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find Author "李少民" 4 results
  • 先天性心脏病合并重度肺动脉高压的诊断及外科治疗

    目的总结先天性心脏病合并重度肺动脉高压患者的诊断及治疗经验。方法2000年1月~2005年8月,收治87例先天性心脏病合并重度肺动脉高压患者,其中室间隔缺损(VSD)58例,房间隔缺损(ASD)4例,VSD合并动脉导管未闭(PDA)6例,VSD合并ASD16例,PDA3例。82例患者行手术治疗,其中75例行常规心脏畸形矫治手术,VSD采用间断缝合涤纶补片修补,7例室间隔水平双向分流平衡的患者进行了单向活瓣VSD修补术;5例因艾森门格综合征放弃手术治疗。结果行手术治疗的82例中共死亡4例,均死于术后低心排血量综合征,其中单向活瓣VSD修补者死亡2例。手术后呼吸机辅助呼吸时间38~178h(56±8h),血管活性药物使用时间58~244h(117±43h)。术后发生并发症3例,均为肺不张,经雾化吸入、吸痰和拍背等治疗后治愈。随访78例,随访时间6个月,气促症状明显减轻,超声心动图提示2例心脏补片处有少量分流,其余患者均恢复良好。结论非有创性检查方法能对肺动脉高压的性质作出准确的判断,采取合适的治疗方法能获得满意的疗效。术前对肺动脉高压性质的准确判定、心肺功能调整以及围手术期处理是此类患者安全康复的关键。

    Release date:2016-08-30 06:23 Export PDF Favorites Scan
  • Effect of postoperative radiotherapy after complete resection in patients with stage ⅢA-N2 non-small cell lung cancer

    ObjectiveTo evaluate the value of postoperative radiotherapy (PORT) in patients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy. MethodsPatients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy were chosen from the SEER Research Plus Database (17 Registries, November 2021Submission [2000-2019]). The patients were divided into a PORT group and a non-PORT group according to whether the PORT was used. To balance baseline characteristics between non-PORT and PORT groups, R software was used to conduct a propensity score matching (PSM) with a ratio of 1 : 1 and a matching tolerance of 0.01. Both the Cox regression analysis and Kaplan-Meier survival analysis were conducted to evaluate the value of PORT in patients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy in terms of overall survival (OS) and disease-specific survival (DSS). ResultsIn total, 2468 patients with stage ⅢA-N2 non-small cell lung cancer were enrolled, including 1078 males and 1390 females with a median age of 65 (58-71) years. There were 1336 patients in the PORT group, and 1132 patients in the non-PORT group. Cox regression analysis showed that PORT was not significantly associated with OS (multivariate analysis: HR=0.951, 95%CI 0.859-1.054, P=0.338) and DSS (multivariate analysis: HR=0.914, 95%CI 0.816-1.025, P=0.123) in patients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy. No statistical difference was found in the OS or DSS between non-PORT group and PORT group before and after PSM analysis (P>0.05). ConclusionPORT does not have a survival benefit for patients with stage ⅢA-N2 non-small cell lung cancer who received complete resection and chemotherapy.

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  • Development and validation of a prognostic model for patients with the lower third and abdominal oesophageal adenocarcinoma

    ObjectiveTo establish an individualized nomogram model and evaluate its efficacy to provide a possible evaluation basis for the prognosis of lower third and abdominal part of oesophageal adenocarcinoma (EAC). MethodsLower third and abdominal part of EAC patients were chosen from the SEER Research Plus Database (17 Regs, 2022nov sub). The patients were randomly allocated to the training cohort and the internal validation cohort with a ratio of 7∶3 using bootstrap resampling. The Cox proportional hazards regression analysis was used to determine significant contributors to overall survival (OS) in EAC patients, which would be elected to construct the nomogram prediction model. C-index, calibration curve and receiver operating characteristic (ROC) curve were performed to evaluate its efficacy. Finally, the efficacy to evaluate the OS of EAC patients was compared between the nomogram prediction model and TNM staging system. ResultsIn total, 3945 patients with lower third and abdominal part of EAC were enrolled, including 3475 males and 470 females with a median age of 65 (57-72) years. 2761 patients were allocated to the training cohort and the remaining 1184 patients to the internal validation cohort. In the training and the internal validation cohorts, the C-index of the nomogram model was 0.705 and 0.713, respectively. Meanwhile, the calibration curve also suggested that the nomogram model had a strong capability of predicting 1-, 3-, and 5-year OS rates of EAC patients. The nomogram also had a higher efficacy than the TNM staging system in predicting 1-, 3-, and 5-year OS rates of EAC patients. ConclusionThis nomogram prediction model has a high efficiency for predicting OS in the patients with lower third and abdominal part of EAC, which is higher than that of the current TNM staging system.

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  • Impact of number of positive regional lymph nodes in N1 stage on the prognosis of patients with non-small cell lung cancer: A propensity score matching study

    ObjectiveTo explore the impact of number of positive regional lymph nodes (nPRLN) in N1 stage on the prognosis of non-small cell lung cancer (NSCLC) patients. MethodsPatients with TxN1M0 stage NSCLC who underwent lobectomy and mediastinal lymph node dissection from 2010 to 2015 were screened from SEER database (17 Regs, 2022nov sub). The optimal cutoff value of nPRLN was determined using X-tile software, and patients were divided into 2 groups according to the cutoff value: a nPRLN≤optimal cutoff group and a nPRLN>optimal cutoff group. The influence of confounding factors was minimized by propensity score matching (PSM) at a ratio of 1∶1. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate overall survival (OS) and lung cancer-specific survival (LCSS) of patients. ResultsA total of 1316 patients with TxN1M0 stage NSCLC were included, including 662 males and 654 females, with a median age of 67 (60, 73) years. The optimal cutoff value of nPRLN was 3, with 1165 patients in the nPRLN≤3 group and 151 patients in the nPRLN>3 group. After PSM, there were 138 patients in each group. Regardless of before or after PSM, OS and LCSS of patients in the nPRLN≤3 group were superior to those in the nPRLN>3 group (P<0.05). N1 stage nPRLN>3 was an independent prognostic risk factor for OS [HR=1.52, 95%CI (1.22, 1.89), P<0.001] and LCSS [HR=1.72, 95%CI (1.36, 2.18), P<0.001]. ConclusionN1 stage nPRLN>3 is an independent prognostic risk factor for NSCLC patients in TxN1M0 stage, which may provide new evidence for future revision of TNM staging N1 stage subclassification.

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