OBJECTIVE:To evaluate the effects of clinical pharmacists'intervention on prophylactic use of antibiotics in re-moval of internal fixation device for fracture. METHODS:Totally 117 patients underwent removal of internal fixation device for fracture were selected from some on third grade class A hospital during Mar.-Jul. 2015 as pre-intervention group. Totally of 266 pa-tients underwent removal of internal fixation device for fracture were selected during Aug. 2015-May 2016 as post-intervention group. Clinical pharmacists performed interventions based on Rationality Evaluation Criteria for Prophylactic Use of Antibiotics in Removal of Internal Fixation Device for Fracture. The prophylactic use of antibiotics was compared between 2 groups before and af-ter intervention. RESULTS:No unreasonable single dose or additional drug during surgery was found before and after intervention. After intervention,utilization rate of antibiotics for prophylactic use,the proportion of patients receiving antibiotics without indica-tions,the proportion of medication duration more than 24 h decreased from 84.6%,71.8%,48.7% to 17.3%,9.8%,4.9%,re-spectively. Average antibiotics cost,the proportion of total drug cost in hospitalization cost,the proportion of antibiotics cost in to-tal drug cost were all decreased significantly compared to before intervention,with statistical significance(P<0.05). There was no statistical significance in the proportion of patients with unreasonable drug choice,unreasonable initial prophylactic medication tim-ing and unreasonable drug combination,the proportion of different antibiotics types,average hospitalization cost and average drug cost(P>0.05). CONCLUSIONS:Clinical pharmacists'interventions significantly reduce the utilization rate of antibiotics for pro-phylactic use in patients underwent removal of internal fixation device for fracture,improve drug use without indications and ratio-nality of prophylactic use of antibiotics. There still are problems,such as unreasonable medication timing,continuous use time of more than 24 h,etc. It is necessary to continuous follow-up intervention.

OBJECTIVE:To put forward relevant suggestions for promoting the R&D cooperation in biomedical field in China. METHODS:Information of all invention co-patents in biomedical fields during 2000-2015 in patent database was collected,includ-ing year,patent name,application number,applicant,patent address,etc.,and descriptive statistical analysis was conducted. RE-SULTS:The number of invention co-patents in biomedical fields had been increasing year by year,and the number of invention co-patents in 2015 was about 9 times than that in 2000. Invention co-patents mainly came from Beijing,Shanghai and Guangdong,accounting for 49.1%. The top 15 applicants had 983 invention co-patents in total,accounting for 8.9% of the total number of co-patents,7 of which were enterprises. And in the invention co-patents applied by the top 10 cities for GDP ranking in 2014,inven-tion co-patents applied by enterprises,scientific research institutions(include hospitals)and universities accounted for 56.2% of all patents. CONCLUSIONS:The R&D cooperation in biomedical fields has mainly focused on a few developed provinces and cities, with low concentration of invention co-patents;the R&D cooperation is mainly led by enterprises,and hospitals have low participa-tion. The government should establish national biomedical information sharing platform,raise the R&D cooperation awareness of large-scale pharmaceutical enterprises and encourage hospitals to actively participate in R&D cooperation activities in biomedicine fields.

OBJECTIVETo explore the role of repeat liver resection in colorectal liver metastasis (CRLM) with early recurrence and to analyze the risk factors of early recurrence.

METHODSClinicopathological and follow-up data of 303 CRLM patients undergoing liver resection in our department between January 2000 and August 2014 were analyzed retrospectively. The 5-year overall survivals between early recurrence(within postoperative 1 year) and non-early recurrence were compared. The impact of repeat liver resection on 5-year survival of early recurrence was analyzed. Clinicopathological features which might be associated with early recurrence were investigated using univariate and multivariate analyses.

RESULTSAmong 303 patients, 192(63.4%) patients had recurrence, including 145 patients of early recurrence and 47 of non-early recurrence. The 5-year overall survival of early recurrence patients was significantly lower compared with non-early recurrence ones(16.0% vs. 63.9%, P=0.000). Among 145 early recurrence patients, 80 were evaluated as resectable, of whom 22 received repeat liver resection. Compared with other 58 patients receiving conservative treatment, above 22 patients receiving repeat liver resection had a significantly higher 5-year overall survival(27.1% vs. 0%, P=0.033). Multivariate analysis revealed T-stage of primary tumor, lymph node metastasis, and larger size(> 5 cm) of metastatic liver focus were independent risk factors of early recurrence, and good efficacy of neo-adjuvant chemotherapy was independent protective factor of early recurrence(all P<0.05). Repeat liver resection was associated with better long-term survival.

CONCLUSIONSThe prognosis of early recurrence after liver resection in CRLM patients is poor, while repeat resection for resectable lesions in recurrence patients can obviously prolong the survival. For those with late T-stage, lymph node metastasis, and larger metastatic liver focus, actively preoperative neo-adjuvant chemotherapy should be considered.

