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Objective To investigate the prognostic factors for chronic heart failure and the prognostic ability of copeptin,big endothelin-1(Big ET-1)and N-terminal pro-brain natriuretic peptide (NT-proBNP)in patients with chronic heart failure. Methods To study 1 5 9 consecutive patients hospitalized for chronic heart failure.Serum concentration of copeptin,NT-proBNP,cTnI,CKMB and plasma Big ET-1 as well as left ventricular ejection fraction (LVEF)and NYHA classⅠtoⅣ on admission were measured.Cardiac events were found by patients to discharge after 360~490 days,prospectively.Results During a median follow-up period of 385 days,the endpoint of recurrence for cardiac events was reached in 65 patients with 159 heart failure.Multivarlate canonical correlation analysis shows the older and the higher NYHA classification as well as the lower LVEF in patients with heart failure.There were higher concentration of copeptin,Big ET-1 and NT-proBNP.On a Cox proportional hazards regression models analyses,age,copeptin,Big ET-1 and NT-proBNP were found to be the inde-pendent predictors of cardiac events.Risk ratio (RR)were 1.215,1.236,4.031 and 13.052,respectively.Logistic regression models analyses,copeptin,Big ET-1 and NT-proBNP were found independent predictors of death.Odd ratio (OR)were 4.003,2.477 and 1.235,respectively.Conclusion Measurement of copeptin,Big ET-1 and NT-proBNP in patients with chronic heart failure can help to identify patients at higher risk for cardiac events and patients for prognosis.
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Objective To compare the prognostic value of the 7th edition of AJCC cancer staging system in nasopharyngeal carcinoma (NPC) patients treated with conventional radiotherapy (CRT) and intensity-modulated radiotherapy (IMRT).Methods From January 2004 to December 2006,totally 1138 NPC patients were treated with CRT (790 patients) and IMRT (348 patients) in Cancer Hospital of Fujian province.The median ages were 47 and 45 years old for two groups ( x2 =1.49,P =0.222 ),respectively.There were 0,41,488,261 and 5,65,176,102 patients in stage Ⅰ,Ⅱ,Ⅲ,Ⅳ of the two groups after restaged with 7th edition of AJCC cancer staging system,respectively (x2 =64.78,P =0.001 ).The 3-year survival was analyzed according to T-category,N-category and overall stage.Results The follow-up rate at 3 years is 96.0％.The median follow-up were 32 months and 33 months for CRT and IMRT groups.N-category was found to be the prognostic factors for overall survival (OS,x2 =6.50,P =0.038 and x2 =13.60,P =0.004) and metastasis free survival ( MFS,x2 =7.78,P =0.009 and x2 =15.30,P =0.002) for CRT and IMRT groups.The clinical stage was prognostic factor for OS in conventional group ( x2 =6.70,P=0.035),and for MFS in IMRT group (x2 =9.12,P=0.028).Conclusions The T-calegory of 7th AJCC staging system shows poor predictive value for the long-term survival of NPC patients.The N-calegory of 7th AJCC staging system can well estimate the OS and MFS for NPC.
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Background and purpose: Cervical nodal metastasis in nasopharyngeal carcinoma plays an important role in the definition of radiotherapy area and clinical staging, it is also one of the main factors influencing prognosis. So this study was designed to explore the pattern of metastatic lymph nodes for patients with nasopharyngeal carcinoma, which may provide a basis for clinical treatment and research. Methods: From Jun. 2005 to Sep. 2007,779 histologically diagnosed nasopharyngeal carcinoma patients had routine MRI scan before radiation therapy at Fujian Provincial Cancer Hospital. Diagnostic radiologists and radiation oncoiogists together assessed the nodal distribution according to the guideline CT-hased delineation of lymph node levels. Then, Chi-sqnare test was used to analyze the correlation between T stage and nodal metastasis rate and between nodal diameter and nodal extracapsular invasion. Results: Of 779 patients, 592(76.0%) had nodal involvement. The distribution was as follows: 1 in level Ⅰ,384 in level Ⅱa, 499 in level Ⅱ_b, 184 in level Ⅲ, 33 in level Ⅳ, 67 in level V_a, 21 in level V_b, 597 in retropharynx.In these patients, a total of 1 479 postive nodes, including 973 (65.79%) extracapsular spread nodes, were detected.The rate of nodal extracapsular invasion was higher when the axial diameter increased. Leap metastasis rate was 1.0%. No significant correlation was found between T stage and nodal involvement. Conclusion: The level Ⅱ and retropharyngeal node were the most frequently involved regions, they had similar metastatic rate and were both the first echo node to metastases of nasopharyngeal carcinoma. Level Ⅰ metastasis was lower. The proportion of extracapsular spread of metastatic lymph nodes increased with axial diameter of lymph nodes-dependent. The cervical node involvement of nasopharyngeal carcinoma was spread orderly down the neck, and the incidence of skip metastasis is rare. The relationship between T stage and nodal involvement has no statistical significance.
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Objective To evaluate the diagnostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) quantitative detection in patients with heart failure.Methods Quantitative enzyme-linked immunosorbent assay (ELISA) improvement method was applied to measuring serum level of NT-proBNP in patients with different degree of heart failure.Results The serum level of NT-proBNP was significantly elevated in patients with heart failure. With the increase of extent of heart failure, NT-proBNP increased in exponent. Receiver operator characteristic curve (ROC) showed that area under curve (AUC) was 0.898. The sensitivity and specificity were 91.9% and 92.3% respectively for diagnosis of heart failure.Conclusion Quantitative detection of NT-proBNP is at present the best laboratory test for evaluating heart function of patients with heart failure.