规范化疼痛护理管理在胃癌病患护理中的应用价值分析

分析在胃癌病患护理中采用规范化疼痛护理管理的作用。方法 选择62例在2022年1月到2023年12月到院就诊治疗的胃癌病患,将所选择的病患进行随机组合,再分别对其实施不同的护理干预。一组为研究组实施规范化疼痛护理管理,另一组为参照组实施常规护理管理。收集两组病患护理后的依从性、疼痛评分、生活质量、住院指标和负面情绪评分。结果 经过数据对比,研究组病患的护理依从性、生活质量均在规范化疼痛护理管理后得到提高,且与参照组比较差异明显(P<0.05);护理后,研究组病患在疼痛评分和负面情绪方面的数据则明显比参照组更低,其差异显著(P<0.05),同时研究组病患的下床活动时间和住院时间用时更短,差异显著(P<0.05)。结论 对胃癌患者实行规范化疼痛护理管理,能显著减轻患者痛苦程度,改善患者的依从感和生存能力,同时使其在护理过程保持积极情绪,值得推荐使用。

Factors predicting survival in patients with proximal gastric carcinoma involving the esophagus

AIM： To investigate the clinicopathologic features which predict surgical overall survival in patients with proxima gastric carcinoma involving the esophagus （PGCE）. METHODS： Electronic pathology database established in the Department of Pathology of the Nanjing Drum Tower Hospital was searched for consecutive resection cases of proximal gastric carcinoma over the period from May 2004 through July 2009. Each retrieved pa- thology report was reviewed and the cases with tumors crossing the gastroesophageal junction line were se- lected as PGCE. Each tumor was re-staged, following the guidelines on esophageal adenocarcinoma, accord- ing to the 7th edition of the American Joint Commission on Cancer Staging Manual. All histology slides were studied along with the pathology report for a retrospec- tive analysis of 13 clinicopathologic features, i.e., age, gender, Helicobacter pylori （H. pylon} infection, surgical modality, Siewert type, tumor Bormann＇s type, size, dif- ferentiation, histology type, surgical margin, lympho- vascular and perineural invasion, and pathologic stage in relation to survival after surgical resection. Prognos- tic factors for overall survival were assessed with uni- and multi-variate analyses. RESULTS： Patients＇ mean age was 65 years （range： 47-90 years）. The male： female ratio was 3.3. The 1-, 3- and 5-year overall survival rates were 87%, 61% and 32%, respectively. By univariate analysis, age, male gender, H. pylori, tumor Bormann＇s type, size, histology type, surgical modality, positive surgical margin, lym- phovascular invasion, and pT stage were not predictive for overall survival; in contrast, perineural invasion （P = 0.003）, poor differentiation （P = 0.0003）, 〉 15 to- tal lymph nodes retrieved （P = 0.008）, positive lymph nodes （P = 0.001）, and distant metastasis （P = 0.005） predicted poor post-operative overall survival. Celiac axis nodal metastasis was associated with significantly worse overall survival （P = 0.007）. By multivariate analysis, ≥ 16 positive nodes （P = 0.018）, lymph node ratio 〉 0.2 （P = 0.003）, and overall pathologic stage （P= 0.002） were independent predictors for poor overa survival after resection. CONCLUSION： Patients with PGCE showed worse over- all survival in elderly, high nodal burden and advanced pathologic stage. This cancer may be more accurately staged as gastric, than esophageal, cancer.

Clinicopathologic Characteristics and Surgical Outcome of Gastric Cancer in Patients Younger than 36 Years of Age

OBJECTIVE This study was designed to determine theclinicopathologic features of young patients who underwentgastrectomy for gastric cancer and to improve the clinicalmanagement of this disease.METHODS From 1981 to 2000,among 1,830 gastric cancerpatients were admitted in our hospital for surgical treatment,66of them were<36 years of age.The clinicopathologic data of theseyoung patients were collected and reviewed.RESULTS The male:female ratio was 1.2:1.Most tumors werelocated in the lower third of the stomach(63.1%).The overall5-year survival rate of 66 cases was 28.7%.The 5-year survivalrates in the patients with early stages and with advanced stages ofgastric carcinoma were 77.8%(7/9)and 21.1%(12/57),respectively.Unfavorable prognostic factors associated with poor 5-yearsurvival included the degree of the invasion in the gastric wall(P<0.05),and curability of resection(non-curative vs.curative;P<0.05).CONCLUSION Gastric cancer in young adults tends to be moreadvanced presentation when diagnosed.However,young patientswith early gastric cancer can tolerate radical treatments well.Itis important to promptly make a precise diagnosis for gastriccarcinoma in young patients and to treat it in early stage.

