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1.
Surg Endosc ; 38(7): 3828-3837, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38822144

RESUMO

BACKGROUND: No consensus has been concluded with regarding to the scope of lymph node (LN) dissection for Siewert type II and III adenocarcinoma of the esophagogastric junction (AEG). This study aimed to explore risk factors for lower perigastric LN (LPLN) metastases (including no. 4d, 5, 6, and 12a LN stations) and analyze the indications for LPLN dissection. METHODS: In total, 302 consecutive patients with Siewert type II and III AEG who underwent total gastrectomy (TG) were enrolled. The logistic regression model was used to perform uni- and multivariate analyses of risk factors for LPLN metastases. Kaplan-Meier curves were used for survival analysis, and log-rank tests were used for group comparisons. Basing on the guidelines of Japanese Gastric Cancer Association, the LN metastases (LNM) as well as the efficiency index (EI) of each LN station was further evaluated. RESULTS: The independent risk factors for LPLN metastases in patients with Siewert type II and III AEG were distance from the esophagogastric junction (EGJ) to the distal end of the tumor (> 4.0 cm), preoperative carcinoembryonic antigen (CEA) ( +), pT4 stage, and HER-2 ( +). LPLN metastases was an independent risk factor for overall survival following TG. The LNM and EI of LPLN were 8.6% and 2.31%, respectively. The LNM of LPLN > 10% under the stratification of the distance from the EGJ to the distal end of the tumor (> 4.0 cm), pT4, preoperative CEA ( +), and HER-2 ( +) exhibited EI values of 3.55%, 2.09%, 2.51%, and 3.64%, respectively. CONCLUSIONS: LPLN metastases was a malignant factor for the prognosis of patients with Siewert type II and III AEG. For patients with preoperative CEA ( +), pT4 stage, HER-2 ( +), and the distance from the EGJ to the distal end of the tumor (> 4.0 cm), TG with LPLN dissection is prioritized for clinical recommendation.


Assuntos
Adenocarcinoma , Neoplasias Esofágicas , Junção Esofagogástrica , Gastrectomia , Excisão de Linfonodo , Metástase Linfática , Neoplasias Gástricas , Humanos , Junção Esofagogástrica/patologia , Adenocarcinoma/cirurgia , Adenocarcinoma/patologia , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Fatores de Risco , Gastrectomia/métodos , Idoso , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Adulto , Linfonodos/patologia , Relevância Clínica
2.
Chaos ; 34(7)2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38980382

RESUMO

Complex ecosystems often exhibit a tipping point around which a small perturbation can lead to the loss of the basic functionality of ecosystems. It is challenging to develop a control strategy to bring ecosystems to the desired stable states. Typically, two methods are employed to restore the functionality of ecosystems: abundance control and ecological regulation. Abundance control involves directly managing species abundance through methods such as trapping, shooting, or poisoning. On the other hand, ecological regulation is a strategy for ecosystems to self-regulate through environment improvement. To enhance the effectiveness of ecosystem recovery, we propose adaptive regulation by combining the two control strategies from mathematical and network science perspectives. Criteria for controlling ecosystems to reach equilibrium with or without noise perturbation are established. The time and energy costs of restoring an ecosystem to equilibrium often determine the choice of control strategy, thus, we estimate the control costs. Furthermore, we observe that the regulation parameter in adaptive regulation affects both time and energy costs, with a trade-off existing between them. By optimizing the regulation parameter based on a performance index with fixed weights for time and energy costs, we can minimize the total cost. Moreover, we discuss the impact of the complexity of ecological networks on control costs, where the more complex the networks, the higher the costs. We provide corresponding theoretical analyses for random networks, predator-prey networks, and mixture networks.

