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1.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-1023884

RESUMEN

Idiopathic pulmonary fibrosis(IPF)is a chronic progressive interstitial lung disease of unknown etiology,with a rapid disease course,poor prognosis,and the absence of effective therapeutic drugs.Mitochondrial dys-function is one of the crucial causes of inducing IPF.Silent information regulator 3(SIRT3)can restore mitochondrial ho-meostasis by inhibiting mitochondrial oxidative stress,repairing mitochondrial DNA damage,and ameliorating abnormal mitochondrial lipid metabolism.This paper summarizes the role and mechanism of SIRT3 in attenuating mitochondrial dys-function based on delineating the relationship between mitochondrial dysfunction and IPF,aiming to provide references for finding effective treatment methods for IPF.

2.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-1027186

RESUMEN

Objective:To evluate the vascular impedance of the pulmonary arteries in fetuses with tetralogy of Fallot (TOF) by Doppler echocardiography.Methods:A total of 42 fetuses with TOF (TOF group) and 84 gestational age-matched normal fetuses(control group)were prospectively collected from August 2022 to January 2023 in the Second Xiangya Hospital of Central South University. The severity of TOF was classified into mild TOF (Z score≥-2), moderate TOF (-4<Z score<-2) or severe TOF (Z score≤-4) according to the Z score values of the pulmonary annulus diameter. The pulsatility indexs (PI) of the main pulmonary artery (MPA), distal left pulmonary artery (DLPA) and distal right pulmonary artery (DRPA) were measured by pulsed-wave Doppler. The differences of clinical data and echocardiographic parameters between TOF group, control group and TOF subgroups were compared.Results:Compared with the control group, MPA-PI increased significantly, whereas DLPA-PI and DRPA-PI decreased in TOF group (all P<0.001). There were no significant differences in MPA-PI and DRPA-PI among mild TOF, moderate TOF and severe TOF (all P>0.05). However, DLPA-PI decreased significantly in severe TOF compared with mild TOF ( P<0.05). Conclusions:Fetuses with TOF present increas vascular impedance in pulmonary trunk and decreased impedance in distal pulmonary artery branches. Further large and follow-up studies are needed to demonstrate the associations between the changes in vascular impedance and the development of pulmonary artery in patients with TOF.

3.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-1018498

RESUMEN

Ulcerative colitis(UC)is an inflammatory bowel disease induced by multiple factors,which causes abnormal activation of intestinal immune cells and excessive release of antibodies and inflammatory factors,repeatedly damaging the intestinal mucosa.Macrophages,as innate intestinal immune cells,often maintain the balance of M1/M2 macrophages polarization to normalize the regression inflammation,and the imbalance of their polarization will cause repeated damage of intestinal mucosa and persistent inflammation,which is a main cause of UC.Nuclear factor E2-related factor 2(Nrf2),as an important regulator of antioxidant and anti-inflammatory,is often used as a target for the treatment of autoimmune diseases.Nrf2 alleviates intestinal high oxidative stress and inflammatory factors by balancing macrophage polarization,which may be of great significance for the prevention and treatment of UC.Summarizing the mechanism of macrophage polarization imbalance on the course of UC and the possible regulatory mechanism of Nrf2 may provide basis for the development of UC targeted therapeutic drugs.

