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Objective: To compare the short-term efficacy and long-term prognosis of laparoscopic and laparotomy radical resection for gallbladder cancer(GBC). Methods: From January 2010 to December 2020,the clinical data and survival information for 133 patients who underwent radical resection of GBC at the Department of Hepatopancreatobiliary Surgery,Zhejiang Provincial People's Hospital,were retrospectively collected. Eighty patients(23 males and 57 females) underwent laparoscopic radical resection and had a median age(M(IQR)) of 66.0(12.8)years(range:28.0 to 82.0 years). Fifty-three patients(45 males and 8 females) who received laparotomy were 63.0(6.0)years old(range:45.0 to 80.0 years old). There were no significant differences in age,gender,body mass index,preoperative albumin,preoperative total bilirubin,N stages,vascular invasion,peri-neural invasion or tumor differentiation between the laparoscopic and laparotomy group(all P>0.05). But there were significant differences in preoperative CA19-9(Z=-2.955, P=0.003), preoperative ALT level(Z=-2.801,P=0.031) and T stage (χ2=19.110,P=0.007) between the two groups. A non-parametric test was used for quantitative data. χ2 test or Fisher exact probability method was used for count data. Results: Patients in the laparoscopic group did not differ from those in the laparotomy group in terms of length of operation,number of lymph node yield,number of positive lymph nodes,the incidence of intraoperative gallbladder rupture,incidence of postoperative bile leakage,abdominal bleeding or abdominal infection,30-day mortality,90-day mortality, the incidence of incision implantation or peritoneal cavity metastasis(all P>0.05). Patients in the laparoscopic group showed less intraoperative bleeding(100.0(200.0)ml vs. 400.0(250.0)ml)(Z=-5.260,P<0.01),fewer days with drainage tube indwelling(6.0(3.8)days vs. 7.0(4.0)days)(Z=-3.351, P=0.001), and fewer postoperative days in hospital(8.0(5.0)days vs. 14.0(7.5)days)(Z=-6.079,P<0.01) than those in the laparotomy group. Patients in the laparoscopic group displayed better overall survival (P<0.01) and progression-free survival (P<0.01). Subgroup analysis for GBC of T1b-T2 and T3 stages revealed comparable overall survival and progression-free survival between the laparoscopic and laparotomy groups (P>0.05). Conclusions: Laparoscopic radical resection can achieve long-term survival for GBC comparable to that with open surgery. Laparoscopic radical resection has advantages over open surgery regarding surgical trauma and postoperative recovery.
Subject(s)
Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Gallbladder Neoplasms/surgery , Laparoscopy , Laparotomy , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
Objective:To determine the frequency of anti-HCV antibody positivity in patients with non-liver disease complaints, to explore whether anti-HCV positive patients had been properly advised and visited hepatologists for further assessments, and to investigate their clinical characteristics as well as the HCV treatment status.Methods:A hospital based survey of non-liver disease patients with anti-HCV positive and their attending physicians was conducted to determine: 1. were the patients adequately advised of the implication of anti-HCV positive finding; 2. to what extent the patients were aware of potential chronic liver disease associated with HCV infection and whether they sought for further assessments and care of hepatologists.Results:A total of 295 294 non-liver disease patients were tested for anti-HCV antibody, and 2 778 of them were found to be positive (0.94%). However, only 45.10% (1 253/2 778) of the anti-HCV antibody (+) patients were referred to hepatologists and received HCV RNA test. In addition, 34.10% (312/915) and 1.42% (13/915) of them had already advanced to cirrhosis and hepatocellular carcinoma (HCC), respectively. Further analysis showed that the patients who declined antiviral therapy were older, with lower education and lower income, possessed poorer knowledge on the risk of chronic hepatitis C, and had more severe liver diseases. Surprisingly, 65% of the surveyed physicians did not know the genotype-guided treatment duration suggested by the guidelines. Alarmingly, 22% of the surveyed physicians did not know the standard assays for the diagnosis of HCV infection.Conclusions:Our findings highlight the challenge and hidden enormous burden of chronic HCV infection among patients with non-liver disease complaints in China.
