Fasting blood glucose levels and prognosis in patients with non-small-cell lung cancer: a prospective cohort study in China.

PURPOSE: Non-small-cell lung cancer (NSCLC) is the most diagnosed lung cancer and is associated with poor prognosis. This study aimed to analyze whether fasting blood glucose (FBG) levels could provide prognostic information in Chinese patients with NSCLC, using the Suzhou Lung Cancer Survival study. PATIENTS AND METHODS: A prospective cohort study of adult patients with primary NSCLC was performed. The patients who were hospitalized between January 2016 and April 2018 in two hospitals affiliated with Soochow University were recruited. Patient information, including lifestyle habits and clinical and laboratory data, were collected through face-to-face interviews and evaluation of medical records. Follow-up was initiated from the date of patient enrollment until May 8, 2018 or until patient death. The long-term survival of patients was assessed every 6 months. Patient vital status was confirmed by using hospital records, telephone interview, or local death registration system. Cox proportional hazards regression was used to estimate hazard ratio and 95% confidence interval (CI) for death, with adjustment for cancer stage, medical treatments, smoking, and other potential confounders. RESULTS: A total of 387 patients were included in the analysis, and the numbers (percentages) of patients with stages I, II, III, and IV NSCLC were 53 (13.7%), 41 (10.6%), 64 (16.5%), and 215 (55.6%), respectively. The median duration of follow-up was 19.1 months. Compared with patients in the second tertile of FBG, the HRs for mortality were 2.16 (95% CI: 1.26-3.73) and 1.87 (95% CI: 1.03-3.42) for those in the lowest one and diabetic group, respectively. Subgroup analysis according to various patient characteristics confirmed these associations. CONCLUSION: Diabetes and low FBG could be important predictors of death in patients with NSCLC. Maintaining appropriate blood glucose levels may improve prognosis in patients with NSCLC.

Post-diagnostic C-reactive protein and albumin predict survival in Chinese patients with non-small cell lung cancer: a prospective cohort study.

Non-small cell lung cancer (NSCLC) is the most commonly diagnosed lung cancer and is associated with poor prognosis. This study aimed to analyze if serum C-reactive protein (CRP), albumin (Alb), and CRP/Alb ratio could provide prognostic information in patients with NSCLC. 387 patients with primary NSCLC were included in this analysis. Cox proportional hazards regression was used to estimate hazard ratio (HR) and 95% confidence interval (CI) of death with adjustment for some potential confounders. The multivariate regression analyses revealed the statistically significant associations of decreased survival of patients with NSCLC with elevated CRP, decreased Alb, and elevated CRP/Alb ratio. The HRs of mortality were 1.56 (95% CI: 0.80-3.04) and 2.64 (95% CI: 1.35-5.16) for patients in the second and the highest tertiles of CRP (P-trend = 0.003). For albumin, the HR was 0.50 (95% CI: 0.29-0.85) for the normal group. The CRP/Alb ratio strongly predicted the survival of patients in the highest tertile with a fourfold risk of dying compared with those in the lowest tertile (HR = 4.14, 95% CI: 2.15-7.98). The subgroup analysis according to various patient characteristics confirmed these associations. In conclusion, serum CRP, albumin, and CRP/Alb ratio are predictive of survival for Chinese patients with NSCLC.

Sewage sludge as an initial fertility driver for rapid improvement of mudflat salt-soils.

Sewage sludge is by-product in the process of centralized wastewater treatment. Land application of sewage sludge is one of the important disposal alternatives. Mudflats in the interaction zone between land and sea can be important alternative sources for arable lands if amended by large amount of organic fertilizers. Rich in organic matter and other nutrients, sewage sludge has been considered as the economic choice for an initial fertility driver. However, sewage sludge amendment has been greatly hampered due to availability of potential toxic metals. Using sewage sludge in compliance with the national standards for agricultural usage could avoid the accumulation of heavy metals. Nevertheless, it is not clear whether massive input of sewage sludge would increase heavy metals concentration in crops. The objective of this study was to investigate impact of sewage sludge amendment (SSA) as an initial fertility driver by one-time input, with the rates of 0, 30, 75, 150, and 300tha-1, on biomass of green manures, soil chemical properties, and growth and heavy metals uptake of maize (Zea mays L.) grown in mudflat soil. Results showed that one-time sewage sludge amendment promoted an initial fertility for infertile mudflat soil, supported growth of ryegrass as the first season green manure. By tilled ryegrass, it modified the chemical properties of mudflat soil by increasing soil organic carbon, total and available N and P, and decreasing soil salinity and pH, which promoted subsequent growth of two green manures for sesbania and ryegrass. The sewage sludge as an initial fertility driver combined with planting and tilling green manures, increased dry matter of the aerial part and grain yield of maize grown in mudflat soil. Cd and Ni concentrations in grain of maize were positively correlated with sewage sludge amendment rates. Importantly, heavy metal concentrations in grain of maize at all SSA rates did not exceed the safety standard for food in China (GB 2762-2012). The study suggests that sewage sludge can be applied as an initial fertility driver for mudflat soil amendment, which provides an innovative solution for arable land resources and solid waste disposal.