Background and Objective: Some patients continue to experience major adverse cardiovascular and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) in frigid places. Indexes of inflammation a...Background and Objective: Some patients continue to experience major adverse cardiovascular and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) in frigid places. Indexes of inflammation and nutrition alone were shown to predict outcomes in patients with PCI. However, the clinical predictive value of mixed indicators is unclear. This study aimed to assess the predictive value of the albumin/neutrophil/lymphocyte ratio (NLR) on the long-term prognosis of patients with coronary heart disease (CHD) following percutaneous coronary intervention (PCI). Methods: A total of 608 post-PCI CHD patients were categorized into low- and high-index groups based on the optimal cut-off values for albumin and NLR. The primary outcome was a composite endpoint comprising all-cause mortality and major adverse cerebrovascular events. The secondary outcome was the comparison of the predictive efficiency of the new nutritional index, albumin/NLR, with that of albumin or NLR alone. Results: Over the five-year follow-up period, 45 patients experienced the composite endpoint. The incidence of endpoint events was significantly higher in the low-index group (12%) compared to the high-index group (4.9%). Receiver operating characteristic (ROC) curve analysis revealed that the albumin/NLR index had a larger area under the curve (AUC: 0.655) than albumin (AUC: 0.621) or NLR (AUC: 0.646), indicating superior predictive efficiency. The prognostic nutritional index had an AUC of 0.644, further supporting the enhanced predictive value of the albumin/NLR index over individual nutritional and inflammatory markers. Conclusion: The albumin/neutrophil/lymphocyte ratio is independently associated with the long-term prognosis of CHD patients post-PCI and demonstrates superior predictive efficiency compared to individual nutritional and inflammatory markers.展开更多
BACKGROUND Oncostatin M(OSM)is a pleiotropic cytokine which is implicated in the path-ogenesis of inflammatory bowel disease(IBD).AIM To evaluate the prognostic role of OSM in IBD patients.METHODS Literature search wa...BACKGROUND Oncostatin M(OSM)is a pleiotropic cytokine which is implicated in the path-ogenesis of inflammatory bowel disease(IBD).AIM To evaluate the prognostic role of OSM in IBD patients.METHODS Literature search was conducted in electronic databases(Google Scholar,Embase,PubMed,Science Direct,Springer,and Wiley).Studies were selected if they reported prognostic information about OSM in IBD patients.Outcome data were synthesized,and meta-analyses were performed to estimate standardized mean differences(SMDs)in OSM levels between treatment responders and non-res-ponders and to seek overall correlations of OSM with other inflammatory bio-markers.RESULTS Sixteen studies(818 Crohn’s disease and 686 ulcerative colitis patients treated with anti-tumor necrosis factor-based therapies)were included.OSM levels were associated with IBD severity.A meta-analysis found significantly higher OSM levels in non-responders than in responders to therapy[SMD 0.80(0.33,1.27);P=0.001],in non-remitters than in remitters[SMD 0.75(95%CI:0.35 to 1.16);P<0.0001]and in patients with no mucosal healing than in those with mucosal heal-ing[SMD 0.63(0.30,0.95);P<0.0001].Area under receiver operator curve values showed considerable variability between studies but in general higher OSM levels were associated with poor prognosis.OSM had significant correlations with Simple Endoscopic Score of Crohn’s disease[r=0.47(95%CI:0.25 to 0.64);P<0.0001],Mayo Endoscopic Score[r=0.35(95%CI:0.28 to 0.41);P<0.0001],fecal calprotectin[r=0.19(95%CI:0.08 to 0.3);P=0.001],C-reactive protein[r=0.25(95%CI:0.11 to 0.39);P<0.0001],and platelet count[r=0.28(95%CI:0.17 to 0.39);P<0.0001].CONCLUSION OSM is a potential candidate for determining the severity of disease and predicting the outcomes of anti-tumor necrosis factor-based therapies in IBD patients.展开更多
Alzheimer’s disease(AD)is a grave illness that results in cognitive and social issues.A recent study examined the association between neuroimaging results,cognitive dysfunction,atypical cellular immune function,and p...Alzheimer’s disease(AD)is a grave illness that results in cognitive and social issues.A recent study examined the association between neuroimaging results,cognitive dysfunction,atypical cellular immune function,and poor prognostic factors in AD patients who demonstrated poor prognosis.Poor prognosis was associated with abnormal cellular immune function,extrapyramidal symptoms,altered consciousness,abnormal electroencephalogram,modified Rankin scale,increased neutrophil lymphocyte ratio,and severe pneumonia.The impaired cellular immune function characterized by a reduction in the blood T lym-phocytes’proportion predicted poor prognosis as an independent risk factor in AD.Early initiation and maintenance of AD medications is associated with better outcomes.展开更多
BACKGROUND Alzheimer’s disease(AD)is a serious disease causing human dementia and social problems.The quality of life and prognosis of AD patients have attracted much attention.The role of chronic immune inflammation...BACKGROUND Alzheimer’s disease(AD)is a serious disease causing human dementia and social problems.The quality of life and prognosis of AD patients have attracted much attention.The role of chronic immune inflammation in the pathogenesis of AD is becoming more and more important.AIM To study the relationship among cognitive dysfunction,abnormal cellular immune function,neuroimaging results and poor prognostic factors in patients.METHODS A retrospective analysis of 62 hospitalized patients clinical diagnosed with AD who were admitted to our hospital from November 2015 to November 2020.Collect cognitive dysfunction performance characteristics,laboratory test data and neuroimaging data from medical records within 24 h of admission,including Mini Mental State Examination Scale score,drawing clock test,blood T lymphocyte subsets,and neutrophils and lymphocyte ratio(NLR),disturbance of consciousness,extrapyramidal symptoms,electroencephalogram(EEG)and head nucleus magnetic spectroscopy(MRS)and other data.Multivariate logistic regression analysis was used to determine independent prog-nostic factors.the modified Rankin scale(mRS)was used to determine whether the prognosis was good.The correlation between drug treatment and prognostic mRS score was tested by the rank sum test.RESULTS Univariate analysis showed that abnormal cellular immune function,extrapyramidal symptoms,obvious disturbance of consciousness,abnormal EEG,increased NLR,abnormal MRS,and complicated pneumonia were related to the poor prognosis of AD patients.Multivariate logistic regression analysis showed that the decrease in the proportion of T lym-phocytes in the blood after abnormal cellular immune function(odd ratio:2.078,95%confidence interval:1.156-3.986,P<0.05)was an independent risk factor for predicting the poor prognosis of AD.The number of days of donepezil treatment to improve cognitive function was negatively correlated with mRS score(r=0.578,P<0.05).CONCLUSION The decrease in the proportion of T lymphocytes may have predictive value for the poor prognosis of AD.It is recommended that the proportion of T lymphocytes<55%is used as the cut-off threshold for predicting the poor prog-nosis of AD.The early and continuous drug treatment is associated with a good prognosis.展开更多
Cardiovascular diseases(CVD)are the leading cause of death in the world and one of the most common diseases in the elderly,with high prevalence and poor prognosis,which seriously affect the health of the elder patient...Cardiovascular diseases(CVD)are the leading cause of death in the world and one of the most common diseases in the elderly,with high prevalence and poor prognosis,which seriously affect the health of the elder patients.One report showed that global deaths from CVD increased from 12.4 million in 1990 to 19.8 million in 2022,reflecting the global population growth and aging,as well as the impact of metabolic,environmental,and behavioral risks.[1]With the progress of aging population,the burden of CVD in the elderly in China has increased year by year,and factors including multiple complications,organ function decline,and high complication rate have made the interventional treatment of CVD in the elderly one of the difficulties and focuses in the field of cardiology in China.展开更多
