AIMTo identify simple and sensitive markers for postoperative complications after gastrectomy, the predictive values were compared among candidate preoperative factors.METHODSThree-hundred and twelve patients with pre...AIMTo identify simple and sensitive markers for postoperative complications after gastrectomy, the predictive values were compared among candidate preoperative factors.METHODSThree-hundred and twelve patients with previously untreated clinical T2-4 gastric cancer who underwent a D2 standard gastrectomy (distal gastrectomy or total gastrectomy) were included in the analysis. Correlations between 21 parameters that can be determined by preoperative routine blood tests and clinically relevant postoperative complications (grade II or higher according to the Clavien-Dindo classification) were evaluated. The optimal cutoff values and clinical significance of the selected markers were further evaluated by subgroup analyses according to age, body mass index, operative procedure and clinical disease stage.RESULTSSixty-six patients (21.1%) experienced grade II or higher postoperative complications. The platelet-lymphocyte ratio (PLR, total lymphocyte count/platelet count × 100) exhibited the highest area under the curve value (0.639) for predicting postoperative complications among the 21 parameters, and the optimal cutoff value was determined to be 0.71 (sensitivity = 70%, specificity = 56%). In the univariate analysis, the odds ratio of a low PLR for the occurrence of postoperative complications was 2.94 (95%CI: 1.66-5.35, P < 0.001), and a multivariate binomial logistic analysis involving other potential risk factors identified a low PLR as an independent risk factor for postoperative complications (OR = 3.32, 95%CI: 1.82-6.25, P < 0.001). In subgroups classified according to age, body mass index, operative procedure and clinical disease stage, the low PLR group exhibited an increased incidence of postoperative complications.CONCLUSIONThe preoperative PLR is a simple and useful predictor of complications after curative gastrectomy in patients with clinical T2-4 gastric cancer.展开更多
OBJECTIVE:To evaluate the influence of clinical pathways in the hospitals using the Traditional Chinese Medicine in treatment of stroke in terms of postoperative complications, length of stay(LOS),costs incurred durin...OBJECTIVE:To evaluate the influence of clinical pathways in the hospitals using the Traditional Chinese Medicine in treatment of stroke in terms of postoperative complications, length of stay(LOS),costs incurred during hospitalization, compared with standard medical care.METHODS:Medline, Embase, China National Knowledge Infrastructure(CNKI) platforms, Wanfang databases and the Cochrane Central Register of Controlled Trials were searched.The search was performed up to August 2014.Each study was assessed independently by two reviewers.The assessment of methodological quality of the included studies was based on the Methodological index for non-randomized studies standard.Meta-analyses were performed using Rev Man software, version5.0.RESULTS:Six studies met the study inclusion criteria and were included in the Meta-analysis for a total sample of 710 patients.The aggregate overall results showed that shorter length of stay in the clinical pathway group was observed during hospital stay was associated with the use of the clinical pathways.No significant differences were found in other effects.CONCLUSION:Regardless the possible limitations,our findings show that clinical pathways can significantly reduce LOS.Although there is no clear evidence that clinical pathways can reduce hospital costs, but the cost of hospitalization path group for each included study were lower than the control group.展开更多
Objective： To observe the clinical Zhongji （CV 3） and Zusanli （ST 36） gynecological surgery. effect of warm needling moxibustion at in treatment of urinary retention after Methods： Forty patients with urinary r...Objective： To observe the clinical Zhongji （CV 3） and Zusanli （ST 36） gynecological surgery. effect of warm needling moxibustion at in treatment of urinary retention after Methods： Forty patients with urinary retention after gynecological surgery were randomly divided into two groups by the randomized method, 20 cases in each group. Patients in the treatment group were treated by warm needling moxibustion at Zhongji （CV 3） and Zusanli （ST 36）. Patients in the control group were treated by inductive urination. The therapeutic effects of the two groups were observed after one course of treatment. Results： The total effective rate was 95.0% in the treatment group and 70.0% in the control group. The difference in the total effective rate between the two groups was statistically significant （P〈O.05）. Conclusion： Warm needling moxibustion at Zhongji （CV 3） and Zusanli （ST 36） is more effective than inductive urination in treating urinary retention after gynecological surgery.展开更多
