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Effect of visceral obesity on outcomes of fluorescence-guided lymphadenectomy during laparoscopic gastrectomy for gastric cancer:Post hoc analysis of a randomized phase 3 trial
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作者 Yihui Tang Zening Huang +16 位作者 Xingqi Zhang Ping Li Jianwei Xie Jiabin Wang Qiyue Chen Longlong Cao Mi Lin Ruhong Tu Guangtan Lin Hualong Zheng Qing Zhong Juli Lin Zihao Yao Dong Wu Chaohui Zheng Jianxian Lin Changming Huang 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2024年第5期503-516,共14页
Objective:To explore the impact of visceral fat area(VFA)on the short-and long-term efficacy of indocyanine green(ICG)-guided D2 lymphadenectomy for gastric cancer(GC).Methods:A post hoc analysis was performed in pati... Objective:To explore the impact of visceral fat area(VFA)on the short-and long-term efficacy of indocyanine green(ICG)-guided D2 lymphadenectomy for gastric cancer(GC).Methods:A post hoc analysis was performed in patients who participated in a phase 3 randomized clinical trial of ICG-guided laparoscopic radical gastrectomy vs.conventional laparoscopic radical gastrectomy from November 2018 to July 2019.The VFA was calculated based on preoperative computed tomography images.Short-term efficacy included the quality of lymph node(LN)dissection and surgical outcomes,while long-term efficacy included overall survival(OS)and recurrence-free survival(RFS).Results:This study included 126 patients each in the ICG(high-VFA,n=43)and non-ICG groups(high-VFA,n=38).Compared with the non-ICG group,the ICG group had significantly more retrieved LNs(low-VFA:50.1 vs.43.9,P=0.001;high-VFA:49.6 vs.37.5,P<0.001)and a significantly lower LN noncompliance rate(low-VFA:32.5%vs.50.0%,P=0.020;high-VFA:32.6%vs.73.7%,P<0.001),regardless of the VFA.The ICG group had a shorter postoperative hospital stay and fewer intra-abdominal infections than the ICG group in the high-VFA patients(P=0.025 and P=0.020,respectively)but not in the low-VFA patients.Regardless of the VFA,the 3-year OS(RFS)was better in the ICG group than in the non-ICG group[low-VFA:83.1%(76.9%)vs.73.9%(67.0%);high-VFA:90.7%(90.7%)vs.73.7%(73.5%);P for interaction=0.474(0.547)].Conclusions:The short-and long-term efficacies of ICG tracing were not influenced by visceral obesity. 展开更多
关键词 Gastric cancer laparoscopic gastrectomy indocyanine green visceral obesity lymph node dissection survival
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Comparison of Hematoxylin-eosin Staining and Methyl Violet Staining for Displaying Ghost Cells
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作者 Wenxin Zhang Yongping Li +5 位作者 Jianxian Lin Shangtao Wan Huanhuan Gao Lanzhi Zhang Jianliang Zheng Ping Zhang 《Eye Science》 CAS 2013年第3期140-143,共4页
