Construction of a Prognostic Prediction Model of Patients with Pathologic N0 in Resected Invasive Mucinous Adenocarcinoma of the Lung / 中国肺癌杂志

BACKGROUND@#Invasive mucinous adenocarcinoma (IMA) was a rare and specific type of lung adenocarcinoma, which was often characterized by fewer lymphatic metastases. Therefore, it was difficult to evaluate the prognosis of these tumors based on the existing tumor-node-metastasis (TNM) staging. So, this study aimed to develop Nomograms to predict outcomes of patients with pathologic N0 in resected IMA.@*METHODS@#According to the inclusion criteria and exclusion criteria, IMA patients with pathologic N0 in The Affiliated Lihuili Hospital of Ningbo University (training cohort, n=78) and Ningbo No.2 Hospital (validation cohort, n=66) were reviewed between July 2012 and May 2017. The prognostic value of the clinicopathological features in the training cohort was analyzed and prognostic prediction models were established, and the performances of models were evaluated. Finally, the validation cohort data was put in for external validation.@*RESULTS@#Univariate analysis showed that pneumonic type, larger tumor size, mixed mucinous/non-mucinous component, and higher overall stage were significant influence factors of 5-year progression-free survival (PFS) and overall survival (OS). Multivariate analysis further indicated that type of imaging, tumor size, mucinous component were the independent prognostic factors for poor 5-year PFS and OS. Moreover, the 5-year PFS and OS rates were 62.82% and 75.64%, respectively. In subgroups, the survival analysis also showed that the pneumonic type and mixed mucinous/non-mucinous patients had significantly poorer 5-year PFS and OS compared with solitary type and pure mucinous patients, respectively. The C-index of Nomograms with 5-year PFS and OS were 0.815 (95%CI: 0.741-0.889) and 0.767 (95%CI: 0.669-0.865). The calibration curve and decision curve analysis (DCA) of both models showed good predictive performances in both cohorts.@*CONCLUSIONS@#The Nomograms based on clinicopathological characteristics in a certain extent, can be used as an effective prognostic tool for patients with pathologic N0 after IMA resection.

Clinical value of Aβ1-42, tau protein and thyroid hormone levels in predicting cognitive impairment after ischemic stroke / 中国神经精神疾病杂志

Objective To investigate the relationship between serum markers β amyloid (Aβ), tau and thyroid hormone levels and post-stroke cognitive impairment (PSCI) in the acute phase of cerebral infarction. Methods A total of 214 patients with acute cerebral infarction were enrolled. The baseline data and serological indicators were collected and the cognitive function of patients was evaluated. All patients were divided into cognitive impairment group and normal group based on follow-up results. The differences of Aβ1-42, tau protein and thyroxine levels between the two groups and their relationship with disease progression were analyzed. The Cox regression analysis and ROC curve were used to compare the above parameters to predict the development of PSCI. Results The total protein level of Tau (210.6 ±98.9 pg/mL) was higher and Aβ1-42 (426.1 ±123.5 pg/mL) and triiodothyronine (T3) (1.43 ±0.57 nmol/L), free thyroxine (FT4) (13.15±2.23 pmol/L) was significantly lower in the cognitive impairment group than in the normal group (P<0.05). Tau protein (r=-0.457), Aβ1-42 (r=0.348), T3 (r=0.211), and FT4 (r=0.306) were all associated with disease progression (P<0.05). Cox regression analysis showed that Aβ1-42 and T3 were important influencing factors in the occurrence of PSCI. The area under the curve of Aβ1-42 combined with T3 was 0.841. The specificity and the sensitivity were 74.8% and 85.3%, respectively, with a diagnostic cutoff value of 0.572. Conclusion Aβ1-42 and T3 levels in the acute phase of cerebral infarction may predict the progression of PSCI.

Research on the specificity of nursing in schizophrenia patients with repetitive transcranial and magnetic stimulation / 中国实用护理杂志

Objective To sum up the specificity in clinical care of repetitive transcranial magnetic stimulation (rTMS),and provide reference for putting forward scientific and effective clinical care project.Methods 200 male schizophrenia patients with rTMS treatment were divided into the research group and the control group with 100 cases in each group randomly.Then,the research group adopted the specific nursing which was obtained from the pre-experiment while the control group adopted the routine care.Moreover,NORS scale was used to evaluate the treatment effect.Changhai Pain Measuring Scale was employed to assess headaches in pre-treatment and post-treatment.Results The data of the research group in NORS scale was obviously lower than the control group,and the difference between two groups had statistical significance.No case occurred adverse reaction in the research group,in contract with many cases with adverse reaction in the control group.Conclusions Specific nursing can reduce complications effectively for schizophrenia patients receiving rTMS treatment,and it is a scientific,effective and mature clinical care method.

EVACUATION OF HYPERTENSIVE INTRACEREBRAL HEMATOMA BY STEREOTACTIC TECHNIQUE / 解放军医学杂志

Evacuation of intracerebral hematomas in 38 hypertensive patients was reported. Hematomas were found in the internal capsule in 24 patients, subcortex in 5. cerebellum in 7 and brain stem in 2. The volume of hematoma was less than 2ml (in the brain stem) in 2 patients, 20-50ml in 15, and over 100ml in 6. The fluid hematoma was to tally aspirated with stereotactic technique in 7 patients. In 17 patients, over 80% of hematoma was evacuated, and in 14 about 60-80% of hematoma was evacuated by the same technic. The results of the operation were good in 11 patients (29.0%), while in 29% there was a mild disability, and in 12 (31.5%) there was a marked disability, 4(10.5%) died.

CLINICAL AND PATHOLOGICAL RESEARCH OF RESECTION OF TEMPORAL EPILEPTOGENIC FOCUS / 解放军医学杂志

This article reports the experience of treatment of 30 cases of temporal epilepsy with surgery. There were 15 male patients and 15 female. The duration of the disease ranged from 5 to 37 years with an average of 13.6 years. 12 patients suffered from grand and petite mal, 8 Jacksonian accompanied by psychomotor epilepsy, and 10 grand mal. Before the operation, the focus with sporadic spikes was found in the temporal lobe with electroencephalogram. Operation: the temporal pole and the medi-basal region were removed in 9 cases, anterior portion of the temporal nesiolobe in 10 cases, temporal neocortical of the temporal lobe in 6 cases, dorsolateral and laterobasal parts in 5 cases. Organic pathological changes were confirmed in all cases by pathological examination. Clinical result of all cases was satisfactory, with an effective rate of 93%. The clinical and pathological changes of epilepsy and efficacy of the treatment are discussed. It is stressed that the localization of the focus of epilepsy depe nds mainly on electroencephalogram. It is very important to look for sporadic spikes using cortical electrode during operation, and complete eradication of the focus is the key to achieve a good treatment effect.