文摘AIMTo identify simple and sensitive markers for postoperative complications after gastrectomy, the predictive values were compared among candidate preoperative factors.METHODSThree-hundred and twelve patients with previously untreated clinical T2-4 gastric cancer who underwent a D2 standard gastrectomy (distal gastrectomy or total gastrectomy) were included in the analysis. Correlations between 21 parameters that can be determined by preoperative routine blood tests and clinically relevant postoperative complications (grade II or higher according to the Clavien-Dindo classification) were evaluated. The optimal cutoff values and clinical significance of the selected markers were further evaluated by subgroup analyses according to age, body mass index, operative procedure and clinical disease stage.RESULTSSixty-six patients (21.1%) experienced grade II or higher postoperative complications. The platelet-lymphocyte ratio (PLR, total lymphocyte count/platelet count × 100) exhibited the highest area under the curve value (0.639) for predicting postoperative complications among the 21 parameters, and the optimal cutoff value was determined to be 0.71 (sensitivity = 70%, specificity = 56%). In the univariate analysis, the odds ratio of a low PLR for the occurrence of postoperative complications was 2.94 (95%CI: 1.66-5.35, P < 0.001), and a multivariate binomial logistic analysis involving other potential risk factors identified a low PLR as an independent risk factor for postoperative complications (OR = 3.32, 95%CI: 1.82-6.25, P < 0.001). In subgroups classified according to age, body mass index, operative procedure and clinical disease stage, the low PLR group exhibited an increased incidence of postoperative complications.CONCLUSIONThe preoperative PLR is a simple and useful predictor of complications after curative gastrectomy in patients with clinical T2-4 gastric cancer.
基金Supported by The Special Fund of Traditional Chinese Medicine Scientific Research(Study on the Key Technology of Data Center of Traditional Chinese Medicine,No.201407001-13)Self-selected Subject of China Academy of Chinese Medical Sciences(Study on Development Strategy and Planning of National Traditional Chinese Medicine Data Center,No.ZZ060815)National "Twelfth Five-Year" Plan for Science Technology of China(No.2013BAI02B10)
文摘OBJECTIVE:To evaluate the influence of clinical pathways in the hospitals using the Traditional Chinese Medicine in treatment of stroke in terms of postoperative complications, length of stay(LOS),costs incurred during hospitalization, compared with standard medical care.METHODS:Medline, Embase, China National Knowledge Infrastructure(CNKI) platforms, Wanfang databases and the Cochrane Central Register of Controlled Trials were searched.The search was performed up to August 2014.Each study was assessed independently by two reviewers.The assessment of methodological quality of the included studies was based on the Methodological index for non-randomized studies standard.Meta-analyses were performed using Rev Man software, version5.0.RESULTS:Six studies met the study inclusion criteria and were included in the Meta-analysis for a total sample of 710 patients.The aggregate overall results showed that shorter length of stay in the clinical pathway group was observed during hospital stay was associated with the use of the clinical pathways.No significant differences were found in other effects.CONCLUSION:Regardless the possible limitations,our findings show that clinical pathways can significantly reduce LOS.Although there is no clear evidence that clinical pathways can reduce hospital costs, but the cost of hospitalization path group for each included study were lower than the control group.
基金supported by Air Force General Hospital,Chinese People's Liberation Army
文摘Objective： To observe the clinical Zhongji （CV 3） and Zusanli （ST 36） gynecological surgery. effect of warm needling moxibustion at in treatment of urinary retention after Methods： Forty patients with urinary retention after gynecological surgery were randomly divided into two groups by the randomized method, 20 cases in each group. Patients in the treatment group were treated by warm needling moxibustion at Zhongji （CV 3） and Zusanli （ST 36）. Patients in the control group were treated by inductive urination. The therapeutic effects of the two groups were observed after one course of treatment. Results： The total effective rate was 95.0% in the treatment group and 70.0% in the control group. The difference in the total effective rate between the two groups was statistically significant （P〈O.05）. Conclusion： Warm needling moxibustion at Zhongji （CV 3） and Zusanli （ST 36） is more effective than inductive urination in treating urinary retention after gynecological surgery.