4.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-992847

RESUMEN

Objective:To evaluate the fetal adrenal gland volume (AGV) and corrected adrenal gland volume (cAGV) in intrauterine growth restriction (IUGR) fetuses and observe their associations with the adverse perinatal outcomes.Methods:From February 2021 to August 2022, 32 IUGR fetuses who underwent fetal ultrasound examination in the Second Xiangya Hospital of Central South University were prospectively selected as the IUGR group, and 32 normal fetuses matched for gestational age during the same period were selected as the control group. Three-dimensional ultrasound was used to obtain fetal adrenal volume images, and the virtual organ computer-aided analysis (VOCAL) was used to measure AGV, then the cAGV was calculated. The values of AGV and cAGV were appropriately compared between the IUGR and the control groups. The pregnancy outcomes were noted. Multiple logistic regression analysis was employed to evaluate the relationship between the cAGV and adverse perinatal outcomes in IUGR fetus, with maternal age and the CPR included as covariates to control for confounding factors.Results:A total of 32 fetuses with IUGR and 32 controls were involved in this prospective study. There was no significant difference in the AGV between these two groups ( P=0.417). The cAGV of the IUGR fetus was substantially larger than that of the normal fetus ( P=0.034). In the multivariate logistic regression analysis, after adjusting for maternal age and fetal CPR, the fetal cAGV was noticeably associated with the fetal distress (adjusted OR=0.005, 95% CI=0.000-0.587, P=0.029) and the total adverse perinatal outcomes (adjusted OR=0.014, 95% CI=0.000-0.475, P=0.018). Conclusions:The value of cAGV is increased in the IUGR fetuses and associated with adverse perinatal outcomes. The evaluation of fetal AGV could be beneficial to monitoring and managing IUGR fetuses.

5.
Journal of Clinical Hepatology ; (12): 2383-2389, 2023.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-998305

RESUMEN

ObjectiveTo investigate the influencing factors for the prognosis of patients with acute-on-chronic liver failure (ACLF), and to establish a short-term prognostic model. MethodsA retrospective analysis was performed for the baseline clinical data of 247 patients with ACLF who were hospitalized in Department of Infectious Diseases, The First Affiliated Hospital of Xi’an Jiaotong University, from January 2011 to December 2016, and the patients were divided into survival group and death group. The two groups were compared to identify the influencing factors for prognosis; a prognostic model was established, and the receiver operating characteristic (ROC) curve was used to assess its predictive efficacy and determine the optimal cut-off value. The independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between groups; the Fisher’s exact test or the Pearson’s chi-square test was used for comparison of categorical data between groups. The univariate and multivariate logistic regression analyses were used to investigate the independent risk factors for 28- and 90-day prognosis, and the Kaplan-Meier method was used to plot the 28-day survival curves. ResultsA total of 220 patients with ACLF were included based on the inclusion and exclusion criteria; there were 148 patients in the 28-day survival group and 72 patients in the 28-day death group, with a 28-day transplantation-free survival rate of 67.27%; there were 115 patients in the 90-day survival group and 105 patients in the 90-day death group, with a 90-day transplantation-free survival rate of 52.27%. The logistic regression analysis showed that female sex (odds ratio [OR]=2.149, P=0.030), high Model for End-Stage Liver Disease (MELD) score (OR=1.120, P<0.001), and low lymphocyte count (OR=0.411, P=0.002) were independent risk factors for 28-day prognosis, and an LS-MELD model for 28-day prognosis was established as Logit (28-day prognosis)=-3.432+0.765×sex-0.890×lymphocyte count×10-9+0.113×MELD(1 for male sex and 2 for female sex). The ROC curve analysis showed that this model had an optimal cut-off value of 0.35, and then the patients were divided into low LS-MELD group (≤0.35) and high LS-MELD group (>0.35); the low LS-MELD group had a significantly higher 28-day survival rate than the high LS-MELD group (P<0.001). ConclusionPeripheral blood lymphocyte count combined with sex and MELD score has a certain value in predicting the short-term prognosis of ALCF patients.

