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【Objective】 To analyze the impact of preoperative anemia on perioperative red blood cell transfusion and prognosis of children undergoing septal defect repair. 【Methods】 The medical records of 208 patients under 18 years old with septal defect, i. e. ventricular septal, atrial septal, ventricular septal with atrial septal defect, in a hospital from December 2018 to March 2022 were collected. They were divided into anemic group (n=52) and non-anemic group (n=156) according to whether they were anemic before operation. The basic information, as well as preoperative, intraoperative and postoperative blood transfusion, postoperative ICU stay, postoperative infection rate and average length of stay were compared between the two groups. 【Results】 The incidence of preoperative anemia in the children with septal defect was 25.0% (52/208). The age, preoperative body weight(kg) and hemoglobin (g/L) of anemic group and non-anemic group was 0.67(0.33, 2) vs 2(1, 3), 6.5(5, 10) vs10.5(8, 14) and 102(91.5, 107) vs 127(121, 134) respectively, all P<0.05. Preoperative, intraoperative and postoperative blood transfusion rates in the anemic and non-anemic groups were 11.54% (6/52) vs 0% (0/156), 92.31% (48/52) vs 72.44% (113/156), 51.92% (27/52) vs 25.0% (39/156), all P<0.05. Postoperative ICU stay (d) and mean length of stay(d) of anemia group and non-anemia group was 3 (2, 6) vs 2 (2, 3) and 19(13, 25) vs14(11, 18) respectively, P<0.05. 【Conclusion】 Preoperative anemia is an important factor affecting perioperative red blood cell transfusion in children with septal defect repair, and also an important reason for prolonging postoperative ICU stay and hospital stay.
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【Objective】 To retrospectively analyze the effect of AB platelet secondary compatible transfusion on the efficacy of matched platelet transfusion. 【Methods】 A total of 2 276 cases of platelet transfusion in our hospital were selected from November 2020 to September 2021, including 2 068 ABO matched platelet transfusions and 206 AB platelet secondary compatible transfusions. 117 cases were selected for the first occasion of AB platelet secondary compatible transfusion. The controls were matched transfusion receipts before given AB platelet secondary compatible transfusion, and the experimental group was given matched transfusion after AB platelet secondary compatible transfusion (take the first, second and third transfusion as group 1, 2 and 3, respectively). The platelet count(Plt), platelet elevation (△Plt) and 24 h Plt correction increase index (CCI) of patients before and after platelet transfusion were used as observation indexes to analyze the effect of AB type mis-matched platelet transfusion on the efficacy of matched platelet preventive transfusion by gender, blood type and disease type. 【Results】 Among the 2 276 platelet transfusions, and the △Plt of matched platelet transfusions was significantly higher than that of AB type secondary compatible transfusions, with the mean values at (14±15)×109/L and (11±14)×109/L(P<0.05). The △Plt of female patients was higher than that of male patients (15±16)×109/L vs (13±14)×109/L(P < 0.05). The △Plt values of MDS, NHL and MM were (9±14) ×109/L, (10±12) ×109/L and (8±11) ×109/L, respectively, which were significantly lower than the average value (P < 0.05). For 117 cases of AB platelet secondary compatible transfusion: the Δ Plt was significantly lower than that of the control group and the experimental group, respectively at (9±12) ×109/L, (13±13) ×109/L and (13±12) ×109/L(P<0.05). The effective rate of 24 h CCI was 52.14%, significantly lower than the control group and experimental group (71.59% vs 71.83%), P<0.05; no significant difference was noticed in △ Plt value and 24 h CCI between the experimental group and the control group(P>0.05). The △Plt of the experimental group 3 was significantly lower compared with the experimental group 1, (10±13) ×109/L vs (14±12) ×109/L, P<0.05, and the effective rate decreased from 73.12%(68/93)to 58.70%(27/46), P>0.05. No significant difference in △Plt and the number of effective 24 h CCI cases was found between the experimental group and the control group in terms of gender, blood type and disease type (P>0.05). 【Conclusion】 The △Plt and the effective rate of AB platelet secondary compatible transfusion were lower than those of matched platelet transfusions, and has no significant effect on short term(less than 10 days) matched platelet transfusion.