Purpose:.To compare the merits and limitations of hematoxylin-eosin(HE) and methyl violet staining for displaying ghost cells from vitreous or aqueous humor.Methods:.A specimen containing ghost cells was adjusted to f... Purpose:.To compare the merits and limitations of hematoxylin-eosin(HE) and methyl violet staining for displaying ghost cells from vitreous or aqueous humor.Methods:.A specimen containing ghost cells was adjusted to five different concentrations:(12×104,.10×104,.8×104, 6×104and 4×104cells / ml) and subjected to smearing and methyl violet and HE staining..The staining results were observed by light microscopy.Results: The ghost cells were readily observed at a cell density of > 8×104cells / ml with methyl violet staining,.but only a few cells were occasionally seen at lower cell densities..In contrast,.ghost cells were seen at all cell densities with HE staining.Conclusion: Methyl violet staining is more rapid and simpler for the identification of ghost cells, but its staining color more readily fades, the slides cannot be stored, and it is only effective at a cell density of > 8 ×104cells / ml. In contrast,.HE staining is more time-consuming but it can display cell morphology and distinguish cell components more explicitly and slides can be permanently stored. HE staining has advantages over methyl violet staining in detecting the ghost cells when the concentration is < 8×104cells / ml. 展开更多
关键词 细胞密度 HE染色 甲基紫 苏木精 显示 伊红 光镜观察 电池组件
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Strengthening the Role of Ocular Pathology in Clinical Thinking Training Targeting for House Staff
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作者 Yungang Ding Wenxin Zhang +3 位作者 Xiaohui Liu Jianxian Lin Jianliang Zheng Yongping Li 《Eye Science》 CAS 2011年第3期180-182,共3页
Ocular pathology serves as one vital branch subject of histopathology, and also as a basic ocular science analysing the pathogenesis of eye disease,the regular pattern of disease progress,and ocular morphology,tissue ... Ocular pathology serves as one vital branch subject of histopathology, and also as a basic ocular science analysing the pathogenesis of eye disease,the regular pattern of disease progress,and ocular morphology,tissue metabolism and functional changes noted during the onset of ocular diseases.The underlying purpose lies in revealing and investigating the mechanism of such diseases and the nature of lesions,providing essential theoretical evidence to diagnosis and treatment of eye diseases.ocular pathology acts as a bridge connecting basic and clinical medical science1.Clinical ophthalmologists,especially junior house staff,should attach importance to ocular pathology,understand,be familiar with,and master basic knowledge in ocular pathological subject to cultivate sound clinical thinking and analytical ability and to improve comprehensive diagnosis and treatment efficacy in clinical setting. 展开更多
关键词 组织病理学 眼部疾病 培养目标 临床 员工 眼科疾病 定位 发病机制
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Reappraise role of lymph node status in patterns of recurrence following curative resection of gastric adenocarcinoma 被引量:1
