1.Related factors of liver cancer recurrence associated with hyperglycemia after radical resection of liver cancer
Qing CAI ; Shibo SUN ; Feng ZHONG ; Qifan ZHANG ; Jie ZHOU
Chinese Journal of Digestive Surgery 2016;15(1):47-52
Objective To investigate the related factors of early liver cancer recurrence associated with elevated fasting glucose levels after radical resection of liver cancer.Methods The retrospective cohort study was adopted.The clinical data of 145 patients with liver cancer who were admitted to the Nanfang Hospital of Southern Medical University from October 2009 to June 2013 werc collected.After radical resection of liver cancer, 111 patients with average level of fasting blood glucose (FBG) < 6.1 mmol/L and 34 patients with level of FBG ≥ 6.1 mmol/L were divided into the normal group and the hyperglycemic group, respectively.The blood glucose levels of patients during the period of hospital stay and follow-up were observed.The status of early recurrence and risk factors affecting recurrence in the 2 groups were analyzed.Follow-up of outpatient examination was applied to patients up to July 1, 2015 with the first recurrence as the end point.Patients had reexaminations once every month within postoperative month 6 and once every 3 months after 6 months.The general information [gender, age, FBG, underlying hepatopathy, preoperative AFP, alanine transaminase (ALT), aspartate aminotransferase (AST), Child-Pugh stage, Barcelona Clinic Liver Cancer (BCLC) stage, history of alcohol drinking], surgical data (surgical method, operation time, number of blood transfusion, volume of intraoperative blood loss), pathological data (histopathological differentiation, number of tumor nodules, diameter of maximal tumor, liver cirrhosis) and follow-up data (postoperative AFP, imaging findings, recurrence time, preventive chemotherapy) were collected.Measurement data with normal distribution were presented as-x ± s and analyzed by the t test.Measurement data with skewed distribution were presented as M (range) and analyzed by the non-parametric test.Count data were analyzed using the chi-square test.With the first recurrence as the end point, the tumor-free survival rate was drawn using the Kaplan-Meier method, and the comparison was analyzed by the logrank test.The risk factors affecting recurrence were analyzed using the Kaplan-Meier method for proportional hazards assumption test firstly, and then eligible factors were done using Log-rank test in the univariate analysis.The multivariate analysis was done using the COX model.Results The postoperative 1-, 2-year overall recurrence rates of liver cancer were 28.3% (41/145) and 45.5% (66/145).And 1-, 2-year recurrence rates of liver cancer were 21.6% (24/111) and 36.9% (41/111) in the normal group and 50.0% (17/34) and 73.5% (25/34) in the hyperglycemic group, respectively, showing significant differences between the 2 groups (x2=10.335, 14.053, P < 0.05).The univariate analysis showed that FBG, Child-Pugh stage, volume of intraoperative blood transfusion and postoperative AFP were risk factors affecting tumor-free survival rate after radical resection of liver cancer (x2 =17.591,6.492, 10.690,12.820, P < 0.05).The tumor-free survival rates at postoperative month 24 in the normal group and hyperglycemic group were 63.1% and 26.5% respectively, showing significant difference between the 2 groups (x2=17.591, P < 0.05).The results of multivariate analysis showed that level of FBG ≥6.1 mmol/L, volume of intraoperative blood transfusion > 200 mL and postoperative level of AFP > 8.1 pg/L were independent risk factors affecting tumor-free survival rate after radical resection of liver cancer (RR =2.542, 2.028, 2.724, 95 % condifence interval : 1.529-4.225,1.183-3.479,1.635-4.538, P < 0.05).Conclusions Elevated FBG level has a stimulative effect on early recurrence of tumor after radical resection of liver cancer.As a result, monitoring and controlling of blood glucose after operation is helpful in decreasing the early recurrence rate of patients with liver cancer.
2.The experience of body image experience in burn patients:a meta-synthesis of qualitative studies
Qifan FENG ; Famei TU ; Jimin WU ; Pingping LIU ; Jiachen LIU ; Siyi ZHANG ; Xin ZHANG
Chinese Journal of Nursing 2024;59(3):362-370
Objective To systematically evaluate and integrate qualitative research related to the psychological experiences and perceptions of body image in bum patients.The goal is to provide a reference basis for developing targeted intervention measures in clinical practice.Methods The databases of CNKI,Wanfang,VIP Chinese Science and Technology Periodical Database,China Biomedical Literature Service System,PubMed,Web of Science,Embase,Medline,Cochrane Library,PsycINFO,and Scopus were applied in our study.Relevant qualitative studies on the body image experience of burn patients from the establishment of the databases until December 2022 were collected.The quality of the included literature was assessed using the 2016 edition of the Joanna Briggs Institute(JBI)Centre for Evidence-based Health Care in Australia,and the results of the literature were integrated using aggregative integration.Results A total of 12 pieces of literature were included,from which 40 research findings were extracted.These findings were ultimately summarized into 4 integrated results:diverse traumatic perceptions of body image changes faced by burn patients,active exploration and negative coping strategies towards body image changes faced by burn patients,emotional information needs and post-traumatic growth.Conclusion Burn patients experience various body image issues that hinder their return to normal life.It is crucial for healthcare professionals to timely attend to the physical and mental well-being of the patients,identify body image disorders,assist families in meeting emotional needs,support patients in self-adjustment,and promote positive outcomes.
3.Distribution and exposure assessment of phthalic acid esters (PAEs) in indoor dust of Shanghai
Qifan YANG ; Bing SHEN ; Jingting CAI ; Zhongling LIU ; Yi LI ; Sichao FENG ; Yihui ZHOU ; Silan LU ; Hong ZHAO ; Zhiling YE ; Jianjing XIONG
Shanghai Journal of Preventive Medicine 2022;34(3):247-251
Objective To characterize the distribution and assess the exposure to phthalic acid esters (PAEs) in the indoor dust of Shanghai City. Methods Samples were collected from 33 sampling sites, including homes, hotels, offices and public places, in Shanghai in 2018, 2019, and 2020. The samples were pretreated by 100 sieves, extracted and concentrated, and then analyzed by gas chromatography-mass spectrometry in selected ion mode (SIM). Results Results on the characteristics of PAEs in indoor dust in different places showed that concentrations of PAEs were in a range of <0.01-2 464 mg·kg-1.The average concentration of 16 PAEs was 613 mg·kg-1. Bis(2-ethylhexyl) phthalate (DEHP), di-iso-butyl phthalate (DiBP), di-n-butyl phthalate (DBP) and di-n-octyl phthalate (DnOP) were the main components of PAEs in indoor dust, accounting for approximately 99.5% of 16 PAEs. The intake of DEHP, DBP, DEP and BBP was lower than the tolerable daily intake (TDI) and reference doses (RfD) set by EU CSTEE and U.S. EPA. Conclusion Average daily dose (ADD) via indoor dust is estimated, and the order of intake through different pathways is hand-oral intake>skin contact>respiratory inhalation. Exposure risk of PAEs in children is greater than that in adults.