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This study aims to evaluate the clinical outcomes of endoscopic vein harvesting (EVH) for coronary artery bypass grafting (CABG) in obese patients.Totally,153 obese patients who underwent EVH (n=81) or standard bridging technique (SBT,n=72) in CABG surgery from May 2012 to October 2014 in our hospital were enrolled in this retrospective non-randomized controlled study.The general situation of operation,postoperative complications and short medium-term outcomes were analyzed.The baseline characteristics were similar between these two groups (P＞0.05).There were no statistical differences in total operation time (226±28 min vs.224±30 min,P＞0.05),number of damaged vessels (0.12±0.05 vs.0.16±0.06,P＞0.05) and short medium-term outcomes including revascularization rate (1.25％ vs.2.78％,P＞0.05),vessel dysfunction rate (11.25％ vs.11.11％,P＞0.05) and mortality (0.00％ vs.0.00％,P＞0.05).Use of EVH was associated with significant reduction of total harvesting time (41±6 min vs.63±11min,P＜0.05),incision length (4.4±1.1 cm vs.18.2±4.5 cm,P＜0.05) and postoperative lower extremity complications (P＜0.05).EVH can reduce the risk of wound complications,whereas does not influence short-and medium-term outcomes in obese patients.It can be considered a reliable procedure of harvesting vessel conduits for obese patients undergoing CABG.
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This study aims to evaluate the clinical outcomes of endoscopic vein harvesting (EVH) for coronary artery bypass grafting (CABG) in obese patients.Totally,153 obese patients who underwent EVH (n=81) or standard bridging technique (SBT,n=72) in CABG surgery from May 2012 to October 2014 in our hospital were enrolled in this retrospective non-randomized controlled study.The general situation of operation,postoperative complications and short medium-term outcomes were analyzed.The baseline characteristics were similar between these two groups (P＞0.05).There were no statistical differences in total operation time (226±28 min vs.224±30 min,P＞0.05),number of damaged vessels (0.12±0.05 vs.0.16±0.06,P＞0.05) and short medium-term outcomes including revascularization rate (1.25％ vs.2.78％,P＞0.05),vessel dysfunction rate (11.25％ vs.11.11％,P＞0.05) and mortality (0.00％ vs.0.00％,P＞0.05).Use of EVH was associated with significant reduction of total harvesting time (41±6 min vs.63±11min,P＜0.05),incision length (4.4±1.1 cm vs.18.2±4.5 cm,P＜0.05) and postoperative lower extremity complications (P＜0.05).EVH can reduce the risk of wound complications,whereas does not influence short-and medium-term outcomes in obese patients.It can be considered a reliable procedure of harvesting vessel conduits for obese patients undergoing CABG.
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Objective: To determine the frequency of anti-HCV antibody positivity in patients with non-liver disease complaints, to explore whether anti-HCV positive patients had been properly advised and visited hepatologists for further assessments, and to investigate their clinical characteristics as well as the HCV treatment status. Methods: A hospital based survey of non-liver disease patients with anti-HCV positive and their attending physicians was conducted to determine: 1. were the patients adequately advised of the implication of anti-HCV positive finding; 2. to what extent the patients were aware of potential chronic liver disease associated with HCV infection and whether they sought for further assessments and care of hepatologists. Results: A total of 295 294 non-liver disease patients were tested for anti-HCV antibody, and 2 778 of them were found to be positive (0.94%). However, only 45.10% (1 253/2 778) of the anti-HCV antibody (+) patients were referred to hepatologists and received HCV RNA test. In addition, 34.10% (312/915) and 1.42% (13/915) of them had already advanced to cirrhosis and hepatocellular carcinoma (HCC), respectively. Further analysis showed that the patients who declined antiviral therapy were older, with lower education and lower income, possessed poorer knowledge on the risk of chronic hepatitis C, and had more severe liver diseases. Surprisingly, 65% of the surveyed physicians did not know the genotype-guided treatment duration suggested by the guidelines. Alarmingly, 22% of the surveyed physicians did not know the standard assays for the diagnosis of HCV infection. Conclusions: Our findings highlight the challenge and hidden enormous burden of chronic HCV infection among patients with non-liver disease complaints in China.
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The current situation of medical equipment management informatization was introduced in China,and its deficiencies were described in standard,top-level design,data island and etc.A development strategy divided into preliminary,intermediate and advanced levels was put forward,which used business support,data fusion and iterative analysis as the tools.The steps and methods for medical equipment management informatization were studied,and it's pointed out industrial informatization was of great significance to enhance the quality,efficacy and ability of medical equipment management.