3.
BMC Surg ; 24(1): 150, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38745222

RESUMO

PURPOSE: To investigate whether the mixed approach is a safe and advantageous way to operate laparoscopic right hemicolectomy. METHODS: A retrospective study was performed on 316 patients who underwent laparoscopic right hemicolectomy in our center. They were assigned to the middle approach group (n = 158) and the mixed approach group (n = 158) according to the surgical approaches. The baseline data like gender、age and body mass index as well as the intraoperative and postoperative conditions including operation time, blood loss, postoperative hospital stay and complications were analyzed. RESULTS: There were no significant differences in age, sex, BMI, ASA grade and tumor characteristics between the two groups. Compared with the middle approach group, the mixed approach group was significantly lower in terms of operation time (217.61 min vs 154.31 min, p < 0.001), intraoperative blood loss (73.8 ml vs 37.97 ml, p < 0.001) and postoperative drainage volume. There was no significant difference in the postoperative complications like postoperative anastomotic leakage, postoperative infection and postoperative intestinal obstruction. CONCLUSIONS: Compared with the middle approach, the mixed approach is a safe and advantageous way that can significantly shorten the operation time, reduce intraoperative bleeding and postoperative drainage volume, and does not prolong the length of hospital stay or increase the morbidity postoperative complications.


Assuntos
Colectomia , Neoplasias do Colo , Laparoscopia , Duração da Cirurgia , Complicações Pós-Operatórias , Humanos , Estudos Retrospectivos , Colectomia/métodos , Masculino , Feminino , Laparoscopia/métodos , Neoplasias do Colo/cirurgia , Pessoa de Meia-Idade , Idoso , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Tempo de Internação/estatística & dados numéricos , Resultado do Tratamento , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Adulto
4.
Chaos ; 33(5)2023 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-37192391

RESUMO

Considering the transmission characteristics of the coronavirus disease 2019 (COVID-19), there are certain time delays in the transition from susceptible individuals to exposed individuals after contact with exposed, symptomatically infected, and asymptomatically infected individuals. A COVID-19 model with time delays and exposed infection is developed and then the global dynamics of this model is investigated by an improved method; moreover, the numerical simulations are carried out. It is shown that the COVID-19-free equilibrium T0 is globally asymptotically stable (GAS) if and only if the control reproduction number Rc≤1, while T0 is unstable and the COVID-19 equilibrium T∗ is GAS if and only if Rc>1. The numerical results reveal that strengthening quarantine measures is helpful to control the COVID-19 epidemic in India. Furthermore, when Rc<1, the numbers of symptomatically infected, asymptomatically infected, and quarantined individuals eventually tend to the zero equilibrium state, and with the increase in the time delay, the three kinds of variables change faster and their peaks become larger; when Rc>1, the three kinds of variables eventually tend to the positive equilibrium state, which are oscillatory and the amplitudes of the oscillation enlarge as the value of time delay increases. The numerical results show that when Rc<1, the smaller the value of time delay, the smaller the final epidemic size. In short, the longer it takes time for susceptible individuals to transform exposed individuals, the harder COVID-19 will be controlled.


Assuntos
COVID-19 , Epidemias , Humanos , COVID-19/epidemiologia , SARS-CoV-2 , Quarentena/métodos , Índia/epidemiologia
5.
BMC Cancer ; 22(1): 1223, 2022 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-36443694

RESUMO

BACKGROUND: Paclitaxel plus S-1(PTXS) has shown definite efficacy for advanced gastric cancer. However, the efficacy and safety of this regimen in neoadjuvant setting for locally advanced gastric cancer (LAGC) are unclear. This study aimed to compare the efficacy of neoadjuvant chemotherapy (NAC) PTXS and oxaliplatin plus S-1 (SOX) regime for patients with LAGC. METHODS: A total of 103 patients with LAGC (cT3/4NanyM0/x) who were treated with three cycles of neoadjuvant SOX regimen (n = 77) or PTXS regimen (n = 26) between 2011 and 2017 were enrolled in this study. NAC-related clinical response, pathological response, postoperative complication, and overall survival were analyzed between the groups. RESULTS: The baseline data did not differ significantly between both groups. After NAC, the disease control rate of the SOX group (94.8%) was comparable with that of the PTXS group (92.3%) (p = 0.641). Twenty-three cases (29.9%) in the SOX group and 10 cases (38.5%) in the PTX group got the descending stage with no statistical difference (p = 0.417). No significant differences were observed in the overall pathological response rate and the overall postoperative complication rate between the two groups (p > 0.05). There were also no differences between groups in terms of 5-year overall and disease-free survival (p > 0.05). CONCLUSIONS: The validity of NAC PTXS was not inferior to that of SOX regimen for locally advanced gastric cancer in terms of treatment response and overall survival. PTXS regimen could be expected to be ideal neoadjuvant chemotherapy for patients with LAGC and should be adopted for the test arm of a large randomized controlled trial.


