Clinical and Pathological Characteristics of Extrapleural Solitary Fibrous Tumor / 昆明医科大学学报

Objective To investigate the clinical and pathological characteristics of the extrapleural solitary fibrous tumor and the relevant differential diagnosis.Methods HE and immunohistochemical staining were performed on 26 samples of isolated fibrous tumors outside the pleura,and a comprehensive analysis was conducted based on the clinical and imaging data.Results The histological morphology of isolated fibrous tumors was diverse,with typical cases showing the irregular arrangement of oval or spindle shaped cells.In the stroma,thick collagen bands,antler like blood vessels,and peritubular transparent degeneration could be seen.The immunohistochemical staining demonstrated that the positive rates of STAT-6、CD34、Bcl-2、CD99、SMA were 96.2% 、92.3% 、92.3% 、76.9% and 26.9%,respectively.Conclusion SFT commonly occurs in the pleura and can also occur in other areas.Its histological characteristics and immunohistochemical phenotype help to clarify the diagnosis.However,when it occurs in uncommon anatomical sites,it is necessary to carefully and meticulously distinguish and comprehensively judge the clinical prognosis of key diseases that need to be distinguished or excluded..

Impact of Intraoperative Plasma Infusion Dose on the Clinical Prognosis of Cardiac Surgery Patients / 中山大学学报(医学科学版)

ObjectiveTo assess the impact of intraoperative plasma infusion dose and coagulation test value INR on the clinical prognosis of patients undergoing cardiac surgery， providing a basis for guiding rational blood use during cardiac surgery. MethodsThe clinical data of 305 surgical patients who received fresh frozen plasma transfusion during cardiac surgery were collected in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2014 to December 2022. The patients were divided into low-dose group （plasma infusion dose <15 mL/kg， n = 214） and high-dose group （plasma infusion dose ≥15 mL/kg， n = 91） based on the intraoperative plasma dose. Univariate analysis， correlation analysis and logistic multivariate regression analysis were used to analyze the relationship between plasma infusion dose， changes in INR before and after plasma transfusion， and the clinical prognosis of patients undergoing cardiac surgery. ResultsThe median plasma infusion dose for all patients was 11.11 （8.17-19.05） mL/kg， while the median plasma infusion dose in the high-dose group and the low-dose group was 17.78 （15.69-20.91） mL/kg and 9.52 （7.77-11.43） mL/kg， respectively， with a statistically significant difference （P <0.001）. The median INR decrease in the high-dose and low-dose groups was 0.98 （0.60-1.26） and 0.50 （0.35-0.76）， respectively， with a statistically significant difference （P<0.001）. Logistic multivariate regression analysis revealed that abnormally elevated preoperative INR values increased the risk of postoperative red blood cell transfusion within 24 hours in cardiac surgery patients （P<0.001）， with an OR 95%CI of 6.757（3.068， 14.822）. Additionally， it also increased the risk of postoperative in-hospital mortality （P< 0.001）， with an OR 95%CI of 5.441 （2.193， 13.499）. INR decrease reduced the risk of postoperative red blood cell transfusion within 24 hours in cardiac surgery patients （P=0.001）， with an OR 95%CI of 0.244（0.107， 0.558）. Correlation analysis showed positive correlation between plasma infusion dose and postoperative ICU days （rs=0.569， P<0.001） and hospital days （rs=0.302， P<0.001） in cardiac surgery patients. ConclusionAmong patients undergoing cardiac surgery who receive intraoperative plasma transfusion， high plasma infusion dose and abnormally elevated preoperative INR values are associated with poorer clinical outcomes， while patients who show a greater degree of INR correction after plasma transfusion exhibit better clinical results.

Expression and Clinical Significance of MKI67 in Pancreatic Cancer / 肿瘤防治研究

Objectives To explore the expression, biological function, and mechanism of MKI67 in pancreatic cancer and its clinical significance. Methods The expression level, diagnosis, and prognostic value of MKI67 in pancreatic cancer were analyzed using public databases. We also investigated the association between the MKI67 with immune cell infiltration and immune checkpoint molecules. We analyzed the functional pathway enrichment to uncover the possible molecular mechanisms. qRT-PCR and Western blot assay were used to verify the expression of MKI67 mRNA and protein. Immunohistochemistry staining was used to detect the expression of MKI67 in tissue protein. Results The high expression of MKI67 was significantly associated with high histological grades and poor outcomes in pancreatic cancer. High MKI67 expression was correlated with poor prognosis of pancreatic cancer patients (P=0.009). MKI67 was an independent risk factor for the patient outcome (95%CI: 1.084-1.743, P<0.05). The MKI67 expression was positively correlated with the helper T cell 2 levels but negatively correlated with plasmacytoid DC, NK cells, mast cells, the T follicular helper, immune DC, and CD8 T cells. Conclusion MKI67 may serve as a biomarker for the diagnosis and prognosis of pancreatic cancer and the mechanism might be associated with immune escape or immunosuppression.

