ABSTRACT
Objective The incidence of early allograft dysfunction (EAD) following deceased donor liver transplantation (DDLT) is high and affects the prognosis of the recipient. This study aimed to investigate the risk factors for EAD following DDLT. Methods This retrospective study included 79 cases of liver transplantation performed in the No. 900 Hospital of PLA Joint Logistic Support Force from January 2015 to December 2017. We collected the clinical data on the donors and recipients, propensity-score matched the pre- and intra-operative data on the recipients, and analyzed the risk factors for EAD identified among 17 donor-related variables. Results EAD was found in 26 (32.9%) of the recipients. Univariate analysis showed statistically significant differences between the EAD and non-EAD groups in the body mass index, warm ischemia time, and cold ischemia time of the donors (P < 0.05), and so did multivariate logistic regression analysis in the levels of serum sodium and alanine aminotransferase and warm ischemia time of the donors (P < 0.05). The best cut-off values of the serum sodium level and warm ischemia time of the donors for predicting post-operative EAD were 152.7 mmol/L and 8 min, respectively. Conclusion The serum sodium and alanine aminotransferase levels and warm ischemia time of the donors are independent risk factors for EAD after DDLT. The serum sodium level and warm ischemia time of the donors play an important role in evaluating the quality of deceased donor organs.
ABSTRACT
Objective To investigate and evaluate the iodine nutritional status of pregnant women and thyroid function of new born children in Jiangbei District, and provide the basis for rational iodine supplement. Methods From March 2014 to October 2014,three survey spots ( representing the city,the rural-urban continum,and the countryside) investigated a total of 161 pregnant women, whose urine were tested for urine iodine.Comparative analysis was done on iodine nutritional status in different geographical areas and different pregnancy.Blood of pregnant women and matching neonatal umbilical cord blood were tested for free triiodothyronine (FT3) and free thyroxine (FT4) and thyroid-stimulating hormone (TSH), with analysis on the relationship between the two. Results Median of the 161 pregnant women urine iodine level was 178.67μg/L.Among them,the iodine excess ( urine iodine,>500 mu g/L) accounted for 3.73%(6/161),iodine sufficiency (urinary iodine 250~499 μg/L) 33.54%(54/161),iodine moderacy (urinary iodine 150 ~249 μg/L) 22.36%(36/161),iodine deficiency (urinary iodine <150 μg/L) 40.37%(65/161).Urine iodine levels in pregnant women from three different geographical areas showed no statistical difference.Median urine iodine of pregnant women in third trimester was 148.23 μg/L.FT3 ,FT4 level of 36 neonatal was (2.60 ±0.35) and (13.81 ±1.63) pmol/L respectively,the average serum TSH level was 3.38 mIU/L.Pregnant women urine iodine level paired with FT3 , TSH level of neonatal serum showed no correlation (P>0.05),but were positively correlated in FT4 level (P<0.01). Conclusion Iodine nutritional status in most pregnant women in Jiangbei District is at appropriate levels,but there is still some iodine deficiency found in them.Urine iodine content of pregnant women in third trimester was low;FT4 levels were positively correlated in matched pregnant woman and newborn.In view of this situation,monitoring of the iodine nutritional status in pregnant women and neonatal thyroid function should be enhanced.
ABSTRACT
<p><b>OBJECTIVE</b>To assess the prognostic value of metastatic lymph node ratio in gastric cancer patients undergoing radical gastrectomy (D2).</p><p><b>METHODS</b>Prognostic analysis of 1042 gastric cancer patients undergoing radical gastrectomy (D2) was performed based on metastatic lymph node ratio (MLR), the N staging in the 6th and 7th edition of UICC staging system respectively. Homogeneity, discriminatory ability, and gradient monotonicity of these three staging methods were compared using linear trend χ(2), likelihood ratio χ(2) statistics and Akaike information criterion (AIC) calculations, respectively. The area under the ROC curve (AUC) was calculated to compare the prognostic value of these three staging methods.</p><p><b>RESULTS</b>The 5-year survival rate of 1042 patients was 47.5%. The metastatic lymph node ratio (P<0.01) and N staging of the 7th edition UICC (P<0.05) were independent prognostic factors according to univariate and multivariate analyses. The AUC was 0.754 in MLR staging group, higher than that in N staging of the 6th (0.692) and 7th (0.705) edition of UICC group. Compared to the 6th and 7th edition of UICC N staging group, homogeneity and linear curve were better and AIC value was lower in MLR staging group (7240.017 vs. 7364.073 and 7325.731).</p><p><b>CONCLUSION</b>Prognostic value of MLR staging is better than that of UICC N staging for patients undergoing radical gastric cancer resection. The MLR staging can be a new method of lymph node staging for gastric cancer patients.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Follow-Up Studies , Gastrectomy , Lymph Nodes , Pathology , Lymphatic Metastasis , Prognosis , Retrospective Studies , Stomach Neoplasms , Pathology , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To compare the advantages and disadvantages of laparoscopic versus open appendectomy in patients with chronic appendicitis.</p><p><b>METHODS</b>Two hundred twenty- four patients were divided into laparoscopic group (n=98) and open appendectomy group (n=126) according to individual willing. Prospective non- randomized study was performed to compare the operative time, operative bleeding, hospitalization time, the discovery and management concerned in operation. Abdominal pain in these chronic appendicitis cases was followed up.</p><p><b>RESULTS</b>The operative time was (54.8+/-21.8) min in open group and (51.8+/-18.0) min in laparoscopic group (t=0.80,P > 0.05). The operative bleeding was (18.6+/-23.3) ml in open group and (9.8+/-4.7) ml in laparoscopic group (t=3.13, P < 0.05). The hospitalization time was (8.9+/-5.3) d in open group and (6.8+/-3.0) d in laparoscopic group (t=2.66,P < 0.05). Twenty- five cases had abdominal adhesion in laparoscopic group, including 9 cases of adhesion around appendix, 6 cases of adhesion between ileocecum and anterior or lateral abdominal wall, 4 cases of adhesion between epiploon and abdominal wall or intestines, 6 cases of adhesion around colon and others. All adhesion had been dissected. Fourteen cases adhesion around appendix had been discovered in 126 cases of open group and dissected (chi(2) =7.95,P < 0.05). In follow- up research, 24 cases still had chronic abdominal pain in 98 case of open group, and 9 cases had chronic abdominal pain in 87 of laparoscopic group, the difference was significant (chi(2)=6.29,P < 0.05).</p><p><b>CONCLUSION</b>The laparoscopic appendectomy possesses more advantages in treating chronic appendicitis and can decrease the incidence of chronic abdominal pain after operation.</p>