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Objective To assess the efficacy and safety of morinidazole combined with appendectomy in treating purulent or gangrenous appendicitis.Methods Double-blind randomized controlled multicenter clinical trial was designed and conducted.Totally 437 patients were included,219 in the control group and 218 in the experimental group.Cases of purulent or gangrenous appendicitis were enrolled and assigned to each of the two groups.The control group received ornidazole injection for 5 to 7 days while the experimental group received morinidazole injection.Both groups underwent appendectomy.Clinical response,micrombiological outcomes,overall response were evaluated.Adverse events and side effects were recorded.Results No significant difference was observed between the two groups regarding the clinical healing rate at 5-10 days after medicine withdrawal,anaerobia clearance and overall healing rates.Adverse events occurred in 140 patients (32.1％).Incidence of adverse events in the control group and the experimental group was 34.7％ and 29.4％,respectively (P ＞ 0.05).The overall incidence of side effects was 15.1％ (66 cases).Side effects were less seen in the experimental group compared with that in the control group (11.5％ vs.18.7％,P ＜ 0.05).The most frequent side effects were aminotransferase rising,thrombocytosis,nausea,vomiting and electrocardiographic abnormality.Conclusions The effect of morinidazole plus operation was comparable with ornidazole in treating purulent or gangrenous appendicitis.The safety of morinidazole is better than ornidazole.
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Objective To evaluate the effect of nodosin,as an effective element extracted from rabdosiae serrae, on hepatocyte regeneration after partial liver transplantation.Methods Wistar rats were used as donors and SD rats as recipients.Rat models with partial liver transplantation were established by modified two-cuff technique.Twenty-four recipient rats were randomly assigned into the nodosin and control groups.In the nodosin group,nodosin at a dosage of 1 00 μg/ml was administered via tail venous route after liver transplantation.Peripheral plasma and liver specimen were obtained at postoperative 3 and 7 d.The levels of alanine transaminase (ALT),aspartate aminotransferase (ALT)and albumin (ALB)in the peripheral plasma were measured by spectrophotometry.Hepatic histomorphological changes were observed under light microscope.The positive cell count of proliferating cell nuclear antigen (PCNA)antibody in the liver tissue was detected by immunohistochemistry. The expression levels of phosphorylated protein kinase (p-AKT ), phosphorylated mammalian target of rapamycin (p-mTOR),cyclin D1 and heme oxygenase (HO)-1 proteins were measured by western blot.The apoptosis of liver cells was detected by Annexin V method and TdT mediated-dUTP nick end labeling (TUNEL).Results Compared with the control group,the serum levels of ALT and AST were significantly lower at 3 d and 7 d after operation,whereas the ALB content was significantly higher in the nodosin group (all in P <0.05).And nodosin could alleviate the pathological injury of rat liver tissue after transplantation.The positive cell count of PCNA in the nodosin group was significantly higher than that in the control group (P <0.05).In the nodosin group,the expression levels of p-AKT,p-mTOR,cyclin D1 and HO-1 proteins were significantly higher than those in the control group (all in P <0.05).The quantity and percentage of apoptotic hepatocytes in the nodosin group were significantly lower than those in the control group (both in P <0.05).Conclusions Application of nodosin can decrease the quantity of apoptotic hepatocytes and accelerate hepatocyte proliferation after liver transplantation in rat models.
