BACKGROUND The neutrophil-to-lymphocyte ratio(NLR),a composite inflammatory biomarker,is associated with the prognosis in patients with colorectal tumors.However,whether the NLR can be used as a predictor of symptomat...BACKGROUND The neutrophil-to-lymphocyte ratio(NLR),a composite inflammatory biomarker,is associated with the prognosis in patients with colorectal tumors.However,whether the NLR can be used as a predictor of symptomatic postoperative ana-stomotic leakage(AL)in elderly patients with colon cancer is unclear.AIM To assess the role of the NLR in predicting the occurrence of symptomatic AL after surgery in elderly patients with colon cancer.METHODS Data from elderly colon cancer patients who underwent elective radical colectomy with anastomosis at three centers between 2018 and 2022 were retrospectively analyzed.Receiver operating characteristic curve analysis was performed to determine the best predictive cutoff value for the NLR.Twenty-two covariates were matched using a 1:1 propensity score matching method,and univariate and multivariate logistic regression analyses were used to determine risk factors for the development of postoperative AL.RESULTS Of the 577 patients included,36(6.2%)had symptomatic AL.The optimal cutoff value of the NLR for predicting AL was 2.66.After propensity score matching,the incidence of AL was significantly greater in the≥2.66 NLR subgroup than in the<2.66 NLR subgroup(11.5%vs 2.5%;P=0.012).Univariate logistic regression analysis revealed statistically significant correlations between blood transfusion intraoperatively and within 2 d postoper-atively,preoperative albumin concentration,preoperative prognostic nutritional index,and preoperative NLR and AL occurrence(P<0.05);multivariate logistic regression analysis revealed that an NLR≥2.66[odds ratio(OR)=5.51;95%confidence interval(CI):1.50-20.26;P=0.010]and blood transfusion intraoperatively and within 2 d postoperatively(OR=2.52;95%CI:0.88-7.25;P=0.049)were risk factors for the occurrence of symptomatic AL.CONCLUSION A preoperative NLR≥2.66 and blood transfusion intraoperatively and within 2 d postoperatively are associated with a higher incidence of postoperative symptomatic AL in elderly patients with colon cancer.The preoperative NLR has predictive value for postoperative symptomatic AL after elective surgery in elderly patients with colon cancer.展开更多
AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary...AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary carcinoma(Amp Ca)underwent surgical treatment(PD,n=159;PSD with regional lymph node dissection,n=69).The patients were divided into two groups:the PD group and the PSD group.Propensity scoring methods were used to select patients with similar disease statuses.A total of 138 matched cases,with 69 patients in each group,were included in the final analysis.RESULTS:The median operative time was shorter among the patients in the PSD group(435 min)compared with those in the PD group(481 min,P=0.048).The median blood loss in the PSD group was significantly less than that in the PD group.The median length of hospital stay was shorter for patients in the PSD group vs the PD group.The incidence of pancreatic fistula was higher among patients in the PD group vs the PSD group.The 1-,3-,and 5-year overall survival and disease-free survival rates for patients in the PSD group were 83%,70%,44%and 73%,61%,39%,respectively,and these values were not different than compared with those in the PD group(P=0.625).CONCLUSION:PSD with regional lymph node dissection presents an acceptable morbidity in addition to its advantages over PD.PSD may be a safe and feasible alternative to PD in the treatment of earlystage Amp Ca.展开更多
Objective：Prognosis of patients with locally advanced rectal cancer（LARC）but achieving yp T1–2N0 stage after neoadjuvant concurrent chemo-radiotherapy（CRT）has been shown to be favorable.This study aims to determ...Objective：Prognosis of patients with locally advanced rectal cancer（LARC）but achieving yp T1–2N0 stage after neoadjuvant concurrent chemo-radiotherapy（CRT）has been shown to be favorable.This study aims to determine whether the long-term outcome of yp T1–2N0 cases can be comparable to that of p T1–2N0 cohort that received definitive surgery for early disease.Method：From January 2008 to December 2013,449 consecutive patients with rectal cancer were treated and their outcome maintained in a database.Patients with LARC underwent total mesorectal