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【Objective】 To retrospectively analyze the safety and product quality of NGL XCF 3000 blood cell separator for collecting platelet-rich plasma (PRP) in 256 cases, so as to provide reference for safe collection and product quality control of PRP. 【Methods】 The data of 256 patients receiving PRP treatment in our hospital from June 2021 to June 2022 were statistically analyzed, and the differences in the collection time, circulating blood volume and the occurrence of adverse reactions to blood donation were analyzed when NGL XCF 3000 was used to collect autologous PRP among patients of different genders, ages and platelet counts. The differences in platelet content, red blood cell(RBC) contamination and white blood cell(WBC) residues in PRP products were analized. 【Results】 1) There were no significant differences in collection time, circulating blood volume and collection volume among patients of different genders, ages and platelet counts (P<0.05). 2) The contents of WBC, RBC and platelet were not significantly different between male and female patients after collection (P<0.05); 3) The WBC contents increased with the increase of age, and the WBC residue in the elder group[ 56 to78 years old, (0.64±0.41) ×109/L] was significantly higher than that in the younger group[group 1,18 to 40 years old, (0.50±0.35)×109/L], with significant difference was Statistically significant (P<0.05). 4) The residues of WBCs and RBCs in in low platelet group [group 1, (100-150)×109/L] were higher than those in other platelet count groups, and the difference was Statistically significant (P<0.05), and the platelet count in this product was significantly lower than that in other platelet count groups (P<0.05). Conclusion The NGL XCF 3000 blood cell separator is safe and stable for PRP collection in patients with different genders, ages and platelet counts of (100-450)×109/L, and the PRP products collected can meet clinical therapeutic needs.
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【Objective】 To retrospectively analyze the efficacy of low dose apheresis platelet prophylactic infusion and explore its feasibility. 【Methods】 A total of 392 inpatients with platelet transfusion in our hospital from November 2020 to September 2021 were selected. The conventional dose (1 therapeutic dose) of apheresis platelet transfusion was set as the control group, and the low dose (0.5 therapeutic dose) as the experimental group. Platelet count before and after infusion, platelet elevation value (△PLT) and 24 h platelet count correction increase index (CCI) were observed, and the efficacy of low-dose platelet infusion was analyzed by disease type and gender. 【Results】 The △PLT value and 24h CCI effective infusion rate in control group were higher than those in experimental group: (16±16) ×109 vs (7±10) ×109, 71.94% vs 60.46%, P<0.05. The △PLT value of the control group was about 1.2-3.5 times that of the experimental group, and the effective rate was about 1-1.4 times. In control group, the △PLT (×109) was AML (20±14) >AA (14±14) >ALL (13±12) >NHL (9±8) >MDS (7±6). In the experimental group, the △PLT (×109) was AA (11±18) >AML (8±8) >ALL (5±7) >NHL (5±7) >MDS (6±16). The 24h CCI was AML(163/188, 86.70%)>AA(23/32, 71.88%)>ALL(65/98, 66.33%)>MDS(9/17, 52.94%)>NHL(12/22, 51.55%) in the control group, and AML(133/188, 70.74%)>AA(19/32, 59.38%)>NHL(12/22, 51.55%)>ALL(47/98, 47.96%)>MDS(8/17, 47.06%) in the experimental group. The effective infusion rates of AML and ALL2 in the experimental groups were 70.74% (133/188) and 47.96% (47/98), respectively, significantly lower than 86.7% (163/188) and 66.33% (65/98) in the control group(P<0.05). No significant difference was noticed in the effective infusion rate between the experimental group and the control group for other diseases (P>0.05). 【Conclusion】 Low-dose apheresis platelet prophylactic infusion can alleviate the between supply shortage, with an effective infusion rate of 60.46% (236/392), which has certain clinical application value. Patients with AML, AA or ALL were recommended with low dose platelets, while patients with MDS and NHL were not recommended.
