Acute trauma is one of the most commonly seen diseases in the Emergency Department,and it attracts more attention due to the increasing disability rate and mortality.Early rapid and accurate assessment of the severity...Acute trauma is one of the most commonly seen diseases in the Emergency Department,and it attracts more attention due to the increasing disability rate and mortality.Early rapid and accurate assessment of the severity of trauma has a positive significance for improving clinical prognosis.The paper aims to review the characteristics of the severity score based on trauma severity,blood biochemical changes and serum biomarkers,and discuss its prognostic significance.展开更多
Background:This study aimed to evaluate the prognostic value of the lymphocyte-to-monocyte ratio(LMR)and cancer antigen 724(CA724)in patients with proximal gastric cancer residing in cold climate regions.Methods:A ret...Background:This study aimed to evaluate the prognostic value of the lymphocyte-to-monocyte ratio(LMR)and cancer antigen 724(CA724)in patients with proximal gastric cancer residing in cold climate regions.Methods:A retrospective analysis was conducted on 313 patients diagnosed with proximal gastric cancer in cold climate regions between 2014 and 2017.Preoperative hematological markers,including LMR and CA724,were assessed.Receiver operating characteristic(ROC)curves were used to determine optimal cutoff values,which were then combined to form the LMR+CA724 score.Statistical analyses included Kaplan-Meier survival curves,log-rank tests,and Cox proportional hazards regression.Results:A high preoperative LMR+CA724 score was significantly associated with older age,advanced pTNM stage,vascular invasion,and elevated levels of NMPVR,NMR,and AAR.The LMR+CA724 score demonstrated a higher area under the curve(AUC)compared to LMR or CA724 alone.Multivariate analysis identified pTNM stage,Borrmann type,histological type,and the LMR+CA724 score as independent prognostic factors for overall survival(OS).A nomogram incorporating these four variables achieved an AUC of 0.817,indicating strong predictive performance.Conclusion:The LMR+CA724 score is a reliable and independent prognostic indicator for patients with proximal gastric cancer in cold climate regions.Its integration into clinical practice may support treatment planning and long-term management by enhancing personalized care.Further prospective studies are warranted to validate these findings in broader and more diverse patient populations.展开更多
BACKGROUND The incidence of prostate cancer(PCa)is on the rise in China.The risk level of patients with PCa is associated with disease-free survival rate at 10 years after radical prostatectomy.Predicting prognosis in...BACKGROUND The incidence of prostate cancer(PCa)is on the rise in China.The risk level of patients with PCa is associated with disease-free survival rate at 10 years after radical prostatectomy.Predicting prognosis in advance according to the degree of risk can provide a reference for patients,especially treatment options and postoperative adjuvant treatment measures for high-risk/extremely high-risk patients.AIM To explore the predictive value of the prognostic nutritional index(PNI)for biological recurrence in Chinese patients with high/extremely high-risk PCa after radical prostatectomy.METHODS The biochemical test results and clinical data of 193 patients who underwent radical prostatectomy for the first time from January 2015 to December 2020 were retrospectively collected.The PNI value of peripheral blood within 1 wk before surgery was calculated,and during the follow-up period,prostate-specific antigen≥0.2 ng/mL was considered to have biological recurrence.The receiver operating characteristic(ROC)curve was used to calculate the optimal critical value and area under the curve(AUC)of the patients.According to the critical value,the progression-free survival of the high PNI group and low PNI group was compared.The independent influencing factors of the patients’prognosis were obtained by the Cox proportional hazards regression model.RESULTS The non-biological recurrence rates at 1,3,and 5 years were 92.02%,84.05%,and 74.85%,respectively.The optimal critical value for PNI to predict biological recurrence was 46.23,and the AUC was 0.789(95%confidence interval:0.651-0.860;P<0.001).The sensitivity and specificity were 82.93%and 62.30%,respectively.In accordance with the optimal critical value of the ROC curve(46.23),193 patients were further divided into a high PNI group(PNI≤46.23,n=108)and low PNI group(PNI>46.23,n=85).The incidence of postoperative complications in the high PNI group was lower than that in the low PNI group(21.18%vs 38.96%).Kaplan-Meier survival analysis showed that the overall survival rate at 5 years in the low PNI group was 87.96%(13/108),which was lower than that in the high PNI group(61.18%,33/85;P<0.05).Low PNI[hazard ratio(HR)=1.74;P=0.003]and positive incisal margin status(HR=2.14;P=0.001)were independent predictors of biological recurrence in patients with high/extremely high-risk PCa.CONCLUSION The PNI has predictive value for the prognosis of patients with high/extremely high-risk PCa,and is an independent prognostic factor.Patients with low PNI value have a shorter time of nonbiological recurrence after prostatectomy.It is expected that the combined prediction of other clinicopathological data will further improve the accuracy and guide postoperative adjuvant therapy to improve the quality of prognosis.展开更多
