Objective To investigate the current status of symptom burden and psychological distress among lung cancer patients in the diagnostic phase, and to explore the chain mediating role of social support and resilience between symptom burden and psychological distress. Methods The patients with lung cancer in the diagnostic phase who were treated in the Department of Thoracic Surgery of the Second Xiangya Hospital of Central South University from October 2022 to June 2023 were investigated by a general information questionnaire using the MD Anderson Symptom Inventory, the Social Support Rating Scale, the Connor-Davidson Resilience Scale, and the Distress Thermometer. The chain mediating role of social support and resilience between symptom burden and psychological distress was analyzed. Results A total of 413 lung cancer patients were enrolled, including 173 males and 240 females, aged (54.69±10.82) years. The detection rate of psychological distress among lung cancer patients in the diagnostic phase was 48.18%, and the average score was (3.84±2.50) points. Psychological distress was positively correlated with symptom burden (P<0.01), and negatively correlated with social support and resilience (P<0.01). The mediating effect of resilience between symptom burden and psychological distress was significant. The chain mediating effect of social support and resilience between symptom burden and psychological distress was also significant. Conclusion Lung cancer patients in the diagnostic phase have a high detection rate of psychological distress. Symptom burden can directly impact psychological distress, and can affect psychological distress through the indirect path of resilience as well as the chain mediating path between social support and resilience among lung cancer patients in the diagnostic phase.

BACKGROUND: Neuroticism has been associated with numerous health outcomes. However, most research has focused on a single specific disorder and has produced controversial results, particularly regarding mortality risk. Here, we aimed to examine the association of neuroticism with morbidity and mortality and to elucidate how neuroticism affects trajectories from a healthy state, to one or more neuroticism-related disorders, and subsequent mortality risk. METHODS: We included 483,916 participants from the UK Biobank at baseline (2006-2010). Neuroticism was measured using the Eysenck Personality Questionnaire. Three clusters were constructed, including worry, depressed affect, and sensitivity to environmental stress and adversity (SESA). Cox proportional hazards regression and multistate models were used. Linear regression was used to examine the association between neuroticism and immune parameters and neuroimaging measures. RESULTS: High neuroticism was associated with 37 non-overlapping diseases, including increased risk of infectious, cardiometabolic, neuropsychiatric, digestive, and respiratory diseases, and decreased risk of cancer. After adjustment for sociodemographic variables, physical measures, healthy behaviors, and baseline diagnoses, moderate-to-high neuroticism was associated with a decreased risk of all-cause mortality. In multistate models, high neuroticism was associated with an increased risk of transitions from a healthy state to a first neuroticism-related disease (hazard ratio [HR] [95% confidence interval (CI)] = 1.09 [1.05-1.13], P  <0.001) and subsequent transitions to multimorbidity (1.08 [1.02-1.14], P  = 0.005), but was associated with a decreased risk of transitions from multimorbidity to death (0.90 [0.84-0.97], P for trend = 0.006). The leading neuroticism cluster showing a detrimental role in the health-illness transition was depressed affect, which correlated with higher amygdala volume and lower insula volume. The protective effect of neuroticism against mortality was mainly contributed by the SESA cluster, which, unlike the other two clusters, did not affect the balance between innate and adaptive immunity. CONCLUSION This study provides new insights into the differential role of neuroticism in health outcomes and into new perspectives for establishing mortality prevention programs for patients with multimorbidity.
Humans ; Neuroticism/physiology* ; Male ; Female ; Middle Aged ; Aged ; Proportional Hazards Models ; Surveys and Questionnaires ; Adult ; Risk Factors

