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1.
Article in Chinese | WPRIM | ID: wpr-1030603

ABSTRACT

@#Objective    To compare the clinical efficacy of different surgical approaches for Siewert type Ⅱ adenocarcinoma of esophagogastric junction (AEG). Methods    The clinical data of the patients with Siewert type Ⅱ AEG who received sugeries in the Department of Thoracic Surgery of Gansu Provincial People's Hospital from August 2014 to December 2019 were retrospectively analyzed. The patients were divided into two groups according to the surgical approach: a transabdominal group (transabdominal diaphragmatic esophageal hiatus approach) and a combined group (thoracoabdominal combined with right thoracic approach). Perioperative clinical data and postoperative follow-up data were collected to compare the short- and long-term efficacy of the two groups. Results     A total of 87 patients were enrolled. There were 48 patients (31 males and 17 females, with an average age of 60.85±8.47 years) in the transabdominal group, and 39 patients (25 males and 14 females, with an average age of 61.13±8.51 years) in the combined group. There was no statistical difference between the two groups in the baseline indicators such as gender, age, tumor size and stage (P>0.05). Compared with the combined group, the operation time, intraoperative blood loss, postoperative bed rest time, postoperative total drainage volume were shorter or less, and the visual analogue scale score on the 3rd day after surgery were lower in the transabdominal group (P<0.05). However, the total number of lymph nodes dissected, the number of thoracic lymph nodes dissected and the number of positive thoracic lymph nodes in the combined group were larger than those in the transabdominal group, and the differences were statistically significant (P=0.001). The median survival time in the combined group and transabdominal group was 25.85 months and 20.86 months, respectively. The 3-year overall survival rate of the combined group was higher than that of the transabdominal group (46.2% vs. 38.9%, χ2=5.995, P=0.014). However, there was no statistical difference between the two groups in the postoperative catheter time, esophageal and gastric resection margin distance, number of abdominal lymph nodes dissected, number of positive abdominal lymph nodes, or incidence of postoperative complications (P>0.05). Conclusion    For patients with Siewert type Ⅱ adenocarcinoma of esophagogastric junction, thoracoabdominal combined with right thoracic approach is safe and effective, and has advantages in thoracic lymph node dissection, bringing more benefits to the patients, so it is recommended to be popularized in clinical practice.

2.
Zhonghua ganzangbing zazhi ; Zhonghua ganzangbing zazhi;(12): 569-573, 2023.
Article in Chinese | WPRIM | ID: wpr-986172

ABSTRACT

Acute-on-chronic liver failure (ACLF) is a type of complex clinical syndrome that is mainly characterized by acute deterioration of liver function based on chronic liver disease, hepatic and extrahepatic organ failures, and a high short-term mortality rate. The comprehensive medical treatment efficacy of ACLF is currently limited; thus, liver transplantation is the only viable potential treatment method. However, considering the severe liver donor shortage, economic and social costs, as well as the differences in disease severity and prognosis of different disease courses, it is particularly important to accurately assess the benefits of liver transplantation in patients with ACLF. Early identification and prediction, timing, prognosis, and survival benefits are discussed here by combining the latest research findings so as to optimize the liver transplantation treatment strategy for ACLF.


Subject(s)
Humans , Liver Transplantation , Acute-On-Chronic Liver Failure , Prognosis , Liver Cirrhosis
3.
Tumor ; (12): 799-808, 2023.
Article in Chinese | WPRIM | ID: wpr-1030330

ABSTRACT

Objective:To evaluate the efficacy and safety of ultrasound-guided high intensity focused ultrasound(HIFU)on pain intensity,pain sensation and overall survival in patients with advanced pancreatic cancer. Methods:Clinical data of advanced pancreatic cancer patients treated by HIFU were collected from the patients enrolled during August 2020 to September 2022 at the second department for oncology of Yueyang Hospital of Integrated Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine.In this study,SPSS 26.0 software was used for the statistical analysis of NRS score and BPI score.The Kaplan-Meier survival analysis method was applied to calculate the median overall survival(OS)and then the survival curve was drawn.At the same time,the incidence of related adverse reactions during and after HIFU treatment was counted. Results:(1)Among the 45 patients,30 patients received HIFU combined with chemotherapy,and the other 15 patients only received HIFU.(2)Among the 45 patients,32 patients had pain relief after HIFU treatment,and the NRS score kept decreased across 1 week,2 weeks,3 weeks and 1 month after HIFU treatment(P<0.05).The pain sensation score of BPI scale also decreased correspondingly,and the difference was statistically significant(P<0.05).(3)The median OS of 45 patients was 11.1 months(95%Cl:9.30-1 2.90),of which 30 patients treated with HIFU combined chemotherapy had a median OS of 12.4 months(95%Cl:9.1 8-15.62),and 15 patients treated with HIFU only had a median OS of 4.6 months(95%Cl:1.11-8.10).(4)No serious adverse events were observed in all patients during and after HIFU treatment.Only 5 patients had asymptomatic mild elevation of blood amylase,and the incidence of mild adverse reactions was 11.1%. Conclusion:HIFU can effectively relieve pain and prolong the median survival time in patients with advanced pancreatic cancer.

