BACKGROUND The advantages and disadvantages of various surgical procedures for radical dissection of left hemicolonic malignancies are controversial.We aimed to determine which procedures are best for patients with di...BACKGROUND The advantages and disadvantages of various surgical procedures for radical dissection of left hemicolonic malignancies are controversial.We aimed to determine which procedures are best for patients with different characteristics.The focus of this study was to investigate the safety and clinical efficacy of three different surgical procedures,namely,robotic-assisted surgery(RAS),handassisted laparoscopic surgery(HALS)and conventional laparoscopic surgery(CLS),for the dissection of malignant tumors of the left hemicolon and the effect of these procedures on long-term prognosis.AIM To determine which procedures are best for patients with malignant tumors of the left hemicolon and the safety and clinical efficacy of three different surgical procedures.METHODS A retrospective analysis of the clinical data of 224 patients with left hemicolonic malignancies admitted to the Department of General Surgery of the First Affiliated Hospital of Nanchang University from June 2015 to June 2024 was conducted.Patient data were analyzed to determine tumor stage,duration of surgery,number of lymph nodes cleared,incidence and severity of postoperative complications,amount of intraoperative bleeding,overall survival(OS),and progressionfree survival.RESULTS The short-term postoperative outcomes after RAS,HALS and CLS were compared.The leukocyte and absolute neutrophil counts on postoperative day 4 were highest after RAS,followed by CLS and then HALS,and the differences were statistically significant(P<0.05).The length of postoperative hospital stay was highest after CLS,followed by RAS and then HALS,and the differences were statistically significant(P<0.05).The postoperative recovery time of gastrointestinal function was shortest after HALS,followed by RAS and CLS,which had equal values,and the differences were statistically significant(P<0.05).Hospitalization costs were highest among patients who underwent RAS,followed by CLS and then HALS,and the differences were statistically significant(P<0.05).The OS among patients who underwent HALS,CLS,and RAS did not significantly differ(P=0.384).CONCLUSION There were no significant differences between procedures in the number of lymph nodes cleared or OS,and all procedures successfully achieved radical dissection of the malignant tumors.HALS had lower hospitalization costs and shorter postoperative recovery time of gastrointestinal function,and CLS performed between HALS and RAS.Different surgical procedures have varying impacts on the length of postoperative hospital stay and the degree of postoperative inflammation,so selection should be individualized to each patient.展开更多
BACKGROUND Laparoscopic radical gastrectomy is widely used,and perioperative complications have become a highly concerned issue.AIM To develop a predictive model for complications in laparoscopic radical gastrectomy f...BACKGROUND Laparoscopic radical gastrectomy is widely used,and perioperative complications have become a highly concerned issue.AIM To develop a predictive model for complications in laparoscopic radical gastrectomy for gastric cancer to better predict the likelihood of complications in gastric cancer patients within 30 days after surgery,guide perioperative treatment strategies for gastric cancer patients,and prevent serious complications.METHODS In total,998 patients who underwent laparoscopic radical gastrectomy for gastric cancer at 16 Chinese medical centers were included in the training group for the complication model,and 398 patients were included in the validation group.The clinicopathological data and 30-d postoperative complications of gastric cancer patients were collected.Three machine learning methods,lasso regression,random forest,and artificial neural networks,were used to construct postoperative complication prediction models for laparoscopic distal gastrectomy and laparoscopic total gastrectomy,and their prediction efficacy and accuracy were evaluated.RESULTS The constructed complication model,particularly the random forest model,could better predict serious complications in gastric cancer patients undergoing laparoscopic radical gastrectomy.It exhibited stable performance in external validation and is worthy of further promotion in more centers.CONCLUSION Using the risk factors identified in multicenter datasets,highly sensitive risk prediction models for complications following laparoscopic radical gastrectomy were established.We hope to facilitate the diagnosis and treatment of preoperative and postoperative decision-making by using these models.展开更多
