniae.Methods Specific primers were designed based on GenBank data.The multiplex PCR system was established through optimization of multiple PCR and detection of its specificity and sensitivity.This technique was used to test artificially infected samples and tracheal secretions of experimental animals (rat, mouse, guinea pig, rabbit, hamster), and comparing the detection results by this method and traditional detection test.Results Target bands of Pasteurella multocida (356 bp), Bordetella bronchiseptica (237 bp), Mycoplasma pneumoniae (266 bp), and Klebsiella pneumoniae (142 bp) were obtained, with a detection sensitivity of Klebsiella pneumoniae of 10 pg, and that of Pasteurella multocida, Bordetella bronchiseptica and Mycoplasma pneumoniae of 1 pg by this newly developed multiplex PCR assay.No target bands were observed from the non-specific pathogens of artificially infected samples.The tracheal secretions taken from 45 experimental animals (mice and rabbits) were tested with this new PCR assay, among which 15 cases of Klebsiella pneumonia and 9 cases of Pasteurella multocida were detected as positive, while all the results of traditional method and serological test were negative.Conclusions A simple, rapid, specific and highly sensitive multiplex PCR system has been successfully established.It is valuable for detection of Pasteurella multocida, Bordetella bronchiseptica, Mycoplasma pneumoniae, and Klebsiella pneumoniae in laboratory animals.
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Objective To investigate the diagnosis and treatment in patients with acute myocardial infarction (AMI) and complicated left ventricular wall rupture (LVWR). Methods A retrospective analysis was made on the clinical features, diagnosis and successful treatment in three AMI patients with LVWR from December 2015 to April 2016. Results Three cases were included in this study. Case 1, the mesh like cardiac rupture after AMI was diagnosed by ultrasonic Doppler. Emergency revascularization was performed due to the combined cardiac shock, and the infarct related artery was opened. The vasoactive drugs were used after revascularization to reduce ventricular pressure load and volume load in the haemodynamic monitoring, and anticoagulation, antiplatelet agents were less used or discontinued to promote local thrombus healing of ventricular rupture. Case 2 was a recurrent myocardial infarction patient. LVWR was diagnosed by ultrasonic Doppler one day after emergency operation. The ruptured ventricular wall was encapsulated by thrombus. The drug therapy was effective in hemodynamic monitoring. LVWR was further confirmed by cardiac CT after clinical stabilization. Case 3 was diagnosed LVWR by ultrasonic Doppler four days after AMI. Because the ruptured ventricular wall was limited by incompletely organized thrombus, and the haemodynamic condition was stable, selective surgical repair of rupture after coronary angiography was performed. Conclusion The effective drug therapy combined with percutaneous coronary intervention and surgical repair can reduce the risk of death in patients with LVWR after AMI.
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Structural heart disease includes congenital cardiovascular structural abnormalities, valvular heart disease and cardiomyopathy, which shows the common features of cardiac anatomical structure and hemodynamic abnormalities, especially anatomical abnormalities. Echocardiography, especially three-dimensional (3D) ultrasound, is good at displaying anatomical structure and blood flow abnormalities. As a non-invasive method of examination, it has advantage in the evaluation of such heart diseases. In recent years, the gradual rise of 3D printing technology can make physical printing, and the printed heart model can stereoscopically display abnormal state of heart diseases. Ultrasound combined with 3D printing technology may provide more intuitive and accurate information for the assessment of structural heart disease.
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Japanese version of the Constitution in Chinese Medicine Questionnaire (CCMQ-J) in Chinese consists of 60 items for 9 sub-scales called Gentleness, Qi-deficiency, Yang-deficiency, Yin-deficiency, Phlegm-wetness, Wet-heat, Blood-stasis, Qi-depression, and Special diathesis. Each question is answered by choosing one form 5 grades of a Likert scale where the grades from 1 to 5 corresponding to Never, Rarely, Sometimes, Often and Always, respectively. In the present study, we examined the relationship of scores based on 597 respondents to 60 items. We tentatively classified 60 items into 12 groups by utilizing the Ward’s hierarchical clustering method and discussed similarity of items and 9 body conditions. Body Mass Index (BMI) and age can be explained by the score of 60 items by partial least square model. Significantly high correlation coefficients between real and estimated values were obtained for BMI (0.81 for male and 0.82 for female) and age (0.82 for male and 0.83 for female). Those results indicate that the answers to the 60 items can reflect aging and BMI properties and CCMQ-J can be used to assess the situation of health for evaluating the actual aging conditions in human.
