ObjectiveTo explore the related factors of postoperative survival of patient with gastric cancer, so as to provide the corresponding evidence support for the prognosis evaluation.MethodsThe clinicopathologic data of patients with gastric cancer who underwent surgical treatment in the Fourth Affiliated Hospital of Baotou Medical College and the Fourth Hospital of Baotou City from January 2006 to December 2009 were retrospectively collected. The influences of clinicopathologic data (gender, age, tumor size, tumor location, lymph node metastasis, tumor thrombus, tumor differentiation, TNM stage, operation mode, and postoperative chemotherapy) on postoperative survival of patients with gastric cancer were analyzed. Univariate analysis was used to analyze the influencing factors of postoperative survival in the patients with gastric cancer and Cox proportional hazards regression was used to analyze the independent risk factors.ResultsA total of 80 patients with gastric cancer were included in this study. Up to December 31, 2014, the median survival time at 50% cumulative survival rate was 95 months. Univariate analysis showed that the survival of patients with gastric cancer was related to tumor size, lymph node metastasis, tumor differentiation, and TNM stage (P<0.05). Further multivariate analysis showed that later TNM stage was an independent risk factor for affecting postoperative survival of patients with gastric cancer (P<0.05).ConclusionPostoperative survival of patients with gastric cancer is related to tumor size, lymph node metastasis, tumor differentiation, and TNM stage; And later TNM stage is an independent risk factor for affecting survival of patients with gastric cancer.
Objective To investigate a best method of obtaining the sural neurofasciocutaneous flap by observing the models of different pedicles based sural neurofasciocutaneous flaps in rabbits and the effect of different pedicles on the survival of the flaps. Methods Forty adult New Zealand rabbits (male or female, weighing 2.5-3.0 kg) were randomly divided into 4 groups (10 rabbits in each). The flaps of 7 cm × 1 cm were designed at the lateral hind legs, and the pedicle was 0.5 cmin length. In group A, the flaps were elevated based on a single perforator pedicle; in group B, the flaps were elevated based on fascia pedicle; in group C, the flaps were elevated based on perforator-plus fascia pedicle; and in group D, the flaps were elevated and sutured in situ. At 7 days after operation, the flap survival rate was recorded, and the blood flow in the center of the flap was monitored by laser doppler flowmetry. The perfusion unit (PU) was measured. Results After operation, the flaps had no obvious swell ing, and the flaps had good color at the proximal end, but pale at the distal end in groups A and B. Obvious swell ing was observed with pale color at the distal flaps in group C, but swell ing decreased gradually. However, the skin color became dark gradually in group D after operation. The flap survival rates were 74.0% ± 2.7%, 60.0% ± 2.5%, 75.0% ± 3.5%, and 0 in groups A, B, C, and D respectively after 7 days of operation. The PU values were 83.39 ± 4.25, 28.96 ± 13.49, 81.85 ± 5.93, and 8.10 ± 3.36 in groups A, B, C, and D respectively. There were significant differences in flap survival rates and PU values between groups A, B, C and group D (P lt; 0.05). Significant differences were found between groups A, C and group B (P lt; 0.05), but no significant difference between group A and group C (P gt; 0.05). Conclusion The sural neurofasciocutaneous flap based on a single perforator pedicle has a rel iable blood supply and enough venous drainage, which is one of the best methods to obtain the sural neurofasciocutaneous flap.
Objective To investigate the effect of perioperative body temperature on the survival of skin flap grafting. Methods From July 2005 to November 2006, 50 cases of Ⅰ-Ⅱ grade patients undergoing elective skin flap grafting were randomly divided 2 groups. Pharyngeal temperature (PT) and skin temperature(ST) were monitored and recorded every 15 minutes. Operativetime, anesthetic time, time from the end of operation to extubation, the volume of blood transfusion, the volume of fluid transfusion and the flap survival 7 days after operation were recorded. In the experimental group, the body temperature was maintained in normal range with water market and forced air heater. In the control group， the body temperature was only monitored without any treatment. Results There were no significant differences in operating room temperature, operative time, anesthetic time, the volume of blood transfusion and fluid transfusion between 2 groups(Pgt;0.05). After induction, PT decreased gradually inboth groups during the first 45 minutes, compared with the time point of intubation(Plt;0.05),but there were no significant differences between the 2 groups(Pgt;0.05); and ST rose in both groups during the first45 minutes, compared with the time point of intubation (Plt;0.05). After 45 minutes of induction, in the experimental group, PT was in the normal range(36℃), and ST didn’t change compared with that of the timepoint of induction(Pgt;0.05). In the control group, both PT and ST decreasedgradually and timedependently compared with the time point of intubation (Plt;0.05). In the experimental group, PT and ST at each time point were higher than those in the control group (Plt;0.05). All the skin flap grafts survived in the experimental group, and skin flap grafts necrosed in 2 cases in the control group.Conclusion Keeping normal body temperature can improve the survival ofskin flap grafting. Therefore, the body temperature should be monitored and maintained in a normal range.