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作者 Yihui Tang Jianxian Lin +10 位作者 Junpeng Lin Jiabin Wang Jun Lu Qiyue Chen Longlong Caolj Mi Lin Ruhong Tu Changming Huang Ping Li Chaohui Zheng Jianwei Xie 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2021年第3期331-342,共12页
Objective: To examine the association between lymph node status and recurrence patterns in completely resected gastric adenocarcinoma.Methods: We retrospectively assessed 1,694 patients who underwent curative gastrect... Objective: To examine the association between lymph node status and recurrence patterns in completely resected gastric adenocarcinoma.Methods: We retrospectively assessed 1,694 patients who underwent curative gastrectomy from January 2010 to August 2014. Patients stratified according to lymph node status and recurrence patterns among different subgroups were compared.Results: Of all, 517(30.5%) patients developed recurrent disease, and complete data of recurrence could be obtained in 493(95.4%) patients. For p^(N0) patients, the patterns of recurrence were different according to p T stage: locoregional recurrence was most common in patients with p T1-2 disease(57.1%), distant recurrence was most common in patients with p T3 disease(57.1%), and peritoneal recurrence was most common in patients with p T4 a disease(66.7%). For p^(N+) patients, distant metastasis was most common pattern irrespective of p T stage. The site-specific trend of recurrence showed that locoregional recurrence increased within 5 years in patients with p^(N0)-2 disease but plateaued 3 years after surgery in patients with p N3 disease. Time to recurrence was significantly longer for the p^(N0) patients compared with the p^(N+) patients(median: 25 vs. 16 months, P=0.001).Moreover, post-recurrence survival was significantly better for the p^(N0) patients than for the p^(N+) patients(median:12 vs. 6 months, P<0.001), especially in patients with non-peritoneal recurrence, late recurrence, single recurrence,and receipt of potential curative treatment.Conclusions: Among clinicopathologic factors, lymph node status is the most important factor associated with recurrence patterns after curative gastrectomy. Lymph node status may be used as an adjunct in clinical decisionmaking about postoperative therapeutic and follow-up strategies. 展开更多
关键词 Recurrence patterns lymph node status post-recurrence survival recurrence-free survival gastric cancer
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Keratinocyte Growth Factor-2 on the Proliferation of Corneal Epithelial Stem Cells in Rabbit Alkali Burned Cornea 被引量:2
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作者 Lin Liu Yongping Li +2 位作者 Shuqi Huang Jianxian Lin Wenxin Zhang 《眼科学报》 2007年第2期107-116,共10页