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Objective To assess the efficacy of cardiac resynchronization therapy (CRT) using real-time three-dimen?sional echocardiography (RT-3DE) and speckle tracking imaging (STI) in patients with heart failure. Methods Thirty-one patients with chronic heart failure were examined by RT-3DE and STI before CRT and 3, 6 months after CRT. The values of left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were measured. RT-3DE was used to evaluate the minimum regional volume for 16 segments (Tmsv-16SD) and the ratio of Tmsv16SD to R-R interval, and the maximum time difference (Tmsv-16Dif). STl was used to evaluate the ratios of standard deviation of the time to peak longitudinal radial and circumferential strain to R-R interval (Tls-16SD%, Trs-16SD%,Tcs-16SD%) from the beginning of Q wave of electrocardiography to the point minimal systolic volume of all 16 segments and the maximum time difference. Results The values of LVEDV and LVESV were smaller 3 and 6 months after CRT than those before CRT. The value of LVEF was significantly improved after CRT (P < 0.05). The values of Tmsv-16SD%, Tmsv-16Dif%, Tls-16SD%, Trs-16SD%, Tcs-16SD%and T-Dif%were gradually decreased after CRT (P<0.05). The values of Tmsv-16SD%, Tmsv-16Dif%,Trs-16SD%and Tcs-16SD%were negatively related with LVEF (r=-0.79,-0.82,-0.69 and-0.74(P<0.05). The better consistency was found between RT-3DE and STI methods(Kappa=0.77). Conclusion Re?al-time three-dimensional echocardiography and speckle tracking imaging can provide more accurate quantitative informa?tion of cardiac resynchronization therapy for assessment of treatment and prognosis in patients with heart failure.
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Objective To investigate the diagnostic value of preoperative real-time three-dimensional color Doppler transthoracic echocardiography on assessment of patients with structural heart disease (SHD). Methods A total of 111 pa?tients were assessed preoperatively using real-time three-dimensional color Doppler transthoracic echocardiography (RT-3D-CDTTE), which include 31 SHD patients and 80 patients without SHD that were designed as negative control. Conven?tional two-dimensional color Doppler transthoracic echocardiography (2D-CDTTE) were used to compared with RT-3D-CDTTE while cardiovascular angiography and intraoperative findings were used as“Golden Standard”simultaneously. First of all, preoperative echocardiographic examination were performed and diagnosis was given. Angiography and intraoperative findings were hired to verify the accuracy of echocardiographic diagnosis before operation. Results (1) The preoperative RT-3D-CDTTE displayed three-dimensional structure and hemodynamic status of SHD cardiac lesions clearly, which were consistent with cardiovascular angiography and intraoperative findings. (2) P value of McNemar test between 2D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.654 (P<0.001). P value of McNemar test between RT-3D-CDTTE and“Golden Standard”was greater than 0.05, Kappa=0.932 (P<0.001). Conclusion RT-3D-CDTTE can provides essen?tial information for preoperative evaluation which is important for decision of SHD management.
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Objective: To analyze the application status of the EQ-5D and SF-6D in cost-utility analysis ( CUA) . Methods: The data from PubMed data base from 2003-2012 was conducted as the main resource in econometric analysis. Results: There is no certain increasing trend of literature quantity in the recent 10 years’ application of EQ-5D and SF-6D in the CUA. The main published language was English and the main country was the United Kingdom. The core authors of researches on the CUA estimated by EQ-5D and SF-6D had not been formed, however, the core periodicals had been formed. The literatures involve wide-spread diseases, mainly known as Motion system and pain diseases. Most of the effectiveness could be calculated with quality adjusted life year ( QALY) , the object of CUA is mainly on the medicine, operation and health intervention. Conclusion: Appicating EQ-5D and SF-6D in CUA and research content of the literatures has wide distribution width, although it has shown centralized trend, which still needs more studies by related researchers.
