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Objective To observe the change of high mobility group protein B1 (HMGB1) in patients with hepatocellular carcinoma (HCC) before and after transcatheter arterial chemoembolization (TACE) and its effect on prognosis.Methods A total of 68 HCC patients only with TACE treatment were selected as the research objects from June 2012 to June 2014 in Shandong Tumor Hospital.The serum levels of HMGB1 of all the patients were detected 1 day before TACE and 1 month after TACE.The change of HMGB1 expression before and after TACE was analyzed.According to the reference data,the patients were divided into the high-expression group (≥ 17.5 ng/ml) and the low-expression group (＜ 17.5 ng/ml).The short-term efficacy of the two groups of patients and their survival time were compared.Results The pre-operative HMGB1 level of patients was (40.6 + 13.6) ng/ml,and the 1-month postoperative HMGB1 level was (20.1 + 6.9) ng/ml,and the difference was statistically significant (t =4.22,P =0.040).The effective rate in patients with low HMGB1 expression after TACE was 65.00％,and 39.29％ in patients with high HMGB1 expression,with a significant difference (x2 =4.390,P =0.036).The 1,2,and 3 year survival rates of low HMGB1 expression group were 77.50％,50.00％ and 27.50％,respectively,which were significandy higher than high HMGB1 expression group (57.14％,21.43％ and 7.14％),with a significant difference (x2 =8.301,P =0.040).Conclusion TACE can reduce the HMGB1 expression level in serum of patiens with HCC.The patients with low expression of HMGB1 have the better short-term efficacy and the longer survival time.
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Objective To compare the short-term efficacies of laparoscopic intersphincteric resection (ISR) and laparotomy for ultra-low rectal cancers by Meta-analysis.Methods We searched case-control trials that compared clinical outcomes of laparoscopic ISR and laparotomy from PubMed, EMBase, Ovid, CNKI and Wanfang database.Relevant published and unpublished data and conference papers were also retrieved.Two reviewers independently assessed the qualities of the included studies.Meta-analysis was performed by using of RevMan5.2 software.Results A total of 5 trials with 552 cases were included.The results of Meta-analysis showed that in terms of blood loss of the operation [mean difference (MD) =-65.42, 95％ CI:-93.45--37.38, Z=4.57, P＜0.000 01], flatus passage time (MD=-0.96, 95％CI:-1.45--0.47, Z=3.83, P=0.000 1) and hospital stays (MD=-1.69,95％CI:-2.19--1.19, Z=6.63, P＜0.00001),laparoscopic ISR were significantly superior than those of laparotomy, with significant differences.In terms of operation time (MD =6.61,95 ％ CI:-21.29-34.51, Z =0.46, P =0.64), the positive rate of circumferential resection margin (OR =1.01, 95％ CI: 0.37-2.80, Z =0.02, P =0.98) and postoperative morbidity (0R=0.73, 95％ CI: 0.45-1.20, Z =1.23, P =0.22), there were no significant differences in the two groups.However, laparotomy may clean more numbers of lymph nodes than those of laparoscopic ISR (MD =-1.16, 95％CI:-2.14--0.18, Z =2.31, P =0.02), with significant difference.Conclusion The shortterm efficacy of laparoscopic ISR is superior than that of laparotomy in the treatment of ultra-low rectal cancer.
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<p><b>OBJECTIVE</b>To compare the clinical short-term safety and efficacy between robotic right colectomy (RRC) and laparoscopic right colectomy(LRC) with meta-analysis.</p><p><b>METHODS</b>A search of the Medline, Embase, Ovid, CNKI and WANFANG databases was performed for studies comparing clinical or oncologic outcomes of RRC with LRC before July 2014. The RevMan 5.2 software was used for meta-analysis. The operative time, estimated blood loss, length of hospital stay, conversion rate to open surgery, postoperative complications and related outcomes were evaluated.</p><p><b>RESULTS</b>Six studies including 217 RRC cases and 400 conventional LRC cases were enrolled and analyzed. The meta-analysis showed that RRC had longer operative time (MD=48.05, 95% CI: 26.52 to 69.57, P<0.01), less estimated blood loss (MD=-17.74, 95% CI: -28.32 to -7.16, P=0.01), faster postoperative intestinal peristalsis recovery (MD=-0.79, 95% CI: -1.10 to -0.48, P<0.01), lower postoperative overall complications (OR=0.63, 95% CI: 0.42 to 0.93, P=0.02). Conversion rate and postoperative hospital stay between the two groups were not significantly different (all P>0.05).</p><p><b>CONCLUSION</b>Compared to LRC, RRC is associated with less estimated blood loss, faster postoperative intestinal peristalsis recovery, lower postoperative overall complications, and longer operative time.</p>