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Objective To investigate the expressions and relationship between lysine-specific demethylase 1 (LSD1) and E-cadherin protein in gastric cancer tissues and adjacent normal tissues,and the correlation with the clinicopathological features and prognosis of patients with gastric cancer.Methods The case-control study was adopted.The gastric cancer tissues and adjacent normal tissues were collected by surgical resection from 80 patients with gastric cancer who were admitted to the Xiangya Hospital of Central South University from June 2008 to June 2009.Expressions of LSD1 and E-cadherin protein were detected by immunohistochemistry (IHC).The follow-up of telephone interview was performed to detect survival of patients till June 2015.Relationships between the expressions of LSD1 and E-cadherin protein and clinicopathological features or prognosis of patients were analyzed.Comparison of count data and correlation were analyzed by the chi-square test and Spearman rank correlation analysis.Survival curve was drawn using the Kaplan-Meier method,and survival analysis was done using the Log-rank test.Results Expressions of LSD1 in cancer tissues and adjacent normal tissues were located at the cell nucleus.The positive expression rate of LSD1 was 67.5％ (54/80) and 43.8％ (35/80) in cancer tissues and adjacent normal tissues,respectively,with a significant difference (x2=9.141,P ＜ 0.05).Expressions of E-cadherin protein in cancer tissues and adjacent normal tissues were located at the cell membrane and cytoplasm.The positive expression rate of E-cadherin was 63.8％ (51/80) and 81.3％ (65/80) in cancer tissues and adjacent normal tissues,respectively,with a significant difference (x2 =6.140,P ＜ 0.05).The positive expression rate of LSD1 was 83.3％ (25/30),76.0％ (19/25) and 40.0％ (10/25) in the low-,moderate-and high-differentiated tumors,37.5％ (6/16),72.7％ (16/22),71.9％ (23/32) and 90.0％ (9/10) in the Ⅰ,Ⅱ,Ⅲ and Ⅳ stages of TNM stage,36.4％ (4/11) and 72.5 ％ (50/69) in patients without and with lymph node metastasis,respectively,showing significant differences (x2=12.870,9.425,4.111,P ＜ 0.05).The positive expression rate of E-cadherin protein was 53.3％ (16/30),56.0％ (14/25) and 84.0％ (21/25) in the low-,moderate-and high-differentiated tumors,75.0％ (12/16),63.6％ (14/22),71.9％ (23/32) and 20.0％ (2/10) in the Ⅰ,Ⅱ,Ⅲ and Ⅳ stages of TNM stage,100.0％ (11/11) and 58.0％ (40/69) in patients without and with lymph node metastasis,70.0％ (49/70) and 20.0％ (2/10) in patients without and with distant metastasis,respectively,showing significant differences (/x2 =6.494,10.073,5.547,7.426,P ＜ 0.05).There was a negative correlation in expressions between LSD1 and E-cadherin protein (r =-0.355,P ＜ 0.05).The survival time and 5-year overall survival rate of patients with positive and negative expressions of LSD1 were (36.9 ± 2.5) months and 31.1％,(47.4 ± 3.4) months and 56.0％,respectively,showing a significant difference (x2=4.550,P ＜0.05).The survival time and 5-year overall survival rate of the patients with positive and negative expressions of E-cadherin protein were (44.0 ± 2.5) months and 46.7％,(32.6 ± 3.5) months and 24.9％,respectively,showing a significant difference (x2 =7.306,P ＜ 0.05).Conclusions Positive expression of LSD1 in gastric cancer tissues is higher than that in adjacent normal tissues.There are increased expression of LSD1 and reduced expression of E-cadherin protein in low-differentiated gastric cancer tissues and high TNM stage,showing a negative correlation between them.Positive expression of LSD1 and negative expression of E-cadherin protein may indicate a poor prognosis.
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Objective To discuss the relationship between lung function before and after radiotherapy and radiation-induced pneumonitis in locally advanced non-small-cell lung cancer.Methods 76 patients were evaluated by pulmonary function tests before radiotherapy and in 1 month and 3 month after radiotherapy respectively.Results All patients were treated radiotherapy with irradiation dose of 60-70 Gy,the radiation pneumonitis occurred in 26 patients (group A),22 patients were grade 1,3 patients were grade 2,1 patient grade 3 and no patient was grade 4 and 5.50 patients without radiation pneumonitis were group B.There were significant difference between group A and group B for FEV1 before radiotherapy [(51.67±19.03) ％,(69.03± 14.54) ％,t =2.34,P ＜ 0.05].There were no significant difference between in 1 month and 3 months after radiotherapy for FVC (P ＞ 0.05).There was significant difference between in 1 month and 3 months after radiotherapy for DLCO (group A,P ＜ 0.01; group B,P ＜ 0.05).Conclusions For locally advanced non-small-cell lung cancer patients,the lower of FEV1 before radiotherapy inclineds to develop radiation pneumonitis,DLCO levels are lower significantly in patients prones to radiation pneumonitis.FEV1 and DLCO are sensitive indicators to predict radiation pneumonitis.
