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Objective:To study the impact of patients with intrahepatic cholangiocellular carcinoma (ICC) who underwent surgical resection with or without lymph node dissection (LND), negative or positive lymph node metastasis detected by LND, different extents of LND, and prognostic factors on long-term prognosis of these patients.Methods:The clinical data of 162 patients who were admitted to the Affiliated Cancer Hospital of Zhengzhou University from June 2014 to October 2019 and underwent surgical resection with postoperative histopathological results confirming ICC were retrospectively analyzed. According to the degree of LND, these patients were divided into three groups: the undissected group ( n=68), N0 dissected group (prophylactic dissection) ( n=41) and N1 dissected group (positive dissection, n=53). Of 94 patients who underwent LND, 23 patients underwernt the first station LND (the routine dissection group, n=23), and 71 patients underwent extended LND (the extended dissection group, n=71). The Kaplan-Meier method was used to construct survival curves. Cox regression analysis was used to detect independent factors affecting survival and long-term prognosis of patients. Results:In this study, there were 87 males and 75 females, with a median age of 60 years.The median survival time of these 162 ICC patients was 10 months. The cumulative survival rates at 1-, 3- and 5-year after surgery were 37.6%, 16.5% and 7.9%, respectively. The 1-, 3- and 5-year cumulative survival rates of the N0 dissection group were 52.1%, 31.7% and 25.4%, respectively, which were significantly better than those of the undissected group (34.2%, 12.7%, 3.4%), and the N1 dissection group (30.3%, 11.4%, 0) ( P<0.05). There were no significant differences in postoperative survival between the extended dissection group and the routine dissection group ( P>0.05). Preoperative CA19-9 >50 U/ml ( RR=1.425, 95% CI: 0.962-2.112), maximum tumor diameter > 5 cm ( RR=0.672, 95% CI: 0.456-0.989), without LND ( RR=1.715, 95% CI: 1.140-2.580), positive margin ( RR=0.591, 95% CI: 0.390-0.897), and without postoperative adjuvant therapy ( RR=0.663, 95% CI: 0.504-0.872) were independent risk factors affecting postoperative survival ( P<0.05). Conclusions:LND in ICC patients improved long-term survival outcomes. However, extended LND did not improve prognosis of these patients. The preoperative CA19-9 level, maximum tumor diameter, lymph node dissection, surgical margin status, and postoperative adjuvant therapy were independent risk factors affecting long-term prognosis of these patients.
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Objective:To evaluate prognostic significance of metastated lymph nodes (LN) in patients with intrahepatic cholangio carcinoma (ICC) after radical resection.Methods:Data were reviewed on 90 patients at Department of Hepatobiliary and Pancreatic Surgery in our hospital from Feb 2013 to Oct 2019, 37 cases had no LN metastasis (N0 group), 21 cases were in N1 group (positive LN<3) and 32 cases in N2 group (positive LN≥3),and Kaplan-Meier method was used to construct survival curve. Univariate and multivariate COX regression analysis was used to screen independent risk factors.Results:In N0 group the 1-and 3-year survival rates were 57.7% and 35.2%, respectively. In N1 group the 1-and 3-year survival rates were 46.7% and 17.5%, respectively in N2 group. the 1-and 3-year survival rates were 19.6% and 0, respectively. There was statistical significance in overall survival rate among the three groups ( χ2=15.272, P<0.05). Multivariate analysis showed that resection margin ( P=0.009) and the number of positive LN ( P=0.002) were independent risk factors affecting the prognosis of patients. Conclusion:Resection margin and the number of metastasing LN were closely related to postoperative prognosis of ICC patients.
