To evaluate the present status of treatment of chronic pancreatitis, 116 consecutive patients with chronic pancreatitis during the last decade (1986～1996) have been surveyed retrospectively. The clinical date has been analized statisticaly. Etiology: biliogenic 56 cases (48.3%), alcoholic 17 (14.6%), idiopathic 34 (29.3%) and other 9 cases (7.8%). Better result was achieved in surgical treatment group (81 cases) than in conservative group (35 cases), pain free: 65.5% vs 33.3%. The accumulated five-year survival rate was 56.3%, 92.2% and 78.1% in alcoholic, billiogenic and idiopathic type of chronic pancreatitis respectively. Morbidity and mortality of diarrhea and diabetes mellitus increased at followup. The authors conclude that the chronic pancreatitis patients associated with obstruction of biliopancreatic duct should undergo operation early and will ameliorate abdominal pain.
In order to study the effect of vascular endothelial cell growth factor (VEGF) on the survival of skin flap 30 SD rats were used. A randomized flap measuring 7.5 cm x 3.0 cm was created on the back of each SD rat. The treatment group (n = 10) received VEGF 40 ng/flap by subcutaneous injection with microinjector during and 24 hours after operation. The control groups received heparin 16 U/flap (n = 10) or normal saline 800 microliters/flap (n = 10). After operation, on the 3rd and 11th day, the survival rate of the skin flaps and the dermovascular density of each flap were investigated by histological and histo-morphometrical examination. The results showed that there was no significant difference in the survival rate between the treatment group and the controls on the 3rd day after operation, while on the 11th day, there was a significant difference between them, and the survival rate was much higher in the treatment group. Besides, dermovascular density was much more increased in the treatment group than that in the controls, especially in the distal 1/3 of the flap (P lt; 0.02). The conclusion was that VEGF could .
Objective To evaluate the long-term efficacy of extended and standard surgery for carcinoma of head of pancreas by using meta-analysis. Methods Related articls （1990-2012） were searched in Pubmed， WOS， Embase， WanFang， SinoMed， and CNKI. Study on quality of these literatures were evaluated by using the Jadad score. The patients with pancreatic head carcinoma underwent extended radical resection and standard radical resection were classified to treatment group and control group， respectively. The mortality， morbidity， and survival rates of 1-， 3-， and 5-year after operation in the two groups were evaluated by using meta-analysis. Results A total of 11 studies fitted the selection crit-eria， including 744 patients. Among them 357 cases were in standard radical resection group and 387 cases in the extended radical resection group. The results of meta-analysis showed that： ①The morbidity after operation did not significantly differed between the extended radical resection group and standard radical resection group （OR=1.360， 95% CI=0.990-1.870， P=0.050）. ②The mortality of the two groups did not significantly differed （OR=0.870， 95% CI=0.430-1.760，P=0.700）. ③There were no significant differences in survival rates of 1-， 3-， and 5-year between the two groups （OR=0.880， 95% CI=0.450-1.720， P=0.710；OR=0.940， 95% CI=0.590-1.480，P=0.710；OR=1.000， 95% CI=0.600-1.67， P=1.000）. Conclusion Compared with standard radical resection， extended radical resection can not improve the survival rates of 1-， 3-， and 5-year after operation， and can’t reduce the mortality and morbidity after operation
Objective To investigate the prognostic factors related to long-term survival after gastrectomy. Methods A total of 351 patients with gastric cancer who underwent gastrectomy were successfully followed-up in our hospital had been selected from January 2004 to December 2009. The clinicopathological and follow-up data were studied by univariate and multivariate analysis. Results The age, location of tumors, T stage, N stage, TNM stage, and differentiation were related with postoperative survival of patients with gastric cancer by using univariate analysis（P＜0.05）. By using multivariate analysis, location of tumors, T stage, N stage, and chemotherapy were independent prognostic factors（P＜0.05）. Conclusions Location of tumors, depth of tumor invation, lymph node metastasis, and chem-otherapy were independent prognostic factors for gastric cancer patients who underwent gastrectomy. Chemotherapy after surgery could increase the survival rate of gastric cancer patients with lymph node metastasis or in TNM stage Ⅲ.