Expression and clinical significance of miR-143 in gallbladder cancer / 中华肝胆外科杂志

Objective:This study aims to explore the expression of miR-143 in gallbladder cancer tissues and its correlation with tumor angiogenesis, clinicopathologic features and clinical prognosis.Methods:The clinical and pathological data of 78 patients with gallbladder cancer who were surgically resected and pathologically confirmed from January 2008 to June 2016 in the Department of General Surgery, Xuancheng Hospital Affiliated to Wannan Medical College were collected, including 20 males and 58 females, with an average age of (68.0±1.4) years. 78 cases of gallbladder cancer tissue were used as the tumor group, and 32 cases of normal gallbladder tissue adjacent to cancer were randomly selected as the control group. The expression level of miR-143 in the tumor group and the control group was detected by in situ hybridization. Microvessel density (MVD) were evaluated with immunohistochemistry to detect the expression of CD34 in tumor group. The expression of miR-143 and its correlation with tumor MVD, pathological characteristics and prognosis were analyzed by Cox regression analysis.Results:The results of in situ hybridization showed that the positive rate of miR-143 in gallbladder cancer tissues and average expression score were significantly lower than those in adjacent normal gallbladder tissues [29.49% (23/78) vs 62.5% (20/32), χ 2=10.39, P=0.001; (2.705±0.172) vs (4.688±0.405), t=5.33, P<0.001]. Correlation analysis showed that the expression of miR-143 was associated with lymph node metastasis of gallbladder cancer ( P=0.036). The MVD counts in the miR-143 positive group were significantly lower than those in the miR-143 negative group [(126.2±8.483) vs (157.4±6.412), t=2.75, P=0.007)]. The median survival time of gallbladder cancer patients with miR-143 positive and negative was 16 and 9 months, respectively. Cox regression analysis showed that the low expression of miR-143 was an independent risk factor affecting the clinical prognosis of gallbladder cancer. Conclusion:The expression of miR-143 is down-regulated in gallbladder cancer and participates in angiogenesis and clinical prognosis of gallbladder cancer.

Analysis of the Expression of Glycoprotein M6A in Glioma based on Bioinformatics Methods / 医学研究杂志

Objective To investigate the expression of glycoprotein M6A(GPM6A)in glioma specimens and its prognostic signifi-cance.Methods Bioinformatics methods were used to analyze the expression of GPM6A in 325 cases obtained from the Chinese Glioma Genome Atlas(CGGA)database.The STRING online database was used to screen and analyze the possible protein PPI interaction net-work and GO functional annotation that interact with GPM6A to explore its potential mechanism.The relationships between GPM6A and glioma cell purity and the level of CD8+T cell were assessed using the TIMER2.0database.Results The online analysis of the CGGA database showed that GPM6A was expressed in histopathological grades(WHO:G2,G3,G4)and histopathological types,and there were significant differences in GPM6A expression levels between all grades and all types of gliomas(Grades:F=50.25,P＜0.001;Types:F=14.26,P＜0.001);the expression level of GPM6A was closely related to molecular IDH mutation status,combined deletion of 1p19q,and patient age(all P＜0.01),regardless of patient gender(t=1.45,P＞0.05).The expression level of GPM6A in primary glioma was higher than that in secondary glioma,and the difference was not statistically significant(t=1.82,P＞0.05).The survival time of patients with low GPM6A expression was significantly shortened(x2=69.79,P＜0.001),but in glioblastoma(GBM)patients,regard-less of the level of GPM6A expression,there was no difference in survival time(x2=0.63,P＞0.05).GO functional analysis showed that GPM6A was closely related to the functions of transmembrane protein transport,synapse formation and development,and information ex-change between cells in the nervous system.TIMER2.0database analysis showed that GPM6A was positively correlated with glioma tumor cell purity and the level of CD8+T cell.Conclusion The prognosis of glioma patients with low GPM6A expression is significantly worse than that of patients with high expression,and its expression level can be used as a predictor for evaluating the prognosis of glioma.