6.
Chinese Journal of Urology ; (12): 786-787, 2021.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-911118

RESUMEN

Ureteral artery fistula (UAF) is a rare complication after long-term indwelling of ureteral stent. In this study, two cases were presented. Both of them underwent pelvic tumor surgery and radiotherapy, and had a history of cutaneous terminal ureterostomy and long-term indwelling of ureteral stents. The first case, a 52-year-old female, was admitted to hospital because of intermittent bleeding from ureteral dermostomy for 1 week on April 2, 2020. CT examination revealed hematocele in the left upper urinary tract, and left nephrectomy was performed.However, bleeding still presented and the distal ureteral resection was performed at the same time, and partial ureteral was ligated. Postoperative diagnostic was ureteral artery fistula. After 8 months of follow-up, no recurrent bleeding presented. Another case, a 82-year-old male, was admitted to hospital because of bleeding at the ureteral dermostomy for an hour on June 15, 2020. Contrast enhanced CT examination revealed intersecting of the left ureter and common iliac artery, and interventional surgery was performed, by which UAF was diagnosed. Embolization of left internal iliac artery and stent implantation of common iliac artery and external iliac artery were performed intraoperatively. The bleeding stopped immediately after the operation, and there was no further bleeding during follow-up of 6 months.

7.
Chinese Journal of Ultrasonography ; (12): 1066-1070, 2019.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-824459

RESUMEN

Objective To construct the Z-score models for normal fetal brain fissures.Methods Four hundred and eighty-seven pregnant woman who underwent prenatal ultrasonography from January to August 2018 in the Second Xiangya Hospital of Central South University were collected randomly for analysis,and all the fetuses(18-38 weeks) were healthy.The calacarine fissure,pariet-ooccipital fissure, sylvian fissure of the fetuses were measured and they were chosed as the dependent variables,while the independent variable were the gestational age and biparietal diamete,as well as femur length.The regression analyses of the mean(M) and the standard deviation(SD) for each parameter were performed separately. Two observers randomly measured the brain fissures depth two hours apart to evaluate the interobserver repeatability.Results The brain fissure depth in normal fetuses during geatational age between 18 to 38 weeks can be evaluated by Z-score model.Positive correlations were found between the depth of calacarine fissure,pariet-ooccipital fissure,sylvian fissure and gestational age,biparietal diameter and femur length. Conclusions Z-score can intuitively reflect the development of brain fissure more accurate,and is valuable, and can be used as a powerful supplement to the traditional method.

8.
Chinese Journal of Ultrasonography ; (12): 1066-1070, 2019.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-800521

RESUMEN

Objective@#To construct the Z-score models for normal fetal brain fissures.@*Methods@#Four hundred and eighty-seven pregnant woman who underwent prenatal ultrasonography from January to August 2018 in the Second Xiangya Hospital of Central South University were collected randomly for analysis, and all the fetuses(18-38 weeks) were healthy. The calacarine fissure, pariet-ooccipital fissure, sylvian fissure of the fetuses were measured and they were chosed as the dependent variables, while the independent variable were the gestational age and biparietal diamete, as well as femur length. The regression analyses of the mean(M) and the standard deviation(SD) for each parameter were performed separately. Two observers randomly measured the brain fissures depth two hours apart to evaluate the interobserver repeatability.@*Results@#The brain fissure depth in normal fetuses during geatational age between 18 to 38 weeks can be evaluated by Z-score model.Positive correlations were found between the depth of calacarine fissure, pariet-ooccipital fissure, sylvian fissure and gestational age, biparietal diameter and femur length.@*Conclusions@#Z-score can intuitively reflect the development of brain fissure more accurate, and is valuable, and can be used as a powerful supplement to the traditional method.

