Background:There is no consensus regarding the influence of prophylactic no.10 lymph node(LN)dissection in patients with advanced gastric cancer(AGC).We aimed to evaluate whether patients with AGC could benefit from n...Background:There is no consensus regarding the influence of prophylactic no.10 lymph node(LN)dissection in patients with advanced gastric cancer(AGC).We aimed to evaluate whether patients with AGC could benefit from no.10 LN dissection and to explore the clinicopathological indicators of no.10 LN metastasis.Methods:We analyzed the data of 218 patients with AGC who underwent standard D2 lymphadenectomy(SD2;n=108)or modified D2 lymphadenectomy(MD2;n=110)between January 2017 and January 2021.In addition,we examined factors influencing no.10 LN metastasis in the SD2 group.Results:Differentiation,tumor location,and no.4 positive LNs were significantly correlated with no.10 LN metastasis(P<0.05).Borrmann classification,differentiation,depth of invasion,LN metastasis(N),and tumor size were found to correlate with survival in univariate analyses.Age,sex,extent of gastrectomy,tumor location,and extent of lymphadenectomy were not associated with survival(P>0.05).The median survival times were 72.23 and 68.56months for the SD2 andMD2 groups,respectively(P=0.635).Postoperative major morbidity and mortality rates were 37.96%and 3.70%in the SD2 group,and 23.64%and 1.82%in the MD2 group,respectively.Conclusions:Based on our findings,prophylactic no.10 lymphadenectomy may be recommended in patients with AGC who exhibit positive no.4 LN status,poor differentiation,and tumors located on the greater curvature.展开更多
BACKGROUND The research findings suggest that the prognosis of children with Wilms tumor(WT)is affected by various factors.Some scholars have indicated that loss of heterozygosity(LOH)on chromosome 16q is associated w...BACKGROUND The research findings suggest that the prognosis of children with Wilms tumor(WT)is affected by various factors.Some scholars have indicated that loss of heterozygosity(LOH)on chromosome 16q is associated with a poor prognosis in patients with WT.AIM To further elucidate this relationship,we conducted a meta-analysis.METHODS This meta-analysis was registered in INPLASY(INPLASY2023100060).We systematically searched databases including Embase,PubMed,Web of Science,Cochrane,and Google Scholar up to May 31,2020,for randomized trials reporting any intrapartum fetal surveillance approach.The meta-analysis was performed within a frequentist framework,and the quality and network inconsistency of trials were assessed.Odds ratios and 95%CIs were calculated to report the relationship between event-free survival and 16q LOH in patients with WT.RESULTS Eleven cohort studies were included in this meta-analysis to estimate the relationship between event-free survival and 16q LOH in patients with WT(I^(2)=25%,P<0.001).As expected,16q LOH can serve as an effective predictor of eventfree survival in patients with WT(risk ratio=1.95,95%CI:1.52–2.49,P<0.001).CONCLUSION In pediatric patients with WT,there exists a partial correlation between 16q LOH and an unfavorable treatment prognosis.Clinical detection of 16q chromosome LOH warrants increased attention to the patient’s prognosis.展开更多
In the present study, we hypothesized that 5-hydroxymethyl-2-furfural could attenuate ischemic brain damage by reducing oxidative injury. Thus, mice were subjected to bilateral common carotid artery occlusion to estab...In the present study, we hypothesized that 5-hydroxymethyl-2-furfural could attenuate ischemic brain damage by reducing oxidative injury. Thus, mice were subjected to bilateral common carotid artery occlusion to establish a model of permanent forebrain ischemia. The mice were intraperitoneally injected with 5-hydroxymethyl-2-furfura130 minutes before ischemia or 5 minutes after ischemia. The survival time of mice injected with 5-hydroxymethyl-2-furfural was longer compared with untreated mice. The mice subjected to ischemia for 30 minutes and reperfusion for 5 minutes were intraperitoneally injected with 5-hydroxymethyl-2-furfural 5 minutes prior to reperfusion, which increased superoxide dismutase content and reduced malondialdehyde content, similar to the effects of Edaravone, a hydroxyl radical scavenger used for the treatment of stroke. These findings indicate that intraperitoneal injection of 5-hydroxymethyl-2-furfural can prolong the survival of mice with permanent forebrain ischemia. This outcome may be mediated by its antioxidative effects.展开更多
BACKGROUND Nomograms for prognosis prediction in colorectal cancer patients are few,and prognostic indicators differ with age.AIM To construct a new nomogram survival prediction tool for middle-aged and elderly patien...BACKGROUND Nomograms for prognosis prediction in colorectal cancer patients are few,and prognostic indicators differ with age.AIM To construct a new nomogram survival prediction tool for middle-aged and elderly patients with stage III rectal adenocarcinoma.METHODS A total of 2773 eligible patients were divided into the training cohort(70%)and the validation cohort(30%).Optimal cutoff values were calculated using the X-tile software for continuous variables.Univariate and multivariate Cox proportional hazards regression analyses were used to determine overall survival(OS)and cancer-specific survival(CSS)-related prognostic factors.Two nomograms were successfully constructed.The discriminant and predictive ability and clinical usefulness of the model were also assessed by multiple methods of analysis.RESULTS The 95%CI in the training group was 0.719(0.690-0.749)and 0.733(0.702-0.74),while that in the validation group was 0.739(0.696-0.782)and 0.750(0.701-0.800)for the OS and CSS nomogram prediction models,respectively.In the validation group,the AUC of the three-year survival rate was 0.762 and 0.770,while the AUC of the five-year survival rate was 0.722 and 0.744 for the OS and CSS nomograms,respectively.The nomogram distinguishes all-cause mortality from cancer-specific mortality in patients with different risk grades.The time-dependent AUC and decision curve analysis showed that the nomogram had good clinical predictive ability and decision efficacy and was significantly better than the tumor-node-metastases staging system.CONCLUSION The survival prediction model constructed in this study is helpful in evaluating the prognosis of patients and can aid physicians in clinical diagnosis and treatment.展开更多
BACKGROUND The prognostic value of preoperative fluorine-18-fluorodeoxyglucose positronemission tomography(18 F-FDG PET)scan for determining overall survival(OS)in breast cancer(BC)patients is controversial.AIM To eva...BACKGROUND The prognostic value of preoperative fluorine-18-fluorodeoxyglucose positronemission tomography(18 F-FDG PET)scan for determining overall survival(OS)in breast cancer(BC)patients is controversial.AIM To evaluate the OS predictive value of preoperative PET positivity after 15 years.METHODS We performed a retrospective search of the Universitair Ziekenhuis Brussel patient database for nonmetastatic patients who underwent preoperative PET between 2002-2008.PET positivity was determined by anatomical region of interest(AROI)findings for breast and axillary,sternal,and distant sites.The prognostic role of PET was examined as a qualitative binary factor(positive vs negative status)and as a continuous variable[maximum standard uptake value(SUVmax)]in multivariate survival analyses using Cox proportional hazards models.Among the 104 identified patients who received PET,36 were further analyzed for the SUVmax in the AROI.RESULTS Poor OS within the 15-year study period was predicted by PET-positive status for axillary(P=0.033),sternal(P=0.033),and combined PET-axillary/sternal(P=0.008)nodes.Poor disease-free survival was associated with PET-positive axillary status(P=0.040)and combined axillary/sternal status(P=0.023).Cox models confirmed the long-term prognostic value of combined PETaxillary/sternal status[hazard ratio(HR):3.08,95%confidence interval:1.42-6.69].SUVmax of ipsilateral breast and axilla as continuous covariates were significant predictors of long-term OS with HRs of 1.25(P=0.048)and 1.54(P=0.029),corresponding to relative increase in the risk of death of 25%and 54%per SUVmax unit,respectively.In addition,the ratio of the ipsilateral axillary SUVmax over the contralateral axillary SUVmax was the most significant OS predictor(P=0.027),with 1.94 HR,indicating a two-fold relative increase of mortality risk.CONCLUSION Preoperative PET is valuable for prediction of long-term survival.Ipsilateral axillary SUVmax ratio over the uninvolved side represents a new prognostic finding that warrants further investigation.展开更多