Correlation of serum albumin level at admission with clinical prognoses in patients with acute traumatic brain injury / 中华神经医学杂志

Objective:To explore the correlation of serum albumin level at admission with clinical prognoses in patients with acute traumatic brain injury (TBI).Methods:One hundred and fifty-four patients with acute moderate-extreme severe TBI (Glasgow Coma Scale [GCS] scores of 3-12 at admission) in Department of Neurosurgery, General Hospital of Western Theater Command from January 1, 2019 to December 31, 2020 were chosen. The comprehensive clinical data of these patients were collected, including age, gender, GCS scores, serum albumin level (hypoalbuminemia defined as<35 g/L), hemoglobin level, comorbidities, treatment measures, and prognoses 6 months after discharge (poor prognosis defined as Glasgow outcome Scale [GOS] scores of 1-2, and good prognosis defined as GOS scores of 3-5). Univariate and multivariate Logistic regressions were used to identify the independent factors for clinical prognoses of these patients, and differences in poor prognosis rate, length of ICU stay, and total hospital cost were compared between different groups.Results:Among the 154 patients, 43 had poor prognosis and 111 had good prognosis. Serum albumin level at admission ( OR=0.916, 95% CI: 0.843-0.996, P=0.001) and GCS scores at admission ( OR=0.701, 95% CI: 0.594-0.828, P<0.001) were independent factors for prognosis. Patients with hypoalbuminemia ( n=70) displayed significantly higher poor prognosis rate, longer ICU stays, and increased total hospitalization cost compared with those without hypoalbuminemia ( n=84, P<0.05); specifically, in patients with GCS scores of 9-12 at admission ( n=58), those with hypoalbuminemia ( n=27) exhibited significantly higher poor prognosis rate, longer ICU stays, and higher total hospitalization cost than their non-hypoalbuminemia counterparts ( n=31, P<0.05); similarly, in patients with GCS scores of 3-8 at admission ( n=96), those with hypoalbuminemia ( n=74) had significantly higher poor prognosis rate than their non-hypoalbuminemia counterparts ( n=22, P<0.05). In patients with good prognosis, those with hypoalbuminemia ( n=56) showed significantly longer total hospital stays, prolonged ICU stays, and increased total hospitalization cost compared with those without hypoalbuminemia ( n=55, P<0.05). Conclusion:Low serum albumin level at admission is likely to lead to poor prognosis, prolonged ICU stays and increased total hospitalization cost in patients with acute TBI.

CALGB140503 study: Is sublobectomy the standard procedure for early peripheral lung cancer? / 中国胸心血管外科临床杂志

@#While lobectomy is the standard surgical procedure for early-stage non-small cell lung cancer (NSCLC), sublobectomy (segmentectomy/wedge resection) has been gaining progress in early-stage peripheral NSCLC in recent years because it preserves more lung parenchyma and has the advantages of good postoperative lung function, relatively less trauma, and faster recovery. However, there has been a lack of standardized randomized clinical trials to study the survival benefits of sublobectomy. The results of a high-profile study from the USA, CALGB140503, have been the subject of intense industry debate since its presentation at the 2022 World Conference on Lung Cancer (IASLC WCLC 2022). The study, which was published in The New England Journal of Medicine on February 9, 2023, was designed to investigate whether sublobectomy was not inferior to lobectomy in terms of survival in patients with early-stage peripheral NSCLC (tumor diameter≤2 cm). The results showed that sublobectomy was not worse than lobectomy for survival in patients with T1aN0M0 peripheral NSCLC with tumor diameter≤2 cm and pathologically confirmed negative hilar and mediastinal lymph nodes. Sublobectomy, including anatomical segmentectomy and wedge resection is an effective NSCLC treatment. The results of this study provide strong evidence for the improved outcomes of sublobectomy in terms of lung function protection and are expected to promote the further use of sublobectomy. However, given the limitations of this study, whether sublobectomy, especially wedge resection, can become a standard procedure still needs to be explored. This paper presents an interpretation of this study and we invite experts in the field to discuss its usefulness in guiding clinical practice and summarise its limitations.

Application of prediction models in clinical research / 上海预防医学

Chronic diseases have become an important public health problem for people under 70 years of age worldwide， while also causing a great economic burden. The establishment of clinical prediction models can help to predict the risk of a disease or the prognostic effect of a study subject in advance by means of index testing at the early stage of chronic diseases， and plays an increasingly important role in clinical practice. This study introduces clinical diagnostic prediction models and clinical prognostic prediction models， and reviews clinical data processing， clinical prediction model building， visualization methods and model evaluation from the perspective of the application of clinical prediction models， which contribute to the correct and reasonable use of prediction models in clinical research.

Clinical efficacy and prognosis of sacubatrovalsartan combined with dapagliflozin in patients with heart failure with reduced ejection fraction / 中华急诊医学杂志

