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颈脊髓中央管综合征钛板内固定和药物治疗的预后因素分析 预览
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作者 张辉 徐南伟 +3 位作者 农鲁明 汤雪明 周鑫叠 蒋巍 《中国组织工程研究》 CAS 北大核心 2020年第3期348-353,共6页
背景:在颈脊髓中央管综合征的治疗中,因为患者神经恢复速度以及程度的不同使临床难以预测神经恢复的程度。颈脊髓中央管综合征的治疗,特别是关于治疗方式,仍然存在争议。目的:探讨药物治疗和钛板内固定治疗颈脊髓中央管综合征预后的影... 背景:在颈脊髓中央管综合征的治疗中,因为患者神经恢复速度以及程度的不同使临床难以预测神经恢复的程度。颈脊髓中央管综合征的治疗,特别是关于治疗方式,仍然存在争议。目的:探讨药物治疗和钛板内固定治疗颈脊髓中央管综合征预后的影响因素。方法:对2012年6月至2017年6月南京医科大学附属常州第二人民医院收治并获得随访的243例颈脊髓中央管综合征患者进行回顾性分析,根据治疗方案分为2组,钛板组152例行钛板置入内固定,药物治疗组91例给予药物治疗。所有患者对治疗方案均知情同意,且得到医院伦理委员会批准。采用美国脊柱损伤学会和日本骨科协会标准对患者神经功能进行评定,记录所有患者治疗前24 h内及治疗后6,12,24个月随访的美国脊柱损伤学会和日本骨科协会评分。将年龄、治疗方式和性别因素纳入颈脊髓中央管综合征治疗后6,24个月随访时的预后单因素分析。之后将年龄、治疗方式和性别因素纳入颈脊髓中央管综合征治疗后6,24个月随访时的预后多因素Logistic回归分析。结果与结论:①243例患者均获24个月以上随访,治疗后恢复良好;②治疗后6个月药物治疗组美国脊柱损伤学会评分和日本骨科协会评分均低于钛板组(P=0.001 2,0.000 0);但治疗后24个月随访时药物治疗组的美国脊柱损伤学会和日本骨科协会评分均高于钛板组(P=0.037 4,0.047 8);③颈脊髓中央管综合征患者治疗后6个月的预后与患者年龄和治疗方式有相关性(P=0.007 2,P <0.000 1),且药物治疗及年龄大于50岁与颈脊髓中央管综合征患者治疗后6个月不良预后相关(P=0.043,P=0.010);④颈脊髓中央管综合征治疗24个月随访时的预后与患者的治疗方式有相关性(P=0.0043),且药物治疗与颈脊髓中央管综合征患者治疗后24个月随访时预后相关(P=0.021);⑤结果提示,钛板内固定治疗时患者的6个月内恢复� 展开更多
关键词 钛板 内固定 药物治疗 颈脊髓中央管综合征 预后 年龄 LOGISTIC回归分析
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髌股关节骨性关节炎严重程度不影响保留髌骨全膝关节置换患者的预后 预览
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作者 徐长波 张翼 殷力 《中国组织工程研究》 CAS 北大核心 2020年第6期833-838,共6页
背景:目前关于全膝关节置换过程中髌骨是否置换尚没有统一标准,对于髌骨置换和不置换的对照研究很多,但是在全膝关节置换不置换髌骨的研究中根据髌股关节炎严重程度分级来比较预后的研究很少。目的:根据髌股关节炎的严重程度进行分级,... 背景:目前关于全膝关节置换过程中髌骨是否置换尚没有统一标准,对于髌骨置换和不置换的对照研究很多,但是在全膝关节置换不置换髌骨的研究中根据髌股关节炎严重程度分级来比较预后的研究很少。目的:根据髌股关节炎的严重程度进行分级,比较髌股关节炎的轻重对保留髌骨的全膝关节置换疗效的影响。方法:回顾性分析2016年1月至2017年1月郑州大学第一附属医院使用强生假体行髌骨保留的全膝关节置换患者192例的临床资料,随访时间大于2年。根据髌股关节炎影像学严重程度Lwano分类系统将患者分为2组,轻度组(0-Ⅰ期)83例,重度组(Ⅱ-Ⅳ期)109例。所有患者对治疗及试验方案均知情同意,且得到医院伦理委员会批准。使用美国膝关节协会评分、功能评分、Feller评分、膝前疼痛评分评估临床预后,使用髌骨倾斜角、适合角、髌骨外移距离、髌韧带比值评估影像学预后。运用t检验,分析患者术前、术后的临床和影像学结果。结果与结论:①术后1例患者出现持续性膝前疼痛,1例患者伤口渗液,清创后二期愈合,其余均一期愈合;②术前轻度组和重度组患者的功能评分和美国膝关节协会评分差异有显著性意义(P <0.05),但术后2组功能评分和美国膝关节协会评分差异均无显著性意义(P> 0.05);③影像学上,2组术前髌骨倾斜角、适合角、髌骨外移距离差异有显著性意义(P <0.05),但术后2组髌骨倾斜角、适合角、髌骨外移距离差异均无显著性意义(P> 0.05);④提示在对保留髌骨的全膝关节置换患者进行至少2年的随访后发现,髌股关节炎的严重程度对患者的临床和影像学预后没有影响;即使在重度髌股关节炎患者中,保留髌骨的全膝关节置换后也能获得良好的预后。 展开更多
关键词 全膝关节置换 髌骨保留 髌股关节炎 软骨 疼痛 预后
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Sonographic Measurement of Optic Nerve Sheath Diameter: A Prognostic Tool for Childhood Cerebral Malaria? 预览
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作者 Kofi-Mensa Savi de Tové Yolande Savi de Tové-Sissinto +6 位作者 Didier Julien Adedemy Djivèdé Akanni Miralda Kiki Patricia Yèkpè-Ahouansou Olivier Biaou Vicentia Boco Achille Massougbodji 《放射学期刊(英文)》 2019年第1期69-81,共13页
Background: Childhood cerebral malaria is one of the most frequent complications of malaria, with high morbidity and mortality. Raised Intracranial Pressure (ICP) is currently recognized as a fundamental element of th... Background: Childhood cerebral malaria is one of the most frequent complications of malaria, with high morbidity and mortality. Raised Intracranial Pressure (ICP) is currently recognized as a fundamental element of the severity of that disease. This study aims to look into the prognostic role of the sonographic measurement of optic nerve sheath diameter (ONSD) in the context of that disease. Methods: This study was conducted in the pediatric and imaging departments of the University Hospital Center of Parakou in Republic of Benin in West Africa. This was a descriptive cross-sectional study with a prospective data collection conducted over a period of 6 months, from March 1st to August 31st, 2014. There were two groups of children with severe malaria and conscious impairment: one with unrousable coma or Cerebral Malaria (Group 1) and the other without unrousable coma (Group 2), benefitting from ONSD sonographic measurement. ONSD was measured 3 mm behind the papilla. Correlation between depth of coma, outcome and ONSD measure on ultrasound was investigated. Results: Group 1 consisted of 37 children and Group 2 of 50 children, i.e. a sample of 87 children. The mean age was 27.21 ± 20.11 months and sex ratio (Male/Female) estimated at 0.89. The average ONSD of the sample was 4.39 ± 0.94 mm with a significant difference (p = 0.0001) between Group 1 (5.09 ± 1.09 mm) and Group 2 (3.87 ± 0.17 mm). Raised ICP prevalence was 48.28% with a significant difference between Group 1 (83.78%) and Group 2 (22%) with p Conclusion: Sonographic measurement of ONSD could be a leading prognostic tool in childhood cerebral malaria management. 展开更多
