1.The impact of frailty on the prognosis of chronic heart failure patients treated with cardiac resynchronization therapy defibrillator implantation
Liang GAO ; Huasheng LYU ; Baopeng TANG ; Xianhui ZHOU ; Xinchun CHENG ; Youquan SHI ; Yaodong LI ; Jianghua ZHANG ; Qiang XING ; Tuerhong ZUKELA ; Yanmei LU
Chinese Journal of Internal Medicine 2025;64(1):45-51
Objective:The aim of this study was to assess the frailty status of patients with heart failure undergoing CRT-D and then explore the predictive value of frailty for all-cause mortality and heart failure-related readmissions in these patients.Methods:We retrospectively included 374 patients with chronic heart failure who underwent CRT-D treatment at the First Affiliated Hospital of Xinjiang Medical University between June 2020 and June 2024. Based on the Tilburg Debilitation Assessment Scale, 175 patients (46.8%) were classified as frail while 199 (53.2%) were classified as non-frail. The baseline data between the two groups was compared using Cox regression analysis and Kaplan-Meier curves were used for survival analysis. P-values of <0.05 indicated statistically significant differences. Results:A total of 374 patients aged 25-93 (68±11) years were enrolled in this study, 101 (27.0%) of which were female. Among these, 175 (46.8%) were categorized as frail, and 199 (53.2%) were classified as non-frail. Over a median follow-up time of 23 (5, 45) months, 35 (9.4%) patients experienced all-cause mortality, with 30 (17.1%) deaths occurring in the frail group and 5 (2.5%) in the non-frail group; meanwhile, readmission events due to heart failure occurred in a total of 174 (46.5%) patients, including 122 (70.1%) in the frail group, and 52 (29.9%) in the non-frail group. Cox analysis showed that frailty was a significant determinant of all-cause mortality ( HR=21.25, 95% CI 3.99-113.30, P<0.001) and readmission among heart failure patients receiving CRT-D ( HR=2.52, 95% CI 1.73-3.68, P<0.001). Log-rank tests showed that the survival rate of patients in the frail group was significantly lower than that of patients in the non-frail group ( HR=7.22, 95% CI 2.80-18.60, P<0.001) and the risk of readmission events due to heart failure was significantly higher among patients in the frail group than among those in the non-frail group ( HR=2.75, 95% CI 1.98-3.81, P<0.001). Conclusions:Frailty is an independent predictor of postoperative all-cause mortality and the occurrence of heart failure-related readmissions in patients with heart failure treated receiving CRT-D.
2.The impact of frailty on the prognosis of chronic heart failure patients treated with cardiac resynchronization therapy defibrillator implantation
Liang GAO ; Huasheng LYU ; Baopeng TANG ; Xianhui ZHOU ; Xinchun CHENG ; Youquan SHI ; Yaodong LI ; Jianghua ZHANG ; Qiang XING ; Tuerhong ZUKELA ; Yanmei LU
Chinese Journal of Internal Medicine 2025;64(1):45-51
Objective:The aim of this study was to assess the frailty status of patients with heart failure undergoing CRT-D and then explore the predictive value of frailty for all-cause mortality and heart failure-related readmissions in these patients.Methods:We retrospectively included 374 patients with chronic heart failure who underwent CRT-D treatment at the First Affiliated Hospital of Xinjiang Medical University between June 2020 and June 2024. Based on the Tilburg Debilitation Assessment Scale, 175 patients (46.8%) were classified as frail while 199 (53.2%) were classified as non-frail. The baseline data between the two groups was compared using Cox regression analysis and Kaplan-Meier curves were used for survival analysis. P-values of <0.05 indicated statistically significant differences. Results:A total of 374 patients aged 25-93 (68±11) years were enrolled in this study, 101 (27.0%) of which were female. Among these, 175 (46.8%) were categorized as frail, and 199 (53.2%) were classified as non-frail. Over a median follow-up time of 23 (5, 45) months, 35 (9.4%) patients experienced all-cause mortality, with 30 (17.1%) deaths occurring in the frail group and 5 (2.5%) in the non-frail group; meanwhile, readmission events due to heart failure occurred in a total of 174 (46.5%) patients, including 122 (70.1%) in the frail group, and 52 (29.9%) in the non-frail group. Cox analysis showed that frailty was a significant determinant of all-cause mortality ( HR=21.25, 95% CI 3.99-113.30, P<0.001) and readmission among heart failure patients receiving CRT-D ( HR=2.52, 95% CI 1.73-3.68, P<0.001). Log-rank tests showed that the survival rate of patients in the frail group was significantly lower than that of patients in the non-frail group ( HR=7.22, 95% CI 2.80-18.60, P<0.001) and the risk of readmission events due to heart failure was significantly higher among patients in the frail group than among those in the non-frail group ( HR=2.75, 95% CI 1.98-3.81, P<0.001). Conclusions:Frailty is an independent predictor of postoperative all-cause mortality and the occurrence of heart failure-related readmissions in patients with heart failure treated receiving CRT-D.