Objective:To investigate the clinical efficacy and prognosis of sacubatrovalsartan combined with dapagliflozin in patients with heart failure with reduced ejection fraction (HFrEF).Methods:Totally 206 consecutive patients with HFrEF in our hospital from March 2021 to September 2021 were enrolled and randomly(random number) divided into the control group ( n = 51), the sacubatrovalsartan group ( n = 52), the dapagliflozin group ( n=51) and the combined treatment group ( n= 52). The baseline clinical data of patients and laboratory examination results were collected. The changes of related results before and after treatment in each group were analyzed and compared. After discharge, the enrolled patients were followed up by outpatient or telephone for an average of 6 months to determine whether the patients had heart failure rehospitalization, ventricular arrhythmia, major adverse cardiovascular events (MACE), etc. Results:After anti-heart failure treatment, there were significant differences in NT-proBNP, left ventricular ejection fraction (LVEF) and soluble growth stimulating gene 2 protein (ST2) among the four groups. NT-proBNP and ST2 in the combined treatment group were significantly lower than those in the other groups, and LVEF was significantly higher. Compared with the control group, the rehospitalization due to heart failure and MACE events in the other three groups were significantly lower ( P < 0.05), and the combined treatment group had the lowest ( P < 0.05). The Kaplan-Meier survival curve showed that the survival probability of the other groups was significantly higher than that of the control group, and was the highest in the combined treatment group. Conclusions:The clinical efficacy and prognosis of HFrEF patients could be significantly improved after the treatment of sacubatrovalsartan combined with dapagliflozin.

Mechanism of the role of NDUFAF4 in increasing radiation resistance of hepatocellular carcinoma by activating Wnt/β-catenin signaling pathway / 中华放射肿瘤学杂志

Objective:To analyze the association between the expression of ubiquinone oxidoreductase complex assembly factor 4 (NDUFAF4) and clinical prognosis of patients with hepatocellular carcinoma (HCC), evaluate the effect of NDUFAF4 on the radiosensitivity of human HCC cell lines, and unravel the underlying mechanism.Methods:The online database and HCC tissue samples were used to investigate the expression of NDUFAF4, and the correlation between NDUFAF4 expression level and clinical prognosis. The si-NDUFAF4 plasmid which down-regulated the expression level of NDUFAF4 was transferred into HepG2 and Huh7 cells. The radiosensitivity of HCC cell lines was detected by clone formation experiment. Nude mice were prepared for tumor-bearing experiment. The β-catenin level was detected by immunofluorescent staining. The expression levels of E-cadherin and N-cadherin proteins were determined by Western blot.Results:Bioinformatics results confirmed that NDUFAF4 was significantly up-regulated in HCC tissues, and the higher the expression level, the worse the patients' clinical prognosis ( P<0.05). The expression level of NDUFAF4 in HCC tissues was significantly higher than that in the adjacent tissues. Clone formation experiment confirmed that knockdown of NDUFAF4 significantly decreased the survival rate of HCC cells ( P<0.01). In vivo experiment showed that knockdown of NDUFAF4 could prevent the proliferation of HCC cells and down-regualte the expression levels of β-catenin and Ki-67. Knockdown of NDUFAF4 significantly down-regulated the expression level of β-catenin protein in the nucleus of HCC cell lines, suggesting that NDUFAF4 could activate the WNT/β-catenin signaling pathway. Knockdown of NDUFAF4 significantly up-regulated the expression level of E-cadherin and down-regulated that of N-cadherin. Conclusions:Knockdown of NDUFAF4 can significantly enhance the radiosensitivity of HCC cell lines by inhibiting the WNT/β-catenin signaling pathway. The expression level of NDUFAF4 is intimately correlated with clinical prognosis. NDUFAF4 can be considered as a new target for lowering the radiation resistance of HCC.

METTL27 is a prognostic biomarker of colon cancer and associated with immune invasion / 南方医科大学学报

OBJECTIVE@#To investigate the expression and gene function of methyltransferase-like protein 27 (METTL27) in colon cancer, its association with immune infiltration and its prognostic significance.@*METHODS@#We analyzed the expression levels of METTL27 in 33 cancers using R language and identified METTL27 as a differential gene in colon cancer. The related signaling pathways of METTL27 were analyzed by gene functional annotation and enrichment. SsGSEA algorithm was used to analyze immune infiltration, and logistic analysis was used to evaluate the correlation between METTL27 expression and clinicopathological features of the patients. Kaplan-meier analysis, univariate and multivariate Cox regression analysis were performed to construct a nomogram for evaluating the correlation between METTL27 expression and clinical prognosis. The expression level of METTL27 was further verified in colorectal cancer cell lines and 16 clinical specimens of colorectal cancer tissues using qPCR and Western blotting.@*RESULTS@#METTL27 was highly expressed in 21 cancers, and its expression was significantly higher in colon cancer than in adjacent tissues (P < 0.001). METTL27-related genes were identified by differential analysis, and functional annotation revealed that METTL27 was significantly enriched in transmembrane transport and lipid metabolism, and 5 related signaling pathways were identified by GSEA. METTL27 expression was negatively correlated with different T helper cells and central memory T cells (P < 0.001). The patients with a high METTL27 mRNA expression had a poor survival outcome. Cox regression analysis showed that METTL27 expression was an independent prognostic factor of the overall survival. The expression level of METTL27 was significantly higher in the colorectal cancer cell line than in normal cells (P < 0.05).@*CONCLUSION@#METTL27 is overexpressed in colon cancer and is associated with a poor prognosis of the patients. A high expression of METTL27 showed is associated less T cell immune infiltration, suggesting the potential of METTL27 as a prognostic marker of colon cancer.

