[Establishment of a nomogram model to predict systemic inflammatory response syndrome after transrectal ultrasound-guided prostate biopsy].

OBJECTIVE: To access the risk factors of systemic inflammatory response syndrome (SIRS) after transrectal ultrasound-guided biopsy of the prostate (TRUS-Bp) and establish a model and a nomogram for the prediction of SIRS after TRUS-Bp. METHODS: We retrospectively analyzed the clinical data on 752 cases of TRUS-Bp in our hospital from January 2010 to January 2017 and included 570 of the cases in this study. We investigated the independent risk factors for SIRS after TRUS-Bp by univariate and logistic regression analyses, constructed a prediction model and nomogram with the R-Statistics software, evaluated the discrimination of the model with the ROC curve, and measured the conformity by SPSS25.0 Bootstrap sampling. RESULTS: At 1－2 postoperative days, 58 (10.2%) of the 570 patients were diagnosed with SIRS, 22 (3.9%) with bacteremia, and 6 (1.1%) with septic shock, but none died. Logistic regression analysis showed that the independent risk factors for SIRS after TRUS-Bp included old age (>70 yr; OR = 1.1, P = 0.01), high number of biopsy needles (>10; OR = 2.3, P < 0.01), diabetes mellitus (OR = 3.4, P < 0.01), and hypoproteinemia (OR = 2.5, P < 0.01). The area under the ROC curve was 0.947 and internal validation showed a conformity of 92%. CONCLUSIONS: Old age (>70 yr), high number of biopsy needles (>10), diabetes mellitus and hypoproteinemia may increase the risk of SIRS after TRUS-Bp. Evaluation with a model nomogram may help predict the probability of SIRS after TRUS-Bp.

[Clinical observation on long-term surviving patients after combined abdominal organ transplantation].

OBJECTIVE: To summarize the treatment experience of long-term surviving patients after combined abdominal organ transplantation. METHODS: From October 2001 to January 2005, 19 patients received combined abdominal organ transplantation in Nanfang Hospital, including 6 with simultaneous kidney-pancreas transplantation (SKPT), 12 with combined liver-kidney transplantation (CLKT), and 1 with simultaneous liver-pancreas transplantation (SLPT). The periods of follow up were from 6 months to 3 years and 8 months. Summarize primary diseases of the patients, factors which impacted on patients long-term survival rate, and immunological characteristics of combined abdominal organ transplantation. RESULTS: All of 19 transplant cases were performed successfully. Among then, 18 were followed up; 16 survived till now; 2 patients undergoing liver-kidney transplantation were dead, one of which died from myocardial infarction in the 18 months after operation, and one died from cytomegalovirus in infection of lung in 13 months; 1 liver-kidney transplantation patient and 2 pancreas-liver transplantation patients experienced acute rejection once; 2 patients were found nephrotoxicity. Among the 18 patients, 4 patients' survival time were over 3 years, 7 over 2 years, 6 over 1 year, 1 over 10 months. CONCLUSIONS: Combined abdominal organ transplantation is effective for treatment of two abdominal organ failure diseases. Factors which impact on patients long-term surviving include choosing suitable recipient, high quality of donated organ, avoidance of surgical complication, the history of myocardial infarction before operation, immunosuppressive regime and virus infection late after transplantation. Combined abdominal organ transplantation has some different immunological characteristics from single organ transplantation.