Abstract： Objective To investigate prognosis factors of primary small cell carcinoma of the esophagus （PSCCE）, and to optimize the treatment strategy of PSCCE. Method We retrospectively analyzed clinical data of 15 patients （13 males and 2 females with an age of 57.7±2.3 years） with middle thoracic PSCCE in West China Hospital from June 2005 to February 2010. We searched ISI and MEDLINE from April 2001 to February 2010 to extract clinical data of 139 PSCCE patients with 94 males and 45 females with an age of 63.3±10.7 years. We analyzed prognosis factors of the 139 patients including gender, age, tumor location, pathological type, lesions stage and treatment strategy by Kaplan-Meier. Difference in survival curves between limited disease patients and extended disease patients was tested by log-rank test. Results Among the 15 patients, 14 patients had limited disease, and 1 patient had extended disease. Their data were not included in survival analysis because the follow-up was incomplete. Among the 139 patients, 88 patients had limited disease with their 2-year survival rate of 31.8% （28/88）. Fifty-one patients had extended disease with their 2-year survival rate of 7.8% （4/51）. The 2-year survival rate between limited-disease patients and extended-disease patients was statistically different（P＜0.05）. Radiation therapy in combination with chemotherapy had significant influence on the survival rate of patients with either local lesions or advanced lesions（P＜ 0.05）, while other factors such as gender, age and tumor location had no significant influence on their survival rate（P＞0.05）. Conclusion Chemotherapy is the fundamental treatment of PSCCE, which plays an important role in reducing PSCCE preoperative staging and restraining PSCCE postoperative recurrence and metastasis. Surgery and radiation therapy are effective for patients with local lesions. Local treatment in combination with chemotherapy is effective for patients with limited disease. Radiation therapy in combination with chemotherapy is the standard therapy for patients with extended lesions,
ObjectiveTo overview the various molecular biological index to judge the prognosis of intrahepatic cholangiocarcinoma (ICC), in order to promote ICC patients follow-up treatment, improve survival rate, and quality of life of the patients. Methods"ICC" and "prognostic factor" were searched as key words by PubMed and CNKI series full-text database retrieval systems from 2000 to 2015. Totally 48 English papers and 15 Chinese papers were obtained. Choice criteria:the molecular biological index that affect the prognosis of ICC patients, and can effectively guide treatment. According to the choice criteria, 45 papers were finally analyzed. ResultsThe indicators of Homer1, mucin 1 (MUC1)\mucin 4 (MUC4), lactate dehydrogenase A (LDH-A), Beclin1, Smad4, protein tyrosine kinase-7 (PTK7), IMP3, cytokeratin 7 (CK7)/cytokeratin 20 (CK20), and sphingosine kinase 1 (SPHK1) could be used as prognostic factors in the survival of patients with ICC, and to determine tumor size and stage, vascular invasion, nerve injury, and lymph node metastasis, are of great clinical significance. ConclusionThese indicators have a significant meanning in the prognosis of ICC and the adjustment of the follow-up treatment.
Objective To assess the value of precise hepatectomy in treatment of primary hepatocellular carcinoma. Methods Three-dimensional (3D) models from MR image were reconstructed by 3D-Doctor software in 32 patients with primary hepatocellular carcinoma scheduled for liver resection between July 2007 and Sept 2009. From these 3D models, the vena cava, portal vein, hepatic vein, and short hepatic vein images were reconstructed, total liver volume, tumor volume, functional liver volume and ratio of functional liver volume to standard liver volume (SFLVR) were calculated. The patients were followed-up for 1-27 months, with an average of 12 months. Results The anatomic detail of liver veins and its relationship with the tumor could be displayed clearly in liver 3D models. By the 3D models, total liver volume was calculated as （1 353±419）ml, tumor volume as （287±248） ml, functional liver volume as （830±289） ml, and SFLVR as （71±22）%. Of 32 patients with hepatocellular carcinoma, right hemihepatectomy was performed in 8 cases, left hemihepatectomy in 2, and segmental or limited resection in 22. All operations were completed successfully. Postoperative complications included pulmonary infection in 1 case, bile leak in 1, moderate ascites (500-3 000 ml) in 8, and massive ascites (gt;3 000 ml) in 2 including one patient developed hepatic failure. Six and 12-month survival rates were 100% and 87%. Three, 6, and 12-month disease-free survival rates were 78%, 72%, and 72%. Conclusions Precise hepatectomy technique provides an accurate picture of liver veins anatomy and its relationship with the tumor， and allows the procedure to be simulated preoperatively for adequate and safe hepatectomy.
