ObjectiveTo construct a model for predicting prognosis risk in patients with pancreatic malignancy (PM).MethodsThe clinicopathological data of 8 763 patients with PM undergone resection between 2010 and 2015 were collected and analyzed by SEER*Stat (v8.3.5) and R software, respectively. The univariate and multivariate Cox proportional hazard regression analysis were used to analyze the factors for predicting prognosis outcome risk and constructed the nomograms of patients with PM, respectively. Kaplan-Meier method was used to evaluate the survival of patients according to relevant factors and the high risk group and low risk group of patients with PM. The discriminative ability and calibration of the nomograms to predict overall survival were tested by using C-index, area under ROC curve (AUC) and calibration plots.ResultsThe multivariate Cox proportional hazard regression analysis showed that age, T staging, N staging, M staging, histological type, the differentiation, number of regional lymph node dissection, chemotherapy, and radiotherapy were independent factors for predicting the prognosis of patients with PM (P<0.05). Based on regression analysis of patients with PM, a nomograms model for predicting the risk of patients with PM was established, including age, T staging, N staging, M staging, histological type, the differentiation, tumor location, type of surgery, number of regional lymph node dissection, chemotherapy, and radiotherapy. The discriminative ability and calibration of the nomograms revealed good predictive ability as indicated by the C-index (0.747 for modeling group and 0.734 for verification group). The 3- and 5-year survival AUC values of the modeling group were 0.766 and 0.781, and the validation group were 0.758 and 0.783, respectively. The calibration plots showed that predictive value of the 3- and 5-year survival were close to the actual values in both modeling group and the verification group. ConclusionsIndependent predictors of survival risk after curative-intent surgery for PM were selected to create nomograms for predicting overall survival. The nomograms provide a basis for judging the prognosis of PM patients.
ObjectiveTo evaluate the effectiveness of total hip arthroplasty (THA) combined with subtrochanteric osteotomy in the treatment of Crowe type Ⅳdevelopmental dysplasia of the hip (DDH).MethodsBetween April 2008 and June 2016, 71 patients with unilateral Crowe type Ⅳ DDH were treated with THA. Of 71 cases, 44 were performed with subtrochanteric osteotomy (osteotomy group) and 27 were performed without subtrochanteric osteotomy (non-osteotomy group). There was no significant difference in gender, age, body mass, height, body mass index, affected side, and preoperative Harris score between 2 groups (P>0.05). The complications were recorded and the effectiveness was assessed by Harris score. Besides, the femoral dislocation height and the settling depth of sleeve were measured in the pelvic anteroposterior X-ray film pre- and post-operatively.ResultsOsteotomy group was followed up 12-90 months (mean. 34.77 months), and non-osteotomy group was followed up 12-79 months (mean, 34.33 months). There was no significant difference in follow-up time between 2 groups (t=–0.088, P=0.930). There was 11 cases of intraoperative or postoperative complications in osteotomy group, and 3 cases of postoperative complications in non-osteotomy group. Among the osteotomy group, 1 case had nonunion due to infection and received revision after 20 months. No loosening or dislocation of the implant occurred in both 2 groups. Significant differences were found in femoral dislocation height and settling depth of sleeve between 2 groups (t=–8.452, P=0.000; t=6.783, P=0.000). Moreover, the osteotomy length was not correlated with the settling depth of sleeve (r=–0.038, P=0.806). At last follow-up, there was no significant difference in Harris score between 2 groups (t=–1.160, P=0.254).ConclusionTHA combined with subtrochanteric osteotomy can provide a favorable outcome for treating Crowe type Ⅳ DDH. Furthermore, patients with higher femoral dislocation and severely narrow femoral proximal canals are prone to be peformed with subtrochanteric osteotomy.