COX MULTIVARIATE REGRESSION ANALYSIS OF RECURRENCE FACTORS FOR COLONIC CARCINOMA

Objective: To determine the independent prognostic factors in the recurrence of colonic carcinoma after curative resection. Methods: Two hundred and one patients undergoing curative resections for colonic carcinoma were investigated by univariate and Cox multivariate regression analyses. Ten factors contributed to the rate were analyzed. Results: Dukes stages, obstruction, postoperative chemotherapy as well as the growth manner of the tumor were significantly associated with the recurrence rate of colonic carcinoma (P<0.05) by univariate analysis, while Dukes stages, obstruction, and postoperative chemotherapy were significant factors by the multivariate analysis. Conclusion: Dukes stages, obstruction, and postoperative chemotherapy are independent prognostic factors in the recurrence of colonic carcinoma.

Evidence-Based Therapy May Improve Outcome in Glomerulonephritis—A Prospective Field Survey

Introduction and aims: Although glomerulonephritis is rare in the general population it is the second most important cause for end-stage renal failure. The therapy of glomerulonephritis is guided by a limited number of individual clinical trials and treatment recommendations are based on meta-analysis and Cochrane Systematic Reviews. The impact of such therapy standards on the prognosis of glomerulonephritis is not known. Methods: Between October 2002 and December 2008 patients with abnormal urine findings and/or decreasing renal function of unknown cause were referred for renal biopsy. In a collaboration of out-patient nephrologists with a major teaching hospital, all patients received treatment recommendations according to evidence-based therapy guidelines based on Cochrane Systematic Reviews. Patient charts were systematically reviewed and patients were re-examined for follow-up until November 2009. Cox Regression analysis was performed to identify independent prognostic factors. Results: Two hundred patients with primary or secondary glomerulonephritis were identified. Complete follow-up data were available from 196 patients with 324 therapeutic interventions. The mean follow-up was 2.8 ± 2.0 years. Among all patients, 37% remained unchanged ill, 13% died, 17% had progressing renal disease, while 19% had a complete and 14% a partial remission. Proteinuria declined in primary glomerulonephritis (5.0 ± 5.4 g/d to 2.1 ± 3.4 g/d, p Conclusions: In a multivariate model of standardised glomerulonephritis therapy the presence of tubulointerstitial fibrosis was associated with death or progresssive renal disease, while prednisolone-based therapy regimens and intensified nephrological follow-up resulted in a significant delay of endstage-renal failure. This result should direct future health care policies because glomerulonephritis accounts for nearly 20% of the dialysis population.

Association of stage 1 hypertension defined by the 2017 ACC/AHA guideline with cardiovascular events and mortality in Chinese adults

Background:The 2017 American College of Cardiology/American Heart Association(ACC/AHA)blood pressure(BP)guideline lowered the threshold defining hypertension to 130/80 mmHg.However,how stage 1 hypertension defined using this guideline is associated with cardiovascular events in Chinese adults remains unclear.This study assessed the association between stage 1 hypertension defined by the 2017 ACC/AHA guideline and clinical outcomes in the Chinese population.Methods:Participants with stage 1 hypertension(n=69,509)or normal BP(n=34,142)were followed in this study from 2006/2007 to 2020.Stage 1 hypertension was defined as a systolic blood pressure of 130-139 mmHg or a diastolic blood pressure of 80-89 mmHg.None were taking antihypertensive medication or had a history of myocardial infarction(MI),stroke,or cancer at baseline.The primary outcome was a composite of MI,stroke,and all-cause mortality.The secondary outcomes were individual components of the primary outcome.Cox proportional hazards models were used for the analysis.Results:During a median follow-up of 11.09 years,we observed 10,479 events(MI,n=995;stroke,n=3408;all-cause mortality,n=7094).After multivariable adjustment,the hazard ratios for stage 1 hypertension vs.normal BP were 1.20(95%confidence interval[CI],1.13-1.25)for primary outcome,1.24(95%CI,1.05-1.46)for MI,1.45(95%CI,1.33-1.59)for stroke,and 1.11(95%CI,1.04-1.17)for all-cause mortality.The hazard ratios for participants with stage 1 hypertension who were prescribed antihypertensive medications compared with those without antihypertensive treatment during the follow-up was 0.90(95%CI,0.85-0.96).Conclusions:Using the new definition,Chinese adults with untreated stage 1 hypertension are at higher risk for MI,stroke,and all-cause mortality.This finding may help to validate the new BP classification system in China.