Precise risk stratification is crucial for selecting the optimal risk-adapted treatment for newly diagnosed multiple myeloma (NDMM) patients. Various prognostic factors and staging systems have been developed to predi...Precise risk stratification is crucial for selecting the optimal risk-adapted treatment for newly diagnosed multiple myeloma (NDMM) patients. Various prognostic factors and staging systems have been developed to predict NDMM patient outcomes. The Durie-Salmon (D-S) staging system reflects tumor burden and clinical progression staging with prognostic value.展开更多
BACKGROUND Acute-on-chronic liver failure(ACLF)is a liver disease based on chronic liver disease,which is significantly influenced by clinical treatment regimen and disease status,and despite the existence of multiple...BACKGROUND Acute-on-chronic liver failure(ACLF)is a liver disease based on chronic liver disease,which is significantly influenced by clinical treatment regimen and disease status,and despite the existence of multiple prognostic assessment indicators for ACLF,the overall sensitivity and accuracy are relatively low.AIM To investigate the prognostic value of the combined detection of alpha-fetoprotein(AFP),plasma prothrombin activity(PTA),and serum prealbumin(PA)in ACLF.METHODS This retrospective study included 87 patients with ACLF admitted from February 2021 to February 2023 and categorized them into the survival(n=47)and death(n=40)groups according to their clinical outcomes 3 months posttreatment.All the participants underwent AFP,PTA,and PA level measurements upon admission.Baseline data,as well as AFP,PTA,and PA levels,were comparatively analyzed.Pearson correlation coefficients were utilized to analyze the correlations of AFP,PTA,and PA with different survival outcomes in patients with ACLF.Receiver operating characteristic(ROC)curves and areas under the curves were used to evaluate the predictive value of AFP,PTA,and PA for ACLF prognosis.RESULTS AFP,PTA,and PA levels were markedly decreased in the death group than in the survival group(P<0.05).Pearson analysis indicated a positive association of the AFP,PTA,and PA levels with the survival of patients with ACLF(P<0.05).ROC curve analysis determined the sensitivity and specificity of the combined diagnosis at 91.24%and 100.00%,respectively,both of which were notably increased compared to the single-index diagnosis.The ROC of their combined diagnosis was 0.989,significantly surpassing 0.907,0.849,and 0.853 of AFP,PTA,and PA,respectively.No statistically significant variance was determined in the sensitivity and specificity of the combined diagnosis vs the single detection(P>0.05).CONCLUSION The combined detection of AFP,PTA,and PA levels demonstrates favorable diagnostic value for the short-term prognosis of patients with ACLF,featuring high sensitivity and specificity.展开更多
BACKGROUND The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined.METHODS All CTO vesse...BACKGROUND The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined.METHODS All CTO vessels treated with successful anatomical PCI in patients from PANDA Ⅲ trial were retrospectively measured for postPCI QFR.The primary outcome was 2-year vessel-oriented composite endpoints (VOCEs,composite of target vessel-related cardiac death,target vessel-related myocardial infarction,and ischemia-driven target vessel revascularization).Receiver operator characteristic curve analysis was conducted to identify optimal cutoff value of post-PCI QFR for predicting the 2-year VOCEs,and all vessels were stratified by this optimal cutoff value.Cox proportional hazards models were employed to calculate the hazard ratio (HR) with 95% CI.RESULTS Among 428 CTO vessels treated with PCI,353 vessels (82.5%) were analyzable for post-PCI QFR.31 VOCEs (8.7%) occurred at 2 years.Mean value of post-PCI QFR was 0.92±0.13.Receiver operator characteristic curve analysis shown the optimal cutoff value of post-PCI QFR for predicting 2-year VOCEs was 0.91.The incidence of 2-year VOCEs in the vessel with post-PCI QFR<0.91 (n=91) was significantly higher compared with the vessels with post-PCI QFR≥0.91 (n=262)(22.0%vs.4.2%,HR=4.98,95%CI:2.32–10.70).CONCLUSIONS Higher post-PCI QFR values were associated with improved prognosis in the PCI practice for coronary CTO.Achieving functionally optimal PCI results (post-PCI QFR value≥0.91) tends to get better prognosis for patients with CTO lesions.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is a global popular malignant tumor,which is difficult to cure,and the current treatment is limited.AIM To analyze the impacts of stress granule(SG)genes on overall survival(OS)...BACKGROUND Hepatocellular carcinoma(HCC)is a global popular malignant tumor,which is difficult to cure,and the current treatment is limited.AIM To analyze the impacts of stress granule(SG)genes on overall survival(OS),survival time,and prognosis in HCC.METHODS The combined The Cancer Genome Atlas-Liver Hepatocellular Carcinoma(TCGA-LIHC),GSE25097,and GSE36376 datasets were utilized to obtain genetic and clinical information.Optimal hub gene numbers and corresponding coefficients were determined using the Least absolute shrinkage and selection operator model approach,and genes for constructing risk scores and corresponding correlation coefficients were calculated according to multivariate Cox regression,respectively.The prognostic model’s receiver operating characteristic(ROC)curve was produced and plotted utilizing the time ROC software package.Nomogram models were constructed to predict the outcomes at 1,3,and 5-year OS prognostications with good prediction accuracy.RESULTS We identified seven SG genes(DDX1,DKC1,BICC1,HNRNPUL1,CNOT6,DYRK3,CCDC124)having a prognostic significance and developed a risk score model.The findings of Kaplan-Meier analysis indicated that the group with a high risk exhibited significantly reduced OS in comparison with those of the low-risk group(P<0.001).The nomogram model’s findings indicate a significant enhancement in the accuracy of OS prediction for individuals with HCC in the TCGA-HCC cohort.Gene Ontology and Gene Set Enrichment Analysis suggested that these SGs might be involved in the cell cycle,RNA editing,and other biological processes.CONCLUSION Based on the impact of SG genes on HCC prognosis,in the future,it will be used as a biomarker as well as a unique therapeutic target for the identification and treatment of HCC.展开更多
Background Increased levels of inflammatory markers have been documented in various settings of coronary artery disease. The vulnerability of coronary lesions in acute myocardial infarction(AMI) at the time of onset m...Background Increased levels of inflammatory markers have been documented in various settings of coronary artery disease. The vulnerability of coronary lesions in acute myocardial infarction(AMI) at the time of onset may be related to serum levels of C reactive protein(CRP) on admission, before CRP levels are affected by myocardial damage.Objective This study assessed the predictive value of CRP levels within six hours after the onset of acute anterior myocardial infarction with primary percutaneous coronary intervention(PCI).Methods The plasma CRP of 76 patients with first acute anterior myocardial infarction was measured within 6 hours after onset. They were divided into 2 groups: group 1( n =20) with elevated CRP( ≥0.3mg/dl ) on admission within 6 hours after onset and group 2( n =56) with normal CRP( <0.3mg/dl ) within 6 hours after onset. All patients were treated by primary PCI. The primary combined end points, including death due to cardiac causes, re MI related to the infarction artery(RIA) and repeat intervention of the RIA, and the restenosis rate were assessed in relation to CRP levels within 6 hours after onset. Left ventricular end diastolic volume index(EDVI),end systolic volume index(ESVI),and ejection fraction(EF) on admission and 6 month after the onset were assessed by left ventriculography. Changes in EDVI(ΔEDVI),ESVI(ΔESVI), and EF(ΔEF) were obtained by subtracting respective on admission values from corresponding 6 month follow up values. Results There were no significant differences in baseline characteristics between the two groups. The primary combined end points were significantly more frequent in group 1(20%) than those in group 2( 1.79% , P <0.01 ).In addition, restenosis rates were significantly higher in group 1 than in group 2(41.18% vs 16.07%, P<0.05). Group 1 showed greater increases in left ventricular volume and less improvement in EF compared with group 2(ΔEDVI 6.31 ±2.17 vs 3.29 ±9.46ml/m 2 , ΔESVI 5.92 ±2.31 vs 3.86 ±1.08ml/m 2 , ΔEF 1.92 ±0.47 vs 4.79 ±1.73% , P <0.05 , respectively).Conclusions CRP levels within 6 hours after the onset of AMI might predict adverse outcome after primary PCI and progressive ventricular remodeling within 6 month of AMI.展开更多
