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Does gastric stump cancer really differ from primary proximal gastric cancer? A multicentre, Propensity score matching-used, retrospective cohort study

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World Journal of Gastrointestinal Surgery 2023年第11期15卷 2553-2563页

作者： Shuan-Hu Wang Jing-Cheng Zhang Liang Zhu He Li Kong-Wang Hu Department of the General Surgery The First Affiliated Hospital of Bengbu Medical CollegeBengbu 233000Anhui ProvinceChina Department of Surgery Technical University of MunichSchool of MedicineKlinikum rechts der IsarMunich 80-819Germany Department of the General Surgery Anhui Provincial HospitalHefei 230001Anhui ProvinceChina Department of the Emergency Surgery The Second Affiliated Hospital of Anhui Medical UniversityHefei 230001Anhui ProvinceChina Department of the General Surgery The First Affiliated Hospital of Anhui Medical UniversityHefei 230001Anhui ProvinceChina Department of the General Surgery The Fuyang Affiliated Hospital of Anhui Medical UniversityFuyang 236000Anhui ProvinceChina

BACKGROUND Although the location of proximal cancer of the remnant stomach is the same as that of primary proximal cancer of the stomach,its clinical characteristics and prognosis are still controversial.AIM To evaluate the clinicopathological features and prognosis factors of gastric stump cancer(GSC)and primary proximal gastric cancer(PGC).METHODS From January,2005 to December,2016,178 patients with GSC and 957 cases with PGC who received surgical treatment were enrolled.Patients in both groups underwent 1:1 Propensity score matching analysis,and both clinical and pathological data were systematically collected for statistical purposes.Quality of RESULTS One hundred and fifty-two pairs were successfully matched after Propensity score matching analysis.Of the 15 demographic and pathological variables collected,the analysis further revealed that the number of lymph nodes and positive lymph nodes were different prognostic and clinicopathological factors between PGC and GSC.Univariate and multivariate analyses showed that gender,differentiation degree and tumor-node-metastasis stage were independent risk factors for patients with GSC.Gender,vascular invasion,differentiation degree,depth of infiltration,positive lymph nodes,and tumor-node-metastasis stage were independent risk factors for patients with PGC.The 5-year overall survival and cancer-specific survival of patients with GSC were significantly lower than those in the PGC group,the scores for overall quality of life in the GSC-malignant group were lower than the GSC-benign,and the differences were statistically significant.CONCLUSION The differences in clinicopathological characteristics between GSC and PGC were clarified,and PGC had a better prognosis than GSC.

关键词： Gastric stump cancer Primary gastric cancer Clinicopathological risk factors Quality of life Propensity score matching

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Red blood cell distribution width improves the prediction of 28-daymortality for patients with sepsis-induced acute kidney injury:A retrospective analysis from MIMIC-IV database usingPropensity score matching

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Journal of Intensive Medicine 2023年第3期3卷 275-282页

作者： Honghao Lai Guosheng Wu Yu Zhong Guangping Chen Wei Zhang Shengjun Shi Zhaofan Xia Department of Burns Zhujiang HospitalSouthern Medical UniversityGuangzhou 510280GuangdongChina Department of Burns Changhai HospitalNaval Medical UniversityShanghai 200433China Research Institute Guangzhou Eighth People’s HospitalGuangzhou Medical UniversityGuangzhouGuangdong 510060China Department of Burns Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdong 510515China

Background:The predictive value of red blood cell distribution width(RDW)for mortality in patients withsepsis-induced acute kidney injury(SI-AKI)remains unclear.The present study aimed to investigate the potentialassociation between RDW at admission and outcomes in patients with SI-AKI.Methods:The Medical Information Mart for Intensive Care(MIMIC)-IV(version 2.0)database,released in Juneof 2022,provides medical data of SI-AKI patients to conduct our related research.Based on propensity scorematching(PSM)method,the main risk factors associated with mortality in SI-AKI were evaluated using Coxproportional hazards regression analysis to construct a predictive nomogram.The concordance index(C-index)and decision curve analysis were used to validate the predictive ability and clinical utility of this model.Patientswith SI-AKI were classified into the high-and low-RDW groups according to the best cut-off value obtained bycalculating the maximum value of the Youden index.Results:A total of 7574 patients with SI-AKI were identified according to the filter criteria.Compared withthe low-RDW group,the high-RDW group had higher 28-day(9.49%vs.31.40%,respectively,P<0.001)and7-day(3.96%vs.13.93%,respectively,P<0.001)mortality rates.Patients in the high-RDW group were moreprone to AKI progression than those in the low-RDW group(20.80%vs.13.60%,respectively,P<0.001).Basedon matched patients,we developed a nomogram model that included age,white blood cells,RDW,combinedhypertension and presence of a malignant tumor,treatment with vasopressor,dialysis,and invasive ventilation,sequential organ failure assessment,and AKI stages.The C-index for predicting the probability of 28-day survivalwas 0.799.Decision curve analysis revealed that the model with RDW offered greater net benefit than that withoutRDW.Conclusion:The present findings demonstrated the importance of RDW,which improved the predictive ability ofthe nomogram model for the probability of survival in patients with SI-AKI.

