目的研究胃肠道恶性肿瘤患者术前营养状况以及营养不良发生的相关因素。方法选取2016年8月至2017年11月在武汉同济医院胃肠外科住院拟行手术治疗的胃肠道恶性肿瘤患者202例,入院后采用主观综合营养评估(subjective global assessment,S...目的研究胃肠道恶性肿瘤患者术前营养状况以及营养不良发生的相关因素。方法选取2016年8月至2017年11月在武汉同济医院胃肠外科住院拟行手术治疗的胃肠道恶性肿瘤患者202例,入院后采用主观综合营养评估(subjective global assessment,SGA)法评估营养状况,记录入院时体重指数(body mass index,BMI)、中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NRL)、营养指标(血红蛋白、白蛋白、前白蛋白)、血清肿瘤标志物(CA199、CA724、CEA)和肿瘤部位、TNM分期、分化程度。采用多元回归分析营养不良的相关因素。结果 202例患者中,SGA法评定营养不良发生率为46%。多因素回归分析显示,在矫正年龄、性别、NRL、CA199、CA724、TNM分期和肿瘤分化程度等因素后,肿瘤部位和CEA是营养不良的独立相关因素。与远端胃、左半结肠、乙状结肠和直肠的恶性肿瘤患者相比,近端胃和右半结肠恶性肿瘤患者的营养不良发生风险增高(OR=2.51,95%CI 1.25~5.03,P=0.009);与CEA<10ng/ml的患者相比,CEA≥10ng/ml的患者营养不良发生风险增高(OR=12.50,95%CI 2.66~58.63,P=0.001)。结论肿瘤部位和CEA水平是胃肠道恶性肿瘤患者营养状态的独立相关因素,对于肿瘤位于近端胃和右半结肠以及CEA≥10ng/ml的消化道肿瘤患者,其营养状况应引起临床医护人员更多的关注。展开更多
BACKGROUND Resection of hepatic metastasis from neuroendocrine tumors(NETs)improves quality of life and prolongs 5-year survival.Ablation can be utilized with surgery to achieve complete resection.Although several stu...BACKGROUND Resection of hepatic metastasis from neuroendocrine tumors(NETs)improves quality of life and prolongs 5-year survival.Ablation can be utilized with surgery to achieve complete resection.Although several studies report long-term out-comes for patients undergoing ablation,none have explored perioperative effects of ablation in patients with metastatic NETs.AIM To determine if intra-operative ablation during hepatectomy increases risk of ad-verse outcomes such as surgical site infections(SSIs),bleeding,and bile leak.METHODS A retrospective analysis of the hepatectomy National Surgical Quality Impro-vement Program database from 2015-2019 was performed to determine the odds of SSIs,bile leaks,or bleeding in patients undergoing intraoperative ablation when compared to hepatectomy alone.RESULTS Of the 966 patients included in the study,298(30.9%)underwent ablation during hepatectomy.There were 78(11.7%)patients with SSIs in the hepatectomy alone group and 39(13.1%)patients with a SSIs in the hepatectomy with ablation group.Bile leak occurred in 41(6.2%)and 14(4.8%)patients in the two groups,respec-tively;bleeding occurred in 117(17.5%)and 33(11.1%),respectively.After con-trolling for confounding variables,ablation did not increase risk of SSI(P=0.63),bile leak(P=0.34)or bleeding(P=0.07)when compared to patients undergoing resection alone on multivariate analysis.CONCLUSION Intraoperative ablation with hepatic resection for NETs is safe in the perioperative period without significant increased risk of infection,bleeding,or bile leak.Surgeons should utilize this modality when appropriate to a-chieve optimal disease control and outcomes.展开更多
Background Surgical site infection(SSI)is a common complication following craniotomy that increases morbidity,mortality,and medical expenses.The objectives of this study were to determine the relevant risk factors ass...Background Surgical site infection(SSI)is a common complication following craniotomy that increases morbidity,mortality,and medical expenses.The objectives of this study were to determine the relevant risk factors associated with SSI after elective craniotomy for brain tumor and analyse the treatments for SSI.Methods A retrospective nested case-control study was conducted using data from patients who underwent craniotomy for brain tumor resection at the Neurosurgical Oncology Department No.6 of Beijing Tiantan Hospital,Capital Medical University,between January 2019 and December 2021.Risk factors for SSI were determined using multivariate logistic regression analysis.We analyzed microbiological and related treatment data for different SSI types.Results Among 2061 patients who underwent craniotomy for brain tumor,31 had SSI(1.50%).In