Relationship between skeletal muscle index at the third lumbar vertebra with infection risk and long-term prognosis in patients with acute-on-chronic liver failure.

Objective: Infection is a major cause of increased mortality in patients with acute-on-chronic liver failure (ACLF). This study aims to examine the potential correlation of the skeletal muscle index at the third lumbar vertebra (L3-SMI) with infections among ACLF patients and to evaluate its impact on the long-term survival. Methods: This retrospective study included 126 patients who underwent abdominal computed tomography (CT) and were diagnosed with ACLF at our center between December 2017 and December 2021. L3-SMI was calculated using CT, and the clinical and biochemical data as well as MELD scores were also collected, so as to analyze the relationship between L3-SMI and infections in ACLF patients and the impact on long-term prognosis. Results: Of the 126 ACLF patients enrolled, 50 had infections. In the multivariate logistic regression analysis, both L3-SMI [odds ratio (OR) = 0.89, 95% confidence interval (CI) = 0.81 - 0.97, P = 0.011] and hepatic encephalopathy (OR = 8.20, 95% CI = 1.70 - 39.59, P = 0.009) were independently associated with the risk of infection development. The overall survival (OS) estimates were obtained using Kaplan-Meier curves, and it was found that patients in the lowest tertile of L3-SMI had significantly lower 3-month, 6-month, 1-year, and 2-year survival rates than those in the highest tertile (P = 0.014; log-rank test). Conclusion: Low L3-SMI is an independent risk factor for the development of infections and significantly influences the long-term survival in ACLF patients.

Long-Term Survival Rate of Autogenous Tooth Transplantation: Up to 162 Months.

Background and Objectives: The purpose of this study is to observe the usefulness of autogenous tooth transplantation by examining the cumulative survival rate according to the period of auto-transplanted teeth as pre-implant treatment. Materials and Methods: This study was conducted on 111 patients who visited Kyungpook National University Dental Hospital and underwent autogenous tooth transplantation between November 2008 and January 2021 (about 13 years). The cumulative survival rate of autogenous tooth transplantation according to the causes of extraction of the recipient tooth (caries, periapical lesion, crack, crown fracture, periodontitis) and condition of opposing teeth (natural teeth vs. fixed prosthesis). The cumulative survival rate of autogenous tooth transplantation according to the age (under 30 vs. over 30) was also investigated and it was examined whether there were any differences in each factor. Results: The average follow-up period was 12 months, followed by a maximum of 162 months. The 24-month cumulative survival rate of all auto-transplanted teeth was 91.7%, 83.1% at 60 months and the 162-month cumulative survival rate was 30.1%. There were no statistical differences between the causes of extraction of the recipient's teeth, differences in the condition of the opposing teeth, and differences under and over the age of 30. Conclusions: The survival rate of autogenous tooth transplantation appears to be influenced by the conditions of the donor tooth rather than the conditions of the recipient tooth. Although autogenous tooth transplantation cannot completely replace implant treatment, it is meaningful in that it can slightly delay or at least earn the time until implant placement is possible.

Early and long-term outcomes after left-side heart valve replacement and tricuspid valve replacement in rheumatic patients / 中华胸心血管外科杂志

