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Objective:To investigate the prognostic factors for long-term outcomes in elderly patients after colorectal cancer(CRC)resection.Methods:Patients(aged ≥60 years)undergone CRC resection in 2004 with more than 10-year survival records from the SEER database were retrospective analyzed.Potential prognostic risk factors for survival, such as age, sex, race, marital status, tumor site and size, clinical staging, TNM staging and lymph node clearance(lymph nodes dissection)were assessed by using the Cox proportional hazards model.Results:A total of 15 775 CRC patients were enrolled in this study, including 7 828(49.6%)males and 7 947(50.4%)females.The 10-year overall survival(OS)was shorter in patients aged over 80 years than in patients aged 60 years( P=0.000). Multivariate analysis showed that females had a better 10-year OS than males( P=0.000). Univariate analysis showed no difference in 10-year OS between females and males( P=0.837). Compared with married patients, single, unmarried or widowed patients displayed a poorer 10-year OS( P=0.000)and that patients with cecum and appendix cancer had the worst 10-year OS( P=0.000), but it did not find any difference between primary tumors in different sites.Patients with a tumor size over 5 cm or at advanced stage(T3-T4, N1-N2 and M1)had a low 10-year OS( P=0.000). Conclusions:Old age, black race, single, unmarried or widowed status, tumor size over 5 cm and advanced stage(T3-T4, N1-N2 and M1)are negative predictors for 10-year OS in CRC patients and these findings can be used for education and treatment improvement strategies for CRC in future.
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With the development of fine anatomy,the concept of mesopancreas has been proposed,and total mesopancreatic excision continues to be used in clinical practice.This method has become the best surgical method of pancreatic head cancer.But due to deep position of pancreas and mesopancreas,the surrounding adjacent organs and complexs tructure and other factors,experts are concerned about at the presence or absence of the mesopancreas.So the scope of clinical surgical resection structural reservations are also controversial.This article reviewed the development of embryonic development of the pancreas and the research progress in order to provide theoretical support for the study of the fine anatomy of the pancreas and the precise operation of pancreatic diseases.
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Objective To explore the effects of fentanyl combined with ischemic post-processing on the pro-tein active concentration of superoside dismutase ( SOD) and the concentration of manlondialdehyde ( MDA) in rab-bits after myocardial ischemia and reperfusion injury.Methods The left anterior descending coronary artery were li-gated for 30 minutes and then reperfusion for 120 minutes to establish myocardial ischemia-reperfusion model of rab-bit.32 Japanese white rabbits were randomly divided into four groups by randomized block method(8 rabbits in each group):Sham-operated group(group S):seperate LAD without ligation;ischemia-reperfusion group(group I/R):re-store reperfusion directly;ischemic post conditioning group( group IPOC):restore reperfusion after ischemic post con-ditioning (filling for 30s/ischemia for 30s,three rounds);combination of fentanyl and ischemic post conditioning group( group F+IPOC):fentanyl post conditioning by ear marginal vein after ischemia 28 minutes,the dose was 5μg/kg, and after 30min,the rabbits was given ischemic post conditioning and then restored reperfusion.Then the differences in the protein active concentration of SOD and in the concentration of MDA were detected.Results The concentra-tion of MDA in the group F+IPOC were lower than that in the group IPOC[(3.52 ±0.45)mmol/mL vs (4.42 ± 0.47)mmol/mL,F =81.619,P <0.01].But the protein active concentration of SOD increased significantly [(178.38 ±20.32)U/mL vs (130.18 ±20.44)U/mL,F=59.359,P<0.01].Conclusion Fentanyl combined with ischemic post-processing can reduce the concentration of MDA and increase the protein active concentration of SOD significantly,which has the effect to decrease the myocardial ischemia and reperfusion injury.
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Objective To investigate the relationships of peripheral blood levels of interleukin 6 receptor (IL-6R),a disintegrin and metalloprotease with thrombospondin type 1 motifs (ADAMTS-1) and high sensitive C reactive protein (hs CRP) with Gensini score and Ambrose classification in patients with coronary heart disease,and to investigate the correlations of IL-6R,ADAMTS-1 and hsCRP levels with unstable coronary atherosclerotic plaques.Methods 328 patients undergoing coronary angiography were admitted,and 272 patients were diagnosed as coronary heart disease including 105 cases with acute myocardial infarction (AMI),126 cases with unstable angina peetoris (UA) and 41 cases with stable angina pectoris (SA).The 56 cases with no coronary artery stenosis were selected as control group.We detected the levels of IL-6R,ADAMTS 1 and hs-CRP in all patients,and then evaluated their Gensini scores by coronary angiography,and appraised the character of the plaque by Ambrose classification.Results The serum levels of IL 6R and ADAMTS-1 were higher in AMI and UA groups than in SA and normal control groups (all P＜0.05).The level of hsCRP was higher in AMI group than in UA,SA and control groups (all P＜0.05).The levels of IL-6R,ADAMTS 1 and hs-CRP were higher in complex lesion group evaluated by Ambrose classification than in simple lesion group and normal control group (all P＜0.05).ADAMTS-1 level was higher in simple lesion group than in normal control group (P＜0.05).The level of IL 6R was positively correlated with ADAMTS-1 levels (r=0.70,P＜0.05),while the serum IL-6R,ADAMTS-1 and hsCRP levels had no relationship with Gensini score in patients with coronary heart disease (all P＞ 0.05).Conclusions The IL-6R,ADAMTS-1 and hs-CRP levels can be the indexes for evaluating the plaque stability in patients with coronary heart disease,but have no relationships with the severity of coronary artery stenosis.