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Objective To study factors affecting prognosis of patients with intrahepatic cholangiocarcinoma (ICC),focusing on the correlation between extent of lymph node dissection and prognosis of patients with ICC.Methods The clinical data of ICC patients who underwent radical resection at the Hepatobiliary and Pancreatic Surgery of Affiliated Cancer Hospital of Zhengzhou University from October 2013 to October 2017 were retrospectively analyzed.According to the extent of lymph node dissection,the patients were divided into the non-dissected lymph node group,the routine dissection lymph node group and the extended lymph node dissection group.The prognoses of the three groups were compared.The Cox stepwise regression model was used to analyze the independent risk factors for prognosis of patients with ICC.Results The 178 patients included 109 males and 69 females.Their ages ranged from 30 to 81 years (average 59 years).There were 80 patients in the non-dissected group,34 patients in the routine lymph node dissection group,and 64 patients in the extended lymph node dissection group.The overall survival rates of the 178 patients at 3 years after liver resection was 29.2％ (52/178),overall median survival 25.8 months.The 3-year survival rates of the non-dissected group,routine dissection group,and extended dissection group were 10.0％ (8/80),52.9％ (18/34),40.6％ (26/64),respectively.The differences among the three groups were significant (P ＜ 0.05).Comparison among the three groups showed that there was no significant difference in survival rates between the routine dissection group and the extended dissection group (P ＞ 0.05).There was a significant difference in survival rates between the non-dissected group and the extended lymph node dissection group (P ＜0.05).Univariate analysis showed that CA19-9,tumor diameter,portal tumor thrombus,and lymph node dissection were related to prognosis of patients with ICC (P ＜ 0.05).Multivariate analysis showed CA19-9,tumor diameter,and extent of lymph nodes clearance were related to patient survival (P ＜ 0.05).Conclusions CA19-9,tumor diameter,and extent of lymph node dissection were independent risk factors of survival in patients with ICC.For patients with ICC who undergo surgical resection,conventional laparoscopic lymph node dissection can achieve good results,and there is no need to extend lymph node dissection.
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Objective@#To investigate the correlations between the systemic immune inflammatory index (SII) and prognosis of patients with gallbladder cancer.@*Methods@#From April 2005 to January 2019, patients with gallbladder cancer underwent surgical treatment in the Department of Hepatobiliary and Pancreatic Surgery, Affiliated Tumor Hospital of Zhengzhou University were followed up and their SII values were analyzed. The receiver operating characteristic curve (ROC) was used to determine the best clinical boundary value of SII. According to the boundary value, patients were divided into two groups: low SII and high SII. Survival curves were drawn by Kaplan-Meier method. The overall survival time of the two groups was analyzed, and univariate analysis of postoperative survival was performed using log-rank test. Cox regression proportional hazard model was used for multivariate analysis of clinical prognosis.@*Results@#A total of 312 patients were included, including 120 males and 192 females, aged 30.0 to 86.0 (61.5±9.9) years. The best clinical cut off value of preoperative SII was determined by ROC curve to be 510.42. A total of 312 patients with gallbladder cancer were divided into low SII group (SII≤510.42) and high SII group (SII>510.42). Kaplan-Meier survival curve was used to analyze the 1, 3 and 5-year survival rates of gallbladder cancer patients in low SII group and high SII group after operation. The survival rates were 65.7%, 39.6% and 30.2%, and 27.9%, 12.0% and 9.6% respectively. The median survival time was 25 months (95% CI: 16.9-33.1) and 9 months (95% CI: 8.1-9.9), respectively. The survival rate of gallbladder cancer patients in low SII group was better. There were significant differences of the overall survival rate between the two groups (P<0.05). Univariate analysis showed that SII>510.42 (HR=0.086, 95% CI: 0.032-0.289) was a risk factor for overall survival of gallbladder cancer patients. Cox multivariate analysis confirmed that preoperative SII (HR=2.649, 95% CI: 1.981-3.543) was an independent risk factor for overall survival of gallbladder cancer patients.@*Conclusions@#SII can be used as an independent prognostic factor to predict the prognosis of patients with gallbladder cancer. The higher the preoperative SII, the worse the prognosis of patients with gallbladder cancer.
