1.Erratum: Author correction to "Sphingosine-1-phosphate, a novel TREM2 ligand, promotes microglial phagocytosis to protect against ischemic brain injury" Acta Pharm Sin B 12 (2022) 1885-1898.
Tengfei XUE ; Juan JI ; Yuqin SUN ; Xinxin HUANG ; Zhenyu CAI ; Jin YANG ; Wei GUO ; Ruobing GUO ; Hong CHENG ; Xiulan SUN
Acta Pharmaceutica Sinica B 2025;15(5):2813-2814
[This corrects the article DOI: 10.1016/j.apsb.2021.10.012.].
2.Clinical value of indocyanine green fluorescence navigation in laparoscopic radical gastrectomy for gastric cancer
Chenbin LU ; Linyan TONG ; Yuqin SUN ; Weiming ZENG ; Qiuxian CHEN ; Jun LU ; Lisheng CAI
Chinese Journal of General Surgery 2025;34(6):1228-1237
Background and Aims:The completeness of lymph node dissection in laparoscopic radical gastrectomy for gastric cancer directly affects postoperative patient prognosis.Indocyanine green(ICG)fluorescence-guided navigation,as an emerging auxiliary technique,enables real-time visualization of lymphatic drainage pathways and enhances surgical precision.This study was performed to evaluate the impact of ICG fluorescence navigation on lymph node dissection,positive lymph node detection,and patient prognosis during laparoscopic D2 radical gastrectomy for gastric cancer.Methods:The clinical data of 168 patients who underwent laparoscopic radical gastrectomy at Zhangzhou Affiliated Hospital of Fujian Medical University from January 2021 to December 2022 were retrospectively analyzed.Among them,51 patients received ICG-guided surgery(ICG group),and 117 underwent conventional surgery(non-ICG group).Perioperative variables,extent of lymph node dissection,positive lymph node detection efficiency,and postoperative survival outcomes were compared between the two groups.Results:There were no statistically significant differences between the two groups in baseline clinicopathologic characteristics,as well as operative time,intraoperative blood loss,postoperative recovery,and incidence of surgical complications(all P>0.05).The ICG group had a significantly higher mean number of lymph nodes dissected than the non-ICG group(48.62 vs.37.20,P<0.001),with a greater proportion of patients achieving≥30 nodes dissected(92.16%vs.69.23%,P=0.001).Stratified analysis showed a significantly higher number of dissected lymph nodes in the ICG group at D2 stations,the supra-pancreatic region(stations 7,8,9,11),in total gastrectomy,T3-4 stage,and stage Ⅲ patients(all P<0.01).In the ICG group,the number and positivity rate of fluorescent lymph nodes were significantly higher than those of non-fluorescent nodes(30.31 vs.17.36;2.03 vs.0.94,both P<0.05).The diagnostic sensitivity of ICG fluorescence imaging for positive lymph nodes was 68.4%,with a negative predictive value of 94.6%for non-fluorescent nodes.No significant differences were observed between the two groups in terms of adjuvant therapy,overall survival(HR=0.737,P=0.471),or disease-free survival(HR=0.502,P=0.089).Conclusion:ICG-guided navigation in laparoscopic radical gastrectomy for gastric cancer is safe and significantly improves lymph node yield,particularly in the supra-pancreatic region,total gastrectomy,and advanced-stage patients.It also enhances positive node detection.However,no survival benefit has been observed in the short term.Further multicenter studies with long-term follow-up are warranted to confirm its clinical value and optimize intraoperative navigation strategies.
