简介：Objective:Thepredictiveandprognosticroleofprognosticnutritionalindex(PNI)ingastriccancerpatientswithperitonealdisseminationremainsunclear.ThisstudyaimstoexploretheroleofthePNIinpredictingoutcomesofgastriccancerpatientswithperitonealdissemination.Methods:Atotalof660patientsdiagnosedwithgastricadenocarcinomawithperitonealmetastasisbetweenJanuary2000andApril2014atSunYat-senUniversityCancerCenterandtheSixthAffiliatedHospitalofSunYatsenUniversitywereretrospectivelyanalyzed.Theclinicopathologiccharacteristicsandclinicaloutcomesofpatientswithperitonealdisseminationwereanalyzed.Results:ComparedwithPNI-highgroup,PNI-lowgroupwascorrelatedwithadvancedage(P=0.036),worseperformancestatus(P<0.001),higherfrequencyofascites(P<0.001)andhigherfrequencyofmultisitedistantmetastasis(P<0.001).Kaplan-MeiersurvivalcurvesshowedthatPNI-highgrouphadasignificantlylongermedianoverallsurvivalthanPNI-lowgroup(13.13vs.9.03months,P<0.001).MultivariatesurvivalanalysisrevealedthatBorrmanntypeIV(P=0.014),presenceofascites(P=0.017)andlowerPNI(P=0.041)wereindependentpoorprognosticfactors,andpalliativesurgery(P<0.001)andfirst-linechemotherapy(P<0.001)weregoodprognosticfactors.Forpatientsreceivingpalliativesurgery,thepostoperativemorbidityratesinthePNI-lowgroupandPNIhighgroupwere9.1%and9.9%,respectively(P=0.797).ThepostoperativemortalityratewasnotsignificantlydifferentbetweenPNI-lowandPNI-highgroups(2.3%vs.0.9%,P=0.362).Conclusions:PNIisausefulandpracticaltoolforevaluatingthenutritionalstatusofgastriccancerpatientswithperitonealdissemination,andisanindependentprognosticfactorforthesepatients.

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简介：AbstractBackground:The detrimental outcomes of right ventricular pacing on left ventricular electromechanical function ultimately result in heart failure, a phenomenon termed pacing-induced cardiomyopathy (PICM) in clinical research. This study aimed to validate prognostic factors that can be used to identify patients with higher susceptibility to progress to the stage of cardiomyopathy before pacemaker implantation.Methods:This observational analysis enrolled 256 patients between January 2013 and June 2016, 23 (8.98%) of whom progressed to PICM after 1 year of follow-up. A Cox proportional hazard model was used to analyze the prognostic factors associated with PICM. Dose-response analysis was used to evaluate the relationship between significant indicators in multifactor analysis and PICM.Results:The mean values of left ventricular ejection fraction before and after pacemaker implantation in 23 patients diagnosed with PICM were 62.3% and 42.7%, respectively. Univariate analysis showed that sex, atrio-ventricular block, paced QRS duration, and ventricular pacing percentage were significantly associated with PICM. In the multivariate analysis, male sex (hazard ratio: 1.20, 95% confidence interval [CI]: 1.09-1.33, P < 0.005), paced QRS duration (hazard ratio: 1.95 per 1 ms increase, 95% CI: 1.80-2.12, P < 0.001), and ventricular pacing percentage (hazard ratio: 1.65 per 1% increase, 95% CI: 1.51-1.79, P < 0.001) were independent prognostic factors associated with the development of PICM. The ventricular pacing percentage and paced QRS duration level defined by the dose-response analysis were positively associated with PICM (P < 0.05).Conclusions:Our findings indicated that paced QRS duration and ventricular pacing percentage were the most sensitive prognostic factors for PICM.