Although there has been significant advancement in the identification and management of colorectal cancer(CRC)in recent years,there is still room for improvement in the current standard treatment regimen.One area of c...Although there has been significant advancement in the identification and management of colorectal cancer(CRC)in recent years,there is still room for improvement in the current standard treatment regimen.One area of concern is the lack of reliable tumor markers to predict treatment efficacy and guide tailored care.Due to its dynamic,effective,and non-invasive benefits over tissue biopsy,the detection of minimal or molecular residual lesions(MRD)based on circulating tumor DNA(ctDNA)is beneficial to the clinical development of drugs for patients with CRC after radical treatment,as well as for continuous monitoring of tumor recurrence and malignancy molecular gene evolution.The detection of ctDNA can currently be used to guide individual postoperative auxiliary treatment decisions(upgrade or downgrade treatment)in CRC,stratify the risk of clinical recurrence more precisely,and predict the risk of recurrence in advance of imaging examination,according to a large number of observational or prospective clinical studies.With increasing clarity comes the possibility of selecting a regimen of treatment based on postoperative ctDNA,which also improves the accuracy of clinical recurrence risk assessment for CRC.Therefore,it is anticipated that the identification of ctDNA would alter the current framework for dealing with CRC and lead to individualized,stratified precision therapy;however,additional confirmation will require subsequent high-quality,prospective,large-scale randomized controlled studies.This article will provide an overview of the definition and clinical significance of MRD,the primary indications and technological challenges for MRD detection,along with the advancement in clinical research about ctDNA detection following radical resection of the CRC.展开更多
The increasing incidence of cardiovascular disease(CVD)is a significant global health concern,affecting millions of individuals each year.Accurate diagnosis of acute CVD poses a formidable challenge,as misdiagnosis ca...The increasing incidence of cardiovascular disease(CVD)is a significant global health concern,affecting millions of individuals each year.Accurate diagnosis of acute CVD poses a formidable challenge,as misdiagnosis can significantly decrease patient survival rates.Traditional biomarkers have played a vital role in the diagnosis and prognosis of CVDs,but they can be influenced by various factors,such as age,sex,and renal function.Soluble ST2(sST2)is a novel biomarker that is closely associated with different CVDs.Its low reference change value makes it suitable for continuous measurement,unaffected by age,kidney function,and other confounding factors,facilitating risk stratification of CVDs.Furthermore,the combination of sST2 with other biomarkers can enhance diagnostic accuracy and prognostic value.This review aims to provide a comprehensive overview of sST2,focusing on its diagnostic and prognostic value as a myocardial marker for different types of CVDs and discussing the current limitations of sST2.展开更多
Objectives:To investigate the oral symptoms of COVID-19's"positive"group in Suining City following the comprehensive liberalization of epidemic prevention and control measures in China.To explore the rel...Objectives:To investigate the oral symptoms of COVID-19's"positive"group in Suining City following the comprehensive liberalization of epidemic prevention and control measures in China.To explore the related influencing factors of symptom differences and provide reference for the treatment of patients in the post-epidemic era.Methods:This study was conducted from January 4,2023 to January 24,2023,with the research subjects being outpatients at the Central Hospital of Suining City,Sichuan Province,who had recovered from COVID-19 infection or were currently infected.An online questionnaire comprising 25 questions was utilized.The data were analyzed using the Chi-square test.Results:1768 valid questionnaires were collected.The data showed that 363 people had oral problems after an infection with novel coronavirus.The oral problems after SARS‐CoV‐2 infection mainly focused on gingiva swelling or bleeding(38.57%),toothache(37.74%),bad breath(27.55%),oral ulcer(30.30%),abnormal taste(24.24%)and some infected people had a variety of oral symptoms.A small number of infected people also have other oral problems.The incidence of oral symptoms was significantly correlated with sex,age,educational level,place of residence,smoking,basic diseases,long-term saline gargle and vaccination of COVID-19 vaccine.In addition,the age,place of residence,smoking history,basic diseases,and vaccination also showed significant differences in prognosis.Conclusions:In the post-epidemic era,the most common oral problems include gingival swelling or bleeding,toothache,bad breath,oral ulcers,and abnormal taste.Maintaining good living habits is the foundation for promoting disease recovery and oral health.展开更多
BACKGROUND The relationship between copeptin and the severity of circulatory dysfunction and systemic stress response in patients with chronic liver disease(CLD)has been established.Nevertheless,the potential of serum...BACKGROUND The relationship between copeptin and the severity of circulatory dysfunction and systemic stress response in patients with chronic liver disease(CLD)has been established.Nevertheless,the potential of serum copeptin levels to predict the prognosis of CLD patients remains unclear.AIM To conduct a systematic review and meta-analysis to investigate the correlation between serum copeptin and transplant-free survival(TFS)in this population.METHODS To achieve the objective of the meta-analysis,PubMed,Embase,the Cochrane Library,and the Web of Science were searched to identify observational studies with longitudinal follow-up.The Cochrane Q test was utilized to assess betweenstudy heterogeneity,and the I2 statistic was estimated.Random-effects models were employed to combine the outcomes,taking into account the potential influence of heterogeneity.RESULTS Ten datasets including 3133 patients were involved.The follow-up durations were 1 to 48 mo(mean:12.5 mo).Overall,it was shown that a high level of serum copeptin was associated with a poor TFS[risk ratio(RR):1.82,95%confidence interval:1.52-2.19,P<0.001;I2=0%].In addition,sensitivity analysis by omitting one dataset at a time showed consistent results(RR:1.73-2.00,P<0.05).Finally,subgroup analyses according to study country,study design,patient diagnosis,cutoff of copeptin,follow-up duration,and study quality score also showed similar results(P for subgroup difference all>0.05).CONCLUSION Patients with CLD who have high serum copeptin concentrations may be associated with a poor clinical prognosis.展开更多
Background:Metabolic dysfunction-associated fatty liver disease(MAFLD)is recently proposed an entity by a group of international experts.However,the impact of MAFLD on the prognosis of patients with hepatocellular car...Background:Metabolic dysfunction-associated fatty liver disease(MAFLD)is recently proposed an entity by a group of international experts.However,the impact of MAFLD on the prognosis of patients with hepatocellular carcinoma(HCC)is not clear.The aim of this study was to explore the influence of MAFLD for the prognosis of HCC after radical resection.Methods:HCC patients who received radical resection were enrolled.The recurrence-free survival(RFS)and overall survival(OS)were compared between MAFLD and non-MAFLD.Results:A total of 576 HCC patients were included,and among them 114(19.8%)met the diagnostic criteria of MAFLD.The median RFS was 34.0 months in the MAFLD group and 19.0 months in the non-MAFLD group.The 1-,3-,and 5-year RFS rates were 64.9%,49.1%and 36.1%in the MAFLD group,which were higher than those of the non-MAFLD group(59.4%,35.3%and 26.5%,respectively,P=0.01).The mean OS was 57.0 months in the MAFLD group and 52.2 months in the non-MAFLD group.There was no statistical difference in OS rate between the MAFLD group and non-MAFLD group.Similar results were found in HBV-related HCC patients in the subgroup analysis.Univariate analysis revealed that MAFLD was a protective factor for RFS in HCC patients after radical resection(P<0.05),and there was no association between MAFLD and OS rate(P>0.05).Multivariate analysis demonstrated that MAFLD was not an independent protective factor for HCC patients with radical resection.Conclusions:MAFLD improves RFS rate in HCC patients with radical resection,but is not an independent protective factor and not associated with OS rate.展开更多
This study explores the predictive value of plasma a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5) levels for major adverse cardiovascular events (MACE) in patients with coronary artery dis...This study explores the predictive value of plasma a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5) levels for major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD). 595 patients admitted to our hospital were selected. Initially, the serum ADAMTS-5 levels of subjects were analyzed. Subsequently, a receiver operating characteristic (ROC) curve was constructed. Furthermore, the serum levels of ADAMTS-5 were assessed in patients, and based on CAD severity, they were categorized into stable angina pectoris (SAP), unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI) groups, with the aim of examining the relationship between ADAMTS-5 levels and CAD severity. Differences in clinical outcomes between patients with high and low levels of ADAMTS-5 were analyzed during the follow-up period. The study found that the serum levels of ADAMTS-5 were significantly higher in the group of patients with coronary artery disease (CAD) compared to the group without CAD, indicating its potential as a diagnostic marker for CAD. The ADAMTS-5 levels in the serum of STEMI patients were higher than those with SAP, while NSTEMI patients showed higher levels of ADAMTS-5 than the UA group. There was a positive correlation between serum ADAMTS-5 levels and the syntax score in CAD patients, suggesting a potential association with adverse clinical outcomes in patients with acute myocardial infarction (AMI). This study indicates that ADAMTS-5 shows promise as a biomarker for CAD and highlights the need for further research and validation.展开更多
