Objective To explore the risk factors of electrocardiogram abnormalities in patients with primary liver cancer and its value in predicting prognosis.Methods A total of 120 primary liver cancer patients with transcatheter arterial chemoembolization(TACE)were selected as the research objects,and they were divided into abnormal group(n=32)and non-abnormal group(n=88)ac-cording to incidence of electrocardiogram abnormalities at 7 days after operation.Baseline data and changes in 24-hour QT interval variability(24-hour QTV),standard deviation of the normal R-R in-terval from the beginning of atrial depolarization to ventricular depolarization(SDNN),standard devia-tion of the normal R-R interval for 5 consecutive minutes(SDANN-index),and mean value of the standard deviation of the normal R-R interval for 5 consecutive minutes(SDNN-index)were compared between two groups;a binary Logistic regression model was used to analyze the influencing factors of e-lectrocardiogram abnormalities in patients with primary liver cancer;the receiver operating characteristic(ROC)curve was used to analyze the area under the curve(AUC),sensitivity and specificity of 24 h QTV,SDNN,SDANN-index and SDNN-index in predicting ECG abnormalities in patients with pri-mary liver cancer.Results Of the 120 primary liver cancer patients with TACE treatment,32 ca-ses had electrocardiogram abnormalities,including 13 cases of sinus tachycardia with T-wave chan-ges,2 cases of ST-T changes,4 cases of supraventricular tachycardia,4 cases of QT interval prolon-gation,4 cases of ventricular premature beats,and 5 cases of atrial premature beats.There were no significant differences in gender,age,super-selective hepatic artery catheterization,gelatin sponge embolization,use of chemotherapy drugs,postoperative vomiting,and blood uric acid on the third day after surgery between the abnormal group and the non-abnormal group(P＞0.05);there were significant differences in tumor diameter,liver function classification,dosage of iodized oil,postop-erative body temperature,and blood potassium on the third day after surgery between the two groups(P＜0.05).Logistic regression model showed that tumor diameter ≥10 cm,grade A of liver func-tion classification,iodized oil dose ≥10 mL,postoperative body temperature ≥38 ℃,and decrea-ses of 24 h QTV,SDNN,SDANN-index and SDNN-index were the independent factors affecting e-lectrocardiogram abnormalities in patients with primary liver cancer(P＜0.05).ROC curve analy-sis showed that the values of AUC of 24 h QTV,SDNN,SDANN-index,SDNN-index and compre-hensive electrocardiogram parameters in predicting electrocardiogram abnormalities in patients with primary liver cancer were 0.682,0.651,0.632,0.752 and 0.786 respectively,with statistically significant differences(P＜0.05).Conclusion Tumor diameter,liver function classification,dose of iodide oil and postoperative body temperature can affect electrocardiogram abnormalities in patients with primary liver cancer,and electrocardiogram monitoring before and after TACE treat-ment is conducive to timely detection of electrocardiogram abnormalities.

