ABSTRACT
Objective:To investigate the expression level of miR-21 in patients with septic acute respiratory distress syndrome, and analyze its correlation with inflammatory factors and its value in evaluating clinical prognosis.Methods:Patients with sepsis admitted to the intensive care unit (ICU) of the First Affiliated Hospital of Hebei North University from October 2020 to March 2022 were prospectively recruited. The patients were divided into an ARDS group and a non-ARDS group according to whether ARDS occurred within 3 days after admission. The ARDS group was divided into a low-risk group and a high-risk group according to the oxygenation index, and the ARDS group was divided into a survival group and a death group according to their 28-day survival status. In addition, 50 healthy volunteers who underwent physical examination during the same period were included in the control group. The expression levels of serum miR-21 and inflammatory factors [tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6)] were compared in each group at admission. To analyze the relationship between miR-21 expression and inflammatory factors and explore the value of miR-21 in predicting the prognosis of sepsis patients with ARDS.Results:A total of 106 patients with sepsis were included. Compared with the healthy control group, the levels of serum miR-21, TNF-α and IL-6 in the ARDS group and non-ARDS group were significantly increased (all P<0.05). Compared with the low-risk group, the levels of serum miR-21, TNF-α and IL-6 in the high-risk group were significantly increased (all P<0.05). Compared with the survival group, the serum miR-21 expression level and TNF-α and IL-6 levels in the death group were significantly increased (all P<0.05). Pearson correlation analysis showed that the serum miR-21 expression level in the ARDS group was positively correlated with IL-6 and TNF-α levels ( r=0.842, 0.697, P<0.001). ROC curve analysis showed that the AUC of serum miR-21 in predicting death from sepsis complicated with ARDS was 0.876 (95% CI: 0.761-0.942), the best cut-off value was 2.25, and its sensitivity and specificity were 92.9% and 71.7%, respectively. Conclusions:The expression level of serum miR-21 is significantly increased in patients with sepsis ARDS, is positively correlated with the level of inflammatory factors, is closely correlated with the severity and prognosis of the disease, and has great value in evaluating the prognosis of patients with sepsis ARDS.
ABSTRACT
OBJECTIVE@#To investigate the prognostic value of serum and cerebrospinal fluid β2-microglobulin (β2-MG) in acute lymphoblastic leukemia (ALL) with central nervous system invasion after chemotherapy.@*METHODS@#40 patients with leukemia who had been confirmed to have central nervous system infiltration were selected for treatment at the Second Affiliated Hospital of Chongqing Medical University from January 2015 to May 2017, and the serum levels of β2-MG and CSF-β2MG were dynamically monitored and performed statistical analysis.@*RESULTS@#After chemotherapy, the changes in serum β2-MG were not statistically significant (P>0.05); the absolute level of CSF-β2MG and the percentage of relative baseline changes were statistically different in different clinical outcome groups(P<0.05), and the decreasing CSF-β2MG levels suggest a better prognosis, with cut-off values of 1.505 and -25%, respectively.@*CONCLUSION@#The best cut-off point may be a predictor of complete remission; the reduction of the absolute and relative levels of CSF-β2MG can suggest a good prognosis for patients.
