Demoralization and depression in Chinese cancer patients.

OBJECTIVE: Demoralization and depression are common in cancer patients and closely related to suicide. But the association and difference between them are not clear. The aim of this study is to investigate demoralization and depression in Chinese cancer patients. METHODS: This study is a cross-sectional study. Two hundred ninety-six cancer patients completed the questionnaire. First is using the DS-II to evaluate demoralization in advanced cancer patients and using the PHQ-9 to evaluate their depression. Then determine the association between demoralization and depression by Pearson rank correlation test. Finally, an ANOVA was conducted using DS-II as the categorical variable and PHQ-9 as the continuous variable and using PHQ-9 as the categorical variable and DS-II as the continuous variable. RESULTS: There is a positive association between demoralization and depression. A special case that patients with high demoralization but low depression was discovered, which accounted for a large proportion. CONCLUSION: Demoralization and depression are two different psychological states, which require medical staff to identify and take corresponding intervention measures in time. Patients with high demoralization but low depression require further attention.

Dog vaccination with EgM proteins against Echinococcus granulosus.

BACKGROUND: Dogs play a pivotal role in the transmission of cystic echinococcosis (CE), a zoonosis caused by the tapeworm Echinococcus granulosus. We showed previously that dogs vaccinated with two E. granulosus adult-worm specific proteins, EgM9 and EgM123, emulsified with Freund's adjuvants induced significant protective efficacy in terms of reduction in worm burden and egg production after 45 days post-infection. It was not known whether this protection can be sustained using adjuvants suitable for use in dogs. METHODS: Recombinant EgM9 and EgM123 were mixed with Quil A or ISCOMs for vaccinating dogs. After three vaccine injections, all the dogs were orally challenge-infected with 200 000 protoscoleces of E. granulosus. After 45 days of infection, all the dogs were euthanized and necropsied for collecting and counting E. granulosus worms. Immunoglobins, including the IgG subclasses IgG1 and IgG2, were detected in the sera of vaccinated dogs by ELISA. To determine whether the protection efficacy could be maintained after 45 days post-infection, we implemented a longevity trial to count eggs in dog faeces for 170 days after infection. RESULTS: The dogs vaccinated with EgM9 and EgM123 mixed with Quil A and ISCOMs showed similar protective efficacy as the proteins emulsified with Freund's adjuvants in our previous study in terms of reduction of worms and eggs at 45 days post-infection. The longevity trial showed that EgM9 protein-vaccinated group released lower number of eggs per gram compared with the egg counts in the control dogs during the dog trial study. CONCLUSION: EgM9 and EgM123 are thus suitable vaccine candidates against E. granulosus infection in dogs.

Exploring Meaning in the Life of Chinese Breast Cancer Survivors.

BACKGROUND: Breast cancer is the most common cancer among women worldwide, and spiritual fulfillment such as experiencing meaning in life plays an important role in coping with the disease. OBJECTIVE: The objectives of this study were to explore and understand Chinese breast cancer survivors' perspective on meaning in life. METHODS: This study used Grounded Theory; 23 participants were recruited using convenience sampling, purposive sampling, and theoretical sampling. Semistructured interviews were conducted, and the data were analyzed using open coding, axial coding, and selective coding. RESULTS: A core category emerged as "satisfaction with my life" to explain Chinese breast cancer survivors' perspective of meaning in life, and 4 subcategories described the core category including (1) living a healthy and peaceful life, (2) having a good relationship with others, (3) achieving purpose in life, and (4) fulfilling responsibility. CONCLUSION: Chinese breast cancer survivors value physical health as well as spiritual fulfillment. The experience of adapting to life with cancer, having a good relationship with others, pursuing life goals, and fulfilling responsibility consists of a satisfying life, which makes life more meaningful. IMPLICATIONS FOR PRACTICE: Health providers should pay more attention to survivors' experience of meaning in life and help them enhance meaning in life and improve their quality of life through building good relationship with others, achieving purpose in life, and fulfilling responsibility for family and society.

Psychometric properties of the Chinese version of Arthritis Self-Efficacy Scale-8 (ASES-8) in a rheumatoid arthritis population.