excision（TME）surgery at4–8 weeks after completion of CRT,and those achieving stage yp I were identified as a group.As a comparison,stage p I group pertains to patients whose initially limited disease was not upstaged after TME surgery alone.After propensity score matching（PSM）,comparisons of local regional control（LC）,distant metastasis-free survival（DMFS）,disease-free survival（DFS）and overall survival（OS）were performed using Kaplan-Meier analysis and log-rank test between yp I and p I groups.Down-staging depth score（DDS）,a novel method of evaluating CRT response,was used for subset analysis.Results：Of the 449 patients,168 matched cases were generated for analysis.Five-year LC,DMFS,DFS and OS for stage p I vs.yp I groups were 96.7%vs.96.4%（P=0.796）,92.7%vs.73.6%（P=0.025）,91.2%vs.73.6%（P=0.080）and 93.1%vs.72.3%（P=0.040）,respectively.In the DDS-favorable subset of the yp I group,LC,DMFS,DFS and OS resulted in no significant differences in comparison with the p I group（P=0.384,0.368,0.277 and0.458,respectively）.Conclusions：LC was comparable in both groups;however,distant metastasis developed more frequently in down-staged LARC than de novo early stage cases,reflecting the need to improve the efficacy of systemic treatment despite excellent pathologic response.DDS can be an indicator to identify a subset of the yp I group whose longterm oncologic outcomes are as good as those of stage p I cohort.展开更多
Objective To define risk stratification and guide optimal surgical timing of perioperative viral respiratory infection(VRI)in children with cardiac surgery.Methods Retrospective study with propensity score-matched ana...Objective To define risk stratification and guide optimal surgical timing of perioperative viral respiratory infection(VRI)in children with cardiac surgery.Methods Retrospective study with propensity score-matched analysis.A total of 2,831 patients had performed RespPCR testing,and finally there were 2,740 negative RespPCR patients and 91 positive RespPCR patients.展开更多
According to the data in China Statistical Yearbook from 1992 to 2008,by using regression model,we adopt least square method and generalized least square method to conduct empirical analysis on the relationship betwee...According to the data in China Statistical Yearbook from 1992 to 2008,by using regression model,we adopt least square method and generalized least square method to conduct empirical analysis on the relationship between urban-rural residents' income and consumption in China's east,northeast,central region and west.The results show that the urban-rural residents' propensity to consume in China's four regions has prominent characteristics.In terms of region,urban residents' marginal propensity to consume takes on irregular fluctuation,while the rural residents' propensity to consume conforms to law of diminishing of marginal propensity to consume;in terms of time sequence,the rural residents' marginal propensity to consume in China's four regions takes on "multi-U-form" fluctuation trend,and the rural residents' marginal propensity to consume in different regions has certain difference,while the urban residents' marginal propensity to consume takes on low-frequency broad width fluctuation trend;the urban-rural residents' average marginal propensity to consume in China's four regions conforms to the law of diminishing.In order to increase consumption and promote the balanced rapid development of regional economy,in light of the urban-rural difference and characteristics of different regions,we should propound effective measures to promote urban-rural residents' propensity to consume,and formulate and implement regional policy in order to stimulate consumption.展开更多
目的:基于倾向性评分匹配法探讨血府逐瘀汤对老年股骨粗隆间骨折患者PFNA术后康复的影响。方法:回顾性分析140例行防旋股骨近端髓内钉(proximal femoral nail antirotation,PFNA)手术治疗的股骨粗隆间骨折患者,使用SPSS 22.0进行倾向性...目的:基于倾向性评分匹配法探讨血府逐瘀汤对老年股骨粗隆间骨折患者PFNA术后康复的影响。方法:回顾性分析140例行防旋股骨近端髓内钉(proximal femoral nail antirotation,PFNA)手术治疗的股骨粗隆间骨折患者,使用SPSS 22.0进行倾向性匹配评分匹配分为观察组(血府逐瘀汤治疗)和对照组(常规支持治疗)各50例,比较两组术后相关康复治疗指标,并对两组用药安全性进行评价分析。结果:观察组证候积分,术后第5、7天患肢肿胀程度,VAS评分,术后第3、7天血清白细胞及C反应蛋白水平均明显低于对照组(P<0.05),而术后第7天血清血红蛋白、红细胞压积水平和术后1个月Harris评分均显著高于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:PFNA联合血府逐瘀汤内服治疗对老年股骨粗隆间骨折术后康复恢复效果确切,可显著减轻患肢肿胀程度,在更短时间内缓解患者局部疼痛,减少术后隐性失血,提升Harris评分,快速恢复髋关节功能,且不增加患者用药安全性风险。展开更多
基金Supported by the Natural Science Foundation of Gansu Province,China,No.21JR1RA075 and No.22JR5RA895and Lanzhou Science and Technology Program,China,No.2021-1-109.
