Objective To investigate the correlation among lymph node metastasis and clinical features, postoperative survival rate in rectal cancer. Methods Seventy-nine patients who had accepted total mesorectal excision (TME) were collected, and the correlation among their clinical features (including gender, age, tumor size, gross type, depth of infiltration, histology type, differentiated degree and the level of blood serum CEA), lymph node metastasis, and postoperative survival rate were analyzed. Results There was significant correlation between six factors (namely the tumor size, gross type, depth of infiltration, histology type, differentiated degree and the level of blood serum CEA) and lymph node metastasis in single factor analysis. However， multivariate analysis showed that only gross type of tumor and depth of tumor infiltration were related to lymph node metastasis. The postoperative survival time of 43 non-metastasis cases was remarkably longer than that of 33 cases with lymph node metastasis (χ2=18.806， P=0.000), and it was longer in 22 cases with ＜4 lymph nodes metastasis than that of 11 cases with ≥4 lymph nodes metastasis (χ2=4.659， P=0.031). Conclusion In rectal cancer patients the clinical features can reflect the condition of lymph node metastasis in a certain extent, and it can help doctors to evaluate the lymph node metastasis and prognosis.
ObjectiveTo evaluate the cost-effectiveness of robot-assisted laparoscopic surgery (RALS) versus conventional laparoscopic surgery (CLS) for early-stage endometrial cancer (EC) from a societal perspective. MethodsA decision-tree model was constructed to conduct cost-utility analysis, simulating the short-term intraoperative to postoperative clinical progression of patients. Primary evaluation metrics included cumulative costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). The willingness-to-pay (WTP) threshold was set at three times the 2024 per capita gross domestic product (GDP) of China. The sensitivity analyses were performed to assess robustness of the model. ResultsThe base-case analysis revealed that patients in the RALS group gained 0.09 more QALYs at an additional cost of ¥39 079.52 compared with CLS group, the derived ICER was ¥437 157.36/QALYs, exceeding the predefined WTP threshold. The results suggested that RALS does not demonstrate superior cost-effectiveness compared with CLS in the management of early-stage EC. Univariate sensitivity analysis indicated that, when the annual surgical volume per robotic device reaches 809 cases, or the cost of Endowrist consumables per robotic surgery drops below ¥6 568.46, RALS will emerge as a more cost-effective surgical strategy. The probabilistic sensitivity analysis revealed that that RALS becomes more cost-effective when the WTP threshold exceeds ¥402 145.80. Conclusion From a Chinese societal perspective, robotic-assisted laparoscopic surgery for early-stage endometrial cancer is not cost-effective compared with conventional laparoscopic surgery at the current WTP threshold of three times per capita GDP.
Fleming proposed the concept of evidence-based pathology (EBP) in 1996. In recent years, there have been a lot of evidence-based studies on the diagnosis and prognosis of diseases. However, there are still limitations and challenges in the development, and the growth in application of evidence-based medicine in the pathology is still slow. This study introduced the history of evidence-based pathology, summarized the primary application areas and the latest research progress, analyzed current opportunities and challenges of evidence-based pathology, and provided some suggestions.
Objective To investigate the expressions of X-linked inhibitor of apoptosis protein （XIAP） and survivin in primary hepatocellular carcinoma tissues，and to explore the relationship between them. Methods The expressions of XIAP and survivin protein in 38 primary hepatocellular carcinoma tissues and 16 paracancerous tissues were detected by using immunohistochemistry and the expressions were scored. Results The positive expression rate of XIAP and survivin in primary hepatocellular carcinoma tissues was 81.6% （31/38）and 78.9% （30/38），respctively （P＜0.001）， and in paracancerous tissues was 12.5% （2/16）and 6.3% （1/16）， respectively （P＜0.001）. The score of XIAP expression in the well， middle，and low differentiated tissues of primary hepatocellular carcinoma was （2.91±1.31），（9.27±3.25）， and （13.08±2.26） score， respectively （F=118.948，P＜0.001）， and the score of survivin expression was （4.85±1.83）， （11.08±3.72），and （13.38±1.76） score， respectively （F=72.202，P＜0.001）. They both significantly correlated with the histological grade，but not with the size of tumor（P＞0.05）. There was significantly correlation between the expression intensity of XIAP and survivin in primary hepatocellular carcinoma tissues （r=0.764， P＜0.001）. Conclusions The expression intensity of XIAP and survivin in primary hepatocellular carcinoma tissues are both related with the differentiation of primary hepatocellular carcinoma. The expression intensity of XIAP is related with the survivin， and they may play an important role in the tumor progression and chemical resistances.