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Objective To compare the perioperative efficacy berween laparoscopic and open gastrectomy for the treatment of advanced gastric cancer.Methods Literatures on the comparison of the efficacy between laparoscopic and open gastrectomy were searched in the PubMed,EMBASE,the Cochrane Library,CNKI and CMCC.Articles were selected according to the inclusion criteria,and data were extracted from these trials by 2 reviewers independently and analyzed by Review Manager 5.0 software.The heterogeneity of the literatures was analyzed using the I2 test.Data were integrated by fixed or random effect model.The count data were presented by odds ratio (OR) and 95％ confidence interval (95％ CI).Results Twelve literatures were retrieved,including 1 published in Chinese and 11 in English,1 randomized controlled study and 11 retrospective non-randomized controlled studies.A total of 2 079 cases of advanced gastric cancer were included in this study,including 882 in the laparoscopic gastrectomy group and 1 197 in the open gastrectomy group.There were significant differences in the operation time,intraoperative blood loss,time to first flatus,time to first diet and duration of hospital stay between the 2 groups (WMD =41.33,-106.00,-0.55,-0.76,-2.62,95％ CI:25.44-57.21,-120.71--91.29,-0.80--0.29,-1.29--0.23,-4.05--1.18,P ＜ 0.05).There were no significant difference in the number of lymph nodes harvested and incidence of complications between the 2 groups (WMD =0.22,OR =0.82,95％CI:-1.48-1.93,0.62-1.08,P ＞ 0.05).Conclusion Laparoscopic gastrectomy can be safely performed for the treatment of advanced gastric cancer,and it brings benefits to patients in perioperative period than open gastrectomy.
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<p><b>OBJECTIVE</b>To compare the safety and efficacy of the medial approach(MA) and the lateral approach (LA) in the treatment of colorectal disease.</p><p><b>METHODS</b>Studies published from January 1994 to April 2013 that compared MA to LA in laparoscopic colorectal resection were collected. Publications in English were mainly identified from Medline, Embase, Cochrane Library, and those in Chinese from Wanfang database and CNKI database. Conversion rate, operative time, blood loss, number of harvested lymph nodes, hospital stay, complication, mortality, recurrence, and hospitalization costs of MA and LA were meta-analyzed using fixed-effect and random-effect models.</p><p><b>RESULTS</b>Five cohort studies (2 randomized controlled trials and 3 retrospective studies) including 881 patients were enrolled and analyzed. Of these patients, 416 and 465 underwent laparoscopic colorectal resection with MA and LA respectively. As compared to LA, MA had significantly lower conversion rate (OR=0.42, 95%CI:0.25-0.72, P=0.001), shorter operative time (WMD=-52.62, 95%CI:-63.23--42.01, P<0.01), less number of harvested lymph nodes (WMD=-1.17, 95%CI:-1.89--0.45, P=0.001), while blood loss was less and hospitalization cost lower. Significant differences in intraoperative complications and postoperative complications were not found between the two group (OR:0.57, 95%CI:0.15-2.18, P=0.41; OR:0.78, 95%CI:0.52-1.17, P=0.23).</p><p><b>CONCLUSIONS</b>Compared with LA, MA has the advantages of shorter operative time and lower conversion rate with similar safety. Differences in blood loss, hospitalization cost and oncological safety between the two approaches warrant further investigation.</p>
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Humans , Laparoscopy , Methods , Proctocolectomy, Restorative , MethodsABSTRACT
Objective To evaluate the effects of L-alanyl-L-glutamine (LALG) intensified parenteral nutrition support in advanced malignant carcinoma patients.Methods 68 patients were randomly divided into two groups,control group (n =34) received only parenteral nutrition,treatment group (n =34) received parenteral nutrition combined with a dose of 0.3 g ·(kg·d)-1 LALG.Nutrition status and immune functions were determined at pre-therapy and 15th days after therapy.Results After the therapy,the pALB and TRF of treatment group were significantly increased [(24.9±8.06) mg/dl vs (27.3±6.05) mg/dl; (1.62±0.43) g/L vs (2.06±0.32) g/L].Before therapy,no significant change in IgA,IgM and IgG was found in two groups (P ＞ 0.05).After the therapy,IgA and IgG of the treatment group after the therapy were significantly different from those before the therapy [(2.85±1.43) mg/L vs (3.63±5.36) mg/L; (0.95±0.43) mg/L vs (1.13±0.09) mg/L],IgA,IgM and IgG of the control group had no difference compared with those before the therapy (P ＞ 0.05),CD4+ of treatment group was significandy different compared with those of control group [(39.19±4.23) ％ vs (36.62±3.58) ％] (P ＜ 0.05).There is no significantly difference between CD:/ CD8+ CD8+ of treatment group and those of control therapy (P ＞ 0.05).After therapy,the score of quality of life in treatment group was higher than that in control group (P ＜ 0.05).Conclusion LALG intensified parenteral nutrition has better effects on improvement of the nutrition and immune functions.