OBJECTIVETo evaluate the correlation between overweight and postoperative complications and prognosis after radical hepatectomy for colorectal liver metastasis (CRLM).

METHODSA total of 192 patients who underwent hepatectomy for colorectal liver metastases between January 2000 and March 2012 were eligible for the study. We retrospectively summarized their clinicopathological data, BMI index and postoperative complications, and investigated the relation between these data and complications and prognosis.

RESULTSOf the 192 patients, 109 cases were classified as overweight with a BMI ≥24 and 83 patients were classified as non-overweight with a BMI <24. Seventy-five complications occurred in 68 of the 192 patients (35.4%) who underwent hepatectomy. Surgical complications (P=0.428), operation time (P=0.837), and blood loss (P=0.272) were not statistically significantly associated with BMI. 173 patients were included to analyze the influence of overweight on oncologic outcome. The median survival for the overweight patients was 59 months, while that of non-overweight patients was 31 months (P=0.016). The overweight patients had a longer OS assessed by both univariate analysis (P=0.016) and multivariate analysis (P=0.031). However, no statistical differences in disease-free survival (DFS) were detected between the overweight and non-overweight groups (P=0.058).

CONCLUSIONSOverweight is not independently associated with an increasing complication rate. BMI does not significantly affect the CRLM-DFS, and high BMI patients might have a better overall survival.

Colorectal Neoplasms ; epidemiology ; surgery ; Disease-Free Survival ; Hepatectomy ; statistics & numerical data ; Humans ; Liver Neoplasms ; epidemiology ; secondary ; surgery ; Overweight ; Postoperative Complications ; epidemiology ; Prognosis ; Retrospective Studies ; Survival Rate

OBJECTIVETo validate the prognostic significance of Clinical Risk Score (CRS) system proposed by Fong et al. after hepatectomy of liver metastasis from colorectal cancer.

METHODSThe clinicopathological data were collected retrospectively from 294 patients with hepatic metastases from colorectal cancer who received liver resection between January 2000 and August 2014 in Peking University Cancer Hospital. Routine follow-up was done by outpatient interview or telephone. Statistical analysis was conducted to compare the survival of different CRS patients.

RESULTSAfter a median follow-up of 19 months (2-129 months) for all the 294 patients, the median overall survival and disease-free survival were 35 months and 11 months, respectively. The postoperative 1-, 3- and 5-year overall survival rates were 89.0%, 49.0%, and 35.7%, and the disease-free survival rates were 47.2%, 22.2%, and 18.2%, respectively. For the six different groups with CRS of 0, 1, 2, 3, 4, 5 accordingly, the median overall survival was 64, 59, 33, 35, 17 and 15 months, respectively, showing a significant difference (P=0.002), and the median disease-free survival was 16, 19, 13, 10, 4 and 6 months, respectively, showing also a significant difference (P<0.001). For patients whose CRS were 0-2 and 3-5, the median overall survival was 44 and 33 months, respectively, with a significant difference between them (P=0.022), and the median disease-free survival was 15 and 8 months, respectively, with also a significant difference (P<0.001).

CONCLUSIONThis CRS system may predict the prognosis for patients with hepatic metastasis from colorectal cancer after hepatectomy, therefore to provide useful reference for making treatment plan for those patients.

Colorectal Neoplasms ; Disease-Free Survival ; Follow-Up Studies ; Hepatectomy ; Humans ; Liver Neoplasms ; mortality ; secondary ; surgery ; Prognosis ; Retrospective Studies ; Risk Assessment ; Survival Rate ; Time Factors ; Treatment Outcome

Objective To identify the risk factors associated with overall survival (OS) for patients undergoing partial hepatectomy for colorectal liver metastases,and to assess the predictive values of five published scoring systems in an independent patient cohort for the purpose of external validation.Methods The clinical,pathologic,and complete follow-up data were prospectively collected from 303 consecutive patients who underwent primary hepatic resection for colorectal liver metastases at the Beijing Cancer Hospital from January 2000 to Aug 2014.The predictive values of the Nordlinger score,the Memorial Sloan-Kettering Cancer Center (MSKCC) score,the Iwatsuki score,the Basingstoke index,and the Konopke scoring system were assessed in this patient set.The clinical and pathologic parameters were further analyzed using univariate and multivariate analyses.Results The 1-,3-and 5-year overall survival were 89.2％,50.8％ and 38.6％,respectively.The median survival time was 37 months.Two risk factors were found to be independent predictors of poor overall survival:the N stage of the primary tumor,and a carcinoembyonic antigen level ＞ 30 μg/L.The MSKCC score had the best independent predictive power for survival when compared with the other 4 prognostic systems (C-index:0.903).Conclusion In our patient cohort,the MSKCC score was the best staging system in predicting survival.