关键词 Cerebral MALARIA Ultrasound OPTIC Nerve SHEATH Diameter Prognosis Correlation
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Stage II/III Rectal Cancer Patients Benefit from Extremely Early Initiation of Postoperative Adjuvant Chemotherapy: A Retrospective Study 预览
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作者 Liuniu Xiao Li Zhu +4 位作者 Yingming Chen Zhenlin Hou Lingwei Jia Junbo Hu Yongdong Feng 《癌症治疗(英文)》 2019年第1期36-52,共17页
Background: For Stage II/III rectal cancer patients, curative resection is the primary treatment, prescribing of postoperative adjuvant chemotherapy (PAC) is regarded as a standard therapy. The interval between surger... Background: For Stage II/III rectal cancer patients, curative resection is the primary treatment, prescribing of postoperative adjuvant chemotherapy (PAC) is regarded as a standard therapy. The interval between surgery and the initiation of PAC is usually within 8 weeks. However, the optimal cut-off is still controversial. This study aimed to explore the impact of extremely early initiation of PAC for II/III rectal cancer. Methods: Patients with Stage II/III rectal cancer treated from January 2013 to December 2015 were retrospectively collected at the Department of Tongji Hospital. According to the starting point of PAC, patients were categorized into two groups: extremely early group (The interval of PAC ≤ 2 weeks) and normal group (The interval of PAC within 3 - 5 weeks). For the sake of evaluating the effectiveness of different intervals, Overall Survival rate (OS), Progress-Free Survival rate (PFS) and Recurrence or Metastasis Rate (RMR) were analyzed, as well as the Quality of Life Score. To estimate the safety of the extremely early PAC, we evaluated the first post chemotherapy adverse reactions and defecation ability, and analyzed the variance laboratory indexes around the first postoperative adjuvant chemotherapy. Results: A total of 267 patients were included in this study. Compared to normal group (192 cases), extremely early group (75 cases) of patients attained a better tendency of OS and PFS, although there were no significant statistical differences (OS: P = 0.0930;PFS: P = 0.1058). However, the RMR was significant lower (P = 0.0452) and the Quality of Life Score was significantly higher (P = 0.0090) in extremely early group. Multivariate analysis also showed that extremely early group had better defecation ability (P = 0.0149) and less side reactions of post chemotherapy, such as vomiting (P , got a higher level of inflammatory cells (P Conclusion: For Stage II/III rectal cancer patients, extremely early to start PAC not only might be effectively prolonging the survival, but indeed decrease the t 展开更多
关键词 RECTAL Cancer Postoperative ADJUVANT CHEMOTHERAPY Prognosis Quality of Life Chemotherapy-Associated ADVERSE Reaction
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Impact of MGMT Promoter Methylation as a Prognostic Marker in Patients with High Grade Glioma: A Single-Center Observational Study 预览
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作者 Vinu Sarathy Srinivasa Belagutty Jayappa +5 位作者 Bhanu Lalkota Kiran Pura Krishnamurthy Vishal Kulkarni Samuel Luke Koramati Nasiruddin Mohammad Radheshyam Naik 《癌症治疗(英文)》 2019年第10期806-814,共9页
Objectives: 1) To correlate the methylation status of the O-6-methylguanine-DNA-methyltransferase (MGMT promoter gene) and response to alkylating agent-based treatment in high-grade gliomas. Background: The MGMT gene ... Objectives: 1) To correlate the methylation status of the O-6-methylguanine-DNA-methyltransferase (MGMT promoter gene) and response to alkylating agent-based treatment in high-grade gliomas. Background: The MGMT gene is epigenetically silenced by promoter hypermethylation in gliomas and this modification has emerged as a relevant predictor of therapeutic response. Methods: 20 cases of high-grade glioma were analyzed for MGMT promoter methylation by methylation-specific PCR. Response to treatment and overall survival data were recorded and data analysed. Results: MGMT promoter methylation was found in 60% of gliomas by methylation-specific PCR. The mean survival time of glioblastoma patients submitted to adjuvant therapy was significantly higher among patients with MGMT promoter methylation (P = 0.035) and methylation status was an independent predictive factor that was associated with improved prognosis. Discussion and Conclusion: MGMT promoter methylation status was a more reliable predictor of response to adjuvant therapy and prognosis of high-grade gliomas. A subset of patients received irinotecan and bevacizumab in the second line setting and patients with unmethylated MGMT seemed to do better than the MGMT promoter methylated group. 展开更多
