BACKGROUND Paradoxically,patients with T4N0M0(stage II,no lymph node metastasis)colon cancer have a worse prognosis than those with T2N1-2M0(stage III).However,no previous report has addressed this issue.AIM To screen...BACKGROUND Paradoxically,patients with T4N0M0(stage II,no lymph node metastasis)colon cancer have a worse prognosis than those with T2N1-2M0(stage III).However,no previous report has addressed this issue.AIM To screen prognostic risk factors for T4N0M0 colon cancer and construct a prognostic nomogram model for these patients.METHODS Two hundred patients with T4N0M0 colon cancer were treated at Tianjin Medical University General Hospital between January 2017 and December 2021,of which 112 patients were assigned to the training cohort,and the remaining 88 patients were assigned to the validation cohort.Differences between the training and validation groups were analyzed.The training cohort was subjected to multi-variate analysis to select prognostic risk factors for T4N0M0 colon cancer,followed by the construction of a nomogram model.RESULTS The 3-year overall survival(OS)rates were 86.2%and 74.4%for the training and validation cohorts,respectively.Enterostomy(P=0.000),T stage(P=0.001),right hemicolon(P=0.025),irregular review(P=0.040),and carbohydrate antigen 199(CA199)(P=0.011)were independent risk factors of OS in patients with T4N0M0 colon cancer.A nomogram model with good concordance and accuracy was constructed.CONCLUSION Enterostomy,T stage,right hemicolon,irregular review,and CA199 were independent risk factors for OS in patients with T4N0M0 colon cancer.The nomogram model exhibited good agreement and accuracy.展开更多
The thyroid, an endocrine gland located at the base of the neck, produces thyroid hormones (triiodothyronine (T3) and thyroxine (T4)). The production of these hormones is possible by iodine and other nutrients such as...The thyroid, an endocrine gland located at the base of the neck, produces thyroid hormones (triiodothyronine (T3) and thyroxine (T4)). The production of these hormones is possible by iodine and other nutrients such as selenium and certain vitamins. To assess the thyroid disturbances in the mountain population of Benin, a survey was conducted in Natitingou, a mountain town located in the department of Atacora, in the northwest of Benin, on a sample of thirty (30) adults (15 men and 15 women), most of whom are educated. The results of the questionnaire revealed that 43% of the surveyed population acknowledged having knowledge on the mentioned subject and have dietary habits based on the consumption of seafood, and also legumes (20%). The examination of the serum results of the dosage of T3, T4 and TSH hormones revealed cases of thyroid disturbances in the region (36.32% in men and 44.98% in women). The analysis of a comparative table including the “VEDALAB Easy Reader+” and five (05) other readers, presents the performance, reading techniques, principles, advantages and disadvantages of each device. Pending further studies, some recommendations were made at the end of this study to the academic authorities regarding probable cases of dysthyroidism for which additional examinations are required and an awareness for the improvement of dietary habits.展开更多
目的探讨基于MRI征象与影像组学诊断进展期胃癌T3和T4a分期效能的对比分析。方法选取于同济大学附属东方医院庐江分院行MRI检查,经病理结果证实,共计纳入208例胃癌患者,其中T3期96例,T4a期112例。首先应用传统影像学征象判断进展期胃癌...目的探讨基于MRI征象与影像组学诊断进展期胃癌T3和T4a分期效能的对比分析。方法选取于同济大学附属东方医院庐江分院行MRI检查,经病理结果证实,共计纳入208例胃癌患者,其中T3期96例,T4a期112例。首先应用传统影像学征象判断进展期胃癌侵犯浆膜层等征象,比较多序列MRI征象在病理证实T3和T4a期胃癌中表现的差异性;其次按7:3的比例随机分为训练组(n=145)和验证组(n=63),分别从常规T2非抑脂序列及高比值DWI序列(b=1000 s/mm^(2))图像中提取影像组学特征,构建影像组学联合模型;然后分别绘制基于传统MRI征象与影像组学联合模型工作特征(receiver operating characteristic,ROC)曲线,并计算ROC曲线下面积(area under the curve,AUC)、特异度及灵敏度,量化两种诊断方式对胃癌T3和T4a分期的诊断效能。结果传统多序列MRI征象诊断AUC:0.929(95%CI:0.887~0.970),特异度0.912,灵敏度0.916;MRI影像组学联合模型训练组诊断AUC:0.975(95%CI:0.974~0.976),特异度0.946,灵敏度0.956,验证组诊断AUC:0.971(95%CI:0.965~0.974),特异度0.946,灵敏度0.943,均具有统计学意义(P<0.05)。结论基于MRI影像组学模型诊断T3和T4a分期效能高于传统MRI征象,值得临床工作中进一步推广使用。展开更多
