Purpose: To investigate the prognostic value of combined serum carcinoembryonic antigen (CEA) levels and fibrinogen/albumin ratio (FAR) in patients with resectable gastric cancer (GC). Introduction: This retrospective study evaluated the CEA, fibrinogen, and albumin levels and other clinicopathological features of GC patients. The prognostic significance of these factors for overall survival (OS) was assessed using Kaplan-Meier curves and univariate and multivariate Cox proportional models. Patients and Methods: A total of 267 patients were included. The optimal cutoff values of CEA and FAR were 3.2 ng/mL and 0.086, respectively. Patients were stratified into three groups based on this cutoff value: CEA-FAR=0 (CEA <3.2 ng/mL and FAR <0.086), CEA-FAR=1 (CEA ≥3.2 ng/mL or FAR ≥0.086), and CEA-FAR=2 (CEA ≥3.2 ng/mL and FAR ≥0.086). Results: Higher CEA-FAR was strongly associated with age, tumor size, tumor invasion, lymph node status, and TNM stage (all P<0.05). The OS rates differed significantly between these 3 groups (88.9% vs 65.0% vs 46.9%, P<0.001). Multivariate analysis showed that CEA-FAR was an independent prognostic factor for OS (P<0.001). The area under the curve was larger for CEA-FAR than for either CEA or FAR alone (0.683, 0.644, and 0.669, respectively). Conclusion: Preoperative CEA-FAR could be a potential blood marker for predicting tumor progression and the prognosis of GC patients. Patients with a higher CEA-FAR should undergo extensive follow-up.
Body image changes are common among patients living with inflammatory bowel disease (IBD) because of the illness and related treatments. Currently, there is little known about how those patients experience and perceive their altered body image in the literature. The aim of this study was to explore the experiences of body image changes in patients with IBD in China and to describe how those changes influence patients' perception of body and self. Methods: This study used a descriptive qualitative approach. A total of 16 participants from three tertiary hospitals in southeast China were recruited through purposive sampling combined with maximum variation strategy. Data were collected through semistructured interviews and analyzed using conventional content analysis method. Results: The following six themes were extracted: (1) "being a constrained person," (2) "being a flawed person," (3) "being a disliked person," (4) "being an alienated person," (5) "being a reconciled person," and ( 6) "being a blessed person." Conclusion: With the diagnosis of IBD and its side effects of treatments, patients' life changed significantly and they were struggling to reinterpret their body and self. As a result, negative self-evaluations and/ or positive self-evaluations towards themselves generated. Further studies are required to explore the underlying mechanism and related influencing factors about how those different images were produced.
Background Lymphoma patients encounter many problems. Studies investigating the illness experiences of Chinese patients with lymphoma are limited. Objective The objectives of this study were to explore the illness experiences of lymphoma patients in China and describe the impacts of this disease on the everyday lives of these individuals. Methods A descriptive qualitative design was used. The data were collected through face-to-face semistructured interviews and analyzed using the conventional content analysis method. Results Nine men and 7 women participated in this study. The following 6 themes emerged: (1) cancer diagnosis reactions, (2) self-image altered, (3) interpersonal relationships influenced, (4) career development hindered, (5) life philosophy changed, and (6) personal growth achieved. Conclusions This study contributes new knowledge to the understanding of the illness experiences of lymphoma patients within the Chinese social and cultural context. This study also reveals how these individuals cope with the complex problems they face. Implications for Practice Nurses could help Chinese patients with lymphoma accept the disease and its treatments by emphasizing the importance of family integrity. Information, such as how to act in response to workplace discrimination, should be provided to patients by oncology nurses.
BackgroundMany adolescents were reported to have severe depressive symptoms, and a careful assessment of its correlates is essential for prevention and intervention programs. This study aimed to gain insight into the prevalence of severe depressive symptoms and its association with factors at four levels (individual, relationship, school and society) in a large sample of Hong Kong Chinese secondary school students.MethodsSecondary school students from Secondary 1 through 7 were selected as participants using a cluster random sampling method. A questionnaire including inventories measuring 24 factors at the four levels (six individual factors, 11 relationship factors, three school factors, and four society factors) was completed by 8,963 participants (56.3% female) with a mean age of 15.1 (SD = 1.8) years. Students with a score of ≥15 on the Patient Health Questionnaire were defined as having severe depressive symptoms. The association between severe depressive symptoms and correlates were examined by t-test and χ2 test. Logistic regression models using a hierarchical approach then examined the individual contribution of these 24 factors to severe depressive symptoms with the control of other factors in the model.Results7.4% of the students have severe depressive symptoms. Twenty-two of the 24 factors were significantly associated with severe depressive symptoms in bivariate analyses. In the logistic regression, 11 factors (three individual factors: age, self-esteem and self-mastery; six relationship factors: tobacco use, alcohol drinking, drug use, paternal psychological control, dinner with parents, and perceived social support from friends; one school factor: felt pressure from homework; and one society factor: number of sibling) were statistically significant. Felt pressure from homework, alcohol drinking, and perceived social support from friends were the strongest correlates of severe depressive symptoms.ConclusionThe prevalence of self-reported severe depressive symptoms in Hong Kong Chinese secondary school students was high, and the identification of multiple associated factors at the four levels simultaneously provides a knowledge basis for the development of a comprehensive, multivariate model of factors influencing severe depressive symptoms in Chinese secondary school students. The factors identified in the present study may be helpful when designing and implementing preventive intervention programs.
The IBDQOL-22 is a valid, reliable, and responsive instrument for assessing disease-specific quality-of-life in patients with IBD in Mainland China.
Background: The number of global hematopoietic stem cell transplantation (HSCT) survivors is increasing rapidly. Survivors encounter many challenges, but studies regarding survivorship experiences in China are scarce. Objective: This study aimed to explore the survivorship experiences of Chinese patients with hematological cancers after HSCT and to describe the impact of HSCT on survivors’ lives. Methods: Descriptive qualitative research was employed. Purposive sampling was used to recruit HSCT survivors who were treated in Zhejiang Province from June 2021 to June 2022. Audio-recorded semi-structured interviews were conducted, transcribed verbatim, and analyzed via conventional content analysis. Results: Fifteen HSCT survivors aged 18-59 years participated in this study. Four themes and 11 subthemes emerged: (1) transplant being harder than you thought (body function impaired, forced to modify diet, disturbed by survivorship uncertainty), (2) difficulty blending into circles (limited activity space, suffering from discrimination), (3) adjusting value judgment (health being a top priority, contributing to family as much as possible, feeling worthless), and (4) still being the lucky one (recovered better than others, genuine relationships acquired, self-improvement achieved). Conclusion: This study offers insight into subjective survivorship experiences of patients with hematological cancers post-HSCT within a Chinese sociocultural context. It also presents changed perceptions of HSCT, life alterations, adjusted value judgments, and positive self-evaluation since treatment. Implications for Practice: Nurses can provide person-centered survivorship care based on understanding the survivorship experiences and needs of Chinese HSCT survivors. Intervention programs and informational materials should be developed to address difficulties encountered by Chinese HSCT survivors.
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