Objective:To evaluate and compare the early and long-term outcomes of rheumatic patients who underwent left-side heart valve replacement with concomitant tricuspid valve replacement, and analyze the difference of early mortality and long-term survival rate between mild pulmonary artery systolic pressure (PASP) and moderate to severe PASP patients.Methods:From January 2009 to December 2018, 79 cases of patients were reviewed and summarized. The mean age before operation was (45.7±7.8) years old. These patients were divided into mild PASP group(<50 mmHg, 38 cases) (1 mmHg=0.133 kPa) and moderate-severe PASP group (>50 mmHg, 41 cases) . Kaplan- Meier method was used to estimate the overall long-term survival rate and the incidence of complications, and to compare the long-term survival rate of patients with mild and moderate -severe PASP elevation. Results:The mortality rate of early postoperative patients was 8.9% (7/79). The causes of death included: low cardiac output syndrome in 3 cases, multiple organ failure caused by pulmonary infection in 2 cases, acute renal insufficiency in 1 case, sudden cardiac arrest in 1 case. Although the mortality rate of early moderate-severe PASP group (12.2% vs. 5.3%) was higher than that of mild PASP group, there was no significant difference ( P>0.05). The mean follow-up time was (51.8±31.7) months (3-115 months). Kaplan- Meier method was used to estimate the 10-year survival rate, the rate of avoiding thrombosis, the rate of avoiding serious bleeding event and the rate of avoiding reoperation, which were (67.2±10.6)%, (85.7±6.2)%, (83.4± 6.9)% and (93.7 ± 3.7)%, respectively. Although the long-term survival rate of mild PASP (78.0±10.6) % was higher than that of moderate-severe PASP (62.8 ± 13.4) %, there was no significant difference ( P>0.05). Conclusion:The early mortality rate of rheumatic patients who underwent left-side heart valve replacement with concomitant tricuspid valve replacement is still relatively high. The recurrent heart failure is the major causes of long-term death.

Effect of Short-term Complications After D2 Radical Gastrectomy on Long-term Survival Rate of Gastric Cancer Patients / 肿瘤防治研究

Objective To investigate the effect of short-term complications after D2 radical gastrectomy on long-term survival rate of gastric cancer patients. Methods A retrospective case-control study was conducted on 421 patients with gastric cancer who underwent D2 radical gastrectomy. According to the short-term postoperative complications, they were divided into experimental group (complication group, n=76) and control group (without complication group, n=345). In order to reduce the selection bias, the long-term survival rate of the two groups was tested by Kaplan-Meier survival analysis method after balancing the variables by propensity score matching (PSM). Log rank method was used for univariate analysis and Cox multivariate analysis was used for prognostic factors. Results There was no significant difference in long-term survival rate between the experimental group and the control group (P > 0.05). Histological type, lymph node metastasis rate and pTNM stage were independent risk factors for long-term survival. Conclusion The short-term complications after D2 radical gastrectomy have no significant impact on the long-term survival rate of gastric cancer patients, but it has certain clinical significance to actively prevent and control complications.

Influence study of near and long term survival rate on different resection regions with gastric cancer in M region / 中国现代普通外科进展

Objective:To study influence study of near and long term survival rate on different resection regions for patients with gastric cancer in M region.Methods:110 patients with M region gastric cancer received treatment in our hospital were divided into observation group(with total gastrectomy) 57 cases and control group (with subtotal gastrectomy) 53 cases,compared with clinical pathology data and radical degree,two groups of patients' operation index,and local recurrence rate and near and long term survival rate in the two groups.Results:Two groups of patients were compared with clinical pathology data and radical degree,the difference was not statistically significant (P＞0.05).The observation group's nearly cutting edge outside distance and lymph nodes were significantly higher than the control group,the difference was statistically significant (P＜0.05).There was no significant difference between the two groups(P＞0.05).The recurrence rate(3.51％) and recurrence rate (15.79％) of the observation group were significantly less than the control group of 16.98％ and 33.96％,and the difference was statistically significant (P＜0.05).The 1 and 3 year survival rates of the observation group were compared with the control group,the difference was not statistically significant (P＞0.05).But the 5 year survival rate of the observation group was 57.89％,which was significantly higher than that in the control group of 35.85％,the difference was statistically significant (P＜0.05).Conclusions There is no significant difference in the survival rate of total gastrectomy in patients with gastric cancer in M region and total gastrectomy,but the long-term survival rate is higher,it is worthy of clinical attention.

Poor prognosis for hepatocellular carcinoma with transarterial chemoembolization pre-transplantation: retrospective analysis.