Analysis of clinical characteristics and prognostic factors of patients infected with Helicobacter pylori under 30 years ol / 公共卫生与预防医学

Objective To analyze the clinical characteristics and prognostic risk factors of helicobacter pylori (Hp) infected patients under 30 years old, and to provide a theoretical basis for the eradication of Hp in young Hp-positive patients under 30 years old. Methods A total of 565 patients with upper gastrointestinal symptoms admitted to our hospital from December 2017 to December 2020 were selected. All patients were Hp positive, and all patients were treated with quadruple eradication therapy of Helicobacter pylori. According to the Hp negative status after treatment, the patients were divided into good prognosis group (Hp negative, n=374) and poor prognosis group (Hp not negative, n=191). A self-made questionnaire was used to analyze the age, gender, familial history of gastrointestinal diseases, life habits (long-term smoking, and drinking), eating habits (irregular diet, and excitant food), DOB baseline value, and treatment compliance of the two groups. Logistic regression was used to analyze the factors that may affect the prognosis of HP positive patients. Results Among the 565 Hp positive patients, 347 were males and 218 were females, with an average age of (23.49±4.29) years, 393 (69.56%) aged 18-24 years old and 172 (30.44%) aged 25-29 years old. The diagnosis results of upper gastrointestinal diseases were 54 cases of gastric cancer (9.56%), 229 cases of peptic ulcer (40.53%), 174 cases of chronic gastritis (30.80%), and 108 cases of reflux esophagitis (19.12%). There were no significant differences in age, sex, family history of gastrointestinal diseases and alcoholism between the two groups (P>0.05). There were statistically significant differences between the two groups in long-term smoking, irregular diet, preference for stimulating food, treatment compliance and baseline value of DOB (P<0.05). The results of logistic regression analysis showed that long-term smoking, poor treatment compliance and high DOB value were independent risk factors affecting the prognosis of Hp positive patients (P<0.05). Conclusion Chronic gastritis and peptic ulcer are the main upper gastrointestinal diseases in Hp-positive young patients under 30 years old. Long-term smoking, poor treatment compliance and high DOB value are independent risk factors affecting the prognosis of patients. Treatment compliance of patients should be improved, and intervention should be strengthened in patients with high DOB value and smoking.

Prognostic factors for ruptured anterior communicating artery aneurysms / 中华神经医学杂志

Objective:To explore the related factors for clinical prognoses of ruptured anterior communicating artery (ACoA) aneurysms.Methods:A retrospective study was performed on the clinical data of 309 patients with ruptured ACoA aneurysms admitted to our hospital from January 2014 to January 2020. The preoperative data included age, gender, smoking history, hypertension, Hunt-Hess grading, Fisher grading, sizes of aneurysms, and spasm of parent artery; and the postoperative data included pneumonia, intracranial infection, cerebral hernia, recurrence and re-hemorrhage of aneurysms, and delayed cerebral ischemia. Clinical prognoses were assessed by modified Rankin scale (mRS). Univariate analysis and multivariate Logistic regression analysis were used to determine the independent risk factors for clinical prognoses. Preoperative model (independent risk factors appeared before surgery) and postoperative model (independent risk factors appeared during the whole treatment process) were constructed; based on these Logistic models, the preoperative and postoperative independent risk factors were concluded. Independent risk factors presented in the preoperative and postoperative models were used as variables to analyze the predictive value of the models by receiver operating characteristic (ROC) curve.Results:Among 309 patients, 264 (85.4%) had good prognosis and 45 (14.6%) had poor prognosis. (1) Univariate analysis showed that significant differences were noted in proportion of smoking patients, and patients with hypertension, Hunt-Hess grading IV-V, Fisher grading IV, wide-necked aneurysm, re-hemorrhage of aneurysms, cerebral vasospasm, pneumonia, intracranial infection, cerebral hernia, delayed cerebral ischemia, and postoperative lumbar cistern drainage between good prognosis group and poor prognosis group ( P<0.05). (2) Multivariate Logistic regression analysis showed that Hunt-Hess grading Ⅳ-V ( OR=24.198, P=0.000, 95%CI: 4.288-136.559), Fisher grading Ⅳ ( OR=4.792, P=0.044, 95%CI: 1.040-22.079), spasm of parent artery ( OR=12.136, P=0.005, 95%CI: 2.121-69.426), pneumonia ( OR=8.177, P=0.018, 95%CI: 1.438-46.506), postoperative cerebral hernia ( OR=147.042, P=0.002, 95%CI: 6.386-3385.519) and delayed cerebral ischemia ( OR=606.720, P=0.000, 95%CI: 52.288-7040.088) were independent risk factors for prognoses; postoperative lumbar cister drainage ( OR=0.072, P=0.050, 95%CI: 0.005-1.000) was the independent protective factor. (3) ROC curve showed that the preoperative model (with Hunt-Hess grading IV-V, Fisher grading Ⅳ and cerebral vasospasm as variables) had excellent discrimination with an area under the curve (AUC) of 0.870 ( 95%CI: 0.82-0.93, P=0.000), and the postoperative model (with variables of preoperative model, pneumonia, delayed cerebral ischemia, and herniation as variables) had excellent discrimination (AUC=0.980, 95%CI: 0.97-0.99, P=0.000). Conclusion:Besides decreasing Hunt-Hess grading and Fisher grading, and relieving the arterial spasm, the management of lumbar subarachnoid continuous drainage and avoidance of postoperative complications, such as cerebral hernia, delayed cerebral ischemia and pneumonia, can also play important roles in improving the prognoses of ruptured ACoA aneurysms.

