ABSTRACT
Objective:To explore the analysis of staging alteration and prognosis of 8th edition of the American Joint Committee on Cancer (AJCC) staging update for breast cancer with different molecular subtypes.Methods:The clinical data of 965 breast cancer patients treated in Xijing Hospital from January 2011 to December 2017 were retrospectively collected, and 103 patients met the inclusion criteria. The staging results between all the patients and patients with 4 different molecular subtypes were compared according to the 7th and 8th edition of the AJCC. Fisher's exact test was used for staging differences, Kaplan-Meier was used for survival analysis, log-rank test was used to compare survival rates of different groups, the prognostic judgement efficacy and staging alteration for all patients and cases with different molecular subtypes in the 8th edition was also compared.Results:Compared with the 7th edition, a total of 52 cases (50.5%) had staging declined and 8 cases (7.8%) had staging risen in the 8th edition, and there was a statistically significant difference in composition change ( P < 0.05). There was no rise in staging for Luminal subtype patients, but the decline in 34 cases, with the decline rate of 87.2% (34/39); no rise in staging for patients of HER2 + subtype, but the decline in4 cases, with the decline rate of 19.0% (4/21). No rise in staging for triple positive subtype patients, but the decline in 14 cases, with the decline rate of 82.4% (14/17). Oppositely, for the patients with previous subtypes, no decline in staging of patients with triple negative subtypes, but the rise in 8 cases with the rise rate of 30.8% (8/26). The difference in all the above staging changes was statistically significant ( P = 0.001). According to the 7th edition of the AJCC, the disease-free survival (DFS) time of all the cases and Luminal subtype patients had no statistical differences among different staging groups ( P > 0.05), but according to the 8th edition of the AJCC, the differences were statistically significant ( P < 0.05). DFS time was shorten with the increase of staging, indicating that the 8th edition of staging could more accurately assess the prognosis of patients. Conclusions:Compared with the 7th edition of the AJCC, for the staging changes determined by the 8th edition of the AJCC, the proportion of staging declined in all the cases is significantly higher than that of staging risen, and patients with different molecular subtypes has different staging changes, among which the patients with the triple negative subtypes have staging risen and the rest have staging declined. The DFS analysis for all the patients and patients with Luminal subtypes indicates that the 8th edition of the AJCC staging is a more accurate predictor of prognosis compared with the 7th edition of the AJCC.
ABSTRACT
Objective To explore the application of propofol combined with small dose fentanyl in manual reduction anesthesia in orthopedics.MethodsOctober 2014 to August 2016 in Huzhou central hospital treated 120 cases of acute long bone closed fracture and ankle, shoulder dislocation and other patients, efficient analysis anesthesia, surgery time, patient recovery time, propofol is added volume and total volume, and detection 3min, 1min, 3min, 5min and waking SpO2, HR, MAP, RR values.After administration before it is administered.ResultsAnesthetic effect experimental group total efficiency is higher, the difference was statistically significant (P<0.05);after simultaneous administration of all patients 1min, 3min, 5min signs were lower than prodrug 3min signs, the difference statistically significant (P<0.05), after clear signs of its former administration 3min with no significant difference;experimental group recovery time, propofol bolus of propofol than with total control were lower, the difference was statistically significant (P<0.05);and the two groups were similar to the operation time, the difference was not statistically significant.ConclusionIn summary, propofol combined with entanyl anesthesia for patients to take the treatment of orthopedic manual reduction obviously.