3.Analysis of the safety and efficacy of neoadjuvant immunotherapy combined with chemotherapy for radical resection of locally advanced gastric cancer: a two-center propensity-matched study
Chenbin LYU ; Jun LU ; Binbin XU ; Hongda PAN ; Qiuxian CHEN ; Jie CHEN ; Yuqin SUN ; Yongbin ZHANG ; Lisheng CAI ; Fenglin LIU
Chinese Journal of Surgery 2025;63(10):952-961
Objective:To investigate the impact of neoadjuvant immunotherapy combined with chemotherapy on the safety and efficacy of radical resection in patients with cT3-4NxM0 gastric cancer.Methods:A retrospective cohort study method was used. The clinicopathological data of 515 patients who underwent radical gastrectomy after neoadjuvant treatment at Second Department of Gastric Surgery,Fudan University Shanghai Cancer Center and Department of Gastric Surgery,Zhangzhou Hospital Affiliated to Fujian Medical University from January 2020 to June 2023 were collected. Among them,379 patients received neoadjuvant chemotherapy alone(chemotherapy group),and 136 patients received neoadjuvant immunotherapy combined with chemotherapy(immunotherapy group). There were 382 males and 133 females,with an age of (58.4±10.9)years(range:26 to 85 years). To reduce the influence of potential confounding factors,a 1∶1 propensity score matching method was adopted,and the clamp value was 0.02. The peri-operative safety,imaging and postoperative pathological tumor regression,and prognosis were compared by independent sample t-test, Mann-Whitney U test, χ 2 test or Fisher exact probability method between the two groups. The Kaplan-Meier method was used to draw survival curves, and the differences between groups were compared by Log-rank test. Results:After matching, there were 101 patients in each of the chemotherapy group and the immunotherapy group. The baseline data of the patients in the two groups were evenly distributed (all P>0.05). According to the RECIST 1.1 criteria, the complete response rate (11.9% (12/101) vs. 4.0% (4/101)), partial response rate(68.3%(69/101) vs. 53.4%(54/101)), stable disease rate (17.8%(18/101) vs. 39.6%(40/101)) and disease progression rate (2.0%(2/101) vs. 3.0%(3/101)) between the immunotherapy group and the chemotherapy group were no statistical defferences ( χ2=14.374, P=0.002), and objective response rate (80.2%(81/101) vs. 57.4%(58/101), χ2=12.203, P<0.01) in the immunotherapy group was higher than that in the chemotherapy group. The results of postoperative pathological examination showed that the immunotherapy group had a higher complete response rate (16.8%(17/101) vs. 6.9% (7/101), χ2=4.728, P=0.030) and major pathological response rate (42.6%(43/101) vs. 23.8% (24/101), χ2=8.062, P=0.005). For the two groups, the operation time (175.0(76.0)minutes vs. 160.0 (30.0)minutes, Z=-0.059, P=0.953), intraoperative blood loss (110.0 (150.0)ml vs. 100.0 (120.0)ml, Z=-0.370, P=0.712), overall incidence of postoperative complications (20.8%(21/101) vs. 18.8%(19/101), χ2=0.125, P=0.724) and incidence of severe complications (5.0%(5/101) vs. 3.0%(3/101), χ2=0.130, P=0.718) were comparable. The median follow-up time of all patients was 46 months(range: 19 to 61 months). The 3-year overall survival rate (63.2% vs. 54.4%, P=0.035) and progression-free survival rate (59.1% vs. 45.6%, P=0.022) of the immunotherapy group were higher than those of the chemotherapy group. Meanwhile, there were no statistically significant differences in the incidence of neoadjuvant-treatment-related adverse events (48.5%(49/101) vs. 40.6% (41/101), χ2=1.283, P=0.411) and the incidence of severe adverse reactions of grade 3 or above (13.9% (14/101) vs. 10.9% (11/101), χ2=0.257, P=0.522) between the two groups. Conclusion:Neoadjuvant immunotherapy combined with chemotherapy can significantly improve the imaging and postoperative pathological tumor response rates and 3-year survival rate of patients with locally advanced gastric cancer,without increasing the incidence of postoperative complications and neoadjuvant treatment-related adverse event.