AIM: To determine the prognostic value of circulating indicators of cell death in acute-on-chronic liver failure (ACLF) patients with chronic hepatitis B virus (HBV) infection as the single etiology. METHODS: Full len...AIM: To determine the prognostic value of circulating indicators of cell death in acute-on-chronic liver failure (ACLF) patients with chronic hepatitis B virus (HBV) infection as the single etiology. METHODS: Full length and caspase cleaved cytokeratin 18 (detected as M65 and M30 antigens) represent circulating indicators of necrosis and apoptosis. M65 and M30 were identified by enzyme-linked immunosorbent assay in 169 subjects including healthy controls (n = 33), patients with chronic hepatitis B (CHB, n = 55) and patients with ACLF (n = 81). According to the 3-mo survival period, ACLF patients were defined as having spontaneous recovery (n = 33) and non-spontaneous recovery which included deceased patients and those who required liver transplantation (n = 48). RESULTS: Both biomarker levels significantly increased gradually as liver disease progressed (for M65: P < 0.001 for all; for M30: control vs CHB, P = 0.072; others: P < 0.001 for all). In contrast, the M30/M65 ratio was significantly higher in controls compared with CHB patients (P = 0.010) or ACLF patients (P < 0.001). In addition, the area under receiver operating characteristic curve (AUC) analysis demonstrated that both biomarkers had diagnostic value (AUC >= 0.80) in identifying ACLF from CHB patients. Interestingly, it is worth noting that the M30/M65 ratio was significantly different between spontaneous and non-spontaneous recovery in ACLF patients (P = 0.032). The prognostic value of the M30/M65 ratio was compared with the Model for End-Stage Liver Disease (MELD) and Child-Pugh scores at the 3-mo survival period, the AUC of the M30/M65 ratio was 0.66 with a sensitivity of 52.9% and the highest specificity of 92.6% (MELD:AUC = 0.71; sensitivity, 79.4%; specificity, 63.0%; Child-Pugh: AUC = 0.77; sensitivity, 61.8%; specificity, 88.9%). CONCLUSION: M65 and M30 are strongly associated with liver disease severity. The M30/M65 ratio may be a potential prognostic marker for spontaneous recovery in patients with HBV-related ACLF. (C) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.展开更多
Histological low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 （LSIL/CIN1） preceded by normal or mildly abnormal cytology is recommended for conservative follow-up, with no separat...Histological low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 （LSIL/CIN1） preceded by normal or mildly abnormal cytology is recommended for conservative follow-up, with no separated management. In this study, we assessed the triage value of human papillomavirus （HPV） 16/18 genotyping in 273 patients with LSIL/CINI. HPV16/18 genotyping was performed at baseline and follow-up was at 6-monthly intervals for up to 2 years. At each follow-up, women positive for cytology or high-risk HPV （hrHPV） were referred for colposcopy. Enrollment cytology, HPV16/18 genotyping, and questionnaire-obtained factors were linked to the 2-year cumulative progression rate. Univariate and multivariate analyses were performed taking into account time-to-event with Cox proportional hazard regression. The results showed that 190 cases （69.6%） regressed, 37 （13.6%） persisted, and 46 （16.8%） progressed. HPV16/18 positivity （hazard ratio （HR）, 2.708; 95% confidence interval （CI）, 1.432-5.121; P=-0.002） is significantly associated with higher 2-year cumulative progression rate. Sub-analysis by enrollment cytology and age restricted the positive association among patients preceded by mildly abnormal cytology and aged 30 years or older. Immediate treatment is a rational recommendation for the high-risk subgroup, when good compliance is not assured.展开更多
Objective:Conversion of normal cells to cancer cells is often accompanied by abnormal synthesis of serum enzymes.Both alkaline phosphatase(ALP)and lactate dehydrogenase(LDH)have been reported to have prognostic value ...Objective:Conversion of normal cells to cancer cells is often accompanied by abnormal synthesis of serum enzymes.Both alkaline phosphatase(ALP)and lactate dehydrogenase(LDH)have been reported to have prognostic value in a variety of malignancies.The aim of this study was to investigate the effect of preoperative serum ALP and LDH levels on the prognosis of patients with periampullary carcinoma who underwent pancreatoduodenectomy(PD).展开更多
AIM： To establish whether there are fundamental differences in the biochemistries of adenocarcinomas of the gastroesophageal junction （GEJ） and the squamous cell carcinomas of the lower third of the esophagus （LTE...AIM： To establish whether there are fundamental differences in the biochemistries of adenocarcinomas of the gastroesophageal junction （GEJ） and the squamous cell carcinomas of the lower third of the esophagus （LTE）. METHODS： Between February 1, 1997 and February 1, 2000, we obtained tissue samples at the moment of resection from 54 patients for biochemical analysis. The full set of data could be comprehensively analyzed in 47 of 54 patients＇ samples （81%）. Of these, 29 were adenocarcinomas of the GEJ Siewert type Ⅰ （n = 8）, type Ⅱ （n = 12）, type Ⅲ （n = 9）, and 18 presented as squamous cell carcinomas of the LTE. We evaluated the mean values of 11-lysosomal enzyme and 1-cytosol protease activities of the tumorous and surrounding mucosae as well as their relative activities, measured as the ratio of activity in tumor and normal tissues from the same patient. These data were further analyzed to establish the correlation with tumor localization, TNM stage （lymph-node involvement）, histological type （papillary, signet-ring cell, tubular）, state of differentiation （good, moderate, poor）, and survival （≤24 or ≥24 mo）. RESULTS： In adenocarcinomas, the activity of α-mannosidase （AMAN）, cathepsin B （CB） and dipeptidyl-peptidase Ⅰ （DPP Ⅰ） increased significantly as compared to the normal gastric mucosa. In squamous cell carcinomas of the esophagus, we also found a significant difference in the activity of cathepsin L and tripeptidyl-peptidase Ⅰ in addition to these three. There was a statistical correlation of AMAN, CB, and DPP Ⅰ activity between the level of differentiation of adenocarcinomas of the GEJ and lymph node involvement,because tumors with no lymph node metastases histologically confirmed as well-differentiated, showed a significantly lower activity. The differences in CB and DPP Ⅰ activity correlated well with the differences in survival rates, since the CB and DPP Ⅰ values of those who died within 24 mo following surgical intervention were significantly higher than of those who survived for 2 years or more. CONCLUSION： Adenocarcinomas of the GEJ form a homogenous group from a tumor-biochemical aspect, and differ from the biochemical characteristics of squamous cell carcinomas of the LTE on many points. When adenocarcinomas of the GEJs are examined at the preoperative phase, the ratio of the performed AMAN, CB, and DPP Ⅰ enzymatic activity of the tissue sample from the tumor and adjacent intact mucosa within 2 cm of the tumor may have a prognostic value even in the preoperative examination period, and may indicate that ranking of these patients into the neo-adjuvant treatment group should be considered.展开更多