【Abstract】 Objective To find out the best method to prepare platelet-rich plasma (PRP) and to evaluate the effect of PRP gel on skin flap survival and its mechanism. Methods Totally, 72 Wistar rats (aged 12 weeks, weighing 250-300 g) were used for the experiment. The arterial blood (8-10 mL) were collected from the hearts of 24 rats to prepare PRP with three kinds of centrifuge methods: in group A, 200 × g centrifuge for 15 minutes, and 500 × g centrifuge for 10 minutes；in group B, 312 × g centrifuge for 10 minutes, and 1 248 × g centrifuge for 10 minutes；and in group C, 200 × g centrifuge for 15 minutes, and 200 × g centrifuge for 10 minutes. The platelet was counted in the whole blood, PRP, and platelet-poor plasma (PPP) to determine an ideal centrifuge. PRP, PPP, and the serum after first centrifuge were collected. The concentrations of platelet-derived growth factor BB (PDGF-BB) and transforming growth factor β1 (TGF-β1) were measured in the PRP, PPP, and serum using the enzyme-linked immunosorbent assay method, and PRP and PPP gels were prepared. The flaps of 11 cm × 3 cm in size were elevated on the back of 48 rats, which were divided into 3 groups: PRP gel (PRP group, n=16) and PPP gel (PPP group, n=16) were injected, no treatment was given in the control group (n=16). The flap survival rate was measured at 7 days. Histological and real-time PCR were used to count the inflammatory cells and blood vessel density, and to detect the expressions of vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), PDGF-AA, and PDGF-BB mRNA at 8 hours, 24 hours, 3 days, and 7 days. Results Platelet counting showed platelet in group A was the highest. ELISA evaluation showed that the concentrations of TGF-β1 and PDGF-BB were significantly higher in PRP than in PPP and serum (P lt; 0.05). The flap survival rate was 61.2% ± 9.1% in PRP group, showing significant differences (P lt; 0.05) when compared with that in PPP group (35.8% ± 11.3%) and control group (28.0% ± 5.4%). The inflammatory cells were significantly lower and the blood vessel density was significantly higher in PRP group than in PPP group and control group (P lt; 0.05). When compared with PPP group and control group, the expressions of VEGF and PDGF-BB increased at all time after operation in PRP group; the expression of EGF increased within 24 hours; and the expression of PDGF-AA increased after 3 days. There were significant differences in PDGF-AA mRNA at 3 days and 7 days, PDGF-BB mRNA at 8 hours, VEGF mRNA at 24 hours and 3 days, and EGF mRNA at 24 hours between PRP group and PPP and control groups (P lt; 0.05). Conclusion 200 × g centrifuge for 15 minutes and 500 × g centrifuge for 10 minutes is the best PRP preparation method. PRP can improve the skin flap survival by regulating the genes involved in angiogenesis.
ObjectiveTo analyze the follow-up data of colorectal cancer in the Database from Colorectal Cancer (DACCA).MethodsThe information in the Dacca database was screened, and the one whose operative date and follow-up date were not blank in the total data was selected. The follow-up data were analyzed, including length of follow-up, survival outcomes, coping styles (doctors’ attitude and reaction for follow-up), follow-up path (whether to choose out-patient, Wechat, QQ tools, phone call, text message, mobile application, face-to-face), the number of follow-up (the number of out-patient follow-up, the number of telephone follow-up, and the number of follow-up within 5 years).ResultsA total of 6 437 data items were analyzed for colorectal cancer adjuvant follow-up. ① The follow-up period of five years (2004–2015) was 56.6% (3 642/6 437), and the follow-up time was 0–201, 67 (26, 97) months. ② The highest data composition ratio of survival outcomes was “Survival” (79.7%, 4 611/5 787), and in the data with five-year follow-up period (2004–2015), the highest data composition ratio of survival outcomes was “Survival” (75.0%, 2 550/3 401), and the survival rate of the five-year follow-up period in 2008 was the highest (91.4%, 235/257). ③ The highest data composition ratio of the coping styles was the doctors’ active follow-up (76.8%, 2 121/2 762). ④ The highest data composition ratio of the follow-up path was out-patient service (90.6%, 4 236/4 676). ⑤ The highest data composition ratio of the number of out-patient follow-up was conducted by the original surgical team (100%, 4 380/4 380), the specific number was 0–130、5 (2, 10) times. The data composition ratio of telephone follow-up was 86.9% (3 808/4 380) and the specific number was 0–68、0 (0, 1) times. The highest frequency of follow-up was in the first year (89.9%, 3 044/3 386) and the specific number was 0–73、5 (3, 9) times.ConclusionBy expounding the characteristics of the colorectal cancer follow-up from colorectal cancer in DACCA, it provides some references for using big data to determine prognosis.