关键词： Red blood cell distribution width Sepsis-induced acute kidney injury Medical Information Mart for Intensive Care IV (MIMIC-IV) Propensity score matching Mortality

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Depressive males have higher odds of lower urinary tract symptoms suggestive of benign prostatic hyperplasia:a retrospective cohort study based on Propensity score matching

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Asian Journal of Andrology 2021年第6期23卷 633-639页

作者： Yang Xiong Yang-Chang Zhang Tao Jin Feng Qin Jiu-Hong Yuan Andrology Laboratory West China HospitalSichuan UniversityChengdu 610041China Department of Urology West China HospitalSichuan UniversityChengdu 610041China Department of Epidemiology and Health Statistics School of Public Health and ManagementChongqing Medical UniversityChongqing 400016China Department of Gastrointestinal Surgery West China HospitalSichuan UniversityChengdu 610041China

Lower urinary tract symptoms suggestive of benign prostate hyperplasia(LUTS/BPH)and depression are both increasing in Chinese aging males.However,the relationship still remains unknown.To explore their relationship,a retrospective cohort study based on Propensity score matching(PSM)was conducted by analyzing the China Health and Retirement Longitudinal Study dataset.After data cleaning,a total of 5125 participants were enrolled and subjected to PSM;1351 pairs were matched and followed for 2 years.Further logistic regression and restricted cubic spline(RCS)were performed to evaluate,model and visualize the relationship between depression and LUTS/BPH.Moreover,subgroup analyses and sensitivity analyses were adopted to verify the robustness of the conclusions.Before PSM,depressive patients showed higher odds of LUTS/BPH in all three models adjusting for different covariates(P0.05).The results of sensitivity analyses indicated identical increased risks of LUTS/BPH in all four models(all P<0.001).In conclusion,depression enhances the risks of LUTS/BPH in aging males.

关键词： aging males benign prostatic hyperplasia depression lower urinary tract symptoms Propensity score matching

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Cholecystectomy is associated with higher risk of recurrence after microwave ablation of hepatocellular carcinoma:a Propensity score matching analysis

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Cancer Biology & Medicine 2020年第2期17卷 478-491页

作者： Hongcai Yang Yi Yang Jianping Dou Rui Cui Zhigang Cheng Zhiyu Han Fangyi Liu Xiaoling Yu Xiang Zhou Jie Yu Ping Liang School of Medicine Nankai UniversityTianjin 300071China Department of Interventional Ultrasound Chinese PLA General HospitalBeijing 100853China Department of Interventional Therapy National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China

Objective:To explore the association between cholecystectomy and the prognostic outcomes of patients with hepatocellular carcinoma(H CC)who underwent microwave ablation(MWA).Methods:Patients with HCC(«=921)who underwent MWA were included and divided into cholecystectomy(n=114)and non-cholecystectomy groups(n=807).After Propensity score matching(PSM)at a 1:2 ratio,overall survival(OS)and disease-free survival(DFS)rates were analyzed to compare prognostic outcomes between the cholecystectomy(«=114)and non-cholecystectomy groups(n=228).Univariate and multivariate Cox analyses were performed to assess potential risk factors for OS and DFS.Major complications were also compared between the groups.Results:After matching,no significant differences between groups were observed in baseline characteristics.The 1-,3-,and 5-year OS rates were 96.5%,82.1%,and 67.1%in the cholecystectomy group,and 97.4%,85.2%,and 74.4%in the non-cholecystectomy group(P=0.396);the 1-,3-,and 5-year DFS rates were 58.4%,34.5%,and 26.6%in the cholecystectomy group,and 73.6%,44.7%,and 32.2%in the non-cholecystectomy group(P=0.026),respectively.The intrahepatic distant recurrence rate in the cholecystectomy group was significantly higher than that in the non-cholecystectomy group(P=0.026),and the local tumor recurrence and extrahepatic recurrence rates did not significantly differ between the groups(P=0.609 and P=0.879).Multivariate analysis revealed that cholecystectomy(HR=1.364,95%Cl 1.023-1.819,P=0.035),number of tumors(2 vs.1:HR=2.744,95%Cl 1.925-3.912,P