the multivariate logistic regression analysis,body mass index(BMI)and operative duration were identified as independent risk factors for SSI.The most common microorganism isolated from SSIs was Staphylococcus epidermidis(22.9%),and drug sensitivity results showed that gram-positive bacteria were sensitive to linezolid,vancomycin and tigecycline,whereas gram-negative bacteria were sensitive to meropenem,cefepime and ceftazidime.Six of the seven patients who underwent bone flap removal due to osteomyelitis were infected with gram-negative bacteria.Conclusions BMI and operative duration were identified as independent risk factors for SSI.Diabetes mellitus,previous ratio therapy,type of incision,recurrence tumor and other risk factors were not found to be associated with the occurrence of SSI in this study.展开更多
After preparing the EU^3＋-doped scheelite nano-material by Pechini method with the nanoparticles of 30-50 nm in diameter, X-ray diffraction （XRD）, transmission electron microscopy （TEM） and high resolution transm...After preparing the EU^3＋-doped scheelite nano-material by Pechini method with the nanoparticles of 30-50 nm in diameter, X-ray diffraction （XRD）, transmission electron microscopy （TEM） and high resolution transmission electron microscopy （HRTEM） were used to show a microcosmic description of the particle morphology and crystal structure. The spectrum signature of the nano-scheelite, which was taken by fluorescence spectrometer, was used to discuss the difference of luminescent performance between the nano-scheelite and bulk scheelite. The atomic site of the nano-scheelite was intuitively shown through HRTEM images and HRTEM simulated images from the relation between luminescent properties and crystal structure, which was analyzed by spectrum probe. The results of antitumor activity examined by the 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide （MTT） method show that the inhibition of human promyelocytic leukemia cell line （HL60） is enhanced immediately with increasing the concentration and presents a reliance on the quantity. The results of fluorescence spectra and structure show that the antitumor activity has something to do with micro-structure and surface charge.展开更多
文摘目的研究胃肠道恶性肿瘤患者术前营养状况以及营养不良发生的相关因素。方法选取2016年8月至2017年11月在武汉同济医院胃肠外科住院拟行手术治疗的胃肠道恶性肿瘤患者202例,入院后采用主观综合营养评估(subjective global assessment,SGA)法评估营养状况,记录入院时体重指数(body mass index,BMI)、中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NRL)、营养指标(血红蛋白、白蛋白、前白蛋白)、血清肿瘤标志物(CA199、CA724、CEA)和肿瘤部位、TNM分期、分化程度。采用多元回归分析营养不良的相关因素。结果 202例患者中,SGA法评定营养不良发生率为46%。多因素回归分析显示,在矫正年龄、性别、NRL、CA199、CA724、TNM分期和肿瘤分化程度等因素后,肿瘤部位和CEA是营养不良的独立相关因素。与远端胃、左半结肠、乙状结肠和直肠的恶性肿瘤患者相比,近端胃和右半结肠恶性肿瘤患者的营养不良发生风险增高(OR=2.51,95%CI 1.25~5.03,P=0.009);与CEA<10ng/ml的患者相比,CEA≥10ng/ml的患者营养不良发生风险增高(OR=12.50,95%CI 2.66~58.63,P=0.001)。结论肿瘤部位和CEA水平是胃肠道恶性肿瘤患者营养状态的独立相关因素,对于肿瘤位于近端胃和右半结肠以及CEA≥10ng/ml的消化道肿瘤患者,其营养状况应引起临床医护人员更多的关注。
文摘BACKGROUND Resection of hepatic metastasis from neuroendocrine tumors(NETs)improves quality of life and prolongs 5-year survival.Ablation can be utilized with surgery to achieve complete resection.Although several studies report long-term out-comes for patients undergoing ablation,none have explored perioperative effects of ablation in patients with metastatic NETs.AIM To determine if intra-operative ablation during hepatectomy increases risk of ad-verse outcomes such as surgical site infections(SSIs),bleeding,and bile leak.METHODS A retrospective analysis of the hepatectomy National Surgical Quality Impro-vement Program database from 2015-2019 was performed to determine the odds of SSIs,bile leaks,or bleeding in patients undergoing intraoperative ablation when compared to hepatectomy alone.RESULTS Of the 966 patients included in the