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OBJECTIVE@#To assess the value of proximal gastrectomy (PG) and total gastrectomy (TG) for the treatment of cancer of cardia and fundus.@*METHODS@#Publications on comparision between PG and TG in the treatment of cancer of cardia and fundus were collected, the data from the publications were matched with the PG group and the TG group respectively according to its corresponding surgical resection, and the data on postoperative complications, motality and 5-year survival rate were meta-analyzed by fixed effect model and random effect model.@*RESULTS@#Thirteen reseaches on 2 219 patients were included in this study, 2 of which were randomly controlled studies. There were no significant differences in the postoperative complications (OR=1.00, 95%CI: 0.44-2.28,P>0.05) and mortality (OR=1.25, 95%CI: 0.62-2.48,P>0.05) between the PG group and the TG group, while there was significant difference in the 5-year survival rate (HR=0.87, 95%CI: 0.76-0.99,P=0.04). The 5-year survival rate in the TG group was higher than that in the PG group.@*CONCLUSION@#Total gastrectomy for the treatment of cancer of cardia and fundus has better long-term therapetic effect.
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Humans , Cardia , Pathology , Gastrectomy , Methods , Gastric Fundus , Pathology , Prognosis , Stomach Neoplasms , Mortality , General Surgery , Survival RateABSTRACT
Objective To evaluate the necessity of indwelling gastrointestinal decompression after gastrectomy. Methods Eight publications on the necessity of gastrointestinal decompression after gastrecomy were colleted, data on recovery time of gastrointestinal function and hospital stay, complications,and motality were Meta-analyzed using fixed effect model and random effect model. Results Eight randomized trails including 975 patients were qualified and included in this study. The differences in time to oral intake ( WMD =0. 61, 95% CI: 0. 17 - 1.05, P ＜ 0. 05 ) and hospital stay ( WMD = 1.20, 95% CI:0. 05 -2. 36, P ＜ 0. 05 ) between the decompression group and non-decompression group were statistically significant, but the difference in time to flatus (WMD = 0. 31,95% CI: -0. 07- 0. 69, P ＞ 0. 05 ) was not significant. There were no significant differences in complications such as nausea and vomiting ( OR = 1.43,95% CI: 0. 61 - 3.31, P ＞ 0. 05 ), pulmonary infection and atelectasis ( OR = 1.43, 95 % CI: 0. 82 - 2. 49,P＞0.05), anastomotic leakage (OR = 1.17, 95%CI: 0.54-2.49, P ＞0.05), abdominal abscess ( OR = 1.08, 95% CI: 0. 50 - 2. 34, P ＞ 0. 05 ), wound dehiscence ( OR = 1.47, 95% CI: 0. 43 - 4. 95,P ＞ 0. 05 ) between the two groups, except for fever ( OR = 1.76, 95% CI: 1.11 - 2. 78, P ＜ 0. 05 ), which was found more frequent in decompression group than in non-decompression group. Conclusions Routine gastrointestinal decompression after gastrectomy was not conductive to the recovery of gastrointestinal function, and could not reduce the incidence of postoperative complications. Postoperative GI decompression increased fever incidence rate and prolonged hospital stay.