Analysis of clinical prognosis and influencing factors of optimal medical therapy for patients with coronary heart disease after percutaneous coronary intervention / 中国综合临床

Objective:To study the clinical prognosis and related factors affecting optimal medical therapy (OMT) compliance of patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI).Methods:A prospective study was conducted to select 3 818 patients who were diagnosed with CAD and successfully underwent PCI in TEDA International Cardiovascular Hospital from October 2016 to September 2017. The clinical information and application of OMT during hospitalization and 1 year later were collected for research.The patients were divided into OMT group and non OMT group according to whether they adhered to OMT during follow-up one year after discharge. After comparing the imbalance baseline data of hypertension,diabetes and hyperlipidemia with propensity score,demographic characteristics, coronary revascularization history, CAD, laboratory related laboratory examinations,and the use of OMT drugs were compared between the two groups. Cox regression model was used to analyze the relationship between long-term OMT and clinical prognosis in patients with CAD.Multivariate binary logistic regression was used to analyze the related factors affecting long-term OMT compliance.Results:A total of 3 818 cases of CAD patients were matched by propensity score and 2 596 patients were included in the study. There were 1 609 males and 987 females. The age was (62.51±9.56) years old.One year later,1298 patients (50%) insisted on OMT,including dual antiplatelet therapy(DAPT), statins, β-blockers and ACEI/ARB were 97.0% (2 517/2 596),94.5%(2 454/2 596),69.6% (1 806/2 596) and 64.2% (1 666/2 596), especially angiotensin converting enzyme inhibitors / angiotensin receptor blockers and β Receptor blockers decreased the most.Cox regression analysis showed that after adjusting for other factors, compared with non-adherence to OMT group,OMT after PCI was associated with better prognosis ( HR=0.416,95% CI 0.270-0.641, P<0.001). The prognosis of CAD patients with history of old myocardial infarction ( HR=1.804,95% CI 1.070-3.041, P=0.027),cardiac insufficiency ( HR=2.074,95% CI 1.161-3.702, P=0.014),multivessel coronary disease ( HR=2.211,95% CI 1.228-3.983, P=0.008) and BMI>24 ( HR=1.570,95% CI 1.037-2.377, P=0.033) were related to worse clinical outcomes. Multi-factor binary Logistic regression showed that OMT at hospitalization was a strong influencing factor of long-term adherence to OMT ( OR=41.278,95% CI 29.961-56.871, P<0.001). Patients with higher education,employee medical insurance and with history of PCI tend to persist in OMT. Conclusion:The medication compliance of patients with long-term OMT after PCI is still poor,while the high compliance of OMT is related to the lower incidence of adverse cardiovascular events,including death, nonfatal myocardial infarction and stroke. If there is no obvious contraindication,all patients after PCI should adhere to OMT.

Relationship between blood pressure after early endovascular treatment and clinical prognoses in patients with acute large vessel occlusion stroke of anterior circulation / 中华神经医学杂志