Objective:To explore correlation of neutrophil-to-lymphocyte ratio(NLR)to severity of coronary artery disease(CAD)and in-hospital clinical outcomes in patients with acute coronary syndrome(ACS).Methods:In this prospec...Objective:To explore correlation of neutrophil-to-lymphocyte ratio(NLR)to severity of coronary artery disease(CAD)and in-hospital clinical outcomes in patients with acute coronary syndrome(ACS).Methods:In this prospective and observational study,we recruited 500 patients with ACS.For all the eligible patients,demographic details were collected,and laboratory parameters were evaluated.The CAD severity was evaluated in terms of the number of involved vessels.The NLR was calculated based on neutrophils and lymphocytes and the correlation of various risk factors and severity and outcome of CAD was performed.Results:77.2%of Patients was male,and 52%of the patients aged between 55-70 years.Based on the type of ACS,396 out of 500 patients had ST-elevation myocardial infarction.An ascending trend in the white blood cell levels and NLR value was noted as the severity of the ACS increased and the highest white blood cell levels and NLR was noted among classⅣpatients.The mean NLR value among the non-survivors were higher compared to the survivors(9.52±5.72 vs.4.76±2.36;P<0.01).Receiver operating curve showed that the cut-off NLR value was 5.76 with a sensitivity of 75.0%and a specificity of 77.3%.Conclusions:The NLR can be used as an independent prognostic marker in ACS.An elevated NLR value serves as a reliable predictor for short-term complications,notably in-hospital mortality.展开更多
Bai et al investigate the predictive value of T lymphocyte proportion in Alzheimer's disease(AD)prognosis.Through a retrospective study involving 62 AD patients,they found that a decrease in T lymphocyte proportio...Bai et al investigate the predictive value of T lymphocyte proportion in Alzheimer's disease(AD)prognosis.Through a retrospective study involving 62 AD patients,they found that a decrease in T lymphocyte proportion correlated with a poorer prognosis,as indicated by higher modified Rankin scale scores.While the study highlights the potential of T lymphocyte proportion as a prognostic marker,it suggests the need for larger,multicenter studies to enhance generalizability and validity.Additionally,future research could use cognitive exams when evaluating prognosis and delve into immune mechanisms underlying AD progression.Despite limitations inherent in retrospective designs,Bai et al's work contributes to understanding the immune system's role in AD prognosis,paving the way for further exploration in this under-researched area.展开更多
BACKGROUND The neutrophil-to-lymphocyte ratio(NLR)is commonly utilized as a prognostic indicator in end-stage liver disease(ESLD),encompassing conditions like liver failure and decompensated cirrhosis.Nevertheless,som...BACKGROUND The neutrophil-to-lymphocyte ratio(NLR)is commonly utilized as a prognostic indicator in end-stage liver disease(ESLD),encompassing conditions like liver failure and decompensated cirrhosis.Nevertheless,some studies have contested the prognostic value of NLR in ESLD.AIM To investigate the ability of NLR to predict ESLD.METHODS Databases,such as Embase,PubMed,Web of Science,Cochrane Library,China National Knowledge Infrastructure,Weipu,and Wanfang,were comprehensively searched to identify studies published before October 2022 assessing the prognostic ability of NLR to predict mortality in patients with ESLD.Effect sizes were calculated using comprehensive meta-analysis software and SATAT 15.1.RESULTS A total of thirty studies involving patients with end-stage liver disease(ESLD)were included in the evaluation.Among the pooled results of eight studies,it was observed that the Neutrophil-to-Lymphocyte Ratio(NLR)was significantly higher in non-survivors compared to survivors(random-effects model:standardized mean difference=1.02,95%confidence interval=0.67-1.37).Additionally,twenty-seven studies examined the associations between NLR and mortality in ESLD patients,reporting either hazard ratios(HR)or odds ratios(OR).The combined findings indicated a link between NLR and ESLD mortality(randomeffects model;univariate HR=1.07,95%CI=1.05-1.09;multivariate HR=1.07,95%CI=1.07-1.09;univariate OR=1.29,95%CI=1.18-1.39;multivariate OR=1.29,95%CI=1.09-1.49).Furthermore,subgroup and meta-regression analyses revealed regional variations in the impact of NLR on ESLD mortality,with Asian studies demonstrating a more pronounced effect.CONCLUSION Increased NLR in patients with ESLD is associated with a higher risk of mortality,particularly in Asian patients.NLR is a useful prognostic biomarker in patients with ESLD.展开更多
BACKGROUND Acute-on-chronic liver disease(AoCLD)accounts for the majority of patients hospitalized in the Department of Hepatology or Infectious Diseases.AIM To explore the characterization of AoCLD to provide theoret...BACKGROUND Acute-on-chronic liver disease(AoCLD)accounts for the majority of patients hospitalized in the Department of Hepatology or Infectious Diseases.AIM To explore the characterization of AoCLD to provide theoretical guidance for the accurate diagnosis and prognosis of AoCLD.METHODS Patients with AoCLD from the Chinese Acute-on-Chronic Liver Failure(ACLF)study cohort were included in this study.The clinical characteristics and outcomes,and the 90-d survival rate associated with each clinical type of AoCLD were analyzed,using the Kaplan-Meier method and the log-rank test.RESULTS A total of 3375 patients with AoCLD were enrolled,including 1679(49.7%)patients with liver cirrhosis acute decompensation(LC-AD),850(25.2%)patients with ACLF,577(17.1%)patients with chronic hepatitis acute exacer-bation(CHAE),and 269(8.0%)patients with liver cirrhosis active phase(LC-A).The most common cause of chronic liver disease(CLD)was HBV infection(71.4%).The most common precipitants of AoCLD was bacterial infection(22.8%).The 90-d mortality rates of each clinical subtype of AoCLD were 43.4%(232/535)for type-C ACLF,36.0%(36/100)for type-B ACLF,27.0%(58/215)for type-A ACLF,9.0%(151/1679)for LC-AD,3.0%(8/269)for LC-A,and 1.2%(7/577)for CHAE.CONCLUSION HBV infection is the main cause of CLD,and bacterial infection is the main precipitant of AoCLD.The most common clinical type of AoCLD is LC-AD.Early diagnosis and timely intervention are needed to reduce the mortality of patients with LC-AD or ACLF.展开更多
BACKGROUND Lung cancer(LC)is the leading cause of morbidity and mortality among malignant neoplasms.Improving the diagnosis and treatment of LC remains an urgent task of modern oncology.Previously,we established that ...BACKGROUND Lung cancer(LC)is the leading cause of morbidity and mortality among malignant neoplasms.Improving the diagnosis and treatment of LC remains an urgent task of modern oncology.Previously,we established that in gastric,breast and cervical cancer,tumor microvessels(MVs)differ in morphology and have different prognostic significance.The connection between different types of tumor MVs and the progression of LC is not well understood.AIM To evaluate the morphological features and clinical significance of tumor MVs in lung squamous cell carcinoma(LUSC).METHODS A single-center retrospective cohort study examined medical records and archival paraffin blocks of 62 and 180 patients with stage I-IIIA LUSC in the training and main cohorts,respectively.All patients underwent radical surgery(R0)at the Orenburg Regional Cancer Clinic from May/20/2009 to December/14/2021.Tumor sections were routinely processed,and routine Mayer's hematoxylin and eosin staining and immunohistochemical staining for cluster of differentiation 34(CD34),podoplanin,Snail and hypoxia-inducible factor-1 alpha were performed.The morphological features of different types of tumor MVs,tumor parenchyma and stroma were studied according to clinicopathological characteristics and LUSC prognosis.Statistical analysis was performed using Statistica 10.0 software.Univariate and multivariate logistic regression analyses were performed to identify potential risk factors for LUSC metastasis to regional lymph nodes(RLNs)and disease recurrence.Receiver operating characteristic curves were constructed to discriminate between patients with and without metastases in RLNs and those with and without disease recurrence.The effectiveness of the