Objective To analyze the pattern of group medication in Parkinson's disease cognitive disorders based on data mining.Methods The famous TCM experience and effective clinical treatment of cognitive impairment in the treatment of Parkinson's disease were retrieved in databases of CNKI,Wanfang and Weipu,from the founding of the databases to August 2024.Medication rules were analyzed.Results A total of 60 Chinese prescriptions were included,including 120 traditional Chinese medicines.High-frequency drugs for the treatment of cognitive impairment in Parkinson's disease included Radix Rehmanniae Praeparata,Radix Paeoniae Alba,Rhizoma Gastrodiae Praeparata,Fructus Lycii,Herba Cistanches,Acorus Calamus and others.The flavour of the medicine were mainly sweet,bitter and pungent,the nature of the medicine was mainly warm,cold and calm and the meridians of the medicine were mainly liver,kidney and heart.Radix Rehmanniae Praeparata-Comu Cervi Pantotrichum,Rhizoma Gastrodiae Praeparata-Hooker's Tree,Radix Rehmanniae Praeparata-Cistanches are the commonly used pairs;Lycium barbarum-Cornus officinalis-Radix Rehmanniae Praeparata,Radix Rehmanniae Praeparata-Radix Angelicae Sinensis-Radix Paeoniae Alba were commonly used combination.Cluster analysis yielded 5 broad categories.Conclusion The primary pharmacological agents employed in traditional Chinese medicine to address cognitive impairment associated with Parkinson's disease emphasize the replenishment of essence and nourishing the marrow.These agents are complemented by nootropic substances that facilitate bodily openness,promote liver health,alleviate wind,resolve phlegm,and invigorate blood circulation and meridian pathways,worth of clinical promotion and application.

Objective To examine of Ye Tianshi's approach to managing internal wind through herbal remedies.Methods A comprehensive search was conducted for medical cases pertaining to internal wind,liver wind,dizziness,head wind,deficiency labor,liver fire,insomnia,convulsions,epilepsy,and headache within the Clinical Guidelines in Medical Cases.Statistical analysis of symptom elements,target locations of symptom elements,frequency of Chinese medicinal substances,their properties,and meridian affiliations was performed using Excel.Prescription patterns were further analyzed through association rules and high-frequency drug clustering.Results The study included a total of 167 medical cases,from which 241 symptom elements and 333 target locations were extracted.A total of 183 prescriptions were analyzed,comprising 132 medicinal substances with an overall frequency of 1309 occurrences.The five most frequently used Chinese medicines were Sheng Di Huang,Fu Shen,E Jiao,Fu Ling,and Shu Di Huang.The predominant property observed was cold,followed by warm and neutral;the most common flavor was sweet,succeeded by bitter and warm.The leading meridian affiliations identified were liver,kidney,lung,heart,and spleen.The drug association rule analysis revealed 14 items,while high-frequency drug clustering resulted in 9 distinct categories.Conclusion Ye Tianshi's therapeutic approach to internal wind emphasizes the concept of"yang transforming into internal wind."The core principles of this treatment strategy involve nourishing bodily fluids to mitigate wind,addressing excess conditions in the upper body while rectifying deficiencies in the lower body,and promoting tranquility in the liver and stomach.Additionally,the use of pungent and sweet flavors is employed to facilitate the transformation of wind,to clear the liver and dispel heat,to eliminate wind and resolve phlegm,to tonify qi and enhance defensive qi,and to clear heat in order to soothe the spirit.This methodology seeks to achieve harmony among the organs and meridians while pacifying internal wind.

