1.Safety evaluation of prophylactic hyperthermic intraperitoneal chemotherapy in elderly patients with locally advanced gastric cancer
Fuhai MA ; Qi AN ; Xianglong CAO ; Guoju WU ; Gang XIAO ; Tao YU
Chinese Journal of Geriatrics 2023;42(7):836-841
Objective:To analyze the short-term effects of prophylactic intraperitoneal hyperthermic chemotherapy(HIPEC)on elderly patients diagnosed with gastric cancer.Methods:The study enrolled patients with gastric cancer who underwent curative gastrectomy combined with postoperative HIPEC at Beijing Hospital between January 2017 and September 2022.The patients were divided into two groups based on age: young patients(age <65 years, n=45)and elderly patients(age≥65 years, n=32). The study evaluated the safety of HIPEC prophylactic application in elderly patients with gastric cancer by comparing their clinicopathological data, postoperative recovery, complications, and laboratory tests with those of another group of patients.Results:The study found that the elderly patients had a higher rate of comorbidities and higher ASA scores compared to the younger patients.Additionally, the elderly patients received HIPEC treatment less frequently than the younger patients( P=0.030). The proportion of young patients receiving one, two, and three times of HIPEC treatment was 8.9%, 57.8%, and 33.3%, respectively, while the proportion of elderly patients receiving the same was 28.1%, 59.4%, and 12.5%, respectively.The study found no significant differences in pathological characteristics between the two groups, including tumor stage, type, location, and differentiation degree.Additionally, there was no difference in the proportion of laparoscopic gastrectomy, type of resection, combined resection, duration of the operation, and intraoperative blood loss between elderly and young patients.The rate of complications between the two groups was also not significantly different(20.0% vs.21.9%; P=0.100). The mean duration of hospitalization after radical gastrectomy was 14.0 days in the young group and 15.5 days in the elderly group, respectively( P=0.480). Conclusions:Elderly patients with gastric cancer treated with radical gastrectomy combined with HIPEC did not experience increased postoperative complications or hospital stay compared to young patients, suggesting that prophylactic HIPEC was safe and feasible for elderly patients with locally advanced gastric cancer, as evidenced by favorable postoperative recovery and laboratory tests.
2.External apical root resorption in orthodontic tooth movement: the risk factors and clinical suggestions from experts' consensus.
Huang LI ; Xiuping WU ; Lan HUANG ; Xiaomei XU ; Na KANG ; Xianglong HAN ; Yu LI ; Ning ZHAO ; Lingyong JIANG ; Xianju XIE ; Jie GUO ; Zhihua LI ; Shuixue MO ; Chufeng LIU ; Jiangtian HU ; Jiejun SHI ; Meng CAO ; Wei HU ; Yang CAO ; Jinlin SONG ; Xuna TANG ; Ding BAI
West China Journal of Stomatology 2022;40(6):629-637
External apical root resorption is among the most common risks of orthodontic treatment, and it cannot be completely avoided and predicted. Risk factors causing orthodontic root resorption can generally be divided into patient- and treatment-related factors. Root resorption that occurs during orthodontic treatment is usually detected by radiographical examination. Mild or moderate root absorption usually does no obvious harm, but close attention is required. When severe root resorption occurs, it is generally recommended to suspend the treatment for 3 months for the cementum to be restored. To unify the risk factors of orthodontic root resorption and its clinical suggestions, we summarized the theoretical knowledge and clinical experience of more than 20 authoritative experts in orthodontics and related fields in China. After discussion and summarization, this consensus was made to provide reference for orthodontic clinical practice.
