AIM:To evaluate the therapeutic effect of alanyl- glutamine dipeptide (AGD) in the treatment of severe acute pancreatitis (SAP) in early and advanced stage. METHODS: Eighty patients with SAP were randomized and receiv...AIM:To evaluate the therapeutic effect of alanyl- glutamine dipeptide (AGD) in the treatment of severe acute pancreatitis (SAP) in early and advanced stage. METHODS: Eighty patients with SAP were randomized and received 100 mL/d of 20% AGD intravenously for 10 d starting either on the day of (early treatment group) or 5 d after (late treatment group) admission. Groups had similar demographics, underlying diseases, Ranson score, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, and Balthazar’s computed tomography (CT) score at the beginning of the study and underwent similar other medical and nutritional management. RESULTS: The duration of acute respiratory distress syndrome (2.7 ± 3.3 d vs 12.7 ± 21.0 d, P < 0.01), renal failure (1.3 ± 0.5 d vs 5.3 ± 7.3 d, P < 0.01), acute hepatitis (3.2 ± 2.3 d vs 7.0 ± 7.1 d, P < 0.01), shock (1.7 ± 0.4 d vs 4.8 ± 3.1 d, P < 0.05), encephalopathy (2.3 ± 1.9 d vs 9.5 ± 11.0 d, P < 0.01) and enteroparalysis (2.2 ± 1.4 d vs 3.5 ± 2.2 d, P < 0.01) and hospital stay (28.8 ± 9.4 d vs 45.2 ± 27.1 d, P < 0.01) were shorter in the early treatment group than in the late treatment group. The 15-d APACHE Ⅱ score was lower in the early treatment group than in the late treatment group (5.0 ± 2.4 vs 8.6 ± 3.6, P < 0.01). The infection rate (7.9% vs 26.3%, P < 0.05), operation rate (13.2% vs 34.2%, P < 0.05) and mortality (5.3% vs 21.1%, P < 0.05) in the early treatment group were lower than in the late treatment group.CONCLUSION: Early treatment with AGD achieved a better clinical outcome in SAP patients.展开更多
In the following four articles, we will provide an overview of the current clinical work in different areas of liver transplantation. For many decades, this transplantation has been the treatment choice for patients ...In the following four articles, we will provide an overview of the current clinical work in different areas of liver transplantation. For many decades, this transplantation has been the treatment choice for patients suffering from chronic and acute liver diseases.展开更多
Objective： To identify the influence of comorbidity on the choice of treatment and survival of elderly patients （≥70 years） with advanced non-small cell lung cancer （NSCLC）. Methods： The clinical characteristic...Objective： To identify the influence of comorbidity on the choice of treatment and survival of elderly patients （≥70 years） with advanced non-small cell lung cancer （NSCLC）. Methods： The clinical characteristics and the choices of treatment of 177 elderly patients, who had a good performance status （PS≤1） were retrospectively analyzed in Oncology Department, Shanghai Pulmonary Hospital, between January 2005 to December 2005. Survival data were only analyzed in those whose had received chemotherapy. All patients were stratified by number of comorbidity as none （0）, mild （1-2） and severe （≥ 3） groups. Results： The proportion of patients, who received chemotherapy, with none, mild and severe comorbidity was significantly different （79.3%, 76.2% and 57.4%, P=0.038）, and there was also significantly different about palliative radiotherapy rate among the three groups （21.7%, 11.7% and 37.0%, P=0.014）. The median survival and 1-year survival rate in none, mild and severe comorbidity groups, were 13.6 vs. 10.2 vs. 7.6 months and 53.5% vs. 41.3% vs. 20.8% respectively （Log-rank, P=0.071）. In univariate and multivariate Cox models analysis, only severe comorbidity was a independent hazard factor of survival of elderly patients with NSCLC. Relative ratio （RR, 95% CI）： （2.09, 1.06-4.15）, P=0.034. Conclusion： Comorbidity may affect the choice of treatment of elderly patients with advanced NSCLC slightly, but only severe comorbidity is a independent prognostic factor of survival.展开更多
文摘AIM:To evaluate the therapeutic effect of alanyl- glutamine dipeptide (AGD) in the treatment of severe acute pancreatitis (SAP) in early and advanced stage. METHODS: Eighty patients with SAP were randomized and received 100 mL/d of 20% AGD intravenously for 10 d starting either on the day of (early treatment group) or 5 d after (late treatment group) admission. Groups had similar demographics, underlying diseases, Ranson score, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, and Balthazar’s computed tomography (CT) score at the beginning of the study and underwent similar other medical and nutritional management. RESULTS: The duration of acute respiratory distress syndrome (2.7 ± 3.3 d vs 12.7 ± 21.0 d, P < 0.01), renal failure (1.3 ± 0.5 d vs 5.3 ± 7.3 d, P < 0.01), acute hepatitis (3.2 ± 2.3 d vs 7.0 ± 7.1 d, P < 0.01), shock (1.7 ± 0.4 d vs 4.8 ± 3.1 d, P < 0.05), encephalopathy (2.3 ± 1.9 d vs 9.5 ± 11.0 d, P < 0.01) and enteroparalysis (2.2 ± 1.4 d vs 3.5 ± 2.2 d, P < 0.01) and hospital stay (28.8 ± 9.4 d vs 45.2 ± 27.1 d, P < 0.01) were shorter in the early treatment group than in the late treatment group. The 15-d APACHE Ⅱ score was lower in the early treatment group than in the late treatment group (5.0 ± 2.4 vs 8.6 ± 3.6, P < 0.01). The infection rate (7.9% vs 26.3%, P < 0.05), operation rate (13.2% vs 34.2%, P < 0.05) and mortality (5.3% vs 21.1%, P < 0.05) in the early treatment group were lower than in the late treatment group.CONCLUSION: Early treatment with AGD achieved a better clinical outcome in SAP patients.
文摘In the following four articles, we will provide an overview of the current clinical work in different areas of liver transplantation. For many decades, this transplantation has been the treatment choice for patients suffering from chronic and acute liver diseases.
文摘Objective： To identify the influence of comorbidity on the choice of treatment and survival of elderly patients （≥70 years） with advanced non-small cell lung cancer （NSCLC）. Methods： The clinical characteristics and the choices of treatment of 177 elderly patients, who had a good performance status （PS≤1） were retrospectively analyzed in Oncology Department, Shanghai Pulmonary Hospital, between January 2005 to December 2005. Survival data were only analyzed in those whose had received chemotherapy. All patients were stratified by number of comorbidity as none （0）, mild （1-2） and severe （≥ 3） groups. Results： The proportion of patients, who received chemotherapy, with none, mild and severe comorbidity was significantly different （79.3%, 76.2% and 57.4%, P=0.038）, and there was also significantly different about palliative radiotherapy rate among the three groups （21.7%, 11.7% and 37.0%, P=0.014）. The median survival and 1-year survival rate in none, mild and severe comorbidity groups, were 13.6 vs. 10.2 vs. 7.6 months and 53.5% vs. 41.3% vs. 20.8% respectively （Log-rank, P=0.071）. In univariate and multivariate Cox models analysis, only severe comorbidity was a independent hazard factor of survival of elderly patients with NSCLC. Relative ratio （RR, 95% CI）： （2.09, 1.06-4.15）, P=0.034. Conclusion： Comorbidity may affect the choice of treatment of elderly patients with advanced NSCLC slightly, but only severe comorbidity is a independent prognostic factor of survival.