9.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-813162

RESUMEN

To investigate hemodynamic parameters in 2 anatomical segments (S1 and S2) of anterior cerebral artery (ACA) in normal pregnancy during the second and third trimester of gestation.
 Methods: The peak systolic velocity (PSV), end diastolic velocity (EDV), time-average maximum velocity (TAMAXV), peak systolic velocity/end diastolic velocity (S/D), resistance index (RI), and pulsation index (PI) in S1 and S2 of fetal anterior cerebral artery (ACA) in 288 normal pregnant women were detected by power Doppler and pulsed Doppler. Multiple regression models were fitted to estimate the relation between Doppler variables and gestational age. The differences of hemodynamic parameters between ACAS1 and ACAS2 were compared.
 Results: The PSV, EDV, and TAMAXV of ACAS1 and ACAS2 were positively correlated with the weeks of pregnancy (P0.05). The PSV, TAMAXV, S/D, PI, and RI of ACAS1 were significantly higher than those of ACAS2, while EDV in ACAS1 was lower than that in ACAS2 (P<0.05).
 Conclusion: The velocity parameters (PSV, EDV, TAMAXV) of the 2 anatomical segments (ACAS1 and ACAS2) are increased with the increase of gestational age in normal pregnant fetus during the second and third trimester of gestation, and the resistance parameters (S/D, PI, RI) are not significantly correlated with gestational age. Distribution of blood flow is different in the blood supply territory between ACAS1 and ACAS2.


Asunto(s)
Femenino , Humanos , Embarazo , Arteria Cerebral Anterior , Fisiología , Velocidad del Flujo Sanguíneo , Feto , Hemodinámica , Tercer Trimestre del Embarazo , Ultrasonografía Prenatal
10.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-813179

RESUMEN

To study the blood flow parameters for 2 anatomical segments of posterior cerebral artery (PCA) in normal singleton fetal.
 Methods: The blood flow velocity parameters peak systolic velocity (PSV), end diastolic velocity (EDV), time-average maximum velocity (TAMAXV), velocity time integral (VTI) and resistance parameters systolic peak velocity and end diastolic velocity ratio (S/D), pulsatility index (PI), resistance index (RI) for 2 anatomical segments in PCA were recorded. The first segment of the PCA (PCAS1) was recorded between the origin of PCA and the proximal part of the posterior communicating artery. The second segment of the PCA (PCAS2) was recorded at the distal part of the posterior communicating artery. The blood parameters in both PCAS1 and PCAS2 were analyzed by using Pearson correlation and multiple curves fitting with gestational age (GA). Paired student's t test was performed to compare the difference in blood parameter between PCAS1 and PCAS2.
 Results: The blood flow velocity parameters in both PCAS1 and PCAS2 were increased with the GA (P0.05). Resistance parameters in PCAS1 were higher than those in PCAS2 (P<0.05).
 Conclusion: The blood flow velocity parameters in both PCAS1 and PCAS2 are increased with GA. The resistance parameters in both PCAS1 and PCAS2 do not change with GA. Study on the velocities and resistance in these 3 arterial branches provides a more comprehensive evaluation on the process of brain circulation.


Asunto(s)
Femenino , Humanos , Embarazo , Velocidad del Flujo Sanguíneo , Fisiología , Diástole , Fisiología , Edad Gestacional , Hemodinámica , Fisiología , Arteria Cerebral Posterior , Fisiología , Sístole , Fisiología
11.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-707703

RESUMEN

Objective To study the changes of blood flow in posterior cerebral artery ( PCA ) in complete transposition of great arteries (CTGA) through the application of the pulsed Doppler . Methods Twenty CTGA fetuses ( CTGA group) and 20 healthy control fetuses ( control group) were involved ,the blood flow indexes peak systolic velocity ( Vs) ,end-diastolic velocity ( Vd) ,pulsatility index ( PI) ,resistance index ( RI) ,velocity-time integral ( VTI) of PCA-S1 ,PCA-S2 and MCA of the fetuses in the two groups were detected by pulsed Doppler . The differences in blood flow indexes between CTGA fetuses and healthy controls were analyzed by independent t -test . The rates of abnormal resistance in PCA-S1 and MCA in CTGA fetuses were compared through Chi-square test ( χ2 test) . Results Compared with control group ,the MCA-PI ,MCA-RI ,PCA-S1-PI and PCA-S1-RI of CTGA group decreased significantly( all P < 0 .05) ,MCA-VTI ,PCA-S1-VTI ,PCA-S2-VTI increased significantly ( all P < 0 .05) ,but no significant difference was found in PCA-S2-PI ,PCA-S2-RI ,Vs and Vd of the MCA and the PCA ( all P > 0 .05 ) . The rate of abnormal resistance in the MCA was significantly lower than that in the PCA-S1 in CTGA group ( P <0 .05) . Conclusions The pulsed Doppler can be used to study the changes of blood flow in PCA of CTGA fetuses and the differences of specific hemodynamic alterations may occured in different segments of the PCA in CTGA fetuses ,indicating a tendency to protect the PCA-supplying areas of the brain when ischemia and hypoxia .