Objective:To investigate the clinical effect of Tongxinluo combined with trimetazidine on cardiac function in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention.Met...Objective:To investigate the clinical effect of Tongxinluo combined with trimetazidine on cardiac function in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention.Method: From March 2014 to September 2016, we selected 190 patients with ST-segment elevation myocardial infarction with percutaneous coronary intervention, according to the admission time is divided into observation group and control group, the control group was treated with conventional therapy (aspirin, isosorbide dinitrate, metoprolol tartrate, clopidogrel sulfate, captopril, atorvastatin calcium and diuretics) and trimetazidine, observation group in the control group based on Tongxinluo combined treatment, each group of 95 cases, and hs-CRP, aldosterone, NT-proBNP, TNF-α, IL-6, and cardiac function (LVEDV,LVESV,LVEF,SV) were compared.Result: The Hs-CRP in the observation group was significantly lower than that in the control group;The aldosterone in the observation group was significantly lower than that in the control group;The levels of NT-proBNP, TNF-α and IL-6 in the observation group were significantly lower than those in the control group;LVVEV and LVESV were significantly lower in the observation group than in the control group, LVEF and SV were significantly higher than those in the control group.Conclusion:Tongxinluo combined with trimetazidine in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention in patients with clinical effect is better, stable plaque, effectively improve microcirculation and cardiac function, recommended a wide range of clinical application.展开更多
The present study proposes an improved method for generating better typical meteorological years( TMYs) used in building energy simulation in China. Modifications are made to the commonly used Sandia method,by optimiz...The present study proposes an improved method for generating better typical meteorological years( TMYs) used in building energy simulation in China. Modifications are made to the commonly used Sandia method,by optimizing the weightings of indices and thus giving more emphasis to dry bulb temperature and relative humidity and less to wind velocity. After analyzing the solar heat gain on the vertical envelop,an index of diffuse radiation rather than direct normal radiation is added for solar radiation. Using the improved method proposed,TMYs for 5 representative cities of 5 major climate zones in China are generated from the meteorological data recorded during the period 1981—2010. The results show that,compared with previous studies,the monthly diffuse solar radiation of typical meteorological months generated by the improved method are the"closest"to the 30-year average,and the comparison between annual diffuse radiation for the TMY and the 30-year annual average is improved,while little adverse effect is produced on global horizontal radiation comparisons,indicating that the improved method is more suitable to generate the TMY data than previous studies.展开更多
To the Editor:Gastric cancer is one of the most common cancers in China.It is mainly found in the middle/lower part of the stomach,[1]where it commonly metastasizes from the infrapyloric lymph node(No.6).Previous stud...To the Editor:Gastric cancer is one of the most common cancers in China.It is mainly found in the middle/lower part of the stomach,[1]where it commonly metastasizes from the infrapyloric lymph node(No.6).Previous studies reported that the risk of No.6 lymph node metastasis was different based on tumor locations.In lower gastric cancer patients,the metastatic rate of No.6 lymph node can reach up to 18.7%,and in upper gastric cancer,the rate is merely 1.9%.[2]The distance between the primary tumor and the pylorus was proved to be related to No.6 lymph node metastasis.However,most of the studies were retrospective and their lymph nodes dissection’s quality control was controversial.展开更多
Background:Urinary catheterization(UC)is a conventional perioperative measure for major abdominal operation.Optimization of perioperative catheter management is an essential component of the enhanced recovery after su...Background:Urinary catheterization(UC)is a conventional perioperative measure for major abdominal operation.Optimization of perioperative catheter management is an essential component of the enhanced recovery after surgery(ERAS)programme.We aimed to investigate the risk factors of urinary retention(UR)after open colonic resection within the ERAS protocol and to assess the feasibility of avoiding urinary drainage during the perioperative period.Methods:A total of 110 colonic-cancer patients undergoing open elective colonic resection between July 2014 and May 2018 were enrolled in this study.All patients were treated within our ERAS protocol during the perioperative period.Data on patients’demographics,clinicopathologic characteristics,and perioperative outcomes were collected and analysed retrospectively.Results:Sixty-eight patients(61.8%)underwent surgery without any perioperative UC.Thirty patients(27.3%)received indwelling UC during the surgical procedure.Twelve(10.9%)cases developed UR after surgery necessitating UC.Although patients with intraoperative UC had a lower incidence of post-operative UR[0%(0/30)vs 15%(12/80),P=0.034],intraoperative UC was not testified as an independent protective factor inmultivariate logistic analysis.The history of prostatic diseases and the body mass index were strongly associated with post-operative UR.Six patients were diagnosed with post-operative urinary-tract infection,among whom two had intraoperative UC and four were complicated with post-operative UR requiring UC.Conclusion:Avoidance of urinary drainage for open elective colonic resection is feasible with the implementation of the ERAS programme as the required precondition.Obesity and a history of prostatic diseases are significant predictors of postoperative UR.展开更多
基金Supported by Jiangxi Provincial Natural Science Foundation of China,No.20224BAB206063.
