The association between socioeconomic status and health-related quality of life among young and middle-aged maintenance hemodialysis patients: multiple mediation modeling

ObjectiveTo explore the relationship between socioeconomic status (SES), illness perception, social functioning, and health-related quality of life (HRQoL) of young and middle-aged maintenance hemodialysis (MHD) patients and the internal mechanism of action.DesignA multicenter cross-sectional study.MethodsAn aggregate of 332 young and middle-aged MHD patients were enrolled from hemodialysis centers in four general hospitals in Guangzhou, Guangdong, China, from June to December 2022. The questionnaires used included one for general demographic data, the Brief Illness Perception Questionnaire (BIPQ), Social Dysfunction Screening Scale (SDSS), and the 12-item Short Form Health Survey (SF-12).ResultsBoth SES and HRQoL were negatively correlated with illness perception and social functioning, respectively. SES was positively correlated with HRQoL. Illness perception was positively correlated with social functioning. The indirect effects of illness perception and social functioning on the relationship between SES and HRQoL were 0.33 and 0.31, making up 41.06% and 38.91% of the sum. The chain indirect effect of illness perception and social functioning was 0.10, making up 12.59% of the total effect, while gender did not play a moderating role.ConclusionIllness perception and social functioning may independently and accumulatively mediate the association between SES and HRQoL. Nurses should consider developing individual intervention program for young and middle-aged MHD patients with low SES, focusing on establishing targeted counseling and health education strategies corresponding to illness perception and social functioning to help patients improve their HRQoL

MicroRNAs are Related to Rituximab in Combination with Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone Resistance in Patients with Diffuse Large B-cell Lymphoma

Aim: Rituximab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) treatment failure is a rigorous problem in patients with diffuse large B-cell lymphoma (DLBCL), which usually predicts poor survival. The study explored the association of microRNAs with R-CHOP resistance in order to find reliable predictive factors and novel therapeutic targets. Methods: Forty-five newly diagnosed cases with DLBCL were administered with R-CHOP regimen. Thirty-three of them were divided into the sensitive group and 12 of them into the resistant group based on their response to the treatment. Both microRNAs and gene expression profilings were examined with microarray in these patients. Results: Six microRNAs were found to have significant difference between R-CHOP sensitive and resistant groups, including microRNA-9, microRNA-146a, microRNA-363, microRNA-488, microRNA-548d-3p, and microRNA-219-1-3p (P 1). Multivariate analysis showed that both microRNA-146a and microRNA-548d-3p were inversely correlated with resistance while microRNA-363 and microRNA-219-1-3p were directly correlated with resistance. Although both molecular subtypes based on cellular origin (Pearson correlation = 0.368, P = 0.023) and multiple extranodal involvement (Pearson correlation = 0.352, P = 0.030) manifested the association with R-CHOP resistance, these specific microRNAs remained independent predictors of clinical outcome in multivariate analysis. In addition, microRNA-146a was proved to have linkages with multiple extranodal involvements. Molecular subtypes based on a cellular origin were not verified to correlate with specific microRNAs. These specific microRNAs could predict resistance in 92.1% of patients in the present study. Conclusion: The expression of specific microRNAs may serve as useful biomarker for prediction of response to R-CHOP therapy in patients with DLBCL