AIM: To analyze the risk factors for central port failure in cancer patients administered chemotherapy, using univariate and multivariate analyses. METHODS: A total of 1348 totally implantable venous access devices (T...AIM: To analyze the risk factors for central port failure in cancer patients administered chemotherapy, using univariate and multivariate analyses. METHODS: A total of 1348 totally implantable venous access devices (TIVADs) were implanted into 1280 cancer patients in this cohort study. A Cox proportional hazard model was applied to analyze risk factors for failure of TIVADs. Log-rank test was used to compare actuarial survival rates. Infection, thrombosis, and surgical complication rates (χ2 test or Fisher's exact test) were compared in relation to the risk factors. RESULTS: Increasing age, male gender and openended catheter use were signifi cant risk factors reducing survival of TIVADs as determined by univariate and multivariate analyses. Hematogenous malignancy decreased the survival time of TIVADs; this reduction was not statistically signifi cant by univariate analysis [hazard ratio (HR) = 1.336, 95% CI: 0.966-1.849, P = 0.080)]. However, it became a signifi cant risk factor by multivariate analysis (HR = 1.499, 95% CI: 1.079-2.083, P = 0.016) when correlated with variables of age, sex and catheter type. Close-ended (Groshong) catheters had a lower thrombosis rate than open-ended catheters (2.5% vs 5%, P = 0.015). Hematogenous malignancy had higher infection rates than solid malignancy (10.5% vs 2.5%, P < 0.001). CONCLUSION: Increasing age, male gender, openended catheters and hematogenous malignancy were risk factors for TIVAD failure. Close-ended catheters had lower thrombosis rates and hematogenous malignancy had higher infection rates.展开更多
The liver, which is a metabolic organ, plays a pivotal role in tolerance induction. Hepatic stellate cells(Hp SCs), which are unique non-parenchymal cells, exert potent immunoregulatory activity during cotransplantati...The liver, which is a metabolic organ, plays a pivotal role in tolerance induction. Hepatic stellate cells(Hp SCs), which are unique non-parenchymal cells, exert potent immunoregulatory activity during cotransplantation with allogeneic islets effectively protecting the islet allografts from rejection. Multiple mechanisms participate in the immune tolerance induced by Hp SCs, including the marked expansion of myeloid-derived suppressor cells(MDSCs), attenuation of effector T cell functions and augmentation of regulatory T cells. Hp SC conditioned MDSC-based immunotherapy has been conducted in mice with autoimmune disease and the results show that this technique may be promising. This article demonstrates how Hp SCs orchestrate both innate immunity and adaptive immunity to build a negative network that leads to immune tolerance.展开更多
为解压缩创造喷水孔结肠开口术能为一个严重地削弱的案例向一个节省时间、有效的外科的过程提供一种完全妨碍的颜色表面的癌症。复杂并发症作为脱垂，收回，和 paracolostomal 脓肿被报导。然而，复杂并发症与一是化学家远侧的手足没被...为解压缩创造喷水孔结肠开口术能为一个严重地削弱的案例向一个节省时间、有效的外科的过程提供一种完全妨碍的颜色表面的癌症。复杂并发症作为脱垂，收回，和 paracolostomal 脓肿被报导。然而，复杂并发症与一是化学家远侧的手足没被报导。我们为减轻恶意的 S 字形的冒号阻塞在减压结肠开口术以后报导批评 intra 腹的疾病的一个案例；一个潜在的致命的条件应该被警告。76 岁的男性与肮脏气味的呕吐为与妨碍的 S 字形的结肠肿瘤有关的症状访问了我们的紧急情况部门我们包含象粪便一样材料。对妨碍的 S 字形的损害近似的突现的喷水孔结肠开口术被创造，并且完全的冒号阻塞的分辨率被追求。不幸地，有有白细胞减少的高发烧的像板的腹部和骤起的广泛的腹的痛苦的膨胀随后发展了。如此的急腹症与 S 字形的肿瘤的切除术显示了第二等的剖腹术与一起一是近似地定位直到以前创造的结肠开口术的化学家冒号片断。最后，病人让一所平静手术后的医院留下来。在现在的文章，我们在喷水孔结肠开口术以后描述了远侧的手足局部缺血的骤起的一个突现的条件并且断定尽管有减压结肠开口术，那将高效地解决尖锐恶意的冒号阻塞；逼近是化学家肠可以与可能的不可逆的腹膜炎进行。任何病人，没有妨碍的损害的切除术，经历减压结肠开口术，应该经常与白血球计数和腹的条件调查被监视。展开更多
