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Objective:To investigate the clinical application value of radiochemotherapy conversion therapy in unresectable locally advanced esophageal cancer.Methods:A total of 298 patients with unresectable locally advanced esophageal cancer who received radiochemotherapy with or without surgery from 2010 to 2016 were screened in the U.S. Surveillance, Epidemiology, and End Results (SEER) 18 oncology database, and the patients were divided into the conversion therapy group (received surgery after radiotherapy, 83 cases) and the radiochemotherapy group (215 cases) according to whether they were operated after radiotherapy. A 1∶1 propensity matching analysis was conducted on the two groups of patients using R language. The information of age, gender, race, T stage, G stage, pathological type and N stage of the patients in the two groups before and after matching was compared. The Kaplan-Meier method was used for survival analysis to compare the cancer specific survival and overall survival (OS) between the two groups before and after matching. A multivariate Cox proportional hazards model was used to analyze the influencing factors of prognosis of patients with unresectable locally advanced esophageal cancer.Results:There were statistically significant differences in gender, race, G stage, pathological type, T stage, and N stage between the conversion therapy group and the radiochemotherapy group before matching (all P < 0.05). There was no statistically significant difference in clinicopathological characteristics between the conversion therapy group and the radiochemotherapy group after matching (all P > 0.05). Before matching, the median OS time of patients in the conversion therapy group was 23 months; the 1-year, 2-year, 3-year, and 5-year OS rates were 68.9%, 42.9%, 24.7%, and 19.8%, respectively; the 1-year, 2-year, 3-year, and 5-year cancer specific survival rates were 68.9%, 45.0%, 28.0%, and 28.0%, respectively. The median OS time of patients in the radiochemotherapy group was 12 months; the 1-year, 2-year, 3-year and 5-year OS rates were 44.5%, 20.5%, 14.0%, and 6.0%, respectively; the 1-year, 2-year, 3-year and 5-year cancer specific survival rates were 46.4%, 21.8%, 14.9%, and 9.1%, respectively. Compared with the radiochemotherapy group, patients in the conversion therapy group had a better cancer specific survival ( χ2 = 15.01, P = 0.001) and OS ( χ2 = 14.85, P < 0.001). After matching, cancer specific survival ( χ2 = 5.06, P = 0.024) and OS ( χ2 = 6.12, P = 0.013) of the conversion therapy group were still superior to the radiochemotherapy group. The results of multivariate Cox regression analysis showed that the cancer specific survival risk and overall survival risk in the radiochemotherapy group were 1.874 times (95% CI 1.275-2.755, P = 0.001) and 1.790 times (95% CI 1.235-2.593, P = 0.002) higher than those in the conversion therapy group. Conclusions:Radiochemotherapy conversion therapy can improve the prognosis of patients with unresectable locally advanced esophageal cancer.