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Objective To investigate the role of contrast-enhanced ultrasound (CEUS) on the diagnostic efficacy of ultrasound-guided percutaneous biopsy of peripheral lung lesions. Methods Ninty-six patients with pleural-based lesions underwent percutaneous ultrasound-guided biopsy. Of the 96 patients,54patients underwent CEUS before biopsy and enhancement information was referred for the selecting of tissue sampling site. The rest of 42 patients didn' t undergo CEUS before biopsy. The difference in the diagnostic accuracy between the two groups was analyzed to evaluate the value of CEUS before biopsy.Results Of the 52 patients in the CEUS group,48 were malignant,and 6 were benign. Of the 42 patients in the un-CEUS group,36 were malignant, and 6 were benign. Necrosis (areas lacking of enhancement) was demonstrated in 41.7％ (20/48) of the patients with malignant lesions in CEUS group, and necrosis incidence was increased with the increase of the dimension of the malignant lesions. No necrosis area was demonstrated in 6 benign lesions. The rate of successful initial biopsy in CEUS group (98.1 ％ ,53/54) was statistically higher than that in un-CEUS group ( 85.7％, 36/42 ) ( P ＜ 0.05 ). Tissue necrosis and denaturalization attributed to most of the inconclusive pathologic diagnosis. Conclusions CEUS before transthoracic peripheral lung lesion biopsy improved the diagnostic accuracy of the procedure by providing information for differentiating viable or necrotic tissue and consequently provide more accurate information about the site of biopsy.
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Objective To establish the cell line from specimens of resectable human gastrointestinal stromal tumors (GIST) and to verify the characteristics of cell biology in vitro. Methods The tissues from biopsies of human GIST were cultured in RPMI 1640 media supplemented with 10% fetal bovine serum. After growing to 90% confluence,the cells were detached for subculture and their characteristics,including morphology,growth kinetics,karyotype analysis,immunohistochemical analysis and tumorigenicity in nude mice were determined. Results GIST named GIST-H1 was successfully established. The cell line was passaged for more than 60 times 1 year. The characteristics demonstrated: The population doubling time calculated in the log phase of growth was 47.5 h. The cloning efficiency in the soft agar averaged 24.8%.Electronmicroscopically,there were rich ribosomes and mitochondrion in the cytoplasm. Immunohistochemical analysis showed CD117(+),SMA(+),dog-1(+),CD34(-),and S-100(-).Karyotype analysis illustrated aneuploidy with the modal chromosomal number 60-98.The GIST cells transplanted in nude mice had high tumorigenicity. Conclusion The immortalized GIST cells are devoloped in vitro and have specific characteristics of GIST.
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Objective: To assess the clinical features, diagnosis and treatment of gastrointestinal stromal tumor in the rectum.Methods: Records of 18 patients diagnosed as GIST in the rectum between January 2002 and April 2009 were re-viewed and the major clinical features, treatment modalities and outcomes were analyzed.Results: The clinical features of GIST in the rectum were nonspecific.Most patients manifested with bloody stool or changes in bowel habits.CT scan or MRI findings showed necrosis and/or hemorrhage in the tumor and well defined tumor margins.Even in the case of large GIST, no lymphadenopathy was not found, which could be a factor for the differential diagnosis of GIST from other rectal neoplasms.All of the resected tumor specimens showed positive expression of CD117 and CD34 in immunohistochemical staining.Low and very low risk patients accounted for 44.4% (8/18).All patients received surgery.Twelve patients were treated with local excision with different approaches.Anterior resection of the rectum (Dixon) was undertaken in three pa-tients and abdominoperineal resection (Miles) in three patients.Neoadjuvant therapy with imatinib was applied for three pa-tients with partial response.After a median follow-up of 34 months (1～84 months), recurrence and/or metastasis occurred in five patients, and three of them were treated with imatinib.One patient received Miles surgery after repeated local exci-sions.Only one patient died of bone metastasis.Recurrence-free survival (RFS) of the local excision group was longer than that of abdominoperineal resection (APR) group (75.0±8.4 months vs 26.0±11.1 months, P=0.023).Conclusion: The treatment for rectal GIST should be individualized and be different from that of rectal cancer.Treatment decision and choice of procedures should be based on careful preoperative evaluation of tumor size, location, extent and risk level.Most of the anorectal GIST were rated as low-risk in this cohort and could be excised locally by different approaches with satisfactory outcome.Neoadjuvant therapy with imatinib may benefit some patients to obtain the opportunity of sphincter-saving.