文摘BACKGROUND The advantages and disadvantages of various surgical procedures for radical dissection of left hemicolonic malignancies are controversial.We aimed to determine which procedures are best for patients with different characteristics.The focus of this study was to investigate the safety and clinical efficacy of three different surgical procedures,namely,robotic-assisted surgery(RAS),handassisted laparoscopic surgery(HALS)and conventional laparoscopic surgery(CLS),for the dissection of malignant tumors of the left hemicolon and the effect of these procedures on long-term prognosis.AIM To determine which procedures are best for patients with malignant tumors of the left hemicolon and the safety and clinical efficacy of three different surgical procedures.METHODS A retrospective analysis of the clinical data of 224 patients with left hemicolonic malignancies admitted to the Department of General Surgery of the First Affiliated Hospital of Nanchang University from June 2015 to June 2024 was conducted.Patient data were analyzed to determine tumor stage,duration of surgery,number of lymph nodes cleared,incidence and severity of postoperative complications,amount of intraoperative bleeding,overall survival(OS),and progressionfree survival.RESULTS The short-term postoperative outcomes after RAS,HALS and CLS were compared.The leukocyte and absolute neutrophil counts on postoperative day 4 were highest after RAS,followed by CLS and then HALS,and the differences were statistically significant(P<0.05).The length of postoperative hospital stay was highest after CLS,followed by RAS and then HALS,and the differences were statistically significant(P<0.05).The postoperative recovery time of gastrointestinal function was shortest after HALS,followed by RAS and CLS,which had equal values,and the differences were statistically significant(P<0.05).Hospitalization costs were highest among patients who underwent RAS,followed by CLS and then HALS,and the differences were statistically significant(P<0.05).The OS among patients who underwent HALS,CLS,and RAS did not significantly differ(P=0.384).CONCLUSION There were no significant differences between procedures in the number of lymph nodes cleared or OS,and all procedures successfully achieved radical dissection of the malignant tumors.HALS had lower hospitalization costs and shorter postoperative recovery time of gastrointestinal function,and CLS performed between HALS and RAS.Different surgical procedures have varying impacts on the length of postoperative hospital stay and the degree of postoperative inflammation,so selection should be individualized to each patient.
基金Natural Science Foundation of Fujian Province,No.2021J011360,and No.2020J011230Natural Science Foundation of Xiamen,China,No.3502Z20214ZD1018,and No.3502Z20227096+2 种基金Medical Innovation Project of Fujian Provincial Health Commission,No.2021CXB019Youth Scientific Research Project of Fujian Provincial Health Commission,No.2022QNB013Bethune Charitable Foundation,No.HZB-20190528-10.
文摘BACKGROUND Laparoscopic radical gastrectomy is widely used,and perioperative complications have become a highly concerned issue.AIM To develop a predictive model for complications in laparoscopic radical gastrectomy for gastric cancer to better predict the likelihood of complications in gastric cancer patients within 30 days after surgery,guide perioperative treatment strategies for gastric cancer patients,and prevent serious complications.METHODS In total,998 patients who underwent laparoscopic radical gastrectomy for gastric cancer at 16 Chinese medical centers were included in the training group for the complication model,and 398 patients were included in the validation group.The clinicopathological data and 30-d postoperative complications of gastric cancer patients were collected.Three machine learning methods,lasso regression,random forest,and artificial neural networks,were used to construct postoperative complication prediction models for laparoscopic distal gastrectomy and laparoscopic total gastrectomy,and their prediction efficacy and accuracy were evaluated.RESULTS The constructed complication model,particularly the random forest model,could better predict serious complications in gastric cancer patients undergoing laparoscopic radical gastrectomy.It exhibited stable performance in external validation and is worthy of further promotion in more centers.CONCLUSION Using the risk factors identified in multicenter datasets,highly sensitive risk prediction models for complications following laparoscopic radical gastrectomy were established.We hope to facilitate the diagnosis and treatment of preoperative and postoperative decision-making by using these models.