Therapeutic response and survival time or 43 patients with multiple myeloma treated with modified VMCP(Vincristine,Melphalan, Cyelophosphamide and perdnisone;mVMCP)multidrug regimen are analyzed,and compared with thos...Therapeutic response and survival time or 43 patients with multiple myeloma treated with modified VMCP(Vincristine,Melphalan, Cyelophosphamide and perdnisone;mVMCP)multidrug regimen are analyzed,and compared with those of 41 patients treated with VACP, M2, MP and other regimens.Therapeutic response to mVMCP regimen was better than that to other combination regimens(83. 5% VS 60.9%;P< 0.01).The median remission duration in patients responding to mVMCP was longer than that to other regimens(18.7 vs 12.2 mouths;P<0.001).But the survival time of two groups of responders was not signifficautly different(32. 5 vs 34.1 mouths; P>0.5).The prognostic significance of various pretreatment characteristics was evaluated in term of therapeutic response.The bone status and renal function had a significant inverse correlation with the survival time of patients responding to chemotherapy.Our data indicate that the patients with MM treated by mean or mVMCP regimen can obtain a better response in early treatment and maintain a longer remission duration as well as a better performance status. although the regimen can not prolong the patients survival time.展开更多
Tuberculosis is one of the leading causes of morbidity and mortality globally. Although different strategies have been designed and implemented to combat it, it has continuously increased in the past five years, resul...Tuberculosis is one of the leading causes of morbidity and mortality globally. Although different strategies have been designed and implemented to combat it, it has continuously increased in the past five years, resulting in 10 million new cases and 1.6 million deaths. This study aims to estimate survival and predictors among tuberculosis patients on treatment in selected health centers in Addis Ababa, Ethiopia. The study employed a retrospective cohort design where data were collected by reviewing medical records of tuberculosis patients who were registered from May 2016 to May 2017 on treatment in 20 selected health centers in Addis Ababa. Independent predictors were identified, and the strength of association between dependent and independent predictors was determined using the Weibull regression model. Before computing Weibull regression analysis, Cox proportional assumption, model diagnosis, and fitness were checked. The hazard ratio was calculated to indicate the strength of association. Of 371 TB patients, about 136 (36.7%) died during the treatment period. Most TB deaths occurred during the intensive phase, and the overall estimated median survival time was 157 days. In the multivariable Weibull model, age (HR = 0.98), baseline weight (HR = 0.96, P = 0.03), tuberculosis treatment phase (continuation phase, HR = 0.48), and tuberculosis type (pulmonary negative TB, HR = 19.92) were found to be independent predictors of time to death of tuberculosis patients. Finally, the study concluded that the survival time to death of the patients is high. The health care providers should give special attention and follow up for pulmonary negative and underweight TB patients.展开更多
Regression models for survival time data involve estimation of the hazard rate as a function of predictor variables and associated slope parameters. An adaptive approach is formulated for such hazard regression modeli...Regression models for survival time data involve estimation of the hazard rate as a function of predictor variables and associated slope parameters. An adaptive approach is formulated for such hazard regression modeling. The hazard rate is modeled using fractional polynomials, that is, linear combinations of products of power transforms of time together with other available predictors. These fractional polynomial models are restricted to generating positive-valued hazard rates and decreasing survival times. Exponentially distributed survival times are a special case. Parameters are estimated using maximum likelihood estimation allowing for right censored survival times. Models are evaluated and compared using likelihood cross-validation (LCV) scores. LCV scores and tolerance parameters are used to control an adaptive search through alternative fractional polynomial hazard rate models to identify effective models for the underlying survival time data. These methods are demonstrated using two different survival time data sets including survival times for lung cancer patients and for multiple myeloma patients. For the lung cancer data, the hazard rate depends distinctly on time. However, controlling for cell type provides a distinct improvement while the hazard rate depends only on cell type and no longer on time. Furthermore, Cox regression is unable to identify a cell type effect. For the multiple myeloma data, the hazard rate also depends distinctly on time. Moreover, consideration of hemoglobin at diagnosis provides a distinct improvement, the hazard rate still depends distinctly on time, and hemoglobin distinctly moderates the effect of time on the hazard rate. These results indicate that adaptive hazard rate modeling can provide unique insights into survival time data.展开更多
AIM: To evaluate the prognostic value of the combined model for end-stage liver disease (MELD) and blood lipid level in patients with decompensated cirrhosis. METHODS: A total of 198 patients with decompensated cirrho...AIM: To evaluate the prognostic value of the combined model for end-stage liver disease (MELD) and blood lipid level in patients with decompensated cirrhosis. METHODS: A total of 198 patients with decompensated cirrhosis were enrolled into the study. The values of triglyceride (TG), cholesterol (TC), high density lipoproteins (HDL) and low density lipoprotein (LDL) of each patient on the fi rst day of admission were retrieved from the medical records, and MELD was calculated. All the patients were followed up for 1 year. The relationship between the change of blood lipid level and the value of MELD score was studied by analysis of variance. The prognostic factors were screened by multivariate Cox proportional hazard model. Draw Kaplan-Meier survival curves were drawn. RESULTS: Forty-f ive patients died within 3 mo and 83 patients died within 1 year. The levels of TG, TC, HDL and LDL of the death group were all lower than those of the survivors. The serum TG, TC, HDL and LDL levels were lowered with the increase of the MELD score. Multivariate Cox proportional hazard model showed that MELD ≥18 and TC ≤2.8 mmol/L were independent risk factors for prognosis of decompensated cirrhosis. Survival analysis showed that MELD ≥18 combined with TC ≤ 2.8 mmol/L can clearly discriminate between the patients who would survive and die in 1 year. CONCLUSION: MELD ≥18 and TC ≤2.8 mmol/L are two important indexes to predict the prognosis of patients with decompensated cirrhosis. Their combination can effectively predict the long-term prognosis of patients with decompensated cirrhosis.展开更多