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【Objective】 To explore the clinical application of a universal platelet product for emergency, which was prepared by suspending O-type apheresis platelet concentrate in AB-type fresh frozen plasma, so as to improve the platelet support ability in emergency and special treatment. 【Methods】 A retrospective analysis of 21 hematological patients, which was divided into 3 groups of platelet transfusion schemes: universal type, AB type and the same type, was performed to analyze the differences in PLT, dose, 24 h PPR, 24 h CCI, follow-up platelet transfusion units and interval, and adverse reactions to transfusion. 【Results】 1)There was no significant difference in PLT, MPV, PDW, K, MA and pH between the initial O-type apheresis platelets and the finished universal platelets (P>0.05). The titers of both anti-A and anti-B in the universal platelets were less than 2. 2) Twenty-one patients were transfused with universal platelet for 27 occasions[1~5 occasions per person; 1 (0.4, 1.0) dose per time]. No adverse reactions to transfusion occurred. 3)There was no significant difference in the effective rate of 24 h CCI and 24 h PPR between the three groups after transfusion(P>0.05). The time interval of the first subsequent platelet transfusion between the compatible group and the universal group was longer than that in the AB-type transfusion group, with significant difference(P0.05) among three groups. 【Conclusion】 In emergency, the application of this universal platelet product can make hematological patients get timely and effective treatment. Its accessibility and effectiveness can be elevated and the infusion interval can be prolonged by improving the preparation method and storage conditions. This product is not only expected to improve the platelet support capacity for patients with emergency and also those undergoing hematopoietic stem cell transplantation during the blood type conversion period, but also may be a practical method to alleviate the contradiction between platelet supply and demand.
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【Objective】 To investigate the changes in peripheral blood routine in blood donors after multiple and frequent platelets donation. 【Methods】 A total of 228 voluntary blood donors who donated apheresis platelets for 5 or more times were selected. The results of peripheral blood routine testing before the first and most recent donation were collected. The data were analyzed in terms of blood donation volume, frequency of blood donation (total frequency/total months), and numbers of blood donation. 【Results】 1) There was statistical significance in the decrease of WBC counts when the accumulative volume of platelet donation >18 treatment doses and the number of blood donation >10 (P18, (P18 treatment doses, blood donation frequency ≥1, and the number of blood donation >18(P18 treatment doses (P0.05), and a significant lead in the Plt value of most recent donation was observed again until the blood donation volume reached ≥76 treatment doses (P1.4 and the number of blood donations≥40, the Plt value of the most recent donation was significantly higher than that of the first one(P18 treatment doses, blood donation frequency >1.4, and the number of donation >18, it is recommended to extend the donation interval and/or take iron supplements appropriately.
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Objective To analyze clinical significance of failure patterns and combined radiotherapy for advanced non-small cell lung cancer after EGFR-TKIs treatment.Methods A total of 111 patients who were treated with EGFR-TKIs for advanced non-small cell lung cancer (NSCLC) with EGFR exon mutation in Peking University Cancer Hospital from January 2009 to June 2013 were retrospectively analyzed.The impact of various failure patterns and combined radiotherapy on survial were analyzed with Kaplan-Meier method.Results Totally 111 patients were enrolled in the study.The median follow-up was 27.7 months (6.6-85.3 months).The median age,median PFS andmedian OS were 59 years (35-80 years old),10.3 months (6.2-30.5 months),and 29.8 months (7.1-90.7 months),respectively.The main failure mode was the progress of the original lesion (65 cases,58.6％) and the main failure site was the progress of intrathoracic lesions (57 cases,51.4％).The survival time of patients with oligoprogress (1-3 lesions during drug resistance) was significantly extended compared with the ones whose lesions were ≥ 4.The median OS were 32.5 months and 26.7 months,respectively (x2 =4.888,P＜0.05).For 43 patients with only intrathoracic progressed,there were 9 patients treated with radiotherapy and 34 patients treated without radiotherapy.The median PFS was 9.6 and 5.7 months,respectively.The median PFS of combined radiotherapy group was significantly prolonged (x2 =9.013,P＜0.05).And the median OS of retreatment after failure were 28.1 and 13.2 months,respectively,with no significant difference between two groups (P＞0.05).For 48 patients with oligo-progress,there were 12 patients treated with radiotherapy and 36 patients treated without radiotherapy.The median PFS were 9.6 and 4.2 months,respectively.The median PFS of the group treated with combined radiotherapy was significantly longer than that of the group without combined radiotherapy treatment (x2 =5.482,P＜0.05).And the median OS of retreatment after failure were 26.0 and 11.8 months,respectively.There was no significant difference between the two groups(P＞0.05).Conclusions Combined local radiotherapy can improve the PFS of patients who had only intrathoracic progress or oligo-progress after EGFR-TKIs treatment.Therefore,the patients whose T790 M mutation indicates negative or who are not in the position to perform coressoponding detection under the intrathoracic/oligo progress stage.The local intervention plays a very critical role for patients who have primary drug restisitance to GEN 1 EGFR-TKIs.
