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排序方式: 共有385条查询结果,搜索用时 281 毫秒
1.
文章通过对国内"医享网"癌症社区"肺癌圈"中33篇精华帖的叙事分析,探究其中生命故事的主体对自我身份的建构路径及其对生命价值的意义探寻,并尝试性地提出一些反思。研究发现,在自述和他述生命故事中,叙事者在信息寻求过程中改善自我印象,并运用"写作疗法""阅读疗法"和叙事隐喻理解疾病,帮助患者重塑自身角色。通过社群互动,患者形塑了对自身的身份认同,并形成了集体层面的生命价值观。从本研究的结论看,疾病叙事是癌症网络社区患者建构个体身份、形成身份认同的重要途径,叙事或可成为未来增进社会对癌症乃至其他疾病的理解、推进治疗与康复的可行之路。  相似文献   
2.
One of the challenges in the design of confirmatory trials is to deal with uncertainties regarding the optimal target population for a novel drug. Adaptive enrichment designs (AED) which allow for a data-driven selection of one or more prespecified biomarker subpopulations at an interim analysis have been proposed in this setting but practical case studies of AEDs are still relatively rare. We present the design of an AED with a binary endpoint in the highly dynamic setting of cancer immunotherapy. The trial was initiated as a conventional trial in early triple-negative breast cancer but amended to an AED based on emerging data external to the trial suggesting that PD-L1 status could be a predictive biomarker. Operating characteristics are discussed including the concept of a minimal detectable difference, that is, the smallest observed treatment effect that would lead to a statistically significant result in at least one of the target populations at the interim or the final analysis, respectively, in the setting of AED.  相似文献   
3.
Randomised controlled trials are considered the gold standard in trial design. However, phase II oncology trials with a binary outcome are often single-arm. Although a number of reasons exist for choosing a single-arm trial, the primary reason is that single-arm designs require fewer participants than their randomised equivalents. Therefore, the development of novel methodology that makes randomised designs more efficient is of value to the trials community. This article introduces a randomised two-arm binary outcome trial design that includes stochastic curtailment (SC), allowing for the possibility of stopping a trial before the final conclusions are known with certainty. In addition to SC, the proposed design involves the use of a randomised block design, which allows investigators to control the number of interim analyses. This approach is compared with existing designs that also use early stopping, through the use of a loss function comprised of a weighted sum of design characteristics. Comparisons are also made using an example from a real trial. The comparisons show that for many possible loss functions, the proposed design is superior to existing designs. Further, the proposed design may be more practical, by allowing a flexible number of interim analyses. One existing design produces superior design realisations when the anticipated response rate is low. However, when using this design, the probability of rejecting the null hypothesis is sensitive to misspecification of the null response rate. Therefore, when considering randomised designs in phase II, we recommend the proposed approach be preferred over other sequential designs.  相似文献   
4.
In Europe, countries following the traditional Mediterranean Diet (MeDi), particularly Southern European countries, have lower prostate cancer (PCa) incidence and mortality compared to other European regions. In the present study, we investigated the association between the MeDi and the relative risk of PCa and tumor aggressiveness in a Spanish population. Among individual score components, it has been found that subjects with PCa were less likely to consume olive oil as the main culinary fat, vegetables, fruits and fish than those without. However, these differences were not statistically significative. A high intake of fruit, vegetables and cooked tomato sauce Mediterranean style (sofrito) was related to less PCa aggressiveness. Results showed that there are no differences in the score of adherence to the Mediterranean dietary patterns between cases and controls, with mean values of 8.37?±?1.80 and 8.25?±?2.48, respectively. However, MeDi was associated with lower PCa agressiveness according to Gleason score. Hence, relations between Mediterranean dietary patterns and PCa are still inconclusive and merit further investigations. Further large-scale studies are required to clarify the effect of MeDi on prostate health, in order to establish the role of this diet in the prevention of PCa.  相似文献   
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6.
Researchers consider older women in rural Appalachia to have low levels of agency and high levels of fatalism regarding decision making about cancer treatment. Using the life course perspective, we examined older women’s agency with information seeking about gynecological cancer. Semistructured interviews with 20 White women living in central Appalachia revealed four trajectories: Surrendering Control, Accepting Death, Self-Care, and Advocacy, each with its own forms of agency. Some women experienced personal transformation, increased self-efficacy, and a passion for community empowerment. Fatalism was not understood apart from placing trust in medical expertise. We implore researchers to further explore rural expressions of agency.  相似文献   
7.