AIM To investigate the clinical significance of routinely used glycemic parameters in a cohort of colorectal cancer(CRC) patients.METHODS Pre-treatment fasting blood glucose, insulin, Hb A1 c and homeostasis model of ...AIM To investigate the clinical significance of routinely used glycemic parameters in a cohort of colorectal cancer(CRC) patients.METHODS Pre-treatment fasting blood glucose, insulin, Hb A1 c and homeostasis model of risk assessment(HOMA-IR) were retrospectively evaluated in a case-control study of 224 CRC and 112 control subjects matched for sex, obesity and diabetes frequency and blood lipid profile.Furthermore, the prognostic value of routinely used glycemic parameters towards progression-free(PFS) and overall survival(OS) was prospectively evaluated.RESULTS Fasting blood glucose, insulin, HOMA-IR and HbA 1c(all P < 0.0001) levels were higher in non-diabetic CRC patients compared with obesity-matched controls. All parameters were associated with increased CRC risk at ROC analysis, but no relationship with clinical-pathological variables or survival outcomes was observed for glycemia, insulinemia or HOMA-IR. Conversely, advanced CRC stage(P = 0.018) was an independent predictor of increased Hb A1 c levels, which were also higher in patients who had disease progression compared with those who did not(P = 0.05). Elevated Hb A1 c levels showed a negative prognostic value both in terms of PFS(HR = 1.24) and OS(HR = 1.36) after adjustment for major confounders, which was further confirmed in a subgroup analysis performed after exclusion of diabetic patients.CONCLUSION HbA 1c might have a negative prognostic value in CRC, thus suggesting that glycemic metabolic markers should be carefully monitored in these patients, independently of overt diabetes.展开更多
Objective: To investigate the expression of nm23 gene and evaluate its prognostic value in breast cancer. Methods: nm23 expressions were detected in 101 breast cancer patients (group 1) by immunohistochemistry. RT-PCR...Objective: To investigate the expression of nm23 gene and evaluate its prognostic value in breast cancer. Methods: nm23 expressions were detected in 101 breast cancer patients (group 1) by immunohistochemistry. RT-PCR and immunohistochemistry were used to measure expressions of nm23 gene in another 68 patients with breast cancer (group 2). Results: nm23 gene expression in group 1 was inversely associated with distant metastasis and lymph node metastasis (P<0.05). In 44 patients with negative lymph node, 9 cases progressed to distant metastasis, 7 of them (77.8%) showed low expression of nm23 gene (P<0.05). In 57 patients with positive lymph node, 24 our of 29 patients who had no distant metastasis (82.8%) expressed nm23 gene at high level (P<0.05). Meanwhile, there were 6 patients with distant metastasis in the group 2, all of thenm expressed nm23 gene mRNA at low level. Conclusion: The results showed that nm23 gene might play an independent role in predicting prognosis of breast cancer.展开更多
Background Previous studies have shown that an echocardiographic right/left ventricular end-diastolic diameter ratio(RV/LV ratio)≥0.9 is an independent predictor of poor prognosis in patients with acute pulmonary emb...Background Previous studies have shown that an echocardiographic right/left ventricular end-diastolic diameter ratio(RV/LV ratio)≥0.9 is an independent predictor of poor prognosis in patients with acute pulmonary embolism. The prognostic value of the RV/LV ratio in patients with idiopathic pulmonary arterial hypertension(IPAH) is still unknown. Methods We retrospectively enrolled 95 consecutive patients with newly diagnosed IPAH and 16 of them were reevaluated by echocardiography at 3-12 months following targeted therapy.Follow-up data were obtained by telephone interviews and review of the patients’ records.Results The RV/LV ratio was in parallel with the severity of World Health Orgnization(WHO) functional class and mean right atrial pressure.The RV/LV ratio was positively correlated with total pulmonary resistance(P P P 2 saturation(P P = 0.001),weight and absence of targeted therapy were independent predictors of death.No significant changes in the RV/LV ratio before and after targeted therapy were observed. A baseline RV/LV ratio≥0.84 or a further increase in the RV/LV ratio during targeted therapy indicated a poor prognosis. Conclusions The RV/LV ratio helps to assess the severity of IPAH and serves as an independent predictor of prognosis in patients with IPAH.展开更多
Objective: to analyze the clinical value and prognosis of TLR4 diagnosis in patients with acute kidney injury. Methods: the initial time of the inclusion study was shown as March 2020, and the deadline was February 20...Objective: to analyze the clinical value and prognosis of TLR4 diagnosis in patients with acute kidney injury. Methods: the initial time of the inclusion study was shown as March 2020, and the deadline was February 2022. The source of the cases was identified as the patients with acute kidney injury admitted to the hospital. The total number of patients was 40. The inclusion group was divided into two groups, 40 patients with acute kidney injury in Group A and healthy people in Group B. The diagnostic value and the final prognosis of the two groups were analyzed. Results: after the intervention, the two groups were compared for the correlation level of serum indicators, SOFA score, baseline serum creatinine, baseline eGFR and lactic acid level, etc. the data was expressed as p 0.05. Conclusion: the diagnosis of acute kidney injury by TLR4 can improve the diagnosis effect of clinical diseases and the prognosis quality of patients. the research results prove that it can be used for clinical promotion.展开更多
Objective To investigate the impact of coronary angiography-derived index of microcirculatory resistance(caIMR) on the long-term prognosis of patients with coronary heart disease (CHD) undergoing elective percutaneous...Objective To investigate the impact of coronary angiography-derived index of microcirculatory resistance(caIMR) on the long-term prognosis of patients with coronary heart disease (CHD) undergoing elective percutaneous coronary intervention(PCI).展开更多
Opportunistic infections caused by viruses,bacteria,fungi,and parasites,are commonly reported in hospitalized human immunodeficiency virus(HIV)-positive patients,but their detrimental contribution to disease severity ...Opportunistic infections caused by viruses,bacteria,fungi,and parasites,are commonly reported in hospitalized human immunodeficiency virus(HIV)-positive patients,but their detrimental contribution to disease severity remains under explored.In this study,we examined the coinfection profiles of 126 HIV-positive patients with suspected respiratory,bloodstream,or neurological infections.Lower respiratory tract(LRT)samples,cerebrospinal fluid,and blood samples collected within the first seven days of admission were subjected to metagenomic next-generation sequencing(mNGS).Additionally,a multiplex polymerase chain reaction(PCR)detection kit to identify ten commonly known respiratory pathogens was applied to the LRT samples.Of 126 HIV-positive patients,111(88.1%)were coinfected with at least one known virus.Epstein-Barr virus(EBV)(71/111,64.0%),human cytomegalovirus(HCMV)(64/111,57.7%),and torque teno virus(TTV)(63/111,56.8%)were the three most prevalent coinfected viruses.Fungal coinfections(58/126,46.0%)and bacterial coinfections(47/126,37.3%)were less frequent than viral coinfections.Higher viral loads of coinfection were associated with fungal coinfections(odds ratio[OR]=2.573,95%confidence interval[CI]:1.150-5.757,P=0.0214)and lower CD4^(+)/CD8^(+)T cell ratios(OR=0.048,95%CI:0.005-0.429,P=0.0067).Importantly,patients with higher loads of HCMV and TTV,but not EBV,exhibited worse clinical outcomes.Specifically,patients with HCMV reads per million(RPM)>0 and TTV RPM>5 exhibited significantly higher risks of poor prognosis and intensive care unit(ICU)admission.In contrast,EBV RPM showed no association with clinical outcomes in this context.In conclusion,HCMV and TTV may serve as prognostic biomarkers linked to poorer outcomes in HIV-positive patients.Detection of HCMV and TTV could predict clinical outcomes and improve patient management strategies.展开更多
