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Xu L, Huang X, Lou Y, Xie W, He J, Yang Z, Yang Y, Zhang Y. Prognostic analysis of percutaneous vertebroplasty (PVP) combined with 125I implantation on lumbosacral vertebral osteoblastic metastases. World J Surg Oncol 2023; 21:391. [PMID: 38124135 PMCID: PMC10731753 DOI: 10.1186/s12957-023-03268-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE Lumbosacral vertebral osteoblastic metastasis is treated with percutaneous vertebroplasty (PVP) combined with 125I seed implantation and PVP alone. Compared to PVP alone, we evaluated the effects of combination therapy with PVP and 125I seed implantation on pain, physical condition, and survival and evaluated the clinical value of PVP combined with 125I particle implantation. METHODS We retrospectively analyzed 62 patients with lumbosacral vertebral osseous metastases treated at our hospital between 2016 and 2019. All the patients met the inclusion criteria for 125I implantation, and they were randomly divided into a combined treatment group and a pure PVP surgery group. The visual analog pain scale (VAS), Karnofsky Performance Status (KPS), and survival time were recorded at different time points, including preoperative, postoperative 1 day, 1 month, 3 months, 6 months, 12 months, and 36 months in each group. The variation in clinical indicators and differences between the groups were analyzed using SPSS version 20.0. Correlations between different variables were analyzed using the nonparametric Spearman's rank test. The Kaplan-Meier method was used to estimate the relationship between survival time and KPS score, VAS score, or primary tumor progression, and survival differences were analyzed using the log-rank test. Multivariate analyses were performed using a stepwise Cox proportional hazards model to identify independent prognostic factors. RESULTS Compared to the PVP treatment group, the pain level in the combined treatment group was significantly reduced (P = 0.000), and the patient's physical condition in the combination treatment group significantly improved. Kaplan-Meier analysis showed that the survival rate of the PVP group was significantly lower than that of the combination group (P = 0.038). We also found that the median survival of patients in both groups significantly increased with an increase in the KPS score (14 months vs. 33 months) (P = 0.020). Patients with more than three transfer sections had significantly lower survival rates than those with one or two segments of the section (P = 0.001). Further, Cox regression analysis showed that age (P = 0.002), the spinal segment for spinal metastasis (P = 0.000), and primary tumor growth rate (P = 0.005) were independent factors that affected the long-term survival of patients with lumbosacral vertebral osseous metastases. CONCLUSIONS PVP combined 125I seeds implantation surgery demonstrated superior effectiveness compared to PVP surgery alone in treating lumbosacral vertebral osseous metastases, which had feasibility in the clinical operation. Preoperative KPS score, spine transfer section, and primary tumor growth rate were closely related to the survival of patients with lumbosacral vertebral osteoblastic metastasis. Age, spinal segment for spinal metastasis, and primary tumor growth can serve as prognostic indicators and guide clinical treatment.
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Affiliation(s)
- Lei Xu
- Department of Orthopedics, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), Chengdu, Sichuan, 610213, China.
| | - Xin Huang
- Department of Orthopedics, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), Chengdu, Sichuan, 610213, China
| | - Yan Lou
- Department of Orthopedic Oncology, Spine Tumor Center, Changzheng Hospital, Naval Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Wei Xie
- Department of Orthopedics, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), Chengdu, Sichuan, 610213, China
| | - Jun He
- Department of Orthopedics, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), Chengdu, Sichuan, 610213, China
| | - Zuozhang Yang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, Yunnan, 650118, People's Republic of China.
| | - Yihao Yang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, Yunnan, 650118, People's Republic of China
| | - Ya Zhang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Yunnan Cancer Center, Kunming, Yunnan, 650118, People's Republic of China
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[Expert consensus on the prevention and treatment of heatstroke in children (2023)]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:551-559. [PMID: 37382122 DOI: 10.7499/j.issn.1008-8830.2212063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Due to the immature development of temperature regulation in the central nervous system, children have a weakened ability to regulate heat and are susceptible to heatstroke, which can lead to organ damage. Based on the evidence evaluation criteria of the Oxford Centre for Evidence-Based Medicine, this expert consensus group evaluated the current evidence on heatstroke in children, and formed this consensus through thorough discussion with the aim of providing reference for the prevention and treatment of heatstroke in children. This consensus includes classifications, pathogenesis, prevention measures, as well as pre-hospital and in-hospital treatment plans for heatstroke in children.
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Sekiguchi Y, Benjamin CL, Manning CN, Butler CR, Szymanski MR, Filep EM, Stearns RL, Distefano LJ, Lee EC, Casa DJ. Using Predictive Modeling Technique to Assess Core Temperature Adaptations from Heart Rate, Sweat Rate, and Thermal Sensation in Heat Acclimatization and Heat Acclimation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13009. [PMID: 36293588 PMCID: PMC9602154 DOI: 10.3390/ijerph192013009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/29/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
Assessing the adaptation of rectal temperature (Trec) is critical following heat acclimatization (HAz) and heat acclimation (HA) because it is associated with exercise performance and safety; however, more feasible and valid methods need to be identified. The purpose of this study was to predict adaptations in Trec from heart rate (HR), sweat rate (SR), and thermal sensation (TS) using predictive modeling techniques. Twenty-five male endurance athletes (age, 36 ± 12 y; VO2max, 57.5 ± 7.0 mL⋅kg-1⋅min-1) completed three trials consisting of 60 min running at 59.3 ± 1.7% vVO2max in a hot environment. During trials, the highest HR and TS, SR, and Trec at the end of trials were recorded. Following a baseline trial, participants performed HAz followed by a post-HAz trial and then completed five days HA, followed by a post-HA trial. A decision tree indicated cut-points of HR (<-13 bpm), SR (>0.3 L·h-1), and TS (≤-0.5) to predict lower Trec. When two or three variables met cut-points, the probability of accuracy of showing lower Trec was 95.7%. Greater adaptations in Trec were observed when two or three variables met cut-points (-0.71 ± 0.50 °C) compared to one (-0.13 ± 0.36 °C, p < 0.001) or zero (0.0 3 ± 0.38 °C, p < 0.001). Specificity was 0.96 when two or three variables met cut-points to predict lower Trec. These results suggest using heart rate, sweat rate, and thermal sensation adaptations to indicate that the adaptations in Trec is beneficial following heat adaptations, especially in field settings, as a practical and noninvasive method.
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Affiliation(s)
- Yasuki Sekiguchi
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
- Sports Performance Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, 3204 Main Street, Lubbock, TX 79409, USA
| | - Courteney L. Benjamin
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
- Department of Kinesiology, Samford University, Birmingham, AL 35229, USA
| | - Ciara N. Manning
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Cody R. Butler
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Michael R. Szymanski
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Erica M. Filep
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
- Department of Kinesiology and Military Science, Texas A&M University-Corpus Christi, Corpus Christi, TX 78412, USA
| | - Rebecca L. Stearns
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Lindsay J. Distefano
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Elaine C. Lee
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Douglas J. Casa
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
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