BACKGROUND Both phases of euthyroid sick syndrome(ESS)are associated with worse prognosis in septic shock patients.Although there are still no indications for supplementation therapy,there is no evidence that both pha...BACKGROUND Both phases of euthyroid sick syndrome(ESS)are associated with worse prognosis in septic shock patients.Although there are still no indications for supplementation therapy,there is no evidence that both phases(initial and prolonged)are adaptive or that only prolonged is maladaptive and requires supplementation.AIM To analyze clinical,hemodynamic and laboratory differences in two groups of septic shock patients with ESS.METHODS A total of 47 septic shock patients with ESS were divided according to values of their thyroid hormones into low T3 and low T3T4 groups.The analysis included demographic data,mortality scores,intensive care unit stay,mechanical ventilation length and 28-day survival and laboratory with hemodynamics.RESULTS The Simplified Acute Physiology Score II score(P=0.029),dobutamine(P=0.003)and epinephrine requirement(P=0.000)and the incidence of renal failure and multiple organ failure(MOF)(P=0.000)were significantly higher for the low T3T4.Hypoalbuminemia(P=0.047),neutrophilia(P=0.038),lymphopenia(P=0.013)and lactatemia(P=0.013)were more pronounced on T2 for the low T3T4 group compared to the low T3 group.Diastolic blood pressure at T0(P=0.017)and T1(P=0.007),as well as mean arterial pressure at T0(P=0.037)and T2(P=0.033)was higher for the low T3 group.CONCLUSION The low T3T4 population is associated with higher frequency of renal insufficiency and MOF,with worse laboratory and hemodynamic parameters.These findings suggest potentially maladaptive changes in the chronic phase of septic shock.展开更多
Breast cancers classified T4 according to the TNM code are frequent in Burkina Faso. A better knowledge of these cancers would help to better organize the fight against breast cancer in general. We conducted this stud...Breast cancers classified T4 according to the TNM code are frequent in Burkina Faso. A better knowledge of these cancers would help to better organize the fight against breast cancer in general. We conducted this study to present the clinical and prognostic aspects of T4 breast cancer in Ouagadougou. It was a descriptive retrospective study based on the medical record of patients received from January 1, 2017 to December 31, 2021 in the cancer department of Yalgado Ouedraogo University Hospital. Patients followed for histologically confirmed breast cancer who were classified in the cT4 category of the TNM code 8e edition were included. We collected a total of 286 patients. Non-salaried patients accounted for 90.56%. In this study, 53.3% of patients lived in urban area and 36.7% in rural area. Menopausal patients accounted for 56.8% of cases. One hundred and thirty-three (46.5%) patients were overweight or obese and 121 (42.3%) patients had a normal weight. The average consultation time, which is the time between the first signs and consultation in a specialized center, was 12 months, with a median of 11 months. According to category T of the TNM code, 19 patients (6.6%) were classified T4d, 176 (61.5%) were classified T4c, 69 (24.1%) were classified T4b and 22 (7.7%) T4a. One hundred and twenty patients (42%) were metastatic. The median overall survival of all patients in our sample was 20 months. In univariate analysis, metastatic status was risk factor for death, while obesity and surgery were protective factors. In multivariate analysis, obesity, surgery and metastatic status were independently associated with survival;obesity and surgery were protective factors. Survival is poor due to advanced stages and difficulties in the management of these cancers. Measures to facilitate access to care would improve the prognosis of these cancers.展开更多
基金Supported by Health Science and Technology Project of Tianjin Health Commission,No.ZC20190Tianjin Key Medical Discipline(Specialty)Construction Project,No.TJYXZDXK-005ATianjin Medical University Clinical Research Fund,No.22ZYYLCCG04.
