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Objective: To development the prognostic nomogram for malignant pleural mesothelioma (MPM). Methods: Two hundred and ten patients pathologically confirmed as MPM were enrolled in this retrospective study from 2007 to 2020 in the People's Hospital of Chuxiong Yi Autonomous Prefecture, the First and Third Affiliated Hospital of Kunming Medical University, and divided into training (n=112) and test (n=98) sets according to the admission time. The observation factors included demography, symptoms, history, clinical score and stage, blood cell and biochemistry, tumor markers, pathology and treatment. The Cox proportional risk model was used to analyze the prognostic factors of 112 patients in the training set. According to the results of multivariate Cox regression analysis, the prognostic prediction nomogram was established. C-Index and calibration curve were used to evaluate the model's discrimination and consistency in raining and test sets, respectively. Patients were stratified according to the median risk score of nomogram in the training set. Log rank test was performed to compare the survival differences between the high and low risk groups in the two sets. Results: The median overall survival (OS) of 210 MPM patients was 384 days (IQR=472 days), and the 6-month, 1-year, 2-year, and 3-year survival rates were 75.7%, 52.6%, 19.7%, and 13.0%, respectively. Cox multivariate regression analysis showed that residence (HR=2.127, 95% CI: 1.154-3.920), serum albumin (HR=1.583, 95% CI: 1.017-2.464), clinical stage (stage Ⅳ: HR=3.073, 95% CI: 1.366-6.910) and the chemotherapy (HR=0.476, 95% CI: 0.292-0.777) were independent prognostic factors for MPM patients. The C-index of the nomogram established based on the results of Cox multivariate regression analysis in the training and test sets were 0.662 and 0.613, respectively. Calibration curves for both the training and test sets showed moderate consistency between the predicted and actual survival probabilities of MPM patients at 6 months, 1 year, and 2 years. The low-risk group had better outcomes than the high-risk group in both training (P=0.001) and test (P=0.003) sets. Conclusion: The survival prediction nomogram established based on routine clinical indicators of MPM patients provides a reliable tool for prognostic prediction and risk stratification.
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Humanos , Mesotelioma Maligno , Prognóstico , Nomogramas , Estudos Retrospectivos , Modelos de Riscos ProporcionaisRESUMO
@#AIM: To evaluate the early objective visual quality and vision related quality of life after implantation of posterior chamber phakic implantable collamer lens with a central hole(ICL V4c)for high myopia by applying the double-pass optical quality analysis system Ⅱ(OQAS Ⅱ)and life quality questionnaire.<p>METHODS: Totally 26 patients(44 eyes)with high myopia were enrolled in this research. The patients were all recieved ICL V4c implantation by the same surgeon in our hospital. The evaluation items included uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure, corneal endothelial cell density(ECD), vault, objective scattering index(OSI), modulation transfer function cut off frequency(MTF cut off), Strehl ratio(SR), predicted visual acuity values(OV 100%, OV 20%, OV 9%)at contrasts of 100%, 20%and 9% and vision related quality of life questionnaire. All measurements were performed preoperative and 1wk, 1mo, 3mo postoperatively.<p>RESULTS: Compared with preoperative BCVA, for the high myopia patients, the 1wk, 1mo and 3mo UCVA postoperative were better at all time points, and the differences were statistically significant(<i>P</i><0.001). Postoperative 1wk intraocular pressure was higher than that in preoperative and postoperative 1mo and 3mo(<i>P</i><0.05). Postoperative corneal endothelial cell counts at all time points were lower than that in preoperative(<i>P</i><0.05), but all within the normal range. No significant difference was found in vault(<i>P</i>=0.790). Compared with preoperative OSI, MTF cut off, SR, OV 100%, OV 20% and OV 9%, the situation improved at postoperative 1wk, 1mo and 3mo, with statistical significance(<i>P</i><0.001). The vision related quality of life questionnaire showed that all patients had high satisfaction in the good subjective visual acuity after operation.<p>CONCLUSION: ICL V4c implantation is safe and effective in correcting high myopia. The objective visual quality and vision related quality of life of patients with high myopia was significantly improved after ICL V4c implantation in the early stage. The research laid a foundation for the establishment of “the comprehensive evaluation system of subjective and objective combination” of ICL in the application of high myopia.
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@#AIM: To evaluate the early objective visual quality and vision related quality of life after implantation of posterior chamber phakic implantable collamer lens with a central hole(ICL V4c)for high myopia by applying the double-pass optical quality analysis system Ⅱ(OQAS Ⅱ)and life quality questionnaire.<p>METHODS: Totally 26 patients(44 eyes)with high myopia were enrolled in this research. The patients were all recieved ICL V4c implantation by the same surgeon in our hospital. The evaluation items included uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure, corneal endothelial cell density(ECD), vault, objective scattering index(OSI), modulation transfer function cut off frequency(MTF cut off), Strehl ratio(SR), predicted visual acuity values(OV 100%, OV 20%, OV 9%)at contrasts of 100%, 20%and 9% and vision related quality of life questionnaire. All measurements were performed preoperative and 1wk, 1mo, 3mo postoperatively.<p>RESULTS: Compared with preoperative BCVA, for the high myopia patients, the 1wk, 1mo and 3mo UCVA postoperative were better at all time points, and the differences were statistically significant(<i>P</i><0.001). Postoperative 1wk intraocular pressure was higher than that in preoperative and postoperative 1mo and 3mo(<i>P</i><0.05). Postoperative corneal endothelial cell counts at all time points were lower than that in preoperative(<i>P</i><0.05), but all within the normal range. No significant difference was found in vault(<i>P</i>=0.790). Compared with preoperative OSI, MTF cut off, SR, OV 100%, OV 20% and OV 9%, the situation improved at postoperative 1wk, 1mo and 3mo, with statistical significance(<i>P</i><0.001). The vision related quality of life questionnaire showed that all patients had high satisfaction in the good subjective visual acuity after operation.<p>CONCLUSION: ICL V4c implantation is safe and effective in correcting high myopia. The objective visual quality and vision related quality of life of patients with high myopia was significantly improved after ICL V4c implantation in the early stage. The research laid a foundation for the establishment of “the comprehensive evaluation system of subjective and objective combination” of ICL in the application of high myopia.
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Lung cancer comorbidity is common in patients. This review focuses on the clinical situations and treatment of patients with both lung cancer and one of the following: chronic obstructive pulmonary disease(COPD), pulmonary embolism(PE) or interstitial lung disease(ILD). Generally, these patients have more limitations on selecting cancer-related therapies, and they have shorter survival time and higher mortality than patients who had lung cancers only.
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BACKGROUND:The study aimed to compare the therapeutic effect of recombinant tissue plasminogen activator (rt-PA) on the onset of acute cerebral infarction (ACI) at different time points of the first 6 hours.METHODS:A retrospective analysis was conducted in 74 patients who received rt-PA thrombolysis treatment within 4.5 hours after ACI and another 15 patients who received rt-PA thrombolysis treatment between 4.5-6 hours after ACI.RESULTS:National Institute of Health Stroke Scale (NIHSS) scores were statistically decreased in both groups (P>0.05) at 24 hours and 7 days after ACI. There was no significant difference in modified ranking scores and mortality at 90 days after the treatment between the two groups (P>0.05).CONCLUSIONS:The therapeutic effect and mortality of rt-PA treatment in patients with ACI between 4.5-6 hours after the onset of the disease were similar to those in patients who received rt-PA within 4.5 hours after the onset of this disease. Therefore, intravenous thrombolytic therapy for ACI within 4.5-6 hours after ACI was effective and safe.