4.
Zhongguo Zhong Yao Za Zhi ; (24): 1980-1987, 2021.
Article in Chinese | WPRIM | ID: wpr-879118

ABSTRACT

Traditional Chinese medicine(TCM) is an important feature of cancer treatment in China. The methods to tap the advantages of TCM, reasonably evaluate and accurately apply Chinese patent medicines have become current research hotspots and difficulties. TCM takes syndrome differentiation and treatment as the core, with the characteristics of overall regulation and multi-targets efficacy. Therefore, the post-marketing survival benefit evaluation of Chinese patent medicines for cancer is different from that in modern medicine. The primary treatment goals in cancer patients include to improve the disease control rate and prolong their survival time. At present, Chinese patent medicines for cancer patients are lacking indepth studies on survival benefit at the post-marketing stage. In addition, the characteristics of individualized treatment with TCM have also increased the complexity of clinical research on TCM. Therefore, it is of certain practical significance and necessity to evaluate the survival benefit of Chinese patent medicines for cancer after marketing. Based on this, in this paper, we first summarized the technical methodological means of survival benefit evaluation at this stage, and then explored the post-marketing survival benefit evaluation of Chinese patent medicines for cancer from three aspects: the evaluation of cancer treatment effect based on survival time and quality of life, treatment-related toxicity and the auxiliary effect of TCM, and the improvement effect for tumor-related symptoms. Based on the practices of early clinical researches, and according to the insufficient efficacy evaluation of current clinical research on Chinese patent medicines, this paper proposed to improve the evaluation system for clinical researches on Chinese patent medicines, establish the evaluation method with TCM characteristics, clarify the dominant population, lay a theoretical foundation for the evaluation of post-marketing survival benefits of Chinese patent medicines for cancer in the future, and promote the modernization process of TCM.


Subject(s)
Humans , China , Drugs, Chinese Herbal/therapeutic use , Marketing , Medicine, Chinese Traditional , Neoplasms/drug therapy , Nonprescription Drugs/therapeutic use , Quality of Life
5.
Article in Chinese | WPRIM | ID: wpr-609901

ABSTRACT

[Objective] To investigate association between the time point of sorafenib administered and suppress effect on tumor growth secondary to the increased expression of vascular endothelial growth factor (VEGF).[Methods] Fifty SD rats were performed intrahepatic implantation using tumor tissues from subcutaneous tumors in nude mice which were administered Walker 256 tumor cells.Ten days after the procedure,MR scans were used to choose forty SD rats with successful hepatic tumor transplantation among fifty experimental animals.Then they were randomly divided into four groups:(A,control group) mere injection of vascular endothelial growth factor (VEGF);(B) administration of sorafenib 72 hours prior to VEGF injection;(C) administration of sorafenib together with VEGF injection;(D) administration of sorafenib 72 hours later to VEGF injection.The tumor growth and median survival time of rodents were observed and compared.After each experimental animal died,immunohistochemical (IHC) methods were applied to detect the expression of VEGF in tumors.[Results] Ten days after the administration of sorafenib,MR showed significant growth of hepatic tumors,the tumor size in experiment group were significiant smaller,than control group (5.4 cm) with statistical significance.Median survival time of four groups were (19.6 ± 1.8) d,(31.2 ± 7.0) d,(27.4 ± 4.9) d,and (26.5 ± 4.6) d,respectively,which indicated that animals in sorafenib groups lived longer than those in control group (P < 0.05).Differences can be obseverd in sorafenib groups with statistical significance existing (P < 0.05).Harvest hepatic tumor tissues from dead animals and HE staining as well as IHC examination were performed.The expression of VEGF in four groups were 88.3 ± 13.6,42.8 ± 8.0,71.9 ± 15.7,and 73.6 ± 13.7.There were statistical significance between control group and sorafenib groups.And further in sorafenib groups,the expressions of VEGF also varied greatly.[Conclusion] Sorafenib can extend the survival time,reduce tumor angiogenesis.And we can conclude that administration of sorafenib before the transient increased expression of VEGF offers survival benefits than that after the evaluation of VEGF levels.

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