<正>Objective To investigate the plasma osteoprotegerin(OPG)measurement for assessing the prognosis of intermediate coronary lesions in elderly patients.Methods We retrospectively analyzed patients meeting the i...<正>Objective To investigate the plasma osteoprotegerin(OPG)measurement for assessing the prognosis of intermediate coronary lesions in elderly patients.Methods We retrospectively analyzed patients meeting the inclusion criteria of suspicious chest pain or confirmed coronary artery disease(CHD),and intermediate stenosis lesions(20%~70%)in 3 main coronary arteries展开更多
BACKGROUND Stable angina pectoris,a clinical manifestation of coronary artery disease(CAD),is commonly evaluated using non-invasive diagnostic tools.Traditionally,stress testing modalities such as exercise electrocard...BACKGROUND Stable angina pectoris,a clinical manifestation of coronary artery disease(CAD),is commonly evaluated using non-invasive diagnostic tools.Traditionally,stress testing modalities such as exercise electrocardiography(ECG),myocardial per-fusion imaging(MPI),and stress echocardiography have been the first-line stra-tegies.However,coronary computed tomography angiography(CCTA),an anatomic imaging modality,is increasingly used for its ability to directly visualize coronary artery stenoses and plaque burden.Despite growing adoption,the comparative effectiveness of CCTA and stress testing in terms of diagnostic accuracy,prognostic value,and clinical outcomes in stable angina remains an area of active debate.AIM To compare the diagnostic and prognostic performance of CCTA with various forms of stress testing in adult patients presenting with suspected or confirmed stable angina.METHODS A comprehensive literature search was performed across PubMed,EMBASE,Scopus,and the Cochrane Central Register of Controlled Trials in accordance with the PRISMA guidelines.Only randomized controlled trials(RCT)published in English within the last 15 years were included.Studies involving adult patients(≥18 years)with stable angina or low-risk chest pain were selected.The intervention was CCTA,and the comparators included ECG,MPI,and stress echocardiography.Data were extracted using a standardized process,and study quality was assessed using the Cochrane Risk of Bias 2.0 tool.Due to heterogeneity in outcome measures and modalities,narrative synthesis was employed.RESULTS Five high-quality RCTs encompassing a total of 5551 patients were included.CCTA demonstrated superior diagnostic accuracy and prognostic capability across multiple studies.It was more effective in predicting major adverse cardiac events,including myocardial infarction and cardiac death,and was associated with fewer un-necessary invasive coronary angiographies and better event-free survival.Studies also reported improved revascu-larization rates in patients evaluated with CCTA,particularly within tiered diagnostic protocols.Stress testing,while useful,showed limitations in sensitivity and downstream clinical decision-making.CONCLUSION CCTA offers a diagnostically superior and clinically impactful strategy for the initial evaluation of patients with stable angina,especially those with intermediate pretest probability of CAD.Compared to conventional stress testing,it enhances risk stratification,reduces unnecessary procedures,and may improve long-term outcomes.These findings support its broader integration into diagnostic pathways for stable angina.展开更多
Evaluating the prognostic significance of biomarkers in pancreatic cyst fluid,accessed through endoscopic ultrasound-guided fine-needle aspiration,is essential for improving the clinical management of pancreatic cysts...Evaluating the prognostic significance of biomarkers in pancreatic cyst fluid,accessed through endoscopic ultrasound-guided fine-needle aspiration,is essential for improving the clinical management of pancreatic cysts.This review synthesizes the evidence from studies published on the field in the last years,focusing on the accuracy and clinical utility of biomarkers such as carcinoembryonic antigen,intracystic glucose,and novel genetic markers including DNA mutation analysis.Our findings indicate that elevated carcinoembryonic antigen levels and decreased intra-cystic glucose levels are strongly associated with mucinous cysts which carry a higher malignancy risk,while DNA mutation analysis has shown increased predictive accuracy for identifying malignant transformations.Integrating these biomarkers with imaging techniques enhances risk stratification and can significantly influence therapeutic decisions.The review highlights the need for standardization of biomarker assays and further validation of biomarker panels to refine their prognostic value in clinical settings,ultimately aiding in the tailored management of patients with pancreatic cysts.展开更多
