ABSTRACT
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.
ABSTRACT
Objective To survey the awareness and knowledge of Helicobacter pylori (Hp) infection among medical staff in Shanghai.Methods A questionnaire survey was conducted among 316 medical staff in Shanghai,including 74 gastroenterologists (GI),158 general practitioners (GP),and 68 gastroenterology nurses(GN),from October 2014 to September 2015.The questionnaire was designed according to the Fourth Helicobacter Pylori Infection Treatment Consensus Report of China (the Consensus).There were 4 parts and 29 questions in the questionnaire,including the knowledge and performance of the Consensus (8 questions),the indications of Hp eradication (8 questions),detection methods of Hp infection (7 questions)and the therapy of Hp eradication (6 questions).Results Total 300 valid questionnaires were received with a response rate of 94.9％ (300/316).The awareness rate of the Consensus in GI,GP and GN groups was 81.1％ (60/74),57.6％ (91/158) and 26.4％ (18/68),respectively (χ2 =43.67,P=0.001).GI had higher awareness rate than GP and GN in indications of Hp eradications (for peptic ulcer,mucosa-associated lymphoid malignancies,post-resection patients of early gastric cancer,and family history of gastric cancer,the χ2 values were 16.68,35.60,33.46 and 39.22,respectively;all P ＜0.05).In part of Hp infection detection methods,the responses of GI,GP and GN groups in C14 or C13 urea breathing test were 97.3％ (72/74),47.5％ (75/158) and 82.1％ (55/68),respectively (χ2 =72.38,P =0.001);in gastric mucosa tissue rapid urease test were 70.3％ (52/74),13.9％ (22/158) and 25.4％ (17/68),respectively (χ2 =78.22,P =0.001);in serological test were 58.1％ (43/74),20.9％ (33/158)and 44.8％ (30/68),respectively (χ2 =40.30,P =0.001);in gastric mucosa tissue section staining were 56.8％ (42/74),13.3％ (21/158) and 22.4％ (15/68),respectively (χ2 =50.35,P =0.00).In part of Hp eradication therapy the responses of GI,GP and GN groups in recommended bismuth quadruple therapy were 71.6％ (53/74),47.5％ (75/158) and 40.3％ (25/62),respectively (χ2 =15.93,P =0.001);in triple therapy were 27.0％ (20/74),51.6％ (81/158) and 42.0％ (26/62),respectively (χ2 =12.42,P =0.002);in 10 or 14 d for treatment duration were 78.4％ (58/74),78.5％ (124/158)and 67.6％ (46/68),respectively (χ2 =3.36,P =0.186).Conclusion Gastroenterologists are more likely to adhere with the Consensus than general practitioners and gastroenterological nurses in the management of Hp infection.The survey suggests that more attention should be paid for popularization and implementation of Hp infection guidelines and consensus among Shanghai medical staff,especially for GP and nurses.
ABSTRACT
Background:Antibiotic resistance rate of Helicobacter pylori (Hp) has increased year by year,which leads to the lowering Hp eradication rate,therefore,it is emergent to find an effective Hp eradication regimen.Aims:To explore the effect of influencing factors on Hp eradication rate,and to investigate the clinical effect of Bifidobacterium on re-eradication of Hp.Methods:A total of 203 Hp-positive patients with gastric diseases diagnosed by gastroscopy and pathology were enrolled.All the patients were given standard triple regimen for 2 weeks,Hp infection was re-examined 4 weeks after treatment.Fifty patients with Hp eradication failure were divided into two groups,patients in experimental group were given Bifidobacterium followed by quadruple therapy,patients in control group were given quadruple therapy directly.Effects of gender,age,gastroscopic diagnosis,pathological diagnosis and different regimens on Hp eradication rate were analyzed,and effect of Bifidobacterium on re-eradication of Hp was evaluated.Results:No significant difference in Hp eradication rate was found between male and female patients (P =0.740).Hp eradication rate decreased with the increase of age,however,the difference was not statistically significant (P =0.872).No significant differences in Hp eradication rate were found between different eradication regimens,gastroscopic diagnosis,and pathological diagnosis (P ＞ 0.05).Reeradication rate of Hp in Bifidobacterium group was higher than that in control group,but the difference was not statistically significant (88.0％ vs.72.0％,P =0.289).Conclusions:The effects of gender,age,gastroscopic diagnosis and pathological diagnosis,different eradication regimens on Hp eradication rate are not statistically different.However,Hp eradication rate is decreased with the increase of age.Hp eradication rate is relatively high in patients with chronic atrophic gastritis.Bifidobacterium can not increase the re-eradication rate in patients with the failure of first time Hp eradication therapy.