Assuntos
Segunda Neoplasia Primária , Neoplasias Gástricas , Humanos , Terapia Neoadjuvante , Paclitaxel , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/cirurgia , Complicações Pós-Operatórias
6.
Int J Colorectal Dis ; 37(8): 1739-1750, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35789424

RESUMO

PURPOSE: Anastomotic leakage (AL) is a common postoperative complication of rectal cancer, and transanal drainage tube (TDT) efficacy is still contentious. This study aimed to evaluate the TDT effect on AL prevention. METHODS: All relevant papers were searched by using a predefined search strategy (two randomized controlled trials (RCTs), one prospective study, and four retrospective studies). Meta-analysis was conducted to estimate AL and re-operation pooled rates. RESULTS: A total of 7 studies (1556 patients) were included: No significant statistic difference was found between two groups on AL rate (odds ratio (OR) 0.61, P = 0.11) and re-operation rate (OR 0.52, P = 0.10). For subgroup analysis, significant statistic difference was found between two groups on AL rate (OR 0.29, P = 0.002) and re-operation rate (OR 0.15, P = 0.04) in patients without neoadjuvant therapy. As for patients without diverting stoma, the AL rate (OR 0.35, P = 0.002) was significantly lower than that in patients without TDT. CONCLUSIONS: TDT may reduce AL morbidity and re-operation rate for patients without high risk of AL, but may be useless for those in high-risk situations.


Assuntos
Laparoscopia , Neoplasias Retais , Canal Anal/cirurgia , Anastomose Cirúrgica/efeitos adversos , Fístula Anastomótica/etiologia , Fístula Anastomótica/prevenção & controle , Fístula Anastomótica/cirurgia , Drenagem/efeitos adversos , Humanos , Laparoscopia/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias Retais/complicações , Estudos Retrospectivos
7.
Future Oncol ; 18(31): 3509-3518, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36317561

RESUMO

Background: Lateral lymph node (LLN) metastasis is a poor prognostic factor for rectal cancer patients. However, the effect of LLNs without malignant characteristics on the prognosis of rectal cancer patients has been uncertain. Methods: Consecutive patients who underwent laparoscopic-assisted low anterior resection were included. Patients with MRI-detected LLNs, but without malignant characteristics, were compared with patients with no MRI-detected LLNs. Results: The local recurrence rate was higher in the LLN-present group than in the LLN-absent group (9.8% vs 2.5%; p = 0.056). The overall survival of patients with no MRI-detected LLNs was significantly better than that of patients with MRI-detected LLNs (p = 0.021). Conclusion: The presence of LLNs, even without malignant features, may lead to worse local control and overall survival.


Lymph node metastasis in the pelvic sidewall of patients with rectal cancer is a serious disease that affects the patient's life expectancy. At present, the assessment of lateral lymph node (LLN) metastasis relies mainly on MRI. Currently, there is no consensus on whether small lymph nodes without malignant features detected by MRI affect patient prognosis. Therefore, the authors designed this study to compare the survival of patients with small LLNs detected by MRI with that of patients without LLNs. The authors found that the presence of LLNs, even without malignant features, may lead to worse local control and overall survival. Therefore, for patients with MRI-detected LLNs, LLN dissection should be conducted by experienced surgeons to improve patient prognosis.


Assuntos
Excisão de Linfonodo , Neoplasias Retais , Humanos , Neoplasias Retais/patologia , Linfonodos/patologia , Metástase Linfática/patologia , Prognóstico , Recidiva Local de Neoplasia/patologia , Estudos Retrospectivos , Estadiamento de Neoplasias
8.
BMC Cancer ; 21(1): 974, 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34461860