This editorial discusses Alpsoy et al’s significant study of prognosis of pancreatic ductal adenocarcinoma(PDAC),which lacks histopathological markers.This study evaluated the synergistic prognolymphocytes.Peritumora...This editorial discusses Alpsoy et al’s significant study of prognosis of pancreatic ductal adenocarcinoma(PDAC),which lacks histopathological markers.This study evaluated the synergistic prognolymphocytes.Peritumoral budding is significantly correlated with tumor volume,while intratumoral budding is closely related to lymph node metastasis.Peritumoral budding and intratumoral budding are confirmed as independent adverse prognostic factors,and their high levels of expression are associated with immature stromal phenotypes,suggesting the key role of epithelial-mesenchymal transition.These breakthrough findings provide a new multidimensional biomarker system for the prognostic assessment of PDAC,and promote the clinical transformation process of incorporating tumor budding indicators into the pathological reporting process.However,the complexity and spatiotemporal heterogeneity of the tumor microenvironment require us to go beyond traditional morphological analysis and move towards multiomics integration and dynamic monitoring.Through standardized pathological assessment,innovative treatment strategies and interdisciplinary collaboration,it is expected to transform tumor microenvironment-related markers into clinically applicable indicators,ultimately improving the treatment predicament of PDAC.This editorial intended to summarize relevant studies and share some of our views,in order to offer perspectives for future research.展开更多
AIM： To predict the visual outcome in patients undergoing macular hole surgery by two novel three-dimensional morphological parameters on optical coherence tomography （OCT）： area ratio factor （ARF） and volume ra...AIM： To predict the visual outcome in patients undergoing macular hole surgery by two novel three-dimensional morphological parameters on optical coherence tomography （OCT）： area ratio factor （ARF） and volume ratio factor （VRF）. METHODS： A clinical case series was conducted, including 54 eyes of 54 patients with an idiopathic macular hole （IMH）. Each patient had an OCT examination before and after surgery. Morphological parameters of the macular hole, such as minimum diameter, base diameter, and height were measured. Then, the macular hole index （Mill）, tractional hole index （THI）, and hole form factor （HFF） were calculated. Meanwhile, novel postoperative macular hole （MH） factors, ARF and VRF were calculated by three-dimensional morphology. Bivariate correlations were performed to acquire asymptotic significance values between the steady best corrected visual acuity （BCVA） after surgery and 2D/3D arguments of MH by the Pearson method with two-tailed test. All significant factors were analyzed by the receiver operating characteristic （ROC） curve analysis of SPSS software which were responsible for vision recovery. ROC curves analyses were performed to further discuss the different parameters on the prediction of visual outcome. RESULTS： The mean and standard deviation values of patients＇ age, symptoms duration, and follow-up time were 64.8＋8.9y （range： 28-81）, 18.6＋11.5d （range： 2-60）, and 11.4＋0.4mo （range： 6-24）, respectively. Steady-post-BCVA analyzed with bivariate correlations was found to be significantly correlated with base diameter （r＇0.521, P〈0.001）, minimum diameter （r=0.514, P〈0.001）, MHI （r -0.531, P〈0.001）, THI （r=-0.386, P=-0.004）, HFF （r=-0.508, P〈0.001）, and ARF （r=-0.532, P〈0.001）. Other characteristic parameters such as age, duration of surgery, height, diameter hole index, and VRF were not statistically significant with steady-post-BCVA. According to area under the curve （AUC） values, values of ARF, MHI, HFF, minimum diameter, THI, and base diameter are 0.806, 0.772, 0.750, 0.705, 0.690, and 0.686, respectively. However, Steady-post-BCVA analysis with bivariate correlations for VRF was no statistical significance. Results of ROC curve analysis indicated that the MHI value, HFF, and ARF was greater than 0.427, 1.027 and 1.558 respectively which could correlate with better visual acuity. CONCLUSION： Compared with MHI and HFF, ARF could effectively express three-dimensional characteristics of macular hole and achieve better sensitivity and specificity. Thus, ARF could be the most effective parameter to predict the visual outcome in macular hole surgery.展开更多