Purpose: To determine whether the topical application of keratinocyte growth factor-2 (KGF-2) can enhance corneal epithelial healing in rabbit alkali burned cornea. In addition, the distribution and proliferation of c... Purpose: To determine whether the topical application of keratinocyte growth factor-2 (KGF-2) can enhance corneal epithelial healing in rabbit alkali burned cornea. In addition, the distribution and proliferation of corneal epithelial stem cells in KGF-2-treated and control corneas were investigated to explain their mechanisms of effects on the epithelium. Methods: Twenty-four New Zealand eyes were divided into four groups, treated with KGF-2 solution (1, 50, 100 μg/ml) and PBS solution. Eighth millimeter filter paper discs, produced by standard paper punch, were soaked for 15 sec in 0.5N NaOH solution. The alkali-soaked discs were applied to the central cornea, centered on the pupil and held gently in position with forceps for 1 min. The cornea was finally irrigated over 1 min with 100 ml balanced salt solution (BSS). Keratinocyte growth factor-2 was then applied topically three times a day. The phosphate-buffered saline (PBS) group was served as a control. Each corneal epithelial defect was subsequently photographed every 24 hours with a slit lamp and was measured by computer-assisted digitizer. In each group, two rabbits were sacrificed for light microscopic examination after the interval of 7, 14 and 21 days. Meanwhile, the cornea epithelium was examined by immunohistochemistry for P63, AE5, EGFR. Results: Topical application of 10 μg/ml to 100 μg/ml KGF-2 significantly accelerated corneal epithelial wound healing when compared with controls. After 24 hours, epithelial healing rate of the 100 μg/ml KGF-2 group and the PBS treated group was (74±6)% and (40±8)% (P < 0.05). After 48 hours, the rate of the C group was (94±6)%, whereas in the control group it was (73±12)% (P < 0.05). Epithelial defects were often recurrent, which happened only two times in the 100 μg/ml KGF-2-treated group, but many times in the control group. In the corneal epithelial stem cell analysis, the number of the P63 positive cells was higher in the KGF-2-treated corneal epithelium than in the controls. The P63 positive cells in the alkali burned epithelium were found not only in the limbal area but also in the central cornea. In addition, the number of stem cells in each group came to the maximum on the 14th day. For example, on the 7th day after alkali injury, it was 40.3±2.1 NPC in the non-limbal area of 50 μg/ml KGF-2-treated group; whereas, it was 84.8±2.7 NPC on the 14th day(P = 0.000). Conclusions: From the daily evaluation of the corneal surface as well as the microscopic examinations at the end of the three periods of observation, we concluded that KGF-2 provided a beneficial effect in the treatment of alkali burns of the cornea. Furthermore, the results of epithelial stem cell analysis demonstrated that KGF-2 accelerated the corneal epithelial healing by markedly stimulating epithelial stem cells proliferation and making them migrate to the central cornea. 展开更多
关键词 角化细胞生长因子-2 角膜上皮干细胞 角膜碱烧伤 治疗 细胞培养
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年龄调整的Charlson合并症指数影响腹腔镜胃癌根治术患者预后的多中心回顾性研究 被引量:10
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作者 王祖凯 林建贤 +23 位作者 许燕常 赵刚 蔡丽生 李国新 徐泽宽 燕速 吴祖光 薛芳沁 孙益红 许东波 张文斌 余佩武 万进 胡建昆 苏向前 季加孚 李子禹 尤俊 李勇 樊林 谢建伟 李平 郑朝辉 黄昌明 《中华消化外科杂志》 CAS CSCD 北大核心 2022年第5期616-627,共12页