BACKGROUND Acute decompensated heart failure(ADHF)is one of the leading causes of mortality,highlighting the importance of early identification of high-risk patients.The fibrosis-5(FIB-5)index,traditionally used to ev...BACKGROUND Acute decompensated heart failure(ADHF)is one of the leading causes of mortality,highlighting the importance of early identification of high-risk patients.The fibrosis-5(FIB-5)index,traditionally used to evaluate hepatic fibrosis,may hold prognostic value in ADHF patients by reflecting systemic congestion,inflammation,and organ dysfunction.The hypothesis of this study is that the FIB-5 index is an independent predictor of 1-month mortality in patients with ADHF.METHODS This retrospective study included 155 patients diagnosed with ADHF between 2020 and 2024.Patients were divided into two groups based on their left ventricular ejection fraction(LVEF≤40%or LVEF>50%).Survival was monitored for one month,and clinical,biochemical,and echocardiographic parameters were compared between survivors and death.Logistic regression and receiver operating characteristic curve analyses were performed to assess the prognostic value of the FIB-5 index.RESULTS During the 1-month follow-up,66 patients(42.6%)died.The mean FIB-5 index was significantly lower in non-survivors(−10.46±6.93)compared to survivors(−8.10±6.67)(P=0.03).Multivariate regression analysis identified the FIB-5 index as an independent predictor of 1-month mortality(OR=1.089,95%CI:1.022–1.160,P=0.009).The receiver operating characteristic curve analysis demonstrated an area under the curve of 0.609(95%CI:0.51–0.699)with sensitivity of 59.6%and specificity of 63.4%.Kaplan-Meier survival analysis revealed significantly higher mortality rates among patients with lower FIB-5 values(log-rank:7.887,P=0.005).CONCLUSIONS The FIB-5 index is an independent predictor of 1-month mortality in ADHF patients.Its low cost,non-invasive nature,and ability to reflect systemic inflammation and congestion make it a promising tool for risk stratification.Prospective studies are needed to validate its utility in clinical practice and evaluate its role in guiding therapeutic decisions.展开更多
Background The over increase of sympathetic drive in chronic heart failure （CHF） is with main responsibility for the deterioration and mortality of the disease.Myocardial 123I-metaiodobenzylganidine （MIBG） scintig...Background The over increase of sympathetic drive in chronic heart failure （CHF） is with main responsibility for the deterioration and mortality of the disease.Myocardial 123I-metaiodobenzylganidine （MIBG） scintigraphy is a non-invasive convenient method to assess sympathetic dysfunction in patients with CHF.The aim of the study was to detect if sympathetic antidrive analysed through myocardial MIBG scintigraphy plays a crucial role in long-term prognosis in CHF.Methods Sixty-four enrolled patients underwent myocardial MIBG scintigraphy, and their plasma concentration of brain natriuretic peptide （BNP）, myocardial contractile reserve （MCR）, rest left ventricular ejection fraction （rest LVEF）and New York Heart Association （NYHA） function class were assessed.They were separated into groups according to median of above parameters.Endpoint was cardiac death and it was recorded in each group during average 54 months＇ follow-up.Results At the end of follow-up, group with lower ratio of heart/mediastinum （H/M） had more death events （P=0.001）,and its BNP level was higher and MCR level was lower （P=0.003 and 0.001, respectively）; but its rest LVEF and NYHA function class were not significantly different.H/M, MCR and BNP correlated closely with death （P=0.000, 0.000 and 0.001, respectively）.Among the three indicators the death risk ratio （RR） of H/M was 4.66, more than MCR and BNP （1.88 and 2.56, respectively）.However, rest LVEF and NYHA function class did not correlate with death （P=0.652 and 0.384, respectively）.The group with lower H/M and MCR, higher BNP had much more death than that with higher H/M and MCR, lower BNP, the RR being 12.8.Conclusions Myocardial MIBG scintigraphy is a long-term prognostic marker in CHF.BNP, MCR are also excellent predictors of long-term prognosis in CHF, but not stronger than myocardial MIBG scintigraphy.If the three indicators were joined together, the prediction would become most powerful.Rest LVEF and NYHA have no significance in long-term prediction of CHF.展开更多
Objective To evaluate the prognostic value of JAK2,MPL and CALR mutations in Chinese patients with primary myelofibrosis(PMF).Methods Four hundred and two Chinese patients with PMF were retrospectively analyzed.The Ka...Objective To evaluate the prognostic value of JAK2,MPL and CALR mutations in Chinese patients with primary myelofibrosis(PMF).Methods Four hundred and two Chinese patients with PMF were retrospectively analyzed.The Kaplan-Meier method,the Log-rank test,the likelihood ratio test and the Cox展开更多
Objective To analyze the serum keratin 18(K18)level of patients with hepatitis B virus(HBV)-related acute-on-chronic liver failure(HBV-ACLF)and its correlation with prognosis.Methods From December 2012 to October 2014...Objective To analyze the serum keratin 18(K18)level of patients with hepatitis B virus(HBV)-related acute-on-chronic liver failure(HBV-ACLF)and its correlation with prognosis.Methods From December 2012 to October 2014,120 patients who visited Fuzhou Infectious Diseases Hospital and were diagnosed with HBV-ACLF were enrolled,and 20 chronic hepatitis B(CHB)pa-展开更多
The decreasing of hazard ratio for cancer incidence (HRCVD) in the range of twenty native tissues (lung, liver, brain, hematologic, neuroendocrine renal, pancreas, lymphoid, bladder, colon, lip-oral-head-neck, leukocy...The decreasing of hazard ratio for cancer incidence (HRCVD) in the range of twenty native tissues (lung, liver, brain, hematologic, neuroendocrine renal, pancreas, lymphoid, bladder, colon, lip-oral-head-neck, leukocytic, rectum and anus, thyroid, soft tissue, prostate, skin, ovarian, breast, uterine) as much, as decreasing of the level of cardiovascular pathology (CVD) in the host before malignization, have been described by C.F. Bell et al. in 2023. Earlier, in 2022, the decreasing of 5-year mortality from cancer in similar range of tissues discussed by us as the inverse dependence from the content of stem CD34 markers in tissues before malignization, with example of population in England. In present article we investigate the interrelation between both data more thoroughly, using accessible and more representative populations level of the data. The analysis shows that high level of HRCVD is able to predicts only high cancer death for tissue sites in the beginning of the range, being applied to the referent data of cancer cases and deaths in estimated population of USA 2024. Along with this, an increasing the content of CD34 stem marker in the native tissues of the same range was favorite for increasing of cancer’s cases at the end of the range, diminishing, in parallel, the signs of vasculo-endothelial pathology, i.e. HR CVD. Thus, the cases (incidence) of cancer depend directly rather from content of CD34, which preexisted in native sites, than that from HRCVD. Further analysis shows that CD34 content averaged over twenty cites dominates over that CD2 marker of total T-cells more than 7 times, in oppose to their ratio in the blood. The enhancement of stem CD34 marker in the range of tissues is accompanied by unidirectional rising of its maturing derivatives, vasculo-endothelial CD31 and total T-cells CD2 markers, which contents relate positively to increasing of cancer death in US population 2024. The increase of CD34 decreases cancer mortality (death: cases) in sites, but indirectly, rather due to enhancement of the denominator. The high HRCVD (more than 1.0) in range of 20 tissues, concerns of those of them, which have had highest mitotic activity (by Ki67), but lowest “stemness” (by CD34), “vascularity” (by CD31), cancer’s incidence (cases) and the worse results of therapy. Oppositely, the normal tissue with lowest HRCVD (below 1.0) and Ki67, but highest CD34, CD31, and cancer incidence (cases) are more sensitive to treatment. Thus, the residential hematopoietic “stemness” in native tissues acts as natural protectors for cardio-vascular system and promoter for cancer incidence in them. The steady and irreversible exhaustion of current regenerative resource (CRR) of BM, which assumed by us as a product of CD34 number and average telomeres length, manifests itself in acceleration of non-malignant CVD and deceleration of malignancy in population +70 (in term the death per 105), according to data extracted from WHO Mortality Database. The similar deficit of CD34 arises artificially during cytotoxic treatment of cancer, when rapid waste of local CRR forces malignant cells to search more “stemness” cites. The competition between malignant and native tissues of the host for scanty CRR seems to be the most important factor for evaluation and prediction of prevalence, curability, and long-term results in oncology.展开更多
基金supported by the National Natural Science Foundation of China (Grant nos. 82470209 and 82170141)the Jiaxing Key Discipiline of Medcine-Nephrology (Grant no. 2023-ZC-011)。
文摘Precise risk stratification is crucial for selecting the optimal risk-adapted treatment for newly diagnosed multiple myeloma (NDMM) patients. Various prognostic factors and staging systems have been developed to predict NDMM patient outcomes. The Durie-Salmon (D-S) staging system reflects tumor burden and clinical progression staging with prognostic value.