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Objective To investigate the correlations between the systemic immune inflammatory index(SⅡ)and prognosis of patients with gallbladder cancer.Methods From April 2005 to January 2019,patients with gallbladder cancer underwent surgical treatment in the Department of Hepatobiliary and Pancre-atic Surgery,Affiliated Tumor Hospital of Zhengzhou University were followed up and their SⅡ values were analyzed.The receiver operating characteristic curve(ROC)was used to determine the best clinical bounda-ry value of SⅡ.According to the boundary value,patients were divided into two groups:low SⅡ and high SⅡ.Survival curves were drawn by Kaplan-Meier method.The overall survival time of the two groups was analyzed,and univariate analysis of postoperative survival was performed using log-rank test.Cox regression proportional hazard model was used for multivariate analysis of clinical prognosis.Results A total of 3 12 patients were included,including 120 males and 192 females,aged 30.0 to 86.0(61.5±9.9)years.The best clinical cut off value of preoperative S11 was determined by ROC curve to be 510.42.A total of 312 patients with gallbladder cancer were divided into low SⅡ group(SⅡ≤510.42)and high SⅡ group(SⅡ＞510.42).Kaplan-Meier survival curve was used to analyze the 1,3 and 5-year survival rates of gallbladder cancer patients in low SⅡ group and high SⅡ group after operation.The survival rates were 65.7％.39.6％and 30.2％,and 27.9％,12.O％and 9.6％respectively.The median survival time was 25 months(95％CI:16.9-33.1)and 9 months(95％CI:8.1-9.9),respectively.The survival rate of gallbladder cancer patients in low SⅡ group was better.There were significant differences of the overall survival rate between the two groups(P＜0.05).Univariate analysis showed that SⅡ＞510.42(HR=0.086,95％C/:0.032-0.289)was a risk factor for overall survival of gallbladder cancer patients.Cox multivariate analysis confirmed that preoperative SⅡ(HR=2.649,95％CI:1.981-3.543)was an independent risk factor for overall survival of gallbladder cancer patients.Conclusions SⅡ can be used as an independent prognostic factor to predict the prognosis of patients with gallbladder cancer.The higher the preoperative SⅡ,the worse the prognosis of patients with gallbladder cancer.
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OBJECTIVE:To provide reference for formulating drug price regulation policy and promoting reasonable drug price. METHODS:According to WHO and HAI drug price standard investigation,questionnaire survey(supplemented by field investigation)about sale price of 63 commonly used drugs with large consumption sum was conducted among 3 districts of different economic development levels in Hubei province. Median price ratio(MPR)was calculated statistically. Primary interview survey(supplemented by literature investigation)about drug distribution cost was conducted among managerial staff of pharmaceutical wholesale and retail enterprises,hospital pharmacy administrators. Suggestions were put forward to control distribution cost and standardizing drug price based on analysis and discussion. RESULTS:Totally 120 questionnaires were sent out,and 118 were effectively received,with effective recovery of 98.33%. Thirty managerial staff from drug wholesale and retail enterprises,hospital pharmacy department were interviewed for investigation of drug distribution cost. MPR of 63 drugs ranged 0.05-44.55 in different types of sample institutions. Among 67 specifications of 53 kinds of drugs,median retail price of 38 specifications(56.72%)was higher than international reference price in first-level sample medical institutions. Among 79 specifications of 63 kinds of drugs,median retail price of 57 specifications(72.15%)was higher than international reference price in second-level sample medical institutions. Among 80 specifications of 63 kinds of drugs,median retail price of 63 specifications(78.75%)was higher than international reference price in third-level sample medical institutions. Among 50 specifications of 37 kinds of drugs,median retail price of 42 specifications(84.00%)was higher than international reference price in sample pharmaceutical retail enterprises. In all sample institutions,maximum MPR of 13 specification were lower than 1;those of 12 specification ranged from 1 to <2;those of 23 specifications ranged from 2 to <5;15 specification ranged from 5 to <10;those of 17 specification were higher than 10. MPR of third-level medical institution samples were higher than those of second-level and first-level ones,and pharmaceutical retail enterprises(P<0.01). MPR of second-level medical institution samples and pharmaceutical retail enterprises were higher than those of first-level medical institutions(P<0.01). There was no statistical significance in the levels of MPR between second-level medical institutions and pharmaceutical retail enterprises(P>0.05). MPR of sample institutions in well-developed regions were higher than in medium-developed or less-developed regions(P<0.01). MPR of sample institutions in medium-developed regions were higher than in less-developed regions(P<0.01). MPR of original drugs were all higher than those of generic drugs in different types of sample institutions(P<0.01). There was no statistical significance in MPR of original drugs among different types of sample institutions(P>0.05). At the same time,MPR of generic drugs in third-level medical institution samples were higher than in second-level and first-level ones and pharmaceutical retail enterprises (P<0.05 or P<0.01). MPR of second-level medical institution samples and pharmaceutical retail enterprises were higher than in first-level ones(P<0.05). There was no statistical significance between second-level medical institution samples and pharmaceutical retail enterprises(P>0.05). Drug production and circulation cost,centralized bidding and purchasing price in Hubei province were higher than the national level. CONCLUSIONS:The drug price of Hubei province is in high level,especially that of three-level medical institutions is higher than other institutions;drug price of well-developed region is higher than those of medium-level and less-developed region;the price of original drugs are higher than those of generic drugs. The cost of pharmaceutical industry,drug circulation cost and the addition of drug price during application link eventually lead to the higher retailing price of drugs. Comprehensive policy measures need to be taken to control the cost of the whole process of drug distribution and to regulate the price of drugs.
