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Objective To investigate clinicopathological features of pancreatic carcinoma with or without lymph node metastasis,and to explore the relationship between the lymph node metastasis and the prognosis of pancreatic carcinoma.Methods The clinical and follow up data of 216 patients with pancreatic carcinoma from 2001 to 2015 were retrospectively analyzed.Kaplan-Meier method was used to estimate survival rates and plot survival curves.Results The postoperative survival time was 4-86 months,the median survival time was 19 months,and the postoperative 1,3 and 5 year survival rates were 65.1％,33.8％,20.5％,respectively.Patients with positive lymph node metastasis were with 1,3,5 year survival rates of 36.5％,12.2％,0％,those with no lymph node metastasis were with 1,3,5 year survival rates of 70.3％,38.0％,21.4％ (x2 =15.803,P ＜ 0.001).Conclusions Lymph node metastasis in patients with pancreatic cancer is worse than that without lymph node metastasis.Lymph node metastasis is one of the main prognostic factors in patients after radical resection of the pancreatic cancer.
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Objective To compare the safety and efficiency between simultaneous resection and staged resection of synchronous colorectal liver metastases.Methods A systematic literature search was performed in PubMed,Embase,Cochrane Library,OVID,Web of Science,WanFang Data,CBM,VIP and CNKI databases for relevant articles published from January 2000 to July,2017.The meta-analysis was performed by RevMan 5.3.The primary outcomes were peri-operative complications,postoperative mortality,five-year survival rate.Results 25 studies with a total of 5 631 patients were finally included.The results of meta-analysis showed that simultaneous and staged resections were similar in peri-operative complications (OR =0.90,P =0.39),postoperative mortality (OR =1.23,P =0.29) and five-year survival rate (OR =1.03,P =0.68).Conclusions Simultaneous resection is safe and efficient in the treatment of patients with SCLMs.However,the results should be interpreted and applied prudently due to the lower level of evidence and the existence of heterogeneity.
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Objective To compare the clinical efficacy between pediatric ABO-incompatible liver transplantation (ILT) and ABO-compatible liver transplantation (CLT) by Meta-analysis. Methods Relevant studies published until May 2017 were electronically retrieved from PubMed, Embase, Cochrane library, China national knowledge internet (CNKI),Wanfang and VIP databases. According to the inclusion and exclusion criteria, the publications eligible were screened and clinical data were extracted. Meta-analysis was performed using the random or fixed effect model analyses with Review Manager 5.3 statistical software. Results Eleven retrospective cohort studies in English were selected. Meta-analysis demonstrated that the postoperative 1-year survival rate of the recipients in the ILT group was significantly lower than that in the CLT group [odds ratio (OR)=0.64, 95% confidence interval (CI) 0.49-0.83, P=0.0007)]. In the ILT group, the incidence of postoperative rejection reactions was considerably higher compared with that in the CLT group (OR=1.96,95% CI 1.03-3.72, P=0.04). No statistical significance was observed in the postoperative 3- and 10-year survival rate of the recipients, 1-, 3- and 10-year survival rate of the graft and the incidence of postoperative biliary tract complications between two groups (all P>0.05). Conclusions Compared with their CLT counterparts, the 1-year survival rate of the ILT recipients is lower, whereas the incidence of rejection reactions is higher. However, the long-term survival rate of both the recipient and graft and the incidence of biliary tract complications do not significantly differ between CLT and ILT. ILT is a relatively ideal option for emergent patients or those lacking of liver graft with compatible blood group for a long period of time.
