ABSTRACT
The prognosis of gastroesophageal junction cancer is relatively poor given its special location and biological behavior. Surgery is the main treatment for adenocarcinoma of esophagogastric junction (AEG), but there is no consensus on the surgical method in different Siewert types. Based on the NCCN guideline and large-scale study results, this review believes that thoracogastroesophageal gastrectomy may benefit patients with Siewert type. In contrast, for patients with Siewert III, partial or total gastrectomy is recommended. However, for Siewert Ⅱ patients, for surgical method we should consider tumor stage, tumor size, distance from the distal end to the junction of the stomach and esophagus, and other factors. No matter which surgical method is selected, R0 resection and thorough lymph node dissection are the most important factors affecting the prognosis. In addition, perioperative chemoradiotherapy or chemotherapy following surgery and adjuvant chemotherapy can benefit some patients at local regional advanced stage. For patients at advanced stage, targeted therapy and immunotherapy are an option of treatment.
ABSTRACT
Purpose To study the clinicopathological characteristics of primary pancreatic neuroendocrine neoplasms. Method 60 cases of resected pancreatic neuroendocrine neoplasms according to the WHO (2010) classification of the digestive system of neuroen-docrine tumor to evaluate morphological standard, and combining with the literature to discuss the clinicopathological characteristics. Results Among the 60 cases, 23 cases were male patients, the rest were females, with male and female ratio of 1 ∶ 1. 61. The age of the patients were ranged from 19 to 69 years, with mean age of 49. 38 ± 11. 60 years. Tumor maximum diameter ranged from 0. 5 to 16 cm, and the mean diameter was 3. 29 ± 3. 53 cm. 30 cases located in the pancreatic head, 27 cases in the body and end of the pancre-as and 3 cases in the neck. Pathological examination showed the G1 (24 cases), G2 (25 cases), G3 (9 cases), and mixed adenon-euroendocrine carcinoma ( MANEC) in 2 cases. Immunohistochemical staining showed that NSE, CgA, Syn, and CD56 were diffusely positive expression. 45 patients were followed up for 4~80 months, 7 cases died, of which 1 case was G2, 4 cases were G3, and 2 ca-ses were MANEC. Conclusion Primary pancreatic neuroendocrine neoplasms is a relatively rare pancreatic malignant tumor, and the diagnosis is based primarily on histologic features and immunohistochemical examination. Accurate pathological assessment has impor-tant value to guide clinical treatment and prognosis.
ABSTRACT
Objective To discuss the training method to promote nursing error reporting initiative and investigate its effects on nursing error and accident incidence.Methods Totally 70 nursing units in our hospital were divided into the test group and the control group with 35 units in each group.One nurse was selected from each unit in the test group to composite the training group and received tripartite training,which included the relevant theoretical knowledge lectures,group discussions and analysis,training scenarios under the guidance of professional teachers.The control group received no special training.Before and after the training,the nulpses'attitude of the erroneous theory of cultural knowledge sharing.nursing error reporting initiative.and its effects on nursing error and accident rate were investigated and compared in the two groups by paired t test.Results After the training,the nurses'sharing the erroneous theory of cultural knowledge and attitude and willingness to report nursing error were statistically different(P＜0.01).Conclusions The training method Can improve initiative and willingness of nursing error reporting,decrease nursing error and accident incidence.