12.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-481968

RESUMEN

Objective To compare the difference of prospective memory(PM) between schizophrenia patients and normal people,and to analyze the internal component of prospective memory using multinomial processing tree(MPT) model.Methods 17 schizophrenia patients and 17 age-and education-matched control participants completed an event-based PM task which was embedded within an ongoing computer-based color-matching task.Internal component of prospective memory was analyzed using multinomial processing tree(MPT) model.Results The scores of prospective memory performance in schizophrenia patients and normal controls were (21.83± 2.46) % and (38.81±2.26) %, and the difference was statistically significant (t=2.11, P<0.05).The difference of ongoing task between schizophrenia patients ((75.88±0.43) %) and controls ((71.44±0.45) %) was statistically significant (t=2.79, P<0.05).The reaction time of schizophrenia patients was significantly longer than that of normal controls((2.34±1.41) s vs (1.81± 1.19) s, t=11.24, P< 0.05).The MPT model revealed a significant group difference in the prospective component (0.82 vs 0.97, G2(1)=14.17, P< 0.01) and retrospective component (0.54 vs 0.41 ,G2(1) 14.17, P<0.01).Conclusion The prospective component of event-based prospective memory of schizophrenia patients was lower than normal controls,which may result in the impairment of PM performance.

13.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-470574

RESUMEN

Objective To explore the differences between schizophrenic patients and normal at prospective memory,and investigate the effect of personality intermediary between schizophrenia and prospective memory.Methods A case-control study was utilized in this research.It used the color matching task to test prospective memory and MMPI-2 scale to test personality differences between the two groups.Results Schizophrenia prospective memory score(19.29±2.30),lower than the normal group(44.74±2.06),the difference was significant(P<0.01).In mediating effect on the personality inspection,the subscales within MMPI-2 of Social Scale(Si) and Anxiety and tension Scale(ANX) regression coefficients were tested(P<0.05),which showed significant effect.Further analysis with sobel statistics showed that only one factor tested was significant.The test coefficients of depression scale (D),mental weakness scale (Pt) and schizophrenia scale (Sc) were significantly different (P< 0.05),which showed that these subscales also had significant mediating effect.Conclusion The prospective memory performance is low in schizophrenia.The personality characteristics that depression,mental weakness,schizo phrenia,social anxiety and tension play an intermediary role in schizophrenia and prospective memory.