Subject(s)
Humans , Central Nervous System , Cerebrospinal Fluid , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Prognosis , Remission Induction , beta 2-MicroglobulinABSTRACT
Objective:To explore the effect of pediatric critical illness score (PCIS), pediatric risk of mortality Ⅲ score (PRISM Ⅲ), pediatric logistic organ dysfunction 2 (PELOD-2), pediatric sequential organ failure assessment (p-SOFA) score and Glasglow coma scale (GCS) in the prognosis evaluation of septic-associated encephalopathy (SAE).Methods:The data of children with SAE admitted to the Pediatric Intensive Care Unit (PICU), Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences from January 2010 to December 2020 were retrospectively analyzed. They were divided into the survival and death groups according to the clinical outcome on the 28th day after admission. The efficiency of PCIS, PRISM Ⅲ, PELOD-2, p-SOFA and GCS scores for predicting death were evaluated by the area under the ROC curve (AUC). The Hosmer-Lemeshow goodness-of-fit test assessed the calibration of each scoring system.Results:Up to 28 d after admission, 72 of 82 children with SAE survived and 10 died, with a mortality rate of 12.20%. Compared with the survival group, the death group had significantly lower GCS [7 (3, 12) vs. 12 (8, 14)] and PCIS scores [76 (64, 82) vs. 82 (78, 88)], and significantly higher PRISM Ⅲ [14 (12, 17) vs. 7 (3, 12)], PELOD-2 [8 (5, 13) vs. 4 (2, 7)] and p-SOFA scores [11 (5, 12) vs. 6 (3, 9)] ( P<0.05). The AUCs of PCIS, PRISM Ⅲ, PELOD-2, p-SOFA and GCS scores for predicting SAE prognosis were 0.773 ( P=0.012, AUC>0.7), 0.832 ( P=0.02, AUC>0.7), 0.767 ( P=0.014, AUC>0.7), 0.688 ( P=0.084, AUC<0.7), and 0.692 ( P=0.077,AUC<0.7), respectively. Hosmer-Lemeshow goodness-of-fit test showed that PCIS ( χ2=5.329, P=0.722) predicted the mortality and the actual mortality in the best fitting effect, while PRISM Ⅲ ( χ2=12.877, P=0.177), PELOD-2 ( χ2=8.487, P=0.205), p-SOFA ( χ2=9.048, P=0.338) and GCS ( χ2=3.780, P=0.848) had poor fitting effect. Conclusions:The PCIS, PRISM Ⅲ and PELOD-2 scores have good predictive ability assessing the prognosis of children with SAE, while the PCIS score can more accurately evaluate the fitting effect of SAE prognosis prediction.
ABSTRACT
Objective:To investigate the differential expression of microRNA (miR)-214-3p in plasma exosomes in different types of uveal melanoma (UM) and evaluate whether miR-214-3p is a potential molecular biomarker for the diagnosis and prognosis of UM.Methods:Twenty-five UM in situ patients who received the enucleation of eyeball were enrolled at Beijing Tongren Hospital from December 2015 to October 2019, including 10 with epithelioid cell melanoma and 10 with spindle cell melanoma as well as 5 metastatic UM patients (1 with spindle cell-like melanoma and 4 with epithelioid cell-like melanoma) and 10 healthy subjects were enrolled during the same period.Blood sample was collected from all the subjects for the isolation of plasma exosomes.The morphology of exosomes was examined under the electron microscope.The exsomal marker proteins were identified by Western blot.The expression level of miR-214-3p in plasma exosomes was detected by real-time fluorescence quantitative PCR.The differential expression of miR-214-3p among different types of UM patients and healthy controls was compared.The diagnostic and classification performance of exosomal miR-214-3p was evaluated using receiver operating characteristic curve.Written informed consent was obtained from each subject prior to entering the study cohort.This study protocol was approved by an Ethics Committee of Capital Medical Univeristy (No.TRECKY2018-056).Results:The isolated exosomes were hemispherical in shape with a concavity on one side.The diameter of the exosomes was about 100 nm and the particle diameter of vesicles from samples was (82.0±2.7) nm.TSG101 protein was detectable and Calnexin protein was not found in the exosomes.The relative expression levels of plasma exosomal miR-214-3p in healthy control group, in situ UM group and metastatic UM group were 0.86(0.57, 1.49), 0.24(0.10, 0.67), and 0.43(0.23, 0.56), respectively.The miR-214-3p relative expression level in plasma exosomes of in situ UM patients and metastatic UM patients was significantly lower than that of healthy controls, and the differences were statistically significant ( Z=2.62, P<0.01; Z=2.08, P<0.05). The relative expression levels of exosomal miR-214-3p in spindle cell-like UM group and epithelioid cell-like UM group were 0.11(0.07, 0.64) and 0.46(0.14, 0.91), respectively, and no significant difference was found in the expression level of plasma exosomal miR-214-3p among different types of UM (all at P>0.05). The area under the curve of plasma exosomal miR-214-3p for UM diagnosis was 0.795. Conclusions:Plasma exosomal miR-214-3p level is significantly reduced in both in situ UM patients and metastatic UM patients.Plasma exosomal miR-214-3p is a new potential diagnostic biomarker for UM, but the exosomal miR-214-3p appears to not be able to distinguish the types of UM.
