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.

乙二胺四乙酸处理和水储存对不同树脂粘结剂与根管牙本质间粘结耐久性的影响(英文)

树脂粘结材料已广泛应用于临床,但其粘结耐久性仍不尽人意,导致牙本质粘结修复体远期存在继发龋、脱落率高等问题,成为目前亟需解决的关键问题。本文通过探讨不同树脂粘结剂(Supper Bond C&B、Panavia F和RelyX Unicem)与根管牙本质间粘结耐久性的差异,以及乙二胺四乙酸(EDTA)处理对不同树脂粘结剂粘结耐久性的影响,发现EDTA处理可以提高树脂粘结剂与根管牙本质间的粘结强度和粘结耐久性,从而可以提高修复体的远期粘结效果。另外,水储存可造成树脂粘结剂与根管牙本质间粘结强度下降。

酪蛋白磷酸肽-无定形磷酸钙、不同玷污层的处理和储存时间对牙本质粘接的影响(英文)

研究目的:评价含有酪蛋白磷酸肽-无定形磷酸钙(CPP-ACP)的再矿化剂Tooth Mousse(TM)的使用、不同玷污层的处理以及样本储存时间对牙本质粘接微拉伸性能的影响。研究方法:将牙本质样本分成保留玷污层组和用15%乙二胺四乙酸(EDTA)处理90秒去除玷污层组。每组根据是否使用TM处理再分亚组。每个亚组分别用三种不同的粘结剂(两步法自酸蚀Clearfil SE Bond(CSE)、一步法自酸蚀G-Bond(GB)和全酸蚀Adper Single Bond 2(SB))与牙本质样本粘接,分别经过3天和6个月的去离子水储存。样本进行切割微拉伸测试并通过扫描电镜分析断裂界面模式。重要结论:经过再矿化剂TM预处理,可以减少牙齿的敏感性,并且对于这三种粘结系统经过长时间储存后的粘结性能没有影响。EDTA的处理对于长期储存的粘结性能没有显著影响。额外的TM和EDTA对短期(3天)粘接力会有效应,但对长期(6个月)的粘接力没有影响。