Family history of cancer in Chinese gastric cancer patients

Objective:The aim of the study was to investigate the influence of gastric cancer family history in the gastric cancer (GC) patients. Methods: Gastric cancer family histories within second degree relatives and clinicopathological features were obtained for 497 patients. Results:Of the 497 probands,235 probands were incorporated into familial gastric cancer (FGC) group (there were at least two GC members in the family); 262 probands were included in the non-FGC group (relatives only affected with non-GCs). Of 614 tumors in relatives,GC was the most frequent,followed by lung cancer,esophageal cancer,hepatocellular cancer,colorectal cancer,urogenital cancer,breast cancer,and pancreatic cancer. Most affected members aggregated within first-degree relatives. The ratio of males to females in affected first-degree relatives was usually higher in male probands. Paternal history of GC was a strong risk for GC in males,while risk of GC by maternal history of GCs was increased in females. Difference in tumor histological types between the two groups was derived from an excess of diffuse GC in non-FGC male probands. The lower site was the most frequent tumor location in all subgroups. Conclusion:Distribution of associated non-GCs in a family history of GC may vary with geographic areas. GC may have different genetic and/or environmental etiology in different families,and a certain subtype may be inherited in a male-influenced fashion.

Clinicopathological significance of LRP16 protein in 336 gastric carcinoma patients

AIM： To investigate the expression of leukemia related protein 16 （LRP16）, and the possible relationship between LRP16 expression and clinicopathological indices in 336 gastric carcinoma patients. METHODS： Immunohistochemistry was used to detect LRP16 expression in 336 cases of paraffin-embedded gastric carcinoma tissues and 60 cases of distal normal mucosa. The relationships between LRP16 expression and patients＇ age, tumor size, histological grade, clinical stage, metastatic status and prognosis were analysed. RESULTS： The expression of LRP16 was 58.6% （197/336） in gastric carcinoma and 31.7% （19/60） in distal normal gastric mucosa. The expression of LRP16 in carcinoma was significantly higher than that in normal mucosa tissues （x^2 = 14.929, P = 0.001）. LRP16 protein expression was found in 44.1% （63/143） carcinomas at stage Ⅰ and Ⅱ, and 69.4% （134/193） carcinomas at stage Ⅲ and Ⅳ （Z2 = 21.804, P = 0.001）, and in 56.9% （182/320） of cancers without metastasis but 93.8% （15/16） of those with metastasis （2 = 8.543, P = 0.003）. The expression of LRP16 was correlated with tumor size, infiltrative depth, clinical stage, lymphatic invasion and distant metastasis （all P 〈 0.05）. Follow-up data showed that there was a significant difference in median survival time between cancer patients with expression of LRP16 （27.0 mo） and those without （48.0 mo, Log rank =31.644, P = 0.001）. CONCLUSION： The expression of LRP16 may be associated with invasion, metastasis and prognosis of gastric cancer.

Comparative Analysis between Clinicopathologic Characteristics and Prognosis in Patients with Local and Infiltrative Gastric Cancer

OBJECTIVE To investigate the differences between theclinicopathologic characteristics and prognostic factors in patientswith localized and infiltrative gastric cancer (GC).METHODS Patients with advanced GC, who were admittedto the Department of Surgical Oncology of the First AffiliatedHospital of China Medical University, Shenyang, during a periodof January 1980-January 2000, were divided into the localizedand infiltrative GC groups. A comparative analysis of theclinicopathologic data and prognosis in the patients enrolled in thestudy was carried out based on the different macroscopic types.RESULTS There were significant differences in the sex ratio,tumor location, histologic type, depth of invasion, lymph nodemetastasis, lymphovascular cancer embolus (LVCE), growthpattern, and degree of radical surgery between the 2 groups.However, there were no significant differences in age, tumorsize, and intravenous cancer embolus between the 2 groups.The prognosis of the infiltrative GC group was poor. There weresignificant differences in the prognosis of the patients betweenthe 2 groups when tumor infiltration was within the muscularlayer or subserosa, yet the differences disappeared once the tumorinfiltration was beyond the serosal layer. The prognosis of thepatients with localized GC was closely related to tumor locationand lymph node metastasis. The prognostic factors of the patientsin the infiltrative GC group included lymph node metastasis,depth of invasion, and tumor size.CONCLUSION There are significant differences in theclinicopathologic characteristics and prognosis between the 2groups. Based on the biological characteristics of the tumors,individualized therapeutic plans will help to improve thetreatment outcome.

