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Objective:To construct a prediction model for prognosis of severe pneumonia patients combined with sepsis.Methods:Clinical data of 318 severe pneumonia patients combined with sepsis admitted at Taizhou People’s Hospital affiliated to Nanjing Medical University from March 2019 to March 2022 were retrospectively analyzed. Patients were randomized into a modeling set ( n=233) and a validation set ( n=85) with a 3∶1 ratio. In the modeling set there were 180 survival cases and 53 fatal cases according to the clinical outcomes within 30 days of admission. Multivariate Cox regression analysis was used to evaluate the independent prognostic factors for patients in the modeling set. A nomogram prediction model was constructed by R based on these prognostic factors and further verified using the data of the validation set with receiver operating curve (ROC), decision curve analysis (DCA), and calibrated with calibration curve analyses. Results:Multivariate Cox regression analysis suggested that septic shock ( HR=2.32, 95% CI 1.37-3.89, P=0.013) and neutrophil/lymphocyte ratio (NLR) ( HR=2.52, 95% CI 1.23-5.61, P=0.017) were independent risk factors for mortality in severe pneumonia patients combined with sepsis within 30 days of admission, while albumin/fibrinogen ratio (AFR) ( HR=0.64, 95% CI 0.41-0.83, P=0.011) and prognostic nutritional index (PNI) ( HR=0.68, 95% CI 0.57-0.83, P=0.009) were independent protective factors. The area under ROC curve (AUC) of the nomogram model based on these four indicators in the modeling and validation sets were 0.875 and 0.880, respectively. The DCA curve analysis indicated that the clinical benefit of this model was better than "All" or "None" curves in both the modeling and verification sets.The calibrate curve analysis indicated that the actual and corrected curves fitted well and were close to the ideal curve. Conclusion:The constructed nomogram model based on septic shock, AFR, NLR and PNI has a well prognostic value in severe pneumonia patients combined with sepsis.
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Objective To explore the expression of Excision repair cross -completion 1 in non-small cell lung cancer and to analyze its clinical significance .Methods ERCC1 protein expression was detected by IHC method in 160 cases of non-small cell lung cancer tissue .We analyzed relationship between the ERCC 1 ex-pression and clinicopathological parameters of non -small cell lung cancer ,as well as its correlation between ER-CC1 expression and the prognosis .At the same time ,160 cases of intraoperative specimens were primarily cul-tured.The relationship between ERCC1 expression and the drug sensitivity of DDP was analyzed .Results ER-CC1 protein was mainly expressed in the nucleus .ERCC1 protein expression in lung cancer tissue showed no rela-tionship with age,gender,tumor size and pathological types .ERCC1 protein expression was associated with TNM stages and lymph node metastases .High expression of ERCC1was significantly correlated with poor prognosis in pa-tients,indicating that ERCC1 is the independent factor of NSCLC patients .MTT results showed that the positive ex-pression rate of ERCC1 in DDP sensitive groups was higher than in DDP resistant groups .Conclusion ERCC1 is an independent factor influencing the prognosis of non -small cell lung cancer ,and associated with DDP resistance .
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Objective To observe the effect of IMRT combined with astragalus polysaccharide (ASP) injection on cervicocerebral tumor,radiation side effects and its influence on immune function. Methods 61 head and neck tumor patients were randomly divided into two groups.One groups received the IMRT combined with Astragalus Polysaccharide (ASP) injection (n=30) while the other group only received the IMRT(n=31). The recent effect, immune function and the side effects of radiotherapy between the 2 groups were observed and compared , changes of T-lymphocyte subsets, natural killer (NK) cell activity and the dermatitis,oral mucosa reaction,thirsty condition on patients in intraoperative or postoperative period were also observed and compared. Results The total effective rate in experimental group and the control group were 83.0% and 80.6% respectively.The cell viability of peripheral blood lymphocyte and NK cell as well as the T3、T4、NK cell value increased in IMRT-ASP group (P<0.05) after treatment. While T3、T4、NK cell value in peripheral blood decreased (P<0.05). Mucosa,dermatitis and salivary gland damage showed in IMRT-ASP group were significantly better than in control group after 3 weeks treatment (P<0.05). Conclusion ASP can improve immune function effect in head and neck tumor patients during RT, and can also eliminate the side effects of radiotherapy.
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Objective:To investigate the clinical characteristics, treatment, and evaluation of the prognosis of syndrome of inap-propriate anti-diuretic hormone (SIADH) in lung-cancer patients. Methods:We review the clinical data of six lung cancer cases, includ-ing four small cell lung cancer, one adenocarcinoma, and one squamous cell carcinoma, with SIADH complication. All six cases were treated in our hospital over the past three years. Results:Patients with various serum sodium levels were provided different therapeutic regimens. Symptoms of fatigue and nervous system disorders, plasma sodium, urine sodium, and plasma osmotic pressure were alleviat-ed. Conclusion:SIADH is a common complication of lung cancer, particularly in small lung cancer cases. Electrolyte disturbances indi-cate poor prognosis, high mortality rate, and delay in treatment because of clinical interest. After a final diagnosis has been made and ap-propriate treatment has been administered, clinical symptoms were relieved and blood sodium levels were quickly and significantly im-proved in these patients.
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Objective:To discuss the value for earlier diagnosis and curative effect evaluation of tuberculosis meningitis(TBM)by detecting the cerebrospinal fluid(CSF)routine,biochemistry and cytology check.Methods:Dynamic Analysis of cerebrospinal fluid routine,biochemistry and cytology variation have been performed on 80 cases with TBM between prior-treatment and post-treatment.Results:There is a obviously rise performed in the cerebrospinal fluid for the pressure,biochemistry index singularity ratio and neutrophil proportion prior treatment,while a progressive decline was observed in post treatment with a significant difference.The typical TBM in forepart showed intermix cytology reaction which had most granulocytes.During the middle period of the treatment,granulocytes reduced,more over immune cells and active hyaline leukocytes increased.During the later period of the treatment,active lymphocytes reaction was the most obvious.Cerebrospinal fluid cytology was back to normal when TBM had been cured.Conclusion:The cerebrospinal fluid cytology check is a significant index in earlier diagnosis of TBM;Dynamic observation on cerebrospinal fluid cytology is helpful for earlier diagnosis of TBM.Furthermore the method has some value in judging the prognosis of the patients suffened TBM.