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@#Objective To analyze the influencing factors for re-positive nucleic acid test in discharged corona-virus disease 2019 (COVID-19) patients in Chengdu, Sichuan Province, and to provide data support for the epidemics prevention and control. Methods The clinical data of 660 discharged COVID-19 patients from January 23, 2020 to February 28, 2021 in our center were retrospectively analyzed. The patients were divided into two groups according to the reexamination of virus nucleic acid, including a negative group [549 patients, including 428 males and 121 females with a median age of 33.0 (28.0, 48.0) years] and a positive group [111 patients, including 76 males and 35 females with a median age of 39.0 (28.0, 51.0) years]. The clinical data of the two groups were compared. Results The re-positive rate of the discharged patients was 16.82%. Univariate analysis showed that the re-positive rate of females was higher than that of males (χ2=4.608, P=0.032). The re-positive rate of confirmed patients was higher than that of asymptomatic infected patients (χ2=8.140, P=0.004). The re-positive rate of domestic patients was higher than that of imported patients (χ2=9.178, P=0.002). The counts of CD3+ (P=0.038), CD4+ (P=0.048) and CD8+ (P=0.040) T lymphocytes in the negative group were higher than those in the positive group. The binary logistic regression analysis showed that the clinical classification and CD8+ T lymphocyte count were independent risk factors affecting the recurrence of virility. Conclusion The gender, origin, T lymphocyte subsets count and clinical type are the influencing factors for re-positive result, and clinical type and CD8+ T lymphocyte count are the independent influencing factors for re-positive result. Therefore, improving the immunity of infected patients, as well as early detection and timely treatment are effective means to reduce the re-positive occurrence.
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Objective To evaluate the impact of clinical and pathological factors on incidence and prognosis of brain metastasis from breast cancer.Methods The clinical data of 4473 stage Ⅳ breast cancer patients were collected from The Surveillance,Epidemiology,and End Results (SEER) database.All these patients were divided into brain metastasis group (n=345) and non-brain metastasis group (n=4 128).The clinical and pathological factors between the two groups were compared using x2 test and binary Logistic regression.The OS of 345 brain metastasis patients was calculated using the Kaplan-Meier method and impact of clinical and pathological factors on the survival rate was analyzed by Log-rank method.Multivariate Cox regression model was used to find out the independent risk factors.Results Between brain metastasis group and non-brain metastasis group,these following clinical and pathological factors showed the scatistical significance on brain metastasis:age,histological grade,T stage,N stage,ER,PR and HER expression (P＜0.05).Binary Logistic regression results showed that age,T stage,N stage,ER,PR were independent factors affecting brain metastasis (P＜0.05).The prognosis analysis showed that marital status,histological grade,ER,PR,molecular subtype,radiotherapy and chemotherapy,surgery at primary lesions,surgery at metastasis site,liver metastasis,lung metastasis and numbers of other organs metastasis were significantly correlated with the survival of breast cancer patients with brain metastasis (P＜0.05).Cox regression analysis showed that histological grade,ER,PR,molecular subtype,radiotherapy and chemotherapy,surgery at primary lesions,surgery at metastasis site were independent prognostic factors in breast cancer patients with liver metastasis.Conclusions Breast cancer patients with brain metastasis have a poor prognosis.Molecular subtype should be considered for prediction of prognosis for patients with brain metastasis.Radiotherapy and surgery at metastasis or primary site may improve survival of patients.
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Objective To investigate the surgical procedure,complication and cosmetic effects of tissue expander in immediate breast reconstruction after nipple sparing mastectomy(NSM).Methods From Jul.2014 to Apr.2018,the clinical data of 23 breast cancer patients (two patients were bilateral) undergoing NSM and expander immediate breast reconstruction were analyzed retrospectively.Results All of the 25 procedures were NSM plus expander based immediate breast reconstruction.The overall complication rate was 12％,including:one seroma,one mild nipple necrosis and one nipple malposition.The median follow up period was 12 months,no grade Ⅲ or Ⅳ contractures were found.Appearance satisfaction was applied to the Harvard scoring system,doctor score:fair(2 cases;8％),good(2 cases;8％),excellent(21 cases;84％);patient score:good(4 cases;16％),excellent(21 cases;84％).No local recurrence was observed.Conclusion NSM with lateral incision and immediate reconstruction was found to be technically feasible and associated with few complications and satisfactory esthetic outcomes.