1
|
Wu JL, Luo JY, Jiang ZB, Huang SB, Chen GR, Ran HY, Liang QY, Huang MS, Lai LS, Chen JW. Inflammation-related nomogram for predicting survival of patients with unresectable hepatocellular carcinoma received conversion therapy. World J Gastroenterol 2023; 29:3168-3184. [PMID: 37346152 PMCID: PMC10280795 DOI: 10.3748/wjg.v29.i20.3168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/02/2023] [Accepted: 04/24/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND The efficacy of conversion therapy for patients with unresectable hepatocellular carcinoma (HCC) is a common clinical concern.
AIM To analyse the prognostic factors of overall survival (OS) in patients with unresectable HCC who received conversion therapy.
METHODS One hundred and fifty patients who met the inclusion criteria were enrolled and divided into a training cohort (n = 120) and a validation cohort (n = 30). Using the independent risk factors in the training cohort, a nomogram model was constructed to predict OS for patients treated with transarterial chemoembolization following hepatic resection. The nomogram was internally validated with the bootstrapping method. The predictive performance of nomogram was assessed by Harrell’s concordance index (C-index), calibration plot and time-dependent receiver operating characteristic curves and compared with six other conventional HCC staging systems.
RESULTS Multivariate Cox analysis identified that albumin, blood urea nitrogen, gamma-glutamyl transpeptidase to platelet ratio, platelet to lymphocyte ratio, macrovascular invasion and tumour number were the six independent prognostic factors correlated with OS in nomogram model. The C-index in the training cohort and validation cohort were 0.752 and 0.807 for predicting OS, which were higher than those of the six conventional HCC staging systems (0.563 to 0.715 for the training cohort and 0.458 to 0.571 for the validation cohort). The calibration plots showed good consistency between the nomogram prediction of OS and the actual observations of OS. Decision curve analyses indicated satisfactory clinical utility. With a total nomogram score of 196, patients were accurately classified into low-risk and high-risk groups. Furthermore, we have deployed the model into online calculators that can be accessed for free at https://ctmodelforunresectablehcc.shinyapps.io/DynNomapp/.
CONCLUSION The nomogram achieved optimal individualized prognostication of OS in HCC patients who received conversion therapy, which could be a useful clinical tool to help guide postoperative personalized interventions and prognosis judgement.
Collapse
Affiliation(s)
- Jia-Lin Wu
- Department of Interventional Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
| | - Jun-Yang Luo
- Department of Interventional Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
| | - Zai-Bo Jiang
- Department of Interventional Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
| | - Si-Bo Huang
- The First Clinical Medical College, Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
| | - Ge-Run Chen
- The First Clinical Medical College, Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
| | - Hui-Ying Ran
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Qi-Yue Liang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Ming-Sheng Huang
- Department of Interventional Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
| | - Li-Sha Lai
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou 510010, Guangdong Province, China
| | - Jun-Wei Chen
- Department of Interventional Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
| |
Collapse
|
2
|
Dong BQ, Chen BY, Liang QY, He S, Lyu W, Liu BT, Zuo YJ, Lin L, Wei H, Wei J, Hang XN, Qiu XX. [Study on the characteristics of major birth defects in 1.69 million cases of fetus in Guangxi Zhuang Autonomous Region]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 40:1554-1559. [PMID: 32062914 DOI: 10.3760/cma.j.issn.0254-6450.2019.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Tracking the information on 1.69 million fetal cases across Guangxi Zhuang Autonomous Region (Guangxi) so as to study the occurrences of total and major birth defects in order to evaluate the ability on related prevention and control programs in Guangxi. Methods: Using the self-developed "Gui Women's System" to establish a database of 1.69 million fetal cases in Guangxi and to analyze the distribution of time, space and population, as well as the outcomes of pregnancy, using the big data. Results: During the 29 months of observation, the overall live birth rate was 99.25%, with stillbirth rate during pregnancy as 0.44%, stillbirth rate during birth as 0.02%, and the 0-6 days mortality rate as 0.14%. The total detection rate on birth defects was 197.63/10 000; the incidence rate was 103.04/10 000, the birth rate was 102.55/10 000. The overall discovery rate of major birth defects was 48.33/10 000, with the incidence rate as 783 000, the birth rate as 0.58/10 000. The discovery rates of major birth defects in 14 cities were between 35 and 68/10 000, and the birth rate dropped significantly to less than 1.00 in 10 000. Nationalities showed that the number of pregnant women with birth defects more than 50 000 would include Hui (9.68/10 000), Yao (9.57/10 000), and Jing (9.37/10 000). With the increasing age of gestation, number of birth defects, incidence of major birth defects also increased. Ninety-five percent of the major birth defects were found within <28 weeks and with the top 5 kinds of major birth defects as complicated congenital heart disease (9.11/10 000), alpha thalassemia (8.36/10 000), and 21-trisomy syndrome (7.85/10 000), beta thalassemia (5.32/10 000) and fetal edema syndrome (4.92/10 000). The top 5 major birth defects appeared as complicated congenital heart disease (9.11/10 000), alpha thalassemia (8.36/10 000), and 21-trisomy syndrome (7.85/10 000), beta thalassemia (5.32/10 000) and fetal edema syndrome (4.92/10 000). Conclusion: Programs leading to increase the rate on discovery of major birth defects were fundamental in effectively reducing the major birth defects.