Objective:To investigate the feasibility of the bortezomib, lenalidomide, and dexamethasone (VRD) regimen combined with autologous hematopoietic stem cell transplantation (auto-HSCT) in patients with multiple myeloma (MM) and renal impairment, analyze treatment efficacy and renal responses stratified based on renal dysfunction severity, and explore the prognostic significance of early renal response and its affecting factors.Methods:This retrospective study, conducted at the First Affiliated Hospital of Soochow University, categorized 316 patients with newly diagnosed MM (NDMM) from August 2018 to October 2022 based on renal function for analysis of clinical characteristics, treatment response, and prognosis. Continuous variables were compared using t-tests or Mann-Whitney U tests, categorical variables utilizing Chi-square tests, survival outcomes employing Kaplan-Meier and Log-rank tests, and renal response predictors with logistic regression.Results:Patients were stratified based on baseline estimated glomerular filtration rate (eGFR) : normal [≥90 ml·min -1· (1.73 m 2) -1, n=160], mild [≥60 ml·min -1· (1.73 m 2) -1 to <90 ml·min -1· (1.73 m 2) -1, n=55], moderate [≥30 ml·min -1· (1.73 m 2) -1 to <60 ml·min -1· (1.73 m 2) -1, n=39], and severe impairment [<30 ml·min -1· (1.73 m 2) -1, n=62]. Moderate and severe renal impairment correlated with advanced International Staging System/Revised International Staging System classification, lower hemoglobin levels, frailty, and higher light-chain/IgD subtype prevalence ( P<0.05). Despite younger age ( P=0.001) and higher transplant rates ( P=0.041) in severe cases, overall response rates ( ORR: 93.7% ; ≥VGPR: 82.9% ) were comparable across groups ( P>0.05). Among 24 dialysis-dependent patients at diagnosis, 11 (45.8% ) achieved dialysis independence after induction [median: 3.0 (0.5–4.0) months], including 10 undergoing auto-HSCT. In 89 evaluable patients [baseline eGFR <50 ml·min -1· (1.73 m 2) -1], renal ORR (RORR) was 70.8% [rapid complete response: 31.5% ; rapid partial response: 11.2% ; rapid minimal response (RMR) : 28.1% ]. Renal response predicted better survival (overall survival: HR=0.36, 95% CI: 0.13–0.99, P=0.049). Moderate-to-severe renal impairment was associated with increased transplant-related adverse events and delayed engraftment ( P<0.05) ; however, auto-HSCT significantly improved outcomes after 33.5-month median follow-up (range: 2–65 months). Multivariate analysis identified 1q21+ ( OR=3.58, 95% CI: 1.17–11.02, P=0.026) and light-chain subtype ( OR=2.86, 95% CI: 1.08–7.69, P=0.036) as independent predictors of poor renal response. Conclusion:VRD regimen plus auto-HSCT demonstrates robust efficacy in NDMM, including patients with renal impairment, with a 70.8% RORR and manageable toxicity. Achieving ≥RMR correlates with superior prognosis, whereas 1q21+ and light-chain subtype independently predict inferior renal response.

Objective To analyze the pattern of group medication in Parkinson's disease cognitive disorders based on data mining.Methods The famous TCM experience and effective clinical treatment of cognitive impairment in the treatment of Parkinson's disease were retrieved in databases of CNKI,Wanfang and Weipu,from the founding of the databases to August 2024.Medication rules were analyzed.Results A total of 60 Chinese prescriptions were included,including 120 traditional Chinese medicines.High-frequency drugs for the treatment of cognitive impairment in Parkinson's disease included Radix Rehmanniae Praeparata,Radix Paeoniae Alba,Rhizoma Gastrodiae Praeparata,Fructus Lycii,Herba Cistanches,Acorus Calamus and others.The flavour of the medicine were mainly sweet,bitter and pungent,the nature of the medicine was mainly warm,cold and calm and the meridians of the medicine were mainly liver,kidney and heart.Radix Rehmanniae Praeparata-Comu Cervi Pantotrichum,Rhizoma Gastrodiae Praeparata-Hooker's Tree,Radix Rehmanniae Praeparata-Cistanches are the commonly used pairs;Lycium barbarum-Cornus officinalis-Radix Rehmanniae Praeparata,Radix Rehmanniae Praeparata-Radix Angelicae Sinensis-Radix Paeoniae Alba were commonly used combination.Cluster analysis yielded 5 broad categories.Conclusion The primary pharmacological agents employed in traditional Chinese medicine to address cognitive impairment associated with Parkinson's disease emphasize the replenishment of essence and nourishing the marrow.These agents are complemented by nootropic substances that facilitate bodily openness,promote liver health,alleviate wind,resolve phlegm,and invigorate blood circulation and meridian pathways,worth of clinical promotion and application.