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Objective:To explore the value of the constructed prognostic prediction model of resectable lung cancer in predicting the survival and prognosis of patients.Methods:A total of 2 267 patients with primary lung cancer in Shanxi Provincial Cancer Hospital from January 2007 to September 2018 were selected. All patients underwent primary lung cancer surgery without a second primary tumor. Gender, age, occupation, tumor site, pathological type, surgical path, surgical method, tumor stage and treatment were selected as the prognostic factors. A Cox proportional hazard model was used to construct a prognostic index (PI) equation to calculate the PI value of each patient. According to the different ranges of PI values, the low-, intermediate- and high-risk prognosis groups were divided, and the survival status of three groups were evaluated.Results:Gender ( RR= 0.684, P= 0.001), age ( RR= 0.591, P < 0.01), occupation ( RR= 1.439, P= 0.001), pathological type ( RR= 3.694, P < 0.01), surgical path ( RR= 0.734, P= 0.001), tumor stage ( RR= 0.352, P= 0.007) were independent factors affecting the prognosis of patients with resectable lung cancer. Female, ≤65 years old, thoracoscopic surgery, and tumor stage Ⅰ were prognostic protective factors, and their risks of poor prognosis were reduced by 31.6%, 40.9%, 26.6%, and 64.8%, respectively. Farmer and adenosquamous carcinoma were prognostic risk factors, and their risks of poor prognosis were increased by 43.9% and 269.4%, respectively. The PI equation was ∑β ix i=-0.380 X 1-0.526 X 2+0.364 X 31+1.307 X 55-0.309 X 6-1.045 X 81 (X 1 was the gender, X 2 was the age, X 31 was the occupation as a farmer, X 55 was the pathological type of adenosquamous carcinoma, X 6 was the surgical path, X 81 was the tumor stage Ⅰ). PI <-1 was the low-risk group, PI ≥-1 and ≤-0.5 was the intermediate-risk group, PI >-0.5 was the high-risk group, and the differences of their survival rates were statistically significant ( P < 0.05). The 1-, 3-, and 5-year survival rates for the low-, risk groups were 96.8%, 87.0% and 77.9%; the intermediate-risk group were 91.8%, 82.2% and 61.7%; the high-risk group were 86.5%, 61.7% and 50.3%. respectively. Conclusion:The prognostic prediction model of resectable lung cancer can predict the prognosis risk and the corresponding survival rate of patients with resectable lung cancer, and it can help clinicians to evaluate the prognosis and formulate subsequent treatment plans.
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Objective@#To explore the value of the constructed prognostic prediction model of resectable lung cancer in predicting the survival and prognosis of patients.@*Methods@#A total of 2 267 patients with primary lung cancer in Shanxi Provincial Cancer Hospital from January 2007 to September 2018 were selected. All patients underwent primary lung cancer surgery without a second primary tumor. Gender, age, occupation, tumor site, pathological type, surgical path, surgical method, tumor stage and treatment were selected as the prognostic factors. A Cox proportional hazard model was used to construct a prognostic index (PI) equation to calculate the PI value of each patient. According to the different ranges of PI values, the low-, intermediate- and high-risk prognosis groups were divided, and the survival status of three groups were evaluated.@*Results@#Gender (RR= 0.684, P= 0.001), age (RR= 0.591, P < 0.01), occupation (RR= 1.439, P= 0.001), pathological type (RR= 3.694, P < 0.01), surgical path (RR= 0.734, P= 0.001), tumor stage (RR= 0.352, P= 0.007) were independent factors affecting the prognosis of patients with resectable lung cancer. Female, ≤65 years old, thoracoscopic surgery, and tumor stage Ⅰ were prognostic protective factors, and their risks of poor prognosis were reduced by 31.6%, 40.9%, 26.6%, and 64.8%, respectively. Farmer and adenosquamous carcinoma were prognostic risk factors, and their risks of poor prognosis were increased by 43.9% and 269.4%, respectively. The PI equation was ∑βixi=-0.380 X1-0.526 X2+0.364 X31+1.307 X55-0.309 X6-1.045 X81 (X1 was the gender, X2 was the age, X31 was the occupation as a farmer, X55 was the pathological type of adenosquamous carcinoma, X6 was the surgical path, X81 was the tumor stage Ⅰ). PI <-1 was the low-risk group, PI ≥-1 and ≤-0.5 was the intermediate-risk group, PI >-0.5 was the high-risk group, and the differences of their survival rates were statistically significant (P < 0.05). The 1-, 3-, and 5-year survival rates for the low-, risk groups were 96.8%, 87.0% and 77.9%; the intermediate-risk group were 91.8%, 82.2% and 61.7%; the high-risk group were 86.5%, 61.7% and 50.3%. respectively.@*Conclusion@#The prognostic prediction model of resectable lung cancer can predict the prognosis risk and the corresponding survival rate of patients with resectable lung cancer, and it can help clinicians to evaluate the prognosis and formulate subsequent treatment plans.