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Objective The aim of this study is to build a risk prediction model for the recurrence and metastasis of thoracic esophageal squamous cell carcinoma after radical surgery,and to analyze the factors affecting the disease free survival (DFS).Methods Conducted analysis of 1 191 patients with thoracic esophageal squamous cell carcinoma,who received radical resection from January 2007 to December 2011.The VaR boundary value of the risk prediction model was obtained by receiver operating characteristic (ROC) curve,and the boundary value was verified.The factors that affected DFS were analyzed by univariate analysis and Cox multiple factor prognosis analysis.Results There were 472 cases had recurrence and metastasis after treatment.There was a significant difference in VaR between patients with and without failure (t =-5.307,P ≤ 0.001).The VaR boundary value was 0.30 according to ROC curve analysis.The recurrence rate of the patients in the VaR ≤ 0.30 group was 27.5％,which was significantly lower than 48.2％ in the ≥0.30 groups (x2 =51.659,P ≤ 0.001).The univariate analysis showed that the patient's sex,the length of the lesion,the degree of tissue differentiation and the VaR value were all factors that significantly affected the recurrence and metastasis of the patients (x2 =13.460,21.111,17.540,39.175,P ≤0.001).Multivariate analysis showed that tissue differentiation and VaR were independent factors affecting recurrence and metastasis of patients (P ≤ 0.001).Conclusions The model can be applied to predict the recurrence and metastasis risk of patients with thoracic esophageal squamous cell carcinoma after radical surgery.
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Objective To analyze the treatment effect and influencing factors of salvage therapy for postoperative recurrence and metastasis patients with pT3N0M0 stage thoracic esophageal squamous cell carcinoma. Methods The clinical data of 174 postoperative recurrence and metastasis patients with pT3N0M0 stage thoracic esophageal squamous cell carcinoma from January 2008 to December 2011 were retrospectively analyzed. The location of recurrence or metastasis, effect of salvage therapy and influencing factors were specifically focused. Results The 1-, 3-and 5-year overall survival rates after recurrence and metastasis in patients with pT3N0M0 stage thoracic esophageal squamous cell carcinoma were 35.0% , 19.3% and 13.3% respectively, and the median survival time was 7 months (95% CI 5.2 to 8.8). Single factor analysis results showed that the gender, age, location of recurrence or metastasis, distant metastasis time and salvage therapy were related to the prognosis in postoperative recurrence and metastasis patients with pT3N0M0 stage thoracic esophageal squamous carcinoma (P＜0.05 or＜0.01), but the weight loss (≥ 5 kg), lesion extent, lesion location, number of lymph node dissection, postoperative adjuvant treatment method and intrathoracic recurrence time were not related to the prognosis in postoperative recurrence and metastasis patients with pT3N0M0 stage thoracic esophageal squamous carcinoma (P＞0.05). Multivariate analysis result showed that the distant metastasis time and salvage therapy were the independent risk factors of prognosis in postoperative recurrence and metastasis patients with pT3N0M0 stage thoracic esophageal squamous carcinoma (P＜0.01). Conclusions Salvage therapy and distant metastasis time are independent risk factors of prognosis in postoperative recurrence and metastasis patients with pT3N0M0 stage thoracic esophageal squamous carcinoma, and chemoradiotherapy or radiotherapy after postoperative recurrence and metastasis in some extent could prolong the survival time.