study,298(30.9%)underwent ablation during hepatectomy.There were 78(11.7%)patients with SSIs in the hepatectomy alone group and 39(13.1%)patients with a SSIs in the hepatectomy with ablation group.Bile leak occurred in 41(6.2%)and 14(4.8%)patients in the two groups,respec-tively;bleeding occurred in 117(17.5%)and 33(11.1%),respectively.After con-trolling for confounding variables,ablation did not increase risk of SSI(P=0.63),bile leak(P=0.34)or bleeding(P=0.07)when compared to patients undergoing resection alone on multivariate analysis.CONCLUSION Intraoperative ablation with hepatic resection for NETs is safe in the perioperative period without significant increased risk of infection,bleeding,or bile leak.Surgeons should utilize this modality when appropriate to a-chieve optimal disease control and outcomes.
文摘Background Surgical site infection(SSI)is a common complication following craniotomy that increases morbidity,mortality,and medical expenses.The objectives of this study were to determine the relevant risk factors associated with SSI after elective craniotomy for brain tumor and analyse the treatments for SSI.Methods A retrospective nested case-control study was conducted using data from patients who underwent craniotomy for brain tumor resection at the Neurosurgical Oncology Department No.6 of Beijing Tiantan Hospital,Capital Medical University,between January 2019 and December 2021.Risk factors for SSI were determined using multivariate logistic regression analysis.We analyzed microbiological and related treatment data for different SSI types.Results Among 2061 patients who underwent craniotomy for brain tumor,31 had SSI(1.50%).In the multivariate logistic regression analysis,body mass index(BMI)and operative duration were identified as independent risk factors for SSI.The most common microorganism isolated from SSIs was Staphylococcus epidermidis(22.9%),and drug sensitivity results showed that gram-positive bacteria were sensitive to linezolid,vancomycin and tigecycline,whereas gram-negative bacteria were sensitive to meropenem,cefepime and ceftazidime.Six of the seven patients who underwent bone flap removal due to osteomyelitis were infected with gram-negative bacteria.Conclusions BMI and operative duration were identified as independent risk factors for SSI.Diabetes mellitus,previous ratio therapy,type of incision,recurrence tumor and other risk factors were not found to be associated with the occurrence of SSI in this study.
基金supported by the National Natural Science Foundation of China(No.40072013)
文摘After preparing the EU^3＋-doped scheelite nano-material by Pechini method with the nanoparticles of 30-50 nm in diameter, X-ray diffraction （XRD）, transmission electron microscopy （TEM） and high resolution transmission electron microscopy （HRTEM） were used to show a microcosmic description of the particle morphology and crystal structure. The spectrum signature of the nano-scheelite, which was taken by fluorescence spectrometer, was used to discuss the difference of luminescent performance between the nano-scheelite and bulk scheelite. The atomic site of the nano-scheelite was intuitively shown through HRTEM images and HRTEM simulated images from the relation between luminescent properties and crystal structure, which was analyzed by spectrum probe. The results of antitumor activity examined by the 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide （MTT） method show that the inhibition of human promyelocytic leukemia cell line （HL60） is enhanced immediately with increasing the concentration and presents a reliance on the quantity. The results of fluorescence spectra and structure show that the antitumor activity has something to do with micro-structure and surface charge.