关键词： Cholecystectomy microwave ablation hepatocellular carcinoma Propensity score matching

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Antibiotics De-Escalation in the Treatment of Ventilator-Associated Pneumonia in Trauma Patients： A Retrospective Study on Propensity score matching Method

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Chinese Medical Journal 2018年第10期131卷 1151-1157页

作者： Hu Li Chun-Hui Yang Li-Ou Huang Yu-Hui Cui Dan Xu Chun-Rong Wu Jian-Guo Tang Department of Critical Care Medicine Shanghai Fifth People's Hospital Fudan University Shanghai 200240 China

Background： Antimicrobial de-escalation refers to starting the antimicrobial treatment with broad-spectrum antibiotics, followed by narrowing the drug spectrum according to culture results. The present study evaluated the effect of de-escalation on ventilator-associated pneumonia （VAP） in trauma patients. Methods： This retrospective study was conducted on trauma patients with VAP, who received de-escalation therapy （de-escalation group） or non-de-escalation therapy （non-de-escalation group）. Propensity score matching method was used to balance the baseline characteristics between both groups. The 28-day mortality, length of hospitalization and Intensive Care Unit stay, and expense of antibiotics and hospitalization between both groups were compared. Multivariable analysis explored the factors that influenced the 28-day mortality and implementation of de-escalation. Results： Among the 156 patients, 62 patients received de-escalation therapy and 94 patients received non-de-escalation therapy. No significant difference was observed in 28-day mortality between both groups （28.6% vs. 23.8%, P = 0.620）. The duration of antibiotics treatment in the de-escalation group was shorter than that in the non-de-escalation group （11 [8-13] vs. 14 [8-19] days, P = 0.045）. The expenses of antibiotics and hospitalization in de-escalation group were significantly lower than that in the non-de-escalation group （6430 ± 2730 vs. 7618 ± 2568 RMB Yuan, P = 0.043 and 19,173 ± 16,861 vs. 24,184 ± 12,039 RMB Yuan, P = 0.024, respectively）. Multivariate analysis showed that high Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ） score, high injury severity score, multi-drug resistant （MDR） infection, and inappropriate initial antibiotics were associated with patients＇ 28-day mortality, while high APACHEⅡ score, MDR infection and inappropriate initial antibiotics were independent factors that prevented the implementation of de-escalation. Conclusions： De-escalation strategy in the treatment of trauma patients with VAP could reduce th

关键词： De-Escalation Propensity score matching Trauma Ventilator-Associated Pneumonia

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Effect of Rhubarb on Gastrointestinal Dysfunction in Critically III Patients： A Retrospective Study Based on propensity score matching

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Chinese Medical Journal 2018年第10期131卷 1142-1150页

作者： Xian Zhang Lyu Wang De-Chang Chen Department of Emergency Medicine Changzheng Hospital The Second Military Medical University Shanghai 200003 China

Background： Gastrointestinal dysfunction plays a critical role in the prognosis of critically ill patients. Previous studies showed rhubarb, a traditional Chinese herb, can protect the intestinal barrier function, prevent intestinal bacterial translocation, and promote gastrointestinal peristalsis, but the clinical studies are less. The aim of this study was to evaluate the effects of rhubarb on gastrointestinal dysfunction in critically ill patients. Methods： From June 2015 to May 2017, a total of 368 critically ill patients with Grade I III acute gastrointestinal injury （AGI） were enrolled in this study. Patients were divided into two groups according to the exposure factors （whether the patients received rhubarb treatment）： the rhubarb group and the usual treatment group. Clinical data were collected within the first 24 h of the Intensive Care Unit （ICU） admission and 7 days after treatment. Survival data on day 28 after ICU admission and the durations oflCU and total hospitalization were also collected. Propensity score matching （PSM） was conducted to reduce confounding bias between the groups. The logistic regression was conducted to screen the influence factors. Results： The eligible patients were divided into rhubarb group （n = 219, 59.5%） and usual treatment group （n = 149, 40.5%）. Betbre PSM, the remission rate of feeding intolerance in rhubarb group and usual treatment group were 59.8% and 39.6%, respectively. After PSM, the remission rate of feeding intolerance in rhubarb group and usual treatment group was 77.9% and 30.9%, respectively. The remission rates of feeding intolerance in rhubarb group were significantly higher than those in the usual treatment group （all P 〈 0.05）. Compared with the usual treatment group, the rhubarb group had a higher rate of AGI improvement, lower level of C-reactive protein, shorter stay in ICU before and after PSM （P 〈 0.05）. There was no significant difference in 28-day mortality between rhubarb and usual treatment groups before and after PSM （48 vs. 33, P 0.959; and 1

