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@#Objective To establish the gene-based esophageal cancer (ESCA) risk score prediction models via whole transcriptome analysis to provide ideas and basis for improving ESCA treatment strategies and patient prognosis. Methods RNA sequencing data of esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC) and adjacent tissues were obtained from The Cancer Genome Atlas database. The edgeR method was used to screen out the differential genes between ESCA tissue and normal tissue, and the key genes affecting the survival status of ESCC and EAC patients were initially identified through univariate Cox regression analysis. The least absolute shrinkage and selection operator regression analysis and multivariate Cox regression analysis were used to further screen genes and establish ESCC and EAC risk score prediction models. Results The risk score prediction models were the independent prognostic factors for ESCA, and the risk score was significantly related to the survival status of patients. In ESCC, the risk score was related to T stage. In EAC, the risk score was related to lymph node metastasis, distant metastasis and clinical stage. The constructed nomogram based on risk score showed good predictive ability. In ESCC, the risk score was related to tumor immune cell infiltration and the expression of immune checkpoint genes. However, this feature was not obvious in EAC. Conclusion 聽 聽The ESCC and EAC risk score prediction models have shown good predictive capabilities, which provide certain inspiration and basis for optimizing the management of ESCA and improving the prognosis of patients.
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Objective@#To identify the risk factors of failed observational treatment of traumatic hemothorax.@*Methods@#Clinical data of traumatic hemothorax combined with observational treatment were selected from the data of chest trauma cases admitted to the thoracic surgery department from January 2012 to December 2018. The treatment effect was analyzed, and the risk factors of failed observational treatment were analyzed by multivariate analysis.@*Results@#The total failure rate of observational treatment was 59.26%(32/54), and the details of hemothorax volume, length of stay in hospital, pneumothorax and patients with more than 3 rib fractures in the failed conservative treatment group were more than those in the successful treatment group(P<0.05). Independent risk factors of failed observational treatment were more than 3 rib fractures(OR=5.535, 95%CI: 1.065-28.754, P=0.042)and pneumothorax(OR=9.529, 95%CI: 1.988-45.580, P=0.005).@*Conclusion@#Pneumothorax and more than 3 rib fractures are the independent risk factors of failed observational treatment, and should be included in the observational treatment decision of traumatic hemothorax.
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Objective:To investigate the risk factors associated with the complications of video-assisted thoracic surgery (VATS) in the treatment of traumatic hemothorax.Methods:A retrospective case-control study was conducted to analyze the clinical data of 94 patients with traumatic hemothorax undergone VATS treatment in Tangdu Hospital of Air Force Medical University from January 1, 2012 to December 31, 2018. There were 75 males and 19 females, aged from 15-78 years [(45.8±14.6)years]. Postoperative complications occurred in 12 patients (complication group) and not in 82 patients (non-complication group). The following data were analyzed for complication-related risk factors using univariate analysis and Logistic regression analysis, including gender, age, mechanism of injury, pneumothorax and hemothorax, number of fractured ribs, abbreviated injury score (AIS), injury severity score (ISS), time from injury to operation, operation time, rib fixation or not, pulmonary air leakage or not, duration of drainage, postoperative volume of drainage, and postoperative length of hospital stay.Results:The proportion of patients with time from injury to operation (>3 days), duration of drainage and postoperative length of hospital stay in complication group [75%(9/12), (7.8±2.6) days, (10.2±2.7)days] were significantly higher or longer than those in non-complication group [37%(30/82), (5.5±1.6)days, (8.0±2.3)days] ( P<0.05 or 0.01). There were no statistically significant differences between the two groups in gender, age, mechanism of injury, pneumothorax and hemothorax conditions, number of fractured ribs (≥3), AIS, ISS, operation time, rib fixation or not, pulmonary air leakage or not and postoperative volume of drainage ( P>0.05). Logistic regression analysis showed time from injury to operation (>3 days) and pulmonary air leakage were significantly associated with the complications of VATS ( P<0.05). Conclusion:Time from injury to operation (>3 days) and pulmonary air leakage are independent risk factors for the complications of VATS in the treatment of traumatic hemothorax.
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Objective:To identify the risk factors of failed observational treatment of traumatic hemothorax.Methods:Clinical data of traumatic hemothorax combined with observational treatment were selected from the data of chest trauma cases admitted to the thoracic surgery department from January 2012 to December 2018. The treatment effect was analyzed, and the risk factors of failed observational treatment were analyzed by multivariate analysis.Results:The total failure rate of observational treatment was 59.26%(32/54), and the details of hemothorax volume, length of stay in hospital, pneumothorax and patients with more than 3 rib fractures in the failed conservative treatment group were more than those in the successful treatment group( P<0.05). Independent risk factors of failed observational treatment were more than 3 rib fractures( OR=5.535, 95% CI: 1.065-28.754, P=0.042)and pneumothorax( OR=9.529, 95% CI: 1.988-45.580, P=0.005). Conclusion:Pneumothorax and more than 3 rib fractures are the independent risk factors of failed observational treatment, and should be included in the observational treatment decision of traumatic hemothorax.
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Traumatic hemothorax is a common disease in chest trauma .If it is not treated properly and effectively , it will lead to continuous blood loss, clotted hemothorax, empyema and other life-threatening conditions.Because of no universally ac-cepted guide or consensus in the treatment of traumatic hemothorax , clinicians often choose different ways to treat different de-grees and types of traumatic hemothorax according to their habits and experience .This article focus on recent studies on the treatment of traumatic hemothorax , summarize the latest achievements in the field of traumatic hemothorax , provide evidence for clinicians'clinical decision-making, and find the current insufficiency of traumatic hemothorax and the direction for further re-search.
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Objective To assess the effect of anticoagulant drugs,elastic compression stockings(ECS)and(Daflon) on the prevetion of the post-thrombotic syndrome(PTS).Methods Fifty-eight deep venous(thrombosis)(DVT) patients were divided into control group and treatment group I and II.The control group (n=15) did not take anticoagulant drugs or the time of anticoagulant drug administration was less than 1 month,and the use of(ECS) was less than 3 months.The treatment group I(n=24) took warfarin for 6 months and the ECS were used in the follow-up time;the treatment group II(n=19),besides warfarin therapy and ECS,took Daflon for 12 months.All the patients were followed up,the general conditions were assessed with clinical score,and the therapeatic results of the 3 groups were assessed.Results The rate of PTS occurrence in control group was significantly higher than that in treatment group 1 and treatment group 2.At 6 months,the clinical score of treatment groups 1 and 2 was significantly lower than that of control group.At 1 and 1.5 years after discharge,the clinical score of treatment group 2 was significantly lower than that of treatment group 1.Conclusions The long-term comprehensive and systemic therapy(including warfarin,ECS and daflon) for DVT could prevent PTS.