My parents used to take us to all of the local weddings.Man,we got better at picking up the ricethan the birds did.We thought that running water was when you ran back to the house with a bucket of water from theneighb...My parents used to take us to all of the local weddings.Man,we got better at picking up the ricethan the birds did.We thought that running water was when you ran back to the house with a bucket of water from theneighbors hour.展开更多
According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(C...According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(CHF)is also increasing.[1–3]Reports have shown that the presence of cognitive impairment(CI)in patients with CHF is associated with poor prognosis,[4–6]and the degree of CI is related to CHF severity.展开更多
Dear Editor,Lung cancer is a major global health concern,with 2.2 million patients diagnosed in 2020.Non-small cell lung cancer(NSCLC)accounts for 80%of these cases,primarily comprising two subtypes:lung adenocarcinom...Dear Editor,Lung cancer is a major global health concern,with 2.2 million patients diagnosed in 2020.Non-small cell lung cancer(NSCLC)accounts for 80%of these cases,primarily comprising two subtypes:lung adenocarcinoma(LUAD)and squamous cell carcinoma(LUSC)[1].Researchers use immunohisto-chemistry,next-generation sequencing,and single-cell RNA sequencing to study genetic alterations,tumor heterogeneity,and tumor microenvironments,aiming to identify potential therapeutic options for specific NSCLC subtypes[2].展开更多
BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses r...BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses revealing a disproportionate burden among women.Despite the characteristically indolent nature of most thyroid carcinomas and their associated high survival rates,emerging evidence points to significant unmet needs regarding psychosocial adaptation and neuropsychiatric sequelae in this growing survivor population.The spectrum of mental health conditions,ranging from affective and anxiety disorders to cognitive impairments,presents substantial barriers to functional recovery and may potentially influence disease trajectories through complex psychoneuroimmunological pathways.Clinical observations consistently report elevated rates of mood disturbances and executive function deficits persisting throughout the cancer continuum,from active treatment into extended follow-up periods.These findings highlight a critical knowledge gap in understanding the dynamic interplay between thyroid cancer biology,its therapeutic interventions,and the development of treatment-resistant psychiatric manifestations that complicate long-term patient care.AIM To analyse the factors influencing the poor prognosis of patients surviving longterm differentiated thyroid cancer with psychiatric disorders and to construct a prediction model.METHODS Forty-eight patients with mental disorders combined with differentiated thyroid cancer who were treated in our hospital during the period of March 2018 to March 2023 were retrospectively selected as the study subjects(thyroid cancer group),and 30 cases each of patients with mental disorders combined with benign thyroid nodules(benign nodules group)and patients with mental disorders alone(mental disorders group),who were treated during the same time period,were selected as controls.The patients with differentiated thyroid cancer were further divided into a poor prognosis group(10 cases)and a good prognosis group(38 cases).The study outcome was poor prognosis as shown by whole body bone imaging within 2 years after thyroid cancer surgery.Factors influencing poor prognosis in survivors of differentiated thyroid cancer were analyzed by univariate and multivariate logistic regression analyses,receiver operating characteristic(ROC)curve analysis was used to assess the predictive efficacy of these factors for poor prognosis,and the DeLong test was used to determine whether there was a statistically significant difference in the area under the curve(AUC)of the model.RESULTS One-way logistic regression analysis