Résumé
ObjectiveTo investigate the prognostic value of the enhancement pattern in arterial phase of preoperative Gd-EOB-DTPA enhanced magnetic resonance imaging (MRI) in evaluating the disease-free survival (DFS) and overall survival (OS) in patients undergoing curative resection for intrahepatic cholangiocarcinoma (ICC). MethodsA retrospective analysis was done on the clinical, preoperative MRI findings and postoperative follow-up results of 93 pathologically confirmed ICC patients undergoing surgery in our hospital between January 2018 and December 2021. Kaplan-Meier survival curves and log-rank test were used to compare the DFS and OS of three groups with different arterial enhancement patterns. Cox regression analysis was used to identify the factors affecting DFS and OS. ResultsThere were significant differences in DFS and OS among the 3 groups (log-rank test, P < 0.05). The arterial enhancement pattern was an independent predictive factor for DFS (using diffuse hyperenhancement as a reference, peripheral rim enhancement: HR = 3.550; 95%CI: 1.16 ~ 10.8; P = 0.026;diffuse hypoenhancement: HR = 3.430; 95%CI: 1.04 ~ 11.3; P = 0.042). The arterial enhancement pattern and tumor location were predictive factors for OS ((using diffuse hyperenhancement as a reference, diffuse hypoenhancement, HR = 8.500; 95%CI: 1.09-66.3; P = 0.041; using tumor distal location as a reference, tumor perihilar location HR=2.583,95%CI: 1.14-5.83, P =0.022). The AUC of arterial enhancement patterns in predicting 1-, 2-, and 3- year DFS were 0.722, 0.748, and 0.617, respectively; in OS, 0.720, 0.704, and 0.730, respectively, which showed better prognostic efficacy than AJCC-TNM staging system. ConclusionArterial-phase enhancement pattern of preoperative Gd-EOB-DTPA enhanced MRI is an independent predictive factor for DFS and OS of ICC patients, with a better prognostic value than AJCC-TNM staging system, and can be used for the clinical management of ICC patients.
Résumé
ObjectiveAt the end of November 2022, Guangzhou implemented the latest Covid-19 epidemic prevention policy and began to gradually lift the lockdown. However, under the new epidemic prevention situation, the situation of SARS-CoV-2 infection in hospitalized patients in China is still unclear. Accordingly, this paper aims to study the SARS-CoV-2 infection of hospitalized patients in Guangzhou under the new epidemic prevention and control situation. MethodsThe results of SARS-CoV-2 nucleic acid tests in our hospital from the end of November 2022 to the beginning of February 2023 were retrospectively analyzed. The positive rate of SARS-CoV-2 nucleic acid tests in outpatients and inpatients under the new epidemic prevention situation, and the nosocomial infection of SARS-CoV-2 in inpatients were statistically analyzed. ResultsThis study retrospectively analyzed the SARS-CoV-2 nucleic acid test results of 13 959 patients, including 6 966 outpatients and 6 993 inpatients. On November 30, 2022, the SARS-CoV-2 nucleic acid test results of outpatients began to be positive, indicating that the outbreak of the SARS-CoV-2 infection had begun. On December 7, one case of SARS-CoV-2 nucleic acid test results of hospitalized patients was positive, and nosocomial infections began to break out. On December 15, the positive rate of SARS-CoV-2 nucleic acid test among patients exceeded 40 %, and the epidemic entered its peak period. After the end of December, the test positive rate gradually decreased, but the positive rate of inpatients was always higher than that of outpatients. Compared with December 2022, the positive rate of SARS-CoV-2 nucleic acid test of patients in many departments in January 2023 decreased, but the positive rate of SARS-CoV-2 nucleic acid test of inpatients in the oncology department increased significantly (P < 0.001). Further analysis found that the nosocomial infection rate of SARS-CoV-2 in inpatients was 86.57 % (329/380). However, the nosocomial infection rate in lymphoma patients [58.33 % (14/24)] was significantly lower than that of the hospitalized patients with other disease types (P < 0.001). ConclusionThe positive rate of SARS-CoV-2 nucleic acid testing among patients reached its peak in mid-December 2022. In January 2023, the positive rate of SARS-CoV-2 nucleic acid testing gradually decreased, while the number or positive rate of SARS-CoV-2 nucleic acid testing positive patients in some departments increased. The nosocomial infection rate among hospitalized patients is as high as 90 %. There are differences in the nosocomial infection rate of SARS-CoV-2 among inpatients with different disease types. In summary, this study provides preliminary data on the epidemiological characteristics of SARS-CoV-2 infection among hospitalized patients in Guangzhou, as well as the protection against infection among hospitalized patients and cross-infection between medical staffs and patients.