In order to reduce power consumption of sensor nodes and extend network survival time in the wireless sensor network (WSN), sensor nodes are scheduled in an active or dormant mode. A chain-type WSN is fundamental y ...In order to reduce power consumption of sensor nodes and extend network survival time in the wireless sensor network (WSN), sensor nodes are scheduled in an active or dormant mode. A chain-type WSN is fundamental y different from other types of WSNs, in which the sensor nodes are deployed along elongated geographic areas and form a chain-type network topo-logy structure. This paper investigates the node scheduling prob-lem in the chain-type WSN. Firstly, a node dormant scheduling mode is analyzed theoretical y from geographic coverage, and then three neighboring nodes scheduling criteria are proposed. Sec-ondly, a hybrid coverage scheduling algorithm and dead areas are presented. Final y, node scheduling in mine tunnel WSN with uniform deployment (UD), non-uniform deployment (NUD) and op-timal distribution point spacing (ODS) is simulated. The results show that the node scheduling with UD and NUD, especial y NUD, can effectively extend the network survival time. Therefore, a strat-egy of adding a few mobile nodes which activate the network in dead areas is proposed, which can further extend the network survival time by balancing the energy consumption of nodes.展开更多
Objective To study the application of positron emission tomography (PET) in detection of myocardia metabolism in pig ventricular fibrillation and asphyxiation cardiac arrest models after resuscitation. Methods Thirt...Objective To study the application of positron emission tomography (PET) in detection of myocardia metabolism in pig ventricular fibrillation and asphyxiation cardiac arrest models after resuscitation. Methods Thirty-two healthy miniature pigs were randomized into a ventricular fibrillation cardiac arrest (VFCA) group (n=16) and an asphyxiation cardiac arrest (ACA) group (n=16). Cardiac arrest (CA) was induced by programmed electric stimulation or endotracheal tube clamping followed by cardiopulmonary resuscitation (CPR) and defibrillation. At four hours and 24 h after spontaneous circulation was achieved, myocardial metabolism was assessed by PET. 18F-FDG myocardial uptake in PET was analyzed and the maximum standardized uptake value (SUVmax) was measured. Results Spontaneous circulation was 200% and 62.5% in VFCA group and ACA group, respectively. PET demonstrated that the myocardial metabolism injuries was more severe and widespread after ACA than after VFCA. The SUVrnax was higher in VFCA group than in ACA group (P〈0.01). In VFCA group, SUVmax at 24 h after spontaneous circulation increased to the level of baseline. Conclusion ACA causes more severe cardiac metabol associated with less successful resuscitation. Myocardial sm injuries than VFCA. Myocardial dysfunction is stunning does occur with VFCA but not with ACA.展开更多
Objective: The incidence of brain metastasis from esophageal cancer(BMEC) has increased in recent years.Thus, it is necessary to identify factors that affect long-term outcomes for such patients.Methods: From January ...Objective: The incidence of brain metastasis from esophageal cancer(BMEC) has increased in recent years.Thus, it is necessary to identify factors that affect long-term outcomes for such patients.Methods: From January 1997 to July 2018, consecutive patients(10,043 patients, 31 with brain metastasis) with esophageal cancer(EC) treated at Zhejiang Cancer Hospital were recruited for retrospective analysis.Demographic, clinical, and pathological variables and the survival data were retrieved.Results: The median time from diagnosis of EC to diagnosis of brain metastases was 7.67(range, 0.43-55.20)months. The median survival time of BMEC patients from diagnosis of primary esophageal tumor was 16.7(range,2.33-163.30) months and the median survival time from the point of diagnosis of brain metastasis was 6.47(range,0.43-148.13) months. Univariate and multivariate analyses showed that the pathology type, EC without chemotherapy, and bone metastasis history were significantly associated with a shorter time interval between the first treatment of EC and brain metastasis. Chemotherapy history after brain metastasis, whole brain radiation therapy(WBRT) history, and surgery were significant predictors for better long-term survival outcomes.Conclusions: Our findings indicate that the use of surgery, WBRT, and chemotherapy can achieve the best therapeutic effects for BMEC patients.展开更多
Objective:To clarify the prognostic value of post-treatment 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients with advanced head and neck squamous cell carcino...Objective:To clarify the prognostic value of post-treatment 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients with advanced head and neck squamous cell carcinoma (HNSCC) after combined intra-arterial chemotherapy and radiotherapy (IACR).Methods:Thirty-six patients with HNSCC who underwent IACR were recruited.The period from the end of IACR to the last post-treatment 18F-FDG PET/CT examination was 8-12 weeks.Both patient-based and lesion-based analyses were used to evaluate the PET/CT images.For lesion-based analysis,36 regions (12 lesions of recurrences and 24 scars at primary sites) were selected.The Kaplan-Meier method was used to assess the overall survival (OS) stratified by 18F-FDG uptake or visual interpretation results.Results:Twelve patients with recurrence were identified by six months after IACR.The sensitivity and specificity in the patient-based analysis were 67% (8/12) and 88% (21/24),respectively.The mean OS was estimated to be 12.1 months (95% CI,6.3-18.0 months) for the higher maximum standardized uptake value (SUVmax) group (n=7) and 44.6 months (95% CI,39.9-49.3 months) for the lower SUVmax group (n=29).OS in the higher SUVmax group (cut-off point,6.1) or positive visual interpretation group was significantly shorter than that in the lower SUVmax or negative visual interpretation group (P<0.001 and P<0.05,respectively).Conclusions:The SUVmax and visual interpretation of HNSCC on post-IACR 18F-FDG PET/CT can provide prognostic survival estimates.展开更多
AIMTo describe a series of Italian patients with orbital metastasis focusing on the outcomes in relation to the different primary site of malignancy.METHODSRetrospective chart review of 93 patients with orbital metast...AIMTo describe a series of Italian patients with orbital metastasis focusing on the outcomes in relation to the different primary site of malignancy.METHODSRetrospective chart review of 93 patients with orbital metastasis collected in a tertiary referral centre in a period of 38y and review of literature.RESULTSOut of 93 patients, 52 were females and 41 were males. Median age at diagnosis was 51y (range 1 to 88y). The patients have been divided into four groups on the basis of the year of diagnosis. The frequency of recorded cases had decreased significantly (P<0.05) during the last 9.5y. Primary tumor site was breast in 36 cases (39%), kidney in 10 (11%), lung in 8 (9%), skin in 6 (6%); other sites were less frequent. In 16 case (17%) the primary tumor remained unknown. The most frequent clinical findings were proptosis (73%), limited ocular motility (55%), blepharoptosis (46%) and blurred vision (43%). The diagnosis were established by history, ocular and systemic evaluation, orbital imaging studies and open biopsy or fine needle aspiration biopsy (FNAB). Treatment included surgical excision, irradiation, chemotherapy, hormone therapy, or observation. Ninety-one percent of patients died of metastasis with an overall mean survival time (OMST) after the orbital diagnosis of 13.5mo.CONCLUSIONBreast, kidney and lung are the most frequent primary sites of cancer leading to an orbital metastasis. When the primary site is unknown, gastrointestinal tract should be carefully investigated. In the last decade a decrease in the frequency of orbital metastasis has been observed. Surgery provides a local palliation. Prognosis remains poor with a OMST of 13.5mo ranging from the 3mo in the lung cancer to 24mo in the kidney tumor.展开更多