showed that tumour diameter[odds ratio(OR)=19.190,P=0.002],T-stage(OR=7.692,P=0.018),extra-glandular infiltration(OR=37.000,P=0.003),degree of differentiation(OR=24.667,P=0.008),serum free T3(OR=22.348,P=0.025),serum free T4(FT4)(OR=1.158,P=0.002),total bilirubin(TBil)(OR=1.792,P=0.004),albumin(OR=0.675,P=0.003),cortisol(OR=1.180,P=0.003),norepinephrine(OR=1.047,P=0.002),angiotensin II(OR=1.975,P=0.002),and superoxide dismutase(OR=0.515,P=0.005)all increased the risk of poor prognosis in patients with psychiatric disorders and long-term differentiated thyroid cancer.Multifactorial logistic regression analysis showed that tumour diameter(OR=16.570,P=0.021),extraglandular infiltration(OR=53.145,P=0.010),FT4(OR=1.186,P=0.007),and TBil(OR=2.823,P=0.048)were independent risk factors for poor prognosis of patients with psychiatric disorders with long-term differentiated thyroid cancer,and the regression equation was:Y=2.808×tumour diameter+3.973×extra-glandular infiltration+0.171×FT4+1.038×TBil-88.138.ROC analysis showed that the predictive power of the overall model(AUC=0.992,P=0.000)was significantly higher than that of independent risk factors(DeLong test P<0.05).CONCLUSION Tumour diameter,extra-glandular infiltration,FT4,and TBil are independent risk factors for poor prognosis in patients with psychiatric disorders with long-term differentiated thyroid cancer,and the combination of these factors is of higher value in predicting the prognosis of patients.These risk factors can be used as a basis to develop a reasonable prognostic management plan in clinical practice for patients with long-term differentiated thyroid cancer with mental disorders,so as to improve the prognosis and quality of life of patients.展开更多
BACKGROUND The prognosis of patients with poorly differentiated gastric neuroendocrine neoplasms(PDGNENs)is dismal and related research is limited.AIM To investigate the prognostic factors,and validate a novel prognos...BACKGROUND The prognosis of patients with poorly differentiated gastric neuroendocrine neoplasms(PDGNENs)is dismal and related research is limited.AIM To investigate the prognostic factors,and validate a novel prognostic nomogram for PDGNEN patients.METHODS We conducted a retrospective study using clinical and pathological data from PDGNEN patients treated at the First Medical Center of the Chinese PLA General Hospital from January 2000 to June 2023.Overall survival(OS)differences were assessed with the Log-rank test and Kaplan-Meier survival curves.Cox regression analysis identified independent risk factors for prognosis.Model performance was evaluated using Harrell’s concordance index,receiver operating characteristic analysis,area under the curve,calibration curves,and decision curve analysis(UDC),including the area under the UDC.RESULTS The study included 336 patients(227 with neuroendocrine carcinoma and 109 with mixed adenoneuroendocrine carcinoma).The average age was 62.7 years.The cohort comprised 80(24.7%)patients in stage I,146(42.9%)in stage II,62(18.1%)in stage III,and 48(14.3%)in stage IV.Significant differences in OS were observed across tumor-node-metastasis stages(P<0.001).Multivariate analysis showed age,Ki-67 index,invasion depth,lymph node metastasis,distant metastasis,and platelet-to-lymphocyte ratio as independent risk factors.We developed a nomogram with a concordance index of 0.779(95%confidence interval:0.743-0.858).Receiver operating characteristic analysis showed area under the curves for 1-year,3-year,and 5-year OS predictions of 0.865,0.850,and 0.890,respectively.The calibration curve demonstrated good agreement with actual outcomes.The area under the UDC for the nomogram vs the 8th American Joint Committee on Cancer tumor-node-metastasis staging system were 0.047 vs 0.027,0.291 vs 0.179,and 0.376 vs 0.216 for 1-year,3-year,and 5-year OS,respectively.CONCLUSION PDGNENs are predominantly found in older men,often in advanced stages at diagnosis,resulting in poor prognosis.The established nomogram demonstrates strong predictive capability and clinical utility.展开更多
