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Nomogram for predicting early complications after distal gastrectomy

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World Journal of Gastrointestinal Surgery 2023年第11期15卷 2500-2512页

作者： Biao Zhang Qing Zhu Zhi-Peng Ji Department of Gastrointestinal Surgery Second Hospital of Shandong UniversityJinan 250033Shandong ProvinceChina

BACKGROUND Reducing or preventing postoperative morbidity in patients with gastric cancer(GC)is particularly important in perioperative treatment *** To identify risk factors for early postoperative complications of GC post-distal gastrectomy and to establish a nomogram prediction *** This retrospective study included 131 patients with GC who underwent distal gastrectomy at the Second Hospital of Shandong University between January 2019 and February *** factors influencing the development of complications after distal gastrectomy in these patients were evaluated using univariate and multivariate logistic regression *** on the results obtained,a predictive nomogram was *** nomogram was validated using internal and external(n=45)*** sensitivity and specificity were established by receiver operating characteristic curve *** curve(DCA)analysis was used to determine its clinical benefit and ten-fold overfitting was used to establish its accuracy and *** Multivariate logistic regression analysis showed that hypertension,diabetes,history of abdominal surgery,and perioperative blood transfusion were independent predictors of postoperative complications of distal *** modeling and validation sets showed that the area under the curve was 0.843[95%confidence interval(CI):0.746-0.940]and 0.877(95%CI:0.719-1.000),the sensitivity was 0.762 and 0.778,respectively,and the specificity was 0.809 and 0.944,respectively,indicating that the model had good sensitivity and *** C-indexes of the modeling and validation datasets were 0.843(95%CI:0.746-0.940)and 0.877(95%CI:0.719-1.000),*** calibration curve(Hosmer Lemeshow test:χ^(2)=7.33)showed that the model had good *** results of the DCA analysis indicated that this model offered good clinical *** accuracy of 10-fold cross-validation was 0.878,indicating that the model had good accuracy and stability.C

关键词： blood transfusion Gastroenterostomy Nomograms Postoperative complications Stomach neoplasms Risk factors

The impact of chemotherapy-naïve open radical cystectomy delay and perioperative transfusion on the recurrence-free survival: A perioperative parameters-based nomogram

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Asian Journal of Urology 2024年第2期11卷 294-303页

作者： Ahmed M.Harraz Ahmed Elkarta Mohamed H.Zahran Ahmed Mosbah Atallah A.Shaaban Hassan Abol-Enein Urology and Nephrology Center Mansoura UniversityEgypt

Objective: To develop and internally validate a nomogram to predict recurrence-free survival (RFS) including the time to radical cystectomy (RC) and perioperative blood transfusion (PBT) as potential ***: Patients who underwent open RC and ileal conduit between January 1996 to December 2016 were split into developing (n=948) and validating (n=237) cohorts. The time to radical cystectomy (TTC) was defined as the interval between the onset of symptoms and RC. The regression coefficients of the independent predictors obtained by Cox regression were used to construct the nomogram. Discrimination, validation, and clinical usefulness in the validation cohort were assessed by the area under the curve, the calibration plot, and decision curve ***: In the developing dataset, the 1-, 5-, and 10-year RFS were 83.0%, 47.2%, and 44.4%, respectively. On multivariate analysis, independent predictors were TTC (hazards ratio [HR] 1.07, 95% confidence interval [CI] 1.05-1.08, p<0.001), PBT (one unit: HR 1.40, 95% CI 1.03-1.90, p=0.03;two or more units: HR 1.72, 95% CI 1.29-2.29, p<0.001), bilateral hydronephrosis (HR 1.54, 95% CI 1.21-1.97, p<0.001), squamous cell carcinoma (HR 0.60, 95% CI 0.45-0.81, p=0.001), pT3-T4 (HR 1.77, 95% CI 1.41-2.22, p<0.001), lymph node status (HR 1.53, 95% CI 1.21-1.95, p<0.001), and lymphovascular invasion (HR 1.28, 95% CI 1.01-1.62, p=0.044). The areas under the curve in the validation dataset were 79.3%, 69.6%, and 76.2%, for 1-, 5-, and 10-year RFS, respectively. Calibration plots showed considerable correspondence between predicted and actual survival probabilities. The decision curve analysis revealed a better net benefit of the ***: A nomogram with good discrimination, validation, and clinical utility was constructed utilizing TTC and PBT in addition to standard pathological criteria.

