Predictive factors for percutaneous nephrolithotomy bleeding risks

Objective:This study aimed to identify predictive factors for percutaneous nephrolithotomy(PCNL)bleeding risks.With better risk stratification,bleeding in high-risk patient can be anticipated and facilitates early identification.Methods:A prospective observational study of PCNL performed at our institution was done.All adults with radio-opaque renal stones planned for PCNL were included except those with coagulopathy,planned for additional procedures.Factors including gender,co-morbidities,body mass index,stone burden,puncture site,tract dilatation size,operative position,surgeon's seniority,and operative duration were studied using stepwise multivariate regression analysis to identify the predictive factors associated with higher estimated hemoglobin(Hb)deficiency.Results:Overall,4.86%patients(n=7)received packed cells transfusion.The mean estimated Hb deficiency was 1.3(range 0-6.5)g/dL and the median was 1.0 g/dL.Stepwise multivariate regression analysis revealed that absence of hypertension(p=0.024),puncture site(p=0.027),and operative duration(p=0.023)were significantly associated with higher estimated Hb deficiency.However,the effect sizes are rather small with partial eta-squared of 0.037,0.066,and 0.038,respectively.Observed power obtained was 0.621,0.722,and 0.625,respectively.Other factors studied did not correlate with Hb difference.Conclusion:Hypertension,puncture site,and operative duration have significant impact on estimated Hb deficiency during PCNL.However,the effect size is rather small despite adequate study power obtained.Nonetheless,operative position(supine or prone),puncture number,or tract dilatation size did not correlate with Hb difference.The mainstay of reducing bleeding in PCNL is still meticulous operative technique.Our study findings also suggest that PCNL can be safely done by urology trainees under supervision in suitably selected patient,without increasing risk of bleeding.

Carbon Emission Factors Prediction of Power Grid by Using Graph Attention Network

Advanced carbon emission factors of a power grid can provide users with effective carbon reduction advice,which is of immense importance in mobilizing the entire society to reduce carbon emissions.The method of calculating node carbon emission factors based on the carbon emissions flow theory requires real-time parameters of a power grid.Therefore,it cannot provide carbon factor information beforehand.To address this issue,a prediction model based on the graph attention network is proposed.The model uses a graph structure that is suitable for the topology of the power grid and designs a supervised network using the loads of the grid nodes and the corresponding carbon factor data.The network extracts features and transmits information more suitable for the power system and can flexibly adjust the equivalent topology,thereby increasing the diversity of the structure.Its input and output data are simple,without the power grid parameters.We demonstrated its effect by testing IEEE-39 bus and IEEE-118 bus systems with average error rates of 2.46%and 2.51%.

Predictive Factors for Pre-Eclampsia: A Case-Control Study in Two Hospitals in Yaounde

Introduction: Pre-eclampsia is a major cause of maternal and prenatal morbidity and mortality, that complicates 2% to 8% of pregnancies worldwide. The aim of this study was to determine the predictive factors for pre-eclampsia in two hospitals in the city of Yaoundé. Methods: A case-control study was conducted at the Gynaecology & Obstetrics department of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital (YGOPH) and the Main Maternity of the Yaoundé Central Hospital (MM-YCH) from February 1 to July 30, 2022. The cases were all pregnant women presenting with pre-eclampsia. The control group included pregnant women without pre-eclampsia. Descriptive statistics followed by logistic regression analyses were conducted with level of significance set at p-value Results: Included in the study were 33 cases and 132 controls, giving a total of 165 participants. The predictive factors for pre-eclampsia after multivariate analysis were: primiparity (aOR = 51.86, 95% CI: 3.01 - 1230.96, p = 0.045), duration of exposure to partner’s sperm Conclusion: The odds of pre-eclampsia increased with primiparity, duration of exposure to partner’s sperm < 3 months, personal history of pre-eclampsia and maternal history of pre-eclampsia. Recognition of these predictor factors would improve the ability to diagnose and monitor women likely to develop pre-eclampsia before the onset of disease for timely interventions.