Ending extreme poverty and achieving sustainable development by 2030 poses a significant challenge for de veloping countries.In the past decade,China has pioneered the Targeted Poverty Alleviation(TPA)strategy and imp...Ending extreme poverty and achieving sustainable development by 2030 poses a significant challenge for de veloping countries.In the past decade,China has pioneered the Targeted Poverty Alleviation(TPA)strategy and implemented a range of anti-poverty programs,aiming to reconcile poverty reduction with environmental restoration.However,the effectiveness of the TPA strategy in facilitating sustainable development in the poor areas of China(PAC)remains unclear.Drawing on a perspective of systems,this study compiles a panel dataset of 832 nationally designated poverty-stricken counties in China from 2013 to 2020 and employ the coupling coordination degree model to examine the coupling and coordination relationships among economic,social,and environmental systems in the PAC.We find that during the TPA period,the socioeconomic level developed rapidly,while the environmental quality was slightly improved in the PAC.The TPA strategy promotes the co ordinated development of social,economic,and ecological systems in the PAC,shifting the relationship between human and environment from imbalance to coordination.Our findings underscore the necessity for the Chinese government to persist in its environmental restoration efforts in the PAC to guarantee a sustained development progress.展开更多
AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2....AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2.1y(range:4-10y),underwent comprehensive ophthalmic and refractive evaluations.Spectral domain-optical coherence tomography(SD-OCT)and multifocal electroretinography(mfERG)were conducted to analyze the macular retinal thickness and the first-order response P1 ring of the mfERG in the amblyopic eye(AE)compared to the fellow good eye(GE).RESULTS:Initially,visual acuity in the AE ranged from 20/800 to 20/40,while the GE exhibited a range of 20/25 to 20/20(P<0.01).After 6mo of treatment,17 patients demonstrated improved visual acuity in the AE to 20/50 or better,while 4 children showed no improvement.SD-OCT revealed comparable macular and optic disc structures between the AE and GE.Prior to treatment,the mfERG P1 ring amplitude was significantly reduced in the AE compared to GE(P<0.05).The AE/GE ratio of P1 ring amplitude showed significant improvement post-treatment.However,a smaller AE/GE ratio before treatment was associated with poorer improvement post-treatment.CONCLUSION:In the management of functional amblyopia,a thorough assessment of amblyopic eye examinations is crucial.Approximately 20%of amblyopic eyes may not achieve significant improvement in visual acuity,despite the absence of detectable organic retinal abnormalities.mfERG may reveal underlying abnormalities.Integrating mfERG into initial assessments or treatment follow-ups can aid in identifying potential hidden retinal defects and predicting the prognosis of the amblyopic eye.展开更多
BACKGROUND Poorly differentiated thyroid carcinoma(PDTC)is a rare and aggressive form of thyroid cancer.Distant metastasis occurs frequently in PDTC.AIM To determine factors associated with distant metastasis and the ...BACKGROUND Poorly differentiated thyroid carcinoma(PDTC)is a rare and aggressive form of thyroid cancer.Distant metastasis occurs frequently in PDTC.AIM To determine factors associated with distant metastasis and the effects of metastasis,either diagnosed on initial presentation or developing during follow-up,on mortality in PDTC patients.METHODS Patients with PDTC diagnosed between January 1,1985 and July 31,2022 were identified using a thyroid cancer database at a medical center in Taiwan.Factors associated with distant metastasis and cancer-specific survival(CSS)were analyzed using binary logistic analysis and Cox regression,respectively.Survival analysis was conducted using the Kaplan–Meier method.RESULTS The study cohort included 39 patients with PDTC,including 16 with distant