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Objective To compare the different goal-directed fluid therapy(GDFT)strategies on the recovery of tissue perfusion and postoperative recovery in patients undergoing hepatectomy. Methods Ninety patients undergoing hepatectomy with ASA physical status Ⅱor Ⅲ were divided into three groups based on fluid treatment by random number table method:control group(conventional fluid therapy), observation group Ⅰ(GDFT filled with colloi) and observation group Ⅱ(GDFT filled with crystalloids),with 30 cases in each group.The ScvO2,Lac and Glu were tested at 5 min before anesthesia induction(T1),5 min before hepatectomy(T2),5 min after hepatectomy(T3)and the end of operation(T4). The duration of operation,fluid requirement,urinary output, bleeding volume and the use of vasoactive agent were recorded. The exhaust time, ambulation time and postoperative hospital stay were recorded. Preoperative and postoperative liver and kidney function tests and postoperative complications were followed up.Results Compared with that in control group,the amount of crystalloids[(1408.5 ± 348.4) ml vs. (1 819.4 ± 315.1) ml],the amount of colloids [(468.6 ± 193.4) ml vs. (1 009.7 ± 440.9) ml],the total volume[(1 867.3 ± 370.4)ml vs.(2 821.3 ± 264.6)ml]were all lower,first flatus time[(51.8 ± 8.5)h vs.(63.6 ± 9.2) h], ambulation time [(3.4 ± 0.7) d vs. (4.3 ± 0.7) d] and postoperative hospital stay [(7.8 ± 1.7)d vs.(10.5 ± 2.9)d]were all shorter,ScvO2at T3,T4was higher,Lac at T2-T4were lower,Glu at T3,T4was lower, and ALT and AST on the third day and the fifth day after surgery were lower in observation groupⅠ(P<0.05).Compared with those in observation groupⅠ,the amount of crystalloids [(2 014.7 ± 388.2)ml vs.(1 408.5 ± 348.4)ml]was increased,and the incidences of postoperative nausea and vomiting[33.3%(10/30)vs.10.0%(3/30)]were significantly higher than those in observation groupⅡ(P<0.05). Conclusions GDFT using colloids in hepatectomy probably improves the microcirculation and tissue oxygenation, protects liver function, promotes gastrointestinal function recovery and shortens postoperative hospital stay. It has a much lower incidence of postoperative nausea and vomiting, compared with crystalloids.
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Objective To clarify the significance of chest radiotherapy in the treatment of oligometastatic stage Ⅳ non-small cell lung cancer ( NSCLC ) and to explore the optimal time of interventional therapy during chest radiotherapy. Methods A total of 192 patients with oligometastatic stage Ⅳ NSCLC admitted to Shanxi Provincial Cancer Hospital from 2008 to 2014 were randomly and evenly divided into the chemotherapy alone, radiotherapy+ early intervention, radiotherapy+ middle intervention and radiotherapy+ late intervention groups. Survival analysis was performed with Kanplan-Meier method. Results The median survival of 192 patients with oligometastatic stage Ⅳ NSCLC was 14. 50 months, and the 1-,2-and 3-year survival rates were 57. 4％,24. 0％ and 10. 7％, respectively. The median survivalin the chemotherapy alone, radiotherapy+ early intervention, radiotherapy+ middle intervention and radiotherapy+late intervention groups was 10,21,18 and 13 months, respectively. The 1-year survival rates were 34％, 73％,71％ and 51％,10％,40％,32％ and 13％ for the 2-year survival rates, and 0％,24％,16％ and 3％for the 3-year survival rates ( P=0. 000) . The median survival of patients with radiotherapy dose ≥ 60 Gy and< 60 Gy was 21 and 13 months, 76％ and 53％ for the 1-year survival rates, 34％ and 21％ for the 2-year survival rates, and 17％ and 10％ for the 3-year survival rates ( P=0. 002 ) . Conclusion Early interventional therapy and high-dose radiotherapy can improve the local control rate and prolong the survival time of patients with oligometastatic stage Ⅳ NSCLC.