关键词： Critically 111 Patients Gastrointestinal Dysfunction Propensity score matching Rhubarb

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Association between Self-Rated Health and Depressive Symptoms in Rural Chinese Adults:A Cohort Study Based on Propensity score matching

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International Journal of Mental Health Promotion 2022年第3期24卷 385-398页

作者： Yang Wang Jinlong Lin MJames C.Crabbe Xiao-Guang Yue Institute of Population Research Peking UniversityBeijing100871China Wolfson College University of OxfordOxfordOX26UDUK Institute of Biomedical and Environmental Science&Technology School of Life SciencesFaculty of Creative ArtsTechnologies and ScienceUniversity of BedfordshireUniversity SquareLutonLU13JUUK School of Life Science Shanxi UniversityTaiyuan030006China Department of Computer Science and Engineering School of SciencesEuropean University CyprusNicosiaCyprus

Health status is widely regarded as a correlate of depressive symptoms.However,health assessments based on clinical diagnosis in rural areas with poor medical conditions are very limited.Self-rated health(SRH)serves as a simple and convenient evaluation indicator,which may be used as an independent predictor of depressive symptoms.To confirm the relationship between SRH and depressive symptoms in rural adults,a longitudinal survey of rural households in China was conducted using the China Family Panel Studies(CFPS)from 2012 to 2016.Propensity score matching and logistic regression analysis were used to explore the association.After data cleansing,3,127 pairs(6,254 participants)aged 16 and older followed for 4 years were enrolled,of which the average age was(50.02±14.19)years old,and the proportions of male and female were 48.64%and 51.36%,respectively.The incidence rate of depressive symptoms within 4 years was 30.86%(95%CI:29.24–32.48)in the group with fair or poor SRH,and 21.59%(95%CI:20.14–23.03)in the group with good SRH.The difference between the two groups was statistically significant(χ^(2)=69.51,P<0.001).The results of univariate unconditional logistic regression analysis showed that there was a correlation between SRH and depressive symptoms in rural adults aged 30 and above(OR=1.65,95%CI:1.46–1.85,P<0.001).Thus,a simple and practical assessment tool based on SRH and other indicators should be established for early prevention and intervention in rural primary mental health care.

关键词： rural adults self-rated health depressive symptoms cohort study Propensity score matching

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腹腔镜对比开腹手术治疗非转移性直肠癌的远期生存:倾向评分匹配的双中心队列研究

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Gastroenterology Report 2020年第4期8卷 319-325,I0002,I0003页

作者： Kang-Lian Tan Hai-Jun Deng Zhi-Qiang Chen Ting-Yu Mou Hao Liu Run-Sheng Xie Xue-Min Liang Xiao-Hua Fan Guo-Xin Li Department of General Surgery Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdongP.R.China Abdominal Pain Center Guangdong Provincial Hospital of Chinese MedicineThe Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhouGuangdongP.R.China

背景:腹腔镜直肠癌手术在中国得到了广泛应用,但与开腹手术相比,腹腔镜手术的疗效尤其是远期生存仍未获充分证实。方法:回顾性分析2012-2014年间南方医科大学南方医院和广东省中医院的非转移性直肠癌病例的临床资料。采用倾向评分匹配... 详细信息

背景:腹腔镜直肠癌手术在中国得到了广泛应用,但与开腹手术相比,腹腔镜手术的疗效尤其是远期生存仍未获充分证实。方法:回顾性分析2012-2014年间南方医科大学南方医院和广东省中医院的非转移性直肠癌病例的临床资料。采用倾向评分匹配方法比较腹腔镜组与开腹组患者的远期生存和近期安全性。结果:两个中心共纳入430例直肠癌患者,倾向评分匹配后获得103对病例。腹腔镜组较开腹组术中出血量减少(P=0.019),手术时间和住院时间缩短(均P<0.001)。两组术后并发症发生率分别为9.7%和10.7%(P=0.818)。两组5年总生存率(75.7%vs 80.6%,P=0.346)、5年无复发生存率(74.8%vs 76.7%,P=0.527)和5年肿瘤特异生存率(79.6%vs 87.4%,P=0.219)的差异均无统计学意义。癌胚抗原水平升高、淋巴结清扫数量不足12枚以及周围神经浸润均为总体生存和无复发生存的独立危险因素。结论:本研究结果提示,仍应将开腹手术作为非转移性直肠癌的治疗首选,但腹腔镜手术也是一项可以接受的治疗选择。