Objective:To explore the influence of blood pressure (BP) profiles 24 h after early endovascular treatment (EVT), including mean blood pressure and blood pressure variability, in clinical prognoses of patients with acute large vessel occlusion stroke (ALVOS) of anterior circulation 90 d after EVT.Methods:Clinical data and blood pressure profiles of patients with ALVOS of anterior circulation who received EVT in our hospital from July 2014 to February 2019 were prospectively collected. The 90-d modified Rankin scale (mRS) scores were used as clinical prognosis evaluation, and modified thrombdysis in cerebral infarction (mTICI) was used as evaluation criteria for recanalization of postoperative occlusive blood vessels. Multivariate Logistic regression analysis was used to determine the independent influencing factors for prognoses 90 d after EVT.Results:(1) Two hundred and sixteen patients were collected; 159 patients were with successful recanalization and 57 patients were with unsuccessful recanalization; 90 d after EVT, 95 patients (44%) had good prognosis and 121 patients (56%) had poor prognosis. As compared with patients in the good prognosis group, patients in the poor prognosis group had signficantly advanced age, signficantly higher proportion of patients with atrial fibrillation, signficantly higher baseline NIHSS scores, and signficantly lower baseline ASPECT scores ( P<0.05); and the differences of occlusion locus were statistically significant between patients from the good and poor prognosis groups ( P<0.05). Patients in the poor prognosis group had significantly higher baseline systolic blood pressure (SBP), mean SBP, max SBP, and significantly higher standard deviation, variable coefficient, and continuous variation of SBP, and statistically higher standard deviation, variable coefficient, and continuous variation of diastolic blood pressure (DBP) as compared with those in the good prognosis group ( P<0.05). Multivariable Logistic regression analysis showed that the standard deviation and continuous variation of SBP were independent influencing factors for clinical prognoses 90 d after EVT ( OR=1.116, 95%CI: 1.002-1.243, P=0.047; OR=1.116, 95%CI: 1.016-1.227, P=0.022). (2) In patients with successful recanalization, as compared with patients in the good prognosis subgroup, patients in the poor prognosis subgroup had signficantly advanced age, statistically higher proportions of patients with diabetes mellitus and atrial fibrillation and baseline NIHSS scores, and statistically lower baseline ASPECT scores ( P<0.05); and the differences of occlusion locus and first choices of treatment were statistically significant between patients in the good and poor prognosis subgroups ( P<0.05). Patients in the poor prognosis subgroup had significantly higher baseline SBP and max SBP, and significantly higher standard deviation, variable coefficient, and continuous variation of SBP, and statistically higher variable coefficient of DBP as compared with those in the good prognosis subgroup ( P<0.05). Multivariable Logistic regression analysis showed the standard deviation, variable coefficient, and continuous variation of SBP were independent influencing factors for clinical prognoses 90 d after EVT ( OR=1.164, 95%CI: 1.021-1.326, P=0.023; OR=1.191, 95%CI: 1.007-1.409, P=0.041; OR=1.141, 95%CI: 1.018-1.279, P=0.024). However, in patients with unsuccessful recanalization, there were no significant differences in blood pressure proliles between the good prognosis subgroup and poor prognosis subgroup ( P>0.05). Conclusion:The blood pressure variability 24 h after EVT is correlated with the clinical prognoses of patients with ALVOS of anterior circulation 90 d after EVT.

Relationship between expression level of 15-PGDH and clinical prognosis of liver transplantation for hepatocellular carcinoma / 器官移植

Objective To investigate the relationship between the expression level of 15-hydroxyprostaglandin dehydrogenase (15-PGDH) and clinical prognosis of liver transplantation for hepatocellular carcinoma. Methods The clinical data of 94 recipients undergoing liver transplantation for hepatocellular carcinoma were retrospectively analyzed. The expression of 15-PGDH in the pathological tissues of all recipients was detected by immunohistochemical staining. The relationship between the expression level of 15-PGDH protein and clinical parameters of hepatocellular carcinoma patients was analyzed. The 5-year tumor-free survival and overall survival rates of liver transplant recipients were calculated. The possible independent risk factors of the clinical prognosis of liver transplant recipients were analyzed. Results The expression level of 15-PGDH was significantly correlated with age, Child-Pugh grade and preoperative level of alpha-fetoprotein (AFP) of the recipients (all P < 0.05). The tumor-free survival and overall survival rates of the recipients with low expression of 15-PGDH were significantly lower than those in their counterparts with high expression of 15-PGDH (both P < 0.05). The expression level of 15-PGDH, degree of tumor differentiation and American Joint Committee on Cancer (AJCC) staging were the independent risk factors of clinical prognosis of liver transplantation for hepatocellular carcinoma (all P < 0.05). Conclusions The expression level of 15-PGDH is an independent risk factor of clinical prognosis of liver transplantation for hepatocellular carcinoma.

Prognostic value of deep medullary vein signs on magnetic sensitive weighted imaging in acute anterior circulation cerebral infarction / 中华神经医学杂志

Objective To investigate the correlations of distribution and grading of deep medullary veins (DMVs) with clinical prognoses of patients with acute anterior circulation infarction by using susceptibility-weighted imaging (SWI).Methods Fifty patients with acute anterior circulation infarction,admitted to our hospital from August 2016 to December 2017,were enrolled in our study.SWI was performed to evaluate the DMVs.Univariate and multivariate Logistic regression models were used to determine the correlation between distribution of DMVs and clinical prognoses of patients.DMVs on the ipsilateral side of the lesions were further graded and analyzed;boxplot was used to describe its relation with modified Rankin scale (mRS) scores of the patients.Results DMVs were observed in 36 patients (72％),with 19 ipsilateral DMVs and 17 contralateral DMVs.The ipsilateral DMVs were independently associated with poor outcome (odds ratio=3.380,95％CI:1.006-11.393,P=0.049).The contralateral DMVs were not independent predictors for outcomes,but appeared commonly in patients with good outcome (44.8％).In patients with ipsilateral DMVs,grading 1,grading 2,and grading 3 were noted in 7,two and three patients,respectively;boxplot analysis showed that DMVs patients of grading 3 had higher mRS scores,with an average of 4.Conclusion The ipsilateral DMVs on SWI are independent predictive biomarkers for poor clinical outcome after stroke,and contralateral DMVs often indicate good prognosis.