RESUMO

BACKGROUND: This study compared the long-term efficacy of different durations of adjuvant chemotherapy for patients with gastric cancer after radical gastrectomy with D2 lymphadenectomy. METHODS: We retrospectively identified 428 patients with stage II-III gastric cancer who underwent D2 gastrectomy between 2009 and 2016. Patients were divided into four groups according to the duration of adjuvant chemotherapy, including 0 week (no adjuvant, group A), 20 to 24 weeks (completed 7-8 cycles every 3 weeks or 10-12 cycles every 2 weeks, group B), and 12 to18 weeks (completed 4-6 cycles every 3 weeks or 6-9 cycles every 2 weeks, group C), and less than 12 weeks (received up to 3 cycles every 3 weeks or 5 cycles every 2 weeks, group D). The chemotherapy regimens included XELOX, SOX, and FOLFOX. 5-year overall survival (OS) and disease-free survival (DFS) were analyzed. RESULTS: The 5-year OS rates for groups A, B, C, and D were 52.3, 73.7, 72.0, and 53.3%, respectively, and the 5-year DFS rates were 50.0, 68.0, 65.4, and 50.0%, respectively. OS and DFS were higher in group B than in groups A and D. Similarly, patients in group C were more likely to have higher OS and DFS than those in groups A and D. Meanwhile, there were no significant differences in OS and DFS between groups B and C. The multivariate analysis confirmed with high statistical significance the efficacy of complete courses of adjuvant chemotherapy, and, among them, the similar impact of 4-6/6-9 and 7-8/10-12 cycles, resulting in similar HRs vs Group A (0.52 and 0.42, respectively). CONCLUSIONS: To reduce toxicity and maintain efficacy, XELOX or SOX chemotherapy regimens administered for 4-6 cycles every 3 weeks or FOLFOX regimen for 6-9 cycles every 2 weeks might be a favorable option for patients with stage II-III gastric cancer after D2 gastrectomy. Prospective multicenter clinical trials with adequate sample sizes are necessary to verify these findings.


Assuntos
Adenocarcinoma/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia Adjuvante/mortalidade , Gastrectomia/mortalidade , Excisão de Linfonodo/mortalidade , Neoplasias Gástricas/tratamento farmacológico , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia , Taxa de Sobrevida , Adulto Jovem
9.
World J Surg Oncol ; 19(1): 187, 2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34172053

RESUMO

BACKGROUND: Postoperative symptomatic anastomotic leakage (AL) is a serious complication after low anterior resection (LAR) for rectal cancer. AL can potentially affect short-term patient outcomes and long-term prognosis. This study aimed to explore the risk factors and long-term survival of symptomatic AL after laparoscopic LAR for rectal cancer. METHODS: From May 2009 to May 2015, 298 consecutive patients who underwent laparoscopic LAR for rectal cancer with or without a defunctioning stoma were included in this study. Univariate and multivariate logistic regression analyses were used to explore independent risk factors for symptomatic AL. Survival analysis was performed using Kaplan-Meier curves, and log-rank tests were used for group comparisons. RESULTS: Among the 298 patients enrolled in this study, symptomatic AL occurred in eight (2.7%) patients. The univariate analysis showed that age of ≤65 years (P = 0.048), neoadjuvant therapy (P = 0.095), distance from the anal verge (P = 0.078), duration of operation (P = 0.001), and pathological tumor (T) category (P = 0.004) were associated with symptomatic AL. The multivariate analysis demonstrated that prolonged duration of operation (P = 0.010) was an independent risk factor for symptomatic AL after laparoscopic LAR for rectal cancer. No statistically significant differences were observed in the 3-year (P = 0.785) and 5-year (P = 0.979) overall survival rates. CONCLUSIONS: A prolonged duration of operation increased the risk of symptomatic AL after laparoscopic LAR for rectal cancer. An impact of symptomatic AL on a long-term survival was not observed in this study; however, further studies are required. TRIAL REGISTRATION: This study was registered in the Chinese Clinical Trial Registry ( ChiCTR2000033413 ) on May 31, 2020.