关键词： laparoscopic surgery open surgery Propensity score matching rectal cancer

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Survival difference between EGFR Del19 and L858R mutant advanced non-small cell lung cancer patients receiving gefitinib:a Propensity score matching analysis

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Chinese Journal of Cancer Research 2017年第6期29卷 553-560页

作者： Minglei Zhuo Qiwen Zheng Jun Zhao Meina Wu Tongtong An Yuyan Wang Jianjie Li Shuhang Wang Jia Zhong Xue Yang Hanxiao Chen Bo Jia Zhi Dong Emei Gao JingjingWang Ziping Wang Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing) Department of Thoracic Medical OncologyPeking University Cancer Hospital&InstituteBeijing 100142China Department of Epidermiololgy and Biostatistics School of Public HealthPeking UniversityBeijing 100191China

Objective： Although superior clinical benefits of epidermal growth factor receptor （EGFR） tyrosine kinase inhibitors （TKIs） in the treatment of advanced non-small-cell lung cancer （NSCLC） had been reported, the survival difference between exon 19 deletion （Dell9） and exon 21 Leu858Arg substitution （L858R） remains controversial. The purpose of this study is to investigate the differences in progression-free survival （PFS） and overall survival （OS） between different EGFR mutant subtypes among advanced NSCLC patients receiving gefitinib. Methods： There were 204 advanced NSCLC patients with EGFR mutations treated with gefitinib were enrolled in this retrospective cohort study. Patients were divided into the EGFR Dell9 group and the L858R mutated group according to their mutant subtype. Propensity score matching （PSM） was conducted by using a nearest-neighbor algorithm （1：1） to adjust for demographical and clinical covariates. Survival curves were constructed with the Kaplan-Meier method and compared by using the log-rank test. Results： The PFS in Dell9 group was similar to that in the L858R group [before PSM 8.6 vs. 7.2 months, P=0.072; after PSM 7.3 vs. 7.2 months, P=0.155]. No differences were detected in OS between the L858R and the Dell9 group （before PSM 17.8 vs. 13.1 months, P=0.253; after PSM 16.9 vs. 13.1 months, P=0.339）. The Dell9 group was significantly younger compared with the L858R mutation group in age （P=0.015）. Conclusions： No significant difference was found in the PFS or OS between the Dell9 and L858R mutant NSCLC patients receiving gefitinib. The age gap might contribute to the survival differences between Dell9 and L858R groups. PSM is of important value to the elimination of potential bias.

关键词： Non-small-cell lung cancer epidermal growth factor receptor tyrosine kinase inhibitors survival Propensity score matching

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Routine nasogastric tube placement in patients with small esophageal perforation after endoscopic foreign body removal may be unnecessary:a Propensity score matching analysis

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Gastroenterology Report 2023年第1期11卷 433-438页

作者： Foqiang Liao Qinyu Yang Zhenyi Zhan Zhenhua Zhu Xiaolin Pan Chong Wang Bimin Li Yin Zhu Youxiang Chen Xu Shu Department of Gastroenterology Digestive Disease HospitalThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxiP.R.China Jiangxi Clinical Research Center for Gastroenterology The First Affiliated Hospital of Nanchang UniversityNanchangJiangxiP.R.China

Background:Nasogastric tube(NGT)placement is part of the post-operative management of upper gastrointestinal perforation,but its routine use in esophageal perforation(EP)caused by foreign bodies remains unclear.The purpose of this research was to investigate the necessity for routine NGT placement in patients with EP after endoscopic foreign body removal.Methods:A total of 323 patients diagnosed with EP caused by foreign bodies at the First Affiliated Hospital of Nanchang University between January 2012 and December 2021 were included in this retrospective study.Patients were divided into the NGT group and the non-NGT group according to whether or not NGT placement was performed.The perforation healing rate,post-operative adverse events,hospital stay,and death rate were analysed using a 1:1 Propensity score matching model.Results:Before matching,there were 263 patients in the NGT group and 60 patients in the non-NGT group.There were significant differences in the time to treatment,infection,albumin,and types of endoscopy between the two groups,while the length of hospital stay in the NGT group was significantly longer than that in the non-NGT group.After 1:1 Propensity score matching,48 pairs of patients were matched between the two groups.The perforation healing rate,post-operative adverse events,length of hospital stay,and death rate did not show significant differences between the two groups.Conclusions:For patients with small EP caused by foreign bodies,routine NGT placement after endoscopic foreign body removal may be unnecessary.

关键词： esophageal perforation foreign body nasogastric tube placement Propensity score matching

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