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At present,surgery is still the best way to treat resectable non-small cell lung cancer (NSCLC).For clinicians,TNM stage is the main indicator to judge surgical outcomes,but the prognosis of patients with same stages still has big differences.The related studies have shown that the prognostic factors for patients with NSCLC after surgical treatment include poor lung function,the suffering from cardiovascular diseases,male,advanced age,comorbidities,advanced TNM stage,non-adenocarcinoma and pneumonectomy.Many results of prognostic factors research are controversial;meanwhile,the effects of molecular biological factors,neoadjuvant therapy and adjuvant therapy on prognosis still need further study.
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Objective To investigate the application of bundles of intervention in the treatment of postoperative delirium in esophageal cancer.Methods Thirty-six cases of delirium associated with esophageal cancer(study group)after the application of bundles of intervention in the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University from November 2015 to August 2016 were analyzed,and 41 cases of postoperative delirium(control group)from January 2015 to October 2015 were treated by routine treatment.Results The mean duration of postoperative delirium was(3.6±0.8)d in the study group and(4.7± 1.2)d in the control group,and the difference was statistically significant(t =4.783,P<0.01).The incidence rates of other complications in the study group and control group were 19.4％(7/36)and 34.1％(14/41),respectively,and there was no significant difference(χ2=2.089,P=0.148).The incidence rates of accidental events in the study group and control group were 13.9％(5/36)and 31.7％(13/41),respectively,and the difference was statistically significant(χ2= 4232,P= 0.040).There was no significant difference in the postoperative exhaust time and removal of chest tube drainage time between the two groups(both P＞ 0.05),but there was a significant difference in postoperative hospital stay and hospital costs between the two groups(t values were 4.726 and 2.065,both P<0.05).Conclusions In the treatment of postoperative delirium in esophageal cancer,applying the bundles of intervention concept is feasible and effective.It can significantly reduce postoperative delirium duration and accelerate the rehabilitation of patients.
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<p><b>OBJECTIVE</b>To analyze the mutations of the RUNX2 gene in a family with cleidocranial dysplasia (CCD).</p><p><b>METHODS</b>The general health status of family members with CCD was investigated through propositus verification method. Oral specialized examination and radiological examination were performed. The peripheral venous blood of the proband and her parents and sisters was collected. Genomic DNA was extracted, and the RUNX2 gene from this DNA was amplified by polymerase chain reaction (PCR). DNA sequences were analyzed with the Blastn program.</p><p><b>RESULTS</b>After Blastn analysis, heterozygous C to T transition mutation at nucleotide 568 occurred in exon 2, which converted arginine to tryptophane at codon 190 (c.568C>T, CGG-->TGG).</p><p><b>CONCLUSION</b>RUNX2 gene is responsible for the CCD in the Chinese family under study. The c.568C>T mutation is the molecular basis of the CCD in the family.</p>
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Humanos , Povo Asiático , Sequência de Bases , Displasia Cleidocraniana , Genética , Subunidade alfa 1 de Fator de Ligação ao Core , Genética , Análise Mutacional de DNA , Éxons , Mutação , Linhagem , Reação em Cadeia da PolimeraseRESUMO
Two cases of cleidocranial dysplasia(CCD) were reported and the characteristics of CCD were analyzed. The propositus verification method was used to family members for general health and oral specialized examination. All patients expressed developmental abnormality of crania, teeth and clavicle.
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Humanos , Clavícula , Displasia Cleidocraniana , DenteRESUMO
Objective To study the influence of probiotic bacteria on rats blood lipids and immune function.Methods Rats fed with high fat diet,as a positive control of lovastatin in different kinds of experimental rats fed with probiotic bacteria.Before the experiment and 30 days after the experiment,the serum TC,TG and immune indicators were examined,compared with the control group.Results Probiotic bacteria feeding rats compared with control group rats,TC and TG in probiotic bacteria feeding rats blood are obviously lower than the eontroled group,(P＜0.01),the immune index is obviously higher than the control group (P＜0.05).Conclusion Probiotic bacteria obviously reduces TG and TG in Probiotic feeding rats blood,and improves the immunological function of probiotic bacteria feeding rats.