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The current situation of medical equipment management informatization was introduced in China,and its deficiencies were described in standard,top-level design,data island and etc.A development strategy divided into preliminary,intermediate and advanced levels was put forward,which used business support,data fusion and iterative analysis as the tools.The steps and methods for medical equipment management informatization were studied,and it's pointed out industrial informatization was of great significance to enhance the quality,efficacy and ability of medical equipment management.
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We explored the status of Babesia infection in natural hosts in Fujian Province.Rodents in Fujian Province were captured by the night trapping method during 2014-2016.Heart blood samples were collected.At the same time blood samples of ox,goats and dogs were also collected,from which the fragments of 18S rRNA gene of Babesia were amplified by polymerase chain reaction (PCR).Data on infection rate were analyzed with Chi-square or Fisher exact test to indicate statistical significance.Results showed that 5 917 cages were laid and 381 rodents were captured,density of rodent was 6.44％.The o verall Babesia infection rate in rodents was 7.61％,while infection rate in domesticated rodents was 1.68％,and the infection rate in wide rodents was 12.87％.The infection rate was higher in wild rodents than that in domesticated rodents,and the statistical analysis result revealed a significant difference.The infection rates in region of Central Fujian and Eastern Fujian was high,and no infection was found in Southern Fujian region.The statistical analysis result revealed a significant difference in infection rate among different regions.The infection rate of goats and dogs were determined to be 1.79 ％ and 0.55 ％,and no infection was found in ox.The infection rate was higher in rodents than that in other host animals,and the statistical analysis result revealed a significant difference.It is suggested that the rodents,especially the wide rodents are the main natural hosts of Babesia.
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<p><b>OBJECTIVE</b>To evaluate the incidence of depression and anxiety caused by pegylated interferon α (PegIFN-α) treatment for chronic hepatitis B (CHB) and assess the efficacy of intervention with escitalopram and alprazolam.</p><p><b>METHODS</b>A total of 165 CHB patients receiving PegIFN-α-based treatment for 12 weeks were assessed for moderate to severe depression and anxiety using Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder Scale (GAD-7)]. The patients identified to have moderate to severe depression and anxiety treated with escitalopram or alprazolam and the psychological condition of the patients was assessed at the 2nd, 4th and 8th weeks of the treatments.</p><p><b>RESULTS</b>In the 165 patients receiving PegIFN-α treatment, 51 patients developed moderate to severe psychiatric symptoms, incuding 37 (22.4%) with depression, 31 (18.8%) with anxiety, and 17 (10.3%) with both. The symptoms of depression and anxiety was both significantly improved by intervention with escitalopram (P=0.000); alprazolam was effective for anxiety (P=0.001) but did not produce obvious effects on depression (P=0.904). Nevertheless, alprazolam had a much better therapeutic effect than escitalopram on anxiety in these patients (t=-3.198, P=0.010).</p><p><b>CONCLUSION</b>Psychological symptoms are common in CHB patients receiving PegIFN-α treatment. The symptoms of depression and anxiety can be ameliorated by intervention with escitalopram and alprazolam, respectively.</p>
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We explored the status of Babesia infection in natural hosts in Fujian Province.Rodents in Fujian Province were captured by the night trapping method during 2014-2016.Heart blood samples were collected.At the same time blood samples of ox,goats and dogs were also collected,from which the fragments of 18S rRNA gene of Babesia were amplified by polymerase chain reaction (PCR).Data on infection rate were analyzed with Chi-square or Fisher exact test to indicate statistical significance.Results showed that 5 917 cages were laid and 381 rodents were captured,density of rodent was 6.44％.The o verall Babesia infection rate in rodents was 7.61％,while infection rate in domesticated rodents was 1.68％,and the infection rate in wide rodents was 12.87％.The infection rate was higher in wild rodents than that in domesticated rodents,and the statistical analysis result revealed a significant difference.The infection rates in region of Central Fujian and Eastern Fujian was high,and no infection was found in Southern Fujian region.The statistical analysis result revealed a significant difference in infection rate among different regions.The infection rate of goats and dogs were determined to be 1.79 ％ and 0.55 ％,and no infection was found in ox.The infection rate was higher in rodents than that in other host animals,and the statistical analysis result revealed a significant difference.It is suggested that the rodents,especially the wide rodents are the main natural hosts of Babesia.