3.Advances in the study of GPSM2 in tumors
Youquan SHI ; Baral SHANTANU ; Yifan CHENG ; Qiannan SUN ; Liuhua WANG ; Yue ZHANG ; Daorong WANG
International Journal of Surgery 2024;51(9):640-644
G-protein signaling modulator 2 is a member of the GPSM family, with emerging significance in various diseases including Chadley-McCullough syndrome, rheumatoid arthritis, and systemic lupus erythematosus. Furthermore, its involvement extends to tumor pathogenesis, encompassing non-small-cell lung cancer, breast cancer, hepatocellular carcinoma, pancreatic carcinoma, serous ovarian cancer, Ewing's sarcoma, and osteosarcoma, influencing proliferation, invasion, and metastasis. There is no relevant review on the mechanism of GPSM2 in tumor progression. This paper will summarize the research progress on GPSM2 in tumors in recent years, focusing on its role and mechanism, with the aim of providing references and guidance for further research.
4.Application of ultrasound monitoring optic nerve sheath diameter in diagnosis and treatment of adult patients with intracranial hypertension
Chengyin LIU ; Xiang′en SHI ; Youquan WANG ; Jinju YANG ; Yuming SUN ; Fangjun LIU ; Hui SHEN ; Fuzheng ZHANG
Chinese Journal of Postgraduates of Medicine 2022;45(5):403-406
Objective:To investigate the effect of ultrasound measurement of optic nerve sheath diameter (ONSD) in adult patients with elevated intracranial pressure (ICP).Method:From June 2017 to March 2020, A total of 64 patients (32 patients with elevated ICP and 32 patients with normal ICP) were placed with invasive intracranial pressure monitoring probe in Beijing Pinggu Hospital. Their ICP and ONSD were continuously monitored. Thirty-two healthy volunteers were recruited as control group to check ONSD. The correlation between ONSD and ICP, and the changes of ICP and ONSD after osmotic therapy were observed.Results:The ONSD in ICP increased group was significantly higher than that in normal ICP group: (5.77 ± 0.3) mm vs. (5.01 ± 0.1) mm, with statistical difference ( P<0.05), and there was a positive correlation between ONSD and ICP. There was no significant difference in ONSD between normal ICP group and control group ( P>0.05). Conclusions:Ultrasound monitoring ONSD can reflect the level of ICP and evaluate the effect of osmotic therapy and the prognosis of patients. Bedside ultrasound examination of optic nerve sheath diameter could be used to judge ICP and to evaluate the curative effect of osmotic therapy, with high clinical application value.
5.New research progress in molecular mechanisms of colorectal liver metastasis
International Journal of Surgery 2016;43(5):353-356
Colorectal cancer is one of the most common malignant tumor with high mortality rate.About a third of patients with colorectal cancer have either simultaneously or metachronous liver metastasis with poor prognosis.Therefore,the studies on the mechanisms of colorectal liver metastasis is significant.Recently,the research on the molecular mechanisms of colorectal liver metastasis is increasing,this paper summarizes some of them,and we hope providing new ideas for the diagnosis and treatment of colorectal cancer patients with liver metastasis.
6.Application progress of uncut Roux-en-Y anastomosis in digestive tract reconstruction after distal gastrectomy of gastric cancer
Yuqin HUANG ; Youquan SHI ; Dong TANG ; Jie WANG ; Daorong WANG
Chinese Journal of Digestive Surgery 2016;15(9):943-946
Digestive tract reconstruction is an important part of gastric carcinoma operation as well as tumor resection and lymph node dissection.Surgeons are seeking the optimal reconstruction method that reduces the occurrence of complications and maintains better quality of postoperative life extremely.Uncut Roux-en-Y anastomosis is a modified procedure in which an artificial jejunal occlusion is devised to avoid Roux stasis syndrome based on Billroth Ⅱ and Braun's anastomosis.Compared to the conventional Roux-en-Y anastomosis,the uncut Roux-en-Y anastomosis retains the advantage of preventing biliary and pancreatic secretions reflux,furthermore,it can decrease the symptoms associated with Roux stasis owing to the abnormal myoelectrical conduction of Roux limb.Because the early studies indicated that there was higher incidence of dehiscence or recanalization of the jejunal occlusion,the uncut Roux-en-Y anastomosis has not been widely applied.Since jejunal occlusion has been optimized recently,the uncut Roux-en-Y reconstruction may be an optional and appropriate method of digestive tract reconstruction after distal gastrectomy.

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