metastasis on initial presentation,5 with metastasis during the follow-up period,and 18 with no evidence of metastasis.Older age(≥45 years)was significantly associated with a higher risk of distant metastasis(odds ratio:5.31;95%confi-dence interval:1.27–22.2;P=0.018),while sex,tumor size,T stage,and N stage were not associated with distant metastasis.Patients with metastatic PDTC,either diagnosed at presentation or developing during follow-up,had poorer 5-year CSS rates(55.0%and 40.0%,respectively)than those without metastasis(5-year CSS,93.8%)(P=0.001 for both comparisons).CONCLUSION Older patients with PDTC have an increased risk of distant metastasis.Patients with metastatic PDTC,both diagnosed at presentation and developing during follow-up,have a dismal prognosis.展开更多
Objective:To investigate the evaluation value of cardiac color Doppler echocardiography(CDE)in assessing poor prognosis in patients with coronary atherosclerotic heart disease(CAD).Methods:A retrospective review was c...Objective:To investigate the evaluation value of cardiac color Doppler echocardiography(CDE)in assessing poor prognosis in patients with coronary atherosclerotic heart disease(CAD).Methods:A retrospective review was conducted of 106 patients with coronary artery disease(CAD)who were treated in the hospital’s cardiovascular department between January 2023 and June 2024.All participants received baseline comprehensive Doppler echocardiography(CDE)assessments.Based on whether they experienced a Major Adverse Cardiovascular Event(MACE)within one year of follow-up,the patients were categorized into either a MACE group or a non-MACE group.The study compared baseline clinical information and CDE parameters,specifically left ventricular ejection fraction(LVEF),wall motion score index(WMSI),and mitral annular E/e’ratio,between the two groups.Independent predictors of MACE were identified using multivariate logistic regression analysis.Results:A total of 29 out of the 106 patients experienced MACE during the oneyear follow-up.Compared with the non-MACE group,the MACE group had a higher prevalence of diabetes mellitus.In terms of CDE parameters,the MACE group had a lower LVEF than the non-MACE group(p<0.05),while WMSI,average E/e’,pulmonary artery systolic pressure(PASP),and mitral regurgitation(MR)proportion were all higher in the MACE group than in the non-MACE group(p<0.05).Multifactor logistic regression analysis revealed that after adjusting for confounding factors such as diabetes,WMSI(OR=3.003,95%CI:1.226–7.356,p=0.016)and mean E/e’(OR=1.281,95%CI:1.006–1.539,p=0.008)were independent predictors of the occurrence of major adverse cardiovascular events(MACE).Conclusion:WMSI and E/e’diagnosed by color Doppler echocardiography(CDE)hold significant and independent assessment value for predicting poor prognosis in patients with coronary artery disease(CAD).展开更多
目的探讨入院时血清淀粉样蛋白A(serum amyloid protein A,SAA)、内毒素(endotoxin,ET)、降钙素原(procalcitonin,PCT)联合检测对脓毒症患者预后不良的早期预测效能,为早期制定干预措施,减少预后不良的发生提供参考依据。方法选取平顶...目的探讨入院时血清淀粉样蛋白A(serum amyloid protein A,SAA)、内毒素(endotoxin,ET)、降钙素原(procalcitonin,PCT)联合检测对脓毒症患者预后不良的早期预测效能,为早期制定干预措施,减少预后不良的发生提供参考依据。方法选取平顶山市第一人民医院2024年1月—2025年6月收治的150例脓毒症患者,根据脓毒症严重程度将其分为轻度组(n=68)、重度组(n=52)、休克组(n=30)。比较三组入院时血清SAA、ET、PCT水平,Spearman检验分析上述血清水平与脓毒症严重程度的相关性。根据脓毒症诊疗指南进行规范治疗,根据发病28 d内患者预后不同分为预后良好、预后不良亚组。比较不同预后脓毒症患者入院时血清SAA、ET、PCT水平;受试者工作特征(receiver operating characteristic,ROC)曲线分析入院时血清SAA、ET、PCT水平联合检测对脓毒症患者预后不良的早期预测效能。结果入院时血清SAA、ET、PCT水平比较,休克组>重度组>轻度组,两两比较差异有统计学意义(P<0.05)。Spearman检验证实,入院时血清SAA、ET、PCT水平与脓毒症患者病情严重程度呈正相关(P<0.05)。预后不良脓毒症患者入院时血清SAA、ET、PCT水平均高于预后良好患者(P<0.05)。ROC曲线分析显示,入院时血清SAA、ET、PCT水平联合预测脓毒症患者预后不良的曲线下面积为0.860,高于上述单独血清指标的0.712、0.733、0.738(P<0.05)。结论不同严重程度脓毒症患者血清SAA、ET、PCT水平不同,病情越严重的脓毒症患者,上述血清指标水平越高,且与脓毒症严重程度呈正相关,其联合检测对脓毒症的预后不良具有较高的早期预测效能。展开更多