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Angelica sinensis(Umbelliferae)is a worldwide-known medicinal plant and also a famous traditional Chinese medicinal herb. It is recorded to possess the efficacy of enriching the blood and invigorating the circulation of blood of the individual.Danggui was extensively applied to the treatment of gynecological disorders. Modern researches indicate that phthalides are main chemical components related to the bioactivities of A.sinensis, such as anti-tumor, analgesic and neuroprotective effect.The advances in studies on the structures and pharmacological activities of phthalides from A.sinensis are reviewed to provide references for further researches and utilization of their medicinal value.
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<p><b>OBJECTIVE</b>To evaluate the effect of long-term therapy with entecavir and Fufang Biejia Ruangan tablet in patients with chronic hepatitis B (CHB)-associated fibrosis and explore the synergistic therapy that accelerates the reversion of liver fibrosis.</p><p><b>METHODS</b>A total of 197 patients with CHB-associated fibrosis were recruited from Nanfang Hospital between June, 2010 and June, 2015. The patients were divided into two groups after matching for age, gender and liver stiffness measurement (LSM), namely group A (n=98) treated with Fufang Biejia Ruangan Tablet plus entecavir, and group B (n=99) to receive entecavir only. HBV DNA quantification, HBV serological indicators, blood biochemical indexes, and results of abdominal ultrasound and FibroScan were recorded every 12 weeks. FibroScan values were converted to Metavir staging.</p><p><b>RESULTS</b>Both groups showed significant decreases in serum levels of HBV DNA, alanine aminotransferase (ALT), and LSM value from baseline (all P<0.05). The median time to achieve Metavir fibrosis staging improvement were 72 weeks in group A and 96 weeks in group B (P<0.05), and the median time to achieve ALT and AST normalization were 12 and 24 weeks in Group A, respectively, significantly shorter than the time in group B (P<0.05). No significant difference was found between the two groups in HBV DNA undetectable rate and HBeAg seroconversion rate.</p><p><b>CONCLUSION</b>The combination therapy with Fufang Biejia Ruangan tablet and entecavir produces a stronger efficacy than entecavir alone in the treatment of chronic hepatitis B patients with liver fibrosis, and Fufang Biejia Ruangan tablet shows an obvious hepatoprotective effect in these patients.</p>
Subject(s)
Humans , Alanine Transaminase , Blood , DNA, Viral , Blood , Drugs, Chinese Herbal , Therapeutic Uses , Guanine , Therapeutic Uses , Hepatitis B e Antigens , Blood , Hepatitis B, Chronic , Drug Therapy , Liver Cirrhosis , Drug Therapy , TabletsABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of ginsenoside Rb1 on cerebral infarction volume as well as IL-1 beta in the brain tissue and sera of focal cerebral ischemia/reperfusion (I/R) injury model rats.</p><p><b>METHODS</b>The I/R rat model was established by using thread according to Zea-Longa. SD rats were randomly divided into five groups, i.e., the sham-operation group, the model group, the low dose ginsenoside Rb1 (20 mg/kg) group, the medium dose ginsenoside Rb1 group (40 mg/kg), and the high dose ginsenoside Rb1 group (80 mg/kg), 12 in each group. Rats in the sham-operation group only received middle cerebral artery occlusion (MCAO) but without thread insertion. The MCAO model was prepared in the rest 4 groups, followed by MCAO2 h later. Ginsenoside Rb1 at each dose was peritoneally administrated to rats in corresponding groups immediately after cerebral ischemia. Equal volume of normal saline was administered to rats in the sham-operation group. Rats' cerebral infarction volume, integrals of neurologic defect degree, expression of IL-1 beta content in the brain tissue and sera were observed 24 h after 2-h cerebral I/R.</p><p><b>RESULTS</b>In the model group, integrals of neurologic defect degree were improved (P < 0.01), IL-1 beta positive cells in the brain tissue increased and serum IL-1 beta content elevated (P < 0.05), when compared with the sham-operation group. In comparison of the model group, integrals of neurologic defect degree were lowered in the medium dose and high dose ginsenoside Rb1 groups (P < 0.05, P < 0.01). The cerebral infarction volume was all shrunken in each ginsenoside Rb1 group, IL-1 beta positive cells in the brain tissue decreased, and IL-1 beta content in serum reduced (P < 0.01, P < 0.05). Compared with the low dose ginsenoside Rb1 group, integrals of neurologic defect degree decreased, the cerebral infarction volume shrunken, and IL-1 beta content in serum reduced in the high dose ginsenoside Rb1 group (P < 0.01, P < 0.05).</p><p><b>CONCLUSION</b>Ginsenoside Rb1 (20, 40, 80 mg/kg) might effectively release local cerebral ischemia by down-regulating the IL-1 beta expression.</p>