关键词 GLIOBLASTOMA MGMT PROMOTER METHYLATION MGMT Gene Aklylating AGENTS TEMOZOLOMIDE Prognosis
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Prognostic Value of Retinal Nerve Fiber Layer and Ganglion Cell Complex after Optic Chiasmal Decompression 预览
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作者 Shaymaa Hassan Salah Ahmed Mohamed Ali 《现代神经外科学进展(英文)》 2019年第1期23-34,共12页
This paper is an attempt to ascertain the role of the optical coherence tomography by measuring the retinal nerve fiber layer thickness and ganglion cell complex area to predict postoperative visual outcome after chia... This paper is an attempt to ascertain the role of the optical coherence tomography by measuring the retinal nerve fiber layer thickness and ganglion cell complex area to predict postoperative visual outcome after chiasmal decompression. 16 eyes scheduled for chiasmal decompression surgery were assessed before and 3 months after surgery with standard automated perimetry and OCT (optical coherence tomography). Preoperative RNFL (retinal nerve fibre layer) thickness and GCC (ganglion cell complex) area were compared with 20 normal control eyes. 13 cases were operated by microscopic assisted endoscopic endonasal transsphenoidal approach;the remaining 3 cases were operated transcranially. Spearman’s correlation analysis was used to evaluate the relationship between preoperative RNFL thickness, GCC area, postoperative mean deviation and temporal visual field sensitivity (1/Lambert). Preoperative measurements of RNFL thickness and all GCC area were significantly reduced in the patients compared with normal control. 3 months postoperative evaluation showed improvement of the visual field, but reduction in global and sectorial RNFL thickness except for nasal sector. Moreover, absolute postoperative (not pre-post change) visual field parameters were significantly correlated to preoperative RNFL (P = 0.00399 for mean deviation, P = 0.0023 for temporal sensitivity), GCC thickness (P = 0.00736 for mean deviation, P = 0.0469 for temporal sensitivity), with FLV (focal loss value) (P = 0.0012 for mean deviation, P = 0.0021 for temporal sensitivity) showed a higher correlation. Reduced RNFL thickness mainly, and GCC area minimally, were associated with the worst visual field outcome. FLV is a new prognostic value. 展开更多
关键词 OPTIC CHIASM DECOMPRESSION Surgery OCT PERIMETRY PROGNOSIS
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Serum Bilirubin as a Predictor of Coronary Artery Disease Severity in Patients Undergoing Primary Percutaneous Coronary Intervention 预览
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作者 Tarek Salah Khalil Waleed Abdou Ibrahim Mohamed Asem Ali Elmalla 《心血管病(英文)》 2019年第5期309-323,共15页
Introduction: Coronary artery disease (CAD) is one of the most common causes of death worldwide. In 2010, about 7 out of total 53 million deaths were due to ischemic heart disease. The aim of this study is to evaluate... Introduction: Coronary artery disease (CAD) is one of the most common causes of death worldwide. In 2010, about 7 out of total 53 million deaths were due to ischemic heart disease. The aim of this study is to evaluate the relationship of serum bilirubin level with the severity and complexity of coronary artery disease (CAD) in the patients undergoing primary percutaneous coronary intervention (PCI). Materials and Methods: 70 patients with STEMI who were undergoing primary PCI were included in the study. All the patients included in the study were subjected to full routine investigations and standard coronary angiographic projections. Total bilirubin level was measured and the patients were divided into two groups. Group 1 was with serum TB (and Group 2 was with serum TB (>1 mg/dl). Severity and complexity of coronary artery lesions will be assessed using Gensini score. Results: After PCI, the two studied groups were compared regarding the number of vessels