ABSTRACT
@#[Abstract] Objective: This study aimed at investigating the epigenetic regulation mechanism of abnormally low expression of SHP-1 gene in esophageal squamous cell carcinoma (ESCC). Methods:Atotal of 71 cases of ESCC tissues and corresponding para-cancer tissues(2 cm from the edge of the cancer) resected during surgery at the Department of thoracic surgery of Hebei Province, the Fourth Hospital of Hebei Medical University from 2008 to 2011 were collected for this study. The expression level of SHP-1 mRNA and protein was detected in esophageal cancer cell lines (Eca109, Kyse170, Yes-2) before and after 5-Aza-dC or TSA treatment by RT-qPCR and Western blotting methods respectively. The methylation status of CpG sites in promoter region of SHP-1 was analyzed by bisulfite genome sequencing (BGS) in three esophageal cancer cell lines before and after 5-Aza-dC treatment. The methylation status of SHP-1 was studied by methylation-specific polymerase chain reaction (MSP) method in esophageal cancer cell lines, ESCC tissues and para-cancer tissues. The association between the SHP-1 promoter methylation status and clinic pathological parameters were analyzed in ESCC patients. Dual-luciferase reporter assay systems method was applied to detect the impacts of methylation status of CpG island in SHP-1 promoter region on gene transcription activity. For prognostic analysis of SHP-1 methylation, survival curves were constructed using the Kaplan-Meier method and the log-rank. Results: After treated with 5-Aza-dC, the expression level of SHP-1 mRNA and protein was significantly up-regulated in Eca109, Kyse170 and Yes-2 cells, meanwhile the methylation status of SHP-1 was decreased (P<0.05). The expression level of SHP-1 had no obviously change after treated with trichostatin A(TSA). The methylation frequency of promoter in ESCC tumor tissues was significantly higher than that in corresponding para-cancer tissues (P<0.05). When stratified for clinic pathologic characteristics, methylation frequency of SHP-1 was associated with TNM stage, pathological differentiation, and LN metastasis (P<0.05). The mRNAexpression level of SHP-1 in the ESCC tissues with SHP-1 methylation was significantly decreased compared to the ESCC tissues with unmethylation of SHP-1 (P<0.05). It was associated with methylation of promoter (P<0.05). The activity of fluorescein reporter vector in methylase treatment group was significantly lower than that in untreated group (P<0.05), indicating that SHP-1expression can be silenced by methylation of SHP-1 promoter. The result of Kaplan-Meier shown that SHP-1 promoter methylation was correlated with ESCC patients’poor survival. Conclusion: The transcriptional activity of SHP-1 can be inhibited with hypermethylated SHP-1 promoter region. The hypermethylated SHP-1 promoter induced the silencing of SHP-1. Therefore, SHP-1 gene may serve as one of prognostic methylation biomarkers for ESCC patients.
ABSTRACT
Tumor-node-metastasis (TNM) staging system is the most important basis for making therapeutic decisions and predicting prognosis of lung cancer patients. The metabolic parameters including standardized uptake value (SUV), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) measured by ¹⁸F-fluorodeoxyglucose-positron emission tomography (¹⁸F-FDG PET/CT) associate with tumor aggressiveness and can provide additional prognostic information. A new staging methodology combines the conventional cTNM with the metabolic tumor burden quantified from the PET images is a better predictor of overall survival with superior stratifying power may help oncologists to make better treatment plans. ¹⁸F-FDG PET/CT image texture analysis, as an emerging research tool, is used to quantify the spatial heterogeneity of radioactive uptake in tumors, thereby to explore the biological characteristics of the tumor. This article reviews developments in evaluating the ¹⁸F-FDG PET/CT metabolic parameters and its role as a prognostic factor for non-small cell lung cancer. .