Assuntos
Laparoscopia , Neoplasias Retais , Idoso , Anastomose Cirúrgica , Fístula Anastomótica , Humanos , Prognóstico , Neoplasias Retais/cirurgia , Estudos Retrospectivos , Fatores de Risco
10.
Appl Math Model ; 89: 907-918, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32839637

RESUMO

Seasonal forcing and contact patterns are two key features of many disease dynamics that generate periodic patterns. Both features have not been ascertained deeply in the previous works. In this work, we develop and analyze a non-autonomous degree-based mean field network model within a Susceptible-Infected-Susceptible (SIS) framework. We assume that the disease transmission rate being periodic to study synergistic impacts of the periodic transmission and the heterogeneity of the contact network on the infection threshold and dynamics for seasonal diseases. We demonstrate both analytically and numerically that (1) the disease free equilibrium point is globally asymptotically stable if the basic reproduction number is less than one; and (2) there exists a unique global periodic solution that both susceptible and infected individuals coexist if the basic reproduction number is larger than one. We apply our framework to Scale-free contact networks for the simulation. Our results show that heterogeneity in the contact networks plays an important role in accelerating disease spreading and increasing the amplitude of the periodic steady state solution. These results confirm the need to address factors that create periodic patterns and contact patterns in seasonal disease when making policies to control an outbreak.

11.
Int J Cancer ; 146(8): 2281-2295, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-31901134

RESUMO

The majority of patients with microsatellite stable (MSS) colorectal cancer (CRC) do not benefit from the immunotherapies directed at rescuing T-cell functions. Therefore, complete understanding of T-cell phenotypes and functional status in the CRC microenvironment is desirable. Here, we applied single-cell mass cytometry to mold the T-cell phenotype in 18 patients with MSS CRC for better understanding of CRC as a systemic disease and to search for tumor-driven T-cell profile changes. We show interpatient and intrapatient phenotypic diversity of T-cell subsets. We revealed increased immunosuppressive/exhausted T-cell phenotypes at tumor lesions. CD8+ CD28- immunosenescent T cells with impaired proliferation capacity dominate the T-cell compartment. As per the transcriptome and quantitative real time-PCR analysis, the accumulation of immunosuppressive cells is driven by the tumor microenvironment. T-cell profiles are similar between patients at early and late stages, indicating that the immunosuppressive microenvironment is formulated early during CRC development. Mapping of T-cell infiltration and understanding of the mechanisms underlying their regulation may provide valuable information to boost the immune response in patients with MSS CRC.


Assuntos
Neoplasias Colorretais/imunologia , Linfócitos T/imunologia , Linfócitos T CD8-Positivos/imunologia , Linfócitos T CD8-Positivos/patologia , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Perfilação da Expressão Gênica , Humanos , Tolerância Imunológica , Fenótipo , Análise de Célula Única , Subpopulações de Linfócitos T/imunologia , Subpopulações de Linfócitos T/patologia , Linfócitos T/patologia , Microambiente Tumoral/imunologia
12.
BMC Cancer ; 20(1): 761, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32795280

RESUMO

BACKGROUND: This study aimed to evaluate the short- and long-term outcomes after laparoscopic resection for low rectal cancer (LRC) compared with mid/high rectal cancer (M/HRC). METHODS: Patients with rectal cancer undergoing laparoscopic resection with curative intent were retrospectively reviewed between 2009 and 2015. After matched 1:1 by using propensity score analysis, perioperative and oncological outcomes were compared between LRC and M/HRC groups. Multivariate analysis was performed to identify independent factors of overall survival (OS) and disease-free survival (DFS). RESULTS: Of 373 patients who met the criteria for inclusion, 198 patients were matched for the analysis. Laparoscopic surgery for LRC required longer operative time (P<0.001) and more blood loss volume (P = 0.015) compared with M/HRC, and the LRC group tended to have a higher incidence of postoperative complications (16.2% vs. 8.1%, P = 0.082). There was no significant difference in local recurrence between the two groups (9.1% vs. 4.0%, P = 0.251), whereas distant metastasis was inclined to be more frequent in LRC patients compared with M/HRC (21.2% vs. 12.1%, P = 0.086). The LRC group showed significantly inferior 5-year OS (77.0% vs. 86.4%, P = 0.033) and DFS (71.2% vs. 86.2%, P = 0.017) compared with the M/HRC group. Multivariate analysis indicated that tumor location was an independent predictor of DFS (HR = 2.305, 95% CI 1.203-4.417, P = 0.012). CONCLUSION: Tumor location of the rectal cancer significantly affected the clinical and oncological outcomes after laparoscopic surgery, and it was an independent predictor of DFS.