Objective:To compare the prognostic factors of mortality among melioidosis patients between lognormal accelerated failure time(AFT),Cox proportional hazards(PH),and Cox PH with time-varying coefficient(TVC)models.Meth...Objective:To compare the prognostic factors of mortality among melioidosis patients between lognormal accelerated failure time(AFT),Cox proportional hazards(PH),and Cox PH with time-varying coefficient(TVC)models.Methods:A retrospective study was conducted from 2014 to 2019 among 453 patients who were admitted to Hospital Sultanah Bahiyah,Kedah and Hospital Tuanku Fauziah,Perlis in Northern Malaysia due to confirmed-cultured melioidosis.The prognostic factors of mortality from melioidosis were obtained from AFT survival analysis,and Cox’s models and the findings were compared by using the goodness of fit methods.The analyses were done by using Stata SE version 14.0.Results:A total of 242 patients(53.4%)survived.In this study,the median survival time of melioidosis patients was 30.0 days(95%CI 0.0-60.9).Six significant prognostic factors were identified in the Cox PH model and Cox PH-TVC model.In AFT survival analysis,a total of seven significant prognostic factors were identified.The results were found to be only a slight difference between the identified prognostic factors among the models.AFT survival showed better results compared to Cox's models,with the lowest Akaike information criteria and best fitted Cox-snell residuals.Conclusions:AFT survival analysis provides more reliable results and can be used as an alternative statistical analysis for determining the prognostic factors of mortality in melioidosis patients in certain situations.展开更多
Background:Traumatic spinal cord injury(SCI)is also a combat-related injury that is increasing in modern warfare.The aim of this work is to inform medical experts regarding the different course of bladder cancer in ab...Background:Traumatic spinal cord injury(SCI)is also a combat-related injury that is increasing in modern warfare.The aim of this work is to inform medical experts regarding the different course of bladder cancer in able-bodied patients compared with SCI patients based on the latest medical scientific knowledge,and to present decision-making aids for the assessment of bladder cancer as a late sequela of traumatic SCI.Methods:A study conducted between January 1998 and December 2019 in the BG Trauma Hospital Hamburg formed the basis for the decision-making aids.Urinary bladder cancer was diagnosed in 40 out of 7396 treated outpatient and inpatient SCI patients.General patient information,latency period,age at initial diagnosis,type of bladder management and survival of SCI patients with bladder cancer were collected and analysed.T category,grading and tumor entity in these patients were compared with those in the general population.Relevant bladder cancer risk factors in SCI patients were analysed.Furthermore,relevant published literature was taken into consideration.Results:Initial diagnosis of urinary bladder cancer in SCI patients occurs at a mean age of 56.4 years(SD±10.7 years),i.e.,approximately 20 years earlier as compared with the general population.These bladder cancers are significantly more frequently muscle invasive(i.e.,T category≥T2)and present a higher grade at initial diagnosis.Furthermore,SCI patients show a significantly higher proportion of the more aggressive squamous cell carcinoma than that of the general population in areas not endemic for the tropical disease schistosomiasis.Consequently,the survival time is extremely unfavourable.A very important finding,for practical reasons is that,in the Hamburg study as well as in the literature,urinary bladder cancer is more frequently observed after 10 years or more of SCI.Based on these findings,a matrix was compiled where the various influencing factors,either for or against the recognition of an association between SCI and urinary bladder cancer,were weighted according to their relevance.Conclusions:The results showed that urinary bladder cancer in SCI patients differs considerably from that in ablebodied patients.The presented algorithm is an important aid in everyday clinical practice for assessing the correlation between SCI and bladder cancer.展开更多
BACKGROUND:The use of livers from nonviable fetuses is particularly attractive for its potential to solve the current limitations of organ availability for the pediatric recipient.Therefore,it is essential to study th...BACKGROUND:The use of livers from nonviable fetuses is particularly attractive for its potential to solve the current limitations of organ availability for the pediatric recipient.Therefore,it is essential to study the feasibility of orthotopic fetal liver transplantation.METHOD:We measured the hepatic and extra-hepatic anatomical structures of fetal and neonatal lambs and established an orthotopic liver transplantation model of the fetal lamb.RESULTS:Mean weight of the liver of fetal lambs at 142 to 145 days gestation was 34.75 g and the mean diameter of the portal vein was 3.03 mm,the supra-hepatic vena cava was 5.88 mm,and the infra-hepatic vena cava was 4.00 mm,which matched the corresponding sizes in neonatal lambs aged up to 2 weeks.Using standard surgical procedures we completed the vascular inosculation of fetal liver.However,all the newborn lamb recipients survived less than 24 hours.CONCLUSIONS:Orthotopic transplantation of the fetal liver is anatomically and technically feasible.However,perioperative issues need to be resolved prior to clinical application.展开更多
Objective:To investigate the correlation between immune cell infiltration pattern and clinical features and prognosis of cervical carcinoma.Methods:All cervical cancer transcript data and related clinical data were do...Objective:To investigate the correlation between immune cell infiltration pattern and clinical features and prognosis of cervical carcinoma.Methods:All cervical cancer transcript data and related clinical data were downloaded from the public database Cancer Genome Atlas(TCGA),and the relative proportions of 22 invasive immune cell types were calculated by Cibersort software.Perl was used to assess the correlation between the pattern of immune cell invasion and clinical characteristics(age,clinical stage,tumor grade)in cervical cancer,and the correlation between the pattern of immune cell invasion and survival in cervical cancer was calculated by the K-M Log-Rank method.Result:The distribution of immune cells in 306 cases of cervical cancer and 3 cases of normal tissues was assessed using Cibersort.Compared with normal tissues,the contents of resting dendritic cells,activated dendritic cells,M1 macrophages and activated CD4+memory T cells were higher;the contents of M2 macrophages,neutrophils,regulatory T cells and activated mast cells were lower in cervical cancer tissues.The contents of M1 macrophages,unactivated CD4+memory T cells,andγδT cells were positively correlated with patient age(P<0.05).The contents of follicular helper T cells,activated and unactivated natural killer(NK)cells,and naive CD4 T cells were negatively correlated with patient age(P<0.05).Those with high resting dendritic cell composition had shorter overall survival,while those with high follicular helper T cell composition had longer overall survival(P<0.05).Conclusion:Compared with normal tissues,the composition of immune cells in cervical cancer tissues has certain specificity,which can provide reference for the early screening and diagnosis of the disease.Patients in different age groups may have different immune cell infiltration patterns,which can be used as a basis to explore drug targets in clinical practice.Resting dendritic cells and follicular helper T cells in cervical cancer can be used as possible efficacy predictors of clinical immunotherapy for cervical cancer.展开更多
