ObjectiveTo evaluate the prognosis value of oncoprotein metadherin (MTDH) in alpha fetoprotein (AFP)negative hepatocellular carcinoma (HCC) patients following curative hepatectomy.
MethodsThe expression of MTDH protein in 152 AFP negative HCC patients underwent curative hepatectomy from 2007 to 2010 in this hospital was detected by immunohistochemical stain. Clinicopathologic data for these patients were analyzed. Survival analysis was evaluated with Kaplan-Meier method and log-rank test to compare survival difference. Cox proportional hazard model analysis was used to assess prognostic significance of MTDH in AFP negative HCC patients.
ResultsThe rate of MTDH high expression in the AFP negative HCC tissue was 60.53% (92/152). MTDH high expression was associated with tumor diameter (P=0.029), Edmondson grade (P=0.032), microvascular invasion (P=0.024), or tumor recurrence (P=0.014). Univariate and Cox proportional hazard model analysis showed that high expression of MTDH was correlated with the poor survival in AFP negative HCC patients (P=0.002, P=0.017).
ConclusionMTDH is an independent predictor for survival in AFP negative HCC patients after curative hepatectomy.
Objective
To probe the relationship of differentiation degree with spread or survival prognosis in retinoblastoma (RB).
Methods
Clinical data, follow up status and eyeball specimens in 156 RB cases were investigated retrospectively. The tumors were divided into differentiated and undifferentiated groups. Conditions of the tumor invasion of ocular or surrounding tissues were reviewed. The fatality rate was obtained from the follow-up materials of 82 cases of RB. The fatality rate and the invasion rate between the two types were compared statistically by Chi-square test. In addition, the relation between the tumor invasion and death ,and the average survival time for dead people after surgery were explored.
Results
Local invasion of tumor cell was found in 8 eyes among 17 eyes with differentiated RB (47.06%),and in 66 eyes among 139 eyes with undifferentiated RB (47.48%).There was no significant difference with regards to the local invasion between the two types ( The fatality rate of cases of differentiated RB was 27.27%,and 22.54% in undifferent iated RB, and there was no statistical difference between the two types .The fat ality rate for patients with orbital and scleral extension was 100%, optic nerve invasion (grade Ⅳ) was 62.50%,and uveal invasion was 22.22%.The survival time for the dead victims were from 5 months to 41 months and averaged to 21.92 months.
Conclusion
There was no significant differ ence both in survival prognosis and local invasion between the two types. The survival prognosis of metastatic RB was dependent on the degree of spread and the efforts of treatment and regardless of the types of differentiation of RB cells.
(Chin J Ocul Fundus Dis, 2001,17:18-20)
In order to study the effect of vascular endothelial cell growth factor (VEGF) on the survival of skin flap 30 SD rats were used. A randomized flap measuring 7.5 cm x 3.0 cm was created on the back of each SD rat. The treatment group (n = 10) received VEGF 40 ng/flap by subcutaneous injection with microinjector during and 24 hours after operation. The control groups received heparin 16 U/flap (n = 10) or normal saline 800 microliters/flap (n = 10). After operation, on the 3rd and 11th day, the survival rate of the skin flaps and the dermovascular density of each flap were investigated by histological and histo-morphometrical examination. The results showed that there was no significant difference in the survival rate between the treatment group and the controls on the 3rd day after operation, while on the 11th day, there was a significant difference between them, and the survival rate was much higher in the treatment group. Besides, dermovascular density was much more increased in the treatment group than that in the controls, especially in the distal 1/3 of the flap (P lt; 0.02). The conclusion was that VEGF could .
Objective To approach the surgical therapeutic efficacy of local recurrence of rectal cancer. Methods Fifty-six patients with local recurrence of rectal cancer suffered from reoperation from January 2003 to January2011 in this hospital were collected. Chi-square test was performed to analyze the complete excision rates of reoperation for different recurrent time after radical resection and different surgical procedures after primary radical resection of rectalcancer. The method of log-rank test was used for survival analysis of the Miles and Dixon procedure. Results ①The opera-tion time and intraoperative bleeding of reoperation for local recurrence of rectal cancer were more than those of the primary radical resection of rectal cancer （P＜0.05）. ②The complete resection rate of the local recurrence of rectal cancer in 5 years after primary radical resection of rectal cancer was higher than that of the local recurrence of rectal cancer within 2 years after primary radical resection of rectal cancer， and the difference was statistically significant （P＜0.01）. ③The complete resection rate of the local recurrence of rectal cancer of the technique of Dixon in the primary radical resection of rectal cancer was higher than that of Miles， and the difference was statistically significant （P＜0.05）. ④The median survival time and 2-year survival rate and 5-year survival rate of the technique of Dixon in the reoperation were longer or higher than those of Miles， and the differences were statistically significant （P＜0.05）. Conclusions Surgical procedure and postoperative recurrence time after primary operation can both influence complete excision rate of reoperation for local recurrence of rectal cancer. And reoperation for local recurrence of rectal cancer can prolong the survival time.
