Peritoneal dialysis effectively removes toxic substances and improves liver functions of liver failure patients.

OBJECTIVE: Liver failure (LF) is a clinically complex disorder that characterizes with hepatic dysfunction. This study aimed at observing the therapeutic effects of peritoneal dialysis on liver function in LF patients. PATIENTS AND METHODS: This study involves 62 patients diagnosed as LF hospitalized from February 2005 to December 2016. The 62 LF patients were randomly divided into 3 groups, including artificial liver applying plasma exchange group (PE, n = 28), peritoneal dialysis group (PD, n = 22), and conservative treatment group (CT, n=12). Laboratory indexes, including serum total bilirubin (TBiL), alanine aminotransferase (ALT), albumin (ALB), blood ammonia (AMMO), international normalized ratio (INR), and creatinine (Cr) were evaluated. Inflammatory cytokines, including tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and procalcitonin (PCT) were examined using enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: Peritoneal dialysis significantly improves clinical outcomes, including decreased mortality, increased survival rate and total effective rate, compared to conservative treatment (p < 0.05). Peritoneal dialysis reduced hospitalization expenses compared to PE method and conservative treatment (p < 0.05). Peritoneal dialysis significantly removed toxic substances (including TBiL, AMMO, Cr) compared to conservative treatment (p < 0.05). The post-treatment level of Cr in peritoneal dialysis group was significantly lower compared to post-treatment level of Cr in PE group (p < 0.05). Peritoneal dialysis significantly improved liver function compared to conservative treatment (p < 0.05). Peritoneal dialysis prevented bleeding tendency compared to conservative treatment (p < 0.05). Peritoneal dialysis alleviated inflammatory response compared to conservative treatment (p < 0.05). CONCLUSIONS: Peritoneal dialysis effectively removed toxic substances and improved liver functions of liver failure patients and with a lower therapeutic cost.

[Prognostic significance of systematic retroperitoneal lymphadenectomy in patients with epithelial ovarian cancer: a Meta-analysis].

Objective: To investigate the survival impact of systematic retroperitoneal lymphadenectomy (SL) and unsystematic lymphadenectomy (USL) in patients with epithelial ovarian cancer. Methods: Randomized control trial (RCT) and observational studies about the effects of SL and USL on patients with epithelial ovarian cancer were searched in major online databases including PubMed, Embase, Web of Science, and Cochrane Library. The literature search was performed up to January 2016. The results were analyzed using RevMan 5.0 software. Results: Totally 14 studies including 1 634 patients in SL group and 1 719 patients in USL group were enrolled. Three of the 14 studies were RCTs, and the other 11 were observational studies. Meta analysis showed that SL was a favorable factor for 5-year overall survival rate (5-OS) compared with USL[RR=0.89, 95% CI (0.81, 0.97), P=0.007]. However, the efficacy of SL on increased 5-OS could not be determined in all type of studies owing to the result of RCTs[RR=0.99, 95% CI (0.85, 1.15), P=0.90], whereas SL improved 5-OS of patients in observational studies[RR=0.84, 95% CI (0.76, 0.93), P=0.001]. Moreover, SL increased 5-OS in patients with early stage (FIGO Ⅰ-Ⅱ) disease comparing with USL[RR=0.78, 95% CI (0.61, 0.99), P=0.04], as well as it could improve 5-OS statistically in advanced stage (FIGO Ⅲ-Ⅳ) disease[RR=0.90, 95% CI (0.82, 0.99), P=0.03]. But analysis on patients with optimal debulking surgery showed that SL could not improve 5-OS of these patients, regardless of early stage[RR=0.71, 95% CI (0.43, 1.17), P=0.18]or advanced stage[RR=1.01, 95% CI (0.90, 1.14), P=0.86]. Conclusions: The impact of SL on the survival of patients with epithelial ovarian cancer is still extremely controversial, which requires more relevant RCTs. In patients with optimal debulking surgery, SL could hardly improve the survival.