Background:This study assessed the frequency of changes in some key receptor status of tumors after neoadjuvant chemotherapy(NAC)in patients with invasive breast cancer and the prognostic impact of these changes.Metho...Background:This study assessed the frequency of changes in some key receptor status of tumors after neoadjuvant chemotherapy(NAC)in patients with invasive breast cancer and the prognostic impact of these changes.Methods:This study included 300 patients diagnosed with invasive breast cancer who were treated with both NAC and surgery between 2012 and 2021.The hormone receptor(HR)and human epidermal growth factor receptor 2(HER2)levels were measured before and after NAC.The prognostic impact of receptor conversion was also evaluated in patients receiving NAC,by using the Kaplan-Meier method and Cox proportional hazards models as statistical methods.Results:The conversion rate of estrogen receptor–positive(ER^(+))to ER-negative(ER^(-))was similar to that of ER^(-)to ER^(+)(9.2%and10.9%,respectively).The proportion of HR^(-)to HR^(+)was remarkably higher than that of HR^(+)to HR^(-)(14.8%vs 9.2%,respectively).The change from HER2^(+)to HER2^(-)was significantly more frequently than that from HER2^(-)to HER2^(+)(20.3%vs 6%,respectively).Patients with ER and HR status changes from(-)to(+)after NAC had significantly worse recurrence-free survival(RFS)and overall survival(OS)than those in the other 3 groups(ER^(-)to ER^(+):RFS:p=0.002,OS:p<0.001;HR^(-)to HR^(+):RFS:p=0.003,OS:p<0.001).The 4 HER2 conversion subgroups were not significantly associated with RFS or OS.Conclusions:This study demonstrated a discordance in HR status after NAC and identified predictors of conversion.Patients whose HR status switched to positive after NAC had the worst 3-year RFS and OS rates.展开更多
Objective: to explore the effect and prognosis of targeted nursing on patients with pneumonia. Methods:100 patients with pneumonia admitted to our hospital from January 2019 to January 2020 were selected and divided i...Objective: to explore the effect and prognosis of targeted nursing on patients with pneumonia. Methods:100 patients with pneumonia admitted to our hospital from January 2019 to January 2020 were selected and divided into groups according to the order of admission. 50 patients in the control group received routine care, while 50 patients in the experimental group received targeted care. The improvement of pulmonary function indexes and the difference of recurrence rate of pneumonia between the two groups were analyzed. Results: the improvement of pulmonary function index in the experimental group was significantly better than that in the control group. The relapse rate of pneumonia in the experimental group was significantly lower than that in the control group, and the difference between the groups was statistically significant (P < 0.05). Conclusion: the targeted nursing method is effective for the improvement of pulmonary function index of patients with pneumonia, and can significantly reduce the recurrence rate of pneumonia and improve the prognosis effect, which can be vigorously promoted in clinical practice.展开更多
Objective: to study the specific effect of collaborative nursing intervention on self-nursing ability and prognosis of patients with chronic obstructive pulmonary disease. Methods: a total of 92 patients admitted in o...Objective: to study the specific effect of collaborative nursing intervention on self-nursing ability and prognosis of patients with chronic obstructive pulmonary disease. Methods: a total of 92 patients admitted in our hospital from March 2020 to March 2021 were selected. The patients were randomly divided into two groups, control group and observation group, with 46 cases in each group. Among them, the nursing intervention selected by the patients in the control group was basic health intervention, and the nursing intervention selected by the patients in the observation group was collaborative nursing intervention based on the control group. After a period of intervention, the self-nursing ability, pulmonary ventilation function and prognosis were analyzed. Results: (1) Self-nursing ability: before intervention, there was no significant difference in self-nursing ability between the two groups, and there was no significant difference between the two groups, P > 0.05;After the intervention, according to the score of ESCA scale (self-nursing