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Objective: To discuss the clinical and pathological features of double primary cancer (DPC) in the stomach and colorectum. Methods: The data of 50 patients who were diagnosed with DPC and underwent surgery at The Affiliated Tumor Hospital of Xinjiang Medical University between June 2015 and June 2018 were retrospectively analyzed. The data that were analyzed included the age of onset, gender ratio, tumor stage, pathological type, and other characteristics. Thirty patients had synchronous DPC (SC), and 20 had metachronous DPC (MC). Statistical analysis was performed in the two groups. Results: The mean age was (65.44±11.94) years with 37 men and 13 women. The ratio of men to women was 2.85:1. The tumor-node-metastasis (TNM) stages were mainly stagesⅡ-Ⅲ(47/50, 94.0%). The pathological pattern was mainly adenocarcinoma (35/50, 70.0%). There was no significant difference in the pathological type, differentiation degree, and tumor stage between the first and second primary cancers in patients with MC (P<0.05). The age of patients diagnosed with SC was older than that of patients diagnosed with MC [(68.87±8.83) years vs. (60.30±14.22) years] (P=0.011). SC and MC showed no differences in gender, TNM stage, pathological type, differentiation degree, and smoking and alcohol consumption status. Conclusions: Screening for second primary cancer should be strengthened over the age of 50 years for patients with gastric cancer or colorectal cancer.
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Objective To investigate the analgesic effect of perioperatively intravenous Parecoxib for pain management after laparoscopic surgery of colorectal cancer,and whether it can reduce opioid requirements and opioid-related adverse effects.Methods 116 patients ungergoing laparoscopic colorectal resection were randomized to receive either intravenous parecoxib at a dose of 40 mg 15 minutes before induction of anesthesia followed by 40 mg every 12 hous for 72 hours (Parecoxib Group,n =59) or without the use of Parecoxib (control group,n =57).All patients had access to patient controlled analgesia (PCA) with Sufentanil within 48 hours after the operation.Patients were assessed with respect to Visual Analog Scale (VAS) from 0-10,and supplementary opiates were provided when VAS was above 4.Results Compared with control group,Parecoxib group had lower VAS scores at rest,while coughing and mobilization at each time point after the operation (P ＜ 0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05).The postoperative hospital stay was less in Parecoxib group (P ＜0.05),and Parecoxib group consumed less opium on post-op day 1 [0 mg(0,7.5) vs.10 mg(7.5,15),Z=2 364,P =0.000],and less total opium consumption in 5 days after surgery [20 mg (10,25) vs.42.5 mg (37.5,45),Z =1 770,P =0.000].Conclusions The use of Parecoxib with PCA Sufentanil in postoperative analgesia resulted in comprehensive enhancement of the analgesic efficacy,reducing the opioid requirement,promoting postoperative recovery and shortening hospital stay.
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<p><b>OBJECTIVE</b>To investigate the treatment methods and prognostic factors of high-risk gastrointestinal stromal tumor (GIST).</p><p><b>METHODS</b>Clinicopathological date and follow-up data of 108 patients with high-risk GIST from January 2002 to February 2016 treated at our department were retrospectively reviewed. The patients were divided into two groups according to whether they received adjuvant therapy after surgery. A group of patients received imatinib adjuvant therapy(adjuvant therapy group, 69 cases). Another group of patients were not treated with imatinib until they were found to have disease progression(follow-up observation group, 39 cases). The survival rate and recurrence rate were compared between two groups, and the risk factors of prognosis were analyzed by Cox regression model.</p><p><b>RESULTS</b>All the cases were followed up with a median time of 48 months(1 to 161 months). Recurrence and / or metastasis occurred in 57(52.8%) patients during follow-up. The postoperative recurrence and / or metastasis rate was 34.8%(24/69) and 84.6%(33/39) respectively in the adjuvant therapy group and the follow-up observation group, the difference was statistically significant(P=0.000). Twenty-eight(25.9%) patients died. The 1-, 3-, 5-, 10-year survival rates of the 108 patients undergoing follow-up were estimated to be 99.8%, 87.7%, 76.0% and 42.7% respectively. The 5-year survival rates were 79.3% and 72.3% in the adjuvant therapy group and the follow-up observation group, the difference was not statistically significant (P=0.648). Univariate analysis showed that mitotic count, radical degree and tumor rupture were predictive factors of survival after resection of primary high-risk GIST (all P<0.05). Multivariate analysis using Cox regression model revealed that the mitotic count (P=0.013, RR=2.400, 95%CI:1.206 to 4.779) and radical degree(P=0.003, RR=3.968, 95%CI:1.609 to 9.784) were independent prognostic factors.</p><p><b>CONCLUSION</b>Comprehensive treatment of radical surgery combined with targeted therapy and close followed up can lead to better long-term survival of high-risk patients with GIST.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Agents , Therapeutic Uses , Combined Modality Therapy , Disease Progression , Follow-Up Studies , Gastrointestinal Stromal Tumors , Drug Therapy , Pathology , General Surgery , Imatinib Mesylate , Therapeutic Uses , Multivariate Analysis , Neoplasm Recurrence, Local , Postoperative Period , Prognosis , Retrospective Studies , Risk Factors , Survival RateABSTRACT
Objective To investigate the value of the levels of urinary NT-proBNP whether is similar with the levels of blood NT-proBNP for the diagnosis of chronic heart failure.Methods 79 patients with chronic heart failure (NYHA Ⅰ~Ⅳ)as a research group,and 53 healthy people as a control group,the levels of urinary and blood NT-proBNP on two groups were measured respectively by Roche cobas h 232 cardiac markers detector and compared the difference of the levels of urinary NT-proBNP and blood NT-proBNP between the two groups.Results The levels of urinary and blood NT-proBNP in pa-tients with chronic heart failure were much higher than those in healthy subjects,respectively (P <0.01).The concentration of urinary NT-proBNP increased gradually with more severe symptoms.The level of urinary NT-proBNP was positively cor-related with the levels of blood NT-proBNP.Conclusion The levels of urinary NT-proBNP is a new candidate marker for the diagnosis of chronic heart failures and it provides a similar accuracy with the levels of blood.
