Objective To compare the transcatheter hepatic arterial chemoembolization(TACE) combined percutaneous ethanol injection(PEI)in treating primary hepatic carcinoma and the simple TACE treatment. Methods 64 primary hepatic carcinoma patients were divided into union treatment group(n = 32)and TACE group(n = 32),with TACE combined PEI treatment and simple TACE treatment,respectively. The tumor size,AFP change,one year,two years,three years survival time and median survival time were observed and recorded during the course of treatment. Results The tumor shrinkage rates and the AFP transferring into negative rates of the union and simple TACE groups were 84.4%,62.7% and 77.4%,50% respectively after the treatment with significant difference between the two groups. The 1 years,2 years,3 years and median survival rates of the union and simple TACE groups were 96.9%,71.9%,37.5%,34.5 mo and 81.3%,31.3%,12.5%,19.5 mo,respectively,showing conspicuously significance of both groups. Conclusion TACE combined PEI for primary hepatic carcinoma is a better treatment of choice.

Objective To compare the therapeutic efficacies of endoscopic submucosal dissection and surgical operation treatment of early gastrointestinal cancers.Methods Sixty patients with early gastrointestinal cancer were divided into the endoscopic submucosal dissection (ESD) treatment group (n =33patients) and surgical operation treatment group (n =27 patients).During the treatment,success rate,survival time,recurrence and metastasis,nutritional status,adverse reaction and complication rate,hospital stay,and cost of treatment were observed for two groups.Results No statistical significances in success rate,survival time,recurrence and metastasis were found between two groups (P ＞ 0.05).The rate of normal nutritional status value was 90.9％ (30/33) in group ESD and 66.7％ (18/27) in the surgical group with a statistically significant difference between two groups (P ＜ 0.05).The rate of adverse reaction and complication was 9.09％ (3/33) in group ESD and 59.2％ (16/27) in the surgical group with a statistically significant difference between two groups (P ＜ 0.05,P ＜ 0.01).The average length of stay (14,81 ± 3.27) days and the average hospitalization expenses (10562.01 ± 3060.08) Yuan were occurred in the group ESD.The average length of hospital stay (19.22 ± 6.91)days and the average hospitalization expenses (16587.87 ±5664.50)Yuan were occurred in the surgical group.The average length of hospital stay in surgical group was longer 4,41 days than group ESD.The average hospitalization expense in surgical group was 6025.86 yuan more than the ESD group.Conclusions The curative effects of ESD treatment was similar to surgical operation,and there was a lower postoperative adverse reaction rate,a shorter time of hospitalization,a relatively low cost of treatment for ESD treatment compared to the surgical operation.Moreover,ESD treatment can especially keep the gastrointestinal integrity for patients,and the life quality rises significantly.

OBJECTIVE: To evaluate the safety and prognosis for patients with early esophageal cancer and precancerous lesions after endoscopic submucosal dissection (ESD).
 METHODS: A total of 89 patients were admitted to the Department of internal medicine in the First People's Hospital of Anqing from August 2008 to August 2011. All patients were treated with ESD at the early stage of esophageal cancer and precancerous lesions. The patients' laboratory data and relevant medical history were collected. The postoperative complications and long-term effects of ESD were analyzed.
 RESULTS: Eighty-nine patients were followed up with 100% response rate. Among 89 cases, 16 were early esophageal cancer, 38 were high-grade esophageal neoplasia and 35 were low-grade esophageal neoplasia. The one-time whole piece resection rate, complete resection rate and curative resection rate was 93.3% (84/89), 92.1% (82/89) and 92.1% (82/89), respectively. Two cases suffered intraoperative perforation with a rate of 2.2% and these 2 patients performed the intraoperative endoscopic repair; one case suffered the postoperative delayed bleeding with a rate of 1.1% and the patient underwent the conservative treatment; three cases suffered the esophageal stenosis with a rate of 3.4%. All patients were followed-up for 10-58 (36.3±21.2) months. In this period, one case recurred after ESD for 3 years with a rate of 1.1%; two cases were dead. The three-year survival rate was 97.8%.
 CONCLUSION The early esophageal cancer and precancerous lesions can be treated with ESD. The method is safe and the prognosis is good.
Dissection ; Endoscopy ; adverse effects ; Esophageal Neoplasms ; surgery ; Esophageal Perforation ; Esophageal Stenosis ; Humans ; Postoperative Complications ; Postoperative Hemorrhage ; Prognosis