Humans
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Tooth Movement Techniques/adverse effects*
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Root Resorption/etiology*
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Consensus
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Dental Cementum
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Risk Factors
3.Short-term efficacy of laparoscopic-assisted radical resection with left colonic artery preservation in elderly patients with rectal cancer
Tao YU ; Qi AN ; Xianglong CAO ; Jian CUI ; Zijian LI ; Gang XIAO ; Guoju WU
Chinese Journal of Geriatrics 2022;41(4):447-450
Objective:To evaluate the short-term efficacy of left colonic artery preservation in laparoscopic-assisted radical resection in elderly patients with rectal cancer.Methods:168 patients aged 65 and over who had undergonelaparoscopic-assisted radical resection of rectal cancer in the gastrointestinal surgery department of Beijing Hospital from December 2017 to December 2020 were retrospectively analyzed.According to different surgical methods, they were divided into the observation group with 90 subjects(the LCA group)and the control group with 78 subjects(the non-LCA group).Basic data, intraoperative, postoperative and clinicopathological data of the two groups were compared and analyzed.Results:There were no statistically significant differences between the two groups in operative time[(172.3±35.5)min vs.(155.5±28.7)min, t=2.182, P=0.103], intraoperative blood loss[(72.6±22.5)ml vs.(67.3±18.4)ml, t=1.473, P=0.128], number of group 253 lymph nodes dissected[(3.8±1.5) vs.(4.2±1.6), t=0.785, P=0.221], and total number of lymph nodes dissected[(14.1±4.3) vs.(15.8±5.0), t=1.652, P=0.113].There was no significant difference in the incidence of anastomotic hemorrhage[4.4%(4/90) vs.3.8%(3/78), χ2=1.182, P=0.133]and the incidence of urinary retention[4.4%(4/90) vs.6.4%(5/78), χ2=1.785, P=0.148].The time to first postoperative flatus[(52.4±23.2)h vs.(68.3±29.3)h, t=2.652, P=0.023]and length of postoperative hospital stay[(9.07±3.56)d vs.(10.68±4.94)d, t=2.785, P=0.017]in the LCA group were shorter than those in the non-LCA group.The incidences of anastomotic leakage in the LCA group and the non-LAC group were 2.2%(2/90)and 5.1%(4/78), respectively, and the difference was statistically significant( t=3.575, P=0.001). Conclusions:LCA preservation in laparoscopic-assisted radical resection of rectal cancer in elderly patients with rectal cancer is safe and feasible, reduces the incidence of anastomotic leakage, and shorten the time to first postoperative flatus and length of postoperative hospital stay.It has good practical clinical value.
4.Clinical features and treatment of coronary artery aneurysms
Yaqin ZHAO ; Cheng LIU ; Youwen LIU ; Chunhui CAO ; Xianglong WEI
Chinese Journal of Postgraduates of Medicine 2020;43(4):305-308
Objective:To investigate the clinical characteristics and therapeutic methods of coronary artery aneurysm (CAA).Methods:The clinical data and coronary angiography of 32 patients confirmed by coronary angiography as coronary aneurysm in Shenzhen Hospital of Southern Medical University and Shenzhen People′s Hospital were collected. They were followed up, and the different therapeutic methods were analyzed.Results:Thirty-two cases (1.8%) of coronary artery aneurysms were found in 1 778 patients undergoing coronary angiography. The main sites of coronary ectasia were right coronary artery, anterior descending branch and circumflex branch, and the left main branch was rare. Among the patients with coronary artery aneurysms, there were 25 patients with coronary artery stenosis. All the 32 patients were given anticoagulant, antiplatelet, improvement of coronary spasm and statin therapy, among whom 2 patients were treated with stent implantation and 6 patients were treated with coronary artery bypass graft (CABG) and ligation of coronary aneurysm. During the follow-up (average 15 months) of 1 patient, acute myocardial infarction reoccurred, and coronary angiography indicated that the stenosed coronary segments after artery ectasia was occluded because of thromboembolism. In the remaining patients, there were no major cardiovascular events such as angina pectoris, acute myocardial infarction and sudden cardiac death.Conclusions:Coronary artery aneurysm is not a rare heart disease. Coronary thromboembolism, thrombosis and vasospasm are the main causes of angina pectoris and myocardial infarction. Anticoagulant, antiplatelet, antispasmodic drugs and suitable coronary artery bypass can significantly improve the clinical prognosis of patients with coronary artery aneurysm.
5.Study on Correlation between Color and HPLC Fingerprint of Glycyrrhizae Radix et Rhizoma
Huirong CHEN ; Xianglong LIN ; Ruiqi YANG ; Guangzhao CAO ; Yonghong YAN ; Huiqin ZOU
World Science and Technology-Modernization of Traditional Chinese Medicine 2018;20(6):935-940
Glycyrrhizae Radix et Rhizoma is one of the traditional herbal medicine used in China, study on the correlation between the cross-section color and HPLC fingerprints of them have important significance for promoting the development of traditional disciplines. Quantitative analysis of the color of sample cross section was carried out by color digital method, fingerprint analysis was carried out by HPLC, and the canonical correlation analysis was carried out between them. The results showed that there was a significant correlation between the color of Glycyrrhizae Radix et Rhizoma cross section and the information of HPLC fingerprinting. Results indicated that, The digitized indexes of color of cross section could reflect the result of fingerprint analysis to some extent.