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung , Diagnostic Imaging , Metabolism , Fluorodeoxyglucose F18 , Image Processing, Computer-Assisted , Lung Neoplasms , Diagnostic Imaging , Metabolism , Positron Emission Tomography Computed Tomography , Methods , PrognosisABSTRACT
Objective: To explore the clinical characteristics, the diagnostic framework, and the treatment methods of B cell lymphoblastic lymphoma (B-LBL), and to clarify the progress of diagnosis and treatment of B-LBL to improve the clinician's understanding of the disease and provide the guidance for prognostic evaluation and therapeutic options. Methods: The clinical data including symptoms, physical signs, ancillary testings, diagnosis, treatment and disease prognosis of a child suffered from B-LBL were retrospectively analyzed; in the meantime, the relative literatures were reviewed. Results: The patient was definitly diagnosed as B-LBL according to the clinical characteristics and received combination therapy with vincristine, daunorubicin, L-asparaginase, and prednisone as the first course, along with the intrathecal injection of methotrexate and dexamethasone to prevent central nervous system leukemia (CNS-L). The patient achieved complete remission (CR) 25 d after the first circle chemotherapy but was diagnosed as degree 4 myelosuppression. Therefore, the second cycle combination therapy was adjusted with cyclophosphamide, cytarabine and 6-MP, and the intrathecal injection to prevent CNS concomitantly. Degree IV myelosuppression appeared repeatedly after 2 cycles and the combination chemotherapy was reajdusted. So mercaptopurine and high dose of methotrexate were given as the 4th cycle, and CNS was prevented continously. The patient kept CR until the second cycle finished but get recurrence after the third chemotherapy (prolymphocytes 10%). Then remission and recurrence were found in the disease counrse during which Mary chemotherapy methods were attempted until the patient got stable CR after treatment for 31 months. Then the patient was treated with oral mercaptopurine (50 g · d-1) and methotrexate 25 mg per week) and kept disease-free survival for more than 3 years. Conclusion: B-LBL is a rapidly developed disease with the bone marrow involvement occurring in the short term and easy to relapse during treatment. However, it is extremely easy to transform to recurrent and refractory B-LBL after the first remission. It is of great importance to estimate the risk stratification and to evaluate the prognosis of LBL patients in order to treat as soon as possible for the improvement of one's life quality and the prolongation of survival.
ABSTRACT
18F-fluoro-deoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) has been used as a crucial imaging modality for staging and prognosis evaluation in the patients with lymphoma. Since biological characteristics, treatment responses and prognosis vary in different subtypes of lymphoma, this review mainly focused on progress of 18F-FDG PET/CT evaluation in prognosis of Hodgkin lymphoma (HL) and diffused large B-cell lymphoma (DLBCL). The significance in prognostic evaluation of interim 18F-FDG PET/CT in HL is well-known, but it still remains controversy in DLBCL. Moreover, the semi-quantitative method of 18F-FDG PET/CT evaluation in lymphoma has bright future.
ABSTRACT
@#Objective: To investigate the role of LncRNA RP11-513G11.1 in the chemoresistance and evaluation of prognosis in small cell lung cancer (SCLC). Methods: From June 2012 to June 2017，98 cases of SCLC tissue, 30 cases of paracancerous tissue and 30 cases of normal lung tissue were performed by surgery, puncture biopsy or bronchoscopic biopsy from the Affiliated Hospital of Southwest Medical University. QRT-PCR was used to detect the expression of LncRNA RP11-513G11.1 in SCLC tissue, paracancerous tissue, normal lung tissue and SCLC sensitive cell strain H69, drug resistance cell strain H69AR.All patients received EP regimen (etoposide+cisplatin). According to their chemosensitivity, they were divided into chemosensitivity group and drug resistance group. The expression of LncRNA RP11-513G11.1 in two groups was detected. The relationship between RP11-513G11.1 expression and prognosis, survival time and risk factors of OS in patients were analyzed. Results: The expression of LncRNA RP11-513G11.1 in H69AR chemoresistant cells (13.790±2.830) was significantly higher than that in H69AR chemosensitive cells (1.080±0.090) (P<0.01),the expression level of LncRNA RP11-513G11.1 in SCLC tissues (8.558±1.130) was significantly higher than that in adjacent tissues (1.188±0.090) and normal lung tissues (1.636±0.150) (all P<0.01), the expression of RP11-513G11.1 in chemoresistant patients was significantly higher than that in chemosensitive patients (4.974±0.313) (P<0.01). The expression of RP11-513G11.1 was not related to gender and age, but was related to disease stage, lymph node metastasis, distant metastasis and chemotherapy resistance in SCLC patients (all P<0.05); High expression RP11-513G11.1 patients was shorter PFS [(12.59 ±2.08) months] and OS [(24.98 ±1.56) months] than those with low expression [(25.47±1.23) months] and [(39.03±2.67) months] (P<0.01). Univariate and multivariate analysis showed that RP11513G11.1 expression, disease stage and distant metastasis were independent prognostic risk factors for SCLC patients (all P<0.05). Conclusion: LncRNARP11-513G11.1 may be a potential biomarker of chemosensitivity and prognosis in SCLC patients.