ObjectiveTo observe the clinical characteristics and survival rate of the patients with extraocular retinoblastoma (RB). MethodsThis is a retrospective case analysis. From November 2003 to May 2015, 38 eyes of 31 patients with RB in the extra-ocular stage from 213 RB patients were enrolled in this study. There were 18 males and 13 females. Bilateral lesions were observed in 7 patients and unilateral lesions were observed in 24 patients.19 patients were diagnosed at less than 2 years old, 10 patients at 2 to 5 years old, and 2 patients at age over 5 years old. First visit time was less than 1 month in 12 patients, from 1 to 3 months in 15 patients, over 3 months to 6 months in 4 patients. Medical history and family history were record at the first visit. All patients underwent orbital CT, MRI, double color Doppler imaging and wide angle digital retinal imaging system. CT and (or) MRI examination detected tumor extraocular invasion. Histopathological examination showed that there were tumor cells invasion of the scleral, optic nerve root and optic nerve. Chemotherapy was done after surgery. In the extra-ocular stage, 3 to 6 rounds of intensive chemotherapy combined with orbital radiotherapy were done. The average follow-up period was (25.5±4.5) months after treatment. The cumulative survival rate was observed after 6 months, 1 and 5 years after treatment, and the relationship between the initial age, time, sex, single eye, tumor and survival time of the patients was analyzed. ResultsThe extraocular RB accounted 14.55% of all RB patients in this study. There is no family history of RB, no special history. There were 15 patients with leukocoria and yellow-white reflection in the pupil; 5 patients with lacrimation, swelling, photophobia and exophthalmos; 11 patients with strabismus. The cumulative survival rate at 6 months, 1, 5 years after treatment was (78.0±9.0)%, (62.0±11.0)%, (57.0±11.0)% respectively. The average survival time was (53.9±7.8) months; the cumulative survival rate was (59.3±11.3)%. When the age of first visit was less than 1 month, 1-3 months, 3-6 months, the median survival time was 78, 15 and 18 months respectively, the cumulative survival rate was 100.0%, (40.0±21.9)% and (25.0±21.7)%, respectively. The survival time of the newly diagnosed patients at 1 month was more than at 1 to 6 months, and the difference was statistically significant (t=9.20, P < 0.05). Conclusions14.55% of all RB patients was extraocular RB in this study. One of the most common clinical manifestations is leukocoria at the first visit. The cumulative survival rate of extraocular RB is lower, while the survival rate of patients with the age of first visit time was less than 1 month is higher.
Objective To study the effect of platelet-rich plasma (PRP) on the survival and quality of fat grafts in the nude mice so as to provide a method and the experimental basis for clinical practice. Methods Fat tissue was harvested from the lateral thigh of a 25-year-old healthy woman and the fat was purified by using saline. The venous blood was taken from the same donor. PRP was prepared by centrifugation (200 × g for 10 minutes twice) and activated by 10% calcium chloride (10 : 1). Then 24 female nude mice [weighing (20 ± 3) g, 5-week-old] were allocated randomly to the experimental group and the control group (12 mice per group). Each subcutaneous layer of two sides of the back (experimental group) was infiltrated with 0.8 mL fat tissue-activated PRP mixtures (10 : 2); the control group was infiltrated with 0.8 mL fat tissue-saline mixtures (10 : 2); 0.14 mL activated PRP and 0.14 mL saline were injected into the experimental group and the control group respectively at 5 and 10 days after the first operation. At 15, 30, 90, and 180 days after the first operation, the samples were harvested for gross and histological observations. Results All nude mice survived to the end of the experiment. No inflammation and abscess formation of the graft were observed. Experimental group was better than control group in angiogenesis, liquefaction, and necrosis. The grafted fat weight and volume in the experimental group were significantly larger than those in the control group at 15, 30, and 90 days (P lt; 0.05); but there was no significant difference between the 2 groups at 180 days (P gt; 0.05). Histological observation showed good morphological and well-distributed adipocytes, increasing vacuoles, few necrosis and calcification in the experimental group; but disordered distribution, obvious necrosis, and calcification in the control group. The necrosis area ratio of the experimental group was significantly lower than that of the control group (P lt; 0.05), and the number of micro-vessels was significantly higher in the experimental group than in the control group at 15 and 180 days (P lt; 0.05). Conclusion The method of repeatedly using the PRP within 180 days in assisting fat grafts can obviously improve the survival and quality.
Objective To investigate the early diagnosis and treatment methods of primary duodenal papilla carcinoma. Methods The medical records of 54 patients with primary duodenal papilla adenocarcinoma underwent operation between January 2002 and December 2008 were reviewed. Results Thirty seven cases received fiberduodenoscopy and 35 cases received ERCP, and the accuracy of them were both 100%. Forty four patients received duodenopancreatectomy and 10 patients received jaundice-reducing operation. The 1-, 3-, and 5-year cumulation survival rate was 68%, 50%, and 29%, respectively. Conclusions Fiberduodenoscopy and ERCP are the effective diagnostic methods for duodenal papilla carcinoma. Early diagnosis and early rational radical operation are essential for successful treatment of duodenal papilla carcinoma.