A model prediction of long-term prognosis in patients with centrally located hepatocellular carcinoma undergoing hepatectomy.

BACKGROUND AND OBJECTIVES: The prognostic prediction for centrally located hepatocellular carcinoma (CL-HCC) after hepatectomy has not been well established. We aimed to develop prognostic nomograms for patients undergoing hepatectomy for CL-HCC. METHODS: A cohort of 380 patients who underwent curative hepatectomy for CL-HCC at our hospital between 2009 and 2015 were retrospectively studied. We randomly divided the subjects into training (n = 210) and validation (n = 170) groups. Univariate and multivariate survival analysis were used to identify prognostic factors. Visually orientated nomograms were constructed using Cox proportional hazards models. The performance of the nomogram was evaluated by the area under the ROC curve (AUC), calibration curve and compared with the conventional staging systems. RESULTS: The statistical nomogram for OS built on the basis of ALBI grade, tumor number, tumor size, classification, hepatectomy methods, capsule formation and microvascular invasion (MVI) had good calibration and discriminatory abilities, with AUC of 0.746 (65-month survival). The nomogram for DFS was based on tumor number, tumor size, classification, HBV-DNA load, capsule formation and MVI, with AUC of 0.733 (65-month survival). These nomograms showed satisfactory performance in the validation cohort (AUC, 0.733 for 65-month OS; and 0.702 for 65-month DFS). The AUC of our nomograms were greater than those of conventional staging systems in the validation cohort. CONCLUSION: The established nomograms might be useful for estimating survival for patients with CL-HCC after liver resection.

Correlation between preoperative CRP/Alb ratio and lymph node metastasis in pa-tients with gastric cancer / 中国肿瘤临床

Objective:To investigate the relationship between Creactive protein(CRP)/albumin ratio (CAR) and lymph node metastasis of gastric cancer. Methods:A total of 96 cases of gastric cancer were included in the study. The clinical pathological stage and lymph node detection in patients with gastric cancer were analyzed, with the preoperative CAR as the dependent variable. Results:1) The pa-tients with preoperative CAR>0.04 has higher transfer rate and metastasis than the patients with preoperative CAR≤0.04, and the dif-ference was significant (P0.04 was significantly higher than that of the patients with preoperative CAR≤0.04, and the difference was significant (P<0.05). 2) The mean CAR of patients with Borrmann typesⅠ,Ⅱ,Ⅲ, andⅣgradually increased;with the progression of the pathological stage of gastric cancer, the mean value of CAR in-creased. 3) During the operation, the total number of lymph node dissections was high and the mean value of CAR before the opera-tion was high. Conclusion:The correlation between preoperative CAR and lymph node metastasis in patients with gastric cancer may reflect the degree of lymph node metastasis to a certain extent.

Effect of micellar polymer PEG-PLL-OPG on osteoporosis and arteriosclerosis in mice / 实用医学杂志

Objective By using PEG-PLL and OPG-expressing plasmid to synthesize a nanocompound PEG-PLL-OPG (PPO), to investigate its effects on osteoblasts (OB) and arteriosclerosis (AS) in mice. Methods The incidences of osteoporosis (OP) and AS were studied in people. Collect people′s serum , and divide them into different groups According to the results of diagnosis, the patients were grouped into the groups of Control, AS, OP, and AS. PPO was used to deal with OB in different groups. The cell apoptosis, cell activity, the adhersion and calcification to scaffold PCL were determined by flow cytometry, MTT, alizarin red stain and SEM,respectively. PPO was also injected intp the ApoE-/-RANKL+/+ mice via caudal vein to demonstrate its effects on BMD and AS. Results PPO could increase the cell activity , inhibit OB apoptosis and promote cell adhersion and calcifica-tion on scaffold PCL in vitro. PPO could also decrease the area and calcification of atheromatous plaque , and in-crease the BMD of collum femoris in vivo. Conclusion PPO may be a new drug for OP and AS treatments.

Promotion of postoperative recovery with fast track surgery for gastric cancer patients undergoing gastrectomy: a prospective randomized controlled study / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the safety and feasibility of fast track surgery (FTS) in the promotion of postoperative recovery for gastric cancer patients undergoing gastrectomy.</p><p><b>METHODS</b>From January to December in 2013, 71 gastric cancer patients were prospectively enrolled and randomized into the FTS group and the control group. Patient in the FTS group received FTS management and those in the control group received routine management. The postoperative recovery and stress were compared between the two groups.</p><p><b>RESULTS</b>FTS was associated with shorter time to bowel function return [(67.8±19.7) h vs. (90.0±20.6) h, P<0.01], shorter hospital stay [(13.5±3.0) d vs. (17.8±7.3) d, P=0.01], lower hospital cost [(23.8±3.7) thousand Yuan vs. (27.8±6.1) thousand Yuan, P<0.05], and less stress response (lower pain score, WBC count, C-reactive protein, all P<0.01). The postoperative complications including ileus, infection, anastomotic leakage were similar (all P>0.05).</p><p><b>CONCLUSION</b>Fast track surgery decreases postoperative stress response and promotes recovery.</p>

Two types of digestive tract reconstruction after proximal gastrectomy for early gastroesophageal junction adenocarcinoma: a randomized controlled study / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the better method of digestive tract reconstruction in proximal gastrectomy for early gastroesophageal junction adenocarcinoma.</p><p><b>METHODS</b>A total of 153 cases of early gastroesophageal junction adenocarcinoma who were planned to receive radical proximal gastrectomy from January 2003 to December 2011 were prospectively enrolled and randomly divided into two groups by table of random number according to methods of digestive tract reconstruction, including 3S anastomosis group (80 cases, 3S jejunal interposition) and traditional anastomosis group (73 cases, esophageal remnant gastric posterior wall anastomosis). Postoperative complications, operative time, mortality, nutritional parameters and postoperative quality of life were compared between these two groups.</p><p><b>RESULTS</b>There were no significant differences between two groups in postoperative complications, operative time and mortality (all P>0.05). 3S anastomosis group was better in nutritional parameters than traditional group six months after operation (P<0.05). As compared to traditional group, incidence of reflux esophagitis decreased [20.0%(16/80) vs. 46.6%(34/73), P<0.01] and gastric emptying time prolonged obviously [(160.8±8.1) min vs. (61.1±10.8) min, P<0.01] in 3S anastomosis group 18 months after operation. Postoperative QLQ-C30 rating scale revealed quality of life was significantly higher in 3S anastomosis group as compared to traditional group.</p><p><b>CONCLUSION</b>Jejunal interposition is a better method of digestive tract reconstruction in proximal gastrectomy for early gastroesophageal junction carcinoma.</p>