Nomogram to predict severe retinopathy of prematurity in Southeast China

AIM:To define the predictive factors of severe retinopathy of prematurity(ROP)and develop a nomogram for predicting severe ROP in southeast China.METHODS:Totally 554 infants diagnosed with ROP hospitalized in the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University and hospitalized in Taizhou Women and Children’s Hospital were included.Clinical data and 43 candidate predictive factors of ROP infants were collected retrospectively.Logistic regression model was used to identify predictive factors of severe ROP and to propose a nomogram for individual risk prediction,which was compared with WINROP model and Digirop-Birth model.RESULTS:Infants from the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University(n=478)were randomly allocated into training(n=402)and internal validation group(n=76).Infants from Taizhou Women and Children’s Hospital were set as external validation group(n=76).Severe ROP were found in 52 of 402 infants,12 of 76 infants,and 7 of 76 infants in training group,internal validation group,and external validation group,respectively.Birth weight[odds ratio(OR),0.997;95%confidence interval(CI),0.996-0.999;P<0.001],multiple births(OR,1.885;95%CI,1.013-3.506;P=0.045),and non-invasive ventilation(OR,0.288;95%CI,0.146-0.570;P<0.001)were identified as predictive factors for the prediction of severe ROP,by univariate analysis and multivariate analysis.For predicting severe ROP based on the internal validation group,the areas under receiver operating characteristic curve(AUC)was 78.1(95%CI,64.2-92.0)for the nomogram,32.9(95%CI,15.3-50.5)for WINROP model,70.2(95%CI,55.8-84.6)for Digirop-Birth model.In external validation group,AUC of the nomogram was also higher than that of WINROP model and Digirop-Birth model(80.2 versus 51.1 and 63.4).The decision curve analysis of the nomogram demonstrated better clinical efficacy than that of WINROP model and Digirop-Birth model.The calibration curves demonstrated a good consistency between the actual severe ROP incidence and the predicted probability.CONCLUSION:Birth weight,multiple births,and noninvasive ventilation are independent predictors of severe ROP.The nomogram has a good ability to predict severe ROP and performed well on internal validation and external validation in southeast China.

Predictive Factors for the Occurrence of Pharyngostoma after Laryngectomy and Total Pharyngo-Laryngectomy in Yaounde and Douala

Introduction and Aims: Pharyngostoma or pharyngo-cutaneous fistula is a frequent complication of totals laryngectomies and pharyngo-laryngectomies. Its incidence varies from one series to another from 13% to 58%. Multiple risk factors are known. The data from our environment concerning this condition are few. Thus, in order to contribute to the study of this complication in our environment, we proposed to carry out this study, whose objective was to determine the predictive factors for the occurrence of pharyngo-cutaneous fistula or pharyngostoma after total laryngectomy and total pharyngo-laryngectomy in Yaounde and Douala. Patients and Methods: This was a retrospective, cross-sectional, descriptive study conducted in the 5 Ear-Nose-Throat (ENT) department of hospital in the city of Yaounde and Douala. The study took place between January 2009 and December 2020. All patients who underwent total laryngectomy or total pharyngo-laryngectomy with a follow-up of at least one month were included in the study. Incomplete records were excluded, as well as those of patients who died before one month of postoperative follow-up. Results: We selected 48 cases of total laryngectomies (TL) and total pharyngo-laryngectomies (TPL), and identified 37 cases of pharyngostoma. 45 men (93.8%) and 3 women (6.3%). The mean age was 56.4 years with extremes ranging from 37 to 86 years. Smoking and alcoholism were noted in 75% and 79.2% of our patients respectively. A tracheotomy before TL and TPL was found in 41.7%. 100% of the tumours found were T3 or T4. The surgery was in 34 cases (70.8%) TL and in 14 cases (29.2%) TPL. Pharyngostomas were observed in 37 cases among 48 patients operated on, i.e. a frequency of 77.1%. The average delay of appearance was 7 to 14 days. We had spontaneous healing with pressure dressing and nasogastric tube feeding in 35 patients (77.8%) and two patients benefited from pectoralis major flap treatment;the healing time was 21 to 30 days. We did not find any correlation between gender, age, tumour site of origin and locoregional extension and the occurrence of pharyngostoma. Preoperative tracheotomy and radiotherapy were not significant risk factors for the occurrence of pharyngostoma. However, preoperative anaemia (p = 0.02), LTP (p = 0.02), early complications (p 0.001) and lack of continuous saliva aspiration postoperatively (p = 0.03) were statistically significant predictors of pharyngostoma in univariate analysis. Conclusion: Pharyngostoma is the most common postoperative complication after TL and TPL. In our setting, the main associated risk factors identified were: preoperative anaemia, LTP, early complications and failure to continuously aspirate saliva postoperatively.

