ABSTRACT
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.
Subject(s)
Humans , Prognosis , Lung Neoplasms/pathology , Adenocarcinoma, Mucinous/pathology , Adenocarcinoma of Lung/pathology , Neoplasm Staging , Lung/pathology , Retrospective StudiesABSTRACT
Objective To investigate the effects of recombinant human brain natriuretic peptide and sodium nitroprusside in the treatment of acute decompensated heart failure.Methods 82 patients with acute decompensated heart failure were randomly divided into observation group and control group,41 cases in each group.The control group was given sodium nitroprusside intravenous infusion therapy on the basis of routine treatment.The observation group was given recombinant human brain natriuretic peptide infusion treatment on the basis of control group treatment.The clinical efficacy was compared between the two groups.Results The total effective rate of the observation group was 95.12％,which was significantly higher than 75.61％ of the control group (x2 =5.33,P ＜ 0.05).After treatment,the left ventricular diastolic end diameter in the observation group [(67.38 ± 6.82) mm] was significantly lower than before treatment and control group after treatment (t =4.12,3.23,all P ＜ 0.05).After treatment,the left ventricular shot ejection fraction in the observation group [(48.91 ± 7.42)％] was significantly higher than before treatment and control group after treatment (t =3.92,3.77,all P ＜ 0.05).The incidence rate of adverse reactions in the observation group was 9.76％,which of the control group was 7.32％.,the difference was not statistically significant (P ＞ 0.05).Conclusion Recombinant human brain natriuretic peptide combined with sodium nitroprusside could significantly improve the clinical curative effect of acute decompensated heart failure,improve heart function of patients,and inhibit myocardial remodeling.It had good security.