Assuntos
Laparoscopia/efeitos adversos , Recidiva Local de Neoplasia/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Protectomia/efeitos adversos , Neoplasias Retais/terapia , Reto/patologia , Capecitabina/uso terapêutico , Quimiorradioterapia Adjuvante , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Recidiva Local de Neoplasia/prevenção & controle , Duração da Cirurgia , Complicações Pós-Operatórias/etiologia , Protectomia/métodos , Prognóstico , Pontuação de Propensão , Neoplasias Retais/mortalidade , Neoplasias Retais/patologia , Reto/cirurgia , Estudos Retrospectivos
13.
Surg Endosc ; 33(1): 33-45, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30386984

RESUMO

BACKGROUND: Although laparoscopic surgery has been recommended as an optional therapy for patients with early gastric cancer, whether patients with locally advanced gastric cancer (AGC) could benefit from laparoscopy-assisted distal gastrectomy (LADG) with D2 lymphadenectomy remains elusive due to a lack of comprehensive clinical data. To evaluate the efficacy of LADG, we conducted a multi-institutional randomized controlled trial to compare laparoscopy-assisted versus open distal gastrectomy (ODG) for AGC in North China. METHODS: In this RCT, after patients were enrolled according to the eligibility criteria, they were preoperatively assigned to LADG or ODG arm randomly with a 1:1 allocation ratio. The primary endpoint was the morbidity and mortality within 30 postoperative days to evaluate the surgical safety of LADG. The secondary endpoint was 3-year disease-free survival. This trial was registered at ClinicalTrial.gov as NCT02464215. RESULTS: Between March 2014 and August 2017, a total of 446 patients with cT2-4aN0-3M0 (AJCC 7th staging system) were enrolled. Of these, 222 patients underwent LADG and 220 patients underwent ODG were included in the modified intention-to-treat analysis. The compliance rate of D2 lymph node dissection was identical between the LADG and ODG arms (99.5%, P = 1.000). No significant difference was observed regarding the overall postoperative complication rate in two groups (LADG 13.1%, ODG 17.7%, P = 0.174). No operation-related death occurred in both arms. CONCLUSIONS: This trial confirmed that LADG performed by credentialed surgeons was safe and feasible for patients with AGC compared with conventional ODG.


Assuntos
Gastrectomia/métodos , Laparoscopia , Neoplasias Gástricas/cirurgia , Adulto , Idoso , China , Intervalo Livre de Doença , Feminino , Gastrectomia/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Complicações Pós-Operatórias/etiologia , Neoplasias Gástricas/mortalidade
14.
Ann Surg Oncol ; 22(12): 3881-7, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25963477

RESUMO

BACKGROUND: Colon cancer nomogram designed by Memorial Sloan-Kettering Cancer Center (MSKCC) is an online prediction tool to predict overall survival for individual patient after curative resection. However, this model was never externally validated. We evaluated the accuracy of this nomogram in an independent external Chinese cohort. METHODS: Clinical data from 1005 patients who underwent primary curative-intent surgery at Peking University Cancer Hospital & Institute between 1996 and 2008 were used for external validation. Clinicopathologic characteristics and the performance of the MSKCC nomogram for prediction of overall survival were evaluated for 985 patients with complete data by using concordance index (C-index) and calibration plot. RESULTS: The C-index for the MSKCC nomogram was 0.71 in the Chinese cohort, compared with 0.67 for American Joint Committee on Cancer (AJCC) stage (P < .0001). This suggests that the nomogram discriminates overall survival better than AJCC staging system. Calibration plot showed a good calibration of the nomogram in the validation cohort. Furthermore, the MSKCC nomogram prediction illustrated the heterogeneity for survival of Chinese patients within each AJCC stage. CONCLUSIONS: The MSKCC nomogram for colon cancer provides more accurate survival predictions than the AJCC staging system when applied to an external Chinese cohort. The MSKCC nomogram improved individualized prediction of survival and may aid in more accurate patient counseling, selection of various treatment options, and follow-up scheduling.


