Abstract： Diseases prognosis is often influenced by multiple factors, and some intricate non-linear relationships exist among those factors. Artificial neural network （ANN）, an artificial intelligence model, simulates the work mode of biological neurons and has a b capability to analyze multi-factor non-linear relationships. In recent years, ANN is increasingly applied in clinical medical fields, especially for the prediction of disease prognosis. This article focuses on the basic principles of ANN and its application in disease prognosis research.
Objective To study the advances in the relationship between the number of infiltrating dendritic cells and the postoperative prognosis of digestive malignant tumor. MethodsThe literature in recent years on the relationship between the number of infiltrating dendritic cells and the postoperative prognosis of digestive malignant tumor was reviewed.ResultsThe number of infiltrating dendritic cells among esophageal cancer,and gastric carcinoma,colonic cancer and pancreatic cancer was associated with a better prognosis.Conclusion The population density of dendritic cells among the malignant tissue could be regarded as an independent indicator in estimating the postoperative prognosis of malignant tumor.
Stomach cancer is a malignancy arising from the stomach mucous epithelium. It accounts for 95% of all stomach malignancy cancer. The prevalence of stomach cancer is high in China and the treatment is debated, especially regarding choice of chemotherapy and treatment duration. In order to identify the best treatment and follow-up for patient with stage T2N0M0 stomach sinus cancer, we searched MEDLINE, SUMsearch, The Cochrane Library (Issue 4, 2004), Clinical Evidence (Issue 4, 2003) and CBMdisc (1981 to 2004). A total of 3 systematic reviews, 28 randomized controlled trails, 3 cohort studies and 3 observational studies were identified. We evaluated the quality of included studies.All studies were divided into 5 grades by the levels and grades of recommendation. We drew a conclusion by synthesizing the results of included studies: The primary treatment for the patient was surgery treatment including gastric deuto-total resection and D1 lymph node dissection. There was no evidence supporting chemotherapy use in either systematic or abdominal cavity after surgery. The survival rate was high in 5 years and 10 years, so the follow-up time should not be long and the follow-up infermission should not less than 1 year. Follow-up included the dynamic and delayed MR sequence with Gd-DTPA, the level of serum CA199, endoscope, and stool occult blood test.
【Abstract】Objective Stromal cell-derived factor-1(SDF-1, CXCL12) is a member of the CXC subfamily of chemokines which, through its cognate receptor (CXCR4), plays an important role in tumor invasion and metastasis. This study analyzed quantitatively the expression of SDF-1 and its relation with clinicopathologic feature and clinical outcome in human breast cancer.Methods Expression of SDF-1 mRNA in 8 breast cancer cell lines, an endothelial cell line HECV and a fibroblast cell MRC5 was studied by using RT-PCR. In addition, the expression of SDF-1 was investigated at both protein (immunohistochemistry) and mRNA(real-time PCR) levels in a group of human normal mammary(n=32) and tumour tissues(n=120). Results SDF-1 expression was identified in MRC5, MDA-MB435s, MDA-MB436, MCF7 cell lines, breast tumour and normal tissues. Significantly higher level of SDF-1 was seen in lymph node positive than in lymph node negative tumours (399.00±210.00 vs 0.89±0.47), P=0.048. The level of SDF-1 expression in patients who developed local recurrence or metastasis, or patients who died of breast cancer was higher than in patients who were disease free as well, (670.00±346.00 vs 0.83±0.35), P=0.01. It was most notable that level of SDF-1 was significantly correlated with over survival (P=0.01) and incidence free survival (P=0.035, by Cox proportion analysis).Conclusion SDF-1 is a factor that is expressed in both stromal cells and some breast cancer cells. Its level are correlated with lymph node involvement, prognosis and survival in patients with breast cancer. SDF-1 may therefore have a potential prognostic value in breast cancer.
ObjectiveTo explore the influencing factors for the prognosis of intracerebral hemorrhage in extremely old patients. MethodsWe retrospectively analyzed the clinical data of 104 extremely old intracerebral hemorrhage patients (≥80 years old) treated between June 2010 and June 2013. According to Glass Outcome Score, the patients were divided into good outcome group (with a score of 4-5) and poor outcome group (with a score of 1-3). The age, gender, consciousness on admission, mean arterial pressure, systolic blood pressure on admission, and complication rate were analyzed and compared between the two groups of patients. ResultsA total of 104 patients were recruited in our study, with 62 in the good outcome group and 42 in the poor outcome group. The gender, age, average arterial pressure on admission between the two groups were not significantly different (P>0.05). The consciousness score at admission in the good outcome group (13.79±2.38) was significantly higher than that of the poor outcome group (8.24±3.80, P<0.05). The complication rate (45.2% vs. 88.1%) and systolic blood pressure on admission [(168.87±25.03) vs. (181.83±29.82) mm Hg (1 mm Hg=0.133 kPa] in the good outcome group were both significantly lower than those in the poor outcome group (P<0.05). ConclusionFor extremely old intracerebral hemorrhage patients, consciousness score and systolic blood pressure at admission, and complication rate are the influencing factors for the prognosis. In addition, a systolic pressure on admission above 180 mm Hg can be a risk factor for poor prognosis in extremely old patients.
