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OBJECTIVE@#To investigate the prognostic value of preoperative serum tumor markers combined with peripheral blood routine indexes in colorectal cancer patients.@*METHODS@#From January 2010 to March 2013, clinicopathological data of colorectal cancer patients receiving surgery treatment at the Third Affiliated Hospital of Sun Yat-sen University were collected.@*INCLUSION CRITERIA@#(1) histologically confirmed adenocarcinoma; (2) primary cancer resected; (3) intact clinical data; (4) no signs of clinical infection. Patients with intestinal perforation or obstruction, hematological diseases or other malignant tumors were excluded. Informations were recorded containing sex, age, tumor location, degree of differentiation, tumor size, vascular tumor thrombus, nerve invasion, depth of infiltration, lymph node metastasis, distant metastasis, TNM stage, peripheral serum CEA, CA199, number of neutrophil, monocyte, platelet and lymphocyte. Positive CEA was defined as ≥5 μg/L, CA199 as ≥35 U/L; while NLR (neutrophil-to-lymphocyte ratio), MLR (monocyte-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio) greater than their cut-off values were defined as positive. ROC curve was used to determine the cut-off values (with greatest area under curve) of NLR, MLR and PLR. The prognostic values of these indexes were analyzed using Kaplan-Meier regression and log-rank test. COX regression was used to perform risk factor analysis.@*RESULTS@#A total of 312 colorectal cancer patients were enrolled, including 192 males and 120 females with median age of 61 (15-85) years. Till March 11, 2018, during median follow-up period of 65 months(2-96), the follow-up rate was 90.4% with loss of 30 cases and the mortality was 37.2% with 116 death. Univariate analysis found that colorectal cancer patients with positive CEA, CA199, NLR (>2.32), MLR (>0.24) and PLR (>164.1) had poor prognosis (all P<0.01). When combining CEA, CA199 with NLR, MLR, PLR, the survival analysis showed that patients with both negative indexes had the best prognosis, one positive the worse and both positive were the worst (all P<0.01). COX regression revealed that CEA(HR= 1.702,95%CI:1.148-2.522, P<0.01), combination of CA199 and MLR (HR=2.292, 95%CI:1.426-3.683, P<0.01) were independent risk factors for colorectal cancer.@*CONCLUSION@#Combination of preoperative serum tumor markers and peripheral blood routine indexes can provide prognostic information for the patients with colorectal cancer.
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Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Biomarcadores Tumorais , Sangue , Plaquetas , Neoplasias Colorretais , Sangue , Diagnóstico , Linfócitos , Estadiamento de Neoplasias , Neutrófilos , Prognóstico , Estudos RetrospectivosRESUMO
Objective To investigate the experiences in observation and nursing care during perioperative period of cavernous sinus dural arteriovenous fistulas(DAVFS) embolized with coil and ONYX glue. Methods In the course of the operation,17 cases of cavernous sinus DAVFS were treated with psychological nursing, perioperation disease observation and complications preventive nursing. Results All patients with DAVFS could be embolized successfully using interventional techniques and without complications. Conclusions The therapeutic method of embolizing cavernous sinus DAVFS with coil and ONYX glue is secure and cost-effective.The key steps of the patients convalescence lie in comprehensive perioperative nursing,observing symptoms carefully and preventing complications.
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Objective To evaluate the expression and clinical significance of plasma circulating microRNA-23b in patients with myasthenia gravis (MG).Methods Plasma samples from 32 MG patients and 32 healthy people were collected in the Second Affiliated Hospital of Harbin Medical University from October 2015 to August 2016. Expression of microRNA-23b was detected by quantitative reverse transcription polymerase chain reaction .The relationship among microRNA-23b expression level, clinical features and quantitative myasthenia gravis score ( QMG ) was analyzed. Results The expression of circulating microRNA-23b in plasma was significantly higher in MG patients (4.587 (3.654, 5.423)) compared with control group (2.889 (1.968, 4.027), Z=-4.169, P<0.01), meanwhile it was positively related to QMG (r=0.661,P<0.01).But the expression of circulating microRNA-23b had no statistically significant difference in MG subgroups .Conclusion Plasma circulating microRNA-23b is highly expressed in MG and has positive correlation with MG severity .