predictive models was assessed by the area under the curve.Survival was analyzed using the Kaplan-Meier method.The log-rank test was used to compare survival curves between patient subgroups.A value of P<0.05 was considered to indicate statistical significance.RESULTS Depending on the morphology,we classified tumor vessels into the following types:normal MVs,dilated capillaries(DCs),atypical DCs,DCs with weak expression of CD34,"contact-type"DCs,structures with partial endothelial linings,capillaries in the tumor solid component and lymphatic vessels in lymphoid and polymorphocellular infiltrates.We also evaluated the presence of loose,fine fibrous connective tissue(LFFCT)and retraction clefts in the tumor stroma,tumor spread into the alveolar air spaces(AASs)and fragmentation of the tumor solid component.According to multivariate analysis,the independent predictors of LUSC metastasis in RLNs were central tumor location(P<0.00001),the presence of retraction clefts(P=0.003),capillaries in the tumor solid component(P=0.023)and fragmentation in the tumor solid component(P=0.009),whereas the independent predictors of LUSC recurrence were tumor grade 3(G3)(P=0.001),stage N2(P=0.016),the presence of LFFCT in the tumor stroma(P<0.00001),fragmentation of the tumor solid component(P=0.0001),and the absence of tumor spread through the AASs(P=0.0083).CONCLUSION The results obtained confirm the correctness of our previously proposed classification of different types of tumor vessels and may contribute to improving the diagnosis and treatment of LUSC.展开更多
Introduction: The end of pregnancy is a high-risk period for both mother and foetus. Rigorous monitoring can prevent complications before delivery. Materials and Method: We conducted a descriptive cross-sectional obse...Introduction: The end of pregnancy is a high-risk period for both mother and foetus. Rigorous monitoring can prevent complications before delivery. Materials and Method: We conducted a descriptive cross-sectional observational study. It took place in the delivery room of the Teacher hospital Mother and Child of Jeanne Ebori Fondation from the 01 October 2020 to 01 October 2021. All patients followed at the Functional Investigation Centre (FIC) of the CHUMEFJE and who gave birth in that same hospital were included. Data were collected on the basis of pregnancy diaries, the fic register and delivery room registers. They were analysed using SPSS Statistical Software. Results: During the period of our study, 4086 parturients arrived in the delivery room. Of these, 150 were followed up at the FIC, giving a prevalence of 3.7%. The majority of parturients (48%) had only one prenatal contact. 6 (4%) patients underwent pelvic scans, and 4 (2.6%) presented with a narrowed pelvis. A vaginal delivery was performed in 80% of cases, and of the caesarean sections, 9 (30%) could be scheduled. The maternal prognosis was marred by one post-partum complication of hypertension, and newborns with poor adaptation to life outside the womb accounted for 3.3% of cases. Conclusion: The Functional Investigation Centre makes it possible to detect anomalies at the end of pregnancy with a view to better planning of delivery.展开更多
BACKGROUND:To investigate the eff ects of early standardized enteral nutrition(EN)on the crosssectional area of erector spine muscle(ESMcsa),plasma growth diff erentiation factor-15(GDF-15),and 28-day mortality of acu...BACKGROUND:To investigate the eff ects of early standardized enteral nutrition(EN)on the crosssectional area of erector spine muscle(ESMcsa),plasma growth diff erentiation factor-15(GDF-15),and 28-day mortality of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients with invasive mechanical ventilation(MV).METHODS:A total of 97 AECOPD patients with invasive MV were screened in the ICUs of the First People's Hospital of Lianyungang.The conventional EN group(stage Ⅰ)and early standardized EN group(stage Ⅱ)included 46 and 51 patients,respectively.ESMcsa loss and GDF-15 levels on days 1 and 7 of ICU admission and 28-day survival rates were analyzed.RESULTS:On day 7,the ESMcsa of the early standardized EN group was significantly higher than that of the conventional EN group,while the plasma GDF-15 levels were significantly lower than those in the conventional EN group(ESMcsa:28.426±6.130 cm^(2) vs.25.205±6.127 cm^(2);GDF-15:1661.608±558.820 pg/mL vs.2541.000±634.845 pg/mL;all P<0.001).The 28-day survival rates of the patients in the early standardized EN group and conventional EN group were 80.40%and 73.90%,respectively(P=0.406).CONCLUSION:ESMcsa loss in AECOPD patients with MV was correlated with GDF-15 levels,both of which indicated acute muscular atrophy and skeletal muscle dysfunction.Early standardized EN may prevent acute muscle loss and intensive care unit-acquired weakness(ICU-AW)in AECOPD patients.展开更多
BACKGROUND Gallbladder cancer(GC)is a common malignant tumor and one of the leading causes of cancer-related death worldwide.It is typically highly invasive,difficult to detect in the early stages,and has poor treatme...BACKGROUND Gallbladder cancer(GC)is a common malignant tumor and one of the leading causes of cancer-related death worldwide.It is typically highly invasive,difficult to detect in the early stages,and has poor treatment outcomes,resulting in high mortality rates.The available treatment options for GC are relatively limited.One emerging treatment modality is hyperthermic intraperitoneal chemotherapy(HIPEC).HIPEC involves delivering heated chemotherapy directly into the abdominal cavity.It combines the strategies of surgical tumor resection and localized chemotherapy administration under hyperthermic conditions,aiming to enhance the concentration and effectiveness of drugs within the local tumor site while minimizing systemic toxicity.AIM To determine the effects of cytoreductive surgery(CRS)combined with HIPEC on the short-term prognosis of patients with advanced GC.METHODS Data from 80 patients treated at the Punan Branch of Renji Hospital,Shanghai Jiao Tong University School of Medicine between January 2018 and January 2020 were retrospectively analyzed.The control group comprised 44 patients treated with CRS,and the research group comprised 36 patients treated with CRS combined RESULTS The baseline data of the research and control groups were similar(P>0.05).Six days after surgery,the alanine aminotransferase,aspartate aminotransferase,total bilirubin,and direct bilirubin levels significantly decreased compared to the preoperative levels in both groups(P<0.05).However,the values did not differ between the two groups six days postoperatively(P>0.05).Similarly,the postoperative creatinine and blood urea nitrogen levels were significantly lower than the preoperative levels in both groups(P<0.05),but they did not differ between the groups six days postoperatively(P>0.05).Furthermore,the research group had fewer postoperative adverse reactions than the control group(P=0.027).Finally,a multivariate Cox analysis identified the tumor stage,distant metastasis,and the treatment plan as independent factors affecting prognosis(P<0.05).The three-year survival rate in the study group was higher than that in the control group(P=0.002).CONCLUSION CRS combined with HIPEC lowers the incidence of adverse reactions and improves survival in patients with advanced GC.展开更多
Objective:To investigate the impact of sarcopenia on the prognosis of frail elderly patients with chronic kidney disease.Methods:A total of 98 elderly frail patients with chronic kidney disease were included in this s...Objective:To investigate the impact of sarcopenia on the prognosis of frail elderly patients with chronic kidney disease.Methods:A total of 98 elderly frail patients with chronic kidney disease were included in this study from June 2020 to July 2022.The patients were randomly divided into a study group of 48 cases and a control group of 50 cases.The control group only received conventional treatment for chronic kidney disease.On the basis of conventional treatment for chronic kidney disease,the study group added sarcopenia intervention treatment.The quality-of-life scores,muscle mass and muscle strength,renal function,and incidence of complications of the two groups were observed and analyzed.Results:The quality-of-life score,muscle mass and muscle strength,and renal function of the study group were significantly better than those of the control group(P<0.05);the incidence of complications in the study group was 12.5%,which was significantly lower than that of the control group 36%of the group(P<0.05).Conclusion:There is a close relationship between sarcopenia and frail elderly patients with chronic kidney disease.Sarcopenia will further aggravate the frailty symptoms and increase the risk of complications in elderly patients with chronic kidney disease.For elderly patients with chronic kidney disease,sarcopenia should be screened and intervened as early as possible to improve the prognosis and quality of life of the patients.展开更多
基金The outstanding young teachers basic research support program of Heilongjiang Provincial Department of Education(No.YQJH2023050).