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Objective To investigate the relationship between body mass index (BMI) and health-related quality of life (HRQOL) in the adult Chinese population.Methods Data of 21 108 adults was collected from a cross-sectional survey performed in 9 provinces of China (Jiangsu,Anhui,Gansu,Qinghai,Fujian,Beijing,Jilin,Jiangxi and Henan province).Rank sum test was used to compare HRQOL with different BMI category.Multiple logistic regression analysis was used to assess the impact of different BMI category on HRQOL after adjusted for sex,age,marital,education,physical activity status,and tobacco and alcohol addiction.Results (1) For healthy subjects,the overweight BMI group had the highest HRQOL score in the physical component summary (PCS) (83.69±14.09) and mental component summary (MCS)(80.29± 15.41),while the underweight group had the worst HRQOL(81.20-± 14.05,74.82± 16.41).For subjects with chronic condition,overweight had the highest H RQOL score in the PCS(74.63± 18.51),and obese group had the best HRQOL in the MCS (76.75± 18.83).The variation among healthy and chronic disease subjects was much greater than the differences among BMI category groups.(2) Compared with normal weight,data on odds ratio(ORs) of impaired HRQOL in PCS(healthy subjects OR=1.23(1.10-1.35),chronic disease subjects OR=1.48(1.20-1.82)) MCS(healthy subjects OR=1.14(1.03-1.26),chronic disease subjects OR=1.37 (1.11-1.68)) and multiple dimensions increased among underweight.ORs of impaired HRQOL in PCS and general health dimension,MCS (healthy subjects OR =0.81 (0.72-0.91),chronic disease subjects OR=0.80(0.71-0.91)) and multiple dimensions decreased among overweight.ORs of impaired HRQOL in physical functioning dimension (healthy subjects OR=1.91 (1.25-2.92),chronic disease subjects OR=1.65(1.21-2.26)) while in MCS and role emotional and mental health dimension decreased among obese.Conclusion Whatever health or chronic disease,the influence of BMI on HRQOL is similar:the HRQOL score for the underweight group is significantly lower than that for other BMI groups in PCS and MCS.Overweight and the obese people has better HRQOL in MCS,and the obese people has poor physical function.The relation above between BMI and HRQOL is more obvious in people with chronic disease.
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<p><b>OBJECTIVE</b>To examine the function of body mass index (BMI) as a moderator reflecting the relationship between chronic disease and health-related quality of life (HRQOL).</p><p><b>METHODS</b>This study included 8 314 participants pooled from a general population-based cross-sectional survey that had been conducted in Beijing and 8 provinces of China (Jiangsu,Anhui,Gansu, Qinghai, Fujian, Jilin, Jiangxi, and Henan). Hierarchical multiple regression was emplayed to test the moderating effect.</p><p><b>RESULTS</b>In physical component summary of SF-36, the regression coefficient of interaction on chronic disease and BMI was not significantly different (β = 0.084, P = 0.142), while the new ΔR(2) was not significantly different (ΔR(2) = 0.000, P = 0.142) either. In mental component summary of SF-36, the interaction on chronic disease and BMI was significantly different (β = 0.132, P = 0.034), so as the new ΔR(2) (ΔR(2) = 0.001, P = 0.034). Compared to the standard regression coefficient, chronic disease had a greater negative impact on HRQOL than BMI on both physical and mental component summaries.</p><p><b>CONCLUSION</b>Our results indicated that BMI could moderate the association between chronic disease and HRQOL. The higher the BMI, the smaller negative impact of chronic disease on HRQOL in mental component summary was seen.</p>
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Humanos , Índice de Masa Corporal , China , Enfermedad Crónica , Estudios Transversales , Análisis Multivariante , Calidad de VidaRESUMEN
Objective To explore the efficacy and the safety of clinical trials of pemetrexed combined with carboplatin and gemcitabine with carboplatin in treating advanced NSCLC of the elderly patients.Methods A total of one hundred and twenty-eight elderly patients with advanced NSCLC were randomly divided into two groups(n=64).The PC group in which patients were treated with pemetrexed combined with carboplatin,and the GC group in which patients were treated with gemcitabine combined with carboplatin.The effects and the safety were assessed by the following indexes, treatment efficiency,side effects,LCSS. Results The treatment efficiency of the PC group and the GC group were 34.38% and 31.25% after chemotherapy.The difference was no statistically significant between two groups.The difference of LCSS was no statistically significant between two groups.Except hair loss,the incidences of nausea and vomiting,leukopenia,thrombocytopenia and neurotoxicity (grade III-IV )in the PC group (6.25%,3.13%,4.67%,7.81%)were significant lower than those in the GC group(17.18%,20.31%,15.63%,18.75%)(P<0.05).The 1-year and 2-year survival rates of the PC and GC groups were 46.2% VS 46.8% and 13.3% VS 12.5%,respectively,with a median survival of 12.1 VS 1 1.3 months,without a statistically significant difference between two groups.Conclusion PC and GC show similar efficacy for elderly NSCLC patients,however,the toxicities in PC patients are lower than those in GC patients.Thus,pemetrexed combined with carboplatin is an effective therapeutic regimen for advanced NSCLC in elderly patients.