Predictors of Adverse Pregnancy Outcomes Following Traumatic Injuries

Objective After traumatic injury in pregnant women,providing timely and appropriate management for high-risk patients is crucial for both pregnant women and fetuses.This study aimed to identify risk factors that predict adverse pregnancy outcomes after traumatic injury.Methods A retrospective cohort study including 317 pregnant patients who experienced trauma was conducted.The collected data included general demographics,injury mechanisms and adverse pregnancy outcomes.Patients were divided into two subgroups based on the absence or presence of trauma-related adverse pregnancy outcomes.Univariate and multivariate logistic regressions were conducted to estimate the associations between clinical variables and adverse pregnancy outcomes.Results A total of 41(12.93%)patients experienced adverse pregnancy outcomes within the first 24 h post-trauma.This study revealed that age>35 years(OR=14.995,95%CI:5.024–44.755,P<0.001),third trimester trauma(OR=3.878,95%CI:1.343–11.204,P=0.012),abdominal pain(OR=3.032,95%CI:1.221–7.527,P=0.017),vaginal bleeding(OR=3.226,95%CI:1.093–9.523,P=0.034),positive scan in focused assessment with sonography for trauma(FAST)positive(OR=8.496,95%CI:2.825–25.555,P<0.001),9≤injury severity score(ISS)<16(OR=3.039,95%CI:1.046–8.835,P=0.041)and ISS≥16(OR=5.553,95%CI:1.387–22.225,P=0.015)increased the probability of posttraumatic adverse pregnancy outcomes.Maternal age,gestational age at delivery,vaginal bleeding and positive FAST results were risk factors for abnormal delivery.Conclusion Advanced maternal age,third trimester,and positive FAST results should alert multidisciplinary trauma teams to closely monitor patients to prevent adverse pregnancy outcomes.

Navigating breast cancer brain metastasis:Risk factors,prognostic indicators,and treatment perspectives

In this editorial,we comment on the article by Chen et al.We specifically focus on the risk factors,prognostic factors,and management of brain metastasis(BM)in breast cancer(BC).BC is the second most common cancer to have BM after lung cancer.Independent risk factors for BM in BC are:HER-2 positive BC,triplenegative BC,and germline BRCA mutation.Other factors associated with BM are lung metastasis,age less than 40 years,and African and American ancestry.Even though risk factors associated with BM in BC are elucidated,there is a lack of data on predictive models for BM in BC.Few studies have been made to formulate predictive models or nomograms to address this issue,where age,grade of tumor,HER-2 receptor status,and number of metastatic sites(1 vs>1)were predictive of BM in metastatic BC.However,none have been used in clinical practice.National Comprehensive Cancer Network recommends screening of BM in advanced BC only when the patient is symptomatic or suspicious of central nervous system symptoms;routine screening for BM in BC is not recommended in the guidelines.BM decreases the quality of life and will have a significant psychological impact.Further studies are required for designing validated nomograms or predictive models for BM in BC;these models can be used in the future to develop treatment approaches to prevent BM,which improves the quality of life and overall survival.