文摘Background and Objective: Some patients continue to experience major adverse cardiovascular and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) in frigid places. Indexes of inflammation and nutrition alone were shown to predict outcomes in patients with PCI. However, the clinical predictive value of mixed indicators is unclear. This study aimed to assess the predictive value of the albumin/neutrophil/lymphocyte ratio (NLR) on the long-term prognosis of patients with coronary heart disease (CHD) following percutaneous coronary intervention (PCI). Methods: A total of 608 post-PCI CHD patients were categorized into low- and high-index groups based on the optimal cut-off values for albumin and NLR. The primary outcome was a composite endpoint comprising all-cause mortality and major adverse cerebrovascular events. The secondary outcome was the comparison of the predictive efficiency of the new nutritional index, albumin/NLR, with that of albumin or NLR alone. Results: Over the five-year follow-up period, 45 patients experienced the composite endpoint. The incidence of endpoint events was significantly higher in the low-index group (12%) compared to the high-index group (4.9%). Receiver operating characteristic (ROC) curve analysis revealed that the albumin/NLR index had a larger area under the curve (AUC: 0.655) than albumin (AUC: 0.621) or NLR (AUC: 0.646), indicating superior predictive efficiency. The prognostic nutritional index had an AUC of 0.644, further supporting the enhanced predictive value of the albumin/NLR index over individual nutritional and inflammatory markers. Conclusion: The albumin/neutrophil/lymphocyte ratio is independently associated with the long-term prognosis of CHD patients post-PCI and demonstrates superior predictive efficiency compared to individual nutritional and inflammatory markers.
文摘BACKGROUND Oncostatin M(OSM)is a pleiotropic cytokine which is implicated in the path-ogenesis of inflammatory bowel disease(IBD).AIM To evaluate the prognostic role of OSM in IBD patients.METHODS Literature search was conducted in electronic databases(Google Scholar,Embase,PubMed,Science Direct,Springer,and Wiley).Studies were selected if they reported prognostic information about OSM in IBD patients.Outcome data were synthesized,and meta-analyses were performed to estimate standardized mean differences(SMDs)in OSM levels between treatment responders and non-res-ponders and to seek overall correlations of OSM with other inflammatory bio-markers.RESULTS Sixteen studies(818 Crohn’s disease and 686 ulcerative colitis patients treated with anti-tumor necrosis factor-based therapies)were included.OSM levels were associated with IBD severity.A meta-analysis found significantly higher OSM levels in non-responders than in responders to therapy[SMD 0.80(0.33,1.27);P=0.001],in non-remitters than in remitters[SMD 0.75(95%CI:0.35 to 1.16);P<0.0001]and in patients with no mucosal healing than in those with mucosal heal-ing[SMD 0.63(0.30,0.95);P<0.0001].Area under receiver operator curve values showed considerable variability between studies but in general higher OSM levels were associated with poor prognosis.OSM had significant correlations with Simple Endoscopic Score of Crohn’s disease[r=0.47(95%CI:0.25 to 0.64);P<0.0001],Mayo Endoscopic Score[r=0.35(95%CI:0.28 to 0.41);P<0.0001],fecal calprotectin[r=0.19(95%CI:0.08 to 0.3);P=0.001],C-reactive protein[r=0.25(95%CI:0.11 to 0.39);P<0.0001],and platelet count[r=0.28(95%CI:0.17 to 0.39);P<0.0001].CONCLUSION OSM is a potential candidate for determining the severity of disease and predicting the outcomes of anti-tumor necrosis factor-based therapies in IBD patients.
文摘Alzheimer’s disease(AD)is a grave illness that results in cognitive and social issues.A recent study examined the association between neuroimaging results,cognitive dysfunction,atypical cellular immune function,and poor prognostic factors in AD patients who demonstrated poor prognosis.Poor prognosis was associated with abnormal cellular immune function,extrapyramidal symptoms,altered consciousness,abnormal electroencephalogram,modified Rankin scale,increased neutrophil lymphocyte ratio,and severe pneumonia.The impaired cellular immune function characterized by a reduction in the blood T lym-phocytes’proportion predicted poor prognosis as an independent risk factor in AD.Early initiation and maintenance of AD medications is associated with better outcomes.
基金Supported by the National Natural Science Foundation of China,No.3206080019 and No.32060182Science and Technology Support Plan of Guizhou Province in China,No.[2020]4Y129Qiannan Prefecture Science and Technology Plan Project,No.[2022]01.
文摘BACKGROUND Alzheimer’s disease(AD)is a serious disease causing human dementia and social problems.The quality of life and prognosis of AD patients have attracted much attention.The role of chronic immune inflammation in the pathogenesis of AD is becoming more and more important.AIM To study the relationship among cognitive dysfunction,abnormal cellular immune function,neuroimaging results and poor prognostic factors in patients.METHODS A retrospective analysis of 62 hospitalized patients clinical diagnosed with AD who were admitted to our hospital from November 2015 to November 2020.Collect cognitive dysfunction performance characteristics,laboratory test data and neuroimaging data from medical records within 24 h of admission,including Mini Mental State Examination Scale score,drawing clock test,blood T lymphocyte subsets,and neutrophils and lymphocyte ratio(NLR),disturbance of consciousness,extrapyramidal symptoms,electroencephalogram(EEG)and head nucleus magnetic spectroscopy(MRS)and other data.Multivariate logistic regression analysis was used to determine independent prog-nostic factors.the modified Rankin scale(mRS)was used to determine whether the prognosis was good.The correlation between drug treatment and prognostic mRS score was tested by the rank sum test.RESULTS Univariate analysis showed that abnormal cellular immune function,extrapyramidal symptoms,obvious disturbance of consciousness,abnormal EEG,increased NLR,abnormal MRS,and complicated pneumonia were related to the poor prognosis of AD patients.Multivariate logistic regression analysis showed that the decrease in the proportion of T lym-phocytes in the blood after abnormal cellular immune function(odd ratio:2.078,95%confidence interval:1.156-3.986,P<0.05)was an independent risk factor for predicting the poor prognosis of AD.The number of days of donepezil treatment to improve cognitive function was negatively correlated with mRS score(r=0.578,P<0.05).CONCLUSION The decrease in the proportion of T lymphocytes may have predictive value for the poor prognosis of AD.It is recommended that the proportion of T lymphocytes<55%is used as the cut-off threshold for predicting the poor prog-nosis of AD.The early and continuous drug treatment is associated with a good prognosis.
文摘Cardiovascular diseases(CVD)are the leading cause of death in the world and one of the most common diseases in the elderly,with high prevalence and poor prognosis,which seriously affect the health of the elder patients.One report showed that global deaths from CVD increased from 12.4 million in 1990 to 19.8 million in 2022,reflecting the global population growth and aging,as well as the impact of metabolic,environmental,and behavioral risks.[1]With the progress of aging population,the burden of CVD in the elderly in China has increased year by year,and factors including multiple complications,organ function decline,and high complication rate have made the interventional treatment of CVD in the elderly one of the difficulties and focuses in the field of cardiology in China.