关键词： Radicalcystectomy blood transfusion Time to radical cystectomy Survival Nomogram

EVALUATION ON FACTORS INFLUENCING LIVER CANCER METASTASIS AFTER LIVER SURGERY BY A MOUSE MODEL

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Chinese Journal of Cancer Research 1999年第2期11卷 101-104页

作者：白莉黄志强黄洁王燕生 Laboratory of Hepatobiliary Diseases Department of General Surgery PLA General Hospital Beijing China

Objective: To evaluate the influence of surgical trauma on liver cancer metastasis. Methods: A mouse model of experimental liver cancer metastasis was established by subcapsule injecting hepatoma ascites tumor cells (H22) into spleen of NIH mice. Simple intrasplenic inoculation, with sham operation, partial hepatectomy, total occlusion of hepatic blood inflow and blood loss and re-perfusion were performed and metastatic effects were observed. Results: There were significant higher metastasis-augmenting effects in sham operation and partial hepatectomy groups. Compared with no-blood transfusion, blood transfusion group was found to be potent to increase intrahepatic metastases. But, neither inhibition nor enhancement with total occlusion of hepatic blood inflow for 20 and 30 minutes was seen. Conclusions: Surgical trauma, especially partial hepatectomy and blood transfusion, are involved in enhancing metastasis, but total occlusion of hepatic blood inflow is not responsible for enhanced liver metastasis in the experimental metastasis model.

关键词： Primary hepatocellular carcinoma Liver metastasis Disease model Hepatectomy Surgical trauma blood transfusion Mice

Genetic diversity and occult hepatitis B infection in Africa: A comprehensive review

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World Journal of Hepatology 2024年第5期16卷 843-859页

作者： Michee M Bazie Mahamoudou Sanou Florencia Wendkuuni Djigma Tegwinde Rebeca Compaore Dorcas Obiri-Yeboah Benoît Kabamba Bolni Marius Nagalo Jacques Simpore Rasmata Ouédraogo Department of Medicine Transmissible Diseases LaboratoryUniversitéJoseph KI-ZERBOOuagadougou 0000Burkina Faso Department of Biochemistry and Microbiology Molecular Biology and Genetics LaboratoryUniversity Joseph KI-ZERBOOuagadougou 0000Burkina Faso Infectious and parasitic disease Laboratory Health Sciences Research InstituteIRSS/CNRSTNational Center for Scientific and Technological ResearchOuagadougou 0000Burkina Faso Department of Microbiology and Immunology School of Medical SciencesUniversity of Cape CoastPMBCape Coast 0000Ghana Department of Clinical Biology Virology LaboratoryCliniques Universitaires Saint LucUniversitéCatholique de LouvainBruxelles 0000Belgium Division of Hematology and Oncology Mayo ClinicAZ 0000United States

BACKGROUND Occult hepatitis B infection(OBI)is a globally prevalent infection,with its frequency being influenced by the prevalence of hepatitis B virus(HBV)infection in a particular geographic region,including *** can be transmitted th-rough blood transfusions and organ transplants and has been linked to the development of hepatocellular carcinoma(HCC).The associated HBV genotype influences the *** To highlight the genetic diversity and prevalence of OBI in *** This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and involved a comprehensive search on PubMed,Google Scholar,Science Direct,and African Journals Online for published studies on the prevalence and genetic diversity of OBI in *** The synthesis included 83 articles,revealing that the prevalence of OBI varied between countries and population groups,with the highest prevalence being 90.9%in patients with hepatitis C virus infection and 38%in blood donors,indicating an increased risk of HBV transmission through blood *** of OBI reactivation have been reported following *** D is the predominant,followed by genotypes A and *** This review highlights the prevalence of OBI in Africa,which varies across countries and population *** study also demonstrates that genotype D is the most prevalent.

