ABSTRACT
Objective To study the prognostic factors which affected the long-term survival in patients with a single large hepatocellular carcinoma (SLHCC) after hepatectomy.Methods The clinical data of 138 SLHCC patients who underwent hepatectomy in the Tianjin Hospital from January 2008 to December 2013 were retrospectively analyzed.There were 115 males and 23 females.Age ranged from 23 to 81 years (median 56.8 years).The impact of an array of clinicopathological factors was analyzed using a variety of statistical methods which included the Kaplan-Meier estimator and the Log-rank test.Results The 1,3,5 year overall survival rates for all the patients were 86.4％,64.8％ and 54.1％,respectively,and the 1,3,5 year disease free survival rates were 68.8％,41.4％ and 33.2％,respectively.Univariate analysis indicated that microvascular invasion,preoperative AFP≥400 μg/L,a maximum tumor diameter ≥ 10 cm,and preoperative AST ≥40 U/L were risk factors of overall survival (all P ＜ 0.05),and microvascular invasion,preoperative AFP≥400 μg/L,and preoperative AST ≥40 U/L were risk factors of disease free survival (all P ＜ 0.05).Multivariate analysis showed that microvascular invasion,preoperative AFP ≥400 μg/L and preoperative AST ≥40 U/L were independent prognostic factors of overall survival and disease free survival for these patients (all P ＜ 0.05).Conclusion Microvascular invasion,preoperative AFP ≥400 μg/L and AST ≥40 U/L were independent prognostic factors of long survival of SLHCC patients.
ABSTRACT
The purpose of this study was to investigate the risk factors of nosocomial infection in patients after neurosurgical operations, so as to provide reasonable, effective preventative measures in the future. A total of 1,600 patients with brain tumors, hydrocephalus, craniocerebral trauma and vascular disease treated in the neurosurgery room were chosen for targeted surveillance; and through analysis on the clinical data of patients, the incidence of nosocomial infection, the site of infection and the distribution of pathogens, we investigated the infection-related risk factors. After operation, there were 128 cases with nosocomial infection, with the infection rate of 8.0%; among the several diseases, the postoperative infection rate of brain tumors was 28.13%, the postoperative infection rate of hydrocephalus was 21.88%, and the susceptible sitesin the first three places were lower respiratory tract, intracranial, urinary tract; a total of 69 pathogens were separated from 128 cases with nosocomial infection, and the first three pathogens were Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus, accounting for 21.74%, 17.39%, 11.59% respectively. The incidence of nosocomial infection was higher in patients with invasive operation during the procedure, with significant difference [P<0.05]. By targeted surveillance on the nosocomial infection in patients after neurosurgical operations, the nosocomial infection rate was high after neurosurgical operations. By strictly implementing the aseptic operation, it could reduce the invasive operation; effectively reduce the infection rate of patients, to facilitate the healing of patients and early rehabilitation