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OBJECTIVE:To investigate the effects of dexmedetomidine on myocardial injury and postoperative cognitive function in patients with cardiopulmonary bypass(CPB)valve replacement. METHODS:A total of 90 patients underwent elective CPB valve replacement in our hospital during Jan. 2015-Dec. 2017 were divided into group C and group D according to random number table,with 45 cases in each group. Group D was given Dexmedetomidine hydrochloride injection 0.6 μg/kg after anesthesia induction and intravenous injection at 0.6μg/(kg·h)to the end of the operation;group C was given 0.9％ Sodium chloride injection at equal volume and rate. SBP,DBP,HR and MAP were observed in 2 groups immediately before medication (T0),immediately after medication (T1), immediately after incision (T2), immediately after sternotomy (T3), immediately before CPB (T4), immediately after CPB stopping(T5)and immediately after operation(T6),respectively. The levels of CK-MB,H-FABP and cTnⅠwere observed at T0,T5,T6,at 6 h(T7)and 24 h(T8)after operation. The levels of S-100β protein and NSE were observed at T0, T8 and 72 h after operation (T9). MMSE and MoCA scores were observed 1 d before operation and 3,7 d after operation. The application of cardiovascular active drugs and the occurrence of ADR were observed during operation. RESULTS:SBP and DBP of group C at T2-T6,SBP at T4-T6 and DBP at T4 of group D were significantly lower than at T0;SBP and DBP of group D were significantly higher than group C at T4-T6. HR of 2 groups at T4 were significantly lower than at T0,while those of 2 groups at T5-T6 were significantly higher than at T0;the group D were significantly lower than group C at T2-T3. MAP of 2 groups at T2-T3 were significantly higher than at T0,and those of group D were significantly higher than group C at T4,with statistical significance(P<0.05). At T5-T8,the levels of CK-MB,H-FABP and cTnⅠ in 2 groups were significantly higher than at T0;the levels of CK-MB and cTnⅠ at T7-T8,the level of H-FABP at T5-T8 ingroup D were significantly lower than group C,with statistical significance(P<0.05). At T8-T9,the levels of S-100β protein and NSE in 2 groups were significantly higher than at T0,but the group D was significantly lower than group C,with statistical significance(P<0.05). MMSE scores and MoCA scores of 2 groups 3 d after operation,MMSE score and MoCA score of group C 7 d after operation were significantly lower than 1 d before surgery;those of group D 3,7 d after operation were significantly higher than group C,with statistical significance(P<0.05). The amount of dopamine and norepinephrine,the rate of adrenalin use in group D were significantly lower than group C,with statistical significance (P<0.05). There was no statistical significance in the amount of milrinone between 2 groups (P>0.05). The incidence of ADR in group D (6.7％) was significantly lower than group C(24.4％), with statistical significance(P<0.05). CONCLUSIONS:Dexmedetomidine is helpful for hemodynamic stability,relieve myocardial damage,and improve postoperative cognitive dysfunction in patients with CPB valve replacement with good safety.
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Objective To investigate the factors associated with postoperative metastasis, recurrence, and survival in patients with stage ⅢA ( N2 ) non?small cell lung cancer ( NSCLC ) , and to provide an objective basis for postoperative radiotherapy in patients. Methods Clinical data were collected from 199 patients who underwent complete resection and were diagnosed with stage ⅢA ( N2 ) NSCLC after surgery in our hospital from 2009 to 2013. The Cox regression model was used for the multivariate analyses of metastasis and recurrence. The survival rates were calculated using the Kaplan?Meier method and analyzed using the log?rank test. Results In the 199 patients, 173 had complete follow?up data. The 1?and 2?year metastasis, recurrence, and survival rates were 38?7%/52?6%, 27?8%/39?1%, and 92?5%/51?4%, respectively. The multivariate analysis showed that pathological type and two positive indices among preoperative CEA/CY211/SCC were two risk factors for metastasis ( P=0?013,0?014) . Positive lymph node number, metastatic lymph node number, lymph node metastasis rate, and two positive indices among preoperative CEA/CY211/SCC were risk factors for recurrence ( P=0?046,0?004,0?028,0?001) . All the above indices were risk factors for low survival rates ( P= 0?013 , 0?011 , 0?002,0?026 ) . Conclusions Patients with stage ⅢA ( N2 ) NSCLC who have positive lymph nodes, lymph node metastases, and two positive indices among preoperative CEA/CY211/SCC may benefit from postoperative radiotherapy.
