Objective To explore the mediating role of activities of daily living and sleep duration in the relationship between pain and depressive symptoms in lung cancer patients undergoing chemotherapy, and to provide suggestions for improving the well-being of cancer patients. Methods Using convenience sampling, middle-aged and elderly lung cancer patients receiving postoperative chemotherapy at the First Affiliated Hospital of Soochow University were selected as the study subjects between January and December 2024. Data were collected using a general information questionnaire, the Numerical Pain Rating Scale, the Center for Epidemiological Studies Depression Scale, and the activities of daily living Scale. Results A total of 252 patients were included. The depression score of lung cancer chemotherapy patients was (20.05±15.73) scores. Pain was positively correlated with activities of daily living and depression (P<0.001) and negatively correlated with sleep duration (P<0.001). The mediating effects of activities of daily living and sleep duration between pain and depression were significant, with simple mediating effects of 0.252 [95%CI (0.044, 0.494)] and 0.127 [95%CI (0.010, 0.281)], respectively. The chain mediating effect was 0.039 [95%CI (0.002, 0.105)]. The total mediating effect value was 0.418, accounting for 33.2% of the total effect. Conclusions The incidence of depression is high among middle-aged and elderly lung cancer patients undergoing chemotherapy. Activities of daily living and sleep duration play a chain mediating role between pain and depression. The mental health of lung cancer chemotherapy patients should be emphasized at different levels. Multi-faceted psychological interventions and emotional support should be implemented to effectively improve their depressive symptoms and enhance their well-being.
Objective To investigate the effectiveness of free palmaris longus tendon graft reconstruction in the treatment of gouty tophus erosion lesions in flexor tendon of wrist and hand. MethodsA retrospective analysis was conducted on 8 patients with gouty tophus erosion lesions in flexor tendon of wrist and hand who underwent free palmaris longus tendon graft reconstruction between June 2017 and December 2023. All patients were male, aged 22-65 years, with an average of 45.9 years. The duration of gout history ranged from 2 to 18 years, with an average of 8.8 years. The duration from the discovery of gouty tophus to operation ranged from 12 to 26 months, with an average of 17.6 months. The gouty tophus eroded the flexor pollicis longus tendon in 4 cases, with Verdan flexor tendon zones being Ⅰ-Ⅱ in 1 case and Ⅳ-Ⅴ in 3 cases. The flexor digitorum profundus tendons were affected in 2 cases for the index finger, 1 for the middle finger, and 1 for the ring finger, all located in zone Ⅳ-Ⅴ. The long axis of the gouty tophus ranged from 2.3 to 4.5 cm, with an average of 3.4 cm. All 8 patients presented with limited finger flexion and extension. Among them, 4 cases were accompanied by median nerve compression symptoms, and 1 case had associated bone and joint destruction in the hand. The total active motion (TAM) of the affected finger was (81.3±30.2)° before operation according to the hand function evaluation criteria for tendon repair by the Chinese Society of Hand Surgery of the Chinese Medical Association, and the functional evaluation was poor. The harvested palmaris longus tendon intraoperatively was 7-9 cm in length. Results Surgical incisions in all 8 patients healed by first intention, with no infections, graft non-union, or significant adhesion complications. All patients were followed up 8-25 months, with an average of 14.8 months. Numbness symptoms resolved in all 4 patients who presented with median nerve compression symptoms. Patients did not experience wrist pain or other discomfort, and function was not compromised. At last follow-up, according to the hand function evaluation criteria for tendon repair by the Chinese Society of Hand Surgery of the Chinese Medical Association, the TAM of 8 patients was (197.5±55.8)°, which significantly improved when compared with that before operation (t=11.638, P<0.001); the hand function of 1 patient with gouty tophus in zone Ⅰ-Ⅱ flexor pollicis longus tendon was good, and the other 7 patients were excellent. ConclusionFree palmaris longus tendon graft reconstruction demonstrates good effectiveness in treating gouty tophus erosion lesions in flexor tendon of wrist and hand.