文摘BACKGROUND The neutrophil-to-lymphocyte ratio(NLR),a composite inflammatory biomarker,is associated with the prognosis in patients with colorectal tumors.However,whether the NLR can be used as a predictor of symptomatic postoperative ana-stomotic leakage(AL)in elderly patients with colon cancer is unclear.AIM To assess the role of the NLR in predicting the occurrence of symptomatic AL after surgery in elderly patients with colon cancer.METHODS Data from elderly colon cancer patients who underwent elective radical colectomy with anastomosis at three centers between 2018 and 2022 were retrospectively analyzed.Receiver operating characteristic curve analysis was performed to determine the best predictive cutoff value for the NLR.Twenty-two covariates were matched using a 1:1 propensity score matching method,and univariate and multivariate logistic regression analyses were used to determine risk factors for the development of postoperative AL.RESULTS Of the 577 patients included,36(6.2%)had symptomatic AL.The optimal cutoff value of the NLR for predicting AL was 2.66.After propensity score matching,the incidence of AL was significantly greater in the≥2.66 NLR subgroup than in the<2.66 NLR subgroup(11.5%vs 2.5%;P=0.012).Univariate logistic regression analysis revealed statistically significant correlations between blood transfusion intraoperatively and within 2 d postoper-atively,preoperative albumin concentration,preoperative prognostic nutritional index,and preoperative NLR and AL occurrence(P<0.05);multivariate logistic regression analysis revealed that an NLR≥2.66[odds ratio(OR)=5.51;95%confidence interval(CI):1.50-20.26;P=0.010]and blood transfusion intraoperatively and within 2 d postoperatively(OR=2.52;95%CI:0.88-7.25;P=0.049)were risk factors for the occurrence of symptomatic AL.CONCLUSION A preoperative NLR≥2.66 and blood transfusion intraoperatively and within 2 d postoperatively are associated with a higher incidence of postoperative symptomatic AL in elderly patients with colon cancer.The preoperative NLR has predictive value for postoperative symptomatic AL after elective surgery in elderly patients with colon cancer.
基金Supported by National Natural Science Foundation of China,No.81170453 and No.81301025Tianjin City High School Science and Technology Fund Planning Project,No.20120118
文摘AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary carcinoma(Amp Ca)underwent surgical treatment(PD,n=159;PSD with regional lymph node dissection,n=69).The patients were divided into two groups:the PD group and the PSD group.Propensity scoring methods were used to select patients with similar disease statuses.A total of 138 matched cases,with 69 patients in each group,were included in the final analysis.RESULTS:The median operative time was shorter among the patients in the PSD group(435 min)compared with those in the PD group(481 min,P=0.048).The median blood loss in the PSD group was significantly less than that in the PD group.The median length of hospital stay was shorter for patients in the PSD group vs the PD group.The incidence of pancreatic fistula was higher among patients in the PD group vs the PSD group.The 1-,3-,and 5-year overall survival and disease-free survival rates for patients in the PSD group were 83%,70%,44%and 73%,61%,39%,respectively,and these values were not different than compared with those in the PD group(P=0.625).CONCLUSION:PSD with regional lymph node dissection presents an acceptable morbidity in addition to its advantages over PD.PSD may be a safe and feasible alternative to PD in the treatment of earlystage Amp Ca.