Recent advances in hemorrhage transformation and clinical prognoses after intravenous thrombolysis in acute ischemic stroke with cerebral small vessel disease / 中华神经医学杂志

The development of neuroimaging has led to a high diagnostic rate of cerebral small vessel disease (CSVD).The hemorrhage transformation (HT) and clinical prognosis after intravenous thrombolysis in acute ischemic stroke (AIS) with CSVD have become hot topics in recent years.Relevant studies have shown that different subtypes of CSVD may have different influences in HT and clinical prognoses in AIS.In clinic,each subtype of CSVD may not exist alone in one patient,therefore,some scholars put forward the concept of total burden of CSVD to further quantitatively assess the severity of CSVD in the whole brain and their effects on HT and clinical prognosis after intravenous thrombolysis of AIS.This article reviews the researches on HT and clinical prognosis after intravenous thrombolysis in AIS with CSVD.

Application of valvuloplasty in mitral valve insufficiency in infants and small children / 中华实用儿科临床杂志

Objective@#To explore the efficacy of valvuloplasty on mitral valve regurgitation (MR) in infants and small children, in order to provide evidence for clinical treatment.@*Methods@#Retrospective analysis was conducted in patients aged less than 3 years old who have undergone mitral repair surgeries at Department of Cardiovascular Surgery, General Hospital of Western Theater Command from January 2015 to December 2017.Cardiopulmonary bypass (CPB) surgery was performed under general anesthesia.The corresponding repair operations were selected for various MR types.All the children were examined by cardiac ultrasound before discharge.Patients were followed up after surgery and mitral regurgitation was recorded.@*Results@#A total of 69 patients were enrolled, including 30 boys and 39 girls, with an average age of (19.3±11.6) months and an average weight of (9.6±2.1) kg.There were 32 cases of Carpentier type Ⅰ, 30 cases of type Ⅱ and 7 cases of type Ⅲ.Twenty-nine patients were diagnosed as simple MR, while the other 40 patients were combined with other cardiac malformations.One patient died at postoperative day 7.One patient still had severe MR after surgery, and then second operation was performed on the 10th day after first surgery.Sixty-five patients were followed up from 1 month to 3 years[(15.9±10.9) months]. During the follow-up period, no patient died or had reoperation.Aggravated MR was observed in 4 patients.@*Conclusions@#Mitral valvuloplasty is a safe and effective surgical method for treating infants and younger children with MR.The key to the success of surgery is to choose the appropriate individualized repair operation.At the same time, the growth potential of mitral valve should be fully considered to avoid restrained development.

Application of valvuloplasty in mitral valve insufficiency in infants and small children / 中华实用儿科临床杂志

Objective To explore the efficacy of valvuloplasty on mitral valve regurgitation (MR) in infants and small children,in order to provide evidence for clinical treatment.Methods Retrospective analysis was conducted in patients aged less than 3 years old who have undergone mitral repair surgeries at Department of Cardiovascular Surgery,General Hospital of Western Theater Command from January 2015 to December 2017.Cardiopulmonary bypass (CPB) surgery was performed under general anesthesia.The corresponding repair operations were selected for various MR types.All the children were examined by cardiac ultrasound before discharge.Patients were followed up after surgery and mitral regurgitation was recorded.Results A total of 69 patients were enrolled,including 30 boys and 39 girls,with an average age of (19.3 ± 11.6) months and an average weight of (9.6 ±2.1) kg.There were 32 cases of Carpentier type Ⅰ,30 cases of type Ⅱ and 7 cases of type Ⅲ.Twenty-nine patients were diagnosed as simple MR,while the other 40 patients were combined with other cardiac malformations.One patient died at postoperative day 7.One patient still had severe MR after surgery,and then second operation was performed on the 10th day after first surgery.Sixty-five patients were followed up from 1 month to 3 years[(15.9 ± 10.9) months].During the follow-up period,no patient died or had reoperation.Aggravated MR was observed in 4 patients.Conclusions Mitral valvuloplasty is a safe and effective surgical method for treating infants and younger children with MR.The key to the success of surgery is to choose the appropriate individualized repair operation.At the same time,the growth potential of mitral valve should be fully considered to avoid restrained development.