RESUMO
BACKGROUND/AIMS: This study aimed to investigate the role of metastatic lymph node ratio (MLR) in the evaluation of prognosis of patients with gastric cancer at different T stages. METHODOLOGY: Clinical information was reviewed retrospectively in a total 535 patients who underwent surgery for gastric cancer. The prognostic value of MLR was compared with that of pN determined according to the UICC/AJCC guidelines (7th Edition), and the characteristics and advantages of MLR were analyzed. Moreover, the role of MLR in the evaluation of prognosis of patients with gastric cancer at different pT stages was investigated. RESULTS: Univariate Kaplan-Meier method was used for the analysis of survival, and the results showed that MLR was closely associated with the prognosis of these patients. Multivariate analysis with Cox proportional hazards regression model showed that MLR was a major independent risk factor in the prognosis of gastric cancer patients. The area under the ROC curve of MLR in predicting the death of gastric cancer patients within 5 years after surgery was not associated with pN stage. MLR was effective in predicting the prognosis of patients with stage pT2 or pT3 gastric cancer (P < 0.05). CONCLUSIONS: MLR is an independent risk factor in the prognosis of gastric cancer. MLR has a prognostic ability comparable to that of pN stage in gastric cancer. Thus, it is more reliable than pN in the evaluation of prognosis of gastric cancer patients, especially those with stage pT2-pT3 gastric cancer.
Assuntos
Linfonodos/patologia , Neoplasias Gástricas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Feminino , Humanos , Estimativa de Kaplan-Meier , Linfonodos/cirurgia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/cirurgia , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
The distribution and processing factors (PFs) of herbicides in cold-/hot-pressed soybean samples (n = 3) were studied on the laboratory scale. The hot-pressing process was found to have a significant effect on herbicide degradation in soybean samples. Specifically, for highly water-soluble pesticides with pKow > 2 in soybean oil, the PF values were generally > 1. Nonlinear curve fitting revealed that the PFs of herbicides in soybean oil were positively correlated with their octanol-water partition coefficients, but negatively correlated with their water solubility and melting points. A principal component analysis confirmed the dominant parameters among the herbicide PFs during soybean oil production. Using the physicochemical parameters of pesticides, the developed multiple linear regression model gave a fitting accuracy of ≥0.80 for predicting the theoretical PF values of pesticides in soybean oil products (0.39 < RMSE < 0.58). Thus, this model may be applicable for safety risk assessments and establishing maximum residue limits for pesticides in processed products.
Assuntos
Herbicidas , Praguicidas , Octanóis , Praguicidas/análise , Solubilidade , Óleo de SojaRESUMO
Our aim was to estimate the efficacy of laparoscopic and open Nissen fundoplication (ONF) in the treatment of gastroesophageal reflux disease (GERD) in children. An electronic systematic review of the published literature was conducted in Cochrane Library, MEDLINE (PubMed), and EmBase in October 2015 in English and without time restrictions. The participants, interventions, and comparisons in the clinical question translated directly into eligibility criteria for study inclusion and exclusion. Study information extraction and methodological quality assessments were accomplished by two reviewers independently. Methodological quality was assessed by using the "Criteria for judging risk of bias in the 'Risk of bias' assessment tool." Odds ratio (OR) with 95 per cent confidence interval was computed as summary statistics. Fixed-effects model was used and a pooled OR was calculated with the Mantel-Haenszel method initially. If the studies were heterogeneous, then the DerSimonian and Laird random effects model was used for meta-analysis. Outcome indices included mortality of patients, recurrence of GERD, reoperation of GERD, patients with complications, length of postoperative hospital stay, and surgery duration of laparoscopic Nissen fundoplication (LNF) and ONF. Statistical analyses were carried out by using Review Manager 5.2. The duration of follow-up varied between two days and four years. Children operated with LNF had a higher recurrence rate of GERD than those undergoing ONF. The pooled OR of LNF versus ONF was 2.98 (95% confidence interval = 1.29-6.87) while the heterogeneity was I2 = 47 per cent and P = 0.13. Statistical analysis showed that there was no significant difference for mortality, reoperation, and complication. The mean duration of surgery was significantly longer in the LNF than the ONF group while the results of length of postoperative hospital stay remained inconformity. In this meta-analysis, children operated with LNF had a higher recurrence rate of GERD than those undergoing ONF. Meanwhile, when considering the outcomes of mortality, reoperation, and complications, there was no significant difference. The mean duration of surgery was significantly longer in the LNF than the ONF group while no consistent conclusion of length of postoperative hospital stay was found.