Objective To evaluate the effect of Chinese medicine(CM)treatment on survival time and quality of life(QOL)in patients with small cell lung cancer(SCLC).Methods This was an exploratory and prospective clinical observa...Objective To evaluate the effect of Chinese medicine(CM)treatment on survival time and quality of life(QOL)in patients with small cell lung cancer(SCLC).Methods This was an exploratory and prospective clinical observation.Patients diagnosed with SCLC receiving CM treatment were included and followed up every 3 months.The primary outcome was overall survival(OS),and the secondary outcomes were progression-free survival(PFS)and QOL.Results A total of 136 patients including 65 limited-stage SCLC(LS-SCLC)patients and 71 extensive-stage SCLC(ES-SCLC)patients were analyzed.The median OS of ES-SCLC patients was 17.27 months,and the median OS of LS-SCLC was 40.07 months.The survival time was 16.27 months for SCLC patients with brain metastasis,9.83 months for liver metastasis,13.43 months for bone metastasis,and 18.13 months for lung metastasis.Advanced age,pleural fluid,liver and brain metastasis were risk factors,while longer CM treatment duration was a protective factor.QOL assessment indicated that after 6 months of CM treatment,scores increased in function domains and decreased in symptom domains.Conclusion CM treatment might help prolong OS of SCLC patients.Moreover,CM treatment brought the trend of symptom amelioration and QOL improvement.These results provide preliminary evidence for applying CM in SCLC multi-disciplinary treatment.展开更多
基金supported by the Department of Gastrointestinal Surgery,Xuzhou Central Hospital,Xuzhou,China
文摘Background:There is no consensus regarding the influence of prophylactic no.10 lymph node(LN)dissection in patients with advanced gastric cancer(AGC).We aimed to evaluate whether patients with AGC could benefit from no.10 LN dissection and to explore the clinicopathological indicators of no.10 LN metastasis.Methods:We analyzed the data of 218 patients with AGC who underwent standard D2 lymphadenectomy(SD2;n=108)or modified D2 lymphadenectomy(MD2;n=110)between January 2017 and January 2021.In addition,we examined factors influencing no.10 LN metastasis in the SD2 group.Results:Differentiation,tumor location,and no.4 positive LNs were significantly correlated with no.10 LN metastasis(P<0.05).Borrmann classification,differentiation,depth of invasion,LN metastasis(N),and tumor size were found to correlate with survival in univariate analyses.Age,sex,extent of gastrectomy,tumor location,and extent of lymphadenectomy were not associated with survival(P>0.05).The median survival times were 72.23 and 68.56months for the SD2 andMD2 groups,respectively(P=0.635).Postoperative major morbidity and mortality rates were 37.96%and 3.70%in the SD2 group,and 23.64%and 1.82%in the MD2 group,respectively.Conclusions:Based on our findings,prophylactic no.10 lymphadenectomy may be recommended in patients with AGC who exhibit positive no.4 LN status,poor differentiation,and tumors located on the greater curvature.
基金Supported by Yunnan Provincial Department of Science and Technology Provincial Basic Research Program(Kunming Medical Joint Special Project,No.2019FE001(-276)Kunming Health Science and Technology Talents Training Project and"Ten Hundred Thousands"Project Training Plan,No.2020-SW(Backup)-121.
文摘BACKGROUND The research findings suggest that the prognosis of children with Wilms tumor(WT)is affected by various factors.Some scholars have indicated that loss of heterozygosity(LOH)on chromosome 16q is associated with a poor prognosis in patients with WT.AIM To further elucidate this relationship,we conducted a meta-analysis.METHODS This meta-analysis was registered in INPLASY(INPLASY2023100060).We systematically searched databases including Embase,PubMed,Web of Science,Cochrane,and Google Scholar up to May 31,2020,for randomized trials reporting any intrapartum fetal surveillance approach.The meta-analysis was performed within a frequentist framework,and the quality and network inconsistency of trials were assessed.Odds ratios and 95%CIs were calculated to report the relationship between event-free survival and 16q LOH in patients with WT.RESULTS Eleven cohort studies were included in this meta-analysis to estimate the relationship between event-free survival and 16q LOH in patients with WT(I^(2)=25%,P<0.001).As expected,16q LOH can serve as an effective predictor of eventfree survival in patients with WT(risk ratio=1.95,95%CI:1.52–2.49,P<0.001).CONCLUSION In pediatric patients with WT,there exists a partial correlation between 16q LOH and an unfavorable treatment prognosis.Clinical detection of 16q chromosome LOH warrants increased attention to the patient’s prognosis.
基金supported by the National Basic Research Program of China (973 Program),No.2003CB517104the National Natural Science Foundation of China,No.30973513+3 种基金Beijing Municipal Science and Technology Program,No.D0206001043191the Natural Science Foundation of Beijing,No.7112061Beijing Key Foundation of Traditional Chinese Medicine,No.KJTS2011-04Beijing Health and Technical Personal of High-Level Plan,No.2009-3-66
文摘In the present study, we hypothesized that 5-hydroxymethyl-2-furfural could attenuate ischemic brain damage by reducing oxidative injury. Thus, mice were subjected to bilateral common carotid artery occlusion to establish a model of permanent forebrain ischemia. The mice were intraperitoneally injected with 5-hydroxymethyl-2-furfura130 minutes before ischemia or 5 minutes after ischemia. The survival time of mice injected with 5-hydroxymethyl-2-furfural was longer compared with untreated mice. The mice subjected to ischemia for 30 minutes and reperfusion for 5 minutes were intraperitoneally injected with 5-hydroxymethyl-2-furfural 5 minutes prior to reperfusion, which increased superoxide dismutase content and reduced malondialdehyde content, similar to the effects of Edaravone, a hydroxyl radical scavenger used for the treatment of stroke. These findings indicate that intraperitoneal injection of 5-hydroxymethyl-2-furfural can prolong the survival of mice with permanent forebrain ischemia. This outcome may be mediated by its antioxidative effects.
基金The National Natural Science Foundation of China,No.81770631.
文摘BACKGROUND Nomograms for prognosis prediction in colorectal cancer patients are few,and prognostic indicators differ with age.AIM To construct a new nomogram survival prediction tool for middle-aged and elderly patients with stage III rectal adenocarcinoma.METHODS A total of 2773 eligible patients were divided into the training cohort(70%)and the validation cohort(30%).Optimal cutoff values were calculated using the X-tile software for continuous variables.Univariate and multivariate Cox proportional hazards regression analyses were used to determine overall survival(OS)and cancer-specific survival(CSS)-related prognostic factors.Two nomograms were successfully constructed.The discriminant and predictive ability and clinical usefulness of the model were also assessed by multiple methods of analysis.RESULTS The 95%CI in the training group was 0.719(0.690-0.749)and 0.733(0.702-0.74),while that in the validation group was 0.739(0.696-0.782)and 0.750(0.701-0.800)for the OS and CSS nomogram prediction models,respectively.In the validation group,the AUC of the three-year survival rate was 0.762 and 0.770,while the AUC of the five-year survival rate was 0.722 and 0.744 for the OS and CSS nomograms,respectively.The nomogram distinguishes all-cause mortality from cancer-specific mortality in patients with different risk grades.The time-dependent AUC and decision curve analysis showed that the nomogram had good clinical predictive ability and decision efficacy and was significantly better than the tumor-node-metastases staging system.CONCLUSION The survival prediction model constructed in this study is helpful in evaluating the prognosis of patients and can aid physicians in clinical diagnosis and treatment.