AIM: To investigate whether transarterial chemoembolization (TACE) before liver transplantation (LT) improves long-term survival in hepatocellular carcinoma (HCC) patients. METHODS: A retrospective study was conducted among 204 patients with HCC who received LT from January 2002 to December 2010 in PLA General Hospital. Among them, 88 patients received TACE before LT. Prognostic factors of serum α-fetoprotein (AFP), intraoperative blood loss, intraoperative blood transfusion, disease-free survival time, survival time with tumor, number of tumor nodules, tumor size, tumor number, presence of blood vessels and bile duct invasion, lymph node metastasis, degree of tumor differentiation, and preoperative liver function were determined in accordance with the Child-Turcotte-Pugh (Child) classification and model for end-stage liver disease. We also determined time of TACE before transplant surgery and tumor recurrence and metastasis according to different organs. Cumulative survival rate and disease-free survival rate curves were prepared using the Kaplan-Meier method, and the log-rank and χ(2) tests were used for comparisons. RESULTS: In patients with and without TACE before LT, the 1, 3 and 5-year cumulative survival rate was 70.5% ± 4.9% vs 91.4% ± 2.6%, 53.3% ± 6.0% vs 83.1% ± 3.9%, and 46.2% ± 7.0% vs 80.8% ± 4.5%, respectively. The median survival time of patients with and without TACE was 51.857 ± 5.042 mo vs 80.930 ± 3.308 mo (χ(2) = 22.547, P < 0.001, P < 0.05). The 1, 3 and 5-year disease-free survival rates for patients with and without TACE before LT were 62.3% ± 5.2% vs 98.9% ± 3.0%, 48.7% ± 6.7% vs 82.1% ± 4.1%, and 48.7% ± 6.7% vs 82.1% ± 4.1%, respectively. The median survival time of patients with and without TACE before LT was 50.386 ± 4.901 mo vs 80.281 ± 3.216 mo (χ(2) = 22.063, P < 0.001, P < 0.05). TACE before LT can easily lead to pulmonary or distant metastasis of the primary tumor. Although there was no significant difference between the two groups, the chance of metastasis of the primary tumor in the group with TACE was significantly higher than that of the group without TACE. CONCLUSION: TACE pre-LT for HCC patients increased the chances of pulmonary or distant metastasis of the primary tumor, thus reducing the long-term survival rate.

Effects ofαInterferon on Long-term Survival Rate and Tumor Recurrence After Radical Hepatic Resection / 中国药房

OBJECTIVE:To investigate the effect of α-interferon on long-term survival rate and tumor recurrence after radical hepatic resection. METHODS:104 patients with primary hepatocellular carcinoma underwent radical hepatic resection were divided into observation group(62 cases)and control group(42 cases). Observation group was treated with IFN-α for 18 months 4-6 weeks after surgery;control group received rountine treatment. Total survival rate and disease-free survival rate after surgery were com-pared between 2 groups. RESULTS:In observation group after surgery,1-year survival rate was 82.26%(51/62),3-year survival rate 61.29%(38/62),and 5-year survival rate 24.19%(15/62);in control group after surgery,1-year survival rate was 41.94%(26/62),3-year survival rate 28.57%(12/42)and 5-year survival rate 9.52%(4/42);there was statistically significant difference in postoperative survival rate between 2 groups (P<0.05). In observation group after surgery,1-year disease-free survival rate was 61.29%(38/62),3-year disease-free survival rate 40.32%(25/62),and 5-year disease-free surial rate 17.74%(11/62);in control group after surgery,1 year disease-free survival rate was 43.55%(27/62),3 year disease-free survival rate 22.58%(14/62),and 5-year disease-free surial rate was 0(0/62);there was statistically significant difference in postoperative disease-free survival rate be-tween 2 groups (P<0.05). CONCLUSIONS:The application of α-interferon after radical hepatic resection can significantly inhibit the recurrence of postoperative tumor,improve the long-term survival rate,and is worthy of clinical research.

Long-term survivals of stage IIb osteosarcoma: a 20-year experience in a single institution.

