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Objective To explore the application value of the liver stiffness measurement (LSM) on complications after hepatectomy.Methods The retrospective case-control study was conducted.The clinical data of 121 hepatocellular carcinoma (HCC) patients who underwent hepatectomy in the Mianyang Central Hospital from January 2011 to April 2017 were collected.All 121 patients received LSM using Fibro Scan,and 81 undergoing laparoscopic liver resection (LR) and 40 undergoing open liver resection (OR) were respectively allocated into the LR and OR groups.Observation indicators:(1) comparisons of intra-and post-operative situations;(2) risk factors analysis affecting postoperative complication of HCC patients;(3) area under the curve (AUC) of LSM and postoperative complications;(4) comparisons of intra-and post-operative situations,when LSM ≤17.5 kPa;(5) comparisons of intra-and post-operative situations,when LSM ＞ 17.5 kPa;(6)comparisons of intra-and post-operative situations between patients with LSM ≤ 17.5 kPa and LSM ＞ 17.5 kPa in the LR group.Measurement data were represented as x±s,and mean comparisons between groups were done using the t test.Comparisons of count data and univariate analysis were analyzed using the chi-square test and Fisher exact probability.The multivariate analysis was done using the logistic regression model,using P＜0.01 as a inclusion criteria in the univariate analysis.The critical value of postoperative complication was calculated using the receiver operating characteristic curve (ROC).Results (1) Comparisons of intra-and post-operative situations:all the 121 patients underwent successful surgery,including 4 with conversion to open surgery in the LR group.Cases with Pringle manner were 51 in the LR group and 17 in the OR group,with a statistically significant difference (x2 =4.555,P＜0.05).Operation time,volume of intraoperative blood loss,case with intraoperative blood transfusion,Ishak score of 1-3 and 4-6 scores,postoperative complications and duration of hospital stay were respectively (248±78)minutes,(292±229)mL,14,14,67,29,(12±7)days in the LR group and (221±78)minutes,(281± 194)mL,9,9,31,10,(13±6)days in the OR group,with no statistically significant difference between groups (t =1.843,0.282,x2 =0.473,0.473,1.431,t =0.075,P＞0.05).(2) Risk factors analysis affecting postoperative complication of HCC patients:39 of 121 patients had postoperative complications.Results of univariate analysis showed that retention 15-minute rate of indocyanine green (ICG R15),LSM,volume of intraoperative blood loss and Ishak score were risk factors affecting postoperative complication of HCC patients (x2 =7.161,32.490,7.725,2.863,P＜0.l).Results of multivariate analysis showed that LSM ＞ 15.0 kPa was an independent risk factor affecting postoperative complication of HCC patients [odds ratio (OR) =6.906,95％ confidence interval (CI):2.307-20.672,P＜0.05].(3) AUC of LSM and postoperative complication:when LSM of postoperative complication ＞ 17.5 kPa,sensitivity,specificity and AUC were respectively 64.1％,85.4％ and 0.749 (95％CI:0.662-0.824,P＜0.05).(4) Comparisons of intra-and post-operative situations,when LSM ≤ 17.5 kPa:duration of hospital stay was respectively (10±5) days in the LR group and (13±7) days in the OR group,with a statistically significant difference between groups (t--2.389,P＜0.05).(5) Comparisons of intra-and post-operative situations,when LSM ＞ 17.5 kPa:operation time,volume of intraoperative blood loss,cases with postoperative complications and hepatic dysfunction were respectively (277±76)minutes,(505±232)mL,21,17 in the LR group and (212-± 109) minutes,(328±250) mL,4,2 in the OR group,with statistically significant differences between groups (t=2.060,2.057,P＜0.05).(6) Comparisons of intra-and post-operative situations between patients with LSM ≤ 17.5 kPa and LSM ＞ 17.5 kPa in the LR group:operation time,volume of intraoperative blood loss,cases with postoperative complications and hepatic dysfunction and duration of hospital stay were respectively (236±76)minutes,(197± 153)mL,8,3,(10±5)days in the LR group and (277± 76)minutes,(505±232) mL,21,17,(16±9)days in the OR group,with statistically significant differences between groups (t=0.657,3.398,x2 =36.547,36.475,t=17.414,P＜0.05).Conclusion LSM is an independent risk factor affecting postoperative compfications after hepatectomy,when LSM ＞ 17.5 kPa,LR is associated with higher incidence of postoperative complications compared with OR.
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Objective To explore the effect of big strain rhodiola injection on levels of leptin and leptin receptor mRNA in serum and liver of rabbit with fatty liver.Methods 120 healthy adult male New Zealand white rabbits were grouped with a random number table method.30 rabbits with normal diet for eight weeks in normal group;90 rabbits in fat group were fed with high fat diet for four weeks to prepare fatty liver model in which 30 rabbits were fed with high-fat diet for four weeks as model group,30 rabbits with high-fat diet and glyburide metformin tablets [150 mg/(kg·d)]for 4 weeks as control group,30 rabbits with high-fat diet and big strain rhodiola injection [40 mg/(kg·d)]for four weeks as experimental group.After the test, levels of serum leptin,hepatic leptin,expression levels of leptin receptor mRNA and levels of liver index were compared among groups.Results Serum leptin and liver leptin in experimental group and control group were all increased to varying degrees,and the serum leptin level [(4.51 ±1.17)ng/mL],liver leptin level [(6.43 ±1.93)ng/mL]of experimental group was lower than that of control group respectively,in which the serum leptin was (7.36 ±1.26)ng/mL and liver leptin was (12.33 ±3.27)ng/mL (P<0.05).Serum leptin and leptin liver receptor mRNA in experimental group and control group were all increased to varying degrees,and the serum leptin mRNA level (0.98 ±0.15),liver mRNA level (1.78 ±0.33)of experimental group was lower than that of control group,in which the mRNA level of serum leptin was (2.57 ±0.29)and liver leptin mRNA levels was (3.31 ±0. 26)(P<0.05).Levels of liver index in experimental group and control group were increased,and liver index of experimental group [(3.98 ±0. 13)%]was lower than that in control group [(4.77 ±0.20)%],and the difference was statistically significant (P<0.05).Conclusion Big strain rhodiola injection could significantly reduce leptin levels in serum and liver of rabbits,reduce expression the leptin receptor mRNA levels and improve liver index,which has guiding significance for the treatment of fatty liver.