文摘BACKGROUND Acute-on-chronic liver failure(ACLF)is a liver disease based on chronic liver disease,which is significantly influenced by clinical treatment regimen and disease status,and despite the existence of multiple prognostic assessment indicators for ACLF,the overall sensitivity and accuracy are relatively low.AIM To investigate the prognostic value of the combined detection of alpha-fetoprotein(AFP),plasma prothrombin activity(PTA),and serum prealbumin(PA)in ACLF.METHODS This retrospective study included 87 patients with ACLF admitted from February 2021 to February 2023 and categorized them into the survival(n=47)and death(n=40)groups according to their clinical outcomes 3 months posttreatment.All the participants underwent AFP,PTA,and PA level measurements upon admission.Baseline data,as well as AFP,PTA,and PA levels,were comparatively analyzed.Pearson correlation coefficients were utilized to analyze the correlations of AFP,PTA,and PA with different survival outcomes in patients with ACLF.Receiver operating characteristic(ROC)curves and areas under the curves were used to evaluate the predictive value of AFP,PTA,and PA for ACLF prognosis.RESULTS AFP,PTA,and PA levels were markedly decreased in the death group than in the survival group(P<0.05).Pearson analysis indicated a positive association of the AFP,PTA,and PA levels with the survival of patients with ACLF(P<0.05).ROC curve analysis determined the sensitivity and specificity of the combined diagnosis at 91.24%and 100.00%,respectively,both of which were notably increased compared to the single-index diagnosis.The ROC of their combined diagnosis was 0.989,significantly surpassing 0.907,0.849,and 0.853 of AFP,PTA,and PA,respectively.No statistically significant variance was determined in the sensitivity and specificity of the combined diagnosis vs the single detection(P>0.05).CONCLUSION The combined detection of AFP,PTA,and PA levels demonstrates favorable diagnostic value for the short-term prognosis of patients with ACLF,featuring high sensitivity and specificity.
基金supported by the CAMS Innovation Fund for Medical Sciences(No.2021-I2M-1-008)the National High Level Hospital Clinical Research Funding(No.2023-GSP-GG-2&No.2023-GSP-QN-34&No.2023-GSPRC-05).
文摘BACKGROUND The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined.METHODS All CTO vessels treated with successful anatomical PCI in patients from PANDA Ⅲ trial were retrospectively measured for postPCI QFR.The primary outcome was 2-year vessel-oriented composite endpoints (VOCEs,composite of target vessel-related cardiac death,target vessel-related myocardial infarction,and ischemia-driven target vessel revascularization).Receiver operator characteristic curve analysis was conducted to identify optimal cutoff value of post-PCI QFR for predicting the 2-year VOCEs,and all vessels were stratified by this optimal cutoff value.Cox proportional hazards models were employed to calculate the hazard ratio (HR) with 95% CI.RESULTS Among 428 CTO vessels treated with PCI,353 vessels (82.5%) were analyzable for post-PCI QFR.31 VOCEs (8.7%) occurred at 2 years.Mean value of post-PCI QFR was 0.92±0.13.Receiver operator characteristic curve analysis shown the optimal cutoff value of post-PCI QFR for predicting 2-year VOCEs was 0.91.The incidence of 2-year VOCEs in the vessel with post-PCI QFR<0.91 (n=91) was significantly higher compared with the vessels with post-PCI QFR≥0.91 (n=262)(22.0%vs.4.2%,HR=4.98,95%CI:2.32–10.70).CONCLUSIONS Higher post-PCI QFR values were associated with improved prognosis in the PCI practice for coronary CTO.Achieving functionally optimal PCI results (post-PCI QFR value≥0.91) tends to get better prognosis for patients with CTO lesions.
基金Supported by Hebei Traditional Chinese Medicine Scientific Research Project,No.2023223.
文摘BACKGROUND Hepatocellular carcinoma(HCC)is a global popular malignant tumor,which is difficult to cure,and the current treatment is limited.AIM To analyze the impacts of stress granule(SG)genes on overall survival(OS),survival time,and prognosis in HCC.METHODS The combined The Cancer Genome Atlas-Liver Hepatocellular Carcinoma(TCGA-LIHC),GSE25097,and GSE36376 datasets were utilized to obtain genetic and clinical information.Optimal hub gene numbers and corresponding coefficients were determined using the Least absolute shrinkage and selection operator model approach,and genes for constructing risk scores and corresponding correlation coefficients were calculated according to multivariate Cox regression,respectively.The prognostic model’s receiver operating characteristic(ROC)curve was produced and plotted utilizing the time ROC software package.Nomogram models were constructed to predict the outcomes at 1,3,and 5-year OS prognostications with good prediction accuracy.RESULTS We identified seven SG genes(DDX1,DKC1,BICC1,HNRNPUL1,CNOT6,DYRK3,CCDC124)having a prognostic significance and developed a risk score model.The findings of Kaplan-Meier analysis indicated that the group with a high risk exhibited significantly reduced OS in comparison with those of the low-risk group(P<0.001).The nomogram model’s findings indicate a significant enhancement in the accuracy of OS prediction for individuals with HCC in the TCGA-HCC cohort.Gene Ontology and Gene Set Enrichment Analysis suggested that these SGs might be involved in the cell cycle,RNA editing,and other biological processes.CONCLUSION Based on the impact of SG genes on HCC prognosis,in the future,it will be used as a biomarker as well as a unique therapeutic target for the identification and treatment of HCC.