4.Clinical efficacy of 3D laparoscopic radical gastrectomy of gastric cancer: a prospective rando-mized controlled study
Qiuxian CHEN ; Mingqiao LIAN ; Mingjie LIAN ; Yuqin SUN ; Chenbin LYU ; Lisheng CAI ; Qianhui XU
Chinese Journal of Digestive Surgery 2025;24(3):367-373
Objective:To investigate the clinical efficacy of 3D laparoscopic radical gastrec-tomy of gastric cancer.Methods:The prospective randomized controlled study was conducted. The clinical data of 90 patients undergoing total laparoscopic radical gastrectomy of gastric cancer in Zhangzhou Affiliated Hospital of Fujian Medical University from January to December 2022 were selected. Patients were randomly divided into the 3D laparoscopic group and the 2D laparoscopic group by the method of random number table. Patients underwent 3D or 2D laparoscopic radical gastrectomy of gastric cancer. Observation indicators: (1) grouping of enrolled patients; (2) intra-operative and postoperative situations; (3) feelings of the major surgeon during the operation. Com-parison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of count data between groups wsa conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data between groups was conducted using the nonparametric test. Results:(1) Group of enrolled patients. A total of 90 patients eligible for total laparoscopic radical gastrectomy of gastric cancer were selected. There were 56 males and 34 females, aged (61±7)years. All 90 patients were randomly divided into the 3D laparoscopic group and the 2D laparoscopic group, with 45 cases in each group. There was no significant difference in gender, age, body mass index, hypertension, diabetes mellitus, history of abdominal surgery, surgical method, tumor site and TNM staging between the two groups ( P>0.05), indicating comparability. (2) Intraoperative and postoperative situations. The operation time of the 3D laparoscopic group and the 2D laparoscopic group were (196±12)minutes and (204±14)minutes, respectively. The digestive tract reconstruction time of the 3D laparoscopic group and the 2D laparoscopic group were (81±8)minutes and (87±12)minutes, respectively. There were significant differences in operation time and digestive tract reconstruction time between the two groups ( t=-2.85, -2.43, P<0.05). After surgery, 3 cases of the 3D laparoscopic group experienced complications (1 case of abdominal infection, 2 cases of intestinal obstruction), and 8 cases of the 2D laparoscopic group experienced complications (2 cases of anastomotic leakage, 2 cases of abdominal infection, 4 cases of intestinal obstruction). There was no significant difference in postoperative complications between the two groups ( χ2=2.59, P>0.05). (3) Feelings of the major surgeon during the operation. After surgery, the major surgeon completed a questionnaire survey. The score of image quality perception of the 3D laparoscopic group and the 2D laparoscopic group were 4.73±0.08 and 4.46±0.09, respectively. The score of hand-eye coordination experience of the 3D laparoscopic group and the 2D laparoscopic group were 4.60±0.09 and 4.55±0.08, respectively. The score of operation comfort of the 3D laparoscopic group and the 2D laparoscopic group were 4.81±0.05 and 4.62±0.08, respectively. The score of eye comfort of the 3D laparoscopic group and the 2D laparoscopic group 4.49±0.07 and 4.68±0.07, respectively. There were significant differences in the above indicators between the two groups ( t=15.04, 2.57, 13.51, -12.88, P<0.05). Conclusions:Compared with 2D laparoscopy, 3D laparoscopic radical gastrec-tomy of gastric cancer has shorter operation time and digestive tract reconstruction time, does not increase postoperative complications, and has better feelings of the major surgeon in image quality perception, hand-eye coordination experience and operation comfort.