文摘BACKGROUND Paradoxically,patients with T4N0M0(stage II,no lymph node metastasis)colon cancer have a worse prognosis than those with T2N1-2M0(stage III).However,no previous report has addressed this issue.AIM To screen prognostic risk factors for T4N0M0 colon cancer and construct a prognostic nomogram model for these patients.METHODS Two hundred patients with T4N0M0 colon cancer were treated at Tianjin Medical University General Hospital between January 2017 and December 2021,of which 112 patients were assigned to the training cohort,and the remaining 88 patients were assigned to the validation cohort.Differences between the training and validation groups were analyzed.The training cohort was subjected to multi-variate analysis to select prognostic risk factors for T4N0M0 colon cancer,followed by the construction of a nomogram model.RESULTS The 3-year overall survival(OS)rates were 86.2%and 74.4%for the training and validation cohorts,respectively.Enterostomy(P=0.000),T stage(P=0.001),right hemicolon(P=0.025),irregular review(P=0.040),and carbohydrate antigen 199(CA199)(P=0.011)were independent risk factors of OS in patients with T4N0M0 colon cancer.A nomogram model with good concordance and accuracy was constructed.CONCLUSION Enterostomy,T stage,right hemicolon,irregular review,and CA199 were independent risk factors for OS in patients with T4N0M0 colon cancer.The nomogram model exhibited good agreement and accuracy.
文摘The thyroid, an endocrine gland located at the base of the neck, produces thyroid hormones (triiodothyronine (T3) and thyroxine (T4)). The production of these hormones is possible by iodine and other nutrients such as selenium and certain vitamins. To assess the thyroid disturbances in the mountain population of Benin, a survey was conducted in Natitingou, a mountain town located in the department of Atacora, in the northwest of Benin, on a sample of thirty (30) adults (15 men and 15 women), most of whom are educated. The results of the questionnaire revealed that 43% of the surveyed population acknowledged having knowledge on the mentioned subject and have dietary habits based on the consumption of seafood, and also legumes (20%). The examination of the serum results of the dosage of T3, T4 and TSH hormones revealed cases of thyroid disturbances in the region (36.32% in men and 44.98% in women). The analysis of a comparative table including the “VEDALAB Easy Reader+” and five (05) other readers, presents the performance, reading techniques, principles, advantages and disadvantages of each device. Pending further studies, some recommendations were made at the end of this study to the academic authorities regarding probable cases of dysthyroidism for which additional examinations are required and an awareness for the improvement of dietary habits.