简介：Normalregionalleftventricular(LV)mechanicalcontractionissynchronous,resultinginefficientejection.Abnormalitiesinelectricalactivationormyocardialdiseasesmayaffectthetimingofregionalcontraction,resultingindiscoordinatedordyssynchronouscontraction,whichisinefficient.Thisarticlereviewsvariousapproachestoquantifydyssynchrony,focusingonLVdyssynchrony,thathavebeenprincipallyrelatedtocardiacresynchronizationtherapy(CRT).SeveralattemptshavebeenmadetoimprovepatientselectionforCRTbyuseofechocardiographicdyssynchrony;however,nonehavegainedclinicalacceptance.ThisreviewfocusesonthedifferentreasonsfortheexistenceLVdyssynchrony,thedyssynchronousstrainpatternsindicativeofCRTresponse,andtheprognosticimplicationsofdyssynchrony.Interestinechocardiographicdyssynchronyremainshighbecauseofitsmechanisticandprognosticimportance.Dyssynchronymayoccurfromelectricalornonelectricalcauses.PatientswithawideQRScomplexwhohavebaselinedyssynchronyfromelectricaldelayingeneralhaveafavorableresponsetoCRT,whereaspatientswithnonelectricaldyssynchrony(fromcontractileheterogeneityorscar)atthebaselinehaveaworseprognosis.Newinsightsintothemeaningofmechanicaldyssynchronycontinuetoemerge,andthisarticle

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简介：AbstractBackground:The association between free triiodothyronine (FT3) and long-term prognosis in dilated cardiomyopathy (DCM) patients has not been evaluated. The purpose of this study was to determine whether the level of FT3 could provide prognostic value in patients with DCM.Methods:Data of consecutive patients diagnosed with DCM were collected from October 2009 to December 2014. FT3 was measured by fluoroimmunoassay. Other biochemical markers, such as free thyroxin (FT4), thyroid-stimulating hormone, red blood cell, hemoglobin, blood urea nitrogen, and serum creatinine, were tested at the same time. Follow-up was performed every 3 months. The primary endpoint was all-cause mortality. Pearson analysis was used to evaluate the correlation of FT3 and other lab metrics with DCM patients’ prognosis. The association of long-term mortality in DCM and FT3 was compared using Cox hazards model.Results:Data of 176 patients diagnosed with DCM were collected. Of them, 24 patients missed FT3 values and six patients were lost to follow-up. Altogether, data of 146 patients were analyzed. During the median follow-up time of 79.9 (53.5-159.6) months, nine patients lost, 61 patients died (non-survival group), and 85 patients survived (survival group). FT3 was significantly lower in non-survival group than that in survival group (3.65 ± 0.83 pmol/L vs. 4.36 ± 1.91 pmol/L; P = 0.003). FT3 also showed a significantly positive correlation with red blood cell and hemoglobin, negatively correlated with age, blood urea nitrogen and serum creatinine (P < 0.05), respectively. Patients in the group of lower FT3 levels (FT3 ≤ 3.49 pmol/L) suffered from a higher risk of all-cause mortality (P for log-rank = 0.001). In multivariate Cox regression analysis, FT3 level was significantly associated with all-cause mortality (hazard ratio: 0.70, 95% confidence interval 0.52-0.95, P for trend = 0.021).Conclusion:Low levels of FT3 were associated with increased all-cause mortality in patients with DCM.

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简介：这研究寻求了在病理学的ENE阴茎癌估计extranodal扩展(ENE)和几个另外的风险因素的度的预示的意义。我们分析了有希望地与证明ENE在31个化疗天真的病人的一个连续系列上收集了数据经历了治疗学的地区性的lymphadenectomy。手术后的外部放射疗法然后被执行。我们学习了一个新奇分级系统和相关病人与他们的结果措施分级的利用的ENE的程度。ENE作为1被分级-如果淋巴节点(行)的囊被破裂不到三分之一个它的圆周或2-如果囊被破坏，超过三分之一个它的圆周或全部行被破坏。我们用Kaplan-Meier方法估计了全面幸存(OS)。Multivariate分析根据比例的危险用在univariate分析作为统计上重要被识别的因素建模的考克斯的意见被执行。ENE的发生率在有阴茎的病理学的节点积极的癌的病人是51.8%。中部的OS和5年的幸存是18个月(95%信心间隔(CI)，14.4-21.6)并且23%分别地。univariate分析上的预示的变量是ENE等级2，≥；有ENE的3行，最大的行≥；35公里，≥；5积极的行和骨盆的行参与。在multivariate分析上，仅仅ENE等级2仍然保持与减少的OS联系了(危险比率(HR)：6.50)。在结论，有ENE的病人有等级2是的差的结果，和ENE在有病理学的ENE的病人的差的OS的一个独立预兆的因素阴茎癌。