For high dimensional data, the SigClust is developed for testing the significance of clustering. The cluster index (CI) for SigClust is conducted by the ratio of the within-cluster and total sum of squares. But its empirical size is too conservative to be over controlled. By removing the cumbrous terms in the CI, an improved index (BCI) is proposed in this paper. The coefficient of variation of the BCI can be significantly reduced, implying that the new index BCI is stable. Moreover, the new significance test (NewSig) maintains the size, meanwhile, provides a greater power. Simulation experiments and two real cancer data examples are analysed for illustrating the performance of the new methodology.  相似文献   
8.
目的探索EEFSEC基因(rs10934853,A)、染色体17q24区(rs1859962,T)和染色体11q13.2(rs7931342,T)的基因变异类型与前列腺癌患病发病风险的关联,分析这些基因型与前列腺癌患者临床特征的关系。方法采用病例对照研究设计,比较病例组中124例患者和对照组中138例正常对照者的EEFSEC基因(rs10934853,A)、染色体17q24区(rs1859962,T)和染色体11q13.2(rs7931342,T)等位基因和基因型频率的差异,并探讨各基因变异与患者的确诊年龄,BMI,Gleason评分,PSA浓度,肿瘤分期等临床特征之间的关联。结果 EEFSEC基因(rs10934853,A)、染色体17q24区(rs1859962,T)和染色体11q13.2(rs7931342,T)的基因型和等位基因在病例组和对照组中的频率分布差异均无统计学意义(P0.05),然而,EEFSEC基因(rs10934853,A)和染色体17q24区(rs1859962,T)存在更强的基因-基因协同的交互作用(P=0.0396,OR=1.722,95%CI=1.0244~2.8944);病例组基因型-表型观察指标关联分析表明,3个SNPs与PCa患者的年龄、Gleason评分、PSA浓度及烟酒均无关联(P0.05),然而,染色体17q24区(rs1859962,T)位点与食用蛋类有关(P=0.005)。结论 EEFSEC基因(rs10934853,A),17q24(rs1859962,T)和11q13.2(rs7931342,T)位点可能与我国北方人群前列腺癌的发病风险无关联,但是存在有基因之间增加PCa发病风险的协同效应。  相似文献   
9.
目的探索THADA基因(rs1465618,G/A),(rs2660753,A/G),LOC101929491基因(rs7679673,A/C)和PRNCR1基因(rs1016343,C/T)等4个单核苷酸多态性位点(SNPs)的常见变异与中国北方人群前列腺癌(PCa)的关联。方法采集来自北京医院的138名正常对照和125例PCa患者的血液样本和临床信息。提取样本DNA,用高分辨率熔解曲线分析技术(HRM)对4个SNP(rs1465618,rs2660753,rs7679673和rs101634343)进行基因分型。结果 rs1465618的GG基因型与AG和AA基因型在病例组与对照组间存在显著性差异(P=0.015,OR=1.985;95%CI=1.012~7.732),病例组与对照组间其余3个SNP位点rs2660753(P=0.545),rs7679673(P=0.634),rs1016343(P=0.705)的各个基因型分布没有统计学意义(P0.05)。病例组不同基因型间的表型和环境影响因素分析观察到,rs1465618与常食用蛋类有关(P=0.004),rs2660753与常食用豆制品有关(P=0.04),rs7679673与Gleason评分等级(P=0.034)、PSA浓度等级(P=0.035)及自觉营养状况(P=0.019)均有关,rs1016343与年龄有关(P=0.019)。数量性状分析表明,rs2660753与PCa患者的病程有关(P=0.023),rs1016343与PCa患者食用蛋类数量有关(P=0.002)。结论 rs1465618与中国北方人群的PCa患病显著关联,而rs2660753、rs7679673和rs1016343的常见变异与中国北方人群PCa患病表型和环境影响因素有明显关联。  相似文献   
10.
目的通过Meta分析对紫杉醇+顺铂(TP)与吉西他滨+顺铂(GP)化疗方案对肺癌抗肿瘤药物治疗患者骨髓抑制的影响进行系统分析,探讨TP和GP的骨髓抑制差别。方法通过荟萃分析对TP与GP的骨髓抑制研究进行同质性检验和合并效应量的估计。结果同质性检验:χ2=91.84,自由度为29,P0.00001;合并效应量的估计:OR合并=1.36,OR合并95%可信限为0.90~2.04。OR合并的检验Z=1.482.41,P=0.14。结论 TP与GP化疗时对患者的骨髓抑制不良反应情况没有本质区别。  相似文献   
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