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Objective:To improve the prognosis stratification, especially early mortality(EM), of elderly patients with newly diagnosed multiple myeloma(NDMM).Methods:In this retrospective study, univariate and multivariate Cox regression analysis were conducted to identify the independent prognostic factors associated with overall survival(OS)and the chi-square test and multivariate Logistic analysis were used to identify the prognostic factors associated with EM in 223 elderly patients(age≥65 years)with NDMM from three centers in the country.Results:Increased NT-pro-BNP(≥300 pg/ml), ECOG-PS≥2 and stage Ⅲ R-ISS were identified as three independent adverse prognostic factors of OS.The rates of EM3, EM6, EM12 and EM24 were 12.1%, 20.1%, 32.2% and 60%, respectively.The most common cause for EM6(particularly EM3)was disease-related complications resulting from ineligibility for treatment due to poor physical performance, severe organ dysfunction or treatment discontinuation due to treatment intolerance, while the most common cause for EM12(particularly EM24)was disease progression or relapse mainly as a result of inadequate treatment.R-ISS staging failed to predict EM, while decreased eGFR, ECOG-PS≥2, and increased NT-pro-BNP were able to estimate the risk of EM, with increased NT-pro-BNP as a common independent factor for EM12( P=0.03)and EM24( P=0.015). Conclusions:R-ISS staging, which primarily reflects MM biology, cannot predict EM.However, factors such as NT-pro-BNP, eGFR and ECOG-PS associated with frailty and impairment of organ functions can be used to estimate the risk of EM, among which NT-pro-BNP may be the most important independent factor for EM.Therefore, incorporation of these frailty-related biomarkers into R-ISS staging may be able to more precisely estimate the prognosis and particularly early death of elderly patients with NDMM.
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Objective To compare the effects of ball of urethra suspension with Yiqi perturbation urine and subtract two methods in the treatment of urinary incontinence after transurethral resection of prostate. Methods From February 2012 to February 2017,60 patients with urinary incontinence after transurethral resection of prostate in the Third People's Hospital of Shuozhou were selected. According to different therapeutic methods,the patients were divid-ed into two groups,with 30 cases in each group. The control group was treated with ball of urethra suspension,the observation group was given Yiqi perturbation for urine. The incidence of urinary incontinence and degree of the two groups after treatment were observed. The incontinence duration,international prostate symptom score,residual urine volume,maximum urine flow rate and patients' quality of life scores were compared between the two groups. Results After treatment,the incidence rate of urinary incontinence in the observation group was 8. 3％ ,which was significantly lower than 23. 3％ in the control group (χ2 = 10. 28,P < 0. 05). The incontinence duration,international prostate symptom score,residual urine volume,maximum urinary flow rate in the observation group were (7. 6 ± 2. 1) d, (21. 2 ± 3. 4)points,(119. 5 ± 60. 4)mL,(4. 1 ± 1. 3)mL/ s,respectively,which were better than those in the control group [(15. 8 ± 3. 2)d,(5. 6 ± 1. 5)points,(19. 7 ± 6. 9)mL and (20. 4 ± 5. 3)mL/ s],the differences between the two groups were statistically significant (t = 11. 73,22. 99,8. 99,22. 99,all P < 0. 05). The quality of life scores in the observation group were better than those in the control group (all P < 0. 05). Conclusion Yiqi perturbation urine for urinary incontinence caused by transurethral resection of benign prostatic hyperplasia is better than the ball of urethra suspension,it can reduce the degree of postoperative incontinence,improve patients' quality of life.