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简介：AIM:Toevaluatetheshort-andlong-termoutcomesofliverresectionforcaudatelobehepatocellularcarcinoma(HCC).METHODS:Weretrospectivelyanalyzed114consecutivepatientswithHCC,originatingfromthecaudatelobe,whounderwentresectionbetweenJanuary2001andJanuary2007.Univariateandmultivariateanalyseswereperformedonseveralclinicopathologicvariablestodeterminethefactorsaffectinglong-termoutcomeandintrahepaticrecurrence.RESULTS:Overallmortalityandmorbiditywere0%and18%,respectively.Afteramedianfollow-upof31mo(interquartilerange,11-66mo),tumorrecurrencehadoccurredin76patients(66.7%).The1-,3-,and5-yeardisease-freesurvivalrateswere65.7%,38.1%,and18.4%,respectively.The1-,3-,and5-yearoverallsurvivalrateswere76.1%,54.7%,and31.8%,respectively.Univariateanalysisshowedthatsubsegmentallocationofthetumor(45.7%vs16.2%,P=0.01),livercirrhosis(12.3%vs47.9%,P=0.03),surgicalmargin(18.5%vs54.6%,P=0.04),vascularinvasion(37.9%vs23.2%,P=0.04)andextendedcaudateresection(42.1%vs15.4%,P=0.04)wererelatedtopoorerlong-termsurvival.Multivariateanalysisshowedthatonlysubsegmentallocationofthetumor,livercirrhosisandsurgicalmarginweresignificantindependentprognosticfactors.CONCLUSION:HepatectomywasaneffectivetreatmentforHCCinthecaudatelobe.Thesubsegmentallocationofthetumor,livercirrhosisandsurgicalmarginaffectedlong-termsurvival.

简介：AbstractBackground:The standard treatment for pediatric differentiated thyroid carcinoma (DTC) still requires consideration because of a lack of clinical evidence. The purpose of this study was to summarize the clinical experiences and explore the risk factors for post-operative recurrence through a retrospective analysis to develop better clinical strategies for pediatric DTC.Methods:This study retrospectively analyzed children and adolescents with DTC who were treated between January 1999 and December 2014 at the Cancer Hospital, Chinese Academy of Medical Sciences. Clinicopathological results and outcomes were collected. A log-rank test of Kaplan-Meier curves and the Cox regression model were used to determine the factors associated with recurrence.Results:Data of 150 patients were collected in this study. During the follow-up, there was only one disease-related death. The recurrence rates at 3, 5, and 10 years were 13.6%, 18.7%, and 28.6%, respectively. There was a significant difference in the rate of recurrence according to age (P < 0.001), extrathyroidal extension (P < 0.001), lymph node metastasis (P = 0.023), and invasion of the trachea and esophageal wall (P = 0.004). Cox regression analysis demonstrated that age (P = 0.006) and extrathyroidal extension (P = 0.013) were significant dependent factors of post-operative recurrence.Conclusions:The prognosis of DTC in children and adolescents is favorable. A close follow-up is recommended because of the high recurrence rate. A comparatively higher recurrence rate was observed in the younger age group, and new age-based divisions may be needed to conveniently evaluate the possibility of recurrence.

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简介：Ovariancancerisoneofthemostlethalmalignantgynecologicaltumors.Morethan70%ofpatientswithovariancancerarediagnosedatadvancedstage.The5-yearsurvivalinpatientswithadvancedovariancancerislessthan30%becauseofthelackofeffectivebiomarkersfordiagnosis,prognosis,andpersonalizedtreatment.MicroRNA(miR)isaclassofsmallnoncodingRNAsthatnegativelyregulategeneexpressionprimarilythroughpost-transcriptionalrepression.ManystudiesontissuemiRinovariancancerhavebeencarriedoutandshowgreatpotentialinclinicalpractice.However,tissuesamplesarenoteasilyavailablebecausesamplingcausesinjury.Researchershavestartedtofocusonplasma/serummiR,assumingthatbloodsamplesmayreplacetissuesamplesinmiRresearchinthefuture.Plasma/serummiRresearchisstillinitsearlystages.Studiesonitsfunctionintheearlydiagnosisofovariancancerhaveachievedsomeprogress,butplasma/serummiRprofilingforprognosisandpersonalizedtreatmentofovariancancerremainsunknown.Athoroughunderstandingofthefunctionofplasma/serummiRinovariancancerwillfacilitateearlydiagnosisandimprovetreatmentforovariancancer.