Objective: To explore the clinical significance of serum sB7-H3 and IL-1 in patients with hepatitis B associated hepatocellular carcinoma. Methods: 122 cases of patients with hepatitis B related liver diseases admitte...Objective: To explore the clinical significance of serum sB7-H3 and IL-1 in patients with hepatitis B associated hepatocellular carcinoma. Methods: 122 cases of patients with hepatitis B related liver diseases admitted to our hospital from January 2015 to June 2018 were selected, including 47 cases of patients with hepatitis B related hepatocellular carcinoma, 41 cases of patients with hepatitis B related cirrhosis and 34 cases of patients with hepatitis B virus, and 45 cases of healthy persons in the same period as normal control group. The serum sB7-H3, IL-1α, IL-1β levels were compared among the four groups. The relationship between serum sB7-H3, IL-1α, IL-1β and clinicopathological characteristics was analyzed, and the correlation of sB7-H3, IL-1α and IL-1β was analyzed by Pearson method. The efficacy of serum sB7-H3, IL-1α, IL-1β in early diagnosis and prognostic evaluation for hepatitis B associated hepatocellular carcinoma were analyzed by ROC and Logistic regression analysis. Results: The serum sB7-H3, IL-1α, IL-1β levels in the four groups were in order from high to low: hepatitis B related hepatocellular carcinoma>hepatitis B related cirrhosis>hepatitis B virus>normal control group, all above had statistical difference (P<0.05). The high levels of serum sB7-H3, IL-1α, IL-1β were significantly correlated with TNM stage, alpha fetoprotein level and lymph node metastasis (P<0.05). Spearman correlation analysis results showed that the serum level of sB7-H3 was positively correlated with IL-1α and IL-1β(r=0.837, 0.756;P<0.05), the serum level of IL-1α was positively correlated with IL-1β(r=0.734, P<0.05). The ROC curve and Logistic regression analysis showed that the AUC of sB7-H3, IL-1α, IL-1β and combined detection for the diagnosis of hepatitis B associated hepatocellular carcinoma was 0.893, 0.887, 0.881, 0.961 (P<0.05), respectively;the AUC of sB7-H3, IL-1α, IL-1β and combined detection for the prognostic evaluation for hepatitis B associated hepatocellular carcinoma was 0.843, 0.837, 0.834, 0.917, respectively. Conclusion:Serum sB7-H3, IL-1α, IL-1β levels could all be used for the early diagnosis and prognostic evaluation of hepatitis B associated hepatocellular carcinoma, and the combined detection is more effective, which has important clinical significance.展开更多
基金supported by Metallurgical Safety and Health Branch of Chinese Metal Society Health Hygiene Scientific Research Foundation(No.:jkws201828).
文摘Acute trauma is one of the most commonly seen diseases in the Emergency Department,and it attracts more attention due to the increasing disability rate and mortality.Early rapid and accurate assessment of the severity of trauma has a positive significance for improving clinical prognosis.The paper aims to review the characteristics of the severity score based on trauma severity,blood biochemical changes and serum biomarkers,and discuss its prognostic significance.
基金supported by the Postdoctoral Scientific Research Development Fund of Heilongjiang Province,2020(Grant No.LBH-Q20157).
文摘Background:This study aimed to evaluate the prognostic value of the lymphocyte-to-monocyte ratio(LMR)and cancer antigen 724(CA724)in patients with proximal gastric cancer residing in cold climate regions.Methods:A retrospective analysis was conducted on 313 patients diagnosed with proximal gastric cancer in cold climate regions between 2014 and 2017.Preoperative hematological markers,including LMR and CA724,were assessed.Receiver operating characteristic(ROC)curves were used to determine optimal cutoff values,which were then combined to form the LMR+CA724 score.Statistical analyses included Kaplan-Meier survival curves,log-rank tests,and Cox proportional hazards regression.Results:A high preoperative LMR+CA724 score was significantly associated with older age,advanced pTNM stage,vascular invasion,and elevated levels of NMPVR,NMR,and AAR.The LMR+CA724 score demonstrated a higher area under the curve(AUC)compared to LMR or CA724 alone.Multivariate analysis identified pTNM stage,Borrmann type,histological type,and the LMR+CA724 score as independent prognostic factors for overall survival(OS).A nomogram incorporating these four variables achieved an AUC of 0.817,indicating strong predictive performance.Conclusion:The LMR+CA724 score is a reliable and independent prognostic indicator for patients with proximal gastric cancer in cold climate regions.Its integration into clinical practice may support treatment planning and long-term management by enhancing personalized care.Further prospective studies are warranted to validate these findings in broader and more diverse patient populations.