基金supported by grants from Sanming Project of Medicine in Shenzhen(No.SZSM202211017)Shenzhen Key Medical Discipline Construction Fund(No.SZXK014).
文摘Although there has been significant advancement in the identification and management of colorectal cancer(CRC)in recent years,there is still room for improvement in the current standard treatment regimen.One area of concern is the lack of reliable tumor markers to predict treatment efficacy and guide tailored care.Due to its dynamic,effective,and non-invasive benefits over tissue biopsy,the detection of minimal or molecular residual lesions(MRD)based on circulating tumor DNA(ctDNA)is beneficial to the clinical development of drugs for patients with CRC after radical treatment,as well as for continuous monitoring of tumor recurrence and malignancy molecular gene evolution.The detection of ctDNA can currently be used to guide individual postoperative auxiliary treatment decisions(upgrade or downgrade treatment)in CRC,stratify the risk of clinical recurrence more precisely,and predict the risk of recurrence in advance of imaging examination,according to a large number of observational or prospective clinical studies.With increasing clarity comes the possibility of selecting a regimen of treatment based on postoperative ctDNA,which also improves the accuracy of clinical recurrence risk assessment for CRC.Therefore,it is anticipated that the identification of ctDNA would alter the current framework for dealing with CRC and lead to individualized,stratified precision therapy;however,additional confirmation will require subsequent high-quality,prospective,large-scale randomized controlled studies.This article will provide an overview of the definition and clinical significance of MRD,the primary indications and technological challenges for MRD detection,along with the advancement in clinical research about ctDNA detection following radical resection of the CRC.
文摘The increasing incidence of cardiovascular disease(CVD)is a significant global health concern,affecting millions of individuals each year.Accurate diagnosis of acute CVD poses a formidable challenge,as misdiagnosis can significantly decrease patient survival rates.Traditional biomarkers have played a vital role in the diagnosis and prognosis of CVDs,but they can be influenced by various factors,such as age,sex,and renal function.Soluble ST2(sST2)is a novel biomarker that is closely associated with different CVDs.Its low reference change value makes it suitable for continuous measurement,unaffected by age,kidney function,and other confounding factors,facilitating risk stratification of CVDs.Furthermore,the combination of sST2 with other biomarkers can enhance diagnostic accuracy and prognostic value.This review aims to provide a comprehensive overview of sST2,focusing on its diagnostic and prognostic value as a myocardial marker for different types of CVDs and discussing the current limitations of sST2.
基金Science and Technology Project of Sichuan Provincial Health Commission(Appropriate Technology Base)(No.2022JDXM021)The Primary Health Development Research Center of Sichuan Province Program(No.SWFZ20-C-086).
文摘Objectives:To investigate the oral symptoms of COVID-19's"positive"group in Suining City following the comprehensive liberalization of epidemic prevention and control measures in China.To explore the related influencing factors of symptom differences and provide reference for the treatment of patients in the post-epidemic era.Methods:This study was conducted from January 4,2023 to January 24,2023,with the research subjects being outpatients at the Central Hospital of Suining City,Sichuan Province,who had recovered from COVID-19 infection or were currently infected.An online questionnaire comprising 25 questions was utilized.The data were analyzed using the Chi-square test.Results:1768 valid questionnaires were collected.The data showed that 363 people had oral problems after an infection with novel coronavirus.The oral problems after SARS‐CoV‐2 infection mainly focused on gingiva swelling or bleeding(38.57%),toothache(37.74%),bad breath(27.55%),oral ulcer(30.30%),abnormal taste(24.24%)and some infected people had a variety of oral symptoms.A small number of infected people also have other oral problems.The incidence of oral symptoms was significantly correlated with sex,age,educational level,place of residence,smoking,basic diseases,long-term saline gargle and vaccination of COVID-19 vaccine.In addition,the age,place of residence,smoking history,basic diseases,and vaccination also showed significant differences in prognosis.Conclusions:In the post-epidemic era,the most common oral problems include gingival swelling or bleeding,toothache,bad breath,oral ulcers,and abnormal taste.Maintaining good living habits is the foundation for promoting disease recovery and oral health.
文摘BACKGROUND The relationship between copeptin and the severity of circulatory dysfunction and systemic stress response in patients with chronic liver disease(CLD)has been established.Nevertheless,the potential of serum copeptin levels to predict the prognosis of CLD patients remains unclear.AIM To conduct a systematic review and meta-analysis to investigate the correlation between serum copeptin and transplant-free survival(TFS)in this population.METHODS To achieve the objective of the meta-analysis,PubMed,Embase,the Cochrane Library,and the Web of Science were searched to identify observational studies with longitudinal follow-up.The Cochrane Q test was utilized to assess betweenstudy heterogeneity,and the I2 statistic was estimated.Random-effects models were employed to combine the outcomes,taking into account the potential influence of heterogeneity.RESULTS Ten datasets including 3133 patients were involved.The follow-up durations were 1 to 48 mo(mean:12.5 mo).Overall,it was shown that a high level of serum copeptin was associated with a poor TFS[risk ratio(RR):1.82,95%confidence interval:1.52-2.19,P<0.001;I2=0%].In addition,sensitivity analysis by omitting one dataset at a time showed consistent results(RR:1.73-2.00,P<0.05).Finally,subgroup analyses according to study country,study design,patient diagnosis,cutoff of copeptin,follow-up duration,and study quality score also showed similar results(P for subgroup difference all>0.05).CONCLUSION Patients with CLD who have high serum copeptin concentrations may be associated with a poor clinical prognosis.
基金supported by a grant from the Foundation of Science and Technology Bureau of Fuzhou(2020-WS-73).
文摘Background:Metabolic dysfunction-associated fatty liver disease(MAFLD)is recently proposed an entity by a group of international experts.However,the impact of MAFLD on the prognosis of patients with hepatocellular carcinoma(HCC)is not clear.The aim of this study was to explore the influence of MAFLD for the prognosis of HCC after radical resection.Methods:HCC patients who received radical resection were enrolled.The recurrence-free survival(RFS)and overall survival(OS)were compared between MAFLD and non-MAFLD.Results:A total of 576 HCC patients were included,and among them 114(19.8%)met the diagnostic criteria of MAFLD.The median RFS was 34.0 months in the MAFLD group and 19.0 months in the non-MAFLD group.The 1-,3-,and 5-year RFS rates were 64.9%,49.1%and 36.1%in the MAFLD group,which were higher than those of the non-MAFLD group(59.4%,35.3%and 26.5%,respectively,P=0.01).The mean OS was 57.0 months in the MAFLD group and 52.2 months in the non-MAFLD group.There was no statistical difference in OS rate between the MAFLD group and non-MAFLD group.Similar results were found in HBV-related HCC patients in the subgroup analysis.Univariate analysis revealed that MAFLD was a protective factor for RFS in HCC patients after radical resection(P<0.05),and there was no association between MAFLD and OS rate(P>0.05).Multivariate analysis demonstrated that MAFLD was not an independent protective factor for HCC patients with radical resection.Conclusions:MAFLD improves RFS rate in HCC patients with radical resection,but is not an independent protective factor and not associated with OS rate.
文摘This study explores the predictive value of plasma a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5) levels for major adverse cardiovascular events (MACE) in patients with coronary artery disease (CAD). 595 patients admitted to our hospital were selected. Initially, the serum ADAMTS-5 levels of subjects were analyzed. Subsequently, a receiver operating characteristic (ROC) curve was constructed. Furthermore, the serum levels of ADAMTS-5 were assessed in patients, and based on CAD severity, they were categorized into stable angina pectoris (SAP), unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and ST-segment elevation myocardial infarction (STEMI) groups, with the aim of examining the relationship between ADAMTS-5 levels and CAD severity. Differences in clinical outcomes between patients with high and low levels of ADAMTS-5 were analyzed during the follow-up period. The study found that the serum levels of ADAMTS-5 were significantly higher in the group of patients with coronary artery disease (CAD) compared to the group without CAD, indicating its potential as a diagnostic marker for CAD. The ADAMTS-5 levels in the serum of STEMI patients were higher than those with SAP, while NSTEMI patients showed higher levels of ADAMTS-5 than the UA group. There was a positive correlation between serum ADAMTS-5 levels and the syntax score in CAD patients, suggesting a potential association with adverse clinical outcomes in patients with acute myocardial infarction (AMI). This study indicates that ADAMTS-5 shows promise as a biomarker for CAD and highlights the need for further research and validation.
