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Objective@#To investigate the clinical features and prognostic factors of extrahepatic biliary neuroendocrine neoplasms(EB-NENs).@*Methods@#The clinical data and survival of 21 patients with EB-NENs admitted from May 2014 to May 2018 were analyzed retrospectively.@*Results@#These 21 EB-NENs patients accounted for 1.6% (21/1313) of all biliary tract neoplasms treated during the study period. Seven (33.3%) cases had lymph node metastasis. Five (23.8%) suffered from distant metastasis. The follow up time was (4~46.5) months with median survival time of (23.23 ±4.17) months. Univariate analysis showed that the risk factors for survival were tumor TNM stage (χ2=9.066, P=0.003), lymph node metastasis(χ2=6.399, P=0.011) and distant metastasis (χ2=9.808, P=0.002). By multivariate analysis, independent risk factors were tumor TNM stage(P=0.008, RR=3.003, 95% CI: 1.332~6.774), lymph node metastasis(P=0.023, RR=5.382, 95% CI: 1.261~22.971) and distant metastasis or not(P=0.007, RR=7.423, 95% CI: 1.730~31.851).@*Conclusion@#EB-NENs was a rare malignant tumor with poor prognosis. Tumor TNM stage, lymph node metastasis and distant metastasis were independent prognostic factors for EB-NENs patients.
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Objective To investigate the clinical features and prognostic factors of extrahepatic biliary neuroendocrine neoplasms(EB-NENs).Methods The clinical data and survival of 21 patients with EB-NENs admitted from May 2014 to May 2018 were analyzed retrospectively.Results These 21 EB-NENs patients accounted for 1.6％ (21/1313) of all biliary tract neoplasms treated during the study period.Seven (33.3％) cases had lymph node metastasis.Five (23.8％) suffered from distant metastasis.The follow up time was (4 ～ 46.5) months with median survival time of (23.23 ± 4.17) months.Univariate analysis showed that the risk factors for survival were tumor TNM stage (x2 =9.066,P =0.003),lymph node metastasis(x2 =6.399,P=0.011) and distant metastasis (x2 =9.808,P=0.002).By multivariate analysis,independent risk factors were tumor TNM stage (P =0.008,RR =3.003,95％ CI:1.332 ～ 6.774),lyraph node metastasis (P =0.023,RR =5.382,95 ％ CI:1.261 ～ 22.971) and distant metastasis or not(P =0.007,RR =7.423,95％ CI:1.730 ～ 31.851).Conclusion EB-NENs was a rare malignant tumor with poor prognosis.Tumor TNM stage,lymph node metastasis and distant metastasis were independent prognostic factors for EB-NENs patients.
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Objective To evaluate pelvic peritoneum reconstruction with barbed suture and irrigation and negative pressure drainage in laparoscopy rectal anterior resection for locally advanced rectal cancer.Methods From 2014 to 2018 159 locally advanced rectal cancer patients treated by laparoscopy were derided into study group (n =76),and those received gravity drainage without pelvic peritoneum reconstruction (n =83).Results There were not significant difference in the operation time between the two groups [(165 ± 18) min vs.(160 ± 17) min,t =0.098,P =0.069].There were significant differences in postoperative drainage tube indwelling duration [(5.7 ± 2.4) d vs.(7.4 ± 3.7) d,t =3.309,P =0.001],intraabdominal infection (7％ vs.17％,x2 =3.991,P =0.046) and anastomotic leakage (4％ vs.13％,x/2 =4.280,P =0.039).There was no significant difference in anastomotic stenosis (5％ vs.10％,x2 =1.088,P =0.297) and intestinal obstruction (9％ vs.11％,x2 =0.117,P =0.732) between the two groups.Conclusion It is simple,safe and reliable to perform pelvic peritoneal reconstruction using barbed suture,combined with irrigation and negative pressure drainage,it can decrease drainage tube indwelling duration,reduce the incidence of intraabdominal infection and anastomotic leakage.
