Objective To investigate the prognostic value of different stages of TNM in patients with appendiceal neuroendocrine tumors (NETs). Methods The clinical data of 40 cases of NETs were analyzed, and follow-up data were staged by the ENETS and AJCC TNM staging system. Kaplan-Miere survival curves were used to compare survival differences in patients with different stages of TNM. Results Of the 40 patients, no one was diagnosed as appendiceal NETs before surgery. Twenty-one patients were diagnosed as acute appendicitis, 16 were diagnosed as chronic appendicitis and 3 were suspected as appendiceal tumors due to thickening of the lumen before surgery. No clinical manifestations were found in 40 patients before surgery including diarrhea, abdominal pain, facial flushing, asthma-like seizures and other carcinoid syndrome performance. All patients underwent appendectomy, and appendix NETs were diagnosed by pathology after surgery. In 40 appendical NETs patients, 15 cases were classified as stageⅠ(37.5%), 10 cases were classified as stageⅡA (25%), 2 cases were classified as stageⅢA (5%), 13 cases were classified at stageⅢB (32.5%), and no patients were classified as stageⅣ. The median survival times (months) were 27, 22, 21 and 18 for patients with different stages, and there were no significant differences in survival times between four stages (χ2=0.8988,P>0.05). Conclusion The clinical features of appendical NETs are nonspecific. The diagnosis of appendical NETs is based on pathological examination and immunohistochemistry. There are no correlation between different TNM stages and prognosis of patients.

OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
Bronchopulmonary Dysplasia/epidemiology* ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Pregnancy ; Respiratory Distress Syndrome, Newborn/epidemiology* ; Retrospective Studies ; Treatment Outcome