文摘Objective:To explore correlation of neutrophil-to-lymphocyte ratio(NLR)to severity of coronary artery disease(CAD)and in-hospital clinical outcomes in patients with acute coronary syndrome(ACS).Methods:In this prospective and observational study,we recruited 500 patients with ACS.For all the eligible patients,demographic details were collected,and laboratory parameters were evaluated.The CAD severity was evaluated in terms of the number of involved vessels.The NLR was calculated based on neutrophils and lymphocytes and the correlation of various risk factors and severity and outcome of CAD was performed.Results:77.2%of Patients was male,and 52%of the patients aged between 55-70 years.Based on the type of ACS,396 out of 500 patients had ST-elevation myocardial infarction.An ascending trend in the white blood cell levels and NLR value was noted as the severity of the ACS increased and the highest white blood cell levels and NLR was noted among classⅣpatients.The mean NLR value among the non-survivors were higher compared to the survivors(9.52±5.72 vs.4.76±2.36;P<0.01).Receiver operating curve showed that the cut-off NLR value was 5.76 with a sensitivity of 75.0%and a specificity of 77.3%.Conclusions:The NLR can be used as an independent prognostic marker in ACS.An elevated NLR value serves as a reliable predictor for short-term complications,notably in-hospital mortality.
文摘Bai et al investigate the predictive value of T lymphocyte proportion in Alzheimer's disease(AD)prognosis.Through a retrospective study involving 62 AD patients,they found that a decrease in T lymphocyte proportion correlated with a poorer prognosis,as indicated by higher modified Rankin scale scores.While the study highlights the potential of T lymphocyte proportion as a prognostic marker,it suggests the need for larger,multicenter studies to enhance generalizability and validity.Additionally,future research could use cognitive exams when evaluating prognosis and delve into immune mechanisms underlying AD progression.Despite limitations inherent in retrospective designs,Bai et al's work contributes to understanding the immune system's role in AD prognosis,paving the way for further exploration in this under-researched area.
基金Supported by the Science and Technology Planning Project of Guangdong Province,China,No.2019B0202280015010 Project of Sun Yatsen University,No.2018024Science and Technology Program of Guangzhou,China,No.202103000060.
文摘BACKGROUND The neutrophil-to-lymphocyte ratio(NLR)is commonly utilized as a prognostic indicator in end-stage liver disease(ESLD),encompassing conditions like liver failure and decompensated cirrhosis.Nevertheless,some studies have contested the prognostic value of NLR in ESLD.AIM To investigate the ability of NLR to predict ESLD.METHODS Databases,such as Embase,PubMed,Web of Science,Cochrane Library,China National Knowledge Infrastructure,Weipu,and Wanfang,were comprehensively searched to identify studies published before October 2022 assessing the prognostic ability of NLR to predict mortality in patients with ESLD.Effect sizes were calculated using comprehensive meta-analysis software and SATAT 15.1.RESULTS A total of thirty studies involving patients with end-stage liver disease(ESLD)were included in the evaluation.Among the pooled results of eight studies,it was observed that the Neutrophil-to-Lymphocyte Ratio(NLR)was significantly higher in non-survivors compared to survivors(random-effects model:standardized mean difference=1.02,95%confidence interval=0.67-1.37).Additionally,twenty-seven studies examined the associations between NLR and mortality in ESLD patients,reporting either hazard ratios(HR)or odds ratios(OR).The combined findings indicated a link between NLR and ESLD mortality(randomeffects model;univariate HR=1.07,95%CI=1.05-1.09;multivariate HR=1.07,95%CI=1.07-1.09;univariate OR=1.29,95%CI=1.18-1.39;multivariate OR=1.29,95%CI=1.09-1.49).Furthermore,subgroup and meta-regression analyses revealed regional variations in the impact of NLR on ESLD mortality,with Asian studies demonstrating a more pronounced effect.CONCLUSION Increased NLR in patients with ESLD is associated with a higher risk of mortality,particularly in Asian patients.NLR is a useful prognostic biomarker in patients with ESLD.
基金Supported by The National Science and Technology Major Project,No.2018ZX10723203 and No.2018ZX10302206Hubei Province’s Outstanding Medical Academic Leader Program,Advantage Discipline Group(Public Health)Project in Higher Education of Hubei Province,No.2023PHXKQ1+2 种基金The Foundation of Health Commission of Hubei Province,No.WJ2021F037 and No.WJ2021M051Project of Hubei University of Medicine,No.FDFR201902 and No.YC2023047and The Hubei Provincial Technology Innovation Project,No.2023BCB129.
文摘BACKGROUND Acute-on-chronic liver disease(AoCLD)accounts for the majority of patients hospitalized in the Department of Hepatology or Infectious Diseases.AIM To explore the characterization of AoCLD to provide theoretical guidance for the accurate diagnosis and prognosis of AoCLD.METHODS Patients with AoCLD from the Chinese Acute-on-Chronic Liver Failure(ACLF)study cohort were included in this study.The clinical characteristics and outcomes,and the 90-d survival rate associated with each clinical type of AoCLD were analyzed,using the Kaplan-Meier method and the log-rank test.RESULTS A total of 3375 patients with AoCLD were enrolled,including 1679(49.7%)patients with liver cirrhosis acute decompensation(LC-AD),850(25.2%)patients with ACLF,577(17.1%)patients with chronic hepatitis acute exacer-bation(CHAE),and 269(8.0%)patients with liver cirrhosis active phase(LC-A).The most common cause of chronic liver disease(CLD)was HBV infection(71.4%).The most common precipitants of AoCLD was bacterial infection(22.8%).The 90-d mortality rates of each clinical subtype of AoCLD were 43.4%(232/535)for type-C ACLF,36.0%(36/100)for type-B ACLF,27.0%(58/215)for type-A ACLF,9.0%(151/1679)for LC-AD,3.0%(8/269)for LC-A,and 1.2%(7/577)for CHAE.CONCLUSION HBV infection is the main cause of CLD,and bacterial infection is the main precipitant of AoCLD.The most common clinical type of AoCLD is LC-AD.Early diagnosis and timely intervention are needed to reduce the mortality of patients with LC-AD or ACLF.