目的探讨新生儿呼吸窘迫综合征(NRDS)患儿肺超声纹理特征、肺部12分区超声评分与预后不良的相关性,并分析其对预后不良风险的预测价值。方法选取2021年8月至2024年12月南阳市第一人民医院128例NRDS患儿为研究对象,根据预后情况分为预后...目的探讨新生儿呼吸窘迫综合征(NRDS)患儿肺超声纹理特征、肺部12分区超声评分与预后不良的相关性,并分析其对预后不良风险的预测价值。方法选取2021年8月至2024年12月南阳市第一人民医院128例NRDS患儿为研究对象,根据预后情况分为预后良好组、预后不良组。比较两组临床资料、肺超声纹理特征、肺部12分区超声评分。采用列联相关性/Spearman相关性分析肺超声纹理特征、肺部12分区超声评分与NRDS患儿病情程度的关系。logistic回归分析预后不良风险的影响因素。采用受试者工作特征(ROC)曲线及曲线下面积(AUC)评价肺超声纹理特征、肺部12分区超声评分对预后不良风险的预测价值。结果128例NRDS患儿治疗后预后良好98例,预后不良30例;预后不良组胎龄、出生体重、出生1 min Apgar评分、动脉血氧分压(PaO_(2))、氧合指数低于预后良好组,动脉血二氧化碳分压(PaCO_(2))、持续气道正压通气(CPAP)时间、有创机械通气占比高于预后良好组(P<0.05);预后不良组对比度、集群阴影、差异性、逆差距、和方差、肺部12分区超声评分高于预后良好组(P<0.05);肺超声纹理特征对比度、集群阴影、差异性、逆差距、和方差、肺部12分区超声评分与出生1 min Apgar评分、PaO_(2)、氧合指数呈负相关,与PaCO_(2)呈正相关(P<0.05);肺超声纹理特征对比度、集群阴影、差异性、逆差距、和方差、肺部12分区超声评分是NRDS患儿预后不良风险的独立影响因素(P<0.05);肺超声纹理特征对比度、集群阴影、差异性、逆差距、和方差、肺部12分区超声评分联合预测预后不良风险的AUC高于各指标单项预测(P<0.001)。结论NRDS预后不良患儿肺超声纹理特征对比度、集群阴影、差异性、逆差距、和方差及肺部12分区超声评分较预后良好患儿升高,其与病情指标密切相关,且为预后不良风险的独立影响因素,联合检测其水平在预测患儿预后不良风险方面具有临床应用价值。展开更多
文摘My parents used to take us to all of the local weddings.Man,we got better at picking up the ricethan the birds did.We thought that running water was when you ran back to the house with a bucket of water from theneighbors hour.
文摘According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(CHF)is also increasing.[1–3]Reports have shown that the presence of cognitive impairment(CI)in patients with CHF is associated with poor prognosis,[4–6]and the degree of CI is related to CHF severity.
基金support through Manipal University Jaipur for the Enhanced Seed Grant under the Endowment Fund(Grant No.E3/2023-24/QE-04-05).
文摘Dear Editor,Lung cancer is a major global health concern,with 2.2 million patients diagnosed in 2020.Non-small cell lung cancer(NSCLC)accounts for 80%of these cases,primarily comprising two subtypes:lung adenocarcinoma(LUAD)and squamous cell carcinoma(LUSC)[1].Researchers use immunohisto-chemistry,next-generation sequencing,and single-cell RNA sequencing to study genetic alterations,tumor heterogeneity,and tumor microenvironments,aiming to identify potential therapeutic options for specific NSCLC subtypes[2].
文摘BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses revealing a disproportionate burden among women.Despite the characteristically indolent nature of most thyroid carcinomas and their associated high survival rates,emerging evidence points to significant unmet needs regarding psychosocial adaptation and neuropsychiatric sequelae in this growing survivor population.The spectrum of mental health conditions,ranging from affective and anxiety disorders to cognitive impairments,presents substantial barriers to functional recovery and may potentially influence disease trajectories through complex psychoneuroimmunological pathways.Clinical observations consistently report elevated rates of mood disturbances and executive function deficits persisting throughout the cancer continuum,from active treatment into extended follow-up periods.These findings highlight a critical knowledge gap in understanding the dynamic interplay between thyroid cancer biology,its therapeutic interventions,and the development of treatment-resistant psychiatric manifestations that complicate long-term patient care.AIM To analyse the factors influencing the poor prognosis of patients surviving longterm differentiated thyroid cancer with psychiatric disorders and to construct a prediction model.METHODS Forty-eight patients with mental disorders combined with differentiated thyroid cancer who were treated in our hospital during the period of March 2018 to March 2023 were retrospectively selected as the study subjects(thyroid cancer group),and 30 cases each of patients with mental disorders combined with benign thyroid nodules(benign nodules group)and patients with mental disorders alone(mental disorders group),who were treated during the same time period,were selected as controls.The patients with differentiated thyroid cancer were further divided into a poor prognosis group(10 cases)and a good prognosis group(38 cases).The study outcome was poor prognosis as shown by whole body bone imaging within 2 years after thyroid cancer surgery.Factors influencing poor prognosis in survivors of differentiated thyroid cancer were analyzed by univariate and multivariate logistic regression analyses,receiver operating characteristic(ROC)curve analysis was used to assess the