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Objective To compare the safety and efficiency of nasogastric ( NG ) feeding with nasojejunal (NJ) feeding in treating severe acute pancreatitis ( SAP).Methods The terms NG tube,NJ tube,SAPand enteral nutritionwere used for literature search in PubMed , Embase, Cochrane Library, WanFang and CNKI databases and the publication deadline was June 1, 2016.Random effect model was used for Meta analysis .Results A total of 5 random clinical trials involving 264 patients ( 136 in NG group and 128 in NJ group ) were included .There was no statistical difference on the incidence of adverse events (mortality:RR=0.77, 95%CI 0.42~1.41, P=0.39; infection complications: RR=0.77, 95%CI 0.45~1.30, P=0.39; digestive complications: RR=1.26, 95%CI 0.73~2.16, P=0.41; stopping nasogastric proportion:RR=0.66, 95%CI 0.10~4.10, P=0.65;MODS rate:RR=0.98, 95%CI 0.71~1.35, P=0.90; the percentage of energy balance: RR=1.00, 95%CI 0.97~1.03, P=0.39 and the average length of hospital stay:RR=0.98, 95%CI 0.71~1.35, P=0.90).Conclusions NG feeding was safe and effective , which was comparable with NJ feeding .NG feeding was more convenient with a higher clinical value .
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Objective To analyze the correlation between the status of the donation after brain and cardiac death (DBCD)donors and postoperative recovery of the organ function in the liver and renal transplant recipients.Methods The assessment data and organ protection measures of 12 DBCD donors admitted to the Organ Transplantation Center in Sichuan Provincial People’s Hospital from August 2011 to November 2013 were retrospectively analyzed.The parameters of postoperative recovery of 12 liver and 22 renal transplant recipients were also assessed.The correlation between the parameters of the donors and postoperative recovery of the liver and renal transplant recipients was statistically analyzed.Results Among 12 liver transplant recipients,1 patient had primary non-function (PNF)(1 /12,8%)and 11 cases developed delayed graft function (DGF) after renal transplantation (11 /22,50%).Intensive care unit (ICU)period,liver function,maintaining systolic blood pressure (SBP),blood coagulation function,blood glucose level and electrolyte (Na +/K +) were significantly correlated with postoperative recovery of the liver and kidney function in the recipients (all in P <0.05 ).Age,cause of brain death,maintaining diastolic blood pressure (DBP),activated partial thromboplastin time (APTT)and pH of arterial blood gas (ABG)were associated with postoperative recovery of the liver function.Total bilirubin and white blood cell count (WBC)were correlated with postoperative recovery of kidney function.Conclusions DBCD donors cater to the specific conditions in China.The incidence of postoperative PNF in liver recipients is relatively low whereas and the incidence of DGF after renal transplantation is relatively high.Assessment of the DBCD donors and organ protection measures should be specifically taken to enhance the clinical efficacy of liver and renal transplantation from DBCD donors.
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Objective To evaluate the effects of asymptomatic arteriovenous fistula closure on left ventricular morphology and function in renal transplant recipients.Methods Between March 2007 and March 2011,a total of 60 patients undergoing consecutive kidney transplantation with asymptomatic arteriovenous fistula were divided randomly into two groups: arteriovenous fistula closure group,and non-arteriovenous fistula closure group.By using echocardiography,the changes in CO,CI,EF,LVEDV and LVMI were analyzed.Results At 12th month after transplantation,the values of CO,LVEDV and LVMI were significantly lower than those before transplantation (P＜0.05).The value of CI also showed a tendency to decrease (P＞0.05),and the value of EF was increased significantly (P＜0.05).At 6th month after arteriovenous fistula closure (18 months after transplantation),the values of CO,CI,LVEDV and LVMI were significantly lower than those before arteriovenous fistula closure (12 months after transplantation) (P＜0.05),and the value of EF was increased significantly (P＜0.05),but the values of CO,CI,EF,LVEDV and LVMI remained unc(b)anged in controls (P＞0.05).At 18th month after transplantation,the values of CO (4.4 ±0.8 L/min),CI [3.0 ± 0.8 L·min-1·m-2],LVEDV (110.0 ± 17.4 ml) and LVMI (114.7 ± 42.5g/m2) in trial group were significantly lower than the values [CO: 5.1 ± 0.9 L/min,CI: 3.5 ± 1.0L·min-1·m-2,LVEDV: 121.4±19.3 mL,LVMI: 138.4±44.1 g/m2] in controls (P＜0.05),and the value of EF (75.2％ ± 7.4％ vs.70.5％ ± 8.2％) significantly higher (P＜005).Conclusion In both groups,kidney transplantation benefits significantly the regression of cardiac mass,cardiac index and left ventricular dimensions,but closure of asymptomatic AVF induces more significant regression.