5.Epidemiological Characteristics of Pancreatic Cancer in 2020 and Its Change Trend from 2010 to 2020 in Cancer Registration Areas of Gansu Province
Qian SUN ; Junguo HU ; Yuqin LIU ; Yancheng YE ; Qinghua CAI ; Hongzong WANG
China Cancer 2025;34(5):377-384
[Purpose]To analyze the incidence and mortality of pancreatic cancer in 2020 and the change trend from 2010 to 2020 in cancer registration areas of Gansu Province.[Methods]The data of pancreatic cancer from 2010 to 2020 were collected from cancer registries in Gansu Province.The crude incidence/mortality rate,age-standardized incidence/mortality rate by Chinese standard population(ASIRC/ASMRC)and world standard population(ASIRW/ASMRW),0~74 years old cumulative rate and proportion of pancreatic cancer were calculated.Joinpoint 4.7.0 software was used to calculate the average annual percentage change(AAPC)of ASIRC/ASMRC of pancreatic cancer in cancer registration areas of Gansu Province from 2010 to 2020.[Results]In 2020,a total of 838 new cases of pancreatic cancer were reported in the cancer registration areas of Gansu Province,with a crude incidence rate of 6.52/105,ASIRC and ASIRW of 4.03/105 and 4.49/105 respectively,accounting for 2.50%of all malignant tumor incidence.In 2020,702 cases of pan-creatic cancer deaths were reported in the cancer registration areas of Gansu Province,with a crude mortality rate of 5.46/105,ASMRC and ASMRW of 3.25/105 and 3.73/105,respectively,ac-counting for 3.98%of all malignant tumor deaths.From 2010 to 2020,a total of 2 413 cases of pancreatic cancer were reported in cancer registration areas in Gansu Province,accounting for 1.90%of all malignant tumors in the province.The crude incidence rate of pancreatic cancer was 5.28/105,the ASIRC was 4.18/105,the ASIRW was 4.63/105,and the cumulative rate of 0~74 years old was 0.49%.From 2010 to 2020,a total of 1 871 pancreatic cancer deaths were reported in cancer registration areas of Gansu Province,accounting for 2.38%of all malignant tumor deaths in the province.The crude mortality rate was 3.92/105,the ASMRC was 3.09/105,the ASMRW was 3.50/105,and the cumulative rate of 0~74 years old was 0.36%.In terms of sex and region,the incidence and mortality of pancreatic cancer from 2010 to 2020 in men were higher than those in women,and higher in rural areas than those in urban areas.From 2010 to 2020,the incidence and mortality were at a low level under the age of 44 years old,and increased significantly after 45 years old,reaching a peak in the age group of 80~84 years old.ASIRC showed no significant change from 2010 to 2020 with an AAPC of 0.41 1%(P>0.05).From 2010 to 2020,the ASMRC showed an significantly increasing trend with an AAPC of 6.515%(P=0.014).[Conclusion]From 2010 to 2020,the ASRIC of pancreatic cancer in Gansu Province showed no significant change,while the ASMRC showed a significantly in-creasing trend.The incidence and mortality rates were higher in men than those in women and higher in rural areas than those in urban areas.Middle-aged and elderly men in rural areas are the key groups of prevention and treatment of pancreatic cancer,so targeted prevention and control measures should be carried out.