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Objective To investigate the effect of miR-10b on migration and invasion of human hepatocellular carcinoma (HCC) cell lines.Methods Transwell assay was used to evaluate the motility and invasiveness in different HCC cell lines,qRT-PCR was then used to detect the expression levels of miR-10b in different HCC cell lines.Artificial mimics of miR-10b were transiently transfected into HepG2 cells,which have low expression of miR-10b,and then the changes in migration and invasion were evaluated by Transwell assay.Antagomirs of miR-10b (miR-10b-AS) were transiently transfected into MHCC97H cells,which have high expression of miR-10b,and then the changes in migration and invasion were evaluated as well.Cell morphology changes were detected by immunofluorescence and electron microscopy,Results There was a significant correlation of miR-10b expression level with cell motility and invasiveness.Low-level expression of miR-10b was observed in HepG2 cells,which exhibited weak motility and invasiveness; whereas high-level expression of miR-10b was observed in MHCC97H cells,which exhibited strong motility and invasiveness.Up-regulation of miR-10b expression in HepG2 cells increased cell motility and invasiveness,whereas inhibition of miR-10b reduced cell motility and invasiveness in MHCC97H cells.Immunofluorescence and electron microscopy results showed that up-regulation of miR-10b in HepG2 cells significantly increased proliferation of filopodia and lamellipodia,whereas inhibition of miR-10b decreased filopodia and lamellipodia amount in MHCC97H cells.Conclusion miR-10b is involved in the invasion and metastasis of HCC cell through regulation of cytoskeleton in vitro and inhibition of miR-10b is likely to be a new molecular target to block metastasis.
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Objective: To evaluate the rationality and practicability of the provincial directory of antibacterial drugs classification management in China. Methods: The directories at the provincial level published after May 2012 were collected from the government websites of health department in different provinces, cities and autonomous regions. The name, number, grading and classification were counted and anzlyzed. According to the relative national standards, the rationality, practicability and existing problems were ana-lyzed, and some revision sugestions were proposed. Results:Up till now, 30 dirctories were issued with the average recording number-varieties of 147. 1(101-194). The average number of unrestricted, restricted and special use level was 56. 4(37-66), 53. 7(34-68) and 37(24-75), respectively. The top 5 was cephalosporins(29. 5), penicillins(24. 8), antifungi drugs(14. 7), quinolones(12. 8) and aminoglycosides(10). Overall, the directories were rational and practicable. However, 29 kinds of antibacterial drugs were with-out registered number of approval, which was not reasonable or practicable. The other problems were inappropriate classification and grading, name writing mistakes, ect. Conclusion:The directories should be revised in time to correct the existing promblems and im-prove the directories.
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OBJECTIVE: To probe into the status quo and the tendency of the application of intravenous infusions. METHODS: Data on the application of intravenous infusions in one of the tertiary Grade A comprehensive hospital in 1996, 1999, 2002 and 2004 were analyzed statistically. RESULTS: The variety of infusion, the total quantity and the total amount of money of infusions increased year by year,the total consumption sum of infusions accounted for 10% of that of the whole year drugs; the majority of which were the consumption of nutritional and dielectric medicines, of which, glucose and sodium chloride injections accounted for 74% of the total; the infusion of treatment type increased fast, much as in cases of anti - infec-tives; the drug expense for each bottle of infusion increased year by year, the amount of money involved in infusion drugs accounted for 60% of the total year round drug consumption sum. CONCLUSION: There is an upward trend in both the quantity and consumption sum of infusions.