关键词： Occult hepatitis B infection blood transfusion Genetic diversity

Coronary artery disease and heart failure:Late-breaking trials presented at American Heart Association scientific session 2023

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World Journal of Cardiology 2024年第7期16卷 389-396页

作者： Avilash Mondal Sashwath Srikanth Sanjana Aggarwal Naga R Alle Olufemi Odugbemi Ikechukwu Ogbu Rupak Desai Department of Internal Medicine Nazareth HospitalPhiladelphiaPA 19152United States Department of Internal Medicine East Carolina University GreenvilleGreenvilleNC 27834United States Department of Internal Medicine Hamdard Institute of Medical Sciences and ResearchNew Delhi 110062India Department of Medicine Narayana Medical CollegeNelloreAndhra Pradesh 524003India Department of Internal Medicine Lincoln Medical CenterBronxNY 10451United States Department of Internal Medicine Mountainview Hospital Sunrise GMELas VegasNV 89108United States Independent Researcher AtlantaGA 30079United States

The late-breaking science presented at the 2023 scientific session of the American Heart Association paves the way for future pragmatic trials and provides meaningful information to guide management strategies in coronary artery disease and heart failure(HF).The dapagliflozin in patient with acute myocardial infarction(DAPA-MI)trial showed that dapagliflozin use among patients with acute MI without a history of diabetes mellitus or chronic HF has better cardiometabolic outcomes compared with placebo,with no difference in cardiovascular *** MINT trial showed that in patients with acute MI and anemia(Hgbtransfusion goal(Hgb≥10 g/dL)was not superior to a restrictive strategy(Hgb 7-8 g/dL)with respect to 30-day all-cause death and recurrent *** ORBITA-2 trial showed that among patients with stable angina and coronary stenoses causing ischemia on little or no antianginal therapy,percutaneous coronary intervention results in greater improvements in anginal frequency and exercise times compared with a sham *** ARIES-HM3 trial showed that in patients with advanced HF who received a HeartMate 3 levitated left ventricular assist device and were anticoagulated with a vitamin K antagonist,placebo was noninferior to daily aspirin with respect to the composite endpoint of bleeding and thrombotic events at 1 *** TEAMMATE trial showed that everolimus with low-dose tacrolimus is safe in children and young adults when given≥6 months after cardiac *** patients being treated for HF with reduced ejection fraction(HFrEF)with specific out-of-pocket(OOP)costs for multiple medication options at the time of the clinical encounter may reduce‘contingency planning’and increase the extent to which patients are taking the medications decided *** primary outcome,which was cost-informed decisionmaking,defined as the clinician or patient mentioning costs of HFrEF medication,occurred in 49%of encounters with the checklist only

关键词： Heart failure Coronary artery disease Clinical trials Myocardial infarction Cardiovascular outcome Percutaneous coronary intervention blood transfusion Cardiac transplant

Safety of early surgery for geriatric hip fracture patients taking clopidogrel:a retrospective case-control study of 120 patients in China

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Chinese Medical Journal 2021年第14期134卷 1720-1725页

作者： Ming-Hui Yang Bo Li Dong-Chen Yao Yan Zhou Wen-Chao Zhang Geng Wang Ping Zhang Shi-Wen Zhu Xin-Bao Wu Department of Orthopedics and Traumatology Beijing Jishuitan HospitalPeking University Fourth School of Clinical MedicineBeijing 100035China Department of Anesthesiology Beijing Jishuitan HospitalPeking University Fourth School of Clinical MedicineBeijing 100035China Department of Geriatric Medicine Beijing Jishuitan HospitalPeking University Fourth School of Clinical MedicineBeijing 100035China

