1.The correlation between serum albumin level on the first day of life and mortality in preterm infants
Zhiyong CAI ; Jindi LIU ; Hongliang BIAN ; Jinlan CAI ; Qing JIN ; Jijing HAN
Chinese Journal of Neonatology 2017;32(6):426-430
Objective To study the correlation of the serum albumin level on the first day of life and the mortality rate in preterm infants .Method Premature infants admitted to the neonatal intensive care unit between January 2015 and December 2015 were recruited for study .Preterm infants were assigned into low level group ( <25 g/L ) , medium level group ( 25 ~30 g/L ) and high level group ( >30 g/L ) according to serum albumin level on the first day after birth .To compare the treatment and related prognostic factors among the three groups with χ2 and F tests.Besides, multivariate logistic regression analysis was used to predict the relative factors of premature infant mortality .Result A total of 364 premature infants were collected, and the mean serum albumin concentration was (27.9 ±5.7) g/L.There were 92 cases of low level group, 179 cases of moderate level group and 93 cases of high level group.There was no significant difference in gender , gestational age , birth weight and gestational age among the preterm infants (P>0.05).The pH, base excess value of first blood gas after birth and the percentage of prenatal steroid hormone in premature infants were lower than those in medium and high level group .The percentage of prenatal eclampsia and Lac value were higher than that of medium group and high level group , and the difference was statistically significant (P<0.05).There were no statistical differences among three groups in the proportion of mechanical ventilation , the duration of mechanical ventilation and oxygen , the length of hospital stay and the incidence rate of patent ductus arteriosus , intracranial hemorrhage , bronchopulmonary dsyplasia, necrotizing enterocolitis, retinopathy of prematurity and periventricular leukomalacia (P>0.05). The incidence of respiratory distress syndrome , sepsis and mortality in the low level group were higher than that of the other groups, and the differences were statistically significant (P<0.05).Multivariate logistic regression analysis showed that low birth weight (OR=1.233, P=0.005), serum albumin concentration (<25 g/L) (OR=3.453, P=0.020), and the complication of respiratory distress syndrome and sepsis (OR=1.363、2.611, P =0.006、0.004) were independent predictors of mortality in preterm infants . Albumin levels lower than 22.8 g/L is associated with mortality , with a sensitivity of 72%and a specificity of 85%.Conclusion The decrease of serum albumin level on the first day of life after birth can be used as an independent risk factor for predicting mortality in premature infants .
2.Analysis of non-tumor diseases affecting the diagnosis and treatment of cancer patients
Sen HAN ; Wei LI ; Jian FANG ; Jun NIE ; Ling DAI ; Weiheng HU ; Xiaoling CHEN ; Jie ZHANG ; Xiangjuan MA ; Guangmin TIAN ; Di WU ; Jieran LONG ; Jindi HAN ; Yang WANG ; Ziran ZHANG ; Weiping LIU ; Jun ZHU
Chinese Journal of Clinical Oncology 2018;45(10):517-520
Objective:To investigate the types of non-tumor diseases in patients with cancer, and to explore the effects of those dis-eases on the diagnosis and treatment of cancer patients. Methods:We collected the medical records of cancer patients from January 2013 to December 2017 in Peking University Cancer Hospital, and screened for non-tumor diseases. The clinical records of the patients in this group were analyzed retrospectively, and the effects of those diseases on the diagnosis and treatment of tumors were dis-cussed. Results:Of the 1,323 cases of inter-hospital consultation, 1,153 cases of non-tumor disease (87.2%) were selected. There were 773 men (67.0%) and 380 women (33.0%) included. The median age was 62 (14-90) years. The primary tumor types included lung can-cer, gastric cancer, lymphoma, colorectal cancer, esophageal cancer, breast cancer, malignant melanoma, liver cancer, cholangiocarci-noma/gallbladder cancer, pancreatic cancer, and other tumors. Non-neoplastic diseases included cardiovascular disease in 356 cases (30.9%), respiratory system disease (17.0%) in 196 cases, digestive system disease in 107 cases (9.3%), skin and venereal diseases in 81 cases (7.0%), nervous system lesions (6.4%) in 74 cases, urinary system disease in 72 cases (6.2%), blood disease in 70 cases (6.1%), en-docrine and metabolic diseases in 47 cases (4.1%), autoimmune disease in 23 cases (2.0%), and other diseases (11.0%) in 127 cases. Impact on tumor diagnosis and treatment was as follows:direct, 771 cases (66.9%);no influence, 313 cases (27.1%);and uncertain, 69 cases (6.0%). Conclusions:Cardiovascular disease is a major non-tumor disease associated with cancer. Non-neoplastic diseases are important factors affecting the diagnosis and treatment plans of cancer.