文摘AIM: To analyze the risk factors for central port failure in cancer patients administered chemotherapy, using univariate and multivariate analyses. METHODS: A total of 1348 totally implantable venous access devices (TIVADs) were implanted into 1280 cancer patients in this cohort study. A Cox proportional hazard model was applied to analyze risk factors for failure of TIVADs. Log-rank test was used to compare actuarial survival rates. Infection, thrombosis, and surgical complication rates (χ2 test or Fisher's exact test) were compared in relation to the risk factors. RESULTS: Increasing age, male gender and openended catheter use were signifi cant risk factors reducing survival of TIVADs as determined by univariate and multivariate analyses. Hematogenous malignancy decreased the survival time of TIVADs; this reduction was not statistically signifi cant by univariate analysis [hazard ratio (HR) = 1.336, 95% CI: 0.966-1.849, P = 0.080)]. However, it became a signifi cant risk factor by multivariate analysis (HR = 1.499, 95% CI: 1.079-2.083, P = 0.016) when correlated with variables of age, sex and catheter type. Close-ended (Groshong) catheters had a lower thrombosis rate than open-ended catheters (2.5% vs 5%, P = 0.015). Hematogenous malignancy had higher infection rates than solid malignancy (10.5% vs 2.5%, P < 0.001). CONCLUSION: Increasing age, male gender, openended catheters and hematogenous malignancy were risk factors for TIVAD failure. Close-ended catheters had lower thrombosis rates and hematogenous malignancy had higher infection rates.
基金Supported by National Science Council,No.NSC 101-2314-B-182A-040-MY2 and No.CMRPG6A0523
文摘The liver, which is a metabolic organ, plays a pivotal role in tolerance induction. Hepatic stellate cells(Hp SCs), which are unique non-parenchymal cells, exert potent immunoregulatory activity during cotransplantation with allogeneic islets effectively protecting the islet allografts from rejection. Multiple mechanisms participate in the immune tolerance induced by Hp SCs, including the marked expansion of myeloid-derived suppressor cells(MDSCs), attenuation of effector T cell functions and augmentation of regulatory T cells. Hp SC conditioned MDSC-based immunotherapy has been conducted in mice with autoimmune disease and the results show that this technique may be promising. This article demonstrates how Hp SCs orchestrate both innate immunity and adaptive immunity to build a negative network that leads to immune tolerance.
文摘为解压缩创造喷水孔结肠开口术能为一个严重地削弱的案例向一个节省时间、有效的外科的过程提供一种完全妨碍的颜色表面的癌症。复杂并发症作为脱垂，收回，和 paracolostomal 脓肿被报导。然而，复杂并发症与一是化学家远侧的手足没被报导。我们为减轻恶意的 S 字形的冒号阻塞在减压结肠开口术以后报导批评 intra 腹的疾病的一个案例；一个潜在的致命的条件应该被警告。76 岁的男性与肮脏气味的呕吐为与妨碍的 S 字形的结肠肿瘤有关的症状访问了我们的紧急情况部门我们包含象粪便一样材料。对妨碍的 S 字形的损害近似的突现的喷水孔结肠开口术被创造，并且完全的冒号阻塞的分辨率被追求。不幸地，有有白细胞减少的高发烧的像板的腹部和骤起的广泛的腹的痛苦的膨胀随后发展了。如此的急腹症与 S 字形的肿瘤的切除术显示了第二等的剖腹术与一起一是近似地定位直到以前创造的结肠开口术的化学家冒号片断。最后，病人让一所平静手术后的医院留下来。在现在的文章，我们在喷水孔结肠开口术以后描述了远侧的手足局部缺血的骤起的一个突现的条件并且断定尽管有减压结肠开口术，那将高效地解决尖锐恶意的冒号阻塞；逼近是化学家肠可以与可能的不可逆的腹膜炎进行。任何病人，没有妨碍的损害的切除术，经历减压结肠开口术，应该经常与白血球计数和腹的条件调查被监视。