简介：男富饶上的精索静脉曲张修理的效果仍然保持争论。它将对有用决定了哪个人将从精索静脉曲张修理有益于大多数，并且在那些个人指向修理努力。为精索静脉曲张修理的预示的因素上的文学的详细评论用PubMedNLM数据库被执行。我们发现postvaricocelectomy精液参数的最好的预言者是外科手术前的精液参数。在精液参数的最大的改进与更大的精索静脉曲张在人被发现。当有争吵，更高的睾丸激素，更年轻的年龄和更大的睾丸尺寸时，在一些，研究在精液参数postvaricocelectomy为改进预言。一张诺模图被开发了基于外科手术前的精液参数，精索静脉曲张等级和这个人(www.fertilitytreatmentresults.com)的年龄预言postvaricocelectomy精液参数。有限数据一致地与更高的基线DNA破碎率在人处于DNA破碎率表明最大的改进。关于繁殖结果，更高的基线精子密度一致地为自然怀孕或帮助繁殖技术(艺术)怀孕率预言。另外，精索静脉曲张修理确实似乎为艺术的更侵略的形式减少需要。在结论，我们现在能开始使用象预言跟随varicocelectomy的修理以后的精液质量和富饶潜力的基线精液质量，精索静脉曲张等级和耐心的年龄那样的特定的参数。

简介：Objective:Tostudytheexpressionofvascularendothelialgrowthfactor(VEGF)andmicrovesseldensity(MVD)inesophagealsquamouscellcarcinoma(ESCC)andclarifytheassociationofVEGFexpressionwiththeangiogenesisandprognosticvalueofthisdisease.Methods:Eighty-twocaseswithprimaryESCCtreatedwithradicaloperationinDepartmentofSurgeryfromJan1981throughMay1994wereenrolled.VEGFexpressionandMVDvaluewereexaminedbyimmunohistochemicalstaining,thestreptavidin-biotinperoxidasecomplexmethod(SPmethod),usinganti-VEGFpolyclonalantibodyandanti-Factor-VIIIantibody,respectively.WealsoanalyzedtherelationshipbetweenVEGFexpressionandMVDvalueandpostoperativesurvivalrateofpatients.Results:Ofthe82cases,63.4%casesshowedpositiveforVEGFintumorcellsandthemedianofMVDintumorwas37(9-150)·mm-2.TherewasaclosecorrelationbetweenMVDandVEGF(P=0.001).The5-yearsurvivalrateofpatientswithlowandhighMVDwas34.1%and12.2%,respectively.The5-yearsurvivalratewas46.7%inpatientswithVEGF-negativetumorand11.5%inpatientswithVEGF-positivetumor.Thesedifferenceswerestatisticallysignificant(P=0.017andP<0.001,respectively).Conclusion:InESCC,angiogenesisismediatedmainlybyVEGFandVEGFmaybeassociatedwithtumorprogressionandincreasedmalignancyviaangiogenesis.

简介：与女乳癌相比，男乳癌是稀罕疾病，并且在临床/病理学的特征和预后之间的关系争论，或甚至大部分未知。在这研究，我们从合用的男乳癌病人在天津医药大学癌症研究所和医院从1996年1月对待到2011年12月的109nonmetastatic用临床、病理学的数据执行了回顾的分析。木头等级测试证明那降低肿瘤舞台，没有淋巴节点参与，和积极雌激素/孕酮受体地位是没有疾病的幸存和外套的好预言者univariate分析上的幸存。然而，hormonotherapy仅仅是没有疾病的幸存，并且不全面幸存的一个好预兆的因素。另外，基于考克斯，比例的危险回归模型，仅仅淋巴节点参与，和雌激素/孕酮受体地位是multivariate分析上的统计上重要的预兆的因素。我们的结果证明尽管辅助全身的治疗在男乳癌广泛地被使用，病人和预后在最后几十年，淋巴节点参与，和雌激素/孕酮受体地位改善了仍然是最重要的预示的因素。有一种更大的样品尺寸的未来的多中心研究着急地被需要进一步理解男乳癌。