affected by one and more than one vessel disease. Single vessel disease was frequent in Group 2 (71%) with significant p value (0.003). Cardiac enzymes (troponin I) was more in Group 1 (S. Bil value (0.02). Also (ALT, AST) were more in Group 1 (p value = 0.01). By comparing the 2 groups, there was a significant difference regarding (EF) between both which was less in Group 1 (S.TB 1), p value significance (0, 0001). Also GENSENI was more in Group 1 (S.TB 1) with mean (80.35 vs 34.71) and significant pvalue (0.0001). There was a highly significant negative correlation between serum bilirubin & GENSENI score (r = -0.762, p value 0.0001). Regarding the incidence of complications, incidence was more in Group 1 (S.TB 1), which means a significant difference between both groups with significant p value (0.0001). There was a significant negative correlation between serum bilirubin & incidence of complications (R = -0.38, pvalue 0.001). Also, there was a significant negative correlation between GENSINI score, complication and bilirubin among both groups (r: -0.762\-0.3 展开更多
关键词 SERUM BILIRUBIN CORONARY ARTERY Disease PROGNOSIS Risk Factors
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Diagnostic and Prognostic Interests of Plasmatic Neuroglobin during Stroke in Adult at the Acute Phase 预览
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作者 J. F. Nnang Essone C. Allognon +5 位作者 R. Nkiema S. R. Aubin Igombé P. Nzoghe Nguema F. Ovono Abessolo E. Anyunzok E. Ngou Milama 《神经科学国际期刊(英文)》 2019年第2期52-70,共19页
Introduction: Neuroglobin (Ngb) owes its name to its preferred location in the nervous system. Its plasma concentration increases during cerebral ischemia. However, the interest of its dosage in the diagnosis and the ... Introduction: Neuroglobin (Ngb) owes its name to its preferred location in the nervous system. Its plasma concentration increases during cerebral ischemia. However, the interest of its dosage in the diagnosis and the prognosis of the strokes in the adult is not defined. Objectives: To determine if plasmatic Ngb can be used as a diagnostic biomarker and prognostic for stroke in adults at the acute phase. Population and Methods: This was a prospective study in 69 people, including 39 suspected stroke (Cerebral ischemia or CI, Intracerebral hemorrhage or ICH) and 30 healthy volunteers (controls). The plasma concentration of Ngb (CmNgb in ng/ml) of the patients was determined at admission day (d1), at the third day (d3) and seventh day (d7). CmNgbtaken at d1 was compared between patients and controls. Its evolution over time, as well as its relation with the clinical parameters, including the Glasgow coma scale and the short-term mortality in stroke subjects was analyzed by the Mann and Whitney tests and the Wilcoxon test (p Results: At d1, the CmNgb of all types of stroke was 3.140 ± 2.700 ng/ml, and did not differ significantly from controls (0.303 ± 0.114 ng/ml, p = 0.070). On the other hand, it was higher in CI victims (5.800 ± 0.720 ng/ml) than in ICH (1.750 ± 0,090 ng/ml) (p = 0.030). It then decreased on d3 in CI victims (2.600 ± 0.112 ng/ml) and ICH (0.420 ± 0.211 ng/ml), returning to normal on d7 (0.420 ± 0.200 ng/ml for CI’s, p = 0.001, and 0.360 ± 0.300 ng/ml for ICH, p = 0.002). There was a relationship between CmNgb, delay of occurrence of the first symptoms of the stroke (3.140 ± 2.700 ng/ml before the 6th hour, and 0.643 ± 0.244 ng/ml after the 6th hour (p = 0.003) and the volume of the hematoma (p = 0.0027). None relationship existed between CmNgb, Glasgow coma scale (p = 0.427) and short-term mortality (CmNgb = 3.95 ng/ml in survivors versus 2.65 ng/ml in deceased p = 0.060). Conclusion: This study shows that the plasma concentration of Neuroglobin is high during stroke in humans in the a 展开更多
关键词 NEUROGLOBIN STROKE Diagnosis Prognosis
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Factors Influencing Prognosis in the Endoscopic Extraction of Foreign Bodies in Kashmiri Population 预览
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作者 M. S. Sheikh S. Gul Afshan +1 位作者 Meelad Mohammad Sheikh S. Bunafsha 《耳鼻喉(英文)》 2019年第1期32-48,共17页