ABSTRACT
Objective:To explore the clinical characteristics,the diagnostic framework,and the treatment methods of B cell lymphoblastic lymphoma(B-LBL),and to clarify the progress of diagnosis and treatment of B-LBL to improve the clinician's understanding of the disease and provide the guidance for prognostic evaluation and therapeutic options.Methods:The clinical data including symptoms,physical signs,ancillary testings,diagnosis, treatment and disease prognosis of a child suffered from B-LBL were retrospectively analyzed;in the meantime,the relative literatures were reviewed.Results:The patient was definitly diagnosed as B-LBL according to the clinical characteristics and received combination therapy with vincristine,daunorubicin,L-asparaginase,and prednisone as the first course,along with the intrathecal injection of methotrexate and dexamethasone to prevent central nervous system leukemia(CNS-L).The patient achieved complete remission(CR)25 d after the first circle chemotherapy but was diagnosed as degree 4 myelosuppression.Therefore,the second cycle combination therapy was adjusted with cyclophosphamide,cytarabine and 6-MP,and the intrathecal injection to prevent CNS concomitantly.DegreeⅣ myelosuppression appeared repeatedly after 2 cycles and the combination chemotherapy was reajdusted. So mercaptopurine and high dose of methotrexate were given as the 4th cycle,and CNS was prevented continously. The patient kept CR until the second cycle finished but get recurrence after the third chemotherapy(prolymphocytes 10%).Then remission and recurrence were found in the disease counrse during which mary chemotherapy methods were attempted until the patient got stable CR after treatment for 31 months.Then the patient was treated with oral mercaptopurine(50 g·d-1)and methotrexate(25 mg per week)and kept disease-free survival for more than 3 years.Conclusion:B-LBL is a rapidly developed disease with the bone marrow involvement occurring in the short term and easy to relapse during treatment.However,it is extremely easy to transform to recurrent and refractory B-LBL after the first remission.It is of great importance to estimate the risk stratification and to evaluate the prognosis of LBL patients in order to treat as soon as possible for the improvement of one's life quality and the prolongation of survival.
ABSTRACT
Myelodysplastic syndromes (MDS) characterized by the presence of ineffective hematopoiesis and an increased risk of transformation to acute myeloid leukemia (AML), is a group of clonal disorders deriving from the hematopoietic stem/progenitor cells. The 59th American Society of Hematology (ASH) Annual Meeting introduced detailed reports on disease genes, the molecular mechanism, therapeutic targets, new drugs and clinical research of MDS. Combined with reports in the 59th ASH Annual Meeting, this article summarizes the latest progress of the related diseases features and prognostic evaluation of MDS.
ABSTRACT
Objective:To investigate the prognostic significance of high sensitivity-C reactive protein (Hs-CRP) in patients with peripher-al T-cell lymphoma (PTCL). Methods:A total of 234 newly diagnosed PTCL patients with a median age of 48 years were analyzed retro-spectively. Serum Hs-CRP levels and other factors, including tumor stage and international prognostic index (IPI), were determined. Af-ter a median follow-up of 23 months, the relationship between Hs-CRP and overall survival (OS) was observed. Results:Serum Hs-CRP level positively correlated with IPI score (r=0.132, P<0.001), tumor stage (r=0.183, P=0.005), B symptoms (r=0.225, P=0.001), and lactic dehydrogenase (r=0.169, P=0.009), but negatively correlated with plasma albumin levels (r=?0.343, P<0.001), hemoglobin concentra-tion (r=?0.239, P<0.001), and platelet count (r=0.131, P=0.045), and is uncorrelated with age (P>0.05), gender (P>0.05), fitness score (P>0.05), and leukocyte count (P>0.05). Patients with serum Hs-CRP levels≤10 mg/L had better OS than patients with serum Hs-CRP levels>10 mg/L. Univariate and multivariate Cox regression models showed that platelet count, Hs-CRP, albumin levels, and IPI score were independent adverse prognostic factors. Conclusion:The baseline Hs-CRP level can serve as a major indicator of prognosis in PT-CL patients.