文摘BACKGROUND The prognostic value of preoperative fluorine-18-fluorodeoxyglucose positronemission tomography(18 F-FDG PET)scan for determining overall survival(OS)in breast cancer(BC)patients is controversial.AIM To evaluate the OS predictive value of preoperative PET positivity after 15 years.METHODS We performed a retrospective search of the Universitair Ziekenhuis Brussel patient database for nonmetastatic patients who underwent preoperative PET between 2002-2008.PET positivity was determined by anatomical region of interest(AROI)findings for breast and axillary,sternal,and distant sites.The prognostic role of PET was examined as a qualitative binary factor(positive vs negative status)and as a continuous variable[maximum standard uptake value(SUVmax)]in multivariate survival analyses using Cox proportional hazards models.Among the 104 identified patients who received PET,36 were further analyzed for the SUVmax in the AROI.RESULTS Poor OS within the 15-year study period was predicted by PET-positive status for axillary(P=0.033),sternal(P=0.033),and combined PET-axillary/sternal(P=0.008)nodes.Poor disease-free survival was associated with PET-positive axillary status(P=0.040)and combined axillary/sternal status(P=0.023).Cox models confirmed the long-term prognostic value of combined PETaxillary/sternal status[hazard ratio(HR):3.08,95%confidence interval:1.42-6.69].SUVmax of ipsilateral breast and axilla as continuous covariates were significant predictors of long-term OS with HRs of 1.25(P=0.048)and 1.54(P=0.029),corresponding to relative increase in the risk of death of 25%and 54%per SUVmax unit,respectively.In addition,the ratio of the ipsilateral axillary SUVmax over the contralateral axillary SUVmax was the most significant OS predictor(P=0.027),with 1.94 HR,indicating a two-fold relative increase of mortality risk.CONCLUSION Preoperative PET is valuable for prediction of long-term survival.Ipsilateral axillary SUVmax ratio over the uninvolved side represents a new prognostic finding that warrants further investigation.
文摘Therapeutic response and survival time or 43 patients with multiple myeloma treated with modified VMCP(Vincristine,Melphalan, Cyelophosphamide and perdnisone;mVMCP)multidrug regimen are analyzed,and compared with those of 41 patients treated with VACP, M2, MP and other regimens.Therapeutic response to mVMCP regimen was better than that to other combination regimens(83. 5% VS 60.9%;P< 0.01).The median remission duration in patients responding to mVMCP was longer than that to other regimens(18.7 vs 12.2 mouths;P<0.001).But the survival time of two groups of responders was not signifficautly different(32. 5 vs 34.1 mouths; P>0.5).The prognostic significance of various pretreatment characteristics was evaluated in term of therapeutic response.The bone status and renal function had a significant inverse correlation with the survival time of patients responding to chemotherapy.Our data indicate that the patients with MM treated by mean or mVMCP regimen can obtain a better response in early treatment and maintain a longer remission duration as well as a better performance status. although the regimen can not prolong the patients survival time.
文摘Tuberculosis is one of the leading causes of morbidity and mortality globally. Although different strategies have been designed and implemented to combat it, it has continuously increased in the past five years, resulting in 10 million new cases and 1.6 million deaths. This study aims to estimate survival and predictors among tuberculosis patients on treatment in selected health centers in Addis Ababa, Ethiopia. The study employed a retrospective cohort design where data were collected by reviewing medical records of tuberculosis patients who were registered from May 2016 to May 2017 on treatment in 20 selected health centers in Addis Ababa. Independent predictors were identified, and the strength of association between dependent and independent predictors was determined using the Weibull regression model. Before computing Weibull regression analysis, Cox proportional assumption, model diagnosis, and fitness were checked. The hazard ratio was calculated to indicate the strength of association. Of 371 TB patients, about 136 (36.7%) died during the treatment period. Most TB deaths occurred during the intensive phase, and the overall estimated median survival time was 157 days. In the multivariable Weibull model, age (HR = 0.98), baseline weight (HR = 0.96, P = 0.03), tuberculosis treatment phase (continuation phase, HR = 0.48), and tuberculosis type (pulmonary negative TB, HR = 19.92) were found to be independent predictors of time to death of tuberculosis patients. Finally, the study concluded that the survival time to death of the patients is high. The health care providers should give special attention and follow up for pulmonary negative and underweight TB patients.
文摘Regression models for survival time data involve estimation of the hazard rate as a function of predictor variables and associated slope parameters. An adaptive approach is formulated for such hazard regression modeling. The hazard rate is modeled using fractional polynomials, that is, linear combinations of products of power transforms of time together with other available predictors. These fractional polynomial models are restricted to generating positive-valued hazard rates and decreasing survival times. Exponentially distributed survival times are a special case. Parameters are estimated using maximum likelihood estimation allowing for right censored survival times. Models are evaluated and compared using likelihood cross-validation (LCV) scores. LCV scores and tolerance parameters are used to control an adaptive search through alternative fractional polynomial hazard rate models to identify effective models for the underlying survival time data. These methods are demonstrated using two different survival time data sets including survival times for lung cancer patients and for multiple myeloma patients. For the lung cancer data, the hazard rate depends distinctly on time. However, controlling for cell type provides a distinct improvement while the hazard rate depends only on cell type and no longer on time. Furthermore, Cox regression is unable to identify a cell type effect. For the multiple myeloma data, the hazard rate also depends distinctly on time. Moreover, consideration of hemoglobin at diagnosis provides a distinct improvement, the hazard rate still depends distinctly on time, and hemoglobin distinctly moderates the effect of time on the hazard rate. These results indicate that adaptive hazard rate modeling can provide unique insights into survival time data.
文摘AIM: To evaluate the prognostic value of the combined model for end-stage liver disease (MELD) and blood lipid level in patients with decompensated cirrhosis. METHODS: A total of 198 patients with decompensated cirrhosis were enrolled into the study. The values of triglyceride (TG), cholesterol (TC), high density lipoproteins (HDL) and low density lipoprotein (LDL) of each patient on the fi rst day of admission were retrieved from the medical records, and MELD was calculated. All the patients were followed up for 1 year. The relationship between the change of blood lipid level and the value of MELD score was studied by analysis of variance. The prognostic factors were screened by multivariate Cox proportional hazard model. Draw Kaplan-Meier survival curves were drawn. RESULTS: Forty-f ive patients died within 3 mo and 83 patients died within 1 year. The levels of TG, TC, HDL and LDL of the death group were all lower than those of the survivors. The serum TG, TC, HDL and LDL levels were lowered with the increase of the MELD score. Multivariate Cox proportional hazard model showed that MELD ≥18 and TC ≤2.8 mmol/L were independent risk factors for prognosis of decompensated cirrhosis. Survival analysis showed that MELD ≥18 combined with TC ≤ 2.8 mmol/L can clearly discriminate between the patients who would survive and die in 1 year. CONCLUSION: MELD ≥18 and TC ≤2.8 mmol/L are two important indexes to predict the prognosis of patients with decompensated cirrhosis. Their combination can effectively predict the long-term prognosis of patients with decompensated cirrhosis.