Objective To examine of Ye Tianshi's approach to managing internal wind through herbal remedies.Methods A comprehensive search was conducted for medical cases pertaining to internal wind,liver wind,dizziness,head wind,deficiency labor,liver fire,insomnia,convulsions,epilepsy,and headache within the Clinical Guidelines in Medical Cases.Statistical analysis of symptom elements,target locations of symptom elements,frequency of Chinese medicinal substances,their properties,and meridian affiliations was performed using Excel.Prescription patterns were further analyzed through association rules and high-frequency drug clustering.Results The study included a total of 167 medical cases,from which 241 symptom elements and 333 target locations were extracted.A total of 183 prescriptions were analyzed,comprising 132 medicinal substances with an overall frequency of 1309 occurrences.The five most frequently used Chinese medicines were Sheng Di Huang,Fu Shen,E Jiao,Fu Ling,and Shu Di Huang.The predominant property observed was cold,followed by warm and neutral;the most common flavor was sweet,succeeded by bitter and warm.The leading meridian affiliations identified were liver,kidney,lung,heart,and spleen.The drug association rule analysis revealed 14 items,while high-frequency drug clustering resulted in 9 distinct categories.Conclusion Ye Tianshi's therapeutic approach to internal wind emphasizes the concept of"yang transforming into internal wind."The core principles of this treatment strategy involve nourishing bodily fluids to mitigate wind,addressing excess conditions in the upper body while rectifying deficiencies in the lower body,and promoting tranquility in the liver and stomach.Additionally,the use of pungent and sweet flavors is employed to facilitate the transformation of wind,to clear the liver and dispel heat,to eliminate wind and resolve phlegm,to tonify qi and enhance defensive qi,and to clear heat in order to soothe the spirit.This methodology seeks to achieve harmony among the organs and meridians while pacifying internal wind.

Objective:To investigate the feasibility of the bortezomib, lenalidomide, and dexamethasone (VRD) regimen combined with autologous hematopoietic stem cell transplantation (auto-HSCT) in patients with multiple myeloma (MM) and renal impairment, analyze treatment efficacy and renal responses stratified based on renal dysfunction severity, and explore the prognostic significance of early renal response and its affecting factors.Methods:This retrospective study, conducted at the First Affiliated Hospital of Soochow University, categorized 316 patients with newly diagnosed MM (NDMM) from August 2018 to October 2022 based on renal function for analysis of clinical characteristics, treatment response, and prognosis. Continuous variables were compared using t-tests or Mann-Whitney U tests, categorical variables utilizing Chi-square tests, survival outcomes employing Kaplan-Meier and Log-rank tests, and renal response predictors with logistic regression.Results:Patients were stratified based on baseline estimated glomerular filtration rate (eGFR) : normal [≥90 ml·min -1· (1.73 m 2) -1, n=160], mild [≥60 ml·min -1· (1.73 m 2) -1 to <90 ml·min -1· (1.73 m 2) -1, n=55], moderate [≥30 ml·min -1· (1.73 m 2) -1 to <60 ml·min -1· (1.73 m 2) -1, n=39], and severe impairment [<30 ml·min -1· (1.73 m 2) -1, n=62]. Moderate and severe renal impairment correlated with advanced International Staging System/Revised International Staging System classification, lower hemoglobin levels, frailty, and higher light-chain/IgD subtype prevalence ( P<0.05). Despite younger age ( P=0.001) and higher transplant rates ( P=0.041) in severe cases, overall response rates ( ORR: 93.7% ; ≥VGPR: 82.9% ) were comparable across groups ( P>0.05). Among 24 dialysis-dependent patients at diagnosis, 11 (45.8% ) achieved dialysis independence after induction [median: 3.0 (0.5–4.0) months], including 10 undergoing auto-HSCT. In 89 evaluable patients [baseline eGFR <50 ml·min -1· (1.73 m 2) -1], renal ORR (RORR) was 70.8% [rapid complete response: 31.5% ; rapid partial response: 11.2% ; rapid minimal response (RMR) : 28.1% ]. Renal response predicted better survival (overall survival: HR=0.36, 95% CI: 0.13–0.99, P=0.049). Moderate-to-severe renal impairment was associated with increased transplant-related adverse events and delayed engraftment ( P<0.05) ; however, auto-HSCT significantly improved outcomes after 33.5-month median follow-up (range: 2–65 months). Multivariate analysis identified 1q21+ ( OR=3.58, 95% CI: 1.17–11.02, P=0.026) and light-chain subtype ( OR=2.86, 95% CI: 1.08–7.69, P=0.036) as independent predictors of poor renal response. Conclusion:VRD regimen plus auto-HSCT demonstrates robust efficacy in NDMM, including patients with renal impairment, with a 70.8% RORR and manageable toxicity. Achieving ≥RMR correlates with superior prognosis, whereas 1q21+ and light-chain subtype independently predict inferior renal response.