predictive efficacy of these factors for poor prognosis,and the DeLong test was used to determine whether there was a statistically significant difference in the area under the curve(AUC)of the model.RESULTS One-way logistic regression analysis showed that tumour diameter[odds ratio(OR)=19.190,P=0.002],T-stage(OR=7.692,P=0.018),extra-glandular infiltration(OR=37.000,P=0.003),degree of differentiation(OR=24.667,P=0.008),serum free T3(OR=22.348,P=0.025),serum free T4(FT4)(OR=1.158,P=0.002),total bilirubin(TBil)(OR=1.792,P=0.004),albumin(OR=0.675,P=0.003),cortisol(OR=1.180,P=0.003),norepinephrine(OR=1.047,P=0.002),angiotensin II(OR=1.975,P=0.002),and superoxide dismutase(OR=0.515,P=0.005)all increased the risk of poor prognosis in patients with psychiatric disorders and long-term differentiated thyroid cancer.Multifactorial logistic regression analysis showed that tumour diameter(OR=16.570,P=0.021),extraglandular infiltration(OR=53.145,P=0.010),FT4(OR=1.186,P=0.007),and TBil(OR=2.823,P=0.048)were independent risk factors for poor prognosis of patients with psychiatric disorders with long-term differentiated thyroid cancer,and the regression equation was:Y=2.808×tumour diameter+3.973×extra-glandular infiltration+0.171×FT4+1.038×TBil-88.138.ROC analysis showed that the predictive power of the overall model(AUC=0.992,P=0.000)was significantly higher than that of independent risk factors(DeLong test P<0.05).CONCLUSION Tumour diameter,extra-glandular infiltration,FT4,and TBil are independent risk factors for poor prognosis in patients with psychiatric disorders with long-term differentiated thyroid cancer,and the combination of these factors is of higher value in predicting the prognosis of patients.These risk factors can be used as a basis to develop a reasonable prognostic management plan in clinical practice for patients with long-term differentiated thyroid cancer with mental disorders,so as to improve the prognosis and quality of life of patients.
文摘BACKGROUND The prognosis of patients with poorly differentiated gastric neuroendocrine neoplasms(PDGNENs)is dismal and related research is limited.AIM To investigate the prognostic factors,and validate a novel prognostic nomogram for PDGNEN patients.METHODS We conducted a retrospective study using clinical and pathological data from PDGNEN patients treated at the First Medical Center of the Chinese PLA General Hospital from January 2000 to June 2023.Overall survival(OS)differences were assessed with the Log-rank test and Kaplan-Meier survival curves.Cox regression analysis identified independent risk factors for prognosis.Model performance was evaluated using Harrell’s concordance index,receiver operating characteristic analysis,area under the curve,calibration curves,and decision curve analysis(UDC),including the area under the UDC.RESULTS The study included 336 patients(227 with neuroendocrine carcinoma and 109 with mixed adenoneuroendocrine carcinoma).The average age was 62.7 years.The cohort comprised 80(24.7%)patients in stage I,146(42.9%)in stage II,62(18.1%)in stage III,and 48(14.3%)in stage IV.Significant differences in OS were observed across tumor-node-metastasis stages(P<0.001).Multivariate analysis showed age,Ki-67 index,invasion depth,lymph node metastasis,distant metastasis,and platelet-to-lymphocyte ratio as independent risk factors.We developed a nomogram with a concordance index of 0.779(95%confidence interval:0.743-0.858).Receiver operating characteristic analysis showed area under the curves for 1-year,3-year,and 5-year OS predictions of 0.865,0.850,and 0.890,respectively.The calibration curve demonstrated good agreement with actual outcomes.The area under the UDC for the nomogram vs the 8th American Joint Committee on Cancer tumor-node-metastasis staging system were 0.047 vs 0.027,0.291 vs 0.179,and 0.376 vs 0.216 for 1-year,3-year,and 5-year OS,respectively.CONCLUSION PDGNENs are predominantly found in older men,often in advanced stages at diagnosis,resulting in poor prognosis.The established nomogram demonstrates strong predictive capability and clinical utility.
