RESUMO
BACKGROUND: Deep venipuncture catheterization is widely used in clinical anesthesia. However, it is worth thinking about how to improve the rate of successful catheter insertion, and relieve patients' discomfort. This paper aimed to compare the clinical advantages between trocar and steel needle. METHODS: Total 503 adult patients were recruited and randomly assigned. The control group was punctured with steel needle, and the experimental group was punctured with trocar needle. Clinical and followed-up information was recorded. Pearson's chi-squared and spearman test were performed to analyze the correlation between intervention and relative parameters. Univariate logistic regression was performed to verify the odds ratio of trocar needle compared with steel needle. RESULTS: Pearson's chi-square test and Spearman's correlation test showed a significant correlation between puncture success, puncture comfort, successful catheter insertion, puncture time, thrombosis, catheter fever, bleeding, infection and interventions (Pâ <â .05). Univariate logistic regression showed that there existed better puncture comfort (odds ratio [OR]â =â 6.548, 95% confidence interval [CI]: 4.320-9.925, Pâ <â .001), higher successful catheter insertion (ORâ =â 6.060, 95% CI: 3.278-11.204, Pâ <â .001), shorter puncture time (ORâ =â 0.147, 95% CI: 0.093-0.233, Pâ <â .001), lesser thrombosis (ORâ =â 0.194, 95% CI: 0.121-0.312, Pâ <â .001), lesser catheter fever (ORâ =â 0.263, 95% CI: 0.158-0.438, Pâ <â .001), lesser bleeding (ORâ =â 0.082, 95% CI: 0.045-0.150, Pâ <â .001) and lesser infection (ORâ =â 0.340, 95% CI: 0.202-0.571, Pâ <â .001) in trocar group compared with steel needle group. CONCLUSION: Trocar application in deep venipuncture catheterization can improve successful catheter insertion, relieve pain and discomfort of patients, reduce incidence of complications, and provide better security for patients.
Assuntos
Cateterismo Venoso Central , Trombose , Humanos , Adulto , Flebotomia/efeitos adversos , Cateterismo Venoso Central/efeitos adversos , Aço , Hemorragia/etiologia , Trombose/etiologia , Instrumentos CirúrgicosRESUMO
Estrogen-related genes and the fat mass and obesity-associated (FTO) gene play a critical role in estrogen metabolism, and those polymorphisms are associated with a poor prognosis in breast cancer. However, little is known about the association between these polymorphisms and the efficacy of anastrozole. The aim was to investigate the impact of the genetic polymorphisms, CYP19A1, 17-ß-HSD-1 and FTO, on the response to anastrozole in metastatic breast carcinoma (MBC) and to evaluate the impact of those polymorphisms on various clinicopathologic features. Two-hundred seventy-two women with hormone receptor-positive MBC treated with anastrozole were identified retrospectively. DNA was extracted from peripheral blood and genotyped for five variants in three candidate genes. Time to progression was improved in patients carrying the variant alleles of rs4646 when compared to patients with the wild-type allele (16.40 months versus 13.52 months; p = 0.049). The rs4646 variant alleles were significantly associated with longer overall survival (37.3 months versus 31.6 months; p = 0.007). This relationship was not observed with the rs10046, rs2830, rs9926298 and rs9939609 polymorphisms. The findings of this study indicate that rs4646 polymorphism in the CYP19A1 gene may serve as a prognostic maker of the response to anastrozole in patients with MBC who are treated with anastrozole.