文摘Background Increased levels of inflammatory markers have been documented in various settings of coronary artery disease. The vulnerability of coronary lesions in acute myocardial infarction(AMI) at the time of onset may be related to serum levels of C reactive protein(CRP) on admission, before CRP levels are affected by myocardial damage.Objective This study assessed the predictive value of CRP levels within six hours after the onset of acute anterior myocardial infarction with primary percutaneous coronary intervention(PCI).Methods The plasma CRP of 76 patients with first acute anterior myocardial infarction was measured within 6 hours after onset. They were divided into 2 groups: group 1( n =20) with elevated CRP( ≥0.3mg/dl ) on admission within 6 hours after onset and group 2( n =56) with normal CRP( <0.3mg/dl ) within 6 hours after onset. All patients were treated by primary PCI. The primary combined end points, including death due to cardiac causes, re MI related to the infarction artery(RIA) and repeat intervention of the RIA, and the restenosis rate were assessed in relation to CRP levels within 6 hours after onset. Left ventricular end diastolic volume index(EDVI),end systolic volume index(ESVI),and ejection fraction(EF) on admission and 6 month after the onset were assessed by left ventriculography. Changes in EDVI(ΔEDVI),ESVI(ΔESVI), and EF(ΔEF) were obtained by subtracting respective on admission values from corresponding 6 month follow up values. Results There were no significant differences in baseline characteristics between the two groups. The primary combined end points were significantly more frequent in group 1(20%) than those in group 2( 1.79% , P <0.01 ).In addition, restenosis rates were significantly higher in group 1 than in group 2(41.18% vs 16.07%, P<0.05). Group 1 showed greater increases in left ventricular volume and less improvement in EF compared with group 2(ΔEDVI 6.31 ±2.17 vs 3.29 ±9.46ml/m 2 , ΔESVI 5.92 ±2.31 vs 3.86 ±1.08ml/m 2 , ΔEF 1.92 ±0.47 vs 4.79 ±1.73% , P <0.05 , respectively).Conclusions CRP levels within 6 hours after the onset of AMI might predict adverse outcome after primary PCI and progressive ventricular remodeling within 6 month of AMI.
基金Supported by National Science and Technology Key Project of China on"Major Infectious Diseases",No.2012ZX10002004-006,No.2012ZX10004904-003-001,No.2013ZX10002002-006-001Beijing Municipal Science and Technology Commission,No.Z131107002213019,No.Z131100004613030+2 种基金High Technical Personnel Training Program in Beijing Health System,No.2011-3-083,No.2013-3-071Special Scientific Research Fund for Beijing Health Development,No.2011-2018-04National Natural Science Foundation of China,No.30800979,No.30800517
文摘AIM: To determine the prognostic value of circulating indicators of cell death in acute-on-chronic liver failure (ACLF) patients with chronic hepatitis B virus (HBV) infection as the single etiology. METHODS: Full length and caspase cleaved cytokeratin 18 (detected as M65 and M30 antigens) represent circulating indicators of necrosis and apoptosis. M65 and M30 were identified by enzyme-linked immunosorbent assay in 169 subjects including healthy controls (n = 33), patients with chronic hepatitis B (CHB, n = 55) and patients with ACLF (n = 81). According to the 3-mo survival period, ACLF patients were defined as having spontaneous recovery (n = 33) and non-spontaneous recovery which included deceased patients and those who required liver transplantation (n = 48). RESULTS: Both biomarker levels significantly increased gradually as liver disease progressed (for M65: P < 0.001 for all; for M30: control vs CHB, P = 0.072; others: P < 0.001 for all). In contrast, the M30/M65 ratio was significantly higher in controls compared with CHB patients (P = 0.010) or ACLF patients (P < 0.001). In addition, the area under receiver operating characteristic curve (AUC) analysis demonstrated that both biomarkers had diagnostic value (AUC >= 0.80) in identifying ACLF from CHB patients. Interestingly, it is worth noting that the M30/M65 ratio was significantly different between spontaneous and non-spontaneous recovery in ACLF patients (P = 0.032). The prognostic value of the M30/M65 ratio was compared with the Model for End-Stage Liver Disease (MELD) and Child-Pugh scores at the 3-mo survival period, the AUC of the M30/M65 ratio was 0.66 with a sensitivity of 52.9% and the highest specificity of 92.6% (MELD:AUC = 0.71; sensitivity, 79.4%; specificity, 63.0%; Child-Pugh: AUC = 0.77; sensitivity, 61.8%; specificity, 88.9%). CONCLUSION: M65 and M30 are strongly associated with liver disease severity. The M30/M65 ratio may be a potential prognostic marker for spontaneous recovery in patients with HBV-related ACLF. (C) 2014 Baishideng Publishing Group Co., Limited. All rights reserved.
基金Project supported by the Zhejiang Provincial Natural Science Foundation of China(No.LQ14H160007)the National Natural Science Foundation of China(No.81402364)+2 种基金the Zhejiang Provincial Medical & Hygienic Science and Technology Project of China(No.2013KYA104)the Special Fund for Scientific Research in the Public Interest from the National Health and Family Planning Commission of the People’s Republic of China(No.2015SQ00243)the National Key Research and Development Program of China(No.2016YFC1302900)
文摘Histological low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 （LSIL/CIN1） preceded by normal or mildly abnormal cytology is recommended for conservative follow-up, with no separated management. In this study, we assessed the triage value of human papillomavirus （HPV） 16/18 genotyping in 273 patients with LSIL/CINI. HPV16/18 genotyping was performed at baseline and follow-up was at 6-monthly intervals for up to 2 years. At each follow-up, women positive for cytology or high-risk HPV （hrHPV） were referred for colposcopy. Enrollment cytology, HPV16/18 genotyping, and questionnaire-obtained factors were linked to the 2-year cumulative progression rate. Univariate and multivariate analyses were performed taking into account time-to-event with Cox proportional hazard regression. The results showed that 190 cases （69.6%） regressed, 37 （13.6%） persisted, and 46 （16.8%） progressed. HPV16/18 positivity （hazard ratio （HR）, 2.708; 95% confidence interval （CI）, 1.432-5.121; P=-0.002） is significantly associated with higher 2-year cumulative progression rate. Sub-analysis by enrollment cytology and age restricted the positive association among patients preceded by mildly abnormal cytology and aged 30 years or older. Immediate treatment is a rational recommendation for the high-risk subgroup, when good compliance is not assured.
基金This study was supported by the National Natural Science Foundation of China(No.81772950).
文摘Objective:Conversion of normal cells to cancer cells is often accompanied by abnormal synthesis of serum enzymes.Both alkaline phosphatase(ALP)and lactate dehydrogenase(LDH)have been reported to have prognostic value in a variety of malignancies.The aim of this study was to investigate the effect of preoperative serum ALP and LDH levels on the prognosis of patients with periampullary carcinoma who underwent pancreatoduodenectomy(PD).
文摘AIM： To establish whether there are fundamental differences in the biochemistries of adenocarcinomas of the gastroesophageal junction （GEJ） and the squamous cell carcinomas of the lower third of the esophagus （LTE）. METHODS： Between February 1, 1997 and February 1, 2000, we obtained tissue samples at the moment of resection from 54 patients for biochemical analysis. The full set of data could be comprehensively analyzed in 47 of 54 patients＇ samples （81%）. Of these, 29 were adenocarcinomas of the GEJ Siewert type Ⅰ （n = 8）, type Ⅱ （n = 12）, type Ⅲ （n = 9）, and 18 presented as squamous cell carcinomas of the LTE. We evaluated the mean values of 11-lysosomal enzyme and 1-cytosol protease activities of the tumorous and surrounding mucosae as well as their relative activities, measured as the ratio of activity in tumor and normal tissues from the same patient. These data were further analyzed to establish the correlation with tumor localization, TNM stage （lymph-node involvement）, histological type （papillary, signet-ring cell, tubular）, state of differentiation （good, moderate, poor）, and survival （≤24 or ≥24 mo）. RESULTS： In adenocarcinomas, the activity of α-mannosidase （AMAN）, cathepsin B （CB） and dipeptidyl-peptidase Ⅰ （DPP Ⅰ） increased significantly as compared to the normal gastric mucosa. In squamous cell carcinomas of the esophagus, we also found a significant difference in the activity of cathepsin L and tripeptidyl-peptidase Ⅰ in addition to these three. There was a statistical correlation of AMAN, CB, and DPP Ⅰ activity between the level of differentiation of adenocarcinomas of the GEJ and lymph node involvement,because tumors with no lymph node metastases histologically confirmed as well-differentiated, showed a significantly lower activity. The differences in CB and DPP Ⅰ activity correlated well with the differences in survival rates, since the CB and DPP Ⅰ values of those who died within 24 mo following surgical intervention were significantly higher than of those who survived for 2 years or more. CONCLUSION： Adenocarcinomas of the GEJ form a homogenous group from a tumor-biochemical aspect, and differ from the biochemical characteristics of squamous cell carcinomas of the LTE on many points. When adenocarcinomas of the GEJs are examined at the preoperative phase, the ratio of the performed AMAN, CB, and DPP Ⅰ enzymatic activity of the tissue sample from the tumor and adjacent intact mucosa within 2 cm of the tumor may have a prognostic value even in the preoperative examination period, and may indicate that ranking of these patients into the neo-adjuvant treatment group should be considered.