文摘目的探讨基于MRI征象与影像组学诊断进展期胃癌T3和T4a分期效能的对比分析。方法选取于同济大学附属东方医院庐江分院行MRI检查,经病理结果证实,共计纳入208例胃癌患者,其中T3期96例,T4a期112例。首先应用传统影像学征象判断进展期胃癌侵犯浆膜层等征象,比较多序列MRI征象在病理证实T3和T4a期胃癌中表现的差异性;其次按7:3的比例随机分为训练组(n=145)和验证组(n=63),分别从常规T2非抑脂序列及高比值DWI序列(b=1000 s/mm^(2))图像中提取影像组学特征,构建影像组学联合模型;然后分别绘制基于传统MRI征象与影像组学联合模型工作特征(receiver operating characteristic,ROC)曲线,并计算ROC曲线下面积(area under the curve,AUC)、特异度及灵敏度,量化两种诊断方式对胃癌T3和T4a分期的诊断效能。结果传统多序列MRI征象诊断AUC:0.929(95%CI:0.887~0.970),特异度0.912,灵敏度0.916;MRI影像组学联合模型训练组诊断AUC:0.975(95%CI:0.974~0.976),特异度0.946,灵敏度0.956,验证组诊断AUC:0.971(95%CI:0.965~0.974),特异度0.946,灵敏度0.943,均具有统计学意义(P<0.05)。结论基于MRI影像组学模型诊断T3和T4a分期效能高于传统MRI征象,值得临床工作中进一步推广使用。
基金approved by the Institutional Review Board(IRB)of Cantonal Hospital Zenica,and the protocols used in the study were approved by the Ethical Committee of Cantonal Hospital Zenica(00-03-35-38-14/22).
文摘BACKGROUND Both phases of euthyroid sick syndrome(ESS)are associated with worse prognosis in septic shock patients.Although there are still no indications for supplementation therapy,there is no evidence that both phases(initial and prolonged)are adaptive or that only prolonged is maladaptive and requires supplementation.AIM To analyze clinical,hemodynamic and laboratory differences in two groups of septic shock patients with ESS.METHODS A total of 47 septic shock patients with ESS were divided according to values of their thyroid hormones into low T3 and low T3T4 groups.The analysis included demographic data,mortality scores,intensive care unit stay,mechanical ventilation length and 28-day survival and laboratory with hemodynamics.RESULTS The Simplified Acute Physiology Score II score(P=0.029),dobutamine(P=0.003)and epinephrine requirement(P=0.000)and the incidence of renal failure and multiple organ failure(MOF)(P=0.000)were significantly higher for the low T3T4.Hypoalbuminemia(P=0.047),neutrophilia(P=0.038),lymphopenia(P=0.013)and lactatemia(P=0.013)were more pronounced on T2 for the low T3T4 group compared to the low T3 group.Diastolic blood pressure at T0(P=0.017)and T1(P=0.007),as well as mean arterial pressure at T0(P=0.037)and T2(P=0.033)was higher for the low T3 group.CONCLUSION The low T3T4 population is associated with higher frequency of renal insufficiency and MOF,with worse laboratory and hemodynamic parameters.These findings suggest potentially maladaptive changes in the chronic phase of septic shock.
文摘Breast cancers classified T4 according to the TNM code are frequent in Burkina Faso. A better knowledge of these cancers would help to better organize the fight against breast cancer in general. We conducted this study to present the clinical and prognostic aspects of T4 breast cancer in Ouagadougou. It was a descriptive retrospective study based on the medical record of patients received from January 1, 2017 to December 31, 2021 in the cancer department of Yalgado Ouedraogo University Hospital. Patients followed for histologically confirmed breast cancer who were classified in the cT4 category of the TNM code 8e edition were included. We collected a total of 286 patients. Non-salaried patients accounted for 90.56%. In this study, 53.3% of patients lived in urban area and 36.7% in rural area. Menopausal patients accounted for 56.8% of cases. One hundred and thirty-three (46.5%) patients were overweight or obese and 121 (42.3%) patients had a normal weight. The average consultation time, which is the time between the first signs and consultation in a specialized center, was 12 months, with a median of 11 months. According to category T of the TNM code, 19 patients (6.6%) were classified T4d, 176 (61.5%) were classified T4c, 69 (24.1%) were classified T4b and 22 (7.7%) T4a. One hundred and twenty patients (42%) were metastatic. The median overall survival of all patients in our sample was 20 months. In univariate analysis, metastatic status was risk factor for death, while obesity and surgery were protective factors. In multivariate analysis, obesity, surgery and metastatic status were independently associated with survival;obesity and surgery were protective factors. Survival is poor due to advanced stages and difficulties in the management of these cancers. Measures to facilitate access to care would improve the prognosis of these cancers.