Assuntos
Colectomia/mortalidade , Neoplasias do Colo/mortalidade , Neoplasias do Colo/cirurgia , Nomogramas , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Técnicas de Apoio para a Decisão , Feminino , Previsões/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Taxa de Sobrevida , Adulto Jovem
15.
J Transl Med ; 12: 15, 2014 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-24444035

RESUMO

BACKGROUND: Golgi phosphoprotein 3 (GOLPH3) has been validated as a potent oncogene involved in the progression of many types of solid tumors, and its overexpression is associated with poor clinical outcome in many cancers. However, it is still unknown the association of GOLPH3 expression with the prognosis of colorectal cancer (CRC) patients who received 5-fluorouracil (5-FU)-based adjuvant chemotherapy. METHODS: The expression of GOLPH3 was determined by qRT-PCR and immunohistochemistry in colorectal tissues from CRC patients treated with 5-FU based adjuvant chemotherapy after surgery. The association of GOLPH3 with clinicopathologic features and prognosis was analysed. The effects of GOLPH3 on 5-FU sensitivity were examined in CRC cell lines. RESULTS: GOLPH3 expression was elevated in CRC tissues compared with matched adjacent noncancerous tissues. Kaplan-Meier survival curves indicated that high GOLPH3 expression was significantly associated with prolonged disease-free survival (DFS, P = 0.002) and overall survival (OS, P = 0.011) in patients who received 5-FU-based adjuvant chemotherapy. Moreover, multivariate analysis showed that GOLPH3 expression was an independent prognostic factor for DFS in CRC patients treated with 5-FU-based chemotherapy (HR, 0.468; 95%CI, 0.222-0.987; P = 0.046). In vitro, overexpression of GOLPH3 facilitated the 5-FU chemosensitivity in CRC cells; while siRNA-mediated knockdown of GOLPH3 reduced the sensitivity of CRC cells to 5-FU-induced apoptosis. CONCLUSIONS: Our results suggest that GOLPH3 is associated with prognosis in CRC patients treated with postoperative 5-FU-based adjuvant chemotherapy, and may serve as a potential indicator to predict 5-FU chemosensitivity.


Assuntos
Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/genética , Fluoruracila/uso terapêutico , Proteínas de Membrana/metabolismo , Idoso , Morte Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Quimioterapia Adjuvante , Neoplasias Colorretais/enzimologia , Neoplasias Colorretais/patologia , Intervalo Livre de Doença , Feminino , Fluoruracila/farmacologia , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Técnicas de Silenciamento de Genes , Humanos , Estimativa de Kaplan-Meier , Masculino , Proteínas de Membrana/genética , Pessoa de Meia-Idade , Análise Multivariada , Poli(ADP-Ribose) Polimerases/metabolismo , Prognóstico , RNA Interferente Pequeno/metabolismo
16.
Math Biosci Eng ; 21(4): 5430-5445, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38872542

RESUMO

A new network-based SIR epidemic model with saturated incidence rate and nonlinear recovery rate is proposed. We adopt an edge-compartmental approach to rewrite the system as a degree-edge-mixed model. The explicit formula of the basic reproduction number $ \mathit{\boldsymbol{R_{0}}} $ is obtained by renewal equation and Laplace transformation. We find that $ \mathit{\boldsymbol{R_{0}}} < 1 $ is not enough to ensure global asymptotic stability of the disease-free equilibrium, and when $ \mathit{\boldsymbol{R_{0}}} > 1 $, the system can exist multiple endemic equilibria. When the number of hospital beds is small enough, the system will undergo backward bifurcation at $ \mathit{\boldsymbol{R_{0}}} = 1 $. Moreover, it is proved that the stability of feasible endemic equilibrium is determined by signs of tangent slopes of the epidemic curve. Finally, the theoretical results are verified by numerical simulations. This study suggests that maintaining sufficient hospital beds is crucial for the control of infectious diseases.