Objective Through conducting a meta-analysis using the methodology of Cochrane review, to assess the effectiveness and safety of graft-versus-host disease (GVHD) prophylaxis with antithymocyte globulins (ATGs) in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods Such databases as PubMed (1966 to March 2011), EMbase (1974 to March 2011), the Science Citation Index databases (1900 to March 2011), The Cochrane Library (1996 to March 2011), CBMdisc (1978 to March 2011), and CNKI (1979 to March 2011) were electronical1y searched. The references of all identified studies were retrieved for collecting more randomized controlled trials (RCTs) and non-RCTs. Two reviewers independently screened the trials according to inclusion and exclusion criteria, abstracted the data, and assessed the methodology quality of the included studies. Meta-analyses were performed using RevMan 5.0.2 software. Results Thirteen clinical trials were included, of which 2 were RCTs involving 310 patients and the other 11 were non-RCTs involving 1480 patients. The results of meta-analyses showed that compared with the Non-ATG group, the pooled risk ratio (RR) and 95%CI of the ATG group in acute GVHD II-IV incidence rate, acute GVHD III-IV incidence rate, chronic GVHD (limited plus extensive) incidence rate, chronic GVHD (extensive) incidence rate, overall survival (OS) rate, non-relapse mortality (NRM) rate, and relapse rate were 0.77 (0.67, 0.87), 0.54 (0.44, 0.68), 0.58 (0.51, 0.65), 0.35 (0.26, 0.46), 1.14 (1.04, 1.25), 0.81 (0.69, 0.93), and 1.24 (0.98, 1.57), respectively. Conclusion The addition of ATGs to GVHD prophylaxis can reduce the incidence of acute and chronic GVHD, decrease NRM, and increase OS, but has no obvious interference with relapse rate.
Survival data include the occurrence and duration of an event. As most survival data are distributed irregularly, the Kaplan-Meier method is often used in survival analysis; however, studies usually only report the Kaplan-Meier curve and median survival time and do not provide the original survival data, which creates issues for subsequent secondary research. This study introduced a systematic method whereby image processing software and R software were used to process and extract survival data from published Kaplan-Meier curves. It also introduced the specific steps required to obtain survival data using an example to show the accuracy and feasibility of the extraction method and provided references for the effective secondary use of survival data.
Objective To research the effects of vascular endothelial growth factor (VEGF) on the survival of reverse flow axial skin flaps. Methods A 8 cm×2 cm full thickness transverse dorsal flap based on right deep circumflex iliacartery was elevated in 20 SpragueDawley rats, which length crossing midline was 4.0 cm. The rats were randomized into two groups:experimental group (n=10), subcutaneous VEGF injections into the flap (200 ng, 200 μl) after flap elevation; controlgroup (n=10), subcutaneous saline injections into the flap (200 μl) after flap elevation. The flap was immediately sutured to its recipient beds then the injection was executed. Seven days after operation, the survival area of flaps and density of vessels were observed and measured, meanwhile its histological representation of the flaps was examined. Results After 7 days of recovery, the mean survival area of flaps was 15.55±0.27 cm2 in experimental group and 13.42±0.57 cm2 in control group. The difference was significant between experimental group and control group (P＜0.01). The mean vessel density of flaps was 21.00±3.16 in control group and 34.40±3.75 in experimental group. The difference was significant between experimental group and control group (P＜0.01). Histological analysis demonstrated that a qualitatively greater amount of granulation tissue, regular collagen fiber and a lot of fibrillated cells were observed in experimental group. Erythrocytes were leaked outfrom vessels, and inflammatory cells were observed around in control group. Conclusion In early survival of flaps, the VEGF can improve the survival of areverse flow axial skin flap through improving angiogenesis and increasing the perfusion of vessel. It is an effective method of improving the survival of reverse flow axial skin flaps that VEGF is fully injected in subcutaneous flaps by single, when flaps are elevated.
ObjectiveTo more comprehensive understanding the survival situation of donors after liver transplantation, which can be applied to clinical diagnosis and treatment.
MethodsThe related literatures in recent years of living donor liver transplantation (LDLT) postoperative complications, quality of life, and liver regeneration were reviewed, and the donors postoperative survival situation were investigated.
ResultsLDLT has become an option, It is safe and feasible for healthy adults to donate partial liver for LDLT.
ConclusionsDonor postoperative survival situation is very important, and it affect the development of LDLT.To improve donors postoperative survival situation, we still need more efforts.
Objective To investigate the early diagnosis and treatment methods of primary duodenal papilla carcinoma. Methods The medical records of 54 patients with primary duodenal papilla adenocarcinoma underwent operation between January 2002 and December 2008 were reviewed. Results Thirty seven cases received fiberduodenoscopy and 35 cases received ERCP, and the accuracy of them were both 100%. Forty four patients received duodenopancreatectomy and 10 patients received jaundice-reducing operation. The 1-, 3-, and 5-year cumulation survival rate was 68%, 50%, and 29%, respectively. Conclusions Fiberduodenoscopy and ERCP are the effective diagnostic methods for duodenal papilla carcinoma. Early diagnosis and early rational radical operation are essential for successful treatment of duodenal papilla carcinoma.
Meta-analysis of survival data is becoming more and more popular. The data could be extracted from the original literature, such as hazard ratio (HR) and its 95% confidence interval, the difference of actual frequency and theoretical frequency (O - E) and its standard deviation. The data can be used to calculate the combined HR using Review Manager (RevMan), Stata and R softwares. RevMan software is easy to learn, but there are some limitations. Stata and R software are powerful and flexible, and they are able to draw a variety of graphics, however, they need to be programmed to achieve.