skills, self-nursing responsibility, self-concept and self-nursing knowledge), the data of the observation group and the control group increased significantly after the intervention, and the difference between the two groups was statistically significant (P < 0.05). (2) Pulmonary ventilation function: before the intervention, the difference between the two groups was not very obvious, and there was no statistical significance, P > 0.05. Conclusion: after the intervention, there was significant difference in the level of ventilation function (FEV1, FVC, FEV1 / FVC) between the observation group and the control group, and the data comparison between the two groups was statistically significant (P < 0.05)展开更多
BackgroundSeveral prognostic biomarkers have been validated for acute myeloid leukemia(AML),a heterogeneous hematopoietic malignancy.However,the factors associated with the cumulative incidence of relapse(CIR)and leuk...BackgroundSeveral prognostic biomarkers have been validated for acute myeloid leukemia(AML),a heterogeneous hematopoietic malignancy.However,the factors associated with the cumulative incidence of relapse(CIR)and leukemia-free survival(LFS)in real-world patients with AML have not been well defined.MethodsThis study examined clinical and mutational data of 246 patients with newly diagnosed AML who received the traditional“3+7”regimen in PLA General Hospital from January 2008 to August 2020.Factors associated with CIR and LFS in patients newly diagnosed with AML were analyzed using next-generation sequencing.ResultsAdditional sex combs-like 1(ASXL1)and Serine/arginine-rich splicing factor 2(SRSF2)mutations were found to be associated with an increased risk of CIR and a reduced LFS in univariate analysis,while only SRSF2 mutations were associated with these factors in the multivariate analysis.Hyperleukocytosis maintained an independent effect on LFS in the multivariate analysis.Hematopoietic stem cell transplantation conferred a significant prognostic benefit on both CIR and LFS in our cohort.Furthermore,we validated the risk classification of patients with AML receiving traditional induction regimens across a broad age range.Based on next-generation sequencing results,we concluded that SRSF2 mutations were predictive of an increased risk of relapse,inferior LFS rates,and non-relapse mortality in patients with newly diagnosed AML.ConclusionThese findings indicate that patients with SRSF2 mutations might not benefit from the conventional“3+7”regimen.Our results may help in developing molecular stratification strategies and could guide treatment decisions for patients with newly diagnosed AML.展开更多
基金supported by grants from the Basic Research Project of Shanxi Science and Technology Department(no.202303021221190)the Shanxi General Surgery“136”Healthcare Engineering Project(no.2024XYZ03)。
文摘Background:This study assessed the frequency of changes in some key receptor status of tumors after neoadjuvant chemotherapy(NAC)in patients with invasive breast cancer and the prognostic impact of these changes.Methods:This study included 300 patients diagnosed with invasive breast cancer who were treated with both NAC and surgery between 2012 and 2021.The hormone receptor(HR)and human epidermal growth factor receptor 2(HER2)levels were measured before and after NAC.The prognostic impact of receptor conversion was also evaluated in patients receiving NAC,by using the Kaplan-Meier method and Cox proportional hazards models as statistical methods.Results:The conversion rate of estrogen receptor–positive(ER^(+))to ER-negative(ER^(-))was similar to that of ER^(-)to ER^(+)(9.2%and10.9%,respectively).The proportion of HR^(-)to HR^(+)was remarkably higher than that of HR^(+)to HR^(-)(14.8%vs 9.2%,respectively).The change from HER2^(+)to HER2^(-)was significantly more frequently than that from HER2^(-)to HER2^(+)(20.3%vs 6%,respectively).Patients with ER and HR status changes from(-)to(+)after NAC had significantly worse recurrence-free survival(RFS)and overall survival(OS)than those in the other 3 groups(ER^(-)to ER^(+):RFS:p=0.002,OS:p<0.001;HR^(-)to HR^(+):RFS:p=0.003,OS:p<0.001).The 4 HER2 conversion subgroups were not significantly associated with RFS or OS.Conclusions:This study demonstrated a discordance in HR status after NAC and identified predictors of conversion.Patients whose HR status switched to positive after NAC had the worst 3-year RFS and OS rates.
