There are 4 methods to determine a minimal clinically important difference (MCID) currently, namely anchor-based method, distribution-based method, opinion-based method, and literature review. The anchor-based method offers the clinical significance of MCID, but it does not consider the measurement error. The anchor-based method is limited due to difficulty to obtained a suitable anchor in most cases, and variation of MCID with the anchor. The distribution-based method takes measurement error into account, and is easily implemented. The distribution-based method can not provide the clinical explanation of MCID, and the MCID from different samples might differ from each other. There is no golden criterion to judge MCID by distribution-based method so far. The opinion-based method and literature review are based on the opinions of experts and the published literature, respectively. They are usually regarded as a supplement to anchor-based method and distribution-based method. It is suggested that anchor-based method, distribution-based method, and opinion-based method should be used together when determining a MCID.
Activities of Daily Living ; Clinical Medicine ; methods ; Health Status Indicators ; Humans ; Outcome Assessment, Health Care ; methods ; Quality of Life ; Surveys and Questionnaires ; standards ; Treatment Outcome

BACKGROUNDTo explore a rapid and accurate method for examining cancer cell from the sputum in patients with lung cancer.

METHODSOne hundred and twenty patients with lung cancer diagnosed by operation and pathologically confirmed were enrolled in this study. Sputum sediment section and sputum smear examinations were performed and compared for diagnosis of lung cancer.

RESULTS(1) The positive rate of lung cancer cell was 71.67% (86/120) by sputum sediment section examination, however, only 31.67% (38/120) by sputum smear examination ( P < 0.001). The diagnostic rate of combination of two methods for lung cancer was 90.83% (109/120), which was significantly higher than that of single sputum sediment section examination ( P < 0.001). (2) With routine HE staining, 55 patients (55/86,63.95%) could be histologically identified by sputum sediment section examination, but only 6 patients (6/38,15.79%) by sputum smear examination ( P < 0.001). (3) In 31 patients unidentified with routine HE staining, 29 were further histologically confirmed by sputum sediment section examination with immunohistochemistry.

CONCLUSIONSCompared to sputum smear examination, sputum sediment section examination can make use of more sputum materials, show a higher sensitivity for cancer cell, and accurately identify the histological classification of tumor. It is supposed to be a good examination for lung cancer and deserved to be extended in clinical application.

Objective To compare the application of multifunctional ureterostomy stent and traditional ureterostomy internal stent in patients with total ureterostomy.Methods Prospectively,102 patients with bladder cancer and undergoing elective radical cystectomy with urinary diversion admitted to our hospital from March 2019 to March 2023 were selected for the study.According to the random number rank method,the patients were divided into the study group(51 cases)and the control group(51 cases).The control group was given a traditional single-J ureteral stomy stent drainage device,and the research group was given a multifunctional ureteral stomy stent drainage device.The differences of OAI score,renal function index(eGFR),recent complications,long-term complications and quality of life(FACT-BL score)were compared between the two groups.Results OAI scores 1 month,3 months and 6 months after surgery(study group:49.33±4.07,57.29±3.90,68.25±3.76;control group:44.25±4.61,52.31±4.58,59.06±4.37)and before surgery(study group:32.71±4.32;control group:33.18±4.74)compared with higher levels(P＜0.05),but the study group was higher than the control group(P＜0.05).Repeated measurement ANOVA results showed that eGFR at 3 months and 6 months after surgery(study group:86.07±4.07,88.01±3.01;control group:83.09±3.06,85.06±5.09)and before surgery(study group:82.05±6.04;control group:81.03±5.06)compared with higher levels(P＜0.05),but the study group was higher than the control group(P＜0.05).The total rate of recent complications in the study group was lower than that in the control group(7.84％VS 23.53％,P＜0.05).The total incidence of long-term complications in the study group was lower than that in the control group(43.14％VS 78.43％,P＜0.05).Emotional status score,physical status score,functional status score,social and family status score,BSS score,FACT-BL total score of the two groups 6 months after surgery(study group:20.25±2.36,24.92±1.87,25.65±1.11,26.02±1.14,32.75±1.76,129.59±5.74;Control group:18.65±3.10,20.18±3.02,23.51±1.29,21.51±2.24,30.26±3.07,114.10±10.37)and preoperative(study group:14.27±3.56,16.57±3.58,17.27±2.35,17.49±2.64,23.41±5.25,89.02±13.62;Control group:14.39±3.44,16.47±3.25,17.22±2.34,17.55±2.59,23.43±5.25,89.25±13.62)were increased(P＜0.05),and the study group was higher than the control group(P＜0.05).Conclusion The application of multifunctional ureteral stent in patients with ureteral cutaneous stomy with total cystotomy can effectively improve the adaptability of stomy,promote the recovery of renal function,reduce the risk of short-term and long-term complications,and improve the quality of life of patients.