The correlation between common postoperative complications and quality of life, serum tumor markers, and prognosis in patients with esophageal cancer.

Background: Esophageal cancer (EC) is highly malignant, with poor prognosis. The main forms of treatment are surgery, radiotherapy, and chemotherapy. In recent years, the incidence and mortality rate of patients with EC has improved. However, the factors that affect the quality of life of EC patients are unclear. This study investigated the postoperative complications and quality of life of EC patients, and identified the related factors. The relationship between complications and quality of life was explored so as to provide guidance for the clinical treatment and rehabilitation these patients. Methods: A total of 120 patients with EC who underwent surgery at the First People's Hospital of Lianyungang from January 2016 to August 2017 were retrospectively enrolled in this study. The patient's subjective quality of life evaluation was documented and clinical data were collated. The correlation between the incidence of postoperative complications and the patient's quality of life, serum tumor markers, and prognosis was analyzed. Results: A total of 36 (30%) EC patients experienced postoperative complications. There were 12 cases of pulmonary complications (10%), 8 cases of arrhythmia (6.67%), 3 cases of anastomotic fistula (2.5%), 5 cases of pneumothorax and pleural effusion (4.17%), and 4 cases of gastroesophageal reflux (3.33%). Incision infection occurred in 2 patients (1.67%) and there was 1 case (0.83%) of chylothorax. Empyema was reported in 1 patient (0.83%). There were significant differences in the overall condition, physical function, fatigue, pain, and swallowing pain between patients with postoperative complications and those without complications (P<0.05). Preoperative and postoperative expression of the tumor marker CYFRA21-1 was found to be independent risk factors for postoperative complications after EC surgery. Conclusions: EC is a common malignant tumor with a high incidence of postoperative complications. Patients with high CYFRA21-1 expression should be aware of the higher risk of postoperative complications. Patients with complications have poorer quality of life and obvious symptoms of fatigue, pain, and swallowing pain. Health education and dietary guidance should be provided to such patients to improve their symptoms.

Association of MDM2 gene SNP 309 polymorphism and human non-small cell lung cancer susceptibility: A meta-analysis.

This updated meta-analysis was performed to evaluate the relationship of a common polymorphism (T309 G, rs2279744 T > G) in the murine double minute 2 (MDM2) gene with susceptibility and prognosis of non-small cell lung cancer (NSCLC). The Cochrane Library, PubMed, Embase, CNKI, WanFang and CNKI databases were searched comprehensively for related study. Odds ratios (ORs) with their 95% confidence intervals (95% CI) were calculated. 11 articles with a total 6470 NSCLC patients and 8027 controls met the inclusion criteria were included. MDM2 T309 G polymorphism might be strongly correlated with an increased risk of NSCLC. The overall pooled analysis indicated that MDM2 309 T/G polymorphism was significantly associated with NSCLC susceptibility in the whole population under allelic (OR: 1.22, 95% CI: 1.08-1.38), recessive (OR: 1.37, 95% CI: 1.15-1.63), dominant (OR: 1.23, 95% CI: 1.04-1.45), and homozygous genetic models (OR: 1.49, 95% CI: 1.20-1.86). The subgroup analysis showed a significant association of MDM2 309 T/G polymorphism with NSCLC susceptibility in Asian population, but not in Caucasian population. Besides, a significant association was found again in the female population. The meta-analysis provides convincing evidence that the MDM2 T309 G polymorphism may contribute to NSCLC susceptibility, especially for Asians and women.

A multicenter, double-blind, randomized, comparison study of the efficacy and safety of tigecycline to imipenem/cilastatin to treat complicated intra-abdominal infections in hospitalized subjects in China.

PURPOSE: To assess the efficacy and safety of tigecycline in treating complicated intra-abdominal infections (cIAIs) in hospitalized patients in China. PATIENTS AND METHODS: A Phase IV, multicenter, randomized, double-blinded, active-controlled, non-inferiority study was conducted. Hospitalized cIAI patients ≥18 years of age were randomized (1:1) to receive intravenous tigecycline (initial dose 100 mg, then 50 mg q12h) or imipenem/cilastatin (500 mg/500 mg or adjusted for renal dysfunction, q6h) for 5-14 days. The primary end point was clinical response for clinically evaluable (CE) subjects at test-of-cure (TOC) assessment. RESULTS: Four hundred and seventy subjects were randomized; 232 in the tigecycline and 231 in the imipenem/cilastatin group were treated. Tigecycline was non-inferior to imipenem/cilastatin with respect to clinical response at TOC for all CE subjects, ie, the lower bound of the two-sided 95% CI (-12.0%, -1.4%) for the treatment difference in cure rate, tigecycline (89.9%) minus imipenem/cilastatin (96.6%), was >-15%. As non-inferiority was concluded in the CE population, superiority of tigecycline over imipenem/cilastatin and superiority of imipenem/cilastatin over tigecycline were tested on the CE and the modified intent-to-treat (mITT) populations according to pre-specified statistical criteria, and neither could be demonstrated (the cure rate was 82.8% vs 88.7%, difference -6.0% [-12.8%, 0.8%], for the mITT population). The subject-level microbiological response rate at TOC for the microbiologically evaluable population was 88.0% (110/125) vs 95.3% (102/107, difference -7.3% [-15.2%, 0.5%]). Nausea, drug ineffectiveness, postoperative wound infection, vomiting, and pyrexia were the most common adverse events in tigecycline-treated subjects; pyrexia, nausea, vomiting, and increased alanine aminotransferase and aspartate aminotransferase levels were most common in imipenem/cilastatin-treated subjects; none were unanticipated. CONCLUSION: Tigecycline was non-inferior to imipenem/cilastatin in treating hospitalized adult patients with cIAI. Superiority of tigecycline over imipenem/cilastatin or imipenem/cilastatin over tigecycline could not be demonstrated. Safety was consistent with the known profile for tigecycline. CLINICALTRIALSGOV IDENTIFIER: NCT01721408.