6.Clinical value of indocyanine green fluorescence navigation in laparoscopic radical gastrectomy for gastric cancer
Chenbin LU ; Linyan TONG ; Yuqin SUN ; Weiming ZENG ; Qiuxian CHEN ; Jun LU ; Lisheng CAI
Chinese Journal of General Surgery 2025;34(6):1228-1237
Background and Aims:The completeness of lymph node dissection in laparoscopic radical gastrectomy for gastric cancer directly affects postoperative patient prognosis.Indocyanine green(ICG)fluorescence-guided navigation,as an emerging auxiliary technique,enables real-time visualization of lymphatic drainage pathways and enhances surgical precision.This study was performed to evaluate the impact of ICG fluorescence navigation on lymph node dissection,positive lymph node detection,and patient prognosis during laparoscopic D2 radical gastrectomy for gastric cancer.Methods:The clinical data of 168 patients who underwent laparoscopic radical gastrectomy at Zhangzhou Affiliated Hospital of Fujian Medical University from January 2021 to December 2022 were retrospectively analyzed.Among them,51 patients received ICG-guided surgery(ICG group),and 117 underwent conventional surgery(non-ICG group).Perioperative variables,extent of lymph node dissection,positive lymph node detection efficiency,and postoperative survival outcomes were compared between the two groups.Results:There were no statistically significant differences between the two groups in baseline clinicopathologic characteristics,as well as operative time,intraoperative blood loss,postoperative recovery,and incidence of surgical complications(all P>0.05).The ICG group had a significantly higher mean number of lymph nodes dissected than the non-ICG group(48.62 vs.37.20,P<0.001),with a greater proportion of patients achieving≥30 nodes dissected(92.16%vs.69.23%,P=0.001).Stratified analysis showed a significantly higher number of dissected lymph nodes in the ICG group at D2 stations,the supra-pancreatic region(stations 7,8,9,11),in total gastrectomy,T3-4 stage,and stage Ⅲ patients(all P<0.01).In the ICG group,the number and positivity rate of fluorescent lymph nodes were significantly higher than those of non-fluorescent nodes(30.31 vs.17.36;2.03 vs.0.94,both P<0.05).The diagnostic sensitivity of ICG fluorescence imaging for positive lymph nodes was 68.4%,with a negative predictive value of 94.6%for non-fluorescent nodes.No significant differences were observed between the two groups in terms of adjuvant therapy,overall survival(HR=0.737,P=0.471),or disease-free survival(HR=0.502,P=0.089).Conclusion:ICG-guided navigation in laparoscopic radical gastrectomy for gastric cancer is safe and significantly improves lymph node yield,particularly in the supra-pancreatic region,total gastrectomy,and advanced-stage patients.It also enhances positive node detection.However,no survival benefit has been observed in the short term.Further multicenter studies with long-term follow-up are warranted to confirm its clinical value and optimize intraoperative navigation strategies.
7.Epidemiological Characteristics of Pancreatic Cancer in 2020 and Its Change Trend from 2010 to 2020 in Cancer Registration Areas of Gansu Province
Qian SUN ; Junguo HU ; Yuqin LIU ; Yancheng YE ; Qinghua CAI ; Hongzong WANG
China Cancer 2025;34(5):377-384
[Purpose]To analyze the incidence and mortality of pancreatic cancer in 2020 and the change trend from 2010 to 2020 in cancer registration areas of Gansu Province.[Methods]The data of pancreatic cancer from 2010 to 2020 were collected from cancer registries in Gansu Province.The crude incidence/mortality rate,age-standardized incidence/mortality rate by Chinese standard population(ASIRC/ASMRC)and world standard population(ASIRW/ASMRW),0~74 years old cumulative rate and proportion of pancreatic cancer were calculated.Joinpoint 4.7.0 software was used to calculate the average annual percentage change(AAPC)of ASIRC/ASMRC of pancreatic cancer in cancer registration areas of Gansu Province from 2010 to 2020.[Results]In 2020,a total of 838 new cases of pancreatic cancer were reported in the cancer registration areas of Gansu Province,with a crude incidence rate of 6.52/105,ASIRC and ASIRW of 4.03/105 and 4.49/105 respectively,accounting for 2.50%of all malignant tumor incidence.In 2020,702 cases of pan-creatic cancer deaths were reported in the cancer registration areas of Gansu Province,with a crude mortality rate of 5.46/105,ASMRC and ASMRW of 3.25/105 and 3.73/105,respectively,ac-counting for 3.98%of all malignant tumor deaths.From 2010 to 2020,a total of 2 413 cases of pancreatic cancer were reported in cancer registration areas in Gansu Province,accounting for 1.90%of all malignant tumors in the province.The crude incidence rate of pancreatic cancer was 5.28/105,the ASIRC was 4.18/105,the ASIRW was 4.63/105,and the cumulative rate of 0~74 years old was 0.49%.From 2010 to 2020,a total of 1 871 pancreatic cancer deaths were reported in cancer registration areas of Gansu Province,accounting for 2.38%of all malignant tumor deaths in the province.The crude mortality rate was 3.92/105,the ASMRC was 3.09/105,the ASMRW was 3.50/105,and the cumulative rate of 0~74 years old was 0.36%.In terms of sex and region,the incidence and mortality of pancreatic cancer from 2010 to 2020 in men were higher than those in women,and higher in rural areas than those in urban areas.From 2010 to 2020,the incidence and mortality were at a low level under the age of 44 years old,and increased significantly after 45 years old,reaching a peak in the age group of 80~84 years old.ASIRC showed no significant change from 2010 to 2020 with an AAPC of 0.41 1%(P>0.05).From 2010 to 2020,the ASMRC showed an significantly increasing trend with an AAPC of 6.515%(P=0.014).