AIM To investigate novel predictors of survival in hepatocellular carcinoma(HCC)patients following transarterial chemoembolization(TACE).METHODS One hundred sixty seven patients with un-resectable HCC were retrospecti...AIM To investigate novel predictors of survival in hepatocellular carcinoma(HCC)patients following transarterial chemoembolization(TACE).METHODS One hundred sixty seven patients with un-resectable HCC were retrospectively analyzed to identify factors that might contribute to their HCC biology and aggressiveness.We correlated routine laboratory results(total bilirubin,AST,ALKP,GGTP,albumin etc.)to maximum tumor diameter,number of tumor nodules,portal vein thrombosis and blood alpha-fetoprotein levels.These 4 parameters were previously combined to form an aggressiveness index(AgI).We used The Wilcoxon ranksum(Mann-Whitney),to test the correlation between the AgI categories and liver function parameters.The Cox proportional hazards model was applied to evaluate the categories of AgI associated with overall survival.RESULTS The AgI was strongly correlated with survival in this novel patient population.Three year survival probability for AgI>or<4 was 42.4%vs 61.8%;P<0.0863 respectively.Several factors independently correlated with AgI using univariate multiple logistic regression of AgI with 8 laboratory parameters.Lower albumin levels had an OR of 2.56(95%CI:1.120-5.863 P<0.026),elevated Alkaline phosphatase and gamma glutamyl transpeptidase(GGTP)had ORs of 1.01(95%CI:1.003-1.026,P<0.017)and 0.99(95%CI:0.99-1.00,P<0.053)respectively.In a Cox proportional hazard model combining mortality for AgI score and liver function parameters,only GGTP levels and the AgI were independently associated with survival.An AgI>4 had HR for mortality of 2.18(95%CI:1.108-4.310,P<0.024).GGTP's single unit change had a HR for mortality of 1.003(95%CI:1.001-1.006,P<0.016).These were considered in the final multivariate model with the total cohort.An AgI>4 had a HR for mortality of 2.26(95%CI:1.184-4.327,P<0.016).GGTP had a HR of 1.003(95%CI:1.001-1.004,P<0.001).CONCLUSION Our study validates the AgI in a new population with un-resectable HCC patients undergoing TACE.The analysis establishes a correlation between GGTP and the AgI.展开更多
Chronic obstructive pulmonary disease(COPD),the third leading cause of death globally,is characterized by persistent airflow limitation.In China,the prevalence among individuals aged 40 and above reaches 13.7%,with a ...Chronic obstructive pulmonary disease(COPD),the third leading cause of death globally,is characterized by persistent airflow limitation.In China,the prevalence among individuals aged 40 and above reaches 13.7%,with a noticeable trend toward younger groups.However,inadequate screening rates at the primary healthcare level and delayed diagnosis pose significant challenges.Researches have indicated that standardized screening questionnaires combined with AI-assisted lung function interpretation technology can enhance the efficiency of early diagnosis.Treatment requires individualized medication combined with non-pharmacological interventions(health education,telemedicine,and smart inhalation devices)to enhance the adherence and the symptom control.In terms of management,the community-based primary healthcare system,home oxygen therapy,and multidisciplinary pulmonary rehabilitation programs can shorten the hospitalization duration during acute exacerbations and then improve outcomes.The findings indicate that an integrated strategy combining early screening,tiered diagnosis and treatment,digital management and community-family collaboration is key to reducing disability and mortality rates from COPD.In the future,it is needed to focus on strengthening primary healthcare capabilities and implementing evidence-based precision interventions to drive a shift from“passive treatment”to“proactive healthcare management,”thereby alleviating socioeconomic burdens.展开更多
文摘AIM To investigate novel predictors of survival in hepatocellular carcinoma(HCC)patients following transarterial chemoembolization(TACE).METHODS One hundred sixty seven patients with un-resectable HCC were retrospectively analyzed to identify factors that might contribute to their HCC biology and aggressiveness.We correlated routine laboratory results(total bilirubin,AST,ALKP,GGTP,albumin etc.)to maximum tumor diameter,number of tumor nodules,portal vein thrombosis and blood alpha-fetoprotein levels.These 4 parameters were previously combined to form an aggressiveness index(AgI).We used The Wilcoxon ranksum(Mann-Whitney),to test the correlation between the AgI categories and liver function parameters.The Cox proportional hazards model was applied to evaluate the categories of AgI associated with overall survival.RESULTS The AgI was strongly correlated with survival in this novel patient population.Three year survival probability for AgI>or<4 was 42.4%vs 61.8%;P<0.0863 respectively.Several factors independently correlated with AgI using univariate multiple logistic regression of AgI with 8 laboratory parameters.Lower albumin levels had an OR of 2.56(95%CI:1.120-5.863 P<0.026),elevated Alkaline phosphatase and gamma glutamyl transpeptidase(GGTP)had ORs of 1.01(95%CI:1.003-1.026,P<0.017)and 0.99(95%CI:0.99-1.00,P<0.053)respectively.In a Cox proportional hazard model combining mortality for AgI score and liver function parameters,only GGTP levels and the AgI were independently associated with survival.An AgI>4 had HR for mortality of 2.18(95%CI:1.108-4.310,P<0.024).GGTP's single unit change had a HR for mortality of 1.003(95%CI:1.001-1.006,P<0.016).These were considered in the final multivariate model with the total cohort.An AgI>4 had a HR for mortality of 2.26(95%CI:1.184-4.327,P<0.016).GGTP had a HR of 1.003(95%CI:1.001-1.004,P<0.001).CONCLUSION Our study validates the AgI in a new population with un-resectable HCC patients undergoing TACE.The analysis establishes a correlation between GGTP and the AgI.
文摘Chronic obstructive pulmonary disease(COPD),the third leading cause of death globally,is characterized by persistent airflow limitation.In China,the prevalence among individuals aged 40 and above reaches 13.7%,with a noticeable trend toward younger groups.However,inadequate screening rates at the primary healthcare level and delayed diagnosis pose significant challenges.Researches have indicated that standardized screening questionnaires combined with AI-assisted lung function interpretation technology can enhance the efficiency of early diagnosis.Treatment requires individualized medication combined with non-pharmacological interventions(health education,telemedicine,and smart inhalation devices)to enhance the adherence and the symptom control.In terms of management,the community-based primary healthcare system,home oxygen therapy,and multidisciplinary pulmonary rehabilitation programs can shorten the hospitalization duration during acute exacerbations and then improve outcomes.The findings indicate that an integrated strategy combining early screening,tiered diagnosis and treatment,digital management and community-family collaboration is key to reducing disability and mortality rates from COPD.In the future,it is needed to focus on strengthening primary healthcare capabilities and implementing evidence-based precision interventions to drive a shift from“passive treatment”to“proactive healthcare management,”thereby alleviating socioeconomic burdens.
