1.Prognostic and subgroup analysis of 162 patients with Barcelona Clinical Liver Cancer (BCLC)stage B hepatocellular carcinoma after hepatectomy
Xing CHEN ; Ti ZHANG ; Yunlong CUI ; Geng LIU ; Jinjin SUN ; Qiang LI
Chinese Journal of Hepatobiliary Surgery 2017;23(5):307-312
Objectives To analyze prognosis and risk factors of Barcelona Clinical Liver Cancer (BCLC) stage B hepatocellular carcinoma patients treated with hepatectomy.Methods Clinical data of 162 BCLC stage B patients who underwent hepatectomy at Tianjin Medical University Cancer Institute & Hospital and the Second Hospital of Tianjin Medical University from June 2007 to December 2013 were retrospectively studied.The correlations between factors (age,gender) and long-term outcome were analyzed to determine independent risk factors.Subsequently,subgroup analysis of BCLC stage B hepatocellular carcinoma was performed.Results Multiple tumors,maximum tumor diameter > 10 cm and AFP > 100 μg/L were con firmed as independent risk factors of overall survival in postoperative BCLC B patients.Based on the risk factors,patients were divided into two groups,namely low-risk subgroup (≤ 1 risk factor) and high-risk subgroup (≥ 2 risk factors).In low-risk subgroup,1,3 and 5-year overall survival (OS) rates were 91.6%,65.5%,61.9% respectively,and mean OS was 72 months.By contrast,1,3 and 5-year OS rates in high-risk subgroup were 67.4%,25.6%,10.8% respectively,and mean OS was 29 months.Further more,1,3 and 5-year OS rates of all patients were 85.2%,54.9%,48.0% respectively,and mean OS was 61 months.Conclusions Relatively favorable long-term outcomes could be yielded in BCLC stage B hepatocellular carcinoma patients treated with liver resection.The independent risk factors including multiple tumors,maximum tumor diameter > 10 cm and AFP > 100 μg/L were closely correlated with overall survival.BCLC stage B hepatocellular carcinoma patients could be divided into low-risk and high-risk subgroups based on the risk factors mentioned above.Survival rates in low-risk subgroup are remarkably superior to those in high-risk subgroup.
2.Study on the correlation of spinal mechanics imbalance and thoraco-dorsal pain in ankylosing spondylitis
Min LI ; Yi LIANG ; Xiaohui WU ; Wenjing YU ; Weien YI ; Quan MA ; Yunlong GENG ; Biying LIU ; Wenqi ZHOU ; Huiwu ZHANG
Chinese Journal of Rheumatology 2019;23(3):170-174
Objective To investigate the correlation of spinal mechanical imbalance and thoraco-dorsal pain of ankylosing spondylitis (AS). Methods The clinical data of 90 patients with AS were collected. Patients were divided into two groups according to the presence of thoracodorsal pain: the AS with thoraco-dorsal pain group (30 cases) and the AS without thoraco-dorsal pain group (60 cases). Clinical symptoms, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis function index (BASFI), Bath ankylosing spondylitis measurement index (BASMI), ankylosing spondylitis disease activity (ASDAS), and spinal mechanical function and nuclear myocardial force test were compared using t-test, one-way analysis of variance (ANOVA) analysis and Spearman correlation analysis. Results ① There were differences between thoraco-dorsal pain group and patients without thoracodorsal pain group at the time of back muscle strength [(0.82±0.41) min vs (1.33±0.74) min, F=12.372, P=0.001]; ②Thoraco-dorsal pain in the AS group was mainly the middle and lower thoracic vertebrae, such as the inflammation of rib head and rib transverse process, facial arthritis, and spinous ligaments, etc. And the missed diagnosis rate of magnetic resonance imagin (MRI) was high. ③ In healthy control group, the anterior flexion strength of thoracodorsal pain group was signific-antly different from that of patients without thoracodorsal pain [(92.1 ±46.3) Nm vs (126.6±35.7) Nm, F=6.440, P=0.002]. ④ There was significant difference in spinal strength as well as left and right rotation strength between the thoracodorsal pain group and patients without thoracodorsal pain [(1.18 ±0.22) vs (1.05 ±0.17), F=10.044, P<0.01];⑤In the thoraco-dorsal pain group, the right/left index was related to BASDAI (r=-0.522, P=0.004). For spinal mobility, the right/left index was related to cross cutting faces to right ( r=0.435, P=0.021), cross cutting faces to left (r=0.528, P=0.004). In spinal strength, the right/left index was related to left turn (r=0.57, P=0.001); right lateral flexion (r=0.368, P=0.049) and left lateral flexion (r=0.369, P=0.049). Conclusion The thoracodorsal pain of AS is dominated by the middle and lower thoracic vertebrae, and the missed diagnosis rate of MRI is high. The imbalance of the left and right side of the spine is one of the factors of the thoracic back pain in AS.
3.Non-alcoholic fatty liver disease related health outcomes and influencing factors among community inhabitants
Yunlong KAN ; Yongmei LI ; Minhua TANG ; Yangbo GENG ; Genming ZHAO ; Yonggen JIANG
Shanghai Journal of Preventive Medicine 2024;36(6):596-601
ObjectiveTo describe different non-alcoholic fatty liver disease (NAFLD) outcomes among community inhabitants, and further to explore the correlation between bio-indicator level variance and the outcomes. MethodsPhysical indicators (height, weight, waist circumstances, hip circumstances, blood pressure, etc), biochemical indicators [fasting plasma glucose, HbA1c, serum triglycerides(TG), serum total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), liver related transaminase, etc] and clinical imaging (B-scan ultrasonography) were collected during the follow-up from the Songjiang Natural Population Sub-cohort. The identification of NAFLD was supported by the definition criteria from Guidelines for the diagnosis and treatment of non⁃alcoholic fatty liver disease. Paired t-test and multifactorial logistic regression model were used to compare the difference between the indicator level of the subjects from different outcome subgroups and to further analyze the correlation between these indicator variance and different NAFLD outcomes. ResultsDuring a median follow-up time of 2.94 years, 12 076 subjects were involved. The cumulative NAFLD incidence and remission rate were 21.57% and 31.15%, respectively. The proportion of subjects who still had NAFLD was 27.96%. Among subjects with newly-developed NAFLD, indicators including blood pressure, BMI, fasting plasma glucose, and plasma lipid level increased, while in the remission subgroup, blood pressure, BMI(WHR), waist-hip ratio(WHR), and TG level were significantly decreased. Increased level of systolic pressure, WHR, BMI, HbA1c, and LDL-C might be the risk factors to the occurrence of NAFLD. While decreased level of WHR, BMI, TC and LDL-C level and elevated HDL-C level were likely to be the influencing factors of NAFLD remission process. ConclusionThe NAFLD morbidity in the community inhabitants is relatively high. BMI, WHR, fasting plasma sugar and plama lipid level variance may act as the influencing factors towards different NAFLD outcomes.