The Arthritis Self-Efficacy Scale-8 (ASES-8) is a valid tool to measure patients' arthritis-specific self-efficacy. However, evidence about reliability and validity of the ASES-8 in Chinese arthritis patients is lacking. This study aimed to culturally adapt and test the psychometric properties of the Chinese version of the ASES-8. Chinese ASES-8 was translated from original English version using translation and back-translation procedures. Validation survey was then conducted in a university-affiliated hospital by a set of questionnaires comprised Chinese ASES-8, pain-VAS, The Hospital Anxiety and Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F), and Short Form 36-Item Health Survey (SF-36) physical functioning subscale. A convenience sample of 134 patients with rheumatoid arthritis was recruited from the department of rheumatology. Validity was assessed by Pearson's correlation analysis and exploratory factor analysis. Reliability was assessed using the intra-class correlation coefficient (ICC) and Cronbach's alpha. Exploratory factor analysis extracted one dimension that explained of the 71.35% variation. Significant negative correlations were found between the ASES-8 and pain-VAS, HADS-D, HADS-A scores (r -0.487 to -0.656, p < 0.01), while positive correlations were found between the ASES-8 and SF-36 PH (r = 0.561, p < 0.01), FACIT-F (r = 0.660, p < 0.01). Excellent test-retest reliability (ICC = 0.98) and internal consistency (Cronbach's alpha = 0.942) were demonstrated. The Chinese version of the ASES-8 had statistically acceptable levels of reliability and validity for assessing self-efficacy in patients with rheumatoid arthritis. This disease-specific scale is particularly valuable for use among patients with rheumatoid arthritis from the Chinese population.

Development of the Chinese version of Meaning in Life Scale for cancer patients and psychometric evaluation.

AIMS AND OBJECTIVES: To develop a Meaning in Life Scale for cancer patients in Chinese version and to test the validity and reliability. BACKGROUND: Meaning in life is a protective factor of psychological well-being and is negatively related to depression and demoralisation among cancer patients. The existing scales measuring meaning in life are mostly designed in English and there is no scale designed for Chinese cancer patients based on Chinese cultural background. DESIGN: Process of instrument development and psychometric evaluation were used. METHODS: Items were generated from literature review and a focus group interview. Delphi technique was used to test the content validity. Item analysis and exploratory factor analysis were performed with data from 251 cancer patients. The internal consistency of the scale was tested by Cronbach's alpha. RESULTS: A 25-item Meaning in Life Scale in Chinese version with five domains was developed. The five factors explained 62·686% of the variance. The Cronbach's alpha for the total scale was 0·897. CONCLUSIONS: The Meaning in Life Scale in Chinese version has acceptable internal consistency reliability and good content validity and acceptable construct validity. The content of the scale reflected the attitudes of cancer patients towards meaning in life based on Chinese cultural background. RELEVANCE TO CLINICAL PRACTICE: The Chinese version of Meaning in Life Scale for Cancer Patients appears to be a new scale to assess meaning in life among Chinese cancer patients exactly and the concept of meaning in life presented in this scale provides new ideas of meaning intervention in routine clinical practice.

[Immune protection of recombinant membrane protein against Taenia multiceps larvae in sheep].

OBJECTIVE: To investigate the immune protection of the recombinant membrane protein(45M) against larvae of Taenia multiceps in sheep. METHODS: Twelve sheep were randomly divided into immune group and control group, and each sheep was immunized four times (three weeks interval) respectively with 50 microg recombinant 45M or GST emulsified with adjuvant. Serum samples were collected at pre-immunization and certain time after immunization, and were analyzed for IgG and IgM by ELISA. At the 105th day after the final inoculation, each sheep was orally challenged by 5000 eggs of T. multiceps. Two weeks after infection, the sheep were sacrificed, serum samples were collected, and number of cysts in brain tissue was counted. Activated oncospheres were cultured with 10% sera of immune group or control group, and observed by light microscopy. RESULTS: The mean number of cysts was 1.5, and the average diameter of the cysts was 2.2 mm. Compared with control group, the reduction rate of cysts in immunized sheep was 68.9%. At the 72th hour after culture with serum of immunized sheep, about 90% oncospheres were killed by antiserum, and the oncospheres began to shrink or expand, and internal structure became fuzzy. ELISA showed that after final immunization (the 9th week), the levels of IgG in sera of immune group (2.32+/-0.76) were significantly higher than those of the control (0.70+/-0.42) (t=4.47, P<0.01). At the 24th week the levels of IgG and IgM in sera of immune group (1.53+/- 0.81, 0.90+/-0.26) were significantly higher than those of the control (0.64+/-0.43, 0.43+/-0.15) (P<0.01). CONCLUSION: The recombinant 45M can induce certain humoral immune response.

[Monthly deworming in dogs for echinococcosis control in two counties of Xinjiang Uygur Autonomous Region].

OBJECTIVE: To verify the application and effectiveness of monthly deworming for all dogs in the control of Echinococcus granulosus infection. METHODS: Baited praziquantel was used to treat all registered dogs monthly by hydatid disease control officers at village level and all stray (unowned) dogs were eliminated in the counties of Hutubi and Wensu in 1987-1990 and 1990-1994 respectively. Prevalence of echinococcosis in dogs and sheep was recorded yearly. RESULTS: The infection rate in dogs decreased from 18.5% and 14.7% before implementation of the control measure to zero in 3-4 years in Hutubi and Wensu Counties respectively. Prevalence of hydatid disease in new born sheep was reduced by more than 85% in comparison to the same age sheep before the control program in both counties. CONCLUSION: "Monthly drug administration to all dogs" is an effective way to the control of echinococcosis in dogs and of hydatid disease in sheep.