基金supported by the National Natural Science Founda-tion of China(Grants No.72373153 and 41871183).
文摘Ending extreme poverty and achieving sustainable development by 2030 poses a significant challenge for de veloping countries.In the past decade,China has pioneered the Targeted Poverty Alleviation(TPA)strategy and implemented a range of anti-poverty programs,aiming to reconcile poverty reduction with environmental restoration.However,the effectiveness of the TPA strategy in facilitating sustainable development in the poor areas of China(PAC)remains unclear.Drawing on a perspective of systems,this study compiles a panel dataset of 832 nationally designated poverty-stricken counties in China from 2013 to 2020 and employ the coupling coordination degree model to examine the coupling and coordination relationships among economic,social,and environmental systems in the PAC.We find that during the TPA period,the socioeconomic level developed rapidly,while the environmental quality was slightly improved in the PAC.The TPA strategy promotes the co ordinated development of social,economic,and ecological systems in the PAC,shifting the relationship between human and environment from imbalance to coordination.Our findings underscore the necessity for the Chinese government to persist in its environmental restoration efforts in the PAC to guarantee a sustained development progress.
基金Supported by the National Natural Science Foundation of China(No.82271100)the Jiangsu Science and Technology Support Program(No.BE2022805)the Clinical Skills Enhancement Program of Jiangsu Province Hospital(No.JSPH-MC-2022-24).
文摘AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2.1y(range:4-10y),underwent comprehensive ophthalmic and refractive evaluations.Spectral domain-optical coherence tomography(SD-OCT)and multifocal electroretinography(mfERG)were conducted to analyze the macular retinal thickness and the first-order response P1 ring of the mfERG in the amblyopic eye(AE)compared to the fellow good eye(GE).RESULTS:Initially,visual acuity in the AE ranged from 20/800 to 20/40,while the GE exhibited a range of 20/25 to 20/20(P<0.01).After 6mo of treatment,17 patients demonstrated improved visual acuity in the AE to 20/50 or better,while 4 children showed no improvement.SD-OCT revealed comparable macular and optic disc structures between the AE and GE.Prior to treatment,the mfERG P1 ring amplitude was significantly reduced in the AE compared to GE(P<0.05).The AE/GE ratio of P1 ring amplitude showed significant improvement post-treatment.However,a smaller AE/GE ratio before treatment was associated with poorer improvement post-treatment.CONCLUSION:In the management of functional amblyopia,a thorough assessment of amblyopic eye examinations is crucial.Approximately 20%of amblyopic eyes may not achieve significant improvement in visual acuity,despite the absence of detectable organic retinal abnormalities.mfERG may reveal underlying abnormalities.Integrating mfERG into initial assessments or treatment follow-ups can aid in identifying potential hidden retinal defects and predicting the prognosis of the amblyopic eye.
基金Supported by New Taipei Municipal TuCheng Hospital(Built and Operated by Chang Gung Medical Foundation),New Taipei City,Taiwan,No.CORPVVP0031the National Science and Technology Council of Taiwan,No.NSTC 112-2314-B-182A-111-MY3.
文摘BACKGROUND Poorly differentiated thyroid carcinoma(PDTC)is a rare and aggressive form of thyroid cancer.Distant metastasis occurs frequently in PDTC.AIM To determine factors associated with distant metastasis and the effects of metastasis,either diagnosed on initial presentation or developing during follow-up,on mortality in PDTC patients.METHODS Patients with PDTC diagnosed between January 1,1985 and July 31,2022 were identified using a thyroid cancer database at a medical center in Taiwan.Factors associated with distant metastasis and cancer-specific survival(CSS)were analyzed using binary logistic analysis and Cox regression,respectively.Survival analysis was conducted using the Kaplan–Meier method.RESULTS The study cohort included 39 patients with PDTC,including 16 with distant metastasis on initial presentation,5 with metastasis during the follow-up period,and 18 with no evidence of metastasis.Older age(≥45 years)was significantly associated with a higher risk of distant metastasis(odds ratio:5.31;95%confi-dence interval:1.27–22.2;P=0.018),while sex,tumor size,T stage,and N stage were not associated with distant metastasis.Patients with metastatic PDTC,either diagnosed at presentation or developing during follow-up,had poorer 5-year CSS rates(55.0%and 40.0%,respectively)than those without metastasis(5-year CSS,93.8%)(P=0.001 for both comparisons).CONCLUSION Older patients with PDTC have an increased risk of distant metastasis.Patients with metastatic PDTC,both diagnosed at presentation and developing during follow-up,have a dismal prognosis.