Objective:To analyze the factors affecting delayed chemotherapy in children with Burkitt lymphoma (BL) and their influence on prognosis.Methods:Retrospective cohort study. Clinical data of 591 children aged ≤18 years with BL from May 2017 to December 2022 in China Net Childhood Lymphoma (CNCL) was collected. The patients were treated according to the protocol CNCL-BL-2017. According to the clinical characteristics, therapeutic regimen was divided into group A, group B and group C .Based on whether the total chemotherapy time was delayed, patients were divided into two groups: the delayed chemotherapy group and the non-delayed chemotherapy group. Based on the total delayed time of chemotherapy, patients in group C were divided into non-delayed chemotherapy group, 1-7 days delayed group and more than 7 days delayed group. Relationships between delayed chemotherapy and gender, age, tumor lysis syndrome before chemotherapy, bone marrow involvement, disease group (B/C group), serum lactate dehydrogenase (LDH) > 4 times than normal, grade Ⅲ-Ⅳ myelosuppression after chemotherapy, minimal residual disease in the interim assessment, and severe infection (including severe pneumonia, sepsis, meningitis, chickenpox, etc.) were analyzed. Logistic analysis was used to identify the relevant factors. Kaplan-Meier method was used to analyze the patients' survival information. Log-Rank was used for comparison between groups.Results:Among 591 patients, 504 were males and 87 were females, the follow-up time was 34.8 (18.6,50.1) months. The 3-year overall survival (OS) rate was (92.5±1.1)%,and the 3-year event-free survival (EFS) rate was (90.5±1.2)%. Seventy-three (12.4%) patients were in delayed chemotherapy group and 518 (87.6%) patients were in non-delayed chemotherapy group. The reasons for chemotherapy delay included 72 cases (98.6%) of severe infection, 65 cases (89.0%) of bone marrow suppression, 35 cases (47.9%) of organ dysfunction, 22 cases (30.1%) of tumor lysis syndrome,etc. There were 7 cases of chemotherapy delay in group B, which were seen in COPADM (vincristine+cyclophosphamide+prednisone+daunorubicin+methotrexate+intrathecal injection,4 cases) and CYM (methotrexate+cytarabine+intrathecal injection,3 cases) stages. There were 66 cases of chemotherapy delay in group C, which were common in COPADM (28 cases) and CYVE 1 (low dose cytarabine+high dose cytarabine+etoposide+methotrexate, 12 cases) stages. Multinomial Logistic regression analysis showed that the age over 10 years old ( OR=0.54,95% CI 0.30-0.93), tumor lysis syndrome before chemotherapy ( OR=0.48,95% CI 0.27-0.84) and grade Ⅲ-Ⅳ myelosuppression after chemotherapy ( OR=0.55,95% CI 0.33-0.91)were independent risk factors for chemotherapy delay.The 3-year OS rate and the 3-year EFS rate of children with Burkitt lymphoma in the delayed chemotherapy group were lower than those in the non-delayed chemotherapy group ((79.4±4.9)% vs. (94.2±1.1)%, (80.2±4.8)% vs. (92.0±1.2)%,both P<0.05). The 3-year OS rate of the group C with chemotherapy delay >7 days (42 cases) was lower than that of the group with chemotherapy delay of 1-7 days (22 cases) and the non-delay group (399 cases) ((76.7±6.9)% vs. (81.8±8.2)% vs. (92.7±1.3)%, P=0.002).The 3-year OS rate of the chemotherapy delay group (9 cases) in the COP (vincristine+cyclophosphamide+prednisone) phase was lower than that of the non-chemotherapy delay group (454 cases) ((66.7±15.7)% vs. (91.3±1.4)%, P=0.005). Similarly, the 3-year OS rate of the chemotherapy delay group (11 cases) in the COPADM1 phase was lower than that of the non-chemotherapy delay group (452 cases) ((63.6±14.5)% vs. (91.5±1.3)%, P=0.001). Conclusions:The delayed chemotherapy was related to the age over 10 years old, tumor lysis syndrome before chemotherapy and grade Ⅲ-Ⅳ myelosuppression after chemotherapy in pediatric BL. There is a significant relationship between delayed chemotherapy and prognosis of BL in children.