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To explore the feasibility and efficacy of isolated caudate lobe resection for caudate lobe in huge hepatocellular carcinoma(10 cm or larger in diameter). Methods: Clinical data of 27 patients with hepatocellular carcinoma larger than 10 cm who underwent isolated caudate lobe resection from January 2001 to December 2011 were retrospectively analyzed. Results: All the patients successfully completed the operation. There was no postoperative death. Median operative time was 288 min, and the estimated intraoperative blood loss was 2 260 mL. Postoperative morbidity rate was 44.4%. The patients were discharged successfully after active treatment. Overall survival rates at 1, 3, and 5 years were 80.2%, 52.1%, and 27.1%, respectively. Conclusion: Isolated caudate lobe resection is safe and effective for caudate lobe huge hepatocellular carcinoma.
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Humans , Carcinoma, Hepatocellular , Mortality , General Surgery , Hepatectomy , Liver Neoplasms , Mortality , General Surgery , Retrospective Studies , Survival Analysis , Treatment OutcomeABSTRACT
Objective By measuring various medical relief standards and simulating the poverty reduction outcomes for compensation for self-paid expenses, to learn the outcomes of medical on poverty reduction in rural areas. Methods Using the detailed medical expenditure of those subject to medical relief in 2016 in Liandu district of Lishui city of Zhejiang province, we calculated their self-paid medical expenses and the proportion of medical relief. The data were analyzed by descriptive analysis. Results Thanks to the medical relief, the self-paid expenses of 458 people fell to under 22 000 yuan,i. e. the poverty line, and 30.25% of them overcame poverty. It was found that different medical relief schemes score different poverty reduction effects among various expense sections. Conclusions Rational choices of medical relief standards for such population call for reference of the distribution pattern of their specific self-paid medical expenses, a benchmark to identify those in need of assistance. Attempts are needed to explore partial assistance for self-paid medical expenses and introduce commercial insurance to make up for the assistance. It is recommended to select appropriate rescue means as required by the demand and supply of the rescue funds.
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Objective To study the method and effectiveness of interruption of mother-to-child transmis-sion among human immunodeficiency virus (HIV)-infected women. Methods Clinical information of 110 cases of HIV-infected pregnant women who gave birth in the eighth municipal hospital of Guangzhou from June 2009 to June 2012 were retrospectively analyzed. Measures such as antiviral treatment , elective caesarean and artificial feeding were taken to interupt mother-to-child transmission , differences in pregnancy outcomes bewteen CD4 t-lymphocyte count > 200/μL and 200 /μL ( 84 cases ) ] and group 2 [< 200/μL group (26 cases)]. In group 1, the rate of anemia, preterm and postpartum hemorrhage was lower than that of group 2; the rate of low birth weight and FGR was obviously lower than that of group 2. There was statisticsly significantly difference between the two groups. 112 infants were all aged 18 months , among those we regularly followed up 88 cases (78.58%) and no infants were HIV-infected. Conclusion Interruptions of moth-er-to-child transmission of HIV are important measures to control AIDS epidemic among children.
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OBJECTIVE@#To explore the technique and effect of liver hanging maneuver in anterior approach for isolated complete liver caudate lobectomy.@*METHODS@#We recruited 17 patients with liver caudate lobe tumor (13 primary hepatocellular carcinoma, 3 cholangiocarcinoma and 1 liver metastasis from colorectal cancer). Isolated complete caudate lobectomy with liver hanging maneuver was performed in 17 patients.@*RESULTS@#All 17 patients were successfully received the above-mentioned operation. The operative time was 166-427 (211.5 ± 20.1) min and the intraoperative blood loss was 372-1 208 (472.7 ± 83.6) mL. There was no operative death. The survival rates of follow up for 1, 3 and 5 years were 76.5%, 52.9% and 23.5%, respectively.@*CONCLUSION@#Liver hanging maneuver for isolated complete resection of the caudate lobe is an ideal approach for liver neoplasms resection.