ABSTRACT
Objective:To investigate the prognostic significance of high sensitivity-C reactive protein (Hs-CRP) in patients with peripher-al T-cell lymphoma (PTCL). Methods:A total of 234 newly diagnosed PTCL patients with a median age of 48 years were analyzed retro-spectively. Serum Hs-CRP levels and other factors, including tumor stage and international prognostic index (IPI), were determined. Af-ter a median follow-up of 23 months, the relationship between Hs-CRP and overall survival (OS) was observed. Results:Serum Hs-CRP level positively correlated with IPI score (r=0.132, P<0.001), tumor stage (r=0.183, P=0.005), B symptoms (r=0.225, P=0.001), and lactic dehydrogenase (r=0.169, P=0.009), but negatively correlated with plasma albumin levels (r=?0.343, P<0.001), hemoglobin concentra-tion (r=?0.239, P<0.001), and platelet count (r=0.131, P=0.045), and is uncorrelated with age (P>0.05), gender (P>0.05), fitness score (P>0.05), and leukocyte count (P>0.05). Patients with serum Hs-CRP levels≤10 mg/L had better OS than patients with serum Hs-CRP levels>10 mg/L. Univariate and multivariate Cox regression models showed that platelet count, Hs-CRP, albumin levels, and IPI score were independent adverse prognostic factors. Conclusion:The baseline Hs-CRP level can serve as a major indicator of prognosis in PT-CL patients.
ABSTRACT
Objective To investigate the prognostic value of oxygen challenge test (OCT) for patients with cardiogenic shock receiving extracorporeal membrane oxygenation (ECMO). Methods A retrospective analysis was conducted. Seventy-eight patients diagnosed with cardiogenic shock receiving veno-arterial (V-A) ECMO admitted to Department of intensive care unit (ICU) of Wuxi People's Hospital Affiliated to Nanjing Medical University from June 2012 to May 2017 were enrolled. Ten-minute OCT was implemented by transcutaneous oximetry at 6 hours after ECMO initiation. The basic data of patients (gender, age, primary disease); the acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, left ventricular ejection fraction (LVEF), mean arterial pressure (MAP) at the start of ECMO treatment; arterial blood gas analysis index, dose of vasoactive agents, transcutaneous oxygen pressure (PtO2), 10-minute OCT value (OCT10), oxygen challenge index (OCI) at 6 hours after ECMO initiation; and the ECMO support time, duration of mechanical ventilation and its parameters, and application of intra-aortic balloon pump (IABP) within 60 days were recorded. Patients were divided into the survival group and the death group according to their 60-day mortality status, and the differences between the two groups were compared. Receiver operating characteristic curve (ROC) analysis was used to analyze the prognostic value of OCT10 and OCI. According to the best boundary value of OCT10and OCI, Kaplan-Meier survival curve was drawn and the 60-day cumulative survival rate was compared. The risk factors affecting prognosis were analyzed by multivariate Logistic regression. Results Sixty-seven patients were finally enrolled in the study, with 31 in the survival group and 36 in the death group. Compared with the survival group, APACHE Ⅱ score, SOFA score, use of IABP in death group were higher, PtO2, OCT10and OCI were lower, and duration of ECMO and ventilation were longer, but there was no significant difference in gender, age, primary disease, LVEF, MAP, ventilator settings, dose of vasoactive agents, or results of arterial blood gas between the two groups. OCT10, OCI, APACHE Ⅱ score and SOFA score were predictive values for 60-day deaths, and the area under ROC curve (AUC) of OCT10was 0.866±0.042 [95% confidence interval (95%CI) = 0.760-0.937], the AUC of OCI was 0.829±0.051 (95%CI = 0.717-0.910), the AUC of APACHE Ⅱ score was 0.860±0.043 (95%CI = 0.754-0.933), and the AUC of SOFA score was 0.821±0.049 (95%CI = 0.708-0.904) (all P < 0.01). The cut-off point for OCT10was ≥70.0 mmHg (1 mmHg = 0.133 kPa) with the sensitivity of 91.67% and the specificity of 67.74%. The cut-off point for OCI was ≥0.68 with the sensitivity of 88.68% and the specificity of 71.58%. According to the cut-off point for OCT10or OCI, the 60-day cumulative survival rate of patients with high OCT10was significantly higher than that of low OCT10[58.06% (18/31) vs. 36.11% (13/36), χ2= 5.425, P = 0.020];the survival rate in high OCI group was significantly higher than that in low OCI group [55.17% (16/29) vs. 39.47% (15/38), χ2= 5.119, P = 0.024]. It was shown by multivariate Logistic regression that OCT10[odds ratio (OR) = 0.883, 95%CI = 0.791-0.965, P = 0.006] and OCI (OR = 0.011, 95%CI = 0.001-0.087, P = 0.005) were independent risk factors for 60-day mortality. Conclusion OCT could predict the prognosis of patients with cardiogenic shock receiving ECMO.