Assuntos
Inibidores da Aromatase/uso terapêutico , Aromatase/genética , Neoplasias da Mama/genética , Nitrilas/uso terapêutico , Triazóis/uso terapêutico , 17-Hidroxiesteroide Desidrogenases/genética , Regiões 3' não Traduzidas , Adulto , Idoso , Idoso de 80 Anos ou mais , Alelos , Dioxigenase FTO Dependente de alfa-Cetoglutarato , Anastrozol , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Feminino , Frequência do Gene , Genótipo , Humanos , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Proteínas/genética , Estudos Retrospectivos , Análise de SobrevidaRESUMO
OBJECTIVE: To discuss the significance of DOG1, CD117 and PDGFRA in the diagnosis of gastrointestinal stromal tumors (GISTs), and analyze their correlations with clinicopathological features and risk ranking. METHOD: DOG1, CD117 and PDGFRA were detected with IHC Envision ldpe-g-nvp in 63 GISTs and 43 cases of non-GISTs, and analyzed for relations with clinicopathological factors (gender, age, location, tumor size, mitotic phase, histology) and risk degree. RESULTS: The positive expression rate of DOG1, CD117 and PDGFRA in GISTs was 84.1% (53/63), 90.5% (57/63), 53.2% (33/63), respectively. Among the 6 CD117 negative cases, all were DOG1 positive and 5 were PDGFRA positive. Rates in patients with non-GISTs was 11.6%, 16.3%, 6.98%, respectively. Expression of DOG1 and PDGFRA demonstrated no significant variation with gender, age, position, tumor size, mitotic phase, histology, and risk rank. However, CD117 was related with position and histology (P=0.008 and P=0.045), those in the mesentery having a higher positive rate than those derived from stomach, small intestine, colon and rectum (50.0% vs 94.7%, P=0.008). Furthermore CD117 was also highly expressed in spindle and epithele types. CONCLUSIONS: DOG1 had a good sensitivity and specificity as a kind of newly discovered marker, especially for KIT negative GISTs. However, DOG1, CD117 and PDGFRA cannot be used for assessing the rish of patients.
Assuntos
Canais de Cloreto/metabolismo , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/metabolismo , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/metabolismo , Proteínas de Neoplasias/metabolismo , Proteínas Proto-Oncogênicas c-kit/metabolismo , Receptor alfa de Fator de Crescimento Derivado de Plaquetas/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Anoctamina-1 , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Colo/patologia , Feminino , Neoplasias Gastrointestinais/patologia , Tumores do Estroma Gastrointestinal/patologia , Humanos , Intestino Delgado/patologia , Masculino , Mesentério/patologia , Pessoa de Meia-Idade , Índice Mitótico , Reto/patologia , Medição de Risco , Sensibilidade e Especificidade , Estômago/patologia , Adulto JovemRESUMO
BACKGROUND: Risk factors that contribute to younger patients with lung cancer are still relatively unknown. The aim of this study was to compare the clinical characteristics, histological types, stages at diagnosis, treatment modalities and survival rates between young and old patients with lung cancer. METHODS: The study was designed as a retrospective review of all lung cancer patients admitted to the Third Affiliated Hospital of Harbin Medical University from 1998 to 2008. Survival analyses using univariate and multivariate approaches were performed to compare the survival rates between different age groups and to discover potential prognostic factors. RESULTS: This research included 3320 patients with primary lung cancer, of whom 626 (18.8%) were 45 years old or younger at the time of diagnosis. The percentage of smokers and the male to female ratios between the young and old patient groups were 51.27% vs. 70.6% (P < 0.001) and 1.99 vs. 2.13 (P = 0.4801), respectively. The young patient group had a higher incidence of adenocarcinoma and fewer surgeries. The 1-year, 3-year and 5-year survival rates in the young patient group were generally lower than those of the old patient group, with significant differences (P = 0.0232). The clinical stage of the tumor was a prognostic factor for both non-small cell lung cancer patients (P < 0.0001) and small cell lung cancer patients (P = 0.0002). Symptoms, diagnostic method, histology, smoking, treatment modality and body mass index were shown to have significant relationships with the survival of lung cancer patients (P < 0.05). CONCLUSIONS: Patients with lung cancer who are younger than 45 years old might have a significantly poorer prognosis than that of older patients. Symptoms, diagnosis method, histology, smoking, treatment modality and body mass index can be independent prognostic factors for lung cancer.