Background:Geriatric hip fracture patients receiving clopidogrel are a surgical *** China,most of these patients undergo delayed surgical treatment after clopidogrel withdrawal for at least 5 to 7 ***,delayed surgery is associated with increased complications and mortality in the older *** retrospective paralleled comparison study investigated the safety of early surgery for geriatric hip fracture patients within 5 days of clopidogrel ***:Acute hip fracture patients(≥65 years)who were hospitalized in the orthogeriatric co-management ward of Beijing Jishuitan Hospital between November 2016 and April 2018 were retrospectively *** patients taking clopidogrel before injury and discontinuedblood loss and the secondary outcomes were transfusion requirement,complications,and *** Student’s t test or Wilcoxon signed rank sum test was used for continuous variables and the Chi-square test was used for categorical ***:Age,body mass index,American Society of Anesthesiologists score,and percentage undergoing general anesthesia were comparable between the groups(P>0.050).The percentages of patients with coronary heart disease(61.7%vs.18.3%;Pblood loss between the clopidogrel group(median:745 mL)and control group(median:772 mL)(P=0.866).The intra-operative transfusion rate was higher in the clopidogrel group(22/60,36.7%)

关键词： Hip fracture Clopidogrel blood loss blood transfusion Complication Mortality

Effect of Desmopressin on Platelet Aggregation and blood Loss in Patients Undergoing Valvular Heart Surgery

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Chinese Medical Journal 2015年第5期128卷 644-647页

作者： Lei Jin Hong-Wen Ji Department of Anesthesiology Fuwai Hospital Chinese Academy of Medical Sciences Beijing 100037 China

Background：blood loss after cardiac surgery can be caused by impaired platelet （PLT） function after cardiopulmonary *** or 1-deamino-8-D-arginine vasopressin （DDAVP） is a synthetic analog of *** can increase the level of von Willebrand factor and coagulation factor Ⅷ,thus it may enhance PLT function and improve *** this study,we assessed the effects of DDAVP on PLT aggregation and blood loss in patients undergoing cardiac ***：A total of 102 patients undergoing valvular heart surgery （from October 2010 to June 2011） were divided into DDAVP group （n =52） and control group （n =50）.A dose of DDAVP （0.3 μtg/kg） was administered to the patients intravenously when they were being *** the same time,an equal volume of saline was given to the patients in the control *** aggregation rate was measured with the AggRAM four-way PLT aggregation measurement *** blood loss and transfusion,hemoglobin levels,PLT counts,and urine outputs at different time were recorded and ***：The postoperative blood loss in the first 6 h was significantly reduced in DDAVP group （202 ± 119 ml vs.258 ± 143 ml,P =0.023）.The incidence of fresh frozen plasma （FFP） transfusion was decreased postoperatively in DDAVP group （3.8% vs.12%,P =0.015）.There was no significant difference in the PLT aggregation,urine volumes,red blood cell transfusions and blood loss after 24 h between two ***：A single dose of DDAVP can reduce the first 6 h blood loss and FFP transfusion postoperatively in patients undergoing valvular heart surgery,but has no effect on PLT aggregation.

关键词： blood Loss blood transfusion Cardiac Surgery Desmopressin Platelet Aggregation

Clinical Analysis of Postpartum Hemorrhage Requiring Massive transfusions at a Tertiary Center

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Chinese Medical Journal 2017年第5期130卷 581-585页

作者： Jun Hu Zhu-Ping Yu Peng Wang Chun-Yan Shi Hui-Xia Yang Department of Obstetrics and Gynecology Peking University First Hospital Beijing 100034 China Department of blood transfusion Peking University First Hospital Beijing 100034 China