基金supported by the China Doctoral Discipline New Teacher Foundation(200802901507)the Sichuan Province Basic Research Plan Project(2013JY0165)the Cultivating Programme of Excellent Innovation Team of Chengdu University of Technology(KYTD201301)
文摘In order to reduce power consumption of sensor nodes and extend network survival time in the wireless sensor network (WSN), sensor nodes are scheduled in an active or dormant mode. A chain-type WSN is fundamental y different from other types of WSNs, in which the sensor nodes are deployed along elongated geographic areas and form a chain-type network topo-logy structure. This paper investigates the node scheduling prob-lem in the chain-type WSN. Firstly, a node dormant scheduling mode is analyzed theoretical y from geographic coverage, and then three neighboring nodes scheduling criteria are proposed. Sec-ondly, a hybrid coverage scheduling algorithm and dead areas are presented. Final y, node scheduling in mine tunnel WSN with uniform deployment (UD), non-uniform deployment (NUD) and op-timal distribution point spacing (ODS) is simulated. The results show that the node scheduling with UD and NUD, especial y NUD, can effectively extend the network survival time. Therefore, a strat-egy of adding a few mobile nodes which activate the network in dead areas is proposed, which can further extend the network survival time by balancing the energy consumption of nodes.
基金supported by Beijing Science Foundation(C160203)Youth Science Foundation of Beijing Chaoyang Hospital
文摘Objective To study the application of positron emission tomography (PET) in detection of myocardia metabolism in pig ventricular fibrillation and asphyxiation cardiac arrest models after resuscitation. Methods Thirty-two healthy miniature pigs were randomized into a ventricular fibrillation cardiac arrest (VFCA) group (n=16) and an asphyxiation cardiac arrest (ACA) group (n=16). Cardiac arrest (CA) was induced by programmed electric stimulation or endotracheal tube clamping followed by cardiopulmonary resuscitation (CPR) and defibrillation. At four hours and 24 h after spontaneous circulation was achieved, myocardial metabolism was assessed by PET. 18F-FDG myocardial uptake in PET was analyzed and the maximum standardized uptake value (SUVmax) was measured. Results Spontaneous circulation was 200% and 62.5% in VFCA group and ACA group, respectively. PET demonstrated that the myocardial metabolism injuries was more severe and widespread after ACA than after VFCA. The SUVrnax was higher in VFCA group than in ACA group (P〈0.01). In VFCA group, SUVmax at 24 h after spontaneous circulation increased to the level of baseline. Conclusion ACA causes more severe cardiac metabol associated with less successful resuscitation. Myocardial sm injuries than VFCA. Myocardial dysfunction is stunning does occur with VFCA but not with ACA.
基金supported by grants from the Public Technology Application Research Project of the Science and Technology Agency of Zhejiang Province,China (No.2017C33084)the Medical Talents Research Project of Zhejiang Province,China (No.2016RCA005)Zhejiang Medical and Health Science and Technology Project (New Technology Product R&D Project No.2020PY001)。
文摘Objective: The incidence of brain metastasis from esophageal cancer(BMEC) has increased in recent years.Thus, it is necessary to identify factors that affect long-term outcomes for such patients.Methods: From January 1997 to July 2018, consecutive patients(10,043 patients, 31 with brain metastasis) with esophageal cancer(EC) treated at Zhejiang Cancer Hospital were recruited for retrospective analysis.Demographic, clinical, and pathological variables and the survival data were retrieved.Results: The median time from diagnosis of EC to diagnosis of brain metastases was 7.67(range, 0.43-55.20)months. The median survival time of BMEC patients from diagnosis of primary esophageal tumor was 16.7(range,2.33-163.30) months and the median survival time from the point of diagnosis of brain metastasis was 6.47(range,0.43-148.13) months. Univariate and multivariate analyses showed that the pathology type, EC without chemotherapy, and bone metastasis history were significantly associated with a shorter time interval between the first treatment of EC and brain metastasis. Chemotherapy history after brain metastasis, whole brain radiation therapy(WBRT) history, and surgery were significant predictors for better long-term survival outcomes.Conclusions: Our findings indicate that the use of surgery, WBRT, and chemotherapy can achieve the best therapeutic effects for BMEC patients.
文摘Objective:To clarify the prognostic value of post-treatment 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients with advanced head and neck squamous cell carcinoma (HNSCC) after combined intra-arterial chemotherapy and radiotherapy (IACR).Methods:Thirty-six patients with HNSCC who underwent IACR were recruited.The period from the end of IACR to the last post-treatment 18F-FDG PET/CT examination was 8-12 weeks.Both patient-based and lesion-based analyses were used to evaluate the PET/CT images.For lesion-based analysis,36 regions (12 lesions of recurrences and 24 scars at primary sites) were selected.The Kaplan-Meier method was used to assess the overall survival (OS) stratified by 18F-FDG uptake or visual interpretation results.Results:Twelve patients with recurrence were identified by six months after IACR.The sensitivity and specificity in the patient-based analysis were 67% (8/12) and 88% (21/24),respectively.The mean OS was estimated to be 12.1 months (95% CI,6.3-18.0 months) for the higher maximum standardized uptake value (SUVmax) group (n=7) and 44.6 months (95% CI,39.9-49.3 months) for the lower SUVmax group (n=29).OS in the higher SUVmax group (cut-off point,6.1) or positive visual interpretation group was significantly shorter than that in the lower SUVmax or negative visual interpretation group (P<0.001 and P<0.05,respectively).Conclusions:The SUVmax and visual interpretation of HNSCC on post-IACR 18F-FDG PET/CT can provide prognostic survival estimates.
文摘AIMTo describe a series of Italian patients with orbital metastasis focusing on the outcomes in relation to the different primary site of malignancy.METHODSRetrospective chart review of 93 patients with orbital metastasis collected in a tertiary referral centre in a period of 38y and review of literature.RESULTSOut of 93 patients, 52 were females and 41 were males. Median age at diagnosis was 51y (range 1 to 88y). The patients have been divided into four groups on the basis of the year of diagnosis. The frequency of recorded cases had decreased significantly (P<0.05) during the last 9.5y. Primary tumor site was breast in 36 cases (39%), kidney in 10 (11%), lung in 8 (9%), skin in 6 (6%); other sites were less frequent. In 16 case (17%) the primary tumor remained unknown. The most frequent clinical findings were proptosis (73%), limited ocular motility (55%), blepharoptosis (46%) and blurred vision (43%). The diagnosis were established by history, ocular and systemic evaluation, orbital imaging studies and open biopsy or fine needle aspiration biopsy (FNAB). Treatment included surgical excision, irradiation, chemotherapy, hormone therapy, or observation. Ninety-one percent of patients died of metastasis with an overall mean survival time (OMST) after the orbital diagnosis of 13.5mo.CONCLUSIONBreast, kidney and lung are the most frequent primary sites of cancer leading to an orbital metastasis. When the primary site is unknown, gastrointestinal tract should be carefully investigated. In the last decade a decrease in the frequency of orbital metastasis has been observed. Surgery provides a local palliation. Prognosis remains poor with a OMST of 13.5mo ranging from the 3mo in the lung cancer to 24mo in the kidney tumor.