基金supported by Natural Science Foundation of China (No.81773241)Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (No.2017I2M-1-006)
文摘Objective：Prognosis of patients with locally advanced rectal cancer（LARC）but achieving yp T1–2N0 stage after neoadjuvant concurrent chemo-radiotherapy（CRT）has been shown to be favorable.This study aims to determine whether the long-term outcome of yp T1–2N0 cases can be comparable to that of p T1–2N0 cohort that received definitive surgery for early disease.Method：From January 2008 to December 2013,449 consecutive patients with rectal cancer were treated and their outcome maintained in a database.Patients with LARC underwent total mesorectal excision（TME）surgery at4–8 weeks after completion of CRT,and those achieving stage yp I were identified as a group.As a comparison,stage p I group pertains to patients whose initially limited disease was not upstaged after TME surgery alone.After propensity score matching（PSM）,comparisons of local regional control（LC）,distant metastasis-free survival（DMFS）,disease-free survival（DFS）and overall survival（OS）were performed using Kaplan-Meier analysis and log-rank test between yp I and p I groups.Down-staging depth score（DDS）,a novel method of evaluating CRT response,was used for subset analysis.Results：Of the 449 patients,168 matched cases were generated for analysis.Five-year LC,DMFS,DFS and OS for stage p I vs.yp I groups were 96.7%vs.96.4%（P=0.796）,92.7%vs.73.6%（P=0.025）,91.2%vs.73.6%（P=0.080）and 93.1%vs.72.3%（P=0.040）,respectively.In the DDS-favorable subset of the yp I group,LC,DMFS,DFS and OS resulted in no significant differences in comparison with the p I group（P=0.384,0.368,0.277 and0.458,respectively）.Conclusions：LC was comparable in both groups;however,distant metastasis developed more frequently in down-staged LARC than de novo early stage cases,reflecting the need to improve the efficacy of systemic treatment despite excellent pathologic response.DDS can be an indicator to identify a subset of the yp I group whose longterm oncologic outcomes are as good as those of stage p I cohort.
文摘Objective To define risk stratification and guide optimal surgical timing of perioperative viral respiratory infection(VRI)in children with cardiac surgery.Methods Retrospective study with propensity score-matched analysis.A total of 2,831 patients had performed RespPCR testing,and finally there were 2,740 negative RespPCR patients and 91 positive RespPCR patients.
文摘According to the data in China Statistical Yearbook from 1992 to 2008,by using regression model,we adopt least square method and generalized least square method to conduct empirical analysis on the relationship between urban-rural residents' income and consumption in China's east,northeast,central region and west.The results show that the urban-rural residents' propensity to consume in China's four regions has prominent characteristics.In terms of region,urban residents' marginal propensity to consume takes on irregular fluctuation,while the rural residents' propensity to consume conforms to law of diminishing of marginal propensity to consume;in terms of time sequence,the rural residents' marginal propensity to consume in China's four regions takes on "multi-U-form" fluctuation trend,and the rural residents' marginal propensity to consume in different regions has certain difference,while the urban residents' marginal propensity to consume takes on low-frequency broad width fluctuation trend;the urban-rural residents' average marginal propensity to consume in China's four regions conforms to the law of diminishing.In order to increase consumption and promote the balanced rapid development of regional economy,in light of the urban-rural difference and characteristics of different regions,we should propound effective measures to promote urban-rural residents' propensity to consume,and formulate and implement regional policy in order to stimulate consumption.
文摘目的:基于倾向性评分匹配法探讨血府逐瘀汤对老年股骨粗隆间骨折患者PFNA术后康复的影响。方法:回顾性分析140例行防旋股骨近端髓内钉(proximal femoral nail antirotation,PFNA)手术治疗的股骨粗隆间骨折患者,使用SPSS 22.0进行倾向性匹配评分匹配分为观察组(血府逐瘀汤治疗)和对照组(常规支持治疗)各50例,比较两组术后相关康复治疗指标,并对两组用药安全性进行评价分析。结果:观察组证候积分,术后第5、7天患肢肿胀程度,VAS评分,术后第3、7天血清白细胞及C反应蛋白水平均明显低于对照组(P<0.05),而术后第7天血清血红蛋白、红细胞压积水平和术后1个月Harris评分均显著高于对照组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:PFNA联合血府逐瘀汤内服治疗对老年股骨粗隆间骨折术后康复恢复效果确切,可显著减轻患肢肿胀程度,在更短时间内缓解患者局部疼痛,减少术后隐性失血,提升Harris评分,快速恢复髋关节功能,且不增加患者用药安全性风险。