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OBJECTIVE@#To explore the clinicopathologic and molecular characteristics of hereditary nonpolyposis colorectal cancer (HNPCC), and to improve the level of diagnosis and treatments of HNPCC.@*METHODS@#Thirty HNPCC patients (HNPCC group) who were treated in Xiangya Hospital were retrospectively analyzed, and 25 patients with sporadic colorectal cancer in the same duration were randomly chosen as a control group. The onset of age, location of tumor, pathological type, treatment method, and prognosis were compared in the 2 groups. The expression loss rate of mismatch repair gene (MMR) MLH1 and MSH2 in the 2 groups was detected by immunohistochemistry.@*RESULTS@#The onset age in the HNPCC group was earlier than that in the control group (P0.05).@*CONCLUSION@#HNPCC patients are characterized with early onset associating with multiple tumors. The accuracy of diagnosis can be improved by combining the detection of MMR gene. Optimal surgical treatment and close follow-up may bring good result to HNPCC patients.
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Aged , Female , Humans , Male , Middle Aged , Adaptor Proteins, Signal Transducing , Genetics , Metabolism , Adenocarcinoma , Diagnosis , Genetics , Pathology , General Surgery , Case-Control Studies , Colorectal Neoplasms, Hereditary Nonpolyposis , Diagnosis , Genetics , Pathology , General Surgery , Endometrial Neoplasms , Pathology , MutL Protein Homolog 1 , MutS Homolog 2 Protein , Genetics , Metabolism , Mutation , Neoplasms, Second Primary , Pathology , Nuclear Proteins , Genetics , Metabolism , Retrospective StudiesABSTRACT
Objective To investigate the detection of BJ-75A-9 mHNA, WNX and CK19 mRNA in peripheral blood cells of lung cancer patients and evaluate its diagnostic value. Methods The expression of BJ-TSA-9, LUNX and CK19 mRNA in peripheral blood cells was delected from 84 lung cancer patients, 32 benign lung lesions and 20 healthy volunteers by nested reverse transcription polymerase chain re-action (Nested-RT-PCR). Results The positive detection rates of BJ-75A-9,LUNX and CK19 mRNA in the peripheral blood of the pa-tients with lung cancer were 59.5%,40.4%and 22.6% respectively. In the 32 peripheral blood samples of the patients with benign lung le-sions,the positive detection rate of BJ-TSA-9,LUNX and CK19 mRNA were 9.3%, 12.5% and 6.3% respectively. No expression of BJ-TSA-9,LUNX and CK19 was detected in lhe samples of the healthy volunteers. The expression level of BJ-TSA-9, WNX and CKI9 mRNA in the peripheral blood of lung cancer stage IV patients was significantly higher than those of stages II and ID (P< 0.05). Conclusion RT-PCR amplification of BJ-TSA-9, LUNX and CK19 mRNA are an efficient way to detect early haematogenous dissemination of cancer cells for lung cancer patients. The detection of BJ-TSA-9 expression is sensitive and specific for lung cancer,and it is superior to both LUNX and CK19 mRNA. The expression of BJ-7SA-9 mRNA in peripheral blood might predict the hematogenous metastatic spreading of lung cancer cells.
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0.05).The main side effects were myelosuppresion,gastrointestinal reation and peripheral nerve toxicity and phlebitis.Conclusion The therapeutic effectiveness of NP regimen was better than MVP regimen.There were no significant difference between the two regimens.They can be used as first line chemotheapy for NSCLC.