6.Correction to: Increase in the prevalence of hypertension among adults exposed to the great Chinese famine during early life.
Lingli LIU ; Xianglong XU ; Huan ZENG ; Yong ZHANG ; Zumin SHI ; Fan ZHANG ; Xianqing CAO ; Yao Jie XIE ; Cesar REIS ; Yong ZHAO
Environmental Health and Preventive Medicine 2018;23(1):11-11
The 'Conclusion' section in the Abstract was published incorrectly in the original publication of the article [1] and is corrected with this erratum as below: "Fetal exposure to the Chinese famine may be associated with an increased risk of hypertension in adulthood in women."
7.Prognostic nutrition index for evaluation of surgical risk and prognosis in elderly patients with gastric cancer
Gang ZHAO ; Xianglong CAO ; Qi AN ; Tao YU ; Hua YANG ; Hongda PAN ; Jian CUI ; Gang XIAO
Chinese Journal of General Practitioners 2018;17(9):703-708
Objective To assess the application of preoperative prognostic nutritional index (PNI) in evaluation the surgical risk and long-term prognosis for elderly patients with gastric cancer.Methods The clinical data of 205 patients aged ≥ 75 years with gastric cancer undergoing radical resection from January 2004 to December 2016 were analyzed retrospectively.The PNI value was calculated by serum albumin (g/L) +5 x lymphocyte count (x 109/L).The receiver operating characteristic (ROC) curve and Youden's index was used to determine the value of PNI in surgical risk and prognosis of patients.Patients were divided into low PNI group and high PNI group based on the cut-off value,the clinicopathological characteristics,postoperative complications and long-term survival were compared between two groups.Results The average PNI value of 205 patients was 47.3 ± 5.5.When 44.9 was set as the cut-off value with the maximal Youden's index,the sensitivity and specificity of PNI were 0.86 and 0.47,respectively.There were statistically significant differences between the two groups of patients in age(t =-2.16,P =0.032),BMI (t =4.88,P =0.000),Charlson comorbidity score (x2 =7.77,P =0.005),gastric resection range (x2 =8.63,P =0.003),postoperative complications (x2 =9.46,P =0.002).The incidence of complications in the high PNI group was 24.8% (33/133),which was lower than that in the low PNI group (45.8%,33/72;x2 =9.46,P =0.002).Multivariate logistic analysis showed that age (P =0.032),Charlson coplications scal (CCS) (P =0.042) and PNI < 44.9 (P =0.027) were independent risk factors for postoperative complications;PNI < 44.9 (P =0.001),gastrectomy (P =0.011),lymph node dissection (P =0.000),tumor differentiation (P =0.001) and TNM stage (P =0.000) were independent prognostic factors for elderly patients with gastric cancer.Conclusions Prognostic nutritional index is a valuable clinical marker in evaluation of surgical risk and prognosis for elderly patients with gastric cancer.
8.Comparison of clinical effects between two models of alimentary reconstruction after total gastrectomy in the elderly patients with gastric cancer
Tao YU ; Xianglong CAO ; Wenzhuo JIA ; Gang ZHAO ; Guoju WU ; Gang XIAO ; Meixiong HUANG
Chinese Journal of Geriatrics 2017;36(3):300-302
Objective To investigate the comparison of clinical effects between two models of alimentary reconstruction after total gastrectomy in the elderly patients with gastric cancer.Methods 70 patients receiving alimentary tract reconstructions of Orr-type Roux-en-Y reconstruction (Orrtype,40 cases) and modified Brawn Ⅰ (30 cases) from January 2007 to December 2012 were retrospectively analyzed.The operative time,amount of bleeding,early postoperative complications and mortality,food intake,nutritional status and alimentary tract function were compared at 6 months after surgery.Results There were no significant differences between the two methods in the operative time [(198.8±14.0)min vs 233.5±30.7)min,t=-l.697,P>0.05)],amount of bleeding [(420 ± 43) ml vs (340 ± 25) ml t =-1.956,P > 0.05],and early postoperative complications [(17.5% vs 16.7%),x2 =0.008,P>0.05].However,times of liquid diet intake and semi liquid diet intake of the Orr-type reconstruction method was comparatively shorter than that of the modified Brawn Ⅰ [(4.8±2.1) d vs (7.6±2.4) d,and (9.5±3.6) d vs (11.5±3.7) d,t=-5.192,P<0.05)].Nutritional status (weight,hemoglobin,total serum proteins and serum albumin) at 6 months after operation showed no significant differences between the two methods.But constituent ratio of Visick scores Ⅰ-Ⅱ of Orr-type was bigger than that of modified Brawn Ⅰ (86.7% vs 62.5%,x2 =5.063,P>0.05).Conclusions Orr-type Roux-en-Y reconstruction method can avoid reflux esophagitis,and the procedure is more simple than the modified Brawn Ⅰ method.Therefore,Orr-type Roux-en-Y reconstruction should be recommended as an adoptable method of digestive reconstruction after total gastrectomy for gastric cancer in the elderly patients.