Subject(s)
Animals , Male , Rats , Brain , Metabolism , Brain Ischemia , Blood , Metabolism , Ginsenosides , Pharmacology , Interleukin-1beta , Metabolism , Rats, Sprague-Dawley , Reperfusion Injury , Blood , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To observe the effects of acute immobilization stress on the mRNA expression of tyrosine kinase B (TrkB) in rats' hippocampus.</p><p><b>METHODS</b>Eighteen SD rats were randomly divided into three groups, i.e., the normal control group, the model group, and the medication group, 6 in each group. The acute immobilization stress model was prepared in the model group using acute immobilization for 2 h. Ginsenoside Rb1 (40 mg/kg) was peritoneally injected to rats in the medication group 30 min before modeling, with the same procedure as those for rats in the model group. No treatment was performed to rats in the normal control group. The plasma adrenocorticotropic hormone (ACTH) and corticosterone (CORT) contents were detected using ELISA. The mRNA expression of TrkB in the rats' hippocampus was detected using real-time fluorescence quantitative RT-PCR.</p><p><b>RESULTS</b>Before modeling there was no statistical difference of plasma CORT or ACTH concentrations among three groups (P >0.05). The plasma CORT and ACTH concentrations increased in the model group and the medication group more significantly after modeling than before modeling, showing statistical difference (P <0.05). Besides, they were obviously higher in the model group than in the normal control group (P <0.05). They were obviously higher in the medication group than in the model control group (P <0.05). Compared with the normal control group, the mRNA expression of TrkB significantly decreased in the model group (87.73 +/- 7.62 vs 50.65 +/- 5.19, P < 0.05), showing statistical difference. The mRNA expression of TrkB was significantly higher in the medication group (78.91 +/- 18.07) than in the model group, showing statistical difference (P <0.05).</p><p><b>CONCLUSION</b>Pretreatment by ginsenoside Rb1 could increase the plasma CORT and ACTH concentrations, maintain the mRNA expression of TrkB, thus relieving injury induced by acute immobilization stress.</p>
Subject(s)
Animals , Male , Rats , Adrenocorticotropic Hormone , Blood , Corticosterone , Blood , Ginsenosides , Pharmacology , Hippocampus , Metabolism , RNA, Messenger , Genetics , Rats, Sprague-Dawley , Receptor, trkB , Genetics , Metabolism , Stress, Psychological , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To investigate the role of B7-H1 expression in IL-10 production, the B7-H1 and IL-10 expression levels in pancreatic carcinoma tissues and to analyze the correlation between B7-H1 expression and IL-10 level.</p><p><b>METHODS</b>The mRNA and protein levels expressions of B7-H1 and IL-10 in 35 cases of pancreatic cancer and corresponding paracarcinoma tissues and 5 cases of normal pancreas tissues were detected by RT-PCR, Western blot and immunohistochemistry respectively.</p><p><b>RESULTS</b>The findings for the first time provided the evidences that there was a clear trend for B7-H1 and IL-10 expressions to be most highly expressed in carcinoma tissue, intermediately expressed in paracarcinoma tissue, and expressed at the lowest level in normal pancreatic tissue at mRNA and protein levels. Moreover, there were statistically significant differences in B7-H1 and IL-10 expression between pancreatic carcinoma tissues, corresponding paracarcinoma tissues and normal pancreatic tissues at mRNA and protein levels (P < 0.05). Furthermore, the immunohistochemistry indicated that there were high expression levels of B7-H1 (60.5% +/- 12.7%) and IL-10 (65.3% +/- 16.2%) in pancreatic carcinoma tissues while there were no significant expressions in normal pancreatic tissues. Meanwhile, correlation analysis revealed that B7-H1 expression was significant associated with IL-10 level in tumor tissues at mRNA (P = 0.008, r = 0.841) and protein levels (P = 0.007, r = 0.838).</p><p><b>CONCLUSIONS</b>Over-expression of B7-H1 may be responsible for the increasing IL-10 production in pancreatic cancer, which caused reduced immune response to tumor cells and contributed to pancreatic carcinoma escape from immune attack.</p>