ABSTRACT
Objective To evaluate the short-term prediction of high-sensitivity cardiac troponin T (hs-cTnT) and other cardiovascular risk biomarkers in patients undergoing maintenance hemodialysis (MHD).Methods We conducted a cohort survey in 296 consecutive MHD patients whose clinical data were retrospectively analyzed.Before MHD,hs-cTnT and other relative cardiovascular biomarkers were detected.The end point (all-cause death) and time of occurring were recorded in the next 13 months.The differences between survival and all-cause death were analyzed by t-test,Mann-Whitney test and x2 test.The best two percentile cutoff point was calculated by X-tile and the survival rate was calculated by Kaplan-Meier Logistic regression analysis was applied to analyze the odd ratio between high risk and non-high risk hs-cTnT group.Non-high risk group was divided into intermediate risk and low risk group based on the 99th percentile of hs-cTnT in healthy population,to further evaluate its short-term prediction value for MHD patients.The short-term significance of hs-cTnT was proved to be independently associated with all-cause death by Logistic regression analysis.Results The mean value of serum hs-cTnT in survival group was 0.05 (0.03～0.07) ng/mL,while in the death group it was 0.07 (0.04～0.14) ng/mL,which had statistical significance (P =0.027).The best two percentile cutoff of hs-cTnT in MHD patients was 0.1 ng/mL.The survival rate in high risk group (hs-cTnT＞0.1 ng/mL) is lower than it in non-high risk group (hs-cTnT≤0.1 ng/mL) (76.67％ vs.96.62％,P ＜0.05).The odd ratios for high risk group and non-high risk group was 7.288 (P＜ 0.001).Moreover,further grouping the non-high risk group by hs-cTnT =0.014 ng/mL,intermediate risk group (hs-cTnT＞0.014 ng/mL) group has lower survival rate than low risk group (hs-cTnT≤0.014ng/mL),while there wasn't any death case occurred in the low risk group.Conclusions Hs-cTnT is an independent risk factor to all-cause death.Thus hs-cTnT can be a strong indicator of short-term prediction and prognostic evaluation.
ABSTRACT
Objective To identify the risk factors associated with overall survival (OS) for patients undergoing partial hepatectomy for colorectal liver metastases,and to assess the predictive values of five published scoring systems in an independent patient cohort for the purpose of external validation.Methods The clinical,pathologic,and complete follow-up data were prospectively collected from 303 consecutive patients who underwent primary hepatic resection for colorectal liver metastases at the Beijing Cancer Hospital from January 2000 to Aug 2014.The predictive values of the Nordlinger score,the Memorial Sloan-Kettering Cancer Center (MSKCC) score,the Iwatsuki score,the Basingstoke index,and the Konopke scoring system were assessed in this patient set.The clinical and pathologic parameters were further analyzed using univariate and multivariate analyses.Results The 1-,3-and 5-year overall survival were 89.2％,50.8％ and 38.6％,respectively.The median survival time was 37 months.Two risk factors were found to be independent predictors of poor overall survival:the N stage of the primary tumor,and a carcinoembyonic antigen level ＞ 30 μg/L.The MSKCC score had the best independent predictive power for survival when compared with the other 4 prognostic systems (C-index:0.903).Conclusion In our patient cohort,the MSKCC score was the best staging system in predicting survival.