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Objective To conduct nutritional risk screening and evaluate the relationship of nutritional risk to complication rate and quality of life in tuberculosis inpatients of Shenzhen. Methods A total of 1 374 patients from tuberculosis department and surgery department in the third people′s hospital of Shenzhen were consecutively enrolled. Data were collected on the nutritional risk screening, complication and quality of life. Results The occurence of nutritional risk at admission of inpatients with tuberculosis among total , younger , elderly patients was 77.7%, 70.9%, 88.9%, respectively. There was a significant increase in the occurrence from admission to 2 weeks in all patients (P < 0.05). On admission and 2 weeks after admission or discharge, the occurence in those patients ≥ 65 years was significantly higher than that in the younger ones (P < 0.05) On the scales of quality of life (SF-36), the scores of physical functioning, role-physical, bodily pain, fatigue and general health were significantly lower than in the patients at risk. Conclusion A large proportion of inpatients of tuberculosis is at nutritional risk and tended to be worsen during the course of admission , which has associated with increased complication rate and lower scores of quality of life.
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Objective To investigate the advantages and prognosis of extended full-thickness transanal local excision in treating early stage low rectal cancer.Methods Clinical gastrointestinal surgery data of transanal local excision surgeries of 163 patients from January 2003 to December 2010 was reviewed.According to the different operation modes,the patients were divided into group A (transanal local expanded full-thickness resection group,78 cases),group B (traditional open operation group,85 cases),to observe the operation status and survival time.Results The operative time [(43.17±12.31) min vs (216.41±60.12) min,t =12.924,P =0.011],the volume of bleeding (30 ml vs 110 ml,Z =-2.522,P =0.012),the postoperative intestinal function recovery time [(1.61±0.76) d vs (3.72±1.46) d,t =2.681,P =0.037),the postoperative hospital stay [(5.39±1.21) d vs (22.79±8.31) d,t =6.964,P =0.023),the rate of complication [3.85 ％ (3/78)vs 24.71％ (21/85),x2 =14.096,P ＜ 0.001] of group A and group B showed statistical significance (P ＜ 0.05),1 year,3 years,5 years survival rate of group A and group B were 100.0 ％,93.5 ％,89.5 ％ and 98.8 ％,95.2 ％,90.3 ％ respectively,the average survival time were respectively 57.08 months and 57.49 months,with no statistical difference (P ＞ 0.05).Conclusions The extended full-thickness transanal local excision in treating early stage low rectal cancer can achieve the effect of laparotomy.Compared with laparotomy,it has more advantages such as shorter operative time,less bleeding,less invasive,faster postoperative recovery,and fewer occurrences of complications.
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Objective: This study investigates the effect of docetaxel + oxaliplatin + S-1 (DOS program) in treating advanced gastric cancer and surgical safety assessment. Methods: Fifty patients with advanced gastric cancer admitted to the Department of Gastrointestinal Surgery, The Affiliated Tumor Hospital of Xinjiang Medical University between January 2011 and May 2012 were enrolled in this study. These patients were randomized into the observation arm (n=25) and the control group (n=25). The observer group was administered three cycles of chemotherapy using a DOS program before surgical treatment, whereas the control group underwent surgery. Results: Compared with the control group, the clinical response rate (64.0%), D2 lymph node dissection rate (88.0% vs. 64.0%), and R0 resection rate (92.0%vs. 68.0%) in the observation group were significantly higher (P0.05). The patients exhibited good tolerance to chemotherapy, with bone marrow suppression and gastrointestinal reactions as the main adverse effects. Conclusion:The DOS program is a highly efficient, advanced gastric cancer neoadjuvant chemotherapy. The program can improve patient survival and has good patient tolerance and compliance, good peri-operative safety, high R0 resection rate, and low postoperative lymph node metastasis rate.