[Conclusion]From 2010 to 2020,the ASRIC of pancreatic cancer in Gansu Province showed no significant change,while the ASMRC showed a significantly in-creasing trend.The incidence and mortality rates were higher in men than those in women and higher in rural areas than those in urban areas.Middle-aged and elderly men in rural areas are the key groups of prevention and treatment of pancreatic cancer,so targeted prevention and control measures should be carried out.
8.Clinical efficacy of 3D laparoscopic radical gastrectomy of gastric cancer: a prospective rando-mized controlled study
Qiuxian CHEN ; Mingqiao LIAN ; Mingjie LIAN ; Yuqin SUN ; Chenbin LYU ; Lisheng CAI ; Qianhui XU
Chinese Journal of Digestive Surgery 2025;24(3):367-373
Objective:To investigate the clinical efficacy of 3D laparoscopic radical gastrec-tomy of gastric cancer.Methods:The prospective randomized controlled study was conducted. The clinical data of 90 patients undergoing total laparoscopic radical gastrectomy of gastric cancer in Zhangzhou Affiliated Hospital of Fujian Medical University from January to December 2022 were selected. Patients were randomly divided into the 3D laparoscopic group and the 2D laparoscopic group by the method of random number table. Patients underwent 3D or 2D laparoscopic radical gastrectomy of gastric cancer. Observation indicators: (1) grouping of enrolled patients; (2) intra-operative and postoperative situations; (3) feelings of the major surgeon during the operation. Com-parison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of count data between groups wsa conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data between groups was conducted using the nonparametric test. Results:(1) Group of enrolled patients. A total of 90 patients eligible for total laparoscopic radical gastrectomy of gastric cancer were selected. There were 56 males and 34 females, aged (61±7)years. All 90 patients were randomly divided into the 3D laparoscopic group and the 2D laparoscopic group, with 45 cases in each group. There was no significant difference in gender, age, body mass index, hypertension, diabetes mellitus, history of abdominal surgery, surgical method, tumor site and TNM staging between the two groups ( P>0.05), indicating comparability. (2) Intraoperative and postoperative situations. The operation time of the 3D laparoscopic group and the 2D laparoscopic group were (196±12)minutes and (204±14)minutes, respectively. The digestive tract reconstruction time of the 3D laparoscopic group and the 2D laparoscopic group were (81±8)minutes and (87±12)minutes, respectively. There were significant differences in operation time and digestive tract reconstruction time between the two groups ( t=-2.85, -2.43, P<0.05). After surgery, 3 cases of the 3D laparoscopic group experienced complications (1 case of abdominal infection, 2 cases of intestinal obstruction), and 8 cases of the 2D laparoscopic group experienced complications (2 cases of anastomotic leakage, 2 cases of abdominal infection, 4 cases of intestinal obstruction). There was no significant difference in postoperative complications between the two groups ( χ2=2.59, P>0.05). (3) Feelings of the major surgeon during the operation. After surgery, the major surgeon completed a questionnaire survey. The score of image quality perception of the 3D laparoscopic group and the 2D laparoscopic group were 4.73±0.08 and 4.46±0.09, respectively. The score of hand-eye coordination experience of the 3D laparoscopic group and the 2D laparoscopic group were 4.60±0.09 and 4.55±0.08, respectively. The score of operation comfort of the 3D laparoscopic group and the 2D laparoscopic group were 4.81±0.05 and 4.62±0.08, respectively. The score of eye comfort of the 3D laparoscopic group and the 2D laparoscopic group 4.49±0.07 and 4.68±0.07, respectively. There were significant differences in the above indicators between the two groups ( t=15.04, 2.57, 13.51, -12.88, P<0.05). Conclusions:Compared with 2D laparoscopy, 3D laparoscopic radical gastrec-tomy of gastric cancer has shorter operation time and digestive tract reconstruction time, does not increase postoperative complications, and has better feelings of the major surgeon in image quality perception, hand-eye coordination experience and operation comfort.