文摘BACKGROUND The incidence of prostate cancer(PCa)is on the rise in China.The risk level of patients with PCa is associated with disease-free survival rate at 10 years after radical prostatectomy.Predicting prognosis in advance according to the degree of risk can provide a reference for patients,especially treatment options and postoperative adjuvant treatment measures for high-risk/extremely high-risk patients.AIM To explore the predictive value of the prognostic nutritional index(PNI)for biological recurrence in Chinese patients with high/extremely high-risk PCa after radical prostatectomy.METHODS The biochemical test results and clinical data of 193 patients who underwent radical prostatectomy for the first time from January 2015 to December 2020 were retrospectively collected.The PNI value of peripheral blood within 1 wk before surgery was calculated,and during the follow-up period,prostate-specific antigen≥0.2 ng/mL was considered to have biological recurrence.The receiver operating characteristic(ROC)curve was used to calculate the optimal critical value and area under the curve(AUC)of the patients.According to the critical value,the progression-free survival of the high PNI group and low PNI group was compared.The independent influencing factors of the patients’prognosis were obtained by the Cox proportional hazards regression model.RESULTS The non-biological recurrence rates at 1,3,and 5 years were 92.02%,84.05%,and 74.85%,respectively.The optimal critical value for PNI to predict biological recurrence was 46.23,and the AUC was 0.789(95%confidence interval:0.651-0.860;P<0.001).The sensitivity and specificity were 82.93%and 62.30%,respectively.In accordance with the optimal critical value of the ROC curve(46.23),193 patients were further divided into a high PNI group(PNI≤46.23,n=108)and low PNI group(PNI>46.23,n=85).The incidence of postoperative complications in the high PNI group was lower than that in the low PNI group(21.18%vs 38.96%).Kaplan-Meier survival analysis showed that the overall survival rate at 5 years in the low PNI group was 87.96%(13/108),which was lower than that in the high PNI group(61.18%,33/85;P<0.05).Low PNI[hazard ratio(HR)=1.74;P=0.003]and positive incisal margin status(HR=2.14;P=0.001)were independent predictors of biological recurrence in patients with high/extremely high-risk PCa.CONCLUSION The PNI has predictive value for the prognosis of patients with high/extremely high-risk PCa,and is an independent prognostic factor.Patients with low PNI value have a shorter time of nonbiological recurrence after prostatectomy.It is expected that the combined prediction of other clinicopathological data will further improve the accuracy and guide postoperative adjuvant therapy to improve the quality of prognosis.
文摘<正>Objective To investigate the plasma osteoprotegerin(OPG)measurement for assessing the prognosis of intermediate coronary lesions in elderly patients.Methods We retrospectively analyzed patients meeting the inclusion criteria of suspicious chest pain or confirmed coronary artery disease(CHD),and intermediate stenosis lesions(20%~70%)in 3 main coronary arteries
文摘BACKGROUND Stable angina pectoris,a clinical manifestation of coronary artery disease(CAD),is commonly evaluated using non-invasive diagnostic tools.Traditionally,stress testing modalities such as exercise electrocardiography(ECG),myocardial per-fusion imaging(MPI),and stress echocardiography have been the first-line stra-tegies.However,coronary computed tomography angiography(CCTA),an anatomic imaging modality,is increasingly used for its ability to directly visualize coronary artery stenoses and plaque burden.Despite growing adoption,the comparative effectiveness of CCTA and stress testing in terms of diagnostic accuracy,prognostic value,and clinical outcomes in stable angina remains an area of active debate.AIM To compare the diagnostic and prognostic performance of CCTA with various forms of stress testing in adult patients presenting with suspected or confirmed stable angina.METHODS A comprehensive literature search was performed across PubMed,EMBASE,Scopus,and the Cochrane Central Register of Controlled Trials in accordance with the PRISMA guidelines.Only randomized controlled trials(RCT)published in English within the last 15 years were included.Studies involving adult patients(≥18 years)with stable angina or low-risk chest pain were selected.The intervention was CCTA,and the comparators included ECG,MPI,and stress echocardiography.Data were extracted using a standardized process,and study quality was assessed using the Cochrane Risk of Bias 2.0 tool.Due to heterogeneity in outcome measures and modalities,narrative synthesis was employed.RESULTS Five high-quality RCTs encompassing a total of 5551 patients were included.CCTA demonstrated superior diagnostic accuracy and prognostic capability across multiple studies.It was more effective in predicting major adverse cardiac events,including myocardial infarction and cardiac death,and was associated with fewer un-necessary invasive coronary angiographies and better event-free survival.Studies also reported improved revascu-larization rates in patients evaluated with CCTA,particularly within tiered diagnostic protocols.Stress testing,while useful,showed limitations in sensitivity and downstream clinical decision-making.CONCLUSION CCTA offers a diagnostically superior and clinically impactful strategy for the initial evaluation of patients with stable angina,especially those with intermediate pretest probability of CAD.Compared to conventional stress testing,it enhances risk stratification,reduces unnecessary procedures,and may improve long-term outcomes.These findings support its broader integration into diagnostic pathways for stable angina.