9.Surgical modalities and prognosis in elderly patients with gastric cancer
Xianglong CAO ; Tao YU ; Hong TANG ; Qi AN ; Hua YANG ; Gang ZHAO
Chinese Journal of General Practitioners 2016;15(9):693-697
Objective To evaluate the surgical modalities and prognosis in elderly patients with gastric cancer.Methods Sixty three gastric cancer patients aged ≥≥ 75 years underwent radical surgery,with D0 + D1 resection in 32 cases and D2 resection in 31 cases,in Beijing Hospital from January 2005 to December 2009.Results More lymph nodes were dissected in D2 group than those in D0 + D1 group (27.42 ± 12.75 vs.14.59 ± 12.11,t =-4.095,P < 0.05).There was no significant difference in postoperative complication rate [25.81% (8/31) vs.31.25% (10/32),x2 =0.095,P > 0.05] and perioperative death rate [3.23% (1/31) vs.6.25% (2/32),x2 =0.324,P > 0.05] between two groups.The 5-year survival rate was higher in D2 group than that in D0 ± D1 group (47.3% vs.21.4%,x2 =6.346,P < 0.05).The 5-year survival rate was higher in POSSUM score (PS) < 20 group than that in PS≥20 group (46.3% vs.11.1%,x2 =5.492,P <0.05).In PS≥20 group,postoperative complication rate did not increase after D2 radical resection(1/8 vs.3/10,x2 =0.824,P > 0.05).Univariate analysis showed that PS < 20 was associated with the prognosis of patients (x2 =5.492,P < 0.05).Cox proportional hazards model showed that lymph node metastasis (OR=4.103,95% CI:1.790-9.405,P < 0.05) and D2 radical gastrectomy(OR =0.313,95% CI:0.158-0.620,P < 0.05) were the independent factors associated with the prognosis of patients aged ≥ 75 years with gastric cancer (all P < 0.05).Conclusion Standardized D2 lymph node dissection is beneficial for gastric cancer patients aged ≥75 years.PS < 20,lymph node metastasis and D2 radical gastrectomy are associated with the prognosis of patients.
10.Effect of fibrinolytic system on the podocyte injury in rats with membranous nephropathy
Jing LIANG ; Yuan ZHANG ; Ling CAO ; Xianglong MENG ; Li WANG
Acta Laboratorium Animalis Scientia Sinica 2016;24(3):283-287
Objective To observe the expression of uPA, tPA and PAI-1 in whole blood of rat membranous ne-phropathy ( MN) models induced by cationic bovine serum albumin ( C-BSA) , and to explore the effect of fibrinolytic sys-tem on podocyte apoptosis and pathological changes. To explore the possible preventive and therapeutic effects and the pos-sible mechanisms of early prevention of fibrinolysis. Methods We developed a MN model with the modified Border meth-od. At the end of the 1st, 2nd, 3th, and 4th week of immunization, respectively, the levels of whole blood uPA, tPA and PAI-1 were determined by ELISA. The rat kidney tissues were examined by light microscopy and electron microscopy to i-dentify the pathological changes. The expression levels of nephrin and WTl were detected with immumofluorescence staining and their correlation was analyzed. Results Compared the treatment group with control group, the levels of whole blood uPA, tPA and PAI-1 of the model group were decreased, while PAI-1 was elevated, showing a significant difference ( P<0. 05). The degree of renal interstitial fibrosis was more serious. Correlation analysis showed that the whole blood tPA and uPA levels were positively correlated with the changes of nephrin protein expression in the kidney tissue, while the whole blood PAI-1 level was negatively correlated with the nephrin protein expression in the kidney tissue. Conclusions In the process of MN development, the fibrinolytic system may have important significance for podocyte apoptosis. Determination of early phase of MN podocyte injury may be another therapy target for prevention of the disease development, and then pro-vide new ideas for clinical research and drug development for MN.

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