ABSTRACT
Objective:To evaluate the diagnostic efficiency and safety of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)in lymph node staging of non-small cell lung cancer(NSCLC)in elderly patients.Methods:Thirty-five patients aged ≥70 years and 58 patients aged 60-69 years with NSCLC receiving EBUS-TBNA in our hospital from March 2015 to December 2018 were enrolled.All patients underwent EBUS for all visible mediastinal and hilar lymph nodes, and those with enlarged lymph nodes(short axis ≥6 mm)were further examined with TBNA.The diagnostic efficiency and safety of EBUS-TBNA were analyzed.Results:The sensitivity of EBUS-TBNA was 0.94, the specificity was 1.00, the Yoden index was 0.94, the positive predictive value was 1.00, and the negative predictive value was 0.82.Tumor staging was changed in 20 patients after EBU-TBNA, resulting in changes in assessment on tumor resectability in 5 cases.EBUS-TBNA had excellent agreement with postoperative pathology in evaluating resectability(Kappa=0.95). The sensitivity and specificity were 1.00 and 0.97, respectively.The incidence of complications of EBUS-TNBA was 6.5%.The elderly group had a worse performance status( P<0.05)compared with the control group, but the complication rates(5.7% vs 6.9%, P>0.05)were similar between the two groups. Conclusions:EBUS-TBNA is highly effective and safe in the diagnosis of NSCLC in patients aged 70 and older.
ABSTRACT
Objective To examine the dose-response relationship between gestational weight gain rate and the neonate birth weight.Methods A total of 18 868 women with singleton gestations who delivered between January 2006 and December 2013 were included in this study.Maternal and neonate details of these women were drawn from the Perinatal Monitoring System database.Gestational weight gain rate was defined as the total weight gain during the last and first prenatal care visits divided by the interval weeks.Both Multiple logistic regression analysis and restricted cubic spline methods were performed.Confounding factors included maternal age,education,pre-pregnancy body mass index (BMI),state of residence,parity,gestational weeks of prenatal care entry,and sex of the neonate.Results The adjusted odds ratio for macrosomia was associated with gestational weight gain rate in lower pre-pregnancy BMI (OR=3.15,95％CI:1.40-7.07),normal (OR=3.64,95％CI:2.84-4.66) or overweight (OR=2.37,95％CI:1.71-3.27).The odds ratios of low birth weight appeared a decrease in those women with lower pre-pregnancy BMI (OR=0.28,95％CI:0.13-0.61) while the normal weight (OR=0.37,95％CI:0.22-0.64) group with gestational weight gain,the rate showed an increase.Association of gestational weight gain rate for macrosomia was found a S-curve in those term delivery women (non-linearity test P＜0.000 1).However,L-curve was observed for low birth weight and gestational weight gain rate in term births (non-linearity test P＜0.000 1).Conclusion A S-curve was seen between gestational weight gain rate and term delivered macrosomia while L-curve was observed among term delivered low birth weight neonates.