文摘Evaluating the prognostic significance of biomarkers in pancreatic cyst fluid,accessed through endoscopic ultrasound-guided fine-needle aspiration,is essential for improving the clinical management of pancreatic cysts.This review synthesizes the evidence from studies published on the field in the last years,focusing on the accuracy and clinical utility of biomarkers such as carcinoembryonic antigen,intracystic glucose,and novel genetic markers including DNA mutation analysis.Our findings indicate that elevated carcinoembryonic antigen levels and decreased intra-cystic glucose levels are strongly associated with mucinous cysts which carry a higher malignancy risk,while DNA mutation analysis has shown increased predictive accuracy for identifying malignant transformations.Integrating these biomarkers with imaging techniques enhances risk stratification and can significantly influence therapeutic decisions.The review highlights the need for standardization of biomarker assays and further validation of biomarker panels to refine their prognostic value in clinical settings,ultimately aiding in the tailored management of patients with pancreatic cysts.
基金Supported by National Natural Science Foundation of China,No.82404058Shanghai Municipal Commission of Health and Family Planning,No.2024ZZ2049Beijing Xisike Clinical Oncology Research Foundation,No.Y-HS202401-0011.
文摘This editorial discusses Alpsoy et al’s significant study of prognosis of pancreatic ductal adenocarcinoma(PDAC),which lacks histopathological markers.This study evaluated the synergistic prognolymphocytes.Peritumoral budding is significantly correlated with tumor volume,while intratumoral budding is closely related to lymph node metastasis.Peritumoral budding and intratumoral budding are confirmed as independent adverse prognostic factors,and their high levels of expression are associated with immature stromal phenotypes,suggesting the key role of epithelial-mesenchymal transition.These breakthrough findings provide a new multidimensional biomarker system for the prognostic assessment of PDAC,and promote the clinical transformation process of incorporating tumor budding indicators into the pathological reporting process.However,the complexity and spatiotemporal heterogeneity of the tumor microenvironment require us to go beyond traditional morphological analysis and move towards multiomics integration and dynamic monitoring.Through standardized pathological assessment,innovative treatment strategies and interdisciplinary collaboration,it is expected to transform tumor microenvironment-related markers into clinically applicable indicators,ultimately improving the treatment predicament of PDAC.This editorial intended to summarize relevant studies and share some of our views,in order to offer perspectives for future research.
