BackgroundThis study aims to analyze the effect of textbook outcome (TO) on the long-term prognosis and adjuvant chemotherapy (AC) compliance of patients with gastric cancer (GC) in a single institute.Materials and methodsConsecutive patients who underwent radical gastrectomy with pathological stage I-III at Union Hospital of Fujian Medical University from January 2010 to June 2017 were included. TO was defined as receiving a complete-potentially curative status, ≥15 lymph nodes examined, hospital stay ≤21 days, and freedom from intraoperative and postoperative complications, re-intervention in 30 days, 30-day readmission to the hospital or intensive care unit, and 30-day postoperative mortality.ResultsTotally 3993 patients were included, of which 3361 (84.2%) patients achieved TO. The overall, disease-specific, and recurrence-free survival of patients achieving TO were significantly better than those of patients without achieving TO (all P < 0.05). The total number of AC cycles was greater and the interval from surgery to first AC was shorter in the TO group compared with the Non-TO group. Age >65 years old, open surgery, pT3-4 stage, and total radical gastrectomy (TG) were identified as related high-risk factors for failure to achieve TO. Laparoscopic surgery facilitated TO achievement in high-risk groups.ConclusionTO is a reliable indicator of favorable prognosis of patients with GC and contributes to postoperative chemotherapy compliance. Age ≤65 years old, non-TG, pT1-2 stage, and laparoscopic surgery may promote the achievement of TO. 相似文献
To determine inter-lab reliability in sleep stage scoring using the 2014 American Academy of Sleep Medicine (AASM) manual. To understand in-depth reasons for disagreement and provide suggestions for improvement.
Methods
This study consisted of 40 all-night polysomnographys (PSGs) from different samples. PSGs were segmented into 37,642 30-s epochs. Five doctors from China and two doctors from America scored the epochs following the 2014 AASM standard. Scoring disagreement between two centers was evaluated using Cohen’s kappa (κ). After visual inspection of PSGs of deviating scorings, potential disagreement reasons were analyzed.
Results
Inter-lab reliability yielded a substantial degree (κ?=?0.75 ± 0.01). Scoring for stage W (κ?=?0.89) and R (κ?=?0.87) achieved the highest agreement, while stage N1 (κ?=?0.45) reflected the lowest. Considering the relative disagreement ratio, N2-N3 (22.09%), W-N1 (19.68%), and N1-N2 (18.75%) were the most frequent combinations of discrepancy. American and Chinese doctors showed certain characteristics in the scoring of discrepancy combination W-N1, N1-N2, and N2-N3. There are seven reasons for disagreement, namely “on-threshold characteristic” (29.21%), “context influence” (18.06%), “characteristic identification difficulty” (8.81%), “arousal-wake confusion” (7.57%), “derivation inconsistence” (2.15%), “on-borderline characteristic” (0.92%), and “misrecognition” (33.27%).
Conclusions
This study demonstrated the sleep stage scoring agreement of the 2014 AASM manual and explored potential sources of labeling ambiguity. Improvement measures were suggested accordingly to help remove ambiguity for scorers and improve scoring reliability at the international level.
The cyanobacterium Arthrospira platensis, spirulina, is a source of pigments such as phycobiliprotein and phycocyanin. Phycocyanin is used in the food, cosmetics, and pharmaceutical industries because of its antioxidant, anti-inflammatory, and anticancer properties. The different steps involved in extraction and purification of this protein can alter the final properties. In this review, the stability of phycocyanin (pH, temperature, and light) is discussed, considering the physicochemical parameters of kinetic modeling. The optimal working pH range for phycocyanin is between 5.5 and 6.0 and it remains stable up to 45 °C; however, exposure to relatively high temperatures or acidic pH decreases its half-life and increases the degradation kinetic constant. Phycobiliproteins are sensitive to light; preservatives such as mono- and di-saccharides, citric acid, or sodium chloride appear to be effective stabilizing agents. Encapsulation within nano- or micro-structured materials such as nanofibers, microparticles, or nanoparticles, can also preserve or enhance its stability. 相似文献