ObjectiveTo investigate the expression and clinical significance of HOXB7 mRNA and protein in colorectal cancer (CRC) tissues.MethodsThe expressions of HOXB7 mRNA were evaluated in 6 cases of adjacent colorectal mucosal (ACRM) tissues and 6 cases of CRC tissues by using RT-PCR. The HOXB7 protein expressions were evaluated in 30 cases of ACRM tissues and 98 cases of CRC tissues by using immunohistochemistry. The correlations between the expression of HOXB7 protein, and the clinicopathologic factors or the patient’ survival were analyzed.ResultsRT-PCR results showed that expression level of HOXB7 mRNA in CRC tissues was significantly higher than that of ACRM tissues (P=0.003). Immunohistochemistry results showed that significantly higher positive-expression rate of HOXB7 protein in CRC tissues compared with ACRM tissues (P<0.05). Positive expression of HOXB7 protein was associated with depth of tumor invasion, lymph node metastasis, and the TNM stage (P<0.05). Kaplan-Meier survival curves showed that positive expression of HOXB7 protein was not inversely correlated with survival of CRC patients (P=0.865).ConclusionPositive expression of HOXB7 protein is a novel biomarker for estimating the progression of CRC, but remains of textual research may be to confirm the significance of HOXB7 protein for prognosis evaluation.
Objective To study the research method of cell survival rate at the procedure of cryopreservation of tissue engineered tendons.Methods In the 4thgeneration of human fibroblasts, the dead cells were stained with propidium iodine (PI), while the living cells with Hoechst 33342(Ho). The living cells and dead cells emitted fluorescence of red and blue respectively after they were stimulated by suitable ultra-violet, then flow cytometry was applied to distinguishthem. The seeding cells were collected to make them to be the cell suspension of suitable concentration(6.0×105 cell/ml) before they were divided into two parts. We cryopreserved and defrosted one part three times to kill the cells and didnot cryopreserve the other part, then we made cell suspension at different ratios of cryopreserved cell to noncryopreserved cells. The fluorescence staining and flow cytometry were used to study the correlation between cell ratios of cryopreservedcell to non-cryopreserved cell and the cell survival rates. We compared the cll survival rates between immediate flow cytometry and that 2 hours after fluorescence staining. Results The results of flow cytometry showed that correlation between the ratio of cryopreservation and the cell survival rate was significant (r=0.970，Plt;0.05), image analysis study also showed the correlation was significant (r=0.982，Plt;0.05).The cell survival rate decreased by use of flow cytometry twohours after fluorescence staining, but there was no significant difference when compared with that of immediate flow cytometry (Pgt;0.05). We could also observe the cells on the tissue engineered tendons by fluorescence image directly.Conclusion Flow cytometry and fluorescence image afterPI and Ho staining is a good way in study cell survival rate at the procedure of cryopreservationof tissue engineered tendons.