基金Supported by European Social Fund,under the Italian Ministry of Education,University and Research,PON03PE_00146_1/10 BIBIOFAR(CUP B88F12000730005 to Guadagni F,partially)
文摘AIM To investigate the clinical significance of routinely used glycemic parameters in a cohort of colorectal cancer(CRC) patients.METHODS Pre-treatment fasting blood glucose, insulin, Hb A1 c and homeostasis model of risk assessment(HOMA-IR) were retrospectively evaluated in a case-control study of 224 CRC and 112 control subjects matched for sex, obesity and diabetes frequency and blood lipid profile.Furthermore, the prognostic value of routinely used glycemic parameters towards progression-free(PFS) and overall survival(OS) was prospectively evaluated.RESULTS Fasting blood glucose, insulin, HOMA-IR and HbA 1c(all P < 0.0001) levels were higher in non-diabetic CRC patients compared with obesity-matched controls. All parameters were associated with increased CRC risk at ROC analysis, but no relationship with clinical-pathological variables or survival outcomes was observed for glycemia, insulinemia or HOMA-IR. Conversely, advanced CRC stage(P = 0.018) was an independent predictor of increased Hb A1 c levels, which were also higher in patients who had disease progression compared with those who did not(P = 0.05). Elevated Hb A1 c levels showed a negative prognostic value both in terms of PFS(HR = 1.24) and OS(HR = 1.36) after adjustment for major confounders, which was further confirmed in a subgroup analysis performed after exclusion of diabetic patients.CONCLUSION HbA 1c might have a negative prognostic value in CRC, thus suggesting that glycemic metabolic markers should be carefully monitored in these patients, independently of overt diabetes.
基金This work was supported by the National 9th Five-Year Program of China(No. 96-906-01-13).
文摘Objective: To investigate the expression of nm23 gene and evaluate its prognostic value in breast cancer. Methods: nm23 expressions were detected in 101 breast cancer patients (group 1) by immunohistochemistry. RT-PCR and immunohistochemistry were used to measure expressions of nm23 gene in another 68 patients with breast cancer (group 2). Results: nm23 gene expression in group 1 was inversely associated with distant metastasis and lymph node metastasis (P<0.05). In 44 patients with negative lymph node, 9 cases progressed to distant metastasis, 7 of them (77.8%) showed low expression of nm23 gene (P<0.05). In 57 patients with positive lymph node, 24 our of 29 patients who had no distant metastasis (82.8%) expressed nm23 gene at high level (P<0.05). Meanwhile, there were 6 patients with distant metastasis in the group 2, all of thenm expressed nm23 gene mRNA at low level. Conclusion: The results showed that nm23 gene might play an independent role in predicting prognosis of breast cancer.
文摘Background Previous studies have shown that an echocardiographic right/left ventricular end-diastolic diameter ratio(RV/LV ratio)≥0.9 is an independent predictor of poor prognosis in patients with acute pulmonary embolism. The prognostic value of the RV/LV ratio in patients with idiopathic pulmonary arterial hypertension(IPAH) is still unknown. Methods We retrospectively enrolled 95 consecutive patients with newly diagnosed IPAH and 16 of them were reevaluated by echocardiography at 3-12 months following targeted therapy.Follow-up data were obtained by telephone interviews and review of the patients’ records.Results The RV/LV ratio was in parallel with the severity of World Health Orgnization(WHO) functional class and mean right atrial pressure.The RV/LV ratio was positively correlated with total pulmonary resistance(P P P 2 saturation(P P = 0.001),weight and absence of targeted therapy were independent predictors of death.No significant changes in the RV/LV ratio before and after targeted therapy were observed. A baseline RV/LV ratio≥0.84 or a further increase in the RV/LV ratio during targeted therapy indicated a poor prognosis. Conclusions The RV/LV ratio helps to assess the severity of IPAH and serves as an independent predictor of prognosis in patients with IPAH.
文摘Objective: to analyze the clinical value and prognosis of TLR4 diagnosis in patients with acute kidney injury. Methods: the initial time of the inclusion study was shown as March 2020, and the deadline was February 2022. The source of the cases was identified as the patients with acute kidney injury admitted to the hospital. The total number of patients was 40. The inclusion group was divided into two groups, 40 patients with acute kidney injury in Group A and healthy people in Group B. The diagnostic value and the final prognosis of the two groups were analyzed. Results: after the intervention, the two groups were compared for the correlation level of serum indicators, SOFA score, baseline serum creatinine, baseline eGFR and lactic acid level, etc. the data was expressed as p 0.05. Conclusion: the diagnosis of acute kidney injury by TLR4 can improve the diagnosis effect of clinical diseases and the prognosis quality of patients. the research results prove that it can be used for clinical promotion.
文摘Objective To investigate the impact of coronary angiography-derived index of microcirculatory resistance(caIMR) on the long-term prognosis of patients with coronary heart disease (CHD) undergoing elective percutaneous coronary intervention(PCI).
基金supported by the Key-Area Research and Development Program of Guangdong Province(2022B1111020002)the Science and Technology Project of Guangzhou(2025A03J3818,2024A03J0883,2023A03J0807,and 202201020527)the National Natural Science Foundation of China(92269108).
文摘Opportunistic infections caused by viruses,bacteria,fungi,and parasites,are commonly reported in hospitalized human immunodeficiency virus(HIV)-positive patients,but their detrimental contribution to disease severity remains under explored.In this study,we examined the coinfection profiles of 126 HIV-positive patients with suspected respiratory,bloodstream,or neurological infections.Lower respiratory tract(LRT)samples,cerebrospinal fluid,and blood samples collected within the first seven days of admission were subjected to metagenomic next-generation sequencing(mNGS).Additionally,a multiplex polymerase chain reaction(PCR)detection kit to identify ten commonly known respiratory pathogens was applied to the LRT samples.Of 126 HIV-positive patients,111(88.1%)were coinfected with at least one known virus.Epstein-Barr virus(EBV)(71/111,64.0%),human cytomegalovirus(HCMV)(64/111,57.7%),and torque teno virus(TTV)(63/111,56.8%)were the three most prevalent coinfected viruses.Fungal coinfections(58/126,46.0%)and bacterial coinfections(47/126,37.3%)were less frequent than viral coinfections.Higher viral loads of coinfection were associated with fungal coinfections(odds ratio[OR]=2.573,95%confidence interval[CI]:1.150-5.757,P=0.0214)and lower CD4^(+)/CD8^(+)T cell ratios(OR=0.048,95%CI:0.005-0.429,P=0.0067).Importantly,patients with higher loads of HCMV and TTV,but not EBV,exhibited worse clinical outcomes.Specifically,patients with HCMV reads per million(RPM)>0 and TTV RPM>5 exhibited significantly higher risks of poor prognosis and intensive care unit(ICU)admission.In contrast,EBV RPM showed no association with clinical outcomes in this context.In conclusion,HCMV and TTV may serve as prognostic biomarkers linked to poorer outcomes in HIV-positive patients.Detection of HCMV and TTV could predict clinical outcomes and improve patient management strategies.