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Objective To investigate the efficacy and safety of preoperative regional intra-arterial chemoembolization combined with systemic vein chemotherapy in the treatment of locally advanced gastric cancer.Methods The clinical data of 78 locally advanced gastric cancer patients treated by radical D2 gastretomy from January 2010 to December 2012 were retrospectively analyzed.Patients were devided into treatment group receiving regional intra-arterial chemoembolization combined with systemic vein chemotherapy (n =36),and those with preoperative systemic vein chemotherapy (n =42) 3 to 4 weeks before surgery.Systemic chemotherapy with mFOLFOX6 was started after 5 weeks of surgery in the two groups.Results The incidence of toxicity reaction and postoperative anastomotic leakage were lower in treatment group than in control group,all P ＜ 0.05.The 1-year recurrence and overall survival rate were similar between the two groups (all P ＞ 0.05).The 3-year liver metastasis rate was higher in treatment group than in control group (x2 =4.063,P ＜ 0.05).The 3-year survival rate was higher than that of the control group(x2 =4.396,P ＜ 0.05).Conclusions Preoperative systemic vein chemotherapy combined with regional intra-arterial chemoembolization decreases toxicity reaction,anastomotic leakage and liver metastasis,while prolonging 3-year overall survival.
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OBJECTIVE:To explore the effects of umbilical therapy by Rheum plamatum combined with early colonic irriga-tion on the quality of life in elderly patients with colon stoma. METHODS:80 patients underwent radical resection of abdominoperi-neal rectal carcinoma were randomly divided into control group and observation,with 40 cases in each group. Control group was given early colonic irrigation;observation group was additionally given umbilical therapy by R. plamatum. Treatment course of 2 groups lasted for one month,and both were followed up for 6 months after treatment. The quality by life in 2 groups was evaluated by using QLQ-C30,and therapy costs were calculated before and after treatment. RESULTS:Compared with before treatment, function score and total health score of 2 groups improved significantly in 1,3,6 months after treatment,while symptom score and single item score decreased significantly,with statistical significance(P<0.05). In 1,3,6 months after treatment,role func-tion,social function,cognitive function,emotional function and total health score of observation group were significantly higher than those of control group,and insomnia and pain score were significantly lower than control group,with statistical significance (P<0.05). 3 and 6 months after treatment,diarrhea and economic difficulty score of observation group were significantly lower than those of control group,with statistical significance(P<0.05). 1 months after treatment,loss of appetite score of observation group were significantly lower than those of control group,with statistical significance (P<0.05). 6 months after treatment, fa-tigue,nausea and vomiting score of observation group were significantly lower than those of control group,with statistical signifi-cance (P<0.05). 6 months after treatment,nursing cost,drug cost and total cost of observation group were significantly lower than those of control group,with statistical significance(P<0.05). CONCLUSIONS:The umbilical therapy by R. plamatum com-bined with early colonic irrigation can improve the quality of life in elderly patients with colon stoma significantly and reduce treat-ment cost.
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Objective To investigate the efficacy and safety of preoperative systemic chemotherapy combined with regional intraarterial chemoembolization in the treatment of locally advanced gastric cancer.Methods Clinical data of 158 patients of locally advanced gastric receiving neoadjuvant chemotherapy cancer from January 2008 to July 2012 were retrospectively analyzed.Patients were divided into two groups:those who received preoperative systemic chemotherapy plus regional intraarterial chemoembolization (group A,n =78) and those who received preoperative systemic chemotherapy (group B,n =80).Radical resection was perfomed after 3 to 4 weeks.Results The overall satisfactory rate was significantly higher (60％) in group A compared with 42％ in group B (x2 =6.136,P ＜0.05).The incidence rate of toxicity reaction (except nausea) and postoperative conplications such as anastomotic leakage,intestinal obstruction,poor wound healing,abdominal infection and pulmonary infection were all lower in group A than in group B (all P ＜ 0.05),while the incidence rate of nausea was higher in group A than in Group B (x2 =16.458,P ＜ 0.01).There was no perioperative mortality related to neoadjuvant therapy in two groups.Conclusions Preoperative systemic chemotherapy combined with regional intraarterial chemoembolization was associated with better efficacy,and fewer toxicity reactions and postoperative complications in the treatment of locally advanced gastric cancer.