An updated approach in the management of 50 patients with foreign body inhalation is presented. Certain risk factors that lead to complications and mortality due to endoscopic extraction of foreign bodies and thus det... An updated approach in the management of 50 patients with foreign body inhalation is presented. Certain risk factors that lead to complications and mortality due to endoscopic extraction of foreign bodies and thus determine prognosis were identified. Remedial measures to reduce morbidity and mortality due to bronchoscopic removal of foreign bodies are suggested. Fifty patients of suspected foreign body inhalation presented to a Unit of the Department of ENT, Head and Neck Surgery of Government Medical College associated SMHS Hospital Srinagar, Kashmir from March 2007 to June 2017. Of these, 49 patients were subjected to rigid tube bronchoscopy for removal of the aspirated foreign bodies and one coughed out the foreign body spontaneously during admission for bronchoscopy. History of foreign body inhalation was positive in 90% of patients and remaining was mostly referred from Paediatric Units with un-resolving collapse-consolidation of the lung. Whereas plain radiography of the chest and the soft tissues of neck were the primary imaging modality used in this study to detect the inhaled foreign bodies or their effects there are reports of virtual bronchoscopy being done with a multidetector computed tomography scanner in 3D image generation from axial cuts of the internal walls of the tracheobronchial tree in the management of patients suspected with foreign body aspiration. Bronchoscopy is a difficult and potentially hazardous procedure in the infant and young child. Telescopes and telescopic forceps were used during bronchoscopy to facilitate extraction of a foreign body inhaled. The type of a foreign body, site of its enlodgement and the complications encountered during its extraction were noted. During bronchoscopy the patients were connected to an ECG monitor and a pulse oximeter. 80% of the patients with foreign body inhalation were children in the age group of 0 - 5 years. There was a definite history of choking over the foreign body in 88% of the patients leading to acute respiratory distress in 46%. Cough 展开更多
关键词 Inhaled Foreign Bodies Collapse-Consolidation Obstructive Emphysema Virtual BRONCHOSCOPY Rigid Tube BRONCHOSCOPY Hypoxic BRADYCARDIA BRONCHOSPASM SUBGLOTTIC OEDEMA Pneumothorax Tracheostomy PROGNOSIS
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TRAIL and TRAIL Receptors as Prognostic Markers in Breast Cancer Patients 预览
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作者 Fawziya A. R. Ibrahim Marwa S. Abouelenein +3 位作者 Ola S. A. Sakr Sanaa S. Ahmed Ebtisam R. Zaher Shaymaa E. el Feky 《美国分子生物学期刊(英文)》 2019年第4期204-217,共14页
Background: Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a key player in the extrinsic pathway of apoptosis;it selectively damages cancer cells through binding to its surface receptors, however, ... Background: Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a key player in the extrinsic pathway of apoptosis;it selectively damages cancer cells through binding to its surface receptors, however, cancers can escape this pathway through expression of dysfunctional decoy receptors. Purpose: The present study directed mainly to elucidate the serum TRAIL levels in breast cancer patients and to explore the variation in gene expression of TRAIL death and decoy receptors in breast cancer tissues, and to explore their role as prognostic markers in breast cancer as well as to detect their correlation with Patients’ Clinical Characteristics. Subjects and Methods: TRAIL levels were assayed in the sera of 124 breast cancer patients and 150 healthy females. Moreover, the expression of TRAIL death and decoy receptors was determined in both malignant and adjacent normal breast tissues collected from patients. ER, PR and Her-2 expression in breast cancer tissue were performed using immunohistochemical method. Apoptotic index (AI) was analyzed using H&E stain under light microscopy. Results: Serum levels of TRAIL in breast cancer patients were significantly lower than controls (P Conclusions: The expression of both DR4 and DR5 is required for TRAIL-induced apoptosis in breast cancer tissues;in addition, serum TRAIL and profiling of TRAIL receptors expression may serve as prognostic markers in breast cancer patients. 展开更多
关键词 BREAST CANCER APOPTOSIS TRAIL PROGNOSIS
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Uterine Rupture: Epidemiological Aspects, Etiologies and Maternal-Fetal Prognosis in the Obstetric Gynecology Department of the Donka CHU Conakry National Hospital, Guinea 预览
