Systemic inflammatory index as a predictive marker for the severity of coronary artery disease in individuals with chronic kidney disease

Objective To evaluate the correlation between the inflammatory intensity,as indicated by the systemic inflammatory index(SII),and the severity of coronary artery disease(CAD)in patients with chronic kidney disease(CKD).Methods A total of 280 CKD patients who underwent coronary angiography were enrolled.CAD was evaluated using the Gen-sini score(GS).Patients were divided into the low,medium and high SII groups according to the tertiles of the SII values.Logist-ic regression analysis was conducted to analyze the relationship between SII and GS.The cutoff points for the sensitivity and spe-cificity of SII in predicting GS were estimated by performing the receiver operating characteristic curve analysis.Results Patients in the higher SII group had a higher prevalence of CAD(P=0.013).In addition,the high SII group had more pa-tients with complex CAD(triple-vessel disease and/or left main coronary artery stenosis)and chronic total occlusion lesions,and more patients required revascularization(P<0.05).Correlation analysis suggested a positive relationship between SII and GS,and in comparison to neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio,SII displayed a stronger correlation with GS(r=0.332,P<0.001).Multifactorial logistic regression analysis revealed that SII is independently associated with the severity of CAD(adjusted OR=1.14,95%CI:1.08-1.21,P<0.01),particularly among elderly patients(age≥65 years).Receiver operating charact-eristic curve analysis indicated that the optimal cutoff value for SII in predicting severe coronary artery stenosis(GS>60)was 6.01(sensitivity:76.30%,specificity:53.50%),with an area under the curve(AUC)of 0.705(95%CI:0.642-0.768,P<0.001),which was sta-tistically significantly better than platelet-to-lymphocyte ratio(AUC=0.646,95%CI:0.579-0.713,P<0.001)and neutrophil-to-lym-phocyte ratio(AUC=0.643,95%CI:0.574-0.712,P<0.001).Conclusions In patients with CKD,SII is independently associated with the severity of CAD,especially in individuals aged 65 ye-ars or older.Furthermore,SII functions as a predictive marker for the severity of coronary lesions.

射流管与偏转板射流液压放大器的模型综述（英文）

射流管与偏转板射流液压放大器的模型对射流型电液伺服阀的性能仿真、设计和使用至关重要。虽然,目前还没有准确的数学模型能够对其性能进行描述,但是有大量的近似模型可供使用。为给射流型电液伺服阀的设计提供一定的理论指导,介绍了六个具有代表性的模型,并对这些模型的应用条件和范围进行了阐述。

Systemic immune-inflammation index for predicting prognosis of colorectal cancer

AIM To investigate the clinical significance of preoperative systemic immune-inflammation index(SII) in patients with colorectal cancer(CRC). METHODS A retrospective analysis of 1383 cases with CRC was performed following radical surgery. SII was calculated with the formula SII =(P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively. The clinicopathological features and follow-up data were evaluated to compare SII with other systemic inflammation-based prognostic indices such as the neutrophil-lymphocyte ratio(NLR) and platelet-lymphocyte ratio(PLR) in patients with CRC.RESULTS The optimal cut-off point for SII was defined as 340. The overall survival(OS) and disease-free survival(DFS) were better in patients with low NLR, PLR, and SII(P < 0.05). The SII was an independent predictor of OS and DFS in multivariate analysis. The area under the receiver-operating characteristics(ROC) curve for SII(0.707) was larger than those for NLR(0.602) and PLR(0.566). In contrast to NLR and PLR, SII could effectively discriminate between the TNM subgroups. CONCLUSION SII is a more powerful tool for predicting survival outcome in patients with CRC. It might assist the identification of high-risk patients among patients with the same TNM stage.