Objective To investigate the differences in clinicopathological characteristics and prognostic survival of human epidermal growth factor receptor 2 (HER2) high expression, HER2 low expression and HER2 negative breast cancer. MethodWe retrospectively collected 1 560 female breast cancer patients who underwent surgical treatment at the Department of Breast and Thyroid Surgery in Renmin Hospital of Wuhan University between January 8, 2010 and December 31, 2015, and divided them into high expression group, low expression group and negative group according to HER2 expression, to compare the differences in clinicopathological characteristics among the three groups of breast cancer patients and to explore the factors influencing prognosis. Results The proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, TNM stage Ⅲ, Ki67 high expression, and hormone receptor negative expression were higher in the high expression group than those in the low expression group and negative group (P<0.050); the proportions of histological grade Ⅲ, tumor diameter >2 cm, lymph node metastasis, and TNM stage Ⅲ were higher in the low expression group than those in the negative group (P<0.050). However, the proportions of Ki67 high expression and hormone receptor negative expression were lower than those of the negative group (P<0.050). The 5-year disease-free survival rate were 85.6%, 80.3% and 74.5% for the high expression, low expression and negative group, respectively, and the 5-year overall survival rate were 90.4%, 86.0% and 80.7%, respectively. The results of multivariate Cox proportional hazard model showed that patients with high histological grade, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year disease-free survival (P<0.050); patients with older age, high histological grade, lymph node metastasis, late TNM stage, Ki67 high expression and weaker HER2 expression intensity had worse 5-year overall survival (P<0.050). Conclusions The intensity of HER2 expression affects the 5-year disease-free survival and overall survival of breast cancer patients, and the higher the intensity of HER2 expression, the better the 5-year disease-free survival and overall survival, while the weaker the HER2 expression, the worse the 5-year disease-free survival and overall survival.
ObjectiveTo analyze the curative effect and prognosis of drug resistant tuberculosis meningitis (TBM). MethodsRetrospective analysis was carried out on the clinical data of thirty-two cases of drug resistant tuberculous meningitis patients hospitalized from January 2010 to December 2015. And the prognosis of the patients was evaluated by meliorated Rankin Scale (mRS). ResultsThirty-one cases (96.9%) were improved in 32 patients with drug resistant TBM, and 1 case (3.1%) was ineffective. After treatment, one patient had hormone-related glaucoma and osteoporosis, and one patient had drug Cushing syndrome. Twenty-seven patients (84.4%) had an mRS score equal to or less than 2 points. ConclusionDrug resistant TBM is difficult to diagnose in the early stage, and the curative effect is satisfying with active anti-tuberculosis treatment.
【摘要】 目的 探讨Survivin表达在结直肠癌发生，转移中的作用及临床意义。 方法 2003年1月－2004年12月间采用免疫组织化学链霉菌抗生物素蛋白-过氧化物酶连结法测定58例结直肠癌、12例结直肠腺瘤和9例正常结肠组织中Survivin的表达水平，研究其与结直肠癌患者临床病理特征及预后的关系。 结果 Survivin蛋白在正常结直肠黏膜中不表达，而在结直肠腺瘤及结直肠癌组织中的表达均高于正常大肠黏膜，差异有统计学意义（Plt;0.05）。不同年龄、性别、浆膜浸润、淋巴结转移、远处转移、分化程度、Dukes分期等之间Survivin的表达差异均无统计学意义（Pgt;0.05）。Kaplan-Meier生存分析提示:Survivin表达阳性患者的5年生存率为51.2%，阴性者为90.9%，两组比较差异有统计学意义（Plt;0.05）。 结论 Survivin的异常表达参与了结直肠癌发生、发展的病理生理过程，对结直肠癌患者的治疗方式的选择、疗效和预后的评估方面具有重要的参考价值。【Abstract】 Objective To determine the expression of Survivin in the onset and metastasis of colorectal adenocarcinoma, and its clinical significance. Methods From January 2003 to December 2004, immunohistochemical staining, streptavidin-perosidase method, was used to detect the Survivin expression in 58 cases of colorectal carcinoma, 12 cases of colorectal adenoma, and 9 cases of normal tissues. Correlation between the expression of Survivin and clinicopathological factors in colorectal cancer was analyzed. Results Survivin was not expressed in normal colorectal tissues. The expression of Survivin in colorectal carcinoma and adenoma was significantly higher than that in norma1 colorectal tissues (Plt;0.05). There was no correlation of Survivin expression with such clinicopathologic factors as age, gender, serosa infiltration, lymph node metastasis, distal metastasis, differentiation level and Dukes stage (Pgt;0.05). The Kaplan-Meier survival analysis demonstrated that patients with Survivin-positive tumors had significantly poorer survival rate (51.2%) than those with Survivin-negative tumors (90.9%) (Plt;0.05). Conclusion Abnormal expression of Survivin plays an important role in carcinogenesis and progress of colorectal carcinoma and can be regarded as a good index for the choice of surgery, and assessment of clinical outcomes and prognosis for colorectal cancer patients.
