Prognostic value of preoperative immune-nutritional scoring systems in remnant gastric cancer patients undergoing surgery

BACKGROUND Remnant gastric cancer(GC)is defined as GC that occurs five years or more after gastrectomy.Systematically evaluating the preoperative immune and nutritional status of patients and analyzing its prognostic impact on postoperative remnant gastric cancer(RGC)patients are crucial.A simple scoring system that combines multiple immune or nutritional indicators to identify nutritional or immune status before surgery is necessary.AIM To evaluate the value of preoperative immune-nutritional scoring systems in predicting the prognosis of patients with RGC.METHODS The clinical data of 54 patients with RGC were collected and analyzed retrospectively.Prognostic nutritional index(PNI),controlled nutritional status(CONUT),and Naples prognostic score(NPS)were calculated by preoperative blood indicators,including absolute lymphocyte count,lymphocyte to monocyte ratio,neutrophil to lymphocyte ratio,serum albumin,and serum total cholesterol.Patients with RGC were divided into groups according to the immune-nutritional risk.The relationship between the three preoperative immune-nutritional scores and clinical characteristics was analyzed.Cox regression and Kaplan–Meier analysis was performed to analyze the difference in overall survival(OS)rate between various immune-nutritional score groups.RESULTS The median age of this cohort was 70.5 years(ranging from 39 to 87 years).No significant correlation was found between most pathological features and immune-nutritional status(P>0.05).Patients with a PNI score<45,CONUT score or NPS score≥3 were considered to be at high immune-nutritional risk.The areas under the receiver operating characteristic curves of PNI,CONUT,and NPS systems for predicting postoperative survival were 0.611[95%confidence interval(CI):0.460–0.763;P=0.161],0.635(95%CI:0.485–0.784;P=0.090),and 0.707(95%CI:0.566–0.848;P=0.009),respectively.Cox regression analysis showed that the three immunenutritional scoring systems were significantly correlated with OS(PNI:P=0.002;CONUT:P=0.039;NPS:P<0.001).Survival analysis revealed a significant difference in OS between different immune-nutritional groups(PNI:75 mo vs 42 mo,P=0.001;CONUT:69 mo vs 48 mo,P=0.033;NPS:77 mo vs 40 mo,P<0.001).CONCLUSION These preoperative immune-nutritional scores are reliable multidimensional prognostic scoring systems for predicting the prognosis of patients with RGC,in which the NPS system has relatively effective predictive performance.

Effects of EDTA irrigation and water storage on the bonding durability of different adhesive resin cements to intra-radicular dentin

One hundred and twenty single-root teeth were selected to evaluate the bonding durability of three different adhesive resin cements to intra-radicular dentin and the effect of ethylenediaminetetraacetic acid （EDTA） irrigation on bonding durability,

Influence of casein phosphopeptide-amorphous calcium phosphate application,smear layer removal, and storage time on resin-dentin bonding

The aim of this study is to evaluate the influence of Tooth Mousse （TM） application, smear layer removal, and storage time on resin-dentin microtensile bond strength （pTBS）. Dentin specimens were divided into two groups： （1） smear layer covered; （2） smear layer removed using 15% EDTA for 90 s. In each group, half the specimens were treated once with TM for 60 min. After bonding procedures using a two-step self-etching adhesive （Clearfil SE Bond （CSE）; Kuraray Medical, Tokyo, Japan）, an all-in-one adhesive （G-Bond （GB）; GC Corp, Tokyo, Japan）, and a total-etch adhesive （Adper Single Bond 2 （SB）; 3M ESPE, St. Paul, MN, USA）, the specimens were stored for 3 d or 6 months in deionized water at 37 ℃, and pTBS was tested and analyzed. With the exception of SB （no TM application） and GB, the pTBS was significantly increased for CSE and SB using EDTA pre-conditioning and 3 d of storage （P≤0.001）. Bond strength of GB decreased significantly when using EDTA （3 d storage, P〈0.05）. TM application only increased the pTBS of GB （no EDTA） and SB （with EDTA） after 3 d （P≤0.02）. Comparing the adhesives after 3 d of storage, CSE exhibited the greatest pTBS values followed by GB and SB （P≤0.02）. The factors of adhesive, EDTA, and TM did not show any significant impact on pTBS when specimens were stored for 6 months （P〉0.05）. The additional application of TM and EDTA for cavity preparation seems only to have a short-term effect, and no influence on pTBS of dentin bonds after a period of 6 months.