文摘Objective:To investigate the evaluation value of cardiac color Doppler echocardiography(CDE)in assessing poor prognosis in patients with coronary atherosclerotic heart disease(CAD).Methods:A retrospective review was conducted of 106 patients with coronary artery disease(CAD)who were treated in the hospital’s cardiovascular department between January 2023 and June 2024.All participants received baseline comprehensive Doppler echocardiography(CDE)assessments.Based on whether they experienced a Major Adverse Cardiovascular Event(MACE)within one year of follow-up,the patients were categorized into either a MACE group or a non-MACE group.The study compared baseline clinical information and CDE parameters,specifically left ventricular ejection fraction(LVEF),wall motion score index(WMSI),and mitral annular E/e’ratio,between the two groups.Independent predictors of MACE were identified using multivariate logistic regression analysis.Results:A total of 29 out of the 106 patients experienced MACE during the oneyear follow-up.Compared with the non-MACE group,the MACE group had a higher prevalence of diabetes mellitus.In terms of CDE parameters,the MACE group had a lower LVEF than the non-MACE group(p<0.05),while WMSI,average E/e’,pulmonary artery systolic pressure(PASP),and mitral regurgitation(MR)proportion were all higher in the MACE group than in the non-MACE group(p<0.05).Multifactor logistic regression analysis revealed that after adjusting for confounding factors such as diabetes,WMSI(OR=3.003,95%CI:1.226–7.356,p=0.016)and mean E/e’(OR=1.281,95%CI:1.006–1.539,p=0.008)were independent predictors of the occurrence of major adverse cardiovascular events(MACE).Conclusion:WMSI and E/e’diagnosed by color Doppler echocardiography(CDE)hold significant and independent assessment value for predicting poor prognosis in patients with coronary artery disease(CAD).
文摘目的探讨新生儿呼吸窘迫综合征(NRDS)患儿肺超声纹理特征、肺部12分区超声评分与预后不良的相关性,并分析其对预后不良风险的预测价值。方法选取2021年8月至2024年12月南阳市第一人民医院128例NRDS患儿为研究对象,根据预后情况分为预后良好组、预后不良组。比较两组临床资料、肺超声纹理特征、肺部12分区超声评分。采用列联相关性/Spearman相关性分析肺超声纹理特征、肺部12分区超声评分与NRDS患儿病情程度的关系。logistic回归分析预后不良风险的影响因素。采用受试者工作特征(ROC)曲线及曲线下面积(AUC)评价肺超声纹理特征、肺部12分区超声评分对预后不良风险的预测价值。结果128例NRDS患儿治疗后预后良好98例,预后不良30例;预后不良组胎龄、出生体重、出生1 min Apgar评分、动脉血氧分压(PaO_(2))、氧合指数低于预后良好组,动脉血二氧化碳分压(PaCO_(2))、持续气道正压通气(CPAP)时间、有创机械通气占比高于预后良好组(P<0.05);预后不良组对比度、集群阴影、差异性、逆差距、和方差、肺部12分区超声评分高于预后良好组(P<0.05);肺超声纹理特征对比度、集群阴影、差异性、逆差距、和方差、肺部12分区超声评分与出生1 min Apgar评分、PaO_(2)、氧合指数呈负相关,与PaCO_(2)呈正相关(P<0.05);肺超声纹理特征对比度、集群阴影、差异性、逆差距、和方差、肺部12分区超声评分是NRDS患儿预后不良风险的独立影响因素(P<0.05);肺超声纹理特征对比度、集群阴影、差异性、逆差距、和方差、肺部12分区超声评分联合预测预后不良风险的AUC高于各指标单项预测(P<0.001)。结论NRDS预后不良患儿肺超声纹理特征对比度、集群阴影、差异性、逆差距、和方差及肺部12分区超声评分较预后良好患儿升高,其与病情指标密切相关,且为预后不良风险的独立影响因素,联合检测其水平在预测患儿预后不良风险方面具有临床应用价值。