14.
Chinese Medical Journal ; (24): 1640-1644, 2014.
Artículo en Inglés | WPRIM (Pacífico Occidental) | ID: wpr-248136

RESUMEN

<p><b>BACKGROUND</b>Surgical resection is the most effective treatment for renal cell carcinoma (RCC). Currently several prognostic factors and models are used for outcome prediction. However, whether intratumoral changes are independent prognostic factors for RCC or not remains unclear. The aim of the study was to investigate the prognostic roles of intratumoral changes in surgical treated localized clear cell renal cell carcinoma (ccRCC).</p><p><b>METHODS</b>Patients who received partial or radical nephrectomy between 2004 and 2009 in our center were retrospectively reviewed. Univariate and multivariate analyses were used to assess gender, age, body mass index (BMI), intratumoral hemorrhage, tumor necrosis, cystic degeneration, sarcomatoid change, Ki-67 expression, Fuhrman grade, and T stage on recurrence-free survival (RFS) and cancer-specific survival (CSS).</p><p><b>RESULTS</b>A total of 378 patients were included in our study. In univariate analysis, age, BMI, intratumoral hemorrhage, tumor necrosis, sarcomatoid change, Ki-67 expression level, Fuhrman grade, and T stage were prognostic factors for RFS. Age, BMI, tumor necrosis, sarcomatoid change, Ki-67 expression level, Fuhrman grade, and T stage were prognostic factors effecting CSS. In multivariate analysis, age, BMI, tumor necrosis, sarcomatoid change, Ki-67, Fuhrman grade, and T stage were independent prognostic factors for both RFS and CSS.</p><p><b>CONCLUSION</b>Intratumoral changes such as tumor necrosis and sarcomatoid change are independent prognostic factors for ccRCC.</p>


Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Carcinoma de Células Renales , Metabolismo , Patología , Cirugía General , Antígeno Ki-67 , Metabolismo , Neoplasias Renales , Metabolismo , Patología , Cirugía General , Análisis Multivariante , Nefrectomía , Pronóstico , Estudios Retrospectivos , Tasa de Supervivencia
15.
Modern Clinical Nursing ; (6): 39-41, 2013.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-441072

RESUMEN

Objective To explore the application of implantable venous access port(IVAP)in tumor patients.Methods Overall,246 tumor patients were enrolled.The clinical application and nursing of IVAPs were reviewed retrospectively.Results IVAPs were implanted successfully in all 246 patients.Complications included thrombosis in 10 patients,infection in 6,blockage in 1 and leakage in another.IVAPs were removed from 15 patients with complications.Conclusions The prevention and management of complications in IVAP are important for the patients embedded with IVAP.

16.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-413096

RESUMEN

Cultivating Clinical thinking ability is an important tache of clinical medical education. Teachers'guidance, the charateristics that suit teaching, the organic combination of the active methods which can mobilize clinical medical interns' learning enthusiasm, such as problem-based learning, and humanity education are effective approaches to enhancing interns' clinical thinking ability.

17.
China Oncology ; (12): 634-636, 2009.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-405609

RESUMEN

Background and purpose: Primary signet ring cell carcinoma(SRCC) of the bladder is rarely diagnosed in the clinic. Few cases have been reported in the literature, so there was lack of understanding of the primary bladder SRCC in terms of diagnosis and treatment. Our study was to investigate the clinical features and treatment strategy for primary SRCC of the bladder and review the status of the disease along with the literature. Methods: 3 cases of primary bladder SRCC were studied, including clinical features, treatment, follow-up and their prognosis.The literature was reviewed. Results: All cases received ultrasound, computerized tomography, cystoscopy, biopsy and other related lab tests for diagnosis and differential diagnosis. Laparoscopic radical cystectomy and orthotopic ileal neobladders were performed in 2 cases, while the other case received laparoscopic radical cystectomy and ileal conduit diversion, Chemotherapy (cisplatin and 5-fluorouracil) was delivered in one case after surgery. One patient died at 6 months postoperatively because of multiple metastasis. The other 2 cases have been followed-up only for 8 and 12 months postoperatively, and no recurrence or metastasis have been observed. Conclusion: Primary SRCC of the bladder lacks distinctive clinical and imaging manifestations. The tumor grows very invasively. Radical cystcctomy is one of the optimal approaches for treatment of SRCC of bladder.