文摘BACKGROUND Lung cancer(LC)is the leading cause of morbidity and mortality among malignant neoplasms.Improving the diagnosis and treatment of LC remains an urgent task of modern oncology.Previously,we established that in gastric,breast and cervical cancer,tumor microvessels(MVs)differ in morphology and have different prognostic significance.The connection between different types of tumor MVs and the progression of LC is not well understood.AIM To evaluate the morphological features and clinical significance of tumor MVs in lung squamous cell carcinoma(LUSC).METHODS A single-center retrospective cohort study examined medical records and archival paraffin blocks of 62 and 180 patients with stage I-IIIA LUSC in the training and main cohorts,respectively.All patients underwent radical surgery(R0)at the Orenburg Regional Cancer Clinic from May/20/2009 to December/14/2021.Tumor sections were routinely processed,and routine Mayer's hematoxylin and eosin staining and immunohistochemical staining for cluster of differentiation 34(CD34),podoplanin,Snail and hypoxia-inducible factor-1 alpha were performed.The morphological features of different types of tumor MVs,tumor parenchyma and stroma were studied according to clinicopathological characteristics and LUSC prognosis.Statistical analysis was performed using Statistica 10.0 software.Univariate and multivariate logistic regression analyses were performed to identify potential risk factors for LUSC metastasis to regional lymph nodes(RLNs)and disease recurrence.Receiver operating characteristic curves were constructed to discriminate between patients with and without metastases in RLNs and those with and without disease recurrence.The effectiveness of the predictive models was assessed by the area under the curve.Survival was analyzed using the Kaplan-Meier method.The log-rank test was used to compare survival curves between patient subgroups.A value of P<0.05 was considered to indicate statistical significance.RESULTS Depending on the morphology,we classified tumor vessels into the following types:normal MVs,dilated capillaries(DCs),atypical DCs,DCs with weak expression of CD34,"contact-type"DCs,structures with partial endothelial linings,capillaries in the tumor solid component and lymphatic vessels in lymphoid and polymorphocellular infiltrates.We also evaluated the presence of loose,fine fibrous connective tissue(LFFCT)and retraction clefts in the tumor stroma,tumor spread into the alveolar air spaces(AASs)and fragmentation of the tumor solid component.According to multivariate analysis,the independent predictors of LUSC metastasis in RLNs were central tumor location(P<0.00001),the presence of retraction clefts(P=0.003),capillaries in the tumor solid component(P=0.023)and fragmentation in the tumor solid component(P=0.009),whereas the independent predictors of LUSC recurrence were tumor grade 3(G3)(P=0.001),stage N2(P=0.016),the presence of LFFCT in the tumor stroma(P<0.00001),fragmentation of the tumor solid component(P=0.0001),and the absence of tumor spread through the AASs(P=0.0083).CONCLUSION The results obtained confirm the correctness of our previously proposed classification of different types of tumor vessels and may contribute to improving the diagnosis and treatment of LUSC.
文摘Introduction: The end of pregnancy is a high-risk period for both mother and foetus. Rigorous monitoring can prevent complications before delivery. Materials and Method: We conducted a descriptive cross-sectional observational study. It took place in the delivery room of the Teacher hospital Mother and Child of Jeanne Ebori Fondation from the 01 October 2020 to 01 October 2021. All patients followed at the Functional Investigation Centre (FIC) of the CHUMEFJE and who gave birth in that same hospital were included. Data were collected on the basis of pregnancy diaries, the fic register and delivery room registers. They were analysed using SPSS Statistical Software. Results: During the period of our study, 4086 parturients arrived in the delivery room. Of these, 150 were followed up at the FIC, giving a prevalence of 3.7%. The majority of parturients (48%) had only one prenatal contact. 6 (4%) patients underwent pelvic scans, and 4 (2.6%) presented with a narrowed pelvis. A vaginal delivery was performed in 80% of cases, and of the caesarean sections, 9 (30%) could be scheduled. The maternal prognosis was marred by one post-partum complication of hypertension, and newborns with poor adaptation to life outside the womb accounted for 3.3% of cases. Conclusion: The Functional Investigation Centre makes it possible to detect anomalies at the end of pregnancy with a view to better planning of delivery.
基金funded by the Social Development Project of Jiangsu Provincial Department of Science and Technology(BE2020670)the Social Development Project of Lianyungang Science and Technology(SF2117).
文摘BACKGROUND:To investigate the eff ects of early standardized enteral nutrition(EN)on the crosssectional area of erector spine muscle(ESMcsa),plasma growth diff erentiation factor-15(GDF-15),and 28-day mortality of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients with invasive mechanical ventilation(MV).METHODS:A total of 97 AECOPD patients with invasive MV were screened in the ICUs of the First People's Hospital of Lianyungang.The conventional EN group(stage Ⅰ)and early standardized EN group(stage Ⅱ)included 46 and 51 patients,respectively.ESMcsa loss and GDF-15 levels on days 1 and 7 of ICU admission and 28-day survival rates were analyzed.RESULTS:On day 7,the ESMcsa of the early standardized EN group was significantly higher than that of the conventional EN group,while the plasma GDF-15 levels were significantly lower than those in the conventional EN group(ESMcsa:28.426±6.130 cm^(2) vs.25.205±6.127 cm^(2);GDF-15:1661.608±558.820 pg/mL vs.2541.000±634.845 pg/mL;all P<0.001).The 28-day survival rates of the patients in the early standardized EN group and conventional EN group were 80.40%and 73.90%,respectively(P=0.406).CONCLUSION:ESMcsa loss in AECOPD patients with MV was correlated with GDF-15 levels,both of which indicated acute muscular atrophy and skeletal muscle dysfunction.Early standardized EN may prevent acute muscle loss and intensive care unit-acquired weakness(ICU-AW)in AECOPD patients.
基金Shanghai Pudong New Area Health Commission’s Excellent Young Medical Talent Training Plan,No.PWRq2020-68Shanghai Pudong New Area Health Commission Discipline Leader Training Project,No.PWRd2020-16Shanghai Pudong New Area Science and Technology Development Fund,No.PKJ2020-Y36.
文摘BACKGROUND Gallbladder cancer(GC)is a common malignant tumor and one of the leading causes of cancer-related death worldwide.It is typically highly invasive,difficult to detect in the early stages,and has poor treatment outcomes,resulting in high mortality rates.The available treatment options for GC are relatively limited.One emerging treatment modality is hyperthermic intraperitoneal chemotherapy(HIPEC).HIPEC involves delivering heated chemotherapy directly into the abdominal cavity.It combines the strategies of surgical tumor resection and localized chemotherapy administration under hyperthermic conditions,aiming to enhance the concentration and effectiveness of drugs within the local tumor site while minimizing systemic toxicity.AIM To determine the effects of cytoreductive surgery(CRS)combined with HIPEC on the short-term prognosis of patients with advanced GC.METHODS Data from 80 patients treated at the Punan Branch of Renji Hospital,Shanghai Jiao Tong University School of Medicine between January 2018 and January 2020 were retrospectively analyzed.The control group comprised 44 patients treated with CRS,and the research group comprised 36 patients treated with CRS combined RESULTS The baseline data of the research and control groups were similar(P>0.05).Six days after surgery,the alanine aminotransferase,aspartate aminotransferase,total bilirubin,and direct bilirubin levels significantly decreased compared to the preoperative levels in both groups(P<0.05).However,the values did not differ between the two groups six days postoperatively(P>0.05).Similarly,the postoperative creatinine and blood urea nitrogen levels were significantly lower than the preoperative levels in both groups(P<0.05),but they did not differ between the groups six days postoperatively(P>0.05).Furthermore,the research group had fewer postoperative adverse reactions than the control group(P=0.027).Finally,a multivariate Cox analysis identified the tumor stage,distant metastasis,and the treatment plan as independent factors affecting prognosis(P<0.05).The three-year survival rate in the study group was higher than that in the control group(P=0.002).CONCLUSION CRS combined with HIPEC lowers the incidence of adverse reactions and improves survival in patients with advanced GC.
文摘Objective:To investigate the impact of sarcopenia on the prognosis of frail elderly patients with chronic kidney disease.Methods:A total of 98 elderly frail patients with chronic kidney disease were included in this study from June 2020 to July 2022.The patients were randomly divided into a study group of 48 cases and a control group of 50 cases.The control group only received conventional treatment for chronic kidney disease.On the basis of conventional treatment for chronic kidney disease,the study group added sarcopenia intervention treatment.The quality-of-life scores,muscle mass and muscle strength,renal function,and incidence of complications of the two groups were observed and analyzed.Results:The quality-of-life score,muscle mass and muscle strength,and renal function of the study group were significantly better than those of the control group(P<0.05);the incidence of complications in the study group was 12.5%,which was significantly lower than that of the control group 36%of the group(P<0.05).Conclusion:There is a close relationship between sarcopenia and frail elderly patients with chronic kidney disease.Sarcopenia will further aggravate the frailty symptoms and increase the risk of complications in elderly patients with chronic kidney disease.For elderly patients with chronic kidney disease,sarcopenia should be screened and intervened as early as possible to improve the prognosis and quality of life of the patients.