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<p><b>BACKGROUND</b>To observe the efficacy and safety of navelbine (NVB) combined with ifosfamide (IFO) and cisplatin (DDP) (NIP regimen) and IFO plus DDP (IP regimen) for advanced non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>One hundred and twenty patients with advanced NSCLC pathologically proved were randomly divided into group A (NIP regimen, n=60) and group B (IP regimen, n=60).</p><p><b>RESULTS</b>In group A, 58 patients were evaluable. The response rates were 58.62%(34/58), 65.58%(17/26) and 53.12% (17/32) in whole group, untreated patients, and retreated patients, respectively. The median duration of survival was 11.3 months. One-year survival rate was 40.0%. In group B, 59 patients could be evaluated. The response rates were 40.68%(24/59), 63.33%(19/30) and 17.24%(5/29) in whole group, untreated patients, and retreated patients, respectively. The median duration of survival was 9 months and 1-year survival rate was 36.7%. There was no significant difference in objective response rate among all the patients and the patients with no prior treatment between the two groups ( P > 0.05, P > 0.05). However, among retreated patients, the response rate in group A was remarkably higher than that in group B ( P < 0.05). The main dose limiting toxicity was myelosuppression. Leukopenia at grade III+IV was significantly higher in the NIP arm than in the IP arm ( P < 0.05).</p><p><b>CONCLUSIONS</b>NIP yields a higher response rate than IP does in retreated patients, with acceptable toxicity, which can be the first line regimen in the retreatment of advanced NSCLC. IP regimen showes a similar response rate and less toxicity in initial patients, compared with NIP regimen, so it might be considered a relevant regimen in initial patients with advanced NSCLC.</p>
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Objective To evaluate the effect of early endoscopic treatment for patients with severe acute biliary pancreatitis.Methods Ninety patients with severe acute biliary pancreatitis were divided into three groups: Thirty patients underwent early endoscopic treatment(group A),30 patients underwent expectant treatment(group B) and 30 patients receive surgical treatment(group C),respectively.complications and safety were evaluated.Results The symptoms and signs disappeared in all 30 cases after early endoscopic treatment.All the 30 patients(100%) of endoscopic treatment(group A) were cured which significantly better than the other groups(group B 83.3% and group C 93.3%,respectively).Conclusions Early endoscopic treatment relieves the orifice obstruction of biliary and pancreatic ducts,decreases the pressure of biliary and pancreatic ducts,it is safe,mini-invasive and highly effective for the treatment of severe acute biliary pancreatitis.
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Objective To analyze the independent factors affecting the prognosis of gastrointestinal stromal tumor(GIST) patients undergoing radical operation.Methods The clinical characteristics and follow up data of the 97 patients with GIST underwent radical opsration from January,2001 to January,2003 in our hospital were retrospectively analyzed by univariate and multivariate methods.Results In the univariate analysis of the 97 cases,gender,tumor location,tumor size,tumor cell type,necrosis,mitotic count,and Gleevec administration postoperatively were found to be related to the prognosis of GIST.Multivariate Cox model analysis showed that tumor location,tumor size,tumor cell type,necrosis,mitotic count,and Gleevec administration postoperatively were independent prognostic factors for patients with GIST.Conclusions Tumor location,tumor size,tumor cell type,necrosis,mitotic count are important prognostic factors for patients with GIST undergoing radical operation.
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Objective To evaluate the effect of mini-abdominal incision for choledochoscopy via cystic duct in exploration of the common bile duct(CBD).Methods The right subcostal incision was 4-6 cm in length.Choledochoscopy via cystic duct stump for exploration and extraction of CBD stones was done in 135 cases.Results The CBD stone was removed in 109 of 135 patients(80.7%).The CBD exploration was negative in 26 cases(19.3%)and retained CBD stones occurred in 4 cases(3.0%).One case(0.7%)had intraoperative injury of common bile duct,2 cases(1.5%)had tear of cystic duct stump,and 2 cases(1.5%)had biliary leakage,all the 5 cases were recovered after treatment.Conclusions The mini-abdominal incision with choledochoscopy via cystic duct for exploration of the CBD is safe and feasible.
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Objective To study the optimal procedure of digestive tract reconstruction after total gastrectomy.Methods The clinical data of 122 patients who underwent total gastrectomy in the recent 6 years were(analyzed) retrospectively.Three types of reconstruction procedures,including Orr-type Roux-en-Y(esophagojejunostomy),P-type jejunal pouch Roux-en-Y esophagojejunostomy and distal jejunal aboral pouch Roux-en-Y esophagojejunostomy,were performed.Results There were no significant differences among the three procedures in heartburn and the amount of food intake,frequencies of meal,weight loss,dumping(syndrome),and hemoglobin and albumin levels.The operation time in P-type group was longer than the other two group(P