Background: The Geriatric Nutritional Risk Index (GNRI) is a nutritional measure for predicting the risk of morbidity and mortality in hospitalized patients. We evaluated the utility of the GNRI to predict the short-term and long-term outcomes after curative surgery for gastric cancer (GC). Patients and Methods: Patients who underwent curative surgery for GC between 2008 and 2016 were reviewed (n=795). We classified patients into two groups according to the GNRI (high GNRI: low and no risk; low GNRI: major and moderate risk) and compared the utility of the GNRI. Results: A low GNRI was an independent prognostic factor for poorer overall survival (hazard ratio=2.34, p0.001). The GNRI tended to be a better prognostic indicator in elderly patients with GC. Low GNRI was associated with postoperative complications (odds ratio=2.27, p=0.002), especially in patients aged ≥75 (odds ratio=2.26, p=0.042). Conclusion: Low GNRI was associated with poor prognosis and occurrence of postoperative complications in patients with GC, especially in elderly patients.
Chronic spontaneous urticaria (CSU) is one of the most intractable human-specific skin diseases. However, as no experimental animal model exists, the mechanism underlying disease pathogenesis in vivo remains unclear, making the establishment of a curative treatment challenging. Here, using a novel approach combining mathematical modeling, in vitro experiments and clinical data analysis, we show that the pathological state of CSU patients can be inferred by geometric features of the skin eruptions. Based on our hierarchical mathematical modelling and the analysis of 105 CSU patient eruption pattern geometries, analyzed by six dermatologists, we demonstrate that the eruption patterns can be classified into five categories, each with distinct histamine, basophils, mast cells and coagulation factors network signatures. Furthermore, our network analysis revealed that tissue factor degradation/activation likely determines boundary/area pattern, and that the state of spontaneous histamine release from mast cells may contribute to divergence of the boundary pattern. Thus, our study not only demonstrates that pathological states of diseases can be defined by geometric features but will also facilitate more accurate decision-making to manage CSU in the clinical setting.
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