Objective To explore the risk factors of electrocardiogram abnormalities in patients with primary liver cancer and its value in predicting prognosis.Methods A total of 120 primary liver cancer patients with transcatheter arterial chemoembolization(TACE)were selected as the research objects,and they were divided into abnormal group(n=32)and non-abnormal group(n=88)ac-cording to incidence of electrocardiogram abnormalities at 7 days after operation.Baseline data and changes in 24-hour QT interval variability(24-hour QTV),standard deviation of the normal R-R in-terval from the beginning of atrial depolarization to ventricular depolarization(SDNN),standard devia-tion of the normal R-R interval for 5 consecutive minutes(SDANN-index),and mean value of the standard deviation of the normal R-R interval for 5 consecutive minutes(SDNN-index)were compared between two groups;a binary Logistic regression model was used to analyze the influencing factors of e-lectrocardiogram abnormalities in patients with primary liver cancer;the receiver operating characteristic(ROC)curve was used to analyze the area under the curve(AUC),sensitivity and specificity of 24 h QTV,SDNN,SDANN-index and SDNN-index in predicting ECG abnormalities in patients with pri-mary liver cancer.Results Of the 120 primary liver cancer patients with TACE treatment,32 ca-ses had electrocardiogram abnormalities,including 13 cases of sinus tachycardia with T-wave chan-ges,2 cases of ST-T changes,4 cases of supraventricular tachycardia,4 cases of QT interval prolon-gation,4 cases of ventricular premature beats,and 5 cases of atrial premature beats.There were no significant differences in gender,age,super-selective hepatic artery catheterization,gelatin sponge embolization,use of chemotherapy drugs,postoperative vomiting,and blood uric acid on the third day after surgery between the abnormal group and the non-abnormal group(P＞0.05);there were significant differences in tumor diameter,liver function classification,dosage of iodized oil,postop-erative body temperature,and blood potassium on the third day after surgery between the two groups(P＜0.05).Logistic regression model showed that tumor diameter ≥10 cm,grade A of liver func-tion classification,iodized oil dose ≥10 mL,postoperative body temperature ≥38 ℃,and decrea-ses of 24 h QTV,SDNN,SDANN-index and SDNN-index were the independent factors affecting e-lectrocardiogram abnormalities in patients with primary liver cancer(P＜0.05).ROC curve analy-sis showed that the values of AUC of 24 h QTV,SDNN,SDANN-index,SDNN-index and compre-hensive electrocardiogram parameters in predicting electrocardiogram abnormalities in patients with primary liver cancer were 0.682,0.651,0.632,0.752 and 0.786 respectively,with statistically significant differences(P＜0.05).Conclusion Tumor diameter,liver function classification,dose of iodide oil and postoperative body temperature can affect electrocardiogram abnormalities in patients with primary liver cancer,and electrocardiogram monitoring before and after TACE treat-ment is conducive to timely detection of electrocardiogram abnormalities.

Objective To assess the efficacy and side effects of intravesical instillation of BCG after transurethral resection of the bladder tumor (TURBT) in non-muscle invasive bladder cancer (NMIBC) patients.Methods The clinical data of patients treated with BCG 120 mg per course induced perfusion or more after TURBT from December 2013 to October 2016 in 18 hospitals of northeast China region,were analyzed retrospectively.The first part,data of 106 patients with moderate,high-risk NMIBC were collected.A total of 83 patients were male,while the other 23 patients were female.The average age was 66.7 years old.The clinical staging were T1 in 86(81.1％) cases,Ta in 20(18.9％) cases and carcinoma in situ in 6 (5.7％) patients.Intravesical instillation of BCG was executed after transurethral resection of the bladder tumor.The incidence rate of recurrence and progression during more than 6 months' follow-up time were observed.Multivariate analyses were done by using logistic analysis and Cox proportional hazards regression model with Kaplan-Meier method.The second part,treatment compliance of 276 patients with bladder cancer,including moderate/high-risk NMIBC in 263 cases,moderate/high-risk NMIBC followed with renal pelvis/ureteral carcinoma in 8 cases were and moderate/high-risk NMIBC with renal pelvis/ureteral carcinoma in 5 cases who treated with BCG after the surgeries,were observed.Patients consisted of 211 males and 65 females with average age of 68.3 years.Results With a median follow-up of 12 months,9 (8.5％) patients experienced tumor recurrence and 2 (1.9％) patients were found progression in the first part.The one-year cancer free recurrence rate of the patients was 91.5％.Statistically significant prognostic factors for recurrence identified by multivariable analyses were prior recurrence of the tumors (OR =3.214,95％CI0.804-12.845,P =0.099).In the second port,an incidence rate of adverse effects was 64.1％ (177/276).The Ⅲ/Ⅳ degree complications were occurred in 11 patients and satisfactory outcomes achieved with active treatment.A total of 36 patients withdrawal with the major causes were recurrence and progression of bladder tumor in 12 cases (4.4 ％),9 cases (3.3 ％) with economic reasons and 11 cases (4.0％) with serious complications.Conclusions NMIBC patients treated with intravesical BCG therapy have approving cancer free recurrence rates and acceptable adverse effects.Prior recurrence may be prognostic factor of recurrence after intravesical BCG therapy.