【摘要】 目的 分析脑中心疝对脑出血患者预后的影响，明确早期判定的重要性。 方法 回顾分析2005年2月－2010年8月所有因脑出血行手术治疗的173例患者的临床资料，其中并发小脑幕切迹疝48例，并发脑中心疝37例。 结果 173例患者治愈97例，轻残25例，中残30例，持续植物状态2例，死亡19例；死亡原因：脑功能衰竭11例，颅内感染2例，肺功能衰竭2例，肾功能衰竭3例，弥散性血管内凝血1例。脑中心疝患者病死率（27.03%）高于非脑中心疝患者（6.62%），差异有统计学意义（χ2=10.393，P=0.001）。脑中心疝分期与GOS分级呈负相关关系（rs=-0.827，P=0.000），分期越早，GOS分级越高；脑中心疝存活的27例患者日常生活、活动分级与脑中心疝分期呈正相关关系（rs=0.630，P=0.000），分期越早，ADL分级越低。 结论 脑中心疝的早期判定可以减少患者并发症的发生，降低病死率及伤残率。【Abstract】 Objective To Analyze the effect of brain center hernia on the prognosis of cerebral hemorrhage patients, and clarify the importance of early judgment of brain center hernia. Methods The recorded data of 173 patients undergoing surgery for cerebral hemorrhage in our hospital from February 2005 to August 2010 were retrospectively analyzed. Among them, there were 48 cases of combined transtentorial herniation and 37 cases of combined brain center hernia. Results Among the 173 patients, 97 were cured, 25 were slightly disabled, 30 were moderately disabled, 2 were in persistent vegetative state (PVS), and 19 died. In the 19 dead patients, 11 died of brain function failure, 2 of intracranial infection, 2 of lung failure, 3 of renal failure, and 1 of disseminated intravascular coagulation (DIC). The mortality of patients with brain center hernia (27.03%) was significantly higher than that of non-brain center hernia patients (6.62%) (χ2=10.393, P=0.001). The period of brain center hernia was negatively correlated with GOS′s stage (rs=-0.827, P=0.000), and the earlier the period, the higher the GOS stage. The brain center hernia period in the 27 survival patients was positively correlated with their ADL stage (rs=0.630, P=0.000), and the earlier the period, the lower the ADL stage. Conclusion Early judgement of brain center hernia can reduce patients′ complications, their mortality and disability rate.
ObjectiveTo study the expression of matrilysin in gastric cancer and to evaluate the correlation between its expression and invasion, metastasis, and prognosis. MethodsA total of 52 patients with gastric cancer were selected and followed up. The expressions of matrilysin in gastric primary focus, normal gastric mucosa, and metastatic lymph nodes were examined by reverse transcriptionpolymerase chain reaction (RT-PCR), Western blot, and immunohistochemistry, respectively. The correlations between matrilysin expression and tumor invasion, metastasis, and prognosis were assessed. ResultsThe expressions of matrilysin in gastric primary focus and metastatic lymph nodes significantly increased, while decreased or loss in normal gastric mucosa (Plt;0.001). The higher concordance was seen between the levels of mRNA and protein (Plt;0.001). Among patients with infiltrating type, penetrated serosa, area of serosa involved more than 20 cm2, and metastatic lymph nodes more than 7, the expression of matrilysin was significantly higher (Plt;0.01). The survival rate of patients with matrilysin higher expression (34.1%) was significantly lower than that with matrilysin lower expression (55.6%), χ2=9.778， P=0.002. Conclusions Up-regulated expression of matrilysin plays an important role in tumor invasion, metastasis, and poor prognosis, and it is a good molecular marker to reflect the biological behaviors of gastric cancer.