目的探讨年龄调整的Charlson合并症指数(ACCI)对腹腔镜胃癌根治术患者预后的影响。方法采用回顾性队列研究方法。收集2016年9月至2017年10月中国腹腔镜胃肠外科研究组-04研究中19家医院收治的242例(福建医科大学附属协和医院54例、莆田... 目的探讨年龄调整的Charlson合并症指数(ACCI)对腹腔镜胃癌根治术患者预后的影响。方法采用回顾性队列研究方法。收集2016年9月至2017年10月中国腹腔镜胃肠外科研究组-04研究中19家医院收治的242例(福建医科大学附属协和医院54例、莆田市第一医院32例、上海交通大学医学院附属仁济医院32例、福建医科大学附属漳州市医院31例、南方医科大学南方医院17例、南京医科大学第一附属医院11例、青海大学附属医院8例、梅州市人民医院8例、福建省立医院7例、复旦大学附属中山医院6例、龙岩市第一医院6例、新疆医科大学附属第一医院5例、陆军军医大学第一附属医院5例、广州中医药大学第二附属医院4例、四川大学华西医院4例、北京大学肿瘤医院4例、厦门大学附属第一医院3例、广东省人民医院3例、西安交通大学第一附属医院2例)行腹腔镜胃癌根治术患者的临床病理资料;男193例,女49例;年龄为62(23~74)岁。观察指标:(1)患者年龄分布与合并症及ACCI情况。(2)ACCI分组及临床病理特征比较。(3)术后早期并发症发生情况及术后早期并发症影响因素分析。(4)随访情况。(5)影响患者3年无复发生存率的因素分析。采用门诊或电话方式进行随访,了解患者术后生存情况。随访时间截至2020年12月。正态分布的计量资料以x±s表示,组间比较采用t检验;偏态分布的计量资料以M(Q_(1),Q_(3))或M(范围)表示,组间比较采用Mann-Whitney U检验。计数资料以绝对数或百分比表示,组间比较采用χ^(2)检验或Fisher确切概率法。等级资料比较采用非参数秩和检验。采用X-Tile软件(3.6.1)分析ACCI分组临界值。采用Kaplan-Meier法计算生存率和绘制生存曲线,采用Log-Rank检验进行生存分析。采用Logistic回归模型分析术后早期并发症影响因素。采用COX比例风险模型进行3年无复发生存率影响的单因素和多因素分析,多因素分析以逐步回归法纳入P<0.05的单因素指标和临床上与预后密切相关的变量。结果(1)患者年龄分布与合并症及ACCI情况。242例患者中,<50岁28例,50~59岁68例,60~69岁113例,70~79岁33例;合并轻度肝病、伴有终末器官损害的糖尿病、脑血管疾病、消化性溃疡、充血性心力衰竭、慢性肺疾病、不伴终末器官损害的糖尿病分别为1、1、2、2、6、8、9例。242例患者ACCI为2(0~4)。(2)ACCI分组及其临床病理特征比较。X-Tile软件分析结果显示:ACCI=3为最佳分组临界值。根据ACCI最佳分组临界值将242例患者分为低ACCI组(ACCI<3)194例和高ACCI组(ACCI≥3)48例。低ACCI组患者年龄,体质量指数,术前合并症,美国麻醉医师协会分级(Ⅰ级、Ⅱ级、Ⅲ级),肿瘤长径,组织学类型(印戒细胞癌或低分化腺癌、中分化或高分化腺癌),肿瘤病理学T分期(T1期、T2期、T3期、T4期),化疗周期分别为(58±9)岁,(22.6±2.9)kg/m2,31例,106、85、3例,(4.0±1.9)cm,104、90例,16、29、72、77例,6(4,6)个;高ACCI组患者上述指标分别为(70±4)岁,(21.7±2.7)kg/m2,23例,14、33、1例,(5.4±3.1)cm,36、12例,3、4、13、28例,4(2,5)个;两组患者上述指标比较,差异均有统计学意义(t=-14.37、1.98,χ^(2)=22.64,Z=-3.11,t=-2.91,χ^(2)=7.22,Z=-2.21、-3.16,P<0.05)。(3)术后早期并发症发生情况及术后早期并发症影响因素分析。242例患者中,33例发生术后早期并发症,包括局部并发症20例,系统性并发症16例,部分患者同时合并多种并发症。20例局部并发症包括腹腔感染12例,吻合口漏7例,切口感染、腹腔出血、吻合口出血各2例,淋巴液漏1例。16例系统性并发症包括肺部感染11例,心律失常、脓毒血症各2例,肝衰竭、肾衰竭、肺动脉栓塞、深静脉血栓、尿路感染、尿潴留各1例。33例发生术后早期并发症患者Clavien-Dindo并发症分级Ⅰ级、Ⅱ级、Ⅲa级、Ⅲb级、Ⅳ级分别为3、22、5、2、1例。低ACCI组患者术后早期并发症、局部并发症、系统性并发症分别为22、13、9例;高ACCI组患者上述指标分别为11、7、7例;两组患者早期并发症、系统性并发症比较,差异均有统计学意义(χ^(2)=4.38,4.66,P<0.05);局部并发症比较,差异无统计学意义(χ^(2)=2.20,P>0.05)。Logistic回归分析结果显示:ACCI是影响腹腔镜胃癌根治术后发生早期并发症的相关因素(比值比=2.32,95%可信区间为1.04~5.21,P<0.05)。(4)随访情况。242例患者均获得随访,随访时间为36(1~46)个月。随访期间,53例患者死亡,13例带瘤生存。242例患者3年无复发生存率为73.5%。低ACCI组患者随访时间为36(2~46)个月,随访期间,29例患者死亡,10例带瘤生存,患者3年无复发生存率为80.0%;高ACCI组患者上述指标分别为35(1~42)个月,24、3例,47.4%;两组患者3年无复发生存率比较,差异有统计学意义(χ^(2)=30.49,P<0.05)。(5)影响患者3年无复发生存率的因素分析。单因素分析结果显示:术前合并症、ACCI、肿瘤长径、组织学类型、血管侵犯、淋巴管侵犯、神经侵犯、肿瘤病理学TNM分期、术后早期并发症是影响腹腔镜胃癌根治术后3年无复发生存率的相关因素(风险比=2.52,3.64,2.62,0.47,2.87,1.90,1.86,21.77,1.97,95%可信区间为1.52~4.17,2.22~5.95,1.54~4.46,0.27~0.80,1.76~4.70,1.15~3.12,1.10~3.14,3.01~157.52,1.11~3.50,P<0.05)。多因素分析结果显示:ACCI、肿瘤病理学TNM分期、辅助化疗是腹腔镜胃癌根治术后3年无复发生存率的独立影响因素(风险比=3.65,11.00,40.66,0.39,95%可信区间为2.21~6.02,1.40~86.73,5.41~305.69,0.22~0.68,P<0.05)。结论ACCI是影响腹腔镜胃癌根治术后发生早期并发症的相关因素,ACCI、肿瘤病理学TNM分期、辅助化疗是腹腔镜胃癌根治术后3年无复发生存率的独立影响因素。 展开更多
关键词 胃肿瘤 全胃切除术 年龄 术前合并症 年龄调整的Charlson合并症指数 术后早期并发症 预后 腹腔镜检查
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