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作者 Boubacar Siddi Diallo Ibrahima Sory Balde +8 位作者 Ibrahima Conte Mamadou Hady Diallo Ousmane Balde Ibrahima Sylla Abdourahmane Diallo Oumou Hawa Bah Loua Avit Telly Sy Namory Keita 《妇产科期刊(英文)》 2019年第4期521-528,共8页
Objectives: The objectives of this work were to calculate the frequency of the uterine rupture, to describe the epidemiological profile, to identify the etiologies and to establish the maternal prognosis and foetal. M... Objectives: The objectives of this work were to calculate the frequency of the uterine rupture, to describe the epidemiological profile, to identify the etiologies and to establish the maternal prognosis and foetal. Methodology: It was about a descriptive survey with compilation of the data in two phases: a retrospective spreading on one period of 6 years and the other forecasting of 1 one year achieved to the service of Obstetric Gynecology of the hospital National Donka, Fallen from Conakry, Guinea. Results: We recorded 24.030 childbirths of which 188 cases of uterine rupture either a frequency of 0.78, which represents an uterine rupture for 128 childbirths. The epidemiological profile was the one of a woman of 24 to 28 years (31.91%), housewives (69.14%), without prenatal follow-up (47.87%), big multipare (37.76%) and évacuées (78.78%). The motives of consultation have been dominated by the hémorragie (95.74%). The rupture was of transverse type in the majority of the case (63.82%). The hysterorraphy was the most performed surgical procedure which is 85.10% followed by the total sub hysterectomy in 10.63%. The newborns of birth weight superior or equal to 4000 g represent 25.53%. The maternal morbidity has been dominated by the anemia of the postpartum (60%). We recorded a rate of maternal létalité of 12.76%. The maternal deaths were due to the hemorrhage in 78.57%. The living newborns endured a respiratory distress in 9.57% and those stillborn represent 87.23%. The etiologies of uterine rupture were dominated by fetal-pelvic disproportions 48.93% followed by an iatrogenic uterine rupture 22.33%. Conclusion: The reduction of this uterine rupture rate would pass by the recentered prenatal consultation offered, the one of obstetric cares and complete néonataux of emergency, the discount to level of the beneficiaries of the basic structures so that they can discover the cases in time susceptible to drag a rupture to evacuate better in time and the promptness in the hold in charge since the admission of the 展开更多
关键词 UTERINE Rupture Etiologie Prognosis
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Prognosis of 148 New Cases of Female Genital Fistula in a Multicentric Study in Niger 预览
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作者 N. Idi N. A. Harouna Malam Brah +2 位作者 A. Idrissa L. Djangnikpo Z. Assoumana 《妇产科期刊(英文)》 2019年第8期1197-1201,共5页
Introduction: We report anatomopathological and treatment results of new cases of obstetrical female genital fistula in main to determine the prognosis. Methodology: Multicentre prospective study over 15 months (Janua... Introduction: We report anatomopathological and treatment results of new cases of obstetrical female genital fistula in main to determine the prognosis. Methodology: Multicentre prospective study over 15 months (January 1st, 2016 to March 31st, 2017) in 5 national centres of female genital fistula treatment. Patients were in all age group. Anatomopathological types were urogenital classified simple, middle and mixte (association of urogenital and recto genital). The methods of treatment were surgery and trans uretral vesical probe. We observed treated patients during 3 months. Results: 148 new cases collected. The study revealed 47.15% of urogenital fistulas were vesico-vaginal and urethro-vaginal (25.71%). 3 cases of rectovaginal fistula including 2 cases in the lower third of the rectum and one in the upper third, 141 patients were treated. The results gave 35 cases treated by trans ureterovesical probe cured and dry, those by surgery were continent and dry (71.62%) but 23 (15.54%) treated but not dry, 12 (4.10%) FGF were not closed tTab5) 7 cases not treated, one referred to urology service, one patient died before treatment and 5 perdu of view. Conclusion: Obstetric fistula remains a serious public health problem in Niger. FGF happened in all age old because of non skilled pre- and per-natal care particularly in rural area. Treatment could be improved but political prevention must be the rule. 展开更多