Background： The reports on massive transfusions （MTs） in obstetrics have recently been an increasing trend. We aimed to define the clinical features, risk factors, main causes, and outcomes of MTs due to severe postpartum hemorrhage （PPH） and the frequency trends over the past 10 years. Methods： We retrospectively analyzed the data of 3552 PPH patients who were at ≥28 weeks of gestation in the Obstetric Department of Peking University First Hospital from January 2006 to February 2015. The clinical records of patients receiving MT with ≥5 units （approximately 1000 ml） of red blood cells within 24 h of giving birth were included. The Pearson＇s Chi-square and Fisher＇s exact tests were used to compare the frequency distributions among the categorical variables of the clinical features. Results： One-hundred six women were identified with MT over the 10-year period. The MT percentage was stable between the first 5-year group （2006-2010） and the second 5-year group （2011-2015）（2.5‰ vs. 2.7‰, χ^2 = 154.85, P = 0.25）. Although uterine atony remained the main cause of MT, there was a rising trend for placental abnormalities （especially placenta accreta） in the second 5-year group compared with the first 5-year group （34% vs. 23%, χ^2 = 188.26, P = 0.03）. Twenty-four （23%） women underwent hysterectomy, and among all the causes of PPH, placenta accreta had the highest hysterectomy rate of 70% （17/24）. No maternal death was observed. Conclusions： There was a rising trend for placental abnormalities underlying the stable incidence of MT in the PPH cases. Placenta accreta accounted for the highest risk of hysterectomy. It is reasonable to have appropriate blood transfusion backup for high-risk patients, especially those with placenta accreta.

关键词： blood transfusion Placenta Accreta Postpartum Hemorrhage Prognosis

Comparative evaluation of a rapid diagnostic test,an antibody ELISA,and a pLDH ELISA in detecting asymptomatic malaria parasitaemia in blood donors in Buea,Cameroon

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Infectious Diseases of Poverty 2017年第1期6卷 931-939页

作者： Tebit Emmanuel Kwenti Longdoh Anna Njunda Beltine Tsamul Shey Dickson Nsagha Nguedia Jules-Clement Assob Kukwah Anthony Tufon Dilonga Henry Meriki Enow George Orock Department of Medical Laboratory Sciences Faculty of Health SciencesUniversity of BueaP.B.63BueaSouthwest RegionCameroon Department of Public Health and Hygiene Faculty of Health SciencesUniversity of BueaP.B.63BueaSouthwest RegionCameroon blood Bank Regional Hospital BueaP.B.32BueaSouthwest RegionCameroon Programme in Medicine Faculty of Health SciencesUniversity of BueaBueaSouthwest RegionCameroon

Background:In malaria endemic areas,infected blood donors serve as a source of infection to blood recipients,which may adversely affect their *** necessitates the proper screening of blood to be used for transfusion in these *** purpose of this study was to determine the prevalence of malaria parasitaemia in blood donors in Buea,Cameroon,and to evaluate the performance of a rapid diagnostic test(RDT),a malaria antibody enzyme-linked immunosorbent assay(ELISA),and a Plasmodium lactate dehydrogenase(pLDH)ELISA in the detection of asymptomatic malaria parasitaemia in the target ***:In a prospective study conducted between September 2015 and June 2016,1240 potential blood donors were *** donors were screened for malaria parasites using Giemsa microscopy(GM)and a RDT.A sub-sample of 184 samples,comprising 88 positive and 96 negative samples,were selected for the evaluation of the pLDH ELISA and the antibody *** chi-square test and correlation analysis were performed as part of the statistical *** statistical significance cut-off was set at P<***:The prevalence of malaria parasitaemia in this study was found to be 8.1%(95%CI:6.6-9.7).The prevalence was not observed to be dependent on the age or sex of the *** RDT had a sensitivity(88.0%),specificity(99.1%),and negative predictive value(99.0%)higher than the *** performance of the pLDH ELISA,which demonstrated the highest positive predictive value(91.6%),was generally comparable to the *** sensitivity was lowest with the antibody ELISA(69.9%),which also demonstrated the highest false positive and false negative *** detection threshold for the pLDH(three parasites/μl)was lower compared to the RDT(50-60 parasites/μl).Non-significant positive correlations were observed between the parasite density and the pLDH titers and malaria antibody ***:Overall,the RDT and the pLDH ELISA demonstrated a perfectly correlated agreem

关键词： blood transfusion Malaria RDT pLDH ELISA Malaria antibody ELISA Comparative evaluation Sensitivity Specificity Buea Cameroon

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