Novel immunological and nutritional-based prognostic index for gastric cancer

AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index(PNI), neutrophillymphocyte ratio(NLR), and platelet-lymphocyte ratio in gastric cancer.METHODS: We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate.Univariate and multivariate analyses were performed to identify risk factors for overall survival(OS). Propensity score analysis was performed to adjust variables to control for selection bias.RESULTS: Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring(hazard ratio, 1.668; 95% confidence interval:1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage Ⅱ-Ⅲ disease(P = 0.019, P < 0.001), T3-T4 tumors(P <0.001), or lymph node metastasis(P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS(P = 0.022, P = 0.030, P < 0.001, and P = 0.024,respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively.CONCLUSION: PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer.

康柏西普联合玻璃体切除术治疗PDR的疗效及术后再积血的影响因素分析

目的:观察康柏西普联合25G微创玻璃体切除术治疗增生性糖尿病视网膜病变(PDR)的临床效果,并分析术后玻璃体再积血的影响因素。方法:选取2017-04/2019-11于我院确诊并治疗的PDR患者179例179眼,根据患者病情和意愿分组,观察组108例行康柏西普联合25G微创玻璃体切除术,对照组71例仅行25G微创玻璃体切除术。比较两组患者术前基线资料、术中情况、手术前后最佳矫正视力(BCVA)、眼压、N1波潜伏期波幅、黄斑区中央凹视网膜厚度(CMT)及术后并发症情况,分析PDR患者术后玻璃体再积血的影响因素。结果:观察组患者手术时间、术中出血率、电凝止血使用率、医源性视网膜裂孔发生率、激光点数及硅油填充率均低于对照组(P<0.05)。两组术后6mo BCVA、CMT及N1波潜伏期波幅均较术前改善,且观察组优于对照组(均P<0.05)。观察组总并发症发生率明显低于对照组(14.8%vs 40.8%,P<0.05)。发生术后玻璃体再出血患者31例31眼,多因素Logistic回归分析结果显示,HbA1c升高、血管闭塞、增生视网膜牵引及未使用康柏西普治疗是PDR患者术后玻璃体再积血的危险因素。结论:康柏西普联合25G微创玻璃体切除术治疗PDR可降低术中出血率,减少并发症,缩短手术时间,进而利于提高视力,改善视功能。有效控制血糖以降低HbA1c水平,术中尽量剥除纤维血管增生膜以解除视网膜牵引,并联合使用康柏西普进行治疗,可降低术后玻璃体再积血发生的风险。

Clinicopathological features and trend changes of gastric carcinoma in Southern China

AIM: To investigate the clinicopathological features of gastric carcinoma in southern China and disease trends changes over the last 18 years.

Vagina vasorum dissection during D2 lymphadenectomy for gastric carcinoma

AIM: To explore the relationship between metastasis and vagina vasorum in the progress of gastric carcinoma and to find some facts and references for gastric surgeons. METHODS: One hundred and seven specimens of left or right gastric arteries (55 left and 52 right) were gathered from 59 patients undergoing radical gastrectomy for gastric carcinoma. All the frozen specimens were cut into 3 μm-thick sections and stained with hematoxylin-eosin (HE) and immunohistochemical method separately. Cytokeratin (CK) and mesothelial cells (MC) were stained with immunohistochemical method. Cancer cells inside vagina vasorum were detected and the structure of artery wall was observed under microscope. RESULTS: Metastatic cancer cells or tubercles were found inside vagina vasorum in some stage Ⅲ or Ⅳ specimens, but not in stageⅠor Ⅱ specimens. Tumor cells in vagina vasorum were CK positive in 26 specimens of 14 tumors. Among them, stage Ⅲ was found in 4 specimens of 2 tumors, and stage Ⅳ in 22 specimens of 12 tumors. None of these specimens was positive for MC. The positive rate of CK increased with TNM staging. Compared with the lower part, tumors in the upper and middle parts of stomach were more likely to metastasize into vagina vasorum. CONCLUSION: Vagina vasorum dissection should be performed during D2 lymphadenectomy for TNM stage Ⅲ or Ⅳ gastric carcinoma.