文摘Objective:To compare the prognostic factors of mortality among melioidosis patients between lognormal accelerated failure time(AFT),Cox proportional hazards(PH),and Cox PH with time-varying coefficient(TVC)models.Methods:A retrospective study was conducted from 2014 to 2019 among 453 patients who were admitted to Hospital Sultanah Bahiyah,Kedah and Hospital Tuanku Fauziah,Perlis in Northern Malaysia due to confirmed-cultured melioidosis.The prognostic factors of mortality from melioidosis were obtained from AFT survival analysis,and Cox’s models and the findings were compared by using the goodness of fit methods.The analyses were done by using Stata SE version 14.0.Results:A total of 242 patients(53.4%)survived.In this study,the median survival time of melioidosis patients was 30.0 days(95%CI 0.0-60.9).Six significant prognostic factors were identified in the Cox PH model and Cox PH-TVC model.In AFT survival analysis,a total of seven significant prognostic factors were identified.The results were found to be only a slight difference between the identified prognostic factors among the models.AFT survival showed better results compared to Cox's models,with the lowest Akaike information criteria and best fitted Cox-snell residuals.Conclusions:AFT survival analysis provides more reliable results and can be used as an alternative statistical analysis for determining the prognostic factors of mortality in melioidosis patients in certain situations.
文摘Background:Traumatic spinal cord injury(SCI)is also a combat-related injury that is increasing in modern warfare.The aim of this work is to inform medical experts regarding the different course of bladder cancer in able-bodied patients compared with SCI patients based on the latest medical scientific knowledge,and to present decision-making aids for the assessment of bladder cancer as a late sequela of traumatic SCI.Methods:A study conducted between January 1998 and December 2019 in the BG Trauma Hospital Hamburg formed the basis for the decision-making aids.Urinary bladder cancer was diagnosed in 40 out of 7396 treated outpatient and inpatient SCI patients.General patient information,latency period,age at initial diagnosis,type of bladder management and survival of SCI patients with bladder cancer were collected and analysed.T category,grading and tumor entity in these patients were compared with those in the general population.Relevant bladder cancer risk factors in SCI patients were analysed.Furthermore,relevant published literature was taken into consideration.Results:Initial diagnosis of urinary bladder cancer in SCI patients occurs at a mean age of 56.4 years(SD±10.7 years),i.e.,approximately 20 years earlier as compared with the general population.These bladder cancers are significantly more frequently muscle invasive(i.e.,T category≥T2)and present a higher grade at initial diagnosis.Furthermore,SCI patients show a significantly higher proportion of the more aggressive squamous cell carcinoma than that of the general population in areas not endemic for the tropical disease schistosomiasis.Consequently,the survival time is extremely unfavourable.A very important finding,for practical reasons is that,in the Hamburg study as well as in the literature,urinary bladder cancer is more frequently observed after 10 years or more of SCI.Based on these findings,a matrix was compiled where the various influencing factors,either for or against the recognition of an association between SCI and urinary bladder cancer,were weighted according to their relevance.Conclusions:The results showed that urinary bladder cancer in SCI patients differs considerably from that in ablebodied patients.The presented algorithm is an important aid in everyday clinical practice for assessing the correlation between SCI and bladder cancer.
基金supported by a grant from the Science and Technology Commission of Shanghai Municipality(07-JC14045)
文摘BACKGROUND:The use of livers from nonviable fetuses is particularly attractive for its potential to solve the current limitations of organ availability for the pediatric recipient.Therefore,it is essential to study the feasibility of orthotopic fetal liver transplantation.METHOD:We measured the hepatic and extra-hepatic anatomical structures of fetal and neonatal lambs and established an orthotopic liver transplantation model of the fetal lamb.RESULTS:Mean weight of the liver of fetal lambs at 142 to 145 days gestation was 34.75 g and the mean diameter of the portal vein was 3.03 mm,the supra-hepatic vena cava was 5.88 mm,and the infra-hepatic vena cava was 4.00 mm,which matched the corresponding sizes in neonatal lambs aged up to 2 weeks.Using standard surgical procedures we completed the vascular inosculation of fetal liver.However,all the newborn lamb recipients survived less than 24 hours.CONCLUSIONS:Orthotopic transplantation of the fetal liver is anatomically and technically feasible.However,perioperative issues need to be resolved prior to clinical application.
基金Scientific research project of Hubei provincial health commission(No.WJ2019M118)。
文摘Objective:To investigate the correlation between immune cell infiltration pattern and clinical features and prognosis of cervical carcinoma.Methods:All cervical cancer transcript data and related clinical data were downloaded from the public database Cancer Genome Atlas(TCGA),and the relative proportions of 22 invasive immune cell types were calculated by Cibersort software.Perl was used to assess the correlation between the pattern of immune cell invasion and clinical characteristics(age,clinical stage,tumor grade)in cervical cancer,and the correlation between the pattern of immune cell invasion and survival in cervical cancer was calculated by the K-M Log-Rank method.Result:The distribution of immune cells in 306 cases of cervical cancer and 3 cases of normal tissues was assessed using Cibersort.Compared with normal tissues,the contents of resting dendritic cells,activated dendritic cells,M1 macrophages and activated CD4+memory T cells were higher;the contents of M2 macrophages,neutrophils,regulatory T cells and activated mast cells were lower in cervical cancer tissues.The contents of M1 macrophages,unactivated CD4+memory T cells,andγδT cells were positively correlated with patient age(P<0.05).The contents of follicular helper T cells,activated and unactivated natural killer(NK)cells,and naive CD4 T cells were negatively correlated with patient age(P<0.05).Those with high resting dendritic cell composition had shorter overall survival,while those with high follicular helper T cell composition had longer overall survival(P<0.05).Conclusion:Compared with normal tissues,the composition of immune cells in cervical cancer tissues has certain specificity,which can provide reference for the early screening and diagnosis of the disease.Patients in different age groups may have different immune cell infiltration patterns,which can be used as a basis to explore drug targets in clinical practice.Resting dendritic cells and follicular helper T cells in cervical cancer can be used as possible efficacy predictors of clinical immunotherapy for cervical cancer.
基金Surpported by National Natural Science Foundation of China(No.81673797)Beijing Municipal Natural Science Foundation(No.7182142)。
文摘Objective To evaluate the effect of Chinese medicine(CM)treatment on survival time and quality of life(QOL)in patients with small cell lung cancer(SCLC).Methods This was an exploratory and prospective clinical observation.Patients diagnosed with SCLC receiving CM treatment were included and followed up every 3 months.The primary outcome was overall survival(OS),and the secondary outcomes were progression-free survival(PFS)and QOL.Results A total of 136 patients including 65 limited-stage SCLC(LS-SCLC)patients and 71 extensive-stage SCLC(ES-SCLC)patients were analyzed.The median OS of ES-SCLC patients was 17.27 months,and the median OS of LS-SCLC was 40.07 months.The survival time was 16.27 months for SCLC patients with brain metastasis,9.83 months for liver metastasis,13.43 months for bone metastasis,and 18.13 months for lung metastasis.Advanced age,pleural fluid,liver and brain metastasis were risk factors,while longer CM treatment duration was a protective factor.QOL assessment indicated that after 6 months of CM treatment,scores increased in function domains and decreased in symptom domains.Conclusion CM treatment might help prolong OS of SCLC patients.Moreover,CM treatment brought the trend of symptom amelioration and QOL improvement.These results provide preliminary evidence for applying CM in SCLC multi-disciplinary treatment.