基金Supported by National Natural Science Foundation of China(No.61675124No.81501559)+1 种基金Natural Science Foundation of the Higher Education Institutions of Jiangsu Province,China(No.15KJB310015)Science and Technology Foundation of Nantong Technology Bureau(No.MS12015180)
文摘AIM： To predict the visual outcome in patients undergoing macular hole surgery by two novel three-dimensional morphological parameters on optical coherence tomography （OCT）： area ratio factor （ARF） and volume ratio factor （VRF）. METHODS： A clinical case series was conducted, including 54 eyes of 54 patients with an idiopathic macular hole （IMH）. Each patient had an OCT examination before and after surgery. Morphological parameters of the macular hole, such as minimum diameter, base diameter, and height were measured. Then, the macular hole index （Mill）, tractional hole index （THI）, and hole form factor （HFF） were calculated. Meanwhile, novel postoperative macular hole （MH） factors, ARF and VRF were calculated by three-dimensional morphology. Bivariate correlations were performed to acquire asymptotic significance values between the steady best corrected visual acuity （BCVA） after surgery and 2D/3D arguments of MH by the Pearson method with two-tailed test. All significant factors were analyzed by the receiver operating characteristic （ROC） curve analysis of SPSS software which were responsible for vision recovery. ROC curves analyses were performed to further discuss the different parameters on the prediction of visual outcome. RESULTS： The mean and standard deviation values of patients＇ age, symptoms duration, and follow-up time were 64.8＋8.9y （range： 28-81）, 18.6＋11.5d （range： 2-60）, and 11.4＋0.4mo （range： 6-24）, respectively. Steady-post-BCVA analyzed with bivariate correlations was found to be significantly correlated with base diameter （r＇0.521, P〈0.001）, minimum diameter （r=0.514, P〈0.001）, MHI （r -0.531, P〈0.001）, THI （r=-0.386, P=-0.004）, HFF （r=-0.508, P〈0.001）, and ARF （r=-0.532, P〈0.001）. Other characteristic parameters such as age, duration of surgery, height, diameter hole index, and VRF were not statistically significant with steady-post-BCVA. According to area under the curve （AUC） values, values of ARF, MHI, HFF, minimum diameter, THI, and base diameter are 0.806, 0.772, 0.750, 0.705, 0.690, and 0.686, respectively. However, Steady-post-BCVA analysis with bivariate correlations for VRF was no statistical significance. Results of ROC curve analysis indicated that the MHI value, HFF, and ARF was greater than 0.427, 1.027 and 1.558 respectively which could correlate with better visual acuity. CONCLUSION： Compared with MHI and HFF, ARF could effectively express three-dimensional characteristics of macular hole and achieve better sensitivity and specificity. Thus, ARF could be the most effective parameter to predict the visual outcome in macular hole surgery.
基金This study was supported by Nantong City Science and Technology Program 2018 (Guidance) Project, No. MSZ18183, TACE Combined with Microwave Ablation on Immune Function of Smal and Medium-sized Hepatocel ular Carcinoma Patients and Therapeutic Observation
文摘Objective: To explore the clinical significance of serum sB7-H3 and IL-1 in patients with hepatitis B associated hepatocellular carcinoma. Methods: 122 cases of patients with hepatitis B related liver diseases admitted to our hospital from January 2015 to June 2018 were selected, including 47 cases of patients with hepatitis B related hepatocellular carcinoma, 41 cases of patients with hepatitis B related cirrhosis and 34 cases of patients with hepatitis B virus, and 45 cases of healthy persons in the same period as normal control group. The serum sB7-H3, IL-1α, IL-1β levels were compared among the four groups. The relationship between serum sB7-H3, IL-1α, IL-1β and clinicopathological characteristics was analyzed, and the correlation of sB7-H3, IL-1α and IL-1β was analyzed by Pearson method. The efficacy of serum sB7-H3, IL-1α, IL-1β in early diagnosis and prognostic evaluation for hepatitis B associated hepatocellular carcinoma were analyzed by ROC and Logistic regression analysis. Results: The serum sB7-H3, IL-1α, IL-1β levels in the four groups were in order from high to low: hepatitis B related hepatocellular carcinoma>hepatitis B related cirrhosis>hepatitis B virus>normal control group, all above had statistical difference (P<0.05). The high levels of serum sB7-H3, IL-1α, IL-1β were significantly correlated with TNM stage, alpha fetoprotein level and lymph node metastasis (P<0.05). Spearman correlation analysis results showed that the serum level of sB7-H3 was positively correlated with IL-1α and IL-1β(r=0.837, 0.756;P<0.05), the serum level of IL-1α was positively correlated with IL-1β(r=0.734, P<0.05). The ROC curve and Logistic regression analysis showed that the AUC of sB7-H3, IL-1α, IL-1β and combined detection for the diagnosis of hepatitis B associated hepatocellular carcinoma was 0.893, 0.887, 0.881, 0.961 (P<0.05), respectively;the AUC of sB7-H3, IL-1α, IL-1β and combined detection for the prognostic evaluation for hepatitis B associated hepatocellular carcinoma was 0.843, 0.837, 0.834, 0.917, respectively. Conclusion:Serum sB7-H3, IL-1α, IL-1β levels could all be used for the early diagnosis and prognostic evaluation of hepatitis B associated hepatocellular carcinoma, and the combined detection is more effective, which has important clinical significance.