关键词 FGF Treatment PROGNOSIS NIGER
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CRKL and CK2 <i>β</i>over Expression Are Independent Predictors of Patients Survival in Endometrioid Endometrial Carcinoma 预览
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作者 Randa Mohamed Kaf Wafaa El-Beshbishi +6 位作者 Ahmed A. Obaya Rham Z. Ahmed Khaled Fathy Helal Mohamed SH. Ramadan Abdelwahab S. Almoregy Ibrahim A. Heggy Ola A. Harb 《妇产科期刊(英文)》 2019年第4期479-493,共15页
Context: The prognostic significance of expression of V-Crk avian sarcoma virus CT10 oncogene homolog-like (CRKL) and Protein kinase CK2 β in endometroid carcinoma is not fully clarified. Aim: To assess the prognosti... Context: The prognostic significance of expression of V-Crk avian sarcoma virus CT10 oncogene homolog-like (CRKL) and Protein kinase CK2 β in endometroid carcinoma is not fully clarified. Aim: To assess the prognostic values and clinicopathological roles of CRKL and CK2 β expression in endometroid carcinoma by correlation their expression levels with clinicopathological parameters, response to therapy, and recurrence of the tumor and patients survival. Settings: Faculty of Medicine, Zagazig University, and Mansoura University. Methods: CRKL and CK2 β expressions were evaluated in 50 paraffin blocks EC patients that were followed up for 5 years. The relationship between their level of expressions, clinicopathological criteria and prognosis of patients was analyzed. Statistical analysis used: SPSS 22.0 for windows (SPSS Inc., Chicago, IL, USA) and MedCalc windows (Software bvba 13, Ostend, Belgium). Results: High expression of CRKL and CK was positively correlated with higher grade of the tumor (p = 0.004 and 0.006 respectively), presence of L.N metastases (p = 0.009 and 0.003 respectively), presence of distant metastases (p = 0.029 and 0.003 respectively) and advanced FIGO stage (p 0.001), poor response to therapy (p = 0.046 and 0.005 respectively), higher incidence of recurrence of the tumor after therapy (p = 0.004 and 0.048 respectively), higher incidence of cancer progression p = 0.018 and 0.044 respectively), poor PFS (p = 0.008 and 0.013 respectively), and OS rates (p 展开更多
关键词 CRKL CK2 β Endometroid Carcinoma IMMUNOHISTOCHEMISTRY PROGNOSIS
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磁共振波谱在脑梗死患者住院治疗前后的应用 预览
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作者 朱超 翟建 +2 位作者 王诗卉 吴晓东 崔翔 《中国医学影像学杂志》 CSCD 北大核心 2019年第4期254-257,共4页
目的探讨脑梗死患者住院期间多体素氢质子磁共振波谱成像(1H-MRS)代谢物变化与临床评分的关系;评价多体素1H-MRS 在判断脑梗死患者预后中的价值。资料与方法19例脑梗死患者分别于住院治疗前后进行两次多体素1H-MRS扫描,经后处理获得代... 目的探讨脑梗死患者住院期间多体素氢质子磁共振波谱成像(1H-MRS)代谢物变化与临床评分的关系;评价多体素1H-MRS 在判断脑梗死患者预后中的价值。资料与方法19例脑梗死患者分别于住院治疗前后进行两次多体素1H-MRS扫描,经后处理获得代谢物变化情况。根据发病时间将19例患者分为急性期组、亚急性期组,在两次行多体素1H-MRS 检查前进行美国国立卫生院神经功能缺损评分(NIHSS),分析治疗前后代谢物的变化与NIHSS 评分变化的相关性。结果急性期、亚急性期患者病灶中心区域治疗前后相对N-乙酰基天门冬氨酸(Rnaa)差异均无统计学意义(P>0.05);而病灶中心区域治疗后相对乳酸(rLac)值均低于治疗前,差异有统计学意义(P<0.01)。急性期、亚急性期患者病灶边缘区治疗后Rnaa 高于治疗前,治疗后rLac值低于治疗前,差异均有统计学意义(P<0.01)。治疗前后病灶边缘区域Rnaa 增加值与NIHSS评分下降值呈正相关(r=0.625,P=0.004)。结论MRI常规检查以及对多体素1H-MRS部分代谢物的测量可以用于脑梗死早期诊断,并可判断疗效及评估患者的临床预后。 展开更多
关键词 脑梗死 磁共振成像 磁共振波谱学 预后
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胰腺癌hENT1蛋白表达与吉西他滨化疗疗效及预后的相关性
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作者 张怡 杨晓丹 +4 位作者 王晓光 吴斌 倪全法 宋政炜 费建国 《中华胰腺病杂志》 CAS 2019年第2期103-106,共4页
目的探讨胰腺癌人平衡型核苷酸转运体1(hENT1)蛋白的表达与吉西他滨化疗疗效、不良反应及预后的关系。方法收集2013年6月至2016年1月间嘉兴市第二医院肝胆胰外科及嘉兴市中医院肝胆胰外科收治的83例胰腺癌患者经内镜超声下细针穿刺活检... 目的探讨胰腺癌人平衡型核苷酸转运体1(hENT1)蛋白的表达与吉西他滨化疗疗效、不良反应及预后的关系。方法收集2013年6月至2016年1月间嘉兴市第二医院肝胆胰外科及嘉兴市中医院肝胆胰外科收治的83例胰腺癌患者经内镜超声下细针穿刺活检的组织。采用免疫组织化学法检测hENT1蛋白的表达,分为hENT1低表达组和高表达组;依据化疗的疗效分为吉西他滨有效组和耐药组。比较两组患者的临床病理参数、不良反应发生率、中位生存期和无进展生存率(PFS)。结果 83例胰腺癌组织中37例(44.6%)hENT1高表达,46例(55.4%)低表达。吉西他滨化疗疗效与患者的性别、年龄、临床症状及肿瘤原发部位、肿瘤大小、TNM分期、CA19-9水平、CEA水平、有无肝脏转移均无相关性,但hENT1高表达组的吉西他滨耐药率显著高于低表达组(78.1%比50.0%),差异有统计学意义(P=0.010)。两组患者均可以耐受吉西他滨化疗不良反应,无化疗相关性死亡,但hENT1低表达组患者白细胞、血小板减少发生率显著高于hENT1高表达组(63.0%比21.6%,47.8%比16.2%),差异均有统计学意义(P值均<0.05)。hENT1低表达组中位生存期和1年PFS均显著低于高表达组(11个月比15个月,19.4%比50.0%),差异均有统计学意义(P值均<0.05)。结论胰腺癌组织中hENT1蛋白表达下降降低了患者对吉西他滨化疗的疗效,增加患者白细胞、血小板减少的发生率。 展开更多
关键词 胰腺肿瘤 平衡型核苷酸转运体1 吉西他滨 预后
单中心胆道闭锁Kasai术后早期肠道并发症诊治分析
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作者 王增萌 陈亚军 +6 位作者 庞文博 彭春辉 张丹 沈秋龙 吴东阳 王丽 王凯 《中华小儿外科杂志》 CSCD 北大核心 2019年第5期404-408,共5页