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OBJECTIVE:To explore the changes of serum phenytoin levels and its pharmacokinetics in menstrual epilepsy.METHODS:9cases of menstrual epilepsy patients who were treated with phenytoin were collected,whose blood concentra?tions of phenytoin in menstrual period and ovulation period were respectively determined by HPLC,pharmacokinetics study was performed in three of them.RESULTS:The mean serum phenytoin levels in menstrual period and ovulation period were(9.25?2.71)?g/ml and(13.33?3.22)?g/ml,respectively(P
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OBJECTIVE:To study the percutaneous permeability of methoxypsoralen liposomal gel METHODS:The preparations were applied on the rat skin in vitro and in vivo with common gel and Mingbailing tincture as control,and the drug concentrations in the receiver,skin,blood and other organs were determined by RP-HPLC RESULTS:In vitro experiment,liposomal gel showed the lowest percutaneous permeation rate and the highest retention in skin In vivo studies illuminated that the skin depositions of drug encapsulated in liposome was(4 37?0 91) and (3 36?0 58) times those of the common gel and tincture respectively CONCLUSION:Methoxypsoralen liposomal gel showed an evident targeting effect on skin
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OBJECTIVE:To measure the concentrations of levofloxacin in aqueous humor after a single eye dripping of drug and calculate the pharmacokinetic parameters.METHODS:32 rabbits were divided into 8 groups.The rabbit eyeballs were enucleated to make a collection of aqueous humor at 0.125,0.25,0.5,0.75,1.0,2.0,3.0 and 4.0 hours after dripping.All measurements were performed with HPLC.RESULTS:In aqueous humor,Tmax:0.940h,Cmax:0.592?g/ml,T1/2(Ka):0.479h,T1/2 (Ke)0.919h.By using 3p87 pharmacokinetic program,the concentration-time curves were fitted as one-compartment op_en model.CONCLUSION:All the concentrations of levofloxacin at different times after dripping in aqueous humor exceeded the minimum inhibitory concentration for 90%(MIC90)of most bacterial pathogens.These results show that levofloxacin lactate eye-drops may be an effective antimicrobial agent for the treatment and prevention of intraocular infections as well as other ocular infections.
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Objective To study the effects of sinomenine on scavenging oxygen free radical and anti-lipid peroxidation in vitro. Methods Superoxide anion free radical(O_2~?) induced by the auto-oxidation of pyrogallol and hydroxyl free radical(?OH) induced by Fenton system were determined by spectrophotometry.The inhibition on homogenate and mitochondrial lipid peroxidation,malondialdehyde(MDA),of rat liver induced by VC-Fe~(2+) system was measured by thiobarabituric acid(TBA) colorimetric method.Results Sinomenine could significantly scavenge O_2~? and ?OH,it's EC_(50) were 1.35 and 0.136 mg/mL respectively.Sinomenine could also remarkably inhibit the lipid peroxidation of rat liver homogenate and mitochondria induced by auto-oxidation and VC-Fe~(2+) system.The scavenging and inhibitory effect exhibited in a concentration-dependent manner.Conclusion The results indicate that sinomenine possesses the effect of scavenging oxygen free radicals and anti-lipid peroxidation,which shows the protection of liver mitochondria.
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oleic acid, and 2% Azone plus 10% oleic acid had the strongest effect in all. Conclusion 2% Azone plus 10% oleic acid as the enhancer of SG is the best.
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OBJECTIVE: To analyze the effect of bidding of antimicrobial drugs on hospital drugs consumption.METHODS: Based on the classification on drug bidding in 2007,the consumption data of antimicrobial drugs in 2006 in a 3-A grade hospital was analyzed,meanwhile,the price reduction rate,the consumption,the average daily cost and the impact factor of the antimicrobial drugs on the drug bidding list of 2007 were analyzed according to different specification or variety.RESULTS: The varieties winning the bid in 2007 which falls into the varieties winning the bid in 2006 represented 56.48% of all the varieties used in 2006,11 of the top 30 kinds of drugs in terms of consumption in 2006 also won the bid in 2007;accounting for 37.73% in consumption sum.In 2007 compared with 2006,cefamandole,cefodizime,pazufloxacin showed a biggest impact factor,whereas cefodizime and pazufloxacin ranked at the first 2 places in terms of weight impact factor.The proportion of the top 10 drugs in the total on the list of consumption sum remained steady from 2006 to 2007.CONCLUSIONS: The continuous drug bidding has positive meaning for patients,yet the benefit brought about by the drug price reduction is inconspicuous on account of the reduced consumption of the varieties which experienced drug reduction.Drug bidding remains to be improved because the average drug costs for patients haven't been brought down by the drug price reduction.
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OBJECTIVE:To develop a preparation and quality control method for sinomenine gel.METHODS:Sinomenine gel was prepared with carpol971as base.TLC and UV were employed for identification of sinomenine.Sinomenine was deter?mined by RP-HPLC.RESULTS:The TLC identification was highly specific and the spots were clear.Recovery was99.6%?1.3%.CONCLUSION:This paper provides a rapid,convenient and accurate method which is suitable for preparation and quality control for sinomenine gel.