Advancing Malaria Prediction in Uganda through AI and Geospatial Analysis Models

The resurgence of locally acquired malaria cases in the USA and the persistent global challenge of malaria transmission highlight the urgent need for research to prevent this disease. Despite significant eradication efforts, malaria remains a serious threat, particularly in regions like Africa. This study explores how integrating Gregor’s Type IV theory with Geographic Information Systems (GIS) improves our understanding of disease dynamics, especially Malaria transmission patterns in Uganda. By combining data-driven algorithms, artificial intelligence, and geospatial analysis, the research aims to determine the most reliable predictors of Malaria incident rates and assess the impact of different factors on transmission. Using diverse predictive modeling techniques including Linear Regression, K-Nearest Neighbor, Neural Network, and Random Forest, the study found that;Random Forest model outperformed the others, demonstrating superior predictive accuracy with an R2 of approximately 0.88 and a Mean Squared Error (MSE) of 0.0534, Antimalarial treatment was identified as the most influential factor, with mosquito net access associated with a significant reduction in incident rates, while higher temperatures correlated with increased rates. Our study concluded that the Random Forest model was effective in predicting malaria incident rates in Uganda and highlighted the significance of climate factors and preventive measures such as mosquito nets and antimalarial drugs. We recommended that districts with malaria hotspots lacking Indoor Residual Spraying (IRS) coverage prioritize its implementation to mitigate incident rates, while those with high malaria rates in 2020 require immediate attention. By advocating for the use of appropriate predictive models, our research emphasized the importance of evidence-based decision-making in malaria control strategies, aiming to reduce transmission rates and save lives.

Discrete Choice Analysis of Temporal Factors on Social Network Growth

Social networks like Facebook, X (Twitter), and LinkedIn provide an interaction and communication environment for users to generate and share content, allowing for the observation of social behaviours in the digital world. These networks can be viewed as a collection of nodes and edges, where users and their interactions are represented as nodes and the connections between them as edges. Understanding the factors that contribute to the formation of these edges is important for studying network structure and processes. This knowledge can be applied to various areas such as identifying communities, recommending friends, and targeting online advertisements. Several factors, including node popularity and friends-of-friends relationships, influence edge formation and network growth. This research focuses on the temporal activity of nodes and its impact on edge formation. Specifically, the study examines how the minimum age of friends-of-friends edges and the average age of all edges connected to potential target nodes influence the formation of network edges. Discrete choice analysis is used to analyse the combined effect of these temporal factors and other well-known attributes like node degree (i.e., the number of connections a node has) and network distance between nodes. The findings reveal that temporal properties have a similar impact as network proximity in predicting the creation of links. By incorporating temporal features into the models, the accuracy of link prediction can be further improved.

Prognostic factors and predictors of postoperative adjuvant transcatheter arterial chemoembolization benefit in patients with resected hepatocellular carcinoma

BACKGROUND Postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) has improved overall survival (OS) in patients with hepatocellular carcinoma (HCC).However,the prognostic and predictive factors remain unclear.AIM To assess the prognostic factors and the predictors of PA-TACE benefit for OS in patients with resected HCC.METHODS Univariate and multivariate analyses were performed to identify the potential prognostic factors for OS.In order to assess the predictive factors of PA-TACE benefit,the interaction variables between treatments for each subgroup were evaluated using the Cox proportional hazards regression model.RESULTS A total of 378 patients (PA-TACE vs surgery alone,189:189) from three centerswere included after a propensity-score 1:1 matching analysis.Compared to the group receiving surgery alone,PA-TACE prolonged the OS rate in patients with resected HCC (P <0.001).The Barcelona Clinic Liver Cancer system and ferritinto-hemoglobin ratio (FHR) were used as the prognostic factors for OS in both groups.Age (P=0.023) and microscopic vascular invasion (MVI)(P=0.002) were also identified in the PA-TACE group,while gender (P=0.027),hepatitis B virus(P=0.034) and albumin-bilirubin grade (P=0.027) were also selected in the surgery alone group.In addition,PA-TACE resulted in longer OS than surgery alone across subgroups [all hazard ratios (PA-TACE-to-surgery alone)<1].Notably,a significantly prolonged OS following PA-TACE was observed in patients with high FHR (P=0.038) and without MVI (P=0.048).CONCLUSION FHR and Barcelona Clinic Liver Cancer stages were regarded as prognostic factors for OS.Moreover,high FHR and the absence of MVI were important predictive factors,which can be used to assist clinicians in selecting which patients could achieve a better OS with PA-TACE.