目的分析胆道闭锁术后早期肠道并发症的发生情况,探讨诊治策略及预后情况。方法2009年1月至2016年6月我院普外科共收治胆道闭锁患儿行Kasai手术治疗358例。随访资料完整、到达随访终点患儿310例,失访48例,10例出现术后早期肠道并发症。... 目的分析胆道闭锁术后早期肠道并发症的发生情况,探讨诊治策略及预后情况。方法2009年1月至2016年6月我院普外科共收治胆道闭锁患儿行Kasai手术治疗358例。随访资料完整、到达随访终点患儿310例,失访48例,10例出现术后早期肠道并发症。对出现术后并发症的10例患儿相关临床资料进行统计分析,并进行随访。结果Kasai术后出现早期肠道并发症患儿男6例,女4例,本中心Kasai术后早期肠道并发症发生率为2.79%(10/358)。术后均表现为呕吐腹胀,症状出现时间为术后(4±1.7)d,时间范围2~7 d。其中3例患儿呕吐黄绿色液体,其余呕吐胃液;此外还有腹引流管引流血性腹水1例,血便1例。立位腹平片均提示肠梗阻,其中6例伴有腹腔游离气。二次手术时间为Kasai术后(6.2±3.6) d,时间范围3~16 d。术中证实为粘连性肠梗阻9例,小肠套叠1例;其中6例气腹患儿均存在空肠Roux-Y端侧吻合口漏,行修补术;另有6例患儿存在肠管坏死,行肠管切除吻合。有2例患儿分别因肠穿孔、Roux-Y端侧吻合口漏行3次手术治疗,分别为肠造瘘术及吻合口漏修补术。住院时间(33.9±28.3) d,范围16~99 d。较我院标准住院时间14 d明显延长。经随访,10例患儿中有5例出现Kasai术后早期胆管炎(术后1个月内),较本中心既往胆管炎发病率9.9%明显升高。10例早期肠道并发症患儿术后3个月有2例黄疸清除,术后6个月有3例黄疸清除,术后1年自肝生存4例。结论胆道闭锁患儿Kasai术后早期肠道并发症表现为腹胀、呕吐,多发生于术后1周内,多为粘连性肠梗阻,容易引起梗阻点近端的空肠端侧吻合口漏,宜尽早手术解除梗阻。Kasai术后早期肠道并发症对远期自肝生存情况有不良影响。 展开更多
关键词 胆道闭锁 肠梗阻 手术后并发症 Kasai手术 预后
年龄对尿激酶溶栓治疗脑梗死患者效果及预后的影响 预览
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作者 吕占举 王锐 《包头医学院学报》 CAS 2019年第4期47-48,共2页
目的:研究不同年龄对尿激酶溶栓治疗脑梗死患者效果及预后的影响。方法:将200例脑梗死患者患者年龄大小分为高龄组109例(年龄≥60岁)以及低龄组91例(年龄<60岁),两组均采取尿激酶溶栓治疗,比较高龄组和低龄组的临床治疗效果、NIHSS... 目的:研究不同年龄对尿激酶溶栓治疗脑梗死患者效果及预后的影响。方法:将200例脑梗死患者患者年龄大小分为高龄组109例(年龄≥60岁)以及低龄组91例(年龄<60岁),两组均采取尿激酶溶栓治疗,比较高龄组和低龄组的临床治疗效果、NIHSS评分、改良Rankin评分和并发症发生情况。结果:低龄组的有效率为90.11%,高于高龄组的74.31%(P<0.05);两组治疗后的NIHSS评分和改良Rankin评分均降低(P<0.05),且低龄组低于高龄组(P<0.05);低龄组溶栓非直接并发症以及溶栓直接并发症的发生率均低于高龄组(P<0.05)。结论:且低龄患者采用尿激酶溶栓治疗效果优于高龄患者、并发症发生率较低、预后情况相对较好。 展开更多
关键词 不同年龄 尿激酶 脑梗死 疗效 预后
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新生儿肺炎克雷伯菌医院感染预后相关因素分析
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作者 刘伟 赖晓全 +1 位作者 谭昆 谭莉 《中华医院感染学杂志》 CAS CSCD 北大核心 2019年第13期2024-2028,共5页
目的探讨新生儿肺炎克雷伯菌(KPN)医院感染患者预后相关危险因素,为临床治疗和预防提供依据。方法回顾性的分析2014年-2017年医院109例KPN感染新生儿的病例资料,其中死亡组20例,生存组89例,分别统计感染部位及耐药情况。预后相关单因素... 目的探讨新生儿肺炎克雷伯菌(KPN)医院感染患者预后相关危险因素,为临床治疗和预防提供依据。方法回顾性的分析2014年-2017年医院109例KPN感染新生儿的病例资料,其中死亡组20例,生存组89例,分别统计感染部位及耐药情况。预后相关单因素分析采用成组t检验或卡方检验,多因素分析采用Logistic回归分析法,生存分析采用Kaplan-Meier法。结果死亡组和生存组均以下呼吸道感染为主;大部分抗菌药物的耐药率死亡组要比生存组高;单因素分析结果显示产妇胎膜早破史、胎龄、出生体质量、CRKP感染、PICC置管史、碳青霉烯类药物使用史是新生儿KPN感染后死亡的相关危险因素;多因素分析结果显示仅CRKP感染是新生儿KPN感染后死亡的独立危险因素,OR值为4.853(95%CI:1.617~14.561);生存分析显示CRKP组患儿的30 d死亡率明显高于CSKP组(P=0.004)。结论 CRKP感染是新生儿KPN感染后死亡的独立危险因素,应对高危患儿加强防控。 展开更多
关键词 新生儿 肺炎克雷伯菌 医院感染 预后 生存分析
浅论影响颅脑损伤患者预后的独立危险因素 预览
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作者 杨波 李元斌 +3 位作者 杨志明 邱戈 胡帮洪 廖鹏 《当代医药论丛》 2019年第12期93-94,共2页
目的:分析影响颅脑损伤患者预后的独立危险因素。方法:选择2016年1月至2018年3月期间崇州市人民医院神经外科收治的50例颅脑损伤患者作为研究对象。对这50例患者的临床资料进行回顾性研究,分析其年龄、格拉斯哥昏迷评分法(GCS)的评分、... 目的:分析影响颅脑损伤患者预后的独立危险因素。方法:选择2016年1月至2018年3月期间崇州市人民医院神经外科收治的50例颅脑损伤患者作为研究对象。对这50例患者的临床资料进行回顾性研究,分析其年龄、格拉斯哥昏迷评分法(GCS)的评分、脑血肿量及脑中线移位值等指标,然后,分析影响其预后的独立危险因素。结果:在这50例患者中,与年龄≤60岁的患者相比,年龄> 60岁患者的残疾率及死亡率更高;与未合并有高钠血症的患者相比,合并有高钠血症患者的残疾率及死亡率更高;与脑血肿量≤30ml的患者相比,脑血肿量> 30ml患者的残疾率及死亡率更高,与不存在脑挫裂伤的患者相比,存在脑挫裂伤患者的残疾率及死亡率更高,与GCS的评分> 9分的患者相比,GCS的评分≤9分患者的残疾率及死亡率更高,与不存在脑血肿的患者相比,存在脑血肿患者的残疾率及死亡率更高,与脑中线移位值> 10mm的患者相比,脑中线移位值≤10 mm患者的残疾率及死亡率更高(P <0.05)。对颅脑损伤患者的年龄、脑血肿量、GCS的评分等因素进行Logistic回归分析的结果显示,脑血肿量> 30ml和GCS的评分≤9分均是影响颅脑损伤患者预后的独立危险因素(P <0.05)。结论:脑血肿量> 30ml和GCS的评分≤9分是影响颅脑损伤患者预后的独立危险因素。 展开更多
关键词 影响因素 格拉斯哥昏迷评分法 神经外科 颅脑创伤 预后
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105例初诊多发性骨髓瘤患者微小残留病的动态监测及其预后价值
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作者 杨珮钰 刘蒙蒙 +8 位作者 樊红琼 杨艳萍 韩薇 于小源 岳婷婷 苏克举 郭强 高素君 靳凤艳 《中华血液学杂志》 CAS CSCD 北大核心 2019年第7期584-588,共5页
目的探讨多发性骨髓瘤(MM)患者微小残留病(MRD)动态变化及其与临床特征、治疗和预后的关系.方法纳入105例治疗后达到非常好的部分缓解(VGPR)的MM患者,采用多参数流式细胞术(MFC)动态监测MRD状态,结合临床数据和随访,进行Kaplan-Meier曲... 目的探讨多发性骨髓瘤(MM)患者微小残留病(MRD)动态变化及其与临床特征、治疗和预后的关系.方法纳入105例治疗后达到非常好的部分缓解(VGPR)的MM患者,采用多参数流式细胞术(MFC)动态监测MRD状态,结合临床数据和随访,进行Kaplan-Meier曲线及Cox回归等分析.结果①纳入本研究的疗效VGPR患者中,MRD转阴率为72.4%(76/105),中位转阴时间为3个月.②MRD阴性患者2年无进展生存(PFS)率明显高于MRD阳性患者(62.2%对41.3%,P=0.001),持续MRD阳性为PFS独立预后不良因素(HR=3.039,P=0.044).③失去MRD阴性状态(转阳)患者预后劣于MRD持续阴性患者,二者中位PFS时间分别为18个月和未达到(P<0.001),中位总生存(OS)时间均未达到(P=0.002).④MRD阴性持续时间≥12个月患者的2年PFS和OS率均显著高于对照组(PFS:77.7%对36.7%,P<0.001;OS:96.4%对57.9%,P<0.001).随MRD阴性持续时间延长,复发/死亡风险显著降低(PFS:HR=0.865,P<0.001;OS:HR=0.823,P<0.001).⑤高危细胞遗传学异常(CA)或不适合自体造血干细胞移植(ASCT)患者中,MRD阴性患者PFS延长(高危CA患者中位PFS:未达到对19个月,P=0.006;不适合ASCT患者中位PFS:未达到对25个月,P=0.052).⑥应用硼替佐米治疗可明显延长MRD阴性持续时间(中位MRD阴性持续时间:25个月对10个月,P=0.034).结论持续MRD阳性是MM独立的预后不良因素,MRD阴性持续时间是另一重要预后因素,而失去MRD阴性状态可能是复发的早期标志,故动态监测MRD有助于指导复发MM治疗时机的选择. 展开更多
关键词 多发性骨髓瘤 微小残留病 多参数流式细胞术 动态监测 预后
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