BACKGROUND: The purpose of this study is to evaluate the disease-free survival (DFS) and overall survival (OS) of patients with stage IIB osteosarcoma at a single institution for 20 years and to compare the results according to the chemotherapy protocols. METHODS: From Jan 1988 to Nov 2008, 167 patients with osteosarcoma were treated at our hospital and among them, 117 patients (67 males and 50 females) with stage IIB osteosarcoma were evaluable. Their mean age was 22.6 years (range, 8 months to 71 years). Seventy-eight cases underwent the modified T10 (M-T10) protocol (group 1), 23 cases underwent the T20 protocol (group 2) and 16 cases underwent the T12 protocol (group 3). The DFS and OS were calculated and compared according to the chemotherapy protocols. RESULTS: At a mean follow-up of 78.9 months, 63 patients were continuously disease-free (63/117), 6 patients were alive after having metastatic lesions, 7 patients died of other cause and 41 patients died of their disease. The 5- and 10-year OS rates were 60.2% and 44.8%, respectively and the 5- and 10-year DFS rates were 53.5% and 41.4%, respectively. There was no significant difference of the OS and DFS between the chemotherapy protocols (p = 0.692, p = 0.113). CONCLUSIONS: At present, we achieved success rates close to the internationally accepted DFS and OS. We were able to achieve the higher survival rates using the M-T10 protocol over the 20 years. However, there was no significant difference of results between the chemotherapy protocols. We think the M-T10 protocol will achieve more favorable results in the near future.

Long-Term Survivals of Stage IIB Osteosarcoma: A 20-Year Experience in a Single Institution

BACKGROUND: The purpose of this study is to evaluate the disease-free survival (DFS) and overall survival (OS) of patients with stage IIB osteosarcoma at a single institution for 20 years and to compare the results according to the chemotherapy protocols. METHODS: From Jan 1988 to Nov 2008, 167 patients with osteosarcoma were treated at our hospital and among them, 117 patients (67 males and 50 females) with stage IIB osteosarcoma were evaluable. Their mean age was 22.6 years (range, 8 months to 71 years). Seventy-eight cases underwent the modified T10 (M-T10) protocol (group 1), 23 cases underwent the T20 protocol (group 2) and 16 cases underwent the T12 protocol (group 3). The DFS and OS were calculated and compared according to the chemotherapy protocols. RESULTS: At a mean follow-up of 78.9 months, 63 patients were continuously disease-free (63/117), 6 patients were alive after having metastatic lesions, 7 patients died of other cause and 41 patients died of their disease. The 5- and 10-year OS rates were 60.2% and 44.8%, respectively and the 5- and 10-year DFS rates were 53.5% and 41.4%, respectively. There was no significant difference of the OS and DFS between the chemotherapy protocols (p = 0.692, p = 0.113). CONCLUSIONS: At present, we achieved success rates close to the internationally accepted DFS and OS. We were able to achieve the higher survival rates using the M-T10 protocol over the 20 years. However, there was no significant difference of results between the chemotherapy protocols. We think the M-T10 protocol will achieve more favorable results in the near future.

The Long-term Results and Causes of Death after Abdominal Aortic Aneurysm Repair

PURPOSE: The purpose of this study was to analyze the causes of late death and the long-term survival of patients following abdominal aortic aneurysm (AAA) repair. METHODS: From 1993 to 2005, 146 (98 intact and 48 ruptured) consecutive AAA patients underwent open repair. The perioperative data was supplemented with a retrospective review of the medical records and the use of the database of the National Statistical Office to calculate the survival rates and the causes of death. RESULTS: There was one operative death (1%) in the intact AAA group and 12 (25%) in the ruptured AAA group. After exclusion of the operative deaths, the survival rates of the intact AAA patients were 94.5% at 1 year, 77.0% at 5 years and 33.2% at 10 years; these findings demonstrated a significant longer survival for the intact AAA patients than for patients with ruptured AAA (86.1% at 1 year, 56.7% at 5 years and 0% at 10 years, respectively). The causes of late death included cardiovascular disease in 52.8% (coronary artery disease in 22.6%, cerebrovascular disease in 20.8%, other arterial aneurysms in 5.7% and graft-related death in 3.8%), malignancies in 11.3% and pulmonary disease in 11.3%. The multivariate analysis showed that the long-term survival rates were influenced by the rupture status, the history of cerebrovascular disease and hypertension. CONCLUSION: This study showed that the long-term survival after intact AAA repair was better than that for ruptured AAA repair even if we exclude the operative deaths. The most common cause of late death was cardiovascular disease. Our findings suggest that the patients with preoperative cerebrovascular disease and hypertension require additional care.