Predictive factors of survival in patients treated with definitive chemoradiotherapy for squamous cell esophageal carcinoma

瞄准：学习的目的是与食道的癌(LASCOC ) 与权威的 chemoradiotherapy (CRT ) 对待的局部地先进的有鳞的房间在病人评估幸存的预兆的因素政体基于 5FU/CDDP 联合。方法：有用在 1994 和 2000 之间的 5FU/CDDP 联合与权威的 CRT 对待的 LASCOC 的所有病人回顾地被包括。对 CRT 的临床的完全的反应(CCR ) 被食道的内视镜检查法和 CT 扫描估计在 CRT 结束以后的 2 瞬间。幸存的预示的因素用 univariate 被估计，多，由艇长回归的变量分析当模特儿。结果：116 个病人的一个总数在学习被包括。到 CRT 的 CCR 在 86/116 (74.1%) 被观察。中部的幸存是 20 瞬间(范围 2-114 ) ， 5 年的幸存是 9.4% 。到 CRT 的应答者病人的中部的幸存在非应答者病人作为与 9 瞬间(范围 2-81 ) 相比是 25 瞬间(范围 3-114 )(P 【 0.001 ) 。在 univariate 分析，幸存与 CCR 被联系(P 【 0.001 ) ，表演地位 【 2 (P = 0.01 ) ，瘤长度 【 6 厘米(P = 0.045 ) 并且 10% 在意义的限制的重量损失 【 (P = 0.053 ) 。在里面多变量分析，幸存对 CCR 依赖(P 【 0.0001 ) ，重量损失 【 10%(P = 0.034 ) 并且表演 【 2 (P = 0.046 ) 。结论：我们的结果建议在有与权威的 CRT 对待的 LASCOC 的病人的那幸存被相关到 CCR，重量损失并且表演地位。

Predictive factors of endoscopic submucosal dissection procedure time for gastric superficial neoplasia

AIM:To identify the determinants of endoscopic submucosal dissection(ESD) operation time.METHODS:This investigation was conducted as a single-center,prospective study in which ESD was performed by the same endoscopist at the Chinese PLA General Hospital.A total of 173 patients underwent ESD operations performed by Dr.Lu from July 2007 to December 2011,and 183 lesions were enrolled.Patient gender,age,tumor location,gross type,tumor size,pathological type and adhesions were recorded prospectively.The order of treatment represented the experience of the operator.Univariate analysis and multivariate analysis were performed to evaluate the relationships between these factors and ESD procedure time.RESULTS:Univariate analysis showed the ESD time was closely related to the gender(P = 0.0210),tumor size(P < 0.0001),location(P < 0.0001),gross type(P < 0.0001) and adhesion(P = 0.0010).The surgical proficiency level was associated with ESD time in unit area(P < 0.0001).Multivariate analysis revealed that the ESD time was positively correlated with tumor size(P < 0.0001),adhesion(P < 0.0001) and location(P < 0.0001),but negatively correlated with surgical proficiency level(P = 0.0046).CONCLUSION:Large tumor size,adjacency to the cardia,and adhesion are predictors of a long ESD time,whereas high surgical proficiency level predicts a short ESD time.

Evolution and predictive factors of thyroid disorder due to interferon alpha in the treatment of hepatitis C