18.
China Oncology ; (12): 512-516, 2009.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-405958

RESUMEN

Background and purpose: The prognostic factors on survival for the patients with prostate carcinoma are still underdeterrnined. This study was to analyze the survival of three common treatment methods for prostate carcinoma and the prognostic factors on survival. Methods: 494 male patients who were diagnosed as prostate cancer were enrolled into the retrospective study. All of the data like age, stage, grade, PSA level, ALP, Hb and treatments were collected. Overall survival and disease specific survival rates for patients were analyzed by Kaplan-Meier method. Prognostic factors on disease specific survival were also analyzed by Log-rank test and Cox proportional hazards model. Results: Disease specific survival rates at 1, 3 and 5 year were 96.0%, 89.0% and 80.0% for all 494 patients, respectively. Disease specific survival rate at 3-year was 92.4% for brachytherapy, 100.0% for radical prostatectomy and 80.6% for hormonal therapy (P=0.008). Multivariate analysis by Cox model showed that stage, PSA level and age significantly impacted on disease specific survival. Conclusion: Brachytherapy and radical prostatectomy provides longer survival time than hormonal therapy for patients with prostate cancer. Clinical stage and PSA level and age of prostate cancer are independent factors impacting on survival significantly.

19.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-596191

RESUMEN

Objective To evaluate the feasibility of retroperitoneal laparoscopic adrenalectomy for large (≥6 cm in diameter) adrenal tumors. Methods Between June 2002 and June 2008,30 patients with large adrenal tumors underwent retroperitoneal laparoscopic adrenalectomy in our hospital. With the patients being placed in the lateral position at the uninjured side,a self-made balloon was used to dilate the retroperitoneal space. Afterwards,3 trocars were inserted via the costal margin at the posterior axillary line and the anterior axillary line,and 2 cm above the anterior superior iliac spine at the middle axillary line to remove the tumors. After resection of the tumor,an drainage tube was indwelled. Results Retroperitoneal laparoscopic surgery was performed successfully in the 30 cases without conversion to open surgery. The mean operation time was 100 min (range,65 to 185 min),and the mean blood loss was 80 ml (range,50 to 250 ml). Over a mean of 18.5-month follow-up (range,3 to 36 months) was achieved in the cases,during which no one had local recurrence. Conclusions Retroperitoneal laparoscopic adrenalectomy is feasible and safe for patients with large adrenal tumors as long as no contraindication of the surgery is found. The diameter of the tumor does not play a role when determining the surgery.

20.
Chinese Journal of Surgery ; (12): 241-247, 2002.
Artículo en Chino | WPRIM (Pacífico Occidental) | ID: wpr-314873

RESUMEN

<p><b>OBJECTIVE</b>To review kidney transplantation in the center and analyze the risk factors affecting long-term allograft survival.</p><p><b>METHODS</b>Thirty-two relative variables were analyzed with SAS statistical software. Using Log-rank method, we investigated influence of these variables on short-and long-term survival of grafts. Kaplan-Meier analysis was used to estimate the 1-, 3-, 5-, 10-years graft survival rates and half-life. Proportional hazards regression analysis (Cox model) was used to assess and rank the relative risk of potential variables.</p><p><b>RESULTS</b>The 1-, 3-, 5-, 10-years graft survival rates were 83%, 75%, 66% and 48%. After excluding the patients died with functioning grafts, the 1-, 3-, 5-, 10 years grafts survival rate increased to 89%, 82%, 75% and 69%, respectively. The mean half-life was 8.78 +/- 0.14 and 14.09 +/- 0.20 years, respectively. By Log-rank analysis, factors affecting short- and long-term graft survival were identified as: renal function, duration of graft function became normal, cold-ischemia time, presence of acute rejection, delayed graft function, immunosuppressive regimen, complication, infection, anti-rejection therapy. Cox model multivariate analysis showed that there were 18 factors affecting graft survival.</p><p><b>CONCLUSIONS</b>New immunosuppressive agents not only significantly increase short-term graft survival, but also have the better long-term outcome tendency. Making assurance to get high quality donor organ and minimizing the death with graft function may be the most feasible way to prolong graft survival at present.</p>


Asunto(s)
Adulto , Femenino , Humanos , Masculino , Cadáver , Supervivencia de Injerto , Inmunosupresores , Farmacología , Trasplante de Riñón , Análisis Multivariante , Trasplante Homólogo
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