文摘Objective:To investigate the clinical effect of Tongxinluo combined with trimetazidine on cardiac function in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention.Method: From March 2014 to September 2016, we selected 190 patients with ST-segment elevation myocardial infarction with percutaneous coronary intervention, according to the admission time is divided into observation group and control group, the control group was treated with conventional therapy (aspirin, isosorbide dinitrate, metoprolol tartrate, clopidogrel sulfate, captopril, atorvastatin calcium and diuretics) and trimetazidine, observation group in the control group based on Tongxinluo combined treatment, each group of 95 cases, and hs-CRP, aldosterone, NT-proBNP, TNF-α, IL-6, and cardiac function (LVEDV,LVESV,LVEF,SV) were compared.Result: The Hs-CRP in the observation group was significantly lower than that in the control group;The aldosterone in the observation group was significantly lower than that in the control group;The levels of NT-proBNP, TNF-α and IL-6 in the observation group were significantly lower than those in the control group;LVVEV and LVESV were significantly lower in the observation group than in the control group, LVEF and SV were significantly higher than those in the control group.Conclusion:Tongxinluo combined with trimetazidine in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention in patients with clinical effect is better, stable plaque, effectively improve microcirculation and cardiac function, recommended a wide range of clinical application.
基金Sponsored by the National Natural Science Foundation of China(Grant No.51278349)Foundation of Fujian Provincial Education Department(Grant No.JA13185)
文摘The present study proposes an improved method for generating better typical meteorological years( TMYs) used in building energy simulation in China. Modifications are made to the commonly used Sandia method,by optimizing the weightings of indices and thus giving more emphasis to dry bulb temperature and relative humidity and less to wind velocity. After analyzing the solar heat gain on the vertical envelop,an index of diffuse radiation rather than direct normal radiation is added for solar radiation. Using the improved method proposed,TMYs for 5 representative cities of 5 major climate zones in China are generated from the meteorological data recorded during the period 1981—2010. The results show that,compared with previous studies,the monthly diffuse solar radiation of typical meteorological months generated by the improved method are the"closest"to the 30-year average,and the comparison between annual diffuse radiation for the TMY and the 30-year annual average is improved,while little adverse effect is produced on global horizontal radiation comparisons,indicating that the improved method is more suitable to generate the TMY data than previous studies.
文摘To the Editor:Gastric cancer is one of the most common cancers in China.It is mainly found in the middle/lower part of the stomach,[1]where it commonly metastasizes from the infrapyloric lymph node(No.6).Previous studies reported that the risk of No.6 lymph node metastasis was different based on tumor locations.In lower gastric cancer patients,the metastatic rate of No.6 lymph node can reach up to 18.7%,and in upper gastric cancer,the rate is merely 1.9%.[2]The distance between the primary tumor and the pylorus was proved to be related to No.6 lymph node metastasis.However,most of the studies were retrospective and their lymph nodes dissection’s quality control was controversial.
基金supported by the China Postdoctoral Science Foundation[grant number 2018M633694]National Natural Science Foundation of China[grant number 81500417]+1 种基金Social Development Fund of Jiangsu Province[grant number BE2015687]Jiangsu Planned Projects for Postdoctoral Research Funds[grant number 1701159C].
文摘Background:Urinary catheterization(UC)is a conventional perioperative measure for major abdominal operation.Optimization of perioperative catheter management is an essential component of the enhanced recovery after surgery(ERAS)programme.We aimed to investigate the risk factors of urinary retention(UR)after open colonic resection within the ERAS protocol and to assess the feasibility of avoiding urinary drainage during the perioperative period.Methods:A total of 110 colonic-cancer patients undergoing open elective colonic resection between July 2014 and May 2018 were enrolled in this study.All patients were treated within our ERAS protocol during the perioperative period.Data on patients’demographics,clinicopathologic characteristics,and perioperative outcomes were collected and analysed retrospectively.Results:Sixty-eight patients(61.8%)underwent surgery without any perioperative UC.Thirty patients(27.3%)received indwelling UC during the surgical procedure.Twelve(10.9%)cases developed UR after surgery necessitating UC.Although patients with intraoperative UC had a lower incidence of post-operative UR[0%(0/30)vs 15%(12/80),P=0.034],intraoperative UC was not testified as an independent protective factor inmultivariate logistic analysis.The history of prostatic diseases and the body mass index were strongly associated with post-operative UR.Six patients were diagnosed with post-operative urinary-tract infection,among whom two had intraoperative UC and four were complicated with post-operative UR requiring UC.Conclusion:Avoidance of urinary drainage for open elective colonic resection is feasible with the implementation of the ERAS programme as the required precondition.Obesity and a history of prostatic diseases are significant predictors of postoperative UR.