文摘Objective: to explore the effect and prognosis of targeted nursing on patients with pneumonia. Methods:100 patients with pneumonia admitted to our hospital from January 2019 to January 2020 were selected and divided into groups according to the order of admission. 50 patients in the control group received routine care, while 50 patients in the experimental group received targeted care. The improvement of pulmonary function indexes and the difference of recurrence rate of pneumonia between the two groups were analyzed. Results: the improvement of pulmonary function index in the experimental group was significantly better than that in the control group. The relapse rate of pneumonia in the experimental group was significantly lower than that in the control group, and the difference between the groups was statistically significant (P < 0.05). Conclusion: the targeted nursing method is effective for the improvement of pulmonary function index of patients with pneumonia, and can significantly reduce the recurrence rate of pneumonia and improve the prognosis effect, which can be vigorously promoted in clinical practice.
文摘Objective: to study the specific effect of collaborative nursing intervention on self-nursing ability and prognosis of patients with chronic obstructive pulmonary disease. Methods: a total of 92 patients admitted in our hospital from March 2020 to March 2021 were selected. The patients were randomly divided into two groups, control group and observation group, with 46 cases in each group. Among them, the nursing intervention selected by the patients in the control group was basic health intervention, and the nursing intervention selected by the patients in the observation group was collaborative nursing intervention based on the control group. After a period of intervention, the self-nursing ability, pulmonary ventilation function and prognosis were analyzed. Results: (1) Self-nursing ability: before intervention, there was no significant difference in self-nursing ability between the two groups, and there was no significant difference between the two groups, P > 0.05;After the intervention, according to the score of ESCA scale (self-nursing skills, self-nursing responsibility, self-concept and self-nursing knowledge), the data of the observation group and the control group increased significantly after the intervention, and the difference between the two groups was statistically significant (P < 0.05). (2) Pulmonary ventilation function: before the intervention, the difference between the two groups was not very obvious, and there was no statistical significance, P > 0.05. Conclusion: after the intervention, there was significant difference in the level of ventilation function (FEV1, FVC, FEV1 / FVC) between the observation group and the control group, and the data comparison between the two groups was statistically significant (P < 0.05)
基金This work was partially supported by grants from the National Natural Science Foundation of China(Nos.82200169,82070178,81770203,81700122,and 81270610)the Military Translational Medicine Fund of the Chinese PLA General Hospital(No.ZH19003)+2 种基金the Medical Big Data and Artificial Intelligence Development Fund of the Chinese PLA General Hospital(Nos.2019MBD-016 and 2019MBD-008)the Military Medical Support Innovation and Generate Special Program(No.21WQ034)the Special Research Fund for Health Protection(No.21BJZ30).
文摘BackgroundSeveral prognostic biomarkers have been validated for acute myeloid leukemia(AML),a heterogeneous hematopoietic malignancy.However,the factors associated with the cumulative incidence of relapse(CIR)and leukemia-free survival(LFS)in real-world patients with AML have not been well defined.MethodsThis study examined clinical and mutational data of 246 patients with newly diagnosed AML who received the traditional“3+7”regimen in PLA General Hospital from January 2008 to August 2020.Factors associated with CIR and LFS in patients newly diagnosed with AML were analyzed using next-generation sequencing.ResultsAdditional sex combs-like 1(ASXL1)and Serine/arginine-rich splicing factor 2(SRSF2)mutations were found to be associated with an increased risk of CIR and a reduced LFS in univariate analysis,while only SRSF2 mutations were associated with these factors in the multivariate analysis.Hyperleukocytosis maintained an independent effect on LFS in the multivariate analysis.Hematopoietic stem cell transplantation conferred a significant prognostic benefit on both CIR and LFS in our cohort.Furthermore,we validated the risk classification of patients with AML receiving traditional induction regimens across a broad age range.Based on next-generation sequencing results,we concluded that SRSF2 mutations were predictive of an increased risk of relapse,inferior LFS rates,and non-relapse mortality in patients with newly diagnosed AML.ConclusionThese findings indicate that patients with SRSF2 mutations might not benefit from the conventional“3+7”regimen.Our results may help in developing molecular stratification strategies and could guide treatment decisions for patients with newly diagnosed AML.