简介：Objective:Ki-67playsanimportantfunctionincelldivision,butitsexactroleisstillunknown.Moreover,fewworksregardingitsoverallfunctionwerepublished.ThepresentstudyevaluatedtheclinicalsignificanceofKi-67indexasaprognosticmarkerandpredictorofrecurrenceindifferentmolecularsubtypesofbreastcancer.TherelationshipofKi-67indexwithdifferentclinicopathologicalfactorswasalsoanalyzed.Methods:Ki-67indexwasmeasuredin107casesofprimarybreastcancerfrom2010-2012.Thesepatientswereevaluatedforestrogenreceptor,progesteronereceptor,andHER2.Ki-67wasdividedaccordingtopercentagelevels:<15%and>15%.Followuprangedfrom32monthsupto6years.Results:Approximately44,23,15,and25casesweregroupedasluminalA,luminalB,HER2subtype,andtriple-negative(TN),respectively.NoluminalApatientsshowedKi-67levelhigherthan15%,andtheirrecurrencewas20%.InluminalBgroup,Ki-67levelhigherthan15%wasobservedin69%ofpatients,andrecurrencewas39%.InHER2subtype,Ki-67washigherthan15%in34%ofcases,andrecurrencewas40%.Intriple-negativecases,Ki-67washigherthan15%in60%ofcases,andrecurrencewasdetectedin32%ofpatients.PatientswithKi-67lessthan15%displayedbetteroverallsurvivalthanthosewithKi-67higherthan15%(P=0.01).PatientswithKi-67higherthan15%exhibitedhigherincidenceofmetastasisandrecurrencethanthosewithKi-67lessthan15%(P=0.000).Conclusions:Ki-67maybeconsideredasavaluablebiomarkerinbreastcancerpatients.

简介：Objectives:ToexploretheprognosticrelevanceofthenumberandratioofmetastaticlymphnodesinresectedCarcinomaoftheampullaofVater(CAV).Methods:Theclinicaldataof155patientswhounderwentpancreaticoduodenectomy(PD)forcanceroftheampullaofVaterbetweenJanuary1990andDecember2010wereretrospectivelyanalyzed.KaplanMeiermethodwasusedinsurvivalanalysisandLogrankmethodincomparison.MultivariateanalysiswasperformedusingCoxproportionalhazardsmodel.Results:Amongthese155patients,thein-hospitalmortalityratewas4.5%,lymphnodepositivediseasewas21.3%,andthe5-yearsurvivalratewas51.6%.Patientswithalymphnoderatio(LNR)>20%weremorelikelytohavetumordifferentiation,depthofduodenalinvolvement,depthofpancreaticinvasion,T-stageandTNM-Stage.ThenumberofthemetastaticlymphnodesisimportantprognosticfactorsoftheCAV.Univariateanalysisshowedthatthefactorsassociatedwiththeprognosisincludedtumorsize(P=0.036),tumordifferentiation(P=0.019),LNR(P=0.032),numberofmetastaticlymphnodes(P=0.024),lymphnodemetastasis(P=0.03),depthofpancreaticinvasion(P=0.001),T-stage(P=0.002),TNMstage(P=0.001),elevatedCA19-9(P=0.000),andjaundice(P=0.021).Multivariateanalysisshowedthatthefactorsassociatedwiththeprognosiswerethenumberofmetastaticlymphnodes(P=0.032;RR:1.283;95%CI:1.022-1.611),tumorsize(P=0.043;RR:1.736;95%CI:1.017-2.963),andelevatedCA19-9(P=0.003;RR:3.247;95%CI:1.504-7.010).Conclusions:LNRisausefulfactorforpredictingtheprognosisoftheradicaltreatmentforCAV,whereasthenumberofmetastaticlymphnodesisthemostimportantfactor.Furtherresearchonthelocations,number,andLNRwillbeclinicallymeaningfultoimprovesurvivalinpatientswithCAV.

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