人性化护理在胃癌手术患者中的护理效果浅析

本文主要研究在胃癌手术治疗过程中,实施人性化护理的效果和价值。方法:本次研究将选择2020年2月2021年2月期间我院收治的84名胃癌患者,确定均需要通过胃癌手术治疗,为了分析不同护理方式对胃癌手术患者恢复的影响,本次研究过程中将所选患者随机分成两组,其中观察组42例患者采用人性化护理方法,而对照组42例患者则采用常规护理方式,通过对比两组患者采用不同护理方式,其住院时长、肛门排气时间、患者满意度情况等,对护理效果进行分析。结果:通过对两组胃癌手术患者的护理效果进行对比研究,最终发现观察组(人性化护理)一组患者的护理效果更为明显,不管是肛门排气时间还是住院时间,都少于对照组(常规护理)一组,而且患者对于人性化护理的满意度更高。差异具有统计学意义(P<0.05)。结论:本次研究发现,在胃癌手术患者的治疗过程中,采用适当的护理方法可以提升质量效果,通过对比分析,发现人性化护理效果更佳,不管是患者康复速度和满意度都更高,因此建议在后期的临床治疗中推广使用。

Bacterial flora concurrent with Helicobacter pylori in the stomach of patients with upper gastrointestinal diseases

AIM： To investigate the non-He/icobacterpy/ori （H. pylori） bacterial flora concurrent with H. pylori infection.METHODS： A total of 103 gastric biopsy specimens from H. pylori positive patients were selected for bacterial culture. All the non-H, pylori bacterial isolates were identified by matrix assisted laser desorption ionization time-of-flight mass spectrometry （MALDI-TOF MS）.RESULTS： A total of 201 non-H, pyiori bacterial isolates were cultivated from 67 （65.0%） of the 103 gastric samples, including 153 isolates identified successfully at species level and 48 at genus level by MALDI-TOF MS. The dominant species were Streptococcus, Neisseria, Rothla and Staphylococcus, which differed fromthe predominantly acid resistant species reported previously in healthy volunteers. The prevalence of non-H. pylori bacteria was higher in non-ulcer dyspepsia group than in gastric ulcer group （100% vs 42.9%, P 〈 0.001）. Six bacterial species with urease activity （Staphylococcus epidermidis, Staphylococcus warneri, Staphylococcus capitis, Staphylococcus aureus, Brevibacteriurn spp. and Klebsiella pneumoniae） were also isolated.CONCLUSION： There is a high prevalence of the non-H, pylori bacteria concurrent with H. pylori infection, and the non-H, pylori bacteria may also play important as-yet-undiscovered roles in the pathogenesis of stomach disorders.

The role of computer-assisted systems for upper-endoscopy quality monitoring and assessment of gastric lesions

This article analyses the literature regarding the value of computer-assisted systems in esogastroduodenoscopy-quality monitoring and the assessment of gastric lesions.Current data show promising results in upper-endoscopy quality control and a satisfactory detection accuracy of gastric premalignant and malignant lesions,similar or even exceeding that of experienced endoscopists.Moreover,artificial systems enable the decision for the best treatment strategies in gastriccancer patient care,namely endoscopic vs surgical resection according to tumor depth.In so doing,unnecessary surgical interventions would be avoided whilst providing a better quality of life and prognosis for these patients.All these performance data have been revealed by numerous studies using different artificial intelligence(AI)algorithms in addition to white-light endoscopy or novel endoscopic techniques that are available in expert endoscopy centers.It is expected that ongoing clinical trials involving AI and the embedding of computer-assisted diagnosis systems into endoscopic devices will enable real-life implementation of AI endoscopic systems in the near future and at the same time will help to overcome the current limits of the computer-assisted systems leading to an improvement in performance.These benefits should lead to better diagnostic and treatment strategies for gastric-cancer patients.Furthermore,the incorporation of AI algorithms in endoscopic tools along with the development of large electronic databases containing endoscopic images might help in upper-endoscopy assistance and could be used for telemedicine purposes and second opinion for difficult cases.