A multicenter retrospective study on survival rate and complications of very preterm infants / 中国当代儿科杂志

OBJECTIVES@#To study the survival rate and the incidence of complications of very preterm infants and the factors influencing the survival rate and the incidence of complications.@*METHODS@#The medical data of the very preterm infants with a gestational age of <32 weeks and who were admitted to the Department of Neonatology in 11 hospitals of Jiangsu Province in China from January 2018 to December 2019 were retrospectively reviewed. Their survival rate and the incidence of serious complications were analyzed. A multivariate logistic regression analysis was used to evaluate the risk factors for death and serious complications in very preterm infants.@*RESULTS@#A total of 2 339 very preterm infants were enrolled, among whom 2 010 (85.93%) survived and 1 507 (64.43%) survived without serious complications. The groups with a gestational age of 22-25@*CONCLUSIONS@#The survival rate is closely associated with gestational age in very preterm infants. A low 1-minute Apgar score (≤3) may increase the risk of death in very preterm infants, while high gestational age, high birth weight, and prenatal use of glucocorticoids are associated with the reduced risk of death. A low 5-minute Apgar score (≤3) and maternal chorioamnionitis may increase the risk of serious complications in these infants, while high gestational age and high birth weight may reduce the risk of serious complications.

Research on the postoperative complications and its risk factors of breast reconstruction with abdominal flaps / 中华外科杂志

<p><b>OBJECTIVE</b>To study the postoperative complications and its risk factors in patients underwent breast reconstruction with abdominal flaps.</p><p><b>METHODS</b>The clinical data of 115 cases underwent breast reconstructions with abdominal flaps from May 2001 to October 2008 was reviewed. The postoperative complications included total flap necrosis, partial flap necrosis, fat necrosis, hernia, bulge, fat liquefaction and infection. The risk factors of complication rates were also evaluated.</p><p><b>RESULTS</b>The total postoperative complications rate was 17.4% (20/115). No severe complications was found, such as total flap necrosis, hernia and bulge. The most common complications of flap was fat necrosis which occurred in 6 cases (5.2%), partial flap necrosis in 5 cases (4.3%) and infection in 1 case (0.9%). The donor-site complications included fat liquefaction which occurred in 8 cases (7.0%) and infection in 3 cases (2.6%). No significant relation was found between patient's age, body mass index (BMI), timing of surgery and the postoperative complication rate. The postoperative complications occurred more frequently in active smokers, patients with radiotherapy history, or reconstructions with pedicled transverse rectus abdominis myocutaneous (TRAM) flaps. But no significant difference was found in those factors.</p><p><b>CONCLUSIONS</b>Fewer complications happens in patients with a reconstruction with deep inferior epigastric perforator (DIEP) flap. Abdominal flap should be performed with more consideration in active smokers or patients with a radiotherapy history. Age and obesity should not be contraindications to breast reconstruction with abdominal flaps.</p>

Cox proportional hazard model analysis of prognosis in patients with carcinoma of esophagus and gastric cardia after radical resection / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the factors affecting the long-term survival of patients with carcinoma of esophagus and gastric cardia after curative resection.</p><p><b>METHODS</b>The clinical data of 906 patients with carcinoma of esophagus and gastric cardia treated by radical resection in 1996 - 2004 were analyzed retrospectively. Twelve clinicopathological factors possibly influencing survival were encoded and assessed by Cox regression analysis.</p><p><b>RESULTS</b>The 1-, 3- and 5-year cumulative survival rates were 89.8%, 75.4% and 71.7%, respectively. The univariate analysis showed that age, length of tumor, pathological differentiation, number of metastatic lymph nodes, depth of invasion, involvement of adjacent organs and the TNM stage influenced the prognosis significantly (P < 0.01). However, multivariate analysis showed that pathologic differentiation, number of metastatic lymph nodes, involvement of adjacent organs and TNM stage were independent prognostic factors (P < 0.05).</p><p><b>CONCLUSION</b>The independent prognostic factors of the patients with carcinoma of esophagus and gastric cardia are pathologic differentiation, TNM stage, number of metastatic lymph nodes, and involvement of adjacent organs. The other factors influencing survival are age, length of tumor and depth of invasion. Furthermore, invasion of adjacent organs suggests worse prognosis, and should be followed-up closely.</p>

A seven-year follow-up analysis on prognosis factors of stroke patients / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe survival conditions of patients with stroke and to analyze the factors associated with survival, a seven-year follow-up study was carried out.</p><p><b>METHODS</b>From Nov. 1995 to Dec. 1996, 189 stroke patients were selected in the Department of Neurology, General Hospital, Tianjin Medical University. Cases were followed up since the onset of stroke. Data collected would include case history, illness and survival conditions. Kaplan-Meier methods were used for survival description. Cox regression was used for prognostic factors analyses.</p><p><b>RESULTS</b>A total number of 82 patients had been dead during the period of study and among them,58 cases died from stroke. The survival rate was 79.86% in one year, 65.46% in three years and 57.46% in seven years. Factors with statistical significance that associated with survival would include: age (RR = 1.065, P < 0.001), physical exercises before stroke (RR = 0.308, P<0.001), hypertension history (RR = 1.785, P < 0.05) and stroke history (RR =2.493, P < 0.001) while factors associated with severity of the illness were: area of cerebral lesion, conditions when discharged from the hospital, rehabilitative treatment of post-discharge and recurrence. We also found that social-psychical factors as rehabilitative confidence, repression, negative event, support from relatives and friends were related to survival of stroke.</p><p><b>CONCLUSIONS</b>Histories on hypertension, stroke and brain injury condition were related to the rate survival on stroke. Patients persisting physical exercises before stroke had better prognosis. The survival rate of patients with recurrence was lower than those without while social psychic factors might be related to survival.</p>