Objective: To investigate the quality of life and associated factors in patients with coronary heart disease (CHD) in China. Methods: A cross-sectional study of 25 provinces and cities in China was performed from June to September 2020. A questionnaire was used to collect the socio-demographic and clinical information of patients with CHD, while the European Five-dimensional Quality of Life Scale (EQ-5D) was used to assess the quality of life. Multiple linear regression model was performed to analyze the associated factors. Results: The median age of the 1 075 responders was 60 (52, 67) years, and 797 (74.1%) were men. The EQ-5D and EQ-VAS indices were 0.7 (0.5, 0.8) and 60.0 (40.0, 80.0). Among the five dimensions in the quality of life scale, the frequency of anxiety/depression was the highest (59.8%), while problems in self-care was the lowest (35.8%). In the multiple linear regression model, female, increasing age, obesity, comorbidity(ies), anxiety/depression, social media channels, and receiving the CABG therapy were associated with the lower EQ-5D index (all P<0.05). In addition, increasing age, obesity, comorbidity (ies), depression, anxiety and depression, social media channels, and receiving the CABG therapy were associated with lower EQ-VAS index (all P<0.05). Conclusion: Over half of the patients with CHD in China have a low quality of life, which is related to gender, age, obesity, treatment pathway, the presence or absence of comorbidity (ies), and psychological state. In addition to managing the adverse effects of traditional socio-demographic factors on the quality of life, clinical practices should pay attention to the psychological state of patients. Moreover, establishing a WeChat group for doctor-patient communication could improve the quality of life of CHD patients.目的： 了解我国冠心病患者生活质量并分析其影响因素。 方法： 在2020年6月至9月对我国25个省市的冠心病患者进行横断面研究，使用问卷收集冠心病患者的一般资料，欧洲五维健康量表（EQ-5D）调查患者生活质量，多元线性回归探讨影响生活质量的因素。 结果： 共回收符合要求的调研问卷1 075份，中位年龄60（52，67）岁，男性占74.1%（797例）。总人群EQ-5D指数中位得分0.7（0.5，0.8）；EQ-视觉模拟量表（VAS）中位得分60.0（40.0，80.0）。在五个维度中，报告焦虑/抑郁的比例最高，为59.8%，自我照顾问题的比例最低，为35.8%。多元线性回归显示，女性、中老年、肥胖、有合并症、有焦虑抑郁、社交媒体渠道、冠状动脉旁路移植（CABG）治疗与EQ-5D评分呈负关联（均P<0.05）；老年、有合并症、有抑郁、焦虑合并抑郁、社交媒体渠道、CABG治疗与EQ-VAS评分呈负关联（均P<0.05）。 结论： 我国冠心病患者一半以上生活质量评分偏低，与性别、年龄、肥胖、治疗方式、有无合并症、情绪状态有关。临床除关注传统社会人口学因素对生活质量的不良影响，也应多关注患者心理状态。同时，医患交流群可改善冠心病患者生活质量。.
To explore the significance of lymphocytes in systemic sclerosis (SSc), by detecting the levels of T lymphocytes, B lymphocytes and natural killer (NK) cells, and analyzing the correlation between the lymphocytes and clinical laboratory indexes.The numbers and proportion of T, CD4+T, CD8+T, B, and NK cells were detected by flow cytometry in peripheral blood of 32 SSc patients who had taken immunosuppressive drugs and 30 healthy controls (HC). The comparison of the lymphocyte subsets in SSc with them in the HC groups, and the correlation between the lymphocytes and other clinical and laboratory indicators were analyzed by the relevant statistical analysis.Compared with the HC group, the numbers of T, CD4+T, CD8+T, and NK cells in peripheral blood of SSc group, who had taken immunosuppressive drugs, were significantly decreased (P < 0.05). More-over, the proportion of NK cells in peripheral blood of the SSc group was also significantly lower than that in the HC group (P=0.004). In addition, all the lymphocyte subsets were decreased in peripheral blood of more than 65% of the SSc patients who had taken immunosuppressive drugs. Compared with CD4+T normal group, the positivity of Raynaud's phenomenon, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) was significantly increased in CD4+T reduction group, respectively (P＝0.024, P < 0.001, P=0.018). ESR was higher in CD8+T reduction group than CD8+T normal group (P＝0.022). The prevalence of fingertip ulcer was significantly increased in B cell decrease group (P=0.019). Compared with NK cell normal group, the prevalence of fingertip ulcer was significantly increased in NK cell lower group (P=0.033), IgM was remarkablely decreased yet (P=0.049). The correlation analysis showed that ESR was negatively correlated with the counts of T lymphocytes (r＝－0.455, P＝0.009), CD4+T lymphocytes (r＝－0.416, P＝0.018), CD8+T lymphocytes (r＝－0.430, P=0.014), B cells (r＝－0.366, P＝0.039).The number of CD4+T, CD8+T, B, and NK cells significantly decreased in peripheral blood of SSc patients who had used immunosuppressive drugs, some lymphocyte subsets might be related with Raynaud's phenomenon and fingertip ulcer, and reflected the disease activity by negatively correlated with ESR and CRP; the numbers of lymphocyte subsets in peripheral blood should be detected regularly in SSc patients who had taken immunosuppressive drugs.
Abstract Aim Cognitive behavioral stress management (CBSM) has been introduced for the postoperative cancer management, but its application in intrahepatic cholangiocarcinoma (ICC) is rare. This current study constructed an offline to online CBSM (OO‐CBSM) program and applying multiple assessing scales, aiming at exploring the benefits of OO‐CBSM regarding anxiety, depression, spiritual well‐being, and quality of life (QoL) in postoperative ICC patients. Methods The study randomly assigned 68 postoperative ICC patients into OO‐CBSM ( N = 34) and normal care (NC) ( N = 34) groups to undergo 10‐week interventions. Hospital anxiety‐and‐depression scale (HADS), Zung's self‐reporting anxiety scale (SAS), and depression scale (SDS), functional‐assessment of chronic‐illness therapy‐spiritual well‐being scale (FACIT‐Sp), European quality‐of‐life‐5 dimensions (EQ‐5D), and quality‐of‐life questionnaire‐core30 (QLQ‐C30) were assessed within 6 months (M). Results HADS‐anxiety scores at M3 ( P = 0.049) and M6 ( P = 0.009), SAS score at M6 ( P = 0.028), HADS‐depression score at M3 ( P = 0.043), and SDS scores at M3 ( P = 0.044) and M6 ( P = 0.028), were lower in the OO‐CBSM group versus the NC group. Meanwhile, FACIT‐Sp scores at M1 ( P = 0.042) and M6 ( P = 0.003) were higher in the OO‐CBSM group over the NC group. Besides, EQ‐5D scores at M3 ( P = 0.067) and M6 ( P = 0.087) disclosed trends to be lower in the OO‐CBSM group versus the NC group, but not statistically significant. QLQ‐C30‐global‐health scores at M3 ( P = 0.049) and M6 ( P = 0.033), and QLQ‐C30‐function score at M6 ( P = 0.046), were higher in OO‐CBSM group over NC group; but QLQ‐C30‐symptom score was not significantly different at any timepoints between them. Conclusion OO‐CBSM attenuates anxiety and depression, and advances spiritual well‐being and QoL in postoperative ICC patients, indicating its potency for the ICC postoperative management.
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