Collapse
Affiliation(s)
- B Q Dong
- School of Public Health Management, Guangxi University of Traditional Chinese Medicine, Nanning 530200, China
| | - B Y Chen
- Guangxi Zhuang Autonomous Region Women and Children Care Hospital, Nanning 530000, China
| | - Q Y Liang
- Guangxi Zhuang Autonomous Region Health and Family Planning Statistics Information Center, Nanning 530021, China
| | - S He
- Guangxi Zhuang Autonomous Region Women and Children Care Hospital, Nanning 530000, China
| | - W Lyu
- Guangxi Zhuang Autonomous Region Health and Family Planning Statistics Information Center, Nanning 530021, China
| | - B T Liu
- Guangxi Zhuang Autonomous Region Health and Family Planning Statistics Information Center, Nanning 530021, China
| | - Y J Zuo
- Guangxi Zhuang Autonomous Region Women and Children Care Hospital, Nanning 530000, China
| | - L Lin
- Guangxi Zhuang Autonomous Region Women and Children Care Hospital, Nanning 530000, China
| | - H Wei
- Guangxi Zhuang Autonomous Region Women and Children Care Hospital, Nanning 530000, China
| | - J Wei
- Guangxi Zhuang Autonomous Region Women and Children Care Hospital, Nanning 530000, China
| | - X N Hang
- Guangxi Zhuang Autonomous Region Women and Children Care Hospital, Nanning 530000, China
| | - X X Qiu
- Guangxi Zhuang Autonomous Region Women and Children Care Hospital, Nanning 530000, China
| |
Collapse
|
3
|
Dong BQ, You JP, Liang QY, Lyu W, Ma JF, Wei HW, Li H. [Study on the distribution and related factors of birth weight of live births in Guangxi Zhuang Autonomous Region of China from 2016 to 2018]. Zhonghua Yu Fang Yi Xue Za Zhi 2019; 53:1259-1264. [PMID: 31795583 DOI: 10.3760/cma.j.issn.0253-9624.2019.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the distribution and related factors of birth weight of live births and full-term infants in Guangxi Zhuang Autonomous Region of China. Methods: Based on Guangxi women and children information system from 2016 to 2018, a large real-time database about maternal and live-birth information was established. It covered 1 712 midwifery institutions in Guangxi. A total of 2 394 240 cases of live births were collected and 2 243 129 cases of which were full-term infants. The multivariate logistic regression model was used to analyze the related factors of low birth weight. Results: The birth weight of 2 394 240 live births, (3 123.49±461.08) g, in Guangxi was approximately normal distribution with a peak distribution to the left. The incidence of low birth weight was 8.05%, and the incidence of macrosomia was 2.07%. The incidence of low birth weight was 10.92% for the puerpera with body mass index (BMI, kg/m(2)) <18.5, 16.82% for the puerpera with height <145 cm, 8.92% for the puerpera with age <20 years old, 7.67% for the puerpera with age ≥35 years old, and 54.65% for the puerpera with premature birth. The birth weight of 2 243 129 full-term infants, (3 176.01±400.78) g, was approximately normal distribution with a peak distribution to the right. The incidence of low birth weight was 2.97%, and the incidence of macrosomia was 2.19%. The incidence of low birth weight was 4.73% for puerpera with BMI<18.5, 8.17% for puerpera with height<145 cm, 4.83% for puerpera with age <20 years old, and 3.05% for puerpera with age ≥35 years old. The risks of low birth weight [OR (95%CI) value] of pregnant women aged <20, 25-29 and 30-34 years old were 1.31 (1.28-1.35), 0.88 (0.86-0.90) and 0.89 (0.87-0.91) times of those aged ≥35 years old. The risks of low birth weight [OR (95%CI) value] of pregnancy BMI <18.5 and 18.5-23.9 kg/m(2) group were 1.98 (1.94-2.03) and 1.20 (1.18-1.23) times of those pregnancy BMI ≥24 kg/m(2). The risks of low birth weight [OR (95%CI) value] of pregnant women's height (cm)<145, 145-154, 155-159 and 160-164 cm were 4.67 (4.39-4.97), 2.36 (2.29-2.44), 1.58 (1.53-1.63) and 1.22 (1.18-1.26) times of those heights ≥165 cm group. The risks of low birth weight [OR (95%CI) value] of pregnant women's gestational age <28, 28-31 and 32-36 years old were 136.65 (124.33-150.20), 1 704.37 (1 509.02-1 925.02) and 33.45 (32.98-33.94) times of those gestational age ≥37 years old. Conclusion: The incidence of low birth weight of live births was higher in Guangxi from 2016 to 2018. There is a higher risk of low birth weight for younger, older, low height, low BMI and preterm women in Guangxi from 2016 to 2018.
Collapse
Affiliation(s)
- B Q Dong
- School of Public Health and Management, Guangxi University of Chinese Medicine, Nanning 530200, China
| | - J P You
- School of Public Health and Management, Guangxi University of Chinese Medicine, Nanning 530200, China
| | - Q Y Liang
- Departments of Statistics, Guangxi Health and Family Planning Statistical Information Center, Nanning 530021, China
| | - W Lyu
- Departments of Statistics, Guangxi Health and Family Planning Statistical Information Center, Nanning 530021, China
| | - J F Ma
- School of Public Health and Management, Guangxi University of Chinese Medicine, Nanning 530200, China
| | - H W Wei
- Departments of Obstetrics, Guangxi Maternal and Child Health Hospital, Nanning 530000, China
| | - H Li
- School of Public Health and Management, Guangxi University of Chinese Medicine, Nanning 530200, China
| |
Collapse
|
4
|
Yu J, To KF, Liang QY. Epstein-Barr virus-driven promoter hypermethylated genes in gastric cancer. Hong Kong Med J 2017; 23 Suppl 5:17-22. [PMID: 28943520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Affiliation(s)
- J Yu
- Institute of Digestive Disease, Department of Medicine and Therapeutics, The Chinese University of Hong Kong
| | - K F To
- Institute of Digestive Disease, Department of Medicine and Therapeutics, The Chinese University of Hong Kong
| | - Q Y Liang
- Institute of Digestive Disease, Department of Medicine and Therapeutics, The Chinese University of Hong Kong
| |
Collapse
|
5
|
Liang QY, Wu JW. Fracture of the patella treated by open reduction and external compressive skeletal fixation. J Bone Joint Surg Am 1987; 69:83-9. [PMID: 3805074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Open reduction combined with external compressive skeletal fixation was used to treat twenty-seven patients who had a separated fracture of the patella. Fixation was obtained by the use of two compressive clamps applied to stainless-steel pins that were inserted just proximal and distal to the proximal and distal poles of the patella. Range-of-motion exercises for the knee were begun at two weeks and the pins were removed at three to four weeks. All of the fractures healed. Twenty-four patients regained a range of motion that was equal to that of the opposite knee. There was no evidence of chronic osteomyelitis. Osteoarthritis was noted in one patient who refused excision of a portion of the patella.
Collapse
|