文摘BACKGROUND Acute decompensated heart failure(ADHF)is one of the leading causes of mortality,highlighting the importance of early identification of high-risk patients.The fibrosis-5(FIB-5)index,traditionally used to evaluate hepatic fibrosis,may hold prognostic value in ADHF patients by reflecting systemic congestion,inflammation,and organ dysfunction.The hypothesis of this study is that the FIB-5 index is an independent predictor of 1-month mortality in patients with ADHF.METHODS This retrospective study included 155 patients diagnosed with ADHF between 2020 and 2024.Patients were divided into two groups based on their left ventricular ejection fraction(LVEF≤40%or LVEF>50%).Survival was monitored for one month,and clinical,biochemical,and echocardiographic parameters were compared between survivors and death.Logistic regression and receiver operating characteristic curve analyses were performed to assess the prognostic value of the FIB-5 index.RESULTS During the 1-month follow-up,66 patients(42.6%)died.The mean FIB-5 index was significantly lower in non-survivors(−10.46±6.93)compared to survivors(−8.10±6.67)(P=0.03).Multivariate regression analysis identified the FIB-5 index as an independent predictor of 1-month mortality(OR=1.089,95%CI:1.022–1.160,P=0.009).The receiver operating characteristic curve analysis demonstrated an area under the curve of 0.609(95%CI:0.51–0.699)with sensitivity of 59.6%and specificity of 63.4%.Kaplan-Meier survival analysis revealed significantly higher mortality rates among patients with lower FIB-5 values(log-rank:7.887,P=0.005).CONCLUSIONS The FIB-5 index is an independent predictor of 1-month mortality in ADHF patients.Its low cost,non-invasive nature,and ability to reflect systemic inflammation and congestion make it a promising tool for risk stratification.Prospective studies are needed to validate its utility in clinical practice and evaluate its role in guiding therapeutic decisions.
文摘Background The over increase of sympathetic drive in chronic heart failure （CHF） is with main responsibility for the deterioration and mortality of the disease.Myocardial 123I-metaiodobenzylganidine （MIBG） scintigraphy is a non-invasive convenient method to assess sympathetic dysfunction in patients with CHF.The aim of the study was to detect if sympathetic antidrive analysed through myocardial MIBG scintigraphy plays a crucial role in long-term prognosis in CHF.Methods Sixty-four enrolled patients underwent myocardial MIBG scintigraphy, and their plasma concentration of brain natriuretic peptide （BNP）, myocardial contractile reserve （MCR）, rest left ventricular ejection fraction （rest LVEF）and New York Heart Association （NYHA） function class were assessed.They were separated into groups according to median of above parameters.Endpoint was cardiac death and it was recorded in each group during average 54 months＇ follow-up.Results At the end of follow-up, group with lower ratio of heart/mediastinum （H/M） had more death events （P=0.001）,and its BNP level was higher and MCR level was lower （P=0.003 and 0.001, respectively）; but its rest LVEF and NYHA function class were not significantly different.H/M, MCR and BNP correlated closely with death （P=0.000, 0.000 and 0.001, respectively）.Among the three indicators the death risk ratio （RR） of H/M was 4.66, more than MCR and BNP （1.88 and 2.56, respectively）.However, rest LVEF and NYHA function class did not correlate with death （P=0.652 and 0.384, respectively）.The group with lower H/M and MCR, higher BNP had much more death than that with higher H/M and MCR, lower BNP, the RR being 12.8.Conclusions Myocardial MIBG scintigraphy is a long-term prognostic marker in CHF.BNP, MCR are also excellent predictors of long-term prognosis in CHF, but not stronger than myocardial MIBG scintigraphy.If the three indicators were joined together, the prediction would become most powerful.Rest LVEF and NYHA have no significance in long-term prediction of CHF.
文摘Objective To evaluate the prognostic value of JAK2,MPL and CALR mutations in Chinese patients with primary myelofibrosis(PMF).Methods Four hundred and two Chinese patients with PMF were retrospectively analyzed.The Kaplan-Meier method,the Log-rank test,the likelihood ratio test and the Cox
文摘Objective To analyze the serum keratin 18(K18)level of patients with hepatitis B virus(HBV)-related acute-on-chronic liver failure(HBV-ACLF)and its correlation with prognosis.Methods From December 2012 to October 2014,120 patients who visited Fuzhou Infectious Diseases Hospital and were diagnosed with HBV-ACLF were enrolled,and 20 chronic hepatitis B(CHB)pa-
文摘The decreasing of hazard ratio for cancer incidence (HRCVD) in the range of twenty native tissues (lung, liver, brain, hematologic, neuroendocrine renal, pancreas, lymphoid, bladder, colon, lip-oral-head-neck, leukocytic, rectum and anus, thyroid, soft tissue, prostate, skin, ovarian, breast, uterine) as much, as decreasing of the level of cardiovascular pathology (CVD) in the host before malignization, have been described by C.F. Bell et al. in 2023. Earlier, in 2022, the decreasing of 5-year mortality from cancer in similar range of tissues discussed by us as the inverse dependence from the content of stem CD34 markers in tissues before malignization, with example of population in England. In present article we investigate the interrelation between both data more thoroughly, using accessible and more representative populations level of the data. The analysis shows that high level of HRCVD is able to predicts only high cancer death for tissue sites in the beginning of the range, being applied to the referent data of cancer cases and deaths in estimated population of USA 2024. Along with this, an increasing the content of CD34 stem marker in the native tissues of the same range was favorite for increasing of cancer’s cases at the end of the range, diminishing, in parallel, the signs of vasculo-endothelial pathology, i.e. HR CVD. Thus, the cases (incidence) of cancer depend directly rather from content of CD34, which preexisted in native sites, than that from HRCVD. Further analysis shows that CD34 content averaged over twenty cites dominates over that CD2 marker of total T-cells more than 7 times, in oppose to their ratio in the blood. The enhancement of stem CD34 marker in the range of tissues is accompanied by unidirectional rising of its maturing derivatives, vasculo-endothelial CD31 and total T-cells CD2 markers, which contents relate positively to increasing of cancer death in US population 2024. The increase of CD34 decreases cancer mortality (death: cases) in sites, but indirectly, rather due to enhancement of the denominator. The high HRCVD (more than 1.0) in range of 20 tissues, concerns of those of them, which have had highest mitotic activity (by Ki67), but lowest “stemness” (by CD34), “vascularity” (by CD31), cancer’s incidence (cases) and the worse results of therapy. Oppositely, the normal tissue with lowest HRCVD (below 1.0) and Ki67, but highest CD34, CD31, and cancer incidence (cases) are more sensitive to treatment. Thus, the residential hematopoietic “stemness” in native tissues acts as natural protectors for cardio-vascular system and promoter for cancer incidence in them. The steady and irreversible exhaustion of current regenerative resource (CRR) of BM, which assumed by us as a product of CD34 number and average telomeres length, manifests itself in acceleration of non-malignant CVD and deceleration of malignancy in population +70 (in term the death per 105), according to data extracted from WHO Mortality Database. The similar deficit of CD34 arises artificially during cytotoxic treatment of cancer, when rapid waste of local CRR forces malignant cells to search more “stemness” cites. The competition between malignant and native tissues of the host for scanty CRR seems to be the most important factor for evaluation and prediction of prevalence, curability, and long-term results in oncology.