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Objective To investigate the practice effect of WeChat software on extended care for patients with anterior resection syndrome. Methods From August 2014 to August 2015, 50 patients with anterior resection syndrome were chosen as control group. From September 2015 to August 2016, 50 patients with anterior resection syndrome were chosen as experimental group. Patients in experimental group could use WeChat software independently. Control group got extended care by telephone, while experimental group was carried out through WeChat platform. They were followed up for 6 months. WeChat software offered patients professional guidance on evaluation and exercise methods of defecation function by video and text with some figures. The questions from patients were answered through WeChat software during followed up. Results The defecation function after 1 month of surgery for patients with excellent, good, average, poor was 15, 20, 12, 3 cases respectively in the experimental group, and 9, 15, 19, 7 cases respectively in the control group. The defecation function after 3 month of surgery for patients with excellent, good, average, poor was 19, 21, 8, 2 cases respectively in the experimental group, and 12, 18, 17, 3 cases respectively in the control group. The difference of the defecation function after 1,3 months of surgery were statistically significant (χ2=8.395, 8.251, P0.05). The compliance of medication, diet and rehabilitation exercise, regular review after 6 months of surgery for patients was (2.14 ± 0.72), (7.21 ± 1.63), (11.20 ± 0.63), (5.04 ± 0.78) points respectively in the experimental group, and (1.37 ± 0.58), (5.72 ± 1.32),(9.75 ± 1.56),(4.72 ± 0.43)points respectively in the control group, and the differences were statistically significant (t=2.68-5.75, P< 0.01).Conclusion WeChat software can improve defecation function and treatment compliance, thus greatly improve the quality of life of patients with mid-low rectal cancer.
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Objective To evaluate Jiangxia umbilical therapy on the quality of life in patients with gastric carcinoma chemotherapy after surgery.Methods Patients with gastric carcinoma chemotherapy after surgery in the Third Affiliated Hospital of Sun Yat-Sen University from January 2016 to December 2016 were chosen as the research subjects.According to the time of chemotherapy,the patients were divided into two groups.Patients with gastric carcinoma chemotherapy in hospital from January 2016 to June 2016 were chosen as control group,while patients in hospital from July 2016 to December 2016 were chosen as observation group.Before chemotherapy,the control group was given tropisetron hydrochloride intravenous injection,while the observation group added Jiangxia umbilical on the basis of this.Nausea and vomiting in the two groups were observed after treatment.Quality of Life Questionnaire of Stomach 22 was applied to analyze and compare the patients' quality of life.Results The incidence rate of anti nausea in the observation group was 88.10％,which in the control group was 61.90％,the difference was statistically significant (x2 =9.571,P ＜ 0.05).The overall quality of life in observation group was significantly better than that in the control group [(20.34 ±:5.84) points vs.(14.32 ± 5.97) points,t =8.686,P ＜ 0.01].The scores in the observation group on the quality of life in the aspects of total score,anxiety scale,reflux scale,eating restricted scale,dry mouth,tastes changing had statistically significant differences compared with the indicators in the control group (all P ＜ 0.05).Conclusion Jiangxia umbilical therapy can not only relieve the chemotherapy-induced nausea and vomiting of patients with gastric carcinoma chemotherapy after surgery,but also can improve their quality of life.
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In the past, liver cirrhosis was thought to be irreversible. However, theoretically, the process of liver cirrhosis could be slowed down by inhibiting extracellular matrix (ECM) production and by promoting its degradation. Wnt signaling pathway has been involved in many physiological and pathological processes and some studies have confirmed that abnormal activation of Wnt signaling pathway could cause activation of hepatic stellate cells, and then further induce ECM formation and prompt cirrhosis progression. We believe that new clinical therapeutic direction would emerge after in-depth exploration of the mechanism of Wnt signaling pathway involved in liver cirrhosis progression.
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Jaundice is frequent clinic symptoms with high incidence especially among the critical patients. The sepsis complicated with jaundice has drawn more and more consideration. However, the pathogenesis about sepsis complicated with jaundice is not confirmed and it is sometimes identified incorrectly as cholestatic jaundice. This article summarises the pathogenesis and elucidate the management about sepsis complicated with jaundice.
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Objective To study the relationship between age with sex and sero-uric acid concentration in Shanwei,and to found the range of criterion of sero-uric scid of themself in all area's laboratory.Methods The specimen of health adults of 789 patients were detected by urate oxidase-indirect peroxidase couple.Results The serum uric acid concentration of males were (341.2?70.3)?mol/L and females (282.3?61.3)?mol/L.It had approached the level of occidend.The difference was very significant compared with males and females in the same age(P
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0.05).Conclusion There are hapatic and renal disease,craniocerebral disease,wound,toxicaion with hypouricemia,the clinical assay should be paid more attention.