Objective To evaluate the correlation between postoperative complications and prognosis after radical hepatic resection for colorectal liver metastasis (CRLM).Methods We retrospectively summarized patients' clinicopathological data and postoperative complications.Postoperative complications were graded using Dindo-Clavien system of classification.Then we investigate the relation between these data and prognosis.Results One hundred and seventy-three patients were recruited.Postoperative complications developed in 59 (34.1％) cases.37 patients had minor complications and 22 patients had major complications.On univariate (x2 =8.106,P =0.004) and multivariate analysis (x2 =8.006,P =0.005),complication was an independent predictor of overall survival (OS).However,in a subgroup of patients with minor compications,morbidity was not associated with a significant reduction in both OS (x2 =3.199,P =0.074) and disease-free survival (x2 =1.313,P =0.252).Conclusions Postoperative complications are an independent factor for long-term outcomes after hepatic resection for CRLM.

Objective:To compare the safety and long-term survival of patients with synchronous rectal cancer liver metastasis, who received either simultaneous or staged resection to treat primary tumor and liver metastases. Methods:Clinicopathologic and peri-operative data were collected retrospectively from 54 patients with synchronous rectal cancer liver metastasis, who received both prima-ry and liver resections between January 2000 and April 2015 at Peking University Cancer Hospital. Routine follow-up was conducted. The safety and long-term survival of 19 patients who underwent simultaneous resection were compared with those of 35 patients who received staged resection. Results:The clinicopathologic data between the two groups were comparable. Postoperative Clavien-Dindo grades 1, 2, 3, and 4 complications were 10.5%(2/19), 31.6%(6/19), 5.3%(1/19), and 10.5%(2/19) for the simultaneous group, respec-tively, and 8.6%(3/35), 17.1%(6/35), 25.7%(9/35), and 0%(0/35) for the staged group correspondingly, which were not significantly different (P=0.093). However, the median postoperative hospital stay of the simultaneous group was significantly shorter than that of the staged group (14 days versus 25 days, P<0.001). The median postoperative overall survival (OS) and disease-free survival (DFS) be-tween these groups were not significantly different [not reached versus 39 months for OS, respectively (P=0.649);10 months versus 10 months for DFS, respectively (P=0.827)]. Conclusion:The postoperative complications in simultaneous resection group were not sig-nificantly increased compared with those in staged resection group for synchronous rectal cancer liver metastasis. The long-term results among the groups were similar.

Objective To evaluate the correlation between overweight and postoperative complications and prognosis after radical hepatectomy for colorectal liver metastasis ( CRLM) .Methods A total of 192 patients who underwent hepatectomy for colorectal liver metastases between January 2000 and March 2012 were eligible for the study.We retrospectively summarized their clinicopathological data, BMI index and postoperative complications, and investigated the relation between these data and complications and prognosis.Results Of the 192 patients, 109 cases were classified as overweight with a BMI≥24 and 83 patients were classified as non-overweight with a BMI <24.Seventy-five complications occurred in 68 of the 192 patients (35.4%) who underwent hepatectomy.Surgical complications ( P=0.428), operation time(P=0.837), and blood loss (P=0.272) were not statistically significantly associated with BMI.173 patients were included to analyze the influence of overweight on oncologic outcome.The median survival for the overweight patients was 59 months, while that of non-overweight patients was 31 months (P=0.016). The overweight patients had a longer OS assessed by both univariate analysis ( P=0.016) and multivariate analysis (P=0.031).However, no statistical differences in disease-free survival (DFS) were detected between the overweight and non-overweight groups ( P =0.058).Conclusions Overweight is not independently associated with an increasing complication rate.BMI does not significantly affect the CRLM-DFS, and high BMI patients might have a better overall survival.

Objective To evaluate the correlation between overweight and postoperative complications and prognosis after radical hepatectomy for colorectal liver metastasis ( CRLM) .Methods A total of 192 patients who underwent hepatectomy for colorectal liver metastases between January 2000 and March 2012 were eligible for the study.We retrospectively summarized their clinicopathological data, BMI index and postoperative complications, and investigated the relation between these data and complications and prognosis.Results Of the 192 patients, 109 cases were classified as overweight with a BMI≥24 and 83 patients were classified as non-overweight with a BMI <24.Seventy-five complications occurred in 68 of the 192 patients (35.4%) who underwent hepatectomy.Surgical complications ( P=0.428), operation time(P=0.837), and blood loss (P=0.272) were not statistically significantly associated with BMI.173 patients were included to analyze the influence of overweight on oncologic outcome.The median survival for the overweight patients was 59 months, while that of non-overweight patients was 31 months (P=0.016). The overweight patients had a longer OS assessed by both univariate analysis ( P=0.016) and multivariate analysis (P=0.031).However, no statistical differences in disease-free survival (DFS) were detected between the overweight and non-overweight groups ( P =0.058).Conclusions Overweight is not independently associated with an increasing complication rate.BMI does not significantly affect the CRLM-DFS, and high BMI patients might have a better overall survival.