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<p><b>BACKGROUND</b>The main treatment strategy of cancer patients with brain meta- stasis is irradiation, while so far there is few research concerning chemotherapy combined with radiotherapy for these patients. The aim of this study is to evaluate the therapeutic effect and toxicity of chemotherapy with VPC regimen combined with whole-brain radiotherapy (WBRT) in small cell lung cancer (SCLC) with brain metastasis.</p><p><b>METHODS</b>A total of 60 SCLC patients with brain metastasis received a cycle of VPC regimen (teniposide 60mg/m² iv on days 1-5, cisplatin 35mg/m² iv on days 1-3, semustine 80mg/m² PO on day 1) every 3-4 weeks. WBRT was administered on day 6 of the first cycle of chemotherapy at a dose of 2Gy given in 5 fractions per week. Patients with less than 3 brain lesions received WBRT at a dose of 30Gy and then small field radiotherapy up to total dose of 50Gy, otherwise they received WBRT at a total dose of 40Gy. Response was evaluated by brain and chest CT or MRI after WBRT and at least 2 cycles of chemotherapy were completed.</p><p><b>RESULTS</b>All the patients completed WBRT combined with chemotherapy. Total response rate of primary pulmonary tumor was 46.7%, with 4 cases of CR. The objective brain response rate was 60.0%, with 11 cases of CR and 25 cases of PR. Symptom relief was observed in all 48 patients with neurological symptoms. Main adverse effects were myelotoxicity, nausea/vomiting, constipation and alopecia. The follow-up rate was 93.3% with a median survival duration of 11.3 months. The 1-, 2- and 5-year survival rate was 43.3%, 35.0% and 6.7%, respectively.</p><p><b>CONCLUSIONS</b>Chemotherapy combined with WBRT can be safely performed for SCLC with brain metastasis and its short-term response is quite satisfactory. It may be worthy of further clinical investigation.</p>
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<p><b>OBJECTIVE</b>To investigate the factors related to sexual dysfunction among breast cancer patients so as to improve the prevention and treatment of the disorder as well as the life quality of the patients.</p><p><b>METHODS</b>Sixty-five breast cancer patients during the rehabilitation period were interviewed by questionnaire on the sexual function before and after treatment.</p><p><b>RESULTS</b>Age and perception of sex were two important factors for the significant difference in the rate of sexual dysfunction among the patients. In the groups of 45-55 and 56-65 years, the rates of sexual dysfunction were 66.7% and 73.9%, respectively. Compared with the < 45-year group (33.3%), the findings were statistically significant (P < 0.01), and the difference was statistically significant between the incorrect perception group (70.3%) and the correct one (47.6%) (P < 0.05). Of all the factors analyzed in the research, the stage of cancer, treatment methods, vaginal dryness, decreased libido, dyspareunia and sex perception had significant correlation with newly developed sexual dysfunction (P < 0.05).</p><p><b>CONCLUSION</b>The stage of cancer, treatment methods, sex perception, vaginal dryness et al had significant correlation with sexual dysfunction of breast cancer patients after treatment. To treat and prevent sexual dysfunction among breast cancer patients, oncology professionals should initiate communication about sexual difficulties, perform comprehensive assessments, and educate and counsel patients about the management of these difficulties.</p>
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Adult , Aged , Female , Humans , Middle Aged , Age Factors , Breast Neoplasms , Psychology , Incidence , Quality of Life , Sexual Dysfunctions, Psychological , EpidemiologyABSTRACT
Objective To evaluate the reason of failure of the interlocking nail.Methods From1998-2001, 72 patients with femur fractures were treated with the interlocking nail.Results 61 cases were followed-up,there were 5 breakages in the locking nail. The failure occurred after operation from 4～9 months.And 3 cases were at the middle of the nail.2 cases were at the first screw of the distal of the fracture.Conclusion The reason of breakage concluded open operation,too much separation of the periosteum,too early full weight bearing and unfit function exercise.
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Object To study the effect of melittin on growth and proliferation of hepatocarcinoma cells. Methods Hepatocarcinoma cell line SMMC7721 was treated by melittin. The growth and proliferation was observed by cell counting and MTT assay; necrosis was estimated by Trypan blue staining. The expression of proliferating cell nuclear antigen (PCNA) and cycle phase were detected by flow cytometer. Results Melittin could significantly inhibit the growth of SMMC7721 and block up cells progress through G 2/M. The percentage of PCNA positive cell was decreased gradually when concentration of melittin was increased. Conclusion Melittin could inhibit the proliferative activity of hepatocarcinoma cell line SMMC7721 and reduce of PCNA positive cell expression and arrest cells in S phase.