Objectives To explore the prognostic factors of patients with pancreatic ductal adenocarcinoma and synchronous liver metastases ( PALM ) receiving palliative treatment .Methods The clinical characteristics , therapeutic approaches and survival outcomes of 108 consecutive patients with PALM who were pathologically diagnosed and received only palliative treatment at Tianjin Medical University Cancer Hospital from January 2001 to December 2015 .were retrospectively analyzed .Survival rates were calculated by Kaplan-Meier method, and factors influencing the survival were analyzed by univariate and multivariate Cox proportional hazard regression model .Results Of these patients, 68 were male and 40 were female, with an average age of 58 years old.Seventy-seven (71.3%) cases or their relatives refused to receive anticancer therapies.Palliative treatments included choledochojejunostomy and /or gastrojejunostomy after exploratory laparotomy for 5 (4.6%) cases, percutaneous transhepatic biliary drainage (n=22, 19.4%), drug analgesia (n=79, 73.1%), drug analgesia combined with percutaneous neurolytic coeliac plexus block (n=17, 15.7%).The median survival time (MS)was 94 days in all patients.Karnofsky performance score (KPS)<80, lymph node metastases, ascites, fasting blood glucose ≥6.1 mmol/L and lactate dehydrogenase ( LDH ) ≥250 U/L were independent risk factors influencing prognosis of PALM . Three groups were categorized according to the number of the above 5 risk factors for 0~1 in low risk group, 2~3 in middle risk group and 4~5 in high risk group, and the MS of 3 groups was 137, 95 and 48 days, respectively, with an extremely statistical significance (P<0.0001).Conclusions KPS, lymph node metastases, ascites, fasting blood glucose and LDH were the risk factors for prognosis of PALM .Patient stratification according to the above factors is more advantageous for judging individualized prognosis and can provide reference for making clinical decision .

AIM: To study the regularity and characteristics of side effects of lopinavir/ritonavir for COVID-19. METHODS: The type of side effects, general information, medical history and prognosis in 61 confirmed and suspected COVID-19 patients with lopinavir/ritonavir were analyzed. RESULTS: Among the 61 patients, 41(67.21%) had lopinavir/ritonavir related side effects, mainly manifested as gastrointestinal reactions (82.93%) and liver function damage (53.66%). Old age, long course of disease and chronic gastrointestinal disease are independent risk factors for side effects. CONCLUSION: Lopinavir/ritonavir has a high incidence of side effects and can be used in COVID-19 patients under the condition of close observation of the patient's symptoms and test results. Special population should improve pharmaceutical care to ensure the safety of drug use.

Objective To investigate the clinical efficacy and safety of endoscopic resection using snares for the treatment of gastric submucosal tumors(SMTs).Methods 66 patients diagnosed with gastric SMTs and treated with endoscopic resection from August 2017 to August 2023 were retrospectively analyzed and divided into the snare group(endoscopic resection using snares,n=33)and the traditional resection group(endoscopic resection using a traditional disposable incision knife,n=33).The operation time,overall resection rate,incidence of adverse reactions,operation cost,hospitalisation cost,and the post-operative hospital days were compared between the two groups.Results The lesion diameter was 8.00(6.00,14.00)mm in the snare group and 8.00(7.50,10.00)mm in the traditional resection group,the difference between the two groups was not statistically significant(P>0.05);The operative time in the snare group was significantly shorter than that in the traditional resection group[26.00(19.00,30.50)min vs 33.00(22.50,49.50)min],the difference was statistically significant(P<0.05);The overall resection rate in both groups was 100.0%;Neither group of patients had intraoperative perforation.There were no statistically significant differences in the incidence of adverse reactions such as intraoperative bleeding,abdominal pain and fever between the two group(P>0.05);The operative cost of the snare group was significantly lower than the traditional endoscopic resection group[(8 642.18±1 078.56)yuan vs(13 266.45±2 160.80)yuan],the difference was statistically significant(P<0.05).Conclusion Compared with traditional surgical instruments,endoscopic resection of gastric SMTs using snares has a shorter operating time,lower surgical costs,safe and effective,making it worthy of promotion.

Humans ; East Asian People ; Nausea/drug therapy* ; Vomiting/drug therapy* ; Antineoplastic Agents/adverse effects* ; Neoplasms/drug therapy*