Objective To analyze the value of systemic inflammatory indicators in diagnosing schizo-phrenia and their correlation with disease condition severity and cognitive dysfunction.Methods A total of 47 patients with schizophrenia visited and treated in this hospital from October 2021 to March 2023 were selected as the study subjects,and 47 healthy volunteers during the same period served as the control group.The morn-ing fasting venous blood was collected in all research subjects,and the blood routine and biochemical indicators were measured.The SII,SIRI,NHR and LHR were calculated.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of SII,SIRI,NHR and LHR in the patients with schizophrenia.The correlation adopted the Pearson correlation analysis.Results The levels of SII,SIRI,NHR and LHR in the schizophrenia group were significantly increased compared with the control group,and the difference was statistically significant(P＜0.05).The ROC curve analysis demonstrated that the area under the curve(AUC)of SII,SIRI,NHR and LHR detection alone in diagnosing schizophrenia were 0.683,0.686,0.774 and 0.766 respectively.AUC of their combination detection was 0.886.SII was positively correlated with the gen-eral symptoms and the positive and negative symptom scale(PANSS)total score,and negatively correlated with the spatial structure,linguistic function and delayed memory(P＜0.05);SIRI was positively correlated with the negative symptoms,general symptom and PANSS total score,and negatively correlated with the im-mediate memory,spatial structure,linguistic function,attention;NHR was positively correlated with the nega-tive symptoms,positive symptoms,general symptoms and PANSS total score,and negatively correlated with immediate memory,linguistic function,attention and delayed memory(P＜0.05).LHR was positively corre-lated with the positive symptoms,general symptoms and PANSS total score,and negatively correlated with the spatial structure,linguistic function,attention and delayed memory(P＜0.05).Conclusion SII,SIRI,NHR and LHR combined detection has higher diagnostic value for the patients with schizophrenia.Further-more,the SII,SIRI,NHR and LHR levels are closely correlated with the disease condition severity and cogni-tive function impairment degree.

Objective To analyze the influencing factors of survival of patients with airway stenosis requiring clinical interventions after lung transplantation. Methods Clinical data of 66 patients with airway stenosis requiring clinical interventions after lung transplantation were retrospectively analyzed. Univariate and multivariate Cox’s regression models were adopted to analyze the influencing factors of survival of all patients with airway stenosis and those with early airway stenosis. Kaplan-Meier method was used to calculate the overall survival and delineate the survival curve. Results For 66 patients with airway stenosis, the median airway stenosis-free time was 72 (52,102) d, 27% (18/66) for central airway stenosis and 73% (48/66) for distal airway stenosis. Postoperative mechanical ventilation time [hazard ratio (HR) 1.037, 95% confidence interval (CI) 1.005-1.070, P=0.024] and type of surgery (HR 0.400, 95%CI 0.177-0.903, P=0.027) were correlated with the survival of patients with airway stenosis after lung transplantation. The longer the postoperative mechanical ventilation time, the higher the risk of mortality of the recipients. The overall survival of airway stenosis recipients undergoing bilateral lung transplantation was better than that of their counterparts after single lung transplantation. Subgroup analysis showed that grade 3 primary graft dysfunction (PGD) (HR 4.577, 95%CI 1.439-14.555, P=0.010) and immunosuppressive drugs (HR 0.079, 95%CI 0.022-0.287, P<0.001) were associated with the survival of patients with early airway stenosis after lung transplantation. The overall survival of patients with early airway stenosis after lung transplantation without grade 3 PGD was better compared with that of those with grade 3 PGD. The overall survival of patients with early airway stenosis after lung transplantation treated with tacrolimus was superior to that of their counterparts treated with cyclosporine. Conclusions Long postoperative mechanical ventilation time, single lung transplantation, grade 3 PGD and use of cyclosporine may affect the survival of patients with airway stenosis after lung transplantation.