AIM:To study predictive factors of thyroid dysfunction associated with interferon-alpha(IFNα) therapy in chronic hepatitis C(CHC) and to describe its long-term evolution in a large population without previous thyroid dysfunction.METHODS:We performed a follow-up of thyroid function and detection of thyroid antibodies in 301 patients treated for CHC with IFNα from 1999 to 2004.RESULTS:Thyroid disorder developed in 30/301(10%) patients with a mean delay of 6 ± 3.75 mo:13 patients had hyperthyroidism,11 had hypothyroidism,and 6 had biphasic evolution.During a mean follow-up of 41.59 ± 15.39 mo,9 patients with hyperthyroidism,3 with hypothyroidism,and 4 with biphasic evolution normalized thyroid function in 7.88 ± 5.46 mo.Recovery rate of dysthyroidism was not modified by treatment discontinuation,but was better for patients with negative thyroid antibodies before antiviral treatment(P = 0.02).Women had signif icantly more dysthyroidism(P = 0.05).Positive thyroid peroxidase and thyroglobulin antibodies were more frequent before antiviral treatment in patients who developed dysthyroidism(P < 0.0003 and P = 0.0003,respectively).In a multivariate model,low fibrosis was found to be a predictive factor of dysthyroidism(P = 0.039).CONCLUSION:In this monocentric population of CHC,dysthyroidism,especially hyperthyroidism,developed in 10% of patients.Low fibrosis was found to be a predictive factor of dysthyroidism.Thyroid disorder recovered in 16/30 patients(53%) and recovery was better in the non-autoimmune form.

Clinical feature and predictive factor analysis for spontaneous regression of retinopathy of prematurity in a Chinese population

AIM:To investigate the ratio of spontaneous regression of retinopathy of prematurity(ROP)and to explore the possible relevant predictive factors.METHODS:A retrospective review of 405 infants who were diagnosed with ROP and mother during pregnancy were collected.Stage,zone,and duration of ROP were recorded.Statistical analysis was performed on 51 possible predictive factors.RESULTS:Totally 356 infants showed spontaneous regression.The incidence was 100%,95.3%,and 22.7%in stage 1,2,and 3,respectively.The 13.4%of the ROP with plus disease eventually resolved spontaneously.All affected eyes of aggressive posterior retinopathy of prematurity(APROP)failed to spontaneously regress.The mean duration of ROP was 7.2wk in patients with spontaneous resolution of ROP.Days of mechanical ventilation(OR=0.981,95%CI,0.965-0.997,P=0.021),retinal hemorrhage(OR=0.173,95%CI,0.064-0.470,P=0.001),delivery pattern(OR=2.750,95%CI,1.132-6.681,P=0.025),maternal anemia in pregnancy(OR=0.142,95%CI,0.036-0.563,P=0.005),the stages(at initial diagnosis OR=0.183,95%CI,0.041-0.816,P=0.026;at final diagnosis OR=0.031,95%CI,0.006-0.167,P<0.001),and with plus disease or not(OR=0.005,95%CI,0.001-0.031,P<0.001)were independent predictive factors of the spontaneous regression of ROP.CONCLUSION:Most mild ROP can spontaneously resolve.Active treatment is still recommended for stage 3 ROP,zone I ROP,AP-ROP,and ROP with plus disease.Prolonged mechanical ventilation and concurrent retinal hemorrhage reduce the likelihood of spontaneous ROP resolution.The pattern of delivery and the mother's anemia during pregnancy can also affect the prognosis of ROP.

Eosinopenia is a predictive factor for the severity of acute ischemic stroke

Previous data have revealed an association between eosinopenia and mortality of acute ischemic stroke.However,the relationship of eosinopenia with infarct volume,infection rate,and poor outcome of acute ischemic stroke is still unknown.The retrospective study included 421 patients(273 males,65%;mean age,68.0± 13.0 years)with first acute ischemic stroke who were hospitalized in the Second Affiliated Hospital of Soochow University,China,from January 2017 to February 2018.Laboratory data,neuroimaging results,and modified Rankin Scale scores were collected.Patients were divided into four groups according to their eosinophil percentage level(<0.4%,0.4-1.1%,1 1-2.3%,≥2.3%).Spearman’s correlation analysis showed that the percentage of eosinophils was negatively correlated with infarct volume(rs=-0.514,P<0.001).Receiver operating characteristic analysis demonstrated that eosinopenia predicted a large infarct volume more accurately than neutrophilia;the area under curve was 0.906 and 0.876,respectively;a large infarct was considered as that with a diameter larger than 3 cm and involving more than two major arterial blood supply areas.Logistic regression analysis revealed that eosinophil percentage was an independent risk factor for acute ischemic stroke(P=0.002).Moreover,eosinophil percentage was significantly associated with large infarct volume,high infection rate(pulmonary and urinary tract infections),and poor outcome(modified Rankin Scale score>3)after adjusting for potential confounding factors(P-trend<0.001).These findings suggest that eosinopenia has the potential to predict the severity of acute ischemic stroke.This study was approved by the Ethics Committee of the Second Affiliated Hospital of Soochow University,China(approval number:K10)on November 10,2015.