17.
Math Biosci Eng ; 21(4): 4835-4852, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38872516

RESUMO

Since the global outbreak of COVID-19, the virus has continuously mutated and can survive in the air for long periods of time. This paper establishes and analyzes a model of COVID-19 with self-protection and quarantine measures affected by viruses in the environment to investigate the influence of viruses in the environment on the spread of the outbreak, as well as to develop a rational prevention and control measure to control the spread of the outbreak. The basic reproduction number was calculated and Lyapunov functions were constructed to discuss the stability of the model equilibrium points. The disease-free equilibrium point was proven to be globally asymptotically stable when $ R_0 < 1 $, and the endemic equilibrium point was globally asymptotically stable when $ R_0 > 1 $. The model was fitted using data from COVID-19 cases in Chongqing between November 1 to November 25, 2022. Based on the numerical analysis, the following conclusion was obtained: clearing the virus in the environment and strengthening the isolation measures for infected people can control the epidemic to a certain extent, but enhancing the self-protection of individuals can be more effective in reducing the risk of being infected and controlling the transmission of the epidemic, which is more conducive to the practical application.


Assuntos
Número Básico de Reprodução , COVID-19 , Quarentena , SARS-CoV-2 , COVID-19/prevenção & controle , COVID-19/transmissão , COVID-19/epidemiologia , Humanos , Número Básico de Reprodução/estatística & dados numéricos , Pandemias/prevenção & controle , China/epidemiologia , Simulação por Computador , Surtos de Doenças/prevenção & controle , Algoritmos
18.
Math Biosci Eng ; 20(9): 16962-16977, 2023 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-37920042

RESUMO

In this paper, we propose a multi-patch SVEIR epidemic model that incorporates vaccination of both newborns and susceptible populations. We determine the basic reproduction number $ R_{0} $ and prove that the disease-free equilibrium $ P_{0} $ is locally and globally asymptotically stable if $ R_{0} < 1, $ and it is unstable if $ R_{0} > 1. $ Moreover, we show that the disease is uniformly persistent in the population when $ R_{0} > 1. $ Numerical simulations indicate that vaccination strategies can effectively control disease spread in all patches while population migration can either intensify or prevent disease transmission within a patch.

19.
Math Biosci Eng ; 20(6): 10392-10403, 2023 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-37322938

RESUMO

The COVID-19 pandemic has caused widespread concern around the world. In order to study the impact of media coverage and vaccination on the spread of COVID-19, we establish an SVEAIQR infectious disease model, and fit the important parameters such as transmission rate, isolation rate and vaccine efficiency based on the data from Shanghai Municipal Health Commission and the National Health Commission of the People's Republic of China. Meanwhile, the control reproduction number and the final size are derived. Moreover, through sensitivity analysis by PRCC (partial rank correlation coefficient), we discuss the effects of both the behavior change constant $ k $ according to media coverage and the vaccine efficiency $ \varepsilon $ on the transmission of COVID-19. Numerical explorations of the model suggest that during the outbreak of the epidemic, media coverage can reduce the final size by about 0.26 times. Besides that, comparing with $ 50\% $ vaccine efficiency, when the vaccine efficiency reaches $ 90\% $, the peak value of infected people decreases by about 0.07 times. In addition, we simulate the impact of media coverage on the number of infected people in the case of vaccination or non-vaccination. Accordingly, the management departments should pay attention to the impact of vaccination and media coverage.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , SARS-CoV-2 , Pandemias/prevenção & controle , China/epidemiologia , Surtos de Doenças/prevenção & controle
20.
J Biol Dyn ; 17(1): 2244980, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37656780

RESUMO

The COVID-19 epidemic has been spreading around the world for nearly three years, and asymptomatic infections have exacerbated the spread of the epidemic. To analyse and evaluate the role of asymptomatic infections in the spread of the epidemic, we establish an improved COVID-19 infectious disease dynamics model. We fit the epidemic data in the four time periods corresponding to the selected 614G, Alpha, Delta and Omicron variants and obtain the proportion of asymptomatic persons among the infected persons gradually increased and with the increase of the detection ratio, the cumulative number of cases has dropped significantly, but the decline in the proportion of asymptomatic infections is not obvious. Therefore, in view of the hidden transmission of asymptomatic infections, the cooperation between various epidemic prevention and control policies is required to effectively curb the spread of the epidemic.


Assuntos
Infecções Assintomáticas , COVID-19 , Humanos , Infecções Assintomáticas/epidemiologia , SARS-CoV-2 , Modelos Biológicos
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