9.Analysis of the safety and efficacy of neoadjuvant immunotherapy combined with chemotherapy for radical resection of locally advanced gastric cancer: a two-center propensity-matched study
Chenbin LYU ; Jun LU ; Binbin XU ; Hongda PAN ; Qiuxian CHEN ; Jie CHEN ; Yuqin SUN ; Yongbin ZHANG ; Lisheng CAI ; Fenglin LIU
Chinese Journal of Surgery 2025;63(10):952-961
Objective:To investigate the impact of neoadjuvant immunotherapy combined with chemotherapy on the safety and efficacy of radical resection in patients with cT3-4NxM0 gastric cancer.Methods:A retrospective cohort study method was used. The clinicopathological data of 515 patients who underwent radical gastrectomy after neoadjuvant treatment at Second Department of Gastric Surgery,Fudan University Shanghai Cancer Center and Department of Gastric Surgery,Zhangzhou Hospital Affiliated to Fujian Medical University from January 2020 to June 2023 were collected. Among them,379 patients received neoadjuvant chemotherapy alone(chemotherapy group),and 136 patients received neoadjuvant immunotherapy combined with chemotherapy(immunotherapy group). There were 382 males and 133 females,with an age of (58.4±10.9)years(range:26 to 85 years). To reduce the influence of potential confounding factors,a 1∶1 propensity score matching method was adopted,and the clamp value was 0.02. The peri-operative safety,imaging and postoperative pathological tumor regression,and prognosis were compared by independent sample t-test, Mann-Whitney U test, χ 2 test or Fisher exact probability method between the two groups. The Kaplan-Meier method was used to draw survival curves, and the differences between groups were compared by Log-rank test. Results:After matching, there were 101 patients in each of the chemotherapy group and the immunotherapy group. The baseline data of the patients in the two groups were evenly distributed (all P>0.05). According to the RECIST 1.1 criteria, the complete response rate (11.9% (12/101) vs. 4.0% (4/101)), partial response rate(68.3%(69/101) vs. 53.4%(54/101)), stable disease rate (17.8%(18/101) vs. 39.6%(40/101)) and disease progression rate (2.0%(2/101) vs. 3.0%(3/101)) between the immunotherapy group and the chemotherapy group were no statistical defferences ( χ2=14.374, P=0.002), and objective response rate (80.2%(81/101) vs. 57.4%(58/101), χ2=12.203, P<0.01) in the immunotherapy group was higher than that in the chemotherapy group. The results of postoperative pathological examination showed that the immunotherapy group had a higher complete response rate (16.8%(17/101) vs. 6.9% (7/101), χ2=4.728, P=0.030) and major pathological response rate (42.6%(43/101) vs. 23.8% (24/101), χ2=8.062, P=0.005). For the two groups, the operation time (175.0(76.0)minutes vs. 160.0 (30.0)minutes, Z=-0.059, P=0.953), intraoperative blood loss (110.0 (150.0)ml vs. 100.0 (120.0)ml, Z=-0.370, P=0.712), overall incidence of postoperative complications (20.8%(21/101) vs. 18.8%(19/101), χ2=0.125, P=0.724) and incidence of severe complications (5.0%(5/101) vs. 3.0%(3/101), χ2=0.130, P=0.718) were comparable. The median follow-up time of all patients was 46 months(range: 19 to 61 months). The 3-year overall survival rate (63.2% vs. 54.4%, P=0.035) and progression-free survival rate (59.1% vs. 45.6%, P=0.022) of the immunotherapy group were higher than those of the chemotherapy group. Meanwhile, there were no statistically