Total and not bevacizumab-bound vascular endothelial growth factor as potential predictive factors to bevacizumab-based chemotherapy in colorectal cancer

AIM: To identify suitable biomarkers of response to bevacizumab(BV)- it remains an open question. The measurement of serum vascular endothelial growth factor(VEGF) has been proposed as a predictive factor for this drug, even if literature data are contradictory. METHODS: We prospectively evaluated the role of BV, total and not BV-bound VEGF and angiopoietin-2(Ang-2) serum levels as potential predictive factors of response for BV in combination with an oxaliplatinbased chemotherapy. BV, Ang-2, total and not BVbound VEGF levels were measured at baseline, before 2^(nd) and 5^(th) cycle of oxaliplatin-based chemotherapy in 20 consecutive metastatic colorectal cancer patients. RESULTS: Results were correlated to response to treatment. Variability in BV levels have been found, with decreased level in less responding patients. In particular, the concentration of BV increased of 3.96 ± 0.69 folds in serum of responsive patients after 3 more cycles of therapy compared to those with stable or progressive disease with a 0.72 ± 0.25 and 2.10 ± 0.13 fold increase, respectively. The determination of free and total VEGF demonstrated that the ratio between the two values, evaluated immediately before the 2^(nd) and the 5^(th) cycle of therapy, decreased from 26.65% ± 1.33% to 15.50% ± 3.47% in responsive patients and from 53.41% ± 4.75 to 34.95% ± 2.88% in those with stable disease. Conversely, in those with progression of disease, the ratio showed the opposite behavior coming up from 25.99% ± 5.23% to 51.71% ± 5.28%. The Ang-2 levels did not show any relationship. CONCLUSION: Our data show that the ratio of not BV-bound VEGF to total VEGF serum and BV plasma concentrations for predicting the response to BV plus oxaliplatin-based chemotherapy could be a promising biomarker of response to BV.

The macular microstructure repair and predictive factors of surgical outcomes after vitrectomy for idiopathic macular hole

To evaluate the macular microstructure repair and explore the factors related to those changes and visual improvement after vitrectomy for idiopathic macular hole(IMH). Totally 19 eyes of 18 IMH patients who underwent macular hole(MH) surgery were evaluated with bestcorrected visual acuity(BCVA) and spectral-domain optical coherence tomography(SD-OCT) images. All 19 eyes closed at 6 mo postoperatively. BCVA was observed gradually improved(P<0.001), with subretinal fluid(SRF) gradually absorbed(P=0.021) and the rate of external limiting membrane(ELM) defects gradually decreased(P=0.011) with follow-up time. Poorer postoperative logMAR BCVA correlated with larger MH minimum diameter(P<0.001), larger MH basal diameter(P=0.008), longer symptom duration(P=0.002) and poorer preoperative logMAR BCVA(P=0.010). More improvement in BCVA correlated only with poorer preoperative in logMAR BCVA(P=0.002). The earlier reconstruction of ELM was associated with smaller MH basal diameter(P=0.022) and shorter symptom duration(P=0.008). In conclusion, smaller basal diameter of MH and shorter symptom duration were key factors in earlier reconstruction of ELM.