ObjectiveTo understand the relation between the occupation and long-term prognosis of the patients with colorectal cancer (CRC) based on the Database from Colorectal Cancer (DACCA). MethodsThe selected updated DACCA database as of June 29, 2022 was used for this study. The included patients were assigned into intellectual occupations group (intellectual group) and manual occupations group (manual group) referring to relevant regulatory documents in China. The survival status of the intellectual group and the manual group was compared, and then were stratified by pTNM stage. ResultsA total of 1 974 patients were included from the DACCA database according to the selection criteria, 349 of whom in the intellectual group and 1 625 of whom in the manual group. The intellectual group had higher 5-year cumulative overall survival rate (92.1% vs. 84.5%, P<0.001) and disease-specific survival rate (92.1% vs. 85.8%, P=0.002), as well as higher 10-year cumulative overall survival rate (72.4% vs. 55.2%, P<0.001) and disease-specific survival rate (75.4% vs. 59.1%, P<0.001) compared to the manual group. The stratified analysis by pTNM stage found that, for the patients with pTNM Ⅲ stage, the 5- and 10-year cumulative overall survival rates of the intellectual group were higher than those of the manual group (94.0% vs. 82.3%, P<0.001; 67.1% vs. 43.7%, P=0.014), simultaneous the 5- and 10-year cumulative disease-specific survival rates were the same as the overall survival rate (94.0% vs. 83.5%, P=0.001; 69.5% vs. 47.9%, P=0.026). Furthermore for the the patients with pTNM Ⅱ stage , it was found that the the 10-year cumulative disease-specific survival rate of the intellectual group was higher than that of the manual group (93.5% vs. 78.7%, P=0.009).ConclusionsFrom the analysis results of this study, occupation might be related to long-term prognosis in CRC cancer patients. A general trend is that the long-term prognosis of patients with intellectual occupations might be better than that of patients with manual occupations, and this difference might be relatively marked in the patients with pTNM Ⅱ and Ⅲ stages, but it needs to be autious and objective.
Objective Chronic graft dysfunction (CGD) has become the major factor that influences the long-term survival of grafts. It is unclear whether the different incidence of CGD has organ specificity. Methods We collected the graft survival rates (GSRs) of solid organ transplantations from the OPTN/SRTR (organ procurement and transplantation network/ scientific registry of transplant recipient). The solid organ transplantations were classified according to the cluster analyses of GSRs during two time periods. We defined the standard of lower survival rate and compared it to the 3-month GSRs (3mGSRs), 1-year GSRs (1y GSRs), 3y GSRs, and 5y GSRs of various solid organ transplantations. Results Deceased donor ECD kidney (DD-ECDK), pancreas transplantation alone (PTA), pancreas after kidney transplantation (PAK), Intestine (In), deceased donor lung (DD-Lu), and heart-lung (H-Lu) were classified into a category which was associated with lower graft survival rates based on the variables of GSRs during the time periods of 1991-1995 and 1996-2000. Compared with those of DD-ECDK, the lowest in the three types of kidney transplantation, the GSRs during the two time periods of the above organ transplantations of lower graft survival were lower [3mGSRs: OR 0.26-0.92, 95%CI (0.20, 0.35)-(0.61,1.39); 1y GSRs : OR 0.30-0.87, 95%CI (0.23,0.37)-(0.78,0.97); 3y GSRs: OR 0.39-0.77, 95%CI (0.30,0.51)-(0.61,0.98); 5y GSRs: OR 0.12-0.87, 95%CI (0.09,0.71)- (0.75,1.0)]. Conclusion The CGD had organ specificity. The grafts of DD-ECDK, PTA, PAK, In, DD-Lu, and H-Lu were identified as the organs with earlier onsets and higher incidence of CGD.
Objective To evaluate the predictive performance of the geometric characteristics, centerline (CL) of pulmonary nodules for prognosis in patients with surgically treatment in the National Lung Screening Trial (NLST). MethodsCT images of 178 patients who underwent surgical treatment and were diagnosed with non-small cell lung cancer (NSCLC) in the low-dose CT (LDCT) cohort from the NLST image database were selected, including 99 males and 79 females, with a median age of 64 (59, 68) years. CT images were processed using commercial software Mimics 21.0 to record the volume, surface area, CL and the area perpendicular to the centerline of pulmonary nodules. Receiver operating characteristic (ROC) curve was used to compare the predictive performance of LD, AD and CL on prognosis. Univariate Cox regression was used to explore the influencing factors for postoperative disease-free survival (DFS) and overall survival (OS), and meaningful independent variables were included in the multivariate Cox regression to construct the prediction model. ResultsThe area under the curve (AUC) of CL for postoperative recurrence and death were 0.650 and 0.719, better than LD (0.596, 0.623) and AD (0.600, 0.631). Multivariate Cox proportional risk regression analysis showed that pulmonary nodule volume (P=0.010), the maximum area perpendicular to the centerline (MApc) (P=0.028) and lymph node metastasis (P<0.001) were independent risk factors for DFS. Meanwhile, age (P=0.010), CL (P=0.043), lymph node metastasis (P<0.001), MApc (P=0.022) and the average area perpendicular to the centerline (AApc) (P=0.016) were independently associated with OS. ConclusionFor the postoperative outcomes of NSCLC patients in the LDCT cohort of the NLST, the CL of the pulmonary nodule prediction performance for prognosis is superior to the LD and AD, CL can effectively predict the risk stratification and prognosis of lung cancer, and spheroid tumors have a better prognosis.