significant differences in the incidence of neoadjuvant-treatment-related adverse events (48.5%(49/101) vs. 40.6% (41/101), χ2=1.283, P=0.411) and the incidence of severe adverse reactions of grade 3 or above (13.9% (14/101) vs. 10.9% (11/101), χ2=0.257, P=0.522) between the two groups. Conclusion:Neoadjuvant immunotherapy combined with chemotherapy can significantly improve the imaging and postoperative pathological tumor response rates and 3-year survival rate of patients with locally advanced gastric cancer,without increasing the incidence of postoperative complications and neoadjuvant treatment-related adverse event.
10.Prevalence and risk factors of hyperuricemia among workers in an electronics factory in Wuhan
Jiajie SUN ; Chao XIA ; Yuqin SHI ; Pengli CAI ; Hao ZHANG ; Jinxin CHENG ; Ruixue ZHAO ; Ling ZHANG ; Wenjun YIN ; Jingrong LIU
Journal of Public Health and Preventive Medicine 2024;35(3):90-94
Objective To understand the prevalence and risk factors of hyperuricemia in electronics factory workers in Wuhan, and to provide evidence for the health protection of electronics factory workers. Methods A total of 1 415 employees in an electronics factory in Wuhan were selected as the research subjects, and the physical examination and determination of various biochemical indicators, as well as questionnaire survey were carried out. Results The detection rate of hyperuricemia among workers in the electronics factory in Wuhan was 32.43%, with 36.33% for men and 14.11% for women, and the difference was statistically significant ( χ2=46.077,P<0.001). The detection rate of hyperuricemia was the highest (33.77%) among those with university or college education, followed by graduate students and above (31.50%). Compared with subjects with good lifestyle habits, people with drinking habits had higher hyperuricemia detection rate (49.38%), and the difference was statistically significant (P =0.001). The detection rates of hyperuricemia in those with central obesity and elevated alanine aminotransferase were 48.23% and 61.29%, respectively, which were significantly higher than those in the subjects without the above diseases (26.91% and 27.21%, respectively), and the differences were statistically significant (P <0.001). Obese people had the highest detection rate of hyperuricemia (66.95%), followed by overweight people (43.75%), and the difference was statistically significant (P <0.001). Multivariate logistic analysis showed that alcohol drinking (OR=1.836, 95% CI=1.139-2.961, P =0.013) and body mass index ≥ 24 kg/m2 (OR=2.175, 95% CI=1.686 -2.806, P <0.001) were risk factors for hyperuricemia in electronic factory workers. Elevated alanine aminotransferase (ALT) was significantly correlated with hyperuricemia (OR=2.964, 95%CI=2.146-4.095 , P <0.001). Female gender was a protective factor for hyperuricemia in workers in the electronics factory (OR=0.441, 95%CI=0.297-0.653 , P <0.001). Conclusion The detection rate of hyperuricemia among workers in an electronics factory in Wuhan is high, and the detection rate of hyperuricemia in men is higher than that in women. Alcohol consumption, overweight and obesity will increase the risk of hyperuricemia. Elevated ALT is associated with hyperuricemia. Maintaining an ideal body mass index and establishing a good lifestyle play an important role in preventing hyperuricemia.


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