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Humans , Blood Loss, Surgical , Carcinoma, Hepatocellular , General Surgery , Cholangiocarcinoma , General Surgery , Colorectal Neoplasms , Pathology , Hepatectomy , Methods , Liver Neoplasms , General Surgery , Survival RateABSTRACT
Objective To compare the CLIP score, the JIS score, and the China staging system (CS) in the prediction of survival of patients with resectable hepatocellular carcinoma (HCC). Methods The Clinicopathologic and follow-up data of 224 patients who underwent hepatic resection for HCC from January 2000 to July 2005 were retrospectively studied. The patient distribution and the survival curve of each staging system were used to compare the ability to stratify and to discriminate prognosis. The likelihood ratio, chi-square test and the linear trend chi-square test were used to compare the homogeneity and the monotonicity of the relationship between stage and mortality rate of each staging system. The increase in the -2 log likelihood statistic on removal of any one staging system was in turn used as a means of ranking the individual staging systems according to their importance within the regression model. The statistical package used was SPSS version 16. 0 and Stata SE version 8.0. Results Based on the China staging system, the percentages of patients categorized as Ⅰa, Ⅰ b, Ⅱa,Ⅱb and Ⅲ a were 14. 3%, 17.4%, 21.9%, 31.7% and 14. 7% respectively, showing excellent stratification ability. However, nearly 81. 6% of the patients were classified as a CLIP score of 0-2, which showed poor stratification ability, and only 3. 1 % of the patients were classified as score 0 category of the JIS scoring system. In the follow-up period, the log-rank test and the corresponding Kaplan-Meier survival curves confirmed each staging system to be able to differentiate patient survival in the different stages. Individual pairwise comparisons revealed inconsistencies across the different staging systems. In particular, using the log-rank test, the JIS scoring system and the China staging system showed significant differences in patient survival on all pairwise comparisons. By contrast, the CLIP scoring system failed to differentiate significantly between score 2 and score 3 patients. The JIS scoring system could identify the best prognostic group who would benefit from curative and aggressive treatments, whereas the discriminatory value of the CLIP score was noted in the intermediate- and advanced-phase HCC patients. The China staging system was shown to have the best homogeneity, overall discriminatory capacity and monotonicity of gradient. The change in the -2 log likelihood statistic on removal of any staging system revealed that for this cohort of patients, the appropriate importance in the ranking of the independent contribution of each factor to the regression model was: CS> CLIP>JIS. Conclusion Among three clinical staging systems, the China staging system had the highest prognostic value, with better stratification and higher discriminatory capacity than the CLIP scoring system and the JIS scoring system for this cohort of patients who received partial hepatectomy for HCC. The CLIP scoring system performed better in identifying the worst prognostic patients.
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Objective To investigate the expressions of estrogen receptor (ER) subtypes and c-met proto-oncogene in human endometrial carcinomas and to assess the clinical significance of ER and c-met in this carcinoma. Methods Reverse transcription PCR (RT-PCR) was used to detect the expressions of ERα, ERβ and c-met proto-oncogene mRNA in 30 samples of endometrial carcinoma and 11 samples of normal endometrium. Results The expression of ERα in endometrial carcinoma (0.70±0.40) was significantly reduced in comparison to that in normal endometrium (1.14±0.56, P<0.05). A similar finding was made for the expression of ERβ in carcinoma (0.24±0.18) versus normal tissues (0.48±0.20, P<0.05). In contrast, c-met mRNA expression was increased in endometrial carcinoma (1.45±0.72) compared to that in normal endometrium (0.42±0.31, P<0.01). A decrease tendency of the expression of ERα was also found from Stage Ⅰ (0.82±0.41) to a more severe Stag Ⅱ-Ⅲ of endometrial carcinoma (0.42±0.17, P<0.05). The analysis of ERα and ERβ mRNA revealed a decrease tendency from shallow to deep invasion of the uterine muscles (P<0.05). We found that the expressions of ERα and ERβ were negatively correlated with c-met proto-oncogene with a coefficient correlation of -0.63 (P<0.01) and -0.32 (P<0.05), respectively. Conclusion ERα and ERβ are both involved in mutagenic action of carcinogen. C-met proto-oncogene plays an important role in the carcinogenesis and development of endometrial carcinoma. C-met and ER expressions show a negative correlation in the development of endometrial carcinoma.
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The paper covered the implementation and social outcomes of the medical relief policy benefiting urban and rural residents in Anhui province. Based on analysis of problems identified, it proposed such recommendations: Enhance government financial support; improve the "safety net"mechanism of community hospitals; build a dynamic management system for those in need of medical relief; and tighten the linkage with social medical insurance.
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OBJECTIVE:To solve the compatibility problems in the clinical medication.METHODS:The drug compati?bility program was designed and developed by means of the Visual Basic and Access.RESULTS:Real time analyses of the prescription drugs and the directly displayed analysing results by the programs served as references for the clinic.CONCLUSION:The program of drug compatibility in hospital is helpful to the rational clinical drug use in hospital,which is consistent with the requirements of modern pharmacy development.
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Objective To study the significance and expression relationship among STAT1,STAT2 and hMLH1 ,hMSH2 proteins in hepatocellur carcinoma(HCC). Methods SABC immunohistochemistry method was used to detect the expression of STAT1,STAT2,hMLH1 and hMSH2 proteins in cancer tissues and paracancer tissue from 37 patients of HCC. Results The positive rates and expressive levels of STAT1,STAT2,and hMLH1, hMSH2 in HCC was significantly lower than those in paracancer liver tissues(P
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0.05), and the 1- and 3-year survival rate of group A was significantly higher than that of group B (P