Purpose To evaluate the prostag landins(PG) levels and to identify the effect of dexamethasone(DXM) on PG in response to photochemical insult in rat retina. Methods The experiments were performed on 36 SD rats which were separated into two groups,control and treated groups,and the latter received daily intraperitoneal injections of DXM (1 mg/kg) for 5 consecutive days,starting 3 days before light exposure.The animals were continually exposed to green fluorescent light(510-560 nm)with an illuminance level of (1900plusmn;106.9)lx for 24 hrs.The retinal concentration of PGE 2 and 6-keto-PGF1alpha; were tested at 6hrs,1,3,7 and 14 days after light exposure. Results The PGE2 and 6-keto-PGF1alpha; levels of the control groups (37.50plusmn;2.75,48.06plusmn;4.0 4,81.90plusmn;4.89) pg/mg and (4.68plusmn;0.69,7.50plusmn;0.57,10.40plusmn;0.71) pg/mg had significantly higher values than those of the treated rats(20.60plusmn;4.28,37.36plusmn; 3.34,54.85plusmn;4.57) pg/mg and (2.50plusmn;0.59,4．68plusmn;0.81,6.87plusmn;1.10)pg/mg (Plt;0.01) after 6 hrs,1 and 3 days light exposure respectively. Conclusion By inhibition of PG synthesis,the DXM may play an ameliorative effect on retinal photochemical injury of rats. (Chin J Ocul Fundus Dis,1999,15:94-96)
OBJECTIVE: To determine an optimal co-culture ratio of the rabbit periosteal osteoblasts (RPOB) and rabbit renal vascular endothelial cells(RRVEC) without direct contact for future study of bone tissue engineering. METHODS: RPOB and RRVEC in the ratios of 1:0(control group), 2:1(group 1), 1:1(group 2) and 1:2(group 3) were co-cultured by six well plates and cell inserts. Four days later, the proliferation of RPOB and RRVEC were examined through cell count. Differentiated cell function was assessed by alkaline phosphatase (ALP) activity assay and 3H proline incorporation assay. RESULTS: When RPOB and RRVEC were indirectly co-cultured, the proliferation of RPOB and 3H proline incorporation was higher in group 1 than in the other experimental groups and control group (P lt; 0.05). ALP activity of RPOB was higher in group 1 than in control group and group 3 (P lt; 0.05), but there was no significant difference between group 1 and group 2 (P gt; 0.05). CONCLUSION: These results suggest that RPOB and RRVEC co-cultured in a ratio of 2:1 is optimal for future study of bone tissue engineering.
PURPOSE:To evaluate the activitv of protein kinase C(PKC) in response to retinal photochemical insult in rat. Furthermore, to investigate the effect of dexamethasone(DXM ) on PKC activity. METHODS :The experiments were performed on 48 SI') rats whieh were separated into two groups,control and treated groups,and the latter received daily intraperitoneal injections of DXM (1 mg/kg)for 5 consecutive days,starting 3 days before light exposure. The animals were continually exposed to green fluorescent light (510nm~560nm) with an illuminance level of (1 900plusmn;106.9)lx for 24 hrs.The retinal enzyme activity of PKC was tested at 6 hrs,1 day,3 days,7 days,and 14 days after light exposure respectively. RESULTS:In animal models,PKC activity showed a transient increase in both groups at 6 hrs after light exposure and then decrease persistently there alter. The activity of PKC was unresponsive to DXM intervention. CONCLUSIONS :These results suggested that the persistent lower PKC activity might result in disturbance of retinal function in rat retinal photochemical injury. （Chin J Ocul Fundus Dis,1997,13: 78-80）