ABSTRACT
Objective: To clarify the predictive value for long-term prognosis of GRACE score and SYNTAX score in patients with non-ST elevation acute coronary syndrome (NSTE-ACS). Methods: A total of 784 NSTE-ACS patients treated in our hospital from 2009-01 to 2014-01 were retrospectively studied. According to the treatment, the patients were divided into 3 groups: Medication group,n=410, Stent group,n=325 and CABG group,n=49. Based on 2 scoring systems, the patients were divided into another 3 groups: Low risk group, Medium risk group and High-risk group. The relationship between GRACE score and SYNTAX score was studied by Pearson correlation analysis, survival analysis was conducted by Kaplan-Meier method, univariate and multivariate analysis were performed by Cox proportional hazard model, and the area under curve (AUC) of ROC analysis was used to compare two methods. Results: All 784 patients completed the follow-up study at the median of 47.7 months. Pearson correlation analysis showed that there was a weak positive correlation between GRACE score and SYNTAX score (r=0.40,P0.05. Cox proportional hazard model and ROC analysis indicated that GRACE and SYNTAX scores had the important predictive value for lone term prognosis of NSTE-ACS. ROC analysis of GRACE score, SYNTAX score, the combination of GRACE and SYNTAX scores showed that 3 of them all had good predictive value for MACE occurrence, three of 95% CI had signiifcant overlapping without statistic differences. Conclusion: GRACE score and SYNTAX score are related, both of them have important while similar predictive value for long term prognosis in NSTE-ACS patients, the combination of 2 scores cannot increase the predictive value. GRACE score is appropriate for the risk stratiifcation in NSTE-ACS patients.
ABSTRACT
Objective To evaluate the predictive value of plasma atrial natriuretic peptide (ANP) level on prognostic of patients with systemic inflammatory response syndrome by dynamic monitoring ANP levels.Methods Ninety-eight patients admitted to the intensive care unite were classified into survival group(n =78) and death group (n =20).The level of plasma ANP,procalcitonin,C-reactive protein and lactic acid were measured.Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score were recorded.Results The plasma ANP level of patients in the death group was 0.40 (0.26) μg/L,significantly higher than that in the survival group(0.22(0.12) μg/L,P =0.000).Along with treatment scheme,the plasma ANP level decreased in survival group,and there were significant difference among three times (0.22 (0.12) μg/L,0.17 (0.09) μg/L,0.13 (0.11) μg/L,P =0.000).But there was no difference in ANP level of patients in death group along with the disease developing (0.38 (0.30) μg/L,0.39 (0.23) μg/L,0.39 (0.22) μg/L,P =0.99).ICU hospitalized time in survive group associated with APACHE Ⅱ score,ANP and PCT(r =0.735,0.628,0.487 respectively,P =0.000,0.001,0.021).Conclusion ANP is proved to be a good clinical index in prognostic evaluation of patients with sepsis.
ABSTRACT
Objective:To investigate high sensitivity-C reactive protein (Hs-CRP) as a prognostic factor in non-Hodgkin lympho-ma (NHL). Methods:Data for 85 consecutive non-Hodgkin lymphoma patients were followed up and reviewed to determine the value of Hs-CRP relative to known prognostic parameters. Results:The progression-free survival (PFS) and overall survival (OS) times of pa-tients with pre-therapeutic baseline serum Hs-CRP levels of≥4 mg/L were shorter than those of patients with basal serum Hs-CRP lev-els of0.05). However, the post-therapeutic, early-to-mid serum Hs-CRP level was not significantly correlated with the OS and PFS times (P>0.05). Multivariate Cox regression analysis showed that the pre-therapeutic baseline serum Hs-CRP level may be an important prognostic parameter for the relapse and survival of NHL patients (P<0.05). Conclusion:The baseline Hs-CRP level can be a major indicator of prognosis in NHL patients.