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Before and after treatment as well as before metastasis,the combined detection of progastrin-releasing peptide (ProGRP) and neuron-specific enolase (NSE) was performed in 150 patients with small cell lung cancer.The follow-up period was 1 year.Enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence immunoassay were conducted.The result showed a negative correlation between the serum levels of ProGRP and NSE the curative effect.And a positive correlation existed between the serum levels of ProGRP and NSE and disease development.The difference had statistical significance (P ＜ 0.05).The levels of ProGRP and NSE may be used to indicate the disease development and evaluate the curative effect.
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Objective To study the relation between kidney function impairment and respiratory tract infections(RTI) in the elderly.Methods Two hundred and twenty-four patients above 65 years old were divided into five groups according to stages of chronic renal disease and estimated glomerular filtration rate (e GFR):(A group,n =65):≥90 ml/(min · 1.73 m2),(B group,n =55):60-89 ml/(min · 1.73 m2),(C group,n =27):30-59 ml/(min · 1.73 m2),(D group,n =28):15-29 ml/(min · 1.73 m2) and(E group,n =49):＜ 15 ml/(min · 1.73 m2).Taking A group as the control baseline.Logistic regression was employed to analyze the relationship between kidney function and RTL Results Compare with A group(10.8％,7/65),the incidences of RTI in three groups(C group,D group and E group were 63.0％ (17/27),85.7％ (24/28) and 100％ (49/49) respectively.The incidence in these groups was higher than that in A group(x2 =26.95,49.46 and 89.00 respectively,P ＜ 0.05).We identified the risk factors with RTI were smoking (Waldx2 =17.66,P ＜ 0.01),respiratory underlying diseases(Waldx2 =14.38,P ＜0.01),invasive operation history(Waldx2 =4.50,P ＜ 0.05),diabetes (Waldx2 =3.86,P ＜ 0.05),stay in hospital for above 2 weeks (Waldx2 =18.18,P ＜ 0.01),Gender(Waldx2 =4.12,P ＜ 0.05),eGFR (Waldx2 =13.57,P ＜ 0.01).After adjusting for other risk factors of RTI,Logistic regression analysis showed that the risk of RTI still increased with the decrease of eGFR (eGFR≥90 ml/(min · 1.73 m2):(Waldx2 =0.053,P ＞0.05);60-89 ml/(min · 1.73 m2):(Waldx2 =0.046,P＞0.05) ;30-59 ml/(minl · 1.73 m2):(Waldx2 =7.61,P＜0.05),15-29 ml/(min · 1.73 m2):(Waldx2 =4.38,P＜0.05); ＜15 ml/(min · 1.73 m2):(Waldx2 =13.57,P＜0.01)).Conclusion Kidney function impairment in patients above 65 years old is an independent risk factor for RTI.
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Objective To study the correlation of the serum levels of pro-gastrin-releasing peptide (ProGRP) and neuro-specific enolase (NSE) with different treatments in limited-disease small cell lung cancer (L-SCLC) patients.Methods 150 L-SCLC patients were randomly divided into three groups including concurrent chemo-radiotherapy group,sequential chemo-radiotherapy group,and chemotherapy group.The serum levels of ProGRP and NSE were detected by enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence immunoassay before and after different treatments.The follow-up phase was 12 months.Results The serum levels of ProGRP and NSE were significantly decreased in all 3 groups after treatment (318.96,250.77,226.18 pg/ml and 31.72,23.95,17.89 μg/L),and the lowest level was observed in concurrent chemo-radiotherapy group,then the sequential chemo-radiotherapy group and chemotherapy group.The short term therapeutic effects were in the same sequence,and there was statistical significance between concurrent chemoradiotherapy group and chemotherapy (P ＜ 0.05).The decrease extent of ProGRP and NSE in effective cases (CR+PR) was significantly higher than that in failure cases in all 3 groups.The serum levels of ProGRP and NSE were increased with disease progress (P ＜ 0.05).Conclusion The serum levels of ProGRP and NSE can be used to reflect the patient' s condition and evaluate therapeutic effect in L-SCLC.The concurrent chemo-radiotherapy is more effective than sequential chemo-radiotherapy and chemotherapy only in L-SCLC.