Predicting factors for the need of extracorporeal membrane oxygenation for suicide attempts by cardiac medication:a single-center cohort study

BACKGROUND:Severe poisoning due to the overdosing of cardiac drugs can lead to cardiovascular failure.In order to decrease the mortality rate,the most severe patients should be transferred as quickly as possible to an extracorporeal membrane oxygenation(ECMO)center.However,the predictive factors showing the need for venous-arterial ECMO(VA-ECMO)had never been evaluated.METHODS:A retrospective,descriptive,and single-center cohort study.All consecutive patients admitted in the largest ICU of Reunion Island(Indian Ocean)between January 2013 and September 2018 for beta-blockers(BB),calcium channel blockers(CCB),renin-angiotensin-aldosterone system blockers,digoxin or anti-arrythmic intentional poisonings were included.ECMO implementation was the primary outcome.RESULTS:A total of 49 consecutive admissions were included.Ten patients had ECMO,39 patients did not have ECMO.Three patients in ECMO group died,while no patients in the conventional group died.The most relevant ECMO-associated factors were pulse pressure and heart rate at first medical contact and pulse pressure,heart rate,arterial lactate concentration,liver enzymes and left ventricular ejection fraction(LVEF)at ICU-admission.Only pulse pressure at first medical contact and LVEF were significant after logistic regression.CONCLUSION:A transfer to an ECMO center should be considered for a pulse pressure<35 mmHg at first medical contact or LVEF<20%on admission to ICU.

Predictive factors for postoperative visual function of primary chronic rhegmatogenous retinal detachment after scleral buckling

AIM： To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment （RRD） after sclera buckling （SB）. METHODS： Totally 48 patients （51 eyes） with primary chronic RRD were included in this prospective interventional clinical cases study, which underwent SB alone from June 2008 to December 2014. Age, sex, symptoms duration, detached extension, retinal hole position, size, type, fovea on/off, proliferative vitreoretinopathy （PVR）, posterior vitreous detachment （PVD）, baseline best corrected visual acuity （BCVA）, operative duration, follow up duration, final BCVA were measured. Pearson correlation analysis, Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity. Student＇s t-test, Wilcoxon twosample test, Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement. RESULTS： Baseline BCVA was 0.8313±0.6911 IogMAR and final BCVA was 0.4761 ±0.4956 IogMAR. Primary surgical success rate was 92.16% （47/51）. Correlation analyses revealed shorter symptoms duration （r =0.3850, P=0.0053）, less detached area （r=0.5489, P〈0.0001）, fovea （r=0.4605, P=0.0007）, no PVR （r=0.3138, P= 0.0250）, better baseline BCVA （r=0.7291, P〈0.0001）, shorter operative duration （r=0.3233, P=0.0207） and longer follow up （r=-0.3358, P=0.0160） were related with better final BCVA, while independent predictive factors were better baseline BCVA [partial R-square （PR2） = 0.5316, P〈0.0001], shorter symptoms duration （PR2= 0.0609, P=0.0101）, longer follow up duration （PR2=0.0278, P =0.0477） and shorter operative duration （PR2=0.0338, P=0.0350）. Patients with vision improvement took up 49.02% （25/51）. Univariate and multivariate analyses both revealed predictive factors for better vision improvement were better baseline vision [odds ratio （OR） =50.369, P= 0.0041] and longer follow up duration （OR=1.144, P= 0.0067）. CONCLUSION： Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA, shorter symptoms duration, shorter operative duration and longer follow up duration, while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.

Relative predictive factors for hepatocellular carcinoma after HBeAg seroconversion in HBV infection

AIM: To determine the predictive factors forhepatocellular carcinoma (HCC) development in patientsafter spontaneous or therapeutic HBeAg seroconversion.METHODS: In 48 patients who seroconverted to anti-HBe positive during follow-up, the background factors forHCC development were analyzed.RESULTS: HCC was developed in six patients duringfollow-up (average follow-up after HBeAg seroconversion:10.9±5.4 years). The incidence of HCC evaluated byKaplan-Meier analysis was significantly higher in patientswith abnormal aspartate aminotransferase (AST＞40 IU/L) level, lower platelet counts (PLT＜10×104/μL),lower albumin level (Alb＜30 g/L), positive HBV-DNA or older age at seroconversion (＞40 years). However, lower platelet count was the only predictive factor for HCC development shown by multivariate proportional-hazard analysis.CONCLUSION: Active hepatitis or advanced hepatitis at HBeAg seroconversion or progressive hepatitis even after HBeAg seroconversion would be the risk factors for HCC development. These predictive factors should be taken into account in determining the frequency of biochemical study or imaging studies for HCC surveillance.